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Article: Editorial comment: Measuring performance in unselected emergency admissions.

Warren, Oliver J

2019 Volume 2, Issue 1, Page(s) 42–43

Language	English
Publishing date	2019-05-13
Publishing country	England
Document type	Journal Article
ZDB-ID	2775176-4
ISSN	2055-3331 ; 2055-3323
ISSN (online)	2055-3331
ISSN	2055-3323
DOI	10.7861/futurehosp.2-1-42
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Article ; Online: Laparoscopic totally extraperitoneal hernia repair in patients with a history of previous abdominopelvic surgery.

Hayward, Romilly / Smith, Jacob J / Kontovounisios, Christos / Qiu, Shengyang / Warren, Oliver J

Updates in surgery

2024

Abstract: A retrospective cohort study of patients undergoing laparoscopic inguinal hernia repair compared short- and long-term outcomes between individuals with or without history of previous abdominopelvic surgery, aiming to determine the feasibility of totally ... ...

Abstract	A retrospective cohort study of patients undergoing laparoscopic inguinal hernia repair compared short- and long-term outcomes between individuals with or without history of previous abdominopelvic surgery, aiming to determine the feasibility of totally extraperitoneal (TEP) repair within this population. All patients who underwent elective TEP inguinal hernia repair by one consultant surgeon across three London hospitals from January 2017 to May 2023 were retrospectively analysed to assess perioperative outcomes. Two hundred sixty-two patients were identified, of whom two hundred forty-three (93%) underwent laparoscopic TEP repair. The most frequent complications were haematoma (6.2%) and seroma (4.1%). Recurrence occurred in four cases (1.6% of operations, 1.1% of hernias). One hundred eighty-four patients (76%) underwent day-case surgery. There were no mesh infections or explanations, vascular or visceral injuries, port-site hernias, damage to testicle, or persisting numbness. There were no requirements for blood transfusion, returns to theatre, or readmissions within 30 days. There was one conversion to open and one death within 60 days of surgery. Eighty-three (34%) had a history of previous AP surgery. There was no significant difference in perioperative outcomes between the AP and non-AP arms. This finding carried true for subgroup analysis of 44 patients whose AP surgical history did not include previous inguinal hernia repair and for those undergoing repair of recurrent hernia. In expert hands, laparoscopic TEP repair is associated with excellent outcomes and low rates of long-term complications, and thus should be considered as standard for patients regardless of a history of AP surgery.
Language	English
Publishing date	2024-04-23
Publishing country	Italy
Document type	Journal Article
ZDB-ID	2572692-4
ISSN	2038-3312 ; 2038-131X
ISSN (online)	2038-3312
ISSN	2038-131X
DOI	10.1007/s13304-024-01810-w
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Article ; Online: Risks Factors Associated with the Development of Crohn's Disease After Ileal Pouch-Anal Anastomosis for Ulcerative Colitis: A Systematic Review and Meta-Analysis.

Fadel, Michael G / Geropoulos, Georgios / Warren, Oliver J / Mills, Sarah C / Tekkis, Paris P / Celentano, Valerio / Kontovounisios, Christos

Journal of Crohn's & colitis

2023 Volume 17, Issue 9, Page(s) 1537–1548

Abstract: Background: Following ileal pouch-anal anastomosis [IPAA] for ulcerative colitis [UC], up to 16% of patients develop Crohn's disease of the pouch [CDP], which is a major cause of pouch failure. This systematic review and meta-analysis aimed to identify ... ...

Abstract	Background: Following ileal pouch-anal anastomosis [IPAA] for ulcerative colitis [UC], up to 16% of patients develop Crohn's disease of the pouch [CDP], which is a major cause of pouch failure. This systematic review and meta-analysis aimed to identify preoperative characteristics and risk factors for CDP development following IPAA. Methods: A literature search of the MEDLINE, EMBASE, EMCare and CINAHL databases was performed for studies that reported data on predictive characteristics and outcomes of CDP development in patients who underwent IPAA for UC between January 1990 and August 2022. Meta-analysis was performed using random-effect models and between-study heterogeneity was assessed. Results: Seven studies with 1274 patients were included: 767 patients with a normal pouch and 507 patients with CDP. Age at UC diagnosis (weighted mean difference [WMD] -2.85; 95% confidence interval [CI] -4.39 to -1.31; p = 0.0003; I2 54%) and age at pouch surgery [WMD -3.17; 95% CI -5.27 to -1.07; p = 0.003; I2 20%) were significantly lower in patients who developed CDP compared to a normal pouch. Family history of IBD was significantly associated with CDP (odds ratio [OR] 2.43; 95% CI 1.41-4.19; p = 0.001; I2 31%], along with a history of smoking [OR 1.80; 95% CI 1.35-2.39; p < 0.0001; I2 0%]. Other factors such as sex and primary sclerosing cholangitis were found not to increase the risk of CDP. Conclusions: Age at UC diagnosis and pouch surgery, family history of IBD and previous smoking have been identified as potential risk factors for CDP post-IPAA. This has important implications towards preoperative counselling, planning surgical management and evaluating prognosis.
Language	English
Publishing date	2023-03-21
Publishing country	England
Document type	Journal Article
ZDB-ID	2390120-2
ISSN	1876-4479 ; 1873-9946
ISSN (online)	1876-4479
ISSN	1873-9946
DOI	10.1093/ecco-jcc/jjad051
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Article ; Online: Comparing and contrasting clinical consensus and guidelines for anal intraepithelial neoplasia in different geographical regions.

Brogden, Danielle R L / Lupi, Micol E E / Warren, Oliver J / Kontovounisios, Christos / Mills, Sarah C

Updates in surgery

2021 Volume 73, Issue 6, Page(s) 2047–2058

Abstract: Anal Squamous Cell Carcinoma (ASCC) is an uncommon cancer with a recognised precursor Anal Intraepithelial Neoplasia (AIN). Although there are consistent evidence-based guidelines for the management of ASCC, historically this has not been the case for ... ...

Abstract	Anal Squamous Cell Carcinoma (ASCC) is an uncommon cancer with a recognised precursor Anal Intraepithelial Neoplasia (AIN). Although there are consistent evidence-based guidelines for the management of ASCC, historically this has not been the case for AIN and as a result there have been geographical variations in the recommendations for the treatment of AIN. More recently there have been updates in the literature to the recommendations for the management of AIN. To assess whether we are now closer to achieving an international consensus, we have completed a systematic scoping review of available guidelines for the screening, treatment and follow-up of AIN as a precursor to ASCC. MEDLINE and EMBASE were systematically searched for available clinical guidelines endorsed by a recognised clinical society that included recommendations on either the screening, treatment or follow-up of AIN. Nine clinical guidelines from three geographical areas were included. The most recent guidelines agreed that screening for AIN in high-risk patients and follow-up after treatment was necessary but there was less consensus on the modality of screening. Six Guidelines recommended the treatment of high-grade AIN and four guidelines describe a follow-up protocol of patients diagnosed with AIN. There appears to be increasing consensus on the treatment and follow-up of patients despite a poor evidence base. There is still significant discrepancy in guidance on the method to identify patients at risk of ASCC and AIN despite consensus between geographical regions on which patient subgroups are at the highest risk.
MeSH term(s)	Anus Neoplasms/diagnosis ; Anus Neoplasms/epidemiology ; Anus Neoplasms/therapy ; Carcinoma in Situ/diagnosis ; Carcinoma in Situ/epidemiology ; Carcinoma in Situ/therapy ; Carcinoma, Squamous Cell ; Consensus ; Humans ; Mass Screening
Language	English
Publishing date	2021-09-04
Publishing country	Italy
Document type	Journal Article ; Review ; Systematic Review
ZDB-ID	2572692-4
ISSN	2038-3312 ; 2038-131X
ISSN (online)	2038-3312
ISSN	2038-131X
DOI	10.1007/s13304-021-01156-7
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Article ; Online: The Drive Toward Transanal Total Mesorectal Excision - Science or Rhetoric?

Warren, Oliver J / Solomon, Michael J

Diseases of the colon and rectum

2015 Volume 58, Issue 9, Page(s) 909–910

MeSH term(s)	Anal Canal/surgery ; Digestive System Surgical Procedures/methods ; Digestive System Surgical Procedures/trends ; Evidence-Based Medicine ; Humans ; Laparoscopy/trends ; Minimally Invasive Surgical Procedures/methods ; Minimally Invasive Surgical Procedures/trends ; Natural Orifice Endoscopic Surgery/trends ; Rectal Neoplasms/surgery ; Rectum/surgery
Language	English
Publishing date	2015-09
Publishing country	United States
Document type	Journal Article
ZDB-ID	212581-x
ISSN	1530-0358 ; 0012-3706
ISSN (online)	1530-0358
ISSN	0012-3706
DOI	10.1097/DCR.0000000000000423
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Article ; Online: Unique case of herniated small bowel infarction within a colonic stomal prolapse.

Miller, Robert Lloyd / Yeung, Derek / McCluney, Simon / Warren, Oliver J

BMJ case reports

2017 Volume 2017

Abstract: The number of permanent colostomies carried out in the United Kingdom is approximately 6400 per year1. Stomal prolapse is a known complication of colostomy formation. We presented the first case of small bowel herniation into a healthy stomal prolapse ... ...

Abstract	The number of permanent colostomies carried out in the United Kingdom is approximately 6400 per year1. Stomal prolapse is a known complication of colostomy formation. We presented the first case of small bowel herniation into a healthy stomal prolapse with subsequent ischaemia of the herniated bowel in a 102-year-old patient. This rare sequela of a relatively common stomal complication highlights an important consideration when faced with a large prolapse presenting acutely. It also raises an important discussion point for the management of our ever-ageing patient population.
MeSH term(s)	Adenocarcinoma/surgery ; Aged, 80 and over ; Cecal Diseases/complications ; Cecal Diseases/diagnosis ; Cecal Diseases/surgery ; Colonic Neoplasms/surgery ; Colostomy ; Diagnosis, Differential ; Humans ; Infarction/complications ; Infarction/diagnosis ; Infarction/surgery ; Male ; Prolapse ; Reoperation
Language	English
Publishing date	2017-08-16
Publishing country	England
Document type	Case Reports ; Journal Article
ISSN	1757-790X
ISSN (online)	1757-790X
DOI	10.1136/bcr-2017-220850
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Article ; Online: What exactly is meant by 'loss of domain' for ventral hernia? A survey of 100 surgeons.

Parker, Samuel G / Halligan, Steve / Erotocritou, Marios / Plumb, Andrew A O / Warren, Oliver J / Windsor, Alastair C J

ANZ journal of surgery

2020 Volume 90, Issue 3, Page(s) 205–207

MeSH term(s)	Hernia, Ventral/pathology ; Hernia, Ventral/surgery ; Herniorrhaphy ; Humans ; Surveys and Questionnaires ; Terminology as Topic
Language	English
Publishing date	2020-03-09
Publishing country	Australia
Document type	Journal Article
ZDB-ID	2050749-5
ISSN	1445-2197 ; 1445-1433 ; 0004-8682
ISSN (online)	1445-2197
ISSN	1445-1433 ; 0004-8682
DOI	10.1111/ans.15602
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Article ; Online: Medical leadership: why it's important, what is required, and how we develop it.

Warren, Oliver J / Carnall, Ruth

Postgraduate medical journal

2010 Volume 87, Issue 1023, Page(s) 27–32

Abstract: Good medical leadership is vital in delivering high-quality healthcare, and yet medical career progression has traditionally seen leadership lack credence in comparison with technical and academic ability. Individual standards have varied, leading to ... ...

Abstract	Good medical leadership is vital in delivering high-quality healthcare, and yet medical career progression has traditionally seen leadership lack credence in comparison with technical and academic ability. Individual standards have varied, leading to variations in the quality of medical leadership between different organisations and, on occasions, catastrophic lapses in the standard of care provided to patients. These high-profile events, plus increasing evidence linking clinical leadership to performance of units, has led recently to more focus on leadership development for all doctors, starting earlier and continuing throughout their careers. There is also an increased drive to see doctors take on more significant leadership roles throughout the healthcare system. The achievement of these aims will require doctors to develop strong personal and professional values, a range of non-technical skills that allow them to lead across professional boundaries, and an understanding of the increasingly complex environment in which 21st century healthcare is delivered. Developing these attributes will require dedicated resources and the sophisticated application of a variety of different learning methodologies such as mentoring, coaching, action learning and networking.
MeSH term(s)	Delivery of Health Care/standards ; Education, Medical, Continuing/organization & administration ; Humans ; Leadership ; Mentors ; Physicians/psychology ; State Medicine/standards ; United Kingdom
Language	English
Publishing date	2010-10-10
Publishing country	England
Document type	Journal Article ; Review
ZDB-ID	80325-x
ISSN	1469-0756 ; 0032-5473
ISSN (online)	1469-0756
ISSN	0032-5473
DOI	10.1136/pgmj.2009.093807
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Article ; Online: Anal squamous cell carcinoma in a high HIV prevalence population.

Brogden, Danielle R L / Khoo, Christopher C / Kontovounisios, Christos / Pellino, Gianluca / Chong, Irene / Tait, Diana / Warren, Oliver J / Bower, Mark / Tekkis, Paris / Mills, Sarah C

Discover. Oncology

2021 Volume 12, Issue 1, Page(s) 3

Abstract: Anal Squamous Cell Carcinoma (ASCC) is a rare cancer that has a rapidly increasing incidence in areas with highly developed economies. ASCC is strongly associated with HIV and there appears to be increasing numbers of younger male persons living with HIV ...

Abstract	Anal Squamous Cell Carcinoma (ASCC) is a rare cancer that has a rapidly increasing incidence in areas with highly developed economies. ASCC is strongly associated with HIV and there appears to be increasing numbers of younger male persons living with HIV (PLWH) diagnosed with ASCC. This is a retrospective cohort study of HIV positive and HIV negative patients diagnosed with primary ASCC between January 2000 and January 2020 in a demographic group with high prevalence rates of HIV. One Hundred and seventy six patients were included, and clinical data was retrieved from multiple, prospective databases. A clinical subgroup was identified in this cohort of younger HIV positive males who were more likely to have had a prior diagnosis of Anal Intraepithelial Neoplasia (AIN). Gender and HIV status had no effect on staging or disease-free survival. PLWH were more likely to develop a recurrence (p < 0.000) but had a longer time to recurrence than HIV negative patients, however this was not statistically significant (46.1 months vs. 17.5 months; p = 0.077). Patients known to have a previous diagnosis of AIN were more likely to have earlier staging and local tumour excision. Five-year Disease-Free Survival was associated with tumour size and the absence of nodal or metastatic disease (p < 0.000).
Language	English
Publishing date	2021-02-11
Publishing country	United States
Document type	Journal Article
ISSN	2730-6011
ISSN (online)	2730-6011
DOI	10.1007/s12672-021-00397-7
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Article ; Online: Exploiting opportunities for leadership development of surgeons within the operating theatre.

Suliman, Amna / Klaber, Robert E / Warren, Oliver J

International journal of surgery (London, England)

2013 Volume 11, Issue 1, Page(s) 6–11

Abstract: It is increasingly recognised that leadership skills are a key requirement in being successful in surgery, regardless of speciality and at all levels of experience and seniority. Where the emphasis was previously on technical ability, knowledge and ... ...

Abstract	It is increasingly recognised that leadership skills are a key requirement in being successful in surgery, regardless of speciality and at all levels of experience and seniority. Where the emphasis was previously on technical ability, knowledge and diagnostic acumen, we now know that non-technical skills such as communication and leadership contribute significantly to patient safety, experience and outcomes, and should be valued. The operating theatre is a unique micro-environment which is often busier, noisier, more stressful and more physically demanding than the clinic or ward setting. As a result surgeons and their trainers, who are striving to develop leadership skills require an in-depth awareness of the challenges in this environment and the opportunities that arise from them to develop leadership effectively. This article outlines why leadership learning is so beneficial in the operating theatre, both for the team and the patient as well as what elements of daily routine activity such as the WHO checklist use, list-planning and audit can be exploited to transform the average busy operating theatre into a rich, learning environment for future leaders in surgery.
MeSH term(s)	Communication ; Computer Simulation ; Humans ; Leadership ; Operating Rooms/organization & administration ; Operating Rooms/standards ; Patient Care Team ; Physicians/organization & administration ; Physicians/standards ; Surgical Procedures, Operative/education ; Surgical Procedures, Operative/standards
Language	English
Publishing date	2013
Publishing country	England
Document type	Journal Article ; Review
ZDB-ID	2212038-5
ISSN	1743-9159 ; 1743-9191
ISSN (online)	1743-9159
ISSN	1743-9191
DOI	10.1016/j.ijsu.2012.11.002
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