346 results on '"Knowles, Charles H."'
Search Results
2. Outcomes from elective colorectal cancer surgery during the SARS‐CoV‐2 pandemic
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Glasbey, James C, Nepogodiev, Dmitri, Simoes, Joana FF, Omar, Omar M, Venn, Mary L, Evans, Jonathan P, Futaba, Kaori, Knowles, Charles H, Minaya‐Bravo, Ana, Mohan, Helen, Chand, Manish, Pockney, Peter, Di Saverio, Salomone, Smart, Neil, Vallance, Abigail, Vimalachandran, Dale, Wilkin, Richard JW, Siaw‐Acheampong, Kwabena, Benson, Ruth A, Bywater, Edward, Chaudhry, Daoud, Dawson, Brett E, Gujjuri, Rohan R, Heritage, Emily, Jones, Conor S, Kamarajah, Sivesh K, Khatri, Chetan, Khaw, Rachel A, Keatley, James M, Knight, Andrew, Lawday, Samuel, Mann, Harvinder S, Marson, Ella J, McLean, Kenneth A, Mckay, Siobhan C, Mills, Emily C, Pellino, Gianluca, Picciochi, Maria, Taylor, Elliott H, Tiwari, Abhinav, Trout, Isobel M, Smart, Neil J, Gallo, Gaetano, Moug, Susan, Pata, Francesco, Vimalchandran, Dale, Abbott, Tom EF, Abukhalaf, Sadi, Adamina, Michel, Ademuyiwa, Adesoji O, Agarwal, Arnav, Akkulak, Murat, Alameer, Ehab, Alderson, Derek, Alakaloko, Felix, Albertsmeiers, Markus, Alser, Osaid, Alshaar, Muhammad, Alshryda, Sattar, Arnaud, Alexis P, Magne Augestad, Knut, Ayasra, Faris, Azevedo, José, Bankhead‐Kendall, Brittany K, Barlow, Emma, Beard, David, Blanco‐Colino, Ruth, Brar, Amanpreet, Breen, Kerry A, Bretherton, Chris, Lima Buarque, Igor, Burke, Joshua, Caruana, Edward J, Chaar, Mohammad, Chakrabortee, Sohini, Christensen, Peter, Cox, Daniel, Cukier, Moises, Cunha, Miguel F, Davidson, Giana H, Desai, Anant, Drake, Thomas M, Edwards, John G, Elhadi, Muhammed, Emile, Sameh, Farik, Shebani, Fiore, Marco, Edward Fitzgerald, J, Ford, Samuel, and Garmanova, Tatiana
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Digestive Diseases ,Patient Safety ,Pneumonia ,Emerging Infectious Diseases ,Clinical Research ,Prevention ,Cancer ,Colo-Rectal Cancer ,Lung ,6.4 Surgery ,Evaluation of treatments and therapeutic interventions ,Good Health and Well Being ,COVIDSurg Collaborative ,COVID-19 ,SARS-CoV-2 ,cancer ,colon cancer ,pandemic ,rectal cancer ,surgery ,surgical oncology ,Clinical Sciences ,Surgery - Abstract
AimThis study aimed to describe the change in surgical practice and the impact of SARS-CoV-2 on mortality after surgical resection of colorectal cancer during the initial phases of the SARS-CoV-2 pandemic.MethodThis was an international cohort study of patients undergoing elective resection of colon or rectal cancer without preoperative suspicion of SARS-CoV-2. Centres entered data from their first recorded case of COVID-19 until 19 April 2020. The primary outcome was 30-day mortality. Secondary outcomes included anastomotic leak, postoperative SARS-CoV-2 and a comparison with prepandemic European Society of Coloproctology cohort data.ResultsFrom 2073 patients in 40 countries, 1.3% (27/2073) had a defunctioning stoma and 3.0% (63/2073) had an end stoma instead of an anastomosis only. Thirty-day mortality was 1.8% (38/2073), the incidence of postoperative SARS-CoV-2 was 3.8% (78/2073) and the anastomotic leak rate was 4.9% (86/1738). Mortality was lowest in patients without a leak or SARS-CoV-2 (14/1601, 0.9%) and highest in patients with both a leak and SARS-CoV-2 (5/13, 38.5%). Mortality was independently associated with anastomotic leak (adjusted odds ratio 6.01, 95% confidence interval 2.58-14.06), postoperative SARS-CoV-2 (16.90, 7.86-36.38), male sex (2.46, 1.01-5.93), age >70 years (2.87, 1.32-6.20) and advanced cancer stage (3.43, 1.16-10.21). Compared with prepandemic data, there were fewer anastomotic leaks (4.9% versus 7.7%) and an overall shorter length of stay (6 versus 7 days) but higher mortality (1.7% versus 1.1%).ConclusionSurgeons need to further mitigate against both SARS-CoV-2 and anastomotic leak when offering surgery during current and future COVID-19 waves based on patient, operative and organizational risks.
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- 2021
3. Safety and Efficacy of Iltamiocel Cellular Therapy for the Treatment of Fecal Incontinence. Results of a Phase 1/2 Study
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Knowles, Charles H., Canestrari, Emanuele, Jankowski, Ron J., Cardello, Kelly, and Raval, Manoj J.
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- 2023
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4. The international anorectal physiology working group (IAPWG) recommendations: Standardized testing protocol and the London classification for disorders of anorectal function
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Carrington, Emma V, Heinrich, Henriette, Knowles, Charles H, Fox, Mark, Rao, Satish, Altomare, Donato F, Bharucha, Adil E, Burgell, Rebecca, Chey, William D, Chiarioni, Guiseppe, Dinning, Philip, Emmanuel, Anton, Farouk, Ridzuan, Felt‐Bersma, Richelle JF, Jung, Kee Wook, Lembo, Anthony, Malcolm, Allison, Mittal, Ravinder K, Mion, Franҫois, Myung, Seung‐Jae, O’Connell, P Ronan, Pehl, Christian, Remes‐Troche, Jose María, Reveille, R Matthew, Vaizey, Carolynne J, Vitton, Veronique, Whitehead, William E, Wong, Reuben K, Scott, S Mark, and Group, All members of the International Anorectal Physiology Working
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Biomedical and Clinical Sciences ,Clinical Sciences ,Clinical Research ,Digestive Diseases ,Anal Canal ,Gastroenterology ,Humans ,Intestinal Diseases ,Manometry ,anorectal function testing ,anorectal manometry ,balloon expulsion test ,functional anorectal disorders ,rectal sensory test ,All members of the International Anorectal Physiology Working Group ,Neurosciences ,Medical Physiology ,Gastroenterology & Hepatology ,Clinical sciences ,Medical physiology - Abstract
BackgroundThis manuscript summarizes consensus reached by the International Anorectal Physiology Working Group (IAPWG) for the performance, terminology used, and interpretation of anorectal function testing including anorectal manometry (focused on high-resolution manometry), the rectal sensory test, and the balloon expulsion test. Based on these measurements, a classification system for disorders of anorectal function is proposed.MethodsTwenty-nine working group members (clinicians/academics in the field of gastroenterology, coloproctology, and gastrointestinal physiology) were invited to six face-to-face and three remote meetings to derive consensus between 2014 and 2018.Key recommendationsThe IAPWG protocol for the performance of anorectal function testing recommends a standardized sequence of maneuvers to test rectoanal reflexes, anal tone and contractility, rectoanal coordination, and rectal sensation. Major findings not seen in healthy controls defined by the classification are as follows: rectoanal areflexia, anal hypotension and hypocontractility, rectal hyposensitivity, and hypersensitivity. Minor and inconclusive findings that can be present in health and require additional information prior to diagnosis include anal hypertension and dyssynergia.Conclusions and inferencesThis framework introduces the IAPWG protocol and the London classification for disorders of anorectal function based on objective physiological measurement. The use of a common language to describe results of diagnostic tests, standard operating procedures, and a consensus classification system is designed to bring much-needed standardization to these techniques.
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- 2020
5. Combined MRI, high-resolution manometry and a randomised trial of bisacodyl versus hyoscine show the significance of an enlarged colon in constipation: the RECLAIM study.
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Wilkinson-Smith, Victoria, Scott, Mark, Menys, Alex, Wiklendt, Lukasz, Marciani, Luca, Atkinson, David, Sansone, Stefano, Zdanaviciene, Ausra, Coupland, Carol, Knowles, Charles H., Dinning, Philip, Taylor, Stuart A., Gowland, Penny, Hoad, Caroline Louise, Corsetti, Maura, and Spiller, Robin C.
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ANUS ,SIGMOID colon ,CHRONIC pain ,MAGNETIC resonance imaging ,MEDICAL sciences ,PEER review of students - Published
- 2025
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6. Local Myoelectric Sensing During Human Colonic Tissue Perfusion.
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Ben-David, Matan, Makwana, Raj, Yered, Tal, Sanger, Gareth J., Knowles, Charles H., Wasserberg, Nir, and Shor, Erez
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ELECTROMYOGRAPHY ,ACTION potentials ,COLECTOMY ,MESENTERIC artery ,PROCTOLOGY ,TISSUE arrays - Abstract
Objectives: Anastomotic leakage (AL) is one of the most devastating complications after colorectal surgery. The verification of the adequate perfusion of the anastomosis is essential to ensuring anastomosis integrity following colonic resections. This study aimed to evaluate the efficacy of measuring the electrical activity of the colonic muscularis externa at an anastomosis site for perfusion analysis following colorectal surgery. Methods: Strips of human isolated colon were maintained in a horizontal tissue bath to record spontaneous contractions and myoelectric activity and spike potentials (using a bipolar electrode array for the wireless transmission of myoelectric data—the xBar system) from the circular muscle. Intraoperative myoelectric signal assessment was performed by placing the electrode array on the colon prior to and following mesenteric artery ligation, just prior to colonic resection. Results: In human isolated colon, the amplitude, duration, and frequency of contractions were inhibited during hypoxia by >80% for each measurement, compared to control values and time-matched oxygenated muscle. Intraoperative (N = 5; mean age, 64.8 years; range, 54–74 years; 60% females) myoelectric signal assessment revealed a decline in spike rate following arterial ligation, with a mean reduction of 112.64 to 51.13 spikes/min (p < 0.0008). No adverse events were observed during the study, and the device did not substantially alter the surgical procedure. Conclusions: The electrical and contraction force of the human colon was reduced by ischemia, both in vitro and in vivo. These preliminary findings also suggest the potential of the xBar system to measure such changes during intraoperative and possibly postoperative periods to predict the risk of anastomotic viability as a surrogate of evolving dehiscence. [ABSTRACT FROM AUTHOR]
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- 2024
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7. Redundancy in the International Anorectal Physiology Working Group Manometry Protocol: A Diagnostic Accuracy Study in Fecal Incontinence
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Ang, Daphne, Vollebregt, Paul, Carrington, Emma V., Knowles, Charles H., and Scott, S. Mark
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- 2022
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8. Faecal incontinence in adults
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Bharucha, Adil E., Knowles, Charles H., Mack, Isabelle, Malcolm, Allison, Oblizajek, Nicholas, Rao, Satish, Scott, S. Mark, Shin, Andrea, and Enck, Paul
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- 2022
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9. Supported Intervention Versus Intervention Alone for Management of Fecal Incontinence in Patients With Inflammatory Bowel Disease: A Multicenter Mixed-Methods Randomized Controlled Trial
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Dibley*, Lesley, Hart, Ailsa, Duncan*, Julie, Knowles, Charles H., Kerry, Sally, Lanz*, Doris, Berdunov*, Vladislav, Madurasinghe*, Vichithranie W., Wade, Tiffany, Terry, Helen, Verjee, Azmina, Fader, Mandy, and Norton, Christine
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- 2023
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10. Reprogramming Sacral Neuromodulation for Sub-Optimal Outcomes: Evidence and Recommendations for Clinical Practice
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Dudding, Thomas C., Lehur, Paul A., Sørensen, Michael, Engelberg, Stefan, Bertapelle, Maria Paola, Chartier-Kastler, Emmanuel, Everaert, Karel, Van Kerrebroeck, Philip, Knowles, Charles H., Lundby, Lilli, Matzel, Klaus E., Muñoz-Duyos, Arantxa, Rydningen, Mona B., and de Wachter, Stefan
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- 2021
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11. The impact of long‐course chemoradiotherapy on the myenteric plexus, neuromuscular functions and responses to prokinetic drugs in the human rectum
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Kung, Victor W. S., Broad, John, Makwana, Raj, Palmer, Alexandra, Baidoo, Nicholas, Epton, Sarah, Elahi, Shezan, Chin‐Aleong, Joanne, Thaha, Mohamed, Knowles, Charles H., and Sanger, Gareth J.
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The long‐term effects of chemoradiotherapy on human rectum are poorly understood. The aims were to investigate changes in inflammatory status, myenteric neuron numbers/phenotype, neuromuscular functions and prokinetic drug efficacy. Macroscopically normal proximal‐to‐mid rectum was obtained from 21 patients undergoing surgery for bowel cancer, 98 days (range: 63–350) after concurrent capecitabine and pelvic radiotherapy, and 19 patients without chemoradiotherapy. Inflammatory status was measured by H&E, CD45 staining and qPCR. Myenteric neurons were examined by immunohistochemistry. Neuromuscular functions and drug efficacy were studied using exogenous agents and electrical field stimulation (EFS) to activate intrinsic nerves. Inflammation was not detected. Numbers of myenteric ganglia/neurons were unchanged (11.7 ± 2.4 vs. 10.3 ± 2.2 neurons/mm myenteric plexus with/without chemoradiotherapy) as were the numbers of cholinergic/nitrergic neurons. EFS stimulated cholinergic and nitrergic neurons so the contractile response of the muscle was the sum of both but dominated by cholinergic (causing contraction) or less often, nitrergic activity (relaxation), followed, after termination of EFS, by neuronally mediated contraction. Inhibition of nitric oxide synthase (by L‐NAME 300 μM) more clearly defined EFS‐evoked contractions. The 5‐HT4agonist prucalopride 10 μM and the cholinesterase inhibitor donepezil 1 µM, respectively increased and greatly increased the composite contractile response to EFS (measured as ‘area‐under‐the curve’) and the contractions isolated by L‐NAME (respectively, by 22 ± 14% and 334 ± 87%; n= 11/8). After chemoradiotherapy, nitrergic‐mediated muscle relaxations occurred more often during EFS (in 29.8 ± 6.1% preparations vs. 12.6 ± 5.1% without chemoradiotherapy, n= 21/18). With L‐NAME, the ability of prucalopride to facilitate EFS‐evoked contraction was lost and that of donepezil approximately halved (contractions increased by 132 ± 36%; n= 8). Several months after chemoradiotherapy, the rectum was not inflamed and myenteric neuron numbers/phenotype unchanged. However, nitrergic activity was increased relative to cholinergic activity, and prokinetic‐like drug activity was lost or greatly reduced. Thus, chemoradiotherapy causes long‐term changes in neuromuscular functions and markedly reduces the efficacy of drugs for treating constipation.
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- 2024
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12. Understanding the physiology of human defaecation and disorders of continence and evacuation
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Heitmann, Paul T., Vollebregt, Paul F., Knowles, Charles H., Lunniss, Peter J., Dinning, Phil G., and Scott, S. Mark
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- 2021
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13. Trials with repeated cross sections: alternatives to parallel group designs in surgery trials
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Knowles, Charles H
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- 2022
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14. Posterior Tibial Nerve Stimulation
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Knowles, Charles H. and Oliveira, Lucia Camara Castro, editor
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- 2020
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15. Clinician Administered and Self-Report Survey Both Effective for Identifying Fecal Incontinence in Patients with Inflammatory Bowel Disease
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Dibley, Lesley, Hart, Ailsa, Duncan, Julie, Knowles, Charles H., Kerry, Sally, Lanz, Doris, Madurasinghe, Vichithranie W., Wade, Tiffany, Terry, Helen, Verjee, Azmina, Fader, Mandy, and Norton, Christine
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- 2021
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16. Clinical effectiveness of subsensory sacral neuromodulation in adults with faecal incontinence: the SUBSoNIC crossover RCT and mechanistic study.
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Vollebregt, Paul F, Goh, Yan Li, Chan, Claire L, Dudding, Thomas, Furlong, Paul, Hamdy, Shaheen, Haviland, Joanne, Hooper, Richard, Jones, James, McAlees, Eleanor, Norton, Christine, O'Connell, P Ronan, Scott, S Mark, Stevens, Natasha, Tubby, Kerry, Worthen, Sian, Wong, Yuk Lam, and Knowles, Charles H
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- 2024
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17. Programming Algorithms for Sacral Neuromodulation: Clinical Practice and Evidence—Recommendations for Day-to-Day Practice
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Lehur, Paul A., Sørensen, Michael, Dudding, Thomas C., Knowles, Charles H., de Wachter, Stefan, Engelberg, Stefan, and Matzel, Klaus E.
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- 2020
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18. Coexistent faecal incontinence and constipation: A cross-sectional study of 4027 adults undergoing specialist assessment
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Vollebregt, Paul F., Wiklendt, Lukasz, Dinning, Phil G, Knowles, Charles H., and Scott, S.Mark
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- 2020
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19. Risk of obstetric anal sphincter injuries (OASIS) and anal incontinence: A meta-analysis
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Sideris, Michail, McCaughey, Tristan, Hanrahan, John Gerrard, Arroyo-Manzano, David, Zamora, Javier, Jha, Swati, Knowles, Charles H, Thakar, Ranee, Chaliha, Charlotte, and Thangaratinam, Shakila
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- 2020
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20. Parsimony prevails: Botulinum toxin and the overactive rectum
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Knowles, Charles H, primary
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- 2024
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21. The lived experience of functional bowel disorders: a machine learning approach
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Ruffle, James K, primary, Henderson, Michelle, additional, Ng, Cho Ee, additional, Liddle, Trevor, additional, Nelson, Amy P. K., additional, Nachev, Parashkev, additional, Knowles, Charles H, additional, and Yiannakou, Yan, additional
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- 2024
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22. High-resolution Anorectal Manometry Measures Are More Accurate Than Conventional Measures in Detecting Anal Hypocontractility in Women With Fecal Incontinence
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Carrington, Emma V., Knowles, Charles H., Grossi, Ugo, and Scott, S. Mark
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- 2019
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23. Systematic Characterization of Defecographic Abnormalities in a Consecutive Series of 827 Patients With Chronic Constipation
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Grossi, Ugo, Heinrich, Henriette, Di Tanna, Gian Luca, Taylor, Stuart A., Vollebregt, Paul F., Knowles, Charles H., and Scott, S. Mark
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- 2021
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24. New Technologies and Applications in Sacral Neuromodulation: An Update
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De Wachter, Stefan, Knowles, Charles H., Elterman, Dean S., Kennelly, Michael J., Lehur, Paul A., Matzel, Klaus E., Engelberg, Stefan, and Van Kerrebroeck, Philip E. V.
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- 2020
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25. Constipation
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Knowles, Charles H., Arnold, Wolfgang, Series editor, Ganzer, Uwe, Series editor, Herold, Alexander, editor, Lehur, Paul-Antoine, editor, Matzel, Klaus E., editor, and O'Connell, P. Ronan, editor
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- 2017
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26. Habit training versus habit training with direct visual biofeedback in adults with chronic constipation: A randomized controlled trial
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Norton, Christine, primary, Bannister, Sybil, additional, Booth, Lesley, additional, Brown, Steve R., additional, Cross, Samantha, additional, Eldridge, Sandra, additional, Emmett, Christopher, additional, Grossi, Ugo, additional, Jordan, Mary, additional, Lacy‐Colson, Jon, additional, Mason, James, additional, McLaughlin, John, additional, Moss‐Morris, Rona, additional, Scott, S. Mark, additional, Stevens, Natasha, additional, Taheri, Shiva, additional, Taylor, Stuart A., additional, Yiannakou, Yan, additional, and Knowles, Charles H., additional
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- 2023
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27. Factors Associated With Efficacy of Percutaneous Tibial Nerve Stimulation for Fecal Incontinence, Based on Post-Hoc Analysis of Data From a Randomized Trial
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Horrocks, Emma J., Chadi, Sami A., Stevens, Natasha J., Wexner, Steven D., and Knowles, Charles H.
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- 2017
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28. Sacral Neuromodulation: Standardized Electrode Placement Technique
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Matzel, Klaus E., Chartier-Kastler, Emmanuel, Knowles, Charles H., Lehur, Paul A., Muñoz-Duyos, Arantxa, Ratto, Carlo, Rydningen, Mona B., Sørensen, Michael, van Kerrebroeck, Philip, and de Wachter, Stefan
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- 2017
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29. Functional and anatomical deficits in visceral nociception with age: mechanism of silent appendicitis in the elderly?
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Cibert-Goton, Vincent, Kung, Victor W.S., McGuire, Cian, Hockley, James R.F., Tranter, Michael M, Dogra, Harween, Belai, Abi, Blackshaw, L. Ashley, Sanger, Gareth J., Knowles, Charles H., Araujo, Eduardo J.A., Winchester, Wendy J., and Bulmer, David C.
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- 2019
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30. Human studies of anorectal sensory function
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Knowles, Charles H.
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- 2018
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31. The Clinical Impact of Obesity in Patients With Disorders of Defecation: A Cross-Sectional Study of 1,155 Patients
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Chaichanavichkij, Pam, primary, Vollebregt, Paul F., additional, Keshishian, Karekin, additional, Knowles, Charles H., additional, and Scott, S. Mark, additional
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- 2023
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32. Systematic review of preoperative and intraoperative colorectal Anastomotic Leak Prediction Scores (ALPS)
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Venn, Mary L, primary, Hooper, Richard L, additional, Pampiglione, Tom, additional, Morton, Dion G, additional, Nepogodiev, Dmitri, additional, and Knowles, Charles H, additional
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- 2023
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33. Chronic Constipation
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Knowles, Charles H., primary and Bharucha, Adil E., additional
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- 2018
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34. Percutaneous tibial nerve stimulation versus sham electrical stimulation for the treatment of faecal incontinence in adults (CONFIDeNT): a double-blind, multicentre, pragmatic, parallel-group, randomised controlled trial
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Knowles, Charles H, Horrocks, Emma J, Bremner, Stephen A, Stevens, Natasha, Norton, Christine, O'Connell, P Ronan, and Eldridge, Sandra
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- 2015
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35. Further Questions Raised as to the Use of Anorectal Manometry in the Diagnostic Assessment of Dyssynergic Defecation.
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Vollebregt, Paul F., Grossi, Ugo, Knowles, Charles H., and Scott, S. Mark
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- 2024
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36. sj-docx-1-tej-10.1177_20417314221139794 – Supplemental material for Cell shape characteristics of human skeletal muscle cells as a predictor of myogenic competency: A new paradigm towards precision cell therapy
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Desprez, Charlotte, Danovi, Davide, Knowles, Charles H, and Day, Richard M
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110599 Dentistry not elsewhere classified ,FOS: Clinical medicine ,FOS: Biological sciences ,69999 Biological Sciences not elsewhere classified - Abstract
Supplemental material, sj-docx-1-tej-10.1177_20417314221139794 for Cell shape characteristics of human skeletal muscle cells as a predictor of myogenic competency: A new paradigm towards precision cell therapy by Charlotte Desprez, Davide Danovi, Charles H Knowles and Richard M Day in Journal of Tissue Engineering
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- 2023
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37. Letter: opioid usage is associated with rectal hyposensitivity in patients with opioid‐induced constipation
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Vollebregt, Paul F., primary, Knowles, Charles H., additional, and Scott, S. Mark, additional
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- 2023
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38. Pathway Of Low Anterior Resection syndrome relief after Surgery (POLARiS) feasibility trial protocol: a multicentre, feasibility cohort study with embedded randomised control trial to compare sacral neuromodulation and transanal irrigation to optimised conservative management in the management of major low anterior resection syndrome following rectal cancer treatment
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Coxon-Meggy, Alexandra Harriet, primary, Vogel, Irene, additional, White, Judith, additional, Croft, Julie, additional, Corrigan, Neil, additional, Meggy, Alun, additional, Stocken, Deborah D, additional, Keller, Deborah, additional, Hompes, Roel, additional, Knowles, Charles H, additional, Quyn, Aaron, additional, and Cornish, Julie, additional
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- 2023
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39. Cell shape characteristics of human skeletal muscle cells as a predictor of myogenic competency: A new paradigm towards precision cell therapy
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Desprez, Charlotte, primary, Danovi, Davide, additional, Knowles, Charles H, additional, and Day, Richard M, additional
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- 2023
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40. Adult‐onset megacolon with focal hypoganglionosis: A detailed phenotyping and prospective cohort study.
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Yoon, Jiyoung, Jung, Kee Wook, Ham, Nam Seok, Kim, Jihun, Do, Yoon Suh, Kim, Seon Ok, Choi, Sang Hyun, Kim, Dong Wook, Hwang, Sung Wook, Park, Sang Hyoung, Yang, Dong‐Hoon, Ye, Byong Duk, Byeon, Jeong‐Sik, Yoon, Yong Sik, Kim, Chan Wook, Yu, Chang Sik, Jung, Hwoon‐Yong, Yang, Suk‐Kyun, Martin, Joanne E., and Knowles, Charles H.
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LONGITUDINAL method ,COHORT analysis ,THERAPEUTICS ,T cells ,SATISFACTION - Abstract
Background: In this prospective cohort study, we evaluated features of "adult‐onset megacolon with focal hypoganglionosis." Methods: We assessed the radiologic, endoscopic, and histopathologic phenotyping and treatment outcomes of 29 patients between 2017 and 2020. Data from community controls, consisting of 19,948 adults undergoing health screenings, were analyzed to identify risk factors. Experts reviewed clinical features and pathological specimens according to the London Classification for gastrointestinal neuromuscular pathology. Key results: The median age of the patients with adult‐onset megacolon with focal hypoganglionosis at symptom onset was 59 years (range, 32.0–74.9 years), with mean symptom onset only 1 year before diagnosis. All patients had focal stenotic regions with proximal bowel dilatation (mean diameter, 78.8 mm; 95% confidence interval [CI], 72–86). The comparison with community controls showed no obvious risk factors. Ten patients underwent surgery, and all exhibited significant hypoganglionosis: 5.4 myenteric ganglion cells/cm (interquartile range [IQR], 3.7–16.4) in the stenotic regions compared to 278 cells/cm (IQR, 190–338) in the proximal and 95 cells/cm (IQR, 45–213) in the distal colon. Hypoganglionosis was associated with CD3+ T cells along the myenteric plexus. Colectomy was associated with significant symptom improvement compared to medical treatment [change in the Global Bowel Satisfaction score, −5.4 points (surgery) vs. ‐0.3 points (medical treatment); p < 0.001]. Conclusions and inferences: Adult‐onset megacolon with focal hypoganglionosis has distinct features characterized by hypoganglionosis due to inflammation. Bowel resection appears to benefit these patients. [ABSTRACT FROM AUTHOR]
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- 2023
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41. Efficacy and mechanism of sub-sensory sacral (optimised) neuromodulation in adults with faecal incontinence: study protocol for a randomised controlled trial
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McAlees, Eleanor, Vollebregt, Paul F., Stevens, Natasha, Dudding, Tom C., Emmanuel, Anton V., Furlong, Paul L., Hamdy, Shaheen, Hooper, Richard L., Jones, James F. X., Norton, Christine, O’Connell, P. Ronan, Scott, S. Mark, and Knowles, Charles H.
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- 2018
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42. Rectocele: Incidental or important? Observe or operate? Contemporary diagnosis and management in the multidisciplinary era
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Bharucha, Adil E., primary and Knowles, Charles H., additional
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- 2022
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43. Ex vivo study of human visceral nociceptors
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McGuire, Cian, Boundouki, George, Hockley, James R F, Reed, David, Cibert-Goton, Vincent, Peiris, Madusha, Kung, Victor, Broad, John, Aziz, Qasim, Chan, Christopher, Ahmed, Shafi, Thaha, Mohamed A, Sanger, Gareth J, Blackshaw, L Ashley, Knowles, Charles H, and Bulmer, David C
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- 2018
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44. Abnormal Perception of Urge to Defecate: An Important Pathophysiological Mechanism in Women With Chronic Constipation
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Vollebregt, Paul F., Wiklendt, Lukasz, Burgell, Rebecca E., Chaichanavichkij, Pam, Dinning, Phil G., Knowles, Charles H., Scott, S. Mark, and Gastroenterology and hepatology
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Adult ,Male ,Hepatology ,Manometry ,Gastroenterology ,Rectum ,Humans ,Bayes Theorem ,Female ,Perception ,Prospective Studies ,Defecation ,Constipation - Abstract
INTRODUCTION: Although the association of absent or attenuated "call to stool" with constipation is well-recognized, no studies have systematically evaluated the perception of urge to defecate in a well-defined cohort of patients with chronic constipation (CC). METHODS: A prospective study of 43 healthy adult women and 140 consecutive adult women attending a tertiary center for investigation of CC. All participants completed a 5-day viscerosensory questionnaire, and all women with CC also underwent anorectal physiologic investigations. Normal urge perception and abnormal urge perception were defined using a Naive Bayes model trained in healthy women (95% having normal urge). RESULTS: In total, 181 toilet visits in healthy women and 595 in women with CC were analyzed. Abnormal urge perception occurred in 70 (50.0%) women with CC. In this group, the urge to defecate was more often experienced as abdominal sensation (69.3% vs 41.4%; P < 0.0001), and the viscerosensory referral area was 81% larger (median pixels anterior: 1,849 vs 1,022; P < 0.0001) compared to women with CC and normal urge perception. Abnormal (vs normal) urge in women with CC was associated with more severe constipation (Cleveland Clinic constipation score: 19 vs 15 P < 0.0001), irritable bowel syndrome (45.7% vs 22.9% P < 0.0001), and a functional evacuation disorder on defecography (31.3% vs 14.3% P = 0.023). A distinct pattern of abnormal urge was found in women with CC and rectal hyposensitivity. DISCUSSION: Abnormal urge perception was observed in 50% of women with CC and was frequently described as abdominal sensation, supporting the concept that sensory dysfunction makes an important contribution to the pathophysiology of constipation.
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- 2022
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45. Double-blinded randomised placebo controlled trial of enterosgel (polymethylsiloxane polyhydrate) for the treatment of IBS with diarrhoea (IBS-D)
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Howell, Carol Angela, primary, Kemppinen, Anu, additional, Allgar, Victoria, additional, Dodd, Matthew, additional, Knowles, Charles H, additional, McLaughlin, John, additional, Pandya, Preeti, additional, Whorwell, Peter, additional, Markaryan, Elena, additional, and Yiannakou, Yan, additional
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- 2022
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46. Total collagen content and distribution is increased in human colon during advancing age
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Baidoo, Nicholas, primary, Crawley, Ellie, additional, Knowles, Charles H., additional, Sanger, Gareth J., additional, and Belai, Abi, additional
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- 2022
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47. Chronic anal pain: A review of causes, diagnosis, and treatment
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Knowles, Charles H., primary and Cohen, Richard C., additional
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- 2022
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48. Coexistent faecal incontinence and constipation: Common but frequently overlooked
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Vollebregt, Paul F., primary, Dinning, Phil G., additional, Knowles, Charles H., additional, and Scott, S. Mark, additional
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- 2022
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49. Rectal Hyposensitivity Is an Important Pathophysiologic Mechanism in Patients with Constipation:Evidence from Large Observational Studies in Patients Referred for Anorectal Physiology Testing
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Vollebregt, Paul F., Burgell, Rebecca E., Knowles, Charles H., Scott, S. Mark, and Gastroenterology and hepatology
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Hepatology ,Manometry ,Gastroenterology ,Rectum ,Anal Canal ,Humans ,Constipation - Published
- 2022
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50. Outcomes from elective colorectal cancer surgery during the SARS-CoV-2 pandemic
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M., Baldini, E., Capelli, P., Isolani, S. M., Ribolla, M., Bondurri, A., Colombo, F., Ferrario, L., Guerci, C., Maffioli, A., Armao, T., Ballabio, M., Bisagni, P., Gagliano, A., Longhi, M., Madonini, M., Pizzini, P., Mochet, S., Usai, A., Incollingo, P., Mancini, S., Marino Cosentino, L., Sagnotta, A., Nespoli, L. C., Tamini, N., Anastasi, A., Bartalucci, B., Bellacci, A., Canonico, G., Capezzuoli, L., Di Martino, C., Ipponi, P., Linari, C., Montelatici, M., Nelli, T., Spagni, G., Tirloni, L., Vitali, A., Abate, E., Casati, M., Casiraghi, T., Laface, L., Schiavo, M., Arminio, A., Cotoia, A., Lizzi, V., Vovola, F., Vergari, R., D'Ugo, S., Depalma, N., Spampinato, M. G., Brachini, G., Chiappini, A., Cicerchia, P. M., Cirillo, B., De Toma, G., Fiori, E., Fonsi, G. B., Iannone, I., La Torre, F., Lapolla, P., Meneghini, S., Mingoli, A., Sapienza, P., Zambon, M., Capolupo, G. T., Mazzotta, E., Gattolin, A., Migliore, M., Rimonda, R., Sasia, D., Travaglio, E., Cervellera, M., Gori, A., Sartarelli, L., Tonini, V., Chessa, A., Fiorini, A., Norcini, C., Colletti, G., Confalonieri, M., Costanzi, A., Frattaruolo, C., Mari, G., Monteleone, M., De Nardi, P., Parise, P., Vignali, A., Belvedere, A., Bernante, P., Jovine, E., Neri, J., Parlanti, D., Pezzuto, A. P., Poggioli, G., Rottoli, M., Tanzanu, M., Violante, T., Borghi, F., Cianflocca, D., Di Maria Grimaldi, S., Donati, D., Gelarda, E., Giraudo, G., Giuffrida, M. C., Marano, A., Palagi, S., Pellegrino, L., Peluso, C., Testa, V., Agresta, F., Prando, D., Zese, M., Armatura, G., Frena, A., Scotton, G., Sammarco, G., Vescio, G., Di Marzo, F., Fontana, T., Kanemitsu, Y., Moritani, K., Al Abdallah, M., Ayasra, Y., Qasem, A., Fahmawee, T., Hmedat, A., Obeidat, K., Abou Chaar, M. K., Al-Masri, M., Al-Najjar, H., Alawneh, F., Alkadeeki, G., Al Maadany, F. S., Aldokali, N., Senossi, O., Subhi, M. T., Burgan, D., Kamoka, E., Kilani, A. I., Ellojli, I., Kredan, A., Bradulskis, S., Dainius, E., Kubiliute, E., Kutkevicius, J., Parseliunas, A., Subocius, A., Venskutonis, D., Rasoaherinomenjanahary, F., Razafindrahita, J. B., Samison, L. H., Hamdan, K. H., Ibrahim, M. R., Tan, J. A., Thanapal, M. R., Amin Sahid, N., Hayati, F., Jayasilan, J., Sriram, R. K., Che, J., Subramaniam, S. M. A., Hussain, A. H., Mohamed Sidek, A. S., Mohd Yunus, M. F., Soh, J. Y., Wong, M., Zakaria, A. D., Zakaria, Z., Fathi, N. Q., Xavier, R. G., Buerba, G. A., Mercado, M. A., Posadas-Trujillo, O. E., Salgado-Nesme, N., Sarre, C., Amrani, L., El Ahmadi, B., El Bouazizi, Y., Majbar, A. M., Benkabbou, A., Mohsine, R., Souadka, A., Hompes, R., Meima-van Praag, E. M., Pronk, A. J. M., Sharabiany, S., Grotenhuis, B., Hartveld, L., Posma-Bouman, L., Derksen, T., Franken, J., Oosterling, S., Konsten, J., Van Heinsbergen, M., Olaogun, J., Abdur-Rahman, L., Adeyeye, A., Bello, J., Olasehinde, O., Popoola, A., Jamal, A., Kerawala, A. A., Memon, A. S., Nafees Ahmed, R., Rai, L., Ayub, B., Ramesh, P., Butt, U. I., Kashif, M., Farooka, M. W., Ayyaz, M., Ayubi, A., Waqar, S. H., Azevedo, C., Machado, D., Mendes, F., De Sousa, X., Fernandes, U., Ferreira, C., Guidi, G., Marcal, A., Marques, R., Martins, D., Vaz Pereira, R., Vieira, B., Almeida, J. I., Ferraz, I., Ribeiro, C. G., Lima da Silva, C., Lopes, L., Marialva, J., Pereira, C., Almeida-Reis, R., Ribeiro, A., Tavares, F., Teixeira, M., Correia de Sa, T., Costa, M. J. M. A., Fernandes, V., Machado, N., Nunes Coelho, M., Afonso, J., Santos, R., Saraiva, P., Silva, R., Almeida, A. C., Amaral, M. J., Andrade, R., Camacho, C., Costa, M., Lazaro, A., Nogueira, O., Oliveira, A., Ruivo, A., Silva, M., Simoes, J., Devezas, V., Jacome, F., Nogueiro, J., Pereira, A., Santos-Sousa, H., Vaz, S., Pinto, J., Tojal, A., Cardoso, P., Cardoso, N., Domingos, J. C., Henriques, P., Manso, M. I., Martins dos Santos, G., Martins, R., Morais, H., Pereira, R., Revez, T., Ribeiro, R., Ribeiro, V. I., Soares, A. P., Sousa, S., Teixeira, J., Amorim, E., Baptista, V. H., Bandovas, J. P., Borges, N., Chumbinho, B., Figueiredo de Barros, I., Frade, S., Gomes, J., Kam da Silva Andrade, A., Pereira Rodrigues, A., Pina, S., Silva, N., Silveira Nunes, I., Sousa, R., Azevedo, P., Costeira, B., Cunha, C., Garrido, R., Miranda, P., Peralta Ferreira, M., Sousa Fernandes, M., Galvao, D., Vieira, A., Patricio, B., Santos, P. M. D. D., Vieira Paiva Lopes, A. C., Cunha, R., Faustino, A., Freitas, A., Mendes, J. R., Parreira, R., Abreu da Silva, A., Claro, M., Costa Santos, D., Deus, A. C., Grilo, J. V., Borges, F., Corte Real, J., Henriques, S., Lima, M. J., Matos Costa, P., Brito da Silva, F., Caiado, A., Fonseca, F., Angelo, M., Baiao, J. M., Martins Jordao, D., Vieira Caroco, T., Baia, C., Canotilho, R., Correia, A. M., Ferreira Pinto, A. P., Peyroteo, M., Videira, J. F., Kassir, R., Sauvat, F., Bezede, C., Chitul, A., Ciofic, E., Cristian, D., Grama, F., Bonci, E., Gata, V., Titu, S., Kazachenko, E., Markaryan, D., Rodimov, S., Tsarkov, P., Tulina, I., Litvina, Y., Provozina, A., Agapov, M., Galliamov, E., Kakotkin, V., Kubyshkin, V., Kamalov, A., Semina, E., Alshahrani, M., Alsharif, F., Eskander, M., Alharthi, M., Aljiffry, M., Basendowah, M., Malibary, N., Nassif, M., Saleem, A., Samkari, A., Trabulsi, N., Al Awwad, S., Alghamdi, M., Alnumani, T., Al Habes, H., Alqannas, M., Alyami, M., Alzamanan, M., Cortes Guiral, D., Elawad, A., Alaamer, O., Alselaim, N., Al-Khayal, K., Alhassan, N., Alobeed, O., Alshammari, S., Bin Nasser, A., Bin Traiki, T., Nouh, T., Zubaidi, A. M., Aleksic, L., Antic, A., Barisic, G., Ceranic, M., Grubac, Z., Jelenkovic, J., Kecmanovic, D., Kmezic, S., Knezevic, D., Krivokapic, Z., Latincic, S., Markovic, V., Matic, S., Miladinov, M., Pavlov, M., Pejovic, I., Tadic, B., Vasljevic, J., Velickovic, D., Buta, M., Cvetkovic, A., Gacic, S., Goran, M., Jeftic, N., Markovic, I., Milanovic, M., Nikolic, S., Pejnovic, L., Savkovic, N., Stevic, D., Vucic, N., Zegarac, M., Karamarkovic, A., Kenic, M., Kovacevic, B., Krdzic, I., Lieske, B., Almgla, N., Boutall, A., Herman, A., Kloppers, C., Nel, D., Rayamajhi, S., Paniagua Garcia Senorans, M., Vigorita, V., Acrich, E., Baena Sanfeliu, E., Barrios, O., Golda, T., Santanach, C., Serrano-Navidad, M., Sorribas Grifell, M., Vives, R. V., Escola, D., Jimenez, A., Cayetano Paniagua, L., Gomez Fernandez, L., Collera, P., Diaz Del Gobbo, R., Farre Font, R., Flores Clotet, R., Gomez Diaz, C. J., Guardia, N., Guariglia, C. A., Osorio, A., Sanchez Jimenez, R., Sanchon, L., Soto Montesinos, C., Alonso-Lamberti, L., Garcia-Quijada, J., Jimenez Miramon, J., Jimenez, V., Jover, J. M., Leon, R., Rodriguez, J. L., Salazar, A., Valle Rubio, A., Aguado, H., Bravo Infante, R., De Lacy, F. B., Lacy, A. M., Otero, A., Turrado-Rodriguez, V., Valverde, S., Anula, R., Cano-Valderrama, O., Del Campo Martin, M., Diez-Valladares, L., Dominguez, I., Dziakova, J., Garcia Alonso, M., Garcia Romero, E., Gomez Latorre, L., Muguerza, J. M., Pizarro, M. J., Saez Carlin, P., Sanchez del Pueblo, C., Sanchez-Pernaute, A., Sanz Ortega, G., Sanz-Lopez, R., Torres, A., Garces-Albir, M., Lopez, F., Martin-Arevalo, J., Moro-Valdezate, D., Pla-Marti, V., Beltran de Heredia, J., De Andres Asenjo, B., Gomez Sanz, T., Jezieniecki, C., Nunez Del Barrio, H., Ortiz de Solorzano Aurusa, F. J., Romero de Diego, A., Ruiz Soriano, M., Trujillo Diaz, J., Vazquez Fernandez, A., Lora-Cumplido, P., Sosa, M. V., Gonzalez-Gonzalez, E., Minaya Bravo, A. M., Alonso de la Fuente, N., Jimenez Toscano, M., Grau-Talens, E. J., Martin-Perez, B., Benavides Buleje, J. A., Carrasco Prats, M., Gimenez FrancesFrances, C., Munoz Camarena, J. M., Parra Banos, P. A., Pena, E., Ramirez Faraco, M., Ruiz-Marin, M., Valero Soriano, M., Estaire Gomez, M., Fernandez Camunas, A., Garcia Santos, E. P., Jimenez Higuera, E., Martinez-Pinedo, C., Munoz-Atienza, V., Padilla-Valverde, D., Picon Rodriguez, R., Sanchez-Garcia, S., Sanchez-Pelaez, D., Colombari, R. C., Del Valle, E., Fernandez, M., Lozano Lominchar, P., Martin, L., Rey Valcarcel, C., Zorrilla Ortuzar, J., Alcaide Matas, F., Garcia Perez, J. M., Troncoso Pereira, P., Mora-Guzman, I., Achalandabaso Boira, M., Sales Mallafre, R., Marin, H., Prieto Calvo, M., Villalabeitia Ateca, I., De Andres Olabarria, U., Duran Ballesteros, M., Fernandez Pablos, F. J., Ibanez-Aguirre, F. J., Sanz Larrainzar, A., Ugarte-Sierra, B., Correa Bonito, A., Delgado Burdalo, L., Di Martino, M., Garcia Septiem, J., Maqueda Gonzalez, R., Martin-Perez, E., Calvo Espino, P., Guillamot Ruano, P., Colao Garcia, L., Diaz Perez, D., Esteban Agusti, E., Galindo Jara, P., Gutierrez Samaniego, M., Hernandez Bartolome, M. A., Serrano Gonzalez, J., Alonso Poza, A., Dieguez, B., Garcia-Conde, M., Hernandez-Garcia, M., Losada, M., Alvarez, E., Chavarrias, N., Gegundez Simon, A., Gortazar, S., Guevara, J., Prieto Nieto, M. I., Ramos-Martin, P., Rubio-Perez, I., Saavedra, J., Urbieta, A., Cantalejo diaz, M., De Miguel Ardevines, M. D. C., Duque-Mallen, V., Gascon Ferrer, I., Gonzalez-Nicolas Trebol, M. T., Gracia-Roche, C., Herrero Lopez, M., Martinez German, A., Matute, M., Sanchez Fuentes, N., Sanchez-Rubio, M., Saudi, S., Blazquez Martin, A., Diez Alonso, M., Hernandez, P., Mendoza-Moreno, F., Ovejero Merino, E., Vera Mansilla, C., Acebes Garcia, F., Bailon, M., Bueno Canones, A. D., Choolani Bhojwani, E., Marcos-Santos, P., Miguel, T., Pacheco Sanchez, D., Perez-Saborido, B., Sanchez Gonzalez, J., Tejero-Pintor, F. J., Cano, A., Capitan-Morales, L., Cintas Catena, J., Gomez-Rosado, J., Oliva Mompean, F., Perez Sanchez, M. A., Rio Lafuente, F. D., Torres Arcos, C., Valdes-Hernandez, J., Cholewa, H., Frasson, M., Martinez Chicote, C., Sancho-Muriel, J., Abad Gurumeta, A., Abad-Motos, A., Martinez-Hurtado, E., Ripolles-Melchor, J., Ruiz Escobar, A., Cuadrado-Garcia, A., Garcia-Sancho Tellez, L., Heras Aznar, J., Mate, P., Ortega Vazquez, I., Picardo, A. L., Rojo Lopez, J. A., Sanchez Cabezudo Noguera, F., Serralta de Colsa, D., Cagigas Fernandez, C., Caina Ruiz, R., Gomez Ruiz, M., Martinez-Perez, P., Poch, C., Santarrufina Martinez, S., Valbuena Jabares, V., Blas Laina, J. L., Cros, B., Escartin, J., Garcia Egea, J., Nogues, A., Talal El-Abur, I., Yanez, C., Cagigal Ortega, E. P., Cervera, I., Diaz Pena, P., Gonzalez, J., Marqueta De Salas, M., Perez Gonzalez, M., Ramos Bonilla, A., Rodriguez Gomez, L., Espin-Basany, E., Rquestr, G., Arulanantham, A., Bandara, G. B. K. D., Jayarajah, U., Ravindrakumar, S., Rodrigo, V. S. D., Srishankar, S., Ali Adil, A. K., Alga, A., Heinius, G., Nordberg, M., Pieniowski, E., Lofgren, N., Arigoni, M., Bernasconi, M., Christoforidis, D., Di Giuseppe, M., La Regina, D., Mongelli, F., Chevallay, M., Dwidar, O., Gialamas, E., Sauvain, M., Crugnale, A. S., Guglielmetti, L., Peros, G., Aghayeva, A., Hamzaoglu, I., Sahin, I., Akaydin, E., Aliyeva, Z., Aytac, E., Baca, B., Ozben, V., Ozmen, B. B., Arikan, A. E., Bilgin, I. A., Kara, H., Karahasanoglu, T., Uras, C., Dincer, H. A., Erol, T., Alhamed, A., Ergun, S., Ozcelik, M. F., Sanli, A. N., Uludag, S. S., Velidedeoglu, M., Zengin, A. K., Kara, Y., Kocatas, A., Azamat, I. F., Balik, E., Bugra, D., Bozkurt, M. A., Kulle, C. B., Gozal, K., Guler, S. A., Koken, H., Tatar, O. C., Utkan, N. Z., Yildirim, A., Yuksel, E., Akin, E., Altintoprak, F., Cakmak, G., Celebi, F., Demir, H., Dikicier, E., Firat, N., Gonullu, E., Kamburoglu, M. B., Kucuk, I. F., Mantoglu, B., Colak, E., Kucuk, G. O., Goksoy, B., Bozkurt, E., Mihmanli, M., Tanal, M., Yetkin, S. G., Akalin, M., Arican, C., Avci, E. K., Aydin, C., Demirli Atici, S., Emiroglu, M., Kaya, T., Kebabci, E., Kilinc, G., Kirmizi, Y., Ogucu, H., Salimoglu, S., Sert, I., Tugmen, C., Tuncer, K., Uslu, G., Yesilyurt, D., Yildiz, A., Lule, H., Oguttu, B., Agilinko, J., Ahmeidat, A., Bekheit, M., Cheung, L. K., Kamera, B. S., Mignot, G., Shaikh, S., Sharma, P., Al-Mohammad, A., Ali, S., Ashcroft, J., Baker, O., Coughlin, P., Davies, R. J., Kyriacou, H., Mitrofan, C. G., Morris, A., Raby-Smith, W., Rooney, S., Singh, A., Tan, X. S., Townson, A., Tweedle, E., Angelou, D., Choynowski, M., Mcaree, B., Mccanny, A., Neely, D., Mosley, F., Arrowsmith, L., Campbell, W., Grove, T., Kontovounisios, C., Warren, O., Clifford, R., Eardley, N., Krishnan, E., Manu, N., Martin, E., Roy Mahapatra, S., Serevina, O. L., Smith, C., Emslie, K., Labib, P., Minto, G., Natale, J., Panahi, P., Rogers, L., Abubakar, A., Akhter Rahman, M. M., O'Brien, H., Sasapu, K., Ng, H. J., Day, A., Hunt, A., Laskar, N., Gupta, A., Steinke, J., Thrumurthy, S., Massie, E., Mcgivern, K., Rutherford, D., Wilson, M., Handa, S., Kaushal, M., Kler, A., Patel, P., Redfern, J., Tezas, S., Aawsaj, Y., Barry, C., Blackwell, L., Emerson, H., Fisher, A., Katory, M., Mustafa, A., Kretzmer, L., Lalou, L., Manku, B., Parwaiz, I., Stafford, J., Abdelkarim, M., Asqalan, A., Gala, T., Ibrahim, S., Maw, A., Mithany, R., Morgan, R., Sundaram Venkatesan, G., Boulton, A. J., Hardie, C., Mcnaught, C., Karandikar, S., Naumann, D., Ayorinde, J., Chase, T., Cuming, T., Ghanbari, A., Humphreys, L., Tayeh, S., Aboelkassem Ibrahim, A., Evans, C., Ikram, H., Loubani, M., Nazir, S., Robinson, A., Sehgal, T., Wilkins, A., Dixon, J., Jha, M., Thulasiraman, S. V., Viswanath, Y. K. S., Curl-Roper, T., Delimpalta, C., Liao, C. C. L., Velchuru, V., Westwood, E., Bond-Smith, G., Mastoridis, S., Tebala, G. D., Verberne, C., Bhatti, M. I., Boyd-Carson, H., Elsey, E., Gemmill, E., Herrod, P., Jibreel, M., Lenzi, E., Saafan, T., Sapre, D., Sian, T., Watson, N., Athanasiou, A., Costigan, F., Elkadi, H., Johnstone, J., Nahm, C., Annamalai, S., Ashmore, C., Kourdouli, A., Askari, A., Cirocchi, N., Kudchadkar, S., Patel, K., Sagar, J., Talwar, R., Abdalla, M., Ismail, O., Newton, K., Stylianides, N., Aderombi, A., Bajomo, O., Beatson, K., Garrett, W., Ng, V., Al-Habsi, R., Divya, G. S., Keeler, B., Egan, R., Fabre, I., Harries, R., Li, Z., Parkins, K., Spencer, N., Thompson, D., Gemmell, C., Grieco, C., Hunt, L., Mahmoud Ali, F., Seebah, K., Shaikh, I., Sreedharan, L., Youssef, M., Shah, J., Mclarty, N., Mills, S., Shenfine, A., Sahnan, K., Michel, M., Patil, S., Ravindran, S., Sarveswaran, J., Scott, L., Bhangu, A., Cato, L. D., Kamal, M., Kulkarni, R., Parente, A., Saeed, S., Vijayan, D., Kaul, S., Khan, A. H., Khan, F., Mukherjee, S., Patel, M., Sarigul, M., Singh, S., Adiamah, A., Brewer, H., Chowdhury, A., Evans, J., Humes, D., Jackman, J., Koh, A., Lewis-Lloyd, C., Oyende, O., Reilly, J., Worku, D., Bisset, C., Moug, S. J., Math, S., Sarantitis, I., Timbrell, S., Vitone, L., Faulkner, G., Brixton, G., Findlay, L., Majkowska, A., Manson, J., Potter, R., Bhalla, A., Chia, Z., Daliya, P., Grimley, E., Malcolm, F. L., Theophilidou, E., Daniels, I. R., Fowler, G., Massey, L., Mcdermott, F., Rajaretnam, N., Beamish, A., Magowan, D., Nassa, H., Price, C., Smith, L., Solari, F., Tang, A. M., Williams, G., Davies, E., Hawkin, P., Raymond, T., Ryska, O., Baron, R. D., Gahunia, S., Mcnicol, F., Russ, J., Szatmary, P., Thomas, A., Jayasinghe, J. D., Knowles, C., Ledesma, F. S., Minicozzi, A., Navaratne, L., Ramamoorthy, R., Sohrabi, C., Thaha, M., Venn, M., Atherton, R., Brocklehurst, M., Mcaleer, J., Parkin, E., Aladeojebi, A., Ali, M., Gaunt, A., Hammer, C., Stebbing, J., Bhasin, S., Bodla, A. S., Burahee, A., Crichton, A., Fossett, R., Yassin, N., Brown, S., Lee, M., Newman, T., Steele, C., Baker, A., Konstantinou, C., Ramcharan, S., Lyons, A., Chung, E., Hagger, R., Hainsworth, A., Karim, A., Owen, H., Ramwell, A., Williams, K., Hall, J., Harris, G., Royle, T., Watson, L. J., Asaad, P., Brown, B., Duff, S., Khan, A., Moura, F., Wadham, B., Mccluney, S., Parmar, C., Shah, S., Babar, M. S., Goodrum, S., Whitmore, H., Balasubramaniam, D., Jayasankar, B., Kapoor, S., Ramachandran, A., Beech, N., Green, L., Kiconco, H., Mcewen, R., Pereca, J., Gash, K., Gourbault, L., Maccabe, T., Newton, C., Baig, M., Bates, H., Dunne, N., Khajuria, A., Sarma, D. R., Shortland, T., Tewari, N., Akhtar, M. A., Brunt, A., Mcintyre, J., Milne, K., Rashid, M. M., Sgro, A., Stewart, K. E., Turnbull, A., Aguilar Gonzalez, M., Talukder, S., Eskander, P., Hanna, M., Olivier, J., Magee, C., Powell, S., Flindall, I., Hanson, A., Mahendran, V., Green, S., Lim, M., Macdonald, L., Miu, V., Onos, L., Sheridan, K., Young, R., Alam, F., Griffiths, O., Houlden, C., Kolli, V. S., Lala, A. K., Seymour, Z., Haynes, A., Hill, C., Leede, E., Mcelhinney, K., Olson, K. A., Riley, C., Thornhill, M., Etchill, E., Gabre-Kidan, A., Jenny, H., Kent, A., Ladd, M. R., Long, C., Malapati, H., Margalit, A., Rapaport, S., Rose, J., Stevens, K., Tsai, L., Vervoort, D., Yesantharao, P., Bigelow, B., Klaristenfeld, D., Huynh, K., Azam, M., Choudhry, A., Marx, W., Abel, M. K., Boeck, M., Chern, H., Kornblith, L., Nunez-Garcia, B., Ozgediz, D., Glencer, A., Sarin, A., Varma, M., Abbott, D., Acher, A., Aiken, T., Barrett, J., Foley, E., Schwartz, P., Zafar, S. N., Hawkins, A., Maiga, A., Bhat, M. A., Uyanik, M. 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- Subjects
Leak ,viruses ,Settore MED/18 - CHIRURGIA GENERALE ,SARS‐CoV‐2 ,surgery ,0302 clinical medicine ,COVID-19 ,SARS-CoV-2 ,cancer ,colon cancer ,pandemic ,rectal cancer ,surgical oncology ,Medicine ,COVID‐ ,skin and connective tissue diseases ,Lung ,Incidence (epidemiology) ,Gastroenterology ,Colo-Rectal Cancer ,030220 oncology & carcinogenesis ,Cohort ,030211 gastroenterology & hepatology ,Original Article ,Patient Safety ,6.4 Surgery ,Cohort study ,medicine.medical_specialty ,COVID-19, Cancer, Colon cancer, Pandemic, Rectal cancer, SARS-CoV-2, Surgery, Surgical oncology ,Clinical Sciences ,Anastomosis ,Preoperative care ,COVIDSurg Collaborative ,NO ,Stoma ,03 medical and health sciences ,Clinical Research ,COVID‐19 ,LS7_4 ,business.industry ,Prevention ,fungi ,SARS‐ ,Evaluation of treatments and therapeutic interventions ,Pneumonia ,Odds ratio ,Original Articles ,Surgery ,respiratory tract diseases ,body regions ,cancer, colon cancer, COVID-19, pandemic, rectal cancer, SARS-CoV-2, surgery, surgical oncology ,Emerging Infectious Diseases ,Good Health and Well Being ,Cancer ,Colon cancer ,Pandemic ,Rectal cancer ,Surgical oncology ,Digestive Diseases ,business ,CoV‐ - Abstract
Aim: This study aimed to describe the change in surgical practice and the impact of SARS-CoV-2 on mortality after surgical resection of colorectal cancer during the initial phases of the SARS-CoV-2 pandemic. Method: This was an international cohort study of patients undergoing elective resection of colon or rectal cancer without preoperative suspicion of SARS-CoV-2. Centres entered data from their first recorded case of COVID-19 until 19 April 2020. The primary outcome was 30-day mortality. Secondary outcomes included anastomotic leak, postoperative SARS-CoV-2 and a comparison with prepandemic European Society of Coloproctology cohort data. Results: From 2073 patients in 40 countries, 1.3% (27/2073) had a defunctioning stoma and 3.0% (63/2073) had an end stoma instead of an anastomosis only. Thirty-day mortality was 1.8% (38/2073), the incidence of postoperative SARS-CoV-2 was 3.8% (78/2073) and the anastomotic leak rate was 4.9% (86/1738). Mortality was lowest in patients without a leak or SARS-CoV-2 (14/1601, 0.9%) and highest in patients with both a leak and SARS-CoV-2 (5/13, 38.5%). Mortality was independently associated with anastomotic leak (adjusted odds ratio 6.01, 95% confidence interval 2.58–14.06), postoperative SARS-CoV-2 (16.90, 7.86–36.38), male sex (2.46, 1.01–5.93), age >70 years (2.87, 1.32–6.20) and advanced cancer stage (3.43, 1.16–10.21). Compared with prepandemic data, there were fewer anastomotic leaks (4.9% versus 7.7%) and an overall shorter length of stay (6 versus 7 days) but higher mortality (1.7% versus 1.1%). Conclusion: Surgeons need to further mitigate against both SARS-CoV-2 and anastomotic leak when offering surgery during current and future COVID-19 waves based on patient, operative and organizational risks. © 2020 The Association of Coloproctology of Great Britain and Ireland Bowel and Cancer Research; Sarcoma UK; Yorkshire Cancer Research; European Society of Coloproctology; National Institute for Health Research: 16.136.79; Department of Health and Social Care; Bowel Disease Research Foundation This report was funded by a National Institute for Health Research (NIHR) Global Health Research Unit Grant (NIHR 16.136.79) using UK aid from the UK Government to support global health research, The Association of Coloproctology of Great Britain and Ireland, Bowel & Cancer Research, Bowel Disease Research Foundation, Association of Upper Gastrointestinal Surgeons, British Association of Surgical Oncology, British Gynaecological Cancer Society; European Society of Coloproctology, NIHR Academy, Sarcoma UK, Vascular Society for Great Britain and Ireland and Yorkshire Cancer Research. The funders had no role in study design, data collection, analysis and interpretation or writing of this report. The views expressed are those of the authors and not necessarily those of the National Health Service, the NIHR or the UK Department of Health and Social Care. This report was funded by a National Institute for Health Research (NIHR) Global Health Research Unit Grant (NIHR 16.136.79) using UK aid from the UK Government to support global health research, The Association of Coloproctology of Great Britain and Ireland, Bowel & Cancer Research, Bowel Disease Research Foundation, Association of Upper Gastrointestinal Surgeons, British Association of Surgical Oncology, British Gynaecological Cancer Society; European Society of Coloproctology, NIHR Academy, Sarcoma UK, Vascular Society for Great Britain and Ireland and Yorkshire Cancer Research. The funders had no role in study design, data collection, analysis and interpretation or writing of this report. The views expressed are those of the authors and not necessarily those of the National Health Service, the NIHR or the UK Department of Health and Social Care.
- Published
- 2021
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