Surgeon-Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland最新文献

{"title":"Positive and negative framing of complication risk and long-term outcomes influences decision-making in hip and knee arthroplasty","authors":"Alex B. Boyle ,&nbsp;Cass R. Sunstein","doi":"10.1016/j.surge.2024.12.006","DOIUrl":"10.1016/j.surge.2024.12.006","url":null,"abstract":"<div><h3>Background</h3><div>The framing effect has been demonstrated in a variety of settings. This study aimed to determine whether framing of complication risk in total hip arthroplasty (THA) and long-term patient satisfaction rates in total knee arthroplasty (TKA) influences patient decision-making and ‘worry’ using hypothetical vignettes.</div></div><div><h3>Methods</h3><div>Two cross-sectional survey studies were undertaken, one based on a THA vignette and one based on a TKA vignette. Participants were randomized into a positive-framing or negative-framing group and asked to read the vignette. They were then asked to indicate whether they would proceed with surgery, and to self-report their degree of ‘worry’ about surgery. For the THA vignette, the positive-framing group was informed ‘98 % of people will have no major complications’ while the negative-framing group was informed that ‘2 % of people will have a major complication’. For the TKA vignette, the positive-framing group was informed ‘80/100 of people will be <em>happy</em> … once they have recovered’ and the negative-framing group was informed ‘20/100 people will be <em>unhappy</em> … once they have recovered’. The vignettes were otherwise identical. The primary outcome was the decision to proceed with surgery. The secondary outcome was self-reported ‘worry’ about surgery.</div></div><div><h3>Results</h3><div>For the THA vignette (622 individuals) 294/310 (95 %) indicated they would proceed with surgery in the positive-framing group while 275/312 (88 %) indicated they would proceed with surgery in the negative-framing group (p = 0.0037). For the TKA vignette (623 individuals), 302/311 (97.1 %) indicated they would proceed with surgery in the positive-framing group and 280/312 (89.7 %) indicated they would proceed with surgery in the negative-framing group (p = 0.0003). Self-reported ‘worry’ differed based on positive or negative framing in both surveys.</div></div><div><h3>Conclusions</h3><div>Framing of complication risk and long-term outcomes influences patient decision-making and ‘worry’ in a THA and TKA vignette. This has implications for shared decision-making and informed consent.</div></div>","PeriodicalId":49463,"journal":{"name":"Surgeon-Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland","volume":"23 1","pages":"Pages 1-5"},"PeriodicalIF":2.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142899688","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ergonomic challenges in surgical practice","authors":"Amir Farah","doi":"10.1016/j.surge.2025.01.003","DOIUrl":"10.1016/j.surge.2025.01.003","url":null,"abstract":"","PeriodicalId":49463,"journal":{"name":"Surgeon-Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland","volume":"23 1","pages":"Page e46"},"PeriodicalIF":2.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143015027","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An evaluation of the stocks of target-controlled infusion (TCI) pumps in Irish departments of anaesthesia and an assessment of the stocks’ ability to support transition to more environmentally sustainable general anaesthesia practice","authors":"Kim O'Brien,&nbsp;Marguerite Nyhan,&nbsp;Dónal Ó Cróinín","doi":"10.1016/j.surge.2025.01.004","DOIUrl":"10.1016/j.surge.2025.01.004","url":null,"abstract":"","PeriodicalId":49463,"journal":{"name":"Surgeon-Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland","volume":"23 1","pages":"Pages e47-e48"},"PeriodicalIF":2.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143025421","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The role of neurosurgery conferences in shaping medical student careers","authors":"Irving Gabriel Calisaya-Madariaga ,&nbsp;Gonzalo Jair Callahuanca-Flores","doi":"10.1016/j.surge.2024.11.014","DOIUrl":"10.1016/j.surge.2024.11.014","url":null,"abstract":"","PeriodicalId":49463,"journal":{"name":"Surgeon-Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland","volume":"23 1","pages":"Pages e37-e38"},"PeriodicalIF":2.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142866080","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Demographics of deceased organ donation in Ireland: A 10 year review showing the worrying increase of suicide as a source for organ donation","authors":"S.G. Potts,&nbsp;Ellen Small,&nbsp;Ian Currie","doi":"10.1016/j.surge.2024.10.003","DOIUrl":"10.1016/j.surge.2024.10.003","url":null,"abstract":"","PeriodicalId":49463,"journal":{"name":"Surgeon-Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland","volume":"23 1","pages":"Page e32"},"PeriodicalIF":2.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142511644","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A systematic review of the role of systemic inflammation-based prognostic scores in patients with abdominal aortic aneurysm","authors":"Nicholas A. Bradley,&nbsp;Campbell S.D. Roxburgh,&nbsp;Donald C. McMillan,&nbsp;Graeme J.K. Guthrie","doi":"10.1016/j.surge.2024.08.014","DOIUrl":"10.1016/j.surge.2024.08.014","url":null,"abstract":"<div><h3>Background and aims</h3><div>Activation of the systemic inflammatory response (SIR) is associated with inferior outcomes across a spectrum of disease. Routinely available measures of the SIR (neutrophil:lymphocyte ratio (NLR), platelet:lymphocyte ratio (PLR), systemic immune-inflammatory index (SII), systemic inflammatory grade (SIG)) have been shown to provide prognostic value in patients undergoing surgical intervention. The present study aimed to review the literature describing the prognostic association of NLR, PLR, SII and SIG in patients undergoing intervention for abdominal aortic aneurysm (AAA).</div></div><div><h3>Methods</h3><div>This PRISMA guidelines were followed. The MEDLINE database was interrogated for relevant studies investigating the effect of peri-operative systemic inflammation-based prognostic systems on all-cause mortality in patients undergoing OSR and EVAR for AAA. Inter-study heterogeneity precluded meaningful meta-analysis; qualitative analysis was instead performed.</div></div><div><h3>Results</h3><div>There were 9 studies included in the final review reporting outcomes on a total of 4571 patients; 1256 (27 %) patients underwent OSR, and 3315 (73 %) patients underwent EVAR. 4356 (95 %) patients underwent a procedure for unruptured AAA, 215 (5 %) patients underwent an emergency procedure for ruptured AAA0.5 studies reported early (inpatient or 30-day) mortality; 2 of these found that elevated NLR predicted inferior survival, however PLR did not provide prognostic value. 6 studies reported long-term mortality; elevated NLR (5 studies), PLR (1 study), and SIG (1 study) predicted inferior survival.</div></div><div><h3>Conclusions</h3><div>It appears that activation of the SIR is associated with inferior prognosis in patients undergoing intervention for AAA, however the evidence is limited by heterogenous methodology and lack of consensus regarding optimal cutoff.</div></div><div><h3>Prospero database registration number</h3><div>CRD42022363765.</div></div>","PeriodicalId":49463,"journal":{"name":"Surgeon-Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland","volume":"23 1","pages":"Pages e1-e8"},"PeriodicalIF":2.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142082347","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The role of gastropexy in paraesophageal hernia repair: A scoping review of current evidence","authors":"Haneen Kamran,&nbsp;Hamza Shafiq,&nbsp;Misha Mansoor,&nbsp;Umm-e-Aimen Minhas,&nbsp;Sameen Tahira,&nbsp;Sameen Shahid,&nbsp;Farah Khan","doi":"10.1016/j.surge.2024.10.001","DOIUrl":"10.1016/j.surge.2024.10.001","url":null,"abstract":"<div><h3>Background</h3><div>Paraesophageal hernias (PEH), involving abdominal components herniating through the esophageal hiatus, pose serious risks like obstruction and perforation, prompting SAGES to recommend repair upon symptom onset in 2013. Despite surgical advancements, high recurrence rates persist post-PEH repair. Gastropexy, securing the stomach to prevent re-herniation, emerges as a potential solution. However, consensus on its application is lacking. This review aims to map existing research, summarize evidence, and identify gaps guiding future gastropexy research in PEH repair.</div></div><div><h3>Methods</h3><div>Following PRISMA guidelines, this scoping review conducted a comprehensive literature search using PubMed, Cochrane, and Embase. Eligible studies, including RCTs, observational, and cohort studies, described gastropexy for PEH treatment in adults published in English after 2013. Articles were rigorously screened, with data extracted and organized into tables detailing study characteristics, conditions, and outcomes.</div></div><div><h3>Results</h3><div>A search yielded 343 studies on gastropexy for PEH, with 17 meeting inclusion criteria. Most were retrospective (47.1 %) or case series (41.2 %). GP, primarily in types III and IV hernias, was mainly performed laparoscopically. Anterior GP was most commonly used (in 64.7 % of included studies), with some studies using additional techniques. Reduced recurrence rates were seen when adjunct procedures such as fundoplication were performed with gastropexy.</div></div><div><h3>Conclusion</h3><div>This review highlights the varied application of gastropexy in PEH repair, aiming to reconcile differing surgeon opinions. The data suggests gastropexy can be safely utilised across different techniques, offering a viable option for addressing PEH and reducing hernia recurrence, particularly in high-risk cases.</div></div>","PeriodicalId":49463,"journal":{"name":"Surgeon-Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland","volume":"23 1","pages":"Pages e21-e31"},"PeriodicalIF":2.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142479006","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparative study of the outcomes of one-stage versus two-stage reconstruction of chronic multiligament knee injury","authors":"S.A. Arojuraye ,&nbsp;Ibrahim Abolaji Alabi ,&nbsp;Ndubuisi Okoh ,&nbsp;Folajuwon Bayode Ayeni ,&nbsp;Musliu Kolawole Odunola ,&nbsp;M.N. Salihu","doi":"10.1016/j.surge.2024.10.004","DOIUrl":"10.1016/j.surge.2024.10.004","url":null,"abstract":"<div><h3>Background</h3><div>Multi-ligament knee injury (MLKI) is a complex orthopaedic knee problem, usually following traumatic knee dislocation. Surgical management is preferred and has resulted in better clinical outcomes. However, the optimal surgical treatment protocol is continuously evolving. This study aimed to compare the outcomes of one-stage versus two-stage reconstruction of MLKI.</div></div><div><h3>Materials and methods</h3><div>This retrospective comparative study was conducted between July 2020 and December 2023 at a government orthopaedic hospital in Nigeria. The inclusion criteria include males and females between 18 and 45 years of age who had one- or two staged knee reconstructions for MLKI and were followed up for a minimum of 12 months. The exclusion criteria were patients below 18 and above 45 years of age, those with previous knee surgery, those associated with femoral or tibia fractures, those with radiological evidence of osteoarthritis, and those with follow-ups less than 12 months. Clinical outcomes using the Lysholm scoring system and complication rate were recorded. The statistical analysis was performed using SPSS version 23.</div></div><div><h3>Results</h3><div>Fifty-one patients (26 in the OS group and 25 in the TS group) were studied. There was a significant difference between the preoperative and postoperative Lysholm scores in the two groups (p = 0.86 and 0.57 for OS and TS, respectively). However, there was no significant difference between the postoperative Lysholm scores in the two groups (p = 0.918).</div></div><div><h3>Conclusion</h3><div>One-stage and two-stage reconstruction of chronic MLKI give similar excellent clinical outcomes.</div></div>","PeriodicalId":49463,"journal":{"name":"Surgeon-Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland","volume":"23 1","pages":"Pages 27-29"},"PeriodicalIF":2.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142523466","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Score card for individual contribution to global and remote surgery","authors":"Rahul M. Jindal","doi":"10.1016/j.surge.2024.11.006","DOIUrl":"10.1016/j.surge.2024.11.006","url":null,"abstract":"","PeriodicalId":49463,"journal":{"name":"Surgeon-Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland","volume":"23 1","pages":"Pages e33-e34"},"PeriodicalIF":2.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142639898","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The prevalence and impact of microaggressions within orthopaedics in the United States of America: A systematic review","authors":"B. Azam ,&nbsp;A. Bakhiet ,&nbsp;W. Moussa ,&nbsp;M.A. Sajid ,&nbsp;M.K. Qureshi ,&nbsp;A. Kumar ,&nbsp;U.A. Halim","doi":"10.1016/j.surge.2024.11.010","DOIUrl":"10.1016/j.surge.2024.11.010","url":null,"abstract":"<div><h3>Background</h3><div>Microaggressions are being increasingly documented within the medical community. With their rising prevalence, there is concern that microaggressions can lead to suboptimal working environments, victim burnout, and compromised patient safety. Orthopaedics, known for macroaggressions like bullying and sexual discrimination, remains the least diverse specialty, potentially predisposing its staff to microaggressions. The aim of this paper was to determine the prevalence of microaggressions within Trauma and Orthopaedics, and ascertain the impact they have within the specialty.</div></div><div><h3>Methods</h3><div>A systematic review was carried out using PRISMA guidelines. Publications pertaining to microaggressions in orthopaedics in the English language were included, with no restrictions relating to study location, date of publication or the victims of microaggressions.</div></div><div><h3>Results</h3><div>29 papers were included in this systematic review, of which 10 papers were eligible for inclusion. The prevalence of microaggressions in orthopaedics based on gender was discussed in 5 papers, whilst microaggressions relating to race/ethnicity were discussed in 2 papers. A further 2 papers discussed microaggressions relating to both race and gender. All were published in the United States of America (USA). It was found that microaggressions are common in orthopaedics, with 80 % of respondents across 3 cross sectional surveys experiencing some form of microaggression.</div></div><div><h3>Conclusion</h3><div>Microaggressions are a significant problem within the American orthopaedic community. They affect surgeons of all grades, and deter medical students from pursuing orthopaedics as a career. It is important to develop mitigating strategies to tackle this behaviour, in the hope that working environments and patient safety improve in orthopaedic departments.</div></div>","PeriodicalId":49463,"journal":{"name":"Surgeon-Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland","volume":"23 1","pages":"Pages 52-60"},"PeriodicalIF":2.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142807343","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}