The Robin Phillips’ Fistula Research Unit at St Mark’s Hospital is conducting research on rectovaginal fistulae (RVF).
Calling all UK and Irish MDTs. We are seeking sites to participate in the IMPACT Audit. This is the first project of this collaborative programme which aims to improve outcomes in patients with advanced cancer.
We are accepting applications for the ACPGBI/Dukes’ regional trainee representatives in East Midlands, West Midlands, Wessex, North East, Wales, Scotland and Ireland.
New curriculum role out, Improving Surgical Training, abstracts for conference and trauma survey
In a first for Paper of the Month, we have selected a pelvic floor paper.
The first Dukes’ Club regional networking events have recently been held in Oxford and Mersey.
Many thanks to Julia Merchant our Oxford deanery representative and Rachael Clifford our Mersey deanery representative for organising theses hugely successful events.
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You are invited to take part in this study on low anterior resection training.
The paper selected this month concerns the treatment of uncomplicated diverticular disease.
Paper of the Month for August is a systematic review and meta analysis of prognostic factors and their relationship with outcomes in colorectal metastasis
Meta‐analysis of prognostic factors for patients with colorectal peritoneal metastasis undergoing cytoreductive surgery and heated intraperitoneal chemotherapy
Hallam et al. BJS Open https://bjssjournals.onlinelibrary.wiley.com/doi/full/10.1002/bjs5.50179
HIPEC for peritoneal cancer is a topic of interest and features at many conferences. This is a constantly developing technique and work is required to improve and refine this. One was to improve outcomes is by good information to guide patient selection.
The authors of this study undertook a systematic review and meta analysis of prognostic factors and their relationship with outcomes in colorectal metastasis. The authors found 24 studies describing outcomes from 3128 patients. They found that increasing peritoneal carcinomatosis index, incomplete cytoreduction, and complications related to the primary tumour affected outcomes (perhaps unsurprisingly).
From the clinical side, this study identified one baseline factor to help select patients (carcinomatosis index) and one related to treatment. This perhaps reinforces the importance of well performed surgery, which is technically feasible from the outset. PRior obstruction or primary perforation may make this more difficult to achieve.
Perhaps the more interesting finding in this study is the number of candidate prognostic markers that were found to be unrelated to outcomes, such as timing of metastasis, tumour differentiation, adjuvant and neoadjuvant therapy, in the supporting studies. These are mechanistically plausible factors and this could reflect Type II error arising from reporting bias in the underlying studies, and that some factors were reported in one or two of the 24 studies.
In summary, this paper gives us a couple of unsurprising candidate papers, and suggests we need to look closely reporting potential prognostic factors across all studies.
ACPGBI and The Dukes’ Club are looking to appoint an Ordinary (Consultant) and an Associate (Trainee) member to the recently convened RCSE Genomics Committee chaired by Professor Sue Clark under the auspices of RCSE, Health Education England and the Academy of Medical Royal Colleges.
Closing date for applications: 15 August 2019
Applications for all positions are made by covering letter addressed to the Honorary Secretary accompanied by an abridged CV (maximum one side A4) to admin@acpgbi.org.uk before the closing date.