Publications
2252 results found
Tilney HS, Purkayastha S, Darzi AW, et al., 2008, APER Rate Has Multiple Limitations as an Indicator of Quality in Rectal Cancer Surgery Reply, ANNALS OF SURGERY, Vol: 248, Pages: 1105-1106, ISSN: 0003-4932
Ashrafian H, le Roux CW, Darzi A, et al., 2008, Effects of Bariatric Surgery on Cardiovascular Function, CIRCULATION, Vol: 118, Pages: 2091-2102, ISSN: 0009-7322
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- Citations: 166
Deeba S, Corcoles EP, Hanna GB, et al., 2008, Use of rapid sampling microdialysis for intraoperative monitoring of bowel ischemia (Diseases of the Colon and Rectum DOI: 10.1007/s10350-008-9375-4), Diseases of the Colon and Rectum, Vol: 51, ISSN: 0012-3706
Katsuno H, Zacharakis E, Aziz O, et al., 2008, Does the Presence of Circulating Tumor Cells in the Venous Drainage of Curative Colorectal Cancer Resections Determine Prognosis? A Meta-Analysis, ANNALS OF SURGICAL ONCOLOGY, Vol: 15, Pages: 3083-3091, ISSN: 1068-9265
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- Citations: 42
Leff DR, Orihuela-Espina F, Atallah L, et al., 2008, Functional prefrontal reorganization accompanies learning-associated refinements in surgery: a manifold embedding approach., Comput Aided Surg, Vol: 13, Pages: 325-339
The prefrontal cortex (PFC) is known to be vital for acquisition of visuomotor skills, but its role in the attainment of complex technical skills which comprise both perceptual and motor components, such as those associated with surgery, remains poorly understood. We hypothesized that the prefrontal response to a surgical knot-tying task would be highly dependent on technical expertise, and that activation would wane in the context of learning success following extended practice. The present series of experiments investigated this issue, using functional Near Infrared Spectroscopy (fNIRS) and dexterity analysis to compare the PFC responses and technical skill of expert and novice surgeons performing a surgical knot-tying task in a block design experiment. Applying a data-embedding technique known as Isomap and Earth Mover's Distance (EMD) analysis, marked differences in cortical hemodynamic responses between expert and novice surgeons have been found. To determine whether refinement in technical skill was associated with reduced PFC demands, a second experiment assessed the impact of pre- and post-training on the PFC responses in novices. Significant improvements (p < 0.01) were observed in all performance parameters following training. Smaller EMD distances were observed between expert surgeons and novices following training, suggesting an evolving pattern of cortical responses. A random effect model demonstrated a statistically significant decrease in relative changes of total hemoglobin (Delta HbT) [coefficient = -3.825, standard error (s.e.) = 0.8353, z = -4.58, p < 0.001] and oxygenated hemoglobin (Delta HbO(2)) [coefficient = -4.6815, s.e = 0.6781, z = -6.90, p < 0.001] and a significant increase in deoxygenated hemoglobin (Delta HHb) [coefficient = 0.8192, s.e = 0.3034, z = 2.66, p < 0.01] across training. The results indicate that learning-related refinements in technical performance are mediated by temporal reductions in prefrontal activation.
Van Herzeele I, Aggarwal R, Neequaye S, et al., 2008, Cognitive training improves clinically relevant outcomes during simulated endovascular procedures, JOURNAL OF VASCULAR SURGERY, Vol: 48, Pages: 1223-1230, ISSN: 0741-5214
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- Citations: 54
Clarka J, Cleator S, Goldin R, et al., 2008, Treatment of primary rectal squamous cell carcinoma by primary chemoradiotherapy: Should surgery still be considered a standard of care?, EUROPEAN JOURNAL OF CANCER, Vol: 44, Pages: 2340-2343, ISSN: 0959-8049
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- Citations: 42
Aziz O, Lo B, Pansiot J, et al., 2008, From computers to ubiquitous computing by 2010: health care, PHILOSOPHICAL TRANSACTIONS OF THE ROYAL SOCIETY A-MATHEMATICAL PHYSICAL AND ENGINEERING SCIENCES, Vol: 366, Pages: 3805-3811, ISSN: 1364-503X
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- Citations: 16
Aziz O, Lo B, Pansiot J, et al., 2008, From computers to ubiquitous computing by 2010: health care, Royal-Society Discussion Meeting on From Computers to Ubiquitous Computer, Pages: 3805-3811
Over the past decade, miniaturization and cost reduction in semiconductors have led to computers smaller in size than a pinhead with powerful processing abilities that are affordable enough to be disposable. Similar advances in wireless communication, sensor design and energy storage have meant that the concept of a truly pervasive 'wireless sensor network', used to monitor environments and objects within them, has become a reality. The need for a wireless sensor network designed specifically for human body monitoring has led to the development of wireless 'body sensor network' (BSN) platforms composed of tiny integrated microsensors with on-board processing and wireless data transfer capability. The ubiquitous computing abilities of BSNs offer the prospect of continuous monitoring of human health in any environment, be it home, hospital, outdoors or the workplace. This pervasive technology comes at a time when Western world health care costs have sharply risen, reflected by increasing expenditure on health care as a proportion of gross domestic product over the last 20 years. Drivers of this rise include an ageing post 'baby boom' population, higher incidence of chronic disease and the need for earlier diagnosis. This paper outlines the role of pervasive health care technologies in providing more efficient health care.
, 2008, Retraction: "The use of adhesion prevention membranes in abdominal surgery" by H. S. Tilney, S. Purkayastha, V. A. Constantinides, R. Morris, A. W. Darzi & P. P. Tekkis., Aliment Pharmacol Ther, Vol: 28
Zacharakis E, Shalhoub J, Selvapatt N, et al., 2008, Revisional laparoscopic parastomal hernia repair, JSLS, Journal of the Society of Laparoendscopic Surgeons, Vol: 12, Pages: 403-406, ISSN: 1086-8089
Background:We herein report a laparoscopically performed re-do operation on a patient who had previously undergone a laparoscopic parastomal hernia repair.Case Report:We describe the case of a 71-year-old patient who presented within 3 months of her primary laparoscopic parastomal hernia repair with recurrence. On relaparoscopy, dense adhesions to the mesh were found, and the mesh had migrated into the hernia sac. This had allowed loops of small bowel to herniate into the sac. The initial part of the procedure involved the lysis of adhesions. A piece of Gore-Tex DualMesh with a central keyhole and a radial slit was cut so that it could provide at least 3 cm to 5 cm of overlap of the fascial defect. The tails of the mesh were wrapped around the bowel, and the mesh was secured to the margins of the hernia with circumferential metal tacking and 4 transfascial sutures. The patient remains in satisfactory condition and no recurrence or any surgery-related problem has been observed during 8 months of follow-up.Conclusion:Revisional laparoscopic repair of parastomal hernias seems feasible and has been shown to be safe and effective in this case. The success of this approach depends on longer follow-up reports and standardization of the technical elements.
Aggarwal R, Darzi A, Grantcharov TP, 2008, A Systematic Review of Skills Transfer After Surgical Simulation Training, ANNALS OF SURGERY, Vol: 248, Pages: 690-691, ISSN: 0003-4932
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- Citations: 6
Davis R, Massey R, Warren O, et al., 2008, Patients' evaluation of a video aimed at encouraging patient participation in healthcare, PSYCHOLOGY & HEALTH, Vol: 23, Pages: 98-99, ISSN: 0887-0446
Yakoub D, Fahmy R, Athanasiou T, et al., 2008, Evidence-based choice of esophageal stent for the palliative management of malignant dysphagia, WORLD JOURNAL OF SURGERY, Vol: 32, Pages: 1996-2009, ISSN: 0364-2313
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- Citations: 24
Deeba S, Corcoles EP, Hanna BG, et al., 2008, Use of rapid sampling microdialysis for intraoperative monitoring of bowel ischemia, DISEASES OF THE COLON & RECTUM, Vol: 51, Pages: 1408-1413, ISSN: 0012-3706
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- Citations: 36
Purkayastha S, Tilney HS, Darzi AW, et al., 2008, Meta-analysis of randomized studies evaluating chewing gum to enhance postoperative recovery following colectomy, ARCHIVES OF SURGERY, Vol: 143, Pages: 788-793, ISSN: 0004-0010
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- Citations: 60
Sevdalis N, Davis R, Koutantji M, et al., 2008, Reliability of a revised NOTECHS scale for use in surgical teams, AMERICAN JOURNAL OF SURGERY, Vol: 196, Pages: 184-190, ISSN: 0002-9610
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- Citations: 170
Lim CBB, Goldin RD, Darzi A, et al., 2008, Characterization of materials eliciting foreign body reaction in stapled human gastrointestinal anastomoses, BRITISH JOURNAL OF SURGERY, Vol: 95, Pages: 1044-1050, ISSN: 0007-1323
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- Citations: 16
Aggarwal R, Cheshire N, Darzi A, 2008, Endovascular simulation-based training, SURGEON-JOURNAL OF THE ROYAL COLLEGES OF SURGEONS OF EDINBURGH AND IRELAND, Vol: 6, Pages: 196-197, ISSN: 1479-666X
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- Citations: 2
Kinross JM, von Roon AC, Holmes E, et al., 2008, The human gut microbiome: implications for future health care., Curr Gastroenterol Rep, Vol: 10, Pages: 396-403
In their intestine, humans possess an "extended genome" of millions of microbial genes-the microbiome. Because this complex symbiosis influences host metabolism, physiology, and gene expression, it has been proposed that humans are complex biologic "superorganisms." Advances in microbiologic analysis and systems biology are now beginning to implicate the gut microbiome in the etiology of localized intestinal diseases such as the irritable bowel syndrome, inflammatory bowel disease, and colon cancer. These approaches also suggest possible links between the gut and previously unassociated systemic conditions such as type 2 diabetes and obesity. The elucidation of the intestinal microbiome is therefore likely to underpin future disease prevention strategies, personalized health care regimens, and the development of novel therapeutic interventions. This review summarizes the research that is defining our understanding of the intestinal microbiome and highlights future areas of research in gastroenterology and human health in which the intestinal microbiome will play a significant role.
Panesar SS, Chikwe J, Mirza SB, et al., 2008, Off-pump coronary artery bypass surgery may reduce the incidence of stroke in patients with significant left main stem disease, THORACIC AND CARDIOVASCULAR SURGEON, Vol: 56, Pages: 247-255, ISSN: 0171-6425
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- Citations: 14
Sevdalis N, Forrest D, Undre S, et al., 2008, Annoyances, disruptions, and interruptions in surgery: The Disruptions in Surgery Index (DiSI), WORLD JOURNAL OF SURGERY, Vol: 32, Pages: 1643-1650, ISSN: 0364-2313
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- Citations: 95
Purkayastha S, Chow A, Athanasiou T, et al., 2008, Inguinal hernia., BMJ Clin Evid, Vol: 2008
INTRODUCTION: The main risk factors for inguinal hernia are male sex and increasing age. Complications of inguinal hernia include strangulation, intestinal obstruction, and infarction. Recurrence can occur after surgery. METHODS AND OUTCOMES: We conducted a systematic review and aimed to answer the following clinical questions: What are the effects of elective treatments for primary unilateral, primary bilateral, and recurrent inguinal hernia in adults? We searched: Medline, Embase, The Cochrane Library, and other important databases up to September 2007 (BMJ Clinical Evidence reviews are updated periodically; please check our website for the most up-to-date version of this review). We included harms alerts from relevant organisations, such as the US Food and Drug Administration (FDA) and the UK Medicines and Healthcare products Regulatory Agency (MHRA). RESULTS: We found 24 systematic reviews, RCTs, or observational studies that met our inclusion criteria. We performed a GRADE evaluation of the quality of evidence for interventions. CONCLUSIONS: In this systematic review, we present information relating to the effectiveness and safety of the following interventions: expectant management, open mesh repair, open suture repair, totally extraperitoneal (TEP) laparoscopic repair, and transabdominal preperitoneal (TAPP) laparoscopic repair.
Deeba S, Aziz O, Sains PS, et al., 2008, Fistula-in-ano: advances in treatment, AMERICAN JOURNAL OF SURGERY, Vol: 196, Pages: 95-99, ISSN: 0002-9610
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- Citations: 28
Zacharakis E, Purkayastha S, Teare J, et al., 2008, Natural orifices translumenal endoscopic surgery (NOTES) - Who should perform it?, SURGERY, Vol: 144, Pages: 1-2, ISSN: 0039-6060
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- Citations: 8
Aziz M, Darzi AW, 2008, Laparoscopic resection for colorectal cancer: Evidence to date, SURGICAL ONCOLOGY CLINICS OF NORTH AMERICA, Vol: 17, Pages: 519-+, ISSN: 1055-3207
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- Citations: 6
Leong JJH, Leff DR, Das A, et al., 2008, Validation of orthopaedic bench models for trauma surgery., J Bone Joint Surg Br, Vol: 90, Pages: 958-965
The aim of this study was to validate the use of three models of fracture fixation in the assessment of technical skills. We recruited 21 subjects (six experts, seven intermediates, and eight novices) to perform three procedures: application of a dynamic compression plate on a cadaver porcine model, insertion of an unreamed tibial intramedullary nail, and application of a forearm external fixator, both on synthetic bone models. The primary outcome measures were the Objective Structural Assessment of technical skills global rating scale on video recordings of the procedures which were scored by two independent expert observers, and the hand movements of the surgeons which were analysed using the Imperial College Surgical Assessment Device. The video scores were significantly different for the three groups in all three procedures (p < 0.05), with excellent inter-rater reliability (alpha = 0.88). The novice and intermediate groups specifically were significantly different in their performance with dynamic compression plate and intramedullary nails (p < 0.05). Movement analysis distinguished between the three groups in the dynamic compression plate model, but a ceiling effect was demonstrated in the intramedullary nail and external fixator procedures, where intermediates and experts performed to comparable standards (p > 0.6). A total of 85% (18 of 21) of the subjects found the dynamic compression model and 57% (12 of 21) found all the models acceptable tools of assessment. This study has validated a low-cost, high-fidelity porcine dynamic compression plate model using video rating scores for skills assessment and movement analysis. It has also demonstrated that Synbone models for the application of and intramedullary nail and an external fixator are less sensitive and should be improved for further assessment of surgical skills in trauma. The availability of valid objective tools of assessment of surgical skills allows further studies into improving methods of
Professor the Lord Darzi of Denham, 2008, Evidence-based medicine and the NHS: a commentary., J R Soc Med, Vol: 101, Pages: 342-344, ISSN: 0141-0768
Tan EK, Vaizey C, Cornish J, et al., 2008, Surgical strategies for faecal incontinence - a decision analysis between dynamic graciloplasty, artificial bowel sphincter and end stoma, COLORECTAL DISEASE, Vol: 10, Pages: 577-586, ISSN: 1462-8910
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- Citations: 25
Knowles CH, Veress B, Tornblom H, et al., 2008, Safety and diagnostic yield of laparoscopically assisted full-thickness bowel biospy, NEUROGASTROENTEROLOGY AND MOTILITY, Vol: 20, Pages: 774-779, ISSN: 1350-1925
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- Citations: 34
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