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Article ; Online: Author response to: Nosocomial SARS-CoV-2 transmission in postoperative infection and mortality: analysis of 14 798 procedures.

Elliott, J A / Kenyon, R / Kelliher, G / Gillis, A E / Tierney, S / Ridgway, P F

2021 Volume 108, Issue 7, Page(s) e250

MeSH term(s)	COVID-19 ; Cross Infection ; Humans ; Postoperative Complications ; SARS-CoV-2
Language	English
Publishing date	2021-04-26
Publishing country	England
Document type	Letter ; Comment
ZDB-ID	2985-3
ISSN	1365-2168 ; 0263-1202 ; 0007-1323 ; 1355-7688
ISSN (online)	1365-2168
ISSN	0263-1202 ; 0007-1323 ; 1355-7688
DOI	10.1093/bjs/znab083
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Article ; Online: Surgical management of a giant hepatic cyst with suspicious radiological features.

Clancy, C / Gibbons, C / Ridgway, P F

Annals of the Royal College of Surgeons of England

2018 Volume 101, Issue 3, Page(s) e76–e78

Abstract: Cysts in the liver have a wide variety of aetiologies. Important features of malignancy based on various imaging techniques must be considered prior to any intervention. Perioperative decision making in complex or difficult cysts is key to appropriate ... ...

Abstract	Cysts in the liver have a wide variety of aetiologies. Important features of malignancy based on various imaging techniques must be considered prior to any intervention. Perioperative decision making in complex or difficult cysts is key to appropriate patient management. A 66-year-old woman was referred to the outpatient department with a one-year history of intermittent, sharp, right upper quadrant pain, radiating to her back. Computed tomography and magnetic resonance imaging showed a large cyst in the right and left lobes of the liver with portal inflow closely related. Features such as wall thickening suspicious for cystadenocarcinoma were present. An open resection was planned but, based on perioperative findings, the cyst had features making it unsafe to perform excision. De-roofing, carefully controlled drainage and assessment of the internal aspect of the cyst were performed, which revealed an extremely close relationship to portal inflow. This case describes the decision-making process when faced with complex indeterminate pathology of the liver and proximity of critical structures.
MeSH term(s)	Abdominal Pain/diagnostic imaging ; Abdominal Pain/etiology ; Abdominal Pain/surgery ; Aged ; Cysts/complications ; Cysts/diagnostic imaging ; Cysts/pathology ; Cysts/surgery ; Drainage/methods ; Female ; Humans ; Liver/diagnostic imaging ; Liver/surgery ; Liver Diseases/complications ; Liver Diseases/diagnostic imaging ; Liver Diseases/pathology ; Liver Diseases/surgery ; Magnetic Resonance Imaging ; Tomography, X-Ray Computed ; Ultrasonography
Language	English
Publishing date	2018-11-28
Publishing country	England
Document type	Case Reports ; Journal Article
ZDB-ID	80044-2
ISSN	1478-7083 ; 0035-8843
ISSN (online)	1478-7083
ISSN	0035-8843
DOI	10.1308/rcsann.2018.0206
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Article ; Online: Nosocomial SARS-CoV-2 transmission in postoperative infection and mortality: analysis of 14 798 procedures.

Elliott, J A / Kenyon, R / Kelliher, G / Gillis, A E / Tierney, S / Ridgway, P F

The British journal of surgery

2020 Volume 107, Issue 13, Page(s) 1708–1712

Abstract: This study used a national administrative database to estimate perioperative SARS-CoV-2 infection risk, and associated mortality, relative to nosocomial transmission rates. The impact of nosocomial transmission was greatest after major emergency surgery, ...

Abstract	This study used a national administrative database to estimate perioperative SARS-CoV-2 infection risk, and associated mortality, relative to nosocomial transmission rates. The impact of nosocomial transmission was greatest after major emergency surgery, whereas laparoscopic surgery may be protective owing to reduced duration of hospital stay. Procedure-specific risk estimates are provided to facilitate surgical decision-making and informed consent. Estimated risks.
MeSH term(s)	COVID-19 ; Cause of Death ; Coronavirus Infections/epidemiology ; Coronavirus Infections/prevention & control ; Cross Infection/prevention & control ; Cross Infection/transmission ; Databases, Factual ; Elective Surgical Procedures/adverse effects ; Elective Surgical Procedures/methods ; Emergencies ; Female ; Humans ; Incidence ; Infection Control/methods ; Length of Stay/statistics & numerical data ; Male ; Pandemics/prevention & control ; Pandemics/statistics & numerical data ; Pneumonia, Viral/epidemiology ; Pneumonia, Viral/prevention & control ; Prognosis ; Risk Assessment ; Surgical Wound Infection/mortality ; Surgical Wound Infection/prevention & control ; Survival Analysis
Keywords	covid19
Language	English
Publishing date	2020-10-08
Publishing country	England
Document type	Journal Article
ZDB-ID	2985-3
ISSN	1365-2168 ; 0263-1202 ; 0007-1323 ; 1355-7688
ISSN (online)	1365-2168
ISSN	0263-1202 ; 0007-1323 ; 1355-7688
DOI	10.1002/bjs.12053
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Article ; Online: Prognosis and management of adult wild type gastrointestinal stromal tumours (GISTs): A pooled analysis and review of literature.

Bhatt, N R / Collins, D / Crotty, P / Ridgway, P F

Surgical oncology

2016 Volume 25, Issue 3, Page(s) 152–157

Abstract: A pooled review was performed to determine survival in adult WT GIST (Wild Type GastroIntestinal Stromal Tumours) and compare the same with pediatric WT GISTs. Electronic databases were searched using the terms "Wild type" AND "GIST". Eighty-two adult ... ...

Abstract	A pooled review was performed to determine survival in adult WT GIST (Wild Type GastroIntestinal Stromal Tumours) and compare the same with pediatric WT GISTs. Electronic databases were searched using the terms "Wild type" AND "GIST". Eighty-two adult patients from 14 studies were included in the pooled analysis. Cumulative survival was greater than 50% in both age groups, hence medial survival could not be computed. Mean survival in adults was 15.7 years ± 0.78 and in children was 18.8 years ± 1.3 (p = 0.241). Median disease free survival in adults was 10 years while 5-year overall survival was 88%. There was no statistically significant difference in the survival between the two groups (p = 0.241). Overall survival in adults with WT GISTs is favourable compared to other adult GIST subtypes likely reflects a common molecular pathway similar to pediatric GIST.
MeSH term(s)	Adolescent ; Adult ; Aged ; Aged, 80 and over ; Combined Modality Therapy ; Disease Management ; Female ; Gastrointestinal Neoplasms/pathology ; Gastrointestinal Neoplasms/therapy ; Gastrointestinal Stromal Tumors/pathology ; Gastrointestinal Stromal Tumors/therapy ; Humans ; Male ; Middle Aged ; Neoplasm Staging ; Prognosis ; Survival Rate ; Young Adult
Language	English
Publishing date	2016-09
Publishing country	Netherlands
Document type	Journal Article ; Review
ZDB-ID	1107810-8
ISSN	1879-3320 ; 0960-7404
ISSN (online)	1879-3320
ISSN	0960-7404
DOI	10.1016/j.suronc.2016.05.003
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Article: Nosocomial SARS-CoV-2 transmission in postoperative infection and mortality: analysis of 14 798 procedures

Elliott, J A / Kenyon, R / Kelliher, G / Gillis, A E / Tierney, S / Ridgway, P F

Br J Surg

Abstract	This study used a national administrative database to estimate perioperative SARS-CoV-2 infection risk, and associated mortality, relative to nosocomial transmission rates. The impact of nosocomial transmission was greatest after major emergency surgery, whereas laparoscopic surgery may be protective owing to reduced duration of hospital stay. Procedure-specific risk estimates are provided to facilitate surgical decision-making and informed consent. Estimated risks.
Keywords	covid19
Publisher	WHO
Document type	Article
Note	WHO #Covidence: #838190
Database	COVID19

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Article: Bare Below the Elbows: A comparative study of a tertiary and district general hospital.

Collins, A M / Connaughton, J / Ridgway, P F

Irish medical journal

2013 Volume 106, Issue 9, Page(s) 272–275

Abstract: A 'Bare Below the Elbows' (BBTE) dress code policy has been introduced by the majority of NHS trusts in the UK. The aim of this Irish study was to evaluate the impact of an educational intervention on perception of medical attire. The study was carried ... ...

Abstract	A 'Bare Below the Elbows' (BBTE) dress code policy has been introduced by the majority of NHS trusts in the UK. The aim of this Irish study was to evaluate the impact of an educational intervention on perception of medical attire. The study was carried out in two centres: a tertiary referral centre (Beaumont Hospital) and a district hospital (MRH, Portlaoise). Two questionnaires, incorporating photographic evaluation of appropriate attire for consultants and junior doctors, were completed pre and post BBTE education. One hundred and five patients participated. Analysis pre BBTE education indicated patients considered formal attire and white coats most appropriate for consultants and junior doctors respectively. Post-intervention analysis revealed a significant reduction in the popularity of both (p <0.001), with scrubs and smart casual attire gaining significant support in both cohorts (p <0.001). Our findings demonstrated that patient opinion on medical attire is malleable. The support of such a policy may be achieved if patients are informed that the aim is to reduce the spread of healthcare-associated infections.
MeSH term(s)	Clothing ; Cross-Sectional Studies ; Elbow ; Female ; Hospitals, General ; Humans ; Ireland ; Male ; Organizational Policy ; Physician-Patient Relations ; Physicians ; Surveys and Questionnaires ; Tertiary Healthcare
Language	English
Publishing date	2013-10
Publishing country	Ireland
Document type	Comparative Study ; Journal Article
ZDB-ID	193134-9
ISSN	0332-3102 ; 0021-129X
ISSN	0332-3102 ; 0021-129X
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Article ; Online: When should surgeons retire?

Bhatt, N R / Morris, M / O'Neil, A / Gillis, A / Ridgway, P F

The British journal of surgery

2016 Volume 103, Issue 1, Page(s) 35–42

Abstract: Background: Retirement policies for surgeons differ worldwide. A range of normal human functional abilities decline as part of the ageing process. As life expectancy and their population increases, the performance ability of ageing surgeons is now a ... ...

Abstract	Background: Retirement policies for surgeons differ worldwide. A range of normal human functional abilities decline as part of the ageing process. As life expectancy and their population increases, the performance ability of ageing surgeons is now a growing concern in relation to patient care. The aim was to explore the effects of ageing on surgeons' performance, and to identify current practical methods for transitioning surgeons out of practice at the appropriate time and age. Methods: A narrative review was performed in MEDLINE using the terms 'ageing' and 'surgeon'. Additional articles were hand-picked. Modified PRISMA guidelines informed the selection of articles for inclusion. Articles were included only if they explored age-related changes in brain biology and the effect of ageing on surgeons' performance. Results: The literature search yielded 1811 articles; of these, 36 articles were included in the final review. Wide variation in ability was observed across ageing individuals (both surgical and lay). Considerable variation in the effects of the surgeon's age on patient mortality and postoperative complications was noted. A lack of neuroimaging research exploring the ageing of surgeons' brains specifically, and lack of real markers available for measuring surgical performance, both hinder further investigation. Standard retirement policies in accordance with age-related surgical ability are lacking in most countries around the world. Conclusion: Competence should be assessed at an individual level, focusing on functional ability over chronological age; this should inform retirement policies for surgeons.
MeSH term(s)	Aging ; Clinical Competence ; Humans ; Retirement/psychology ; Retirement/standards ; Surgeons/psychology ; Surgeons/standards
Language	English
Publishing date	2016-01
Publishing country	England
Document type	Journal Article ; Review
ZDB-ID	2985-3
ISSN	1365-2168 ; 0263-1202 ; 0007-1323 ; 1355-7688
ISSN (online)	1365-2168
ISSN	0263-1202 ; 0007-1323 ; 1355-7688
DOI	10.1002/bjs.9925
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Article ; Online: A novel value-based scoring system for endoscopic ultrasound-guided drainage of pancreatic fluid collections: a single-centre comparative study of plastic and lumen-apposing metal stents (NOVA study).

Parihar, Vikrant / Basir, Yasir / Nally, Deirdre / Mellotte, Gregory / Manoharan, Thilagraj / Walker, Caroline / Ridgway, P F / Conlon, K C / Breslin, Niall / Harewood, Gavin C / Ryan, Barbara M

European journal of gastroenterology & hepatology

2020 Volume 32, Issue 2, Page(s) 157–162

Abstract: Objective: Healthcare resources are finite. Value in healthcare can be defined as patient health outcomes achieved per monetary unit spent. Attempts have been made to quantify the value of luminal endoscopy, but there is little in the medical literature ...

Abstract	Objective: Healthcare resources are finite. Value in healthcare can be defined as patient health outcomes achieved per monetary unit spent. Attempts have been made to quantify the value of luminal endoscopy, but there is little in the medical literature describing the value of the complex therapeutic endoscopic activity. This study aimed to characterise the value of endoscopic ultrasound (EUS)-guided drainage of pancreatic fluid collections (PFCs) with either plastic or lumen-apposing metal stents (LAMSs). Methods: This is a single-centre, retrospective-prospective comparative study of 39 patients, who underwent EUS-guided PFC drainage between 2009 and 2018. Procedure value was calculated using the formula Q/(T/C), where Q is the quality of procedure adjusted for complications, T procedure duration and C is the complexity adjustment. Quality and complexity were estimated on a 1-4 Likert scale based on the American Society for Gastrointestinal Endoscopy criteria. Time (in minutes) was recorded from the patient entering and leaving the procedure room. Endoscopy time calculated from procedure time was considered a surrogate marker of cost as individual components of procedure cost were not itemized. Results: Of 39 identified patients who underwent EUS-guided PFC drainage, 11 received double pigtail plastic stents (DPPSs) and 28 received LAMSs. The two groups were comparable in age, gender and aetiology. Nearly 40% of the LAMS interventions were considered high value but only 11% of the plastic stent interventions achieved the same. The difference predominantly was due to a higher rate of complications and longer procedure time. Conclusion: In this single-centre study, EUS-guided PFC drainage using LAMS was found to be a higher value procedure compared to the use of DPPS.
MeSH term(s)	Drainage ; Endoscopy, Gastrointestinal ; Endosonography ; Humans ; Plastics ; Prospective Studies ; Retrospective Studies ; Stents ; Ultrasonography, Interventional
Chemical Substances	Plastics
Language	English
Publishing date	2020-08-17
Publishing country	England
Document type	Journal Article
ZDB-ID	1034239-4
ISSN	1473-5687 ; 0954-691X
ISSN (online)	1473-5687
ISSN	0954-691X
DOI	10.1097/MEG.0000000000001891
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Article ; Online: Trends in the Use of Laparoscopic Versus Open Paediatric Appendicectomy: A Regional 12-Year Study and a National Survey.

Bhatt, N R / Dunne, E / Faraz, M / Gillis, A E / Conlon, K C / Paran, S / Ridgway, P F

World journal of surgery

2017 Volume 42, Issue 11, Page(s) 3792–3802

Abstract: Background: In adult patients, it is generally accepted that laparoscopic appendicectomy (LA) is the predominant operative pathway in treating acute appendicitis. The case for a similar pathway utilising LA in children is less clear. We investigate ... ...

Abstract	Background: In adult patients, it is generally accepted that laparoscopic appendicectomy (LA) is the predominant operative pathway in treating acute appendicitis. The case for a similar pathway utilising LA in children is less clear. We investigate usage, trends and complications after LA in children in a single co-located adult/paediatric centre with contemporaneous adults as controls. Methods: A retrospective case-control study was conducted over 12 years including patients who underwent appendicectomy, and the paediatric series (<16 years) was divided into age-groups-based quartiles. An anonymous questionnaire-based national survey was circulated among general and paediatric surgeons. Results: Of the 5784 appendicectomy patients, 2960 were children. LA rate in paediatric appendicitis was 65%. Yearly trends in LA reached a steady state in both groups after 2010 (Δ 0-1%/year). Rates of LA and LA IAA (respectively) differed significantly between age groups: 60, 3% (0-9 years); 65, 1% (10-13 years); 71, 2% (14-16 years) and 93, 3% (>16 years) (p = 0.001, 0.02). The national survey showed respondents believed LA was not superior to OA in paediatric patients except in terms of cosmesis. There was strong support in the use of LA in older children and children >40 kg. Conclusion: The use of LA in paediatric appendicectomies in the study region is similar to international rates, but not increasing over time. Irish surgeons still favour OA in younger children and prefer a case-by-case approach rather LA being the preferred pathway. This is despite the regional and international evidence showing favourable outcomes with LA in children.
MeSH term(s)	Abdominal Abscess/epidemiology ; Acute Disease ; Adolescent ; Adult ; Aged ; Aged, 80 and over ; Appendectomy/adverse effects ; Appendectomy/trends ; Appendicitis/surgery ; Child ; Child, Preschool ; Female ; Humans ; Infant ; Infant, Newborn ; Laparoscopy/trends ; Length of Stay ; Male ; Middle Aged ; Retrospective Studies ; Young Adult
Language	English
Publishing date	2017-10-31
Publishing country	United States
Document type	Comparative Study ; Journal Article
ZDB-ID	224043-9
ISSN	1432-2323 ; 0364-2313
ISSN (online)	1432-2323
ISSN	0364-2313
DOI	10.1007/s00268-018-4688-5
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Article: Postoperative exercise training is associated with reduced respiratory infection rates and early discharge: A case-control study.

Bhatt, N R / Sheridan, G / Connolly, M / Kelly, S / Gillis, A / Conlon, K C / Lane, S / Shanahan, E / Ridgway, P F

The surgeon : journal of the Royal Colleges of Surgeons of Edinburgh and Ireland

2017 Volume 15, Issue 3, Page(s) 139–146

Abstract: Introduction: Pulmonary complications are a significant cause of morbidity, mortality and increased hospital stay following complex abdominal surgery. We investigated whether postoperative early aerobic activity with a pedal exerciser reduced ... ...

Abstract	Introduction: Pulmonary complications are a significant cause of morbidity, mortality and increased hospital stay following complex abdominal surgery. We investigated whether postoperative early aerobic activity with a pedal exerciser reduced respiratory morbidity and length of stay and improved pulmonary function. Methods: A prospective case-control study on 30 cases and 30 case matched controls aged 18 years or more who underwent major surgery was conducted. Controls were case-mix matched prospectively from a similar general surgical service not utilising postoperative exercising. Thirty consecutive cases were started on a twice-daily aerobic exercise program with pedal exerciser post-operatively day 2 or from when sitting independently. Primary outcome measures were respiratory tract infection (RTI), deep vein thrombosis (DVT) or pulmonary embolus (PE). Secondary outcome measure was subjective breathlessness and Length of Stay (LOS) postoperatively. Results: The rate of RTI was only 16.6% in the exercise group and 43.3% in the control group (P = 0.024). None of the cases or controls suffered from a DVT or PE. Median postoperative length of stay in the control group was 11 ± 7.5 days whereas in the cases it was 8.5 ± 5.00 days (P = 0.049). The Borg subjective breathlessness score in the cases group showed a decline in the subjective breathlessness on postoperative day 4 (P = 0.002). Conclusions: Early aerobic activity with a pedal exerciser halves the rate of postoperative RTI and postoperative hospital stay after complex abdominal surgery. Subjective breathlessness was also reduced with the use of pedal exerciser, signifying potential to improve exercise endurance in the postoperative patient.
Language	English
Publishing date	2017-06
Publishing country	Scotland
Document type	Journal Article
ZDB-ID	2102927-1
ISSN	1479-666X
ISSN	1479-666X
DOI	10.1016/j.surge.2015.07.003
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