Publications by authors named "Adam D Gerrard"
Worldwide, colorectal cancer (CRC) is the second most fatal cancer [...
View Article and Find Full Text PDFAim: Microscopically positive resection margins (R1) are associated with poorer outcomes in colon cancer. While the sequalae of a positive margin related to the primary tumour (R1Tumour) are relatively well known, comparatively less is known when the positive margin pertains to a metastatic lymph node (R1LNM). The aim of this study is to confirm the significance and impact of R1LNM margins in colon cancer patients.
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- Lynch syndrome (LS) patients have a high risk of colorectal cancer, currently monitored through biennial colonoscopy, which can be burdensome and invasive.
- This study assessed whether faecal immunochemical testing (FIT) for faecal haemoglobin could effectively replace the need for routine colonoscopy in LS surveillance.
- Results showed FIT has low sensitivity for detecting adenomas, with no improvement when a second test was added, suggesting it may not be a viable alternative to colonoscopy.
Article Synopsis
- The study evaluated the non-return rate of faecal immunochemical tests among patients referred for high-risk colorectal cancer symptoms, finding that 11.9% of 7345 patients did not submit their tests.
- Non-returners tended to be younger, predominantly male, and from lower socioeconomic backgrounds, and they exhibited different clinical outcomes compared to those who returned the test.
- Despite a higher prevalence of colorectal cancer in those who underwent investigations, the overall cancer prevalence was similar between returners and non-returners over a median follow-up of 25 months, indicating potential issues in care access or follow-up for non-returners.
Article Synopsis
- Faecal immunochemical testing (FIT) is commonly used for detecting colorectal cancer (CRC) in screening programs, but the effectiveness of repeat tests to improve detection rates is still uncertain.
- A systematic review analyzed 68 studies on the efficacy of double FIT tests compared to single tests, focusing on different patient populations (asymptomatic, mixed, symptomatic).
- Results showed that using a second FIT test significantly increased the detection of CRC, with some studies noting a reduction in missed cases by at least 50%, and an estimated sensitivity of 94% for the double test in certain cohorts.
Article Synopsis
- Lymph nodes (LNs) are important in detecting colorectal cancer spread, but traditional imaging methods like CT and MRI have limitations in accurately assessing them.
- B-mode and contrast-enhanced ultrasound (CEUS) could enhance LN detection, but further research is needed before they can be widely adopted in clinical settings.
- A pilot study using a mouse model found that a new scoring system based on various LN characteristics may provide better predictive accuracy for cancer involvement than simply measuring LN size.
Article Synopsis
- The study investigated how different types of reamers (acorn vs. fluted) affect the size and shape of the tibial tunnel's outer aperture during ACL reconstruction.
- Results showed that a 10-degree deviation from the guidewire had minimal impact on the acorn reamer's aperture dimensions but significantly increased the length of the aperture when using the fluted reamer.
- The fluted reamer produced a larger and irregularly shaped aperture compared to the acorn reamer, highlighting the importance of choosing the right reamer for optimal tunnel creation in ACL surgery.
Article Synopsis
- - A 22-year-old man suffered a 15-meter fall and was stable for over 10 hours before suddenly experiencing severe hemorrhagic shock, necessitating urgent surgery.
- - During the initial surgery, 2 liters of blood were found in his abdomen, but no active bleeding source was identified at that time.
- - After closing the abdomen, additional bleeding was detected, leading to a second surgery where a previously overlooked injury to the proper hepatic artery was discovered, highlighting the complexity of abdominal injuries.
Surgeon-led Intraoperative Ultrasound Localization for Nonpalpable Breast Cancers: Results of 5 Years of Practice.
Clin Breast Cancer
December 2019
Article Synopsis
- - The study investigates surgeon-led intraoperative ultrasound (IOUS) as an alternative to wire-guided localization for breast conserving therapy (BCT) in nonpalpable breast cancer patients, showing promising results in lesion detection and surgical outcomes.
- - Researchers conducted a retrospective study on 95 patients who underwent IOUS-marked BCT between 2014 and 2018, successfully identifying and removing all tumors, with a re-excision rate of 14 cases (only 2 contained residual tumors).
- - The findings indicate that IOUS is a safe and effective localization technique for BCT, providing benefits such as reduced reliance on radiology services, making it a valuable option for breast cancer treatment in the UK.
Arthroscopic Excision of Medial Knee Plica: A Meta-Analysis of Outcomes.
Knee Surg Relat Res
December 2018
Article Synopsis
- - A meta-analysis was conducted to evaluate the outcomes of surgical intervention for medial knee plica, with a focus on patient-reported satisfaction scores like "good" and "excellent".
- - Out of 731 articles reviewed, 12 met the inclusion criteria, leading to a total analysis of 643 knees, and 7 articles were used for a more detailed meta-analysis.
- - The overall success rate for favorable outcomes post-surgery was 84.2%, suggesting that arthroscopic surgical excision is a valid option for treating symptomatic medial knee plica, especially if non-surgical treatments have failed.
Article Synopsis
- - Primary bile duct perforation in adults is uncommon and often leads to serious complications like biliary peritonitis, which can be life-threatening.
- - A case involving a 72-year-old man showed that he was admitted with pancreatitis but was later diagnosed with a contained bile duct perforation limited to the lesser sac.
- - The patient's condition was successfully treated using stenting through endoscopic retrograde cholangiopancreatography, avoiding the need for more invasive procedures.
Meta-analysis of epidural analgesia versus peripheral nerve blockade after total knee joint replacement.
Eur J Orthop Surg Traumatol
January 2017
Article Synopsis
- The study aimed to compare the effectiveness and side effects of epidural analgesia versus peripheral nerve blockade (PNB) in managing postoperative pain after total knee joint replacement (TKR).
- Results from 12 randomized controlled trials showed no significant difference in pain scores between the two methods, but epidural analgesia was linked to higher risks of nausea, hypotension, and urinary retention.
- Additionally, comparisons between adductor canal block (ACB) and femoral nerve block (FNB) indicated no significant difference in pain relief at 24 and 48 hours post-surgery.
Article Synopsis
- * A case study of a 47-year-old woman who abused NSAIDs revealed she developed these strictures 1 year after cessation, with imaging showing numerous ileal strictures and lymphadenopathy.
- * Despite concerns of a possible malignancy due to the lymphadenopathy, surgery confirmed diaphragm disease, emphasizing that significant lymph node enlargement shouldn't exclude this diagnosis in patients with a clear NSAID history.