Michael J Solomon

Michael J Solomon
The University of Sydney · Faculty of Medicine (Sydney Medical School)

MBBCh, BAO(Hons); MSc (Cl Epi); DMedSc (Uni of Sydney); DMed (Ireland); LRCPI;FRACS;FRCSI(Hons)

About

420
Publications
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Publications

Publications (420)
Article
This study aimed to examine coping strategies used by advanced colorectal cancer (CRC-A) survivors to manage death anxiety and fear of cancer progression, and links between these strategies and quality of life (QoL), distress, and death acceptance. Qualitative semi-structured interviews of 38 CRC-A survivors (22 female) were analysed via framework...
Article
Background: Although pelvic exenteration remains the only curative option for locally advanced rectal cancer and locally recurrent rectal cancer, only limited evidence is available on the differences in surgical and quality-of-life outcomes between the two. Objective: This study aimed to compare surgical outcomes and identify any differences or...
Article
Background Pelvic exenteration (PE) has become the standard of care for locally advanced and recurrent rectal cancer. The high short term morbidity reported from this procedure is well established, however, longer term complications of such radical surgery and their management have not been fully addressed. This study aimed to investigate the inci...
Article
Full-text available
Background To inform effective genomic medicine strategies, it is important to examine current approaches and gaps in well-established applications. Lynch syndrome (LS) causes 3–5% of colorectal cancers (CRCs). While guidelines commonly recommend LS tumour testing of all CRC patients, implementation in health systems is known to be highly variable....
Article
Full-text available
Background Radical surgery is the mainstream treatment for patients presenting with advanced primary or recurrent gastrointestinal cancers; however, the rate of postoperative complications is exceptionally high. The current evidence suggests that improving patients’ fitness during the preoperative period may enhance postoperative recovery. Thus, th...
Article
Background: Early-onset colorectal cancer (EOCRC) (<50 years) incidence has increased in Australia and worldwide. However, the diagnosis of EOCRC is often delayed. Recent research has discovered some differences from later-onset colorectal cancer (LOCRC) (>50 years). An awareness of the unique features of EOCRC is crucial to reduce time from sympt...
Article
Background: There is clinical uncertainty regarding an association between preoperative functional capacity of cancer patients, and postoperative outcomes. The aim of this systematic review and meta-analysis is to investigate whether poor performance on preoperative six-minute walk test (6MWT) or five-times sit to stand test (5STS) is associated w...
Article
Objective: To compare patient-reported urinary, bowel and sexual functioning of ALaCaRT Trial participants randomised to Open or Laparoscopic surgery for rectal cancer. Summary Bakground Data: The primary endpoint, non-inferiority of laparoscopic surgical resection adequacy, was not established. Methods: Participants completed QLQ-CR29 at b...
Article
Advanced pelvic malignancy, regardless of the cancer of origin, is often multivisceral and complex. The management of advanced pelvic malignancy is resource-intensive and requires multidisciplinary input. The definition of resectability is evolving with improving multimodal therapy, preoperative staging and optimisation, perioperative care, and adv...
Article
Objective: This study aimed to comprehensively report complications associated with pelvic exenteration and to determine the strength of associations between three different grading methodologies and length of stay, quality-of-life as well as physical outcomes. Background: It is generally accepted that pelvic exenteration is associated with high...
Article
Full-text available
PurposeSelection of an open or minimally invasive approach to total mesorectal excision (TME) is generally based on surgeon preference and an intuitive assessment of patient characteristics but there consensus on criteria to predict surgical difficulty. Pelvimetry has been used to predict the difficult surgical pelvis, typically using only bony lan...
Article
Background: Low anterior resection syndrome has a significant impact on the quality of life in rectal cancer survivors. Previous studies comparing laparoscopic to open rectal resection have neglected bowel function outcomes. Objective: To assess if there is a difference in the functional outcome between patients undergoing laparoscopic versus op...
Article
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Background Preoperative assessment of mental health rarely occurs within routine surgery. Any screening tool selected to form part of this process must be deemed practical, acceptable and valid by clinicians and consumers alike. This study aims to assess the acceptability and face validity of two existing mental health screening tools to select one...
Article
Background Laparoscopic-assisted surgery for rectal cancer is widely used, however the healthcare costs are thought to be higher than for open resection. This secondary endpoint analysis of a randomized controlled trial aimed to evaluate total healthcare costs of laparoscopic-assisted surgery compared with open resection for rectal cancer over a 12...
Article
Background To describe our institutional experience in the management of locally advanced primary, and recurrent pelvic sarcoma through pelvic exenteration (PE). Methods Patients undergoing PE for locally advanced primary or recurrent pelvic sarcoma between 2003 and 2017 were identified from a prospectively maintained database at a single quaterna...
Article
Background To determine the effectiveness of an individualised, daily targeted step count intervention and usual care compared with usual care alone on improving surgical and patient reported outcomes. Methods The Fit-4-Home trial was a pragmatic, randomised controlled trial conducted from April 2019 to February 2021. Patients undergoing elective...
Article
Aim Postoperative functional outcomes following pelvic exenteration surgery for treatment of advanced or recurrent pelvic malignancies are poorly understood. The aim of this study was to determine the short-term functional outcomes following pelvic exenteration surgery using objective measures of physical function. Method Patients undergoing pelvi...
Article
Objective: The primary aim of this study was to evaluate the agreement between surgeons and two validated total knee arthroplasty (TKA) appropriateness tools, and secondarily to compare Australian appropriateness rates to those reported internationally. Methods: A consecutive sample of patients from one public hospital arthroplasty clinic and a...
Article
Aim To describe the long-term course of pain and fatigue in patients undergoing pelvic exenteration and to evaluate potential prognostic factors for these outcomes. Design Prospective cohort study. Settings Royal Prince Alfred Hospital, Sydney, Australia. Patients Consecutive patients undergoing pelvic exenteration surgery between July 2008 and...
Article
Background Despite relatively few COVID-19 cases within New South Wales, the uncertainty surrounding the pandemic has prevented a return to business as usual for the delivery of surgical services. This study aims to describe the evolving impact of COVID-19 on surgical activity and patient outcomes at a major public tertiary referral hospital. Meth...
Article
Objective To assess the association between having a serious mental illness and surgical outcomes for adults, including in‐hospital and 30‐day mortality, post‐operative complications, and hospital length of stay. Study design Systematic review and meta‐analysis of publications in English to 30 July 2018 of studies that examined associations betwee...
Article
Background: Knee arthroplasty is a high-risk, resource-intensive procedure that should be reserved for patients in whom the benefit will outweigh the risks. The provision of high-quality, publicly available decision aids can help patients to balance the benefits against the harms of treatments and to assist informed decision-making. The aim of thi...
Article
Tumour infiltration of the lateral pelvic compartment has previously been associated with the highest rate of involved resection margins and carries significant risk of morbidity. In this study, consecutive patients undergoing pelvic exenteration at a single centre between 1994 and 2019 who required en bloc resection of the common or external iliac...
Article
Introduction Reporting of pelvic exenteration specimens for locally recurrent rectal cancer (LRRC) can be challenging for structured pathological analysis and currently, there is a lack of specific guidelines. The aim of this study was to assess the quality of pathology reporting in a cohort of patients who underwent pelvic exenteration for LRRC in...
Article
Objective: To describe quality of life (QOL) and survival outcomes following pelvic exenteration (PE) in old and young patients. Background: PE is a management option for complete resection in locally advanced pelvic cancers. Few studies have examined the impact of age on the outcome in elderly patients following PE. Patients and methods: Pros...
Chapter
Pelvic bone infiltration by locally advanced primary or recurrent pelvic cancer has traditionally been considered an inoperable situation [1–7]. In the last decade, with improved magnetic resonance imaging (MRI) and innovation of surgical technique and technology, pelvic exenteration (PE) surgery with en bloc composite bone resection for anterior,...
Article
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Background People with serious mental illness (SMI) have significantly worse surgical outcomes compared to the general population. There are many contributing factors to this complex issue, however consideration of the surgical experience from the patient’s own perspective has never been undertaken. This lack of understanding prevents the provision...
Article
Full-text available
Background: Sarcopenia is associated with poor postoperative outcomes in oncology patients. Computed tomography (CT) scans can be used to identify muscle wasting and sarcopenia. This study aimed to investigate if pelvic exenteration surgery leads to muscle wastage and thus, induction or exacerbation of sarcopenia. Methods: This is a retrospective r...
Article
BACKGROUND: Anorectal cancer arising in IBD can be challenging to manage. There is a paucity of reports describing locally advanced and recurrent anorectal cancer in this setting. OBJECTIVE: This study aimed to describe patients who underwent extended radical pelvic resection for locally advanced and recurrent IBD-Associated anorectal cancer. DESIG...
Article
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Introduction: Long term results of ossiculoplasty surgery are considered poor with displacement and extrusion amongst the common reasons for failure. Application of 3Dimensional (3D) printing may help overcome some of these barriers, however digital methods to attain accurate 3D morphological studies of ossicular anatomy are lacking, exacerbated b...
Article
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Background Maintaining employment for adults with cancer is important, however, little is known about the impact of surgery for rectal cancer on an individual's capacity to return to work (RTW). This study aimed to determine the impact of laparoscopic vs. open resection on RTW at 12 months. Methods Analyses were undertaken among participants rando...
Article
Full-text available
Aim This study aims to assess surgical outcomes and survival following first, second and third pelvic exenterations for pelvic malignancy. Method Consecutive patients undergoing pelvic exenteration for pelvic malignancy at a quaternary referral centre from January 1994 and December 2017 were included. Demographics and surgical outcomes were compar...
Article
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Aim: To report early outcomes of six patients who underwent combined pelvic exenteration (PE), cytoreductive surgery (CRS) and hyperthermicintraperitoneal chemotherapy (HIPEC) for advanced or recurrent colorectal cancerwith colorectal peritoneal metastases (CPM) at a single centre. The literature contains limited data on the safety and oncological...
Article
Background: Cost-effective cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) for treatment of patients with peritoneal malignancy remains an ongoing financial challenge for healthcare systems, hospitals and patients. This study aims to describe the detailed in-hospital costs of CRS and HIPEC compared with an Austral...
Article
Background The difficulty of performing total mesorectal excision (TME) for rectal cancer partly relies on the surgeon’s subjective assessment of the individual patient’s pelvic anatomy and tumour characteristics, which generally influences the choice of platform used (open, laparoscopic, robotic or trans-anal surgery). Recent studies have found as...
Article
The oncological outcomes of patients with locally recurrent rectal cancer (LRRC) have improved dramatically in recent decades due to the evolution of extended radical surgical techniques and the development of expert multi-disciplinary teams at specialist units. LRRC is now considered a salvageable and potentially curable situation in selected pati...
Article
Objectives The use of robotic-assisted surgery (RAS) remains predominantly in the private sector. In the public sector, the effect of the implementation of RAS on theatre staff is unknown. The aim of this study was to examine the knowledge and attitudes of theatre staff before and after implementation of RAS in the public sector.Methods In all, 250...
Article
Introduction Re‐operative pelvic surgery is rarely hostile and unsafe. Kraske’s procedure has historically been used to approach the mid‐rectum and to resect retrorectal tumors. However, it provides limited access to the pelvis and is best in the “virgin” pelvis. We have encountered a select group of patients who required completion proctectomy or...
Article
The coronavirus disease 19 (COVID-19) pandemic has become the focus of attention worldwide, and herein we seek to highlight the potential problem of ‘collateral mortality’ from delayed or deferred treatments in patients with cancer. We propose potential solutions to ensure continuity of care in the field of surgical oncology.
Article
Background This study aimed to describe short- and medium-term longitudinal quality-of-life (QoL) outcomes after cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC).Methods Consecutive patients undergoing CRS and HIPEC were recruited. The primary outcome was QoL, measured using the short-form 36 questionnaire and expre...
Article
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Background Fistula in ano is a common condition treated by surgeons worldwide. Despite this, there is a paucity of high-quality data to aid decision-making. Hence, management presents a difficult and frustrating dilemma for the treating surgeon. Methods A prospective regional survey was sent to all members of General Surgeons Australia. Questions...
Article
Aim: To identify whether personality traits and decision-making styles affect quality of life (QoL) outcomes and levels of psychological distress following pelvic exenteration (PE). Method: Patients undergoing PE between 2008 and 2015 were identified from a prospectively maintained database at a single quaternary referral centre. Patients were i...
Article
Full-text available
Introduction: Three-dimensional (3D) tools have played a significant role in advancing anatomical knowledge, in simulation and clinical practice in Otology. Technology is evolving at a rapid rate with new applications being reported at an overwhelming pace. It is important to continuously review new applications, assess emerging trends, and identi...
Article
Objectives: To determine what constitutes a clear resection margin (R0) in patients with LRRC. Summary of background data: R0 is the most important predictor of survival in patients with LRRC. However, it is not clear what constitutes an R0. A 1-2 mm margin is often used to define R0 but this is based on primary rectal cancer studies. The same d...
Article
Full-text available
Background: Sarcopenia is common in oncology patients and has been found to be associated with poorer outcomes after surgery. Pelvic exenteration is a major surgery associated with high rates of morbidity. The aim of this study was to determine if preoperative sarcopenia is associated with postoperative complications and outcomes after pelvic exent...
Article
Introduction: The purpose of this study was to review recommendations made from a specialist pelvic exenteration (PE) multidisciplinary team (MDT) and to provide insights as to the impact of the MDT on patient selection and clinical decision making. Materials & methods: A retrospective review was conducted at Royal Prince Alfred Hospital's PE MD...
Article
Aim: There is current debate as to the optimal management of lateral pelvic Lymph nodes (LPLN) in rectal cancer between western and eastern centres. This paper aims to report the rate of histologically proven positive LPLNs in a group of patients undergoing conventional western approach to primary and recurrent rectal cancer. Method: A retrospec...
Article
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Aim: To compare postoperative QOL between patients undergoing pelvic exenteration (PE) and pelvic exenteration with sacrectomy (PES); and to investigate the influence of high (L5 to S2) versus low (≤S3) sacrectomy on QOL and functional outcomes. Method: Patients undergoing en bloc sacrectomy as part of a PE, and PE alone from 2008 to 2015 were i...
Poster
Full-text available
Ischiorectal fossa tumours are rare, heterogenous, and can be malignant. The approach to excision of ischiorectal fossa tumours is dependent on the size of the tumour, its association with surrounding structures, and the histopathology. The most common operative approach is local excision via a perineal or posterior approach. We have developed a no...
Poster
Full-text available
Re-operative pelvic surgery is rarely hostile and unsafe. The posterior trans-sacral approach (Kraske’s procedure) has historically been used to approach the mid-rectum and to resect retrorectal tumours as it provides excellent access to the pre-sacral space. However, this manoeuvre provides limited access to the pelvis and is best in the “virgin”...
Article
Full-text available
Background: The effect of immunonutrition vs standard polymeric nutrition in the preoperative phase on patient outcomes is still unclear, which could be due to contributing factors such as poorly reported compliance and unequal provision of protein, energy, and volume. The aim of this study was to examine the effects of preoperative immunonutritio...
Article
Background Technological developments have allowed advances in minimally invasive techniques for total mesorectal excision such as laparoscopy, robotics, and transanal surgery. There remains an ongoing debate about the safety, benefits, and appropriate clinical scenarios for which each technique is employed. The aim of this study was to provide a p...
Article
Background/objectives: Despite best practice guidelines, feeding methods after colorectal surgery vary due to the difficulties translating evidence into practice. The aim was to determine the effectiveness of diets delivered into the gastrointestinal tract (GIT) on gut motility following colorectal surgery. Subjects/methods: EMBASE, MEDLINE, CIN...
Article
Full-text available
Background: Despite advances in the rates of total mesorectal excision (TME) for rectal cancer surgery, decreased local recurrence rates and increased 5-year survival, there still exists large variation in the quality of treatment received. Up to 30 per cent of rectal cancers are locally advanced at presentation and approximately 5-10 per cent sti...
Chapter
The ileoanal pouch procedure is a surgical technique that restores gastrointestinal continuity after surgical removal of the colon and rectum. The most common surgical indications that require the removal of the entire colon and rectum are ulcerative colitis and familial adenomatous polyposis. Much less commonly, it may also be performed for patien...
Article
Objective Within Australia, robotic-assisted surgery (RAS) has largely been undertaken within the private sector, and predominately based within urology. This is rapidly developing, with RAS becoming increasingly prevalent across surgical specialties and within public hospitals. At this point in time there is a need to consider how this generation...
Article
Background: Cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) is an accepted therapeutic approach in selected patients with peritoneal malignancy. The aim of this study was to describe early outcomes in the first 50 patients managed with CRS and HIPEC in a newly established peritoneal malignancy centre in Sydney, Au...
Article
Full-text available
Background: The physical activity (PA) level of patients undergoing major cancer surgery remains unclear. This pilot study aimed to: (i) Compare preoperative PA level between patients undergoing major cancer surgery and the general population; (ii) describe PA trajectories following major cancer surgery; (iii) Compare objective versus subjective P...
Article
Background: Pelvic exenteration (PE) provides a potentially curative option for advanced or recurrent malignancy confined to the pelvis. A clear (R0) resection margin is the strongest prognostic factor predicting long-term survival, driving most technical advances in PE surgery. The aim of this cohort study was to describe changing trends in exten...
Article
Full-text available
Background: Lynch syndrome (LS) is an inherited, cancer predisposition syndrome associated with an increased risk of colorectal, endometrial and other cancer types. Identifying individuals with LS allows access to cancer risk management strategies proven to reduce cancer incidence and improve survival. However, LS is underdiagnosed and genetic ref...