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ACPGBI Conference Review

This ACPGBI Conference is an annual event that runs over three days for specialists in the field of coloproctology and includes surgeons, gastroenterologists, oncologists, pathologists and nurses.  Although it covers a variety of bowel diseases, bowel cancer and its treatment are heavily featured in the programme. Here are some highlights from this year’s meeting in Bournemouth in July 2017:

Association of Coloproctology Nurses Symposium

 

After a welcome by the outgoing president of the association the day started with the Edward Salts lecture, which this year was given by Sarah Beck, genetic counsellor who gave a hugely informative lecture on genetics and hereditary bowel cancer.  Her talk covered autosomal dominant and autosomal recessive gene traits and the associated bowel conditions i.e. FAP, Lynch Syndrome.

 

One of the visiting speakers, Henriette Vind Thaysen, a CNS from Denmark gave a fascinating lecture on the use of animated films in providing patient information prior to rectal cancer surgery.  The short films, similar in style to those used in safety presentations on board aircraft, demonstrated how animated film can convey information more effectively than written information.

 

Karen Curran, senior specialist nurse, pelvic floor nursing team at Oxford, presented her experience of developing a nurse-led sacral nerve stimulation (SNS) service for patients. Her talk highlighted the importance of a team approach, organisational commitment and support and demonstrated the positive impact such a service can have on the quality of life for patients with bowel control problems.

 

Maria Pettman, colorectal nurse consultant discussed the role of the nurse endoscopist and polypectomy. Her talk covered the issue of the relatively low rate of polyp removal by nurse endoscopists despite a comparable polyp detection rate with their medical colleagues.

 

Possible explanations for this included less opportunity to practice removing polyps on dedicated training lists and lack of confidence in removing polyps preferring to leave this to a medical endoscopist.

 

The final session of the nurses’ day was a presentation by Ashok Handa, consultant vascular surgeon and Lucy Fulford-Smith, clinical fellow, on values-based medicine and the impact of the Montgomery ruling on patient consent.

 

http://www.medicalprotection.org/uk/for-members/news/news/2015/03/20/new-judgment-on-patient-consent

 

This informative session covered the importance of incorporating values-based medicine with evidence-based medicine in clinical decision making. This concept was clearly highlighted in the Montgomery ruling

 

https://bmcmedicine.biomedcentral.com/articles/10.1186/1741-7015-11-40

 

Interesting presentations from the rest of the conference included:

 

A presentation from Mr Brendan Moran, colorectal surgeon, Basingstoke Hospital on Significant Polyps and Early Colorectal Cancers (SPECC).  The presentation covered how, particularly with the implementation of bowel cancer screening, more patients are being diagnosed with significant polyps or very early cancers. The problem of over-treatment versus under-treatment was discussed. The Pelican Centre has run a series of SPECC courses across the country, bringing together MDTs to discuss the important issue of how to manage this group of patients.  Further information on this can be found here: http://www.pelicancancer.org/specc

 

A medico-legal symposium provided a fascinating insight in how doctors get into trouble.  Although focused on medical staff, the potential pitfalls which can lead a healthcare professional to run into trouble were the same for all disciplines.

 

The symposium covered topics such as Who gets into trouble? This particularly focused on personality type and lack of insight as key features of those who end up facing disciplinary action.  A presentation by a solicitor for the Medical Defence Union highlighted how important it is to seek legal representation early and to ensure you have qualified advice before responding to an accusation. ‘Always tell the truth’ was the resounding message.

 

Presentations of colorectal cancer papers covered such topics as:

  • Decision making for malignant polyps
  • Earlier age of presentation of colorectal cancer
  • Health-related quality of life and functional outcomes following curative treatments for rectal cancer
  • Chemoradiation and local excision of T2N0 tumours offers equivalent overall survival compared to standard resection
  • Outcomes following salvage surgery for local re-growth in ‘watch & wait’ patients following complete clinical response to chemoradiation.

 

These papers can be found in the July edition of the Journal of Colorectal Disease – Conference Supplement.

 

https://acpgbiconferences.org.uk/programme/tuesday/

 

 

An entertaining and innovative approach was taken by Nicola Fernhead, consultant colorectal surgeon and president in waiting of the ACPGBI, to present an update on current and breaking trials in colorectal research.  Further information can be found here https://www.acpgbi.org.uk/research/

 

 

A plenary session entitled ‘Supporting Staff Wellbeing and Resilience with Schwartz Rounds  – The Patient I will Never Forget – saw 4 panel members present their individual experiences of an interaction with a patient that has stayed within their memory. The session, facilitated by Alison Proudfoot (Point of Care Foundation) and Sean Elyan, consultant clinical oncologist, explored the issues raised in each of the situations. Questions and comments from the floor highlighted how the themes raised were experienced by many people in the room. For further information on the Point of Care Foundation can be seen here:  www.pointofcarefoundation.org.uk

 

For further information on the history and mission of the Schwartz centre see here:  http://www.theschwartzcenter.org/about-us/story-mission/

 

 

The advanced and complex cancer symposium covered the following:

 

  • Should the bowel primary be resected in patients with unresectable metastatic disease
  • Managing peritoneal disease – the role of cytoreductive surgery and HIPEC
  • Surgery for recurrent disease – the role of the complex cancer clinic
  • A presentation of the launch of IMPACT – Improving the Management of Patients with Advanced Colorectal Tumours. This ACPGBI initiative led by Nicola Fernhead aims to identify key issues in the care and management of patients with advanced colorectal tumours such as diagnosis, patient interaction and use of appropriate language, the role of advanced and complex cancer clinics and onward referral / 2nd opinion, the role of palliative care.   For further information on this initiative see here:

 

http://www.acpgbi.org.uk/content/uploads/2017/02/ACPGBI-Advanced-Malignancy-Initiative-15-May-2017-v4.pdf