Colorectal Surgical Oncology
Inflammatory Bowel Disease
- REACCT collaborative: Research in Early Age Colorectal Cancer Trends. Data collected and submitted to the first study. Details here: twitter.com/REACCTcollab
- Lateral pelvic lymph nodes. Impact of lateral pelvic lymph nodes on outcome after neoadjuvant chemoradiation for rectal cancer. A systematic review has been completed and is the writeup phase. We have looked at RAH data which demonstrates that patients with lateral node disease have a significantly higher rate of local recurrence, despite being treated with chemoradiation. We are now in the final stages of leading and completing an international case:control study looking at whether surgical resection of these nodes after chemoradiation affects outcome (this includes our patients, and those form major centres in the Netherlands and the USA).Outcome after minimally invasive total mesorectal excision for rectal cancer. This is a binational Australia and New Zealand study which we are leading, comparing the outcomes of laparoscopic, robotic, open, and trans-anal resection of rectal cancer using the Binational Colorectal Cancer Audit database (paper published).
- Systematic review of the role of palliative pelvic exenteration (published on behalf of Pelvex Group).
- Outcomes of pelvic exenteration at the Royal Adelaide Hospital (published)
- Impact of microsatellite instability on response to chemotherapy in colon cancer. A systematic review and prospective study of RAH data completed and both papers published. This work has also resulted in a completed Masters thesis which is currently being examined (Hanumat Chouhan, previous research fellow).
- CovidSurg: an international cohort study, aiming to assess the outcomes of surgery in patients diagnosed in COVID-19
- CovidSurg-Cancer: an international cohort study assessing the safety of surgery for all types of cancer during the COVID-19 pandemic and the impact of the pandemic in cancer delay and treatment pathways. https://globalsurg.org/covidsurg/
- SUNRRISE Trial Single Use Negative pRessure dressing for Reduction In Surgical site infection following Emergency laparotomy. This is a randomised controlled trial being run nationally and internationally, and likely to begin recruiting late 2019. Protocol here: www.birmingham.ac.uk/research/activity/mds/trials/bctu/trials/coloproctology/SUNRRISE/index.aspx
- Improving return of bowel function after colorectal surgery: A systematic review, case – control study, and the STIMULAX open label randomised controlled trial of post-operative STIMUlants and LAXatives after major colorectal surgery. All these studies have completed and are at various stages of publication. https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=375650
- Establishing a rapidly modifiable web-based enhanced recovery after surgery (ERAS) protocol in colorectal surgery. This project is now complete and the protocol has been in effect since April this year. http://tinyurl.com/raheras This is a modern, progressive ERAS protocol with a focus on opioid avoidance to improve patient outcome. The protocol also provides a standardised launching pad on which to implement clinical trials where other variables are controlled as per current standard of care.
- Prediction of anastomotic leak after colorectal surgery. One retrospective and one prospective study have been completed in colonic surgery, validating for the first time a calculator which can accurately predict the risk of anastomotic leak, better than the estimate of the operating surgeon.7, 8 This has resulted in two high impact publications, and a web-based calculator which we now use routinely: www.anastomoticleak.com We are now expanding this to validate the calculator for rectal surgery, and further increase the utilisation of artificial intelligence analytics in collaboration with colleagues at the University of Auckland.
- Intra-peritoneal local anaesthetic infusion during and after laparoscopic colorectal surgery. Randomised controlled trial completed and paper published. This work has also resulted in a completed and accepted Masters thesis (Jaime Duffield, previous research fellow).
Inflammatory Bowel Disease
- Surgical and medical treatment of the rectal stump after total colectomy for acute severe colitis (systematic review and RAH data published).
- EEN: The role of elemental enteral nutrition in the treatment of acute Crohns flare: review and Royal Adelaide experience (data collection completed, paper in submission).