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

{"title":"For better music in the operating room.","authors":"Wenhan Wu","doi":"10.1016/j.surge.2025.02.012","DOIUrl":"https://doi.org/10.1016/j.surge.2025.02.012","url":null,"abstract":"","PeriodicalId":49463,"journal":{"name":"Surgeon-Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143537505","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":"Ventriculo-pleural shunt --- A second line option in the management of complex hydrocephalus.","authors":"Hanqiao Li, John Caird","doi":"10.1016/j.surge.2025.02.006","DOIUrl":"https://doi.org/10.1016/j.surge.2025.02.006","url":null,"abstract":"<p><strong>Background: </strong>Ventriculo-pleural(V-Pl) shunt is considered as an alternative management of hydrocephalus when previous management options of hydrocephalus, including ventriculoperitoneal (VP) shunt, ventriculo-atrial (VA) shunt and endoscopic third ventriculostomy (ETV), may be contraindicated or have failed.</p><p><strong>Aim: </strong>The aim is to identify the indications of V-Pl shunt after the failure of first-line managements of hydrocephalus, to evaluate the efficacy of V-Pl shunt with regarding to other shunt options and to discuss the potential complications.</p><p><strong>Methods: </strong>15 patients who underwent V-Pl shunt (or V-Pl shunt related surgeries) from 2021 to 2024, are recorded retrospectively. The data was collected via patients' medical charts and national image archiving system (Republic of Ireland). Related literature and case reports were searched via keyword selections on research databases, including Pubmed and Google Scholar.</p><p><strong>Results: </strong>The indications for shunt treatment were spina bifida, tumour related hydrocephalus, congenital hydrocephalus, arachnoid cysts and idiopathic intracranial hypertension. Indications for favouring V-Pl shunt over VP/VA shunt or ETV are multiple shunt failures, persistent shunt-related symptoms, severe kyphoscoliosis, abdominal ascites/pseudocyst, jugular vein thrombosis. Complications of V-Pl shunt include shunt failure, over-drainage, pleuritic chest pain, pneumothorax and rarely slit-ventricle syndrome.</p><p><strong>Conclusion: </strong>V-Pl shunt can be considered as a second line management for hydrocephalus when VP/VA shunt and ETV options have been exhausted.</p>","PeriodicalId":49463,"journal":{"name":"Surgeon-Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143505674","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":"Beyond the operating theatre: The psychological burden of surgical complications on surgeons.","authors":"Michael El Boghdady","doi":"10.1016/j.surge.2025.02.007","DOIUrl":"https://doi.org/10.1016/j.surge.2025.02.007","url":null,"abstract":"","PeriodicalId":49463,"journal":{"name":"Surgeon-Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143517032","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":"Rise and fall of marginal gains revisited.","authors":"Ronan A Cahill","doi":"10.1016/j.surge.2025.01.008","DOIUrl":"https://doi.org/10.1016/j.surge.2025.01.008","url":null,"abstract":"","PeriodicalId":49463,"journal":{"name":"Surgeon-Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143476912","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":"Visuo-spatial ability and speed of execution of a complex surgical task.","authors":"Gaspard Gregoire, Florent Barry, Guillaume Lacroix, Pierre Guerreschi, Romain Nicot","doi":"10.1016/j.surge.2025.02.001","DOIUrl":"https://doi.org/10.1016/j.surge.2025.02.001","url":null,"abstract":"<p><strong>Objective: </strong>Visuo-spatial ability (VSA) plays a role in preoperative planning, anatomical navigation and decision-making during surgery. This study aimed to test hypothesis that a correlation link existed between VSA and the speed of execution of a complex surgical task.</p><p><strong>Method: </strong>The study was carried out on 49 students just before starting their surgical internship, at Lille Medical Faculty in October 2023. They answered a biographical questionnaire including confounding factors on VSA, then completed the Mental Rotation Test - A (MRT-A). They were timed on two separate tasks: conforming a titanium plate to mandibular angles on a 3D printed model, and excising a lesion from the helix of a silicone cast ear model, followed by a reconstruction using a \"small ear\" flap.</p><p><strong>Results: </strong>A weak correlation between the MRT-A score and the time required to complete the right and left plates conformation (r = -0.377, p = 0.007; r = -0.349, p = 0.014 respectively). There was a moderate correlation between the MRT-A score and the time required to complete the entire plate conformation workshop (r = -0.457, p = 0.001). There was no significant correlation between the MRT-A score and the time required to complete the ear workshop (r = -0.127; p = 0.375). A significant regression equation was found [F(2,48) = 104.960; p < 0.0001)], with a R² of 0.814.</p><p><strong>Conclusion: </strong>A correlation was found between VSA and the speed of a conformation of titanium plate on mandibular angle, but no link was established between speed and performance of a complex surgical task on flapless excision suture workshop.</p>","PeriodicalId":49463,"journal":{"name":"Surgeon-Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143476914","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":"Benefits of patient education in surgery.","authors":"Caroline Kamau-Mitchell","doi":"10.1016/j.surge.2025.02.002","DOIUrl":"https://doi.org/10.1016/j.surge.2025.02.002","url":null,"abstract":"<p><strong>Background: </strong>Research has found that 48 % of patients are anxious before surgery but patient education which involves preparing them about what to expect is associated with higher satisfaction after surgery. Patient satisfaction is important because previous research found that patients who had surgery in hospitals with the highest quartile of satisfaction had lower relative risk reductions of 11-13 % in 30-day postoperative mortality, minor complications, and failure to rescue. In using patient satisfaction as a metric in surgery, it is not yet known whether exceptions should be made for emergencies and coronavirus patients because of restricted opportunities for patient education.</p><p><strong>Methods: </strong>This study analysed the survey responses of 38,689 patients who had surgery or clinical procedures from UK NHS hospitals. Regression analysis found that patient education (captured in patients' interactions with surgeons, physicians, and other staff e.g., preparing them about what to expect from surgery or clinical procedures) significantly increased patient satisfaction. It explained 34.9 %-49.7 % of adjusted variance in patient satisfaction. Multivariate analysis of variance found that patient satisfaction was lower after emergencies and among patients in coronavirus wards, likely because of restricted time or opportunities for patient education.</p><p><strong>Conclusions: </strong>This study shows the benefits of patient education in surgery which prepares patients about what to expect. However, patient satisfaction should not be used as an isolated metric after emergency surgery and that involving coronavirus patients because of restricted time or opportunity for patient education.</p>","PeriodicalId":49463,"journal":{"name":"Surgeon-Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143469768","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":"Intra-operative consultation: The benefits and optimization of asking for second surgical opinions","authors":"Philip M. Kemp Bohan ,&nbsp;Beverly Tomita ,&nbsp;Caoimhe C. Duffy ,&nbsp;Simon A. Wallace ,&nbsp;Jennifer M. Leonard ,&nbsp;Lewis J. Kaplan ,&nbsp;Gary A. Bass","doi":"10.1016/j.surge.2025.02.004","DOIUrl":"10.1016/j.surge.2025.02.004","url":null,"abstract":"<div><h3>Background</h3><div>Intra-operative consultation (IOC) presents an opportunity for successful collaboration around direct patient care in an unanticipated fashion. Besides technical performance and cognitive guidance, successful IOC benefits from incorporating a blend of non-technical skills (NTS) such as communication, teamwork, and decision-making during the ideally supportive episode. Failure to use such skills may lead to untoward consequences for the surgeon who requests IOC despite successful patient rescue.</div></div><div><h3>Objective</h3><div>This narrative review explores the role of NTS within the context of IOC, particularly focusing on the dynamics between the surgeon seeking assistance and the surgeon providing aid.</div></div><div><h3>Methods</h3><div>A comprehensive literature search was performed using PubMed and OVID Medline, covering publications up to January 2024. Search terms included “non-technical skills,” “intra-operative consultation,” “conflict management in surgery,” and “surgical teamwork.” Manuscript selection was based on relevance to NTS within the context of IOC. The findings were synthesized to craft a narrative review of the importance of NTS during IOCs.</div></div><div><h3>Results</h3><div>IOC setting variability reflects consulting surgeon experience, case complexity, intra-operative events, resource availability, and responding surgeon specialty. Essential expectations for both the consulting and responding surgeon include embracing a collegial, non-judgmental approach that prioritizes patient safety and team cohesion. Strategies for conflict management—effective communication, active listening, and appropriate non-verbal cues—are readily leveraged to establish a supportive environment during IOC. Additionally, cultural elements - such as the reluctance to seek help due to fear of potential reputational damage - stand as barriers to viewing requesting IOC as a hallmark of maturity and professional practice.</div></div><div><h3>Conclusions</h3><div>NTS supports effective and successful IOC, positioning it as a valuable tool for ongoing professional development. By fostering a culture of consultation and collaboration, the surgical community can enhance both patient care and surgeon well-being. Incorporating NTS into surgical training is one means by which to adaptively overcome existing cultural barriers which impede IOC and may asymmetrically impact early career surgeons.</div></div>","PeriodicalId":49463,"journal":{"name":"Surgeon-Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland","volume":"23 2","pages":"Pages 114-119"},"PeriodicalIF":2.3,"publicationDate":"2025-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143460359","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":"Surgeon personality diversity across generations and subspecialties","authors":"Vincent Q. Sier ,&nbsp;Roderick F. Schmitz ,&nbsp;Reinier W.A.M. Wertenbroek ,&nbsp;Abbey Schepers ,&nbsp;Joost R. van der Vorst","doi":"10.1016/j.surge.2025.02.003","DOIUrl":"10.1016/j.surge.2025.02.003","url":null,"abstract":"<div><h3>Background</h3><div>Traditional exploration of surgical professionals' personality traits focuses on general characteristics at the domain-level of the five-factor model. Personality has been related to clinically-relevant areas such as clinical decision-making and team effectiveness, yet there is limited insight in the personality of surgeons at the facet-level of the Big Five. Here, we performed a large-scale study examining domain- and facet-variations of personality in four surgical generations and subspecialties.</div></div><div><h3>Method</h3><div>The Big Five Inventory-2, measuring the five domains and fifteen corresponding facets of personality, was distributed among all general surgery departments in the Netherlands. Surgically-interested medical students were approached via the surgical student society. A normative sample was matched for age to the surgical population. Corrected one-way analyses of variance were performed.</div></div><div><h3>Results</h3><div>The surgical population (medical students (n = 126), surgical residents not-in-training (n = 147), surgical residents-in-training (n = 227), and surgeons (n = 539)) scored higher on open-mindedness, conscientiousness, extraversion, agreeableness, and lower on negative emotionality relative to the normative population. Higher conscientiousness (p &lt; 0.01) and lower negative emotionality (p &lt; 0.001) were observed to increase per generation, together with lower open-mindedness scores in surgical residents (p &lt; 0.001). Differences at the facet-level were present in five domains, including sub-traits such as productiveness, trust, and anxiety. Across environments, personality variances were observed in surgical subspecialty (conscientiousness, negative emotionality), teaching region (open-mindedness), and academics (open-mindedness).</div></div><div><h3>Conclusion</h3><div>We delineated nuanced personality variations across generations and subspecialties in the surgical population, marking a starting point in the introduction of personality insights in the professional domain of healthcare.</div></div>","PeriodicalId":49463,"journal":{"name":"Surgeon-Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland","volume":"23 2","pages":"Pages 78-86"},"PeriodicalIF":2.3,"publicationDate":"2025-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143450777","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":"Surgical interventions in acute complicated mastoiditis - is a cortical mastoidectomy always required? A 5-year retrospective cohort study.","authors":"N R Walker, A Eleftheriadou, S Mortaja, S D Sharma","doi":"10.1016/j.surge.2025.01.007","DOIUrl":"https://doi.org/10.1016/j.surge.2025.01.007","url":null,"abstract":"<p><strong>Objectives: </strong>Anecdotally, surgical intervention for acute complicated mastoiditis within our centre differed between clinicians. We aimed to assess our outcomes and experience.</p><p><strong>Methods: </strong>A retrospective observational study was undertaken of children with mastoiditis without intracranial complications admitted between January 2017-September 2022. Electronic records were utilised for data collection. Mann-Whitney U and Chi-square test were used for statistical analysis. Operative intervention, length of stay (LOS), complications and 30 day readmission were analysed.</p><p><strong>Results: </strong>There were 101 patients with a median age of 2 years and 50 (55 %) were male. Thirty-nine patients (39 %) underwent surgery. Thirty-two patients had mastoiditis with subperiosteal abscess formation without intracranial collections. Seventeen patients (44 %) underwent cortical mastoidectomy (median LOS 5.5 days). Twenty two patients (56 %) underwent incision and drainage (I + D) of abscess plus myringotomy (median LOS 5 days), p = 0.58. The mastoidectomy group had 2 complications and the I + D group had none.</p><p><strong>Conclusions: </strong>For mastoiditis with local subperiosteal abscess and no intracranial component, a cortical mastoidectomy may not always be required.</p>","PeriodicalId":49463,"journal":{"name":"Surgeon-Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143434231","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":"Optimal approaches to flap reconstruction following abdominoperineal resection: A systematic review.","authors":"Gavin G Calpin, Matthew G Davey, Barry Maguire, Stefan Morarasu, Noel E Donlon, Kevin C Cahill, John O Larkin","doi":"10.1016/j.surge.2025.01.010","DOIUrl":"https://doi.org/10.1016/j.surge.2025.01.010","url":null,"abstract":"<p><strong>Purpose: </strong>Abdominoperineal resection (APR) frequently results in a large volume perineal defect. Flap reconstruction is commonly undertaken to reduce the rate of perineal complications associated with primary closure. Several techniques can be employed including vertical rectus abdominis (VRAM), gluteal myocutaneous and gluteal fasciocutaneous flaps. We aimed to compare perineal complication rates between flap reconstruction techniques.</p><p><strong>Methods: </strong>A systematic review was conducted following PRISMA guidelines. Databases were searched for studies reporting perineal complications following flap reconstruction post-APR. Demographic data for each study was extracted along with overall perineal complication rate, infectious complication, flap necrosis, dehiscence, and failure.</p><p><strong>Results: </strong>In total, 31 studies with 764 patients were included. Rectal cancer was the underlying pathology in 71.3 % (545/764), anal cancer in 23.6 % (180/764), and other in 5.1 % (39/764). VRAM flap reconstruction was performed in 57.2 % of cases (437/764), gluteal myocutaneous in 25.1 % (192/764), and gluteal fasciocutaneous in 17.7 % (135/764). Infection, dehiscence, haematoma, seroma, and flap failure rates were comparable among the different groups. Flap necrosis occurred in 4.6 % of the VRAM group and was significantly higher than in the other groups (P = 0.028). The rate of reoperation (9.1 %) was also significantly higher in the VRAM group (P = 0.038). Perineal hernia formation occurred in 14.9 % of the gluteal fasciocutaneous group and was significantly higher than in the other groups (P < 0.001).</p><p><strong>Conclusion: </strong>Flap necrosis and reoperation rates are higher after VRAM flap reconstruction. Perineal hernia rates are higher in gluteal fasciocutaneous flap reconstruction. A randomised controlled trial is needed to further investigate the outcomes of flap reconstruction.</p>","PeriodicalId":49463,"journal":{"name":"Surgeon-Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143416000","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}