Akrivia Health Database-deep patient characterisation using a secondary mental healthcare dataset in England and Wales: cohort profile.

Purpose: The Akrivia Health cohort was created to extract data from electronic health records in secondary mental health and dementia care services in England and Wales. The data are anonymised, structured and harmonised from the source electronic health records across a range of information technology systems, enabling for unified, privacy-preserving access for research purposes.

Participants: The cohort contains data from electronic health records for over 4.

Preceptorship in robotic colorectal surgery: experience from the Australian private sector.

This article describes a post-fellowship preceptorship training program to train sub-specialty colorectal surgeons in gaining proficiency in robotic colorectal surgery using a dual-surgeon model in the Australian private sector. The Australian colorectal surgeon faces challenges in gaining robotic colorectal surgery proficiency with limited exposure and experience in the public setting where the majority of general and colorectal surgery training is currently conducted. This training model uses graded exposure with a range of simulation training, wet lab training, and clinical operative cases to progress through both competency and proficiency in robotic colorectal surgery which is mutually beneficial to surgeons and patients alike.

The National Aeronautics and Space Administration-task load index: NASA-TLX: evaluation of its use in surgery.

Background: The technical difficulty an operation creates for a surgeon is difficult to measure. Current measures are poor surrogates. In both research and teaching settings it would be valuable to be able to accurately measure this degree of difficulty.

Successful patient-oriented surgical outcomes in robotic vs laparoscopic right hemicolectomy for cancer - a systematic review.

Aim: Minimally invasive surgical approaches for cancer of the right colon have been well described with significant patient and equivalent oncological benefits. Robotic surgery has advanced in its ability to provide multi-quadrant abdominal access, leading the surgical community to widen its application outside of the pelvis to other abdominal compartments. Globally it is being realized that a patient's surgical episode of care is becoming the epicentre of cancer treatment.

Medullary colorectal carcinoma revisited: a clinical and pathological study of 102 cases.

Aim: Medullary carcinoma is a recently described subtype of mismatch repair deficient (MMRd) colorectal carcinoma (CRC) which, despite being poorly differentiated by traditional morphological criteria, has been reported to have a good prognosis. We investigated the pathological and clinical features of medullary CRC in an unselected cohort of CRCs undergoing surgical resection.

Methods: All CRCs resected within a single health district database from 1998 to 2012 were categorized prospectively and underwent retrospective review to identify 91 medullary CRCs, with 11 additional cases from 2013 to 2014.

A further investigation of combined mismatch repair and BRAFV600E mutation specific immunohistochemistry as a predictor of overall survival in colorectal carcinoma.

Mutation specific immunohistochemistry (IHC) is a promising new technique to detect the presence of the BRAFV600E mutation in colorectal carcinoma (CRC). When performed in conjunction with mismatch repair (MMR) IHC, BRAFV600E IHC can help to further triage genetic testing for Lynch Syndrome. In a cohort of 1426 patients undergoing surgery from 2004 to 2009 we recently demonstrated that the combination of MMR and BRAFV600E IHC holds promise as a prognostic marker in CRC, particularly because of its ability to identify the poor prognosis MMR proficient (MMRp) BRAFV600E mutant subgroup.

Cost analysis of transanal endoscopic microsurgery for rectal tumours.

Objective: Transanal endoscopic microsurgery (TEM) is considered to be a safe and effective treatment for selected rectal neoplasms. We demonstrate that in addition to the recognized clinical benefits of the less invasive TEM approach, there are substantial economic benefits.

Method: We reviewed our prospective database of patients undergoing TEM excision of a rectal lesion between July 1997 and December 2003.

Transanal endoscopic microsurgery for carcinoma of the rectum.

Background: The authors present their experience with rectal cancers managed by transanal endoscopic microsurgery (TEM).

Methods: This prospective study investigated patients undergoing primary TEM excision for definitive treatment of rectal cancer between January 1996 and December 2003 by a single surgeon in a tertiary referral colorectal surgical unit.

Results: For this study, 52 patients (30 men and 22 women) underwent TEM excision of a rectal cancer.

Endoscopic mucosal resection (EMR) in the management of large colo-rectal polyps.

Background: Colonoscopic polypectomy plays a major role in preventing colo-rectal cancer. However, resection of sessile, broad-based pedunculated and flat lesions carries a high risk of perforation. Endoscopic Mucosal Resection (EMR) may significantly reduce this risk.

Transanal endoscopic microsurgery: where are we now?

Aims: This review of literature aimed to assess the role and establish the current status of transanal endoscopic microsurgery (TEM) in the management of benign and malignant rectal lesions.

Methods: A review of the literature was undertaken through the Medline database and by cross-referencing previous publications, thus identifying 54 relevant publications on TEM in the management of rectal lesions. Aggregated results of various parameters were calculated but statistical comparisons deemed unsuitable due to heterogeneity of data.

Laparoscopy for colorectal malignancy.

Laparoscopy for colorectal pathology is technically demanding with a steep learning curve. In expert hands, there is no doubt that there is a place for laparoscopy in the operative armamentarium for the treatment of benign disease. The question of its application in the treatment of carcinoma is more difficult to address.

Sacral nerve stimulation for faecal incontinence.

Faecal incontinence is a common problem. Conservative measures are effective in a significant proportion of patients. Failure of conservative management has until recently meant recourse to surgical intervention.

Laparoscopy for rectal carcinoma: anterior resection.

Laparoscopic anterior resection is a technically demanding procedure with a steep learning curve. In expert hands, this procedure has a place in the operative armamentarium for the treatment of benign disease. Its application in the treatment of rectal carcinoma is more difficult to address.

Randomized clinical trial of suction versus standard clearance of the diathermy plume.

Background: Diathermy smoke contains complex hydrocarbons and organic material, and may contain viable tumour cells or viral particles. These particles measure from 0.05 to more than 25 microm, and long-term exposure to such particles may have adverse effects on health.

Laparoscopic adrenalectomy: a 6-year experience of 59 cases.

Background: The aims of this paper were to review our experience with laparoscopic transperitoneal adrenalectomy, report on outcomes in comparison with the published literature, and demonstrate any learning curve with the technique.

Methods: A review of our database and patient records was carried out for the period April 1995 to December 2000. Patient demographics, tumour characteristics, operating times, outcomes and lengths of stay were studied.

Changing pattern of adrenalectomy at a tertiary referral centre 1970-2000.

Background: In 1987, a report from this unit described the changing indications for open adrenalectomy over a 15-year period. The indications for adrenalectomy had switched from it being the principal therapeutic procedure used in advanced breast cancer in the early 1970s, to being predominately performed for Cushing's disease or incidental, asymptomatic, adrenal masses by the early 1980s. The aim of the present study was to evaluate the changes in the presentation and management of adrenal disease in the last 15 years and to compare these findings with our previously published results.