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Objectives: This is a qualitative study which aims to understand the lived experience of dietary changes among Chinese survivors of colorectal cancer who participated in a dietary intervention., Setting: The surgical and oncological departments of four public hospitals in Hong Kong., Participants: Fifty-five Chinese colorectal cancer survivors who were aged 18 years or above and had received potentially curative treatment in the surgical and oncological departments in Hong Kong were examined. Participants' mean age was 64 years, with 29 (53%) males., Intervention: A 12-month dietary intervention delivered via face-to-face motivational interviews, fortnightly motivational phone calls, monthly electronic pamphlets, quarterly newsletters and quarterly group meeting., Outcome Measure: We adopted the qualitative approach to capture participants' perspectives and to apply the understanding pragmatically in everyday life. Content analysis was conducted., Results: We identified themes of motives to changes of dietary practices including (1) individual commitment to dietary change; (2) adaptive strategies in interpersonal contexts and (3) working with healthcare professionals during the journey., Conclusions: The findings demonstrated how Chinese custom and culture posing unique challenges to colorectal cancer survivors and the need of having dietary advice from healthcare professionals. Participants were motivated to change their eating habits by support from family, friends and healthcare professionals. Our findings could help healthcare professionals provide specific dietary advice and guidance to Chinese colorectal cancer survivors., Trial Registration Number: NCT01708824., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Introduction: Cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) is increasingly used to treat peritoneal metastases from appendiceal or colorectal origin. We evaluate our institution's experience and survival outcomes with this procedure, and its efficacy in symptom relief., Methods: This is a single-centre retrospective observational study on patients with peritoneal metastases (PM) from appendiceal neoplasm or colorectal cancer who underwent CRS/HIPEC in Queen Mary Hospital. Our primary endpoints were overall survival (OS) and morbidity and mortality of this procedure; secondary endpoints included disease-free survival (DFS) and symptom-free survival., Results: Between 2006 and 2018, thirty CRS/HIPEC procedures were performed for 28 patients - 17 (60.7%) had appendiceal PM while 11 (39.9%) had colorectal PM. The median peritoneal cancer index was 20; complete cytoreduction was achieved in 83.3% patients. High-grade morbidity occurred in 13.3% cases. There was no 30-day mortality. Two-year OS were 71.6% and 50% for low-grade appendiceal PM and colorectal PM patients (p = 0.20). Complete cytoreduction improved OS (2-year OS 75.4% vs 20%, p = 0.04). Median DFS was 11.8 months. Median symptom-free duration was 36.8 months; patients with complete cytoreduction were more likely to remain asymptomatic (82.9% at 1 year, vs 60% in incomplete cytoreduction group, p < 0.01). 91.7% low-grade appendiceal PM patients and 58.4% colorectal PM patients remained asymptomatic at post-operative one year (p = 0.31)., Conclusion: CRS/HIPEC is beneficial to appendiceal PM and selected colorectal PM patients - improving survival and offering prolonged symptom relief, with reasonable morbidity and mortality. Complete cytoreduction is key to realising this benefit., Competing Interests: Declaration of competing interest We have no conflicts of interest to disclose. We would like to acknowledge Dr JWC Ho and Prof WL Law for starting the cytoreductive surgery/ HIPEC programme in our centre., (Copyright © 2020. Published by Elsevier Taiwan LLC.)

Objective: To explore influences on post-diagnosis dietary decision-making in colorectal cancer survivors (CRC) for future intervention development., Methods: Individual semi-structured interviews were conducted with 30 CRC survivors. All interviews were recorded and transcribed verbatim for grounded theory analysis., Results: Most CRC survivors interviewed reported making both short- and long-term changes post-diagnosis, influenced by physical symptoms and personal beliefs: short-term treatment-driven changes to facilitate recovery, manage treatment side-effects and avoid disruption in treatment; short-term 'patient role' driven changes heavily influenced by family members and cultural beliefs; long-term changes driven by residual symptoms and illness beliefs, including cancer causal attributions and beliefs about preventing future recurrences. Traditional Chinese medicinal (TCM) beliefs were influential in both short- and long-term dietary decision-making, which may explain why survivors focused on specific food items rather than food patterns., Conclusion: While our findings suggested that the majority of CRC survivors made dietary changes post-diagnosis, their dietary pattern and motivation may change over the course of their illness trajectory. Also, the types of changes made are often not consistent with existing dietary recommendations. It is necessary to consider illness perception and cultural beliefs when delivering dietary care or developing interventions for this population., (© 2019 John Wiley & Sons Ltd.)

Objective: Totally extraperitoneal (TEP) inguinal hernioplasty for inguinal hernia is associated with less postoperative pain, shorter hospital stays, less chronic pain, and increased patient satisfaction when compared with the open Lichtenstein approach‥ However, only few studies to date have compared conventional with needlescopic TEP hernioplasty for treating unilateral inguinal hernias in adult patients. We report our prospective study that compared the postoperative outcomes of these two approaches over a 2-year period., Methods: From July 2007 to June 2009, a total of 32 patients underwent attempted unilateral needlescopic TEP hernioplasty. All data were prospectively collected and analysed, including demographic features, types of hernia, and postoperative outcome. The results were compared with those of an agematched cohort of 32 patients who underwent conventional TEP hernioplasty in the same period., Results: Needlescopic TEP hernioplasty was successfully performed in 24 patients. The other eight procedures were completed with conventional TEP approaches after changing one or two 5-mm ports. The most common hernia type was Nyhus type III (38/64, 59.3%). There was no significant difference in the mean operative time, hospital stay, and postoperative pain scores between the needlescopic and conventional approaches. There was no major complication detected on the first visit, except seroma formation (9 patients in the needlescopic group and 11 in the conventional group), all of which was resolved with conservative management. No recurrence of hernia was noted in either group during the mean follow-up period of 88.0 weeks., Conclusion: Needlescopic TEP hernioplasty was a feasible technique in selected patients for inguinal hernia repair. Postoperative recovery following both approaches was similar. However, because this was a small cohort study, larger prospective, randomized controlled trials are required to establish the longterm benefit, safety and complications of needlescopic surgery., (Copyright © 2011 Asian Surgical Association. Published by Elsevier B.V. All rights reserved.)

Aims: To describe the process and explore the feasibility of training a colorectal nurse in Hong Kong to perform flexible sigmoidoscopy., Background: Given the shortage and high turnover rate of medical staff, a pilot programme was designed to train and expand the role of colorectal nurse clinicians. It was hoped that such nurses could share some of the clinical duties of the medical staff. An advanced practice nurse was selected for the programme. One of the training components was the performance of flexible sigmoidoscopy., Design: This was a descriptive, case review study., Method: A one-year-structured endoscopic training programme was designed for the nurse clinician. Weekly sessions were conducted by one of the trainers. The training process included the following: (1) procedural observation; (2) supervised withdrawal, advancement and manipulation of the sigmoidoscope and (3) a final assessment of the nurse's competency in performing sigmoidoscopy independently., Results: In total, 119 outpatients (58 male and 61 female) with a mean age of 57·02 years (SD 14·6 years; range: 18-83 years) underwent flexible sigmoidoscopy by the nurse over 11 months. The mean procedural time was 9·38 minutes (SD 3·5 minutes; range 3-26 minutes). The procedure was terminated prematurely if it could not be tolerated by the patient or if the bowel preparation was inadequate. The mean depth of insertion was 53·5 cm (SD 12·2 cm; range 6-60 cm). In total, 82 patients had a normal exam, 32 patients had abnormalities. There were no procedural complications, and no patient required an unplanned hospital admission after the procedure., Conclusion: In Queen Mary Hospital, nurses can be trained to perform flexible sigmoidoscopy in a safe and effective manner., Relevance to Clinical Practice: Nurse endoscopists could increase the use of flexible sigmoidoscopy in colorectal cancer screening and can also enhance the professional development of colorectal nurses., (© 2010 The Authors. Journal compilation © 2010 Blackwell Publishing Ltd.)