Publications
101 results found
Faiz O, Aylin P, Bottle A, 2008, Changing trends in surgery for acute appendicitis (Br J Surg 2008; 95: 363-368), The British journal of surgery, Vol: 95, ISSN: 1365-2168
Aylin P, Bottle A, Faiz O, 2008, Demonstrating safety through in-hospital mortality analysis following elective abdominal aortic aneurysm repair in England (Br J Surg 2008; 95: 64-71), The British journal of surgery, Vol: 95, ISSN: 1365-2168
Faiz O, Tekkis P, McGuire A, et al., 2008, Is theatre utilization a valid performance indicator for NHS operating theatres?, BMC health services research, Vol: 8, ISSN: 1472-6963
BACKGROUND: Utilization is used as the principal marker of theatre performance in the NHS. This study investigated its validity as: a managerial tool, an inter-Trust indicator of efficient theatre use and as a marker of service performance for surgeons. METHODS: A multivariate linear regression model was constructed using theatre data comprising all elective general surgical operating lists performed at a NHS Teaching hospital over a seven-year period. The model investigated the influence of: operating list size, individual surgeons and anaesthetists, late-starts, overruns, session type and theatre suite on utilization (%). RESULTS: 7,283 inpatient and 8,314 day case operations were performed on 3,234 and 2,092 lists respectively. Multivariate analysis demonstrated that the strongest independent predictors of list utilization were the size of the operating list (p < 0.01) and whether the list overran (p < 0.01). Surgeons differed in their ability to influence utilization. Their overall influence upon utilization was however small. CONCLUSION: Theatre utilization broadly reflects the surgical volume successfully admitted and operated on elective lists. At extreme values it can expose administrative process failure within individual Trusts but probably lacks specificity for meaningful use as an inter-Trust theatre performance indicator. Unadjusted utilization rates fail to reflect the service performance of surgeons, as their ability to influence it is small.
Faiz O, Banerjee S, Tekkis P, et al., 2007, We still need to operate at night!, World journal of emergency surgery : WJES, Vol: 2, ISSN: 1749-7922
INTRODUCTION: In the past the National Confidential Enquiry into Peri-operative deaths (NCEPOD) have advocated a reduction in non-essential night-time operating in NHS hospitals. In this study a retrospective analysis of the emergency general surgical operative workload at a London Teaching centre was performed. METHODS: All general surgical and vascular emergency operations recorded prospectively on the theatre database between 1997 and 2004 were included in the study. Operations were categorised according to whether they commenced during the daytime(08:01-18:00 hours), evening(18:01-00:00 hours) or night-time(00:01-08:00 hours). The procedure type and grade of the participating surgical personnel were also recorded. Bivariate correlation was used to analyse changing trends in the emergency workload. RESULTS: In total 5,316 emergency operations were performed over the study period. The numbers of daytime, evening and night-time emergency procedures performed were 2,963(55.7%), 1,832(34.5%), and 521(9.8%) respectively. Laparotomies and complex vascular procedures collectively accounted for half of all cases performed after midnight whereas they represented only 30% of the combined daytime and evening emergency workload. Thirty-two percent (n = 166) of all night-time operations were supervised or performed by a consultant surgeon. The annual volume of emergency cases performed increased significantly throughout the study period. Enhanced daytime (r = 0.741, p < 0.01) and evening (r = 0.548, p < 0.01) operating absorbed this increase in workload. There was no significant change in the absolute number of cases performed at night but the proportion of the emergency workload that took place after midnight decreased significantly throughout the study (r = -0.742, p < 0.01). CONCLUSION: A small but consistent volume of complex cases require emergency surgery after midnight. Provision of an emergency general surgical service must incorporate this need.
Faiz O, Moffat DB, 2006, Anatomy at a glance, Publisher: Wiley-Blackwell, ISBN: 9781405133487
This new edition of Anatomy at a Glance:Explains the terminology of descriptive anatomy.
Faiz OD, Banerjee S, Tekkis PP, et al., 2005, We still need to operate at night!, Annual Meeting of the Association-of-Surgeons-of-Great-Britain-and-Ireland, Publisher: WILEY-BLACKWELL, Pages: 96-97, ISSN: 0007-1323
Thakur K, Faiz O, Tekkis P, et al., 2002, Do primary tumour characteristics predict axillary nodal status in breast cancer?, BRITISH JOURNAL OF SURGERY, Vol: 89, Pages: 75-75, ISSN: 0007-1323
Faiz O, Fentiman IS, 2000, Management of breast pain, International journal of clinical practice, Vol: 54, Pages: 228-232, ISSN: 1368-5031
Mastalgia is a common problem among premenopausal women, and those with severe and protracted symptoms merit treatment. A range of non-hormonal and hormonal agents is available for symptom control among mastalgia sufferers but many are ineffective. Tamoxifen is the most effective and least toxic agent available for the treatment of severe chronic breast pain. Dosage with tamoxifen must be tailored to individual patient requirement and symptom control balanced against troublesome side-effects.
Faiz O, Fentiman IS, 1998, Hormone replacement therapy and breast cancer, International journal of clinical practice, Vol: 52, Pages: 98-101, ISSN: 1368-5031
Hormone replacement therapy (HRT) leads to a similar annual increase in risk of breast cancer as does each extra year of remaining premenopausal. Taken for more than 10 years HRT leads to a 35% increase in risk of developing breast cancer. It does not increase a woman's risk of dying of breast cancer, and may improve the prognosis. Some breast cancer patients can safely take HRT and some formulations might reduce the subsequent risk of relapse.
García-Granero E, Faiz O, Muñoz E, et al., Macroscopic assessment of mesorectal excision in rectal cancer: a useful tool for improving quality control in a multidisciplinary team., Cancer, Vol: 15, Pages: 3400-3411
BACKGROUND: High quality of surgical technique and the use of descriptive measures to assess and report surgical proficiency have been shown to influence locoregional tumor control in patients with rectal cancer. In this study, the authors have aimed to audit the implementation of a macroscopic assessment of mesorectal excision (MAME) and to investigate factors that influenced surgical quality and disease recurrence. METHODS: All curative resections for rectal cancer were prospectively evaluated for MAME between 1998 and 2007. Mesorectal specimens were graded into 3 types: complete, nearly complete, and incomplete categories. Univariate and multivariate analyses identified independent risk factors for noncomplete mesorectum categories as well as local and overall tumor recurrence. RESULTS: Of 359 specimens, 294 (81.9%) underwent evaluation; 82.3% were "complete." Abdominoperineal resection (APR) was the sole covariate associated with inadequate mesorectal excision (odds ratio [OR]=2.7; P=.003). Independent predictors of local recurrence were circumferential resection margin (CRM) involvement (OR=3.6; P=.027) and noncomplete mesorectum (OR=4.4; P=.008). CRM+ (OR=3.1; P=.004), poorly differentiated tumors (OR=14.2; P=.010), nodal involvement (OR=2.9; P=.010), and APR (OR=2.9; P=.006) were independent risk factors for overall recurrence. In lower third tumors, noncomplete mesorectum occurred more frequently in APR compared with sphincter-saving procedures (31.1% vs 18.8%; P=.088). CONCLUSIONS: This study demonstrates the value of auditing MAME. Good proficiency of mesorectal excision is associated with lower tumor recurrences after curative surgery, and is a morphological tool found to be useful in clinical practice. Copyright (c) 2009 American Cancer Society.
García-Granero E, Faiz O, Flor-Lorente B, et al., Prognostic implications of circumferential location of distal rectal cancer, Colorectal Dis.
Abstract Purpose: The study evaluated the prognostic importance of circumferential tumor position of mid and low rectal cancers Method: All uT2, uT3 or uT4 tumors of the middle and lower rectum that underwent total mesorectal excision (TME) with curative intent between 1996 and 2006 were included. The predominant circumferential tumor position (anterior, posterior or circumferential) was defined on pre-operative endorectal ultrasound examination (ERUS). The relationships between tumour position and other characteristics and recurrence were explored. Results: Two hundred and five 205 patients with distal rectal cancer patients were operated for a uT2-T4 tumor. Median follow-up was 49 months. The location of the tumor was predominantly anterior, posterior or circumferential positions in 128, 49 and 27 patients respectively. Anterior tumors were more likely to receive neoadjuvant therapy (p=0.016) and perioperative blood transfusion (p=0.012). No significant differences were observed between circumferential position and pT or pN stage, circumferential resection margin involvement or mesorectal excision quality. Sixty three (30.7%) patients developed recurrence which was local only in 16(7.8%). Although tumours involving 360(0) of the rectal wall had a higher risk of local recurrence (p=0.048), those with a predominant anterior or posterior position were not related with a higher risk of local or overall recurrence. Conclusion: Anterior rectal tumors do not differ in pathological characteristics from posterior tumors and their prognosis is no worse if circumferential resection is complete.
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