The Christie NHS FT Annual Report & Accounts 2019-20

The Christie NHS Foundation Trust Annual Report & Accounts 2019-10

Anaesthetics, Theatre and Surgery

Our directorate of Anaesthetics, Theatre and Surgery is a specialist tertiary centre that concentrates on rare cancers, specialist procedures and multi-disciplinary cancer surgery. All of our specialties work as a single service in a network across populations ranging from 1.5m to 25m. In most cases, our teams of surgeons, anaesthetists, nurses and allied health care professionals work in a network across more than one hospital or community site. Our Anaesthetic, Theatre and Surgical team are an integral part of the comprehensive cancer centre. Working with all other clinical groups allows for specialist multidisciplinary care of patients requiring multimodality therapies to occur under one roof. Additionally, many patients undergoing radiotherapy or chemotherapy for their cancer may suffer from complications or side effects that require surgical opinions or management. We provide a crucial service to local, regional and national populations. Much of our work is based on rare and specialist cancers under the remit of specialised and highly specialised commissioning, whilst ensuring patients being treated non surgically, within the comprehensive centre, are supported appropriately. The following specialties are represented within the directorate • Anaesthetists • Colorectal and peritoneal surgery • Urological surgery • Gynaecological surgery • Plastic surgery Our current services and populations served are summarised below: • Rare cancers • Anal cancer: 3.2 million • Peritoneal tumours and appendix neoplasia (pseudomyxoma peritonei): 25 million • Penile cancer: 8 million • Retroperitoneal/abdomino-pelvic sarcoma: 5.45 million

• Testicular cancer: 6 million • Vulval cancer : 1.5 million Specialist procedures • Electro-chemotherapy: 3.2 million • Intraoperative peritoneal chemotherapy: 25 million • Photodynamic therapy: 4 million • Post-radiation and post-chemotherapy side effects requiring surgical management: 3.2 million • Robotic surgery: 3.2 million (urological, colorectal, gynaecological) • Specialist abdominal wall reconstruction: 3.2 million • Specialist diagnostics: 3.2 million (including multi disciplinary cancer team (MDCT) approach, virtual MDCT, and template prostate biopsies) Multidisciplinary treatment We formed the UK’s first MDCT, which has been functioning since 1970 and has grown significantly over the last three decades. The MDCT undertakes the management of specialist pelvic cancer and retro peritoneal cancers and conditions including: • Advanced and recurrent rectal, anal and colon cancers requiring combined chemo-radiation and multispecialty surgery, including perineal reconstruction. • Advanced gynaecological malignancy requiring multi-specialty surgery, including ovarian debulking and cytoreductive surgery. • Retroperitoneal / abdomino-pelvic sarcomas requiring chemotherapy, radiation and/or surgery. • Melanoma requiring reconstruction, chemotherapy and on rare occasions MDCT surgery. • Prophylactic breast cancer surgery. • A multidisciplinary approach to living with and beyond cancer: treating radiation and cancer induced fistulae, bleeding and intractable

symptoms of urinary tract and bowel, recurrent tumours post radiation and chemotherapy, and late onset radiation induced tumours.

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