BDRF funded project wins European prize for best abstract

At the recent European Society of Coloproctology meeting in Vienna, BDRF funded work was awarded Best Y-ESCP Abstract Submission.

The project titled: “An investigation of transcutaneous vagal nerve stimulation (tVNS) on return of bowel function and inflammatory cytokine response after colorectal surgery “

This was part of the BDRF portfolio of Delphi Projects funded in 2017 and was led by Stephen Chapman at The University of Leeds who comments;

 

“We are delighted to see this work recognised, which would not have been possible without the generosity of our patients, collaborators, and supporters.

The results of this early study are exciting because they identify an opportunity for patients to be actively involved in the prevention of ileus after surgery.

We have learnt that patients of all capacities have an astounding desire to take control of their recovery, and we look forward to taking this work forward in the near future”.

Peter Rowbottom, CEO of Bowel Disease Research Foundation comments –

“We’re very proud of Stephen and his team in not only winning this award but also for the results of the trial.   A great example of collaborative research that is helping to answer fundamental questions that will ultimately help improve patient care and develop clinical practice”

The Delphi Question that this project addressed was “How can post-operative ileus be reduced?”

Problem addressed, background & strategic significance:

Surgery on the bowel often leads to postoperative ileus (POI) – a condition in which the bowel “goes to sleep”.

In most patients, the bowel soon returns to normal, but in 10-20% of patients POI is prolonged. This delays recovery and increases the risk of vomiting, constipation, breathing difficulties, and blood clots in the legs and lungs. A stimulator device, called GammaCore®, may be able to reduce the occurrence of POI by stimulating the nerves to the bowel and reducing the time taken for return of normal bowel function.

It is easy to use, has no known serious side-effects and the device can be used at home or in hospital.

Methods:

We will ask patients to use the device twice a day. It is used by placing it gently on the neck for 2 minutes (both sides) in the morning and at night. Half of patients will have a functioning device and the other half will have a “dummy” device which looks and feels the same but does not produce nerve stimulation. This will allow the effect of the functioning device to be compared. The treatment will be assessed in several ways, including: time taken for the bowel to recover, blood tests before and after surgery, an MRI scan to look at the bowel and patients’ acceptance of the device.

How will this project help build on the Delphi question and what further plans are proposed?

This feasibility study will provide early data on GammaCore® for reducing POI. It will not provide a definitive answer, but will give valuable information about possible benefits and early patient acceptance. This will inform the design of a larger, randomised comparison to formally test the device, its underlying mechanisms, patient satisfaction and wider adoption in the NHS.

Results: Thirty participants were recruited (15 active vs. 15 sham). After right-sided surgery, the mean time to bowel recovery (GI-2) was 3.6 (95% CI: 0.4) and 4.6 (95% CI: 0.9) days for active and sham stimulation groups, respectively. After left-sided surgery, the mean time to GI-2 was 4.5 (95% CI: 0.5) and 5.1 (95% CI: 0.9) days, respectively. Overall, 84% of participants felt confident using the device. There was no difference in adverse events between groups.

Conclusion: Non-invasive vagus nerve stimulation administered by patients is feasible before and after colorectal surgery. Ongoing work addresses its therapeutic mechanism. Future work will assess its efficacy in a larger cohort.

 

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