ANZ Journal of Surgery最新文献

Early detection of colonic anastomotic leak. 结肠吻合口漏的早期检测。

IF 1.5 4区医学

ANZ Journal of Surgery Pub Date : 2024-10-01 DOI: 10.1111/ans.19243

Claudia Paterson, Andrew G Hill

引用次数: 0

Where the rubber meets the road: pearls and pitfalls of implementing competency-based assessment. 橡胶与道路的交汇处：实施基于能力的评估的珍珠与陷阱。

IF 1.5 4区医学

ANZ Journal of Surgery Pub Date : 2024-10-01 DOI: 10.1111/ans.19246

Julia Adriana Kasmirski, Christopher Wu, Brenessa Lindeman

引用次数: 0

Standard v mini percutaneous nephrolithotomy in the supine modified lithotomy position: a randomized pilot study on 10-25 mm stones. 仰卧位改良碎石术中的标准与迷你经皮肾镜碎石术：针对 10-25 毫米结石的随机试验研究。

IF 1.5 4区医学

ANZ Journal of Surgery Pub Date : 2024-10-01 DOI: 10.1111/ans.19227

Philip McCahy, Anthony Dat, Daniel Gilbourd, Eldho Paul, Shekib Shahbaz

{"title":"Standard v mini percutaneous nephrolithotomy in the supine modified lithotomy position: a randomized pilot study on 10-25 mm stones.","authors":"Philip McCahy, Anthony Dat, Daniel Gilbourd, Eldho Paul, Shekib Shahbaz","doi":"10.1111/ans.19227","DOIUrl":"https://doi.org/10.1111/ans.19227","url":null,"abstract":"Background: Percutaneous nephrolithotomy (PCNL) is the recommended treatment for stones >2 cm in size. The majority of PCNL are still conducted with larger telescopes using tracts up to 30F in size. We have conducted a randomized pilot study comparing mini PCNL with our standard 22F PCNL for renal stones between 10 and 25 mm in diameter.Methods: Patients were randomized to either PCNL (24F Amplatz sheath/22F nephrosocope) or mini PCNL (18F Amplatz sheath/11F nephroscope). All operations were performed in the modified supine position. Patients were reviewed with imaging to assess stone clearance and complications.Results: Eighteen well matched patients were randomized. All procedures were completed as planned and all were tubeless with no complications. There were no differences in operative time, analgesia requirements or length of stay. Seven of nine (77.75%) standard PCNL were completely stone free at CT review with a 2 mm and a 5 mm fragments in the other patients. Four (44.4%) of the mini PCNL group were stone free, with stone fragments 4-10 mm remaining in the others. 40 patients/arm would be required for an adequately powered study.Conclusion: There was no advantage in using mini PCNL compared to our standard 24F PCNL in this pilot study. There may be benefits in using mini PCNL compared to the more widely used 30F PCNL and it may be a more cost-effective alternative to laser pyeloscopic stone procedures.","PeriodicalId":8158,"journal":{"name":"ANZ Journal of Surgery","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142339963","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

Cystic pancreatic neuroendocrine tumour (cPNET): a diagnostic conundrum. 囊性胰腺神经内分泌肿瘤（cPNET）：诊断难题。

IF 1.5 4区医学

ANZ Journal of Surgery Pub Date : 2024-10-01 DOI: 10.1111/ans.19251

Vibhu Jain, Debajyoti Chatterjee, Harish Bhujade, Kailash Chand Kurdia

引用次数: 0

Pointing to success: a discussion of the role of acad achievements in the selection of specialist surgical trainees. 指向成功：讨论学术成就在外科专科学员选拔中的作用。

IF 1.5 4区医学

ANZ Journal of Surgery Pub Date : 2024-10-01 DOI: 10.1111/ans.19247

Daniel Jesudason, Thomas Muecke, Hugo Walker, Stephen Bacchi, Robert Casson, Weng Onn Chan

{"title":"Pointing to success: a discussion of the role of acad achievements in the selection of specialist surgical trainees.","authors":"Daniel Jesudason, Thomas Muecke, Hugo Walker, Stephen Bacchi, Robert Casson, Weng Onn Chan","doi":"10.1111/ans.19247","DOIUrl":"https://doi.org/10.1111/ans.19247","url":null,"abstract":"Background: In Australia and New Zealand, competitive selection processes for surgical specialty training programs often use a standardized curriculum vitae (CV) to assess criteria such as professional achievements. This review aims to assess the predictive validity, standardization, and implicit biases of these selection methods, as well as their implications for trainees and the diversity of surgical cohorts.Methods: The 2023 CV scoring criteria were collected for all available specialty surgical programs in Australia and New Zealand. In 2023, each of the 11 surgical craft programs published publicly available standardized CV scoring criteria. In this study, scored items that constitute 'professional achievements' were recorded and tabulated. Observational analysis of the collected data was then conducted.Results: In 2023, each of the 11 specialty surgical craft programs published publicly available structured CVs, of which 10/11 allocated points for professional achievements. Designated points for professional achievements were classified as awards, scholarships, committee positions, and prior training courses: 4/11 programs offered points for scholarships/grants, 6/11 programs offered points for academic and/or non-academic prizes, and 8/11 programs offered points for professional development courses. Observational analysis of these findings suggests that professional achievements are desired in training program applicants.Conclusion: Variability in medical school opportunities and inherent heterogeneity reduce the CV's efficacy, unfairly disadvantaging some applicants. Observational analysis of hence highlights the need for future research to assess potential updates in CV parameters to enhance predictive validity, reduce bias, and promote diversity.","PeriodicalId":8158,"journal":{"name":"ANZ Journal of Surgery","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142339961","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

Provision and outcomes of publicly funded bariatric surgery in a metropolitan versus a provincial population of New Zealand. 新西兰大都市与外省人口中公费减肥手术的提供情况和结果。

IF 1.5 4区医学

ANZ Journal of Surgery Pub Date : 2024-10-01 DOI: 10.1111/ans.19206

Henry Witcomb Cahill, Matthew McGuinness, Jamie Struthers, Ian Bissett, Christopher Harmston

{"title":"Provision and outcomes of publicly funded bariatric surgery in a metropolitan versus a provincial population of New Zealand.","authors":"Henry Witcomb Cahill, Matthew McGuinness, Jamie Struthers, Ian Bissett, Christopher Harmston","doi":"10.1111/ans.19206","DOIUrl":"https://doi.org/10.1111/ans.19206","url":null,"abstract":"Background: Obesity is an important health problem worldwide. The prevalence of obesity in Aotearoa New Zealand (AoNZ) is the third highest amongst OECD countries. Previous studies have demonstrated inequity in the provision of bariatric and metabolic surgery (BMS) across AoNZ, but detailed data regarding patients and surgical outcomes is lacking. The aim of this study is to examine the rates and outcomes of BMS between patients domiciled in a metropolitan versus provincial area in AoNZ.Methods: A 5-year retrospective observational cohort study of all patients who received BMS domiciled in a metropolitan or a provincial area in the Northern region of AoNZ was performed. Interrogation of patient electronic medical records and clinical notes was performed to collect the required baseline characteristics, secondary outcome measure data and confirm domicile.Results: The rate of BMS was 6.1 times higher in the population with class III obesity domiciled in the metropolitan versus the provincial population. Patients in the metropolitan area were less obese, had lower rates of diabetes and had a wider range of procedures performed. Māori were underrepresented in both cohorts. There was a higher resolution of diabetes in the provincial patients.Conclusion: This study has highlighted significant differences in the rate, type and outcomes of BMS between a metropolitan and provincial area in the Northern region of AoNZ. This represents a significant health inequity. Changes in national and regional policies are needed to ensure equitable care for patients with obesity in AoNZ.","PeriodicalId":8158,"journal":{"name":"ANZ Journal of Surgery","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142339962","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

Effectiveness of combined botulinum toxin and fissurectomy on chronic anal fissures - a systematic review. 肉毒杆菌毒素和肛裂切除术联合治疗慢性肛裂的效果--系统性综述。

IF 1.5 4区医学

ANZ Journal of Surgery Pub Date : 2024-09-30 DOI: 10.1111/ans.19248

Rakesh Quinn, Giuleta Jamsari, Gary Kk Low, Sinan Albayati

{"title":"Effectiveness of combined botulinum toxin and fissurectomy on chronic anal fissures - a systematic review.","authors":"Rakesh Quinn, Giuleta Jamsari, Gary Kk Low, Sinan Albayati","doi":"10.1111/ans.19248","DOIUrl":"https://doi.org/10.1111/ans.19248","url":null,"abstract":"Background: Anal fissures are a debilitating benign condition, thought to be due to the hypertonicity of the internal anal sphincter resulting in localized ischaemia inhibiting healing. There are several surgical and non-surgical treatment options for chronic anal fissures. Clinical practice surveys report a trend toward sphincter-sparing options, reserving the more successful treatment of lateral sphincterotomy, with an incontinence rate up to 10%, for refractory fissures.Methods: A search of MEDLINE, Cochrane Database of Systematic Reviews and EMBASE for studies assessing sphincter-sparing treatment with botulinum toxin and fissurectomy was performed following PRISMA guidelines. Outcomes assessed included healing rate, persistence, recurrence, re-intervention and incontinence rates.Results: Fifteen non-randomized studies assessed 978 patients managed with botulinum toxin and fissurectomy. The mean age was 40.8 years with a female predominance of 58.9%. Healing rate was reported on 14 of the 15 studies, with a healing rate of 81% (95% CI:0.67, 0.90). Persistence rate was reported as 15% (95% CI:0.07, 0.28) and a recurrence rate of 6% (95% CI: 0.01, 0.19). Re-intervention was required in 8% of patients with 55.1% requiring a repeat dose of botulinum toxin with or without fissurectomy. Incontinence appears to be transient with studies reporting a rate of 1% with median long-term follow up 23 months (range: 5-60 months).Conclusion: Combination fissurectomy and botulinum toxin is a safe and viable sphincter sparing treatment option, with moderate success rate and negligible complications. Randomized controlled trials are required to further strengthen the evidence for its use in chronic anal fissures.","PeriodicalId":8158,"journal":{"name":"ANZ Journal of Surgery","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2024-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142339949","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

Patience is key for the surgeon in the management of a large haemorrhagic phaeochromocytoma with cardiomyopathy. 外科医生在处理伴有心肌病的巨大出血性嗜铬细胞瘤时，耐心是关键。

IF 1.5 4区医学

ANZ Journal of Surgery Pub Date : 2024-09-30 DOI: 10.1111/ans.19245

James A Pasch, Hazel Serrao-Brown, Daniel Nguyen, Jaswinder S Samra, Roderick Clifton-Bligh, Mark S Sywak

引用次数: 0

25, 50 and 75 years ago. 25 年前、50 年前和 75 年前。

IF 1.5 4区医学

ANZ Journal of Surgery Pub Date : 2024-09-30 DOI: 10.1111/ans.19244

Julian A Smith

引用次数: 0

Fostering collaboration: an exploration of knowledge exchange between Rongoā Māori practitioners and surgical clinicians. 促进合作：对毛利族医生和外科临床医生之间知识交流的探索。

IF 1.5 4区医学

ANZ Journal of Surgery Pub Date : 2024-09-30 DOI: 10.1111/ans.19238

Nasya Thompson, Tamara Glyn, Donna Kerridge, Jonathan Koea

{"title":"Fostering collaboration: an exploration of knowledge exchange between Rongoā Māori practitioners and surgical clinicians.","authors":"Nasya Thompson, Tamara Glyn, Donna Kerridge, Jonathan Koea","doi":"10.1111/ans.19238","DOIUrl":"https://doi.org/10.1111/ans.19238","url":null,"abstract":"Background: This research investigates the potential for collaboration of Rongoā Māori, the Indigenous healing practices of Māori, with New Zealand's contemporary healthcare system. It aims to bridge the gap between Rongoā Māori and Western medicine by exploring the perspectives of practitioners from both fields, identifying barriers to integration, and highlighting potential areas for collaboration.Methods: Qualitative interviews were conducted with both Rongoā practitioners and Western surgeons. The data collected were subjected to thematic analysis to extract key themes related to the integration process, challenges faced, and the potential for mutual recognition and respect between the two healing paradigms.Results: The study reveals a deep respect for Rongoā Māori among Western surgeons but identifies significant systemic barriers that impede its integration. These include bureaucratic challenges and the absence of clear referral pathways. Rongoā practitioners express concerns over being overlooked within the healthcare system and highlight a lack of awareness among healthcare professionals about their practices. Despite these challenges, there is a shared interest in collaborative approaches to healthcare that respect and incorporate Rongoā Māori.Conclusions: The findings underscore the need for systemic changes to facilitate the integration of Rongoā Māori into mainstream healthcare, including the development of clear referral pathways and initiatives to raise awareness among healthcare professionals. The study highlights the need for a more collaborative healthcare approach that values the contributions of Rongoā Māori, aiming to improve patient care through holistic practices.","PeriodicalId":8158,"journal":{"name":"ANZ Journal of Surgery","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2024-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142339950","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