Publications
315 results found
Atkin GK, Martins J, Tozer P, et al., 2011, For many high anal fistulas, lay open is still a good option., Tech Coloproctol, Vol: 15, Pages: 143-150
BACKGROUND: Optimal treatment for high/complex anal fistulas is uncertain. We have studied one surgeon's results over a ten-year period, concentrating on high fistulas. METHODS: Demographic, fistula anatomy and treatment data were recorded for all patients undergoing surgery for anal fistula. Outcome data were recorded for patients who had been followed up for a minimum of 4 weeks. RESULTS: One hundred and eighty patients were studied. Outcome data were available for 52 low and 84 high fistulas. Fistulotomy was performed for 50 low and 48 high fistulas, with closure rates of 98 and 96%, respectively. There was fistula recurrence in two patients with high fistulas. Symptoms of sphincter disturbance were similar after lay open of low and high fistulas. Treatment of a high fistula by drainage seton had a lower rate of inadvertent passage of flatus but a similar rate of minor soiling compared with fistulotomy. CONCLUSIONS: Lay open of low and high anal fistulas is effective and associated with a similar, predictable rate of minor sphincter disturbance, amounting to a third to one quarter of patients with mild leakage of flatus and mucus. Patients with high fistulas can be cured, but when a surgeon is in doubt, a second opinion at an expert centre should be sought before definitive intervention.
Skipworth JRA, Morkane C, Raptis DA, et al., 2011, Pancreaticoduodenectomy for advanced duodenal and ampullary adenomatosis in familial adenomatous polyposis, HPB, Vol: 13, Pages: 342-349, ISSN: 1365-182X
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- Citations: 29
Tozer P, Ng SC, Siddiqui MR, et al., 2011, MRI Guided Biologic Therapy for Crohn's Perianal Fistulae: 3 Year Follow up Data, Conference on Digestive Disease Week 2011, Publisher: W B SAUNDERS CO-ELSEVIER INC, Pages: S279-S279, ISSN: 0016-5085
Tozer PJ, Burling D, Gupta A, et al., 2011, Tacrolimus suppresses IL-12/IL23 p40 in Crohn's disease and heals fistulae refractory to anti-TNF-α therapy: authors' reply, ALIMENTARY PHARMACOLOGY & THERAPEUTICS, Vol: 33, Pages: 980-981, ISSN: 0269-2813
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- Citations: 1
Tozer P, Al-Hassi OH, Rayment N, et al., 2011, DENDRITIC CELL HOMING AND IMMUNE CELL FUNCTION IN CROHN'S ANAL FISTULAE, Annual Meeting on British-Society-of-Gasenterology, Publisher: B M J PUBLISHING GROUP, ISSN: 0017-5749
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- Citations: 2
Sinha A, Tekkis PP, Phillips RKS, et al., 2011, Parametric survival analysis and predictive models for prophylactic surgery in familial adenomatous polyposis, Annual Meeting of the Society-of-Academic-and-Research-Surgery, Publisher: WILEY-BLACKWELL, Pages: 13-13, ISSN: 0007-1323
Tozer P, Rayment N, Al-Hassi OH, et al., 2011, THE RECTAL MUCOSA IN PATIENTS WITH CROHN'S ANAL FISTULAE HARBOURS LOWER NUMBERS OF BIFIDOBACTERIA, AND THE FISTULA TRACTS ARE DEVOID OF A MICROBIAL ECOSYSTEM, Annual Meeting on British-Society-of-Gasenterology, Publisher: B M J PUBLISHING GROUP, Pages: A221-A221, ISSN: 0017-5749
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- Citations: 1
Sinha A, Phillips RKS, Linge C, et al., 2011, In-vitro charachteristics of desmoid tumour cells in familial adenomatous polyposis, Annual Meeting of the Society-of-Academic-and-Research-Surgery, Publisher: WILEY-BLACKWELL, Pages: 14-14, ISSN: 0007-1323
Will OCC, Deheragoda M, Phillips RKS, et al., 2011, The role of cell proliferation and crypt fission in adenoma aggressiveness: a comparison of ileoanal pouch and rectal adenomas in familial adenomatous polyposis, COLORECTAL DISEASE, Vol: 13, Pages: 387-392, ISSN: 1462-8910
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- Citations: 3
Gibbons DC, Sinha A, Phillips RKS, et al., 2011, Colorectal cancer: no longer the issue in familial adenomatous polyposis?, FAMILIAL CANCER, Vol: 10, Pages: 11-20, ISSN: 1389-9600
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- Citations: 25
von Roon AC, Will OCC, Man RF, et al., 2011, Mucosectomy With Handsewn Anastomosis Reduces the Risk of Adenoma Formation in the Anorectal Segment After Restorative Proctocolectomy for Familial Adenomatous Polyposis, ANNALS OF SURGERY, Vol: 253, Pages: 314-317, ISSN: 0003-4932
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- Citations: 34
Tozer PJ, Burling D, Gupta A, et al., 2011, Review article: medical, surgical and radiological management of perianal Crohn's fistulas, ALIMENTARY PHARMACOLOGY & THERAPEUTICS, Vol: 33, Pages: 5-22, ISSN: 0269-2813
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- Citations: 57
Sinha A, Tekkis PP, Rashid S, et al., 2010, Risk factors for secondary proctectomy in patients with familial adenomatous polyposis, BRITISH JOURNAL OF SURGERY, Vol: 97, Pages: 1710-1715, ISSN: 0007-1323
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- Citations: 35
Sinha A, Neale KF, Phillips RK, et al., 2010, Jejunal Cancer in Patients With Familial Adenomatous Polyposis, CLINICAL GASTROENTEROLOGY AND HEPATOLOGY, Vol: 8, Pages: 904-904, ISSN: 1542-3565
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- Citations: 2
Farinella E, Soobrah R, Phillips RKS, et al., 2010, Familial adenomatous polyposis (FAP) and gender. Does gender influence the genetic transmission of FAP?, FAMILIAL CANCER, Vol: 9, Pages: 405-406, ISSN: 1389-9600
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- Citations: 2
Sinha A, Gibbons DC, Phillips RK, et al., 2010, Surgical prophylaxis in familial adenomatous polyposis: do pre-existing desmoids outside the abdominal cavity matter?, FAMILIAL CANCER, Vol: 9, Pages: 407-411, ISSN: 1389-9600
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- Citations: 2
Will OC, Leedham SJ, Elia G, et al., 2010, Location in the large bowel influences the APC mutations observed in FAP adenomas, FAMILIAL CANCER, Vol: 9, Pages: 389-393, ISSN: 1389-9600
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- Citations: 8
Beggs AD, Latchford AR, Vasen HFA, et al., 2010, Peutz-Jeghers syndrome: a systematic review and recommendations for management, GUT, Vol: 59, Pages: 975-986, ISSN: 0017-5749
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- Citations: 421
West NJ, Clark SK, Phillips RKS, et al., 2010, Eicosapentaenoic acid reduces rectal polyp number and size in familial adenomatous polyposis, GUT, Vol: 59, Pages: 918-925, ISSN: 0017-5749
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- Citations: 155
Gupta A, Postgate AJ, Burling D, et al., 2010, A Prospective Study of MR Enterography Versus Capsule Endoscopy for the Surveillance of Adult Patients With Peutz-Jeghers Syndrome, AMERICAN JOURNAL OF ROENTGENOLOGY, Vol: 195, Pages: 108-116, ISSN: 0361-803X
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- Citations: 80
Sinha A, Tekkis PP, Neale KF, et al., 2010, Risk factors predicting intra-abdominal desmoids in familial adenomatous polyposis: a single centre experience, TECHNIQUES IN COLOPROCTOLOGY, Vol: 14, Pages: 141-146, ISSN: 1123-6337
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- Citations: 17
Postgate AJ, Will OC, Fraser CH, et al., 2009, Capsule endoscopy for the small bowel in juvenile polyposis syndrome: a case series, ENDOSCOPY, Vol: 41, Pages: 1001-1004, ISSN: 0013-726X
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- Citations: 24
Postgate A, Hyer W, Phillips R, et al., 2009, Feasibility of Video Capsule Endoscopy in the Management of Children With Peutz-Jeghers Syndrome: A Blinded Comparison With Barium Enterography for the Detection of Small Bowel Polyps, JOURNAL OF PEDIATRIC GASTROENTEROLOGY AND NUTRITION, Vol: 49, Pages: 417-423, ISSN: 0277-2116
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- Citations: 42
Ranchod P, Tandon R, Tonkin DM, et al., 2009, Results of surgery for intestinal failure, JOURNAL OF GASTROENTEROLOGY AND HEPATOLOGY, Vol: 24, Pages: A248-A249, ISSN: 0815-9319
Tozer PJ, Whelan K, Phillips RKS, et al., 2009, Etiology of Perianal Crohn's Disease: Role of Genetic, Microbiological, and Immunological Factors, INFLAMMATORY BOWEL DISEASES, Vol: 15, Pages: 1591-1598, ISSN: 1078-0998
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- Citations: 34
Will OCC, Hansmann A, Phillips RKS, et al., 2009, Adrenal Incidentaloma in Familial Adenomatous Polyposis: A Long-Term Follow-Up Study and Schema for Management, DISEASES OF THE COLON & RECTUM, Vol: 52, Pages: 1637-1644, ISSN: 0012-3706
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- Citations: 6
Latchford AR, Neale KF, Spigelman AD, et al., 2009, Features of duodenal cancer in patients with familial adenomatous polyposis., Clin Gastroenterol Hepatol, Vol: 7, Pages: 659-663
BACKGROUND & AIMS: Most patients with familial adenomatous polyposis (FAP) develop duodenal adenomas; duodenal cancer is a major cause of mortality in this patient group. We reviewed cases of duodenal cancer in patients with FAP to identify factors that determine long-term cancer risk. METHODS: Twenty FAP patients (12 male) were identified from a registry database search. Data from registry and medical notes and endoscopic and histopathologic reports were evaluated. RESULTS: Of the cancers that developed in these patients, 11 were ampullary and 9 were duodenal. The median age at cancer diagnosis was 53 years. Seventeen patients died (median age at death, 57 y; median survival from diagnosis, 11 mo); the cause of death was metastatic or duodenal/ampullary cancer in 14 patients. Fifteen patients presented symptomatically (including 3 interval cancers while on surveillance). Two were diagnosed at surveillance and 3 were diagnosed during surgery performed for endoscopic features of advanced benign disease. Duodenal cancers were associated with a significantly lower mean colonic polyp count than ampullary cancers (496 +/- 282 vs 1322 +/- 735; P = .025); there appeared to be familial clustering of this cancer. When endoscopic data were available (n = 11 of 20), all ampullary cancers arose from ampullas greater than 1 cm. The Spigelman stage did not predict risk of ampullary cancer but did predict duodenal cancer (median stage 2 vs stage 4 for duodenal cancer). CONCLUSIONS: Once cancer arises in patients with FAP, prognosis is poor, so cancer prevention should be the main goal. Surveillance intervals should reflect both Spigelman staging and ampullary disease.
Ng SC, Lied GA, Arebi N, et al., 2009, Clinical and surgical recurrence of Crohn's disease after ileocolonic resection in a specialist unit, EUROPEAN JOURNAL OF GASTROENTEROLOGY & HEPATOLOGY, Vol: 21, Pages: 551-557, ISSN: 0954-691X
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- Citations: 36
Will OCC, Phillips RKS, Hyer W, et al., 2009, SYMPTOMATIC POLYPOSIS IN A 4-YEAR-OLD: THE EXCEPTION PROVES THE RULE, JOURNAL OF PAEDIATRICS AND CHILD HEALTH, Vol: 45, Pages: 320-321, ISSN: 1034-4810
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- Citations: 2
Himpson RC, Cohen CRG, Sibbons P, et al., 2009, An experimentally successful new sphincter-conserving treatment for anal fistula., Dis Colon Rectum, Vol: 52, Pages: 602-608
PURPOSE: A new sphincter-conserving treatment was evaluated in a porcine model. METHODS: A total of 36 fistulas were created by procedures that have been published previously. At fistula induction a skin biopsy was taken from which to culture fibroblasts. Four weeks after induction, when fistulas were well established, the fistula tracks were cored out. Collagen paste modified from Permacol injection (Covidien, Mansfield, MA) was then used as a solitary infill material in 11 tracks, cultured autologous fibroblasts being added to this in a further 18 tracks. The track was cored out in seven controls, but these tracks were not treated with infill material. All of the internal and external openings were closed. Anorectal excision was then carried out under terminal anesthesia at 2 to 12 weeks. Histologic examination of individual tracks was performed by an experienced pathologist. RESULTS: In this quadruped all of the infilled tracks healed, autologous fibroblasts having the best tissue integration, but only two of seven control tracks healed. CONCLUSIONS: Removal of the fistula track followed by injection of collagen healed all of the cases. The addition of autologous fibroblasts improved the histologic appearance of the tracks. A pilot study in human fistula patients is in progress.
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