Resources

Colorectal Goes Viral

Colorectal Goes Viral is an innovative educational series of webcasts that will connect and inspire the global colorectal community. ACPGBI have partnered with international colorectal leaders to discuss their vision for the future of our specialty in post-COVID times. We are very grateful to Johnson and Johnson for funding the series.

Using Colon Capsule Endoscopy (CCE) to manage low to intermediate risk patients on a lower GI two week wait pathway

In June 2020, Clinical guidance on triaging patients with lower GI symptoms was published. This guidance supported the use of Colon Capsule Endoscopy (CCE) in patients with NG12 specified symptoms and a Faecal Immunochemical test (FIT) result of between 10-100ug/gm. Following release of this guidance, the National Cancer Team allocated funding to Cancer Alliances to establish pilot CCE clinics, where CCE would be offered to those patients on a two week wait lower GI pathway with a FIT result between 10-100ug/gm or a FIT result <10ug/gm referred due to concerning symptoms.

PROSPER: a randomised comparison of surgical treatments for rectal prolapse

Rectal prolapse is a profoundly disabling condition, occurring mainly in elderly and parous women. There is no accepted standard surgical treatment, with previous studies limited in methodological quality and size. PROSPER aimed to address these deficiencies by comparing the relative merits of different procedures.

Systematic review of the clinical effectiveness of neuromodulation in the treatment of faecal incontinence

Over the past 18 years neuromodulation therapies have gained support as treatments for faecal incontinence (FI); sacral nerve stimulation (SNS) is the most established of these. A systematic review was performed of current evidence regarding the clinical effectiveness of neuromodulation treatments for FI.

Sacral nerve stimulation for faecal incontinence and constipation in adults

Faecal incontinence (FI) and constipation are both socially‐embarrassing and physically‐disabling conditions that impair quality of life. For both, surgery may be required in a minority of people when more conservative measures fail. However, the invasiveness and irreversible nature of direct surgery on bowel and sphincter muscles, poor long‐term outcomes and well‐established compIications makes such procedures unappealing for these benign conditions. A less‐invasive surgical option to treat faecal incontinence and constipation is direct, low‐voltage stimulation of the sacral nerve roots, termed sacral nerve stimulation (SNS). SNS has become the first line surgical treatment for FI in people failing conservative therapies. Its value in the treatment of constipation is less clear.

Surgery for constipation: systematic review and practice recommendations

C. H. Knowles, U. Grossi, M. Chapman, J. Mason, on behalf of the NIHR CapaCiTY working group, Pelvic floor Society

Surgery for constipation: systematic review and practice recommendations Graded practice and future research recommendations

C. H. Knowles, U. Grossi, E. J. Horrocks, D. Pares, P. F. Vollebregt, M. Chapman, S. Brown, M. Mercer-Jones, A. B. Williams, Y. Yiannakou, R. J. Hooper, N. Stevens, J. Mason, on behalf of the NIHR CapaCiTY working group, The Pelvic floor Society and, European Society of Coloproctology

Surgery for constipation: systematic review and practice recommendations Results III: Rectal wall excisional procedures (Rectal Excision)

M. Mercer-Jones, U. Grossi, D. Pares, P. F. Vollebregt, J. Mason, C. H. Knowles, on behalf of the NIHR CapaCiTY working group, the Pelvic floor Society

Surgery for constipation: systematic review and practice recommendations Graded practice and future research recommendations

C. H. Knowles, U. Grossi, E. J. Horrocks, D. Pares, P. F. Vollebregt, M. Chapman, S. Brown, M. Mercer-Jones, A. B. Williams, Y. Yiannakou, R. J. Hooper, N. Stevens, J. Mason, on behalf of the NIHR CapaCiTY working group, The Pelvic floor Society and, European Society of Coloproctology

Surgery for constipation: systematic review and practice recommendations