ANZ Journal of Surgery最新文献

{"title":"Laparoscopic and robotic inguinal hernia repair - are they rational and scientific?","authors":"Kaushik Bhattacharya","doi":"10.1111/ans.70004","DOIUrl":"https://doi.org/10.1111/ans.70004","url":null,"abstract":"","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":"143057854","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":"Proximal humerus fracture dislocations: outcomes of management.","authors":"Filip Cosic, Nathan Kirzner, Elton Edwards, Richard Page, Lara Kimmel, Belinda Gabbe","doi":"10.1111/ans.19385","DOIUrl":"https://doi.org/10.1111/ans.19385","url":null,"abstract":"<p><strong>Purpose: </strong>Proximal humerus fracture dislocations are amongst the most severe proximal humerus injuries, presenting a challenging management problem. The aim of this study was to report on long-term outcomes of management of proximal humerus fracture dislocations.</p><p><strong>Methods: </strong>Patients with a proximal humerus fracture dislocation managed at a Level 1 trauma centre from January 2010 to December 2018 were included. Patients with isolated tuberosity fracture dislocations or pathological fractures were excluded. Outcome measures were the Oxford Shoulder Score (OSS), EQ-5D-5L, return to work and radiological outcomes. Complications recorded included further surgery, loss of position/fixation, non-union/malunion and avascular necrosis.</p><p><strong>Results: </strong>Sixty-nine patients were included with a proximal humerus fracture dislocation in the study period; 48 underwent surgical management and 21 were managed successfully with closed reduction alone. The mean (SD) age of the cohort was 59.7 (±20.4), and 54% were male. Overall patients reported a mean OSS of 39.8 (±10.3), a mean EQ-5D utility score of 0.73 (±0.20), and 78% were able to return to work at a median of 1.2 months. There was a high prevalence of complications in both patients managed operatively or with closed reduction (25% and 38% respectively). In patients undergoing surgical management, 21% required subsequent surgery.</p><p><strong>Conclusion: </strong>Patient reported outcome measures post proximal humerus fracture dislocations do not return to normal population levels. Further, these injuries are associated with a high prevalence of complications. Appropriate patient counselling should be undertaken before embarking on definitive management.</p>","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":"143057856","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":"Decoding the RELARC trial - is D2 dissection sufficient in right colon cancer?","authors":"Zi Qin Ng, Satish Warrier","doi":"10.1111/ans.19421","DOIUrl":"https://doi.org/10.1111/ans.19421","url":null,"abstract":"","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":"143057852","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":"Patient and tumour characteristics in older patients (70 years or older) undergoing transperineal prostate biopsy: a retrospective cohort study.","authors":"Sean Lim, Shayan Soroush, Gavin Wei, Matthew Harper, Scott Donnellan, Weranja Ranasinghe","doi":"10.1111/ans.19417","DOIUrl":"https://doi.org/10.1111/ans.19417","url":null,"abstract":"<p><strong>Backgrounds: </strong>PSA screening is advocated in men with a life expectancy of >10 years. With a rising mean life expectancy of 81 years in Australia, many men in their 70s have life expectancies of >10 years. Additionally, advanced age is an independent risk factor for high grade prostate cancer. Hence, we aimed to identify patient and disease characteristics and outcomes of men >70 years undergoing transperineal prostate biopsies (TPB) for suspected prostate cancer.</p><p><strong>Methods: </strong>All patients aged 70 years old and above who underwent TPB for suspected prostate cancer between 1st January 2019 and 1st July 2022 at a large tertiary centre were identified. Data including patient Charlson Comorbidity Indices (CCI), pre-operative PSA, Multiparametric prostate MRI (mpMRI), histopathological results, subsequent intervention, and treatment intent (curative vs palliative) were obtained via scanned and electronic medical records.</p><p><strong>Results: </strong>Of 229 patients, median age was 74 years and 72.5% patients had a CCI of ≤4 (>53% estimated 10-year survival). 80.8% were diagnosed with prostate cancer and 65.9% had ISUP ≥ 2 disease. 86.4% of patients with PIRADS 4 or 5 lesions resulted in clinically significant prostate cancer. 3.9% had mild biopsy complications. 76.8% of those with prostate cancer underwent treatment with curative intent.</p><p><strong>Conclusion: </strong>Men >70 years of age have a higher risk of clinically significant prostate cancer and low biopsy risk. Hence, many may benefit from early diagnosis and treatment. Decision on screening and further investigation should be based on assessment of individual risks, benefits and life expectancy.</p>","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":"143057855","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 importance of medical management in acute type B aortic dissections.","authors":"Peregrine Narborough, Tin Ngan, Nisal Samaratunga, Timothy Shiraev","doi":"10.1111/ans.19401","DOIUrl":"https://doi.org/10.1111/ans.19401","url":null,"abstract":"","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":"143051013","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":"Vulvar varicosities: a painful presentation, but who should be managing them?","authors":"Larissa Dearie, Stacey Telianidis, Kalpa Perera","doi":"10.1111/ans.19363","DOIUrl":"https://doi.org/10.1111/ans.19363","url":null,"abstract":"","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":"143057860","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":"Enteroatmospheric fistula - tips, teats and tricks.","authors":"Wei Ming Ong, Reizal Mohd Rosli, Samiha Arulshankar, Wendy Sansom, Vinna An, Suat Chin Ng","doi":"10.1111/ans.19414","DOIUrl":"https://doi.org/10.1111/ans.19414","url":null,"abstract":"<p><p>Enteroatmospheric fistula is a severe complication associated with an open abdomen, and management of this can be challenging. This article describes a practical and accessible wound management option for enteroatmospheric fistula using a generic silicone bottle teat and vacuum-assisted closure dressing.</p>","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":"143057853","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":"Suture material in pancreticojejunal anastomosis: a systematic review.","authors":"Douglas Chung, Supun Bakmiwewa, Arul Suthananthan, Marwan Idrees","doi":"10.1111/ans.19408","DOIUrl":"https://doi.org/10.1111/ans.19408","url":null,"abstract":"<p><strong>Background: </strong>Post-operative pancreatic fistula is a common and morbid complication of pancreaticojejunal anastomosis. While gastrointestinal anastomosis is typically performed using absorbable sutures, this issue has prompted experimentation with non-absorbable sutures. This study aims to assess the available literature to provide recommendations on suture choice in this anastomosis.</p><p><strong>Methods: </strong>Two independent reviewers performed searches of EMBASE, MEDLINE, PubMed, Google Scholar, and the Cochrane Library of Systematic Review. References were screened for additional articles. Articles comparatively assessing suture choice in pancreaticojejunal anastomosis were included.</p><p><strong>Results: </strong>Of 2237 records screened, nine articles were included in this review. Suture materials assessed include polydioxanone, polyglactin 910, polyglycolic acid, polypropylene, polyester, silk, nylon, plain and chromic catgut, and polybutester. Clinical studies suggested polyester reduced rates of fistula formation. Ex vivo findings favoured polydioxanone and polyglactin 910. 5-0 was found to be favourable to 6-0 in duct-to-mucosa anastomosis with monofilament absorbable sutures. Barbed sutures were suggested to reduce fistula formation. Limitations were identified in many of the included articles.</p><p><strong>Conclusion: </strong>There is limited research available on this topic, and it is not possible to strongly recommend any single suture as superior to others. Polyester is promising in clinical studies, and would benefit from further studies assessing validity. Polydioxanone and polyglactin 910 have rational indications for use. In particular, polydioxanone is suggested when poor healing is expected. Barbed sutures may reduce rates of fistula formation. More research is required to draw a strong conclusion.</p>","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":"143057858","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":"Robotic versus laparoscopic colorectal surgery for patients with obesity: an updated systematic review and meta-analysis.","authors":"Tyler McKechnie, Jigish Khamar, Christopher Chu, Amin Hatamnejad, Ghazal Jessani, Yung Lee, Aristithes Doumouras, Nalin Amin, Dennis Hong, Cagla Eskicioglu","doi":"10.1111/ans.19319","DOIUrl":"https://doi.org/10.1111/ans.19319","url":null,"abstract":"<p><strong>Background: </strong>Obesity poses significant challenges in colorectal surgery, affecting operative difficulty and postoperative recovery. The choice of minimally invasive approach for this patient population remains a challenge during preoperative planning. This review aims to provide an updated synthesis of studies comparing laparoscopic and robotic approaches for adult patients with obesity undergoing colorectal surgery.</p><p><strong>Methods: </strong>MEDLINE, Embase and CENTRAL were searched up to August 2023. Articles were included if they compared laparoscopic and robotic colorectal surgery outcomes in adults with obesity (BMI ≥30 kg/m²). Outcomes included overall postoperative morbidity, conversion to laparotomy, and operative time. Inverse variance random-effects meta-analyses were used to pool effect estimates.</p><p><strong>Results: </strong>After screening 2187 citations, 10 observational studies were included with 3281 patients with obesity undergoing robotic surgery (mean age: 58.1 years, female: 43.9%) and 11 369 patients with obesity undergoing laparoscopic surgery (mean age: 58 years, female: 53.2%). Robotic surgery resulted in longer operative times (MD 46.71 min, 95% CI 33.50-59.92, p < 0.01, I² = 93.79%) with statistically significant reductions in conversions to laparotomy (RR 0.50, 95% CI 0.39-0.65, p < 0.01, I² = 67.15%). No significant differences were seen in postoperative morbidity (RR 0.94, 95% CI 0.82-1.08, p = 0.40, I² = 36.08%).</p><p><strong>Conclusion: </strong>These data suggest that robotic colorectal surgery in patients with obesity may reduce the risk for conversion to laparotomy, but at the expense of increased operative times and with no overt benefits in postoperative outcomes. Further high quality randomized controlled trials assessing the utility of robotic surgery in patients with obesity undergoing colorectal surgery are warranted.</p>","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":"143057857","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":"Synchronous gastric adenocarcinoma and gastrointestinal stromal tumour.","authors":"Preekesh Suresh Patel, Neville Angelo, Suheelan Kulasegaran","doi":"10.1111/ans.19395","DOIUrl":"https://doi.org/10.1111/ans.19395","url":null,"abstract":"","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":"143057859","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}