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Article: Limitations concerning evaluation of the current guidelines using the Appraisal of Guidelines Research and Evaluation II.

Gavriilidis, Paschalis / Askari, Alan / Gavriilidis, Efstratios / Di Saverio, Salomone / Davies, R Justin / de'Angelis, Nicola

Annals of translational medicine

2023 Volume 11, Issue 10, Page(s) 373

Language	English
Publishing date	2023-06-26
Publishing country	China
Document type	Journal Article
ZDB-ID	2893931-1
ISSN	2305-5847 ; 2305-5839
ISSN (online)	2305-5847
ISSN	2305-5839
DOI	10.21037/atm-2023-10
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Article: Evaluation of the current guidelines for the management of haemorrhoidal disease using the Appraisal of Guidelines Research and Evaluation II instrument.

Gavriilidis, Paschalis / Askari, Alan / Gavriilidis, Efstratios / Di Saverio, Salomone / Davies, R Justin / de'Angelis, Nicola

Annals of translational medicine

2023 Volume 11, Issue 6, Page(s) 265

Abstract: Background: Haemorrhoids are a very common disease and many professional societies have produced guidelines for their treatment. The aim of this study is to appraise the quality of the existing guidelines in the management of haemorrhoids.: Methods: ... ...

Abstract	Background: Haemorrhoids are a very common disease and many professional societies have produced guidelines for their treatment. The aim of this study is to appraise the quality of the existing guidelines in the management of haemorrhoids. Methods: A systematic search of the literature was conducted in the EMBASE, Google Scholar, Cochrane library, and PubMed databases. The quality of guidelines was independently appraised using the Appraisal of Guidelines Research and Evaluation II (AGREE II) instrument by five of the authors. Results: Six guidelines of varying quality were identified and included in this study. The highest scoring guidelines were the SICCR (Società Italiana di Chirurgia Colorectale, which is Italian Society of Colorectal Surgery), ESCP (European Society of Coloproctology) and ASCRS (American Society of Colon and Rectal Surgeons) guidelines, scoring 86% each overall. There was considerable variability across not just the studies but across the different domains. The highest scoring domains were domain VI: editorial independence (median =95% across all studies) and domain I: Scope & Purpose (85%). The lowest scores were observed in domain V: Applicability (48%) and domain II: Stakeholder Involvement (41%). Only three of the six gained unanimous support for their use, whilst two of the guidelines were unanimously declared not suitable for clinical use. Conclusions: With the notable exception of three guidelines (SICCR, ESCP and ASCRS), the general quality of haemorrhoid guidelines is poor. Stakeholder (especially patient) involvement and instructions on how to implement recommendations is lacking from the majority of guidelines. This is an area that requires urgent attention if we are to improve guidelines in haemorrhoid management.
Language	English
Publishing date	2023-02-16
Publishing country	China
Document type	Journal Article ; Review
ZDB-ID	2893931-1
ISSN	2305-5847 ; 2305-5839
ISSN (online)	2305-5847
ISSN	2305-5839
DOI	10.21037/atm-22-4255
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Article ; Online: Commentary on: Risk factors predictive of severe diverticular hemorrhage. International Journal of Surgery, in press.

Davies, R Justin

International journal of surgery (London, England)

2011 Volume 9, Issue 4, Page(s) 353–354

MeSH term(s)	Colonic Diseases/complications ; Colonic Diseases/diagnosis ; Diverticulum/complications ; Diverticulum/diagnosis ; Female ; Gastrointestinal Hemorrhage/etiology ; Humans ; Male
Language	English
Publishing date	2011
Publishing country	England
Document type	Comment ; Journal Article
ZDB-ID	2212038-5
ISSN	1743-9159 ; 1743-9191
ISSN (online)	1743-9159
ISSN	1743-9191
DOI	10.1016/j.ijsu.2011.01.010
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Article ; Online: Colorectal cancer: summary of NICE guidance.

Bromham, Nathan / Kallioinen, Maija / Hoskin, Peter / Davies, R Justin

BMJ (Clinical research ed.)

2020 Volume 368, Page(s) m461

Language	English
Publishing date	2020-03-02
Publishing country	England
Document type	Journal Article
ZDB-ID	1362901-3
ISSN	1756-1833 ; 0959-8154 ; 0959-8146 ; 0959-8138 ; 0959-535X ; 1759-2151
ISSN (online)	1756-1833
ISSN	0959-8154 ; 0959-8146 ; 0959-8138 ; 0959-535X ; 1759-2151
DOI	10.1136/bmj.m461
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Article ; Online: Discontinuity of marginal artery at splenic flexure and rectosigmoid junction: A systematic review and meta-analysis.

Cirocchi, Roberto / Randolph, Justus / Cheruiyot, Isaac / Davies, R Justin / Gioia, Sara / Henry, Brandon Michael / Anania, Gabriele / Donini, Annibale / Mingoli, Andrea / Sapienza, Paolo / Avenia, Stefano

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

2023 Volume 25, Issue 7, Page(s) 1361–1370

Abstract: Aim: The aim of this study was to provide comprehensive evidence-based assessment of the discontinuity of the marginal artery at the splenic flexure (SF) and the rectosigmoid junction (RSJ).: Method: A systematic review was conducted of literature ... ...

Abstract	Aim: The aim of this study was to provide comprehensive evidence-based assessment of the discontinuity of the marginal artery at the splenic flexure (SF) and the rectosigmoid junction (RSJ). Method: A systematic review was conducted of literature published to 26 December 2022 in the electronic databases PubMed, SCOPUS and Web of Science to identify studies eligible for inclusion. Data were extracted and pooled into a meta-analysis using the Metafor package in R. The primary outcomes were the pooled PPEs of the marginal artery at the SF and the RSJ. The secondary outcome was the size of vascular anastomoses. Results: A total of 21 studies (n = 2,864 patients) were included. The marginal artery was present at the splenic flexure in 82% (95% CI: 62-95) of patients. Approximately 81% (95% CI: 63-94%) of patients had a large macroscopic anastomosis, while the remainder (19%) had small bridging ramifications forming the vessel. The marginal artery was present at the RSJ in 82% (95% CI: 70-91%) of patients. Conclusion: The marginal artery may be absent at the SF and the RSJ in up to 18% of individuals, which may confer a higher risk of ischaemic colitis. As a result of high interstudy heterogeneity noted in our analysis, further well-powered studies to clarify the prevalence of the marginal artery at the SF and the RSJ, as well as its relationship with other complementary colonic collaterals (intermediate and central mesenteric), are warranted.
MeSH term(s)	Humans ; Colon, Transverse/surgery ; Colon, Sigmoid/surgery ; Rectum/surgery ; Rectum/blood supply ; Colon/blood supply ; Arteries
Language	English
Publishing date	2023-06-14
Publishing country	England
Document type	Meta-Analysis ; Systematic Review ; Journal Article ; Review
ZDB-ID	1440017-0
ISSN	1463-1318 ; 1462-8910
ISSN (online)	1463-1318
ISSN	1462-8910
DOI	10.1111/codi.16624
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Zs.A 5799: Show issues

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Article ; Online: Does the Choice of Extraction Site During Minimally Invasive Colorectal Surgery Change the Incidence of Incisional Hernia? Protocol for a Systematic Review and Network Meta-Analysis.

Meyer, Jeremy / Simillis, Constantinos / Joshi, Heman / Xanthis, Athanasios / Ashcroft, James / Buchs, Nicolas / Ris, Frédéric / Davies, R Justin

International journal of surgery protocols

2021 Volume 25, Issue 1, Page(s) 216–219

Abstract: Background: Various sites are used for specimen extraction in oncological minimally invasive colorectal surgery. The objective is to determine if the choice of extraction site modulates the incidence of incisional hernia (IH).: Methods/design: A ... ...

Abstract	Background: Various sites are used for specimen extraction in oncological minimally invasive colorectal surgery. The objective is to determine if the choice of extraction site modulates the incidence of incisional hernia (IH). Methods/design: A systematic review will be performed in accordance to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. MEDLINE, Embase and CENTRAL will be searched to look for original studies reporting the incidence of IH after minimally invasive colorectal surgery. Studies will be excluded from the analysis if: 1) they do not report original data, 2) the outcome of interest (incidence of incisional hernia) is not clearly reported and does not allow to extrapolate and/or calculate the required data for network meta-analysis, 3) they include pediatric patients, 4) they include a patients' population with a conversion rate to laparotomy >10%, 5) they do not compare at least two different extraction sites for the operative specimen, 6) they report patients who underwent pure (and not hybrid) natural orifice transluminal endoscopic surgery (NOTES). Network meta-analysis will be performed to determine the incidence of IH per extraction site. Discussion: By determining which specimen extraction site leads to reduced rate of IH, this systematic review and network meta-analysis will help colorectal surgeons to choose their extraction site and reduce the morbidity and costs associated with IH. Registration: The systematic review and meta-analysis protocol is registered in the International Prospective Register of Ongoing Systematic Reviews (PROSPERO) with number CRD42021272226. Highlights: Various sites are used for specimen extraction in oncological minimally invasive colorectal surgery, and the choice of the site may probably modulate the incidence of incisional hernia.The present protocol aims to design a systematic review which will identify original studies comparing two extraction sites during minimally invasive colorectal surgery in terms of incidence of incisional hernia.Network meta-analysis will be performed to determine the incidence of IH per extraction site.
Language	English
Publishing date	2021-09-20
Publishing country	England
Document type	Journal Article
ISSN	2468-3574
ISSN (online)	2468-3574
DOI	10.29337/ijsp.164
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Article ; Online: A systematic review of the literature assessing operative blood loss and postoperative outcomes after colorectal surgery.

Charalambides, Maria / Mavrou, Athina / Jennings, Thomas / Powar, Michael P / Wheeler, James / Davies, R Justin / Fearnhead, Nicola S / Simillis, Constantinos

International journal of colorectal disease

2021 Volume 37, Issue 1, Page(s) 47–69

Abstract: Purpose: There is no consensus in the literature regarding the association between operative blood loss and postoperative outcomes in colorectal surgery, despite evidence suggesting a link. Therefore, this systematic review assesses the association ... ...

Abstract	Purpose: There is no consensus in the literature regarding the association between operative blood loss and postoperative outcomes in colorectal surgery, despite evidence suggesting a link. Therefore, this systematic review assesses the association between operative blood loss, perioperative and long-term outcomes after colorectal surgery. Methods: A literature search of MEDLINE, EMBASE, Science Citation Index Expanded and Cochrane was performed to identify studies reporting on operative blood loss in colorectal surgery. Results: The review included forty-nine studies reporting on 61,312 participants, with a mean age ranging from 53.4 to 78.1 years. The included studies demonstrated that major operative blood loss was found to be a risk factor for mortality, anastomotic leak, presacral abscess, and postoperative ileus, leading to an increased duration of hospital stay. In the long term, the studies suggest that significant blood loss was an independent risk factor for future small bowel obstruction due to colorectal cancer recurrence and adhesions. Studies found that survival was significantly reduced, whilst the risk of colorectal cancer recurrence was increased. Reoperation and cancer-specific survival were not associated with major blood loss. Conclusion: The results of this systematic review suggest that major operative blood loss increases the risk of perioperative adverse events and has short and long-term repercussions on postoperative outcomes. Laparoscopic and robotic surgery, vessel ligation technology and anaesthetic considerations are essential for reducing blood loss and improving outcomes. This review highlights the need for further high quality, prospective, multicentre trials with a greater number of participants, and accurate and standardised methods of measuring operative blood loss.
MeSH term(s)	Aged ; Blood Loss, Surgical ; Colorectal Surgery/adverse effects ; Digestive System Surgical Procedures ; Humans ; Laparoscopy/adverse effects ; Middle Aged ; Operative Time ; Postoperative Complications/etiology ; Prospective Studies
Language	English
Publishing date	2021-10-26
Publishing country	Germany
Document type	Journal Article ; Review ; Systematic Review
ZDB-ID	84975-3
ISSN	1432-1262 ; 0179-1958
ISSN (online)	1432-1262
ISSN	0179-1958
DOI	10.1007/s00384-021-04015-4
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Zs.A 2121: Show issues

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Article ; Online: A systematic review and meta-analysis of variants of the branches of the superior mesenteric artery: the Achilles heel of right hemicolectomy with complete mesocolic excision?

Cirocchi, Roberto / Randolph, Justus / Davies, R Justin / Cheruiyot, Isaac / Gioia, Sara / Henry, Brandon Michael / Carlini, Luigi / Donini, Annibale / Anania, Gabriele

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

2021 Volume 23, Issue 11, Page(s) 2834–2845

Abstract: Aim: Dissection with subsequent ligation and resection of arteries at their origin (central vascular ligation) is essential for adequate oncological resection during right hemicolectomy with complete mesocolic excision. This technique is technically ... ...

Abstract	Aim: Dissection with subsequent ligation and resection of arteries at their origin (central vascular ligation) is essential for adequate oncological resection during right hemicolectomy with complete mesocolic excision. This technique is technically demanding due to the highly variable arterial pattern of the right colon. Therefore, this study aims to provide a comprehensive evidence-based assessment of the arterial vascular anatomy of the right colon. Methods: A thorough systematic literature search through September 2020 was conducted on the electronic databases PubMed, Scopus and Web of Science to identify studies eligible for inclusion. Data were extracted and pooled into a meta-analysis using MetaXl software. Results: A total of 41 studies (n = 4691 patients) were included. The ileocolic artery (ICA), right colic artery (RCA) and middle colic artery (MCA) were present in 99.7% (95% CI 99.4%-99.8%), 72.6% (95% CI 61.3%-82.5%) and 96.9% (95% CI 94.2%-98.8%) respectively of patients. Supernumerary RCA and MCA were observed in 3.2% and 11.4% respectively of all cases. The RCA shared a common trunk with the ICA and MCA in 13.2% and 17.7% respectively of patients. A retro-superior mesenteric vein course of the ICA and RCA was observed in 55.1% and 11.4% respectively of all cases. Conclusion: The vascular anatomy of the right colon displays several notable variations, namely the absence of some branches (RCA absent in 27.4% of cases), supernumerary branches, common trunks, and retro-superior mesenteric vein courses. These variations should be taken into consideration during right hemicolectomy with complete mesocolic excision to ensure adequate oncological resection while minimizing intra-operative complications.
MeSH term(s)	Colectomy ; Colonic Neoplasms/surgery ; Humans ; Laparoscopy ; Mesenteric Artery, Superior ; Mesocolon/surgery
Language	English
Publishing date	2021-08-26
Publishing country	England
Document type	Journal Article ; Meta-Analysis ; Review ; Systematic Review
ZDB-ID	1440017-0
ISSN	1463-1318 ; 1462-8910
ISSN (online)	1463-1318
ISSN	1462-8910
DOI	10.1111/codi.15861
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Zs.A 5799: Show issues

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Article ; Online: Surgical anatomy of the accessory middle colic artery: a meta-analysis with implications for splenic flexure cancer surgery.

Cheruiyot, Isaac / Cirocchi, Roberto / Munguti, Jeremiah / Davies, R Justin / Randolph, Justus / Ndung'u, Bernard / Henry, Brandon Michael

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

2021 Volume 23, Issue 7, Page(s) 1712–1720

Abstract: Aim: Surgical resection of splenic flexure cancers (SFCs) is technically demanding due to the complex regional anatomy, characterized by the presence of embryological adhesions, close proximity to the pancreas and spleen, and a highly heterogeneous ... ...

Abstract	Aim: Surgical resection of splenic flexure cancers (SFCs) is technically demanding due to the complex regional anatomy, characterized by the presence of embryological adhesions, close proximity to the pancreas and spleen, and a highly heterogeneous arterial supply and lymphatic drainage. The accessory middle colic artery (AMCA) is increasingly being recognized as an important source of blood supply to the splenic flexure. The aim of this study is to determine the prevalence and anatomical features of the AMCA. Method: A systematic search of the scientific literature was conducted on PubMed and Embase from inception to November 2020 to identify potentially eligible studies. Data were extracted and prevalence was pooled into a meta-analysis using MetaXL and Meta-Analyst software. Results: A total of 16 studies (n = 2203 patients) were included. The pooled prevalence (PP) of the AMCA was 25.4% (95% CI 18.1-33.4). Its prevalence was higher in patients without a left colic artery (LCA) (PP = 83.2%; 95% CI 70.4-93.1). The commonest origin for the AMCA was the superior mesenteric artery (PP = 87.9%; 95% CI 86.4-90.7). The AMCA shared a common trunk/gave rise to pancreatic branches in 23.1% of cases (95% CI 15.3-31.9). Conclusion: The AMCA contributes to the vascularization of the splenic flexure in approximately 25% of individuals, and may be an important feeder artery to SFCs, especially in the absence of a LCA. Preoperative identification of this artery is important to ensure optimal surgery for SFC and minimize complications.
MeSH term(s)	Colon, Transverse/surgery ; Drainage ; Humans ; Mesenteric Artery, Inferior ; Mesenteric Artery, Superior ; Neoplasms ; Pancreas
Language	English
Publishing date	2021-03-25
Publishing country	England
Document type	Journal Article ; Meta-Analysis ; Review
ZDB-ID	1440017-0
ISSN	1463-1318 ; 1462-8910
ISSN (online)	1463-1318
ISSN	1462-8910
DOI	10.1111/codi.15630
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Article: Haemorrhoids.

Davies, R Justin

Clinical evidence

2006 , Issue 15, Page(s) 711–724

MeSH term(s)	Hemorrhoids/surgery ; Hemorrhoids/therapy ; Humans ; Ligation ; Sclerotherapy
Language	English
Publishing date	2006-06
Publishing country	England
Document type	Journal Article ; Review
ZDB-ID	1495368-7
ISSN	1462-3846
ISSN	1462-3846
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