Occult hepatic metastases (OHMs) were detected by ultrasound and/or CT scanning in 17 of 71 (24 per cent) patients undergoing apparently curative resection for colorectal carcinoma. One of the patients with OHMs survived 5 years; in contrast, only 5 of 54 patients without evidence of OHMs at surgery died of disseminated disease. The presence or absence of OHMs at the time of surgery predicts the majority of deaths from disseminated disease following apparently curative resection for colorectal carcinoma.

Background: Laparoscopic cholecystectomy is commonly performed, and several factors increase the

More patients perform paid work after LRYGBP and LAGB than beforehand, and the number of weekly hours they work increases. After surgery, patients claim fewer state benefits.

BackgroundThe National Bariatric Surgery Registry (NBSR) is the largest bespoke database in the field in the United Kingdom.ObjectivesOur aim was to analyze the NBSR to determine whether the effects of obesity surgery on associated co-morbidities observed in small randomized controlled clinical trials could be replicated in a "real life" setting within U.K. healthcare.SettingUnited Kingdom.MethodsAll NBSR entries for operations between 2000 and 2015 with associated demographic and co-morbidity data were analyzed retrospectively.ResultsA total of 50,782 entries were analyzed. The patients were predominantly female (78%) and white European with a mean age of 45 ± 11 years and a mean body mass index of 48 ± 8 kg/m2. Over 5 years of follow-up, statistically significant reductions in the prevalence of type 2 diabetes, hypertension, dyslipidemia, sleep apnea, asthma, functional impairment, arthritis, and gastroesophageal reflux disease were observed. The "remission" of these co-morbidities was evident 1 year postoperatively and reached a plateau 2 to 5 years after surgery. Obesity surgery was particularly effective on functional impairment and diabetes, almost doubling the proportion of patients able to climb 3 flights of stairs and halving the proportion of patients with diabetes related hyperglycemia compared with preoperatively. Surgery was safe with a morbidity of 3.1% and in-hospital mortality of .07% and a reduced median inpatient stay of 2 days, despite an increasingly sick patient population.ConclusionsObesity surgery in the U.K. results not only in weight loss, but also in substantial improvements in obesity-related co-morbidities. Appropriate support and funding will help improve the quality of the NBSR data set even further, thus enabling its use to inform healthcare policy.

Readmissions and complications following cholecystectomy are common and associated with patient and disease characteristics.