Colorectal Surgery

The research in colorectal surgery focuses mainly on colorectal cancer, functional disorders, proctology, diverticulosis and peritoneal carcinomatosis.

The main fields of research:

Research group

Wilhelm Graf MD, PhD, Professor
Urban Karlbom, MD, PhD, Associate Professor
Joakim Folkesson, MD, PhD
Helgi Birgisson, MD, PhD, Associate Professor
Helene Siilin, MD, PhD
Filip Sköldberg, MD, PhD
Åsa Collin, MD, PhD student
Peter Moberger, MD, PhD student
Lana Ghanipour, MD, PhD
Konstantinos Tsimogannis, MD, PhD
Peter Cashin, MD, PhD
Malin Enblad, MD, PhD student
 

Colorectal Cancer

The department of colorectal surgery in Uppsala has a long tradition in the research of colorectal cancer. We have been involved in and organized multi-institutional trials in adjuvant treatment in colorectal cancer. Many of those trials have been published in well-known journals and there is still a lot of research ongoing among those patients included in the trials. We are looking for late adverse effects to adjuvant treatment (both radiotherapy and chemotherapy) in patients treated for colorectal cancer. We are also involved in several trials finding out the best way of giving adjuvant treatment in rectal cancer as well as how to combine radiotherapy and chemotherapy in rectal cancer treatment as well as how to use chemotherapy in treatment of patients with colonic cancer. Furthermore we are involved in several trials regarding the palliative care of patients with colorectal cancer.

Another branch in our colorectal cancer research is to find predictive tests and prognostic variables in patients treated for colorectal cancer. We paritcipate in a cooperation with Umeå university, of biobanking tumour tissue and blood from cance patients (U-CAN http://www.u-can.uu.se/?languageId=1). We have a strong link to the human protein research project, (HPR project; http://www.proteinatlas.org/) at Uppsala University and the Science of life labarotorium (http://www.scilifelab.se/) involved in finding good prognostic markers.

In the Uppsala-Örebro health-care region there is a quality control register for colorectal cancer surgery. Based upon these data and also the national quality control register for rectal cancer we have used this registration for several epidemiological studies showing the need of good pathology, good surgery and also good patient care. Also those registers are valuable to evaluate volumes in the treatment of cancer.

Another important topic is screening for colorectal cancer. Although the most evidence based screening tool is fecal occult blood testing, this has not been accepted as standard of care in Sweden. Therefore we are investigating other screening modalities like evaluating examination of DNA or tumor markers in the stools or to implement as a randomized trial exploring screening with colonoscopy.

We have also been involved in several important trials regarding surgical technique in colorectal cancer treatment. This includes a trial of preoperative bowel prep in colorectal cancer, a randomized trial regarding the use of covering stomas in rectal cancer surgery and also the use of different staplers.

A cooperation and research together with clinical pathologists and radiologist are also an integral part of our research.

Dissertations on the subject from our institution:

Functional Disorders

We have a long tradition in research in both incontinence and constipation. We have specialist nurses performing rectal sensibility and biofeedaback treatment.  We have adopted a modern surgical techniques like sacral nerv stimulation, gracily plasty and STARR.

Dissertations on the subject from our institution:

Proctology

Our main interest has been the treatment of patients with fistulas but also patients with haemorrhoids. Large randomized trials have been run regarding the surgical techniques in haemorrhoid surgery and fistula treatment. There are ongoing trials to try to explain and understand how a fistula in anus appears and how this should be treated.

Dissertations on the subject from our institution:

Inflammatory Bowel Disease

Dissertations on the subject from our institution:

Diverticulosis

We have had a long interest in the treatment on diverticulosis and diverticulitis. Two PhD students have published their theses. In those reports we have shown the long-term risk for patients with diverticulosis to develop colorectal cancer. We have also shown that no antibiotic treatment is necessary in the management of mild diverticulitis.

Dissertations on the subject from our institution:

Peritoneal Carcinomatosis (PC)

The department of Colorectal surgery at Akademiska sjukhuset, Uppsala University Hospital started in the 1990’s with curative treatments for patients with peritoneal carcinomatosis (PC) and was the first institution in the Nordic countries to offer treatment with cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC).

Read more about the PC-group and their dissertations.

Publications 2018-2019, Colorectal Surgery

  • Sverrisson, Ingvar; Folkvaljon, Folke; Chabok, Abbas; Stattin, Pär et al.

    Anastomotic leakage after anterior resection in patients with rectal cancer previously irradiated for prostate cancer

    Part of European Journal of Surgical Oncology, p. 341-346, 2019.

  • Danielson, Johan; Karlbom, Urban; Graf, Wilhelm; Wester, Tomas

    Persistent fecal incontinence into adulthood after repair of anorectal malformations

    Part of International Journal of Colorectal Disease, p. 551-554, 2019.

    Open access
  • Afshari, Kevin; Chabok, Abbas; Naredi, Peter; Smedh, Kennet et al.

    Prognostic factors for survival in stage IV rectal cancer: A Swedish nationwide case-control study

    Part of Surgial oncology, p. 102-106, 2019.

  • Isacson, Daniel; Smedh, Kennet; Hosseinali Khani, Maziar; Chabok, Abbas

    Long-term follow-up of the AVOD randomized trial of antibiotic avoidance in uncomplicated diverticulitis

    Part of British Journal of Surgery, p. 1542-1548, 2019.

  • Andreasson, Anna; Hagström, Hannes; Sköldberg, Filip; Onnerhag, Kristina et al.

    The prediction of colorectal cancer using anthropometric measures: A Swedish population-based cohort study with 22 years of follow-up

    Part of United European Gastroenterology journal, p. 1250-1260, 2019.

  • Enblad, Malin

    Colorectal and appendiceal peritoneal metastases: From population studies to genetics

    Open access
  • Thorisson, Arnar; Nikberg, Maziar; Torkzad, Michael R; Laurell, Helena et al.

    Diagnostic Accuracy of Acute Diverticulitis with Non-Enhanced Low-Dose CT

    2018.

  • Liu, Yang; Yonemura, Yutaka; Levine, Edward A.; Glehen, Olivier et al.

    Cytoreductive Surgery Plus Hyperthermic Intraperitoneal Chemotherapy for Peritoneal Metastases From a Small Bowel Adenocarcinoma: Multi-Institutional Experience

    Part of Annals of Surgical Oncology, p. 1184-1192, 2018.

    Open access
  • Sköldberg, Filip; Olen, Ola; Ekbom, Anders; Schmidt, Peter T.

    Appendectomy and Risk of Subsequent Diverticular Disease Requiring Hospitalization: A Population-Based Case-Control Study

    Part of Diseases of the Colon & Rectum, p. 830-839, 2018.

  • Cashin, Peter; Mahteme, Haile; Syk, I.; Frodin, J. E. et al.

    Quality of life and cost effectiveness in a randomized trial of patients with colorectal cancer and peritoneal metastases

    Part of European Journal of Surgical Oncology, p. 983-990, 2018.

  • Sverrisson, Ingvar; Hosseinali Khani, Maziar; Chabok, Abbas; Smedh, Kennet

    Low risk of intra-abdominal infections in rectal cancer patients treated with Hartmann's procedure: a report from a national registry

    Part of International Journal of Colorectal Disease, p. 327-332, 2018.

    Open access
  • Enblad, Malin; Ghanipour, Lana; Cashin, Peter

    Prognostic scores for colorectal cancer with peritoneal metastases treated with cytoreductive surgery and hyperthermic intraperitoneal chemotherapy

    Part of International Journal of Hyperthermia, p. 1390-1395, 2018.

  • Isacson, Daniel; Andreasson, Karl; Nikberg, Maziar; Smedh, Kennet et al.

    Outpatient management of acute uncomplicated diverticulitis results in health-care cost savings

    Part of Scandinavian Journal of Gastroenterology, p. 449-452, 2018.

  • Enblad, Malin; Graf, Wilhelm; Birgisson, Helgi

    Risk factors for appendiceal and colorectal peritoneal metastases

    Part of European Journal of Surgical Oncology, p. 997-1005, 2018.