ANZ Journal of Surgery最新文献

{"title":"Index cases of intracranial aneurysms in autosomal dominant polycystic kidney disease: longitudinal experience from a single renal transplantation centre.","authors":"Joel Ern Zher Chan, Kate S Olakkengil, Shantanu Bhattacharjya, Santosh Antony Olakkengil","doi":"10.1111/ans.70134","DOIUrl":"https://doi.org/10.1111/ans.70134","url":null,"abstract":"<p><strong>Background: </strong>The prevalence of intracranial aneurysms (ICAs) is higher in patients with autosomal dominant polycystic kidney disease (ADPKD) than in the general population. This extrarenal manifestation carries significant mortality and morbidity risks. Our study aims to estimate the prevalence of, and to characterize patients with ICA(s) among the ADPKD cohort of South Australia's statewide transplantation centre.</p><p><strong>Methods: </strong>A retrospective review of prospectively collected data was conducted for all patients who underwent nephrectomy/ies between 1 January 1995 and 31 December 2021. Incidences of neuroimaging and radiologically diagnosed ICAs, and the presence of risk factors including family history are compared between ADPKD patients and those with an alternate primary nephrological diagnosis (control). Descriptive statistics and a narrative review of cases are presented.</p><p><strong>Results: </strong>Seven patients had ICAs (14.3% ADPKD patients, 23.3% those with neuroimaging). Six did not meet current criteria for ICA screening, and five had no known family history of ICA. Three patients suffered aneurysmal rupture (mean age of 36). Two of these cases involved smaller ICAs. Cases demonstrated detectable vascular changes on early neuroimaging, hypoplastic anatomical variants, aneurysmal growth, de novo ICA formation, and association with other vascular abnormalities.</p><p><strong>Conclusion: </strong>Early detection of ICAs and pre-aneurysmal changes should be prioritized in ADPKD. Although limited by the small study cohort, our findings are consistent with previous literature suggesting ICA ruptures occur earlier in ADPKD and in smaller aneurysms. Further investigation is required into how these ICAs behave. Nonetheless, it is vital that centres coordinate a multidisciplinary, patient-centred approach to ICA screening, surveillance, and management for ADPKD patients.</p>","PeriodicalId":8158,"journal":{"name":"ANZ Journal of Surgery","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143959012","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":"Head and neck cancer after liver transplantation in the north of Spain.","authors":"Belén Salvatierra-Vicario, Emilio Fábrega-García, Javier Crespo, Jose I Fortea-Ormaechea, Patricia Corriols-Noval, Carmelo Morales-Angulo","doi":"10.1111/ans.70133","DOIUrl":"https://doi.org/10.1111/ans.70133","url":null,"abstract":"<p><strong>Backgrounds: </strong>De novo neoplasms after liver transplantation are one of the most frequent causes of morbidity and mortality in the long-term transplanted population. This study aimed to investigate the incidence, clinical characteristics and survival outcomes of de novo head and neck cancer in liver transplant recipients at our tertiary hospital.</p><p><strong>Methods: </strong>A retrospective observational study was conducted at a tertiary hospital, including 585 patients who underwent liver transplantation at our institution between 1995 and 2024. These patients were regularly monitored for the development of head and neck carcinoma, among other conditions. The overall survival of patients diagnosed with de novo head and neck tumours was analyzed.</p><p><strong>Results: </strong>Among the 585 patients, 14 (2.4%) developed head and neck cancer. The mean follow-up period after cancer diagnosis was 8.5 months (range, 1-84 months) with only three patients surviving 5 years after diagnosis. Notably, 13 of the 14 (93%) of these patients had alcohol-related liver disease.</p><p><strong>Conclusions: </strong>Our study revealed a notable incidence of head and neck cancer, particularly among patients with a history of alcohol consumption following liver transplantation. Patients diagnosed with advanced-stage disease had a poor prognosis. Regular otorhinolaryngology follow-up is therefore recommended for this population.</p>","PeriodicalId":8158,"journal":{"name":"ANZ Journal of Surgery","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143958538","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":"Ten-year review of oesophagectomy in a regional New Zealand hospital: making the case for a low-volume centre.","authors":"Cain Anderson, Rebecca Veitch, Binura Lekamalage, Daniel Mafi, Jeremy Rossaak, Barnaby Smith, Riteshkumar Patel","doi":"10.1111/ans.70137","DOIUrl":"https://doi.org/10.1111/ans.70137","url":null,"abstract":"<p><strong>Background: </strong>Oesophageal cancer is a highly aggressive malignancy with poor survival rates. The treatment approach is multimodal, employing endoscopy and chemoradiotherapy; however, surgical resection remains a mainstay of management. Centres with high volumes of resections are associated with improved outcomes, but an optimal number for annual caseload is not defined. International benchmarks for morbidity and mortality have been established by the Oesophageal Complications Consensus Group (ECCG) using data from high-volume centres. This study compared data from a New Zealand low-volume centre against these.</p><p><strong>Methods: </strong>This retrospective study included all patients undergoing oesophagectomy at Tauranga Hospital between 2014 and 2023, with primary analysis comparing mortality and complications to the ECCG benchmarks. Secondary analysis stratified data by age, ethnicity, comorbidity, and preoperative treatment.</p><p><strong>Results: </strong>Sixty-one patients underwent oesophagectomy, with a 30-day mortality of 0% and a 90-day mortality of 1.6%, both below the ECCG benchmarks. However, complication rates were higher, with anastomotic leak (16.4%) and Clavien-Dindo ≥3B complications (26.2%) exceeding the benchmark rates. There were no significant differences in outcomes stratified by demographic or clinical subgroups.</p><p><strong>Conclusion: </strong>This study finds better mortality outcomes and poorer morbidity outcomes than the benchmark. These results suggest that low-volume centres which concurrently perform similar complex oncological resections and have access to dedicated Intensive Care, interventional radiology, and endoscopy may have comparable results to high-volume centres. If similar centres achieve good outcomes, consideration must be given to keeping regional oesophagectomy services to reduce inequities and improve access to healthcare.</p>","PeriodicalId":8158,"journal":{"name":"ANZ Journal of Surgery","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143958550","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":"How to fixate the cystic duct for transcystic common bile duct exploration.","authors":"Nathan Bui, Simon Ho, Hai Bui","doi":"10.1111/ans.70128","DOIUrl":"https://doi.org/10.1111/ans.70128","url":null,"abstract":"","PeriodicalId":8158,"journal":{"name":"ANZ Journal of Surgery","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143959982","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":"Opioid prescribing patterns in trauma patients: assessing the impact of injury and treatment factors.","authors":"S McLaughlin, S Speakman, J Johns, M McGuinness, C Swanson, L Muller, T Muwanga-Magoye, C Harmston","doi":"10.1111/ans.70111","DOIUrl":"https://doi.org/10.1111/ans.70111","url":null,"abstract":"<p><strong>Background: </strong>Increasing rates of opioid prescribing are a growing concern due to associations with dependency and misuse. Management of pain in trauma is important, but represents an under-investigated opioid initiation event. This study aimed to analyze opioid prescription patterns at discharge in trauma patients within a provincial setting in Aotearoa New Zealand.</p><p><strong>Methods: </strong>To address this aim, a cohort of 500 trauma patients aged 18-64 years, admitted to Tauranga or Whakatāne Hospital between 21 April 2017 and 31 December 2017, were retrospectively assessed. Data were sourced from the Midland Trauma Registry (MTR), which captures patients admitted to hospital within 7 days of injury. Opioid prescriptions at discharge and repeat prescriptions up to 12 months post-discharge were assessed, with doses standardized using Morphine Milligram Equivalents (MMEs).</p><p><strong>Results: </strong>Of the 473 opioid-naïve patients identified, 69.1% were prescribed opioids at discharge. A higher Injury Severity Score (ISS) was associated with increased opioid prescribing at discharge and a higher likelihood of repeated opioid prescriptions after discharge. Within 3 months, 36.1% of patients received repeat prescriptions, decreasing to 13.5% between 3 and 6 months and 7.3% between 6 and 12 months.</p><p><strong>Conclusion: </strong>This is the first reported study assessing opioid prescribing after trauma in Aotearoa New Zealand and found that a higher ISS was associated with increased opioids prescribed at discharge and a greater risk of repeat prescriptions. These findings highlight the importance of education and prescribing protocols to balance pain management with the risk of long-term use.</p>","PeriodicalId":8158,"journal":{"name":"ANZ Journal of Surgery","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143960515","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":"Comment on ‘Development of a nomogram model to predict postoperative urinary retention risk after transabdominal preperitoneal inguinal hernia repair’","authors":"Amnuay Kleebayoon PhD,&nbsp;Viroj Wiwanitkit MD","doi":"10.1111/ans.70024","DOIUrl":"10.1111/ans.70024","url":null,"abstract":"","PeriodicalId":8158,"journal":{"name":"ANZ Journal of Surgery","volume":"95 5","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143957322","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":"Cost-effectiveness analysis of hydrophilic coated catheters for intermittent catheterisation in traumatic spinal cord injury in New Zealand.","authors":"Madeleine Bain, Muthuthantrige 'Ashani' Couchman, Carolyn Rutherford, Matt Kirchmann, Vinita Nand","doi":"10.1111/ans.70132","DOIUrl":"https://doi.org/10.1111/ans.70132","url":null,"abstract":"<p><strong>Background: </strong>Intermittent catheterisation is the standard treatment for incomplete bladder emptying in spinal cord injuries (SCI), but urinary tract infections (UTI) remain a common and costly complication. Hydrophilic-coated catheters have been shown to decrease infection rates; however, they are more expensive compared to uncoated catheters. The aim was to model the cost-effectiveness of hydrophilic-coated catheters (HCIC) compared to uncoated catheters in New Zealand (NZ) patients with traumatic SCI who intermittently catheterise.</p><p><strong>Methods: </strong>A probabilistic economic Markov model adapted to NZ costing and demographics modelled economic and quality-of-life benefits for the two catheter types in SCI patients using intermittent catheters. Inputs included UTI rates, severity of infection, utility values, SCI demographics, catheter costs and UTI treatment in New Zealand dollars. The model output reports UTI rates, life years gained, quality-adjusted life-years and incremental cost-effectiveness ratios for the two catheter types.</p><p><strong>Results: </strong>HCIC use is predicted to reduce UTIs by 11%, resulting in a 7% increase in quality adjusted life years (QALY). Over a patient's lifetime, it is estimated that 3.8 simple infections and 2.1 prolonged infections treated in primary care could be avoided, and it is predicted to avoid 1.3 severe complex infections that require hospitalization. The incremental cost-effectiveness ratio of $27 919/QALY falls within NZ Government willingness to pay threshold for therapeutic interventions.</p><p><strong>Conclusion: </strong>Reducing UTI's with HCIC has quality of life and economic benefits to the patient and healthcare system, as it is a common and costly complication in New Zealand. This model demonstrates that HCIC is likely to be cost-effective in New Zealand SCI patients.</p>","PeriodicalId":8158,"journal":{"name":"ANZ Journal of Surgery","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143958470","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 Wellington developmental dysplasia of the hip screening experience.","authors":"Samuel MacGill, Koen de Ridder","doi":"10.1111/ans.70010","DOIUrl":"https://doi.org/10.1111/ans.70010","url":null,"abstract":"","PeriodicalId":8158,"journal":{"name":"ANZ Journal of Surgery","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143959767","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":"Effects of coronavirus severity and vaccination numbers on postsurgical mortality for elective surgical procedures in the VA population","authors":"Henyah W. Dardir BA,&nbsp;Ahmed Adham R. Elsayed MD,&nbsp;William P. Newman MD, PhD,&nbsp;Marilyn G. Klug PhD,&nbsp;Marc D. Basson MD, PhD, MBA","doi":"10.1111/ans.70107","DOIUrl":"10.1111/ans.70107","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>This study investigated whether previous COVID severity and vaccination affected subsequent elective postsurgical mortality and readmission rates at 30, 90 and 365 days.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>21 855 veterans were divided into two cohorts, a no-COVID (NC) cohort of 19 338 patients and a previous COVID cohort of 2547 patients. Patients with acute COVID &lt;22 days prior to surgery were excluded. COVID patients were further divided into 1776 Mild and 771 Moderate/Severe. Another comparison cohort was based on vaccinations.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Patients with moderate/severe COVID had higher 30-day (5.9% vs. 3.5%, <i>P</i> = 0.003), 90-day (5.6% vs. 3.41%, <i>P</i> &lt; 0.001), and 365-day mortality (6.07% vs. 3.23%, <i>P</i> &lt; 0.001) than mild COVID or NC patients. They were also more likely to be readmitted (<i>P</i> &lt; 0.001) than mild or NC. Mild COVID increased readmission risk by 16.6% (OR = 1.166). NC patients with no vaccine had higher mortality than vaccinated NC patients (log-rank, <i>P</i> &lt; 0.01). Mortality in NC patients decreased with more time between vaccine dose and surgery (Breslow-Day <i>P</i> &lt; 0.001). The only significant interaction was between mild COVID and time to vaccination predicting death (Breslow-Day <i>P</i> &lt; 0.001).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>History of moderate/severe COVID, lack of COVID vaccination, and recency of COVID vaccination may be associated with higher elective surgery mortality and postsurgical readmission rates.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8158,"journal":{"name":"ANZ Journal of Surgery","volume":"95 5","pages":"955-962"},"PeriodicalIF":1.5,"publicationDate":"2025-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/ans.70107","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143965871","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}

{"title":"Early-stage low rectal cancer - re-thinking the standard of care.","authors":"Zachary Bunjo, Tarik Sammour","doi":"10.1111/ans.70139","DOIUrl":"https://doi.org/10.1111/ans.70139","url":null,"abstract":"","PeriodicalId":8158,"journal":{"name":"ANZ Journal of Surgery","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143954932","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}