ANZ Journal of Surgery最新文献

Subhepatic Appendix Encountered During Laparoscopic Cholecystectomy. 腹腔镜胆囊切除术中遇到的肝下阑尾。

IF 1.6 4区医学

ANZ Journal of Surgery Pub Date : 2026-05-08 DOI: 10.1111/ans.70739

Ali Jad Yousef, Mohammad Nebih Nofal

引用次数: 0

Luminal Peri-Anastomotic Antibacterial Washout to Prevent Colorectal Anastomotic Leakage: A Pilot Audit of Outcomes. 管腔吻合口周围抗菌冲洗预防结直肠吻合口瘘：一项结果的试点审计。

IF 1.6 4区医学

ANZ Journal of Surgery Pub Date : 2026-05-08 DOI: 10.1111/ans.70733

Daniel Cattanach, Stephen Ridley Smith, Natalie Lott, Yui Kaneko, Arun Nadarajah

{"title":"Luminal Peri-Anastomotic Antibacterial Washout to Prevent Colorectal Anastomotic Leakage: A Pilot Audit of Outcomes.","authors":"Daniel Cattanach, Stephen Ridley Smith, Natalie Lott, Yui Kaneko, Arun Nadarajah","doi":"10.1111/ans.70733","DOIUrl":"https://doi.org/10.1111/ans.70733","url":null,"abstract":"Background: Oral antibiotics usually given for 24 h prior to surgery have been shown to result in lower anastomotic leak rates, as a result of luminal decontamination. Delivering antibiotics into the lumen of the intestine at the time of surgery may be a simpler way to achieve this outcome.Methods: An audit was undertaken of the first 50 consecutive patients undergoing luminal peri-anastomotic antibiotic washout performed by a single surgeon at two surgical institutions. The luminal washout initially involved metronidazole (500 mg) and gentamicin (240 mg) followed by the addition of ampicillin (1000 mg) for latter patients. The combined solution was delivered to the lumen of both sides of the colorectal anastomosis using either a soaked Raytec surgical gauze or syringe, or both. Follow up was performed for 30 days to assess for anastomotic leak, complications, clostridium difficile colitis and acute kidney injury, and at 90 days for mortality.Results: The 30 and 90 day mortality was zero. There were no anastomotic leaks and no cases of clostridium difficile colitis. Complications occurred in six patients, with three readmissions within 30 days. There were no cases of acute kidney injury.Conclusion: Peri-anastomotic luminal washout with antibiotics is feasible and safe. It does not appear to have deleterious effects and should be compared to peri-operative oral antibiotics in larger clinical trials.","PeriodicalId":8158,"journal":{"name":"ANZ Journal of Surgery","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2026-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147855800","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

Challenges in Diagnosis and Treatment of Early Onset Colorectal Cancer During Pregnancy. 妊娠期早发性结直肠癌诊断与治疗的挑战。

IF 1.6 4区医学

ANZ Journal of Surgery Pub Date : 2026-05-08 DOI: 10.1111/ans.70717

Juliet Sutherland, Tatila Helu, Oliver Waddell, Hannah Scowcroft, Tim Eglinton

引用次数: 0

Does Everyone Need CEA? A Case for Selective Omission After Colorectal Cancer Resection. 人人都需要CEA吗？结直肠癌术后选择性遗漏1例。

IF 1.6 4区医学

ANZ Journal of Surgery Pub Date : 2026-05-06 DOI: 10.1111/ans.70735

Matthew P Irwin, Muhammad F Rosley, Samuel Dickson, Gregory J Nolan

引用次数: 0

Comparison of Histopathologic Features of Right and Left Sided Colon Cancer. 左右两侧结肠癌的组织病理特征比较。

IF 1.6 4区医学

ANZ Journal of Surgery Pub Date : 2026-05-06 DOI: 10.1111/ans.70727

A Petrie, D A Carson, B Cribb

{"title":"Comparison of Histopathologic Features of Right and Left Sided Colon Cancer.","authors":"A Petrie, D A Carson, B Cribb","doi":"10.1111/ans.70727","DOIUrl":"https://doi.org/10.1111/ans.70727","url":null,"abstract":"Introduction: Colorectal cancer is one of the most common cancers in Aotearoa New Zealand. Evidence supports that right colon cancer (RCC) and left colon cancer (LCC) represent distinct entities, with RCC associated with a poorer prognosis, despite accounting for stage. Oncogenic mutations in MMR protein expression, BRAF V600E, and RAS genes have been shown to differ significantly between RCC and LCC, influencing tumour behaviour and prognosis.Methods: Histopathologic features of RCC and LCC in patients treated between 2018 and 2023 in a centre in Aotearoa New Zealand were evaluated. RCC was defined as arising from caecum to distal transverse colon, and LCC from splenic flexure to rectosigmoid junction. The primary outcomes were the rates of deficient MMR protein expression (dMMR), BRAF V600E, and NRAS gene mutations. Secondary outcomes included tumour characteristics, lymph node status, and AJCC prognostic stage.Results: A total of 376 patients were included, for a total of 390 tumours. RCC had a higher rate of dMMR tumours compared to LCC (50.4% vs. 13.75%; adjusted OR 6.36, 95% CI: 3.57-11.35). There were no significant differences in the rates of BRAF V600E or NRAS gene mutations between sides. RCC was more likely to be mucinous adenocarcinoma (23% RCC vs. 10% LCC; OR 2.99, 95% CI: 1.64-5.49), and to be high-grade (18.7% vs. 12.5%; OR 1.68, 95% CI: 1.03-2.92) compared to LCC.Conclusion: RCC was associated with a higher rate of dMMR and high-grade tumours, and a greater proportion of mucinous adenocarcinomas.","PeriodicalId":8158,"journal":{"name":"ANZ Journal of Surgery","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2026-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147832877","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

Left Behind After Impact: The Hidden Toll of Trauma Recovery in New Zealand. 冲击后的遗留：新西兰创伤恢复的隐藏代价。

IF 1.6 4区医学

ANZ Journal of Surgery Pub Date : 2026-05-05 DOI: 10.1111/ans.70722

Sarah Logan, Duncan Finlayson, Nikita Quinn, Daniel Jemberie, Laura R Joyce, Andrew McCombie, Christopher Wakeman

{"title":"Left Behind After Impact: The Hidden Toll of Trauma Recovery in New Zealand.","authors":"Sarah Logan, Duncan Finlayson, Nikita Quinn, Daniel Jemberie, Laura R Joyce, Andrew McCombie, Christopher Wakeman","doi":"10.1111/ans.70722","DOIUrl":"https://doi.org/10.1111/ans.70722","url":null,"abstract":"Background: Major trauma recovery extends beyond physical healing, with psychological outcomes and patient experiences influencing long-term well-being. This study explored trauma survivors' experiences of follow-up care and Accident Compensation Corporation (ACC) in New Zealand, and how these relate to psychological distress and social support.Methods: A retrospective cohort study was conducted at Christchurch Hospital using New Zealand Major Trauma Registry data (May 2016-March 2020, Injury Severity Score ≥ 12). In 2020, eligible patients were invited to complete a follow-up survey including DSM-5-aligned screeners for PTSD, anxiety, and depression, questions on follow-up care and ACC, and a validated social support scale. Associations were assessed with chi-square and Mann-Whitney U tests; free-text responses underwent thematic analysis.Results: Of 415 eligible patients, 134 (32.3%) responded. Issues accessing follow-up care were reported by 20 patients (14.9%), and ACC-related challenges by 33 (24.6%). Thematic analysis identified insufficient follow-up, lack of mental health support, communication gaps, and premature return-to-work expectations. Psychological morbidity was strongly associated with reported difficulties: patients screening positive for PTSD, anxiety, or depression were 3-5 times more likely to report problems with follow-up or ACC (all p < 0.001). Lower perceived social support was also significantly associated with increased reported difficulties (p = 0.01-0.03). Injury severity and ICU admission were not associated.Conclusion: Mental health symptoms and poor social support were strongly linked to dissatisfaction with trauma follow-up and ACC processes. Routine psychological screening, improved communication, and coordinated support may enhance recovery outcomes in New Zealand's no-fault trauma system.","PeriodicalId":8158,"journal":{"name":"ANZ Journal of Surgery","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2026-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147832886","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

Artificial Intelligence Models Using Magnetic Resonance Imaging to Predict Response to Chemoradiotherapy in Rectal Cancer: A Systematic Review. 使用磁共振成像的人工智能模型预测直肠癌放化疗的反应：系统综述。

IF 1.6 4区医学

ANZ Journal of Surgery Pub Date : 2026-05-05 DOI: 10.1111/ans.70724

Winnie Lay, Ha My Ngoc Nguyen, Elias El-Barhoun, Rory F Kokelaar, Justin M Yeung

{"title":"Artificial Intelligence Models Using Magnetic Resonance Imaging to Predict Response to Chemoradiotherapy in Rectal Cancer: A Systematic Review.","authors":"Winnie Lay, Ha My Ngoc Nguyen, Elias El-Barhoun, Rory F Kokelaar, Justin M Yeung","doi":"10.1111/ans.70724","DOIUrl":"https://doi.org/10.1111/ans.70724","url":null,"abstract":"Background: Pathological complete response (pCR) following neoadjuvant chemoradiotherapy (nCRT) in locally advanced rectal cancer (LARC) is a key prognostic marker with implications for response-adapted management. Although magnetic resonance imaging (MRI) is central to response assessment, differentiating residual tumour from treatment-related changes remains challenging. Artificial intelligence (AI) and machine learning (ML) models applied to MRI show promise in predicting pCR; however, variability in methodology and performance limits clinical translation.Methods: A search of Embase, Medline, Cochrane and Web of Science was conducted in April 2025 in accordance with Preferred Reporting Items for Reviews and Meta-Analysis (PRISMA) guidelines. Eligible studies used MRI-only AI or ML models to predict pCR following chemoradiotherapy in adults with rectal cancer. Screening, full-text review and data extraction were performed independently by two reviewers. Risk of bias was assessed using Quality Assessment of Diagnostic Accuracy Studies (QUADAS-2).Results: Twenty-two studies comprising 94 predictive models were included. Most studies were retrospective, used T2-weighted MRI and demonstrated variability in MRI protocols, modelling methods and validation strategies. Only five studies conducted external validation. Median AUC was 0.801, with performance ranging from poor to excellent (AUC 0.49-0.997).Conclusion: MRI-based AI models demonstrate moderate discriminative performance for predicting pCR following neoadjuvant therapy in LARC. However, methodological heterogeneity, inconsistent reporting and limited external validation currently hinder generalisability. Greater methodological standardisation and multicentre external validation are required before clinical implementation.","PeriodicalId":8158,"journal":{"name":"ANZ Journal of Surgery","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2026-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147832945","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

Anastomotic Failure Is Not Affected by Anastomotic Technique in Minimally Invasive Two-Stage Oesophagectomy. 微创两期食管切除术中吻合技术不影响吻合失败。

IF 1.6 4区医学

ANZ Journal of Surgery Pub Date : 2026-05-05 DOI: 10.1111/ans.70716

L Vu, C Cabalag, L Ng, B Choo, A Hardley, S Kariyawasam

{"title":"Anastomotic Failure Is Not Affected by Anastomotic Technique in Minimally Invasive Two-Stage Oesophagectomy.","authors":"L Vu, C Cabalag, L Ng, B Choo, A Hardley, S Kariyawasam","doi":"10.1111/ans.70716","DOIUrl":"https://doi.org/10.1111/ans.70716","url":null,"abstract":"Background: The choice of anastomotic technique in minimally invasive oesophagectomy (MIO) may influence postoperative morbidity and long-term outcomes. The primary aim of our study is to determine whether circular (CS) or linear-stapled (LS) anastomosis is associated with anastomotic complications following MIO.Methods: A retrospective cohort study was conducted of patients undergoing two-stage MIO with intrathoracic anastomosis for oesophageal cancer between January 2011 and December 2023. The primary outcome was anastomotic leak and stricture formation. Secondary outcomes included postoperative complications and overall survival. Multivariate logistic regression was used to identify independent risk factors for anastomotic leak and stricture.Results: A total of 245 patients were included: 161 (65.7%) underwent CS and 84 (34.3%) LS anastomosis. The leak rate was higher in the circular group (13.0%) compared to the linear group (8.3%), though not statistically significant (p = 0.271). Leaks in the linear group were more likely to be Grade C (71.1% vs. 28.6%). The incidence of post-operative complications, long-term disease-free survival, and overall survival were comparable. Stricture rates were similar between techniques (17.4% circular vs. 16.6% linear; p = 0.817). On multivariate analysis, active or recent smoking (within 3 months) was independently associated with stricture formation. Ischaemic heart disease was independently associated with anastomotic leak.Conclusions: Anastomotic technique (circular or linear-stapled) was not associated with an increased risk of anastomotic leak or stricture in patients undergoing MIO with intrathoracic anastomosis. Modifiable patient factors, including recent smoking and ischaemic heart disease, were independent predictors for anastomotic complications.","PeriodicalId":8158,"journal":{"name":"ANZ Journal of Surgery","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2026-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147832583","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

Analysis of Voiding Impairment Following Transperineal Prostate Biopsy: Do Alpha-Blockers Reduce the Risk? 经会阴前列腺活检后排尿障碍分析：α -受体阻滞剂能降低风险吗？

IF 1.6 4区医学

ANZ Journal of Surgery Pub Date : 2026-05-04 DOI: 10.1111/ans.70711

Yi Zheng, Dong Ye, Zhenghao Chen, Zhenan Zhang, Huifeng Wu

{"title":"Analysis of Voiding Impairment Following Transperineal Prostate Biopsy: Do Alpha-Blockers Reduce the Risk?","authors":"Yi Zheng, Dong Ye, Zhenghao Chen, Zhenan Zhang, Huifeng Wu","doi":"10.1111/ans.70711","DOIUrl":"https://doi.org/10.1111/ans.70711","url":null,"abstract":"Backgrounds: To identify predictors of voiding impairment following transperineal prostate biopsy (TPPB) and evaluate the effect of alpha-blocker pretreatment: METHODS: A prospective observational study was conducted between June 2022 and May 2024, enrolling 279 patients undergoing TPPB. Patients were stratified into four groups according to the duration of alpha-blocker pretreatment. Baseline characteristics and voiding parameters were collected, including the international prostate symptom score (IPSS), quality of life, maximal flow rate (Qmax), and post-void residual urine. Follow-up assessments were performed at 7 and 30 days post-biopsy. The rate of voiding impairment and post-biopsy voiding parameters were compared across groups. Logistic regression analyses were conducted to identify independent predictors of post-biopsy voiding impairment.Results: Baseline characteristics were comparable among all groups. At 7 days post-biopsy, patients with alpha-blocker pretreatment duration of < 12 months exhibited a lower voiding impairment rate, lower IPSS scores, and higher Qmax compared with patients without alpha-blocker pretreatment (p < 0.05). In contrast, patients with alpha-blocker pretreatment duration of > 12 months showed no differences in voiding impairment rate or voiding parameters compared to those without alpha-blocker pretreatment (p > 0.05). Logistic regression analyses demonstrated that diabetes mellitus (DM) was independently associated with post-biopsy voiding impairment, whereas alpha-blocker pretreatment for < 12 months exerted a protective effect (p < 0.01).Conclusion: TPPB is associated with voiding impairment. DM may serve as a predictor of post-biopsy voiding impairment, while alpha-blocker pretreatment for < 12 months may play a protective role.","PeriodicalId":8158,"journal":{"name":"ANZ Journal of Surgery","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2026-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147832467","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

How to Do a Novel Transversalis Fascial Mesh Repair for Complex Ventral Hernias. 如何应用新型筋膜横肌补片修补复杂腹疝。

IF 1.6 4区医学

ANZ Journal of Surgery Pub Date : 2026-05-04 DOI: 10.1111/ans.70718

Mina Sarofim, Ernest Cheng, Andrew Gilmore

引用次数: 0