Patients with Crohn's disease who smoke have a 2.5-fold increased risk of surgical recurrence and a twofold risk of clinical recurrence compared to non-smokers. Patients with Crohn's disease should be encouraged to stop smoking since the risk of disease relapse is minimised upon its cessation.

NHB donors carry the potential of expanding the cadaveric kidney pool. Although, transplants from NHB donors are associated with a greater incidence of early adverse events, long-term outcomes appear comparable with those of transplants from HB donors.

Hand-assisted laparoscopic nephrectomy appeared to have the same donor and recipient complication rate with standard laparoscopy but offered substantial advantages in terms of shortened operative and warm ischemia time as well as decreased intraoperative bleeding.

Summary Mini‐open donor nephrectomy (MODN) potentially combines advantages of standard open (SODN) and laparoscopic techniques (LDN). This article is a comparison of these techniques. A literature search was performed for studies comparing MODN with SODN or LDN. Nine studies met our selection criteria. Of the 1038 patients, 433 (42%) underwent MODN, 389 (37%) SODN and 216 (21%) LDN. MODN versus SODN: Operative time (P = 0.17), warm ischemia time (P = 0.20) and blood loss (P = 0.30) were not significantly different. Hospital stay and time to return to work were shorter for MODN by 1.67 days (P < 0.001) and 5 weeks (P = 0.03). Analgesia requirement and overall complications were less in the MODN group (P < 0.001) and (P = 0.03). Ureteric complications (P = 0.21) and 1‐year graft survival (P = 0.28) were not significantly different. MODN versus LDN: Operative and warm ischemia times were significantly shorter for the MODN by 55 min (P = 0.005) and 147 s (P < 0.001). Analgesia requirement was greater for the MODN group by 9.62 mEq morphine (P = 0.04). No significant differences were found for blood loss (P = 0.8), hospital stay (P = 0.35), donor complications (P = 0.40) or ureteric complications (P = 0.83). MODN appears to provide advantages for the donor in comparison to SODN and also has a shorter operative time when compared with the LDN.

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Background Breast angiosarcomas are rare tumours of vascular origin. Secondary angiosarcoma occurs following radiotherapy for breast cancer. Angiosarcomas have high recurrence and poor survival rates. This is concerning owing to the increasing use of adjuvant radiotherapy for the treatment of invasive breast cancer and ductal cancer in situ (DCIS), which could explain the rising incidence of angiosarcoma. Outcome data are limited and provide a poor evidence base for treatment. This paper presents a national, trainee-led, retrospective, multicentre study of a large angiosarcoma cohort. Methods Data for patients with a diagnosis of breast/chest wall angiosarcoma between 2000 and 2015 were collected retrospectively from 15 centres. Results The cohort included 183 patients with 34 primary and 149 secondary angiosarcomas. Median latency from breast cancer to secondary angiosarcoma was 6 years. Only 78.9 per cent of patients were discussed at a sarcoma multidisciplinary team meeting. Rates of recurrence were high with 14 of 28 (50 per cent) recurrences in patients with primary and 80 of 124 (64.5 per cent) in those with secondary angiosarcoma at 5 years. Many patients had multiple recurrences: total of 94 recurrences in 162 patients (58.0 per cent). Median survival was 5 (range 0–16) years for patients with primary and 5 (0–15) years for those with secondary angiosarcoma. Development of secondary angiosarcoma had a negative impact on predicted breast cancer survival, with a median 10-year PREDICT prognostic rate of 69.6 per cent, compared with 54.0 per cent in the observed cohort. Conclusion A detrimental impact of secondary angiosarcoma on breast cancer survival has been demonstrated. Although not statistically significant, almost all excess deaths were attributable to angiosarcoma. The increased use of adjuvant radiotherapy to treat low-risk breast cancer and DCIS is a cause for concern and warrants further study.