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Article ; Online: Systematic review of survival following liver or lung metastasectomy for metastatic anal squamous cell carcinoma.

Hurt, L / Barlow, E / Davies, M / Harris, D A / Barrington, C / Harries, R L

Annals of the Royal College of Surgeons of England

2024

Abstract: Introduction: Metastatic anal squamous cell carcinoma (SCC) carries a poor prognosis and the evidence base for surgical resection of metastases remains limited. The aim of this study was to establish the survival outcomes for patients undergoing ... ...

Abstract	Introduction: Metastatic anal squamous cell carcinoma (SCC) carries a poor prognosis and the evidence base for surgical resection of metastases remains limited. The aim of this study was to establish the survival outcomes for patients undergoing metastasectomy for anal SCC. Methods: A systematic review was performed using the MEDLINE Results: There were 10 studies with a total of 98 patients. There was heterogeneity in results reporting, with recurrence free survival the most reported outcome. For all studies reporting on liver metastasectomy, the one-year overall survival rate was 87%. In studies with adequate follow-up reported, the three and five-year overall survival rates were 53% and 38% respectively. Only one study reported on lung metastasectomy patients; the overall median survival was 24 months. None of the studies reported on quality of life measures. The ROBINS-I tool identified a critical risk of bias in six studies, a serious risk in one study and a moderate risk in three studies. Conclusions: The evidence base for metastasectomy in metastatic anal SCC is limited. Further information is required to inform future treatment methods and use of a standardised outcomes reporting method is needed to support this.
Language	English
Publishing date	2024-03-18
Publishing country	England
Document type	Journal Article ; Review
ZDB-ID	80044-2
ISSN	1478-7083 ; 0035-8843
ISSN (online)	1478-7083
ISSN	0035-8843
DOI	10.1308/rcsann.2023.0005
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Article ; Online: The use of deep neuromuscular blockade and reversal in ventral hernia surgery.

Harries, R L / Smart, N J

Hernia : the journal of hernias and abdominal wall surgery

2020 Volume 25, Issue 2, Page(s) 551–552

MeSH term(s)	Hernia, Ventral/surgery ; Herniorrhaphy ; Humans ; Neuromuscular Blockade
Language	English
Publishing date	2020-02-12
Publishing country	France
Document type	Letter
ZDB-ID	1388125-5
ISSN	1248-9204 ; 1265-4906
ISSN (online)	1248-9204
ISSN	1265-4906
DOI	10.1007/s10029-020-02132-7
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Article ; Online: Is there a role for botulinum toxin A in the emergency setting for delayed abdominal wall closure in the management of the open abdomen? A systematic review.

Luton, O W / Mortimer, M / Hopkins, L / Robinson, Dbt / Egeler, C / Smart, N J / Harries, R

Annals of the Royal College of Surgeons of England

2022 Volume 105, Issue 4, Page(s) 306–313

Abstract: Introduction: Emergency laparotomy for either trauma or non-trauma indications is common and management is varied. Use of the open abdomen technique allowing for planned re-look is an option; however, performing delayed definitive fascial closure (DFC) ... ...

Abstract	Introduction: Emergency laparotomy for either trauma or non-trauma indications is common and management is varied. Use of the open abdomen technique allowing for planned re-look is an option; however, performing delayed definitive fascial closure (DFC) following this can be a challenge. The use of botulinum toxin-A (BTX) infiltration into the lateral abdominal wall has been well documented within the elective setting; its use within the emergency setting is undecided. This systematic review assesses the efficacy and safety of BTX injection into the lateral abdominal wall muscles in the emergency setting. The primary outcome is DFC rate. Methods: Systematic review was performed according to the PROSPERO registered protocol (CRD42020205130). Papers were dual screened for eligibility, and included if they met pre-stated criteria where the primary outcome was DFC. Articles reporting fewer than five cases were excluded. Bias was assessed using the Cochrane Risk of Bias and Joanna Brigg's appraisal tools. Findings: Fourteen studies were screened for eligibility, twelve full texts were reviewed and two studies were included. Both studies showed evidence of bias due to confounding factors and lack of reporting. Both studies suggested significantly higher rates of DFC than reported in the literature against standard technique (90.7% vs 66%); however, these data are difficult to interpret due to strict study inclusion criteria or lack of a control population. Conclusion: The use of BTX is deemed safe and its effects in the emergency situation may have great potential. Unfortunately, to date, there is insufficient evidence to facilitate opinion.
MeSH term(s)	Humans ; Botulinum Toxins, Type A/therapeutic use ; Abdominal Wall/surgery ; Abdomen/surgery ; Abdominal Muscles/surgery ; Abdominal Cavity ; Laparotomy/methods ; Abdominal Wound Closure Techniques
Chemical Substances	Botulinum Toxins, Type A (EC 3.4.24.69)
Language	English
Publishing date	2022-02-17
Publishing country	England
Document type	Systematic Review ; Journal Article
ZDB-ID	80044-2
ISSN	1478-7083 ; 0035-8843
ISSN (online)	1478-7083
ISSN	0035-8843
DOI	10.1308/rcsann.2021.0284
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Article ; Online: Testicular torsion treatment: the horns of a dilemma?

Lewis, S / Hopkins, L / Evans, T / Lewis, W / Harries, R

Annals of the Royal College of Surgeons of England

2019 Volume 102, Issue 1, Page(s) 49–53

Abstract: Introduction: Testicular torsion treatment rests on the horns of a dilemma, with widespread national variation in whether the responsible surgical specialty is general surgery or urology, even in hospitals with both general surgery and urology emergency ...

Abstract	Introduction: Testicular torsion treatment rests on the horns of a dilemma, with widespread national variation in whether the responsible surgical specialty is general surgery or urology, even in hospitals with both general surgery and urology emergency service assets. This study aimed to quantify higher surgical trainee operative experience and confidence in managing suspected testicular torsion in a single UK deanery (Wales). Materials and methods: Anonymised logbook data were obtained via the Intercollegiate Surgical Curriculum Programme version 10 using the head of school report function for all general surgery ( Results: Median operative scrotal explorations recorded for all general surgery higher surgical trainees and senior general surgery higher surgical trainees (ST7+) was 7 (range 1-22) and 10 (range 1-22), compared with 21 (range 9-64, Discussion and conclusion: General surgery higher surgical trainees receive less than 50% of the operative exposure of urology higher surgical trainees in emergency scrotal surgery, which has important implications for curriculum competence development and patient safety.
MeSH term(s)	Adult ; Attitude of Health Personnel ; Child ; Clinical Competence/standards ; Education, Medical, Graduate/statistics & numerical data ; General Surgery/education ; General Surgery/statistics & numerical data ; Hospitals, Teaching/statistics & numerical data ; Humans ; Male ; Pediatrics/education ; Pediatrics/statistics & numerical data ; Spermatic Cord Torsion/surgery ; Surveys and Questionnaires ; Urologists/education ; Urologists/standards ; Urology/education ; Urology/statistics & numerical data ; Wales
Language	English
Publishing date	2019-11-22
Publishing country	England
Document type	Comparative Study ; Journal Article ; Multicenter Study
ZDB-ID	80044-2
ISSN	1478-7083 ; 0035-8843
ISSN (online)	1478-7083
ISSN	0035-8843
DOI	10.1308/rcsann.2019.0150
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Article ; Online: Outcomes of surgically managed recurrent parastomal hernia: the Sisyphean challenge of the hernia world.

Harries, R L / Daniels, I R / Smart, N J

Hernia : the journal of hernias and abdominal wall surgery

2020 Volume 25, Issue 1, Page(s) 133–140

Abstract: Purpose: The management of a recurrent (symptomatic) parastomal hernia (PSH) presents a dilemma. The aim of this study was to review the outcome of patients who underwent a recurrent PSH repair.: Methods: Retrospective review of consecutive patients ... ...

Abstract	Purpose: The management of a recurrent (symptomatic) parastomal hernia (PSH) presents a dilemma. The aim of this study was to review the outcome of patients who underwent a recurrent PSH repair. Methods: Retrospective review of consecutive patients undergoing recurrent PSH repairs at a single institution between 2010 and 2019. Primary outcome recorded was recurrence. Secondary outcomes recorded were 30-day post-operative complications, surgical site occurrence (SSO) incidence and to assess if EHS classification altered with each recurrence. Results: Thirty-eight patients underwent 59 recurrent PSH repairs during the study period. Median number of PSH repairs per patient from ostomy formation was 2 (2-8). Post-operative complications occurred following 52.5% of repairs. Recurrence rate for all recurrent PSH hernia repairs was 45.7%, with a median follow-up of 58 months (0-115). A trend was seen towards a shorter PSH recurrence-free survival in those who had at least two previous PSH repairs at the start of the study period when compared to those who had less. Recurrence was not associated with operative urgency, type of repair, mesh type or SSO occurrence. A significant decrease in recurrence was seen with retro-rectus mesh placement when compared to onlay (p = 0.003). EHS classification did not change between each recurrence in 70.8% of patients. Conclusion: Recurrence rates after recurrent PSH repair are high. The recurrence-free survival was worse after the second or more attempt at repair for recurrence. Further studies are warranted to explore prophylaxis, optimal repair method, and where re-recurrence occurs, the benefit of repeated surgical intervention.
MeSH term(s)	Hernia, Ventral/surgery ; Herniorrhaphy/adverse effects ; Humans ; Ostomy/adverse effects ; Recurrence ; Reoperation ; Retrospective Studies ; Surgical Mesh ; Surgical Stomas/adverse effects ; Treatment Outcome
Language	English
Publishing date	2020-03-06
Publishing country	France
Document type	Journal Article
ZDB-ID	1388125-5
ISSN	1248-9204 ; 1265-4906
ISSN (online)	1248-9204
ISSN	1265-4906
DOI	10.1007/s10029-020-02161-2
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Article ; Online: Impact of climate on landscape form, sediment transfer and the sedimentary record

Harries , R. / Gailleton, B. / Kirstein , L. / Attal , M. / Whittaker , A. / Mudd , S.

Earth Surface Processes and Landforms

2021

Abstract: The relationship between climate, landscape connectivity and sediment export from mountain ranges is key to understanding the propagation of erosion signals downstream into sedimentary basins. We explore the role of connectivity in modulating the ... ...

Abstract	The relationship between climate, landscape connectivity and sediment export from mountain ranges is key to understanding the propagation of erosion signals downstream into sedimentary basins. We explore the role of connectivity in modulating the composition of sediment exported from the Frontal Cordillera of the south‐central Argentine Andes by comparing three adjacent and apparently similar semi‐glaciated catchment‐fan systems within the context of an along‐strike precipitation gradient. We first identify that the bedrock exposed in the upper, previously glaciated reaches of the cordillera is under‐represented in the lithological composition of gravels on each of three alluvial fans. There is little evidence for abrasion or preferential weathering of sediment sourced from the upper cordillera, suggesting that the observed bias can only be explained by sediment storage in these glacially widened and flattened valleys of the upper cordillera (as revealed by channel steepness mapping). A detailed analysis of the morphology of sedimentary deposits within the catchments reveals catchment‐wide trends in either main valley incision or aggradation, linked to differences in hillslope–channel connectivity and precipitation. We observe that drier catchments have poor hillslope–channel connectivity and that gravels exported from dry catchments have a lithological composition depleted in clasts sourced from the upper cordillera. Conversely, the catchment with the highest maximum precipitation rate exhibits a high degree of connectivity between its sediment sources and the main river network, leading to the export of a greater proportion of upper cordillera gravel as well as a greater volume of sand. Finally, given a clear spatial correlation between the resistance of bedrock to erosion, mountain range elevation and its covariant, precipitation, we highlight how connectivity in these semi‐glaciated landscapes can be preconditioned by the spatial distribution of bedrock lithology. These findings give insight into the extent to which sedimentary archives record source erosion patterns through time.
Subject code	550
Language	English
Publishing country	de
Document type	Article ; Online
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Article ; Online: Quality of Life After Bariatric and Body Contouring Surgery in the Australian Public Health System.

Barbaro, Antonio / Kumar, Ajan / Asokan, Gayatri / Green, Luke / Ibrahim, Abdullah / Goel, Raghav / Harries, Richard / Kanhere, Harsh / Prowse, Phoebe / Trochsler, Markus

The Journal of surgical research

2023 Volume 285, Page(s) 76–84

Abstract: Introduction: The goals of bariatric surgery are weight loss, improved management of obesity-related diseases, and enhanced health-related quality of life (HRQoL). The aim of this study is to determine HRQoL among postoperative bariatric surgery ... ...

Abstract	Introduction: The goals of bariatric surgery are weight loss, improved management of obesity-related diseases, and enhanced health-related quality of life (HRQoL). The aim of this study is to determine HRQoL among postoperative bariatric surgery patients. The aim of this study was to evaluate the utility of bariatric surgery and the role of body contouring surgery (BCS) when considering quality of life in low-volume centres in the Australian public health system. Methods: This cohort study compared patients who underwent bariatric surgery between 2008 and 2018, to those awaiting surgery. An additional analysis was completed for patients who also underwent BCS. Patients completed the Short Form-36 quality of life (SF-36) survey. Linear regression was used to assess the differences in mean scores between cohorts for each of the SF-36 domains. Results: A total of 131 postoperative patients were identified, with a follow up rate of 68%. The mean follow up was 5.4 y. The mean scores for all domains of the SF-36 in the postoperative group were higher than the preoperative group (P ≤ 0.0001). A significant difference in scores persisted after controlling for patients' current BMI. When considering patients who underwent BCS (n = 24), there was a further global improvement in HRQoL in physical function (P = 0.0065), role limitation to physical health (P = 0.0026), pain (P = 0.0004), energy (P = 0.0023) and general health perceptions (P = 0.0023). Conclusions: Bariatric surgery followed by BCS may improve HRQoL for the patient when compared to bariatric surgery alone. We advocate for the use of bariatric surgery followed by BCS in low-volume centres in the Australian public health system.
MeSH term(s)	Humans ; Body Contouring ; Quality of Life ; Obesity, Morbid/surgery ; Cohort Studies ; Public Health ; Australia ; Bariatric Surgery
Language	English
Publishing date	2023-01-16
Publishing country	United States
Document type	Journal Article
ZDB-ID	80170-7
ISSN	1095-8673 ; 0022-4804
ISSN (online)	1095-8673
ISSN	0022-4804
DOI	10.1016/j.jss.2022.12.037
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Article ; Online: Diagnosis of colorectal and emergency surgical site infections in the era of enhanced recovery: an all-Wales prospective study.

Reeves, Nicola / Cuff, Simone / Boyce, Kathryn / Harries, Rhiannon / Roberts, Christopher / Harrison, Wendy / Torkington, Jared

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

2021 Volume 23, Issue 5, Page(s) 1239–1247

Abstract: Aim: Surgical site infections (SSIs) are associated with increased morbidity, hospital stay and cost. The literature reports that 25% of patients who undergo colorectal surgical procedures develop a SSI. Due to the enhanced recovery programme, patients ... ...

Abstract	Aim: Surgical site infections (SSIs) are associated with increased morbidity, hospital stay and cost. The literature reports that 25% of patients who undergo colorectal surgical procedures develop a SSI. Due to the enhanced recovery programme, patients are being discharged earlier with some SSIs presenting in primary care, making accurate recording of SSIs difficult. The aim of this study was to accurately record the 30-day SSI rate after surgery performed by colorectal surgeons nationally within Wales. Method: During March 2019, a national prospective snapshot study of all patients undergoing elective or emergency colorectal and general surgical procedures under the care of a colorectal consultant at 12 Welsh hospitals was completed. There was a multimodal 30-day follow-up using electronic records, clinic visits and/or telephone calls. Diagnosis of SSI was based on Centers for Disease Control and Prevention diagnostic criteria. Results: Within Wales, of the 545 patients included, 13% developed a SSI within 30 days, with SSI rates of 14.3% for elective surgery and 11.7% for emergency surgery. Of these SSIs, 49.3% were diagnosed in primary care, with 28.2% of patients being managed exclusively in the community. There were two peaks of diagnosis at days 5-7 and days 22-28. SSI rates between laparoscopic (8.6%) and open (16.2%) surgeries were significantly different (p = 0.028), and there was also a significantly different rate of SSI between procedure groups (p = 0.001), with high SSI rates for colon (22%) and rectal (18.9%) surgery compared with general surgical procedures. Conclusion: This first all-Wales prospective study demonstrated an overall SSI rate of 13%. By incorporating accurate primary care follow-up it was found that 49.3% of these SSIs were diagnosed in primary care.
MeSH term(s)	Colorectal Neoplasms ; Colorectal Surgery ; Humans ; Prospective Studies ; Rectum ; Risk Factors ; Surgical Wound Infection/diagnosis ; Surgical Wound Infection/epidemiology ; Surgical Wound Infection/etiology
Language	English
Publishing date	2021-02-18
Publishing country	England
Document type	Journal Article
ZDB-ID	1440017-0
ISSN	1463-1318 ; 1462-8910
ISSN (online)	1463-1318
ISSN	1462-8910
DOI	10.1111/codi.15569
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Article ; Online: Author response to: The impact of virtual-reality simulation training on operative performance in laparoscopic cholecystectomy: meta-analysis of randomized clinical trials.

Humm, Gemma / Mohan, Helen / Fleming, Christina / Harries, Rhiannon / Wood, Christopher / Dawas, Khaled / Stoyanov, Danail / Lovat, Laurence B

BJS open

2022 Volume 6, Issue 6

MeSH term(s)	Humans ; Cholecystectomy, Laparoscopic ; Randomized Controlled Trials as Topic ; Simulation Training ; Virtual Reality
Language	English
Publishing date	2022-11-18
Publishing country	England
Document type	Journal Article ; Comment
ISSN	2474-9842
ISSN (online)	2474-9842
DOI	10.1093/bjsopen/zrac136
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Article ; Online: The impact of virtual reality simulation training on operative performance in laparoscopic cholecystectomy: meta-analysis of randomized clinical trials.

Humm, Gemma / Mohan, Helen / Fleming, Christina / Harries, Rhiannon / Wood, Christopher / Dawas, Khaled / Stoyanov, Danail / Lovat, Laurence B

BJS open

2022 Volume 6, Issue 4

Abstract: Background: Simulation training can improve the learning curve of surgical trainees. This research aimed to systematically review randomized clinical trials (RCT) evaluating the performance of junior surgical trainees following virtual reality training ( ...

Abstract	Background: Simulation training can improve the learning curve of surgical trainees. This research aimed to systematically review randomized clinical trials (RCT) evaluating the performance of junior surgical trainees following virtual reality training (VRT) and other training methods in laparoscopic cholecystectomy. Methods: MEDLINE (PubMed), Embase (Ovid SP), Web of Science, Scopus and LILACS were searched for trials randomizing participants to VRT or no additional training (NAT) or simulation training (ST). Outcomes of interest were the reported performance using global rating scores (GRS), the Objective Structured Assessment of Technical Skill (OSATS) and Global Operative Assessment of Laparoscopic Skills (GOALS), error counts and time to completion of task during laparoscopic cholecystectomy on either porcine models or humans. Study quality was assessed using the Cochrane Risk of Bias Tool. PROSPERO ID: CRD42020208499. Results: A total of 351 titles/abstracts were screened and 96 full texts were reviewed. Eighteen RCT were included and 15 manuscripts had data available for meta-analysis. Thirteen studies compared VRT and NAT, and 4 studies compared VRT and ST. One study compared VRT with NAT and ST and reported GRS only. Meta-analysis showed OSATS score (mean difference (MD) 6.22, 95%CI 3.81 to 8.36, P < 0.001) and time to completion of task (MD -8.35 min, 95%CI 13.10 to 3.60, P = <0.001) significantly improved after VRT compared with NAT. No significant difference was found in GOALS score. No significant differences were found between VRT and ST groups. Intraoperative errors were reported as reduced in VRT groups compared with NAT but were not suitable for meta-analysis. Conclusion: Meta-analysis suggests that performance measured by OSATS and time to completion of task is improved with VRT compared with NAT for junior trainee in laparoscopic cholecystectomy. However, conclusions are limited by methodological heterogeneity and more research is needed to quantify the potential benefit to surgical training.
MeSH term(s)	Animals ; Cholecystectomy, Laparoscopic ; Humans ; Laparoscopy/education ; Randomized Controlled Trials as Topic ; Simulation Training/methods ; Swine ; Virtual Reality
Language	English
Publishing date	2022-08-03
Publishing country	England
Document type	Journal Article ; Meta-Analysis ; Systematic Review ; Research Support, Non-U.S. Gov't
ISSN	2474-9842
ISSN (online)	2474-9842
DOI	10.1093/bjsopen/zrac086
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