<Emphasis Type="Bold">Invited commentary to:</Emphasis> ‘Survival following oncological minimally invasive colorectal procedures’ (Eur. Surg. 2002;34:354–358)

Summary   Background: Since 1992, oncological minimally invasive colorectal procedures are routinely performed at our institution. The aim of this study was to evaluate postoperative survival. Methods: A retrospective analysis assessing postoperative survival following oncological minimally invasive colorectal procedures conducted from March 1992 to September 1998 is presented. Mean postoperative follow-up for all patients was 5.5 years. Results: Minimally invasive colorectal procedures were conducted in 105 patients for treatment of carcinoma of caecum (n=8); ascending (n=21), transverse (n=4), descending (n=7) and sigmoid colon carcinoma (n=30); and rectal carcinoma (n=35). The procedures conducted were ileocaecal resection (n=3), right hemicolectomy (n=26), resection of transverse colon (n=4), left hemicolectomy (n=4), resection of descending colon (n=3), sigmoid resection (n=30), rectal resection (n=26), amputation of the rectum (n=8), and sigmoidostomy (n=1). Postoperative mortality was 1.0 % (n=1). Following 90 curative colorectal resections, local recurrence developed in five patients (5.6 %) and two trocar-site metastases were observed (2.2 %). Mean 5-year survival for stages I–III was 68 % for curative colorectal resections (87 %, 91 % and 28 % for stages I, II and III, respectively,n=83; 44 % vs. 20 % for IIIA vs. IIIB,n=29). Seven patients (8 %) died from tumour-unrelated causes. Mean survival following palliative resections was 10.5 months (n=15). Conclusions: Up to now, in our experience, postoperative survival following minimally invasive colorectal resections is comparable to that following ‘open’ surgery. Additional trials are required in order to compare long-term outcomes.     

<Emphasis Type="Bold">Invited commentary to:</Emphasis> ‘Clinical pathways as a tool for process costing in cardiac surgery’ (Eur. Surg. 2003;35:51–54)

Background: By developing a standard clinical pathway, we tried to assess the cost of a coronary bypass procedure at our in institution in order to find possibilities for cost containment and financial decision-making. Methods: A standard clinical pathway was designed for an aortocoronary bypass procedure. Using this pathway, we assessed the procedural costs in a stepwise manner for each individual patient to obtain the average cost for a bypass operation at our institution.     

Editors’ Note to: Comparison of adductor canal block and IPACK block (interspace between the popliteal artery and the capsule of the posterior knee) with adductor canal block alone after total knee arthroplasty: a prospective control trial on pain and knee function in immediate postoperative period

European Journal of Orthopaedic Surgery & Traumatology -