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Article ; Online: Laparoscopic enteropexy for prolapsing ileostomy.

Papettas, T / Wong, L

Annals of the Royal College of Surgeons of England

2012 Volume 94, Issue 6, Page(s) 445

MeSH term(s)	Humans ; Ileal Diseases/surgery ; Ileostomy/methods ; Laparoscopy/methods ; Prolapse
Language	English
Publishing date	2012-04-13
Publishing country	England
Document type	Journal Article
ZDB-ID	80044-2
ISSN	1478-7083 ; 0035-8843
ISSN (online)	1478-7083
ISSN	0035-8843
DOI	10.1308/003588412X13373405386015m
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Article ; Online: The benefits of index telephone consultations in patients referred on the two-week wait colorectal cancer pathway.

Wanigasooriya, K / Sarma, D R / Woods, P / O'Connor, P / Matthews, A / Aslam, M I / Dando, C / Ferguson, H / Francombe, J / Lal, N / Murphy, P D / Papettas, T / Ramcharan, S / Busby, K

Annals of the Royal College of Surgeons of England

2022 Volume 105, Issue 4, Page(s) 314–322

Abstract: Introduction: The coronavirus disease 2019 (COVID-19) pandemic led to hospitals in the UK substituting face-to-face (FtF) clinics with virtual clinic (VC) appointments. We evaluated the use of virtual two-week wait (2-ww) lower gastrointestinal (LGI) ... ...

Abstract	Introduction: The coronavirus disease 2019 (COVID-19) pandemic led to hospitals in the UK substituting face-to-face (FtF) clinics with virtual clinic (VC) appointments. We evaluated the use of virtual two-week wait (2-ww) lower gastrointestinal (LGI) clinic appointments, conducted using telephone calls at a district general hospital in England. Methods: Patients undergoing index outpatient 2-ww LGI clinic assessment between 1 June 2019 and 31 October 2019 (FtF group) and 1 June 2020 and 31 October 2020 (VC group) were identified. Relevant data were obtained using electronic patient records. Compliance with national cancer waiting time targets was assessed. Environmental and financial impact analyses were performed. Results: In total, 1,531 patients were analysed (median age=70, male=852, 55.6%). Of these, 757 (49.4%) were assessed virtually via telephone; the remainder were seen FtF ( Conclusion: Virtual 2-ww LGI clinics were effective, safe and were associated with tangible environmental and financial benefits.
MeSH term(s)	Humans ; Male ; Aged ; Referral and Consultation ; COVID-19/epidemiology ; Telephone ; Appointments and Schedules ; Colorectal Neoplasms/diagnosis ; Colorectal Neoplasms/therapy
Language	English
Publishing date	2022-04-29
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.2021.0364
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Article ; Online: Is it time for one-step nucleic acid amplification (OSNA) in colorectal cancer? A systematic review and meta-analysis.

Wild, J B / Iqbal, N / Francombe, J / Papettas, T / Sanders, D S / Ramcharan, S

Techniques in coloproctology

2017 Volume 21, Issue 9, Page(s) 693–699

Abstract: Background: Lymph node metastasis (LNM) is prognostic in colorectal cancer (CRC). However, evaluation by routine haematoxylin and eosin histology (HE) limits nodal examination and is subjective. Missed LNMs from tissue allocation bias (TAB) might under- ... ...

Abstract	Background: Lymph node metastasis (LNM) is prognostic in colorectal cancer (CRC). However, evaluation by routine haematoxylin and eosin histology (HE) limits nodal examination and is subjective. Missed LNMs from tissue allocation bias (TAB) might under-stage disease, leading to under-treatment. One-step nucleic acid amplification (OSNA) for CK19 messenger ribonucleic acid (mRNA), a marker of LNM, analyses the whole node. The aim of the present systematic review and meta-analysis was to assess recent studies on OSNA versus HE and its implications for CRC staging and treatment. Methods: Databases including OVID, Medline and Google Scholar were searched for OSNA, LNM and CRC. Study results were pooled using a random-effects model. Summary receiver operator curves (SROC) assessed OSNA's performance in detecting LNM when compared to routine HE histology. Results: Five case-control studies analysing 4080 nodes from 622 patients were included. The summary estimates of pooled results for OSNA were sensitivity 0.90 [95% confidence interval (CI) 0.86-0.93], specificity 0.94 (95% CI 0.93-0.95) and diagnostic odds ratio 179.5 (CI 58.35-552.2, p < 0.0001). The SROC curve indicated a maximum joint sensitivity and specificity of 0.88 and area under the curve of 0.94, p < 0.0001. On average, 5.4% HE-negative nodes were upstaged by OSNA. Conclusions: OSNA is as good as routine HE. It may avoid TAB and offer a more objective and standardised assay of LNM. However, for upstaging, its usefulness as an adjunct to HE or superiority to HE requires further assessment of the benefits, if any, of adjuvant therapy in patients upstaged by OSNA.
Language	English
Publishing date	2017-09
Publishing country	Italy
Document type	Journal Article
ZDB-ID	2083309-X
ISSN	1128-045X ; 1123-6337
ISSN (online)	1128-045X
ISSN	1123-6337
DOI	10.1007/s10151-017-1690-0
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Article ; Online: Short and medium-term outcomes for general surgery in nonagenarian patients in a district general hospital.

Hayes, A J / Davda, A / El-Hadi, M / Murphy, P / Papettas, T

Annals of the Royal College of Surgeons of England

2016 Volume 98, Issue 6, Page(s) 401–404

Abstract: Introduction Surgeons are increasingly performing surgery on older patients. There are currently no tools specifically for risk prediction in this group. The aim of this study was to review general surgical operations carried out on patients aged over 90 ...

Abstract	Introduction Surgeons are increasingly performing surgery on older patients. There are currently no tools specifically for risk prediction in this group. The aim of this study was to review general surgical operations carried out on patients aged over 90 years and their outcome, before comparing these with predictors of morbidity and mortality. Methods A retrospective review was carried out at our district general hospital of all general surgery patients aged over 90 years who underwent a general surgical operation over a period of 14 years. Information collected included demographics, details of procedures, P-POSSUM (Portsmouth Physiological and Operative Severity Score for the enUmeration of Mortality and morbidity), complications and outcomes. Results A total of 119 procedures were carried out, 72 involving entry into the peritoneal cavity. Overall, 14 patients (12%) died within 30 days and 34 (29%) died within one year. Postoperative complications included infection (56%), renal failure (24%), need for transfusion (17%) and readmission within 30 days (11%). Logistical regression analysis showed that the P-POSSUM correlated well with observed mortality and infection was a significant predictor of in-hospital mortality (p=0.003). Conclusions The P-POSSUM correlates significantly with outcome and should be used when planning major elective or emergency surgery in patients over 90 years of age. Infective complications appear to be a significant predictor of postoperative mortality. This study supports operative intervention as an option in this extreme age group but we emphasise the importance of appropriate patient selection and judicious clinical care.
MeSH term(s)	Abdomen/surgery ; Aged, 80 and over ; Blood Transfusion/statistics & numerical data ; Female ; Hospitals, District ; Hospitals, General ; Humans ; Male ; Multivariate Analysis ; Patient Outcome Assessment ; Patient Readmission/statistics & numerical data ; Postoperative Complications/epidemiology ; Renal Insufficiency/mortality ; Retrospective Studies ; Surgical Procedures, Operative/mortality ; United Kingdom/epidemiology
Language	English
Publishing date	2016-05-03
Publishing country	England
Document type	Journal Article ; Observational Study
ZDB-ID	80044-2
ISSN	1478-7083 ; 0035-8843
ISSN (online)	1478-7083
ISSN	0035-8843
DOI	10.1308/rcsann.2016.0142
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Article ; Online: Time to contrast enema and ileostomy closure rates following low anterior resection: does laparoscopic surgery make a difference? A prospective cohort study.

Lambert, Joel / Pandey, Steve / Papettas, Trifonas

International journal of colorectal disease

2016 Volume 31, Issue 6, Page(s) 1259–1260

MeSH term(s)	Contrast Media/chemistry ; Enema ; Humans ; Ileostomy ; Laparoscopy/adverse effects ; Postoperative Complications/etiology ; Prospective Studies ; Rectum/surgery ; Time Factors ; Treatment Outcome ; Wound Closure Techniques
Chemical Substances	Contrast Media
Language	English
Publishing date	2016-06
Publishing country	Germany
Document type	Letter
ZDB-ID	84975-3
ISSN	1432-1262 ; 0179-1958
ISSN (online)	1432-1262
ISSN	0179-1958
DOI	10.1007/s00384-015-2464-7
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Article: Opportunities for learning in the surgical workplace and how they can be exploited: a practical guide.

Papettas, Trifonas / Saedon, Habiba / Saedon, Mahmud

British journal of hospital medicine (London, England : 2005)

2012 Volume 72, Issue 12, Page(s) 707–710

Abstract: Training times and the working week have been shortened but the amount needed to be learned remains the same. This article demonstrates how trainees in surgery can incorporate learning opportunities into their normal working day. ...

Abstract	Training times and the working week have been shortened but the amount needed to be learned remains the same. This article demonstrates how trainees in surgery can incorporate learning opportunities into their normal working day.
MeSH term(s)	Employee Performance Appraisal ; Humans ; Inservice Training/methods ; Mentors ; Outpatient Clinics, Hospital ; Specialties, Surgical/education ; Teaching Rounds ; United Kingdom
Language	English
Publishing date	2012-01-12
Publishing country	England
Document type	Journal Article
ISSN	1750-8460
ISSN	1750-8460
DOI	10.12968/hmed.2011.72.12.707
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Article ; Online: Temporal artery biopsy for giant cell arteritis: retrospective audit.

Saedon, Habiba / Saedon, Mahmud / Goodyear, Steve / Papettas, Trifonas / Marshall, Colette

JRSM short reports

2012 Volume 3, Issue 10, Page(s) 73

Abstract: Objectives: Temporal artery biopsy (TAB) is performed in suspected cases of sight-threatening giant cell arteritis (GCA). We aimed to determine the feasibility of TAB in patients who are suspected of having GCA.: Design, setting and participants: A ... ...

Abstract	Objectives: Temporal artery biopsy (TAB) is performed in suspected cases of sight-threatening giant cell arteritis (GCA). We aimed to determine the feasibility of TAB in patients who are suspected of having GCA. Design, setting and participants: A retrospective audit of all patients undergoing TAB at a single teaching hospital between 2005 and 2011, identified from the histopathology database. Main outcome measures: (1) Clinical profile and biochemical criteria associated with positive histology. (2) Proportion of negative histology patients who were commenced on steroid therapy. Results: One hundred and fifty-three TAB were performed (mean age 70.8 years, men:women = 3:2, 110 Caucasian: 43 Asian). Thirty-two biopsies were positive for GCA and 121 were negative. In total, 68 (61%) of 112 negative TAB patients were clinically diagnosed with GCA despite histological findings (P < 0.001). Nine out of 153 biopsies were non-arterial. Histologically positive TAB patients were of higher mean age (77.1 [95% CI 74.5-79.7] versus 69.1 [95% CI 66.7-71.6]; P < 0.001) and had a higher erythrocyte sedimentation rate (ESR) (60 [95% CI 46.1-73.9] versus 39.8 [95% CI 34.2-45.3]; P < 0.01)] than those with negative histology. Conclusions: Raised ESR and higher age may be the most useful indicators of GCA. Many histologically negative individuals were nevertheless clinically diagnosed and managed as GCA.
Language	English
Publishing date	2012-10-22
Publishing country	England
Document type	Journal Article
ZDB-ID	2563002-7
ISSN	2042-5333 ; 2042-5333
ISSN (online)	2042-5333
ISSN	2042-5333
DOI	10.1258/shorts.2012.012069
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Article: Geographic variation in follow-up after rectal cancer surgery.

Neils, David M / Virgo, Katherine S / Longo, Walter E / Ode, Kenichi / Audisio, Riccardo A / Shariff, Umar S / Papettas, Trifonas / McGarry, Alaine E / Gammon, Steven R / Johnson, Frank E

International journal of oncology

2007 Volume 30, Issue 3, Page(s) 735–742

Abstract: Most patients with rectal cancer are treated with curative-intent surgery; adjuvant chemotherapy and radiation are often used as well. A recent survey of members of the American Society of Colon and Rectal Surgeons (ASCRS) revealed considerable variation ...

Abstract	Most patients with rectal cancer are treated with curative-intent surgery; adjuvant chemotherapy and radiation are often used as well. A recent survey of members of the American Society of Colon and Rectal Surgeons (ASCRS) revealed considerable variation in surveillance intensity after primary treatment. We evaluated whether geographic factors may be responsible for the observed variation. Vignettes of hypothetical patients and a questionnaire based on the vignettes were mailed to the 1782 members of ASCRS. Repeated-measures analysis of variance was used to compare practice patterns, as revealed by the responses, according to US Census Regions and Divisions, Metropolitan Statistical Areas (MSA), and state-specific managed care organization (MCO) penetration rates. There was significant variation in surveillance intensity according to the US Census Region and Division in which the surgeon practiced. Non-US respondents employed CT of the abdomen and pelvis, chest radiography, and colonoscopy significantly more often than US respondents. MSA was not a significant source of variation. Surveillance patterns varied significantly by MCO penetration rate for office visits and CT of the abdomen and pelvis but not for other modalities. The US Census Region and Division in which the surgeon practices have a significant effect on surveillance intensity following completion of primary curative-intent therapy for rectal cancer patients. The MSA in which the surgeon practices does not affect surveillance intensity significantly and MCO penetration rate affects follow-up intensity minimally. All significant differences are clinically rather modest, however. These data should be useful in the design of controlled trials on this topic.
MeSH term(s)	Delivery of Health Care ; Follow-Up Studies ; Geography ; Humans ; Medical Oncology/methods ; Postoperative Care/methods ; Practice Patterns, Physicians' ; Rectal Neoplasms/epidemiology ; Rectal Neoplasms/surgery ; Surveys and Questionnaires ; Treatment Outcome ; United States
Language	English
Publishing date	2007-03
Publishing country	Greece
Document type	Journal Article
ZDB-ID	1154403-x
ISSN	1019-6439
ISSN	1019-6439
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Article: Patient surveillance after curative-intent surgery for rectal cancer.

Johnson, Frank E / Longo, Walter E / Ode, Kenichi / Shariff, Umar S / Papettas, Trifonas / McGarry, Alaine E / Gammon, Steven R / Lee, Paul A / Audisio, Riccardo A / Grossmann, Erik M / Virgo, Katherine S

International journal of oncology

2005 Volume 27, Issue 3, Page(s) 815–822

Abstract: The follow-up of patients with rectal cancer after potentially curative resection has significant financial and clinical implications for patients and society. The ideal regimen for monitoring patients is unknown. We evaluated the self-reported practice ... ...

Abstract	The follow-up of patients with rectal cancer after potentially curative resection has significant financial and clinical implications for patients and society. The ideal regimen for monitoring patients is unknown. We evaluated the self-reported practice patterns of a large, diverse group of experts. There is little information available describing the actual practice of clinicians who perform potentially curative surgery on rectal cancer patients and follow them after recovery. The 1795 members of the American Society of Colon and Rectal Surgeons were asked, via a detailed questionnaire, how often they request 14 discrete follow-up modalities in their patients treated for cure with TNM stage I, II, or III rectal cancer over the first five post-treatment years. 566/1782 (32%) responded and 347 of the respondents (61%) provided evaluable data. Members of the American Society of Colon and Rectal Surgeons typically follow their own patients postoperatively rather than sending them back to their referral source. Office visit and serum CEA level are the most frequently requested items for each of the first five postoperative years. Endoscopy and imaging tests are also used regularly. Considerable variation exists among these highly experienced, highly credentialed experts. The surveillance strategies reported here rely most heavily on relatively simple and inexpensive tests. Endoscopy is employed frequently; imaging tests are employed less often. The observed variation in the intensity of postoperative monitoring is of concern.
MeSH term(s)	Adult ; Aged ; Humans ; Middle Aged ; Monitoring, Physiologic/methods ; Neoplasm Staging ; Postoperative Care/methods ; Postoperative Care/statistics & numerical data ; Practice Patterns, Physicians'/statistics & numerical data ; Rectal Neoplasms/pathology ; Rectal Neoplasms/surgery ; Surveys and Questionnaires
Language	English
Publishing date	2005-09
Publishing country	Greece
Document type	Journal Article
ZDB-ID	1154403-x
ISSN	1019-6439
ISSN	1019-6439
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