Minutes of Monthly Meeting
Monday, 13th May 2013
18:30
Venue: Seminar rooms, new QEHB
Attendees:
Prof Morton
Andy Torrance
Ravi Vohra
Kay Futaba
Tom Pinkney
Dave Bartlett
Aneel Bhangu
Ewen Griffiths
Emma Hamilton
Anne Gaunt
Henry Ferguson
Laura Magill
Kelly Handley
Hosaam Nasr
Jane Pilsbury
Charlotte Small
Nick Cawley
Apologies:
Paul Marriott
Abi Patel
1. Welcome to our anaesthetic colleagues (JP, CS, NC) interested in setting up a trainee
research collaborative within their specialty.
2. WMRC update
AT presented an update in current projects:
ROSSINI – Accepted for publication in BMJ
National Appendicectomy Audit – accepted for publication to BJS
DREAMS – Past the 800 patient point. Currently at least 6 months ahead of recruitment
schedule. TMG considering increasing to 1400 patients to increase power from 80% to 90%
ROCSS – 29 patients recuited at 5 sites. HTA funding to be applied for in the autumn. More
sites needed
ASLAN – 150 patient pilot to finish within the next 2 months.
Additionally:
WPBA – Preliminary data to be presented at West Midlands surgical society meeting
Gallstone pancreatitis – Rejected by HPB. For submission to The Surgeon
3. New studies presentations
Hypomagnesaemia Post Open Abdominal Aortic Aneurysm (AAA) Repair - Hosaam
Nasr
Low magnesium may contribute to cardiac arrhythmias in the immediate peri-operative phase
in open AAA repair. A two stage study was suggested:
1 – a retrospective review of AAA repairs to identify incidence of hypomagnesaemia and
post-op cardiac compliocations.
2 – A prospective study to include magnesium measurement pre- and post-surgery. This may
include magnesium infusion as an intervention.
Agreed this would work well as a multi-centre trial. Could include EVAR. Need to decide
on intervention, if any. Would be good to involve all the regional vascular trainees as they
will be based at each major vascular centre. Need a management team. To liaise with Prof
Morton and Prof Bradbury.
CHOP-OP - Ravi Vohra
RfPB funding application for feasibility studygoing in next week. Prof suggested that study
may be underpowered based on published studies which have more patients and fewer events.
Study could be extended to include other Upper GI surgery to improve recruitment ie liver
surgery. May have to compete with other upper GI trials. Blinding was discussed and
matched controls are to be arranged by the pharma company. May have difficulty
standardising other interventions that contribute to post-op pneumonia eg ERAS, anti-biotic
use, extubation policy, etc. Larger sample may help adjust for this variability. Management
team required and around 4 centres for the feasibility. ?rename – is “chop” appropriate in a
surgical trial??
Cholecystectomy multicentre audit - Ewen Griffiths
Suggested a prospective ‘snapshot’ audit of the provision of cholecystectomy
nationally/regionally. High volume operation/condition, performed almost universally.
Identified many variables of interest – General surgeon vs specialist upper GI, Hot
gallbladders, complications, OTC, conversion rates, etc.
An popular idea and feasible to deliver through the collaborative. It was suggested that a
focused question with a few key data points was desirable. A literature review was proposed
(RV agreed to undertake) to help clarify the knowledge gap. A management team should be
identified
Embolisation Vs Surgery for acute upper GI bleed - Ewen Griffiths
An audit of surgical Vs radiological management in acute upper GI bleeds. To identify
variation in management and outcome across hospitals.
An important question. Infrequent events, very few taken to theatre in larger centres. Would
require a large audit. Difficult to deliver due to this low incidence and long (~1yr) follow-up.
Highlighted that often patient factors dictate why embolisation is chosen over surgery and
vice-versa – bias.
4. Any other business
Due to time pressures, Henry Ferguson to present his study next month
Joint East and West Midlands Surgical Society meeting, Friday 17th May
AT presenting
Dinner to follow, WMRC members will now be going
5. Next meeting – 3rd June 2013, QEHB