Imperial College London

DrLakshmanaAyaru

Faculty of MedicineDepartment of Metabolism, Digestion and Reproduction

Honorary Senior Clinical Lecturer
 
 
 
//

Contact

 

l.ayaru

 
 
//

Location

 

Hammersmith HospitalHammersmith Campus

//

Summary

 

Publications

Publication Type
Year
to

36 results found

Boger P, Rahman I, Hu M, Ayaru L, Bhandari P, Chedgy F, Green S, Hayat M, Hopper AD, Ishaq S, Martin J, McCallum I, Phull P, Pugh S, Russo E, Suzuki N, Thomas-Gibson S, Zeino Z, Patel Pet al., 2021, Endoscopic full thickness resection in the colo-rectum: outcomes from the UK Registry, EUROPEAN JOURNAL OF GASTROENTEROLOGY & HEPATOLOGY, Vol: 33, Pages: 852-858, ISSN: 0954-691X

Journal article

Harlow C, Sivananthan A, Ayaru L, Patel K, Darzi A, Patel Net al., 2020, Endoscopic submucosal dissection: an update on tools and accessories, Therapeutic Advances in Gastrointestinal Endoscopy, Vol: 13, Pages: 1-13, ISSN: 2631-7745

Endoscopic submucosal dissection (ESD) is a minimally invasive therapeutic procedure to remove larger polyps or early non-metastatic lesions. It has long been used in Asia, but is now fast growing in popularity in the West.There are multiple challenges faced by ESD practitioners. While the practice of ESD in gastric lesions is relatively well established, the oesophagus with its narrow lumen and challenging workspace, and the colon with its tortuous course and folds are more challenging frontiers. The nature of performing a procedure endoscopically means that conventional methods offer no mechanism for providing counter-traction while performing dissection, impeding visibility and increasing the rate of complications.There are a multitude of tools available to those performing ESD for the different stages of the procedure. This article reviews the accessories currently used in regular ESD practice including the knives used to cut and dissect lesions, the cap and hood devices used to improve visibility and safety, injection fluids to lift the submucosal plane, haemostatic devices, generators, and finally, emerging traction apparatus. There is some evidence behind the use of these tools, however, ESD remains the domain of a small number of practitioners and the practice relies heavily on expert experience. Evolution of the ESD toolbox will make the procedure more accessible to more endoscopists, which in turn will drive the development of a more substantial evidence base to evaluate efficacy and safety of the multitude of tools.

Journal article

Banister T, Spiking J, Ayaru L, 2018, Discharge of patients with an acute upper gastrointestinal bleed from the emergency department using an extended Glasgow Blatchford Score, BMJ Open Gastroenterology, Vol: 5, ISSN: 2054-4774

Objective To use an extended Glasgow-Blatchford Score (GBS) cut-off of ≤1 to aid discharge of patients presenting with acute upper gastrointestinal bleeding (AUGIB) from emergency departments.Background The GBS accurately predicts the need for intervention and death in AUGIB, and a cut-off of 0 is recommended to identify patients for discharge without endoscopy. However, this cut-off is limited by identifying a low percentage of low-risk patients. Extension of the cut-off to ≤1 or ≤2 has been proposed to increase this proportion, but there is controversy as to the optimal cut-off and little data on performance in routine clinical practice.Methods Dual-centre study in which patients with AUGIB and GBS ≤1 were discharged from the emergency department without endoscopy unless there was another reason for admission. Retrospective analysis of associated adverse outcome defined as a 30-day combined endpoint of blood transfusion, intervention or death.Results 569 patients presented with AUGIB from 2015 to 2018. 146 (25.7%) had a GBS ≤1 (70, GBS=0; 76, GBS=1). Of these, 103 (70.5%) were managed as outpatients, and none had an adverse outcome. GBS ≤1 had a negative predictive value=100% and the GBS had an area under receiver operator characteristic​​ (AUROC)=0.89 (95% CI 0.86 to 0.91) in predicting adverse outcomes. In 2008–2009, prior to risk scoring (n=432), 6.5% of patients presenting with AUGIB were discharged safely from the emergency department in comparison with 18.1% (p<0.001) in this cohort. A GBS cut-off ≤2 was associated with an adverse outcome in 8% of cases.Conclusion GBS of ≤1 is the optimal cut-off for the discharge of patients with an AUGIB from the emergency department.

Journal article

Oakland K, Jairath V, Uberoi R, Guy R, Ayaru L, Mortensen N, Murphy MF, Collins GSet al., 2017, Derivation and validation of a novel risk score for safe discharge after acute lower gastrointestinal bleeding: a modelling study, LANCET GASTROENTEROLOGY & HEPATOLOGY, Vol: 2, Pages: 635-643, ISSN: 2468-1253

Journal article

Ayaru L, Ypsilantis P-P, Nanapragasam A, Choi RC-H, Thillanathan A, Min-Ho L, Montana Get al., 2015, Prediction of Outcome in Acute Lower Gastrointestinal Bleeding Using Gradient Boosting, PLOS ONE, Vol: 10, ISSN: 1932-6203

Journal article

Chen Y, Ayaru L, Mathew S, Morris E, Pereira SP, Behboudi Set al., 2014, Expansion of Anti-Mesothelin Specific CD4(+) and CD8(+) T Cell Responses in Patients with Pancreatic Carcinoma, PLOS ONE, Vol: 9, ISSN: 1932-6203

Journal article

Coda S, Thompson AJ, Kennedy GT, Roche KL, Ayaru L, Bansi DS, Stamp GW, Thillainayagam AV, French PMW, Dunsby Cet al., 2014, Fluorescence lifetime spectroscopy of tissue autofluorescence in normal and diseased colon measured ex vivo using a fiber-optic probe, Biomedical Optics Express, Vol: 5, Pages: 515-538, ISSN: 2156-7085

We present an ex vivo study of temporally and spectrally resolved autofluorescence in a total of 47 endoscopic excision biopsy/resection specimens from colon, using pulsed excitation laser sources operating at wavelengths of 375 nm and 435 nm. A paired analysis of normal and neoplastic (adenomatous polyp) tissue specimens obtained from the same patient yielded a significant difference in the mean spectrally averaged autofluorescence lifetime −570 ± 740 ps (p = 0.021, n = 12). We also investigated the fluorescence signature of non-neoplastic polyps (n = 6) and inflammatory bowel disease (n = 4) compared to normal tissue in a small number of specimens.

Journal article

Ali A, Swingland J, Choi CH, Chan J, Khan S, Bose S, Ayaru Let al., 2012, ARTIFICIAL NEURAL NETWORK FOR THE RISK STRATIFICATION OF ACUTE UPPER GASTROINTESTINAL BLEEDING: MULTICENTRE COMPARATIVE ANALYSIS VS THE GLASGOW BLATCHFORD AND ROCKALL SCORES, GUT, Vol: 61, Pages: A62-A62, ISSN: 0017-5749

Journal article

Choi CH, Swingland J, Ali A, Bose S, Ayaru Let al., 2012, ASSESSING RISK OF ADVERSE OUTCOME IN ACUTE LOWER GASTROINTESTINAL BLEEDING: ARTIFICIAL NEURAL NETWORK VS SIGN GUIDELINES AND BLEED SCORE, GUT, Vol: 61, Pages: A156-A157, ISSN: 0017-5749

Journal article

Thomas T, Ayaru L, Lee EY, Cirocco M, Kandel G, May G, Kortan P, Marcon NEet al., 2011, Length of Barrett's segment predicts success of extensive endomucosal resection for eradication of Barrett's esophagus with early neoplasia, SURGICAL ENDOSCOPY AND OTHER INTERVENTIONAL TECHNIQUES, Vol: 25, Pages: 3627-3635, ISSN: 0930-2794

Journal article

Matull W-R, Dhar DK, Ayaru L, Sandanayake NS, Chapman MH, Dias A, Bridgewater J, Webster GJM, Bong JJ, Davidson BR, Pereira SPet al., 2011, R0 but not R1/R2 resection is associated with better survival than palliative photodynamic therapy in biliary tract cancer, LIVER INTERNATIONAL, Vol: 31, Pages: 99-107, ISSN: 1478-3223

Journal article

Chan JCH, Ayaru L, 2011, Analysis of risk scoring for the outpatient management of acute upper gastrointestinal bleeding, Frontline Gastroenterology, Vol: 2, Pages: 19-25

Journal article

Pereira SP, Ayaru L, Ackroyd R, Mitton D, Fullarton G, Zammit M, Grzebieniak Z, Messmann H, Ortner M-A, Gao L, Trinh MM, Spenard Jet al., 2010, The pharmacokinetics and safety of porfimer after repeated administration 30-45 days apart to patients undergoing photodynamic therapy, ALIMENTARY PHARMACOLOGY & THERAPEUTICS, Vol: 32, Pages: 821-827, ISSN: 0269-2813

Journal article

Chan J, Ayaru L, 2010, Risk scoring for the outpatient management of acute upper gastrointestinal bleeding, UEGW, Pages: A43-A44

Conference paper

Thomas T, Ayaru L, Lee EY, Cirocco M, Kortan PP, May GR, Kandel G, Marcon Net al., 2009, Extensive Endomucosal Resection (EMR) for Complete Eradication of Barrett's Esophagus (BE) with High-Grade Intraepithelial Neoplasia (HGIN) or Intramucosal Carcinoma (IMC): Efficacy, Safety and Factors Predicting Complete Eradication, Annual Meeting of the American-Society-for-Gastrointestinal-Endoscopy/Digestive Disease Week, Publisher: MOSBY-ELSEVIER, Pages: AB340-AB340, ISSN: 0016-5107

Conference paper

Ayaru L, Stoeber K, Webster GJ, Hatfield ARW, Wollenschlaeger A, Williams G, Pereira SPet al., 2009, DIAGNOSIS OF PANCREATICOBILIARY MALIGNANCY BY DETECTION OF MINICHROMOSOME MAINTENANCE PROTEIN 5 IN BILIARY BRUSH CYTOLOGY SPECIMENS, Annual Meeting of the British-Society-of-Gastroenterology, Publisher: B M J PUBLISHING GROUP, Pages: A25-A25, ISSN: 0017-5749

Conference paper

Pereira SP, Matull WR, Dhar DK, Ayaru L, Sandanayake NS, Chapman MHet al., 2009, Palliative photodynamic therapy for biliary tract carcinoma may improve survival and has a similar outcome to attempted curative surgery with positive resection margins, 12th World Congress of the International-Photodynamic-Association (IPA) on Photodynamic Therapy - Back to the Future, Publisher: SPIE-INT SOC OPTICAL ENGINEERING, ISSN: 0277-786X

Conference paper

Ayaru L, Stoeber K, Webster GJ, Hatfield ARW, Wollenschlaeger A, Okoturo O, Rashid M, Williams G, Pereira SPet al., 2008, Diagnosis of pancreaticobiliary malignancy by detection of minichromosome maintenance protein 5 in bile aspirates, BRITISH JOURNAL OF CANCER, Vol: 98, Pages: 1548-1554, ISSN: 0007-0920

Journal article

Alisa A, Boswell S, Pathan AA, Ayaru L, Williams R, Behboudi Set al., 2008, Human CD4(+) T cells recognize an epitope within alpha-fetoprotein sequence and develop into TGF-beta-producing CD4(+) T cells, JOURNAL OF IMMUNOLOGY, Vol: 180, Pages: 5109-5117, ISSN: 0022-1767

Journal article

Ayaru L, Kurzawinski TR, Shankar A, Webster GJM, Hatfield ARW, Pereira SPet al., 2008, Complications and diagnostic difficulties arising from biliary self-expanding metal stent insertion before definitive histological diagnosis, JOURNAL OF GASTROENTEROLOGY AND HEPATOLOGY, Vol: 23, Pages: 315-320, ISSN: 0815-9319

Journal article

Sandanayake NS, Johnson GJ, Smyth CM, Church NI, Ayaru L, Chapman MH, Hatfield AR, Pereira SP, Webster GJet al., 2008, Azathioprine in the management of relapsing autoimmune pancreatitis/IgG4 sclerosing cholangitis, Annual General Meeting of the British-Society-of-Gastroenterology, Publisher: B M J PUBLISHING GROUP, Pages: A24-A24, ISSN: 0017-5749

Conference paper

Pereira SP, Ayaru L, Rogowska A, Mosse A, Hatfield ARW, Bown SGet al., 2007, Photodynamic therapy of malignant biliary strictures using meso-tetrahydroxyphenylchlorin, EUROPEAN JOURNAL OF GASTROENTEROLOGY & HEPATOLOGY, Vol: 19, Pages: 479-485, ISSN: 0954-691X

Journal article

Ayaru L, Stoeber K, Webster GJ, Hatfield AR, Williams GH, Pereira SPet al., 2007, Diagnosis of pancreaticobiliary malignancy by detection of minichromosome maintenance 5 protein in bile aspirates, Annual Meeting of the British-Society-of-Gastroenterology, Publisher: B M J PUBLISHING GROUP, Pages: A14-A14, ISSN: 0017-5749

Conference paper

Matull WR, Ayaru L, Dias A, Dhar D, Davidson BR, Pereira SPet al., 2007, Prognostic factors in biliary tract carcinoma: Multivariate analysis of 259 patients, Annual Meeting of the British-Society-of-Gastroenterology, Publisher: B M J PUBLISHING GROUP, Pages: A3-A3, ISSN: 0017-5749

Conference paper

Ayaru L, Stoeber K, George W, Hatfield A, Williams G, Pereira Set al., 2007, Diagnosis of pancreaticobiliary malignancy by detection of minichromosome maintenance 5 protein in bile aspirates, Digestive Disease Weeking Meeting/ASGE Postgraduate Course Meeting, Publisher: MOSBY-ELSEVIER, Pages: AB210-AB210, ISSN: 0016-5107

Conference paper

Ayaru L, Pereira SP, Alisa A, Pathan AA, Williams R, Davidson B, Burroughs AK, Meyer T, Behboudi Set al., 2007, Unmasking of alpha-fetoprotein-specific CD4(+) T cell responses in hepatocellular carcinoma patients undergoing embolization, JOURNAL OF IMMUNOLOGY, Vol: 178, Pages: 1914-1922, ISSN: 0022-1767

Journal article

Ayaru L, Wittmann J, MacRobert AJ, Novelli M, Bown SG, Pereira SPet al., 2007, Photodynamic therapy using verteporfin photosensitization in the pancreas and surrounding tissues in the Syrian golden hamster, PANCREATOLOGY, Vol: 7, Pages: 20-27, ISSN: 1424-3903

Journal article

Ayaru L, Pereira SP, Meyer T, Davidson BR, Burroughs AK, Williams R, Behboudi Set al., 2006, Alpha-fetoprotein specific CD4(+) T cell responses are unmasked during transarterial embolisation in hepatocellular carcinoma, Annual Meeting of the British-Society-of-Gastroenterology, Publisher: B M J PUBLISHING GROUP, Pages: A24-A24, ISSN: 0017-5749

Conference paper

Ayaru L, Pereira SP, Meyer T, Davidson BR, Burroughs AK, Williams R, Behboudi Set al., 2006, Alpha-fetoprotein specific CD4+ T cell responses are unmasked during transarterial embolisation in hepatocellular carcinoma, 41st Annual Meeting of the European-Association-for-the-Study-of-the-Liver, Publisher: ELSEVIER SCIENCE BV, Pages: S11-S11, ISSN: 0168-8278

Conference paper

Matull WR, Dias A, Ayaru L, Davidson B, Pereira Set al., 2005, Biliary tract cancer: A dual tertiary centre experience in the United Kingdom, 56th Annual Meeting of the American-Association-for-the-Study-of-Liver-Diseases, Publisher: JOHN WILEY & SONS INC, Pages: 379A-379A, ISSN: 0270-9139

Conference paper

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.

Request URL: http://wlsprd.imperial.ac.uk:80/respub/WEB-INF/jsp/search-html.jsp Request URI: /respub/WEB-INF/jsp/search-html.jsp Query String: respub-action=search.html&id=00746158&limit=30&person=true