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

{"title":"Losing your head? An evaluation of the readability and reliability of patient information available online for avascular necrosis of the head of the femur","authors":"Amber Downes,&nbsp;Ciaran Stanley,&nbsp;Ryan Donnelly,&nbsp;Terence Murphy","doi":"10.1016/j.surge.2023.05.002","DOIUrl":"10.1016/j.surge.2023.05.002","url":null,"abstract":"<div><h3>Title</h3><p>Losing your head? An evaluation of the readability and reliability of patient information available online for Avascular Necrosis of the Head of Femur.</p></div><div><h3>Background</h3><p>Avascular necrosis of the head of femur commonly affects patients with an average age of 58.3 years, and is generally managed in the elective setting, allowing patients a timeframe to research their diagnosis and management options. The aim of this study is to evaluate the readability and reliability of the information available online to patients about this condition.</p></div><div><h3>Methods</h3><p>Google, Bing and Yahoo internet search engines were utilised, using the search terms “Avascular necrosis head of femur” and “hip avascular necrosis”, with the first 30 URLs selected for analysis. Readability was assessed using an online readability calculator to produce 3 scores (Gunning FOG, Flesch Kincaid Grade and Flesch Reading Ease). Information quality was assessed using a HONcode detection web-extension and the JAMA benchmark criteria.</p></div><div><h3>Results</h3><p>86 webpages were identified for inclusion for assessment.</p></div><div><h3>Conclusion</h3><p>The majority of the information available online about avascular necrosis of the head of the femur is not at an appropriate reading level for the general population, and less than 20% of the most accessible information available online is accredited to be of sufficient quality to be providing advice to patients. Medical professionals must work together to improve health literacy among the patients encountered, and ensure recommendation of only reliable and accessible sources of information should patients ask for guidance on finding these resources.</p></div>","PeriodicalId":49463,"journal":{"name":"Surgeon-Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9898508","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":"Efficacy of mesh coverage in surgical bullectomy for primary spontaneous pneumothorax: A systematic review and meta-analysis","authors":"Selvie Yeo ,&nbsp;Jianye Chen ,&nbsp;Lowell Leow ,&nbsp;Haidong Luo ,&nbsp;John Kit Chung Tam","doi":"10.1016/j.surge.2023.08.002","DOIUrl":"10.1016/j.surge.2023.08.002","url":null,"abstract":"<div><h3>Background and purpose</h3><p><span>Thoracic surgeons are now adopting a new method of using a mesh covering to reduce recurrence in surgical pleurodesis for </span>pneumothorax. We aimed to review the literature and compare the outcomes of using mesh covering as an additional procedure during surgical pleurodesis.</p></div><div><h3>Methods</h3><p>A comprehensive search was performed from inception to October 2022 on PubMed, Embase, Cochrane and Scopus. Randomised controlled trials (RCTs) and observational cohort studies (OCSs) comparing the use of mesh coverage, and different materials were included. Data were extracted to compare recurrence and other outcomes using a random effect model.</p></div><div><h3>Results</h3><p>23 studies consisting of 2 RCTs and 21 OCSs totalling 5092 patients were included. Patients with a mesh had a significantly lower recurrence (OR = 0.22, 95% CI 0.12–0.42, <em>p</em> &lt; 0.0001) and a shorter duration of chest tube drainage (SMD = −0.74 days, 95% CI −0.28 to −1.20, <em>p</em><span><span> &lt; 0.0001) but no significant difference in the length of operation. The use of polyglycolic acid (PGA) and </span>vicryl mesh was associated with a significantly shorter duration of chest tube drainage [(PGA, SMD = 0.83 days, 95% CI 0.14–1.52, </span><em>p</em> &lt; 0.0001), (vicryl, SMD = 1.06 days, 95% CI 0.71–2.82, <em>p</em> = 0.0005)]. They also had a shorter post-operative length of stay than oxidized regenerative cellulose (ORC) but this was not statistically significant.</p></div><div><h3>Conclusion</h3><p>The use of a mesh material reduced the incidence of post-operative air leaks in the short term and the recurrence rate in the long term. Some mesh materials such as PGA and vicryl performed better than other materials.</p></div>","PeriodicalId":49463,"journal":{"name":"Surgeon-Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10265622","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 use of digital technologies to support home-based prehabilitation prior to major surgery: A systematic review","authors":"Malene Blumenau Pedersen ,&nbsp;John Saxton ,&nbsp;Sara Birch ,&nbsp;Brigitta Rasmussen Villumsen ,&nbsp;Jørgen Bjerggaard Jensen","doi":"10.1016/j.surge.2023.05.006","DOIUrl":"10.1016/j.surge.2023.05.006","url":null,"abstract":"<div><h3>Background</h3><p>Prehabilitation is a multidimensional and multidisciplinary approach, to prepare patients for surgery, with the aim of improving postoperative outcomes.</p><p>Worldwide, healthcare systems are facing challenges with a gap between demand and supply of healthcare services. Telehealth<span> is seen as a solution for delivering sustainable and efficient treatments. The effect of providing prehabilitation using telehealth solutions is unclear.</span></p></div><div><h3>Objective</h3><p>This systematic review investigated the existing literature regarding the effects and feasibility of technologies for remotely supporting home-based prehabilitation compared to standard care on pre- and postoperative outcomes in adults undergoing elective major surgery.</p></div><div><h3>Methods</h3><p>A literature search identified relevant studies published between 1 January 2012 and December 2022 in PubMed, PsychInfo, Cinahl and the Cochrane Library. We included RCTs, feasibility and pilot studies. The quality of studies was evaluated using Cochrane's Risk of bias assessment and by narratively rating the certainty of evidence.</p></div><div><h3>Results</h3><p>Six randomized controlled trials and 20 pilot/feasibility studies were included. The number and content of the interventions varied, depending on context and resources. Multiple approaches in the use of digital healthcare solutions were applied and the results highlight the potential of providing health services remotely.</p></div><div><h3>Conclusion</h3><p>The use of technologies to support remote home-based prehabilitation in patients undergoing elective major surgery is feasible and has high acceptability, though telehealth is a broad term and wide-ranging strategies are used.</p><p>Digital technologies for supporting home-based prehabilitation are likely to play an essential role in future health care as resources are scarce and innovative solutions are needed.</p></div>","PeriodicalId":49463,"journal":{"name":"Surgeon-Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9654950","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":"Standard setting for orthopaedic trauma competencies in postgraduate specialty training- catching those falling behind the curve","authors":"Michael Pullinger ,&nbsp;Ignatius Liew ,&nbsp;Kate Spacey ,&nbsp;Niel Kang ,&nbsp;Phillip Johnston ,&nbsp;Anish Sanghrajka","doi":"10.1016/j.surge.2023.06.003","DOIUrl":"10.1016/j.surge.2023.06.003","url":null,"abstract":"<div><h3>Background</h3><p>The Curriculum for Trauma and Orthopaedics focuses on producing competent Day-One Consultants. However, the expected development trajectory is not clear. It is important, yet difficult to objectively identify trainees who are “falling behind”. This project proposes practical, consensus-based thresholds of Operative Trauma Competence at each Waypoint stage of training.</p></div><div><h3>Methods</h3><p>32 trainers and 73 trainees in one Deanery were identified. The trainers and trainees were asked their PBA level expectation of a trainee at ST4, ST6 and ST8 for nine trauma competencies. Lower quartile values were calculated providing thresholds.</p></div><div><h3>Results</h3><p><span>53 (72%) trainees and 22 (69%) trainers responded. At ST8, the lower quartile threshold was level 4 for all procedures. At ST6, three operation groups became apparent: Group 1 (hip hemiarthroplasty, Dynamic hip screw; k-wire distal radius<span> fracture and Weber C Ankle open reduction, internal fixation (ORIF)) Group 2 (Tibial Nail; </span></span>Olecranon<span> Tension band wire, ORIF radial shaft; distal radius plate fixation)- Group 3 (supracondylar fracture fixation)Threshold levels for procedures were: Group 1- 4a; Group 2–3b and Group 3- 3a.At ST4, there was more variation and spread in responses, however, expectations could still be similarly grouped: Group 1- 3a; Group 2- 2b and Group 3- 2a.</span></p></div><div><h3>Conclusion</h3><p>In an increasingly competency-based training environment we provide tangible thresholds for expectations of orthopaedic trainees’ progression and development. We identified two groups: basic trauma (Group 1 where level 4 competencies should be attained by ST6) and intermediate trauma (Groups 2 and 3 where level 4 competencies should be attained by ST8.)</p></div>","PeriodicalId":49463,"journal":{"name":"Surgeon-Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9892630","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":"Analysis of risk factors for complicated appendicitis during pregnancy and evaluation of clinical prediction model: A prospective cohort study","authors":"Xiaosong Zheng,&nbsp;Xiaojun He","doi":"10.1016/j.surge.2023.05.001","DOIUrl":"10.1016/j.surge.2023.05.001","url":null,"abstract":"<div><h3>Objective</h3><p>To investigate the risk factors and the value of clinical prediction model<span> for complicated appendicitis (CA) during pregnancy.</span></p></div><div><h3>Methods</h3><p>Prospective analysis of pregnant patients who underwent appendectomy<span> at a single tertiary care center between February 2020 and February 2023 and who ultimately had pathologically confirmed acute appendicitis (AA). According to intraoperative conditions and postoperative pathology, they were divided into the CA group and the uncomplicated appendicitis (UA) group. The two groups of patients were then compared in terms of demographic characteristics, disease features, ancillary tests and predictive models of acute appendicitis.</span></p></div><div><h3>Results</h3><p><span><span>A total of 90 patients with AA in pregnancy were included, 21 of whom had CA in pregnancy and 69 had UA in pregnancy. Multivariate regression analysis showed that gestational week, neutrophil ratio and C-reactive protein (CRP) were independent risk factors for CA during pregnancy. Relative to the </span>first trimester, the </span>third trimesters had an increased risk of complicated appendicitis (OR = 12.48, 95% CI: 1.56–99.57, P = 0.017). Neutrophil ratio ≥85.30% (OR = 24.54, 95% CI: 2.59–232.72, P = 0.005) and CRP ≥34.26 mg/L (OR = 7.86, 95% CI: 2.18–28.38, P = 0.002) had a significantly increased risk of CA. The AIR and AAS score models were statistically different between the two groups, but with a lower sensitivity of 52.38% and 42.86%, respectively.</p></div><div><h3>Conclusion</h3><p>The third trimesters, neutrophil ratio ≥85.30% and CRP ≥34.26 mg/L may be key predictors of CA in pregnancy. The current scoring model is inadequate to identify complex appendicitis in pregnancy and further research is needed.</p></div>","PeriodicalId":49463,"journal":{"name":"Surgeon-Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9490647","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 new checklist surgical hand scrub to replace time-based methods – A pixel intensity analysis","authors":"Lercan Aslan ,&nbsp;Omer Subasi ,&nbsp;Duygu Mizikoglu ,&nbsp;Olgar Birsel ,&nbsp;Seval Tanrikulu Kirisci ,&nbsp;Ada Bas ,&nbsp;Munam Arshad ,&nbsp;Ismail Lazoglu ,&nbsp;Aksel Seyahi","doi":"10.1016/j.surge.2023.04.002","DOIUrl":"10.1016/j.surge.2023.04.002","url":null,"abstract":"<div><h3>Background</h3><p>Hand scrubbing is an absolute precaution to avoid surgical site infections. World Health Organization (WHO) recommends 4-min overall scrubbing (4MS) for surgical hand hygiene. However, we hypothesize that the more methodical 10-stroke counting technique (10SS) via locational partitioning of the arm is superior to WHO's superficial guideline dictating only the duration.</p></div><div><h3>Purpose</h3><p>The mechanical efficiency of 4MS and 10SS techniques are compared.</p></div><div><h3>Methods</h3><p>24 healthcare professionals were recruited for the study. A novel methodology was devised to quantify the average brightness change of skin-applied UV ink before and after scrubbing via pixel intensity analysis. A black-box setup is constructed with an integrated high-resolution camera to photograph the UV-stained dorsal arm. Each stain was then digitally isolated for brightness comparison.</p></div><div><h3>Results</h3><p>It was observed that the 10SS technique was overall more successful in removing the UV ink in comparison to the 4MS method (p = 0.014). In addition, a bias was observed in removing more percentage of the proximal stains when compared to middle and distal stains with the 4MS technique (p = 0.0027), while location-based brightness change averages were statistically equal with the 10SS technique (p = 0.423).</p></div><div><h3>Conclusions and Clinical Relevance</h3><p>10SS provided not only a more mechanically efficient scrubbing but also a more homogenous cleaning than 4MS. We recommend the use of the 10SS technique to achieve more effective pre-surgical hand hygiene.</p></div>","PeriodicalId":49463,"journal":{"name":"Surgeon-Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9366627","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 geographic diversity of authorship in leading general surgery journals; A study of 24,332 authors","authors":"Jed O. Campbell ,&nbsp;Aashray K. Gupta ,&nbsp;Amy Lu ,&nbsp;Ye Fang Lim ,&nbsp;Neel Mishra ,&nbsp;Joseph N. Hewitt ,&nbsp;Christopher D. Ovenden ,&nbsp;Joshua G. Kovoor ,&nbsp;Stephen Bacchi ,&nbsp;Markus Trochsler ,&nbsp;Adam Wells","doi":"10.1016/j.surge.2023.08.004","DOIUrl":"10.1016/j.surge.2023.08.004","url":null,"abstract":"<div><h3>Background</h3><p>Research guides evidence-based general surgery practice, advocacy, policy and resource allocation, but is seemingly lacking representation from those countries with greatest disease burden and mortality. Accordingly, we conducted a geographic study of publications in the most impactful general surgery journals worldwide.</p></div><div><h3>Methods</h3><p>The six general surgery journals with the highest 2020 impact factors were selected. Only journals specific to general surgery were included. For all original articles over the past five years, the affiliated country and city were extracted for the first, second and last author. Number of publications were adjusted per capita, and compared to Human Development Index (HDI) using logistic regression.</p></div><div><h3>Results</h3><p>8274 original articles were published in the top six ranked general surgery journals over 2016–2020, with 24,332 affiliated authors. Authors were most commonly associated with the US (27.88%), Japan (9.09%) and China (8.46%), or per capita, The Netherlands, Sweden and Singapore. There is a linear association between publishing in a top six journal and HDI of country of affiliation. Just four publications were from medium or low HDI countries over the period.</p></div><div><h3>Conclusion</h3><p>Authorship in leading general surgery journals is predominantly from wealthy, Western countries. Authorship is associated with affiliation with a high HDI country, with few authors from medium or low HDI countries. There is a lack of representation in literature from Africa, Russia, and parts of Southeast Asia, and thus a lack of locally relevant evidence to guide surgical practice in these areas of high disease burden and low life expectancy.</p></div>","PeriodicalId":49463,"journal":{"name":"Surgeon-Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1479666X23000902/pdfft?md5=02ffef3545f576cc0c9db54dae524d00&pid=1-s2.0-S1479666X23000902-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10131357","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 double-barrel wet colostomy: An alternative for urinary diversion after pelvic exenteration","authors":"Jesse P. Wright ,&nbsp;Whitney M. Guerrero ,&nbsp;Jonathan R. Lucking ,&nbsp;Leonardo Bustamante-Lopez ,&nbsp;John R.T. Monson","doi":"10.1016/j.surge.2023.03.004","DOIUrl":"10.1016/j.surge.2023.03.004","url":null,"abstract":"<div><h3>Aim</h3><p><span><span>Pelvic exenteration is a radical procedure used to treat locally advanced and/or recurrent pelvic </span>malignancies<span><span>. Different reconstruction options exist, the most popular being the end colostomy with </span>ileal conduit<span><span>. The double barrel wet colostomy (DBWC) offers concomitant fecal and urinary diversion through a single stoma, but is infrequently utilized. We aim to review the evidence base of the </span>postoperative complications, long-term oncologic risks and </span></span></span>quality of life following creation of a double barrel wet colostomy.</p></div><div><h3>Methods</h3><p>A narrative review of the literature was performed evaluating the DBWC. Patient demographics, perioperative complications, operative variables, long terms oncologic outcomes and quality of life data were extracted. Descriptive statistics were used to define the data.</p></div><div><h3>Results</h3><p>Fourteen articles with a total of 300 patients undergoing DBWC following pelvic exenteration were selected. 41% of malignancies were gastrointestinal in origin while 41.7% were gynecologic and 5.3% genitourinary. 42% of patients experienced at least one complication within in 40 days of surgery, the most common being wound infection (8.7%) and urinary leak (8.3%). There was no evidence of malignancy within the DBWC during long-term surveillance. Quality of life following DBWC is comparable to other reconstructive methods.</p></div><div><h3>Conclusion</h3><p>The DBWC is a well described reconstructive method for urinary and fecal diversion utilizing a single stoma following pelvic exenteration. The short- and long-term outcomes following DBWC are comparable to other reconstructive methods and the quality of life with a DBWC is acceptable. DBWC should remain a readily available option for reconstruction following pelvic exenteration.</p></div>","PeriodicalId":49463,"journal":{"name":"Surgeon-Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9775829","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":"Plastic surgery online, how accessible are our units?","authors":"Cameron Clarke ,&nbsp;Simon Filson","doi":"10.1016/j.surge.2023.05.003","DOIUrl":"10.1016/j.surge.2023.05.003","url":null,"abstract":"<div><h3>Background</h3><p>The Covid-19 pandemic has highlighted the importance of remote patient and professional communication. This has been especially important for highly specialised and regionally-based specialties such as plastic surgery. The aim of this study was to review how UK plastic surgery units represent themselves online and their phone accessibility.</p></div><div><h3>Patients and methods</h3><p>UK plastic surgery units were identified using the BAPRAS website and their websites and telephone accessibility assessed.</p></div><div><h3>Results</h3><p>Whilst a minority of units have clearly invested heavily in ensuring comprehensive webpages, nearly a third have no dedicated webpage at all. We found significant variation in quality and user-friendliness of online resources both for patients and for other healthcare professionals, with less than a quarter of units providing comprehensive contact details, emergency referral guidance, or information about changes to services due to Covid-19, to highlight a few areas. Communication with the BAPRAS website was also poor with less than half of web-links connecting to correct and relevant webpage and only 13.5% of phone numbers connecting directly to a useful plastic surgery number. In the phone component of our study we found that 47% of calls to ‘direct’ numbers went to voicemail but wait-times were significantly less than going through hospital switchboards and connections were more accurate.</p></div><div><h3>Conclusion</h3><p>In a world where a business’ credibility is so heavily based on their online appearance and, in an increasingly online era of medicine, we hope that this study may be a resource for units to improve their web-based resources and prompt further research in enhancing patient experience online.</p></div>","PeriodicalId":49463,"journal":{"name":"Surgeon-Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10257443/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9680482","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 decline in transurethral resection of the prostate gland in Irish public hospitals between 2005 and 2021","authors":"Glenn Curtin ,&nbsp;Lorraine Scanlon ,&nbsp;John O'Kelly ,&nbsp;Paul Sweeney ,&nbsp;Derek B. Hennessey","doi":"10.1016/j.surge.2023.05.005","DOIUrl":"10.1016/j.surge.2023.05.005","url":null,"abstract":"<div><h3>Background</h3><p>Lower urinary tract symptoms<span> due to an enlarged prostate is a common condition. Transurethral resection of the prostate<span> gland (TURP) has been the gold standard treatment. The objective of this study was to assess the trends in the prevalence of TURP procedures in Irish public hospitals within the period of 2005–2021. In addition, we explore the attitudes and practices of urologist in Ireland on this topic.</span></span></p></div><div><h3>Methods</h3><p>An analysis using the Hospital In-Patient Enquiry (HIPE) system using code 37203-00 was undertaken. 16,176 discharges contained the code of interest and had undergone a TURP procedure. The data from this cohort was further analysed. In addition, members of the Irish Society of Urology undertook a bespoke questionnaire to understand the TURP surgery practices.</p></div><div><h3>Results</h3><p>There has been a substantial decline in the prevalence of TURP procedures in Irish public hospitals from 2005 to 2021. The number of patients discharged from Irish hospitals with a TURP procedure was 66% less in 2021 compared to 2005. 75% (n = 36) of urologist surveyed felt that the declining TURP numbers were due to lack of resources, access to theatre/inpatient beds and outsourcing. 91.5% (n = 43) felt that the declining TURP numbers would result in a lack of training opportunities for trainees, 83% (39) felt this has increased morbidity for patients.</p></div><div><h3>Conclusions</h3><p>TURP procedures in Irish public hospitals has declined over the 16-year period studied. This decline is a concern for patient morbidity and urology training.</p></div>","PeriodicalId":49463,"journal":{"name":"Surgeon-Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10000684","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}