Publications
192 results found
Pucher P, Sodergren MH, Alkhusheh M, et al., 2013, The Effects of Natural Orifice Translumenal Endoscopic Surgery (NOTES) on Cardiorespiratory Physiology: A Systematic Review, SURGICAL INNOVATION, Vol: 20, Pages: 183-189, ISSN: 1553-3506
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- Citations: 3
Halligan S, Wooldrage K, Dadswell E, et al., 2013, Computed tomographic colonography versus barium enema for diagnosis of colorectal cancer or large polyps in symptomatic patients (SIGGAR): a multicentre randomised trial., Lancet, Vol: 381, Pages: 1185-1193
BACKGROUND: Barium enema (BE) is widely available for diagnosis of colorectal cancer despite concerns about its accuracy and acceptability. Computed tomographic colonography (CTC) might be a more sensitive and acceptable alternative. We aimed to compare CTC and BE for diagnosis of colorectal cancer or large polyps in symptomatic patients in clinical practice.METHODS: This pragmatic multicentre randomised trial recruited patients with symptoms suggestive of colorectal cancer from 21 UK hospitals. Eligible patients were aged 55 years or older and regarded by their referring clinician as suitable for radiological investigation of the colon. Patients were randomly assigned (2:1) to BE or CTC by computer-generated random numbers, in blocks of six, stratified by trial centre and sex. We analysed the primary outcome-diagnosis of colorectal cancer or large (≥10 mm) polyps-by intention to treat. The trial is an International Standard Randomised Controlled Trial, number 95152621.FINDINGS: 3838 patients were randomly assigned to receive either BE (n=2553) or CTC (n=1285). 34 patients withdrew consent, leaving for analysis 2527 assigned to BE and 1277 assigned to CTC. The detection rate of colorectal cancer or large polyps was significantly higher in patients assigned to CTC than in those assigned to BE (93 [7·3%] of 1277 vs 141 [5·6%] of 2527, relative risk 1·31, 95% CI 1·01-1·68; p=0·0390). CTC missed three of 45 colorectal cancers and BE missed 12 of 85. The rate of additional colonic investigation was higher after CTC than after BE (283 [23·5%] of 1206 CTC patients had additional investigation vs 422 [18·3%] of 2300 BE patients; p=0·0003), due mainly to a higher polyp detection rate. Serious adverse events were rare.INTERPRETATION: CTC is a more sensitive test than BE. Our results suggest that CTC should be the preferred radiological test for patients with symptoms suggestive of colorectal cancer.FUNDING: NIH
Atkin W, Dadswell E, Wooldrage K, et al., 2013, Computed tomographic colonography versus colonoscopy for investigation of patients with symptoms suggestive of colorectal cancer (SIGGAR): a multicentre randomised trial., Lancet
BACKGROUND: Colonoscopy is the gold-standard test for investigation of symptoms suggestive of colorectal cancer; computed tomographic colonography (CTC) is an alternative, less invasive test. However, additional investigation after CTC is needed to confirm suspected colonic lesions, and this is an important factor in establishing the feasibility of CTC as an alternative to colonoscopy. We aimed to compare rates of additional colonic investigation after CTC or colonoscopy for detection of colorectal cancer or large (≥10 mm) polyps in symptomatic patients in clinical practice.METHODS: This pragmatic multicentre randomised trial recruited patients with symptoms suggestive of colorectal cancer from 21 UK hospitals. Eligible patients were aged 55 years or older and regarded by their referring clinician as suitable for colonoscopy. Patients were randomly assigned (2:1) to colonoscopy or CTC by computer-generated random numbers, in blocks of six, stratified by trial centre and sex. We analysed the primary outcome-the rate of additional colonic investigation-by intention to treat. The trial is an International Standard Randomised Controlled Trial, number 95152621.FINDINGS: 1610 patients were randomly assigned to receive either colonoscopy (n=1072) or CTC (n=538). 30 patients withdrew consent, leaving for analysis 1047 assigned to colonoscopy and 533 assigned to CTC. 160 (30·0%) patients in the CTC group had additional colonic investigation compared with 86 (8·2%) in the colonoscopy group (relative risk 3·65, 95% CI 2·87-4·65; p<0·0001). Almost half the referrals after CTC were for small (<10 mm) polyps or clinical uncertainty, with low predictive value for large polyps or cancer. Detection rates of colorectal cancer or large polyps in the trial cohort were 11% for both procedures. CTC missed 1 of 29 colorectal cancers and colonoscopy missed none (of 55). Serious adverse events were rare.INTERPRETATION: Guidelines are needed
Clark J, Orihuela-Espina F, Sodergren M, et al., 2013, A quantitative scale to define endoscopic torque control during natural orifice surgery, MINIMALLY INVASIVE THERAPY & ALLIED TECHNOLOGIES, Vol: 22, Pages: 17-25, ISSN: 1364-5706
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, 2013, Pathological site retargeting under tissue deformation using geometrical association and tracking., Pages: 67-74
Recent advances in microscopic detection techniques include fluorescence spectroscopy, fibred confocal microscopy and optical coherence tomography. These methods can be integrated with miniaturised probes to assist endoscopy, thus enabling diseases to be detected at an early and pre-invasive stage, forgoing the need for histopathological samples and off-line analysis. Since optical-based biopsy does not leave visible marks after sampling, it is important to track the biopsy sites to enable accurate retargeting and subsequent serial examination. In this paper, a novel approach is proposed for pathological site retargeting in gastroscopic examinations. The proposed method is based on affine deformation modelling with geometrical association combined with cascaded online learning and tracking. It provides online in vivo retargeting, and is able to track pathological sites in the presence of tissue deformation. It is also robust to partial occlusions and can be applied to a range of imaging probes including confocal laser endomicroscopy.
Nayagam S, Selvapatt N, Auguste JL, et al., 2012, QUALITY OF COLONOSCOPIC PROCEDURES AMONG INDEPENDENTLY PRACTISING GASTROENTEROLOGY TRAINEES IN A NW LONDON COHORT: ARE THEY REACHING NATIONAL STANDARDS?, GUT, Vol: 61, Pages: A59-A60, ISSN: 0017-5749
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- Citations: 1
Russo E, Hicks L, Hoare J, et al., 2012, COLONOSCOPY IN PATIENTS PRESENTING WITH MELAENA AND A NORMAL UPPER GASTROINTESTINAL ENDOSCOPY: A RETROSPECTIVE REVIEW FROM A SINGLE UK CENTRE, GUT, Vol: 61, Pages: A163-A163, ISSN: 0017-5749
Coomber RS, Sodergren MH, Clark J, et al., 2012, Natural orifice translumenal endoscopic surgery applications in clinical practice., World J Gastrointest Endosc, Vol: 4, Pages: 65-74
To review natural orifice translumenal endoscopic surgery (NOTES) applications in clinical practice and assess the evidence base for each application as reported in the literature. An electronic literature search was performed. Inclusion criteria were publications relating to NOTES applications in humans. For each type of operation the highest level of evidence available for clinical NOTES publications was evaluated. Morbidity and short-term operative outcomes were compared with gold standard published evidence where available. Finally, registered trials recruiting patients for NOTES applications were identified. Human NOTES publications with the highest level of evidence in each application are identified. There were no RCTs in the literature to date. The strongest evidence came in the form of large, multi-centre trials with 300-500 patients. The results are encouraging, comparable with gold standard techniques on morbidity and mortality. While short-term operative outcomes were also similar when compared to the gold standard techniques, other than improved cosmesis little else can definitely be concluded as a clear benefit of a NOTES procedure. The most common procedures are cholecystectomy, appendicectomy and peritoneoscopy mainly performed via transvaginal access. It is evident that morbidity appears to be higher when the transgastric route is used. The safety profile of hybrid NOTES transvaginal procedures is beginning to be confirmed as is evident from the large number of procedures presented in this review. A number of authors have presented work on pure NOTES procedures but the results are inconsistent and thus the vast majority of NOTES procedures worldwide are performed in a hybrid fashion with a variable amount of laparoscopy. This review of the clinical applications of NOTES summarises the growing evidence behind this surgical discipline and highlights NOTES procedures with an acceptable safety profile.
Sodergren MH, Orihuela-Espina F, Froghi F, et al., 2011, Value of orientation training in laparoscopic cholecystectomy, BRITISH JOURNAL OF SURGERY, Vol: 98, Pages: 1437-1445, ISSN: 0007-1323
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- Citations: 21
Sodergren M, Clark J, Beardsley J, et al., 2011, A novel flexible endoluminal stapling device for use in NOTES colotomy closure: a feasibility study using an ex vivo porcine model, SURGICAL ENDOSCOPY AND OTHER INTERVENTIONAL TECHNIQUES, Vol: 25, Pages: 3266-3272, ISSN: 0930-2794
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- Citations: 6
Sodergren MH, Orihuela-Espina F, Mountney P, et al., 2011, Orientation Strategies in Natural Orifice Translumenal Endoscopic Surgery, ANNALS OF SURGERY, Vol: 254, Pages: 257-266, ISSN: 0003-4932
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- Citations: 12
Walker DG, Williams HRT, Kane SP, et al., 2011, Differences in Inflammatory Bowel Disease Phenotype between South Asians and Northern Europeans Living in North West London, UK, AMERICAN JOURNAL OF GASTROENTEROLOGY, Vol: 106, Pages: 1281-1289, ISSN: 0002-9270
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- Citations: 51
Sodergren MH, Clark J, Karimyan V, et al., 2011, Natural orifice translumenal endoscopic surgery (NOTES) navigation performance: a pilot study comparing surgeons and gastroenterologists, EUROPEAN SURGERY-ACTA CHIRURGICA AUSTRIACA, Vol: 43, Pages: 153-157, ISSN: 1682-8631
Powell N, Knight H, Dunn J, et al., 2011, Images of the terminal ileum are more convincing than cecal images for verifying the extent of colonoscopy, ENDOSCOPY, Vol: 43, Pages: 196-201, ISSN: 0013-726X
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- Citations: 17
Sodergren MH, Pucher P, Clark J, et al., 2011, Disinfection of the Access Orifice in NOTES: Evaluation of the Evidence Base., Diagn Ther Endosc, Vol: 2011
Introduction. Appropriate prevention of infection is a key area of research in natural orifice translumenal endoscopic surgery (NOTES), as identified by the Natural Orifice Surgery Consortium for Assessment and Research (NOSCAR). Methods. A review of the literature was conducted evaluating the evidence base for access orifice preparation/treatment in NOTES procedures in the context of infectious complications. Recommendations based on the Oxford Centre for Evidence-Based Medicine guidelines were made. Results. The most robust evidence includes several experimental randomised controlled trials assessing infectious complications in the transgastric approach to NOTES. Transvaginal procedures are long established for accessing the peritoneal cavity following disinfection with antiseptic. Only experimental case series for transcolonic and transvesical approaches are described. Conclusion. Grade C recommendation requiring no preoperative preparation can be made for the transgastric approach. Antiseptic irrigation is recommended for transvaginal (grade C) NOTES access, as is current practice. Further human trials need to be conducted to corroborate the current evidence base for transgastric closure. It is important that future trials are conducted in a methodologically robust fashion, with emphasis on clinical outcomes and standardisation of enterotomy closure and postoperative therapy.
Sodergren MH, Orihuela-Espina F, Clark J, et al., 2010, Evaluation of Orientation Strategies in Laparoscopic Cholecystectomy, ANNALS OF SURGERY, Vol: 252, Pages: 1027-1036, ISSN: 0003-4932
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- Citations: 17
Sodergren MH, Coomber R, Clark J, et al., 2010, What Are the Elements of Safe Gastrotomy Closure in NOTES? A Systematic Review, SURGICAL INNOVATION, Vol: 17, Pages: 318-331, ISSN: 1553-3506
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- Citations: 19
Powell N, Russo EA, Hoare J, et al., 2010, LONGITUDINAL ANALYSIS OF EROSIVE AND NON-EROSIVE GASTRO-OESOPHAGEAL REFLUX DISEASE, Annual General Meeting of the British-Society-of-Gastroenterology, Publisher: B M J PUBLISHING GROUP, Pages: A25-A26, ISSN: 0017-5749
Milestone AN, Teare JP, Goldin RD, 2010, Linear Ulceration in Collagenous Colitis: A Case Series and Literature Review, Digestive Disease Week/111th Annual Meeting of the American-Gastroenterological-Association, Publisher: MOSBY-ELSEVIER, Pages: AB343-AB343, ISSN: 0016-5107
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- Citations: 2
Williams HRT, Cox IJ, Walker DG, et al., 2009, Erratum: Characterization of inflammatory bowel disease with urinary metabolic profiling (American Journal of Gastroenterology (2009) 104 (1435-1444) DOI: 10.1038 / ajg.2009.175), American Journal of Gastroenterology, Vol: 104, ISSN: 0002-9270
Williams HRT, Cox IJ, Walker DG, et al., 2009, Characterization of Inflammatory Bowel Disease With Urinary Metabolic Profiling (vol 104, pg 1435, 2009), AMERICAN JOURNAL OF GASTROENTEROLOGY, Vol: 104, Pages: 1894-1894, ISSN: 0002-9270
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- Citations: 3
Williams HRT, Cox IJ, Walker DG, et al., 2009, Characterization of Inflammatory Bowel Disease With Urinary Metabolic Profiling, AMERICAN JOURNAL OF GASTROENTEROLOGY, Vol: 104, Pages: 1435-1444, ISSN: 0002-9270
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- Citations: 135
Russo E, Powell N, O'Gallagher K, et al., 2009, Alarm Signs in Patients with Gastrooesophageal Reflux Disease, Digestive Disease Week/110th Annual Meeting of the American-Gastroenterological-Association, Publisher: W B SAUNDERS CO-ELSEVIER INC, Pages: A457-A457, ISSN: 0016-5085
Walker DG, Williams HR, Padaruth S, et al., 2009, Does the Clinical Phenotype of Inflammatory Bowel Disease Differ Between Caucasian and South Asian Patients Living in the UK?, Digestive Disease Week/110th Annual Meeting of the American-Gastroenterological-Association, Publisher: W B SAUNDERS CO-ELSEVIER INC, Pages: A356-A356, ISSN: 0016-5085
Russo E, Powell N, Mansfield G, et al., 2009, The Evolving Epidemiology of Gastro-Oesophageal Reflux Disease: A 20 Year Endoscopy Perspective, Digestive Disease Week/110th Annual Meeting of the American-Gastroenterological-Association, Publisher: W B SAUNDERS CO-ELSEVIER INC, Pages: A738-A738, ISSN: 0016-5085
Sodergren MH, Clark J, Athanasiou T, et al., 2009, Natural orifice translumenal endoscopic surgery: critical appraisal of applications in clinical practice, SURGICAL ENDOSCOPY AND OTHER INTERVENTIONAL TECHNIQUES, Vol: 23, Pages: 680-687, ISSN: 0930-2794
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- Citations: 62
Powell N, Russo E, Mansfield G, et al., 2009, ALARM SIGNS IN PATIENTS WITH GASTRO-OESOPHAGEAL REFLUX DISEASE?, Annual Meeting of the British-Society-of-Gastroenterology, Publisher: B M J PUBLISHING GROUP, Pages: A143-A143, ISSN: 0017-5749
Walker DG, Williams HRT, Padaruth S, et al., 2009, INFLAMMATORY BOWEL DISEASE IN CAUCASIAN AND UK SOUTH ASIAN PATIENTS: DIFFERENCE IN CLINICAL PHENOTYPE, Annual Meeting of the British-Society-of-Gastroenterology, Publisher: B M J PUBLISHING GROUP, Pages: A60-A60, ISSN: 0017-5749
Powell N, Russo E, Mansfield G, et al., 2009, THE EVOLVING EPIDEMIOLOGY OF GASTRO-OESOPHAGEAL REFLUX DISEASE: AN ENDOSCOPIC PERSPECTIVE, Annual Meeting of the British-Society-of-Gastroenterology, Publisher: B M J PUBLISHING GROUP, Pages: A143-A143, ISSN: 0017-5749
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