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  1. Article ; Online: Impact of the COVID-19 Pandemic on Access to Cancer Surgery: Analysis of Surgical Wait Times in British Columbia, Canada.

    Shojaei, Delaram / Bakos, Brendan / Loree, Jonathan / Mah, Allison / So, Alan / McGahan, Colleen / Phang, Terry P / Brown, Carl James

    Disaster medicine and public health preparedness

    2023  Volume 17, Page(s) e565

    Abstract: Objective: As coronavirus disease 2019 (COVID-19) spread, efforts were made to preserve resources for the anticipated surge of COVID-19 patients in British Columbia, Canada. However, the relationship between COVID-19 hospitalizations and access to ... ...

    Abstract Objective: As coronavirus disease 2019 (COVID-19) spread, efforts were made to preserve resources for the anticipated surge of COVID-19 patients in British Columbia, Canada. However, the relationship between COVID-19 hospitalizations and access to cancer surgery is unclear. In this project, we analyze the impact of COVID-19 patient volumes on wait time for cancer surgery.
    Methods: We conducted a retrospective study using population-based datasets of regional surgical wait times and COVID-19 patient volumes. Weekly median wait times for urgent, nonurgent, cancer, and noncancer surgeries, and maximum volumes of hospitalized patients with COVID-19 were studied. The results were qualitatively analyzed.
    Results: A sustained association between weekly median wait time for priority and other cancer surgeries and increase hospital COVID-19 patient volumes was not qualitatively discernable. In response to the first phase of COVID-19 patient volumes, relative to pre-COVID-19 pandemic levels, wait time were shortened for urgent cancer surgery but increased for nonurgent surgeries. During the second phase, for all diagnostic groups, wait times returned to pre-COVID-19 pandemic levels. During the third phase, wait times for all surgeries increased.
    Conclusion: Cancer surgery access may have been influenced by other factors, such as policy directives and local resource issues, independent of hospitalized COVID-19 patient volumes. The initial access limitations gradually improved with provincial and institutional resilience, and vaccine rollout.
    MeSH term(s) Humans ; British Columbia/epidemiology ; Waiting Lists ; Retrospective Studies ; Pandemics ; COVID-19/epidemiology ; Neoplasms/epidemiology ; Neoplasms/surgery
    Language English
    Publishing date 2023-12-22
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2375268-3
    ISSN 1938-744X ; 1935-7893
    ISSN (online) 1938-744X
    ISSN 1935-7893
    DOI 10.1017/dmp.2023.223
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Transanal endoscopic microsurgery: a review.

    Heidary, Behrouz / Phang, Terry P / Raval, Manoj J / Brown, Carl J

    Canadian journal of surgery. Journal canadien de chirurgie

    2014  Volume 57, Issue 2, Page(s) 127–138

    Abstract: Rectal adenomas and cancers occur frequently. Small adenomas can be removed colonoscopically, whereas larger polyps are removed via conventional transanal excision. Owing to technical difficulties, adenomas of the mid- and upper rectum require radical ... ...

    Abstract Rectal adenomas and cancers occur frequently. Small adenomas can be removed colonoscopically, whereas larger polyps are removed via conventional transanal excision. Owing to technical difficulties, adenomas of the mid- and upper rectum require radical resection. Transanal endoscopic microsurgery (TEM) was first designed as an alternative treatment for these lesions. However, since its development TEM has been also used for a variety of rectal lesions, including carcinoids, rectal prolapse and diverticula, early stage carcinomas and palliative resection of rectal cancers. The objective of this review is to describe the current status of TEM in the treatment of rectal lesions. Since the 1980s, TEM has advanced substantially. With low recurrence rates, it is the method of choice for resection of endoscopically unresectable adenomas. Some studies have shown benefits to its use in treating early T1 rectal cancers compared with radical surgery in select patients. However, for more advanced rectal cancers TEM should be considered palliative or experimental. This technique has also been shown to be safe for the treatment of other uncommon rectal tumours, such as carcinoids. Transanal endoscopic microsurgery may allow for new strategies in the treatment of rectal pathology where technical limitations of transanal techniques have limited endoluminal surgical innovations.
    MeSH term(s) Anal Canal/surgery ; Colonic Neoplasms/surgery ; Humans ; Microsurgery ; Natural Orifice Endoscopic Surgery ; Proctoscopy ; Rectal Neoplasms/surgery
    Language English
    Publishing date 2014-03-11
    Publishing country Canada
    Document type Journal Article ; Review
    ZDB-ID 410651-9
    ISSN 1488-2310 ; 0008-428X
    ISSN (online) 1488-2310
    ISSN 0008-428X
    DOI 10.1503/cjs.022412
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    In stock of ZB MED Cologne/Königswinter

    Zs.A 221: Show issues Location:
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    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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  3. Article ; Online: Prognostic significance of autocrine motility factor receptor expression by colorectal cancer and lymph node metastases.

    Halwani, Yasmin / Kojic, Liliana D / Chan, Simon K / Phang, Terry P / Masoudi, Hamid / Jones, Steven J M / Nabi, Ivan R / Wiseman, Sam M

    American journal of surgery

    2015  Volume 209, Issue 5, Page(s) 884–9; discussion 889

    Abstract: Background: Autocrine motility factor receptor (AMFR) has been linked to metastasis and tumorigenicity. The aim of this study was to evaluate expression and prognostic significance of AMFR in colorectal carcinoma.: Methods: AMFR expression was ... ...

    Abstract Background: Autocrine motility factor receptor (AMFR) has been linked to metastasis and tumorigenicity. The aim of this study was to evaluate expression and prognostic significance of AMFR in colorectal carcinoma.
    Methods: AMFR expression was evaluated in 127 colon cancer specimens, 131 rectal cancer specimens, and 47 colonic and 25 rectal corresponding lymph node metastases. Clinicopathological correlates of prognostic significance were established by univariate and multivariate analysis. Spearman's correlation determined the association of expression between cancers and their metastases.
    Results: AMFR was over-expressed by 22% of colon cancers and 18% of rectal cancers. AMFR over-expression correlated significantly with improved disease-free survival (DFS) (P < .05) in colon cancer and decreased DFS in corresponding nodal metastases. In rectal cancer, AMFR over-expression significantly correlated with decreased overall survival, DFS, and disease-specific survival (P < .001, P = .031, P = .005, respectively) and decreased overall survival in corresponding metastases.
    Conclusion: AMFR may serve as a molecular prognosticator for colon cancer and rectal cancer.
    MeSH term(s) Biomarkers, Tumor/biosynthesis ; Blotting, Western ; Cell Line, Tumor ; Colorectal Neoplasms/diagnosis ; Colorectal Neoplasms/metabolism ; Colorectal Neoplasms/secondary ; Flow Cytometry ; Humans ; Immunohistochemistry ; Lymph Nodes/metabolism ; Lymph Nodes/pathology ; Lymphatic Metastasis ; Neoplasm Staging ; Prognosis ; Receptors, Autocrine Motility Factor/biosynthesis ; Retrospective Studies
    Chemical Substances Biomarkers, Tumor ; AMFR protein, human (EC 2.3.2.27) ; Receptors, Autocrine Motility Factor (EC 2.3.2.27)
    Language English
    Publishing date 2015-05
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2953-1
    ISSN 1879-1883 ; 0002-9610
    ISSN (online) 1879-1883
    ISSN 0002-9610
    DOI 10.1016/j.amjsurg.2015.01.010
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    In stock of ZB MED Cologne/Königswinter

    Uk I Zs.42: Show issues Location:
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  4. Article ; Online: Can CT replace MRI in preoperative assessment of the circumferential resection margin in rectal cancer?

    Maizlin, Zeev V / Brown, Jacqueline A / So, Genhee / Brown, Carl / Phang, Terry P / Walker, Michelle L / Kirby, John M / Vora, Parag / Tiwari, Pari

    Diseases of the colon and rectum

    2010  Volume 53, Issue 3, Page(s) 308–314

    Abstract: Unlabelled: The surgical circumferential resection margin in total mesorectal excision surgery is defined by the relationship of the tumor to the mesorectal fascia. Patients with anticipated tumor invasion of the mesorectal fascia receive neoadjuvant ... ...

    Abstract Unlabelled: The surgical circumferential resection margin in total mesorectal excision surgery is defined by the relationship of the tumor to the mesorectal fascia. Patients with anticipated tumor invasion of the mesorectal fascia receive neoadjuvant therapy to downstage/downsize the tumor and to obtain tumor-free resection margins.Tumor relationship to the mesorectal fascia is accurately determined by MRI. Compared with MRI, multidetector-row computed tomography is more widely available, faster, less costly, and provides the ability to simultaneously assess the liver, peritoneum, and retroperitoneum for metastases.
    Purpose: The objective of this study was to compare the accuracy of multidetector-row CT with conventional MRI in diagnosis of rectal cancer invasion of the mesorectal fascial envelope.
    Materials and methods: During a 2-year period, all patients were enrolled in this study who had biopsy-proven rectal carcinoma and were referred, as a part of the routine preoperative staging workup, for a CT scan of the abdomen and pelvis and also an MRI of the pelvis.All examinations were reviewed independently by 2 radiologists who were blinded from one another, from the findings of the other modality, and from clinical information. Both observers were dedicated abdominal radiologists who are experienced in reading pelvic CT and MRI. Categorical agreement between MRI and multidetector-row CT for all the evaluated parameters of the tumor position, mesorectal fascia, and lymph nodes, as well as the interobserver agreement between CT and MRI, was determined by the intraclass correlation weighted kappa statistic to measure the data set's consistency.
    Results: Among the study's 92 patients, the tumor characteristics suggested by multidetector-row CT agreed with those of MRI, with a weighted kappa ranging from 0.488 to 0.748 for the first reader and 0.577 to 0.800 for the second reader. Interobserver agreement ranged from 0.506 to 0.746.Agreement regarding mesorectal fascia characteristics differed significantly between multidetector-row CT and MRI, depending on the level of assessment. In the distal rectum, agreement was 0.207 for the first reader and 0.385 for the second reader. In the mid rectum, agreement was 0.420 and 0.527, respectively, and in the proximal rectum agreement was 0.508 and 0.520. Interobserver agreement was 0.737 at the distal level and 0.700 at the mid and proximal levels. Agreement regarding measurement of the distance from the tumor to the mesorectal fascia was 0.425 for the first reader and 0.723 for the second reader, with interobserver agreement of 0.766. Agreement in assessment of the number of lymph nodes ranged from 0.743 to 0.787 for the first reader and 0.754 to 0.840 for the second reader. Interobserver agreement ranged from 0.779 to 0.841. Agreement in assessment of the size of the lymph nodes ranged from 0.540 to 0.830 for the first reader and 0.850 to 0.940 for the second reader. Interobserver agreement ranged from 0.900 to 0.920. Agreement in assessment of the distance from nodes to the mesorectal fascia was 0.320 for the first reader and 0.401 for the second reader, with interobserver agreement of 0.950.
    Conclusion: The results of this study differ from previously published data by demonstrating substantial agreement between readers in multidetector-row CT assessment of the tumor, mesorectal fascia, and lymph nodes. With the exceptions of mesorectal fascia in the distal rectum and the distance from the nodes to mesorectal fascia, other evaluated parameters were assessed with moderate and substantial agreement between multidetector-row CT and MRI. However, our findings suggest that multidetector-row CT does not correlate well enough with MRI findings to replace it in rectal cancer staging.
    MeSH term(s) Adult ; Aged ; Aged, 80 and over ; Biopsy ; Contrast Media ; Fascia/diagnostic imaging ; Fascia/pathology ; Fasciotomy ; Female ; Humans ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Neoplasm Invasiveness/diagnostic imaging ; Neoplasm Invasiveness/pathology ; Neoplasm Staging ; Preoperative Care ; Rectal Neoplasms/diagnostic imaging ; Rectal Neoplasms/pathology ; Rectal Neoplasms/surgery ; Tomography, X-Ray Computed ; Triiodobenzoic Acids
    Chemical Substances Contrast Media ; Triiodobenzoic Acids ; ioversol (N3RIB7X24K)
    Language English
    Publishing date 2010-03
    Publishing country United States
    Document type Comparative Study ; Journal Article
    ZDB-ID 212581-x
    ISSN 1530-0358 ; 0012-3706
    ISSN (online) 1530-0358
    ISSN 0012-3706
    DOI 10.1007/DCR.0b013e3181c5321e
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    In stock of ZB MED Cologne/Königswinter

    Uk I Zs.237: Show issues Location:
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    bis Jg. 2021: Bestellungen von Artikeln über das Online-Bestellformular
    ab Jg. 2022: Lesesaal (EG)

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