Annals of the Royal College of Surgeons of England最新文献_第8页

Kommerell's diverticulum: an unusual cause of unilateral vocal cord palsy? 科默梅尔氏憩室：单侧声带麻痹的异常病因？

IF 1.1 4区医学

Annals of the Royal College of Surgeons of England Pub Date : 2024-11-01 Epub Date: 2023-01-23 DOI: 10.1308/rcsann.2022.0092

F Shaikh, D Walker

引用次数: 0

Opinion, uptake and current practice of robot-assisted upper gastrointestinal and oesophagogastric surgery in the UK: AUGIS national survey results. 英国对机器人辅助上消化道和食道胃手术的看法、接受程度和当前实践：AUGIS全国调查结果。

IF 1.1 4区医学

Annals of the Royal College of Surgeons of England Pub Date : 2024-11-01 Epub Date: 2024-03-06 DOI: 10.1308/rcsann.2024.0013

P May-Miller, S R Markar, N Blencowe, J A Gossage, A Botros, P H Pucher

{"title":"Opinion, uptake and current practice of robot-assisted upper gastrointestinal and oesophagogastric surgery in the UK: AUGIS national survey results.","authors":"P May-Miller, S R Markar, N Blencowe, J A Gossage, A Botros, P H Pucher","doi":"10.1308/rcsann.2024.0013","DOIUrl":"10.1308/rcsann.2024.0013","url":null,"abstract":"Introduction: The uptake of upper gastrointestinal (GI) robotic surgery in the United Kingdom (UK), and Europe more widely, is expanding rapidly. This study aims to present a current snapshot of the practice and opinions of the upper GI community with reference to robotic surgery, with an emphasis on tertiary cancer (oesophagogastric) resection centres.Methods: An electronic survey was circulated to the UK upper GI surgical community via national mailing lists, social media and at an open-invitation conference on robotic upper GI surgery in January 2023. The survey included questions on surgeons' current practice or planned adoption (if any) of robotics at individual and unit level, and their opinions on robotic upper GI surgery in general. Priority ranking and Likert-scale response options were used.Results: In total, 81 respondents from 43 hospitals were included. Thirty-four resectional centres responded, including 30 of 31 (97%) recognised upper GI cancer centres in England. Respondents reported performing robotic surgery in 21 of 34 (61.8%) resectional centres, with a median of 65 procedures per centre performed at the time of the survey (range 0-500, interquartile range 93.75). Every centre without a robotic programme expressed a desire or had active plans to implement one. Respondents ranked surgeon ergonomics as the most important reason for pursuing robotics, followed by improvements in patient outcomes and oncological efficacy.Conclusions: Robotic upper GI practice is nascent but rapidly growing in the UK with plans for uptake in almost all tertiary centres. There is growing opinion that this is likely to become the predominant surgical approach in future with benefits to both patients and surgeons. This snapshot offers a point of reference to all stakeholders in upper GI surgery.","PeriodicalId":8088,"journal":{"name":"Annals of the Royal College of Surgeons of England","volume":" ","pages":"682-687"},"PeriodicalIF":1.1,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11528355/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140038615","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}

引用次数: 0

Association of Upper GI Surgery of Great Britain and Ireland (AUGIS) Delphi consensus recommendations on the adoption of robotic upper GI surgery. 大不列颠及爱尔兰上消化道外科协会（AUGIS）关于采用机器人上消化道手术的德尔菲共识建议。

IF 1.1 4区医学

Annals of the Royal College of Surgeons of England Pub Date : 2024-11-01 Epub Date: 2024-03-06 DOI: 10.1308/rcsann.2024.0014

P H Pucher, N Maynard, S Body, K Bowling, M Asif Chaudry, M Forshaw, S Hornby, S R Markar, S J Mercer, S R Preston, B Sgromo, G I van Boxel, J A Gossage

{"title":"Association of Upper GI Surgery of Great Britain and Ireland (AUGIS) Delphi consensus recommendations on the adoption of robotic upper GI surgery.","authors":"P H Pucher, N Maynard, S Body, K Bowling, M Asif Chaudry, M Forshaw, S Hornby, S R Markar, S J Mercer, S R Preston, B Sgromo, G I van Boxel, J A Gossage","doi":"10.1308/rcsann.2024.0014","DOIUrl":"10.1308/rcsann.2024.0014","url":null,"abstract":"Background: The adoption of robotic platforms in upper gastrointestinal (GI) surgery is expanding rapidly. The absence of centralised guidance and governance in adoption of new surgical technologies may lead to an increased risk of patient harm.Methods: Surgeon stakeholders participated in a Delphi consensus process following a national open-invitation in-person meeting on the adoption of robotic upper GI surgery. Consensus agreement was deemed met if >80% agreement was achieved.Results: Following two rounds of Delphi voting, 25 statements were agreed on covering the training process, governance and good practice for surgeons' adoption in upper GI surgery. One statement failed to achieve consensus.Conclusions: These recommendations are intended to support surgeons, patients and health systems in the adoption of robotics in upper GI surgery.","PeriodicalId":8088,"journal":{"name":"Annals of the Royal College of Surgeons of England","volume":" ","pages":"688-693"},"PeriodicalIF":1.1,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11528368/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140038608","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}

引用次数: 0

The performance of large language models in intercollegiate Membership of the Royal College of Surgeons examination. 大语言模型在英国皇家外科学院校际会员考试中的表现。

IF 1.1 4区医学

Annals of the Royal College of Surgeons of England Pub Date : 2024-11-01 Epub Date: 2024-03-06 DOI: 10.1308/rcsann.2024.0023

J Chan, T Dong, G D Angelini

{"title":"The performance of large language models in intercollegiate Membership of the Royal College of Surgeons examination.","authors":"J Chan, T Dong, G D Angelini","doi":"10.1308/rcsann.2024.0023","DOIUrl":"10.1308/rcsann.2024.0023","url":null,"abstract":"Introduction: Large language models (LLM), such as Chat Generative Pre-trained Transformer (ChatGPT) and Bard utilise deep learning algorithms that have been trained on a massive data set of text and code to generate human-like responses. Several studies have demonstrated satisfactory performance on postgraduate examinations, including the United States Medical Licensing Examination. We aimed to evaluate artificial intelligence performance in Part A of the intercollegiate Membership of the Royal College of Surgeons (MRCS) examination.Methods: The MRCS mock examination from Pastest, a commonly used question bank for examinees, was used to assess the performance of three LLMs: GPT-3.5, GPT 4.0 and Bard. Three hundred mock questions were input into the three LLMs, and the responses provided by the LLMs were recorded and analysed. The pass mark was set at 70%.Results: The overall accuracies for GPT-3.5, GPT 4.0 and Bard were 67.33%, 71.67% and 65.67%, respectively (p = 0.27). The performances of GPT-3.5, GPT 4.0 and Bard in Applied Basic Sciences were 68.89%, 72.78% and 63.33% (p = 0.15), respectively. Furthermore, the three LLMs obtained correct answers in 65.00%, 70.00% and 69.17% of the Principles of Surgery in General questions (p = 0.67). There were no differences in performance in the overall and subcategories among the three LLMs.Conclusions: Our findings demonstrated satisfactory performance for all three LLMs in the MRCS Part A examination, with GPT 4.0 the only LLM that achieved the pass mark set.","PeriodicalId":8088,"journal":{"name":"Annals of the Royal College of Surgeons of England","volume":" ","pages":"700-704"},"PeriodicalIF":1.1,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11528401/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140038616","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}

引用次数: 0

A survey of patient acceptability of the use of artificial intelligence in the diagnosis of paediatric fractures: an observational study. 在儿科骨折诊断中使用人工智能的患者接受度调查：一项观察性研究。

IF 1.1 4区医学

Annals of the Royal College of Surgeons of England Pub Date : 2024-11-01 Epub Date: 2024-03-13 DOI: 10.1308/rcsann.2024.0008

Fhg Roberts, Trw Roberts, Y Gelfer, C Hing

{"title":"A survey of patient acceptability of the use of artificial intelligence in the diagnosis of paediatric fractures: an observational study.","authors":"Fhg Roberts, Trw Roberts, Y Gelfer, C Hing","doi":"10.1308/rcsann.2024.0008","DOIUrl":"10.1308/rcsann.2024.0008","url":null,"abstract":"Introduction: This study aimed to assess carer attitudes towards the use of artificial intelligence (AI) in management of fractures in paediatric patients. As fracture clinic services come under increasing pressure, innovative solutions are needed to combat rising demand. AI programs can be used to diagnosis fractures, but patient perceptions towards its use are uncertain.Methods: We conducted a cross-sectional survey of carers of paediatric patients presenting to fracture clinic at a tertiary care centre, combining single-best-answer questions and Likert-type questions. We investigated patient perception of clinical review in the emergency department (ED), disruption to school to attend fracture clinic, and attitudes towards AI.Results: Of the paediatric fracture patients participating in this study, 45% were seen within two hours, 29% were seen between two and four hours, and 26% were seen after four hours; 75% were seen by both a nurse and a doctor, 16% were seen only by a nurse and 9% only by a doctor. A total of 61% of children had to take time off school for their appointment and 59% of parents had to take time off. Of all respondents, 56% agreed that more research is needed to reduce waiting times, 76% preferred a nurse or doctor to review their child's radiograph, 64% were happy for an AI program to diagnose their child's fracture, and 82% were happy with an AI program being used as an adjunct to a clinician's diagnosis.Conclusions: Carer perceptions towards the use of AI in this setting are positive. However, they are not yet ready to relinquish human decision making to automated systems.","PeriodicalId":8088,"journal":{"name":"Annals of the Royal College of Surgeons of England","volume":" ","pages":"694-699"},"PeriodicalIF":1.1,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11528354/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140118563","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}

引用次数: 0

Could resistance training prevent or improve work-related musculoskeletal disorders among surgeons? 阻力训练能否预防或改善外科医生因工作引起的肌肉骨骼疾病？

IF 1.1 4区医学

Annals of the Royal College of Surgeons of England Pub Date : 2024-10-22 DOI: 10.1308/rcsann.2024.0089

A Vijay, P A Brennan, M Fagbohun, R S Oeppen, D Parry

{"title":"Could resistance training prevent or improve work-related musculoskeletal disorders among surgeons?","authors":"A Vijay, P A Brennan, M Fagbohun, R S Oeppen, D Parry","doi":"10.1308/rcsann.2024.0089","DOIUrl":"https://doi.org/10.1308/rcsann.2024.0089","url":null,"abstract":"Studies have demonstrated the negative impact that work-related musculoskeletal disorders (WMSDs) have on surgeons. These are also likely to affect some allied healthcare professionals such as interventional radiologists. Problems from WMSDs include pain, diminished technical and cognitive performance, and work absence. These could contribute to burnout, to which surgeons are already vulnerable owing to other working practices such as shift patterns and long hours. WMSDs could negatively affect working performance, and lead to poorer surgical outcomes and patient care. Surgeons are at risk of WMSDs of the neck and back that result from fixed and damaging postures while operating. Some have reduced their operation numbers and working days as result of WMSDs. Theatre ergonomics (e.g. table positioning, operating stools and monitors), intraoperative breaks and stretching may improve WMSDs for some. Strength/resistance training (RT) may be used to prevent or mitigate WMSDs. RT can also enhance general health and concentration, and combat intraoperative fatigue. Low engagement times of moderate-intensity RT of 20 minutes, twice a week, improve neck and back pain from WMSDs. Moreover, RT has been shown to reduce all-cause mortality by up to 15%, increase bone density, improve proprioception and reduce the fear of movement due to pain. Alongside ergonomic improvement and stretching, we recommend RT as an activity to improve general health and WMSDs.","PeriodicalId":8088,"journal":{"name":"Annals of the Royal College of Surgeons of England","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2024-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142456671","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}

引用次数: 0

Improving communication during damage control surgery: a survey of adult major trauma centres in England. 改善损伤控制手术过程中的沟通：英国成人重大创伤中心调查。

IF 1.1 4区医学

Annals of the Royal College of Surgeons of England Pub Date : 2024-10-22 DOI: 10.1308/rcsann.2024.0087

E N Patton, I Lisagors, I Tyrrell-Marsh, S Agarwal, L V Wee, A Darwish, S R Smith

{"title":"Improving communication during damage control surgery: a survey of adult major trauma centres in England.","authors":"E N Patton, I Lisagors, I Tyrrell-Marsh, S Agarwal, L V Wee, A Darwish, S R Smith","doi":"10.1308/rcsann.2024.0087","DOIUrl":"https://doi.org/10.1308/rcsann.2024.0087","url":null,"abstract":"Introduction: Deficiencies in non-technical skills can severely impede the functioning of teams in high-intensity scenarios, such as in damage control surgery for the critically injured trauma patient. Truncated preoperative checklists, modified from the standard World Health Organization preoperative checklist, and situational reporting at intervals during surgery are long-established practices in the military, and are recommended in the National Health Service guidelines on major incidents. These tools allow the multiprofessional team to create a shared mental model of the anaesthetic and operative plan, thereby improving team efficiency. Our aim was to establish whether adult major trauma centres in England are using truncated preoperative checklists and situational reporting for damage control surgery.Methods: An online survey was devised and distributed via the national programme of care for trauma in November 2020.Results: Responses were received from all 23 adult major trauma centres in England. Nine centres (39.1%) reported using a truncated preoperative checklist for damage control surgery albeit in a variety of formats. Common components were blood products received and/or available, presence of allergies, tranexamic acid and antibiotic administration, availability of viscoelastic tests, equipment required, availability of cell saver, role allocation and reference to other personnel needed, and discussion of the plan. Twelve centres (52.2%) have formal policies in place for situational reporting. Again, these were in multiple formats but all focused on patient physiology to direct surgical planning.Conclusions: We have identified key components to advanced communication aids for damage control surgery, providing a foundation on which other major trauma centres can build their own versions of these potentially lifesaving tools.","PeriodicalId":8088,"journal":{"name":"Annals of the Royal College of Surgeons of England","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2024-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142456672","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}

引用次数: 0

Mammary myofibroblastoma of the male breast: a case report and literature review. 男性乳房的乳腺肌纤维母细胞瘤：病例报告和文献综述。

IF 1.1 4区医学

Annals of the Royal College of Surgeons of England Pub Date : 2024-10-22 DOI: 10.1308/rcsann.2024.0076

R Elayyan, M Rizk, C Shah, R Price, N Garg

{"title":"Mammary myofibroblastoma of the male breast: a case report and literature review.","authors":"R Elayyan, M Rizk, C Shah, R Price, N Garg","doi":"10.1308/rcsann.2024.0076","DOIUrl":"https://doi.org/10.1308/rcsann.2024.0076","url":null,"abstract":"Mammary myofibroblastoma (MFB) is a rare benign spindle cell tumour predominantly affecting males, but also observed in postmenopausal females. Its diagnosis remains challenging owing to overlapping histological features with malignant lesions and limited tissue sampling in core biopsies. We present a case of incidentally discovered mammary MFB in a 63-year-old man and review its clinical, radiological and histopathological characteristics. The patient, who had a history of distal pancreatectomy and splenectomy, presented with an incidental left anterior chest wall nodule discovered on computed tomography scan. Clinical examination revealed a benign left retroareolar lump, confirmed by breast ultrasound and mammography. Ultrasound-guided core biopsy demonstrated characteristic spindle cells, prompting immunohistochemical staining confirming the diagnosis of MFB. The lesion was surgically excised with clear margins. Mammary MFB is commonly seen in postmenopausal women and older men, presenting as painless, mobile breast lumps. Imaging findings are nonspecific, resembling fibroadenomas or fat necrosis. Histologically, MFB lacks mammary ducts or lobules and displays characteristic spindle cells with collagenous stroma. Immunohistochemistry aids in differentiating it from other spindle cell tumours. Surgical excision is curative, with no reported cases with recurrence. Mammary MFB should be considered in the differential diagnosis of breast masses in males and postmenopausal women. Despite the challenges in diagnosis, its benign nature and favourable prognosis warrant timely recognition and appropriate management through surgical excision. Further research is needed to establish clear management guidelines and explore its underlying pathogenesis.","PeriodicalId":8088,"journal":{"name":"Annals of the Royal College of Surgeons of England","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2024-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142456673","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}

引用次数: 0

Assessing the readability and quality of online written information on epistaxis. 评估有关鼻衄的在线书面信息的可读性和质量。

IF 1.1 4区医学

Annals of the Royal College of Surgeons of England Pub Date : 2024-10-22 DOI: 10.1308/rcsann.2024.0053

Z R Almansoor, R Abrar, H Raja

引用次数: 0

A comparison of general surgery training programmes across 11 countries: improving understanding of the experience level of international medical graduates in the UK. 比较 11 个国家的普通外科培训课程：加深对英国国际医学毕业生经验水平的了解。

IF 1.1 4区医学

Annals of the Royal College of Surgeons of England Pub Date : 2024-10-22 DOI: 10.1308/rcsann.2024.0086

K M Spellar, A Z Chacko, C Beaton

{"title":"A comparison of general surgery training programmes across 11 countries: improving understanding of the experience level of international medical graduates in the UK.","authors":"K M Spellar, A Z Chacko, C Beaton","doi":"10.1308/rcsann.2024.0086","DOIUrl":"https://doi.org/10.1308/rcsann.2024.0086","url":null,"abstract":"Introduction: Within the past five years there has been a significant increase in the number of international medical graduates (IMGs) joining the United Kingdom's (UK) workforce. Having mentors and supervisors who understand the needs of IMGs and clinical and cultural differences in the workplace can benefit in the transition to working in a new country. Improving knowledge of and understanding differences between general surgical training programmes and grades across different countries could therefore aid in the support of IMGs within the UK.Methods: Data on general surgical training programmes of the top ten countries for the primary medical qualifications of IMGs in the UK were collected to provide comparison with the UK training programme.Results: The following countries were included: UK, India, Pakistan, Nigeria, Egypt, Ireland, Sudan, Sri Lanka, Romania, Iraq and South Africa. Training programme lengths ranged from 3 to 10 years. Only some training programmes provide additional training and qualification in sub-specialisation in general surgery. Other differences included a requirement for internship/non specialist training prior to training, differences in lengths of time spent in other surgical specialties and a requirement for research.Conclusion: Understanding the training programmes of other countries may help UK surgeons to understand the prior experience of IMGs and enable them to provide better training and support.","PeriodicalId":8088,"journal":{"name":"Annals of the Royal College of Surgeons of England","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2024-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142456669","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}

引用次数: 0