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

{"title":"Total thyroidectomy or hemithyroidectomy for differentiated thyroid carcinoma?","authors":"Jennifer L McGarry, Alexandra Zaborowski, Nicola McShane, Badriya Alkeni, Tessa Walton, Emma Kearns, Ryan Choo Rui Jye, Niall McInerney, Mel Corbett, Rachel Crowley, Marcia Bell, Tom Moran, Fergal O'Duffy, Orla Young, Denis Evoy, Aoife Lowery, Michael Kerin, Ruth S Prichard","doi":"10.1016/j.surge.2026.04.002","DOIUrl":"https://doi.org/10.1016/j.surge.2026.04.002","url":null,"abstract":"<p><strong>Background: </strong>Optimal surgical management for differentiated thyroid cancer (DTC) remains controversial, particularly regarding initial hemithyroidectomy versus total thyroidectomy. Understanding factors predicting the need for completion thyroidectomy and residual disease in the remnant lobe is critical for risk-adapted treatment.</p><p><strong>Methods: </strong>We conducted a multicentre retrospective cohort study of 387 patients undergoing surgical management of DTC between 2015 and 2024 across three tertiary centres. Demographic, clinical, cytological, and pathological data were extracted and compared by surgical extent. Among patients initially treated with hemithyroidectomy, predictors of proceeding to completion thyroidectomy were assessed. In patients undergoing completion thyroidectomy, clinicopathological factors associated with residual disease in the completion lobe were identified using both univariate and multivariate logistic regression analyses.</p><p><strong>Results: </strong>Of 387 patients (median age 44 years, 78.0% female), 243 (63.0%) initially underwent hemithyroidectomy, and 143 (37.0%) underwent total thyroidectomy. Among hemithyroidectomy patients, 174 (71.3%) proceeded to completion thyroidectomy. Among completion thyroidectomy patients, residual disease was found in 63 (36.2%). Those undergoing completion thyroidectomy were more likely to have larger tumour (p < 0.001), nodal disease (0.006), extrathyroidal spread (0.003) and lymphovascular invasion (0.004). On multivariate analysis, male sex (OR 4.20, 95% CI [1.13, 15.63], p = 0.034) was independently associated with higher odds of residual disease in the completion lobe, while papillary subtype was associated with a lower odds of residual disease (OR 0.12, 95% CI [0.03, 0.50], p = 0.0045).</p><p><strong>Conclusion: </strong>Larger nodule size and adverse pathological features were associated with higher rates of completion thyroidectomy. Among patients undergoing completion surgery, male sex independently predicted residual disease (OR 4.20, p = 0.034), while papillary histology was associated with a reduced risk (OR 0.12, p = 0.0045). These findings support risk-adapted surgical strategies and highlight the need for individualised decision-making and further prospective research to refine risk prediction in DTC.</p>","PeriodicalId":49463,"journal":{"name":"Surgeon-Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147787407","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":"Trans-anal minimally invasive surgery (TAMIS): Case series on short-term outcomes and systematic review of the literature.","authors":"Osama Zaman, Shafquat Zaman, Mohamed Ebraheem, Aaminah Chaudhry, Ali Yasen Mohamedahmed, Akinfemi Akingboye, Stelios Vakis, Najam Husain, Georgios Kakaniaris","doi":"10.1016/j.surge.2026.03.004","DOIUrl":"https://doi.org/10.1016/j.surge.2026.03.004","url":null,"abstract":"<p><strong>Background: </strong>Colorectal cancer is the third most common malignancy worldwide with rectal cancer accounting for approximately 30% of all new cases. Surgery is the standard of care in the treatment of localised malignancy and can be performed through open and various minimally invasive approaches. Trans-anal minimally invasive surgery (TAMIS) represents a rectal-sparing hybrid technique between single-port laparoscopy and trans-anal endoscopic microsurgery (TEM) for resection of benign and early-stage rectal cancers. We present our initial experience with TAMIS including short-term outcomes and provide an updated systematic review.</p><p><strong>Methods: </strong>A retrospective case series of patients with rectal lesions who underwent TAMIS between February 2022 to June 2024 at a district general hospital in the UK was performed. Basic patient demographics, intra- and postoperative outcomes including complications were collected and analysed. A comprehensive search of various electronic databases for the systematic review was conducted including PubMed, Embase, MEDLINE, and Web of Knowledge. Studies (excluding case reports) including patients diagnosed with rectal malignancy or benign polyps and treated with TAMIS were included. Analysed outcome measures were excision quality and complications.</p><p><strong>Results: </strong>Our case series cohort included a total of 25 patients with a mean age of 70.7 years (SD = 14.3). Mean distance of lesion from the anal verge was 5.8 cm (SD = 3.2), with intra-operative blood loss of 6.0 mls (SD = 10.5), and an operative duration of 67.0 min (SD = 38.9). Final histopathological analysis showed adenocarcinoma in 20%, morbidity rate of 12%, R0 resections in 72%, and 30-day re-admission rate of 16%. The mean length of stay was 2.4 days (SD = 1.8). A total of 48 studies, with 1964 patients were included in the systematic review, with a mixture of case series, comparative studies and published abstracts. Average age was 64.4 years (SD = 6.4) and 42.8% were female. Mean distance of lesion from the anal verge was 6.9 cm (SD = 1.3) with an operative duration of 71.2 min (SD = 18.5). Length of stay was 1.5 days (SD = 1.3), R0 resection rates of 91.8%, morbidity rate of 11.6%, and recurrence rate of 4.7%, respectively.</p><p><strong>Conclusion: </strong>Although TAMIS is a safe and feasible option in the treatment of benign polyps and early-stage malignancy, outcomes remain similar in the decade since the first published review. TAMIS is still a relatively new technique and it is anticipated that outcomes will likely improve with time.</p>","PeriodicalId":49463,"journal":{"name":"Surgeon-Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147595792","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":"Comparing diverting and primary repair/anastomotic techniques for managing colorectal trauma: A systematic review and meta-analysis.","authors":"Abdullah Y Ali, Saaniyah Sajed, Annaliisa S Cordova, Ahmed Adham R Elsayed, Marc D Basson","doi":"10.1016/j.surge.2026.03.002","DOIUrl":"https://doi.org/10.1016/j.surge.2026.03.002","url":null,"abstract":"<p><strong>Purpose: </strong>Colorectal trauma management has evolved significantly, with ongoing debate regarding optimal surgical approach between fecal diversion and primary repair/anastomotic techniques. This systematic review and meta-analysis compared diverting and non-diverting operative management strategies for colorectal trauma.</p><p><strong>Methods: </strong>A systematic review was conducted following PRISMA guidelines, searching for four databases through October 2024. Studies comparing fecal diversion to primary repair/anastomosis in colorectal trauma were included. Meta-analysis was performed using R software.</p><p><strong>Results: </strong>Forty-nine studies comprising 7201 patients were included (7 randomized trials, 40 observational studies, 2 case series). Of these, 4007 (55.6%) patients underwent non-diverting procedures, while 3090 (42.9%) received fecal diversion. Penetrating injury was the most common mechanism. Patients in the diverting group had higher injury severity scores, greater fecal contamination, and more associated injuries. Meta-analysis of 5397 patients demonstrated significantly lower mortality for non-diverting procedures compared to fecal diversion (OR 0.46, CI 0.29-0.75, p < 0.0001). Infectious complications were also significantly lower in the non-diverting group (OR 0.49, CI 0.3-0.8, p < 0.0001) among 4078 patients analyzed.</p><p><strong>Conclusions: </strong>Non-diverting operative procedures are a feasible choice for the management of civilian penetrating and blunt colon trauma. Previously established criteria for mandatory fecal diversion do not independently predict poor outcomes and should not be the sole guide in clinical decision-making. On the other hand, diverting ostomy should be conducted in the setting of rectal trauma.</p>","PeriodicalId":49463,"journal":{"name":"Surgeon-Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147534115","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 importance of mechanism in penetrating spinal injuries - A comparative study between gunshot wounds versus stab wounds to the spine managed at a major trauma centre in South Africa.","authors":"Reuben He, Victor Kong, Cynthia Cheung, Jonathan Ko, Daniel Lee, Joshua Ahn, Shuba Kosna, William Yeung, Hong Lee, Howard Wain, Wanda Bekker, Grant Laing, Damian Clarke","doi":"10.1016/j.surge.2026.02.006","DOIUrl":"https://doi.org/10.1016/j.surge.2026.02.006","url":null,"abstract":"<p><strong>Introduction: </strong>Although both gunshot wounds (GSW) and stab wounds (SW) can cause a penetrating spinal injury, the mechanisms underlying these injuries are distinct. This study compares spinal GSWs and SWs regarding their presenting characteristics, associated injuries, clinical management, and patient outcomes.</p><p><strong>Methods: </strong>Longitudinal data (2012-2022) were collected from the Hybrid Electronic Medical Registry database to identify all patients with spinal GSW and SW over the study period.</p><p><strong>Results: </strong>There were 201 (54%) patients with spinal GSW and 169 (46%) patients with spinal SW. Thoracic level spinal cord injury and American Spinal Injury Association Impairment Scale (AIS) grade D injury were associated with the need for spinal surgery (P < 0.05). In the SW group, three AIS E, two AIS D, two AIS C, and one AIS A patient had spinal surgery. In the GSW cohort, six of the seven patients who underwent spinal surgery had a spinal cord injury, compared to six of the eight patients in the SW group. Significantly more GSW patients underwent surgical intervention for concurrent body injuries compared to SW patients. The most common procedure in both groups was a laparotomy. Patients in the GSW group had significantly higher complication rates than the SW group and higher rates of intensive care unit (ICU) admission. The in-hospital mortality rate was approximately ten times higher in the GSW group.</p><p><strong>Conclusion: </strong>GSWs and SWs of the spine are distinct entities. GSWs are more likely to have severe systemic illness from concurrent organ injuries compared to SWs. In contrast, SWs are more likely to be incomplete cord injuries and carry a much better prognosis for neurological improvement/ambulation. The indications for surgery must be individualised.</p>","PeriodicalId":49463,"journal":{"name":"Surgeon-Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146259787","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":"Validation and clinical utility of predictive nomograms for sentinel node positivity in cutaneous malignant melanoma in Ireland.","authors":"N Christodoulides, N Quirke, R Leon, A Ghinis, Q Jeantet, S Potter","doi":"10.1016/j.surge.2026.02.003","DOIUrl":"https://doi.org/10.1016/j.surge.2026.02.003","url":null,"abstract":"<p><strong>Background: </strong>Sentinel lymph node biopsy (SLNB) is an important prognostic tool in cutaneous malignant melanoma. Nomograms such as those from Memorial Sloan Kettering (MSK), the Melanoma Institute of Australia (MIA), and LifeMath aim to predict SLNB positivity. We sought to compare and validate these tools in an Irish cohort.</p><p><strong>Methods: </strong>Clinical and pathological data were extracted from patient records to calculate predicted SLNB positivity using each of the three nomograms. Model performance was assessed for discrimination and calibration. Sensitivity, specificity, negative predictive value (NPV) and potential SLNB reduction were examined at thresholds of 5-15%. Decision curve analysis (DCA) was used to evaluate clinical utility.</p><p><strong>Results: </strong>Among 215 patients, 35 (16%) had a positive SLNB. All three models showed good predictive ability, with the MSK nomogram performing best. At a 5% threshold, DCA demonstrated minimal clinical benefit compared to a treat-all approach. In tumours with a predicted SLNB positivity risk of 10%, all three nomograms demonstrated clear net benefit and the potential to reduce unnecessary biopsies.</p><p><strong>Conclusion: </strong>The MSK, MIA and LifeMath nomograms are well calibrated in an Irish melanoma cohort, with the MSK model showing the strongest performance. While limited at the 5% threshold, these tools may help refine patient selection for SLNB at a 10% threshold, acting as an adjunct to clinical decision-making and potentially reducing unnecessary procedures and associated morbidity.</p>","PeriodicalId":49463,"journal":{"name":"Surgeon-Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146195907","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":"Trends in incidence, management and survival in medullary thyroid cancer in Ireland - A 25-year population-based study.","authors":"T J Crotty, G P Sexton, E F Cleere, M L Healy, C Grant, R S R Woods, J P O'Neill, J Kinsella, P Lennon, C V Timon, C W R Fitzgerald","doi":"10.1016/j.surge.2026.01.004","DOIUrl":"https://doi.org/10.1016/j.surge.2026.01.004","url":null,"abstract":"<p><strong>Introduction: </strong>Medullary thyroid cancer (MTC) is a potentially aggressive thyroid malignancy arising from parafollicular C-cells. While current evidence demonstrates a rising incidence of differentiated thyroid cancer (DTC) both in Ireland and globally, trends in MTC incidence and prognosis remain less well defined. This study aims to analyse the incidence, management and survival of patients with MTC in the Irish population.</p><p><strong>Methods: </strong>A retrospective analysis of patients diagnosed with MTC between 1994 and 2019 was performed using data from the Irish National Cancer Registry (NCRI). Patients were grouped into two time periods: 1994-2007 and 2008-2019. Kaplan-Meier survival analysis was used to estimate overall survival (OS) and disease-specific survival (DSS). Univariate and multivariate Cox proportional hazard models were applied to identify factors associated with survival outcomes.</p><p><strong>Results: </strong>A total of 152 patients were diagnosed with MTC. The median age at diagnosis was 53 years. The incidence rate was 0.14 cases per 100,000 person-years. Five-year OS and DSS were 67% and 73.2%, respectively. On multivariate analysis, surgical management was independently associated with improved OS and DSS (HR 0.18, p = 0.013), while chemotherapy was associated with significantly poorer survival (HR 4.29, p = 0.014).</p><p><strong>Conclusion: </strong>This study highlights evolving trends in the incidence, management and survival of patients with MTC in Ireland over a 25-year period. A trend towards improved overall survival was observed in patients diagnosed in the later cohort.</p>","PeriodicalId":49463,"journal":{"name":"Surgeon-Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146127145","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":"Rethinking the role of endoscopy for colorectal cancer following diverticulitis: An exploratory model for guiding endoscopic assessment.","authors":"Muhammad Usman, Elon Correa, Wenyuan Chung, Lasitha Samarakoon, Deepak Paul, Sudarshan Rao Kadri","doi":"10.1016/j.surge.2026.01.002","DOIUrl":"https://doi.org/10.1016/j.surge.2026.01.002","url":null,"abstract":"<p><strong>Background: </strong>The association between diverticulitis and colorectal (CRC) remains controversial, with current guidelines differing significantly in terms of post-diverticulitis endoscopic assessment. This study is aimed at developing an exploratory model to identify patients at high risk of CRC following diverticulitis.</p><p><strong>Methods: </strong>This retrospective cohort study analyzed 1546 patients diagnosed with diverticulitis between January 2021 and December 2023 at a UK tertiary care hospital. Ordinal logistic regression was used to identify predictors associated with CRC risk.</p><p><strong>Results: </strong>Of 1546 patients, the mean age was 69.2 years SD ± 12.9, and 51.5 % were female. Increasing age (OR 1.28 per SD, 95 % CI 1.14-1.45, p < 0.001) and male sex (OR 1.75, 95 % CI 1.39-2.21, p < 0.001) were high risk predictors associated with increased risk of CRC. Conversely, abdominal pain (OR 0.60, 95 % CI 0.44-0.80, p = 0.001) and per-rectal bleeding (OR 0.71, 95 % CI 0.56-0.89, p = 0.004), and presence of diverticulosis showed a protective association (OR 0.68, 95 % CI 0.47-0.97, p = 0.033), which could be due to confounding. CT findings did not achieve statistical significance as independent predictors in the multivariable model.</p><p><strong>Conclusions: </strong>This exploratory model identifies patient characteristics that stratify CRC risk following diverticulitis. These findings may help personalize decisions regarding post-diverticulitis colonoscopy, optimizing resource allocation while maintaining appropriate cancer surveillance. However, this model would require external validation before use in clinical practice.</p>","PeriodicalId":49463,"journal":{"name":"Surgeon-Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-02-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146114665","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":"Transmetatarsal amputation versus multiple toes amputations for non-ischemic diabetic foot infection management","authors":"Moustafa Mabrouk ,&nbsp;Ahmed Fouda ,&nbsp;Mohammed ElKassaby","doi":"10.1016/j.surge.2025.08.005","DOIUrl":"10.1016/j.surge.2025.08.005","url":null,"abstract":"<div><h3>Background</h3><div>The management of diabetic foot infections (DFIs) is a complex multidisciplinary process and often necessitates surgical interventions. Unfortunately, amputations such as single or multiple toes amputations (MTA) or full transmetatarsal amputation (TMA) are often the unavoidable solution. This study aimed to compare the clinical outcomes of TMA versus MTA in managing non-ischemic diabetic foot infections.</div></div><div><h3>Methods</h3><div>This was a retrospective study on non-ischemic diabetic foot infection patients comparing the results of TMA and MTA in terms of healing, ulcer recurrence and overall complications, including further formal amputations.</div></div><div><h3>Results</h3><div>The healing rate was substantially higher in TMA group (89.3 % vs. 74.5 %, p=0.004). TMA group exhibited a significantly lower incidence of further proximal amputation (8.7 % vs. 21.3 %, p=0.002) and ulcer recurrence (11.3 % vs. 25.3 %, p=0.002). Tissue necrosis occurred less frequently in TMA group (4.5 % vs. 12.8 %, p&lt;0.05). No significant differences were found between the groups regarding infection, hematoma, or residual edema.</div></div><div><h3>Conclusions</h3><div>Transmetatarsal amputation for diabetic foot infection demonstrated superior healing rates, lower ulcer recurrence, and reduced need for proximal amputation compared to multiple toe amputations for managing non-ischemic diabetic foot infections.</div></div><div><h3>Level of evidence</h3><div>level 3 retrospective study</div></div>","PeriodicalId":49463,"journal":{"name":"Surgeon-Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland","volume":"24 1","pages":"Pages 39-42"},"PeriodicalIF":2.3,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145008551","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":"Do hospital and surgeon volumes impact the outcomes of patients undergoing cholecystectomy in Ireland? A national registry based study","authors":"E. Linehan ,&nbsp;J.D. Kehoe ,&nbsp;T. Gall ,&nbsp;G. McEntee ,&nbsp;J. Conneely ,&nbsp;R.M. O'Connell","doi":"10.1016/j.surge.2025.08.008","DOIUrl":"10.1016/j.surge.2025.08.008","url":null,"abstract":"<div><h3>Introduction</h3><div>Biliary pathology can have an enormous burden on both the patient and the health service with acute cholecystitis being diagnosed in 10 % of patients that present with acute abdominal pain. Emergency or elective laparoscopic cholecystectomy is the recommended treatment option for these patients. It has been shown previously that surgical and hospital volume affect outcomes from emergency abdominal surgery in Ireland, but no such investigation has been done specifically for cholecystectomies.</div></div><div><h3>Aim</h3><div>To determine if there is a link between the hospital and surgeon volume of cholecystectomies performed and their associated outcomes in Irish hospitals.</div></div><div><h3>Methods</h3><div>This was a retrospective registry study using National Quality Assurance &amp; Improvement System (NQAIS). All patients who underwent cholecystectomy in Irish public hospitals from January 2017 until December 2023 were identified. Hospitals and surgeons were divided into groups of high, medium and low volume based on the number of cholecystectomies performed per year during the study period. Data including the demographics, admission details and outcomes of patients who underwent cholecystectomy were extracted from the database for analysis.</div></div><div><h3>Results</h3><div>A total of 28,835 patients in 35 hospitals were included. Adverse outcomes were reported in 1952 patients who underwent a cholecystectomy. An association was found between adverse outcomes including bile duct injury (0.10 % vs 0.03 %, p &lt; 0.001) and critical care admission (2.7 % vs 1.97 %, p &lt; 0.022) and patients who had surgery in low volume hospitals compared to high volume centres. No statistically significant difference in adverse outcome was reported for the low surgical volume patients. Risk factors associated with adverse outcome following cholecystectomy were age &gt;65, high pre-operative morbidity, emergency surgery and low hospital volume (p &lt; 0.001).</div></div><div><h3>Discussion</h3><div>Patients undergoing cholecystectomy in low volume hospitals have a higher risk of adverse events. Surgeons who perform low volumes of cholecystectomies appear to perform a higher percentage of emergency cholecystectomies without a statistically significant difference in their outcomes.</div></div>","PeriodicalId":49463,"journal":{"name":"Surgeon-Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland","volume":"24 1","pages":"Pages 18-23"},"PeriodicalIF":2.3,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145662589","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":"One-year comparative outcomes of robotic vs. laparoscopic colorectal cancer resections in a UK district hospital","authors":"Mathew Cherian Moolamannil ,&nbsp;Abigail Mwendauya ,&nbsp;Yüksel Gerçek ,&nbsp;Katharine Bevan ,&nbsp;Kanapathi Rajaratnam ,&nbsp;Fanourios Georgiades","doi":"10.1016/j.surge.2025.11.004","DOIUrl":"10.1016/j.surge.2025.11.004","url":null,"abstract":"<div><h3>Aim</h3><div>We aim to describe our centre's one-year experience after establishing our robotic programme for colorectal surgery.</div></div><div><h3>Method</h3><div>Demographic, peri-operative, and follow-up data from a prospectively maintained database were collected for all laparoscopic and robotic-assisted colorectal procedures carried out at our centre. All robotic colorectal resections were completed with the DaVinci Xi (Intuitive Surgical, USA) robotic platform.</div></div><div><h3>Results</h3><div>Fifty-eight robotic colorectal resections were compared to 58 from the laparoscopic cohort, all indicated for malignancy. No statistical difference was observed between the demographics of the two cohorts regarding sex, age, body mass index (BMI), and American Society of Anesthesiologists (ASA) grade. 33/58 (56.9 %) robotic resections were left-sided compared to 36/58 (62.1 %) laparoscopic resections. One robotic case was converted to open (1.7 %), with four (6.9 %) in the laparoscopic group converted to open. Laparoscopic procedures were shorter (median operative time 282 min compared to 384 min, p &lt; 0.001, Wilcoxon rank-sum). Subgroup analysis for patients with ASA grades 1&amp;2 showed shorter operative times in the laparoscopic cohort compared to the robotic cohort (p = 0.003, Wilcoxon rank-sum). The median length of stay was five days for both cohorts. Significant postoperative complications (Clavien-Dindo ≥3) occurred in 3.45 % (n = 2/58) vs. 10.3 % (n = 6/58), which was not significantly different statistically. No mortalities were recorded within 90 days of the procedures in both cohorts, but at one-year follow-up, we observed one mortality in each cohort.</div></div><div><h3>Conclusions</h3><div>Other than longer operative times for ASA grades 1/2 patients, robotic colorectal resection outcomes in a small district hospital setting are comparable to laparoscopic resections.</div></div>","PeriodicalId":49463,"journal":{"name":"Surgeon-Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland","volume":"24 1","pages":"Pages 24-30"},"PeriodicalIF":2.3,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145483493","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}