11 November 2022

15 November 2022 (Last updated 15 Nov 2022)

The first face-to-face North Wales Chapter meeting since the relaxation of Covid restrictions took place on Friday afternoon, 11^th November, at the fantastic Venue Cymru, overlooking the pebbly beach of Llandudno.

The truly multidisciplinary attendance of over 60 people, consisting of surgeons, trainees, specialist nurses, physiotherapists, dieticians, occupational therapists, radiologists, pathologists, and oncologists were treated to a ‘tour de force’ of exceptional talks. We were honoured to be joined by The ACPGBI President, Mr Charles Maxwell-Armstrong, who co-chaired the session. Mr Mike Thornton introduced the event and highlighted some of the aims and benefits of being a member of ACPGBI, as there were many potential new members in the audience. The upcoming ACC in March 2023 and ACPGBI annual meeting in July 2023 were promoted.

The theme for the meeting was ‘Improving outcomes from colorectal cancer in North Wales, chosen because Wales is in the unenviable position of having some of the worst cancer outcomes in Europe. The topics for the presentations were chosen to reflect the need for a multidisciplinary approach to tackling this problem. The programme attracted 3 CPD points.

Mr Doug Speake, Consultant at Western General Hospital in Edinburgh, delivered an inspirational talk, including operative videos, of his experience with robotic-assisted precision surgery for colorectal cancer using the Versius platform, by CMR. Versius has recently been introduced to our health board as part of an All-Wales Robotic-Assisted Surgery partnership between NHS Wales and CMR. Mr Michael Davies, Consultant from Cardiff, joined the meeting remotely via Teams and spoke about the evidence base for FIT and the latest national symptomatic FIT guidelines. It is hoped the adoption of these guidelines in primary care will improve detection of colorectal cancer and ensure optimal utilisation of resources. Rachael Barlow, clinical lead for prehabilitation in CVUHB gave a fascinating insight into the potential gains from a multifaceted prehabilitation programme, something we would love to replicate in North Wales. A take-away phrase from this talk was, “Stage the patient, not just the cancer”. Dr Madhuchanda Chatterjee, Consultant Oncologist within our health board, spoke on some exciting opportunities for achieving excellent clinical response to selected patients with dMMR tumours based on recent studies using immunotherapy. This will potentially challenge decision making in the MDT in the future and we all need to be aware of how to recruit our patients to trials utilising this therapy.

After a break for coffee, the audience were treated to further impressive talks. Mr Paul Sutton, Consultant at The Christie, challenged our prejudices by demonstrating what extended pelvic resection can offer patients with advanced disease, both impressing and terrifying us in equal measure with some of his intraoperative pictures! Mr Rob Jones from the Royal Liverpool Hospital followed, discussing the survival advantages to be gained by patients who undergo interventions for liver metastases, emphasizing that significant and meaningful benefits, including quality of life and survival, can be achieved in selected patients. Patients from North Wales are referred to both these tertiary centres for care of advanced disease and these talks will comfort those of us in the MDT who are considering patients for referral. Mr Chris Battersby, Consultant in Wrexham, highlighted some of the potential pitfalls of missed pathology given the popularisation of managing appendicitis non-operatively, wrapped up the afternoon.

Attendees were invited to the evening networking reception with buffet and wine. It was a great afternoon of high quality talks with excellent feedback. I am very grateful to our industry partners who helped support the event with educational grants allowing the meeting invite to be extended to non-members of ACPGBI and trainees. These included CMR, CJMedical, BOWA and Ethicon. I also wish to thank Venue Cymru for support in bringing the event together.

 

Mike Thornton
North Wales ACPGBI Chapter Rep
Consultant Colorectal Surgeon
Wrexham Maelor Hospital

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