BackgroundExtracorporeal shockwave therapy (ESWT) is used to manage different tendinopathies and appears to be effective in some tendinopathies but not others. The reasons for this are unclear. There is evidence that patient outcomes can be influenced by a patient-centred approach. There is therefore a need to qualitatively evaluate patient experiences for a treatment like ESWT where uncertainties exist. The aim of this study was to understand patients’ overall perspective of ESWT to manage their tendinopathy.MethodsA qualitative semi-structured face-to-face interview study design was used and the data was analysed thematically using ‘Framework Analysis’.ResultsEleven participants that have had radial ESWT (rESWT) to treat a range of tendinopathies were recruited from a private London sports clinic and interviewed in person or via Skype™. Four main themes and 16 subthemes were identified. Subthemes included previous failed treatment, clinician factors, mechanisms of ESWT, positive aspects, negative aspects, responsibility over own health and perceived outcomes.ConclusionThe participants understood the procedural aspects of rESWT, but were largely unaware of its mechanism of action and whether it was found to be effective for their condition or not. The participants felt that self-management measures were equally or more important than rESWT to help treat their tendinopathies. Recommendations would be for rESWT providers to offer patients written information, maintain continuity of care, address patients’ expectations, feedback on progress, and encourage self-management measures such as activity modification.Electronic supplementary materialThe online version of this article (10.1186/s13047-018-0254-5) contains supplementary material, which is available to authorized users.

ADJUVANT RADIOTHERAPY IS AN INDEPENDENT RISK FACTOR FOR SMALL BOWEL OBSTRUCTION AFTER CURATIVE RECTAL CANCER SURGERYAim: Small bowel obstruction (SBO) as a complication is not uncommon after curative rectal cancer surgery; adjuvant radiotherapy (RT) may have a contributory role. This study aimed at determining the prevalence and risk factors for this complication. Methods:The medical records of 260 consecutive patients with rectal cancer (excluding rectosigmoid cancer) who underwent curative surgery at our institution between January 1995 and December 2000 were retrospectively reviewed to determine the prevalence of SBO requiring hospitalization and intervention. Possible risk factors for SBO were recorded and analysed using univariate and multivariate analysis. Results: The median duration of follow up was 76.1 months (range, 3.3-141.8 months). Forty-four patients (16.9%) developed SBO and 19 of them required surgical intervention. Three patients (6.8%) died as a consequence of SBO. Seventy-eight patients (30%) received adjuvant RT with a median dose of 50 Gy (range 30-64 Gy). Patients receiving RT were more likely to develop SBO (25.6% vs 13.2%, P = 0.014). The median duration between adjuvant RT and the first episode of SBO was 23.5 months (range, 5.7-99.4 months). Multivariate analysis showed that adjuvant RT was the only independent risk factor for SBO (OR = 2.27, 95% CI = 1.17-4.42, P = 0.016). Gender, operative approach (open vs laparoscopic), abdominoperineal resection, perioperative blood transfusion, postoperative intra-abdominal sepsis, tumour stage, and disease recurrence were not associated with the development of SBO. Conclusion: Adjuvant RT is the only independent risk factor for SBO after curative surgery for rectal cancer. Patients should be well informed of this potential complication when they are offered adjuvant RT.2 J.C.