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RESEARCH REPORT
2007-2011
Northern Network Colorectal
Surgical Service
Introduction
Located across three University of Adelaide teaching hospitals, the Northern
Network Colorectal Surgical Service is unique in Australia.
In 2000, the surgeons working within the Colorectal Units at the Royal Adelaide Hospital, Lyell
McEwin Hospital and The Queen Elizabeth Hospital formed a collaborative partnership - the
Northern Network Colorectal Surgical Service.
This unique partnership has successfully facilitated the production of high quality, internationally
published research and a multidisciplinary approach to ongoing clinical education and
development.
The core membership is comprised of surgical and research personnel affiliated with SA Health
and The University of Adelaide. However, an inclusive approach to research and training provides
opportunities for medical students and trainees, specialist nursing staff, and research students to
be involved in the activities of the Northern Network Colorectal Surgical Service.
Meeting on a regular basis provides a forum for the discussion of topical and current clinical
concepts and issues, and the development and review of research activities. Members have been
involved in both clinical and laboratory-based research and have been based at the Basil Hetzel
Institute for Medical Research, the Hanson Institute, the Colorectal Surgical Units, and the
University of Adelaide Discipline of Surgery.
2012 Membership
University of Adelaide staff
Nick Rieger, FRACS, MS, Associate Professor
David Rodda, FRACS, Senior Lecturer
Jacqueline Stephens, MPH, Clinical Research Officer
University of Adelaide affiliated staff
Peter Hewett, FRACS, Clinical Professor
Alex Karatassas, FRACS, Clinical Lecturer
Andrew Luck, FRACS, MS, Clinical Senior Lecturer
James Moore, FRACS, MS, Clinical Senior Lecturer
Michelle Thomas, FRACS, PhD, Clinical Senior Lecturer
SA Health members
Andrew Hunter, FRACS
Matthew Lawrence, FRACS
Elizabeth Murphy, FRACS, PhD
Matt Ryan, FRACS
Darren Tonkin, FRACS
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Research Chairperson
The role of the research chairperson is central to the organisation and coordination of the research
meetings of the Northern Network Colorectal Surgical Service. The chairperson, with the
assistance of the research officer, is responsible for the agenda of any research meetings held and
to ensure that the agenda items are both interesting and informative.
Past & Present Chairpersons
 2000-2007: A/Prof Nicholas Rieger
 2008-2009: Mr Matt Lawrence
 2010-2011: Prof Peter Hewett
 2012-2013: Mr James Moore
Current Grants
$50,000 (2011-2012), CSSANZ, The Wait Study, JWE Moore
$229,250 (2005-2007), NHMRC, The ALCCaS Trial, PJ Hewett
Teaching
The Northern Network Colorectal Surgical Service is involved in the training of both medical and
research personnel. Each year the Colorectal Units across the three Northern Network Colorectal
Surgical Service hospitals teach medical students, interns and surgical trainees. Postgraduate
students enrolled in the Master of Surgery or Doctorate of Philosophy have completed their
candidature. Several members of the team are lecturers at the University of Adelaide and
supervise students undertaking research placements as part of the Master of Minimally Invasive
Surgery and the Master of Surgical Science.
Postgraduate Students
PhD Candidates
Sumi Krishnan, PhD candidate, 2007-2011, “The efficacy of local anaesthetic infiltrated at the
incision site for post-operative pain management following abdominal surgery.”
Dr Michelle Thomas, PhD, 2010, “Predictors of response to adjuvant chemotherapy for colorectal
cancer.”
Honours Candidates
Olivia Corso, Honours, 2006, “Pilot study investigating the safety of 96h ropivacaine incision site
infusion for post-operative pain management following right hemicolectomy.”
Future Students
The Northern Network Colorectal Surgical Service provides a unique research setting and a
supportive learning environment. Students who are interested in pursuing a career in surgical and
clinical research are encouraged to contact our team to discuss research opportunities. Further
information can be found at: http://hdr.health.adelaide.edu.au/discipline/11//48
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RESEARCH
The Northern Network Colorectal Surgical Service has a long-standing history of high quality
academic and industry-sponsored research. This is reflected by our history of publishing in
internationally esteemed journals such as the British Journal of Surgery, Lancet and Annals of
Surgery.
Members of the Northern Network Colorectal Surgical Service conduct research in the following
areas:
 Assessments of the safety and efficacy of new and/or emerging surgical and oncological
interventions.
 Investigations into novel treatment options, including new investigational drugs and modifications
to treatment regimens.
 The use of preoperative CT and PET scans for colorectal cancer staging.
 Improvements in postoperative care, including the application of fast track surgery.
 Quality of life improvements for patients with colorectal diseases, such as cancer, haemorrhoidal
disease, anal fissure, and pelvic floor disorders.
Our researchers have a history of successful competitive grant funding from the National Health &
Medical Research Council and the Cancer Council of SA. Funding has also been received from
research foundations, including the Colorectal Surgical Society of Australasia Research
Foundation, Bowel Cancer Trust, and The Hospital Research Foundation. In the past, industry
sponsored research and funding support has also been received from companies such as Covidien
Healthcare, Johnson & Johnson Ethicon, Orphan Australia and Wyeth Consumer Healthcare.
Our research has been presented at leading national and international surgical conferences and
our members have been invited guest speakers on a range of speciality topics, including minimally
invasive surgical techniques, cancer treatment and incontinence issues.
ALaCaRT
Investigators: Peter Hewett, Darren Tonkin, Andrew Luck
Photo: Basil Popowycz, The Queen Elizabeth Hospital
ALaCaRT is a multicentre, Australian phase III randomised clinical trial to compare the use of
laparascopic-assisted resection to open resection for rectal cancer. This study is sponsored and
coordinated by the Sydney-based Australasian Gastro-Intestinal Trials Group, NHMRC Clinical
Trials Centre, and The University of Sydney. The study commenced recruitment in 2011 with the
Queen Elizabeth and Lyell McEwin Hospitals participating as study sites.
Designed as a non-inferiority study, the aim of ALaCaRT is to determine whether laparoscopicassisted resection is as safe and effective as the current standard open rectal cancer resection.
The study will also assess patient recovery and morbidity, disease-free survival and cancer
recurrence rates, and patient quality of life.
ANZCTR No. ACTRN12609000663257
Funding Source:
2011-2013, NHMRC APP1009973, $932,568
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WAIT Study
Investigators: James Moore, Sudarsha (“Sid”) Selva-Nayagam, Scott Carruthers
Co-Investigators: Peter Hewett, Tim Price, Andrew Luck
The WAIT Study is a multicentre, randomised clinical trial that will assess the safety and efficacy of
a modified preoperative chemotherapy regimen for locally advanced rectal cancer. This study has
resulted from a broad collaboration between the NORTHERN NETWORK COLORECTAL
SURGICAL SERVICE surgeons and the oncology staff located across the Lyell McEwin, Royal
Adelaide, and The Queen Elizabeth Hospitals. The objective of the WAIT Study is to assess
whether the administration of additional chemotherapy during the period between preoperative
neoadjuvant chemoradiotherapy and the surgical resection of the rectal cancer results in
oncological benefits. The complete clinical response, complete pathological response and disease
control associated with this
treatment modification are the main
outcomes of the study.
ANZCTR No.
ACTRN12611000339954
Funding Sources:
2011-2012, CSSANZ, $50,000
Parastomal Hernia
Prevention Trial
Investigators:
Andrew Luck
Elizabeth Murphy
When a patient has to undergo the
extensive removal of their lower
rectum, they are often left with a
permanent colostomy.
Photo: Grant Cochrane, freedigitalphotos.net
Patients who have permanent
colostomies live full and active lives, however, there can be complications. The most common longterm complication is the development of hernia at the site of the colostomy, a "parastomal hernia”.
While many of these hernias do not cause any problems, for some patients they can be painful,
unsightly, and can lead to problems including bowel obstruction and maintenance issues; and
these hernias are difficult to treat once they develop.
In 2007, we commenced a randomised clinical trial to assess the safety and efficacy of implanting
prophylactic mesh around the colostomy site in the prevention of parastomal herniae. The study
aims to evaluate the formation of clinically and radiologically apparent parastomal herniae, impact
of operating time and length of hospital stay, and the short-term and long-term complications
associated with the procedure.
Funding Source: None
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REGIONAL RESEARCH
Research is currently being conducting throughout the Northern Network Colorectal Surgical
Service on the following topics:
 An investigation into the role of endoanal ultrasound in management of obstetric anal sphincter
injury. Investigators: Donna Coates (RN), Elizabeth Murphy.
 Peripoperative anaemia management with intravenous iron in abdominal surgery. Investigators:
Elizabeth Murphy, Bernd Froessler (Anaesthetist), Raj Singh (Gastroenterologist).
 Gene expression analysis in pre-cancerous colorectal lesions. Investigators: Elizabeth Murphy,
Andrew Ruszkewicz (Pathologist), Raj Singh and William Tam (Gastroenterologists).
 Sex differences in mechanisms that promote colorectal cancer. Investigators: Elizabeth Murphy,
Jacqui Adams (Oncologist), A/Prof Vicki Clifton (Robinson Institute).
 Long-term Quality of life of anal SCC patients after radiotherapy and/or chemotherapy.
Investigators: Peter Hewett, Jacqueline Stephens, Jonathon Yong (Surgical Trainee).
 Single centre, pilot study, randomised control trial comparing Doppler guided haemorrhoid artery
ligation versus rubber band ligation for 2nd and 3rd degree haemorrhoids presenting with per
rectal bleeding. Investigators: Peter Hewett, Jacqueline Stephens, Maree Weston (Surgical
Trainee).
 The WarmUp Study: Does surgical warm-up improve the performance of laparoscopic surgery?
Investigators: Peter Hewett, Jacqueline Stephens, Maree Weston (Surgical Trainee).
 The prognostic significance of lymph node yield amongst paitents with rectal cancer receiving
long course preoperative radiotherapy. Investigators: Nick Rieger, Jacqueline Stephens, Samson
Tou (MMIS student).
 Awareness of the cost, safety and efficacy of disposable and reusable instruments used in
Minimally Invasive Surgery (MIS) among various categories of surgical staff. Investigators: Peter
Hewett, Jacqueline Stephens, Ravindran Odayappan (MMIS student).
 Clinico-pathological features and adjuvant chemotherapy in Stage II colon cancer. Investigators:
Szelin Peng, Michelle Thomas, Andrew Ruskiewicz (Pathologist), Matthew Lawrence, Andrew
Hunter, James Moore.
 Colorectal stenting for malignant obstruction: an eight year clinical experience. Investigators:
Hanu Chouhan, James Moore, Andrew Hunter.
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PREVIOUS RESEARCH
The ALCCaS Trial
Investigators: Peter Hewett, Nick Rieger, Andrew Luck
In the late 1990s, the short and long term benefits and satisfactory surgical oncological treatment
of colon cancer with laparoscopic-assisted resection was topical. A lack of evidence lead to the
collaboration of a group of Australian and New Zealand surgeons to conduct a multicentre,
prospective, randomised clinical trial to assess the safety and efficacy of this technique. The
Northern Network Colorectal Surgical Service was one of the primary Australian study sites for the
ALCCaS Trial with Professor Peter Hewett, located at The Queen Elizabeth Hospital, taking on the
role of the Australian principal investigator. Ultimately, of the patients recruited into the study, 183
(30.5%) patients were recruited by five surgeons across the Northern Network Colorectal Surgical
Service.
ANZCTR No. ACTRN012605000103662
Funding Sources:
2002-2004, NHMRC ID 207815, $495,000
2005-2007, NHMRC ID 349381, $229,250
1998-2001, Johnson & Johnson Medical, $150,000
Key Publication:
Hewett PJ, Allardyce RA, Bagshaw PF, Frampton CM, Frizelle FA, Rieger NA, Smith SJ, Solomon
MJ, Stephens JH, Stevenson ARL. Short-term outcomes of the Australasian, randomized, clinical
study comparing laparoscopic and conventional open surgical treatments of colon cancer: The
ALCCaS Trial. Ann Surg. 2008 Nov; 248(5):728-38.
VSL#3TM Trial
Investigators: Peter Hewett, Jacqueline Stephens
The standard approach for mid and low rectal cancers is sphincter saving surgery with the resultant
anastomosis protected with a temporary loop ileostomy. However, once this ileostomy is reversed
and bowel continuity restored, many patients experience disordered bowel symptoms, including
diarrhoea and urgency. The purpose of this clinical trial was to assess the efficacy of a probiotic in
improving patient‟s bowel function following ileostomy closure.
Between March 2005 and April 2008, we conducted a prospective, double-blind, placebo-controlled
randomised clinical. From across the Northern Network Colorectal Surgical Service hospitals, 63
patients were enrolled into the study. The patient‟s bowel symptoms and quality of life were
documented throughout the 4-week treatment regimen. This research found that the use of the
TM
probiotic preparation, VSL#3 , did not alter the postoperative bowel function of patients
undergoing loop ileostomy reversal.
ANZCTR No. ACTRN12610000932066
Funding Source:
2005-2008, Orphan Australia, study product
Key Publication:
Stephens JH, Hewett PJ. Clinical Trial Assessing VSL#3 for The Treatment Of Anterior Resection
Syndrome. ANZ J Surg. [accepted]
Page 7 of 16
Predictors of response to adjuvant chemotherapy for colorectal cancer
Investigator: Michelle Thomas
Supervisors: James Moore, Peter Hewett
It is well recognized that not all patients with stage C colorectal cancer (CRC) derive a survival
benefit from adjuvant chemotherapy. It would therefore be advantageous to identify factors that
define a target group for treatment. It has been suggested that those most likely to benefit are
women with proximal tumours. Recent work has suggested microsatellite instability (MSI) may be a
useful marker however the limited studies performed are conflicting.
The aim of this research was to determine if gender, site, tumour histology or microsatellite (MSI)
status predict survival benefit from 5FU-based adjuvant chemotherapy in stage C CRC. Data was
collated on stage C colorectal cancer cases that underwent curative resection over a 20-year
period (inclusive of years prior to standard chemotherapy). Pathology was re-evaluated, DNA
extracted from the formalin fixed paraffin specimen and MSI status established. Primary endpoint
was cancer-related death. Kaplan-Meier curves were constructed for univariate analysis and
differences analysed by log rank test. Multivariate analysis was performed using Cox proportional
hazard model adjusting for age, gender, site, distinct pathological variables and MSI. A
compounding effect between these factors and chemotherapy benefit was measured by interaction
testing.
A total of 811 unselected cases were included in the study. Thirty-seven percent received
chemotherapy. Chemotherapy significant improved cancer-specific survival (HR of dying 0.66 (95%
CI 0.52-0.83 p=0.0003). Female gender offered a survival advantage overall (HR 0.81 95% CI
0.68-0.97; p=0.02) however site did not influence outcome (HR 1.03). On interaction testing,
gender, site and tumour histology did not significantly influence the survival effect of chemotherapy.
802 cases were included in the MSI analysis of which 77 exhibited MSI. MSI status did not
influence prognosis (HR of cancer death 1.45, 95% CI 0.90-2.21; p= 0.13). However, in the nonchemotherapy cohort, MSI conferred a significantly less favourable outcome (HR 1.89, 95%CI
1.13-3.16; p= 0.02). Chemotherapy produced a survival benefit in both the MSI (HR 0.08 95% CI
0.02-0.27; p=<0.0001) and the microsatellite stable (MSS) cohort (HR 0.62, 95% CI 0.47-0.81;
p=0.001). On interaction testing, neither compounded the benefit of chemotherapy, however of all
the tested parameters, MSI came closest to significance (p=0.08).
The results of this research suggest that 5FU-based adjuvant chemotherapy for stage C colorectal
cannot be targeted using gender, tumour site, histological characteristics or MSI.
Funding Sources:
2003-2005, Faculty of Health Sciences Divisional scholarship
2003-2005, University of Adelaide Department of Surgery Scholarship
Page 8 of 16
The Efficacy of Local Anaesthetic Infiltrated at the Incision Site for PostOperative Pain Management Following Abdominal Surgery
Investigator: Sumithra Krishnan
Supervisors: Peter Hewett, Ray Morris, Alex Karatassas
The application of continuous local anaesthetic infiltration for patients undergoing laparoscopic
colorectal surgery had not been previously examined. In 2007, a prospective, randomised, doubleblind, placebo-controlled clinical trial was commenced to investigate the safety and efficacy of the
use of a commercial infiltration device in patients undergoing either open or laparoscopic colorectal
surgery.
Eligible patients, who consented to participate, were
randomised (2:1) to receive a continuous infiltration
of either levobupivacaine or placebo (saline) for the
first 96-hours post-operation. At the end of surgery
an ON-Q® PainBuster with a SilverSoakerTM
catheter was inserted in the pre-peritoneal layer. All
patients had opioids available via patient-controlledanalgesia for break-through pain. The primary
outcome measured was total opioid consumption.
Secondary outcomes included pain scores, 30-day
morbidity and mortality, time to bowel movement,
mobilisation and length of hospitalisation.
A total of 81 patients were recruited: 55 in the
levobupivacaine group (31 laparoscopic, 24 open)
and 26 in the placebo group (20 laparoscopic, 6
open). This study found that there was no difference
in opioid consumption or pain scores between the
levobupivacaine and placebo groups for laparoscopic
surgery. However, in patients having open surgery,
the levobupivacaine treatment showed a trend
towards reduced total opioid consumption. There
was no difference in time to bowel function,
mobilisation, and hospitalisation between both
groups. Therefore, the authors concluded that
continuous local anaesthetic infiltration may be more
beneficial in open surgery.
ANZCTR No. ACTRN12607000439448
Funding Sources:
2008-2010, Adelaide University Divisional
Scholarship, $21,000pa
Photo: Sura Nualpradid, freedigitalphotos.net
2008-2010, Iflow Corp (USA) and Surgical Specialities (Aust), study product
2011, University of Adelaide Student Travel Grant, $3,000
Page 9 of 16
RECENT PUBLICATIONS
Accepted, yet to be published
Hanu Chouhan, Moore J, Hunter A. Colorectal stenting for malignant obstruction: an eight year
clinical experience. [accepted]
Hewett PJ. Does Laparoscopic Colectomy Have a Higher Intraoperative Complication Rate Than
Open Colectomy? Ann Surg. 2010 Jan [Epub ahead of print]
Rieger N. Single incision laparoscopic (SIL) assisted colectomy. In: Solomon MJ, O„Connell R,
th
Madoff R (Eds). Operative Surgery of the Colon, Rectum and Anus. 6 edition. Hodder Arnold;
2012. [in press]
Stephens JH, Hewett PJ. Clinical trial assessing VSL#3 for the treatment of Anterior Resection
Syndrome. ANZ J Surg. [accepted]
2011
Allardyce RA, Bagshaw PF, Frampton CM, Frizelle FA, Hewett PJ, Rieger NA, Smith JS, Solomon
MJ, Stevenson AR; Australasian Laparoscopic Colon Cancer Study Group. Ethical issues with the
disclosure of surgical trial short-term data. ANZ J Surg. 2011 Mar;81(3):125-131.
Field K, Platell C, Rieger N, Skinner I, Wattchow D, Jones I, Chen F, Kosmider S, Wohlers T,
Hibbert M, Gibbs P. Lymph node yield following colorectal cancer surgery. ANZ J Surg. 2011
Apr;81(4):266-271
Hewett P, Lu CT. Bowel Cancer. In: Wichmann MW, Borgstrom DC, Caron NR, Maddern G. (Eds).
st
Rural Surgery: Challenges and solutions for the rural surgeon. 1 Ed. London: Springer; 2011:245250.
Hewett P. Rectal Cancer. In: Wichmann MW, Borgstrom DC, Caron NR, Maddern G. (Eds). Rural
st
Surgery: Challenges and solutions for the rural surgeon. 1 Ed. London: Springer; 2011:251-254.
Rieger N. Stoma Surgery. In: Wichmann MW, Borgstrom DC, Caron NR, Maddern G. (Eds). Rural
st
Surgery: Challenges and solutions for the rural surgeon. 1 Ed. London: Springer; 2011:255-258.
Norwood MG, Stephens JH, Hewett PJ. The nursing and financial implications of laparoscopic
colorectal surgery: data from a randomized controlled trial. Colorectal Dis. 2011 Nov;13(11):13031307.
2010
Allardyce RA, Bagshaw PF, Frampton CM, Frizelle FA, Hewett PJ, Rieger NA, Smith JS, Solomon
MJ, Stevenson AR; Australasian Laparoscopic Colon Cancer Study Group. Australasian
Laparoscopic Colon Cancer Study shows that elderly patients may benefit from lower
postoperative complication rates following laparoscopic versus open resection. Br J Surg. 2010
Jan;97(1):86-91.
Lu CT, Stephens JH, Rieger NA. Factors Influencing Medical Oncology Referral in Dukes‟ C
Colonic Cancer. Asia Pac J Clin Onc. 2010 Sep;6(3):191-6.
Hyman N, Moore J, Cataldo P, Osler T. The high yield of 1-year colonoscopy after resection: is it
the handoff? Surg Endosc. 2010 Mar;24(3):648-652.
Liren L, Fang Y, Pan ZZ, Wu XJ, Wan DS, Hardingham JE, Rieger N. Length of lymphangiogensis
in the rectal tissues distal to rectal cancer. Tumour Biol. 2010 Dec;31(6):667-671.
Page 10 of 16
Olakkengil SA, Norwood MG, Strickland AD, Behnia-Willison F, Mohan Rao M, Hewett PJ.
Perspectives of laparoscopic donors toward a new procedure: transvaginal donor nephrectomy. J
Laparoendosc Adv Surg Tech A. 2010 Dec;20(10):803-806.
Rieger NA, Lam FF. Single-incision laparoscopically assisted colectomy using standard
laparoscopic instrumentation. Surg Endosc. 2010 Apr;24(4):888-890.
Stephens JH, Rieger NA, Farmer KC, Bell SW, Hooper JE, Hewett PJ. Implantation of ethylene
vinyl alcohol copolymer for faecal incontinence management ANZ J Surg. 2010 May;80(5):324330.
Strickland AD, Norwood MG, Behnia-Willison F, Olakkengil SA, Hewett PJ. Transvaginal natural
orifice translumenal endoscopic surgery (NOTES): a survey of women's views on a new technique.
Surg Endosc. 2010 Oct;24(10):2424-31.
2009
Ananda SS, Mc Laughlin SJ, Chen F, Hayes IP, Hunter AA, Skinner IJ, Steel MC, Jones IT, Hastie
IA, Rieger NA, Shedda S, Compston DJ, Gibbs P. Initial impact of Australia‟s national bowel cancer
screening program. Med J Aust 2009 Oct;191(7):378-381.
Caruso M, Moore J, Goodall GJ, Thomas M, Phillis S, Tyskin A, Cheetham G, Lerda N, Takahashi
H, Ruszkiewicz A. Over-expression of cathepsin E and trefoil factor 1 in sessile serrated adenomas
of the colorectum identified by gene expression analysis. Virchows Arch. 2009 Mar;454(3):291302.
Ciccocioppo A, Stephens JH, Hewett PJ, Rieger NA. Complete pathologic response after
preoperative rectal cancer chemoradiotherapy. ANZ J Surg. 2009 Jun;79(6):481-484.
2008
Allardyce RA, Bagshaw PF, Frampton CM, Frizelle FA, Hewett PJ, Rieger NA, Smith S, Solomon
MJ, Stevenson ARL. The Australian Laparoscopic Colon Cancer Study. ANZ J Surg. 2008
Oct;78(10):832-833.
Allardyce RA, Bagshaw PF, Frampton CM, Frizelle FA, Hewett PJ, Rieger NA, Smith S, Solomon
MJ, Stevenson ARL. Australian and New Zealand study comparing laparoscopic and open
surgeries for colon cancer in adults: organization and conduct. ANZ J Surg. 2008 Oct;78(10):840847.
Hewett PJ, Allardyce RA, Bagshaw PF, Frampton CM, Frizelle FA, Rieger NA, Smith S, Solomon
MJ, Stephens JH, Stevenson ARL. Short-term outcomes of the Australasian randomized clinical
study comparing laparoscopic and conventional open surgical treatments for colon cancer: the
ALCCaS trial. Ann Surg. 2008 Nov;248(5);728-738.
Kawakami K, Ooyama A, Ruszkiewicz A, Jin M, Watanabe G, Moore J, Oka T, Iacopetta B,
Minamoto T. Low expression of gamma-glutamyl hydrolase mRNA in primary colorectal cancer
with the CpG island methylator phenotype. Br J Cancer. 2008 May;98(9):1555-1561.
Kosmider S, Jones IT, Hibbert M, Johns J, McLaughlin S, Hunter A, Chapman M, Gibbs P.
Establishing a national colorectal cancer database: lessons learnt from Bio21-MMIM. ANZ J Surg.
2008 Sep;78(9):803–809.
Page 11 of 16
Price T, Pittman K, Patterson W, Colbeck M, Rieger N, Hewett P, Rodda D, Townsend A, Maddern
G, Luke C, Roder D. Management and survival trends in advanced colorectal cancer. Clin Oncol (R
Coll Radiol). 2008 Oct;20(8):626-630.
Rieger NA. How to treat: Faecal Incontinence. Australian Doctor. Feb 2008
Roberts-Thomson IC, Tucker GR, Hewett PJ, Cheung P, Sebben RA, Khoo EE, Marker JD,
Clapton WK. Single-center study comparing computed tomography colonography with conventional
colonoscopy. World J Gastroenterol. 2008 Jan 21;14(3):469-473.
Stephens JH, Moore JW. Can targeted intervention in CRC patients' relatives influence screening
behaviour? A pilot study. Colorectal Dis. 2008 Feb;10(2):179-186.
Sturm LP, Windsor JA, Cosman PH, Cregan P, Hewett PJ, Maddern GJ. A systematic review of
skills transfer after surgical simulation training. Ann Surg. 2008 Aug;248(2):166-179.
Tan PY, Stephens JH, Rieger NA, Hewett PJ. Laparoscopically assisted colectomy; a study of risk
factors and predictors of open conversion. Surg Endosc. 2008 Jul;22(7):1708-1714.
Wattchow D, Brookes S, Murphy E, DeFontgallard D, Costa M. Regional Variation in the
Innervation of the Human Colon and Changes in Patients with Slow Transit Constipation.
Neurogastroenterol Motil. 2008 Dec;20(12):1298-1305.
Yano H, Moran BJ, Cecil TD, Murphy EM. Cytoreductive Surgery and Intraperitoneal
Chemotherapy for Peritoneal Mesothelioma. Eur J Surg Oncol. 2009 Sep;35(9):980-985.
2007
Corso OH, Morris RG, Hewett PJ, Karatassas A. Safety of 96-hour incision-site continuous infusion
of ropivacaine for postoperative analgesia after bowel cancer resection. Ther Drug Monit. 2007
Feb;29(1):57-63.
Iacopetta B, Grieu F, Phillips M, Ruszkiewicz A, Moore J, Minamoto T, Kawakami K. Methylation
levels of LINE-1 repeats and CpG island loci are inversely related in normal colonic mucosa.
Cancer Sci. 2007 Sep;98(9):1454-1460.
Kichenadasse G, Zakaria J, Rodda DJ, Hewett PJ, Rieger NA, Stephens JH, Pittman K, Patterson
K, Borg M, Price TJ. Squamous cell carcinoma of the anal canal at The Queen Elizabeth Hospital:
A local experience. Asia Pac J Clin Onc. 2007 Dec;3(4):214-218.
Kumar A, Hewett PJ. Fast-track or laparoscopic colorectal surgery? ANZ J Surg. 2007
Jul;77(7):517-518.
Lee JS, Rieger NA, Stephens JH, Hewett PJ, Rodda DJ, Lawrence MJ. Six-year prospective
analysis of the rectal bleeding clinic at the Queen Elizabeth Hospital, Adelaide, South Australia.
ANZ J Surg. 2007 Jul;77(7):553-556.
Murphy EM, Sexton R, Moran BJ. Early Results of Surgery in 123 Patients with Pseudomyxoma
Peritonei From a Perforated Appendiceal Neoplasm. Dis Colon Rectum. 2007 Jan;50(1):37-42.
Murphy EMA, DeFontgalland D, Wattchow DA, Brookes SJH, Costa M. Quantification of
Subclasses of Human Colonic Myenteric Neurones by Immunoreactivity to Hu, Choline
Acetyltransferase and Nitric Oxide Synthase. Neurogastroenterol Motil. 2007 Feb;19(2):126-134.
Page 12 of 16
Rieger NA, Barnett FS, Moore JW, Ananda SS, Croxford M, Johns J, Gibbs P. Quality of pathology
reporting impacts on lymph node yield in colon cancer. J Clin Oncol. 2007 Feb;25(4):463-464.
Watt AM, Faragher IG, Griffin TT, Rieger NA, Maddern GJ. Self-expanding metallic stents for
relieving malignant colorectal obstruction: a systematic review. Ann Surg. 2007 Jul;246(1):24-30.
Page 13 of 16
Further information:
Northern Network Colorectal Surgical Service
Level 6, Main Building, The Queen Elizabeth Hospital
28 Woodville Road, Woodville South SA 5011
Postal Address
Northern Network Colorectal Surgical Service
Discipline of Surgery, The University of Adelaide
The Queen Elizabeth Hospital
28 Woodville Road, Woodville South SA 5011
Telephone: (08) 82228482 | Facsimile: (08) 82226028
Web: health.adelaide.edu.au/surgery/nncss/
Disclaimer: The information contained within this booklet is correct at the time of printing, November 2011.