19 Apr

The National Complicated intra-ABdominal Infection (CABI) Audit

The YSRC and NITCAR (National Infection Trainee Collaborative for Audit and Research) are delighted to launch a national prospective audit evaluating the current management strategies and related outcome of patients with Complicated intra-ABdominal Infection (CABI). The audit is aimed at gathering baseline data to inform a randomised clinical trial evaluating the role of long-term antibiotics (up to 4 weeks) in the management of CABI not amenable to source control.

Please review the attached documents and we would be grateful if these could be circulated widely amongst your trainees. The audit is also on the HQIP quality accounts, which is an incentive for trusts to participate.

Please visit our weblink for accessing the protocol and other details:


Please do not hesitate with any queries on our dedicated email:

Looking forward to working with you on an exciting project.

14 Apr

Audit of Best Medical Therapy for Arterial Referrals to Vascular clinic (ABTARV)

VERN image

The study has been piloted in Norfolk and Norwich University Hospital, and Northampton General Hospital. All individuals contributing data will be citable authors on any future paper(s), and we aim to present the results at the Vascular Society Meeting 2016.


There is strong evidence that patients with coronary atherosclerotic disease are at a high cardiovascular risk, and therefore require optimisation from a cardiac perspective including a minimum of an antiplatelet agent and a statin, treatment of hypertension, and diabetic control. Patients with peripheral arterial disease or abdominal aortic aneurysms are known to be at high risk of cardiovascular events and also require best medical therapy.


The aim of this audit is to determine the proportion of patients referred to vascular clinics with arterial disease who are on best medical therapy, through a multicentre audit of referrals over a 3 month period.


This audit aims to be conducted across several hospitals as a retrospective audit over a 3 month period from January 1st 2015 to March 31st 2015. The audit will involve review of the referral letter, clinic letter, and any resultant imaging and blood results for each patient referred with a possible arterial problem. Data collected will include reason for referral, past medical history (including recent test for diabetes, MI, stroke, hypertension, cholesterol), smoking history, and current medications.

Submit data to p.stather@nhs.net Please ensure prior to submitting, to secure caldicott guardian approval and use only nhs.net email addresses to transmit data (nhs.uk email address is not sufficient) Submission deadline: 15th June 2016

03 Mar

Register by Sunday 14th for the National Margins Audit

Data collection started on Monday 1st of February, but registration is still open until Sunday 14th.

Don’t miss out. So far a massive 80 sites have registered, but we are still inviting further investigators to join this important project.

The National Margins Audit is looking at variation in breast resection margin practice across the UK and the impact this has on re-excision rates and other short term outcomes. The full protocol is available on the London Surgical Research Group website http://lsrg.org.uk/projects/national-margins-audit. A list of the sites that have registered to date are also on the website. If your site has not already registered, we strongly encourage you to do so.

To join, please contact Sarah Tang directly sarah.tang@lsrg.org.uk by Sunday 14th February.

22 Jan

Data collection starts 1st February – join the National Margins Audit now

The London Surgical Research Group is excited to invite you to join the National Margins Audit. This project will study national variation in margin practice in breast conserving surgery and margin re-excision rates.

This is an important study which follows ASCO’s endorsement of “no ink on tumour” as an adequate margin in 2014. Wider margins have not been found to be associated with lower local recurrence rates in a meta analysis of 28,000 women following breast conserving therapy. Pursuing wider margins may increase re-excision rates and result in higher complication rates, poor cosmesis, poor patient experience and increased healthcare costs.

There is no clear national or regional consensus on adequate margins in the UK. We hope the results of this audit will help drive an update in national guidelines and result in greater uniformity in margin practice across the UK.

National data collection is between the 1st of February and 31st March 2016. Please contact sarah.tang@lsrg.org.uk to register. Further information on this project including the full protocol can be found on the LSRG website and on the National Margins Audit YouTube channel https://youtu.be/i3o9_pBYXpQ

26 Apr

HART (Hughes Abdominal Repair Trial)

 Hughes Abdominal Repair Trial

The Hughes Abdominal Repair Trial (HART) recruits colorectal cancer patients undergoing abdominal surgery requiring a midline incision of at least 5cm. This surgical study aims to compare the rates of incisional hernia one year following one of two closure methods. The two closure methods are standard mass and the Hughes repair. It is thought that the Hughes repair may be able to prevent hernias.HART study




HART flow chart

The HART trial has successfully completed its feasibility and is progressing with the pilot study. We are now closed for recruiting new sites

The authorship model is that of the national collaborative approach.

For more information please contact research@welshbarbers.org

Yours sincerely,

Rhiannon Harries

Follow us on twitter @HARTtrial

HART Expression of Interest Form v1 0 27Mar2015

HART Protocol Synopsis, v3.0, 19Mar2015.FINAL

12 Dec

Delphi Champions – Last Call for Trainee Involvement

The Association of Coloproctology and BDRF would like to ask for your help!¬†They would like trainees to become involved in the ACPGBI equivalent of the SANDPIT research workshops. So if you enjoyed the NRCM workshops then you will love these…

The ACPGBI, BDRF and RCS, together with patient groups, wish to develop a co-ordinated strategy to evolve and implement the Delphi research agenda. In the first instance we would like to hear from individuals or groups who wish to participate in answering any of these questions. We are now seeking Delphi Champions. These Champions will be invited to attend the Delphi Games in spring 2015, a series of themed meetings that will bring together clinicians, methodologists, patients and funders to develop our trials strategy..

The ACPGBI has agreed to provide a start-up fund to help groups grow. Additional resources are available through the RCS .

If you are interested in becoming a Delphi Champion, or simply want to support work on a specific research question, then please do apply providing:

• your name, position and place of work
• contact details
• which research question(s) (maximum of 3) you would like to help develop
• paragraph of less than half a side of A4 explaining your interest
• a short CV of maximum one side A4
• are there any other key players that we should invite to the games? Please also let us know if there are researchers from other disciplines or overseas groups that we should invite to collaborate.

****Closing date for expressions of interest is 15 December 2014.****

Please email completed applications to gsaffery@bdrf.org.uk.
Please do put your name forward – you have the making of a Champion!

Yours sincerely
Nicola Fearnhead
Chair, ACPGBI Research & Audit Committee

Simon Bach
RCS Subspecialty Lead for Colorectal Surgery
NCRI Colorectal Cancer Clinical Studies Group

Reproduced from Tiernan et al, Colorectal Dis. Oct 5. doi: 10.1111/codi.12790. with permission:

Highest priority list of cancer-related research questions:

1 What is the optimal treatment for early rectal cancer? What are the relative roles of endoscopic mucosal resection (EMR), transanal endoscopic microsurgery (TEMS), radiotherapy, chemotherapy and resectional surgery? In cases of early rectal cancer amenable to local excision techniques, are there benefits from additional treatment modalities?
2 What is the best method to predict complete pathological response to chemoradiotherapy in rectal cancer treated with neoadjuvant chemoradiotherapy prior to surgery? Do these patients require immediate resectional surgery? If not, what is the best strategy for surveillance?
3 What is the optimal treatment for endoscopically removed polyp cancers? When is surgical resection necessary? What is the long-term outcome of polyp cancers treated with polypectomy alone?
4 What are the short and long-term outcomes after extralevator abdominoperineal excision of rectum (ELAPE)? Is there an oncological gain and is it justified?
5 What biomarkers (including genetic profiling) affect response to chemoradiotherapy for rectal cancer?
6 Why do some patients develop colorectal cancer metastases? Can early markers of metastatic disease be developed?
7 What is the optimal timing of resection of liver and/or lung metastases from colorectal cancer – before, during or after primary surgery?
8 What is the optimal method of wound closure after abdominoperineal excision of rectum (APER)? In which situations are mesh or plastic reconstruction indicated, and is there a benefit from these techniques?
9 Is there a benefit to preoperative (chemo)radiotherapy in T3 rectal cancer with non-threatened margins? If so, does it justify any potential additional toxicity?
10 Is chemotherapy better given before or after surgery for locally advanced colon cancer? Or both before and after?
11 Is there a price to cancer survivorship after treatment for colon, rectal and anal cancer? What is the impact of treatment on quality of life? What level of poor function is justified to avoid a permanent stoma?
12 What is the role of delayed resection of the primary tumour in chemoresponsive metastatic colorectal cancer?
13 What are the optimal methods and intervals for population screening for colorectal cancer? How can uptake of screening be improved? Are there subgroups of the population who are at higher risk and should be screened earlier or at different intervals?
14 Which colorectal adenomas indicate significantly increased risk of future colorectal cancer? What is the optimal screening strategy for these patients?
15 What is the optimal surveillance strategy for patients who have undergone transanal local excision of rectal cancer?

Highest priority list of non-cancer research questions:

1 How can early detection and outcome of anastomotic leakage be improved? Are there any new techniques or approaches that will reduce anastomotic leak rates in colorectal surgery?
2 What is the best method of i) preventing parastomal hernias ii) repairing parastomal hernias?
3 What are the indications for, and what is the optimal timing of, surgery for Crohn’s disease in the era of biological therapy?
4 What are the short and long term outcomes of minimally invasive approaches (e.g. percutaneous radiological drainage, laparoscopic washout and drainage) to managing complicated diverticultis?
5 How can postoperative ileus be reduced?
6 What is the optimal multimodal strategy for managing fistulating perianal Crohn’s disease?
7 How does reporting and sharing of surgeon specific outcomes affect clinical practice?
8 What are the short and long-term outcomes of laparoscopic ventral mesh rectopexy (VMR), and is the mesh material important?
9 What are the predictive factors for poor outcome in patients with severe intra-abdominal sepsis? How can outcomes be improved?
10 When should a colorectal anastomosis be defunctioned? Are there predictive factors which would aid decision-making about need for diversion?

13 Sep

Invitation for the National HTC Annual Meeting 2014

The NIHR colorectal therapies health technologies co-operative (HTC) are delighted to announce the National HTC meeting 2014 on Thursday the 9th of October 2014 from 10:00 to 16:30 at the Royal Armouries Museum, Leeds. Registration for the event is free.

The meeting will bring together the current key players in the network and introduce and welcome potential new collaborators. This event is open to clinicians, patients, academics, scientists and industry partners looking to work together to advance patient care by accelerating new science and technologies into patient benefit.

Lunch and refreshments will be provided.

Apply now to attend this FREE event. Please note that places are limited and will be allocated on a first come, first serve basis.

If you have any questions about the event please contact us at colorectalhtc@leeds.ac.uk.

Register here

Please circulate this widely among your contacts.

03 Aug

Countdown to ORCHESTRA study – 4 weeks to go

The countdown to the start of ORCHESTRA is on!

We have now finished a successful pilot study and ironed out a few teething problems with the online data collection system.

The study will start on September 1st 2014. We would like to use the last few weeks to get as many centres as possible to collaborate. Thank you to all the General Surgeons and Urologists that have signed up but we are still looking for more! If you have considered joining the study but not yet done anything about it then NOW is the time! Please could you all ask around your friends and colleagues to take part. Study details and sign-up form are at www.pstrn.org.uk

One observation from the pilot study is that it has been useful to have more than one trainee involved. With junior doctor changeover this week it would be a good time to see if any new doctors joining your department would like to get involved.

Any trainee contributing data will be recognised as an investigator and acknowledged accordingly (PubMed searchable) and when the study is complete there will be opportunities for contributing to the paper itself.

Please get in touch with any queries or problems encountered and we will endeavour to help.

We look forward to collaborating with you!
Best Wishes,

The Orchestra Team