Incorporation of routine biofeedback into the management of patients with rectal cancer who are undergoing anterior resection offers potential for improved anal continence compared with standard management. A multicentre randomised controlled trial was performed to investigate t…
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Title: A study of some of the psychological issues affecting women undergoing treatment for urinary incontinence. Background: There is evidence suggesting that effective clinical treatment of urinary incontinence (UI) is not reflected in patients’ quality of life reports or in p…
Minimally invasive surgery (MIS) is fast becoming a preferred choice for patients and surgeons, due to its biological, aesthetic and commercial benefits. The dynamic hip screw (DHS) is the standard implant for the treatment of fractures of the proximal femur, which is considered…
Demand for Total Knee Replacement (TKR) surgery is high and rising; not just in numbers of procedures, but in the diversity of patient demographics and increase of expectations. Accordingly, greater efforts are being invested into the pre-clinical analysis of TKR designs, to imp…
Metal-on-metal (MoM) hip joint replacements have been increasingly used for younger and more active patients in recent years due to their improved wear performance compared to conventional metal-on-polymer bearings. MoM bearings operate at body temperature within a corrosive joi…
The subject matter for this research work is the area of perioperative recovery for patients undergoing major abdominal surgery. During clinical studies we have investigated some of the factors influencing postoperative recovery as well as suggesting strategies to improve patien…
Hernia surgery remains one of the most common operations carried out by general surgeons worldwide with more than 800,000 repairs performed in the USA alone in 2003. Advancement in surgical technique has meant fewer recurrences are now encountered with figures dropping to less t…
Colorectal cancer remains the second commonest cause of cancer death in Western Europe and North America. Each year in the UK, there are approximately 35,000 new cases and 16,000 deaths attributable to the disease. Despite a trend towards earlier presentation and improvements in…
Introduction Squamous cell carcinoma of the auricle has an unusually high rate of lymph node metastases when compared to similar tumours at other sites. The lymph nodes affected are close to the base of the skull and in the neck. Development of metastasis carries a poor prognosi…
Pancreatic cancer is a devastating disease with a five year survival of only 2-3%. Only 10-15% of patients have resectable disease at presentation and the only potential cure is major surgery with adjuvant chemotherapy. The outcomes of surgery are disappointing with a median sur…
Aims: This thesis has three main aims: • To investigate the potential role of human bone marrow stromal cells (HBMSC) in Impaction Bone Grafting (IBG). • To investigate the potential role of a synthetic graft, Poly (DL-lactic acid), (PDLLA) as a tissue engineering scaffold and a…
This thesis evaluates and explores the effectiveness of post discharge physiotherapy exercise following total knee arthroplasty (TKA) for osteoarthritis in three ways. 1. A systematic review evaluated the effectiveness of post discharge physiotherapy exercise on function, walkin…
Changes in oxygen levels, due to the environment or disease initiates a plethora of acute and chronic responses in the body to enable optimal physiological adaptation to overcome impaired oxygen delivery. Homeostatic regulation mechanisms in the cardiovascular and respiratory sy…
Increased arterial stiffness is associated with ageing, cardiovascular disease diabetes and renal failure. The aims of this thesis were to investigate the reproducibility of a tissue Doppler imaging (TDI) based ultrasound system to calculate indices of arterial stiffness, and to…
This thesis defines mortality in acromegaly in a modern patient cohort, elucidates underlying explanations for the increased mortality and explores the impact of treatment, focussing on somatostatin analogue therapy. Results confirm there remains a 30% increase in mortality in p…