Publications
269 results found
Shanthakumar D, Leiloglou M, Kelliher C, et al., 2023, Tissue optics for margin assessment in breast conserving surgery: Systematic review & meta-analysis, Association of Breast Surgery Conference
Shanthakumar D, Leiloglou M, Chalau V, et al., 2023, Intra-operative multispectral imaging for precision in breast conserving surgery, Association of Breast Surgery Conference
Leiloglou M, Kedrzycki M, Shanthakumar D, et al., 2023, Fluorescence and multispectral imaging use for tumour identification in breast conserving surgery, Association of Breast Surgery Conference
Leiloglou M, Shanthakumar D, Gkouzionis I, et al., 2023, Investigation of multispectral imaging classification routines for intraoperative margin assessment in breast conserving surgery, European Conferences on Biomedical Optics
Leiloglou M, Kedrzycki M, Chalau V, et al., 2023, 5-ALA induced fluorescence imaging for margin status identification during breast conserving surgery, Association of Breast Surgery Conference
Che Bakri NA, Kwasnicki RM, Dhillon K, et al., 2022, ASO author reflections: Improving management of upper limb complications after breast cancer treatments, Annals of Surgical Oncology, Vol: 29, Pages: 566-567, ISSN: 1068-9265
Leiloglou M, Kedrzycki MS, Elson DS, et al., 2022, ASO author reflections: towards fluorescence guided tumor identification for precision breast conserving surgery., Annals of Surgical Oncology, Vol: 29, Pages: 564-565, ISSN: 1068-9265
St John ER, Ezzat A, Holford N, et al., 2022, Digital consent to improve patient perception of shared decision-making: comparative study between paper and digital consent processes in patients undergoing breast surgery, BRITISH JOURNAL OF SURGERY, Vol: 109, Pages: 1172-1173, ISSN: 0007-1323
- Author Web Link
- Cite
- Citations: 3
Patel R, Suwa Y, Kinross J, et al., 2022, Neuroenhancement of surgeons during robotic suturing, Surgical Endoscopy: surgical and interventional techniques, Vol: 36, Pages: 4803-4814, ISSN: 0930-2794
BackgroundThe initial phases of robotic surgical skills acquisition are associated with poor technical performance, such as low knot-tensile strength (KTS). Transcranial direct-current stimulation (tDCS) can improve force and accuracy in motor tasks but research in surgery is limited to open and laparoscopic tasks in students. More recently, robotic surgery has gained traction and is now the most common approach for certain procedures (e.g. prostatectomy). Early-phase robotic suturing performance is dependent on prefrontal cortex (PFC) activation, and this study aimed to determine whether performance can be improved with prefrontal tDCS.MethodsFifteen surgical residents were randomized to either active then sham tDCS or sham then active tDCS, in two counterbalanced sessions in a double-blind crossover study. Within each session, participants performed a robotic suturing task repeated in three blocks: pre-, intra- and post-tDCS. During the intra-tDCS block, participants were randomized to either active tDCS (2 mA for 15 min) to the PFC or sham tDCS. Primary outcome measures of technical quality included KTS and error scores.ResultsSignificantly faster completion times were observed longitudinally, regardless of active (p < 0.001) or sham stimulation (p < 0.001). KTS was greater following active compared to sham stimulation (median: active = 44.35 N vs. sham = 27.12 N, p < 0.001). A significant reduction in error scores from “pre-” to “post-” (p = 0.029) were only observed in the active group.ConclusiontDCS could reduce error and enhance KTS during robotic suturing and warrants further exploration as an adjunct to robotic surgical training.
Grant Y, Al-Mufti R, Hogben K, et al., 2022, Patient level costs of staged unilateral versus immediate bilateral symmetrisation mammoplasty in breast conserving surgery, Association of Breast Surgery
Leiloglou M, Kedrzycki M, Chalau V, et al., 2022, Indocyanine green fluorescence image processing techniques for breast cancer macroscopic demarcation, Scientific Reports, Vol: 12, ISSN: 2045-2322
Re-operation due to disease being inadvertently close to the resection margin is a major challenge in breast conserving surgery (BCS). Indocyanine green (ICG) fluorescence imaging could be used to visualize the tumor boundaries and help surgeons resect disease more efficiently. In this work, ICG fluorescence and color images were acquired with a custom-built camera system from 40 patients treated with BCS. Images were acquired from the tumor in-situ, surgical cavity post-excision, freshly excised tumor and histopathology tumour grossing. Fluorescence image intensity and texture were used as individual or combined predictors in both logistic regression (LR) and support vector machine models to predict the tumor extent. ICG fluorescence spectra in formalin-fixed histopathology grossing tumor were acquired and analyzed. Our results showed that ICG remains in the tissue after formalin fixation. Therefore, tissue imaging could be validated in freshly excised and in formalin-fixed grossing tumor. The trained LR model with combined fluorescence intensity (pixel values) and texture (slope of power spectral density curve) identified the tumor’s extent in the grossing images with pixel-level resolution and sensitivity, specificity of 0.75 ± 0.3, 0.89 ± 0.2.This model was applied on tumor in-situ and surgical cavity (post-excision) images to predict tumor presence.
Thiruchelvam PTR, Leff DR, Godden AR, et al., 2022, Primary radiotherapy and deep inferior epigastric perforator flap reconstruction for patients with breast cancer (PRADA): a multicentre, prospective, non-randomised, feasibility study, The Lancet Oncology, Vol: 23, Pages: 682-690, ISSN: 1213-9432
BACKGROUND: Radiotherapy before mastectomy and autologous free-flap breast reconstruction can avoid adverse radiation effects on healthy donor tissues and delays to adjuvant radiotherapy. However, evidence for this treatment sequence is sparse. We aimed to explore the feasibility of preoperative radiotherapy followed by skin-sparing mastectomy and deep inferior epigastric perforator (DIEP) flap reconstruction in patients with breast cancer requiring mastectomy. METHODS: We conducted a prospective, non-randomised, feasibility study at two National Health Service trusts in the UK. Eligible patients were women aged older than 18 years with a laboratory diagnosis of primary breast cancer requiring mastectomy and post-mastectomy radiotherapy, who were suitable for DIEP flap reconstruction. Preoperative radiotherapy started 3-4 weeks after neoadjuvant chemotherapy and was delivered to the breast, plus regional nodes as required, at 40 Gy in 15 fractions (over 3 weeks) or 42·72 Gy in 16 fractions (over 3·2 weeks). Adverse skin radiation toxicity was assessed preoperatively using the Radiation Therapy Oncology Group toxicity grading system. Skin-sparing mastectomy and DIEP flap reconstruction were planned for 2-6 weeks after completion of preoperative radiotherapy. The primary endpoint was the proportion of open breast wounds greater than 1 cm width requiring a dressing at 4 weeks after surgery, assessed in all participants. This study is registered with ClinicalTrials.gov, NCT02771938, and is closed to recruitment. FINDINGS: Between Jan 25, 2016, and Dec 11, 2017, 33 patients were enrolled. At 4 weeks after surgery, four (12·1%, 95% CI 3·4-28·2) of 33 patients had an open breast wound greater than 1 cm. One (3%) patient had confluent moist desquamation (grade 3). There were no serious treatment-related adverse events and no treatment-related deaths. INTERPRETATION: Preoperative radiotherapy followed by skin-sparing mastectomy and immediat
Jiwa N, Ezzat A, holt J, et al., 2022, Nipple aspirate fluid and its use for the early detection of breast cancer, Annals of Medicine and Surgery, Vol: 77, Pages: 1-6, ISSN: 2049-0801
Nipple aspirate fluid is the physiological biofluid lining ductal epithelial cells. Historically, cytology of nipple fluid has been the gold standard diagnostic method for assessment of ductal fluid in patients with symptomatic nipple discharge. The role of biomarker discovery in nipple aspirate fluid for assessment of asymptomatic and high-risk patients is highly attractive but evaluation to date is limited by poor diagnostic accuracy. However, the emergence of new technologies capable of identifying metabolites that have been previously thought unidentifiable within such small volumes of fluid, has enabled testing of nipple biofluid to be re-examined. This review evaluates the use of new technologies to evaluate the components of nipple fluid and their potential to serve as biomarkers in screening.
Shanthakumar D, Elson D, Darzi A, et al., 2022, Tissue optical imaging as an emerging technique for intraoperative margin assessment in breast-conserving surgery, Publisher: SPRINGER, Pages: 153-154, ISSN: 1068-9265
Ezzat A, Vyas K, Asenov M, et al., 2022, Portable confocal endomicroscopy for ductal feature characterization: Toward margin assessment in breast-conserving surgery, Publisher: SPRINGER, Pages: 190-191, ISSN: 1068-9265
Ezzat A, Vyas K, Holford N, et al., 2022, Systematic review of clinical applications of confocal fluorescence microscopy for intra-operative breast cancer diagnostics, 23rd Annual Meeting of the American-Society-of-Breast-Surgeons, Publisher: SPRINGER, Pages: 189-190, ISSN: 1068-9265
Chauhan H, Jiwa N, Leff D, 2022, Clinico-pathological predictors of positive resection margins, Publisher: SPRINGER, Pages: 191-192, ISSN: 1068-9265
Courtney A, Parks R, Wilkins A, et al., 2022, Mastitis and mammary abscess management audit (MAMMA), Publisher: SPRINGER, Pages: 90-91, ISSN: 1068-9265
Jiwa N, Kumar S, Gandhewar R, et al., 2022, Diagnostic Accuracy of Nipple Discharge Fluid Cytology: A Meta-Analysis and Systematic Review of the Literature, Publisher: SPRINGER, Pages: 1774-1786, ISSN: 1068-9265
- Author Web Link
- Cite
- Citations: 2
Jiwa N, Leff D, 2022, ASO Authors Reflection: Diagnostic Accuracy of Nipple Discharge Fluid Cytology: A Meta-Analysis and Systematic Review of the Literature, ANNALS OF SURGICAL ONCOLOGY, Vol: 29, Pages: 1787-1788, ISSN: 1068-9265
Maier-Hein L, Eisenmann M, Sarikaya D, et al., 2022, Surgical data science-from concepts toward clinical translation, MEDICAL IMAGE ANALYSIS, Vol: 76, ISSN: 1361-8415
- Author Web Link
- Cite
- Citations: 49
Shanthakumar D, Chalau V, Darzi A, et al., 2022, Multiwavelength laser induced fluorescence spectroscopy for breast cancer diagnostics, Association of Breast Surgery
Lee A, Kwasnicki R, Hasaan K, et al., 2021, Outcome reporting in therapeutic mammaplasty: a systematic review, BJS Open, Vol: 5, Pages: 1-12, ISSN: 2474-9842
BackgroundTherapeutic mammaplasty (TM) is an oncological procedure which combines tumour resection with breast reduction and mastopexy techniques. Previous systematic reviews have demonstrated the oncological safety of TM but reporting of critically important outcomes such as quality of life, aesthetic and functional outcomes are limited, piecemeal or inconsistent. This systematic review aims to identify all outcomes reported in clinical studies of TM to facilitate development of a Core Outcome Set.MethodsMedline, EMBASE, CINAHL and Web of Science were searched from inception to 5 August 2020. Included studies reported clinical outcomes following TM for adult women. Two authors independently screened articles for eligibility. Data was extracted regarding the outcome definition and classification type (e.g., oncologic, quality of life, etc), time of outcome reporting and measurement tools. ResultsOf 5709 de-duplicated records, 148 were included in the narrative synthesis. The majority of studies (n=102, 68.9 per cent) reported measures of survival and/or recurrence; approximately three-quarters (n=75, 73.5 per cent) had less than 5 years follow-up. Aesthetic outcome was reported in half of studies (n=75, 50.7 per cent) using mainly subjective, non-validated measurement tools. The time-point at which aesthetic assessment was conducted was highly variable, and only defined in 48 (64.0 per cent) studies and none included a pre-operative baseline for comparison. Few studies reported quality of life (n=30, 20.3 per cent), functional outcomes (n=5, 3.4 per cent) or resource use (n=28, 18.9 per cent).ConclusionsGiven the oncological equivalence of TM and mastectomy, treatment decisions are often driven by aesthetic and functional outcomes, which are infrequently and inconsistently reported with non-validated measurement tools.PROSPERO: CRD42020200365
Teh JJ, Cai W, Kedrzycki M, et al., 2021, 392 Magseed-guided wide local excision during the COVID-19 pandemic: a tenable solution to barriers in accessing elective breast cancer surgery, Association of Surgeons in Training, Publisher: British Journal of Surgery Society, ISSN: 0007-1323
Gandhewar R, Jiwa N, Leff D, 2021, Improving Confidence and Technique When Preparing Nipple Smears for Cytology, Publisher: OXFORD UNIV PRESS, Pages: 113-113, ISSN: 0007-1323
Dave RV, Kim B, Courtney A, et al., 2021, Breast cancer management pathways during the COVID-19 pandemic: outcomes from the UK 'Alert Level 4' phase of the B-MaP-C study (vol 124, pg 1785, 2021), BRITISH JOURNAL OF CANCER, Vol: 125, Pages: 905-905, ISSN: 0007-0920
Che Bakri NA, Kwasnicki RM, Dhillon K, et al., 2021, ASO visual abstract: objective assessment of postoperative morbidity following breast cancer treatments with wearable activity monitors: The "BRACELET" study., Annals of Surgical Oncology, Vol: 28, Pages: 1-1, ISSN: 1068-9265
Koh A, Parks RM, Courtney A, et al., 2021, The Mastitis and Mammary abscess Management Audit (MAMMA), British Journal of Surgery, Vol: 108, Pages: e286-e287, ISSN: 0007-1323
Dave RV, Kim B, Courtney A, et al., 2021, Breast cancer management pathways during the COVID-19 pandemic: outcomes from the UK 'Alert Level 4' phase of the B-MaP-C study (Mar, 10.1038/s41416-020-01234-4, 2021), BRITISH JOURNAL OF CANCER, Vol: 125, Pages: 772-772, ISSN: 0007-0920
- Author Web Link
- Cite
- Citations: 2
Kedrzycki MS, Leiloglou M, Chalau V, et al., 2021, ASO visual abstract: the impact of temporal variation in indocyanine green administration on tumor identification during fluorescence-guided breast surgery, Annals of Surgical Oncology, Vol: 28, Pages: 650-651, ISSN: 1068-9265
This data is extracted from the Web of Science and reproduced under a licence from Thomson Reuters. You may not copy or re-distribute this data in whole or in part without the written consent of the Science business of Thomson Reuters.