Majid Hashemi

Publications (7)21.48 Total impact

• Article: The impact of hospital and surgeon volume on clinical outcome following bariatric surgery.

  Sheraz R Markar, Marta Penna, Alan Karthikesalingam, Majid Hashemi
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  ABSTRACT: The dramatic rise in the prevalence of obesity worldwide has led to the rapid growth of bariatric surgery. The aim of this pooled analysis is to evaluate the relationship between institutional and surgeon volume and outcomes following bariatric surgery. Medical, Embase, trial registries, conference proceedings and reference lists were searched for trials comparing clinical outcome following bariatric surgery at high and low volume hospitals and by high and low volume surgeons. Outcomes analysed were mortality, morbidity and length of hospital stay. Fifteen publications were included in this analysis. In total, 289,732 bariatric procedures were included in the institutional volume analysis, and 32,920 bariatric operations were included in the surgeon volume analysis. Mortality was reduced following surgery at high volume institutions (0.24 vs. 2.18 %; pooled odds ratio = 0.26; P = 0.004) and by high volume surgeons (0.41 vs. 2.77 %; pooled odds ratio = 0.21; P < 0.001). Similarly, morbidity was reduced in high volume institutions (7.84 vs. 8.85 %; pooled odds ratio = 0.52; P < 0.001) and with high volume surgeons (6.92 vs. 7.29 %; pooled odds ratio = 0.47; P < 0.001). There were insufficient data for conclusive statistical analysis of length of hospital stay. This pooled analysis does suggest a benefit in the centralisation of bariatric surgery to high volume institutions and surgeons with respect to mortality and morbidity. Future high-powered studies with adjustment for procedural and patient case mix are required to further define the volume-outcome relationship in bariatric surgery.
  Obesity Surgery 04/2012; 22(7):1126-34. · 3.29 Impact Factor
• Article: Gastroesophageal reflux and voice changes: objective assessment of voice quality and impact of antireflux therapy.

  Shahin Ayazi, Judith Pearson, Majid Hashemi
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  ABSTRACT: Voice-related complaints are the most common extraesophageal manifestation of gastroesophageal reflux disease (GERD). The aim of this study was to compare objectively measured voice parameters in normal subjects and patients with GERD and to assess the impact of antireflux surgery on these parameters in patients with reflux disease. Normal subjects and patients with reflux symptoms were asked to read a standardized, phonetically balanced text while the impedance across vocal cords was recorded using electroglottography. Irregularity in the voice frequency (CFx) and amplitude (CAx) as well as irregularity of the closed phase ratio of vocal cords (CQx) were calculated. These 3 voice parameters were compared between the normal subjects and patients with gastroesophageal reflux. In a subgroup of GERD patients who underwent antireflux surgery, electroglottography was repeated 3 months or later after surgery and the voice parameters were compared with preoperative values. There were 55 normal subjects and 32 patients with GERD. Compared with normal subjects, GERD patients had a significantly higher irregularity in both voice frequency (P=0.04) and amplitude (P=0.03). The CQx did not differ significantly between the 2 groups (P=0.18). In 16 GERD patients who underwent surgery, a significant improvement in postoperative values was observed for both voice frequency (CFx: 48.4 vs. 30.4, P=0.002) and amplitude (CAx: 25.9 vs. 9.3, P=0.004). There are measurable alterations in voice quality in patients with GERD when compared with normal subjects. Antireflux surgery improves the irregularity in both amplitude and frequency of voice in patients with reflux disease.
  Journal of clinical gastroenterology 11/2011; 46(2):119-23. · 2.21 Impact Factor
• Article: The role of integrated F-18-FDG-PET scanning in the detection of M1 disease in oesophageal adenocarcinoma and impact on clinical management.

  Soumil Vyas, Sheraz R Markar, Lydia Iordanidou, Samantha Read, David Stoker, Majid Hashemi, Ian Mitchell, Mark Winslet, Jamshed Bomanji
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  ABSTRACT: The aim of this study was to evaluate the efficacy of F-18-fluorodeoxyglucose positron emission tomography (FDG-PET) scanning in the staging of oesophageal adenocarcinoma. One hundred four patients with biopsy-proven adenocarcinoma underwent (18)F-FDG-PET scan. FDG avid lesions were further investigated to their diagnostic conclusion. Nineteen patients (18.26%) were found to have non-loco-regional FDG uptake. Of the patients, 3.84% were found to have M1 disease and 7.69% were found to have a second primary tumour. The sensitivity and specificity of FDG-PET scanning to detect metastatic disease in our series was 57.14% and 84.53%, respectively. The overall diagnostic accuracy was 82.69%. PET scanning improves staging and prevents unnecessary surgery in patients with M1 disease. It represents a good adjunct to computed tomography scanning and endoscopic ultrasound in the staging of oesophageal adenocarcinoma. The detection of asymptomatic coexisting synchronous cancers is an added benefit provided by PET scanning over similar diagnostic modalities.
  Journal of Gastrointestinal Surgery 10/2011; 15(12):2127-35. · 2.83 Impact Factor
• Article: Influence of circular stapler diameter on postoperative stenosis after laparoscopic gastrojejunal anastomosis in morbid obesity.

  Sheraz R Markar, Marta Penna, Vishal Venkat-Ramen, Alan Karthikesalingam, Majid Hashemi
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  ABSTRACT: The aim of the present study was to provide a pooled analysis of individual small trials comparing 21-mm and 25-mm circular stapled laparoscopic gastrojejunal (GJ) anastomosis in morbid obesity surgery. A systematic literature search of MEDLINE, Embase, and Cochrane library databases was performed to identify all relevant studies comparing 21-mm and 25-mm circular stapled laparoscopic GJ anastomosis in morbid obesity surgery. The primary outcomes were GJ stenosis and the interval to GJ stenosis. The secondary outcomes were the estimated weight loss, GJ diameter, and the number of endoscopic dilations. Pooled odds ratios were calculated for categorical outcomes and weighted mean differences for continuous outcomes. Five trials were included, comprising 1217 patients (393 with 21-mm and 824 with 25-mm circular GJ anastomoses). The primary outcome analysis revealed a significantly increased incidence of intraluminal stenosis associated with the 21-mm circular stapler (pooled odds ratio 3.54; P < .0001). The secondary outcome analysis revealed a significantly reduced GJ anastomotic diameter on endoscopy with the 21-mm circular stapler group (weighted mean difference -1.67; P = .002). Statistical analysis revealed no significant difference between the groups for the interval to stenosis, number of endoscopic dilations, and estimated weight loss. The results of the present pooled analysis have demonstrated a significantly increased incidence of symptomatic stenosis associated with the 21-mm circular stapler compared with the 25-mm stapler. This serves as evidence to validate the preferential selection of the 25-mm circular stapler for laparoscopic GJ bypass.
  Surgery for Obesity and Related Diseases 05/2011; 8(2):230-5. · 3.93 Impact Factor
• Article: Buried penis in super obesity: a technique for urethral catheterization under direct vision.

  James C Hewes, John Kelly, Majid Hashemi
  Surgery for Obesity and Related Diseases 02/2011; 7(3):332. · 3.93 Impact Factor
• Article: Hand-sewn versus stapled oesophago-gastric anastomosis: systematic review and meta-analysis.

  Sheraz R Markar, Alan Karthikesalingam, Soumil Vyas, Majid Hashemi, Mark Winslet
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  ABSTRACT: In this meta-analysis, data from relevant randomised controlled trials has been pooled together to gain a consensus in the comparison of outcome following hand-sewn versus stapled oesophago-gastric (OG) anastomoses. Medline, Embase, Cochrane, trial registries, conference proceedings and reference lists were searched for randomised controlled trials comparing hand-sewn and stapled OG anastomoses. Primary outcome measures were 30-day mortality, anastomotic leakage and stricture. Secondary outcomes were operative time, cardiac complications and pulmonary complications. Nine randomised trials were included in this meta-analysis. There was no significant difference between the groups for 30-day mortality (pooled odds ratio = 1.71; 95% CI = 0.822 to 3.56; P = 0.15) and anastomotic leakage (pooled odds ratio = 1.06; 95% CI = 0.62 to 1.80; P = 0.83). There was a significantly increased rate of anastomotic stricture associated with stapled OG anastomosis (pooled odds ratio = 1.76; 95% CI = 1.09 to 2.86; P = 0.02). Meta-analysis of randomised controlled trials comparing hand-sewn with stapled OG anastomosis demonstrates that a stapled anastomosis is associated with a shorter operative time but with an increased rate of post-operative anastomotic stricture.
  Journal of Gastrointestinal Surgery 01/2011; 15(5):876-84. · 2.83 Impact Factor
• Article: Splenic rupture as an unusual cause of massive hematemesis.

  Judith Pearson, Atif Alvi, Majid Hashemi
  The Journal of trauma 11/2007; 63(4):E88-9. · 2.48 Impact Factor