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Article ; Online: A prospective case control study of functional outcomes and related quality of life after colectomy for neoplasia.

Brigic, Adela / Sakuma, Samia / Lovegrove, Richard E / Bassett, Paul / Faiz, Omar / Clark, Susan K / Mortensen, Neil / Kennedy, Robin H

International journal of colorectal disease

2017 Volume 32, Issue 6, Page(s) 777–787

Abstract: Aim: Our aim was to assess bowel function and its effect on overall quality of life (QOL) when compared to healthy controls after colectomy.: Methods: Patients undergoing resection of colorectal neoplasia were recruited pre-operatively and followed ... ...

Abstract	Aim: Our aim was to assess bowel function and its effect on overall quality of life (QOL) when compared to healthy controls after colectomy. Methods: Patients undergoing resection of colorectal neoplasia were recruited pre-operatively and followed up at 6 and 12 months, to assess 'early' bowel function. Patients who underwent surgery 2 to 4 years previously were recruited for assessment of 'intermediate' bowel function. Healthy relatives were recruited as controls. The Memorial Sloan-Kettering Cancer Centre and EQ-5D questionnaires were used to assess bowel function and QOL, respectively. Statistical assessment included regression analyses, parametric and non-parametric tests. The association between QOL and Memorial Sloan-Kettering Cancer Centre (MSKCC) scores was evaluated using Spearman's rank correlation. Results: Ninety-one patients were recruited for assessment of 'early' and 85 for 'intermediate' bowel function. There were 85 controls. Patients had a significantly higher number of bowel movements at each follow-up (p < 0.001). At 12 months after surgery, patients reported difficulty with gas-stool discrimination. The 'intermediate' group were found to have lower scores for flatus control (<0.001) and total frequency score (p 0.03), indicating worse function. Patients with higher total MSKCC scores, no symptoms of urgency and those able to control flatus reported better QOL (p 0.006, 0.007 and 0.005, respectively) at 6 and 12 months. Gas-stool differentiation and complete evacuation correlated with better QOL in the 'intermediate' bowel function group (p 0.02 and 0.02, respectively). Conclusion: Colonic resection adversely affects elements of bowel function up to 4 years after surgery. Good colonic function, represented by higher MSKCC scores, correlates with better QOL.
Language	English
Publishing date	2017-06
Publishing country	Germany
Document type	Journal Article
ZDB-ID	84975-3
ISSN	1432-1262 ; 0179-1958
ISSN (online)	1432-1262
ISSN	0179-1958
DOI	10.1007/s00384-016-2714-3
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Article ; Online: Use of a sterile glove as a retrieval bag in laparoscopic surgery.

Rolton, Daniel J / Lovegrove, Richard E / Dehn, Thomas

Annals of the Royal College of Surgeons of England

2009 Volume 91, Issue 5, Page(s) 440

MeSH term(s)	Gloves, Surgical ; Humans ; Laparoscopy/methods ; Specimen Handling/instrumentation
Language	English
Publishing date	2009-07-22
Publishing country	England
Document type	Journal Article
ZDB-ID	80044-2
ISSN	1478-7083 ; 0035-8843
ISSN (online)	1478-7083
ISSN	0035-8843
DOI	10.1308/rcsann.2009.91.5.440b
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Article ; Online: Laparoscopic splenectomy and diaphragmatic rupture repair in a 27-week pregnant trauma patient.

Rolton, Daniel J / Lovegrove, Richard E / Dehn, Thomas C

Surgical laparoscopy, endoscopy & percutaneous techniques

2009 Volume 19, Issue 4, Page(s) e159–60

Abstract: Report of a 27-week pregnant woman having diaphragmatic rupture and intrathoracic ruptured spleen is presented. She was managed by laparoscopic reduction of the intrathoracic viscus, with repair of the defect and splenectomy. ...

Abstract	Report of a 27-week pregnant woman having diaphragmatic rupture and intrathoracic ruptured spleen is presented. She was managed by laparoscopic reduction of the intrathoracic viscus, with repair of the defect and splenectomy.
MeSH term(s)	Abdominal Injuries/surgery ; Accidents, Traffic ; Cesarean Section ; Female ; Hernia, Diaphragmatic, Traumatic/surgery ; Humans ; Laparoscopy ; Pregnancy ; Splenectomy/methods ; Splenic Rupture/surgery ; Term Birth ; Wounds, Nonpenetrating/surgery ; Young Adult
Language	English
Publishing date	2009-08
Publishing country	United States
Document type	Case Reports ; Journal Article
ZDB-ID	1475108-2
ISSN	1534-4908 ; 1530-4515 ; 1051-7200
ISSN (online)	1534-4908
ISSN	1530-4515 ; 1051-7200
DOI	10.1097/SLE.0b013e3181b05c6c
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Article ; Online: Management of haemorrhoids: Symptoms govern treatment.

Middleton, Simon B / Lovegrove, Richard E / Reece-Smith, Howard

BMJ (Clinical research ed.)

2008 Volume 336, Issue 7642, Page(s) 461

MeSH term(s)	Hemorrhage/etiology ; Hemorrhoids/therapy ; Humans ; Prolapse
Language	English
Publishing date	2008-02-28
Publishing country	England
Document type	Comment ; Letter
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.39500.442384.1F
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Article ; Online: DECIDE: Delphi Expert Consensus Statement on Inflammatory Bowel Disease Dysplasia Shared Management Decision-Making.

Kabir, Misha / Thomas-Gibson, Siwan / Tozer, Phil J / Warusavitarne, Janindra / Faiz, Omar / Hart, Ailsa / Allison, Lisa / Acheson, Austin G / Atici, Semra Demirli / Avery, Pearl / Brar, Mantaj / Carvello, Michele / Choy, Matthew C / Dart, Robin J / Davies, Justin / Dhar, Anjan / Din, Shahida / Hayee, Bu'Hussain / Kandiah, Kesavan /

Journal of Crohn's & colitis

2023 Volume 17, Issue 10, Page(s) 1652–1671

Abstract: Background and aims: Inflammatory bowel disease colitis-associated dysplasia is managed with either enhanced surveillance and endoscopic resection or prophylactic surgery. The rate of progression to cancer after a dysplasia diagnosis remains uncertain ... ...

Abstract	Background and aims: Inflammatory bowel disease colitis-associated dysplasia is managed with either enhanced surveillance and endoscopic resection or prophylactic surgery. The rate of progression to cancer after a dysplasia diagnosis remains uncertain in many cases and patients have high thresholds for accepting proctocolectomy. Individualised discussion of management options is encouraged to take place between patients and their multidisciplinary teams for best outcomes. We aimed to develop a toolkit to support a structured, multidisciplinary and shared decision-making approach to discussions about dysplasia management options between clinicians and their patients. Methods: Evidence from systematic literature reviews, mixed-methods studies conducted with key stakeholders, and decision-making expert recommendations were consolidated to draft consensus statements by the DECIDE steering group. These were then subjected to an international, multidisciplinary modified electronic Delphi process until an a priori threshold of 80% agreement was achieved to establish consensus for each statement. Results: In all, 31 members [15 gastroenterologists, 14 colorectal surgeons and two nurse specialists] from nine countries formed the Delphi panel. We present the 18 consensus statements generated after two iterative rounds of anonymous voting. Conclusions: By consolidating evidence for best practice using literature review and key stakeholder and decision-making expert consultation, we have developed international consensus recommendations to support health care professionals counselling patients on the management of high cancer risk colitis-associated dysplasia. The final toolkit includes clinician and patient decision aids to facilitate shared decision-making.
MeSH term(s)	Humans ; Colitis ; Delphi Technique ; Hyperplasia ; Inflammatory Bowel Diseases/complications ; Inflammatory Bowel Diseases/diagnosis ; Inflammatory Bowel Diseases/therapy ; Neoplasms ; Risk ; Systematic Reviews as Topic
Language	English
Publishing date	2023-05-12
Publishing country	England
Document type	Journal Article
ZDB-ID	2390120-2
ISSN	1876-4479 ; 1873-9946
ISSN (online)	1876-4479
ISSN	1873-9946
DOI	10.1093/ecco-jcc/jjad083
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Article ; Online: Unusual computed tomography findings in a patient presenting with acute abdominal pain.

Chan, James K K / Lovegrove, Richard / Dunckley, Matt / Woo, Eric K / Farouk, Marwan

BMJ (Clinical research ed.)

2009 Volume 339, Page(s) b3192

MeSH term(s)	Abdominal Pain/diagnostic imaging ; Abdominal Pain/etiology ; Aged, 80 and over ; Female ; Humans ; Ischemia/complications ; Ischemia/diagnostic imaging ; Mesentery/blood supply ; Tomography, X-Ray Computed
Language	English
Publishing date	2009-08-19
Publishing country	England
Document type	Case Reports ; 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.b3192
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Article ; Online: The National Bowel Cancer Project: social deprivation is an independent predictor of nonrestorative rectal cancer surgery.

Tilney, Henry / Lovegrove, Richard E / Smith, Jason J / Thompson, Michael R / Tekkis, Paris P

Diseases of the colon and rectum

2009 Volume 52, Issue 6, Page(s) 1046–1053

Abstract: Purpose: This study was designed to assess the impact of social deprivation on rates of abdominoperineal excision of the rectum in the United Kingdom.: Methods: Data were extracted from the Association of Coloproctology of Great Britain and Ireland ... ...

Abstract	Purpose: This study was designed to assess the impact of social deprivation on rates of abdominoperineal excision of the rectum in the United Kingdom. Methods: Data were extracted from the Association of Coloproctology of Great Britain and Ireland Colorectal Cancer Database (2000-2005). Social deprivation was assessed by using the Index of Multiple Deprivation (2004) score. Logistic regression was performed to identify independent predictors of nonrestorative surgery. Results: A total of 12,128 patients underwent anterior resection or abdominoperineal excision for Dukes A-C cancer in 101 centers; 2,625 patients (21.6 percent) underwent abdominoperineal excision (median, 20.8 (interquartile range, 16.5-27.9) percent per unit). Abdominoperineal excision rates decreased from 24.3 to 18.2 percent (P < 0.001) and varied between the least and most deprived groups from 18 to 26.4 percent, respectively (P < 0.001). Independent predictors of abdominoperineal excision were: year of surgery (odds ratio = 0.855 per year increase, P < 0.001), female vs. male gender (odds ratio = 0.82, P < 0.001), use of neoadjuvant radiotherapy (odds ratio = 2.4, P < 0.001), and social deprivation (most vs. least deprived: odds ratio = 1.638, P < 0.001). Conclusions: Abdominoperineal excision rates vary considerably between centers. Gender and deprivation status independently predict formation of a permanent stoma. These results have important implications for intercenter comparisons of surgical quality and may suggest inequalities in health care provision.
MeSH term(s)	Aged ; Aged, 80 and over ; Chi-Square Distribution ; Female ; Humans ; Logistic Models ; Male ; Middle Aged ; Radiotherapy, Adjuvant ; Rectal Neoplasms/pathology ; Rectal Neoplasms/radiotherapy ; Rectal Neoplasms/surgery ; Risk Factors ; Socioeconomic Factors ; Treatment Outcome ; United Kingdom
Language	English
Publishing date	2009-06
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	212581-x
ISSN	1530-0358 ; 0012-3706
ISSN (online)	1530-0358
ISSN	0012-3706
DOI	10.1007/DCR.0b013e3181a65f41
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Article ; Online: To divert or not to divert: A retrospective analysis of variables that influence ileostomy omission in ileal pouch surgery.

Lovegrove, Richard E / Tilney, Henry S / Remzi, Feza H / Nicholls, R John / Fazio, Victor W / Tekkis, Paris P

Archives of surgery (Chicago, Ill. : 1960)

2011 Volume 146, Issue 1, Page(s) 82–88

Abstract: Hypothesis: A model could be developed to identify patients who can safely undergo restorative proctocolectomy (RPC) without proximal diversion.: Design: Logistic regression analysis was used to identify independent factors favoring omission of ... ...

Abstract	Hypothesis: A model could be developed to identify patients who can safely undergo restorative proctocolectomy (RPC) without proximal diversion. Design: Logistic regression analysis was used to identify independent factors favoring omission of ileostomy at the time of RPC. A propensity nomogram was developed and validated using measures of calibration, discrimination, and subgroup analysis. Setting: Two tertiary referral centers. Patients: A total of 4013 patients undergoing RPC between January 1977 and December 2005 were included in the study sample. Main outcome measure: The decision to omit loop ileostomy at the time of RPC. Results: After study group exclusions, proximal diversion was performed in 3196 of 3733 patients (85.6%) undergoing RPC; 45.4% of 3733 patients were women. The mean (SD) age at surgery was 37.4 (12.8) years. Ulcerative colitis was the indication for RPC in 2304 patients (61.7%) and familial adenomatous polyposis in 364 patients (9.8%), and a J pouch was performed in 2657 patients (71.2%). The following were found to be associated with ileostomy omission: stapled anastomosis (odds ratio [OR], 6.4), no preoperative corticosteroid use (OR, 3.2), familial adenomatous polyposis diagnosis (OR, 2.6), cancer diagnosis (OR, 3.4), female sex (OR, 1.6), and age at surgery younger than 26 years (OR, 2.1) (P < .01 for all). The model discriminated well (area under the receiver operating characteristic curve, 74.9%), with no significant differences between observed and expected outcomes (P = .49). Omission of proximal diversion demonstrated no significant effect on postoperative adverse events, although it was associated with a 2-day increase in the median length of hospital stay (P < .01). Conclusion: Incorporation of a 5-point nomogram in the preoperative assessment of patients undergoing RPC may aid clinicians in identifying a select group of patients who may be candidates for ileostomy omission during RPC.
MeSH term(s)	Adenomatous Polyposis Coli/surgery ; Adult ; Colitis, Ulcerative/surgery ; Colonic Pouches/adverse effects ; Female ; Humans ; Ileostomy/adverse effects ; Male ; Middle Aged ; Multivariate Analysis ; Nomograms ; Patient Selection ; Proctocolectomy, Restorative
Language	English
Publishing date	2011-01
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	80055-7
ISSN	1538-3644 ; 0004-0010 ; 0096-6908 ; 0272-5533
ISSN (online)	1538-3644
ISSN	0004-0010 ; 0096-6908 ; 0272-5533
DOI	10.1001/archsurg.2010.304
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Article ; Online: Sentinel lymph node biopsy in breast cancer: an analysis of the maximum number of nodes requiring excision.

Gill, Jasper / Lovegrove, Richard / Naessens, Katrien / Pursell, Roslyn / Cominos, Timothy / McCormick, Colin / Umeh, Hilary / Courtney, Stephen / Smith, Brendan

The breast journal

2011 Volume 17, Issue 1, Page(s) 3–8

Abstract: Sentinel lymph node biopsy (SNB) is now the standard of care in assessment of patients with clinically staged T1-2, N0 breast cancers. This study investigates whether there is a maximum number of sentinel lymph nodes (SLN) that need to be excised without ...

Abstract	Sentinel lymph node biopsy (SNB) is now the standard of care in assessment of patients with clinically staged T1-2, N0 breast cancers. This study investigates whether there is a maximum number of sentinel lymph nodes (SLN) that need to be excised without compromising the false-negative (FN) rate of this procedure. Data were prospectively collected for 319 patients undergoing SNB between February 2001 and December 2006 at our institution. This data were analysed, both in terms of the order of SLN retrieval and relative isotope counts of the SLNs, in order to determine the maximum number of SLNs that need to be retrieved without increasing the FN rate. Furthermore, we investigated the relationship between SLN blue dye concentration and the presence of SLN metastases. The SLN identification rate was 97% with no false-negative cases amongst patients undergoing simultaneous axillary clearance historically during technique validation. In patients with SLN metastases, excision of the first 4 SLNs encountered results in the identification of a metastatic SLN in all cases. Although the majority (86%) of SNB metastases are in the hottest node, the SLN containing the metastasis is in the first 4 hottest nodes in 99% of patients with nodal metastases. The remaining 1% of SLN metastases were identified by blue dye. There was no statistically significant association between the SLN blue dye concentration and the presence of SLN metastases. A policy to remove a maximum of four blue and/or hot SLNs along with any palpably abnormal lymph nodes does not result in an increased false-negative rate of detection of SLN metastases.
MeSH term(s)	Adult ; Aged ; Aged, 80 and over ; Breast Neoplasms/pathology ; Coloring Agents ; Female ; Humans ; Lymph Nodes/diagnostic imaging ; Lymph Nodes/pathology ; Lymphatic Metastasis ; Middle Aged ; Prospective Studies ; Radionuclide Imaging ; Radiopharmaceuticals ; Rosaniline Dyes ; Sentinel Lymph Node Biopsy/methods ; Technetium Tc 99m Aggregated Albumin ; Young Adult
Chemical Substances	Coloring Agents ; Radiopharmaceuticals ; Rosaniline Dyes ; Technetium Tc 99m Aggregated Albumin ; technetium Tc 99m nanocolloid ; sulfan blue (FH1929ICIT)
Language	English
Publishing date	2011-01
Publishing country	United States
Document type	Journal Article
ZDB-ID	1289960-4
ISSN	1524-4741 ; 1075-122X
ISSN (online)	1524-4741
ISSN	1075-122X
DOI	10.1111/j.1524-4741.2010.01019.x
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Article ; Online: An assessment of between-recti distance and divarication in patients with and without abdominal aortic aneurysm.

De'Ath, Henry D I / Lovegrove, Richard E / Javid, Mahsa / Peter, Noel / Magee, Timothy R / Galland, Robert B

Annals of the Royal College of Surgeons of England

2010 Volume 92, Issue 7, Page(s) 591–594

Abstract: Introduction: The study assessed whether there is a greater incidence of divarication of the recti and whether between-recti distance is greater in patients with abdominal aortic aneurysm (AAA).: Patients and methods: The study consisted of two parts: ...

Abstract	Introduction: The study assessed whether there is a greater incidence of divarication of the recti and whether between-recti distance is greater in patients with abdominal aortic aneurysm (AAA). Patients and methods: The study consisted of two parts: a radiological and a clinical assessment. All patients with a confirmed AAA on computerised tomography were included and compared with patients in whom AAA was excluded with imaging. Between-recti distance was measured using a computerised image viewer and clinical divarication was assessed by a surgical registrar or consultant. Results: In the radiological part of the study, 108 patients with AAA were compared with 84 with colorectal cancer. Median between-recti distance was 38 mm (range, 25-59 mm) in the AAA group and 27 mm (range, 20-44.5 mm) in the non-AAA group (P=0.006). AAA diameter did not correlate with between-recti distance. The clinical study included 50 patients (25 AAA). The groups were well matched, with only a greater incidence of diabetes in the AAA group (20% vs 0%; P=0.018). AAA patients were more likely to have clinically detected divarication of the recti (76% vs 36%; P=0.004). Conclusions: Patients with AAA have greater radiological and clinical evidence of divarication. It is suggested that patients with divarication be screened for AAA.
MeSH term(s)	Aged ; Aortic Aneurysm, Abdominal/complications ; Body Mass Index ; Cohort Studies ; Female ; Humans ; Male ; Middle Aged ; Muscular Diseases/complications ; Muscular Diseases/diagnostic imaging ; Muscular Diseases/pathology ; Rectus Abdominis/diagnostic imaging ; Rectus Abdominis/pathology ; Tomography, X-Ray Computed
Language	English
Publishing date	2010-09-06
Publishing country	England
Document type	Journal Article
ZDB-ID	80044-2
ISSN	1478-7083 ; 0035-8843
ISSN (online)	1478-7083
ISSN	0035-8843
DOI	10.1308/003588410X12771863937089
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