Imperial College London

MrKapilSahnan

Faculty of MedicineFaculty of Medicine Centre

Honorary Clinical Lecturer
 
 
 
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Contact

 

k.sahnan15 Website

 
 
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Location

 

St Marks HospitalNorthwick Park and St Marks Site

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Summary

 

Publications

Publication Type
Year
to

164 results found

Mata R, Sahnan K, Pellino G, Spinelli A, Espín-Basany Eet al., 2024, Robotic Total Mesorectal Excision With Transanal Transection and Single-Stapled Anastomosis: A Step-By-Step Video Demonstration., Dis Colon Rectum

Journal article

Alves Martins BA, Shamsiddinova A, Alquaimi M, Worley G, Tozer P, Sahnan K, Perry-Woodford Z, Hart A, Arebi N, Matharoo M, Warusavitarne J, Faiz Oet al., 2023, Creation of an institutional preoperative checklist to support clinical risk assessment in patients with ulcerative colitis (UC) considering ileoanal pouch surgery, Frontline Gastroenterology, ISSN: 2041-4145

Background: Total proctocolectomy with ileal pouch–anal anastomosis (IPAA) is the most established restorative operative approach for patients with ulcerative colitis. It has associated morbidity and the potential for major repercussions on quality of life. As such, patient selection is crucial to its success. The main aim of this paper is to present an institutional preoperative checklist to support clinical risk assessment and patient selection in those considering IPAA.Methods: A literature review was performed to identify the risk factors associated with surgical complications, decreased functional outcomes/quality of life, and pouch failure after IPAA. Based on this, a preliminary checklist was devised and modified through an iterative process. This was then evaluated by a consensus group comprising the pouch multidisciplinary team (MDT) core members.Results: The final preoperative checklist includes assessment for risk factors such as gender, advanced age, obesity, comorbidities, sphincteric impairment, Crohn’s disease and pelvic radiation therapy. In addition, essential steps in the decision-making process, such as pouch nurse counselling and discussion regarding surgical alternatives, are also included. The last step of the checklist is discussion at a dedicated pouch-MDT.Discussion: A preoperative checklist may support clinicians with the selection of patients that are suitable for pouch surgery. It also serves as a useful tool to inform the discussion of cases at the MDT meeting.

Journal article

Deputy M, Pitman F, Sahnan K, Miskovic D, Faiz Oet al., 2023, An early experience in robotic ileoanal pouch surgery with robotic intracorporeal single-stapled anastomosis (RiSSA) at a tertiary referral centre, COLORECTAL DISEASE, Vol: 25, Pages: 1169-1175, ISSN: 1462-8910

Journal article

Picciochi M, Glasbey JC, Li E, Kamarajah SK, Nepogodiev D, Simoes JFF, Bhangu A, Nathan A, Ismail NSM, Durrani AJ, Georgiades F, Liew I, Dornseifer MD, Parmar CD, Kolias AG, Baili EA, Nugur AK, Albanese E, Ghobrial M, Demetriades AK, Attwood JP, Singh B, Barlow CM, Fraser SM, Dube MK, Aujayeb A, Thekkinkattil DK, Botha AJ, Akinyemi TO, Peng WKE, Hammouche SA, Mohamed MKA, Elmesalmi MKA, Cannoletta MG, Wong KY, Fawi HMT, Cheng SF, Odejinmi FO, Horsfall HRML, Machairas N, Cuthbert RC, Malik SS, Callan RG, Egan RJ, Moawad NN, Ferguson DW, Grundy N, Collins ML, Herron JBT, Khatri C, Lewis SE, Alhammali T, Beamish AJ, Singisetti KK, Shalhoub J, Chean CS, Sivaprakasam R, Devarakonda S, Benjamin MW, Ashcroft J, Lapolla P, Henein C, Forde CT, Sohail MZ, Clegg RJ, Seymour ZM, Parasyris S, Dimitrokallis N, Davies BJ, Fahmy WFA, Wuraola OK, Serlis A, Gurung B, Kelly AJ, Talwar R, Cullis PS, Gracie DJ, Baker MP, Cross GW, Mar WWW, Hasan R, Pournaras DJ, Ng CE, Ramasamy AR, Iskandar ANA, Shiwani HA, Bansal S, McAleer SF, Ahmed O, Kempanna UR, Reilly J-J, Davies RJ, Anwar S, Harris GA, Ahmed U, Elsanhoury KT, Chin WJ, Ponugoti NK, Faiz J, Sheen JRC, Yusuf IH, Sheng Z, Stewart GD, Zaman S, Liyanage ASD, Iyengar KP, Aggarwal R, Ooi SZY, Mahmud A, Goh MA, Wheeler JMD, Eardley NJ, Boghdady ME, Soares D, O'Connor AD, Kariya AD, Brzeszczynski FF, Moreau JL, Saed A, Pilkington I, Navaratnam DM, Ryan NA, Majd HS, Ismail L, Shah HB, Khan AM, Nankivell PC, Fahmy WFA, Tyler RW, Siragusa L, Mannan SS, Bogani G, Abbasy J, Solli P, Donato ND, Burke JR, Hakeem A, Aljanadi F, Baldwin AJ, Bekheit M, Bobak PP, Fehervari M, Barra F, Thaha MA, Syed N, Olivier JB, Mohammed KAK, Williams KJ, Martin T, Coonar AS, Ho MWS, Yao MW, Charalabopoulos AK, Korompelis PG, Mak KA, Elsayed AAA, Hawley ER, Azzam AY, Kirk AJB, Sherif AE, Hussein MKA, Blair JA, Viswanath YKS, Cole SJ, Attarde DS, Allan AY, Gerogiannis IN, Dindyal S, Siddique MH, Sahid S, Neville JJ, Naumann DN, Byrne MH, Garcia SMA, Mohamedahmed AYYet al., 2023, Elective surgical services need to start planning for summer pressures, British Journal of Surgery, Vol: 110, Pages: 508-510, ISSN: 0007-1323

Journal article

Faheem W, Lin J, Nandra T, Richardson S, Saliu D, Wilson D, Jackson TA, Magill L, McCluskey L, Perry R, Welch C, Wilson D, Copeland C, Cunningham EL, Davis D, Treml J, Pinkney T, Quinn T, Nightingale P, Jelley B, Gaunt V, Lochlainn MN, Giridharan K, Alsahab M, Makin S, Torsney K, Masoli J, Ronan L, Burton JK, Todd O, Taylor J, Willott R, Cox N, Healy R, Haddad N, Ramakrishna S, Subhan Z, Mazzoleni A, Nynaes O, Crofts J, McNicholas E, Robinson HJ, Thyn T, Baillie J, McKeown W, Rice C, Sloan GW, Williamson K, Hayat Y, Lim VH, Millichamp K, Bazaraa A, Chilton A, Harbinson A, Headlam J, Hunter E, Hussain Z, Mahmood AW, Ng L, Sundara S, Tan F, Wheeler A, Wright S, Baldwin JBG, O'shea K, Hodhody G, Mayor K, Patel R, Bhakta S, Goujon M, Jakupaj A, Dove J, Kearney M, McCormack V, Moore K, Pope L, Shah H-A, Shaw ME, Smith GM, Love R, Mukundan M, Shahid M, Alareed A, Beharry K, Bhat G, Bremakumar S, Caines L, Darko S, Rai N, De Mucha PV, Adams P, McDonald H, Mills S, Parry F, Rickard F, Winearls S, Farah R, Grange R, Herbert F, Lonsdale-Eccles E, Ul Ain Q, Watson H, Bultynck C, Cavaliere C, Doherty C, Evans S, Furmedge D, MacCuish AH, Hindley E, Meyer C, Mullarkey E, Pullen R, Ryan A, Sarma D, Seymour E, Stambollouian K, Thayabaran D, Wu C, Peck G, Raza M, Sahnan K, Dhillon A, Abiola OO, Bryant C, Bygate R, Frewen J, Greaves I, Morrow O, Tetlow S, Tinson G, Yunus A, Bedi S, Evans O, Giet L, Behbahani A, Bhattacharya S, Hunt C, Mishra R, Connor L, Poynton J, Deacon E, Durcan R, Fisken E, Hall SA, Noble J, Prendergast EL, Macharouthu A, Macrae V, Murphy-Ackroyd E, Rose EC, Watt N, Blair M, Mackenzie ER, McCormack R, Irwin SJ, Einarsson A, Khor M, Alhadadi B, Cameron E, Campbell A, Capek E, Christie L, Connell L, Cook A, Deosaran J, Elliott M, Evans E, Fancourt S, Henderson S, Hussain A, Jones K, Kelly D, McErlean CM, Miller H, Naeem F, Ostrowski C, Parkinson M, Sami F, Shepherd A, Whyte L, Wright E, Ferguson EEC, Gallagher M, McCluskey HJ, Beveridge L, Clements HA, Hart J, Hendet al., 2023, Increasing frailty is associated with higher prevalence and reduced recognition of delirium in older hospitalised inpatients: results of a multi-centre study, European Geriatric Medicine, Vol: 14, Pages: 325-332, ISSN: 1878-7649

PurposeDelirium is a neuropsychiatric disorder delineated by an acute change in cognition, attention, and consciousness. It is common, particularly in older adults, but poorly recognised. Frailty is the accumulation of deficits conferring an increased risk of adverse outcomes. We set out to determine how severity of frailty, as measured using the CFS, affected delirium rates, and recognition in hospitalised older people in the United Kingdom.MethodsAdults over 65 years were included in an observational multi-centre audit across UK hospitals, two prospective rounds, and one retrospective note review. Clinical Frailty Scale (CFS), delirium status, and 30-day outcomes were recorded.ResultsThe overall prevalence of delirium was 16.3% (483). Patients with delirium were more frail than patients without delirium (median CFS 6 vs 4). The risk of delirium was greater with increasing frailty [OR 2.9 (1.8–4.6) in CFS 4 vs 1–3; OR 12.4 (6.2–24.5) in CFS 8 vs 1–3]. Higher CFS was associated with reduced recognition of delirium (OR of 0.7 (0.3–1.9) in CFS 4 compared to 0.2 (0.1–0.7) in CFS 8). These risks were both independent of age and dementia.ConclusionWe have demonstrated an incremental increase in risk of delirium with increasing frailty. This has important clinical implications, suggesting that frailty may provide a more nuanced measure of vulnerability to delirium and poor outcomes. However, the most frail patients are least likely to have their delirium diagnosed and there is a significant lack of research into the underlying pathophysiology of both of these common geriatric syndromes.

Journal article

Worley GHT, Vaughan-Shaw P, Sahnan K, 2023, Surgical management of ulcerative colitis, BRITISH JOURNAL OF SURGERY, ISSN: 0007-1323

Journal article

Pata F, Di Martino M, Podda M, Di Saverio S, Ielpo B, Pellino G, ACIE Appy Study Collaborativeet al., 2023, Correction: Evolving Trends in the Management of Acute Appendicitis During COVID-19 Waves: The ACIE Appy II Study., World J Surg, Vol: 47

Journal article

NIHR Global Health Unit on Global Surgery, COVIDSurg Collaborative, 2022, Elective surgery system strengthening: development, measurement, and validation of the surgical preparedness index across 1632 hospitals in 119 countries., The Lancet, Vol: 400, Pages: 1607-1617, ISSN: 0140-6736

BACKGROUND: The 2015 Lancet Commission on global surgery identified surgery and anaesthesia as indispensable parts of holistic health-care systems. However, COVID-19 exposed the fragility of planned surgical services around the world, which have also been neglected in pandemic recovery planning. This study aimed to develop and validate a novel index to support local elective surgical system strengthening and address growing backlogs. METHODS: First, we performed an international consultation through a four-stage consensus process to develop a multidomain index for hospital-level assessment (surgical preparedness index; SPI). Second, we measured surgical preparedness across a global network of hospitals in high-income countries (HICs), middle-income countries (MICs), and low-income countries (LICs) to explore the distribution of the SPI at national, subnational, and hospital levels. Finally, using COVID-19 as an example of an external system shock, we compared hospitals' SPI to their planned surgical volume ratio (SVR; ie, operations for which the decision for surgery was made before hospital admission), calculated as the ratio of the observed surgical volume over a 1-month assessment period between June 6 and Aug 5, 2021, against the expected surgical volume based on hospital administrative data from the same period in 2019 (ie, a pre-pandemic baseline). A linear mixed-effects regression model was used to determine the effect of increasing SPI score. FINDINGS: In the first phase, from a longlist of 103 candidate indicators, 23 were prioritised as core indicators of elective surgical system preparedness by 69 clinicians (23 [33%] women; 46 [67%] men; 41 from HICs, 22 from MICs, and six from LICs) from 32 countries. The multidomain SPI included 11 indicators on facilities and consumables, two on staffing, two on prioritisation, and eight on systems. Hospitals were scored from 23 (least prepared) to 115 points (most prepared). In the second phase, surgical preparedness

Journal article

Wickramasinghe D, Carvello M, Di Candido F, Maroli A, Adegbola S, Sahnan K, Morar P, Spinelli A, Warusavitarne Jet al., 2022, Factors associated with stoma formation in ileocolic resection for Crohn's disease and the development of a predictive scoring system, LANGENBECKS ARCHIVES OF SURGERY, Vol: 407, Pages: 2997-3003, ISSN: 1435-2443

Journal article

Dilke SM, Hadjittofi C, Than M, Tozer PJ, Stearns AT, EQuLAR Study Groupet al., 2022, Anterior Resection Syndrome and Quality of Life With Long-term Follow-up After Rectal Cancer Resection., Dis Colon Rectum, Vol: 65, Pages: 1251-1263

BACKGROUND: Surgical and systemic therapies continue to advance, enabling restorative resections for distal rectal cancer. These operations are associated with low anterior resection syndrome. Recent studies with methodological and size limitations have investigated the incidence of low anterior resection syndrome after anterior resection. However, the long-term trajectory of low anterior resection syndrome and its effect on health-related quality of life remain unclear. OBJECTIVE: The purpose of this study was to assess the impact of anterior resection and reversal of ileostomy on long-term health-related quality of life and low anterior resection syndrome. DESIGN: Patient demographics were analyzed alongside low anterior resection syndrome and health-related quality-of-life qualitative scores (EORTC-QLQ-C30) obtained through cross-sectional postal questionnaires. SETTING: Patients who underwent anterior resection of the rectum for cancer with defunctioning ileostomy between 2003 and 2016 at 2 high-volume centers in the United Kingdom were identified, excluding those experiencing anastomotic leakage. PATIENTS: Among 478 eligible patients, 311 (65.1%) participated at a mean of 6.5 ± 0.2 years after anterior resection. Demographics and neoadjuvant chemoradiotherapy rates were similar ( p > 0.05) between participants and nonparticipants. RESULTS: The percentage of patients who experienced major low anterior resection syndrome was 53.4% (166/311). Health-related quality-of-life functional domain scores improved in the years after reversal of ileostomy, with significant changes in constipation ( p = 0.01), social function ( p = 0.03), and emotional scores ( p = 0.02), as well as a reduction in the prevalence of major low anterior resection syndrome ( p = 0.003). LIMITATIONS: The main limitation of this study was that the data collected were cross-sectional rather than longitudinal, and that nonresponders may have had worse cancer symptoms. CONCLUSIONS: In this

Journal article

Sahnan K, Warusavitarne J, 2022, Anal fistulas are not all the same, TECHNIQUES IN COLOPROCTOLOGY, Vol: 26, Pages: 773-774, ISSN: 1123-6337

Journal article

Tripartite Gastrointestinal Recovery SBO Group, 2022, A core outcome set for clinical studies of adhesive small bowel obstruction., Colorectal Dis, Vol: 24, Pages: 1204-1210

AIM: Adhesive small bowel obstruction (ASBO) is a common surgical emergency condition. Research in the field is plentiful; however, inconsistency in outcome reporting makes comparisons challenging. The aim of this study was to define a core outcome set (COS) for studies of ASBO. METHODS: The long list of outcomes was identified through systematic review, and focus groups across different geographical regions. A modified Delphi consensus exercise of three rounds was undertaken with stakeholder groups (patients and clinicians). Items were rated on a 9-point Likert scale. Items exceeding 70% rating at 7-9 were passed to the consensus meeting. New item proposals were invited in round 1. Individualised feedback on prior voting compared to other participants was provided. An international consensus meeting was convened to ratify the final COS. RESULTS: In round 1, 56 items were rated by 118 respondents. A total of 18 items reached consensus, and respondents proposed an additional 10 items. Round 2 was completed by 90 respondents, and nine items achieved consensus. In round 3, 80 surveys were completed; one item achieved consensus, and five borderline items were identified. The final COS included 26 outcomes, mapped to the following domains: Interventions, need for stoma, septic complications, return of gut function, patient reported outcomes, and recurrence of obstruction, as well as mortality, failure to rescue, and time to resolution. CONCLUSION: This COS should be used in future studies in the treatment of adhesive SBO. Further studies to define a core measurement set are needed to identify the optimum tools to measure each outcome.

Journal article

Pata F, Di Martino M, Podda M, Di Saverio S, Ielpo B, Pellino G, ACIE Appy Study Collaborativeet al., 2022, Evolving Trends in the Management of Acute Appendicitis During COVID-19 Waves: The ACIE Appy II Study., World J Surg, Vol: 46, Pages: 2021-2035

BACKGROUND: In 2020, ACIE Appy study showed that COVID-19 pandemic heavily affected the management of patients with acute appendicitis (AA) worldwide, with an increased rate of non-operative management (NOM) strategies and a trend toward open surgery due to concern of virus transmission by laparoscopy and controversial recommendations on this issue. The aim of this study was to survey again the same group of surgeons to assess if any difference in management attitudes of AA had occurred in the later stages of the outbreak. METHODS: From August 15 to September 30, 2021, an online questionnaire was sent to all 709 participants of the ACIE Appy study. The questionnaire included questions on personal protective equipment (PPE), local policies and screening for SARS-CoV-2 infection, NOM, surgical approach and disease presentations in 2021. The results were compared with the results from the previous study. RESULTS: A total of 476 answers were collected (response rate 67.1%). Screening policies were significatively improved with most patients screened regardless of symptoms (89.5% vs. 37.4%) with PCR and antigenic test as the preferred test (74.1% vs. 26.3%). More patients tested positive before surgery and commercial systems were the preferred ones to filter smoke plumes during laparoscopy. Laparoscopic appendicectomy was the first option in the treatment of AA, with a declined use of NOM. CONCLUSION: Management of AA has improved in the last waves of pandemic. Increased evidence regarding SARS-COV-2 infection along with a timely healthcare systems response has been translated into tailored attitudes and a better care for patients with AA worldwide.

Journal article

Knight SR, Chu K, Lapitan MC, Dare AJ, Pius R, Shaw CA, Drake TM, Norman L, Ademuyiwa AO, Adisa AO, Aguilera ML, Al-Saqqa SW, Al-Slaibi I, Bhangu A, Biccard BM, Brocklehurst P, Costas-Chavarri A, Elhadi M, Fairfield CJ, Fitzgerald JE, Ghosh D, Glasbey J, Henegouwen MIVB, Ingabire JCA, Kingham TP, Lawani I, Lieske B, Lilford R, Martin J, Mclean KA, Moore R, Morton D, Nepogodiev D, Ntirenganya F, Pata F, Pinkney T, Qureshi AU, Ramos-De la Medina A, Riad A, Salem HK, Simoes J, Spence R, Smart N, Tabiri S, Thomas H, West M, Whitaker J, Weiser TG, Harrison EMet al., 2022, Effects of hospital facilities on patient outcomes after cancer surgery: an international, prospective, observational study, LANCET GLOBAL HEALTH, Vol: 10, Pages: E1003-E1011, ISSN: 2214-109X

Journal article

Chapman SJ, Lee MJ, Blackwell S, Arnott R, ten Broek RPG, Delaney CP, Dudi-Venkata NN, Fish R, Hind D, Jayne DG, Mellor K, Mishra A, O'Grady G, Sammour T, Thorpe G, Wells C, Wolthuis AM, Fearnhead NS, Adegbola S, Bagaglini G, Bath M, Bibby N, Bisset C, Blefari N, Blencowe NS, Bolton W, Bulte JP, Burch J, Campanelli M, Cano-Valderrama O, Carver J, Challand C, Chan S, Chandler S, Clerc D, Coe P, Cox D, Cross KLR, Culkin A, Cuthill V, Daniels S, Dawson A, Dawson L, Dixon F, Downey C, Drake T, Duff S, Dunning G, Espin-Basany E, Evans MD, Fakhrul-Aldeen M, Fisher N, Fleetwood-Beresford S, Gallo G, Garoufalia Z, George R, Han J, Harji D, Harmston R, Harris DA, Mohammed M, Helliwell J, Hepburn J, Herrod P, Horwood N, Keane C, Kelly S, Kroon HM, Lonsdale MDS, Major G, Mattison J, McLean AL, Millan M, Limbert S, McDermott F, Mehraj A, Moriarty C, Moug S, Murray E, Naylor M, Nepogodiev D, Oliver J, Pandey D, Pata F, Paterson HM, Peckham-Cooper A, Pellino G, Pockney P, Proctor VK, Proud D, Rew V, Rutegard M, Sahnan K, Sayers A, Siragusa L, Smillie RW, Spratt J, Swain D, Taylor S, Tejedor P, Thomas O, Thompson J, Tsimogiannis K, Tuohey D, Vissapragada R, Younis MU, Vaughan-Shaw PG, Whyte K, Wheelband K, Williams A, Yates A, Young Ret al., 2022, Core outcome set for clinical studies of postoperative ileus after intestinal surgery, BRITISH JOURNAL OF SURGERY, Vol: 109, Pages: 493-496, ISSN: 0007-1323

Journal article

Adamina M, Ademuyiwa A, Adisa A, Bhangu AA, Bravo AM, Cunha MF, Emile S, Ghosh D, Glasbey JC, Harris B, Keller D, Lawday S, Lederhuber H, Leventoglu S, Li E, Modolo MM, Mittal R, Mohan HM, Nepogodiev D, Parreno-Sacdalan MD, Pata F, Pockney P, Rutegard M, Simoes JFF, Smart N, Varghese C, Siaw-Acheampong K, Benson RA, Bywater E, Chaudhry D, Dawson BE, Evans JP, Gujjuri RR, Heritage E, Jones CS, Kamarajah SK, Khatri C, Khaw RA, Keatley JM, Knight A, Smart NJ, Minaya-Bravo A, Gallo G, Moug S, Di Saverio S, Vallance A, Vimalchandra D, Griffiths EA, Evans RPT, Townen P, Roberts K, McKay S, Isaac J, Satoi S, Edwards J, Coonar AS, Marchbank A, Caruana EJ, Layton GR, Patel A, Brunelli A, Ford S, Desai A, Gronchi A, Fiore M, Almond M, Tirotta F, Dumitra S, Kolias A, Price SJ, Fountain DM, Jenkinson MD, Hutchinson P, Marcus HJ, Piper RJ, Lippa L, Servadei F, Esene I, Freyschlag C, Neville I, Rosseau G, Schaller K, Demetriades AK, Robertson F, Alamri A, Shaw R, Schache AG, Winter SC, Ho M, Nankivell P, Biel JR, Batstone M, Ganly I, Vidya R, Wilkins A, Singh JK, Thekinkattil D, Sundar S, Fotopoulou C, Leung EY, Khan T, Chiva L, Sehouli J, Fagotti A, Cohen P, Gutelkin M, Ghebre R, Konney T, Pareja R, Bristow R, Dowdy S, Shylasree TS, Seenivasagam RK, Ng J, Fujiwar K, Stewart GD, Lamb B, Narahari K, McNeill A, Colquhoun A, McGrath JS, Bromage S, Barod R, Kasivisvanathan V, Klatte T, Abbott TEF, Abukhalaf S, Ademuyiwa AO, Agarwal A, Akkulak M, Alameer E, Alderson D, Alakaloko F, Albertsmeier M, Alser O, Alshaar M, Alshryda S, Arnaud AP, Augestad KM, Ayasra F, Azevedo J, Bankhead-Kendall BK, Barlow E, Beard D, Blanco-Colino R, Brar A, Breen KA, Bretherton C, Buarque IL, Burke J, Chaar M, Chakrabortee S, Christensen P, Cox D, Cukier M, Davidson GH, Drake TM, Edwards JG, Elhadi M, Farik S, Fitzgerald JE, Garmanova T, Gomes GMA, Grecinos G, Gruendl M, Halkias C, Harrison EM, Hisham I, Hutchinson PJ, Hwang S, Isik A, Jonker P, Kaafarani HMA, Kruijff S, Lawani I, Litvin A, Loehrer A, Lofet al., 2022, The impact of surgical delay on resectability of colorectal cancer: An international prospective cohort study, Colorectal Disease, Vol: 24, Pages: 708-726, ISSN: 1462-8910

AimThe SARS-CoV-2 pandemic has provided a unique opportunity to explore the impact of surgical delays on cancer resectability. This study aimed to compare resectability for colorectal cancer patients undergoing delayed versus non-delayed surgery.MethodsThis was an international prospective cohort study of consecutive colorectal cancer patients with a decision for curative surgery (January–April 2020). Surgical delay was defined as an operation taking place more than 4 weeks after treatment decision, in a patient who did not receive neoadjuvant therapy. A subgroup analysis explored the effects of delay in elective patients only. The impact of longer delays was explored in a sensitivity analysis. The primary outcome was complete resection, defined as curative resection with an R0 margin.ResultsOverall, 5453 patients from 304 hospitals in 47 countries were included, of whom 6.6% (358/5453) did not receive their planned operation. Of the 4304 operated patients without neoadjuvant therapy, 40.5% (1744/4304) were delayed beyond 4 weeks. Delayed patients were more likely to be older, men, more comorbid, have higher body mass index and have rectal cancer and early stage disease. Delayed patients had higher unadjusted rates of complete resection (93.7% vs. 91.9%, P = 0.032) and lower rates of emergency surgery (4.5% vs. 22.5%, P < 0.001). After adjustment, delay was not associated with a lower rate of complete resection (OR 1.18, 95% CI 0.90–1.55, P = 0.224), which was consistent in elective patients only (OR 0.94, 95% CI 0.69–1.27, P = 0.672). Longer delays were not associated with poorer outcomes.ConclusionOne in 15 colorectal cancer patients did not receive their planned operation during the first wave of COVID-19. Surgical delay did not appear to compromise resectability, raising the hypothesis that any reduction in long-term survival attributable to delays is likely to be due to micro-metastatic disease.

Journal article

Deputy M, Sahnan K, Worley G, Patel K, Balinskaite V, Bottle A, Aylin P, Burns EM, Hart A, Faiz Oet al., 2022, The use of, and outcomes for, inflammatory bowel disease services during the Covid-19 pandemic: a nationwide observational study, ALIMENTARY PHARMACOLOGY & THERAPEUTICS, Vol: 55, Pages: 836-846, ISSN: 0269-2813

Journal article

Tabiri S, Kamarajah SK, Nepogodiev D, Li E, Simoes J, Sravanam S, Owusu SA, Mahama H, Agyeman YN, Arthur J, Kunfah SM, Gyamfi FE, Owusu EA, Loffler MW, Wandoh P, Bhangu A, Siaw-Acheampong K, Argus L, Chaudhry D, Dawson BE, Glasbey JC, Gujjuri RR, Jones CS, Khatri C, Keatley JM, Lawday S, Mann H, Marson EJ, Mclean KA, Picciochi M, Taylor EH, Tiwari A, Simoes JFF, Trout IM, Venn ML, Wilkin RJW, Dajti I, Gjata A, Boccalatte L, Modolo MM, Cox D, Pockney P, Townend P, Aigner F, Kronberger I, Hossain K, VanRamshorst G, Lawani I, Ataide G, Baiocchi G, Buarque I, Gohar M, Slavchev M, Agarwal A, Brar A, Martin J, Olivos M, Calvache J, Perez Rivera CJ, Hadzibegovic AD, Kopjar T, Mihanovic J, Klat J, Novysedlak R, Christensen P, El-Hussuna A, Batista S, Lincango E, Emile SH, Mengesha MG, Hailu DS, Tamiru H, Kauppila J, Arnaud A, Albertsmeiers M, Lederhuber H, Loffler M, Metallidis S, Tsoulfas G, Lorena MA, Grecinos G, Mersich T, Wettstein D, Ghosh D, Kembuan G, Brouk P, Khosravi M, Mozafari M, Adil A, Mohan HM, Zmora O, Fiore M, Gallo G, Pata F, Pellino G, Satoi S, Ayasra F, Chaar M, Fakhradiyev IR, Jamal M, Elhadi M, Gulla A, Roslani A, Martinez L, Ramos De la Medina A, Outani O, Jonker P, Kruijff S, Noltes M, Steinkamp P, van der Plas W, Ademuyiwa A, Osinaike B, Seyi-olajide J, Williams E, Pejkova S, Augestad KM, Soreide K, Al Balushi Z, Qureshi A, Sayyed R, Daraghmeh MAM, Abukhalaf S, Cukier M, Gomez H, Shu S, Vasquez X, Parreno-Sacdalan MD, Major P, Azevedo J, Cunha M, Santos I, Zarour A, Bonci E-A, Negoi I, Efetov S, Litvin A, Ntirenganya F, AlAmeer E, Radenkovic D, Xiang FKH, Hoe CM, Yong JNC, Moore R, Nhlabathi N, Colino RB, Bravo AM, Minaya-Bravo A, Jayarajah U, Wickramasinghe D, Elmujtaba M, Jebril W, Rutegard M, Sund M, Isik A, Leventoglu S, Abbott TEF, Benson R, Caruna E, Chakrabortee S, Demetriades A, Desai A, Drake TD, Edwards JG, Evans JP, Ford S, Fotopoulou C, Griffiths E, Hutchinson P, Jenkinson MD, Khan T, Knight S, Kolias A, Leung E, McKay S, Norman L, Ots Ret al., 2022, Impact of Bacillus Calmette-Guerin (BCG) vaccination on postoperative mortality in patients with perioperative SARS-CoV-2 infection, BJS Open, Vol: 5, ISSN: 2474-9842

Journal article

Vogel I, Vaughan-Shaw PG, Gash K, Withers KL, Carolan-Rees G, Thornton M, Dhruvao Rao PK, Torkington J, Cornish JAet al., 2022, Improving the time to ileostomy closure following an anterior resection for rectal cancer in the UK, COLORECTAL DISEASE, Vol: 24, Pages: 120-127, ISSN: 1462-8910

Journal article

COVIDSurg Collaborative, GlobalSurg Collaborative, 2022, SARS‐CoV‐2 infection and venous thromboembolism after surgery: an international prospective cohort study, Anaesthesia, Vol: 77, Pages: 28-39, ISSN: 0003-2409

SARS-CoV-2 has been associated with an increased rate of venous thromboembolism in critically ill patients. Since surgical patients are already at higher risk of venous thromboembolism than general populations, this study aimed to determine if patients with peri-operative or prior SARS-CoV-2 were at further increased risk of venous thromboembolism. We conducted a planned sub-study and analysis from an international, multicentre, prospective cohort study of elective and emergency patients undergoing surgery during October 2020. Patients from all surgical specialties were included. The primary outcome measure was venous thromboembolism (pulmonary embolism or deep vein thrombosis) within 30 days of surgery. SARS-CoV-2 diagnosis was defined as peri-operative (7 days before to 30 days after surgery); recent (1–6 weeks before surgery); previous (≥7 weeks before surgery); or none. Information on prophylaxis regimens or pre-operative anti-coagulation for baseline comorbidities was not available. Postoperative venous thromboembolism rate was 0.5% (666/123,591) in patients without SARS-CoV-2; 2.2% (50/2317) in patients with peri-operative SARS-CoV-2; 1.6% (15/953) in patients with recent SARS-CoV-2; and 1.0% (11/1148) in patients with previous SARS-CoV-2. After adjustment for confounding factors, patients with peri-operative (adjusted odds ratio 1.5 (95%CI 1.1–2.0)) and recent SARS-CoV-2 (1.9 (95%CI 1.2–3.3)) remained at higher risk of venous thromboembolism, with a borderline finding in previous SARS-CoV-2 (1.7 (95%CI 0.9–3.0)). Overall, venous thromboembolism was independently associated with 30-day mortality (5.4 (95%CI 4.3–6.7)). In patients with SARS-CoV-2, mortality without venous thromboembolism was 7.4% (319/4342) and with venous thromboembolism was 40.8% (31/76). Patients undergoing surgery with peri-operative or recent SARS-CoV-2 appear to be at increased risk of postoperative venous thromboembolism compared with patients with no his

Journal article

Adegbola SO, Sarafian M, Sahnan K, Pechlivanis A, Phillips RKS, Warusavitarne J, Faiz O, Haddow J, Knowles C, Tozer P, Holmes E, Hart Aet al., 2022, Lack of anti-TNF drugs levels in fistula tissue - a reason for nonresponse in Crohn's perianal fistulating disease?, Publisher: LIPPINCOTT WILLIAMS & WILKINS, Pages: 18-26, ISSN: 0954-691X

Conference paper

McLean KA, Kamarajah SK, Chaudhry D, Gujjuri RR, Raubenheimer K, Trout I, AlAmeer E, Creagh-Brown B, Harrison EM, Nepogodiev D, Roslani AC, Li E, Pata F, Medina AR-D, van Ramshorst GH, Valente DCA, Sayyed R, Simoes J, Smart N, Bhangu A, Glasbey JC, Khaw RA, Ahmed W, Akhbari M, Baker D, Borakati A, Mills E, Murray V, Thavayogan R, Yasin I, Glasbey J, Ridley W, Sarrami M, Zhang G, Egoroff N, Pockney P, Richards T, Edwards M, Lee M, Pinkney T, Pearse R, Vohra R, Sohrabi C, Jamieson A, Nguyen M, Rahman A, English C, Tincknell L, Kakodkar P, Kwek I, Punjabi N, Burns J, Varghese S, Erotocritou M, McGuckin S, Vayalapra S, Dominguez E, Moneim J, Bhatia S, Kouli O, Salehi M, Tan HL, Yoong A, Zhu L, Seale B, Nowinka Z, Patel N, Chrisp B, Harris J, Maleyko I, Muneeb F, Gough M, James CE, Skan O, Chowdhury A, Rebuffa N, Khan H, Down B, Fatimah HQ, Siaw-Acheampong K, Benson RA, Bywater E, Dawson BE, Evans JP, Heritage E, Jones CS, Khatri C, Keatley JM, Knight A, Lawday S, Mann HS, Marson EJ, Mckay SC, Mills EC, Pellino G, Picciochi M, Taylor EH, Tiwari A, Simoes JFF, Trout IM, Venn ML, Wilkin RJW, Smart NJ, Minaya-Bravo A, Gallo G, Moug S, Di Saverio S, Vallance A, Vimalchandran D, Griffiths EA, Evans RPT, Townend P, Roberts K, McKay S, Isaac J, Satoi S, Edwards J, Coonar AS, Marchbank A, Caruana EJ, Layton GR, Patel A, Brunelli A, Ford S, Desai A, Gronchi A, Fiore M, Almond M, Tirotta F, Dumitra S, Kolias A, Price SJ, Fountain DM, Jenkinson MD, Hutchinson P, Marcus HJ, Piper RJ, Lippa L, Servadei F, Esene I, Freyschlag C, Neville I, Rosseau G, Schaller K, Demetriades AK, Robertson F, Alamri A, Shaw R, Schache AG, Winter SC, Ho M, Nankivell P, Biel JR, Batstone M, Ganly I, Vidya R, Wilkins A, Singh JK, Thekinkattil D, Sundar S, Fotopoulou C, Leung E, Khan T, Chiva L, Sehouli J, Fagotti A, Cohen P, Gutelkin M, Ghebre R, Konney T, Pareja R, Bristow R, Dowdy S, Rajkumar STS, Ng J, Fujiwara K, Stewart GD, Lamb B, Narahari K, McNeill A, Colquhoun A, McGrath J, Bromage S, Barod R, Kaset al., 2021, Death following pulmonary complications of surgery before and during the SARS-CoV-2 pandemic, BRITISH JOURNAL OF SURGERY, Vol: 108, Pages: 1448-1464, ISSN: 0007-1323

Journal article

Adegbola SO, Sarafian M, Sahnan K, Ding NS, Faiz OD, Warusavitarne J, Phillips RKS, Tozer PJ, Holmes E, Hart ALet al., 2021, Differences in amino acid and lipid metabolism distinguish Crohn's from idiopathic/cryptoglandular perianal fistulas by tissue metabonomic profiling and may offer clues to underlying pathogenesis, EUROPEAN JOURNAL OF GASTROENTEROLOGY & HEPATOLOGY, Vol: 33, Pages: 1469-1479, ISSN: 0954-691X

Journal article

Iqbal N, Dilke SM, Geldof J, Sahnan K, Adegbola S, Bassett P, Tozer Pet al., 2021, Is fistulotomy with immediate sphincter reconstruction (FISR) a sphincter preserving procedure for high anal fistula? A systematic review and meta-analysis, COLORECTAL DISEASE, Vol: 23, Pages: 3073-3089, ISSN: 1462-8910

Journal article

The Vascular and Endovascular Research Network, COVIDSurg Collaborative, Shalhoub J, 2021, Impact of COVID-19 on Vascular Patients Worldwide: Analysis of the COVIDSurg Data, The Journal of Cardiovascular Surgery: a journal on cardiac, vascular and thoracic surgery, ISSN: 0021-9509

Journal article

Khatri C, Ward AE, Nepogodiev D, Ahmed I, Chaudhry D, Dhaif F, Bankhad-Kendall B, Kaafarani H, Bretherton C, Mahmood A, Marais L, Parsons N, Bhangu A, Metcalfe A, Parsons N, Khatri C, Siaw-Acheampong K, Chaudhry D, Dawson BE, Evans JP, Glasbey JC, Gujjuri RR, Heritage E, Jones CS, Kamarajah SK, Khatri C, Keatley JM, Lawday S, Li E, Mckay SC, Nepogodiev D, Pellino G, Tiwari A, Simoes JFF, Trout IM, Venn ML, Wilkin RJW, Bhangu A, Ademuyiwa AO, Agarwal A, Al Ameer E, Alderson D, Alser O, Arnaud AP, Augestad KM, Bankhead-Kendall B, Benson RA, Chakrabortee S, Blanco-Colino R, Brar A, Bravo AM, Breen KA, Buarque IL, Caruana E, Cunha MF, Davidson GH, Desai A, Di Saverio S, Edwards J, Elhadi M, Farik S, Fiore M, Fitzgerald JE, Ford S, Gallo G, Ghosh D, Gomes GMA, Griffiths E, Halkias C, Harrison EM, Hutchinson P, Isik A, Kaafarani H, Kolias A, Lawani I, Lederhuber H, Leventoglu S, Loffler MW, Martin J, Mashbari H, Mazingi D, Mohan H, Moore R, Moszkowicz D, Ng-Kamstra JS, Metallidis S, Moug S, Niquen M, Ntirenganya F, Outani O, Pata F, Pinkney TD, Pockney P, Radenkovic D, Ramos-De la Medina A, Roberts K, Santos I, Schache A, Schnitzbauer A, Stewart GD, Shaw R, Shu S, Soreide K, Spinelli A, Sundar S, Tabiri S, Townend P, Tsoulfas G, van Ramshorst G, Vidya R, Vimalachandran D, Wright N, Simoes JFF, Mak JKC, Kulkarni R, Sharma N, Nankivell P, Tirotta F, Parente A, Breik O, Kisiel A, Cato LD, Saeed S, Bhangu A, Griffiths E, Pathanki AM, Ford S, Desai A, Almond M, Kamal M, Chebaro A, Lecolle K, Truant S, El Amrani M, Zerbib P, Pruvot FR, Mathieu D, Surmei E, Mattei L, Marin H, Dudek J, Singhal T, El-Hasani S, Nehra D, Walters A, Cuschieri J, Davidson GH, Ho M, Wade RG, Johnstone J, Bourke G, Brunelli A, Elkadi H, Otify M, Pompili C, Burke JR, Bagouri E, Chowdhury M, Abual-Rub Z, Kaufmann A, Munot S, Lo T, Young A, Kowal M, Wall J, Peckham-Cooper A, Winter SC, Belcher E, Stavroulias D, Di Chiara F, Wallwork K, Qureishi A, Lami M, Sravanam S, Mastoridis S, Shah K, Chidambaram S, Smet al., 2021, Outcomes after perioperative SARS-CoV-2 infection in patients with proximal femoral fractures: an international cohort study, BMJ Open, Vol: 11, Pages: 1-10, ISSN: 2044-6055

Objectives Studies have demonstrated high rates of mortality in people with proximal femoral fracture and SARS-CoV-2, but there is limited published data on the factors that influence mortality for clinicians to make informed treatment decisions. This study aims to report the 30-day mortality associated with perioperative infection of patients undergoing surgery for proximal femoral fractures and to examine the factors that influence mortality in a multivariate analysis.Setting Prospective, international, multicentre, observational cohort study.Participants Patients undergoing any operation for a proximal femoral fracture from 1 February to 30 April 2020 and with perioperative SARS-CoV-2 infection (either 7 days prior or 30-day postoperative).Primary outcome 30-day mortality. Multivariate modelling was performed to identify factors associated with 30-day mortality.Results This study reports included 1063 patients from 174 hospitals in 19 countries. Overall 30-day mortality was 29.4% (313/1063). In an adjusted model, 30-day mortality was associated with male gender (OR 2.29, 95% CI 1.68 to 3.13, p<0.001), age >80 years (OR 1.60, 95% CI 1.1 to 2.31, p=0.013), preoperative diagnosis of dementia (OR 1.57, 95% CI 1.15 to 2.16, p=0.005), kidney disease (OR 1.73, 95% CI 1.18 to 2.55, p=0.005) and congestive heart failure (OR 1.62, 95% CI 1.06 to 2.48, p=0.025). Mortality at 30 days was lower in patients with a preoperative diagnosis of SARS-CoV-2 (OR 0.6, 95% CI 0.6 (0.42 to 0.85), p=0.004). There was no difference in mortality in patients with an increase to delay in surgery (p=0.220) or type of anaesthetic given (p=0.787).Conclusions Patients undergoing surgery for a proximal femoral fracture with a perioperative infection of SARS-CoV-2 have a high rate of mortality. This study would support the need for providing these patients with individualised medical and anaesthetic care, including medical optimisation before t

Journal article

Adegbola SO, Sahnan K, Twum-Barima C, Iqbal N, Reza L, Lung P, Warusavitarne J, Tozer P, Hart Aet al., 2021, Current review of the management of fistulising perianal Crohn's disease, FRONTLINE GASTROENTEROLOGY, Vol: 12, Pages: 515-523, ISSN: 2041-4137

Journal article

Sahnan K, Adegbola S, Iqbal N, Twum-Barima C, Reza L, Lung P, Warusavitarne J, Hart A, Tozer Pet al., 2021, Managing non-IBD fistulising disease, FRONTLINE GASTROENTEROLOGY, Vol: 12, Pages: 524-534, ISSN: 2041-4137

Journal article

Alyami A, Hoad CL, Tench C, Bannur U, Clarke C, Latief K, Argyriou K, Lobo A, Lung P, Baldwin-Cleland R, Sahnan K, Hart A, Limdi JK, Mclaughlin J, Atkinson D, Parker GJM, O'Connor JPB, Little RA, Gowland PA, Moran GWet al., 2021, Quantitative Magnetic Resonance Imaging in Perianal Crohn's Disease at 1.5 and 3.0 T: A Feasibility Study, DIAGNOSTICS, Vol: 11

Journal article

Pellino G, Podda M, Pata F, Di Saverio S, Ielpo B, ACIE Appy Study Collaborativeet al., 2021, Inequalities in screening policies and perioperative protection for patients with acute appendicitis during the pandemic: Subanalysis of the ACIE Appy study., Br J Surg, Vol: 108, Pages: e332-e335

Journal article

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