Ewen A Griffiths

Ewen A Griffiths
  • MD FRCS
  • Consultant at University Hospitals Birmingham NHS Foundation Trust

About

387
Publications
232,341
Reads
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10,628
Citations
Introduction
Ewen Griffiths graduated MB ChB from Dundee University, Scotland in 2000. He is a Fellow of the Royal Collage of Surgeons (Glasgow) and has completed training in General and Upper GI Surgery. His research in to ‘hypoxia associated factors’ in oesophagogastric cancer at Paterson Institute of Cancer Research, Christie Hospital, Manchester and Wythenshawe Hospital, Manchester led to many publications and the award of MD (Doctorate in Medicine) from Manchester University in 2006.
Current institution
University Hospitals Birmingham NHS Foundation Trust
Current position
  • Consultant
Additional affiliations
October 2016 - present
University of Birmingham
Position
  • Lecturer
Description
  • Institute of Cancer and Genomic Sciences within the College of Medical and Dental Sciences.
September 2012 - present
University Hospitals Birmingham NHS Foundation Trust
Position
  • Consultant Upper GI and General Surgeon
July 2011 - July 2012
Royal Adelaide Hospital
Position
  • Senior Upper Gastrointestinal Surgery Fellow
Education
February 2010
Royal College of Physicians and Surgeons of Glasgow
Field of study
  • General Surgery / Oesophagogastric Surgery
January 2004 - January 2006
The University of Manchester
Field of study
  • Hypoxia inducible factors in oesophagogastric cancer
July 1995 - July 2000
University of Dundee
Field of study
  • Medicine and Surgery

Publications

Publications (387)
Article
Background Many patients with locally advanced gastro-oesophageal cancers are unable to complete adjuvant 5-fluorouracil, leucovorin, oxaliplatin, and docetaxel (FLOT) chemotherapy, raising questions about its therapeutic utility. The aim of this study was to examine whether pathological response to neoadjuvant FLOT can guide its adjuvant use. Met...
Article
Background Long-term symptom burden and health-related quality-of-life outcomes after curative oesophageal cancer treatment are poorly understood. Existing tools are cumbersome and do not address the post-treatment population specifically. The aim of this study was to validate the six-symptom LASORS tool for identifying patients after curative oeso...
Article
Full-text available
Traditionally, liver retraction for laparoscopic gastrectomy is done via manual methods, such as the placement of retractors through the accessory ports and using a Nathanson retractor. However, these techniques often posed issues including extra abdominal incisions, risk of liver injury or ischaemia, and the potential for compromised visualization...
Article
Background Oesophago-gastric cancer surgery negatively affects quality of life with a high postoperative symptom burden. Several conditions that may be diagnosed and treated after surgery are recognised. However, consensus regarding their definition and management is lacking. This study aimed to develop consensus regarding the definition, investiga...
Article
Background The oesophagogastric cancer (OGC) staging pathway is extensive, contributing to prolonged waiting times from referral to treatment. NHS England guidance details the ideal timeframe from referral to finalisation of the patient’s treatment plan and stipulates a time of 21 days from OGD to communication of the treatment plan to the patient....
Article
Full-text available
Fundoplication is a durable, effective, and well-accepted treatment for gastroesophageal reflux disease. Nonetheless, troublesome postoperative symptoms do occasionally occur with management varying widely among centers. In an attempt to standardize definition and management of postfundoplication symptoms, a panel of international experts convened...
Article
The optimal treatment for paraesophageal hiatus hernia (PEH) is controversial. While crural buttressing with mesh shows promises in reducing recurrences, the decision to use mesh during minimally invasive PEH repair is largely subjective. Due to these uncertainties, we conducted a survey to examine current clinical practices among surgeons and to a...
Article
Background CDH1 (E‐cadherin) genetic mutations are associated with a 30%−70% increased lifetime risk of hereditary diffuse gastric cancer (HDGC). Although prophylactic total gastrectomy (PTG) reduces long‐term risk of gastric cancer, the associated morbidity and mortality remain unclear. This systematic review aims to characterise postoperative sur...
Article
Objective The aim of this study was to quantify LNM risk and outcomes following treatment of early esophago-gastric (EG) adenocarcinoma. Background The standard of care for early T1N0 EG cancer is endoscopic resection (ER). Radical surgical resection is recommended for patients perceived to be at risk of lymph node metastasis (LNM). Current models...
Conference Paper
Background Anastomotic leak (AL) is a common and severe complication after esophagectomy. Guidelines for the management of AL are lacking due to limited evidence, in which case consensus can provide a sound base for guiding clinical practice. This study aimed to develop a consensus-based guideline and clinical algorithm on the diagnosis and treatme...
Article
Background Oesophageal adenocarcinoma (OAC) is a disease with a high mortality and morbidity rate. Immunotherapy has recently demonstrated progress in the treatment of OAC but its impact on long term survival is currently uncertain. Tissue resident memory (TRM) T cells are a subset of lymphocytes within the tumour/tissue infiltrating lymphocyte (TI...
Article
Background Oesophago-gastric cancer surgery negatively affects quality of life with a high post-operative symptom burden. Several conditions that may be diagnosed and treated after surgery are recognised. However, consensus regarding their definition and management is lacking. We aimed to develop consensus regarding the definition, investigation an...
Chapter
Gastric carcinoma remains a global healthcare challenge representing a fifth of all new cancer diagnoses worldwide. Despite improvements in oncological and surgical treatment, prognosis remains poor, particularly in patients who present with advanced disease. Novel therapeutic strategies have begun to emerge however, including trastuzumab and the c...
Article
Full-text available
Objective/Background Various anastomotic and reconstruction techniques are used for minimally invasive total (miTG) and distal gastrectomy (miDG). Their effects on postoperative morbidity have not been extensively studied. Methods MiTG and miDG patients were selected from 9356 oncological gastrectomies performed 2017-2021 in 44 centers. Endpoints...
Article
Aim Textbook outcome (TO) is a multidimensional composite measure representing an ideal perioperative course, which has been utilised to assess the quality of care in oesophagogastric cancer surgery. We aim to determine TO rates among oesophagogastric cancer patients in a UK tertiary centre, investigate predictors of TO attainment, and evaluate the...
Article
Objective To evaluate prognostic differences between minimally invasive esophagectomy (MIE) and open esophagectomy (OE) in patients with surgery after a prolonged interval (>12 wk) following chemoradiotherapy (CRT). Background Previously, we established that a prolonged interval after CRT prior to esophagectomy was associated with poorer long-term...
Article
Full-text available
The peroral endoscopic myotomy (POEM) procedure has revolutionized the management of achalasia in many centres around the world as it offers patients a minimally invasive endoscopic solution to their dysphagia caused by achalasia. Alongside its success in alleviating dysphagia, concerns regarding postoperative gastroesophageal reflux disease have e...
Article
Textbook outcome (TO) is a composite measure representing an ideal perioperative course, which has been utilized to assess the quality of care in oesophagogastric cancer (OGC) surgery. We aim to determine TO rates among OGC patients in a UK tertiary center, investigate predictors of TO attainment, and evaluate the relationship between TO and surviv...
Article
Full-text available
Background: Textbook outcomes are composite outcome measures that reflect the ideal overall experience for patients. There are many of these in the elective surgery literature but no textbook outcomes have been proposed for patients following emergency laparotomy. The aim was to achieve international consensus amongst experts and patients for the b...
Article
Textbook outcome (TO) is a multidimensional composite measure representing an ideal perioperative course, which has been utilised to assess the quality of care in oesophagogastric cancer surgery. We aim to determine TO rates among oesophagogastric cancer patients in a UK tertiary centre, investigate predictors of TO attainment, and evaluate the rel...
Article
actions Cite Collections share page navigation Title & authors Abstract Conflict of interest statement Eur J Surg Oncol . 2024 Mar 7;50(6):107983. doi: 10.1016/j.ejso.2024.107983. Online ahead of print. Predictors of anastomotic leak and conduit necrosis after oesophagectomy: Results from the oesophago-gastric anastomosis audit (OGAA) Ewen A Gr...
Article
Full-text available
Background Both anastomotic leak (AL) and conduit necrosis (CN) after oesophagectomy are associated with high morbidity and mortality. Therefore, the identification of preoperative, modifiable risk factors is desirable. The aim of this study was to generate a risk scoring model for AL and CN after oesophagectomy. Methods Patients undergoing curati...
Article
Full-text available
Background: Textbook outcomes are composite outcome measures that reflect the ideal overall experience for patients. There are many of these in the elective surgery literature but no textbook outcomes have been proposed for patients following emergency laparotomy. The aim was to achieve international consensus amongst experts and patients for the b...
Article
Objective The aim of this study is to identify risk factors for readmission after elective esophagogastric cancer surgery and characterize the impact of readmission on long-term survival. The study will also identify whether the location of readmission to either the hospital that performed the primary surgery (index hospital) or another institution...
Article
Full-text available
Background Textbook outcomes are composite outcome measures that reflect the ideal overall experience for patients. There are many of these in the elective surgery literature but no textbook outcomes have been proposed for patients following emergency laparotomy. The aim was to achieve international consensus amongst experts and patients for the be...
Article
Background Controversy remains surrounding the optimal management of patients with T1N0 early oesophago-gastric (OG) cancer. Current guidelines recommend consideration of radical surgery for T1b disease because of the greater risk of nodal metastasis. However, data to accurately predict risk for individual patients is sparse; individual units may s...
Article
Background Oesophago-gastric (OG) cancer surgery is life-changing with a significant impact on quality of life (QOL). OG cancer surgery reconfigures the upper gastrointestinal (GI) tract altering its physiological function. Certain disorders such as anastomotic stricture are well recognised whereas others, such as small intestinal bacterial overgro...
Article
Full-text available
Antibiotics are recognized widely for their benefits when used appropriately. However, they are often used inap-propriately despite the importance of responsible use within good clinical practice. Effective antibiotic treatment is an essential component of universal healthcare, and it is a global responsibility to ensure appropriate use. Currently...
Article
Full-text available
BACKGROUND: The CovidSurg-Cancer Consortium aimed to explore the impact of COVID-19 in surgical patients and services for solid cancers at the start of the pandemic. The CovidSurg-Gynecologic Oncology Cancer subgroup was particularly concerned about the magnitude of adverse outcomes caused by the disrupted surgical gynecologic cancer care during th...
Article
Introduction: Staging laparoscopy (SL) has become commonplace in the preoperative staging pathway for oesophagogastric (OG) cancer. SL is often performed before curative treatment to examine for macroscopic peritoneal metastases (PM) or positive peritoneal cytology (PPC). The aim of this study was to develop an objective risk scoring system to pre...
Article
Introduction: There is a paucity of data on the optimal management of oesophagopleural fistula (OPF) following pneumonectomy. The current published literature is limited to case reports and small case series. Although rare, OPF can have a significant impact on both the morbidity and mortality of patients. Methods: Two cases of OPF managed at our...
Article
Purpose: There is limited evidence regarding the prognostic effects of pathological lymph node (LN) regression after neoadjuvant chemotherapy for esophageal adenocarcinoma, and a definition of LN response is lacking. This study aimed to evaluate how LN regression influences survival after surgery for esophageal adenocarcinoma. Methods: Multicent...
Article
Background: Chemoradiotherapy (CRT) is a core component of multimodality treatment for locally advanced esophageal cancer. The timing of surgery following CRT may influence the probability of performing an oncological resection and the associated operative morbidity. Objective: To determine the impact of delayed surgical intervention following C...
Article
Full-text available
Background: This study assessed the potential cost-effectiveness of high (80-100%) vs low (21-35%) fraction of inspired oxygen (FiO2) at preventing surgical site infections (SSIs) after abdominal surgery in Nigeria, India, and South Africa. Methods: Decision-analytic models were constructed using best available evidence sourced from unbundled da...
Article
Introduction This study aimed to characterize the outcomes of esophagogastric (OG) cancer patients and compare perioperative outcomes with pre-pandemic data. Methods Three international prospective cohort studies were included in this analysis. First, COVIDSurg-Cancer (n = 1999) included patients with an OG cancer planned for surgery from the star...
Chapter
Lower gastrointestinal (GI) bleeding occurs from lesions distal to the ligament of Treitz and poses a huge burden on healthcare systems worldwide. It results in significant morbidity, but its mortality is low and usually in patients with advanced age and multiple co-morbidities. Initial assessment should focus on history, examination, assessment of...
Article
Full-text available
Background: Anastomotic leak is a severe complication after oesophagectomy. Anastomotic leak has diverse clinical manifestations and the optimal treatment strategy is unknown. The aim of this study was to assess the efficacy of treatment strategies for different manifestations of anastomotic leak after oesophagectomy.
Article
Background Anastomotic leak (AL) is a serious complication after esophagectomy. It is associated with prolonged hospital stay, increased costs, and increased risk for 90-day mortality. Controversy exists concerning the impact of AL on survival. This study was designed to investigate the effect of AL on long-term survival after esophagectomy for eso...
Article
Full-text available
Background: Anastomotic leak is a severe complication after oesophagectomy. Anastomotic leak has diverse clinical manifestations and the optimal treatment strategy is unknown. The aim of this study was to assess the efficacy of treatment strategies for different manifestations of anastomotic leak after oesophagectomy. Methods: A retrospective co...
Article
Full-text available
Large hiatus hernias with a significant paraesophageal component (types II-IV) have a range of insidious symptoms. Management of symptomatic hernias includes conservative treatment or surgery. Currently, there is no paraesophageal hernia disease-specific symptom questionnaire. As a result, many clinicians rely on the health-related quality of life...
Article
Introduction: Cholecystectomy for benign biliary disease is common and its delivery should be standardised. However, the current practice of cholecystectomy in Aotearoa New Zealand is unknown. Methods: A prospective, national cohort study of consecutive patients having cholecystectomy for benign biliary disease was performed between August and O...
Article
Objective: To identify prognostic factors associated with 90-day mortality in patients with oesophageal perforation (OP), and characterize the specific timeline from presentation to intervention, and its relation to mortality. Background: OP is a rare gastro-intestinal surgical emergency with a high mortality rate. However, there is no updated e...
Article
Full-text available
Background: The risk of reoperations after abdominal and pelvic surgery is multifactorial and difficult to predict. The risk of reoperation is frequently underestimated by surgeons as most reoperations are not related to the initial procedure and diagnosis. During reoperation, adhesiolysis is often required, and patients have an increased risk of...
Article
Full-text available
Background: Shared decision-making (SDM) between clinicians and patients is one of the pillars of the modern patient-centric philosophy of care. This study aims to explore SDM in the discipline of trauma and emergency surgery, investigating its interpretation as well as the barriers and facilitators for its implementation among surgeons. Methods:...
Article
Full-text available
Background: Local treatment improves the outcomes for oligometastatic disease (OMD, i.e. an intermediate state between locoregional and widespread disseminated disease). However, consensus about the definition, diagnosis and treatment of oligometastatic oesophagogastric cancer is lacking. The aim of this study was to develop a multidisciplinary Eu...
Article
Full-text available
Introduction: Failure to rescue (FTR) is an important outcome measure after esophagectomy and reflects mortality after postoperative complications. Differences in FTR have been associated with hospital resection volume. However, insight into how centers manage complications and achieve their outcomes is lacking. Anastomotic leak (AL) is a main con...
Article
Full-text available
Background Acute mesenteric ischaemia (AMI) is a condition with high mortality. This survey assesses current attitudes and practices to manage AMI worldwide. Methods A questionnaire survey about the practices of diagnosing and managing AMI, endorsed by several specialist societies, was sent to different medical specialists and hospitals worldwide....
Article
Full-text available
Background: Artificial intelligence (AI) is gaining traction in medicine and surgery. AI-based applications can offer tools to examine high-volume data to inform predictive analytics that supports complex decision-making processes. Time-sensitive trauma and emergency contexts are often challenging. The study aims to investigate trauma and emergenc...
Article
Full-text available
Background The 2015 Lancet Commission on global surgery identified surgery and anaesthesia as indispensable parts of holistic health-care systems. However, COVID-19 exposed the fragility of planned surgical services around the world, which have also been neglected in pandemic recovery planning. This study aimed to develop and validate a novel index...
Article
Full-text available
Anastomotic leak (AL) is a common but severe complication after esophagectomy, and over 10% of patients with AL suffer mortality. Different prognostic factors in patients with AL are known, but a tool to predict mortality after AL is lacking. This study aimed to develop a prediction model for postoperative mortality in patients with AL after esopha...
Article
Background Patients with CDH1 (E-cadherin) gene mutations have a 60–80% increased lifetime risk of hereditary diffuse gastric cancer (HDGC). Although prophylactic total gastrectomy may reduce long-term risk of gastric cancers, the associated morbidity and mortality remains unclear. This systematic review aims to characterise postoperative surgical...
Article
Background Staging laparoscopy (SL) has become commonplace in the preoperative staging pathway for oesophagogastric (OG) cancer due to the tendency for peritoneal carcinomatosis (PC) to be present, which may be macroscopic peritoneal metastases (PM) or positive peritoneal cytology (PPC). The aim of this study was to develop an objective risk scorin...
Article
Background Both conduit necrosis (CN) and anastomotic leak (AL) after oesophagectomy is associated with high morbidity and mortality and therefore identification of preoperative, modifiable risk factors are desirable. Once identified, risk factors can be used to create a risk scoring model which can be used to aid preoperative counselling and guide...
Article
Full-text available
Background The prognostic benefits of primary tumour and lymph node (LN) downstaging after neoadjuvant chemotherapy for oesophageal adenocarcinoma are well described. Pathological primary tumour regression grading (TRG) is widely used in the assessment of response to chemotherapy and has been shown to have prognostic value in this patient group. Ho...
Article
Full-text available
Background A feeding jejunostomy is one method to provide adequate nutrition after oesophagectomy. This bypasses the anastomosis allowing healing before oral feeding resumes. However, routinely using feeding jejunostomies may not be appropriate for patients within an Enhanced Recovery After Surgery protocol due to complications. Feeding jejunostomi...
Article
Background Bile duct stones (BDS) are present in 10–20% of patients with symptomatic gallstones. They require treatment to reduce the risk of further morbidity. There are two accepted treatment methods. A two-stage approach is most common where preoperative magnetic resonance cholangiopancreatography (MRCP) and endoscopic retrograde cholangiopancre...
Article
Full-text available
Background The literature lacks robust evidence comparing definitive chemoradiotherapy (dCRT) with neoadjuvant chemoradiotherapy and surgery (nCRS) for oesophageal squamous cell carcinoma (ESCC). This study aimed to compare long-term survival of these approaches in patients with ESCC. Methods A systematic review performed according to PRISMA guide...
Article
Background Objective: To compare overall (OS) and recurrence-free survival (RFS) in esophageal adenocarcinoma patients with a complete pathological response (pCR) following neoadjuvant chemotherapy (nCT) or neoadjuvant chemoradiotherapy (nCRT). Background In the absence of survival differences in several prior studies comparing nCT with nCRT, the...
Conference Paper
Background Perforation of the oesophagus (OP) represent a potentially lethal yet poorly managed clinical condition due to its rarity, variation in clinical presentation and little consensus on the optimal management of these patients. Previous studies have shown that timely and appropriate treatment of OPs is the most important determinant of patie...
Article
Full-text available
Anastomotic leak (AL) is a common but severe complication after esophagectomy, and over 10% of patients with AL suffer mortality. Different prognostic factors in patients with AL are known, but a tool to predict mortality after AL is lacking. This study aimed to develop a prediction model for postoperative mortality in patients with AL after esopha...
Article
Full-text available
Background The SARS-CoV-2 pandemic is still ongoing and a major challenge for health care services worldwide. In the first WSES COVID-19 emergency surgery survey , a strong negative impact on emergency surgery (ES) had been described already early in the pandemic situation. However, the knowledge is limited about current effects of the pandemic on...
Article
Full-text available
Background The 2015 Lancet Commission on global surgery identified surgery and anaesthesia as indispensable parts of holistic health-care systems. However, COVID-19 exposed the fragility of planned surgical services around the world, which have also been neglected in pandemic recovery planning. This study aimed to develop and validate a novel index...
Article
Full-text available
Background The 2015 Lancet Commission on global surgery identified surgery and anaesthesia as indispensable parts of holistic health-care systems. However, COVID-19 exposed the fragility of planned surgical services around the world, which have also been neglected in pandemic recovery planning. This study aimed to develop and validate a novel index...
Article
Full-text available
Background The 2015 Lancet Commission on global surgery identified surgery and anaesthesia as indispensable parts of holistic health-care systems. However, COVID-19 exposed the fragility of planned surgical services around the world, which have also been neglected in pandemic recovery planning. This study aimed to develop and validate a novel index...
Article
Full-text available
Background The 2015 Lancet Commission on global surgery identified surgery and anaesthesia as indispensable parts of holistic health-care systems. However, COVID-19 exposed the fragility of planned surgical services around the world, which have also been neglected in pandemic recovery planning. This study aimed to develop and validate a novel index...
Article
Full-text available
Background The 2015 Lancet Commission on global surgery identified surgery and anaesthesia as indispensable parts of holistic health-care systems. However, COVID-19 exposed the fragility of planned surgical services around the world, which have also been neglected in pandemic recovery planning. This study aimed to develop and validate a novel index...
Article
Full-text available
Background The 2015 Lancet Commission on global surgery identified surgery and anaesthesia as indispensable parts of holistic health-care systems. However, COVID-19 exposed the fragility of planned surgical services around the world, which have also been neglected in pandemic recovery planning. This study aimed to develop and validate a novel index...
Article
Full-text available
Background The 2015 Lancet Commission on global surgery identified surgery and anaesthesia as indispensable parts of holistic health-care systems. However, COVID-19 exposed the fragility of planned surgical services around the world, which have also been neglected in pandemic recovery planning. This study aimed to develop and validate a novel index...
Article
Full-text available
Background The 2015 Lancet Commission on global surgery identified surgery and anaesthesia as indispensable parts of holistic health-care systems. However, COVID-19 exposed the fragility of planned surgical services around the world, which have also been neglected in pandemic recovery planning. This study aimed to develop and validate a novel index...
Article
Full-text available
Immune checkpoint blockade has recently proven effective in subsets of patients with esophageal adenocarcinoma (EAC) but little is known regarding the EAC immune microenvironment. We determined the single cell transcriptional profile of EAC in 8 patients who were treatment-naive (n = 4) or had received neoadjuvant chemotherapy (n = 4). Analysis of...
Article
Whilst multimodality treatment is established as standard of care for locally advanced esophageal cancers the precise choice of oncological neoadjuvant treatment remains unclear. Uptake of FLOT is increasing, yet collective experience in patients with esophageal cancer is unclear. This study aimed to assess the effectiveness of FLOT as first-line t...
Article
The prognostic benefit of primary tumour and lymph node (LN) downstaging after neoadjuvant chemotherapy for oesophageal adenocarcinoma (OAC) is well described. However, there is no robust evidence regarding the prognostic effect of pathological LN regression despite emerging evidence of a discrepancy, in some patients, between tumour regression gra...
Article
Full-text available
on behalf of the Oesophagogastric Anastomosis Audit collaborative Objective: This Delphi exercise aimed to gather consensus surrounding risk factors, diagnosis, and management of chyle leaks after esophagectomy and to develop recommendations for clinical practice. Background: Chyle leaks following esophagectomy for malignancy are uncommon. Although...
Article
Full-text available
Objective: This Delphi exercise aimed to gather consensus surrounding risk factors, diagnosis, and management of chyle leaks after esophagectomy and to develop recommendations for clinical practice. Background: Chyle leaks following esophagectomy for malignancy are uncommon. Although they are associated with increased morbidity and mortality, diagn...
Conference Paper
Full-text available
Aim: There is some evidence that patient outcomes for surgeons improve with years of experience. We aimed to investigate the relationship between surgeon experience and patient outcomes following an emergency laparotomy in a large sample of the UK National Emergency Laparotomy Audit (NELA) database. Method: A 5-year retrospective observational stud...
Article
Full-text available
Backgrounds/aims: Bile duct stones (BDS) can be managed either prior to laparoscopic cholecystectomy (LC) using endoscopic retrograde cholangiopancreatography (ERCP) or with laparoscopic bile duct exploration (LBDE) at the time of LC. The latter is underutilised. The aim of this study was to use the dataset of the previously performed CholeS study...
Article
Aim We aimed to characterise the global surgical gastric cancer population and variability in disease presentation across different resource settings. Method GlobalSurg3 was a multicentre, international prospective cohort study of patients undergoing surgery for cancer. Primary outcomes were death or major complications (Clavien-Dindo III/IV) with...

Questions

Questions (11)
Question
Cholecystectomy is amongst the most common surgical operations performed worldwide. Surgical candidates are treated for biliary pathologies, such as biliary cholic, cholecystitis and gallstone pancreatisis. The universal establishment of safe cholecystectomy is a complex process that relies not only on the operation itself, but also on various other factors such as promoting adequate training, improving hospital infrastructure, and enhancing peri-operative patient care. There remains a paucity of evidence around the variations of safe provision of laparoscopic surgery for gallbladder disease interntionally, including low- and middle-income countries.
To bridge this knowledge gap, the Global Evaluation of Cholecystectomy Knowledge and Outcomes (GECKO) study (GlobalSurg 4) will be an international collaborative effort, delivered by the GlobalSurg network, that will allow contemporaneous data collection on the quality of cholecystectomies using measures covering infrastructure, care processes and outcomes. It will be disseminated via contacts from the National Institute for Health and Care Research (NIHR) Global Surgery unit, leading emergency general surgeons and specialist organisations.
The study will span between 31st July 2023 to 19th November 2023, with follow-up at 30-day and one-year postoperatively
DETAILS
REGISTRATION FORM
Question
Dear Colleague,
Emergency laparotomy Delphi exercise - invitation to contribute and co-author: 
You are invited to contribute to a Delphi exercise that will design a new type of outcome for patients who have emergency laparotomy for trauma and non-trauma - called a "Textbook Outcome". If you contribute to all rounds of the Delphi exercise, you will be listed as a co-author.
You are welcome to join this initiative whether you are a surgeon or not.
Textbook Outcomes are composite measures. Instead of "30-day mortality", a Textbook Outcome might be something like "discharged alive with no complications or readmissions in 30 days". We believe this is a more patient-centred approach to outcomes.
You may wish to read this article from the British Journal of Surgery for more details:
(Naumann DN, Bhangu A, Brooks A, Martin M, Cotton BA, Khan M, Midwinter MJ, Pearce L, Bowley DM, Holcomb JB, Griffiths EA. A call for patient-centred textbook outcomes for emergency surgery and trauma. Br J Surg. 2022 Aug 18:znac271. doi: 10.1093/bjs/znac271. Epub ahead of print. PMID: 35979582)
We look forward to hearing from you,
The BEACON Initiative team
Question
Dear Colleague,
Following the success of the OGAA Delphi and OG Covid-19 survey, we would like to invite you to participate in our multicenter project titled ‘Chyle LEak following Oesophagectomy for oesophageal cancer (CLEO)’.
• Please enter the email in the survey if you are willing to take part in the second round
• We are offering collaborative authorship for those taking part in both rounds (we need email for that- to contact you back)
• This study is open only for fully qualified Upper GI Consultants/ attendings performing Oesophagectomy
You can access the online Delphi survey by following this link
We look forward to your reply and again appreciate your participation.
Best wishes,
Manju Subramanya
Ewen Griffiths
Sivesh Kamarajah
Question
Dear Colleague,
I would like to invite you to please consider participating in the GlobalSurg-CovidSurg Week study.
Study key points:
>All surgical/ anaesthetic teams can participate: the study is open to all surgical specialties, including obstetrics.
>All hospitals worldwide can participate: study is open for all countries (you do not need to have operated on SARS-CoV-2 patients).
>Short data collection window: collaborators will collect data on all patients operated by their specialty over a 7-day block in October 2020.
>Inclusive study authorship: all collaborators who submit data will be recognised as PubMed-citable co-authors; please see our Lancet paper for an example (click “expand” under ‘COVIDSurg Collaborative’ to see a full list of co-authors).
Earlier this year our collaborative has run two studies, CovidSurg and CovidSurg-Cancer, which collected data on over40,000 patients from 1,020 hospitals in 85 countries. Our first paper was published in The Lancet (all contributors listed as co-authors). It demonstrated that patients who undergo surgery with perioperative SARS-CoV-2 are at high risk of pulmonary complications and death.
GlobalSurg-CovidSurg Week has two aims:
>To determining the optimal timing for surgery in patients who were previously infected with SARS-CoV-2.
>To determine key global surgical indicators, such as perioperative mortality rates, surgical volume, surgical case-mix. We are keen to work with collaborators from all types of hospital (rural hospitals, district hospitals, private hospitals, university hospitals) across all countries. You can participate even if your hospital has not treated SARS-CoV-2 infected patients.
A graphic summary is available online. Please find attached the study protocol (UK centres should register this as clinical audit). Template patient information sheets and consent forms can be found on our website.
Please register your interest in taking part using our online form at https://globalsurgery.redcap.bham.ac.uk/surveys/index.php?s=ERAME4NJHR.
Thank you very much for your time.
Best wishes
Ewen Griffiths
Question
PREVENTION AND MANAGEMENT OF ANASTOMOTIC LEAK: COLORECTAL AND OESOPHAGO-GASTRIC
Wednesday 12th June 2019
The University of Birmingham
Birmingham, UK
Professor Dion Morton
Institute of Cancer and Genomic Sciences, Barling Professor of Surgery, Head of Academic Department of Surgery, University of
Birmingham and Course Chairman
COURSE FACULTY
Mr Aneel Bhangu, Senior Clinical Lecturer in International Surgery, Institute of Cancer and Genomic Sciences, University Hospitals,
Birmingham NHS Foundation Trust
Mr Ewen Griffiths, Consultant General and Upper Gastrointestinal Surgeon, University Hospitals Birmingham NHS Foundation Trust
Mr Thomas Pinkney, Consultant Colorectal Surgeon and Senior Clinical Lecturer, University Hospitals Birmingham NHS Foundation Trust
GUEST SPEAKERS
Professor Dr Willem Bemelman, Professor of Minimally Invasive and Colorectal Surgery, Academic Medical Centre, Amsterdam
Mr Stefan Bouwense, Upper GI Fellow, Radboud University Medical Centre, Nijmegen
Mr Sanjay Chaudhri, Consultant Colorectal and General Surgeon, University Hospitals of Leicester NHS Trust
Dr Matteo Frasson, Clinical Associate Professor, University Hospital La Fe, Valencia
Mr James Gossage, Consultant Oesophagogastric and General Surgeon, Guys and St Thomas’ NHS Foundation Trust
Mr Richard Hardwick, Consultant Surgeon and Upper GI Surgery Lead, Cambridge University Hospitals NHS Foundation Trust
Professor David Jayne, Bowel Cancer UK & Royal College of Surgeons of England Chair of Surgery, St James’s University Hospital, Leeds
Dr Ana Maria Minaya-Bravo, University Henares Hospital, Madrid
Mr Pieter Tanis, Consultant Gastrointestinal & Oncology Surgeon, Academic Medical Centre, Amsterdam
Mr Pritam Singh, Senior Upper GI Fellow, Nottingham University Hospitals NHS Trust
Frans van Workum, Upper GI Researcher, Radboud University Medical Centre, Nijmegen
PROGRAMME
WEDNESDAY 12TH JUNE 2019
08.30 Registration, refreshments and exhibition
09.15 Introduction and welcome Dion Morton
AM SESSION: Preventing anastomotic failure
SESSION 1: International cohort studies to inform practice
09.30 LOWER GI: ESCP Cohort studies summary of results Matteo Frasson
09.45 UPPER GI: Oesophagastric Anastomotic Audit Ewen Griffiths
10.00 Outcomes and definitions of leak:
Colorectal Thomas Pinkney
Upper GI Stefan Bouwense
TENTACLE Study Frans van Workum
10.20 Panel discussion
10.45 Refreshments and exhibition
SESSION 2: Changing practice
11.15 New 3 stage intervention model & anastomosis checklist from ESCP team Ana Maria Minaya-Bravo &
Sanjay Chaudhri
11.30 The need for standardisation of oesophagectomy anastomosis Ewen Griffiths
11.45 Technologies to prevent Colorectal surgery (IntAcT trial) David Jayne
12.00 Upper GI Delphi Exercise on Oesophagectomy Leaks Pritam Singh
12.15 Interventional study design and how to test anastomoses: Aneel Bhangu
Colorectal anastomoses
12.30 Panel discussion
13.00 Lunch and exhibtion
PM SESSION: Managing anastomotic failure
SESSION 3: Failure to salvage
14.00 Failure to salvage in oesophageal James Gossage
14.15 Failure to salvage in colorectal Pieter Tanis
14.30 Panel discussion
SESSION 4: Controlling leaks
15.00 Options in the management of oesophageal leak - who should get conservative Richard Hardwick
management, endoscopic therapies (covered stents and endoVAC therapy) or
a re-thoracotomy? Workshops (30 minutes each)
15.15 Options in the management of colorectal leaks Willem Bemelman
15.30 Panel discussion
15.45 Refreshments and exhibition
SESSION 5: Future plans
16.00
17.00 Discussion and close
MORE DETAILS AND BOOKING VIA
AESCULAP ACADEMIA
Brookdale Road | Thorncliffe Park | Sheffield | S35 2PW
Tel: +44 (0) 114 225 9143
Question
The techniques used for oesophagectomy can vary greatly amongst countries, units and surgeons. This is also true for outcomes and historically oesophagectomy has been associated with significant morbidity and mortality. Operative access, anastomostic technique and the treatment of leaks (conservative, stent, endoVac or reoperative) have been continued areas of disagreement amongst oesophago-gastric surgeons and their influence on mortality and morbidity has long been disputed. This audit seeks to provide up to date information in the international variances in practice.
Please complete this Google Form:  https://goo.gl/LzvECw 
Please see attached invitation letter for some further details. 

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