A5016751623- Bariatric Surgery and Outcomes
- Esophageal and GI Pathology
- Gastric Cancer Management and Outcomes
- Nutrition and Health in Aging
- Obesity and Health Practices
- Esophageal Cancer Research and Treatment
- Body Contouring and Surgery
- Frailty in Older Adults
- Cardiac, Anesthesia and Surgical Outcomes
- Enhanced Recovery After Surgery
- Clinical Nutrition and Gastroenterology
- Diet and metabolism studies
- Respiratory Support and Mechanisms
- Lung Cancer Diagnosis and Treatment
- Medical Coding and Health Information
- Neonatal Respiratory Health Research
- Transplantation: Methods and Outcomes
- Abdominal Surgery and Complications
- Trauma and Emergency Care Studies
- Metastasis and carcinoma case studies
- Pelvic and Acetabular Injuries
- Hernia repair and management
- Cardiovascular Function and Risk Factors
- Colorectal Cancer Surgical Treatments
- Gastrointestinal motility and disorders
The Alfred Hospital
2013-2024
Alfred Health
2020-2024
Monash University
2020-2024
Middlemore Hospital
2020
Background Endoscopic vacuum‐assisted closure ( EndoVAC ) therapy is a recent innovation described for use in upper gastrointestinal perforations and leaks, with reported success of 80–90%. It provides sepsis control collapses the cavity preventing stasis, encouraging healing defect. Whilst promising, initial reports this new technique have not established clear indications, feasibility optimal technique. Methods We analysed all patients who underwent between 2014 2016. The involved standard...
Abstract Background & Objectives Low muscle mass, measured using computed tomography (CT), is associated with poor surgical outcomes. We aimed to include CT‐muscle mass in malnutrition diagnosis the Global Leadership Initiative on Malnutrition (GLIM) criteria, compare it International Classification of Diseases 10th Revision (ICD‐10) and assess impact postoperative outcomes after oesophagogastric (OG) cancer surgery. Methods One hundred eight patients who underwent radical OG surgery had...
Outcomes of oesophago-gastric cancer are poor and highly variable between centres. It is important that complex multimodal treatments applied optimally. Low case volumes at Australian centres mean the analysis crude outcomes an inadequate assessment overall quality care. Detailed across a range domains offers opportunity to measure performance.We compared data from UK National Oesophago-gastric Cancer Audit 2010 with prospective Alfred Hospital database.There were 314 17 279 patients...
Bariatric surgery has not been widely used in the Australian public health system. As obesity is strongly associated with socio-economic status, excluding its use from system will deny many of most in-need access to a potentially very effective treatment. Alternatively, rigorous follow-up and behavioural change requirements, highly successful outcomes private may translate system.The Alfred Hospital rapidly expanded bariatric 2007. A 6-year prospective study was conducted annual review...
Low muscularity is associated with adverse surgical outcomes. We aimed to determine whether low an increased risk of post-operative complications and reduced long-term survival after oesophago-gastric cancer surgery.Patients who underwent radical surgery preoperative abdominal computed tomography (CT) imaging were included. skeletal muscle index (SMI), measured by CT, was determined using pre-defined cut-points. Oncological, surgical, outcome data obtained from a prospective database.Of 108...
Retrieval and analysis of an adequate number lymph nodes is critical for accurate staging oesophageal gastric cancer. Higher total node counts reported by pathologists are associated with improved survival. A prospective study was undertaken to understand the factors contributing variability in after oesophagogastric cancer resections determine whether a novel strategy ex vivo dissection resected specimens into nodal stations improves pathologists.The involved 88 patients potentially curable...
To evaluate the long-term outcomes of revisional malabsorptive bariatric surgery.Malabsorptive procedures are increasingly performed in setting. We collated and analysed prospectively recorded data for all patients who underwent a Biliopancreatic diversion + / - duodenal switch (BPD DS) over 17-year period.We identified 102 BPD DS. Median follow-up was 7 years (range 1-17). There were 21 (20.6%) permanently lost to at median 5 postoperatively. Mean total weight loss since procedure 22.7% (SD...
Intermediate to long-term weight regain is a major challenge following sleeve gastrectomy (SG). Physiological changes that mediate the extent of loss remain unclear. We aimed determine if there were specific esophago-gastric transit and emptying alterations associated with regain.Participants greater than 12 months post-SG categorized into optimal (n = 29) poor (PWL) 72). All patients underwent liquid contrast barium swallow demonstrating normal post-surgical anatomy protocolized nuclear...
To develop and validate a classification of sleeve gastrectomy leaks able to reliably predict outcomes, from protocolized computed tomography (CT) findings readily available variables.Leaks post remain morbid resource-consuming. Incidence, treatments, outcomes are variable, representing heterogeneity the problem. A predictive tool at presentation would aid management outcomes.From prospective database (2009-2018) we reviewed patients with staple line leaks. Delphi process was undertaken on...
Abstract Background Surgical audit is key in upholding the standards of surgical care but may be inadequate capturing morbidity experienced by patients being transferred across different health systems. The aim this study was to assess utility an objective framework evaluation clinical issues surrounding interhospital transfers (IHTs). Methods A retrospective cohort conducted at a Victorian state bariatric hospital. Patients with surgery related complications between 2014 and 2021 were...
<title>Abstract</title> <bold>Background</bold> Low muscle mass, myosteatosis, and excess adiposity are associated with adverse outcomes after oesophagogastric (OG) cancer surgery. There is limited prospective data to evaluate body composition throughout treatment. We aimed measure longitudinal changes in skeletal adipose tissue describe variations according baseline BMI. <bold>Methods</bold> This study included patients having OG surgery at Alfred Health, Melbourne, Australia. CT images...
Abstract Purpose There are significant alterations in gastro-intestinal function, food tolerance, and symptoms following sleeve gastrectomy (SG). These substantially change over the first year, but it is unclear what underlying physiological basis for these changes is. We examined oesophageal transit gastric emptying how correlate with tolerance. Material Methods Post-SG patients undertook protocolised nuclear scintigraphy imaging along a clinical questionnaire at 6 weeks, months, 12 months....
Significant controversy exists regarding the indications and outcomes after laparoscopic adjustable gastric banding (LAGB) conversions to sleeve gastrectomy (LSG).To comprehensively determine long-term of as a revisional procedure LAGB across range measures predictors outcomes.Six hundred revision LSG (RLSG) 1200 controls (primary (PLSG)) were included. Patient demographics, complications, follow-up, patient-completed questionnaires collected.RLSG vs controls; females 87% 78.8%, age 45 ±...
Abstract Background To determine whether a bariatric surgical procedure is associated with reduction in healthcare utilisation among patients obesity and high pre‐procedural needs. Methods Design: Retrospective cohort study. Setting: Tertiary Victorian public hospital. Participants: Twenty‐nine adults who underwent publicly funded primary surgery between 2008 2018 at the Alfred Hospital, Melbourne had resource use over year prior to surgery, defined as least two of ≥3 hospital admissions, ≥7...
Abstract Purpose Bariatric surgery is an efficacious intervention for substantial and sustained weight reduction in individuals with morbid obesity resulting health improvements. However, the changes to a patient’s related quality of life (HRQoL) medium longer term after bariatric have not been adequately characterized. Our aim was evaluate change patient HRQoL 5 years following Australian government-funded hospital system determine significance relationships between physical mental...
Purpose: Substantially altered anatomy and physiology are observed following sleeve gastrectomy (LSG).Mechanisms of oesophago-gastric transit remain incompletely elucidated.We aimed to determine the mechanisms LSG.Methods: Twenty-six patients demonstrating optimal progress post LSG underwent high-resolution manometry, utilising Chicago extended protocols.Concurrent video fluoroscopy pressure measurement were performed (n = 7) with semi-solid swallows.Results: Demographics: Age 45.3 AE 15.0...