Roel Hompes
University of Oxford
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Publication
Featured researches published by Roel Hompes.
Annals of Surgery | 2017
Marta Penna; Roel Hompes; Steve Arnold; Greg Wynn; Ralph Austin; Janindra Warusavitarne; Brendan Moran; George B. Hanna; Neil Mortensen; Paris P. Tekkis
Objective: This study aims to report short-term clinical and oncological outcomes from the international transanal Total Mesorectal Excision (taTME) registry for benign and malignant rectal pathology. Background: TaTME is the latest minimally invasive transanal technique pioneered to facilitate difficult pelvic dissections. Outcomes have been published from small cohorts, but larger series can further assess the safety and efficacy of taTME in the wider surgical population. Methods: Data were analyzed from 66 registered units in 23 countries. The primary endpoint was “good-quality TME surgery.” Secondary endpoints were short-term adverse events. Univariate and multivariate regression analyses were used to identify independent predictors of poor specimen outcome. Results: A total of 720 consecutively registered cases were analyzed comprising 634 patients with rectal cancer and 86 with benign pathology. Approximately, 67% were males with mean BMI 26.5 kg/m2. Abdominal or perineal conversion was 6.3% and 2.8%, respectively. Intact TME specimens were achieved in 85%, with minor defects in 11% and major defects in 4%. R1 resection rate was 2.7%. Postoperative mortality and morbidity were 0.5% and 32.6% respectively. Risk factors for poor specimen outcome (suboptimal TME specimen, perforation, and/or R1 resection) on multivariate analysis were positive CRM on staging MRI, low rectal tumor <2 cm from anorectal junction, and laparoscopic transabdominal posterior dissection to <4 cm from anal verge. Conclusions: TaTME appears to be an oncologically safe and effective technique for distal mesorectal dissection with acceptable short-term patient outcomes and good specimen quality. Ongoing structured training and the upcoming randomized controlled trials are needed to assess the technique further.
Colorectal Disease | 2012
S Q Ashraf; Roel Hompes; A. Slater; I. Lindsey; Simon Bach; Neil Mortensen; Chris Cunningham
Aim Transanal endoscopic microsurgery (TEM) for early rectal cancer (ERC) gives results similar to major surgery in selected cases. Endorectal ultrasound (ERUS) is an important part of the preoperative selection process. This study reports its accuracy and impact for patients entered on the UK TEM database.
Colorectal Disease | 2016
Constantinos Simillis; Roel Hompes; Marta Penna; Shahnawaz Rasheed; Paris P. Tekkis
The surgical technique used for transanal total mesorectal excision (TaTME) was reviewed including the oncological quality of resection and the peri‐operative outcome.
British Journal of Surgery | 2014
Roel Hompes; S M Rauh; Frédéric Ris; J B Tuynman; N J Mortensen
Robotic transanal minimally invasive surgery (TAMIS) may be an option for rectum‐preserving excision of neoplasms. Recent cadaveric studies showed improved vision, control and manoeuvrability compared with use of laparoscopic instruments. This study reports the clinical application.
Colorectal Disease | 2016
R. W. Motson; Mark H. Whiteford; Roel Hompes; M. Albert; William Fa Miles
This article documents the consensus of an expert group of surgeons from the Second International Trans‐anal Total Mesorectal Excision (TaTME) Conference held in Paris in July 2014. It outlines three facets of the TaTME procedure: (i) the technique and its indications, (ii) training and adoption, and (iii) data collection and the TaTME registry.
Colorectal Disease | 2013
Roel Hompes; R. McDonald; C. Buskens; I. Lindsey; N. C. Armitage; Jonathan Hill; A. Scott; Neil Mortensen; C. Cunningham
Patients with unfavourable pathology after transanal endoscopic microsurgery (TEM) should be offered completion surgery (CS) if appropriate. The aim of this retrospective cohort study was to assess the short‐term outcome and long‐term oncological results of CS and identify factors compromising the quality of resection specimens.
Techniques in Coloproctology | 2016
Marta Penna; Roel Hompes; Hugh Mackenzie; F. Carter; N. K. Francis
The interest and adoption of transanal total mesorectal excision (taTME) is growing rapidly worldwide. This new technique has arisen thanks to advances in minimally invasive surgery and transanal approaches. The ultimate goal of the procedure is to improve clinical, oncological and functional outcomes of rectal excision by obtaining a meticulous TME resection in cancer cases, whilst avoiding injury to surrounding pelvic structures. Transanal TME is a complex procedure and demands excellent, prerequisite surgical skills in order to complete the operation in a safe and efficient manner. The ‘‘bottom-up’’ approach also reveals a completely new viewpoint of the pelvic anatomy for most surgeons. The combination of complexity and unfamiliarity has triggered the occurrence of adverse events, such as urethral injuries [1, 2], which were rarely encountered previously in conventional laparoscopic or open resections. Uptake of a new operation is also associated with a proficiency-gain curve during which there is increased morbidity and mortality [3]. These adverse outcomes during the introduction and dissemination of taTME must be honestly reported, properly analysed and addressed accordingly. Only then can we avoid a ‘‘dip’’ in the adoption curve we saw early on in the laparoscopic experience due to port site metastasis.
Colorectal Disease | 2015
Gary Nicholson; Joep Knol; B. Houben; C. Cunningham; Shazad Ashraf; Roel Hompes
The new approach of transanal total mesorectal excision is technically challenging and demands a stable field of dissection with optimal view of anatomical landmarks. We aimed to describe and demonstrate a modification of both the insufflation of carbon dioxide and smoke evacuation, in order to optimize dissection.
Colorectal Disease | 2011
J. Ragg; R. McDonald; Roel Hompes; O. M. Jones; C. Cunningham; Ian Lindsey
Aim Chronic constipation is classified as outlet obstruction, colonic inertia or both. We aimed to determine the incidence of isolated colonic inertia in chronic constipation and to study symptom pattern in those with prolonged colonic transit time.
Techniques in Coloproctology | 2016
Marta Penna; J. J. Knol; Jurriaan B. Tuynman; Paris P. Tekkis; Neil Mortensen; Roel Hompes
Abstract Transanal total mesorectal excision (TaTME) is a novel approach pioneered to tackle the challenges posed by difficult pelvic dissections in rectal cancer and the restrictions in angulation of currently available laparoscopic staplers. To date, four techniques can be employed in order to create the colorectal/coloanal anastomosis following TaTME. We present a technical note describing these techniques and discuss the risks and benefits of each.