Introduction The Association of Coloproctology first published surgeon specific outcome data in September 2013. There has been some concern this may lead to surgeons refusing to operate on higher risk patients. Furthermore, Published by the Royal College of Surgeons of England, “Access Ages 2” suggests that there is a marked decline in rates of elective surgery in over 65s. It described a 9 fold difference in the rate of colorectal cancer excision for over 75s depending on where the patient lives. We hypothesised that concern over poor outcomes may lead to a reduction in the age of patients offered elective colorectal cancer excision. Method Data was prospectively collected on all patients undergoing elective colorectal cancer resections in our unit. We compared the patient selection for one year before and after publication of surgeon specific data. Results In the 12 months prior to publication of surgeon specific data, our Unit (4 Consultant Colorectal Surgeons) operated on 114 patients with a median age of 71 (IQR 63–77.5), compared to 84 patients with a median age of 72.5 (65–77) for the subsequent 12 months (p = 0.351, Mann-Whitney). There were more patients in the 75–85 age range than in the 65–75 range. The comorbidities identified in both groups were comparable. Conclusion There was no difference in the age group of patients offered elective surgery following the publication of surgeon specific outcome data. Fears that the publication may lead to older patients being denied surgery were unfounded. Disclosure of interest None Declared. Reference http://www.rcseng.ac.uk/news/docs/access-all-ages-2

Introduction Extralevator APER for low rectal cancer is used to avoid the adverse oncological outcomes of inadvertent perforation and a positive circumferential resection margin associated with the conventional APER technique. Removal of the levators leaves a large defect requiring pelvic floor reconstruction. Controversy still exists on the best method of closure. The aim of this study is to present the outcomes of biosynthetic mesh for pelvic floor reconstruction. Method Perineal reconstruction was done using biosynthetic mesh. We evaluated the short term outcomes with regards to perineal wound complications and perineal hernias. Results 25 patients had biosynthetic mesh repairs. 23 of the patients had surgery for rectal cancer and 2 for anal cancer. Median operative time was 3.5 h. At a median follow up period of 26 months, there were 4 perineal complications (2 wound infections, 1 haematoma and 1 wound dehiscence) but no meshes were removed. 1 patient required vacuum assisted dressing for wound dehiscence. There were no perineal hernias. There was no mortality. Conclusion The low complication rate, good outcomes in perineal wound healing and absence of perineal hernia demonstrates that use of biosynthetic mesh for pelvic floor reconstruction is safe and feasible. Disclosure of interest None Declared.