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

{"title":"Early ureteroscopy and laser lithotripsy in the management of obstructing urolithiasis with associated urosepsis – A prospective multi-institutional study","authors":"James Connor , John O’Kelly , Steven Anderson , Ailish Naughton , David Galvin , Kieran Breen , Diarmaid Moran , Mark Quinlan , Barry McGuire , Niall Davis","doi":"10.1016/j.surge.2025.04.012","DOIUrl":"10.1016/j.surge.2025.04.012","url":null,"abstract":"","PeriodicalId":49463,"journal":{"name":"Surgeon-Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland","volume":"23 4","pages":"Page 255"},"PeriodicalIF":2.3,"publicationDate":"2025-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144578849","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 MISHAP Trial: Managing Injuries - a Study of Hand Appearance and Psychosocial Dysfunction","authors":"I. Marinescu , E. Phoenix , E. Geary , D. Mclaughlin , C. Morrison , R. Dolan","doi":"10.1016/j.surge.2025.04.014","DOIUrl":"10.1016/j.surge.2025.04.014","url":null,"abstract":"","PeriodicalId":49463,"journal":{"name":"Surgeon-Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland","volume":"23 4","pages":"Page 256"},"PeriodicalIF":2.3,"publicationDate":"2025-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144578851","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 effect of self-confidence, life satisfaction and death anxiety on organ donation in student nurses: Moderator effect.","authors":"Dilek Soylu, Adem Doğaner","doi":"10.1016/j.surge.2025.07.001","DOIUrl":"https://doi.org/10.1016/j.surge.2025.07.001","url":null,"abstract":"<p><strong>Purpose: </strong>Organ donation is influenced by culture, religion, death rituals, and the perceived needs of the body after death. This study examined the moderating role of death anxiety in the effect of self-confidence and life satisfaction on attitudes to organ donation.</p><p><strong>Methods: </strong>This study was descriptive, cross-sectional, and relationship-seeking. The study was conducted with a total of 247 nursing students between January and February 2024. Moderator effect was used, using the Death Anxiety Scale. In the data collection, a Personal Information Form, the Organ Donation Attitude Scale, Life Satisfaction Scale, Self-Confidence Scale were used.</p><p><strong>Results: </strong>Death Anxiety Scale was determined to have a significant moderating effect on the Organ Donation Attitude Scale (β = 0.0452, p < 0.001) and there was seen to be a moderating role of Death Anxiety Scale on the effect of Life Satisfaction Scale on Organ Donation Attitude Scale (β = 0.1586, p = 0.033).</p><p><strong>Conclusions: </strong>There was determined to be a moderating role of Death Anxiety Scale in the effect of Self-Confidence Scale and Life Satisfaction Scale on Organ Donation Attitude Scale.</p>","PeriodicalId":49463,"journal":{"name":"Surgeon-Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144602079","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":"Bridging generational gaps in Surgery: A narrative review on values, well-being, and training preferences.","authors":"Floortje Huizing, Vincent Q Sier, Annelot D Sark, Heleen S Snijders, Joost R van der Vorst, Roderick F Schmitz, Abbey Schepers, Joris J Blok","doi":"10.1016/j.surge.2025.07.003","DOIUrl":"https://doi.org/10.1016/j.surge.2025.07.003","url":null,"abstract":"<p><strong>Background and purpose: </strong>Intergenerational differences in surgery create both challenges and opportunities. While differening perspectives and expectations may deter younger generations from pursuing surgical careers, it is crucial to balance these with the core values that define the surgical profession. This narrative review was conducted to better understand how the profession needs to evolve.</p><p><strong>Methods: </strong>A structured literature search on generational changes in surgery was conducted using PubMed and Google Scholar. Relevant search terms were employed, covering (i) surgeons/surgery, (ii) generation/cohort and (ii) culture/identity/behaviour. After independent title and abstract screening by three authors, consensus was reached to include relevant studies published in English up to November 2023.</p><p><strong>Main findings: </strong>Full-text evaluation led to an inclusion of 50 studies, reviewed for returning themes. Identified themes included: generations (n = 9), work engagement (n = 8), work-life balance (n = 7), training and education (n = 4) and attractiveness of the profession (n = 8). An additional 14 relevant studies were included based on reference lists and external sources.</p><p><strong>Conclusions: </strong>This review summarizes key factors contributing to surgical well-being and generational dynamics. Awareness of these factors is increasing. While generational differences exist, many distinctions may be attributed to life phases, lifestyles or systemic changes in the past decades. Addressing these topics daily can foster intergenerational dialogue and a supportive environment for future surgeons.</p>","PeriodicalId":49463,"journal":{"name":"Surgeon-Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144602078","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 effect of timing of emergency cholecystectomy for acute cholecystitis on peri-operative outcomes: A national registry-based study.","authors":"John David Kehoe, Robert O'Connell, Eimear Linehan, Niall Hardy, Ben Creavin, Tamara Gall, Gerry McEntee, John Conneely","doi":"10.1016/j.surge.2025.06.004","DOIUrl":"https://doi.org/10.1016/j.surge.2025.06.004","url":null,"abstract":"<p><strong>Introduction: </strong>A selection of international guidelines suggest that emergency cholecystectomy within 72 h of admission is the treatment of choice for acute cholecystitis. The aim of this study was to analyse the interval from presentation to operative intervention for acute cholecystitis in Ireland and its impact on peri-operative outcomes.</p><p><strong>Methods: </strong>This was a national retrospective observational study of all patients that underwent an emergency cholecystectomy for acute cholecystitis in Ireland between January 2017 and July 2023. Data collected included: demographics, co-morbidities, length of stay, operative approach, post-operative interventions, in-patient mortality, and readmissions. Subjects were stratified based on time from presentation to theatre and outcomes were compared between groups.</p><p><strong>Results: </strong>3585 patients underwent an emergency cholecystectomy for acute cholecystitis-2005(55.9 %) within 72 h of admission, 1072(29.9 %) within 72 hours-7 days, 416(11.6 %) within 8-14 days and 92(2.6 %) beyond 14 days. Earlier progression to theatre was predicted by female sex (X²(3) = 10.402,p = 0.015), less co-morbidities (X²(12) = 95.723,p=<0.001), and younger age (H(3) = 92.591,p=<0.001). On logistic regression, age >65(OR 1.565,p < 0.001), male sex(OR 1.348,p = 0.002), increasing co-morbidities(OR 1.586,p = 0.009) and increased \"time to theatre\"(72hrs-7days(OR 1.616,p < 0.001), 8-14days(OR 3.84,p < 0.001), >14days(OR 5.929,p < 0.001)) were risk factors for a composite of adverse outcomes (mortality, 30-day readmission, post-operative ERCP/IR drain, conversion to open, CBD injury). Subgroup analysis of the <72 h group displayed no difference in outcome.</p><p><strong>Conclusion: </strong>Despite international guidance, just over half of emergency cholecystectomies for acute cholecystitis are performed within 72 h in Ireland. Prolonging \"time to theatre\" is associated with a stepwise deterioration in outcomes across a wide variety of measures.</p>","PeriodicalId":49463,"journal":{"name":"Surgeon-Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144602080","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":"Enhancing medical student learning in the operating theatre: the need for integrated preparation.","authors":"Lachlan Dick, Sannah Ali, Katie Hughes","doi":"10.1016/j.surge.2025.06.003","DOIUrl":"https://doi.org/10.1016/j.surge.2025.06.003","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":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144545819","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 efficacy of lidocaine- and nifedipine-based conservative therapies in acute hemorrhoidal disease: A retrospective cohort study.","authors":"Michele Schiano di Visconte","doi":"10.1016/j.surge.2025.06.002","DOIUrl":"https://doi.org/10.1016/j.surge.2025.06.002","url":null,"abstract":"<p><strong>Background: </strong>Acute hemorrhoidal disease (AHD) is a prevalent anorectal condition that significantly impacts patients' quality of life and healthcare systems. Despite the availability of various conservative treatments, comparative efficacy data remains limited. This retrospective study evaluates two treatment regimens for AHD, focusing on symptom relief, patient-reported outcomes, and treatment tolerability.</p><p><strong>Methods: </strong>Medical records of 123 patients with AHD treated at a tertiary care center between October 2022 and October 2024 were reviewed. Patients were divided into two groups: Group A treated with oral diosmin/hesperidin, bromelain, and topical lidocaine, and Group B treated with oral diosmin/hesperidin, bromelain, and topical nifedipine. Symptoms were evaluated using the Hemorrhoidal Disease Symptom Score (HDSS), Visual Analog Scale (VAS) for pain, and Short Health Scale for Hemorrhoidal Disease (SHS-HD) at baseline and on days 7, 14, and 21.</p><p><strong>Results: </strong>Both groups showed significant improvements in symptoms during the study period. Group A demonstrated faster pain reduction (VAS day 7:0.17 ± 0.52 vs. 2.20 ± 1.11, p < 0.001) and greater improvement in HDSS score (day 7: 0.02 ± 0.87 vs. 10.16 ± 3.38, p < 0.001). Improvements in SHS-HD scores were more rapid for Group A, with scores on day 7 showing a significant difference (Group A: 7.58 ± 2.58 vs. Group B: 12.27 ± 4.21, p < 0.001). Both regimens were well tolerated, with no significant adverse events.</p><p><strong>Conclusions: </strong>The combination of oral diosmin/hesperidin, bromelain, and lidocaine provides superior initial symptom relief compared with nifedipine-based regimens. Lidocaine is the preferred topical agent for rapid pain management in AHD patients. Further studies are required to confirm these results.</p>","PeriodicalId":49463,"journal":{"name":"Surgeon-Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144530715","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":"Venous thromboembolism (VTE) prevention in the trauma patient: A national survey of practice.","authors":"Bibi Ayesha Bassa, Michele Fernandes, Elizabeth Little, Kaitlin Alexander, Frank Lyons, Valeria Lima Passos, Fionnuala Ni Ainle, Etimbuk Umana","doi":"10.1016/j.surge.2025.06.001","DOIUrl":"https://doi.org/10.1016/j.surge.2025.06.001","url":null,"abstract":"<p><strong>Aim: </strong>Due to complex injury patterns, the safe timing of venous thromboembolism (VTE) prophylaxis in trauma patients is challenging. The purpose of this study was to characterize current thromboprophylaxis practice in trauma patients amongst trauma providers in Ireland.</p><p><strong>Methods: </strong>We conducted a national, cross-sectional survey of trauma providers. The survey was sponsored by the Irish Network for VTE Research (INViTE) and disseminated through the national trauma and VTE office. The survey was a 35-item questionnaire and collected information regarding non-pharmacologic prophylaxis practice, preferred pharmacologic agent and dose, timing to initiation of prophylaxis in high-risk patients and selection of patients for extended thromboprophylaxis post discharge.</p><p><strong>Results: </strong>A total of 116 trauma providers responded (estimated response rate among surgical specialities 11 %). Majority of respondents (72/116; 65 %) were consultant doctors or fellows. Thirty-seven percent of respondents (43/116) reported having a VTE guideline for trauma patients at their institution. Majority of respondents (115/116; 99 %) reported using some form of mechanical prophylaxis. The most common pharmacologic dosing regimen reported was enoxaparin 40 mg 24-hourly (44/116; 38 %). Forty-four percent of respondents (51/116) indicated adjusting doses in patients with obesity. A high degree of variability in initial timing of prophylaxis following traumatic brain injury, solid organ injury, and spinal column injuries was observed.</p><p><strong>Conclusion: </strong>There is variable VTE prevention practice among trauma providers in Ireland. A standardized, national approach to VTE prevention in trauma care is needed.</p>","PeriodicalId":49463,"journal":{"name":"Surgeon-Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144512639","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":"Pitfalls of crude pooling in assessing diagnostic accuracy: A cautionary note.","authors":"Javier Arredondo Montero","doi":"10.1016/j.surge.2025.05.005","DOIUrl":"https://doi.org/10.1016/j.surge.2025.05.005","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":"2025-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144318480","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":"Ultrasound-guided versus laparoscopic-guided transversus abdominus plane block for laparoscopic cholecystectomy - A systematic review and meta-analysis of randomised clinical trials.","authors":"Matthew G Davey, Gordon R Daly, Noel E Donlon, Nuala A Healy, Arnold D K Hill","doi":"10.1016/j.surge.2025.05.003","DOIUrl":"https://doi.org/10.1016/j.surge.2025.05.003","url":null,"abstract":"<p><strong>Background: </strong>The use of transversus abdominus plane (TAP) blocks have come into vogue in recent times, with the ambition to reduce post-operative pain following laparoscopic cholecystectomy. TAP block is commonly performed using an ultrasound-guided approach (US-TAP), with emerging data indicating that laparoscopic-guided (L-TAP) approach may also be useful.</p><p><strong>Aim: </strong>To perform a systematic review and meta-analysis of randomised clinical trials (RCTs) comparing outcomes following US-TAP and L-TAP block in patients undergoing laparoscopic cholecystectomy.</p><p><strong>Methods: </strong>A systematic review was performed in accordance with PRISMA guidelines. Meta-analysis was performed using Review Manager version 5.4.</p><p><strong>Results: </strong>6 RCTs including 428 patients were included. Overall, 212 patients were randomised to US-TAP (49.5 %) and 216 to L-TAP (50.5 %) respectively. A non-significant difference was observed between groups for mean age, gender, mean body mass indices, and American Society of Anesthesiologists grades (all P > 0.050). At meta-analyses, a non-significant difference was observed for US-TAP and L-TAP with respect to 2-, 6-, 12-, 24-, and 48-h post-operative visual analogue scores. A non-significant difference was also observed in relation to intraoperative duration, breakthrough opioid consumption, and post-operative vomiting, at meta-analysis. Patients who underwent US-TAP had longer anesthetic administration times (mean difference: 6.38, 95 % confidence interval: 2.77-10.00, P < 0.001) compared to those randomised to undergo L-TAP.</p><p><strong>Conclusion: </strong>L-TAP and US-TAP provided similar post-operative pain scores, intraoperative duration, breakthrough opioid consumption, and post-operative vomiting following laparoscopic cholecystectomy. However, the time taken to perform L-TAP was significantly shorter. Should expertise allow, L-TAP should be considered in patients undergoing laparoscopic cholecystectomy.</p>","PeriodicalId":49463,"journal":{"name":"Surgeon-Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144227376","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}