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

{"title":"Personality traits and surgical performance: A human factors perspective","authors":"Michael El Boghdady , Joris J. Blok","doi":"10.1016/j.surge.2025.07.008","DOIUrl":"10.1016/j.surge.2025.07.008","url":null,"abstract":"","PeriodicalId":49463,"journal":{"name":"Surgeon-Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland","volume":"23 6","pages":"Page 421"},"PeriodicalIF":2.3,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145281480","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 ,&nbsp;Gordon R. Daly ,&nbsp;Noel E. Donlon ,&nbsp;Nuala A. Healy ,&nbsp;Arnold D.K. Hill","doi":"10.1016/j.surge.2025.05.003","DOIUrl":"10.1016/j.surge.2025.05.003","url":null,"abstract":"<div><h3>Background</h3><div>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.</div></div><div><h3>Aim</h3><div>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.</div></div><div><h3>Methods</h3><div>A systematic review was performed in accordance with PRISMA guidelines. Meta-analysis was performed using Review Manager version 5.4.</div></div><div><h3>Results</h3><div>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 <em>P</em> &gt; 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, <em>P</em> &lt; 0.001) compared to those randomised to undergo L-TAP.</div></div><div><h3>Conclusion</h3><div>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.</div></div>","PeriodicalId":49463,"journal":{"name":"Surgeon-Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland","volume":"23 6","pages":"Pages 399-405"},"PeriodicalIF":2.3,"publicationDate":"2025-12-01","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}

{"title":"List of editors","authors":"","doi":"10.1016/S1479-666X(25)00163-5","DOIUrl":"10.1016/S1479-666X(25)00163-5","url":null,"abstract":"","PeriodicalId":49463,"journal":{"name":"Surgeon-Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland","volume":"23 6","pages":"Page i"},"PeriodicalIF":2.3,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145532563","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":"POSE-UK: Paediatric orthopaedic surgery exposure in the UK","authors":"Chloe Jane Lowe ,&nbsp;Jun Wei Lim ,&nbsp;Stephanie Buchan ,&nbsp;Anouska Ayub ,&nbsp;Felicity Pease ,&nbsp;Emily Baird","doi":"10.1016/j.surge.2025.04.003","DOIUrl":"10.1016/j.surge.2025.04.003","url":null,"abstract":"<div><h3>Aim</h3><div>This study aims to investigate the early exposure of orthopaedic<span> trainees to paediatric orthopaedics and explore their training experiences, focusing on the factors influencing their decision to either select or deselect paediatric orthopaedics as a subspecialty.</span></div></div><div><h3>Method</h3><div>A national survey was distributed electronically to members of the British Orthopaedic Trainees' Association following a pilot survey sent to British Society of Children's Orthopaedic Surgery members. The survey concentrated on trainees' experiences and interest in paediatric orthopaedics. It included open, closed, and free-text questions, with the responses thematically analysed using NVivo software.</div></div><div><h3>Results</h3><div>133 responses were received from trainees across the UK and Ireland. The findings showed significant variation in the timing of the first exposure to paediatric orthopaedics, with 25 % not encountering it until Specialty Trainee level 6 or later. Most participants had mixed placements involving both adult and paediatric orthopaedics. Limited theatre exposure and insufficient emphasis on paediatric orthopaedic surgery during training may contribute to a lack of interest. A worrying lack of confidence was noted amongst trainees in performing standard emergency paediatric orthopaedic procedures, which are expected competencies for newly appointed consultants, regardless of their intended subspecialty. Furthermore, many trainees indicated that they might not meet the required work-based assessments and indicative numbers necessary to complete training.</div></div><div><h3>Conclusion</h3><div>Earlier and more extensive exposure to paediatric orthopaedics during training could help foster greater interest in the subspecialty. Enhanced training in standard emergency paediatric orthopaedic presentations is essential to ensure trainees are confident in performing these procedures as newly appointed general orthopaedic consultants.</div></div>","PeriodicalId":49463,"journal":{"name":"Surgeon-Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland","volume":"23 6","pages":"Pages 347-351"},"PeriodicalIF":2.3,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144182950","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":"Letter to editor on “Primary closure versus Graham patch omentopexy in perforated peptic ulcer: A systematic review and meta-analysis”","authors":"Timotius Ivan Hariyanto","doi":"10.1016/j.surge.2025.09.005","DOIUrl":"10.1016/j.surge.2025.09.005","url":null,"abstract":"","PeriodicalId":49463,"journal":{"name":"Surgeon-Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland","volume":"23 6","pages":"Page 420"},"PeriodicalIF":2.3,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145132186","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":"10.1016/j.surge.2025.06.002","url":null,"abstract":"<div><h3>Background</h3><div>Acute hemorrhoidal disease (AHD) is a prevalent anorectal condition that significantly impacts patients' quality of life<span> 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.</span></div></div><div><h3>Methods</h3><div><span>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, </span>bromelain<span><span>, and topical lidocaine, and Group B treated with oral diosmin/hesperidin, bromelain, and topical </span>nifedipine<span>. 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.</span></span></div></div><div><h3>Results</h3><div>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, <em>p</em><span> &lt; 0.001) and greater improvement in HDSS score (day 7: 0.02 ± 0.87 vs. 10.16 ± 3.38, p &lt; 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 &lt; 0.001). Both regimens were well tolerated, with no significant adverse events.</span></div></div><div><h3>Conclusions</h3><div><span>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</span><strong>.</strong></div></div>","PeriodicalId":49463,"journal":{"name":"Surgeon-Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland","volume":"23 6","pages":"Pages 406-411"},"PeriodicalIF":2.3,"publicationDate":"2025-12-01","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":"Call Yourself a Surgeon? The use of the title surgeon among non-surgical cosmetic practitioners in the United Kingdom","authors":"James Olding ,&nbsp;Rohan Shankarghatta ,&nbsp;Bachun Cheema ,&nbsp;Nafeesa Hussain ,&nbsp;Hassan Hussain ,&nbsp;Alessandra Kuhn Dall’Magro ,&nbsp;Ashraf Messiha","doi":"10.1016/j.surge.2025.04.050","DOIUrl":"10.1016/j.surge.2025.04.050","url":null,"abstract":"<div><h3>Background</h3><div>The global growth in cosmetic procedures has generated ongoing debate around what constitutes a medical procedure. Non-surgical procedures account for the majority of all cosmetic treatments performed, however in many jurisdictions, regulatory frameworks have not kept pace. In the United Kingdom, the term surgeon has partial protection in law in a medical context, being restricted to medical doctors registered with the General Medical Council (GMC). UK law thus permits all medically qualified doctors to call themselves surgeons. This sets up a conflict with multiple Codes of Conduct and Regulatory guidance documents, which set out clear definitions of what constitutes a surgeon.</div></div><div><h3>Methods</h3><div>We conducted a review of a public database including 350 non-surgical aesthetics doctors, identifying, practitioners presenting as surgeons. Information was checked against the GMC register, and guidance form Advertising Standards Authority Guidance and the Royal College of Surgeons of England.</div></div><div><h3>Results</h3><div>We found that 62 % of practitioners presenting as surgeons did not meet the identified criteria in regulatory guidance. These consisted in practising surgeons without specialist registration (equivalent to board certification), hair restoration surgery practitioners, and practitioners solely offering non-surgical treatments.</div></div><div><h3>Discussion</h3><div>Collaborative dialogue across surgical and medical aesthetics sectors is needed to agree accepted terminology in medical and surgical aesthetics practice. This is crucial to both empower patient choice and to allow aesthetics practitioners to meaningfully convey their previous experience and training, which may have been in a surgical setting. Doctors who have not undertaken surgical training should avoid terminology that could confuse patients.</div></div>","PeriodicalId":49463,"journal":{"name":"Surgeon-Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland","volume":"23 6","pages":"Pages 342-346"},"PeriodicalIF":2.3,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144081511","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 impact of direct consultant-to-consultant referrals on the spinal care pathway: A clinical audit","authors":"Arnav Barve ,&nbsp;Paul McCarroll ,&nbsp;Kevin Clesham ,&nbsp;Harry Marland ,&nbsp;Jake M. McDonnell ,&nbsp;Stacey Darwish ,&nbsp;Marcus Timlin ,&nbsp;Sam Lynch ,&nbsp;Seamus Morris ,&nbsp;Joseph S. Butler ,&nbsp;Keith Synnott","doi":"10.1016/j.surge.2025.05.001","DOIUrl":"10.1016/j.surge.2025.05.001","url":null,"abstract":"<div><h3>Background</h3><div>The institution in focus is a tertiary referral centre for all spinal pathology in the country. Traditionally, referrals to this centre have been reviewed by an on-call resident at the referring hospital. However, on May 10, 2023, this changed to a direct consultant-to-consultant referral protocol. This study aims to evaluate the impact of this change in protocol on the spinal care pathway.</div></div><div><h3>Methods</h3><div>A retrospective review was conducted based on patients with spinal pathology referred to the tertiary centre from February 2023 to August 2023. Referrals made using the traditional referral system (‘Before’ from 08/02/2023–09/05/2023) were compared to referrals made through the consultant-led referral system (‘After’ from 10/05/2023–08/08/2023). Parameters such as the number of referrals, number of surgically managed patients, and patients with complete imaging at the time of referral (TOR) were statistically compared between the groups.</div></div><div><h3>Results</h3><div>There were 31.2 % fewer referrals in the ‘After’ group (223) than in the ‘Before’ group (324). The proportion of patients with complete imaging at TOR increased significantly (67.3 % vs. 81.6 %, p &lt; 0.05). Also, the number of patients who were treated surgically increased significantly (33.3 % vs. 40.4 %, p &lt; 0.05). Furthermore, the number of patients referred for follow-up to the outpatient department (OPD) decreased significantly (5.2 % vs. 0.9 %; p &lt; 0.05).</div></div><div><h3>Conclusion</h3><div>The consultant-to-consultant referral protocol decreased the overall referral numbers, increased the number of patients with complete imaging, increased the surgical yield, and decreased the rates of OPD follow-up. This can be attributed to more efficient consultant-led local decision-making, which fortifies the benefits of this referral protocol.</div></div>","PeriodicalId":49463,"journal":{"name":"Surgeon-Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland","volume":"23 6","pages":"Pages 359-364"},"PeriodicalIF":2.3,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144163530","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":"Use of omental flap in left-sided hepatectomy for prevention of delayed gastric emptying: a systematic review and meta-analysis","authors":"Stefan Simeonovski ,&nbsp;Karim Ataya ,&nbsp;Tsonka Lukanova ,&nbsp;Yusuf Ahmed ,&nbsp;Dima Salloum ,&nbsp;Ivelin Takorov","doi":"10.1016/j.surge.2025.07.006","DOIUrl":"10.1016/j.surge.2025.07.006","url":null,"abstract":"<div><h3>Background</h3><div>Delayed gastric emptying (DGE) is a widespread complication after left-sided hepatectomy (LSH). The usage of omental flap (OF) in patients after LSH is thought to reduce the incidence of DGE. Therefore, a meta-analysis was performed in order these findings to be explored.</div></div><div><h3>Methods</h3><div>Pubmed, Embase and Cochrane Central were searched for studies comparing usage of omental flap to no-OF in patients after LSH. The primary outcome was DGE. Statistical analysis was performed using Review Manager 5.4 (Cochrane Collaboration). Heterogeneity was assessed using I² statistics. Odds ratios (OR) were computed for binary endpoints using a random-effects model.</div></div><div><h3>Results</h3><div>358 patients were included from 7 studies, of which 2 were randomized controlled trials (RCTs). Male sex was predominant (68 %). OF was used for prevention of DGE in 155 cases. In 3 of the studies the greater omentum was divided for the preparation of the flap. DGE (OR 0.10; 95 % CI 0.04–0.23; p &lt; 0.00001; I² = 0 %) and overall morbidity (OR 0.31; 95 % CI 0.13–0.74; p = 0.008; I² = 0 %) were significantly reduced in the OF group, compared to the no-OF group.</div></div><div><h3>Discussion</h3><div>Utilization of omental flap in patients with left-sided hepatectomy significantly reduces the incidence of DGE and overall morbidity, compared to the no-omental flap procedure.</div></div>","PeriodicalId":49463,"journal":{"name":"Surgeon-Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland","volume":"23 6","pages":"Pages 387-392"},"PeriodicalIF":2.3,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144765730","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 ,&nbsp;Vincent Q. Sier ,&nbsp;Annelot D. Sark ,&nbsp;Heleen S. Snijders ,&nbsp;Joost R. van der Vorst ,&nbsp;Roderick F. Schmitz ,&nbsp;Abbey Schepers ,&nbsp;Joris J. Blok ,&nbsp;Future Surgeon Initiative","doi":"10.1016/j.surge.2025.07.003","DOIUrl":"10.1016/j.surge.2025.07.003","url":null,"abstract":"<div><h3>Background and purpose</h3><div>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.</div></div><div><h3>Methods</h3><div>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.</div></div><div><h3>Main findings</h3><div>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.</div></div><div><h3>Conclusions</h3><div>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.</div></div>","PeriodicalId":49463,"journal":{"name":"Surgeon-Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland","volume":"23 6","pages":"Pages 333-341"},"PeriodicalIF":2.3,"publicationDate":"2025-12-01","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}