Publications
563 results found
Deijen CL, Velthuis S, Tsai A, et al., 2015, COLOR III: a multicentre randomised clinical trial comparing transanal TME versus laparoscopic TME for mid and low rectal cancer, Surgical Endoscopy, Vol: 30, Pages: 3210-3215, ISSN: 0930-2794
INTRODUCTION: Total mesorectal excision (TME) is an essential component of surgical management of rectal cancer. Both open and laparoscopic TME have been proven to be oncologically safe. However, it remains a challenge to achieve complete TME with clear circumferential resections margin (CRM) with the conventional transabdominal approach, particularly in mid and low rectal tumours. Transanal TME (TaTME) was developed to improve oncological and functional outcomes of patients with mid and low rectal cancer. METHODS: An international, multicentre, superiority, randomised trial was designed to compare TaTME and conventional laparoscopic TME as the surgical treatment of mid and low rectal carcinomas. The primary endpoint is involved CRM. Secondary endpoints include completeness of mesorectum, residual mesorectum, morbidity and mortality, local recurrence, disease-free and overall survival, percentage of sphincter-saving procedures, functional outcome and quality of life. A Quality Assurance Protocol including centralised MRI review, histopathology re-evaluation, standardisation of surgical techniques, and monitoring and assessment of surgical quality will be conducted. DISCUSSION: The difference in involvement of CRM between the two treatment strategies is thought to be in favour of the TaTME. TaTME is therefore expected to be superior to laparoscopic TME in terms of oncological outcomes in case of mid and low rectal carcinomas.
Markar SR, Mackenzie H, Wiggins T, et al., 2015, Management and Outcomes of Esophageal Perforation: A National Study of 2,564 Patients in England, AMERICAN JOURNAL OF GASTROENTEROLOGY, Vol: 110, Pages: 1559-1566, ISSN: 0002-9270
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- Citations: 59
Abbassi-Ghadi N, Jones EA, Gomez-Romero M, et al., 2015, A Comparison of DESI-MS and LC-MS for the Lipidomic Profiling of Human Cancer Tissue, Journal of the American Society for Mass Spectrometry, Vol: 27, Pages: 255-264, ISSN: 1044-0305
In this study, we make a direct comparison between desorptionelectrospray ionization-mass spectrometry (DESI-MS) and ultraperformance liquidchromatography-electrospray ionization-mass spectrometry (UPLC-ESI-MS) platformsfor the profiling of glycerophospholipid (GPL) species in esophageal cancertissue. In particular, we studied the similarities and differences in the range of GPLsdetected and the congruency of their relative abundances as detected by eachanalytical platform. The main differences between mass spectra of the two modalitieswere found to be associated with the variance in adduct formation of common GPLs,rather than the presence of different GPL species. Phosphatidylcholines as formateadducts in UPLC-ESI-MS accounted for the majority of differences in negative ionmode and alkali metal adducts of phosphatidylcholines in DESI-MS for positive ion mode. Comparison of therelative abundance of GPLs, normalized to a common peak, revealed a correlation coefficient of 0.70 (P < 0.001).The GPL profile detected by DESI-MS is congruent to UPLC-ESI-MS, which reaffirms the role of DESI-MS forlipidomic profiling and a potential premise for quantification.
Clancy NT, Arya S, Stoyanov D, et al., 2015, Intraoperative measurement of bowel oxygen saturation using a multispectral imaging laparoscope, Biomedical Optics Express, Vol: 6, Pages: 4179-4190, ISSN: 2156-7085
Intraoperative monitoring of tissue oxygen saturation (StO2) has potentially important applications in procedures such as organ transplantation or colorectal surgery, where successful reperfusion affects the viability and integrity of repaired tissues. In this paper a liquid crystal tuneable filter-based multispectral imaging (MSI) laparoscope is described. Motion-induced image misalignments are reduced, using feature-based registration, before regression of the tissue reflectance spectra to calculate relative quantities of oxy- and deoxyhaemoglobin. The laparoscope was validated in vivo, during porcine abdominal surgery, by making parallel MSI and blood gas measurements of the small bowel vasculature. Ischaemic conditions were induced by local occlusion of the mesenteric arcade and monitored using the system. The MSI laparoscope was capable of measuring StO2 over a wide range (30-100%) with a temporal error of ± 7.5%. The imager showed sensitivity to spatial changes in StO2 during dynamic local occlusions, as well as tracking the recovery of tissues post-occlusion.
Hicks LC, Huang J, Kumar S, et al., 2015, Analysis of Exhaled Breath Volatile Organic Compounds in Inflammatory Bowel Disease: A Pilot Study, JOURNAL OF CROHNS & COLITIS, Vol: 9, Pages: 731-737, ISSN: 1873-9946
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- Citations: 46
Wiggins T, Markar SR, Arya S, et al., 2015, Anastomotic reinforcement with omentoplasty following gastrointestinal anastomosis: A systematic review and meta-analysis, SURGICAL ONCOLOGY-OXFORD, Vol: 24, Pages: 181-186, ISSN: 0960-7404
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- Citations: 25
Markar SR, Wiggins T, Antonowicz S, et al., 2015, Minimally invasive esophagectomy: Lateral decubitus vs. prone positioning; systematic review and pooled analysis, SURGICAL ONCOLOGY-OXFORD, Vol: 24, Pages: 212-219, ISSN: 0960-7404
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- Citations: 43
Balog J, Kumar, Alexander J, et al., 2015, In vivo endoscopic tissue identification tool utilising Rapid Evaporative Ionization Mass Spectrometry (REIMS), Angewandte Chemie International Edition, Vol: 54, Pages: 11059-11062, ISSN: 1433-7851
Gastrointestinal cancers are a leading cause of mortality, accounting for 23 % of cancer-related deaths worldwide. In order to improve outcomes from these cancers, novel tissue characterization methods are needed to facilitate accurate diagnosis. Rapid evaporative ionization mass spectrometry (REIMS) is a technique developed for the in vivo classification of human tissue through mass spectrometric analysis of aerosols released during electrosurgical dissection. This ionization technique was further developed by utilizing surface induced dissociation and was integrated with an endoscopic polypectomy snare to allow in vivo analysis of the gastrointestinal tract. We tested the classification performance of this novel endoscopic REIMS method in vivo. It was shown to be capable of differentiating between healthy layers of the intestinal wall, cancer, and adenomatous polyps based on the REIMS fingerprint of each tissue type in vivo.
Murugaesu N, Wilson GA, Birkbak NJ, et al., 2015, Tracking the genomic evolution of esophageal adenocarcinoma through neoadjuvant chemotherapy, Cancer Discovery, Vol: 5, Pages: 821-831, ISSN: 2159-8274
Esophageal adenocarcinomas are associated with a dismal prognosis. Deciphering the evolutionary history of this disease may shed light on therapeutically tractable targets and reveal dynamic mutational processes during the disease course and following neoadjuvant chemotherapy (NAC). We exome sequenced 40 tumor regions from 8 patients with operable esophageal adenocarcinomas, before and after platinum-containing NAC. This revealed the evolutionary genomic landscape of esophageal adenocarcinomas with the presence of heterogeneous driver mutations, parallel evolution, early genome-doubling events, and an association between high intratumor heterogeneity and poor response to NAC. Multiregion sequencing demonstrated a significant reduction in thymine to guanine mutations within a CpTpT context when comparing early and late mutational processes and the presence of a platinum signature with enrichment of cytosine to adenine mutations within a CpC context following NAC. Esophageal adenocarcinomas are characterized by early chromosomal instability leading to amplifications containing targetable oncogenes persisting through chemotherapy, providing a rationale for future therapeutic approaches.
Cope AC, Mavroveli S, Bezemer J, et al., 2015, Making Meaning From Sensory Cues: A Qualitative Investigation of Postgraduate Learning in the Operating Room, ACADEMIC MEDICINE, Vol: 90, Pages: 1125-1131, ISSN: 1040-2446
Chiappini C, Campagnolo P, Almeida CS, et al., 2015, Mapping Local Cytosolic Enzymatic Activity in Human Esophageal Mucosa with Porous Silicon Nanoneedles, Advanced Materials, Vol: 27, Pages: 5147-5152, ISSN: 1521-4095
Porous silicon nanoneedles can map Cathepsin B activity across normal and tumor human esophageal mucosa. Assembling a peptide-based Cathepsin B cleavable sensor over a large array of nanoneedles allows the discrimination of cancer cells from healthy ones in mixed culture. The same sensor applied to tissue can map Cathepsin B activity with high resolution across the tumor margin area of esophageal adenocarcinoma.
Clancy NT, Arya S, Stoyanov D, et al., 2015, Imaging the spectral reflectance properties of bipolar radiofrequency-fused bowel tissue, Conference on Clinical and Biomedical Spectroscopy and Imaging IV held at the European Conferences on Biomedical Optics, Publisher: Society of Photo-Optical Instrumentation Engineers (SPIE), Pages: 953717-1-953717-6, ISSN: 0277-786X
Delivery of radiofrequency (RF) electrical energy is used during surgery to heat and seal tissue, such as vessels, allowing resection without blood loss. Recent work has suggested that this approach may be extended to allow surgical attachment of larger tissue segments for applications such as bowel anastomosis.In a large series of porcine surgical procedures bipolar RF energy was used to resect and re-seal the small bowel in vivo with a commercial tissue fusion device (Ligasure; Covidien PLC, USA). The tissue was then imaged with a multispectral imaging laparoscope to obtain a spectral datacube comprising both fused and healthy tissue. Maps of blood volume, oxygen saturation and scattering power were derived from the measured reflectance spectra using an optimised light-tissue interaction model.A 60% increase in reflectance of visible light (460-700 nm) was observed after fusion, with the tissue taking on a white appearance. Despite this the distinctive shape of the haemoglobin absorption spectrum was still noticeable in the 460-600 nm wavelength range. Scattering power increased in the fused region in comparison to normal serosa, while blood volume and oxygen saturation decreased.Observed fusion-induced changes in the reflectance spectrum are consistent with the biophysical changes induced through tissue denaturation and increased collagen cross-linking. The multispectral imager allows mapping of the spatial extent of these changes and classification of the zone of damaged tissue. Further analysis of the spectral data in parallel with histopathological examination of excised specimens will allow correlation of the optical property changes with microscopic alterations in tissue structure. © (2015) COPYRIGHT Society of Photo-Optical Instrumentation Engineers (SPIE). Downloading of the abstract is permitted for personal use only.
Huddy JR, Ni M, Mavroveli S, et al., 2015, A research protocol for developing a Point-Of-Care Key Evidence Tool 'POCKET': a checklist for multidimensional evidence reporting on point-of-care in vitro diagnostics., BMJ Open, Vol: 5, Pages: e007840-e007840, ISSN: 2044-6055
INTRODUCTION: Point-of-care in vitro diagnostics (POC-IVD) are increasingly becoming widespread as an acceptable means of providing rapid diagnostic results to facilitate decision-making in many clinical pathways. Evidence in utility, usability and cost-effectiveness is currently provided in a fragmented and detached manner that is fraught with methodological challenges given the disruptive nature these tests have on the clinical pathway. The Point-of-care Key Evidence Tool (POCKET) checklist aims to provide an integrated evidence-based framework that incorporates all required evidence to guide the evaluation of POC-IVD to meet the needs of policy and decisionmakers in the National Health Service (NHS). METHODS AND ANALYSIS: A multimethod approach will be applied in order to develop the POCKET. A thorough literature review has formed the basis of a robust Delphi process and validation study. Semistructured interviews are being undertaken with POC-IVD stakeholders, including industry, regulators, commissioners, clinicians and patients to understand what evidence is required to facilitate decision-making. Emergent themes will be translated into a series of statements to form a survey questionnaire that aims to reach a consensus in each stakeholder group to what needs to be included in the tool. Results will be presented to a workshop to discuss the statements brought forward and the optimal format for the tool. Once assembled, the tool will be field-tested through case studies to ensure validity and usability and inform refinement, if required. The final version will be published online with a call for comments. Limitations include unpredictable sample representation, development of compromise position rather than consensus, and absence of blinding in validation exercise. ETHICS AND DISSEMINATION: The Imperial College Joint Research Compliance Office and the Imperial College Hospitals NHS Trust R&D department have approved the protocol. The checklist tool will be
Chadwick G, Groene O, Riley S, et al., 2015, Gastric Cancers Missed During Endoscopy in England, CLINICAL GASTROENTEROLOGY AND HEPATOLOGY, Vol: 13, Pages: 1264-+, ISSN: 1542-3565
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- Citations: 47
Munasinghe A, Markar SR, Mamidanna R, et al., 2015, Is It Time to Centralize High-risk Cancer Care in the United States? Comparison of Outcomes of Esophagectomy Between England and the United States, ANNALS OF SURGERY, Vol: 262, Pages: 79-85, ISSN: 0003-4932
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- Citations: 77
Mackenzie H, Ni M, Miskovic D, et al., 2015, Clinical validity of consultant technical skills assessment in the English National Training Programme for Laparoscopic Colorectal Surgery, BRITISH JOURNAL OF SURGERY, Vol: 102, Pages: 991-997, ISSN: 0007-1323
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- Citations: 42
Arya S, Mackenzie H, Hanna GB, 2015, Non-vascular experimental and clinical applications of advanced bipolar radiofrequency thermofusion technology in the thorax and abdomen: a systematic review, SURGICAL ENDOSCOPY AND OTHER INTERVENTIONAL TECHNIQUES, Vol: 29, Pages: 1659-1678, ISSN: 0930-2794
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- Citations: 8
Du X, Clancy N, Arya S, et al., 2015, Robust surface tracking combining features, intensity and illumination compensation, International Journal of Computer Assisted Radiology and Surgery, Vol: 10, Pages: 1915-1926, ISSN: 1861-6410
Purpose Recovering tissue deformation during robotic-assisted minimally invasivesurgery (MIS) procedures is important for providing intra-operative guidance,enabling in vivo imaging modalities and enhanced robotic control. The tissue motioncan also be used to apply motion stabilization and to prescribe dynamicconstraints for avoiding critical anatomical structures.Methods Image-based methods based independently on salient features or onimage intensity have limitations when dealing with homogeneous soft-tissues orcomplex reflectance. In this paper, we use a triangular geometric mesh model inorder to combine the advantages of both feature and intensity information andtrack the tissue surface reliably and robustly.Results Synthetic and in vivo experiments are performed to provide quantitativeanalysis of the tracking accuracy of our method, we also show exemplar results forregistering multispectral images where there is only a weak image signal.Conclusions Compared to traditional methods, our hybrid tracking method ismore robust and has improved convergence in the presence of larger displacements,tissue dynamics and illumination changes.
Singh M, Harris-Birtill DCC, Markar SR, et al., 2015, Application of Gold Nanoparticles for Gastrointestinal Cancer Theranostics: A Systematic Review., Nanomedicine: Nanotechnology, Biology, and Medicine, Vol: 11, Pages: 2083-2098, ISSN: 1549-9634
Gold nanoparticles (GNPs) are readily synthesised structures that absorb light strongly to generate thermal energy which induces photothermal destruction of malignant tissue. This review examines the efficacy, potential challenges and toxicity from in vitro and in vivo applications of GNPs in oesophageal, gastric and colon cancers. A systematic literature search of Medline, Embase, Web of Science and Cochrane databases was performed using PRISMA guidelines. Two hundred and eighty-four papers were reviewed with sixteen studies meeting the inclusion criteria. The application of GNPs in eleven in vivo rodent studies with GI adenocarcinoma demonstrated excellent therapeutic outcomes but poor corroboration in terms of the cancer cells used, photothermal irradiation regimes, fluorophores and types of nanoparticles. There is compelling evidence of the translational potential of GNPs to be complimentary to surgery and feasible in the photothermal therapy of GI cancer but reproducibility and standardisation require further development prior to GI cancer clinical trials.
Huddy J, Weldon S-M, Ralhan S, et al., 2015, Sequential simulation of clinical pathways: a tool for public and patient involvement in diagnostic research, UK Diagnostic Forum
Barham P, Berrisford R, Titcomb D, et al., 2015, EVALUATING INNOVATIVE SURGERY: A NESTED IDEAL PHASE 2 STUDY WITHIN AN EXTERNAL RANDOMISED PILOT (THE ROMIO TRIAL), 2nd Digestive-Disorders-Federation Conference, Publisher: BMJ PUBLISHING GROUP, Pages: A39-A39, ISSN: 0017-5749
Markar SR, Khanderia E, Acharya A, et al., 2015, THE INFLUENCE OF GASTRIC CANCER SCREENING UPON STAGE AT DIAGNOSIS AND SURVIVAL, 2nd Digestive-Disorders-Federation Conference, Publisher: BMJ PUBLISHING GROUP, Pages: A126-A126, ISSN: 0017-5749
Hicks L, Huang J, Kumar S, et al., 2015, EXHALED VOLATILE ORGANIC COMPOUND BREATH ANALYSIS IN INFLAMMATORY BOWEL DISEASE, 2nd Digestive-Disorders-Federation Conference, Publisher: BMJ PUBLISHING GROUP, Pages: A6-A6, ISSN: 0017-5749
Foster J, Falk S, Ewings P, et al., 2015, A PILOT RANDOMISED CONTROLLED TRIAL USING OBJECTIVE VIDEO ASSESSMENT TO INVESTIGATE THE IMPACT OF THE INTERVAL BETWEEN LONG-COURSE CHEMORADIOTHERAPY AND RESECTION OF ADVANCED RECTAL CANCER UPON TECHNICAL PERFORMANCE OF SURGERY, 2nd Digestive-Disorders-Federation Conference, Publisher: BMJ PUBLISHING GROUP, Pages: A356-A356, ISSN: 0017-5749
Singh M, Nabavi E, Zhou Y, et al., 2015, APPLICATION OF GOLD NANORODS FOR IN VIVO THERANOSTICS OF HUMAN OESOPHAGEAL ADENOCARCINOMA, 2nd Digestive-Disorders-Federation Conference, Publisher: BMJ PUBLISHING GROUP, Pages: A471-A471, ISSN: 0017-5749
Markar SR, Mackenzie H, Wiggins T, et al., 2015, MANAGEMENT AND OUTCOMES OF OESOPHAGEAL PERFORATION: A NATIONAL STUDY OF 2564 PATIENTS IN ENGLAND, GUT, Vol: 64, Pages: A38-A38, ISSN: 0017-5749
Huddy JR, Ni MZ, Markar SR, et al., 2015, Point-of-care testing in the diagnosis of gastrointestinal cancers: Current technology and future directions, WORLD JOURNAL OF GASTROENTEROLOGY, Vol: 21, Pages: 4111-4120, ISSN: 1007-9327
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- Citations: 18
Wei R, Arya S, Williams P, et al., 2015, Therma response during ex vivo mucosa-to-mucosa bipolar radiofrequency induced intestinal sealing, Annual Meeting of the Society-of-Academic-and-Research-Surgery (SARS(, Publisher: WILEY-BLACKWELL, Pages: 40-40, ISSN: 0007-1323
Kumar S, Wiggins T, Balog J, et al., 2015, The iEndoscope - a novel method for mass spectrometric characterization of human tissue, Annual Meeting of the Society-of-Academic-and-Research-Surgery (SARS(, Publisher: WILEY-BLACKWELL, Pages: 36-37, ISSN: 0007-1323
Ahmed K, Anderson O, Jawad M, et al., 2015, Design and validation of the surgical ward round assessment tool: a quantitative observational study, AMERICAN JOURNAL OF SURGERY, Vol: 209, Pages: 682-688, ISSN: 0002-9610
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- Citations: 7
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