Isolated colonic inertia is an unusual cause of chronic constipation. Most patients with colonic inertia have associated outlet obstruction. These data question the clinical significance of isolated colonic inertia.

A method to estimate CLs of flow rate measured by the thermodilution technique is presented and validated. Application demonstrates an accurate measurement of low flow, but limitations at higher flow and in detecting falls in flow. Appreciating the magnitude of such is critical to informed clinical decision making when using flow rate in an access surveillance programme.

These data show that proctographic findings can help predict functional outcomes after LVMR. Presence of an enterocele and a vertical axis of the rectum at rest may be associated with a better resolution of symptoms.

A team approach to fistula surgery, with a weekly ward round and elective fistula list, was introduced at the Royal Darwin Hospital in April 1999. This study has evaluated the impact of this team approach and assessed factors influencing fistula patency. Data was prospectively recorded on all patients who underwent fistula surgery between 1993 and August 2000. Three hundred and forty-seven operations were performed in 161 patients, with 142 (41 YO) for revision of an established fistula. One hundred and nine operations (in 79 patients) were performed after the onset of the team approach. A 30-day fistula patency rate was significantly greater for new operations than revision operations, at 86 and 77% (P=0.047). Primary and secondary patency rates were 56 and 75Y0, respectively, at 1 year, and 38 and 42% at 3 years. Factors associated with reducedduration of fistula patency following any operation included operations before the team approach (P= 0.0002), operations out-of-hours (P=0.020), use of an interposition graft (P=0.035), and persons NOT of aboriginal race (P= 0.007). Diabetes was suggestive of reduced patency (P= 0.065). The only factor associated with reduced secondary patency was the use of an interposition graft (P=0.020). Factors not shown to influence primary or secondary patency included the artery or vein used, peripheral vascular disease, hypertension, cerebrovascular disease, and the particular surgeon who performed the operation. Out-of-hours surgery was reduced, from 37 to 28% by the dedicated theatre list. We conclude that the team approach to fistula surgery, with a dedicated theatre list, prolongs fistula patency, plus allows the surgeon to sleep at night. An interposition graft should be avoided whenever possible.KEY WORDS: arteriovenous fistula, fistula patency, haemodialysis.