Surgery for bowel cancer is major surgery which by its nature involves risk for patients.  Currently there are unanswered questions around the use of pre-operative radiotherapy, surgical techniques, and the treatment of complications.

This stream of research is focused on developing answers to these and other questions around the peri-operative care of our patients with bowel cancer.

Project 1: Complete pathological response in relation to mesorectal invasion.

This project investigates whether pre-operative radiotherapy is associated with a higher completive pathological response in early T3 rectal cancer, compared with more extensive tissue invasion. A paper is currently being prepared for publication in the journal 'British Journal of Surgery'.

Project 2: Oncologic outcome in standard abdominoperineal resection - do we need to change technique?

This project aims to audit patients who have undergone abdominoperineal resection and examines whether a change in technique from a standard abdominoperineal resection to a more radical extra-levator abdominoperineal excision is warranted. A paper is currently being prepared for publication to the journal 'Colorectal Disease'.

Project 3: Hyperbaric Oxygen for Anastomatic Complications following low anterior resection.

This project examines the potential benefits of hyperbaric oxygen therapy for anastomatic complications following low anterior resection post chemo-radiation. The pilot study examined a limited number (<10) of cases and the patient outcomes. A paper on this work has been published online by 'International Journal of Colorectal Disease'.

Project 4: Failure to tattoo lesions at initial colonoscopy necessitates repeat endoscopy prior to surgery

The aim of this study is to assess the current practice of endoscopic tattoo use by endoscopists in patients referred for surgical resection. This is a valuable technique to allow accurate identification of the precise site of malignant lesions at the time of subsequent surgery. The outcome of this project is to quantify the current practice and to raise awareness of the need for a standardised approach to tattoo use.