Publications
2252 results found
Kinross J, Vernazza J, Holloway P, et al., 2010, Metabonomic profiling of plasma in secondary peritonitis: A novel diagnostic and prognostic strategy based on systems metabolism, Electronic Poster of Distinction in Association-of-Surgeons-of-Great-Britain-and-Ireland-International-Surgical-Congress, Publisher: WILEY-BLACKWELL, Pages: 80-80, ISSN: 0007-1323
Faiz O, Brown T, Bottle A, et al., 2010, Impact of hospital institutional volume on postoperative mortality after major emergency colorectal surgery in English National Health Service Trusts, 2001 to 2005, Diseases of the colon and rectum, Vol: 53, Pages: 393-401, ISSN: 1530-0358
PURPOSE: The aim of this study was to investigate the effects of institutional volume on postoperative mortality in patients undergoing emergency major colorectal surgical procedures in England between 2001 and 2005. METHODS: All of the emergency excisional colorectal procedures performed between the above dates were included from the Hospital Episode Statistics data set. Institutions were divided into high-, medium-, and low-volume tertiles according to the total major emergency colorectal caseload. RESULTS: During the study period, 37,094 emergency excisional colorectal procedures were performed in 166 English National Health Service institutions. Overall 30-day postoperative mortality was 15.49%, increasing to 29.18% at 1 year after surgery. Overall 30- and 365-day mortality rates were similar among institutional volume tertiles (P > .05) after adjustment for age, sex, social deprivation, diagnosis, procedure type, and comorbidity score. CONCLUSION: Hospital Episode Statistics data suggest that institutions with high volumes of emergency colorectal caseload do not demonstrate lower mortality after emergency major excisional colorectal surgery.
Faiz O, Warusavitarne J, Bottle A, et al., 2010, Nonelective excisional colorectal surgery in English National Health Service Trusts: a study of outcomes from Hospital Episode Statistics Data between 1996 and 2007, Journal of the American College of Surgeons, Vol: 210, Pages: 390-401, ISSN: 1879-1190
BACKGROUND: Nonelective colorectal surgery is associated with substantial patient morbidity and mortality. This study sought to describe the practice of emergency colorectal surgery in the United Kingdom during an 11-year period using the Hospital Episode Statistics (HES) database. STUDY DESIGN: All nonelective admissions in patients undergoing 1 of 8 colorectal resectional procedures between 1996 and 2007 were included. Time trends, univariate, and multivariate mortality and length of stay outcomes were analyzed. RESULTS: A total of 102,236 major urgent/emergency procedures were performed in English National Health Service Trusts between April 1996 and March 2007. Thirty-day in-hospital postoperative mortality rates in patients with colorectal cancer and diverticular disease were 13.3% and 15.4%, respectively. The corresponding 1-year postoperative mortality was 34.7% and 22.6%. On multivariate analysis, benign diagnosis, advanced age, high comorbidity score, social deprivation, and specific procedure types were independent predictors of early and 1-year postoperative mortality (p < 0.001). Independent risk factors for extended hospital stay were advanced age, social deprivation, distal (compared with proximal) bowel resection, and a diagnosis of ulcerative colitis (p < 0.001). CONCLUSIONS: HES data suggest that in everyday practice, postoperative mortality among patients undergoing nonelective admission followed by colorectal resection is high. Additional investigation is required to assess the reliability of HES data for monitoring institutional variation in this context.
Noonan D, Payne C, Shang J, et al., 2010, Force adaptive multi-spectral imaging with an articulated robotic endoscope, Publisher: Springer, Pages: 245-252
Noonan DP, Mylonas GP, Shang J, et al., 2010, Gaze contingent control for an articulated mechatronic laparoscope, Pages: 759-764
Ahmed K, Rowland S, Patel V, et al., 2010, Is the structure of anatomy curriculum adequate for safe medical practice?, Surgeon, Vol: 8, Pages: 318-324, ISSN: 1479-666X
INTRODUCTION: Anatomy has been considered a core subject within the medical education curriculum. In the current setting of ever-changing diagnostic and treatment modalities, the opinion of both students and trainers is crucial for the design of an anatomy curriculum which fulfils the criteria required for safe medical practice. METHODS: Medical students, trainees and specialist trainee doctors and specialists from the London (England) area were surveyed to investigate the how curriculum changes have affected the relevance of anatomical knowledge to clinical practice and to identify recommendations for optimum teaching methods. The survey employed 5-point Likert scales and multiple-choice questions. Where the effect of training level was statistically significant (p < 0.05), post-hoc analysis was carried out using Mann-Whitney U tests. Significance levels were modified according to the Bonferroni method. RESULTS: Two hundred and twenty-eight individuals completed the survey giving a response rate of 53%. Medical students, trainees and specialists all agreed (mean Likert score 4.51, 4.79, 4.69 respectively) that knowledge of anatomy is important for medical practice. Most of the trainees (88.4%) and specialists (81.3%) used dissection to learn anatomy, but only 61.4% of medical students used this approach. Dissection was the most commonly recommended approach for learning anatomy across all the groups (41.7%-69.3%). CONCLUSIONS: Knowledge of anatomy is perceived to be important for safe clinical practice. Anatomy should be taught with other relevant system or clinical modules. Newer tools for anatomy teaching need further validation before incorporation into the curriculum.
King D, Lee H, Darzi A, 2010, Laparoscopy and research in surgical oncology: Current state of the art and future trends, Minimal Invasive Surgical Oncology, Editors: Matteotti, Ashley, Publisher: Springer
Mayer EK, Bottle A, Darzi A, et al., 2010, Risk-adjusted funnel plot analysis of radical cystectomy outcomes across English NHS Trusts, Annual Meeting of the British-Association-of-Urological-Surgeons, Publisher: WILEY-BLACKWELL PUBLISHING, INC, Pages: 29-29, ISSN: 1464-4096
Caproni M, Orihuela-Espina F, James DRC, et al., 2009, An analysis framework for Near InfraRed Spectroscopy based brain-computer interface and prospective application to robotic surgery, IEEE/RSJ International Conference on Intelligent Robots and Systems, 2009. IROS 2009., Publisher: IEEE, Pages: 2143-2148
As medical robotics gathers increasing attention, the ergonomics of the surgical-console design becomes an important issue. Motivated by the need of augmenting the surgeon mastery, we explore the capabilities of a near infrared brain-computer interface as a complementary input modality to enhance the human-robot interaction at the robotic console. A multistage analysis framework is proposed and evaluated by an exploratory off-line synchronous study. The three stages of the data processing flow, namely dimensionality reduction, solution to binary problems and aggregation into multi-class decision are examined to address key challenges during the pattern recognition step. Early experimental results endorse near infrared based brain-computer interface as a suitable additional communication modality between the surgeon and the robotic console.
Valibeik S, Ballantyne J, Lo B, et al., 2009, Establishing affective human robot interaction through contextual information, Pages: 867-872
Determining human intention is a challenging task for establishing affective human robot interaction. The aim of this paper is to provide a vision based framework to achieve a level of understanding about people in an environment before engaging in active communication or interaction. The proposed method combines multiple cues in a Bayesian framework to identify people in the scene and determine potential intentions. To improve the system performance, contextual feedback is used, which allows the Bayesian network to evolve and adjust itself according to the surrounding environment. Our results demonstrate the effectiveness of the technique in dealing with human-robot interaction in a relatively crowded environment. © 2009 IEEE.
Saso S, Vecht JA, Rao C, et al., 2009, Statin Therapy May Influence the Incidence of Postoperative Atrial Fibrillation What Is the Evidence?, TEXAS HEART INSTITUTE JOURNAL, Vol: 36, Pages: 521-529, ISSN: 0730-2347
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- Citations: 10
Ashrafian H, Bueter M, Ahmed K, et al., 2009, Metabolic surgery: an evolution through bariatric animal models, Obes Rev
Mayer EK, Bottle A, Darzi AW, et al., 2009, Provision of radical pelvic urological surgery in England, and compliance with improving outcomes guidance, BJU INTERNATIONAL, Vol: 104, Pages: 1446-1451, ISSN: 1464-4096
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- Citations: 6
Arora S, Sevdalis N, Suliman I, et al., 2009, What makes a competent surgeon?: Experts' and trainees' perceptions of the roles of a surgeon, AMERICAN JOURNAL OF SURGERY, Vol: 198, Pages: 726-732, ISSN: 0002-9610
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- Citations: 65
Ahmed K, Keeling A, Khan RS, et al., 2009, What Does Competence Entail in Interventional Radiology?, Cardiovasc Intervent Radiol, ISSN: 0174-1551
Kroeze SGC, Mayer EK, Chopra S, et al., 2009, Assessment of Laparoscopic Suturing Skills of Urology Residents: A Pan-European Study, EUROPEAN UROLOGY, Vol: 56, Pages: 865-872, ISSN: 0302-2838
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- Citations: 44
Darzi A, 2009, <i>Review of the Week</i> Sci-fi medicine: an odyssey, BRITISH MEDICAL JOURNAL, Vol: 339, ISSN: 0959-535X
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- Citations: 2
Panesar SS, Rao C, Vecht JA, et al., 2009, Development of the Veritas plot and its application in cardiac surgery: an evidence-synthesis graphic tool for the clinician to assess multiple meta-analyses reporting on a common outcome, CANADIAN JOURNAL OF SURGERY, Vol: 52, Pages: E137-E145, ISSN: 0008-428X
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- Citations: 7
Ahmed K, Ashrafian H, Hanna GB, et al., 2009, Assessment of specialists in cardiovascular practice, Nature Rev Cardiol
Aziz O, Skapinakis P, Rahman S, et al., 2009, Behavioural interventions for smoking cessation in patients hospitalised for a major cardiovascular event, INTERNATIONAL JOURNAL OF CARDIOLOGY, Vol: 137, Pages: 171-174, ISSN: 0167-5273
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- Citations: 9
Weiser TG, Makary MA, Haynes AB, et al., 2009, Standardised metrics for global surgical surveillance., Lancet, Vol: 374, Pages: 1113-1117
Public health surveillance relies on standardised metrics to evaluate disease burden and health system performance. Such metrics have not been developed for surgical services despite increasing volume, substantial cost, and high rates of death and disability associated with surgery. The Safe Surgery Saves Lives initiative of WHO's Patient Safety Programme has developed standardised public health metrics for surgical care that are applicable worldwide. We assembled an international panel of experts to develop and define metrics for measuring the magnitude and effect of surgical care in a population, while taking into account economic feasibility and practicability. This panel recommended six measures for assessing surgical services at a national level: number of operating rooms, number of operations, number of accredited surgeons, number of accredited anaesthesia professionals, day-of-surgery death ratio, and postoperative in-hospital death ratio. We assessed the feasibility of gathering such statistics at eight diverse hospitals in eight countries and incorporated them into the WHO Guidelines for Safe Surgery, in which methods for data collection, analysis, and reporting are outlined.
Ashrafian H, Rao C, Darzi A, et al., 2009, Benchmarking in surgical research, LANCET, Vol: 374, Pages: 1045-1047, ISSN: 0140-6736
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- Citations: 13
De Silva DJ, Darzi AW, 2009, <i>Hospitals and bottling factories</i> Improving quality of care, BMJ-BRITISH MEDICAL JOURNAL, Vol: 339, ISSN: 1756-1833
Deeba S, Purkayastha S, Jeyarajah S, et al., 2009, Surgical removal of a tea spoon from the ascending colon, ten years after ingestion: a case report., Cases Journal, Vol: 2, ISSN: 1757-1626
INTRODUCTION: The presentation of ingested foreign bodies in the gastrointestinal system is common in the emergency setting. The majority responds to conservative management and passes spontaneously; however, giant foreign bodies pose a management difficulty. We report a peculiar case of a giant foreign body (spoon) that presented very late after ingestion and the management of this presentation. CASE PRESENTATION: A 30-year-old British white male barrister presented with abdominal pain 10 years after he swallowed a spoon that never passed spontaneously. His workup revealed the spoon lodged in his ascending colon. Laparoscopic retrieval was not feasible so a laparotomy was done for retrieval. He did well and went home with no complications. CONCLUSION: Symptomatic giant ingested foreign bodies represent a management challenge sometimes and usually necessitate surgical intervention when all conservative means fail. We review the literature on management of giant ingested foreign bodies.
Chow A, Mayer EK, Darzi AW, et al., 2009, Patient-reported outcome measures: The importance of patient satisfaction in surgery, SURGERY, Vol: 146, Pages: 435-443, ISSN: 0039-6060
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- Citations: 220
Aziz O, Darzi AW, 2009, Robot-Assisted Laparoscopic Colorectal Surgery, Atlas of Procedures in Surgical Oncology with Critical, Evidence-Based Commentary Notes, Publisher: WORLD SCIENTIFIC, Pages: 165-170
Sevdalis N, Undre S, Henry J, et al., 2009, Development, initial reliability and validity testing of an observational tool for assessing technical skills of operating room nurses, INTERNATIONAL JOURNAL OF NURSING STUDIES, Vol: 46, Pages: 1187-1193, ISSN: 0020-7489
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- Citations: 19
Warren OJ, Rogers PLB, Watret AL, et al., 2009, Defining the role of recombinant activated factor VII in pediatric cardiac surgery: Where should we go from here?, PEDIATRIC CRITICAL CARE MEDICINE, Vol: 10, Pages: 572-582, ISSN: 1529-7535
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- Citations: 22
Aggarwal R, Crochet P, Dias A, et al., 2009, Development of a virtual reality training curriculum for laparoscopic cholecystectomy, BRITISH JOURNAL OF SURGERY, Vol: 96, Pages: 1086-1093, ISSN: 0007-1323
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- Citations: 179
Deeba S, Corcoles E, Hanna GB, et al., 2009, Translational research: The use of rapid sampling microdialysis for bedside monitoring of bowel ischemia, 95th Annual Clinical Congress of the American-College-of-Surgeons/64th Annual Sessions of the Owen H Wangensteen Forum on Fundamental Surgical Problems, Publisher: ELSEVIER SCIENCE INC, Pages: S19-S20, ISSN: 1072-7515
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