Home| Professor of Surgery |
| Lead, Academic Surgical Unit |
Contact details:
| Tel: | +44 20 7377 7079 |
| Fax: | +44 20 7377 7283 |
| Email: | n.s.williams@qmul.ac.uk |
| Address: | Academic Surgical Unit, |
Biography
Norman Williams is the Lead of the Acdemic Surgical Unit at Barts and The London School of Medicine and Dentistry, from where he originally qualified. His early surgical training was in London and Bristol , before moving to Leeds General Infirmary/ University as a Research Fellow, and subsequently Lecturer and Senior Lecturer. His principal clinical and research interests are in coloproctology. During his Lecturer years, he went as a Fullbright Scholar to the University of California , Los Angeles (UCLA), and gained particular expertise in gastrointestinal motility. He has won the Patey Prize of the Surgical Research Society, the Moynihan Fellowship of the Association of Surgeons and the BUPA Society of Authors' Prize (Jointly) for the textbook "Surgery of the Anus, Rectum and Colon ". He was awarded the Nessim Habif Prize for Surgery in 1995 and the Galen Medal in Therapeutics in recognition of the advances made in colorectal surgery in 2002. He was elected as a Fellow of the Academy of Medical Sciences in 2004 and to the Council of The Royal College of Surgeons of England in 2005 and is now Chairman of its Academic and Research Board. He has been President of European Digestive Surgery, Vice-Chairman of the Editorial Board of the British Journal of Surgery, Chairman of the UKCCCR Committee on Colorectal Cancer, a member of the National Cancer Research Network Steering Group and the MRC Physiology and Infection Board. He is President of the Ileostomy and Internal Pouch Support Group of Great Britain and The International Surgical Group (2006-7) and is President Elect of The Society of Academic and Research Surgeons (2007-9). He has been the Sir Alan Parks Visiting Professor 2002, the John Goligher Lecturer 2002, the Zachary-Cope Lecturer for the Royal College of Surgeons 2003 and the GB Ong Visiting Professor in Hong Kong in 2004.
Research Activity
Norman Williams' abiding interest has been the understanding of large bowel function in health and disease and the application of such knowledge to improve the care of patients, particularly from the surgical perspective. In his early research years he concentrated on the feasibility of restoring gastrointestinal continuity and normal function in patients who required anorectal excision for benign and malignant disease. This required the examination scientifically of older rationales that had resulted in such patients requiring a permanent stoma. Thus, the spread of rectal cancer required re-evaluation, as did the physiological principles which had previously prevented reconstitution of anatomy. Established dogma was challenged and refuted.
He later went on to devise a new technique to replace the anal sphincter completely using an electrically stimulated gracilis muscle. This idea emanated from basic research performed by his group in muscle physiology, and when used in man the technique provided unique physiological and biochemical data on the transformation of fast to slow twitch muscle. Allied to this work has been a progressive programme to understand functional colorectal disorders and more recently diverticular disease. New methods of measurement were devised and validated such as integrated dynamic proctography and ambulatory manometry. His group have attempted to correlate cellular and molecular events with physiological abnormalities. For instance, they demonstrated for the first time that the TRPV1 neuroreceptor resides in the rectal wall and is upregulated in patients with rectal hypersensitivity. This work also resulted in the development and evaluation of new surgical therapies for selected patients such as rectal augmentation. The work on diverticular disease showed a cholinergic denervation hypersensitivity picture which challenges conventional views as to the underlying aetiology. More recently his group have become interested in tissue engineering, and are investigating the interaction between porcine collagen and the human gut with a view to using this in reconstructive colorectal surgery.
Throughout his career Professor Williams has had an interest in the non-surgical therapy of colorectal cancer and was instrumental in setting up and running various adjuvant therapy trials including the use of photodynamic therapy to prevent local recurrence. As chairman of the UKCCCR Colorectal Cancer Sub-Ccommittee, he helped to set up the QUASAR study which was the largest adjuvant chemotherpy trial ever performed. He still remains chairman of the steering group for this study. He also established and nurtured a molecular genetics unit within the Centre, which is now applying microarray technology to this tumour.
Key Publications
• Williams NS, Dixon MF, Johnston D. Re-appraisal of the 5 centimetre rule of distal excision for carcinoma of the rectum: a study of distal intra-mural spread and of patients' survival. Br J Surg 1983; 70:150-154
• Williams NS. The rationale for preservation of the anal sphincter in patients with low rectal cancer. Br J Surg 1984; 71:575-78
• Quirke P, Durdey P, Dixon MF, Williams NS. Local recurrence of rectal adenocarcinoma due to inadequate surgical resection. Histopathological study of lateral tumour spread and surgical excision. Lancet 1986; 2(8514):996-99
• Durdey P, Weston PM, Williams NS. Colonoscopy or barium enema as initial investigation of colonic disease. Lancet 1987; 2(8558):549-51
• Williams NS, Patel J, George BD, Hallan RI , Watkins ES. Development of an electrically stimulated neoanal sphincter. Lancet 1991;338(8776):1166-69
• George BD, Patel J, Watkins ES, Williams NS, Swash M. Physiological and histochemical adaptation of the electrically stimulated gracilis muscle to neoanal sphincter function. Br J Surg 1993; 80(10):1342-1346
• Williams NS, Hughes SF, Stuchfield B. Continent colonic conduit for rectal evacuation in severe constipation. Lancet 1994; 343:1321-1324
• Williams NS, Ogunbiyi OA, Scott SM, Fajobi OA, Lunniss PJ. Rectal augmentation and stimulated gracilis anal neosphincter - A new approach in the management of faecal urgency and incontinence. Diseases of Colon and Rectum 2001; 44:192-198
• Chan CLH, Facer P, Davis JB, Smith GD, Egerton J, Bountra C, Williams NS, Anand P. Sensory fibres expressing capsaicin receptor TRPV1 in patients with rectal hypersensitivity and faecal urgency. Lancet 2003; 361:385-391
• Golder M, Burleigh DE, Belai A, Ghali L, Lunniss PJ, Navsaria HA, Williams NS. Smooth muscle cholinergic denervation hypersensitivity in diverticular disease - a pathological effector mechanism in an irritable colon. Lancet 2003; 361(9373):1945-1951
• Gray R, Barnwell R, McConkey C, Hills RK, Williams NS. Kerr D - QUASAR Collaborative Group Analysis and Writing Committee. QUASAR: a randomised study of adjuvant chemotherapy versus observation including 3239 colorectal cancer patients. Lancet 2007; in press
• Murphy J, Chan CLH, Vasudevan SP, Scott SM, Lunniss PJ, Williams NS. Rectal Augmentation: Short and mid term evaluation of a novel procedure for severe faecal urgency and incontinence. Ann Surg 2007; - in press
