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Could it be that the neo-adj chemo takes care of the invisible disease and offset inadequate surgery such as R1 D1 resection as regards loco-regional control ? What would be the role of biologics?

May be the indoor activity is more in the present times than in the past. Besides fast food joints are far more along with the verity and abundance.

Mr John Nicholls was the most popular multi-linguist, flamboyant surgeon amongst the other giants at the St Marks hospital, the birth place of most of the celebrated Ano-Rectal surgeons, I visited as a trainee surgeon in nineties. Enjoyed his elegant J pouch procedure for IBD with hand sewn anastomoses and surgery for complex fistula.

Excellent overview, though it did not cover on fistulae related to Crohns and Tuberculosis.

In the dermal advancement flap if we excise both the ext & internal openings and close the defect it would be logical.

professor R J NICHOLLS , A great human being always sincere with his profession.I underwent his treatment in St Marks Hospital for the duration of 1998-2002. underwent many surgeries and now I am living happy life.MAY ALLAH BLESS HIM A LOT. I am MUHAMMAD AAMIR from Pakistan.

04/12/2020

I've had bowel since 2017. Basildon Hospital Essex UK. 15 months later stoma reversed. Cancer came back after stoma reversed. Since then I've had and still got this Anastomosis Leak. That's it.

This man has golden hands and he is the best 😘😘😘