There are currently several projects under consideration at various stages in the planning process. A selection of these are:
MBP+ / AMBRACE
This is a four-arm open label randomised controlled trial of pre-operative mechanical bowel preparation (MBP) +/- oral antibiotic prophylaxis (Abx) in patients undergoing elective colectomy for cancer. There is international equipoise presently between whether either or both pre-operative interventions has an impact on surgical site infection and anastomotic leak in patients undergoing colectomy for colon cancer.11-13 Patients will randomised to one of the following arms: Group 1: MBP only, Group 2: Abx only, Group 3: MBP and Abx, Group 4: Nothing. The primary outcome will be surgical site infection, and secondary outcomes will include anastomotic leak, colonic microbiome analysis, and local / distant colon cancer recurrence. This study will need to be a large multi-centre collaboration, and a research assistant will be crucial to facilitate this.
Post-operative ileus novel treatments
After completion of the STIMULAX Trial, we hope to establish the standard of care for post-operative return of bowel function, and use this new baseline to test novel treatments with the hope of improving this even further. Several novel drugs are currently under consideration.
Leak Check 2 / Double Check
If Leak Check identifies modifiable risk factors for anastomotic leak (likely), then a followup international study is in the planning stages to test whether modification of these factors in the pre-operative and intra-operative stage could reduce the incidence of post-operative anastomotic leak.
MBP+ / AMBRACE
This is a four-arm open label randomised controlled trial of pre-operative mechanical bowel preparation (MBP) +/- oral antibiotic prophylaxis (Abx) in patients undergoing elective colectomy for cancer. There is international equipoise presently between whether either or both pre-operative interventions has an impact on surgical site infection and anastomotic leak in patients undergoing colectomy for colon cancer.11-13 Patients will randomised to one of the following arms: Group 1: MBP only, Group 2: Abx only, Group 3: MBP and Abx, Group 4: Nothing. The primary outcome will be surgical site infection, and secondary outcomes will include anastomotic leak, colonic microbiome analysis, and local / distant colon cancer recurrence. This study will need to be a large multi-centre collaboration, and a research assistant will be crucial to facilitate this.
Post-operative ileus novel treatments
After completion of the STIMULAX Trial, we hope to establish the standard of care for post-operative return of bowel function, and use this new baseline to test novel treatments with the hope of improving this even further. Several novel drugs are currently under consideration.
Leak Check 2 / Double Check
If Leak Check identifies modifiable risk factors for anastomotic leak (likely), then a followup international study is in the planning stages to test whether modification of these factors in the pre-operative and intra-operative stage could reduce the incidence of post-operative anastomotic leak.