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4. Plasmonic Beam Shaping in the Mid-infrared

Author

Pugh, J. R., Stokes, J., Nash, G. R., Stacey, C. D., and Cryan, M. J.

Subjects
Physics - Optics
Abstract

Simulation results, fabrication details and measurements are presented for a one dimensional aperture and grating array for the purpose of plasmonic beam shaping of the {\lambda}=3.99{\mu}m output of an optically pumped semiconductor laser., Comment: 2 pages, 2 figures

Published
2011

5. Single Lateral Mode Mid-Infrared Laser Diode using Sub-Wavelength Modulation of the Facet Reflectivity

Author

Nash, G. R., Stokes, J. L., Pugh, J. R., Przeslak, S. J. B., Heard, P. J., Rarity, J. G., and Cryan, M. J.

Subjects
Physics - Optics
Abstract

The characteristics of mid-infrared laser diodes have been investigated before and after the patterning of sub-wavelength metallic apertures on the emitting facet. Before modification of the facet the emitted spectrum consisted of a large number of peaks associated with different spatial modes, whereas afterwards the spectrum was dominated by a single peak. Simulations showed that the patterning of the facet caused the effective reflectivity to be different for each lateral mode, suggesting that the peak in the measured spectra is associated with the single lateral mode which is most strongly reflected from the modified facet., Comment: 12 pages, 3 figures

Published
2011
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6. Baseline MRI predictors of successful organ preservation in the Organ Preservation in Rectal Adenocarcinoma (OPRA) trial.

Author

Williams, Hannah, Yuval, Jonathan B, Verheij, Floris S, Miranda, Joao, Lin, Sabrina T, Omer, Dana M, Qin, Li-Xuan, Gollub, Marc J, Kim, Tae-Hyung, Garcia-Aguilar, Julio, Patil, S, Kim, J K, Thompson, H M, Marco, M R, Lee, M, Paty, P B, Weiser, M R, Nash, G M, Pappou, E, and Wei, I H

Subjects
PROPORTIONAL hazards models, PRESERVATION of organs, tissues, etc., PROGRESSION-free survival, NEOADJUVANT chemotherapy, OVERALL survival, RECTAL cancer
Abstract

Background: Prospective randomized trials have not yet identified baseline features predictive of organ preservation in locally advanced rectal cancers treated with total neoadjuvant therapy and a selective watch-and-wait strategy. Methods: This was a secondary analysis of the OPRA trial, which randomized patients with stage II–III rectal adenocarcinoma to receive either induction or consolidation total neoadjuvant therapy. Patients were recommended for total mesorectal excision, or watch and wait based on clinical response at 8 ± 4 weeks after completing treatment. Standardized baseline clinical and radiological variables were collected prospectively. Survival outcomes, including total mesorectal excision-free survival, disease-free survival, and overall survival, were assessed by intention-to-treat analysis. Cox proportional hazards models were used to evaluate associations between baseline variables and survival outcomes. Results: Of the 324 patients randomized for the OPRA trial, 38 (11.7%) had cT4 tumours, 230 (71.0%) cN-positive disease, 101 (32.5%) mesorectal fascia involvement, and 64 (19.8%) extramural venous invasion. Several baseline features were independently associated with recommendation for total mesorectal excision on multivariable analysis: nodal disease (HR 1.66, 95% c.i. 1.12 to 2.48), extramural venous invasion (HR 1.57, 1.07 to 2.29), mesorectal fascia involvement (HR 1.45, 1.01 to 2.09), and tumour length (HR 1.11, 1.00 to 1.22). Of these, nodal disease (HR 2.02, 1.15 to 3.53) and mesorectal fascia involvement (HR 2.02, 1.26 to 3.26) also predicted worse disease-free survival. Age (HR 1.03, 1.00 to 1.06) was associated with overall survival. Conclusion: Baseline MRI features, including nodal disease, extramural venous invasion, mesorectal fascia involvement, and tumour length, independently predict the likelihood of organ preservation after completion of total neoadjuvant therapy. Mesorectal fascia involvement and nodal disease are associated with disease-free survival. Prospective randomized studies have not yet evaluated baseline features that predict organ preservation in locally advanced rectal cancer treated with total neoadjuvant therapy and a selective watch-and-wait strategy. This secondary analysis of the OPRA trial demonstrated that baseline MRI features, including nodal status, extramural venous invasion, mesorectal fascia involvement, and tumour length, independently predict total mesorectal excision-free survival. Nodal status and mesorectal fascia involvement are associated with disease-free survival. [ABSTRACT FROM AUTHOR]

Published
2024
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7. Perceived Level of Nationalism among Senior High School Students and its Relationship to their Attitude towards History.

Author

Ildefonso, Cashmere Lorraine C., Cabrera, Dhanvher Carl D., Cabauatan, Mark John Paul D., Pira, Kenneth Kyle S., Vicente, Princess Mecca M., Romero, Ashton Nash G., Dela Peña, Lady Valen Charon A., Barbieto, Eloisa C., Abraham, Joshua P., and Amor Padilla, Alexis

Subjects
HIGH school students, NATIONALISM
Abstract

Nationalism is the love of one's country and people. This includes pride in one's cultural heritage, support for the country's aspirations, patriotism, and advocacy of national independence. This study aims to determine the level of nationalism among Senior High School students and its relationship to their level of attitude toward history. The research utilized both quantitative and qualitative research designs and conducted the at Saint Mary's University Senior High School with 389 students from STEM, HumSS, ABM, ICT, HE strands and AD Track, utilizing an adopted questionnaire. The respondents' level of nationalism achieved a mean interpreted as high, likewise, a favorable interpretation for level of attitude towards history. The result also indicates a significant difference in the respondent's level of nationalism in terms of sex, strands, and grade level; and level of attitude towards history with strands. However, there is a no significant difference in terms of ethnicity, as such for level of attitude towards history in terms of sex, grade level and ethnicity. Moreover, there is a moderate positive correlation between the respondents' level of nationalism and attitude towards history. Furthermore, the respondents have a high patriotic sentiment in strengthening their sense of nationalism. This research serves as a valuable contribution to understanding and instilling a sense of nationalism among the youth with history as its companion. [ABSTRACT FROM AUTHOR]

Published
2024
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9. Metamaterial control of the surface acoustic wave streaming jet.

Author

Pouya, C and Nash, G R

Subjects
*ACOUSTIC surface waves, *ACOUSTIC streaming, *JET streams, *SPEED of sound, *RAYLEIGH waves
Abstract

The phenomenon of surface acoustic wave (SAW) streaming, where a streaming jet is created, occurs when an SAW propagating on the surface of a solid interacts with water, and underpins the increasingly important area of SAW microfluidics. A key characteristic of the streaming jet is the Rayleigh angle, i.e. the angle at which the jet is formed relative to the surface normal of the solid, which is determined by the ratio of the velocity of the acoustic wave in the fluid and in the solid. Although the ability to dynamically tune this angle would offer a novel tool for microfluidic control, the SAW velocity is normally fixed by the characteristics of the solid and liquid material properties. In this paper we show, using finite element method modelling, that changing the SAW Rayleigh wave phase velocity by patterning a metamaterial array, consisting of square annular holes, onto the surface of an SAW device can change the acoustic streaming Rayleigh angle by approximately a factor of two, in good agreement with calculations based on the change in velocity. [ABSTRACT FROM AUTHOR]

Published
2024
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10. Paparazzi v British media

Author

Nash G. Sorariba

Subjects
media, right of privacy, media self-regulation, statutory control, free press, Communication. Mass media, P87-96, Journalism. The periodical press, etc., PN4699-5650
Abstract

Inspite of the tragedy of Princess Diana and the public backlash against paparazzi, the British Government has refused to implement recommendations of statutory control in 'privacy'. It must have faith in self-regulation by the media; and it does not believe control is necessary in a democracy.

Published
2019
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11. Study of natural and induced tissue response in Macrobrachium rosenbergii de Man

Author

Nash, G. L.

Subjects
590, Shrimp culture, Macrobrachium rosenbergii
Abstract

The tissue response of the giant freshwater prawn Macrobrachium rosenbergii de Man, was studied histologically by investigating clinical cases of natural infectious and non-infectious diseases which occurred in cultured prawns and by carrying out the following experimental intramuscular injection of alcian blue dye, intramuscular injection of BCG vaccine (also using TEM), intramuscular injection of complete Freund's adjuvant, intramuscular and systemic injection of heat-killed Aeromonas hydrophila, intramuscular and systemic injection of heat-killed and live Vibrio parahaemolyticus and Vibrio anguillarum, grafting or insertion of pieces of cuticle into the muscle of the same or different prawns and by cuticular traumatization or wounding of slight, moderate and severe degrees (also using SEM). Results demonstrated histologically the presence of a unified system of haemocytic cells participating in a range of defensive activities in varying degrees of intensity; viz. infiltration, aggregation, coagulation, melanization, phagocytosis, encapsulation, nodule formation and fibroplasia. More pronounced haemocytic activity occurred in the gills, hepatopancreas, heart and antennal gland, in addition to locally at the site of injection, wounding or grafting. Electron microscopy revealed that the haemocytes which participate in the tissue inflammatory response consist of cell types belonging to all three main classes, namely agranular, semi-granular and granular haemocytes, although semi-granular and granular haemocytes appeared to predominate. Findings of the experimentally induced tissue response were comparable to observations in the natural infectious and non-infectious disease conditions in Macrobrachium and in general, similar to those reported in natural infections and experimental challenges of other important wild and cultured crustaceans including penaeid shrimps, crabs and crayfish. A routine study of the haemocytic tissue response in cultured prawns can be recommended as a useful means of monitoring their health status and identifying the early stages of a disease process. This can prove of assistance in developing disease control strategies.

Published
1990

16. Negative Luminescence

Author

Ashley, T., Nash, G. R., Lotsch, H. K. V., Rhodes, William T., editor, Asakura, Toshimitsu, editor, Brenner, Karl-Heinz, editor, Hänsch, Theodore W., editor, Kamiya, Takeshi, editor, Krausz, Ferenc, editor, Monemar, Bo, editor, Venghaus, Herbert, editor, Weber, Horst, editor, Weinfurter, Harald, editor, and Krier, Anthony, editor

Published
2006
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22. Consensus Guidelines from The American Society of Peritoneal Surface Malignancies on Standardizing the Delivery of Hyperthermic Intraperitoneal Chemotherapy (HIPEC) in Colorectal Cancer Patients in the United States

Author

Turaga, K., Levine, E., Barone, R., Sticca, R., Petrelli, N., Lambert, L., Nash, G., Morse, M., Adbel-Misih, R., Alexander, H. R., Attiyeh, F., Bartlett, D., Bastidas, A., Blazer, T., Chu, Q., Chung, K., Dominguez-Parra, L., Espat, N. J., Foster, J., Fournier, K., Garcia, R., Goodman, M., Hanna, N., Harrison, L., Hoefer, R., Holtzman, M., Kane, J., Labow, D., Li, B., Lowy, A., Mansfield, P., Ong, E., Pameijer, C., Pingpank, J., Quinones, M., Royal, R., Salti, G., Sardi, A., Shen, P., Skitzki, J., Spellman, J., Stewart, J., and Esquivel, J.

Published
2014
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28. AMERICAN COLLEGE CHAPELS

Author

Gray, Clifton D., Cowling, Donald J., Gage, Harry M., Gilkey, Charles W., Alton, Alfred E., Mierow, C. C., Knox, Raymond C., Lingle, Walter L., Shaw, Avery A., Harper, W. A., Apple, Henry H., Johnson, Wallace B., Dimnent, Edward D., Kroeze, B. H., Lewis, William M., Aronoff, Alice J., Rall, Edward Everett, Bohn, W. F., Greene, Clarence W., Wicks, Robert R., Mitchell, L. E., Silver, Earl Reed, Bell, Bernard I., Whaling,, H. M., Gardner, D. C., Blanshard, Frances, Ellery, Edward, Kinsolving, Arthur B., Crochett, Walter H., Henshaw,, F. R., Kirkwood, Marie, Wishart, Charles F., and Nash, G. W.

Published
1930

31. The impact of stapling technique and surgeon specialism on anastomotic failure after right-sided colorectal resection: an international multicentre, prospective audit

Author

Glasbey, Jc, Nepogodiev, D, Battersby, N, Bhangu, A, El-Hussuna, A, Frasson, M, Singh, B, Vennix, S, Zmora, O, Pinkney, T, Chaudhri, S, Bemelman, W, Christensen, P, D'Hoore, A, Laurberg, S, Morton, D, Rubbini, M, Vaizey, C, Mehta, S, Ives, N, Magill, L, Perry, R, Sheward, N, Cillo, M, Estefania, D, Patron Uriburu, J, Ruiz, H, Salomon, M, Makhmudov, A, Selnyahina, L, Varabei, A, Vizhynis, Y, Claeys, D, Defoort, B, Muysoms, F, Pletinckx, P, Vergucht, V, Debergh, I, Feryn, T, Reusens, H, Nachtergaele, M, Francart, D, Jehaes, C, Markiewicz, S, Monami, B, Weerts, J, Bouckaert, W, Houben, B, Knol, J, Sergeant, G, Vangertruyden, G, Haeck, L, Lange, C, Sommeling, C, Vindevoghel, K, Castro, S, De Bruyn, H, Huyghe, M, De Wolf, E, Reynders, D, de Buck van Overstraeten, A, Wolthuis, A, Delibegovic, S, Christiani, A, Marchiori, M Jr, Rocha de Moraes, C, Tercioti, V Jr, Arabadjieva, E, Bulanov, D, Dardanov, D, Stoyanov, V, Yonkov, A, Angelov, K, Maslyankov, S, Sokolov, M, Todorov, G, Toshev, S, Georgiev, Y, Karashmalakov, A, Zafirov, G, Wang, X, Condic, D, Kraljik, D, Mrkovic, H, Pavkovic, V, Raguž, K, Bencurik, V, Holášková, E, Skrovina, M, Farkašová, M, Grolich, T, Kala, Z, Antos, F, Pruchova, V, Sotona, O, Chobola, M, Dusek, T, Ferko, A, Örhalmi, J, Hoch, J, Kocian, P, Martinek, L, Bernstein, I, Gotschalck Sunesen, K, Leunbach, J, Thorlacius-Ussing, O, Uth Oveson, A, Dahl Chirstensen, S, Gamez, V, Oeting, M, Schou Loeve, U, Ugianskis, A, Jessen, M, Krarup, P, Linde, K, Mirza, Q, Overgaard Stovring, J, Erritzøe, L, Loft Jakobsen, H, Lykke, J, Palmgren Colov, E, Husted Madsen, A, Linde Friis, T, Amstrup Funder, J, Dich, R, Kjaer, S, Rasmussen, S, Schlesinger, N, Dilling Kjaer, M, Qvist, N, Khalid, A, Ali, G, Hadi, S, Rosell Walker, L, Kivelä, A, Lehtonen, T, Lepistö, A, Scheinin, T, Siironen, P, Kössi, J, Kuusanmäki, P, Tomminen, T, Turunen, A, Rautio, T, Vierimaa, M, Huhtinen, H, Karvonen, J, Lavonius, M, Rantala, A, Varpe, P, Cotte, E, Francois, Y, Glehen, O, Kepenekian, V, Passot, G, Maggiori, L, Manceau, G, Panis, Y, Gout, M, Rullier, E, van Geluwe, B, Chafai, N, Lefevre, Jh, Parc, Y, Tiret, E, Couette, C, Duchalais, E, Agha, A, Hornberger, M, Hungbauer, A, Iesalnieks, I, Weindl, I, Crescenti, F, Keller, M, Kolodziejski, N, Scherer, R, Sterzing, D, Bock, B, Boehm, G, El-Magd, M, Krones, C, Niewiera, M, Buhr, J, Cordesmeyer, S, Hoffmann, M, Krückemeier, K, Vogel, T, Schön, M, Baral, J, Lukoschek, T, Münch, S, Pullig, F, Horisberger, K, Kienle, P, Magdeburg, J, Post, S, Batzalexis, K, Germanos, S, Agalianos, C, Dervenis, C, Gouvas, N, Kanavidis, P, Kottikias, A, Katsoulis, Ie, Korkolis, D, Plataniotis, G, Sakorafas, G, Akrida, I, Argentou, M, Kollatos, C, Lampropoulos, C, Tsochatzis, S, Besznyák, I, Bursics, A, Egyed, T, Papp, G, Svastics, I, Atladottir, J, Möller, P, Sigurdsson, H, Stefánsson, T, Valsdottir, E, Andrews, E, Foley, N, Hechtl, D, Majeed, M, Mccourt, M, Hanly, A, Hyland, J, Martin, S, O'Connell, Pr, Winter, D, Connelly, T, Joyce, W, Wrafter, P, Berkovitz, R, Avital, S, Haj Yahia, I, Hermann, N, Shpitz, B, White, I, Lishtzinsky, Y, Tsherniak, A, Wasserberg, N, Horesh, N, Keler, U, Pery, R, Shapiro, R, Tulchinsky, H, Badran, B, Dayan, K, Iskhakov, A, Lecaros, J, Nabih, N, Angrima, I, Bardini, R, Pizzolato, E, Tonello, M, Arces, F, Balestri, R, Ceccarelli, C, Prosperi, V, Rossi, E, Giannini, I, Vincenti, L, Di Candido, F, Di Iena, M, Guglielmi, A, Caputi-Iambrenghi, O, Marsanic, P, Mellano, A, Muratore, A, Annecchiarico, M, Bencini, L, Amore Bonapasta, S, Coratti, A, Guerra, F, Asteria, Cr, Boccia, L, Gerard, L, Pascariello, A, Manca, G, Marino, F, Casaril, A, Inama, M, Moretto, G, Bacchelli, C, Carvello, M, Mariani, N, Montorsi, M, Spinelli, A, Romairone, E, Scabini, S, Belli, A, Bianco, F, De Franciscis, S, Maria Romano, G, Delrio, P, Pace, U, Rega, D, Sassaroli, C, Scala, D, De Luca, R, Ruggieri, E, Elbetti, C, Garzi, A, Romoli, L, Scatizzi, M, Vannucchi, A, Curletti, G, Durante, V, Galleano, R, Mariani, F, Reggiani, L, Bellomo, R, Infantino, A, Franceschilli, L, Sileri, P, Clementi, I, Coletta, D, La Torre, F, Mingoli, A, Velluti, F, Di Giacomo, A, Fiorot, A, Massani, M, Padoan, L, Ruffolo, C, Caruso, S, Franceschini, F, Laessig, R, Monaci, I, Rontini, M, Annunziata Azienda SM, De Nardi, P, Elmore, U, Lemma, M, Rosati, R, Tamburini, A, De Luca, M, Sartori, A, Benevento, A, Bottini, C, Ferrari, Cc, Pata, F, Tessera, G, Pellino, G, Selvaggi, F, Lanzani, A, Romano, F, Sgroi, G, Steccanella, F, Turati, L, Yamamoto, T, Ancans, G, Gerkis, S, Leja, M, Pcolkins, A, Sivins, A, Latkauskas, T, Lizdenis, P, Saladžinskas, Ž, Švagždys, S, Tamelis, A, Razbadauskas, A, Sokolovas, M, Dulskas, A, Samalavicius, N, Jotautas, V, Mikalauskas, S, Poskus, E, Poskus, T, Strupas, K, Camenzuli, C, Cini, C, Predrag, A, Psaila, J, Spiteri, N, Buskens, C, de Groof EJ, Gooszen, J, Tanis, P, Belgers, E, Davids, P, Furnee, E, Postma, E, Pronk, A, Smakman, N, Clermonts, S, Zimmerman, D, Omloo, J, van der Zaag, E, van Duijvendijk, P, Wassenaar, E, Bruijninckx, M, de Graff, E, Doornebosch, P, Tetteroo, G, Vermaas, M, Iordens, G, Knops, S, Toorenvliet, B, van Westereenen HL, Boerma, E, Coene, P, van der Harst, E, Van Der Pool, A, Raber, M, Melenhorst, J, de Castro, S, Gerhards, M, Arron, M, Bremers, A, de Wilt, H, Ferenschild, F, Yauw, S, Cense, H, Demirkiran, A, Hunfeld, M, Mulder, I, Nonner, J, Swank, H, van Wagensveld, B, Bolmers, M, Briel, J, van Geloven, A, van Rossem, C, Klemann, V, Konsten, J, Leenders, B, Schok, T, Bleeker, W, Gidwani, A, Lawther, R, Loughlin, P, Skelly, B, Spence, R, Brun, M, Helgeland, M, Ignjatovic, D, Øresland, T, Yousefi, P, Flåten Backe, I, Helmer Sjo, O, Nesbakken, A, Tandberg-Eriksen, M, Cais, A, Hallvard Traeland, J, Herikstad, R, Kørner, H, Lauvland, N, Jajtner, D, Kabiesz, W, Rak, M, Gmerek, L, Horbacka, K, Horst, N, Krokowicz, P, Kwiatkowski, A, Pasnik, K, Karcz, P, Romaniszyn, M, Rusek, T, Walega, P, Czarencki, R, Obuszko, Z, Sitarska, M, Wojciech, W, Zawadzki, M, Amado, S, Clara, P, Couceiro, A, Malaquias, R, Rama, N, Almeida, A, Barbosa, E, Cernadas, E, Duarte, A, Silva, P, Costa, S, Martinez Insua, C, Marques, R, Pereira, J, Pereira, C, Sacchetti, M, Carvalho Pinto, B, Jorge Vieira Sousa, P, Oliveira, A, Cardoso, R, Carlos, S, Corte-Real, J, Moniz Pereira, P, Souto, R, Carneiro, C, Marinho, R, Nunes, V, Rocha, R, Sousa, M, Leite, J, Melo, F, Pimentel, J, Ventura, L, Vila Nova, C, Copăescu, C, Bintintan, V, Ciuce, C, Dindelegan, G, Scurtu, R, Seicean, R, Domansky, N, Karachun, A, Moiseenko, A, Pelipas, Y, Petrov, A, Pravosudov, I, Aiupov, R, Akmalov, Y, Parfenov, A, Suleymanov, N, Tarasov, N, Jumabaev, H, Mamedli, Z, Rasulov, A, Aliev, I, Chernikovskiy, I, Kochnev, V, Komyak, K, Smirnov, A, Achkasov, S, Bolikhov, K, Shelygin, Y, Sushkov, O, Zapolskiy, A, Gvozdenovic, M, Jovanovic, D, Lausevic, Z, Cvetković, D, Maravić, M, Milovanovic, B, Stojakovic, N, Tripković, I, Mihajlovic, D, Nestorovic, M, Pecic, V, Petrovic, D, Stanojevic, G, Barisic, G, Dimitrijevic, I, Krivokapic, Z, Markovic, V, Popovic, M, Aleksic, A, Dabic, D, Kostic, I, Milojkovic, A, Perunicic, V, Lukic, D, Petrovic, T, Radovanovic, D, Radovanovic, Z, Cuk, Vm, Cuk, Vv, Kenic, M, Kovacevic, B, Krdzic, I, Korcek, J, Rems, M, Toplak, J, Escarrâ, J, Gil Barrionuevo, M, Golda, T, Kreisler Moreno, E, Zerpa Martin, C, Álvarez Laso, C, Cumplido, P, Padin, H, Baixauli Fons, J, Hernández-Lizoain, J, Martinez-Ortega, P, Molina-Fernández, M, Sánchez-Justicia, C, Antonio Gracia Solanas, J, Córdoba Díaz de Laspra, E, Echazarreta-Gallego, E, Elia-Guedea, M, Ramirez, J, Arredondo Chaves, J, Diez González, P, Elosua, T, Sahagún, J, Turienzo Frade, A, Álvarez Conde, J, Castrillo, E, Diaz Maag, R, Maderuelo, V, Saldarriaga, L, Aldrey Cao, I, Fernández Varela, X, Núñez Fernández, S, Parajó Calvo, A, Villar Álvarez, S, Blesa Sierra, I, Lozano, R, Márquez, M, Porcel, O, Menendez, P, Fernández Hevia, M, Flores Sigüenza, L, Jimenez Toscano, M, Lacy Fortuny, A, Ordoñez Trujillo, J, Espi, A, Garcia-Botello, S, Martín-Arévalo, J, Moro-Valdezate, D, Pla-Martí, V, Blanco-Antona, F, Abrisqueta, J, Ibañez Canovas, N, Lujan Mompean, J, Escolá Ripoll, D, Martinez Gonzalez, S, Parodi, J, Fernández López, A, Ramos Fernández, M, Castellvi Valls, J, Ortiz de Zarate, L, Ribas, R, Sabia, D, Viso, L, Alonso Gonçalves, S, José Gil Egea, M, Pascual Damieta, M, Pera, M, Salvans Ruiz, S, Bernal, J, Landete, F, Ais, G, Etreros, J, Aguiló Lucia, J, Boscá, A, Deusa, S, García Del Caño, J, Viciano, V, García-Armengol, J, Roig, J, Blas, J, Escartin, J, Fatás, J, Fernando, J, Ferrer, R, Arias Pacheco, R, García Flórez, L, Moreno Gijón, M, Otero Díez, J, Solar Garcia, L, Aguilar Teixido, F, Balaguer Ojo, C, Bargallo Berzosa, J, Lamas Moure, S, Enrique Sierra, J, Fermiñán, A, Herrerias, F, Rufas, M, Viñas, J, Codina-Cazador, A, Farrés, R, Gómez, N, Julià, D, Planellas, P, López, J, Luna, A, Maristany, C, Muñoz Duyos, A, Puértolas, N, Alcantara Moral, M, Serra-Aracil, X, Concheiro Coello, P, Gómez, D, Carton, C, Miguel, A, Reoyo Pascual, F, Valero Cerrato, X, Zambrano Muñoz, R, Cervera-Aldama, J, García González, J, Ramos-Prada, J, Santamaría-Olabarrieta, M, Urigüen-Echeverría, A, Coves Alcover, R, Espinosa Soria, J, Fernandez Rodriguez, E, Hernandis Villalba, J, Maturana Ibañez, V, De la Torre Gonzalez, F, Huerga, D, Pérez Viejo, E, Rivera, A, Ruiz Ucar, E, Garcia-Septiem, J, Jiménez, V, Jiménez Miramón, J, Ramons Rodriquez, J, Rodriguez Alvarez, V, Garcea, A, Ponchietti, L, Borda, N, Enriquez-Navascues, J, Saralegui, Y, Febles Molina, G, Nogues, E, Rodríguez Méndez, Á, Roque Castellano, C, Sosa Quesada, Y, Alvarez-Gallego, M, Pascual, I, Rubio-Perez, I, Diaz-San Andrés, B, Tone-Villanueva, F, Alonso, J, Cagigas, C, Castillo, J, Gómez, M, Martín-Parra, J, Mengual Ballester, M, Pellicer Franco, E, Soria Aledo, V, Valero Navarro, G, Caballero Rodríguez, E, Gonzalez De Chaves, P, Hernandez, G, Perez Alvarez, A, Soto Sanchez, A, Cesar Becerra Garcia, F, Guillermo Alonso 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Subjects
Crohn’s disease, Male, Leak, Surgi-cal technique, anastomotic leak, Bowel anastomosis, colorectal cancer, Crohn's disease, epidemiology, international, oversewn, stapler, surgery, surgical technique, Colorectal cancer, medicine.medical_treatment, 030230 surgery, Colon/surgery, Tumours of the digestive tract Radboud Institute for Health Sciences [Radboudumc 14], 0302 clinical medicine, Epidemiology, Prospective Studies, Treatment Failure, Young adult, Prospective cohort study, Colectomy, Aged, 80 and over, General Surgery/statistics & numerical data, Medical Audit, ddc:617, Anastomosis, Surgical, Gastroenterology, Middle Aged, Colorectal Neoplasms/surgery, Colorectal surgery, 030220 oncology & carcinogenesis, Female, Colectomy/adverse effects, Colorectal Neoplasms, Anastomotic Leak/etiology, Adult, medicine.medical_specialty, Adolescent, Colon, bowel anastomosis, Colorectal Surgery/statistics & numerical data, Anastomosis, NO, Young Adult, 03 medical and health sciences, Surgical Stapling, medicine, Humans, Aged, ta3126, business.industry, Anastomosis, Surgical/adverse effects, Surgical Stapling/adverse effects, Bowel anastomosi, medicine.disease, Surgery, Reconstructive and regenerative medicine Radboud Institute for Health Sciences [Radboudumc 10], General Surgery, business, Colorectal Surgery
Abstract

AIM: There is little evidence to support choice of technique and configuration for stapled anastomoses after right hemicolectomy and ileocaecal resection. This study aimed to determine the relationship between stapling technique and anastomotic failure.METHOD: Any unit performing gastrointestinal surgery was invited to contribute data on consecutive adult patients undergoing right hemicolectomy or ileocolic resection to this prospective, observational, international, multicentre study. Patients undergoing stapled, side-to-side ileocolic anastomoses were identified and multilevel, multivariable logistic regression analyses were performed to explore factors associated with anastomotic leak.RESULTS: One thousand three hundred and forty-seven patients were included from 200 centres in 32 countries. The overall anastomotic leak rate was 8.3%. Upon multivariate analysis there was no difference in leak rate with use of a cutting stapler for apical closure compared with a noncutting stapler (8.4% vs 8.0%, OR 0.91, 95% CI 0.54-1.53, P = 0.72). Oversewing of the apical staple line, whether in the cutting group (7.9% vs 9.7%, OR 0.87, 95% CI 0.52-1.46, P = 0.60) or noncutting group (8.9% vs 5.7%, OR 1.40, 95% CI 0.46-4.23, P = 0.55) also conferred no benefit in terms of reducing leak rates. Surgeons reporting to be general surgeons had a significantly higher leak rate than those reporting to be colorectal surgeons (12.1% vs 7.3%, OR 1.65, 95% CI 1.04-2.64, P = 0.04).CONCLUSION: This study did not identify any difference in anastomotic leak rates according to the type of stapling device used to close the apical aspect. In addition, oversewing of the anastomotic staple lines appears to confer no benefit in terms of reducing leak rates. Although general surgeons operated on patients with more high-risk characteristics than colorectal surgeons, a higher leak rate for general surgeons which remained after risk adjustment needs further exploration.

Published
2018
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