J. N. L. Simson

Learn More
BACKGROUND The outcome of local excision of early rectal cancer using transanal endoscopic microsurgery (TEM) lacks consensus. Screening has substantially increased the early diagnosis of tumours. Patients need local treatments that are oncologically equivalent to radical surgery but safer and functionally superior. METHODS A national database, collated(More)
BACKGROUND The aim of this study was to determine the postoperative complications of Transanal Endoscopic Microsurgery (TEMS) excision of rectal lesions. METHOD A prospective audit of 262 consecutive TEMS procedures performed by a single surgeon between 1999 and 2008. RESULTS The mean age of patients was 72 years. The mean area of the lesions excised(More)
INTRODUCTION During Transanal Endoscopic Microsurgical (TEMS) full-thickness excision of a rectal lesion above the peritoneal reflection, entrance to the peritoneal cavity is inevitable. This has been regarded as a complication that requires conversion to an open procedure. We describe our experience of full thickness intraperitoneal excision of rectal(More)
OBJECTIVE Transanal endoscopic microsurgery (TEM) is a minimally invasive technique for excision of selected benign and malignant rectal neoplasms. It is considered a safe and effective treatment but recurrence rates of 1-13% are reported for benign lesions. The aim of this study was to assess risk factors for local recurrence of benign rectal lesions and(More)
OBJECTIVE To assess the outcomes of transanal endoscopic microsurgery in small (<3 cm), large (3-5 cm), and giant (>5 cm) lesions and compare these with reports of alternative techniques. DESIGN Data from January 1998 to February 2010 were prospectively collected. Lesions were divided into 3 groups according to the maximum diameter (group A, <3 cm;(More)
Solitary abscess of the spleen is a potentially lethal condition. It is difficult to diagnose but relatively easy to treat, resulting in cure of the majority of the patients. A case is described to illustrate the important factors in aetiology, presentation, diagnosis and treatment. All cases reported since 1960 are reviewed: the mortality of untreated(More)
OBJECTIVE To define the relative risk of malignant transformation in colorectal adenomas less than 10 mm in diameter. DESIGN Prospective study. SETTING District general hospital, UK. SUBJECTS AND MATERIALS 1228 polyps detected endoscopically in 445 patients over the 10-year period 1989-1999. MAIN OUTCOME MEASURES Site, size, histological type and(More)
OBJECTIVE Transanal endoscopic microsurgery (TEM) is a safe and effective treatment for the excision of benign rectal adenomas. In recent years it has been used for the excision of malignant lesions, although its use in this context remains controversial. The aim of this study was to investigate the local recurrence of rectal cancers following local(More)
Stripped, proximal bullfrog duodenum was mounted in an Ussing chamber between HCO3--buffered nutrient (serosal) and unbuffered secretory (luminal) solutions. This preparation showed stable electrical parameters and caused alkalinization of the secretory solution at a rate of 0.95 +/- 0.03 mueq.cm-2.h-1 (mean +/- SE; n = 100). Anoxia and 2,4-dinitrophenol(More)