Intestinal Adaptation Following Massive Small Intestinal Resection: Mechanisms And Management
Funder
National Health and Medical Research Council
Funding Amount
$256,980.00
Summary
Short bowel syndrome (SBS) remains a major clinical problem in paediatric and adult clinical practice. The Department of Gastroenterology and Clinical Nutrition at the Royal Children's Hospital has gained recognition as a national centre of excellence for the management of infants and children with SBS and intestinal failure. Due to the significant personal and heath-care burden related to SBS there has been an urgent need to improve understanding about the process of intestinal adaptation follo ....Short bowel syndrome (SBS) remains a major clinical problem in paediatric and adult clinical practice. The Department of Gastroenterology and Clinical Nutrition at the Royal Children's Hospital has gained recognition as a national centre of excellence for the management of infants and children with SBS and intestinal failure. Due to the significant personal and heath-care burden related to SBS there has been an urgent need to improve understanding about the process of intestinal adaptation following massive small bowel resection (MSBR) in order to develop new treatments aimed at improving clinical outcome for patients with SBS. Over the past 5 years we have developed a preclinical model for the study of intestinal adaptation in infants using the juvenile pig. Our recent studies in this model have revealed that elemental formula is inferior to whole protein formula suggesting that the current clinical recommendations need urgent re-evaluation. Using the preclinical model in this proposal, we aim to define the mechanisms underlying the adaptive response and evaluate novel therapies aimed at enhancing adaptation following MSBR. Supplementation of enteral feeds with bovine colostrum isolate resulted in normal growth in the preclinical model despite MSBR. In this proposal we plan to advance this observation for the first time to human clinical trials in infants with SBS. Even small gains in enteral tolerance during the early post-operative period may have a significant impact on morbidity and mortality of children with SBS due to parenteral-nutrition related liver disease and gut-related sepsis. This research proposal provides a unique link between studies aimed at providing the scientific basis for understanding the mechanisms of intestinal adaptation using an established preclinical model and translating the results of these studies onto human trials, taking advantage of the clinical expertise available in the management of children with SBS.Read moreRead less
Regulation Of Intestinal Stem Cells And Intestinal Growth
Funder
National Health and Medical Research Council
Funding Amount
$419,018.00
Summary
How the small intestine grows is important for preterm babies and those with short bowel syndrome. This study investigates the mechanisms of growth in the normal situation and in animal model of short bowel syndrome. It investigates particular growth pathways that regulate growth and particularly that of intestinal stem cells.
AUSTRALASIAN MULTICENTRED PROSPECTIVE RANDOMISED STUDY OF LAPAROSCOPIC VS CONVENTIONAL SURGICAL TREATMENT OF COLON CA
Funder
National Health and Medical Research Council
Funding Amount
$495,000.00
Summary
Colon cancer is one of the most common solid tumours in western society. The usual initial treatment is excision of the cancer by an operation done through a cut down the midline of the abdominal wall. Over the past 10 years, minimally invasive technology has changed the approach to many surgical operations. A good example of this is an operation to remove the gall bladder. This is now routinely done using a laparoscope (telescope) which is introduced at the umbilicus. An image on a video screen ....Colon cancer is one of the most common solid tumours in western society. The usual initial treatment is excision of the cancer by an operation done through a cut down the midline of the abdominal wall. Over the past 10 years, minimally invasive technology has changed the approach to many surgical operations. A good example of this is an operation to remove the gall bladder. This is now routinely done using a laparoscope (telescope) which is introduced at the umbilicus. An image on a video screen of the gall bladder is then used to guide instruments to remove the gall bladder without making a large incision in the abdominal wall. This is called a laparoscopic cholecystectomy. The safety of a laparoscopic assisted approach in the removal of colon cancer is yet to be determined. This study will compare the long term and short term outcomes of people who have colon cancers removed either by a laparotomy (a cut in the midline of the abdominal wall) or by a laparoscopic assisted approach (telescope).Read moreRead less
Australasian Randomised Clinical Trial Comparing Laparoscopic And Open Surgical Treatment Of Colon Cancer: Follow-up.
Funder
National Health and Medical Research Council
Funding Amount
$233,000.00
Summary
Colon cancer is one of the most common solid tumours in western society. The usual initial treatment is excision of the cancer by an operation done through a cut down the midline of the abdominal wall. Over the past 15 years, minimally invasive technology has changed the approach to many surgical operations. A good example of this is an operation to remove the gall bladder. This is now routinely done using a laparoscope (telescope) which is introduced at the umbilicus. An image on a video screen ....Colon cancer is one of the most common solid tumours in western society. The usual initial treatment is excision of the cancer by an operation done through a cut down the midline of the abdominal wall. Over the past 15 years, minimally invasive technology has changed the approach to many surgical operations. A good example of this is an operation to remove the gall bladder. This is now routinely done using a laparoscope (telescope) which is introduced at the umbilicus. An image on a video screen of the gall bladder is then used to guide instruments to remove the gall bladder without making a large incision in the abdominal wall. This is called a laparoscopic cholecystectomy. The safety of a laparoscopic assisted approach in the removal of colon cancer is yet to be determined. This study will compare the long term and short term outcomes of people who have colon cancers removed whether by laparotomy ( a cut in the midline of the abdominal wall) or by a laparoscopic assisted approach (telescope).Read moreRead less