Patients who can undergo surgical resection for metastatic uveal melanoma have a more favorable survival compared to those who do not.

The Royal College of Surgeons have proposed using outcomes from necrotising enterocolitis (NEC) surgery for revalidation of neonatal surgeons. The aim of this study was therefore to calculate the number of infants in the UK/Ireland with surgical NEC and describe outcomes that could be used for national benchmarking and counselling of parents. A prospective nationwide cohort study of every infant requiring surgical intervention for NEC in the UK was conducted between 01/03/13 and 28/02/14. Primary outcome was mortality at 28-days. Secondary outcomes included discharge, post-operative complication, and TPN requirement. 236 infants were included, 43(18%) of whom died, and eight(3%) of whom were discharged prior to 28-days post decision to intervene surgically. Sixty infants who underwent laparotomy (27%) experienced a complication, and 67(35%) of those who were alive at 28 days were parenteral nutrition free. Following multi-variable modelling, presence of a non-cardiac congenital anomaly (aOR 5.17, 95% CI 1.9–14.1), abdominal wall erythema or discolouration at presentation (aOR 2.51, 95% CI 1.23–5.1), diagnosis of single intestinal perforation at laparotomy (aOR 3.1 95% CI 1.05–9.3), and necessity to perform a clip and drop procedure (aOR 30, 95% CI 3.9–237) were associated with increased 28-day mortality. These results can be used for national benchmarking and counselling of parents.

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Introduction: Infantile hypertrophic pyloric stenosis (IHPS) is a common surgical condition, but there are no guidelines regarding preoperative fluid resuscitation. Our aim was to evaluate a novel consensus care pathway for IHPS, incorporating a standardized fluid and electrolyte replacement regime. Methods: One hundred patients were initially reviewed and compared to thirty-three patients following the introduction of a clinical pathway, whereby infants requiring electrolyte correction received 150 ml/kg/24 h of 0.45% saline, 5% dextrose and 10 mmol KCl, with systematic blood sampling until correction was achieved. We measured time to electrolyte correction, time to surgery and total length of hospitalization. Data were described using the median and interquartile range, and differences between the groups' categorical and continuous data were described using Chisquared and the Mann-Whitney U-tests, respectively. Results: Time in hours taken to correct electrolytes was reduced: 25(16.5-42) versus 9.5(4.5-24.75) p ¼ 0.004. Time to surgery from admission in uncorrected patients decreased from 50(40.25-66.75) to 39(28.75-41.75) p ¼ 0.018. Subsequently, there was a reduction in total length of stay: 94(71-93.5) versus 75(64.5-93.5) p ¼ 0.025. Parental satisfaction increased from 77% in the pre-pathway group to 83% in the pathway group. Conclusion: A consensus care pathway for IHPS reduces the time taken to correct preoperative electrolyte abnormalities, decreases length of hospitalization and improves parental satisfaction.

The Acknowledgements section in this Article is incomplete. "This article is submitted as an observational study in the category of original articles. A small subset of information from this article has been presented at the annual congress of the British Association of Paediatric Surgeons". should read: "This article is submitted as an observational study in the category of original articles. A small subset of information from this article has been presented at the annual congress of the British Association of Paediatric Surgeons.