Surgery Research

Emergency Medicine
General Surgery
Ophthalmology
Oral and Maxillofacial Surgery
Otolaryngology - Head & Neck Surgery
Paediatric Surgery
Plastic Surgery
Urology
Vascular Endovascular and Transplant Surgery (VETS)

Emergency Medicine

The Emergency Medicine and Nursing Research Group in the Emergency Department is chaired by Dr. Martin Than, and includes Professor Mike Ardagh, Dr. Paul Gee, and Dr. Sandra Richardson.

Their research themes include diagnostic decision-making, particularly in relation to the diagnosis of acute coronary syndrome and venous thromboembolism, the health implications of seismic events, toxicology, ethics and emergency nursing.

In addition to grants from the Health Research Council and the Canterbury Medical Research Foundation, the group is supported by the Emergency Care Foundation, a charitable trust dedicated to supporting research, education and innovation in emergency health care.

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General Surgery

The department has considerable expertise in clinically-based research, as well as translational research from laboratory based research programs. The collaborations this department has with other clinicians and researchers from New Zealand’s hospitals and universities are one of the strengths of their research program.

Clinical trials

ALCCaS RCT. Australasian laparoscopic colon cancer study, a randomized controlled multi-centre trial of laparoscopic versus open surgery for colorectal cancer.
An individual patient data meta-analysis using the combined databases of major international prospective randomized controlled trials (similar to ALCCaS) to define the patterns of colon cancer disease recurrence following laparoscopic or open surgery.
A La CaRT. The Australasian multicentre randomised controlled trial of laparoscopic versus open resection for rectal cancer
Cimetidine trial: A multicentre phase3 randomized controlled trial on effect of Cimetidine on outcomes in patients with colorectal cancer.
Randomised controlled trial comparing tailored vs standard sphincterotomy for idiopathic fissure in ano.

Clinical studies

Colorectal function following spinal injuries.
Various aspects of inflammatory bowel disease in a population-based IBD cohort, including the characteristics of resectional surgery, perianal disease and the outcomes of ileal pouch surgery, in particular cost and disability.
Management of rectal cancer.
Prospective studies of elective gastrointestinal operations and outcomes, including AIN, GIST's, diverticular disease and colorectal cancer.
The natural history of diverticulitis and risk factors for recurrence.
Multi-national study on the outcomes of patients having surgery for locally recurrent rectal cancer.

Laboratory-based research

Toxin-producing strains of enteric bacteria and colorectal cancer (J Keenan)
The role of outer membrane vesicles in modulation of intestinal function by gram-negative bacteria (J Keenan in collaboration with the Departments of Physiology and Medicine, University of Otago).
Genetic and environmental influences on inflammatory bowel diseases (J Keenan in collaboration with Departments of Pathology and Medicine, University of Otago, Christchurch).
A study of host iron levels and H. pylori pathogenesis (J Keenan).

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Ophthalmology

The Ophthalmology Department currently has funding from the Health Research Council (NZ) to study “Retinopathy of Prematurity.”

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Oral and Maxillofacial Surgery

This department is involved in a number of research projects, including:

Demographics of Facial Fractures
Influence of Alcohol in Facial Injuries
Patterns of Orbito-zygomatic fractures
Facial Laser Scanning
Evaluation of Cone Beam CT scanning in orbital reconstruction
Oral Epithelial Dysplasia
Bisphosphonate induced Jaw Necrosis
Trial of New Delivery System in Management of Xerostomia

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Otolaryngology - Head & Neck Surgery

Clinical Research in this department covers most areas of the specialty, including General Otolaryngology, Rhinology, Head & Neck Surgery and Otology-Neurotology. Many members of the department undertake clinical research.

Mr Robert Allison leads much of the clinical research on head and neck cancer. Current studies involve a review of the management of laryngeal cancer in Christchurch, outcomes following lateral temporal bone resection for malignancy, a review of patients undergoing surgery for metastatic cutaneous squamous cell carcinoma to the parotid gland (this study is being carried out in conjunction with Waikato Hospital). He is also involved in an ongoing, prospective study examining the effects of pharyngeal pouch surgery on swallowing.

Mr Scott Stevenson is involved in research including rhinology and sleep medicine, he also leads research into general topics, including intervention rates for adenotonsillectomy, postoperative analgesia and bolus obstruction of the oesophagus.

Associate Professor Phil Bird is involved in outcomes research following cochlear implantation. He is also involved in collaborative research looking at the risk to inner ear function from middle ear surgery and cochlear implantation. This is a major collaboration with Dr Greig O’Beirne from the University of Canterbury, involving two PhD students.

There is also collaborative research with Professor Evan Begg from the Department of Clinical Pharmacology, relating to pharmokinetics of steroids when delivered via the intratympanic route. In conjunction with Mr Jeremy Hornibrook from the Otolaryngology Department, he is undertaking research in to intratympanic gadolinium as a marker for endolymphatic hydrops in the inner ear, comparing it with electrocochleography and clinical indicators of Ménière’s Disease.

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Paediatric Surgery

Professor Spencer Beasley has had a longstanding research interest in studying the effects of Adriamycin on the foetus, and refining the rodent model of the VATER association, as a means of investigating various aspects of oesophageal atresia and related congenital structural abnormalities. More recently, the role of Sonic Hedgehog in both normal development of the foregut and hindgut, and in abnormal development has been studied.

Recent clinical research in Paediatric Surgery has included a study of the factors that predict outcome and complications after herniotomy and orchidopexy, the relationship between the operative appearance of the hernial sac at herniotomy and prediction of a contralateral hernia, quality of life after laparoscopic ACE procedure, and the predictors of outcome following laparoscopic appendectomy in children.

Other research includes a study of the parameters of operative experience that predict progress in surgical trainees (surgical education), the use of the operative logbook as a tool to measure the characteristics of accredited training posts (surgical education), and, the effect of the paediatric surgical outreach programme on improving outcome for children.

Up until the Canterbury earthquakes, we had a project investigating a possible solution to the difficult problem of "short gut syndrome", where there is inadequate length of small bowel for effective absorption to occur. This happens in a variety of situations, including Crohn disease, embolic or vascular disease, closed loop obstruction, malrotation with volvulus, gastroschisis with atresia, necrotizing enterocolitis, CIIPS, extensive aganglionosis (Hirschsprung disease), and polyposis. Currently, therapeutic options are limited, and range from TPN until adaption occurs for less severe situations, to small bowel transplantation with its associated problems of rejection. We are investigating techniques of tissue-engineering bowel using the Yamanaka et al. technique in which induced pluripotent stem cells (iPS) dedifferentiated from somatic fibroblasts by retroviral transduction of four transcription factors, are encouraged to differentiate into cells normally found in the gut. This technology using iPS cells overcomes the ethical problem of using fertilized eggs, obviates the need for immunosuppression, and has the potential to restore functional gut in those with "short gut syndrome". We are refining the technique to differentiate iPS cells more reliably into components of the gut, including smooth muscle, with the longer term goal of employing tissue engineering techniques to rebuild gut using the patients’ own cells. The value of these new technologies is that ultimately they may dispense with the need for small bowel transplantation, and allow patients who have inadequate gut for absorption to "grow" their own small bowel.