Use of a modified Delphi approach to develop research priorities for the Association of Coloproctology of Great Britain and Ireland

Tiernan, Jim; Cook, Andrew; Geh, Ian; George, Bridget St; Magill, Laura; Northover, John; Verjee, Azmina; Wheeler, James O.; Fearnhead, Nicola

doi:10.1111/codi.12790

Cited by 90 publications

(100 citation statements)

References 14 publications

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“…26,27 Strengths of the current study include an outline of ongoing studies. This is important as, although the volume of evidence for prophylactic mesh has increased, the respective gaps in evidence still persist in ongoing research.…”

Section: Discussionmentioning

confidence: 99%

Systematic Review and Meta-analysis of Prophylactic Mesh During Primary Stoma Formation to Prevent Parastomal Hernia

Chapman

Wood

Drake

et al. 2017

Diseases of the Colon &Amp; Rectum

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word count: 294 Words Manuscript word count: 3,062 WordsMeSH Keywords: stoma, parastomal hernia, prophylactic mesh Acknowledgments: The authors acknowledge assistance from Leeds NIHR Healthcare Technology Cooperative (HTC) in Colorectal Therapies in design and execution of the study. Also acknowledged is the assistance of corresponding authors of included studies for their responses to data enquiries.

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Section: Discussionmentioning

confidence: 99%

Systematic Review and Meta-analysis of Prophylactic Mesh During Primary Stoma Formation to Prevent Parastomal Hernia

Chapman

Wood

Drake

et al. 2017

Diseases of the Colon &Amp; Rectum

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“…Recent evidence suggests that the management of POI should be a research priority in patients undergoing colorectal surgery [10]. This study will produce a generalizable profile of gastrointestinal recovery and its management across diverse international settings, supporting the design of future interventional trials.…”

Section: Discussionmentioning

confidence: 66%

“…These are associated with improvements in gastrointestinal recovery, but compliance to individual components (and subsequent outcomes) are variable [8,9]. Consequently, POI has been recognized as a key area of unmet clinical need in colorectal surgery [10].…”

Section: Introductionmentioning

confidence: 99%

Ileus Management International (IMAGINE): protocol for a multicentre, observational study of ileus after colorectal surgery

2018

Colorectal Disease

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Aim The management of postoperative ileus following colorectal surgery remains controversial. It is the commonest complication after elective colorectal resection and is associated with an increased incidence of postoperative adverse events. The prevention and management of postoperative ileus remains unstandardized. This study aims to describe an international profile of gastrointestinal recovery after colorectal surgery and will assess the role of non-steroidal anti-inflammatory drugs, when used as postoperative analgesia, in expediting the return of gastrointestinal function.Methods A multicentre, student-and trainee-led, prospective cohort study will be conducted across both Europe and Australasia. Adult patients undergoing elective colorectal resection during 2-week data collection periods between January and April 2018 will be included. A site-specific questionnaire will capture compliance to Enhanced Recovery after Surgery components at participating centres. The primary outcome is time to gastrointestinal recovery, measured using a composite outcome of bowel function and oral tolerance. The impact of non-steroidal anti-inflammatory drugs on gastrointestinal recovery will be evaluated along with safety data with respect to anastomotic leak, acute kidney injury and complications within 30 days of surgery.Discussion This protocol describes the methodology of an international, observational assessment of gastrointestinal recovery after colorectal surgery. It discusses key challenges and describes how the results will impact on future investigation. The study will be conducted across a large student-and trainee-led collaborative network, with prospective quality assurance and data validation strategies.

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“…It occurs in 10–20 per cent of patients after elective colonic resection, making it the most common complication ahead of anastomotic leak and surgical‐site infection. In 2014, the Association of Coloproctology in Great Britain and Ireland identified ileus as an unmet clinical challenge. Its clinical manifestations are profound, contributing to postoperative pain, vomiting and malnutrition.…”

Section: Introductionmentioning

confidence: 99%

Safety and efficacy of non-steroidal anti-inflammatory drugs to reduce ileus after colorectal surgery

Blanco‐Colino¹,

Chapman²,

Pata³

et al. 2019

British Journal of Surgery

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Background Ileus is common after elective colorectal surgery, and is associated with increased adverse events and prolonged hospital stay. The aim was to assess the role of non‐steroidal anti‐inflammatory drugs (NSAIDs) for reducing ileus after surgery. Methods A prospective multicentre cohort study was delivered by an international, student‐ and trainee‐led collaborative group. Adult patients undergoing elective colorectal resection between January and April 2018 were included. The primary outcome was time to gastrointestinal recovery, measured using a composite measure of bowel function and tolerance to oral intake. The impact of NSAIDs was explored using Cox regression analyses, including the results of a centre‐specific survey of compliance to enhanced recovery principles. Secondary safety outcomes included anastomotic leak rate and acute kidney injury. Results A total of 4164 patients were included, with a median age of 68 (i.q.r. 57–75) years (54·9 per cent men). Some 1153 (27·7 per cent) received NSAIDs on postoperative days 1–3, of whom 1061 (92·0 per cent) received non‐selective cyclo‐oxygenase inhibitors. After adjustment for baseline differences, the mean time to gastrointestinal recovery did not differ significantly between patients who received NSAIDs and those who did not (4·6 versus 4·8 days; hazard ratio 1·04, 95 per cent c.i. 0·96 to 1·12; P = 0·360). There were no significant differences in anastomotic leak rate (5·4 versus 4·6 per cent; P = 0·349) or acute kidney injury (14·3 versus 13·8 per cent; P = 0·666) between the groups. Significantly fewer patients receiving NSAIDs required strong opioid analgesia (35·3 versus 56·7 per cent; P < 0·001). Conclusion NSAIDs did not reduce the time for gastrointestinal recovery after colorectal surgery, but they were safe and associated with reduced postoperative opioid requirement.

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Use of a modified Delphi approach to develop research priorities for the Association of Coloproctology of Great Britain and Ireland

Cited by 90 publications

References 14 publications

Systematic Review and Meta-analysis of Prophylactic Mesh During Primary Stoma Formation to Prevent Parastomal Hernia

Systematic Review and Meta-analysis of Prophylactic Mesh During Primary Stoma Formation to Prevent Parastomal Hernia

Ileus Management International (IMAGINE): protocol for a multicentre, observational study of ileus after colorectal surgery

Safety and efficacy of non-steroidal anti-inflammatory drugs to reduce ileus after colorectal surgery

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