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Article ; Online: Surgical treatment of Boerhaave syndrome in the past, present and future: updated results of a specialised surgical unit.

Triantafyllou, T / Lamb, P / Skipworth, R / Couper, G / Deans, C

Annals of the Royal College of Surgeons of England

2024

Abstract: Introduction: Boerhaave syndrome is a rare clinical entity associated with high rates of morbidity and mortality. Early recognition of the symptoms, and identification of the site and extension of the injury are key in improving the prognosis.: ... ...

Abstract	Introduction: Boerhaave syndrome is a rare clinical entity associated with high rates of morbidity and mortality. Early recognition of the symptoms, and identification of the site and extension of the injury are key in improving the prognosis. Methods: This study presents data on the mortality, morbidity and length of hospital stay in patients diagnosed with Boerhaave syndrome. The data were retrieved from a prospectively collected database in a single surgical unit between 2012 and 2022. The study makes a comparison with the surgical outcomes of the previous decade. Results: Some 33 patients were diagnosed with Boerhaave syndrome and were treated surgically between 2012 and 2022 in a specialist upper gastrointestinal surgical unit. All patients underwent standard surgical repair (in-theatre diagnostic endoscopy, T-tube placement through thoracotomy and feeding jejunostomy through laparotomy). The mean size of the defects in the oesophageal lumen was 3.3cm. Delayed presentation was noted for 13 patients (39%); 8 patients (24%) died in hospital, and 19 patients (58%) developed postoperative complications. Mortality was similar to the rate recorded for the 20 patients from the previous decade (24% vs 20%, respectively). The mean length of hospital stay was 41 days, and was comparable to the 35.7 days reported between 1997 and 2011. Conclusions: Early and aggressive management of spontaneous oesophageal rupture ameliorates the postoperative recovery and prognosis. The surgical results of our unit were found comparable to the previous decade in the population of patients who were treated surgically.
Language	English
Publishing date	2024-04-02
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.2024.0020
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Article ; Online: Protocol for a scoping review on 'surgical sabermetrics:' technology-enhanced measurement of operative non-technical skills.

Howie, Emma / Wigmore, Stephen J / Daglius Dias, Roger / Skipworth, Richard / Yule, Steven

BMJ open

2023 Volume 13, Issue 2, Page(s) e064196

Abstract: Introduction: Surgeons need high fidelity, high quality, objective, non-judgemental and quantitative feedback to measure their performance in order to optimise their performance and improve patient safety. This can be provided through surgical ... ...

Abstract	Introduction: Surgeons need high fidelity, high quality, objective, non-judgemental and quantitative feedback to measure their performance in order to optimise their performance and improve patient safety. This can be provided through surgical sabermetrics, defined as 'advanced analytics of digitally recorded surgical training and operative procedures to enhance insight, support professional development and optimise clinical and safety outcomes'. The aim of this scoping review is to investigate the assessment of surgeon's non-technical skills using sabermetrics principles, focusing on digital, automated measurements that do not require a human observer. Methods and analysis: To investigate the current methods of digital, automated measurements of surgeons' non-technical skills, a systematic scoping review will be conducted following Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews guidelines, using databases from medicine and other fields. Covidence software is used for screening of potential studies. A data extraction tool will be developed specifically for this study to evaluate the methods of measurement. Quality assurance will be assessed using Quality Assessment Tool for Diverse Designs. Multiple reviewers will be responsible for screening of studies and data extraction. Ethics and dissemination: This is a review study, not using primary data, and therefore, ethical approval is not required. A range of methods will be employed for dissemination of the results of this study, including publication in journals and conference presentations.
MeSH term(s)	Humans ; Research Design ; Review Literature as Topic ; Surgeons
Language	English
Publishing date	2023-02-03
Publishing country	England
Document type	Journal Article
ZDB-ID	2599832-8
ISSN	2044-6055 ; 2044-6055
ISSN (online)	2044-6055
ISSN	2044-6055
DOI	10.1136/bmjopen-2022-064196
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Article ; Online: Optimising Outcomes in Non Small Cell Lung Cancer: Targeting Cancer Cachexia.

Phillips, Iain / Stares, Mark / Allan, Lindsay / Sayers, Judith / Skipworth, Richard / Laird, Barry

Frontiers in bioscience (Landmark edition)

2022 Volume 27, Issue 4, Page(s) 129

Abstract: Lung cancer is the commonest malignancy worldwide and the leading cause of cancer death. Half of patients with lung cancer present with advanced disease. The number of systemic therapies including immunotherapy and targeted treatment are rapidly ... ...

Abstract	Lung cancer is the commonest malignancy worldwide and the leading cause of cancer death. Half of patients with lung cancer present with advanced disease. The number of systemic therapies including immunotherapy and targeted treatment are rapidly increasing. Despite this, the outcomes for many patients with locally advanced and advanced lung cancer are poor, as many patients are too unwell for treatment. One of the reasons patients with Non-Small Cell Lung Cancer are not fit for treatment is cancer cachexia, which is common (upto 75% of patients) in this group. This metabolic syndrome presents clinically as weight loss (muscle +/- fat), decreased physical function (patients less active) and anorexia on a background of systemic inflammation. Currently there is not an optimal management pathway for these patients, however, there is emerging data that multi-modal intervention including nutritional support, physical training and pharmacological therapy may have a role in treating cachexia. This review discusses assessment and intervention in cancer cachexia.
MeSH term(s)	Cachexia/drug therapy ; Cachexia/therapy ; Carcinoma, Non-Small-Cell Lung/complications ; Carcinoma, Non-Small-Cell Lung/therapy ; Exercise ; Humans ; Immunotherapy ; Lung Neoplasms/complications ; Lung Neoplasms/therapy
Language	English
Publishing date	2022-04-18
Publishing country	Singapore
Document type	Journal Article ; Review
ZDB-ID	2704569-9
ISSN	2768-6698 ; 2768-6698
ISSN (online)	2768-6698
ISSN	2768-6698
DOI	10.31083/j.fbl2704129
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Article ; Online: The Implementation of Minimally Invasive Surgery in the Treatment of Esophageal Cancer: A Step Toward Better Outcomes?

Triantafyllou, Tania / van der Sluis, Pieter / Skipworth, Richard / Wijnhoven, Bas P L

Oncology and therapy

2022 Volume 10, Issue 2, Page(s) 337–349

Abstract: Esophagectomy is considered the cornerstone of the radical treatment of esophageal cancer. In the past decades, minimally invasive techniques including robot-assisted approaches have become popular. The aim of minimally invasive surgery is to reduce the ... ...

Abstract	Esophagectomy is considered the cornerstone of the radical treatment of esophageal cancer. In the past decades, minimally invasive techniques including robot-assisted approaches have become popular. The aim of minimally invasive surgery is to reduce the surgical trauma, resulting in faster recovery, reduction in complications, and better quality of life after surgery. Secondly, a more precise dissection may lead to better oncological outcomes. As such, minimally invasive esophagectomy is now seen by many as the standard surgical approach. However, evidence supporting this viewpoint is limited. This narrative review summarizes recent prospectively designed studies on minimally invasive esophagectomy.
Language	English
Publishing date	2022-08-10
Publishing country	New Zealand
Document type	Journal Article ; Review
ZDB-ID	2848647-X
ISSN	2366-1089 ; 2366-1070
ISSN (online)	2366-1089
ISSN	2366-1070
DOI	10.1007/s40487-022-00206-3
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Article: Cannabinoids in the treatment of cancer anorexia and cachexia: Where have we been, where are we going?

Seymour-Jackson, Emily / Laird, Barry J A / Sayers, Judith / Fallon, Marie / Solheim, Tora S / Skipworth, Richard

Asia-Pacific journal of oncology nursing

2023 Volume 10, Issue Suppl 1, Page(s) 100292

Abstract: Cachexia-anorexia cancer syndrome remains an unmet clinical need with a dearth of treatment and no standard of care. Acting through the endocannabinoid system, cannabinoids are one potential cancer cachexia treatment. Herein, the potential mechanisms for ...

Abstract	Cachexia-anorexia cancer syndrome remains an unmet clinical need with a dearth of treatment and no standard of care. Acting through the endocannabinoid system, cannabinoids are one potential cancer cachexia treatment. Herein, the potential mechanisms for cannabinoids for cancer cachexia are discussed as are previous and ongoing clinical trials.
Language	English
Publishing date	2023-08-07
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	2984639-0
ISSN	2349-6673 ; 2347-5625
ISSN (online)	2349-6673
ISSN	2347-5625
DOI	10.1016/j.apjon.2023.100292
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Article ; Online: Validation of the emergency surgery score (ESS) in a UK patient population and comparison with NELA scoring: a retrospective multicentre cohort study.

Clinch, D / Dorken-Gallastegi, A / Argandykov, D / Gebran, A / Proano Zamudio, J A / Wong, C S / Clinch, N / Haddow, L / Simpson, K / Imbert, E / Skipworth, Rje / Moug, S J / Kaafarani, Hma / Damaskos, D

Annals of the Royal College of Surgeons of England

2024

Abstract: Introduction: Accurate risk scoring in emergency general surgery (EGS) is vital for consent and resource allocation. The emergency surgery score (ESS) has been validated as a reliable preoperative predictor of postoperative outcomes in EGS but has been ... ...

Abstract	Introduction: Accurate risk scoring in emergency general surgery (EGS) is vital for consent and resource allocation. The emergency surgery score (ESS) has been validated as a reliable preoperative predictor of postoperative outcomes in EGS but has been studied only in the US population. Our primary aim was to perform an external validation study of the ESS in a UK population. Our secondary aim was to compare the accuracy of ESS and National Emergency Laparotomy Audit (NELA) scores. Methods: We conducted an observational cohort study of adult patients undergoing emergency laparotomy over three years in two UK centres. ESS was calculated retrospectively. NELA scores and all other variables were obtained from the prospectively collected Emergency Laparotomy and Laparoscopic Scottish Audit (ELLSA) database. The primary and secondary outcomes were 30-day mortality and postoperative intensive care unit (ICU) admission, respectively. Results: A total of 609 patients were included. Median age was 65 years, 52.7% were female, the overall mortality was 9.9% and 23.8% were admitted to ICU. Both ESS and NELA were equally accurate in predicting 30-day mortality (c-statistic=0.78 (95% confidence interval (CI), 0.71-0.85) for ESS and c-statistic=0.83 (95% CI, 0.77-0.88) for NELA, Conclusions: In the UK population, ESS and NELA both predict 30-day mortality and ICU admission with no statistically significant difference but with higher c-statistics for NELA score. Both scores have certain advantages, with ESS being validated for a wider range of outcomes.
Language	English
Publishing date	2024-03-13
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/rcsann.2023.0105
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Article: Intragastric laparoscopy for oesophageal eroded mesh removal: An approach to avoid resection.

Gillespie, Carla / Ng, Ada / Skipworth, Richard / Leibman, Steven / Smith, Garett

Journal of minimal access surgery

2020 Volume 16, Issue 4, Page(s) 426–428

Abstract: The augmentation of hiatal repair for large hiatus hernia with mesh is controversial. There is some evidence that recurrence rates are less with mesh repair; however, there is a risk of mesh erosion. Complicated erosion may require complex revisional ... ...

Abstract	The augmentation of hiatal repair for large hiatus hernia with mesh is controversial. There is some evidence that recurrence rates are less with mesh repair; however, there is a risk of mesh erosion. Complicated erosion may require complex revisional surgery and oesophagogastric resection. We present a novel approach to the treatment of oesophageal mesh erosion, by utilising a combined approach of endoscopy and intragastric laparoscopy. The symptomatic relief from this procedure may obviate the need for foregut resection in some patients.
Language	English
Publishing date	2020-09-25
Publishing country	India
Document type	Case Reports
ZDB-ID	2186884-0
ISSN	1998-3921 ; 0972-9941
ISSN (online)	1998-3921
ISSN	0972-9941
DOI	10.4103/jmas.JMAS_286_19
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Article ; Online: A Modified AUGIS Delphi Process to Establish Future Research Priorities in Benign Upper Gastrointestinal Surgery.

Wilson, Michael S J / Vaughan-Shaw, P / Boyle, C / Yong, G L / Oglesby, S / Skipworth, R / Lamb, P / Griffiths, E A T / Attwood, S E A

World journal of surgery

2019 Volume 44, Issue 4, Page(s) 1216–1222

Abstract: Background: The aim of our study was to use a modified Delphi process to determine the research priorities amongst benign upper gastrointestinal (UGI) surgeons in the United Kingdom.: Methods: Delphi methodology may be utilised to develop consensus ... ...

Abstract	Background: The aim of our study was to use a modified Delphi process to determine the research priorities amongst benign upper gastrointestinal (UGI) surgeons in the United Kingdom. Methods: Delphi methodology may be utilised to develop consensus opinion amongst a group of experts. Members of the Association of Upper Gastrointestinal Surgeons of Great Britain and Ireland were invited to submit individual research questions via an online survey (phase I). Two rounds of prioritisation by multidisciplinary expert healthcare professionals (phase II and III) were completed to determine a final list of high-priority research questions. Results: Four hundred and twenty-seven questions were submitted in phase I, and 51 with a benign UGI focus were taken forward for prioritisation in phase II. Twenty-eight questions were ranked in phase III. A final list of 11 high-priority questions had an emphasis on acute pancreatitis, Barrett's oesophagus and benign biliary disease. Conclusion: A modified Delphi process has produced a list of 11 high-priority research questions in benign UGI surgery. Future studies and awards from funding bodies should reflect this consensus list of prioritised questions in the interest of improving patient care and encouraging collaborative research.
MeSH term(s)	Acute Disease ; Barrett Esophagus/surgery ; Biliary Tract Diseases/surgery ; Delphi Technique ; Digestive System Surgical Procedures/methods ; Humans ; Pancreatitis/surgery ; Research ; Upper Gastrointestinal Tract/surgery
Language	English
Publishing date	2019-12-02
Publishing country	United States
Document type	Journal Article
ZDB-ID	224043-9
ISSN	1432-2323 ; 0364-2313
ISSN (online)	1432-2323
ISSN	0364-2313
DOI	10.1007/s00268-019-05308-0
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Article: Albumin versus balanced crystalloid for resuscitation in the treatment of sepsis: A protocol for a randomised controlled feasibility study, "ABC-Sepsis".

Cafferkey, John / Ferguson, Andrew / Grahamslaw, Julia / Oatey, Katherine / Norrie, John / Lone, Nazir / Walsh, Timothy / Horner, Daniel / Appelboam, Andy / Hall, Peter / Skipworth, Richard / Bell, Derek / Rooney, Kevin / Shankar-Hari, Manu / Corfield, Alasdair / Gray, Alasdair

Journal of the Intensive Care Society

2022 Volume 24, Issue 1, Page(s) 78–84

Abstract: Background: Patients presenting with suspected sepsis to secondary care often require fluid resuscitation to correct hypovolaemia and/or septic shock. Existing evidence signals, but does not demonstrate, a benefit for regimes including albumin over ... ...

Abstract	Background: Patients presenting with suspected sepsis to secondary care often require fluid resuscitation to correct hypovolaemia and/or septic shock. Existing evidence signals, but does not demonstrate, a benefit for regimes including albumin over balanced crystalloid alone. However, interventions may be started too late, missing a critical resuscitation window. Methods: ABC Sepsis is a currently recruiting randomised controlled feasibility trial comparing 5% human albumin solution (HAS) with balanced crystalloid for fluid resuscitation in patients with suspected sepsis. This multicentre trial is recruiting adult patients within 12 hours of presentation to secondary care with suspected community acquired sepsis, with a National Early Warning Score ≥5, who require intravenous fluid resuscitation. Participants are randomised to 5% HAS or balanced crystalloid as the sole resuscitation fluid for the first 6 hours. Objectives: Primary objectives are feasibility of recruitment to the study and 30-day mortality between groups. Secondary objectives include in-hospital and 90-day mortality, adherence to trial protocol, quality of life measurement and secondary care costs. Discussion: This trial aims to determine the feasibility of conducting a trial to address the current uncertainty around optimal fluid resuscitation of patients with suspected sepsis. Understanding the feasibility of delivering a definitive study will be dependent on how the study team are able to negotiate clinician choice, Emergency Department pressures and participant acceptability, as well as whether any clinical signal of benefit is detected.
Language	English
Publishing date	2022-05-30
Publishing country	England
Document type	Journal Article
ZDB-ID	2701626-2
ISSN	1751-1437 ; 1751-1437
ISSN (online)	1751-1437
ISSN	1751-1437
DOI	10.1177/17511437221103692
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Article ; Online: A decade of the Oesophageal Cancer Clinical and Molecular Stratification Consortium.

Peters, C J / Ang, Y / Ciccarelli, F D / Coles, H / Coleman, H G / Contino, G / Crosby, T / Devonshire, G / Eldridge, M / Freeman, A / Grehan, N / McCord, M / Nutzinger, B / Zamani, S / Parsons, S L / Petty, R / Sharrocks, A D / Skipworth, R J E / Smyth, E C /

Soomro, I / Underwood, T J / Fitzgerald, R C

Nature medicine

2023 Volume 30, Issue 1, Page(s) 14–16

MeSH term(s)	Humans ; Esophageal Neoplasms/genetics ; Adenocarcinoma
Language	English
Publishing date	2023-12-19
Publishing country	United States
Document type	Letter
ZDB-ID	1220066-9
ISSN	1546-170X ; 1078-8956
ISSN (online)	1546-170X
ISSN	1078-8956
DOI	10.1038/s41591-023-02676-y
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Zs.A 4212: Show issues			Location: Je nach Verfügbarkeit (siehe Angabe bei Bestand) bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular Jg. 1995 - 2021: Lesesall (2.OG) ab Jg. 2022: Lesesaal (EG)
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