Abstract
s / International Journal of Surgery 10 (2012) S1–S52 S27 ABSTRACTS diagnosed with a SSI compared with eleven in twenty-one (52%) patients who underwent linear closure. Conclusion: The results from this study suggest that purse-string closure of ileostomy wounds is favourable to linear closure in reducing the rates of SSIs. 0691: ENHANCED RECOVERY AFTER COLORECTAL SURGERY: FACTORS AFFECTING LENGTH OF STAY Matthew Aldridge, Nicola Dowling, Emma Chater, Henry Ferguson, Steve Pandey. Worcestershire Acute Hospitals NHS Trust, Worcester, UK Aim: Enhanced Recovery after Surgery (ERAS) has been shown to reduce the length of stay (LOS) after elective colorectal surgery. This programme was implemented at Worcestershire Royal Hospital in January 2011. The aim of this study was to identify factors which impact on LOS. Method: All patients undergoing elective colorectal surgery between January and December 2011 were included, with no exclusions based on factors such as age, BMI or co-morbidities. A prospectively collected ERAS database was analysed to study short term outcomes. Patients who stayed in hospital for 5 days or less were compared with those who stayed longer. Results: There were a total of 191 patients (89 females, median age 68, laparoscopic rate 52%), of which 90 (47%) were discharged within 5 days. Statistically significant factors for increased LOS were open operations (p 70 (p1⁄40.004), planned/unplanned HDU stay >48 hours (p1⁄40.004), and postoperative complications (p<0.001), of which the most significant was prolonged post-operative ileus (p<0.001). Conclusions: We are encouraged by our early results. Having identified factors which have a significant impact on LOS, we can now tailor our programme accordingly. Increased laparoscopic rates in the future should improve our results further. 0693: COLONOSCOPIC BOWEL CANCER SURVEILLANCE FOLLOWING COLORECTAL RESECTION Adam Peckham-Cooper, Richard Wilkin, Max Sellers, Sian Davies, J. Eccersley. Burton Hospital Foundation Trust, Derbyshire, UK Aims: At a hospital in the West Midlands deanery, the protocol for follow up and surveillance after colorectal resection includes a colonoscopy at 1-year post resection, 3 years and 5 years. This audit aimed to examine the sensitivity of the protocol in detecting further cancers and explore if this had an effect on mortality. Methods: All patients undergoing colorectal resection between January 2005 December 2006 were included using a prospective database. Data was collected retrospectively utilising the local HCISTM and GI Reporting ToolTM (Unisoft-Medical-Systems). Results: 200 Cancer resections were performed (elective and emergency) in the time period. Preliminary data analysis demonstrated an 81% survival rate at 1 year and 56% at 5 years. At completion colonoscopy 1 patient had a synchronous cancer found and 1 patient had a large hyperplastic polyp removed. 44% of patients having a colonoscopy at 1 year had polyps biopsied or removed. In this study cohort, the 5 year colonoscopic surveillance programme revealed no further colorectal cancers. Conclusions: Surveillance colonoscopy could be reduced to one completion scope at 5 years with no increase risk to patients but significant financial savings. The psychosocial benefits of regular surveillance followup to the patient should however not be underestimated. 0718: THE TRUE PLACE OF INTRASPHINCTERIC BOTOX IN ANAL FISSURE MANAGEMENT Sarah Braungart, Geetinder Kaur. Scunthorpe General Hospital, Scunthorpe,
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