Wirral University Teaching Hospital and Whiston Hospital Trust

More information about this job 

Applications are invited for an exciting opportunity for a peri-CCT or overseas equivalent general surgery trainee to undertake the full time post of Clinical Fellow in Abdominoplastic Surgery within the General Surgery directorate at Wirral University Teaching Hospital and Whiston Hospital Trust.

This is a truly unique opportunity providing general surgery complex hernia experience along with sub specialist abdominal wall reconstruction experience with training from both a general surgical and plastic surgical perspective. The post will prepare the post holder to take up independent practice as a future consultant general surgeon with a subspecialty interest in complex abdominal wall surgery.

The post holder will also have an honorary contract at Whiston Hospital which will allow them to work in the regional plastic surgery unit to gain experience in plastic surgery of the abdominal wall.

This post is available from January 2022 for 12 months. It is are aimed at peri-/post-CCT trainees who have completed their general surgery training.

Applications from suitably qualified international trainees are also welcomed.

The post will commence in February 2023.

Informal enquiries may be made via switchboard 0151 678 5111 x2220 or email

Mr Ciaran Walsh, Consultant Colorectal Surgeon at ciaran.walsh@nhs.net

Or email

Mr Greg Simpson, Consultant Colorectal Surgeon at gregory.simpson4@nhs.net

Imperial College, London.

The closing date is 11 August 2022

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3 funded PhDs in colorectal surgery are coming up at Imperial College, London starting in April – projects in colorectal cancer, microbiome and pelvic floor.

On calls in general surgery at Charing Cross Hospital.

https://www.imperial.ac.uk/jobs/description/MED02852/clinical-research-fellow-x-3

For questions about the job, contact:

As events continue to unfold in the conflict in Ukraine, we would like to express our support for those affected by the crisis. Further information and support can be found at:

• RCSEd and AoMRC Statement on the Ukraine Crisis and its impact on healthcare workers
• Royal College of Surgeons of England message of solidarity to the people of Ukraine
• Royal College of Surgeons in Ireland Statement on Ukraine
• A message to all Ukrainian health and care staff in the UK from Secretary of State

Our website’s Covid 19 section also has signposts to wellbeing support.

North Middlesex University Hospital NHS Trust

The closing date is 07 June 2022

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Applications are invited for the post of Senior Colorectal Fellow for 12 months based in the North Middlesex University Hospital. This post has been approved by the Royal College of Surgeons and the Association of Coloproctology of Great Britain & Ireland as part of the RCS Senior Clinical Fellowship Scheme.

Main duties of the job

Applications are welcomed for a Senior Colorectal Fellow ST7+ (peri or post-CCT). This is a fixed-term post to start in October 2022.

For questions about the job, contact:

St Mark’s Hospital is the only specialist GI hospital in the UK, with a world-renowned reputation for the management of complex GI disorders and research.  The successful applicant will be expected to work towards an MD (Res) or PhD via Imperial College, London. The post carries a salary and has a strong clinical component which will allow the fellow to also gain a thorough understanding of pelvic floor disorders and their management.  They will be supervised by Miss Carolynne Vaizey and Mr Gregory Thomas.

Please contact Mr Gregory Thomas for further information (gregorythomas1@nhs.net).

Download the winning poster here

Three posts available and applications now open.

Closing date 3/1/2022:

Further information:

https://www.swansea.ac.uk/jobs-at-swansea/current-vacancies/details/?nPostingID=97778&nPostingTargetID=133652&ID=QHUFK026203F3VBQB7VLO8NXD&lg=UK&mask=suext

Complete mesocolic excision versus conventional surgery for colon cancer: A systematic review and meta-analysis. Crane J, Hamed M, Borucki JP, El-Hadi A, Shaikh I, Stearns AT. Published: Colorectal Disease 2 May 2021. https://doi.org/10.1111/codi.15644

The study results demonstrate an overall survival benefit from CME/D3 at 3 and 5 years (relative risk reduction of 31% and 22% respectively) and disease-free survival benefit with relative risk reduction estimated at 40%, 28% and 33% respectively at 1, 3 and 5 years postoperatively.

More lymph nodes were retrieved with CME (6 nodes more than conventional surgery). And while the CME procedure took a longer operative time (28 minutes longer), there was no significant difference in overall complications, anastomotic leak or blood loss when compared with conventional surgery.

Method and outcomes

Design

Systematic review and meta-analysis

Population

Patient with colon cancer who had complete mesocolic excision (D3 dissection) versus patients who had conventional surgery (D1 and D2 dissection)

Primary outcome

Long-term oncological outcomes (overall and disease-free survival) at 1, 3 and 5 years.

Secondary outcomes

• Perioperative outcomes (operation duration, blood loss, overall complications including anastomotic leakage and 30-day mortality)
• Pathological outcomes (length of bowel resected, lymph node harvest and risk of R1 resection).

Results

• 31 studies were included in the review ( out of 2463 screened records)
• This included 13830 patients in the CME/D3 versus 12810 patients in the conventional cohort.
• Oncological outcomes:
  • Disease free survival at 1,3, and 5 years was statistically significantly better in CME group with RR 0.60 (95% CI 0.45–0.81, P < 0.001); RR 0.72 (95% CI 0.62–0.83, P = 0.001); RR 0.67 (95% CI 0.52–0.86, P < 0.001) respectively.
  • Overall survival was statistically significantly better in CME group at 3 nd 5 years RR 0.69 (95% CI 0.51–0.93, P = 0.016) and RR 0.78 (95% CI 0.64–0.95, P = 0.011) respectively. And not statistically different at year 1 RR 0.85 (95% CI 0.67–1.09, P = 0.201)
• Pathological outcomes:
  • LN yield (29 studies): significantly higher in the CME group (weighted mean of 6.1 additional LN)
  • The risk of R1 resection (12 studies): in favour of the CME group: RR 0.61 (95% CI 0.27–1.38, P = 0.234).
  • No difference in the resected bowel length.
• Perioperative outcomes:
  • No difference in overall complications (21 studies), Anastomotic leak (18 studies), blood loss (31 studies), or 30-day mortality (8 studies)
  • Increased operative time for CME (weighted mean difference 27.7 min, P = 0.041)

Timing of surgery following SARS-CoV-2 infection: an international prospective cohort study. COVIDSurg Collaborative and GlobalSurg Collaborative. Published: Anaesthesia 09 March 2020: https://doi.org/10.1111/anae.15458

What is known about this subject?

The postoperative mortality and pulmonary complications are higher in patients with SARS-COV-2 infection and elective surgery should be delayed in this group of patients to reduce this risk. However, There has been no agreement on the time this group of patients should wait for before being offered elective surgery and whether this interval should be different according to the severity and duration of SARS-CoV-2 symptoms.

Method and outcomes

Design

International, multicentre, prospective cohort study.

Population

• Patients undergoing any type of surgery (elective or emergency) for any indication in October 2020.
• Patients with a history of preoperative SARS-CoV-2 were classified into three groups: asymptomatic; symptomatic but symptoms now resolved; or symptomatic with ongoing symptoms.
• Time from the diagnosis of SARS-CoV-2 infection to the day of surgery was collected as a categorical factor and pre-determined to be analysed in the following categories: 0–2 weeks; 3–4 weeks; 5–6 weeks; and ≥ 7 weeks.

Primary outcome

30-day postoperative mortality.

Secondary outcomes

The incidence of 30-day postoperative pulmonary complications.

Results

• 140,231 patients across 1674 hospitals in 116 countries were included.
• 3127 (2.2%) patients had a pre-operative SARS-CoV-2 diagnosis.
• The overall 30-day postoperative mortality rate was 1.5%
• The time from SARS-CoV-2 diagnosis to surgery and associated mortality:
  • 0-2 weeks in 1138 patients (36.4%) → 30-day mortality 9.1%
  • 3-4 weeks in 461 patients (14.7%) → 30-day mortality 6.9%
  • 5-6 weeks in 326 patients (10.4%) → 30-day mortality 5.5%
  • >7 weeks in 1202 patients (38.4%) → 30-day mortality 2.0%
• The 30-day mortality rate in patients who did not have a pre-operative SARS-CoV-2 infection was 1.4%
• These findings were also consistent across subgroups stratified by age, ASA physical status, and the grade and urgency of surgery.
• Patients with persistent symptoms at surgery had higher 30-day mortality compared with patients whose symptoms have resolved or were asymptomatic. This also includes patients who had surgery >7 weeks after infection.
• Similar results were reported for postoperative pulmonary complications in relation to the duration between SARS-CoV-2 infection and surgery

Implications for colorectal practice?

This study provides important data on the impact of the interval between SARS-CoV-2 infection and surgery on postoperative mortality and pulmonary complication. It provides important guidance for recovery planning and restarting elective surgery. In patients with SARS-CoV-2 infection, postoperative mortality risk is high if they undergo any surgery at the first 6 weeks from the onset of SARS-CoV-2 infection and if they have persistent symptoms. These patients should wait for at least 7 weeks before being offered elective surgery. The study findings should inform shared decision-making and help the benefit versus risk discussion between anaesthetists, surgeons and patients when more urgent surgery might be indicated such as patients with advanced cancers.