A5035469816- COVID-19 and healthcare impacts
- Colorectal Cancer Surgical Treatments
- Colorectal Cancer Screening and Detection
- Diverticular Disease and Complications
- Cardiac, Anesthesia and Surgical Outcomes
- Pancreatic and Hepatic Oncology Research
- Economic and Financial Impacts of Cancer
- Esophageal and GI Pathology
- Colorectal and Anal Carcinomas
- Enhanced Recovery After Surgery
- Liver physiology and pathology
- Bariatric Surgery and Outcomes
- Anorectal Disease Treatments and Outcomes
- Healthcare cost, quality, practices
- Cardiovascular Effects of Exercise
- Gallbladder and Bile Duct Disorders
- Sports Performance and Training
- Pediatric Hepatobiliary Diseases and Treatments
- Sports injuries and prevention
- Stoma care and complications
- Appendicitis Diagnosis and Management
- Health Systems, Economic Evaluations, Quality of Life
- Global Health and Surgery
- Surgical site infection prevention
- Intestinal and Peritoneal Adhesions
Oxford University Hospitals NHS Trust
2020-2022
University of Edinburgh
2022
Churchill Hospital
2017-2021
University of Oxford
2017-2021
Glasgow Royal Infirmary
2018
The Football Association
2017
English Institute of Sport
2017
University of Glasgow
2017
The University of Sydney
2016
Western General Hospital
2012
•Lockdown and re-deployment due to the COVID-19 pandemic have caused significant disruption cancer diagnosis management.•A 3-month delay surgery across all stage 1–3 cancers is estimated cause >4700 attributable deaths per year in England.•The impact on life-years lost of 3–6-month for disease varies widely between tumour types.•Strategic prioritisation patients diagnostics has potential mitigate delays.•The resource-adjusted benefit avoiding management compares favourably with admission...
To evaluate the impact of faecal immunochemical testing (FIT) prioritisation to mitigate delays in colorectal cancer (CRC) urgent diagnostic (2-week-wait (2WW)) pathway consequent from COVID-19 pandemic.
Abstract Aim Organ‐saving treatment for early‐stage rectal cancer can reduce patient‐reported side effects compared to standard total mesorectal excision (TME) and preserve quality of life. An optimal strategy achieving organ preservation longer‐term oncological outcomes are unknown; thus there is a need high trials. Method Can we S ave the rectum by watchful waiting or T rans A nal surgery following (chemo) R adiotherapy versus otal early RE ctal C ancer (STAR‐TREC) an international...
Anastomotic leak after colorectal surgery increases postoperative mortality, cancer recurrence, permanent stoma formation, and poor bowel function. Anastomosis between the colon rectum is a particularly high risk. Traditional management mandates laparotomy, disassembly of anastomosis, formation an often-permanent stoma. After laparoscopic it may be possible to manage anastomotic failure with laparoscopy, thus avoiding laparotomy.The purpose this study was determine feasibility failed low...
ABSTRACT Background Cancer diagnostics and surgery have been disrupted by the response of healthcare services to COVID-19 pandemic. Progression cancers during delay will impact on patient long-term survival. Methods We generated per-day hazard ratios cancer progression from observational studies applied these age-specific, stage-specific survival for England 2013-2017. modelled per-patient three months six periods disruption one year two years. Using resource costing, we contextualise...
Australia has the highest incidence of colorectal cancer (CRC) in world. The young-onset CRC (yCRC) is increasing developed nations. Our aim was to determine yCRC New South Wales, demographic and clinico-pathological characteristics these patients, their survival.A population-based cohort study all cases diagnosed NSW during 2001-2008. Data on newly were obtained from Central Cancer Registry; mortality data Registry Births Deaths Marriages (to 2012). tumour-related factors patients under 50...
We report the case of 65-year-old man who developed massive rectal bleeding associated with use a fecal collecting device: Flexi-Seal Fecal Management System. A colonoscopy showed an acute laceration anterior wall mucosa, 6 cm from anal verge, active bleeding. The tear was most likely result event, such as sudden movement device within rectum or trauma sustained during insertion. Massive transfusion required, and surgical endoscopic treatment necessary to ensure hemostasis. This is, our...
The aim of the study was to compare outcomes for emergency management diverticulitis before and after creation a regional subspecialist colorectal unit.We retrieved data on all admissions from surgical audit database compared results (January 1998 August 2002) (August 2002 December 2008) establishment surgery unit in 2002. Additional were electronic patient records. primary outcome measures mortality rate anastomosis following resection.There 879 patients 1280 subspecialization. Nonoperative...
Treatment of early rectal cancer is evolving towards organ-preserving therapy which includes endoscopic resection and transanal approaches. We aimed to explore the role local treatments such as polypectomy (Endoscopic Mucosal Resection (EMR) or Endoscopic submucosal dissection (ESD)) microsurgery/ minimal invasive surgery (TEM/TAMIS) in patients who had cancer. considered these outcomes alongside conventional major using total mesorectal excision (TME) for stage disease.All identified at MDT...
Accurate preoperative staging of colorectal cancers is critical in selecting patients for neoadjuvant therapy prior to resection. Inaccurate staging, particularly understaging, may lead involved resection margins and poor oncological outcomes. Our aim determine imaging accuracy compared histopathology define the effect inaccurate on patient selection treatment(NT). Staging treatment were determined undergoing resections adenocarcinomas a single tertiary centre(2016-2020). Data obtained 948...
Colonic submucosal lipomas are rare benign tumours of the colon, which may be discovered incidentally at colonoscopy, through imaging such as CT or autopsy. These can cause complications bleeding, intussusception and bowel obstruction. We describe case a patient in whom small lipoma was identified time colonoscopy who did not receive follow-up treatment. The presented 1 year later with obstruction resulting from this polyp required urgent surgery. With increasing use CT, lesions likely to...
ABSTRACT Background The COVID-19 pandemic has caused disruption across cancer pathways for diagnosis and treatment. In England, 32% of colorectal (CRC) is diagnosed via urgent symptomatic referral from primary care, the “2-week-wait” (2WW) pathway. Access to routine endoscopy likely be a critical bottleneck causing delays in CRC management due chronic limitation capacity, acute competition physician time, safety concerns. Methods We used age-specific, stage-specific 10 year survival England...
Background: Cancer diagnostics and surgery have been disrupted by the response of healthcare services to COVID-19 pandemic. Progression cancers during delay will impact on patient long-term survival.Methods: We generated per-day hazard ratios cancer progression from observational studies applied these age-specific, stage-specific survival for England 2013-2017. modelled per-patient three months six periods disruption one year two years. Using resource costing, we contextualise attributable...
Background: The COVID-19 pandemic has caused disruption across cancer pathways for diagnosis and treatment. In England, 32% of colorectal (CRC) is diagnosed via urgent symptomatic referral from primary care, the "2-week-wait" (2WW) pathway. Access to routine endoscopy likely be a critical bottleneck causing delays in CRC management due chronic limitation capacity, acute competition physician time, safety concerns. Methods: We used age-specific, stage-specific 10 year survival England...
The coronavirus pandemic has significantly disrupted the way we deliver healthcare worldwide. We have been flexible and creative in order to continue providing elective colorectal cancer operations restart services for benign cases during recovery period of pandemic. In this paper, describe impact on our how implemented new patient pathways allow us care.Data major resections were prospectively collected an Enhanced Recovery After Surgery (ERAS) database. Data number proctology telemed...
Objectives: Suspected scaphoid fractures are a common reason for referral from the emergency department to fracture clinics. Few patients actually have fracture. Cross sectional imaging has potential improve early diagnosis and reduce unneccessary immobilisation. The aim of this audit was investigate effectiveness virtual pathway, incorporating magnetic resonance (MRI) scan, suspected fractures. secondary whether accuracy other clinical signs, such as anatomical snuffbox pain on wrist ulnar...
Abstract Backgrounds Laparoscopic appendicectomy (LA) is the most common index procedure for junior surgical trainees. Despite shift towards competency‐based training, there no method of quantitatively assessing performance during LA. This study aimed to obtain expert consensus regarding items required create a LA Rating Scale (LARS). Methods A list steps surgery, as well descriptors “poor”, “average” and “excellent” each these were created potential inclusion into an objective assessment...