Publications by authors named "Martyn C Stott"

5 Publications

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Liver Transplantation for Non-Resectable Liver Metastases from Colorectal Cancer: A Systematic Review and Meta-Analysis.

World J Surg 2021 Jul 28. Epub 2021 Jul 28.

Department of Hepato-Pancreato-Biliary Surgery, Manchester Royal Infirmary, Manchester University NHS Foundation Trust, Oxford Road, Manchester, M13 9WL, UK.

Backgrounds: Colorectal liver metastases were historically considered a contraindication to liver transplantation, but dismal outcomes for those with metastatic colorectal cancer and advancements in liver transplantation (LT) have led to a renewed interest in the topic. We aim to compare the current evidence for liver transplantation for non-resectable colorectal liver metastases (NRCLM) with the current standard treatment of palliative chemotherapy.

Methods: A systematic review and meta-analysis of proportions was conducted following screening of MEDLINE, EMBASE, SCOPUS and CENTRAL for studies reporting liver transplantation for colorectal liver metastases. Post-operative outcomes measured included one-, three- and five-year survival, overall survival, disease-free survival and complication rate.

Results: Three non-randomised studies met the inclusion criteria, reporting a total of 48 patients receiving LT for NRCLM. Survival at one-, three- and five-years was 83.3-100%, 58.3-80% and 50-80%, respectively, with no significant difference detected (p = 0.22, p = 0.48, p = 0.26). Disease-free survival was 35-56% with the most common site of recurrence being lung. Thirteen out of fourteen deaths were due to disease recurrence.

Conclusion: Although current evidence suggests a survival benefit conferred by LT in NRCLM compared to palliative chemotherapy, the ethical implications of organ availability and allocation demand rigorous justification. Concomitant improvements in the management of patients following liver resection and of palliative chemotherapy regimens is paramount.
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July 2021

Roux-en-Y versus single loop reconstruction in pancreaticoduodenectomy: A systematic review and meta-analysis.

Int J Surg 2021 Apr 24;88:105923. Epub 2021 Mar 24.

Department of Hepato-Pancreato-Biliary Surgery, Manchester Royal Infirmary, Manchester, UK.

Background: Post-operative pancreatic fistula (POPF) and delayed gastric emptying (DGE) both remain problematic complications following pancreaticoduodenectomy. This systematic review and meta-analysis evaluates whether Roux-en-Y compared to a single loop reconstruction in pancreaticoduodenectomy significantly reduces rates of these complications.

Methods: A systematic review and meta-analysis was conducted according to the PRISMA guidelines by screening EMBASE, MEDLINE/PubMed, CENTRAL and bibliographic reference lists for comparative studies meeting the predetermined inclusion criteria. Post-operative outcome measures included: POPF, DGE, bile leak, operating time, blood loss, need for transfusion, wound infection, intra-abdominal collection, post-pancreatectomy haemorrhage, overall morbidity, re-operation, overall mortality, hospital length of stay. Pooled odds ratios or mean differences with 95% confidence intervals were calculated using either fixed- or random-effects models.

Results: Fourteen studies were identified including four randomised controlled trials (RCTs) and 10 observational studies reporting a total of 2,031 patients. Data synthesis showed no statistically significant difference between the two groups in any of the outcome measures except operating time, which was longer in those undergoing Roux-en-Y reconstruction.

Discussion: Roux-en-Y is not superior to single loop reconstruction in pancreaticoduodenectomy but may prolong operating time. Future high-quality randomised studies with appropriate study design and sample size power calculation may be required to further validate this conclusion.
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April 2021

The importance of social media to the academic surgical literature: Relationship between Twitter activity and readership metrics.

Surgery 2021 Sep 19;170(3):650-656. Epub 2021 Feb 19.

Department of General Surgery, Manchester Royal Infirmary, Manchester, UK. Electronic address:

Background: Social media has an increasing role within professional surgical practice, including the publishing and engagement of academic literature. This study aims to analyze the relationship between social media use and traditional and alternative metrics among academic surgical journals.

Method: Journals were identified through the InCites Journal Citation Reports 2019, and their impact factor, h-index, and CiteScore were noted. Social media platforms were examined, and Twitter activity interrogated between 1 January to 31 December 2019. Healthcare Social Graph score and an aggregated Altmetric Attention Score were also calculated for each journal. Statistical analysis was carried out to look at the correlation between traditional metrics, Twitter activity, and altmetrics.

Results: Journals with a higher impact factor were more likely to use a greater number of social media platforms (R = 0.648; P < .0001). Journals with dedicated Twitter profiles had a higher impact factor than journals without (median, 2.96 vs 1.88; Mann-Whitney U = 390; P < .001); however, over a 1-year period (2018-2019) having a Twitter presence did not alter impact factor (Mann-Whitney U = 744.5; P = .885). Increased Twitter activity was positively correlated with impact factor. Longitudinal analysis over 6 years suggested cumulative tweets correlated with an increased impact factor (R = 0.324, P = .004). Novel alternative measures including Healthcare Social Graph score (R = 0.472, P = .005) and Altmetric Attention Score (R = 0.779, P = .001) positively correlated with impact factor.

Conclusion: Higher impact factor is associated with social media presence and activity, particularly on Twitter, with long-term activity being of particular importance. Modern alternative metrics correlate with impact factor. This relationship is complex, and future studies should look to understand this further.
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September 2021

Letter to Editor: Small and Laterally Placed Incisional Hernias Can Be Safely Managed with an Onlay Repair.

World J Surg 2019 11;43(11):2945-2946

Department of Renal and Pancreas Transplantation, Manchester Royal Infirmary, Manchester University NHS Foundation Trust, Manchester, UK.

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November 2019

Is the Use of a Robotic Camera Holder Economically Viable? A Cost Comparison of Surgical Assistant Versus the Use of a Robotic Camera Holder in Laparoscopic Liver Resections.

Surg Laparosc Endosc Percutan Tech 2017 Oct;27(5):375-378

East Lancashire Hospitals NHS Trust, Royal Blackburn Hospital, Blackburn, UK.

The laparoscopic approach has gained acceptance in the field of hepatopancreaticobiliary surgery. It offers several advantages including reduced blood loss, reduced postoperative pain, and shorter length of stay. However, long operating times can be associated with surgeon and assistant fatigue and image tremor. Robotic camera holders have been designed to overcome these drawbacks but may come with significant costs. The aim of this study was to economically evaluate their use compared with standard assistants using a single surgeon consecutive series of laparoscopic liver resections from January 2014 to May 2015. Only use of nurse assistants with no advanced training and postgraduate year 2 doctors were cheaper than utilization of the device. We suggest the use of a robotic camera holder is cost-beneficial and may have wider service and educational benefits.
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October 2017