Application and maintenance of the portable device was technically straightforward. All dogs receiving portable NPWT after transfer of a free skin graft to the distal extremity had a successful outcome.

No abstract

fluid therapy (NRFT) in patients undergoing laparoscopic and open colorectal surgery. Methods A simple model was applied to evaluate the various variables reported in the published randomised, controlled trials comparing the role of RFT and NRFT by the use of principles of meta-analysis. The primary outcome measure was postoperative morbidity. Secondary endpoints were mortality and hospital stay. A random effects model was applied. Results Seventeen randomised, controlled trials on 2165 patients were included. The incidence of postoperative morbidity (OR 0.84; 95% CI 0.57 to 1.24; z¼0.90; ¼0.37) and mortality (OR 0.93 Introduction This aim of this study is to review how investigation and management of colovesical fistulae has progressed in our institution over a 12-year period and to propose a clear protocol to ensure prompt diagnosis and treatment in the future. Methods A retrospective case note review was conducted of all patients with colovesical fistulae who underwent definitive surgery over a 12-year period. Variables collected include patient demographics, symptoms, investigations, operative data, histology, complications and length of stay. Results 56 patients (38 male) underwent operative intervention for colovesical fistula. The most common symptoms are pneumaturia (69%), faecaluria (32%) and symptoms associated with recurrent UTIs (68%). Cystoscopy was the most accurate test to identify fistulae (91%) followed by CT (60%) and barium enema (31%). Two patients were unfit for major surgery and underwent palliative loop colostomies. The most common pathology was diverticular disease. Of the 54 remaining patients, 45% underwent laparoscopic resection with a conversion rate of 33% (due to adhesions or multiple abscesses). Sigmoid colectomy, (52%) anterior resection (30%) and hartmanns (9%) are the most common procedures performed. Bladder repair was required in 25% of cases with a further 16% requiring partial resection. All patients received a postoperative cystogram to ensure bladder had healed and 70% of patients were defunctioned to protect the anastomosis. There was no mortality reported peri-operatively; the anastomotic leak rate was 5% and recurrence rate was 5%. Median postoperative stay was 12.5 days (range 4e91) in the laparoscopic group and 16 days (range 6e62) in the open group. Conclusion Surgical management for colovesical fistulae is effective and safe. Laparoscopic resections are increasing in popularity and deliver encouraging results comparable to open resection. A large multi-centre randomised controlled trial is required to validate its potential benefits over open surgery.