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  1. Article ; Online: Impact on blood loss and transfusion rates following administration of tranexamic acid in major oncological abdominal and pelvic surgery: A systematic review and meta-analysis.

    Fowler, Hayley / Law, Jennifer / Tham, Su Ming / Gunaravi, Sisyena A / Houghton, Neil / Clifford, Rachael E / Fok, Matthew / Barker, Jonathan A / Vimalachandran, Dale

    Journal of surgical oncology

    2022  Volume 126, Issue 3, Page(s) 609–621

    Abstract: Background and objectives: Major bleeding and receiving blood products in cancer surgery are associated with increased postoperative complications and worse outcomes. Tranexamic acid (TXA) reduces blood loss and improves outcomes in various surgical ... ...

    Abstract Background and objectives: Major bleeding and receiving blood products in cancer surgery are associated with increased postoperative complications and worse outcomes. Tranexamic acid (TXA) reduces blood loss and improves outcomes in various surgical specialities. We performed a systematic review and meta-analysis to investigate TXA use on blood loss in elective abdominal and pelvic cancer surgery.
    Methods: A literature search was performed for studies comparing intravenous TXA versus placebo/no TXA in patients undergoing major elective abdominal or pelvic cancer surgery.
    Results: Twelve articles met the inclusion criteria, consisting of 723 patients who received TXA and 659 controls. Patients receiving TXA were less likely to receive a red blood cell (RBC) transfusion (p < 0.001, OR 0.4 95% CI [0.25, 0.63]) and experienced less blood loss (p < 0.001, MD -197.8 ml, 95% CI [-275.69, -119.84]). The TXA group experienced a smaller reduction in haemoglobin (p = 0.001, MD -0.45 mmol/L, 95% CI [-0.73, -0.18]). There was no difference in venous thromboembolism (VTE) rates (p = 0.95, OR 0.98, 95% CI [0.46, 2.08]).
    Conclusions: TXA use reduced blood loss and RBC transfusion requirements perioperatively, with no significant increased risk of VTE. However, further studies are required to assess its benefit for cancer surgery in some sub-specialities.
    MeSH term(s) Antifibrinolytic Agents ; Blood Loss, Surgical/prevention & control ; Humans ; Pelvic Neoplasms/surgery ; Tranexamic Acid ; Venous Thromboembolism
    Chemical Substances Antifibrinolytic Agents ; Tranexamic Acid (6T84R30KC1)
    Language English
    Publishing date 2022-04-26
    Publishing country United States
    Document type Journal Article ; Meta-Analysis ; Systematic Review
    ZDB-ID 82063-5
    ISSN 1096-9098 ; 0022-4790
    ISSN (online) 1096-9098
    ISSN 0022-4790
    DOI 10.1002/jso.26900
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    In stock of ZB MED Cologne/Königswinter

    Zs.A 706: Show issues Location:
    Je nach Verfügbarkeit (siehe Angabe bei Bestand)
    bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular
    Jg. 1995 - 2021: Lesesall (1.OG)
    ab Jg. 2022: Lesesaal (EG)

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  2. Article ; Online: Intra-operative assessment of left-sided colorectal anastomotic integrity: a systematic review of available techniques.

    Clifford, Rachael E / Fowler, Hayley / Manu, Nicola / Sutton, Paul / Vimalachandran, Dale

    Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland

    2020  Volume 23, Issue 3, Page(s) 582–591

    Abstract: Aim: Anastomotic leak (AL) after colorectal resection is associated with increased rates of morbidity and mortality: potential permanent stoma formation, increased local recurrence, reduced cancer-related survival, poor functional outcomes and ... ...

    Abstract Aim: Anastomotic leak (AL) after colorectal resection is associated with increased rates of morbidity and mortality: potential permanent stoma formation, increased local recurrence, reduced cancer-related survival, poor functional outcomes and associated quality of life. Techniques to reduce leak rates are therefore highly sought.
    Method: A literature search was performed for published full text articles using PubMed, Cochrane and Scopus databases with a focus on colorectal surgery 1990-2020. Additional papers were detected by scanning references of relevant papers.
    Results: A total of 53 papers were included after a thorough literature search. Techniques assessed included leak tests, endoscopy, perfusion assessment and fluorescence studies. Air-leak testing remains the most commonly used method across Europe, due to ease of reproducibility and low cost. There is no evidence that this reduces the leak rate; however, identification of a leak intra-operatively provides the opportunity for either suture reinforcement or formal takedown with or without re-do of the anastomosis and consideration of diversion. Suture repair alone of a positive air-leak test is associated with an increased AL rate. The use of fluorescence studies to guide the site of anastomosis has demonstrated reduced leak rates in distal anastomoses, is safe, feasible and has a promising future.
    Conclusion: Although over reliance on any assessment tool should be avoided, intra-operative techniques with the aim of reducing AL rates are increasingly being employed. Standardization of these methods is imperative for routine use. However, in the interim it is recommended that all anastomoses should be assessed intra-operatively for mechanical failure, particularly distal anastomoses.
    MeSH term(s) Anastomosis, Surgical/adverse effects ; Anastomotic Leak/etiology ; Anastomotic Leak/prevention & control ; Colorectal Neoplasms/surgery ; Humans ; Quality of Life ; Reproducibility of Results
    Language English
    Publishing date 2020-10-25
    Publishing country England
    Document type Journal Article ; Review ; Systematic Review
    ZDB-ID 1440017-0
    ISSN 1463-1318 ; 1462-8910
    ISSN (online) 1463-1318
    ISSN 1462-8910
    DOI 10.1111/codi.15380
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    In stock of ZB MED Cologne/Königswinter

    Zs.A 5799: Show issues Location:
    Je nach Verfügbarkeit (siehe Angabe bei Bestand)
    bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular
    Jg. 1995 - 2021: Lesesall (2.OG)
    ab Jg. 2022: Lesesaal (EG)

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    This service is chargeable due to the Delivery terms set by subito. Orders including an article and supplementary material will be classified as separate orders. In these cases, fees will be demanded for each order.

  3. Article ; Online: Reply to Mathew.

    Fowler, Hayley / Clifford, Rachael E / Sutton, Paul / Watson, Angus J M / Fearnhead, Nicola / Rose, Azmina / Bach, Simon / Jackson, Richard / Moran, Brendan / Vimalachandran, Dale

    Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland

    2021  Volume 23, Issue 3, Page(s) 752–753

    Language English
    Publishing date 2021-01-09
    Publishing country England
    Document type Letter ; Comment
    ZDB-ID 1440017-0
    ISSN 1463-1318 ; 1462-8910
    ISSN (online) 1463-1318
    ISSN 1462-8910
    DOI 10.1111/codi.15490
    Database MEDical Literature Analysis and Retrieval System OnLINE

    Full text online

    More links

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    In stock of ZB MED Cologne/Königswinter

    Zs.A 5799: Show issues Location:
    Je nach Verfügbarkeit (siehe Angabe bei Bestand)
    bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular
    Jg. 1995 - 2021: Lesesall (2.OG)
    ab Jg. 2022: Lesesaal (EG)

    Order via subito

    This service is chargeable due to the Delivery terms set by subito. Orders including an article and supplementary material will be classified as separate orders. In these cases, fees will be demanded for each order.

  4. Article ; Online: Targeting Acid Ceramidase to Improve the Radiosensitivity of Rectal Cancer.

    Clifford, Rachael E / Govindarajah, Naren / Bowden, David / Sutton, Paul / Glenn, Mark / Darvish-Damavandi, Mahnaz / Buczacki, Simon / McDermott, Ultan / Szulc, Zdzislaw / Ogretmen, Besim / Parsons, Jason L / Vimalachandran, Dale

    Cells

    2020  Volume 9, Issue 12

    Abstract: Previous work utilizing proteomic and immunohistochemical analyses has identified that high levels of acid ceramidase (AC) expression confers a poorer response to neoadjuvant treatment in locally advanced rectal cancer. We aimed to assess the ... ...

    Abstract Previous work utilizing proteomic and immunohistochemical analyses has identified that high levels of acid ceramidase (AC) expression confers a poorer response to neoadjuvant treatment in locally advanced rectal cancer. We aimed to assess the radiosensitising effect of biological and pharmacological manipulation of AC and elucidate the underlying mechanism. AC manipulation in three colorectal cancer cell lines (HT29, HCT116 and LIM1215) was achieved using siRNA and plasmid overexpression. Carmofur and a novel small molecular inhibitor (LCL521) were used as pharmacological AC inhibitors. Using clonogenic assays, we demonstrate that an siRNA knockdown of AC enhanced X-ray radiosensitivity across all colorectal cancer cell lines compared to a non-targeting control siRNA, and conversely, AC protein overexpression increased radioresistance. Using CRISPR gene editing, we also generated AC knockout HCT116 cells that were significantly more radiosensitive compared to AC-expressing cells. Similarly, two patient-derived organoid models containing relatively low AC expression were found to be comparatively more radiosensitive than three other models containing higher levels of AC. Additionally, AC inhibition using carmofur and LCL521 in three colorectal cancer cell lines increased cellular radiosensitivity. Decreased AC protein led to significant poly-ADP ribose polymerase-1 (PARP-1) cleavage and apoptosis post-irradiation, which was shown to be executed through a p53-dependent process. Our study demonstrates that expression of AC within colorectal cancer cell lines modulates the cellular response to radiation, and particularly that AC inhibition leads to significantly enhanced radiosensitivity through an elevation in apoptosis. This work further solidifies AC as a target for improving radiotherapy treatment of locally advanced rectal cancer.
    MeSH term(s) Acid Ceramidase/metabolism ; Apoptosis/radiation effects ; CRISPR-Cas Systems/genetics ; Cell Line, Tumor ; Cell Survival/radiation effects ; Gene Editing ; Humans ; Models, Biological ; Organoids/pathology ; Organoids/radiation effects ; Radiation Tolerance ; Rectal Neoplasms/enzymology ; Rectal Neoplasms/radiotherapy ; Tumor Suppressor Protein p53/metabolism ; X-Rays
    Chemical Substances Tumor Suppressor Protein p53 ; Acid Ceramidase (EC 3.5.1.23)
    Language English
    Publishing date 2020-12-15
    Publishing country Switzerland
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 2661518-6
    ISSN 2073-4409 ; 2073-4409
    ISSN (online) 2073-4409
    ISSN 2073-4409
    DOI 10.3390/cells9122693
    Database MEDical Literature Analysis and Retrieval System OnLINE

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