ANZ Journal of Surgery最新文献

{"title":"Predictors of Cranioplasty Failure: A Retrospective Cohort Study of 302 Patients.","authors":"I Gonzalez Matheus, M Redmond, S Olson, M Wagels","doi":"10.1111/ans.71006","DOIUrl":"https://doi.org/10.1111/ans.71006","url":null,"abstract":"<p><strong>Background: </strong>Cranioplasty is a frequently performed neurosurgical procedure, yet long-term durability remains variable and the factors predicting success or failure are not well established.</p><p><strong>Methods: </strong>We conducted a review of 302 adult patients who underwent cranioplasty at two tertiary centres between 2014 and 2021. Cranioplasty failure was defined as implant removal due to infection, structural failure or autologous bone resorption. Univariate and multivariate logistic regression analyses were performed to assess associations between failure and clinical variables including cranioplasty material, indication for initial craniectomy, defect site and size and having a prior cranioplasty.</p><p><strong>Results: </strong>The overall cranioplasty failure rate was 11.3%. Autologous bone was used in the majority of reconstructions (66.5%), with the remainder utilising alloplastic materials. Infection rates did not differ significantly between autologous and alloplastic reconstructions. Univariate analysis showed higher failure rates following trauma-related craniectomies. Multivariate regression demonstrated that trauma-related indications were independently associated with increased failure risk (OR 3.06, p = 0.003), while other factors including material type, defect site and prior cranioplasty were not statistically significant. In a separate model, large defects were not significantly associated with failure (OR 0.72, p = 0.50).</p><p><strong>Conclusion: </strong>Cranioplasty failure remains a multifactorial complication. Trauma-related indication was independently associated with increased failure risk, while material type, defect site and prior cranioplasty were not significant predictors. These findings highlight the need for prospective studies and longer-term surveillance, particularly in patients undergoing reconstruction following traumatic brain injury.</p>","PeriodicalId":8158,"journal":{"name":"ANZ Journal of Surgery","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2026-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149179205","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":"25, 50 and 75 Years Ago.","authors":"Julian A Smith","doi":"10.1111/ans.71000","DOIUrl":"https://doi.org/10.1111/ans.71000","url":null,"abstract":"","PeriodicalId":8158,"journal":{"name":"ANZ Journal of Surgery","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2026-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149179149","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":"Platelet-Rich Plasma (PRP) for Pilonidal Sinus Disease: An Updated Systematic Review and Meta-Analysis.","authors":"Swetha Prabhakaran, Athanasia Siderellis, Joseph Cherng Huei Kong","doi":"10.1111/ans.71004","DOIUrl":"https://doi.org/10.1111/ans.71004","url":null,"abstract":"<p><strong>Background: </strong>Platelet-rich plasma (PRP) has been utilised in wound healing in pilonidal sinus disease (PSD). This study aims to perform an updated systematic review and meta-analysis on the utility of PRP in PSD.</p><p><strong>Methods: </strong>This study was undertaken in accordance with the PRISMA guidelines. PubMed, EMBASE and Medline databases were last searched on 22 February 2026 following PROSPERO Registration (ID CRD420251246388). Any comparative study investigating the role of PRP in facilitating wound healing in patients with PSD was included. Systematic reviews, meta-analyses, case reports and conference proceedings were excluded. A Newcastle-Ottawa score and a GRADE assessment were performed.</p><p><strong>Results: </strong>Fourteen studies met the inclusion criteria. A total of 1346 patients were included in this study with 647 in the PRP group and 699 in the control group. There was heterogeneity in PRP administration. Pooled analysis demonstrated a statistically significant reduction in healing time (p < 0.01), as well as in return-to-work time (p < 0.01) with PRP application. Pooled analysis also demonstrated a significant reduction in pain severity with PRP application (p < 0.01) as well as a significantly lower recurrence rate (p = 0.03). No significant differences were noted between the two groups with regards to return to activities of daily living or complication rates.</p><p><strong>Conclusion: </strong>The use of PRP as an adjunct in the management of PSD has been shown to significantly reduce wound healing time, pain severity, time to return to work and post-operative recurrence rate. Further research is required to determine an optimal protocol.</p>","PeriodicalId":8158,"journal":{"name":"ANZ Journal of Surgery","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2026-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149179128","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 'Paediatric Myringoplasty Outcomes: Baseline Hearing Severity and the Apparent Age Effect'.","authors":"Ercan Yılmaz","doi":"10.1111/ans.71007","DOIUrl":"https://doi.org/10.1111/ans.71007","url":null,"abstract":"","PeriodicalId":8158,"journal":{"name":"ANZ Journal of Surgery","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2026-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149164827","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":"What Does Panniculectomy Actually Unload?","authors":"Federica Tomaselli, Roberta Albanese, Damiano Tambasco","doi":"10.1111/ans.71005","DOIUrl":"https://doi.org/10.1111/ans.71005","url":null,"abstract":"","PeriodicalId":8158,"journal":{"name":"ANZ Journal of Surgery","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2026-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149164051","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":"Postpartum Spontaneous Ureteric Rupture.","authors":"H Lucas, N Corcoran, N Sathianathen","doi":"10.1111/ans.70939","DOIUrl":"https://doi.org/10.1111/ans.70939","url":null,"abstract":"","PeriodicalId":8158,"journal":{"name":"ANZ Journal of Surgery","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2026-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149164229","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":"One Audit, One Definition, Two Answers: How Many Deaths After Elective Colorectal Surgery Are Potentially Preventable?","authors":"Danielly Ferreira Mendes, Bredley Perdigão Campolina, Leonardo Pereira Levada","doi":"10.1111/ans.71002","DOIUrl":"https://doi.org/10.1111/ans.71002","url":null,"abstract":"","PeriodicalId":8158,"journal":{"name":"ANZ Journal of Surgery","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2026-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149103260","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 Role of A Surgeon in Restoring the Senses & in Biomedical Engineering.","authors":"Graeme M Clark","doi":"10.1111/ans.70946","DOIUrl":"https://doi.org/10.1111/ans.70946","url":null,"abstract":"<p><p>This review is based on my 2025 Jepson Lecture and outlines my personal journey to restore hearing in people with a severe sensorineural hearing loss. My dream started as a 5-year-old as I told my kindergarten teacher when I grow up 'I want to fix ears' because my father is deaf. The journey resulted in a career in surgery followed by auditory neuroscience, engineering and audiology. While the key stages in the development of the multi-channel cochlear implant are highlighted, their importance in discovering the first restoration of a human sense, and in understanding brain function is presented as well. The discoveries also underpin the development of modern neural interfaces in general that restore human function. And so, a new discipline in biomedical engineering has emerged.</p>","PeriodicalId":8158,"journal":{"name":"ANZ Journal of Surgery","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2026-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149103216","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":"Validation of the PANAMA Score in Patients With Pancreatic Ductal Adenocarcinoma Undergoing Distal Pancreatectomy.","authors":"Simeng Li, Hiro Masuda, Krishna Kotecha, Nazim Bhimani, Nick Pavlakis, Stephen Clarke, Angela Chou, Anthony Gill, Kai Brown, Jaswinder Samra, Anubhav Mittal","doi":"10.1111/ans.70999","DOIUrl":"https://doi.org/10.1111/ans.70999","url":null,"abstract":"<p><strong>Background: </strong>The PANAMA score was developed as a post-NAT prognostic tool for PDAC. Prior validations have been dominated by pancreatic head cancers. Pancreatic body and tail tumours represent a biologically distinct subgroup and remain underrepresented in NAT cohorts. Whether the score reliably predicts outcomes in distal PDAC remains unknown.</p><p><strong>Methods: </strong>A retrospective study was conducted at a single centre including patients with PDAC who received NAT followed by distal pancreatectomy between January 2015 and December 2024. Patients were stratified into low-, intermediate- and high-risk groups based on the original PANAMA score. Overall survival (OS) and disease-free survival (DFS) were assessed. Prognostic performance of the PANAMA score and AJCC staging was compared.</p><p><strong>Results: </strong>Fifty-two patients were included. Median OS and DFS were 40.8 months (95% CI: 28.7-55.0) and 11.6 months (95% CI: 9.7-14.5), respectively. High-risk patients showed worse OS compared to intermediate- and low-risk groups (21.8, 31.1 and 55.0 months, respectively, p = 0.009). A similar pattern was observed for DFS (10.3, 11.2 and 29.2 months, respectively, p = 0.029). The AJCC stage outperformed the PANAMA score in OS prediction (C-index 0.70 vs. 0.64).</p><p><strong>Conclusion: </strong>The PANAMA score effectively stratifies patients with pancreatic body and tail PDACs undergoing neoadjuvant therapy and resection into prognostic groups.</p>","PeriodicalId":8158,"journal":{"name":"ANZ Journal of Surgery","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2026-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149103305","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":"A Word of Caution: Watch and Wait in the Total Mesorectal Excision Era.","authors":"K Broughton, R Cohen, A Armanios, S Jamin, E Eguare, H Yoo, G Lim, E Maclean, M Teoh, M Nyandoro, M H Wallace, J Ryan","doi":"10.1111/ans.70998","DOIUrl":"https://doi.org/10.1111/ans.70998","url":null,"abstract":"<p><strong>Background: </strong>Watch and wait strategies offer organ preservation for selected patients with rectal cancer following neoadjuvant chemoradiotherapy (nCRT). Long-term outcomes following nCRT and total mesorectal excision (TME) provide important context for evaluating these approaches. We report regional surgical, pathological, and long-term oncological outcomes following nCRT and TME, with oncological outcomes stratified by treatment response.</p><p><strong>Methods: </strong>A multicentre retrospective cohort study included patients with rectal cancer treated with curative-intent nCRT followed by TME across four Western Australian centres between 2006 and 2020. Overall survival (OS), cancer-specific survival (CSS), and disease-free survival (DFS) were estimated using Kaplan-Meier methods. Local and metastatic recurrence were estimated using cumulative incidence functions, with death without the recurrence of interest treated as a competing event. Outcomes were stratified by baseline clinical stage, pathological stage, and American Joint Committee on Cancer (AJCC) tumour regression grade (TRG).</p><p><strong>Results: </strong>Among 573 patients, anastomotic leak occurred in 10.8% of patients with an anastomosis and an intended permanent stoma was formed in 31.9%. A pathological complete response occurred in 21.8%, and 3.1% had a positive circumferential resection margin. Five-year OS was 85.7%, CSS was 89.3% and DFS was 76.7%. The five-year cumulative incidences of local and metastatic recurrence were 3.4% and 16.5%, respectively. Baseline clinical stage was not associated with oncological outcomes, whereas pathological stage and AJCC TRG provided significant prognostic stratification. Five-year DFS was 92.2% for TRG 0% and 62.9% for TRG 3, with corresponding metastatic recurrence of 3.9% and 24.9%.</p><p><strong>Conclusion: </strong>Long-course nCRT followed by TME achieved favourable long-term oncological outcomes. Pathological stage and AJCC TRG provided greater prognostic stratification than baseline clinical stage. These response-stratified estimates provide regional context for evaluating contemporary organ-preservation programmes.</p>","PeriodicalId":8158,"journal":{"name":"ANZ Journal of Surgery","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2026-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149103244","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}