ANZ Journal of Surgery最新文献_第2页

Locked down: Orthopaedic surgery in a regional health service during the COVID-19 pandemic.

IF 1.5 4区医学

ANZ Journal of Surgery Pub Date : 2025-02-03 DOI: 10.1111/ans.70007

Thomas Page, Margaret Rogers, Kevin Eng, Kirsten Porter, Stephen D Gill, Richard S Page

{"title":"Locked down: Orthopaedic surgery in a regional health service during the COVID-19 pandemic.","authors":"Thomas Page, Margaret Rogers, Kevin Eng, Kirsten Porter, Stephen D Gill, Richard S Page","doi":"10.1111/ans.70007","DOIUrl":"https://doi.org/10.1111/ans.70007","url":null,"abstract":"Background: COVID-19 affected access to healthcare. Victoria, Australia was heavily affected. Hospitals deferred non-urgent operations and preserved health resources to manage people with COVID-19. Elective orthopaedic surgery was directly impacted. This study investigated changes to orthopaedic procedures and the elective surgery waitlist during the COVID-19 at a large regional health service in Victoria.Methods: Data were acquired from University Hospital Geelong, a publicly funded regional health service in Victoria, Australia. Orthopaedic surgeries and waitlist numbers were collated for financial years ending (FYE) 2020-2023. Procedures were displayed as total, planned and unplanned (i.e., trauma).Results: From FYE 2020 to 2023 there was 8244 orthopaedic surgery cases with 8850 procedures. Planned joint replacements of knee, hip and shoulder decreased collectively by 19% in FYE 2022 and increased by 66% in FYE 2023. Waiting lists rose from 247 in FYE 2020 and peaked at 786 in FYE 2022, before falling to 390 in FYE 2023. The number of fractured neck of femur procedures were consistent each year (average 152/year), while ankle and wrist fractures declined by 55% and 43% during FYE 2022 and increased in FYE 2023 by 106% and 159% respectively.Conclusion: Changes to planned orthopaedic procedures and waitlists in a regional centre were evident throughout the pandemic. These results can help to inform strategies to optimize the provision of orthopaedic surgery during future major disruptive events.","PeriodicalId":8158,"journal":{"name":"ANZ Journal of Surgery","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143078443","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

Don't take this lying down: an urgent wakeup call: the weight of diet and lifestyle in the young-onset colorectal cancer surge.

IF 1.5 4区医学

ANZ Journal of Surgery Pub Date : 2025-02-01 DOI: 10.1111/ans.19416

Maria Kristina Vanguardia, Chen Lew, Thang Chien Nguyen, William Teoh, Vignesh Narasimhan

引用次数: 0

Single breast incision for breast conservation surgery and sentinel lymph node biopsy: a systematic review.

IF 1.5 4区医学

ANZ Journal of Surgery Pub Date : 2025-01-31 DOI: 10.1111/ans.19389

Lucy P Aitchison, Andrew J Spillane

{"title":"Single breast incision for breast conservation surgery and sentinel lymph node biopsy: a systematic review.","authors":"Lucy P Aitchison, Andrew J Spillane","doi":"10.1111/ans.19389","DOIUrl":"https://doi.org/10.1111/ans.19389","url":null,"abstract":"Background: Breast conservation surgery and sentinel lymph node biopsy via a single incision allows excision of tumours from all quadrants of the breast, with access to both axillary and internal mammary nodal basins with no additional incisions.Objectives: This systematic review aims to consolidate the current literature on the efficacy, safety, functional and cosmetic outcomes of single-incision breast conserving surgery and sentinel lymph node biopsy.Data sources and review methods: A comprehensive search of Pubmed, EMBASE, Medline and GoogleScholar was conducted from inception to 7th July 2024 for all peer-reviewed articles assessing breast conserving surgery and sentinel lymph node biopsy via single incision using PRISMA guidelines.Results: The literature search generated 426 articles. 400 were excluded by abstract review with the remaining 26 articles reviewed in full. An additional three articles were retrieved from review of full article reference lists. 13 articles were excluded, leaving 10 articles meeting the inclusion criteria. The technique demonstrated success across all quadrants of the breast. Eight studies documented successful axillary dissection completed via a single incision. Four studies compared the single-incision approach to the conventional two-incision technique. There was no difference in complication rates. The single-incision technique was associated with higher patient satisfaction and reduced post-operative axillary pain.Conclusion: Single-incision breast conservation surgery and sentinel lymph node biopsy is surgically safe and can be feasible for tumours in all quadrants of the breast and is associated with improvement in cosmesis, pain and patient satisfaction. Further studies are required to confirm its long-term oncological safety.","PeriodicalId":8158,"journal":{"name":"ANZ Journal of Surgery","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143073601","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

Urological complications following pelvic exenteration are comparable to those following radical cystectomy.

IF 1.5 4区医学

ANZ Journal of Surgery Pub Date : 2025-01-31 DOI: 10.1111/ans.19424

Darcy Noll, Thomas Milton, Ryash Vather, Jonathan Cho, Tarik Sammour

{"title":"Urological complications following pelvic exenteration are comparable to those following radical cystectomy.","authors":"Darcy Noll, Thomas Milton, Ryash Vather, Jonathan Cho, Tarik Sammour","doi":"10.1111/ans.19424","DOIUrl":"https://doi.org/10.1111/ans.19424","url":null,"abstract":"Introduction: Radical cystectomy and urinary diversion is required for both primary muscle-invasive bladder cancer and in the setting of pelvic exenteration for advanced malignancy of pelvic organs. Acute and chronic complications following radical cystectomy can be a significant cause of morbidity. We compared the rates of urological complications following these two procedures at our tertiary referral centre.Methods: Patients who underwent radical cystectomy and urinary diversion either alone or as part of pelvic exenteration between June 2017 and April 2024 at our hospital were included. Short and long-term post-operative urological complications were collected, and data for patients who underwent PE were collected prospectively as part of a larger database.Results: One hundred eleven patients underwent cystectomy: 44 as part of pelvic exenteration (PE), 67 cystectomy alone. Post-operative urological complications occurred in 45% of patients undergoing PE and 42% undergoing cystectomy alone (P = 0.703). Urosepsis was the most frequent complication in both cohorts, occurring in 27% and 24% of patients who underwent PE and cystectomy alone respectively. Return to theatre was required in 9% of PE patients and 7% of non-PE patients. ASA status was predictive of complication development in the non-PE cohort, no factors analysed were predictive in the PE cohort.Conclusions: In this cohort, the rate of urological complications and return to the theatre following radical cystectomy and urinary diversion were comparable among those undergoing PE and cystectomy alone. No individual factor was identified that was predictive of post-operative complications.","PeriodicalId":8158,"journal":{"name":"ANZ Journal of Surgery","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143073603","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

Extensive gastrointestinal metastasis of cutaneous angiosarcoma.

IF 1.5 4区医学

ANZ Journal of Surgery Pub Date : 2025-01-30 DOI: 10.1111/ans.19400

Lei He, Ting Lu, Qin Shen, Ying Liu, Yang Zhang

引用次数: 0

Vascular encasement image defined risk factors independently predict surgical complications in neuroblastoma.

IF 1.5 4区医学

ANZ Journal of Surgery Pub Date : 2025-01-30 DOI: 10.1111/ans.19420

Rachael Stokes, Aidan Bannon, Bonnie Leung, Jasmin Alloo, David Davies-Payne, Mark Winstanley, Andrew Wood, Stephen Evans, James Hamill

{"title":"Vascular encasement image defined risk factors independently predict surgical complications in neuroblastoma.","authors":"Rachael Stokes, Aidan Bannon, Bonnie Leung, Jasmin Alloo, David Davies-Payne, Mark Winstanley, Andrew Wood, Stephen Evans, James Hamill","doi":"10.1111/ans.19420","DOIUrl":"https://doi.org/10.1111/ans.19420","url":null,"abstract":"Background: Specific image defined risk factors (IDRF) immediately prior to surgery may be more relevant to paediatric oncology surgeons than pre-neoadjuvant IDRFs at diagnosis. The aim of this study was to determine IDRF subtypes that independently predict postoperative complications.Methods: We searched the New Zealand Children's Cancer Registry for all cases of neuroblastoma treated at a single paediatric oncology centre between January 2007 and February 2021 and determined the IDRF status on pre-operative imaging at diagnosis and after neoadjuvant therapy. Surgical complications (Clavien-Dindo grade) were correlated with total number of IDRFs (pre- and post-chemotherapy) and three subsets: vascular encasement (VE), invasive (I), and extensive (E).Results: Of 101 patients, 73 underwent surgical resection, and 32 (44%) had a surgical complication. Of the 54 IDRF-positive tumours, all were treated by neoadjuvant therapy and in 17, all IDRFs resolved. Complications correlated with the number of post-neoadjuvant therapy VE-IDRFs at OR 1.2 (95% CI 1.0-1.4, P = 0.02) and extensive IDRFs at OR 1.7 (95% CI 1.1-1.9, P = 0.02). Pre-neoadjuvant IDRF status was not independently associated with complications when controlling for post-neoadjuvant IDRF status. The total number of VE-IDRF reduced from 181 pre-neoadjuvant therapy to 86 post, with tumour encasing the aorta and/or vena cava being the most common.Conclusions: The vascular encasement and extensive subtypes of IDRF may be more useful prognostic indicators of surgical complications than the total number of IDRFs. This may have implications for reporting IDRF status on preoperative imaging and surgical planning but needs validation in larger cohort studies.","PeriodicalId":8158,"journal":{"name":"ANZ Journal of Surgery","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143063320","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

Variations in pelvic tilt between relaxed-seated and flexed-seated positions affect stability assessment in 3D modelling in total hip replacement.

IF 1.5 4区医学

ANZ Journal of Surgery Pub Date : 2025-01-30 DOI: 10.1111/ans.19317

Bryn Gilbertson, Sina Babazadeh, Dirk van Bavel

{"title":"Variations in pelvic tilt between relaxed-seated and flexed-seated positions affect stability assessment in 3D modelling in total hip replacement.","authors":"Bryn Gilbertson, Sina Babazadeh, Dirk van Bavel","doi":"10.1111/ans.19317","DOIUrl":"https://doi.org/10.1111/ans.19317","url":null,"abstract":"Background: The spinopelvic axis is becoming recognized as an essential contributor to impingement and instability leading to dislocation. Computer-assisted hip surgery uses standing and relaxed-seated radiographs as a surrogate marker of pelvic tilt in all seated positions. However, the flexed-seated position is a high-risk position for dislocation, and the standing and relaxed-seated radiographs may not reflect this risk. This study aims to determine whether adding a flexed-seated radiograph affects stability assessment in 3D modelling of THR.Methods: Ninety patients with osteoarthritis underwent computer-assisted THR and received standing, relaxed-seated, and flexed-seated radiographs. Sacral slope (SS) was measured and analysed using Pearson correlation. Key measures were degree of tilt between positions, as well as correlations between dynamic hip movements.Results: Of the examined patients, 96.7% anteriorly tilted their pelvis moving from relaxed-seated to flexed-seated, and 50% of patients anteriorly tilted by >10° SS. There was a moderate correlation between standing SS and flexed-seated SS (r = 0.33, P ≤ 0.1). There was a strong correlation between relaxed-seated SS and flexed-seated SS (r = 0.77, P ≤ 0.001); however, there was a wide variance of flexed-seated SS for any given relaxed-seated or standing SS.Conclusion: The flexed-seated position poses a higher risk of anterior impingement in 96.7% of patients compared to the relaxed seated-position. The flexed-seated position cannot be predicted by existing radiographs, making it a valuable marker in surgical planning to mitigate the risk of hip instability.","PeriodicalId":8158,"journal":{"name":"ANZ Journal of Surgery","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143063317","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

Day zero parathyroid hormone levels predict cure after parathyroidectomy.

IF 1.5 4区医学

ANZ Journal of Surgery Pub Date : 2025-01-29 DOI: 10.1111/ans.19411

Brodie D Laurie, David Leong, Hieu Nguyen, Simon Ryan, Dean Lisewski

{"title":"Day zero parathyroid hormone levels predict cure after parathyroidectomy.","authors":"Brodie D Laurie, David Leong, Hieu Nguyen, Simon Ryan, Dean Lisewski","doi":"10.1111/ans.19411","DOIUrl":"https://doi.org/10.1111/ans.19411","url":null,"abstract":"Objective: To evaluate the predictive value of day zero post-operative parathyroid hormone (PTH) levels in determining cure for primary hyperparathyroidism (pHPT) following parathyroidectomy.Methods: This multicentre, retrospective diagnostic accuracy study utilized data from a single surgeon. Patients who underwent parathyroidectomy for pHPT were included, with exclusions for secondary or tertiary causes and incomplete follow-up. Day zero post-operative PTH levels were the key predictor variable, while cure at 6 months, defined by normocalcaemia, was the outcome. Diagnostic parameters including sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy were calculated for an optimal PTH cut-off determined using a receiver operating characteristic (ROC) curve and Youden's index.Results: Out of 291 patients included, 278 (95.5%) were cured at 6 months. An optimal PTH cut-off of <3 pmol/L was identified, correlating with a true positive rate of 81.3% and a false positive rate of 0%. Patients with day zero PTH <3 pmol/L (77.7% of the cohort) were all cured at six months. The PTH <3 pmol/L cut-off demonstrated a sensitivity of 81.3%, specificity of 100%, PPV of 100%, NPV of 20%, and an accuracy of 82.1%.Conclusion: Day zero post-operative PTH level < 3 pmol/L is a reliable predictor of cure for pHPT following parathyroidectomy. A PTH level of <3 pmol/L is an effective cut-off to identify patients who will be cured, potentially reducing the need for prolonged biochemical monitoring.","PeriodicalId":8158,"journal":{"name":"ANZ Journal of Surgery","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143063385","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

Treating cryptogenic anorectal fistulas with hyperbaric oxygen therapy - an unexplored area with potential.

IF 1.5 4区医学

ANZ Journal of Surgery Pub Date : 2025-01-29 DOI: 10.1111/ans.70002

Gillian Lim, Zi Qin Ng, Satish Warrier

引用次数: 0

Clinical impact of the Z0011 trial on axillary surgical management in Australia and New Zealand from the BreastSurgANZ Quality Audit.

IF 1.5 4区医学

ANZ Journal of Surgery Pub Date : 2025-01-28 DOI: 10.1111/ans.19404

Christine Zhao, Nina Sriram, Kerry Hitos, T Michael Hughes, Nicholas Ngui

{"title":"Clinical impact of the Z0011 trial on axillary surgical management in Australia and New Zealand from the BreastSurgANZ Quality Audit.","authors":"Christine Zhao, Nina Sriram, Kerry Hitos, T Michael Hughes, Nicholas Ngui","doi":"10.1111/ans.19404","DOIUrl":"https://doi.org/10.1111/ans.19404","url":null,"abstract":"Background: The clinical management of the axilla in early breast cancer has changed since the Z0011 trial, which showed that axillary lymph node dissection (ALND) is not necessary in select patients with a positive sentinel lymph node biopsy (SLNB). Studies have shown a significant decrease in the rates of completion ALND (cALND) since Z0011. The aims of this study were to investigate the effect of the Z0011 trial on the management of positive axillary sentinel nodes and the trends in axillary surgical management since 2005 in Australia and New Zealand.Methods: This study utilized prospectively maintained data from the BreastSurgANZ Quality Audit (BQA). Patients with early breast cancer between 2005 and 2023 satisfying the Z0011 trial inclusion criteria undergoing SLNB or SLNB followed by cALND were identified.Results: There were 91 196 patients who underwent breast-conserving surgery and SLNB of which 12 035 were node positive therefore satisfying the Z0011 trial inclusion criteria, of which 8194 (68.1%) received SLNB only with no cALND. There has been a 55.4% reduction in the rate of cALND after 2010 when the Z0011 trial was published (P < 0.001). There was a significant downward trend in the number of cALND performed per year (R2 = 0.890, P < 0.001).Conclusion: The Z0011 trial was a practice changing trial and since its publication in 2010 has been correlated with de-escalation in surgical management of the axilla and decline in the rates of cALND in Australia and New Zealand.","PeriodicalId":8158,"journal":{"name":"ANZ Journal of Surgery","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143057851","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