Clinical Service Line 01 - Critical Care, Anaesthetics, Theatres, ITU/HDU

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    P009 Outcome of the FiLaC procedure, who are most suitable?
    (2022) Ahmed, S; Sagar, J; Younis, F; Gurjar, S; Das, P
    N/A
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    A systematic review of outcomes and quality of life after ileorectal anastomosis for ulcerative colitis
    (2023) Al-Rashedy, M.
    Background and study aims: Ileorectal anastomosis (IRA) is one option for restoring bowel continuity in patients who have undergone subtotal colectomy for ulcerative colitis (UC). This systematic review aims to assess short- and long-term outcomes after IRA for UC, including anastomotic leak rates, IRA failure (as defined by conversion to pouch or end stoma), cancer risk in the rectal remnant, and quality of life (QoL) post-IRA surgery. Materials & methods: The Preferred Reporting Items for Systematic Reviews and Meta-Analysis checklist was used to demonstrate the search strategy. A systematic review of PubMed, Embase, Cochrane library, and Google Scholar from 1946 to August 2022 was undertaken. Results: This systematic review included 20 studies, representing 2538 patients who underwent IRA for UC. The mean age ranged from 25 to 36 years and the mean postoperative follow-up ranged between 7 and 22 years. The overall leak rate reported across 15 studies was 3.9 % (n = 35/907) ranging from 0 % to 16.7 %. The failure of IRA (requiring conversion to pouch or end stoma) as reported across 18 of the studies was 20.4 % (n = 498/2447). The risk of developing cancer in the remaining rectal stump following IRA was reported by 14 studies and was accumulatively 2.4 % (n = 30/1245). Five studies reported on patient QoL using a variety of different instruments and 66.0 % of patients (n = 235/356) reported a "high" QoL score. Conclusion: IRA was associated with a relatively low leak rate and a low risk of colorectal cancer in the rectal remnant. However, it does carry a significant failure rate which invariably requires conversion to an end stoma or the formation of an ileoanal pouch. IRA provided a QoL to most of the patients.
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    P18 Colectomy rates in ulcerative colitis: a systematic review and meta-analysis
    (2022) Dai , N.; Haider , O.; Askari, A.; Segal , J.
    Abstract Introduction Surgical management in UC is almost exclusively utilised in medically refractory cases and is therefore a useful marker for the efficacy of medical management. Our aim was to understand the prevalence of colectomy in UC and how this has changed over time. Methods A systematic search of the medical literature was conducted using MEDLINE (1946 to May 2021), EMBASE and EMBASE classic (1947 to May 2021) to identify all studies with a population of n>500 that reported colectomy rates in patients >18 years of age with UC. The primary outcome was the prevalence of colectomy at 1, 5 and 10 years after diagnosis. A secondary outcome was that of colectomy rates at 2, 15 and 20 years and in the pre-biologics (defined as pre-2004) compared to post-biologics eras (defined as post-2004). Results 31 papers with a combined 294,359 patients with UC were included for review and meta-analysis. The prevalence of colectomy at 1, 2, 5, 10, 15 and 20-years post-diagnosis were 3%, 3%, 5%, 10%, 10%, 14% respectively. The pooled relative risk for colectomy in the post-biologics era was 0.68 (95% CI 0.42 to 1.09) at 1-year post-diagnosis and 0.71 (95% CI 0.56 to 0.91) at 5-years post-diagnosis. Conclusions The overall colectomy rate has decreased over the past five decades. Biologics appear to reduce the risk of colectomy, but the relative risk reduction is modest and other treatment factors and improved care are likely to have contributed to this reduction. https://doi.org/10.1136/gutjnl-2022-BSG.80
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    888 Utility of a Virtual Mock Interview Course to Prepare Trainees on UK Core Surgical Training Interviews – a Cross-Sectional Study
    (2022) Wise , K; Ebrahim , S; Raja , H
    Abstract Aim To assess the usefulness of a virtual mock interview course to prepare trainees for UK Core Surgical Training (CST) interviews. Method Junior doctors interested in applying for CST attended a one-day interview course delivered by highly ranked surgical trainees. All attendees were invited to complete pre- and post-interview course questionnaires to assess usefulness in improving the confidence and preparedness for interviews. Results A total of 60 trainees attended the course with an 87% (52/60) response rate to both pre- and post-course surveys. Most trainees were FY2 doctors (50%) applying to CST for the first time (78%). Before the course, 60% of attendees reported feeling “not so confident” for their upcoming interview; 38% of participants felt “somewhat confident” whilst 2% reported feeling “very confident.” 100% of doctors found the pre-mock interview presentations “very useful” or “extremely useful”. Matched data revealed an improvement in attendees’ overall confidence (p<0.0001), with 98% reporting they felt “somewhat” or “very confident” and 2% reporting feeling “extremely confident” about upcoming interviews. Conclusions We demonstrate evidence of a successful CST virtual mock interview course that significantly aids preparation and improves confidence for junior doctors.
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    326 Is Patient Satisfaction Affected by Replacing Face-to-Face Appointments with Telephone Assessments for Balance Complaints?
    (2022) Bastawrous , D.; Kaleva , A.; Singh , P.
    Abstract Aim It was found that 91% of surgeons conducted virtual consultations during COVID-19 pandemic. In March 2020, ENT UK recommended that telephone review should be the first approach for all outpatients who do not need urgent treatment. Dizziness diagnoses may be made primarily from the medical history, making telephone clinics suitable. This study aims are to determine the level of patient satisfaction with telephone consultations for balance complaints. Method The electronic patient records of ENT patients were reviewed retrospectively to identify all adult patients with first presentation of dizziness between October 2020 and May 2021.Patients were contacted by telephone and completed the short form patient satisfaction questionnaire (PQS-18). The statistical software SPSS was used for analysis. Results 26 out of 37 patients contacted were reached successfully giving a response rate of 70%. There were 12 patients in the telephone consultation group and 14 patients in the face-to-face group. Average general satisfaction and satisfaction with technical quality were lower in the telephone consultation group (p-values of 0.012 and 0.007 respectively). Total average score was also lower in telephone consultation group with p-value of 0.028. 91% of patients who had initial assessment by telephone needed a follow up face to face consultation as opposed to only 14% in the face-to-face group. Conclusion Patients were less satisfied with primary assessment of balance complaints by telephone. Most of these patients required face-to-face follow up consultations.