Matt Lee
@wannabehawkeye
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#Colorectalsurgery @uobsurgery #ibd #emgensurg #sbo #PROMs / caffeine, music, games, sci-fi.
South Yorkshire
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I've accepted a job offer to join the
@UoBSurgery
as an Academic
#colorectal
Surgeon.
-
#IBD
&
#egs
care
@uhbtrust
- building a portfolio of related
#surgicalresearch
-working with fantastic academic & clinical colleagues in ambitious institutions
#Excited
#SoMe4Surgery
86
17
331
Incredible 24 hours - the wonderful Mrs Lee gave birth to a daughter, Charlotte. Delighted is an understatement. Mum and baby well.
74
2
306
Some bubbles to toast handing over bleep 2615 (gen surg registrar on call) at the end of my last reg on call block. A day of interesting operating, and hopefully made some people better.
9 years on this tier rota, lots learned.
#surgicallife
#SoMe4Surgery
16
1
185
Very proud to wear these robes and receive my
#PhD
from
@sheffielduni
today. Pictured with my wife who was equal parts supportive and tolerant throughout the time! Thanks to my supervisors and mentors for their support too! Rerum cognoscere causas.
#graduation
#surgicalresearch
34
6
179
In the distance, the three wise men saw a Lonestar....
#colorectalsurgery
#colorectalchristmas
19
24
163
Spent 8 of last 11 yrs at
@SheffieldHosp
(CST/PhD/HST in general/colorectal surgery).
End of an era.
Excellent training & mentorship throughout. Grateful for experiences and support. Strongly recommend to all.
On to a locum role
@LeedsEGS
for a little while.
#some4surgery
17
5
135
Had a lovely visit to
@RCSnews
today for
#rcsdipday
to collect
#FRCS
diploma, accompanied by my biggest supporter.
19
2
130
You know what, I really enjoy my job.
I get to do
#surgery
things
I get to do
#research
things
Both complement each other, and both bring massive satisfaction. Have been having chats about plans for 2022, and am excited for what we try to do next.
#surgicalresearch
6
6
82
New peak in my academic career today. Two grant rejections within 24 hours of each other.
#livingthedream
4
3
77
Your F1 calls you about a laparotomy & adhesiolysis from 3 days ago. Someone did a random troponin for reasons unclear. No chest pain reported, ECG normal.
Does a raised post-op trop with no ECG changes matter in non-cardiac
#surgery
? Does it change what you do?
🧵 1/5
Whats a troponin?
214
Just one of those things
1339
Ask cardio, do nothing
1488
Treat as ACS
243
14
21
73
Last night I dreamed that I was doing a lap chole and this person had four gallbladders laid on top of each other, and each time I thought I was finished there was another one behind it to take out.
Interpretations welcome.
#some4surgery
19
0
72
After 5 yrs at
@SheffieldHosp
(3yr research fellow, st4+5), it's time to train elsewhere for a bit. Thanks to
@stevebrownsheff
@ArunL_Surgeon
+ others for training/mentoring, and
@DebbyHawkins2
&
@Steele4Caroline
for supporting research. Off to
@DBH_NHSFT
for a bit!
#surgery
12
2
66
Very pleased to be elected as research and audit rep for
@Dukes_Club
Look forward to developing the role further and working with
@ACPGBI
R&A committee
#colorectalresearch
6
12
64
Sign language to help communication in theatre during covid? Nice idea (there's a video too)
From correspondence in
@BJSurgery
#surgicalresearch
#humanfactors
#communication
@des_winter
4
25
61
I'd particularly like to thank reviewer 3 for missing the point of the manuscript, then dissecting grammar issues that reflect transatlantic differences in English and should be dealt with by the copy editor. Heres your 3 pages of point by point response.
#AcWri
3
7
58
If you're working on a paper, how can you design a good 'table 1'. This is a paper I keep coming back to.
4
12
52
Why are 4% of you picking AXR???? A test with minimal ability to rule anything in or out. Not a useful test for undifferentiated abdo pain.
13
2
51
Paper on
#ppu
with
@petecoe1
Hannah Boyd-Carson,
@SoniaLockwood79
@ArinSaha6
exploring NELA 2013-17 data in
@AnnalsofSurgery
:
⬆lap use ⬇conversion rates, key outcomes similar.
Should we going lap first?
#emgensurg
#tugs
5
9
46
Finally got the post op delirium paper accepted. Wooo!
Will be open access. Uses a bit of an interesting method, and has interesting findings, so will tweet and share when in press.
#surgicalresearch
3
1
47
I think this is a good move from
@RCSnews
, definitely adds value to membership. Other societies with journals should take note.
#some4surgery
#surgicalresearch
4
9
45
Proud of the team getting this study published in
@BJSurgery
. Grateful to
@BritishHernia
for funding and
@SheffieldHosp
for being the NHS sponsor.
Enjoyable study with interesting findings for
#hernia
and
#emgensurg
(
@asgbi
@asgbi_ma
)
@sheffunimdh
@MASH_2019_
@Neil_J_Smart
MASH is published! The main findings from the study are now available through BJS A big thank you to all of our collaborators for making this possible
#hernia
#emergsurg
#collaborate
1
10
31
1
14
44
The appendicitis is glorified diverticulitis, and can be treated with NSAIDs if uncomplicated. Bigger study needed to support, but how would you feel about it?
Discuss?
#surgicalresearch
@ASGBI_MA
@Dukes_Club
@roux_group
In June's BJS: Antibiotics versus placebo in adults with CT-confirmed uncomplicated acute appendicitis (APPAC III)
@AmyLightnerMD
@bplwijn
@des_winter
@ksoreide
@MalinASund
@evanscolorectal
@nfmkok
@robhinchliffe1
@young_bjs
0
25
43
13
12
39
This is me for the next few days.
@WSESurgery
#edinburgh
Lots to see on the programme. Plus,
@segun_lamidi
poster on
#coredescriptors
of
#ppu
,
@GIR_COS
poster on
#sbo
#coreoutcomes
and will be presenting the Indicates
#nutrition
#risk
paper.
#emgensurg
#conferencetime
1
7
41
Today's emergency list kicked off just after 0800, finished last general case at 2010. Minimal to no gaps in theatre use. Theatre team were on form so it was super efficient! And fun.
Brilliant stuff.
@SheffieldHosp
#teamwork
#canwesend
#wealreadyhave
3
1
40
First public sharing of
#prodigi
#prom
study
Surgeons: how do you know when your patients guts are recovered? Do your questions capture the whole experience?
@dmbaker13
@SJ_Chapman
@Profgljones
@littlemissileo
@DeenaHarji
@asgbi
@ACPGBI
#surgicalresearch
1
9
40
Fantastic trip to
#PISA
for
@WSESurgery
2023 last week.
Broad content relevant to
#emgensurg
or
#trauma
practices
Rescue, frailty, futility, robots, mycotic infections. Free papers also of a good standard. Networking also 👍.
Lots to think about
#surgicalresearch
2
5
40
Started the academic year with a full house of decisions coming back yesterday:
Accept without revisions X1
Reject without review x1
Minor amendments x2
Can't win them all.
#surgicalresearch
4
0
38
Understand
@josiewalshaw1
did a great job presenting the scoping review on
#emergency
#umbilicalhernia
@EHSprague2024
!
Manuscript accepted in
@BjsOpen
. Watch this space 👀👀
#some4surgery
#surgicalresearch
1
7
39
With reference to previous chats. Can we start CT scanning people instead of diagnostic laparoscopy please. Avoids unnecessary surgery and concomitant surgical risk!
#surgicalresearch
@asgbi
@ACPGBI
@ASiTofficial
#emgensurg
The 🇬🇧 normal appendicectomy rate (NAR) in people aged 16-45 in 2017 was 20%. The rate was much higher in women🚺 (28%) than men🚹 (12%).
Amongst patients in 🇮🇪🇮🇹🇵🇹🇪🇸 NARs were much lower than in 🇬🇧: 10% in women🚺 & just 3% in men🚹!
#RIFTstudy
:
2
18
27
12
13
39
Working on a paper and thanks to a typo have invented a new outcome:
Inpatient morality.🤔
5
2
38
The most frustrating parts of my
#surgicalresearch
training is securing the follow-on job.
A small number of Unis have funding for senior lecturers, otherwise its no job without a competitively funded personal fellowship.
Pretty demoralising after 7+ years of effort.
4
3
38
Now that's a nice slide.
@DeenaHarji
telling audience about methods for
#prom
development in
#lrrc
#acpgbi2023
#surgicalresearch
0
7
37
Something I've been thinking about doing for a while. A blog. Would be interested to hear thoughts (and suggestions for topics!)
@DeenaHarji
@HeywoodNick
@SJ_Chapman
@Tom_Drake1
@DrJamesGlasbey
@dalevim
@Neil_J_Smart
@DanHind1
@MikeBradburn2
11
11
37
Eposter presentation on
#MACHO
'project in progress' from
@WRSC_research
at
#nrcm2019
Thanks to all collaborators for help so far!
#surgicalresearch
2
9
37
Today:
Paper edits on the train📝
Ward round including some teaching🚶♂️
Operating with
@pinkney_t
and
@Melissa__Cunha
😷
Then a quick post work beer with some of the juniors.
Really enjoy my job.
#some4surgery
1
1
35
@timricketts_
With apologies for my handwriting
Good test will give Dx and stratify rapidly. This is a CT. All AXR does is give bonus radiation for no benefit.
And delays
Which are bad.
Bowel sounds not useful for DX or stratification really.
#some4surgery
@ASGBI_MA
1
9
36
Delighted to award the Golden sigmoidoscope to
@NTewari
on behalf of the 'Imposters' for winning the
#duke21
@Dukes_Club
quiz.
@roux_group
@richlaing
3
2
36
Was great to present the DISCUSS project to develop a patient decision aid for those choosing between drugs and surgery for
#uc
at the
#ibd
@ACPGBI
@MidOxIBD
session yesterday. Generously funded by
@CrohnsColitisR
and led by Prof Lobo &
@Profgljones
#TeamWork
#surgicalresearch
2
5
34
Excited to be giving a talk on the state of the art of small bowel obstruction at
#DKS2022
Prepping talk has made me look really critically at what we think we know.
Punchline is there's lots to do. Watch this space...
#emgensurg
@sheffunimdh
#surgicalresearch
2
7
34
Redoing charts on a Sunday evening so they are ready for
@ASiTofficial
meeting. What would you rather be doing than
#rstats
?
ps
#ggsci
is one of my favourites
1
5
35
There is an entity called MINS (myocardial injury after non-cardiac surgery). It is essentially evidence of cellular damage w/o ECG changes. The new european cardiology guidelines recommend screening for it post-op...
But does it impact outcomes?
🧵2/5
1
6
35
If you are a
#colorectalsurgery
trainee then you cant miss out on the
@Dukes_Club
weekend in april. Great talks, great networking opps, food, and an after dinner quiz hosted by me and
@PVaughanShaw
. Whats not to love?
#trainees
#IBD
#ColorectalCancer
1
22
33
Good week for
#surgicalresearch
last week:
- Ella (
#anaesthetic
ACF) got small grant for CV outcomes after nephrectomy
-
@RealDanAshmore
had paper accepted into
@BjsOpen
-More
#AFAR
recruitment!
-Positive feedback on
#prodigi
at
@ACPGBI
0
4
33
Got a couple of
#emgensurg
/
#emlap
projects going for funding in the near future, and would like to work with potential UK sites to discuss and refine app. One cohort, one
#RCT
. If interested pls DM and can chat (starts 2023 & 2025)
#surgicalresearch
@asgbi
@ACPGBI
@NELANews
8
10
32
Great to see
@MissJBanks
from
@ShefUni_ClinMed
as part of team. Well done to
@CBizzle1
@SJ_Chapman
and Alice Murray on appointment to this role. Look forward to working with you on some
#colorectalsurgery
#surgicalresearch
Delighted to announce new Associate Specialty Leads for
#ColorectalSurgery
Jessica Banks Carly Bisset
@SJ_Chapman
Alice Murray
Appointed for 3 years to drive
#research
initiatives to advance the field of colorectal surgery
@susanmoug
@dalevim
@jim_tiernan
3
9
59
0
8
30
Non-covid news: Pleased to hear the
@nasbo2017
main paper achieved a high Altmetric in
@BjsOpen
- and was one of the most downloaded articles (2,400ish downloads).
The
#hernia
paper will hopefully be in the same journal soon!
It's great to see what
#collaboration
can achieve!
1
5
32
@drkeithsiau
Or follow the
@NCEPOD
and
@NASBO2017
recommendations and do a CT instead of AXR (which has poor sensitivity and specificity, and patient will still get a ct.)
1
4
32
What's this
Team
Planning
Now?
Could it be a
Really
Cool
Trial?
#emgensurg
#surgicalresearch
#some4surgery
1
2
30
Think I might have achieved something educational - asked one of our fy1's to give indications for abdominal xr. 'The only reason would be to check gastrografin in
#SBO
'.
5
2
31
New
@NCEPOD
report out on
#sbo
and
#lbo
. Provides recs on care. Basics right including
#nutrition
#hydration
, push for early imaging, forward planning for cons Mx pts. Also highlights need for proper networks for colonic
#stents
#some4surgery
@asgbi
@ACPGBI
1
13
30
This weeks
#surgicalresearch
update:
AFAR = 204🧑🤝🧑
PRODIGI 4a = 18🧑🤝🧑
Grant submissions = 1✅
Abstracts submitted = 1✅
Papers in progress = 3🏗️
Projects in development = 2🏗️
Papers rejected = 1❌
Grants rejected = 1❌
Win some, lose some
#SoMe4Surgery
2
1
30
Last
@NASBO2017
now published in
@BjsOpen
- Outcomes
#sbo
due to
#hernia
.
Moderately comorbid pop, surprisingly high mortality.
@NRCM2020
@ACPGBI
@asgbi
@Augishealth
@NELANews
@RCSnews
@BDRF1
@RCSEd
#openaccess
#emgensurg
#SoMe4Surgery
3
16
29
#vaccinated
today. No selfie. Grateful to the teams who worked hard to develop, trial, and get this rolled out at such a great pace.
3
1
30
Having an educational chat with
@stevebrownsheff
this afternoon and he has suggested that I should aim to emulate this man - Lawson Tait. Is it for his many contributions to the field? No. His sideburns are better than mine and I should aim to surpass them.
#surgicaltraining
4
1
29
Good day so far:
Nice email from
@ColorectalDis
Great messages from
@josiewalshaw1
about her
@eurohernias
presentations
More
#PRODIGI
chat with
@Profgljones
And now to head to London for
#ACC2024
for
@ACPGBI
and some
#pilonidal
chat
#SoMe4Surgery
#surgicalresearch
1
0
29
Finishing slides for
@ACPGBI
#acpgbi2023
- PRO-diGI (GI recovery
#PROM
) - free paper & research plenary
-
@PITSTOP_Study
cohort - free papers (
@stevebrownsheff
presenting study in plenary)
Look forward to sharing!
#surgicalresearch
#some4surgery
#colorectalresearch
1
7
28
Looking for some UK based surgeons to tell us their thoughts on acute umbilical
#hernia
management to inform a trial (CST-Consultant). If you could spare 5 mins for a survey please send a DM and I'll send a link. Cheers
#emgensurg
#surgicalresearch
@asgbi
@ACPGBI
15
30
28
Big
@asgbi
for the team
#prodigi
presentations from
@dmbaker13
and Me
@Mr_AdilRashid
presenting prelim work on
#sbo
#cds
@RealDanAshmore
presenting his
#systematicreview
on
#malnutrition
identification in
#egs
And....
#surgicalresearch
...
1
7
25
If trainees engage & recruit to these funded trials (star-trec,
@SunrriseRCT
@SunflowerStudy
@PITSTOP_Study
they will change practice, & learn more about research than by publishing 3 (average) 1st author papers
@NatalieBlencowe
@lizzyelsey
@ASiTofficial
@JCST_Surgery
#Dukes2019
1
11
26
The AFAR protocol (
#AF
after surgery) published in this months
@ColorectalDis
. Hoping to restart in coming months & open to new sites.
If you offer
#colorectalcancer
#surgery
to patients 65+ & are interested, pls get in touch!
@stevebrownsheff
1
9
25
This year
@petecoe1
and I are lucky to be supervising two students on the new
@sheffunimdh
#BSc
in
#surgicalscience
. Two strong candidates (
@segun_lamidi
and Kate), already making progress on their exciting projects in
#emgensurg
and
#IBD
....watch this space.
#Surgicalresearch
2
1
26
1/
International consensus on what should go into 'table 1' in future studies of
#crohns
#fistula
Grateful to collabs for support with this &
@Kate_M_Williams
for delivering during her
#BSc
at
@sheffunimdh
#openaccess
@ColorectalDis
@cam_colorectal
3
11
25
Interesting review from
@AnnalsofSurgery
On appetite measurement after major surgery. Lots to think about for GI surgeons.
@SJ_Chapman
@JessieAElliott
#surgicalresearch
0
5
25
Has been great to work with
@josiewalshaw1
,
@Neil_J_Smart
and
@NatalieBlencowe
on this paper.
You might pick up the trail of crumbs towards what will be the METEOR
#RCT
once we have completed ASTEROID.
#emgensurg
#surgicalresearch
Day 1 of
#ASGBI2024
☑️
Enjoyed presenting on emergency hernias, sigmoid volvulus & all things EGS
2
4
61
0
2
26
Early morning start as I'm on my way to talk at the
@Dukes_Club
@roux_group
@SurgOncTA
research skills day.
#surgicalresearch
5
2
25
#colorectalsurgery
&
#herniafriends
How should we describe a
#parastomalhernia
in future research projects? If you treat patients with PSH please could you complete our survey?
#some4surgery
@ACPGBI
@eurohernias
@BritishHernia
@AmericanHernia
1
15
25
Off to Copenhagen to talk about
#SBO
and (controversially?)
#postopaf
at the Danish Surgical Society Meeting.
@Neil_J_Smart
says its a great meeting. Look forward to it!
#Surgery
2
1
24
Just off to give a lecture to year 2 about.... Gallstones.
My favourite.
5
0
24
.
@segun_lamidi
BSc on standardising descriptors in Perforated
#pepticulcer
disease now published in
@BJSurgery
. Thx to
@asgbi
and
@WSESurgery
for supporting, and the many (international) collaborators & steering group!
#surgicalresearch
#emgensurg
3
6
25
Had a great chat with
@kennethmclean92
this morning about the new 'intro to research skills' course which will be the
#bestvirtualcourse
at
#asit2021
.
#surgicalresearch
0
2
25
Really pleased to open
#AFAR
study:
#afib
after
#colorectalcancer
#surgery
at
@SheffieldHosp
- SIVs for other sites planned! Kindly funded by
@NIHRresearch
Open to other (UK) sites. Please get in touch!
@stevebrownsheff
@MikeBradburn2
#colorectalsurgery
#surgicalresearch
1
10
24
Just wanted to say a big thank you to all the teams who recruited to
@MASH_2019_
& all patients who agreed to participate *in the middle of a pandemic*
Final number approx 270 (uploads ongoing)->exceeds expectations.
#emgensurg
#hernia
#collaborate
@susanmoug
@misshollyman
1
4
24
Thanks for opp to present
@asgbi
. UK surgeons, can you help us design the
#NASBO2017
trial?
@NatalieBlencowe
@Neil_J_Smart
@ACPGBI
@Dukes_Club
@ASiTofficial
@RCSnews
@WMRC_UK
#colorectalsurgery
0
23
24
@PITSTOP_Study
data finally out:
We do lots of :
🔪BIG OPERATIONS that translate
⚖️MODEST RECURRENCE reduction
⏫BIGGER COMPLICATION RISK.
Less may well be more
🙏to collabs and team
@stevebrownsheff
#surgicalreseach
#some4surgery
#pilonidal
🎇 Real-world practice and outcomes in pilonidal surgery: Pilonidal Sinus Treatment Studying The Options (PITSTOP) cohort
😷The aim of this study was to provide real-world data on current surgical practice and report patient and risk-adjusted outcomes, informing future trial
0
23
32
2
6
24
'There is a lack of successors in the 35-40 bracket'
Yep. Because securing a clinical academic post at Consultant/SL level now seems to demand a fully funded research fellowship, which have around 8% overall success rate if looking at NIHR stats.
Lack of clinical academics threatens NHS research and teaching, “The foundations [of university medicine] are starting to be eroded,” she said. “The pipeline for clinical academics is really looking quite frightening . . . & it is not being talked about.”
12
144
228
2
3
24
And here is the paper on
@nasbo2017
cancer subgroup:
A frequently challenging situation to make decisions in. Food for thought.
#emgensurg
#colorectalresearch
#collaboration
1
15
24
Fab view of
#jupiter
and
#saturn
over the wing of
#BA0820
on our approach into
#Copenhagen
for
#hernia2021
#stargazing
#flying
1
1
24
Exciting to see the
#survey
paper on clinician preferences in Mx of acute
#hernia
from
@MASH_2019_
study in press at
#annalsRCS
What do you think?
#emgensurg
#surgicalresearch
@BritishHernia
@asgbi
@eurohernias
(NB main paper under review)
0
7
24
Second
@MASH_2019_
presentation at
#asgbi2021
from
@susiekgreen
on variation in technical aspects of acute
#hernia
surgery in UK. Lots of variation in approach and type of repair.
#emgensurg
#collaborate
@BritishHernia
@asgbi
@WSESurgery
1
10
24
Surgery for acute
#UC
- sick patient, sick colon -> slick surgery required. Nice phrase from Gethin Williams.
#IBD
#ACPGBI2021
1
6
24
Delighted to open
@AfarStudy
at
@SurgeryRde
@ExeterHeSRU
with PI
@Neil_J_Smart
#colorectalsurgery
#atrialfibrillation
#colorectalcancer
Looking forward to opening additional sites soon!
@susanmoug
@CBizzle1
@dalevim
@JKDhesi
@Shirley106Chan
@jim_tiernan
1
2
24
Final
#surgicalresearch
team meeting for the year for STH gen surg.
2021:
>200 patients recruited,
AFAR, PRODIGI, MEERKAT, ORION, PITSTOP, NIFTy led locally,
PhD students securing funding.
Great team
@DebbyHawkins2
@Steele4Caroline
@stevebrownsheff
@NiloferHusnoo
@Aghague
1
4
23
Our
#metaanalysis
in
@BjsOpen
found MINS assoc/w death rates of
-9% at 1mon
-8% at 66mo
-25% at 1yr)
MINS was associated with a 21% rate of major adverse cardiovascular events (e.g. MI, arrhythmia, CVA, cardiac death, amputation)
Pretty stark.
🧵3/5
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4
23
Really great collaboration across sites during a challenging period. Grateful to all for support of the study and
@BritishHernia
for funding.
#rct
ideas brewing - watch this space...
Outstanding presentation of
@MASH_2019_
at
#Hernia2021
by Vicky Proctor. Wide variation in UK practice regarding acutely symptomatic hernias. Opportunities for RCTs in the future.
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