I was invited to Huddersfield by the Yorkshire and Humber Strategic Clinical Network to give an update on oesophageal cancer and Barrett’s oesophagus to primary care cancer leads. A number of key points emerged. Even though the incidence of oesophageal cancer is increasing in the UK especially in male patients, overall survival is increasing. Five-year survival from cases that have been operated on in Leeds is around 40-50%.
It is very important for patients with Barrett’s oesophagus to have 2 yearly endoscopy and for those with dysplasia (where the oesophageal lining has started to become unstable), endoscopic surveillance is done by a specialist and more definitive treatment such as radio frequency ablation is considered. Patients with oesophageal cancer too advanced for surgery can be offered palliative anti-cancer treatment such as chemotherapy (medical treatment) and/or radiotherapy (radiation treatment) in addition to an oesophageal stent (a tube that is inserted that opens up the gullet to allow improved swallowing).
I was privileged to be able to attend the excellent BOMSS Meeting in Leamington Spa last week. Internationally recognised speakers attended including George Fielding (New York), Bruno Dillemans (Bruges), Michel Gagner (Montreal) and John Dixon (Melbourne). A lively debate took place on Thursday with the three bariatric surgeons debating the ideal weight loss surgery option for a hypothetical patient aged 28 years with a BMI of 42. Audience participation was encouraged and they voted for their recommendation before and after the debate. There was a swing of opinion favouring the adjustable gastric band rather than the roux en y gastric by pass for this case after the arguments were heard. The debate continues…
The fact that this controversy exists was emphasized by Professor Jane Blazeby from Bristol. She requested support from surgeons around the UK for a multi-centre randomised trial of sleeve vs gastric bypass vs adjustable gastric band to try and work out which weight loss operation produces the best outcome and quality of life for patients. This is a large project which will require a lot of patients to take part and I hope that Leeds can support recruitment of patients for this study. We may finally be able to produce an answer regarding the most effective weight loss surgery procedure of these 3 options.
I had the pleasure of presenting some evidence for weight loss surgery to the British Fertility Society Meeting in Sheffield on 8th January 2014. There is evidence that weight loss surgery may improve female fertility in patients with ‘morbid’ obesity (BMI >= 35) and lead to an increase in the chance of pregnancy afterwards. Pregnancy itself should be avoided in patients 12-18 months after undergoing weight loss surgery and contraception should be carefully considered by patients undergoing a bariatric procedure. A number of pregnancy outcomes are improved after weight loss surgery.
In June 2013 surgeon level outcome data was published for the first time.
Outcomes for NHS patients who have received weight loss surgery have been made available to the public. Surgeons have been able to enter their own data into the National Bariatric Surgery Registry database which is hosted by the British Obesity and Metabolic Surgery Society. Outcomes for operations performed by Mr Jeremy Hayden can be obtained by visiting http://nbsr.e-dendrite.com and entering his name in the ‘surgeon’ section.
Welcome to my new website. I am a Consultant Surgeon based in Leeds who treats both NHS and private patients with a variety of health problems. My expertise includes weight loss surgery, cancer surgery (of the oesophagus or ‘gullet’ and stomach) and other common conditions such as gallstones, hernias and reflux disease. I deal with other complex problems including revisional surgery. I hope that you find the content helpful and interesting. I have produced this new website with the expert help of Lyz Corden, a website designer based in Leeds (http://www.diligentdesign.co.uk). I hope that we have produced a site that makes it easy for the visitor find a solution for their surgical problem. I would welcome any comments regarding the usefulness of the site and any ways that it can be improved.