Background Many surgeons routinely place intraperitoneal drains after elective colorectal surgery. However, enhanced recovery after surgery guidelines recommend against their routine use owing to a lack of clear clinical benefit. This study aimed to describe international variation in intraperitoneal drain placement and the safety of this practice. Methods COMPASS (COMPlicAted intra-abdominal collectionS after colorectal Surgery) was a prospective, international, cohort study which enrolled consecutive adults undergoing elective colorectal surgery (February to March 2020). The primary outcome was the rate of intraperitoneal drain placement. Secondary outcomes included: rate and time to diagnosis of postoperative intraperitoneal collections; rate of surgical site infections (SSIs); time to discharge; and 30-day major postoperative complications (Clavien–Dindo grade at least III). After propensity score matching, multivariable logistic regression and Cox proportional hazards regression were used to estimate the independent association of the secondary outcomes with drain placement. Results Overall, 1805 patients from 22 countries were included (798 women, 44.2 per cent; median age 67.0 years). The drain insertion rate was 51.9 per cent (937 patients). After matching, drains were not associated with reduced rates (odds ratio (OR) 1.33, 95 per cent c.i. 0.79 to 2.23; P = 0.287) or earlier detection (hazard ratio (HR) 0.87, 0.33 to 2.31; P = 0.780) of collections. Although not associated with worse major postoperative complications (OR 1.09, 0.68 to 1.75; P = 0.709), drains were associated with delayed hospital discharge (HR 0.58, 0.52 to 0.66; P < 0.001) and an increased risk of SSIs (OR 2.47, 1.50 to 4.05; P < 0.001). Conclusion Intraperitoneal drain placement after elective colorectal surgery is not associated with earlier detection of postoperative collections, but prolongs hospital stay and increases SSI risk.

Adult intussusception (AI) is uncommon condition that represents 1-5 % of intestinal obstruction and is frequently caused by an underlying disease with 70-90% of cases having a demonstrable cause based on imaging findings and surgical results. The most common causes of colonic AI are neoplasm. We report a case of right colo-colic intussusception sustained by a malignant tumor.

The development of second generation ultrasound (US) contrast-medium and specific imaging techniques with dedicated softwares, allows to observe the liver perfusion in real time, becoming an useful and less invasive method to describe precisely the vascularization of hepatic lesions. This significantly increased the ability of US to detect and characterize focal liver lesions. The aim of this review article is to evaluate the role of contrast enhancement US in the diagnosis of hepatocellular carcinoma in cirrhotic liver, with reference to the guidelines of American Association for the Study of Liver Diseases, European Association for the Study of the Liver and European Federation of Societies for Ultrasound in Medicine and Biology.

Background/Aims The person in this case study was a man with prostatic cancer and diastasis rectus abdominis. Perineal rehabilitation was needed to prevent urinary incontinence, before and after a radical prostatectomy. This study reports on an original application of kinesio tape to reduce the diastasis rectus abdominis so that he could carry out the rehabilitation programme. Methods Three green-coloured Y-type tapes (width 5 cm and length 15 cm) were positioned to form an X, orthogonally at the linea alba, separating the tape half in width and two-thirds of a grid in length into 2 ends, under 75% pulling force (above and below the navel), and two green-coloured I-type tapes (width 5 cm and length 30 cm) positioned in parallel at the rectus abdominis, from the external face of the 5th, 6th and 7th costal cartilage and by the xiphoid process to the upper part of the pubis tubercle and pubic symphysis under 50% pulling force. Kinesio tapes were applied daily before every session of the perineum rehabilitation. Findings A significant reduction of the diastasis was observed by ultrasound, after the kinesio tape was applied. Conclusions This case demonstrates that it was possible to perform a pre- and post-operative perineal rehabilitation programme after the application of kinesio tape, which efficiently reduced the diastasis rectus while performing exercises, with the aim to prevent urinary incontinence.