Catalogo dei prodotti della ricerca

Background: A reliable system for grading operative difficulty of laparoscopic cholecystectomy would standardise description of findings and reporting of outcomes. The aim of this study was to validate a difficulty grading system (Nassar scale), testing its applicability and consistency in two large prospective datasets. Methods: Patient and disease-related variables and 30-day outcomes were identified in two prospective cholecystectomy databases: the multi-centre prospective cohort of 8820 patients from the recent CholeS Study and the single-surgeon series containing 4089 patients. Operative data and patient outcomes were correlated with Nassar operative difficultly scale, using Kendall’s tau for dichotomous variables, or Jonckheere–Terpstra tests for continuous variables. A ROC curve analysis was performed, to quantify the predictive accuracy of the scale for each outcome, with continuous outcomes dichotomised, prior to analysis. Results: A higher operative difficulty grade was consistently associated with worse outcomes for the patients in both the reference and CholeS cohorts. The median length of stay increased from 0 to 4 days, and the 30-day complication rate from 7.6 to 24.4% as the difficulty grade increased from 1 to 4/5 (both p < 0.001). In the CholeS cohort, a higher difficulty grade was found to be most strongly associated with conversion to open and 30-day mortality (AUROC = 0.903, 0.822, respectively). On multivariable analysis, the Nassar operative difficultly scale was found to be a significant independent predictor of operative duration, conversion to open surgery, 30-day complications and 30-day reintervention (all p < 0.001). Conclusion: We have shown that an operative difficulty scale can standardise the description of operative findings by multiple grades of surgeons to facilitate audit, training assessment and research. It provides a tool for reporting operative findings, disease severity and technical difficulty and can be utilised in future research to reliably compare outcomes according to case mix and intra-operative difficulty.

Utilisation of an operative difficulty grading scale for laparoscopic cholecystectomy / Vohra, Ravinder S.; Kirkham, Amanda J.; Pasquali, Sandro; Marriott, Paul; Johnstone, Marianne; Spreadborough, Philip; Alderson, Derek; Griffiths, Ewen A.; Fenwick, Stephen; Elmasry, Mohamed; Nunes, Quentin M.; Kennedy, David; Basit Khan, Raja; Khan, Muhammad A. S.; Magee, Conor J.; Jones, Steven M.; Mason, Denise; Parappally, Ciny P.; Mathur, Pawan; Saunders, Michael; Jamel, Sara; Haque, Samer U. l.; Zafar, Sara; Hanif Shiwani, Muhammad; Samuel, Nehemiah; Dar, Farooq; Jackson, Andrew; Lovett, Bryony; Dindyal, Shiva; Winter, Hannah; Fletcher, Ted; Rahman, Saquib; Wheatley, Kevin; Nieto, Tom; Ayaani, Soofiyah; Youssef, Haney; Nijjar, Rajwinder S.; Watkin, Helen; Naumann, David; Emesih, Sophie; Sarmah, Piyush B.; Lee, Kathryn; Joji, Nikita; Lambert, Joel; Heath, Jonathan; Teasdale, Rebecca L.; Weerasinghe, Chamindri; Needham, Paul J.; Welbourn, Hannah; Forster, Luke; Finch, David; Blazeby, Jane M.; Robb, William; Mcnair, Angus G. K.; Hrycaiczuk, Alex; Charalabopoulos, Alexandros; Kadirkamanathan, Sritharan; Tang, Cheuk-Bong; Jayanthi, Naga V. G.; Noor, Nigel; Dobbins, Brian; Cockbain, Andrew J.; Nilsen-Nunn, April; de Siqueira, Jonathan; Pellen, Mike; Cowley, Jonathan B.; Ho, Wei-Min; Miu, Victor; White, Timothy J.; Hodgkins, Kathryn A.; Kinghorn, Alison; Tutton, Matthew G.; Al-Abed, Yahya A.; Menzies, Donald; Ahmad, Anwar; Reed, Joanna; Khan, Shabuddin; Monk, David; Vitone, Louis J.; Murtaza, Ghulam; Joel, Abraham; Brennan, Stephen; Shier, David; Zhang, Catherine; Yoganathan, Thusidaran; Robinson, Steven J.; Mccallum, Iain J. D.; Jones, Michael J.; Elsayed, Mohammed; Tuck, Liz; Wayman, John; Carney, Kate; Aroori, Somaiah; Hosie, Kenneth B.; Kimble, Adam; Bunting, David M.; Hosie, Kenneth B.; Fawole, Adeshina S.; Basheer, Mohammed; Dave, Rajiv V.; Sarveswaran, Janahan; Jones, Elinor; Kendal, Chris; Tilston, Michael P.; Gough, Martin; Wallace, Tom; Singh, Shailendra; Mockford, Justine Downing Katherine A.; Issa, Eyad; Shah, Nayab; Chauhan, Neal; Wilson, Timothy R.; Forouzanfar, Amir; Wild, Jonathan R. L.; Nofal, Emma; Bunnell, Catherine; Madbak, Khaliel; Rao, Sudhindra T. V.; Devoto, Laurence; Siddiqi, Najaf; Khawaja, Zechan; Hewes, James C.; Gould, Laura; Chambers, Alice; Urriza Rodriguez, Daniel; Sen, Gourab; Robinson, Stuart; Carney, Kate; Bartlett, Francis; Rae, David M.; Stevenson, Thomas E. J.; Sarvananthan, Kas; Dwerryhouse, Simon J.; Higgs, Simon M.; Old, Oliver J.; Hardy, Thomas J.; Hornby, Reena Shah Steve T.; Keogh, Ken; Frank, Lucinda; Al-Akash, Musallam; Upchurch, Emma A.; Frame, Richard J.; Hughes, Michael; Jelley, Clare; Weaver, Simon; Roy, Sudipta; Sillo, Toritseju O.; Galanopoulos, Giorgios; Cuming, Tamzin; Cunha, Pedro; Tayeh, Salim; Kaptanis, Sarantos; Heshaishi, Mohamed; Eisawi, Abdalla; Abayomi, Michael; Sing Ngu, Wee; Fleming, Katie; Bajwa, Dalvir S.; Chitre, Vivek; Aryal, Kamal; Ferris, Paul; Silva, Michael; Lammy Sarah Mohamed, Simon; Khawaja, Amir; Hussain, Adnan; A Ghazanfar, Mudassar; Bellini, MARIA IRENE; Ebdewi, Hamdi; Elshaer, Mohamed; Gravante, Gianpiero; Drake, Benjamin; Ogedegbe, Arikoge; Mukherjee, Dipankar; Arhi, Chanpreet; Giwa Nusrat Iqbal, Lola; F Watson, Nicholas; Kumar Aggarwal, Smeer; Orchard, Philippa; Villatoro, Eduardo; Willson, Peter D.; Wa Jessica Mok, Kam; Woodman, Thomas; Deguara, Jean; Garcea, Giuseppe; I Babu, Benoy; Dennison, Ar; Malde, Deep; Lloyd, David; Satheesan, Steve; Al-Taan, Omer; Boddy, Alexander; Slavin, John P.; Jones, Robert P.; Balance, Laura; Gerakopoulos, Stratos; Jambulingam, Periyathambi; Mansour, Sami; Sakai, Naomi; Acharya, Vikas; Sadat, Mohammed M.; Karim, Lawen; Larkin, David; Amin, Khalid; Khan, Amarah; Law, Jennifer; Jamdar, Saurabh; Smith, Stella R.; Sampat, Keerthika; O'Shea, Kathryn M.; Manu, Mangta; Asprou, Fotini M.; Malik, Nabeela S.; Chang, Jessica; Johnstone, Marianne; Lewis, Michael; Roberts, Geoffrey P.; Karavadra, Babu; Photi, Evangelos; Hewes, James; Gould, Laura; Chambers, Alice; Rodriguez, Dan; A O'Reilly, Derek; Rate, Anthony J.; Sekhar, Hema; Henderson, Lucy T.; Starmer, Benjamin Z.; Coe, Peter O.; Tolofari, Sotonye; Barrie, Jenifer; Bashir, Gareth; Sloane, Jake; Madanipour, Suroosh; Halkias, Constantine; Trevatt, Alexander E. J.; Borowski, David W.; Hornsby, Jane; Courtney, Michael J.; Virupaksha, Suvi; Seymour, Keith; Robinson, Sarah; Hawkins, Helen; Bawa, Sadiq; Gallagher, Paul V.; Reid, Alistair; Wood, Peter; Finch, J. G.; Guy Finch, J.; Parmar, J.; Stirland, E.; Gardner-Thorpe, James; Al-Muhktar, Ahmed; Peterson, Mark; Majeed, Ali; Bajwa, Farrukh M.; Martin, Jack; Choy, Alfred; Tsang, Andrew; Pore, Naresh; Andrew, David R.; Al-Khyatt, Waleed; Taylor Santosh Bhandari, Christopher; Chambers, Adam; Subramanium, Dhivya; Toh, Simon K. C.; Carter, Nicholas C.; Tate, Sophie; Pearce, Belinda; Wainwright, Denise; Mercer, Stuart J.; Knight, Benjamin; Vijay, Vardhini; Alagaratnam, Swethan; Sinha, Sidhartha; Khan, Shahab; El-Hasani, Shamsi S.; Hussain, Abdulzahra A.; Bhattacharya, Vish; Kansal, Nisheeth; Fasih, Tani; Jackson, Claire; Siddiqui, Midhat N.; Chishti, Imran A.; Fordham, Imogen J.; Siddiqui, Zohaib; Bausbacher, Harald; Geogloma, Ileana; Gurung, Kabita; Tsavellas, George; Basynat, Pradeep; Kiran Shrestha, Ashish; Basu, Sanjoy; Chhabra Mohan Harilingam, Alok; Rabie, Mohamed; Akhtar, Mansoor; Kumar, Pradeep; Jafferbhoy, Sadaf F.; Hussain, Najam; Raza, Soulat; Haque, Manzarul; Alam, Imran; Aseem, Rabiya; Patel, Shakira; Asad, Mehek; Booth, Michael I.; Ball, William R.; Wood, Christopher P. J.; Pinho-Gomes, Ana C.; Kausar, Ambareen; Rami Obeidallah, Moh'D; Varghase, Joseph; Lodhia, Joshil; Bradley, Donal; Rengifo, Carla; Lindsay, David; Gopalswamy, Sivakumar; Finlay, Ian; Wardle, Stacy; Bullen, Naomi; Yusuf Iftikhar, Syed; Awan, Altaf; Ahmed, Javed; Leeder, Paul; Fusai, Guiseppe; Bond-Smith, Giles; Psica, Alicja; Puri, Yogesh; Hou, David; Noble, Fergus; Szentpali, Karoly; Broadhurst, Jack; Date, Ravindra; Hossack, Martin R.; Li Goh, Yan; Turner, Paul; Shetty, Vinutha; Riera, Manel; Macano, Christina A. W.; Sukha, Anisha; Preston, Shaun R.; Hoban, Jennifer R.; Puntis, Daniel J.; Williams, Sophie V.; Krysztopik, Richard; Kynaston, James; Batt, Jeremy; Doe, Matthew; Goscimski, Andrzej; Jones, Gareth H.; Smith, Stella R.; Hall, Claire; Carty, Nick; Ahmed, Jamil; Panteleimonitis, Sofoklis; Gunasekera, Rohan T.; Sheel, Andrea R. G.; Lennon, Hannah; Hindley, Caroline; Reddy, Marcus; Kenny, Ross; Elkheir, Natalie; Mcglone, Emma R.; Rajaganeshan, Rajasundaram; Hancorn, Kate; Hargreaves, Anita; Prasad, Raj; Longbotham, David A.; Vijayanand, Dhakshinamoorthy; Wijetunga, Imeshi; Ziprin, Paul; Nicolay, Christopher R.; Yeldham, Geoffrey; Read, Edward; Gossage, James A.; Rolph, Rachel C.; Ebied, Husam; Phull, Manraj; Khan, Mohammad A.; Popplewell, Matthew; Kyriakidis, Dimitrios; Hussain, Anwar; Henley, Natasha; Packer, Jessica R.; Derbyshire, Laura; Porter, Jonathan; Appleton, Shaun; Farouk, Marwan; Basra, Melvinder; Jennings, Neil A.; Ali, Shahda; Kanakala, Venkatesh; Ali, Haythem; Lane, Risha; Dickson-Lowe, Richard; Zarsadias, Prizzi; Mirza, Darius; Puig, Sonia; Al Amari, Khalid; Vijayan, Deepak; Sutcliffe, Robert; Marudanayagam, Ravi; Hamady, Zayed; Prasad, Abheesh R.; Patel, Abhilasha; Durkin, Damien; Kaur, Parminder; Bowen, Laura; Byrne, James P.; Pearson, Katherine L.; Delisle, Theo G.; Davies, James; Tomlinson, Mark A.; Johnpulle, Michelle A.; Slawinski, Corinna; Macdonald, Andrew; Nicholson, James; Newton, Katy; Mbuvi, James; Farooq, Ansar; Sidhartha Mothe, Bhavani; Zafrani, Zakhi; Brett, Daniel; Francombe, James; Spreadborough, Philip; Barnes, James; Cheung, Melanie; Al-Bahrani, Ahmed Z.; Preziosi, Giuseppe; Urbonas, Tomas; Alberts, Justin; Mallik, Mekhlola; Patel, Krashna; Segaran, Ashvina; Doulias, Triantafyllos; Sufi, Pratik A.; Yao, Caroline; Pollock, Sarah; Manzelli, Antonio; Wajed, Saj; Kourkulos, Michail; Pezzuto, Roberto; Wadley, Martin; Hamilton, Emma; Jaunoo, Shameen; Padwick, Robert; Sayegh, Mazin; Newton, Richard C.; Hebbar, Madhusoodhana; Farag, Sameh F.; Spearman, John; Hamdan, Mohammed F.; D'Costa, Conrad; Blane, Christine; Giles, Mathew; Peter, Mark B.; Hirst, Natalie A.; Hossain, Tanvir; Pannu Yesar El-Dhuwaib, Arslan; Morrison, Tamsin E. M.; Taylor, Greg W.; Thompson, Ronald L. E.; Mccune, Ken; Loughlin, Paula; Lawther, Roger; Byrnes, Colman K.; Simpson, Duncan J.; Mawhinney, Abi; Warren, Conor; Mckay, Damian; Mcilmunn, Colin; Martin, Serena; Macartney, Matthew; Diamond, Tom; Davey, Phil; Jones, Claire; Clements, Joshua M.; Digney, Ruairi; Ming Chan, Wei; Mccain, Stephen; Gull, Sadaf; Janeczko, Adam; Dorrian, Emmet; Harris, Andrew; Dawson, Suzanne; Johnston, Dorothy; Mcaree, Barry; Ghareeb, Essam; Thomas, George; Connelly, Martin; Mckenzie, Stephen; Cieplucha, Krzysztos; Spence, Gary; Campbell, William; Hooks, Gareth; Bradley, Neil; Hill, Arnold D. K.; Cassidy, John T.; Boland, Michael; Burke, Paul; Nally, Deirdre M.; Hill, Arnold D. K.; Khogali, Elmoataz; Shabo, Wael; Iskandar, Edrin; Mcentee, Gerry P.; O'Neill, Maeve A.; Peirce, Colin; Lyons, Emma M.; O'Sullivan, Adrian W.; Thakkar, Rohan; Carroll, Paul; Ivanovski, Ivan; Balfe, Paul; Lee, Matthew; Winter, Des C.; Kelly, Michael E.; Hoti, Emir; Maguire, Donal; Karunakaran, Priyadarssini; Geoghegan, Justin G.; Mcdermott, Frank; Martin, Sean T.; Cross, Keith S.; Cooke, Fiachra; Zeeshan, Saquib; Murphy, James O.; Mealy, Ken; Mohan, Helen M.; Nedujchelyn, Yuwaraja; Fahad Ullah, Muhammad; Ahmed, Irfan; Giovinazzo, Francesco; Milburn, James; Prince, Sarah; Brooke, Eleanor; Buchan, Joanna; Khalil, Ahmed M.; Vaughan, Elizabeth M.; Ramage, Michael I.; Aldridge, Roland C.; Gibson, Simon; Nicholson, Gary A.; Vass, David G.; Grant, Alan J.; Holroyd, David J.; Angharad Jones, M.; Sutton, Cherith M. L. R.; O'Dwyer, Patrick; Nilsson, Frida; Weber, Beatrix; Williamson, Tracey K.; Lalla, Kushik; Bryant, Alice; Ross Carter, C.; Forrest, Craig R.; Hunter, David I.; Nassar, Ahmad H.; Orizu, Mavis N.; Knight, Katrina; Qandeel, Haitham; Suttie, Stuart; Belding, Rowena; Mcclarey, Andrew; Boyd, Alan T.; Guthrie, Graeme J. K.; Lim, Pei J.; Luhmann, Andreas; Watson, Angus J. M.; Richards, Colin H.; Nicol, Laura; Madurska, Marta; Harrison, Ewen; Boyce, Kathryn M.; Roebuck, Amanda; Ferguson, Graeme; Pati, Pradeep; Wilson, Michael S. J.; Dalgaty, Faith; Fothergill, Laura; Driscoll, Peter J.; Mozolowski, Kirsty L.; Banwell, Victoria; Bennett, Stephen P.; Rogers, Paul N.; Skelly, Brendan L.; Rutherford, Claire L.; Mirza, Ahmed K.; Lazim, Taha; Lim, Henry C. C.; Duke, Diana; Ahmed, Talat; Beasley, William D.; Wilkinson, Marc D.; Maharaj, Geta; Malcolm, Cathy; Brown, Timothy H.; Al-Sarireh, Bilal; Shingler, Guy M.; Mowbray, Nicholas; Radwan, Rami; Morcous, Paul; Wood, Simon; Kadhim, Abbas; Stewart, Duncan J.; Baker, Andrew L.; Tanner, Nicola; Shenoy, Hrishikesh; Hafiz, Shazia; De Marchi, Joshua A.; Singh-Ranger, Deepak; Hisham, Elzanati; Ainley, Paul; O'Neill John Terrace, Stephen; Napetti, Sara; Hopwood, Benjamin; Rhys, Thomas; Downing, Justine; Kanavati, Osama; Coats, Maria; Aleksandrov, Danail; Kallaway, Charlotte; Yahya, Salama; Weber, Beatrix; Templeton, Alexa; Trotter, Martin; Lo, Christina; Dhillon, Ajit; Heywood, Nick; Aawsaj, Yousif; Hamdan, Alhafidz; Reece-Bolton, Obuobi; Mcguigan, Andrew; Shahin, Yousef; Aymon, ; Alison Luther, Ali; A Nicholson, James; Rajendran, Ilayaraja; Boal, Matthew; Ritchie, Judith. - In: SURGICAL ENDOSCOPY. - ISSN 0930-2794. - 33:1(2019), pp. 110-121. [10.1007/s00464-018-6281-2]

Utilisation of an operative difficulty grading scale for laparoscopic cholecystectomy

Maria Irene Bellini;
2019

Abstract

Background: A reliable system for grading operative difficulty of laparoscopic cholecystectomy would standardise description of findings and reporting of outcomes. The aim of this study was to validate a difficulty grading system (Nassar scale), testing its applicability and consistency in two large prospective datasets. Methods: Patient and disease-related variables and 30-day outcomes were identified in two prospective cholecystectomy databases: the multi-centre prospective cohort of 8820 patients from the recent CholeS Study and the single-surgeon series containing 4089 patients. Operative data and patient outcomes were correlated with Nassar operative difficultly scale, using Kendall’s tau for dichotomous variables, or Jonckheere–Terpstra tests for continuous variables. A ROC curve analysis was performed, to quantify the predictive accuracy of the scale for each outcome, with continuous outcomes dichotomised, prior to analysis. Results: A higher operative difficulty grade was consistently associated with worse outcomes for the patients in both the reference and CholeS cohorts. The median length of stay increased from 0 to 4 days, and the 30-day complication rate from 7.6 to 24.4% as the difficulty grade increased from 1 to 4/5 (both p < 0.001). In the CholeS cohort, a higher difficulty grade was found to be most strongly associated with conversion to open and 30-day mortality (AUROC = 0.903, 0.822, respectively). On multivariable analysis, the Nassar operative difficultly scale was found to be a significant independent predictor of operative duration, conversion to open surgery, 30-day complications and 30-day reintervention (all p < 0.001). Conclusion: We have shown that an operative difficulty scale can standardise the description of operative findings by multiple grades of surgeons to facilitate audit, training assessment and research. It provides a tool for reporting operative findings, disease severity and technical difficulty and can be utilised in future research to reliably compare outcomes according to case mix and intra-operative difficulty.
2019
cholecystectomy; difficulty grading; laparoscopic; operative difficulty; surgery; adult; aged; cholecystectomy, laparoscopic; conversion to open surgery; female; humans; length of stay; male; middle aged; multivariate analysis; postoperative complications; prospective studies; ROC curve
01 Pubblicazione su rivista::01a Articolo in rivista
Utilisation of an operative difficulty grading scale for laparoscopic cholecystectomy / Vohra, Ravinder S.; Kirkham, Amanda J.; Pasquali, Sandro; Marriott, Paul; Johnstone, Marianne; Spreadborough, Philip; Alderson, Derek; Griffiths, Ewen A.; Fenwick, Stephen; Elmasry, Mohamed; Nunes, Quentin M.; Kennedy, David; Basit Khan, Raja; Khan, Muhammad A. S.; Magee, Conor J.; Jones, Steven M.; Mason, Denise; Parappally, Ciny P.; Mathur, Pawan; Saunders, Michael; Jamel, Sara; Haque, Samer U. l.; Zafar, Sara; Hanif Shiwani, Muhammad; Samuel, Nehemiah; Dar, Farooq; Jackson, Andrew; Lovett, Bryony; Dindyal, Shiva; Winter, Hannah; Fletcher, Ted; Rahman, Saquib; Wheatley, Kevin; Nieto, Tom; Ayaani, Soofiyah; Youssef, Haney; Nijjar, Rajwinder S.; Watkin, Helen; Naumann, David; Emesih, Sophie; Sarmah, Piyush B.; Lee, Kathryn; Joji, Nikita; Lambert, Joel; Heath, Jonathan; Teasdale, Rebecca L.; Weerasinghe, Chamindri; Needham, Paul J.; Welbourn, Hannah; Forster, Luke; Finch, David; Blazeby, Jane M.; Robb, William; Mcnair, Angus G. K.; Hrycaiczuk, Alex; Charalabopoulos, Alexandros; Kadirkamanathan, Sritharan; Tang, Cheuk-Bong; Jayanthi, Naga V. G.; Noor, Nigel; Dobbins, Brian; Cockbain, Andrew J.; Nilsen-Nunn, April; de Siqueira, Jonathan; Pellen, Mike; Cowley, Jonathan B.; Ho, Wei-Min; Miu, Victor; White, Timothy J.; Hodgkins, Kathryn A.; Kinghorn, Alison; Tutton, Matthew G.; Al-Abed, Yahya A.; Menzies, Donald; Ahmad, Anwar; Reed, Joanna; Khan, Shabuddin; Monk, David; Vitone, Louis J.; Murtaza, Ghulam; Joel, Abraham; Brennan, Stephen; Shier, David; Zhang, Catherine; Yoganathan, Thusidaran; Robinson, Steven J.; Mccallum, Iain J. D.; Jones, Michael J.; Elsayed, Mohammed; Tuck, Liz; Wayman, John; Carney, Kate; Aroori, Somaiah; Hosie, Kenneth B.; Kimble, Adam; Bunting, David M.; Hosie, Kenneth B.; Fawole, Adeshina S.; Basheer, Mohammed; Dave, Rajiv V.; Sarveswaran, Janahan; Jones, Elinor; Kendal, Chris; Tilston, Michael P.; Gough, Martin; Wallace, Tom; Singh, Shailendra; Mockford, Justine Downing Katherine A.; Issa, Eyad; Shah, Nayab; Chauhan, Neal; Wilson, Timothy R.; Forouzanfar, Amir; Wild, Jonathan R. L.; Nofal, Emma; Bunnell, Catherine; Madbak, Khaliel; Rao, Sudhindra T. V.; Devoto, Laurence; Siddiqi, Najaf; Khawaja, Zechan; Hewes, James C.; Gould, Laura; Chambers, Alice; Urriza Rodriguez, Daniel; Sen, Gourab; Robinson, Stuart; Carney, Kate; Bartlett, Francis; Rae, David M.; Stevenson, Thomas E. J.; Sarvananthan, Kas; Dwerryhouse, Simon J.; Higgs, Simon M.; Old, Oliver J.; Hardy, Thomas J.; Hornby, Reena Shah Steve T.; Keogh, Ken; Frank, Lucinda; Al-Akash, Musallam; Upchurch, Emma A.; Frame, Richard J.; Hughes, Michael; Jelley, Clare; Weaver, Simon; Roy, Sudipta; Sillo, Toritseju O.; Galanopoulos, Giorgios; Cuming, Tamzin; Cunha, Pedro; Tayeh, Salim; Kaptanis, Sarantos; Heshaishi, Mohamed; Eisawi, Abdalla; Abayomi, Michael; Sing Ngu, Wee; Fleming, Katie; Bajwa, Dalvir S.; Chitre, Vivek; Aryal, Kamal; Ferris, Paul; Silva, Michael; Lammy Sarah Mohamed, Simon; Khawaja, Amir; Hussain, Adnan; A Ghazanfar, Mudassar; Bellini, MARIA IRENE; Ebdewi, Hamdi; Elshaer, Mohamed; Gravante, Gianpiero; Drake, Benjamin; Ogedegbe, Arikoge; Mukherjee, Dipankar; Arhi, Chanpreet; Giwa Nusrat Iqbal, Lola; F Watson, Nicholas; Kumar Aggarwal, Smeer; Orchard, Philippa; Villatoro, Eduardo; Willson, Peter D.; Wa Jessica Mok, Kam; Woodman, Thomas; Deguara, Jean; Garcea, Giuseppe; I Babu, Benoy; Dennison, Ar; Malde, Deep; Lloyd, David; Satheesan, Steve; Al-Taan, Omer; Boddy, Alexander; Slavin, John P.; Jones, Robert P.; Balance, Laura; Gerakopoulos, Stratos; Jambulingam, Periyathambi; Mansour, Sami; Sakai, Naomi; Acharya, Vikas; Sadat, Mohammed M.; Karim, Lawen; Larkin, David; Amin, Khalid; Khan, Amarah; Law, Jennifer; Jamdar, Saurabh; Smith, Stella R.; Sampat, Keerthika; O'Shea, Kathryn M.; Manu, Mangta; Asprou, Fotini M.; Malik, Nabeela S.; Chang, Jessica; Johnstone, Marianne; Lewis, Michael; Roberts, Geoffrey P.; Karavadra, Babu; Photi, Evangelos; Hewes, James; Gould, Laura; Chambers, Alice; Rodriguez, Dan; A O'Reilly, Derek; Rate, Anthony J.; Sekhar, Hema; Henderson, Lucy T.; Starmer, Benjamin Z.; Coe, Peter O.; Tolofari, Sotonye; Barrie, Jenifer; Bashir, Gareth; Sloane, Jake; Madanipour, Suroosh; Halkias, Constantine; Trevatt, Alexander E. J.; Borowski, David W.; Hornsby, Jane; Courtney, Michael J.; Virupaksha, Suvi; Seymour, Keith; Robinson, Sarah; Hawkins, Helen; Bawa, Sadiq; Gallagher, Paul V.; Reid, Alistair; Wood, Peter; Finch, J. G.; Guy Finch, J.; Parmar, J.; Stirland, E.; Gardner-Thorpe, James; Al-Muhktar, Ahmed; Peterson, Mark; Majeed, Ali; Bajwa, Farrukh M.; Martin, Jack; Choy, Alfred; Tsang, Andrew; Pore, Naresh; Andrew, David R.; Al-Khyatt, Waleed; Taylor Santosh Bhandari, Christopher; Chambers, Adam; Subramanium, Dhivya; Toh, Simon K. C.; Carter, Nicholas C.; Tate, Sophie; Pearce, Belinda; Wainwright, Denise; Mercer, Stuart J.; Knight, Benjamin; Vijay, Vardhini; Alagaratnam, Swethan; Sinha, Sidhartha; Khan, Shahab; El-Hasani, Shamsi S.; Hussain, Abdulzahra A.; Bhattacharya, Vish; Kansal, Nisheeth; Fasih, Tani; Jackson, Claire; Siddiqui, Midhat N.; Chishti, Imran A.; Fordham, Imogen J.; Siddiqui, Zohaib; Bausbacher, Harald; Geogloma, Ileana; Gurung, Kabita; Tsavellas, George; Basynat, Pradeep; Kiran Shrestha, Ashish; Basu, Sanjoy; Chhabra Mohan Harilingam, Alok; Rabie, Mohamed; Akhtar, Mansoor; Kumar, Pradeep; Jafferbhoy, Sadaf F.; Hussain, Najam; Raza, Soulat; Haque, Manzarul; Alam, Imran; Aseem, Rabiya; Patel, Shakira; Asad, Mehek; Booth, Michael I.; Ball, William R.; Wood, Christopher P. J.; Pinho-Gomes, Ana C.; Kausar, Ambareen; Rami Obeidallah, Moh'D; Varghase, Joseph; Lodhia, Joshil; Bradley, Donal; Rengifo, Carla; Lindsay, David; Gopalswamy, Sivakumar; Finlay, Ian; Wardle, Stacy; Bullen, Naomi; Yusuf Iftikhar, Syed; Awan, Altaf; Ahmed, Javed; Leeder, Paul; Fusai, Guiseppe; Bond-Smith, Giles; Psica, Alicja; Puri, Yogesh; Hou, David; Noble, Fergus; Szentpali, Karoly; Broadhurst, Jack; Date, Ravindra; Hossack, Martin R.; Li Goh, Yan; Turner, Paul; Shetty, Vinutha; Riera, Manel; Macano, Christina A. W.; Sukha, Anisha; Preston, Shaun R.; Hoban, Jennifer R.; Puntis, Daniel J.; Williams, Sophie V.; Krysztopik, Richard; Kynaston, James; Batt, Jeremy; Doe, Matthew; Goscimski, Andrzej; Jones, Gareth H.; Smith, Stella R.; Hall, Claire; Carty, Nick; Ahmed, Jamil; Panteleimonitis, Sofoklis; Gunasekera, Rohan T.; Sheel, Andrea R. G.; Lennon, Hannah; Hindley, Caroline; Reddy, Marcus; Kenny, Ross; Elkheir, Natalie; Mcglone, Emma R.; Rajaganeshan, Rajasundaram; Hancorn, Kate; Hargreaves, Anita; Prasad, Raj; Longbotham, David A.; Vijayanand, Dhakshinamoorthy; Wijetunga, Imeshi; Ziprin, Paul; Nicolay, Christopher R.; Yeldham, Geoffrey; Read, Edward; Gossage, James A.; Rolph, Rachel C.; Ebied, Husam; Phull, Manraj; Khan, Mohammad A.; Popplewell, Matthew; Kyriakidis, Dimitrios; Hussain, Anwar; Henley, Natasha; Packer, Jessica R.; Derbyshire, Laura; Porter, Jonathan; Appleton, Shaun; Farouk, Marwan; Basra, Melvinder; Jennings, Neil A.; Ali, Shahda; Kanakala, Venkatesh; Ali, Haythem; Lane, Risha; Dickson-Lowe, Richard; Zarsadias, Prizzi; Mirza, Darius; Puig, Sonia; Al Amari, Khalid; Vijayan, Deepak; Sutcliffe, Robert; Marudanayagam, Ravi; Hamady, Zayed; Prasad, Abheesh R.; Patel, Abhilasha; Durkin, Damien; Kaur, Parminder; Bowen, Laura; Byrne, James P.; Pearson, Katherine L.; Delisle, Theo G.; Davies, James; Tomlinson, Mark A.; Johnpulle, Michelle A.; Slawinski, Corinna; Macdonald, Andrew; Nicholson, James; Newton, Katy; Mbuvi, James; Farooq, Ansar; Sidhartha Mothe, Bhavani; Zafrani, Zakhi; Brett, Daniel; Francombe, James; Spreadborough, Philip; Barnes, James; Cheung, Melanie; Al-Bahrani, Ahmed Z.; Preziosi, Giuseppe; Urbonas, Tomas; Alberts, Justin; Mallik, Mekhlola; Patel, Krashna; Segaran, Ashvina; Doulias, Triantafyllos; Sufi, Pratik A.; Yao, Caroline; Pollock, Sarah; Manzelli, Antonio; Wajed, Saj; Kourkulos, Michail; Pezzuto, Roberto; Wadley, Martin; Hamilton, Emma; Jaunoo, Shameen; Padwick, Robert; Sayegh, Mazin; Newton, Richard C.; Hebbar, Madhusoodhana; Farag, Sameh F.; Spearman, John; Hamdan, Mohammed F.; D'Costa, Conrad; Blane, Christine; Giles, Mathew; Peter, Mark B.; Hirst, Natalie A.; Hossain, Tanvir; Pannu Yesar El-Dhuwaib, Arslan; Morrison, Tamsin E. M.; Taylor, Greg W.; Thompson, Ronald L. E.; Mccune, Ken; Loughlin, Paula; Lawther, Roger; Byrnes, Colman K.; Simpson, Duncan J.; Mawhinney, Abi; Warren, Conor; Mckay, Damian; Mcilmunn, Colin; Martin, Serena; Macartney, Matthew; Diamond, Tom; Davey, Phil; Jones, Claire; Clements, Joshua M.; Digney, Ruairi; Ming Chan, Wei; Mccain, Stephen; Gull, Sadaf; Janeczko, Adam; Dorrian, Emmet; Harris, Andrew; Dawson, Suzanne; Johnston, Dorothy; Mcaree, Barry; Ghareeb, Essam; Thomas, George; Connelly, Martin; Mckenzie, Stephen; Cieplucha, Krzysztos; Spence, Gary; Campbell, William; Hooks, Gareth; Bradley, Neil; Hill, Arnold D. K.; Cassidy, John T.; Boland, Michael; Burke, Paul; Nally, Deirdre M.; Hill, Arnold D. K.; Khogali, Elmoataz; Shabo, Wael; Iskandar, Edrin; Mcentee, Gerry P.; O'Neill, Maeve A.; Peirce, Colin; Lyons, Emma M.; O'Sullivan, Adrian W.; Thakkar, Rohan; Carroll, Paul; Ivanovski, Ivan; Balfe, Paul; Lee, Matthew; Winter, Des C.; Kelly, Michael E.; Hoti, Emir; Maguire, Donal; Karunakaran, Priyadarssini; Geoghegan, Justin G.; Mcdermott, Frank; Martin, Sean T.; Cross, Keith S.; Cooke, Fiachra; Zeeshan, Saquib; Murphy, James O.; Mealy, Ken; Mohan, Helen M.; Nedujchelyn, Yuwaraja; Fahad Ullah, Muhammad; Ahmed, Irfan; Giovinazzo, Francesco; Milburn, James; Prince, Sarah; Brooke, Eleanor; Buchan, Joanna; Khalil, Ahmed M.; Vaughan, Elizabeth M.; Ramage, Michael I.; Aldridge, Roland C.; Gibson, Simon; Nicholson, Gary A.; Vass, David G.; Grant, Alan J.; Holroyd, David J.; Angharad Jones, M.; Sutton, Cherith M. L. R.; O'Dwyer, Patrick; Nilsson, Frida; Weber, Beatrix; Williamson, Tracey K.; Lalla, Kushik; Bryant, Alice; Ross Carter, C.; Forrest, Craig R.; Hunter, David I.; Nassar, Ahmad H.; Orizu, Mavis N.; Knight, Katrina; Qandeel, Haitham; Suttie, Stuart; Belding, Rowena; Mcclarey, Andrew; Boyd, Alan T.; Guthrie, Graeme J. K.; Lim, Pei J.; Luhmann, Andreas; Watson, Angus J. M.; Richards, Colin H.; Nicol, Laura; Madurska, Marta; Harrison, Ewen; Boyce, Kathryn M.; Roebuck, Amanda; Ferguson, Graeme; Pati, Pradeep; Wilson, Michael S. J.; Dalgaty, Faith; Fothergill, Laura; Driscoll, Peter J.; Mozolowski, Kirsty L.; Banwell, Victoria; Bennett, Stephen P.; Rogers, Paul N.; Skelly, Brendan L.; Rutherford, Claire L.; Mirza, Ahmed K.; Lazim, Taha; Lim, Henry C. C.; Duke, Diana; Ahmed, Talat; Beasley, William D.; Wilkinson, Marc D.; Maharaj, Geta; Malcolm, Cathy; Brown, Timothy H.; Al-Sarireh, Bilal; Shingler, Guy M.; Mowbray, Nicholas; Radwan, Rami; Morcous, Paul; Wood, Simon; Kadhim, Abbas; Stewart, Duncan J.; Baker, Andrew L.; Tanner, Nicola; Shenoy, Hrishikesh; Hafiz, Shazia; De Marchi, Joshua A.; Singh-Ranger, Deepak; Hisham, Elzanati; Ainley, Paul; O'Neill John Terrace, Stephen; Napetti, Sara; Hopwood, Benjamin; Rhys, Thomas; Downing, Justine; Kanavati, Osama; Coats, Maria; Aleksandrov, Danail; Kallaway, Charlotte; Yahya, Salama; Weber, Beatrix; Templeton, Alexa; Trotter, Martin; Lo, Christina; Dhillon, Ajit; Heywood, Nick; Aawsaj, Yousif; Hamdan, Alhafidz; Reece-Bolton, Obuobi; Mcguigan, Andrew; Shahin, Yousef; Aymon, ; Alison Luther, Ali; A Nicholson, James; Rajendran, Ilayaraja; Boal, Matthew; Ritchie, Judith. - In: SURGICAL ENDOSCOPY. - ISSN 0930-2794. - 33:1(2019), pp. 110-121. [10.1007/s00464-018-6281-2]
01a Articolo in rivista
File allegati a questo prodotto
File Dimensione Formato  
Griffiths_Utilisation_2019.pdf

accesso aperto

Tipologia: Versione editoriale (versione pubblicata con il layout dell'editore)
Licenza: Creative commons
Dimensione 1.29 MB
Formato Adobe PDF
1.29 MB Adobe PDF

I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.

Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11573/1634714
Citazioni
  • ???jsp.display-item.citation.pmc??? 36
  • Scopus 97
  • ???jsp.display-item.citation.isi??? 90
social impact