ANZ Journal of Surgery最新文献

{"title":"The Value of Procalcitonin in Early Diagnosis of Anastomotic Leak After Colorectal Surgery.","authors":"Imen Ben Ismail, Dhiaeddine Bilel, Hakim Zenaidi, Hana Fredj, Amel Mokline, Saber Rebii","doi":"10.1111/ans.70700","DOIUrl":"https://doi.org/10.1111/ans.70700","url":null,"abstract":"<p><strong>Background: </strong>Anastomotic leakage (AL) is the most feared complication after colorectal surgery, with high morbidity and mortality. Early detection remains challenging, as clinical and radiological signs are often delayed. This study aimed to evaluate the diagnostic value of procalcitonin (PCT) kinetics between postoperative days (POD) 1 and 3 in predicting AL after colorectal surgery.</p><p><strong>Methods: </strong>A prospective analytical study was conducted from January 2021 to January 2024 at the Department of General Surgery, Trauma and Burns Center, Ben Arous, Tunisia. Patients undergoing colorectal resection with immediate anastomosis were included. Serum levels of white blood cells (WBC), C-reactive protein (CRP), and PCT were measured on POD1 and POD3. The diagnostic performance of each marker and their kinetics was assessed using receiver operating characteristic (ROC) analysis.</p><p><strong>Results: </strong>Among 114 included patients, 11 (9.6%) developed an AL. Significant associations were found with older age (p = 0.038), absence of bowel preparation (p = 0.048), and manual anastomosis (p = 0.013). PCT and CRP levels at POD3 were significantly higher in patients with AL (p < 0.001). The optimal PCT cutoff at POD3 was 3.53 ng/mL (AUC = 0.85; sensitivity = 81%; specificity = 80%). The ΔPCT (POD3-POD1) > 0.51 ng/mL showed the best performance (AUC = 0.94). The combined variable (CRP + PCT at POD3) achieved an AUC = 0.95 and a negative predictive value of 98.9%.</p><p><strong>Conclusions: </strong>PCT kinetics between POD1 and POD3 are a reliable early predictor of AL after colorectal surgery. Combined monitoring of PCT and CRP improves diagnostic accuracy and may optimize postoperative management.</p>","PeriodicalId":8158,"journal":{"name":"ANZ Journal of Surgery","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2026-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147760113","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":"Reconsidering Laparoscopic Peritoneal Lavage for Hinchey III Perforated Diverticulitis: A Staged Pathway Hypothesis for Selected High-Capability Centres.","authors":"Ju Yong Cheong, Maseelan Naidoo, Heng Chin Chiam, Boris Ruggiero, Christian Beardsley, Esh Jeyarajan, Merwe Hartslief, Omar Mouline, Craig Moore, Tara Connelly, Jin Kim","doi":"10.1111/ans.70697","DOIUrl":"https://doi.org/10.1111/ans.70697","url":null,"abstract":"","PeriodicalId":8158,"journal":{"name":"ANZ Journal of Surgery","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2026-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147760616","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":"Wide-Awake Local Anaesthesia No Tourniquet Hand Surgery in Australia: An Analysis of Adoption, Perceptions and Implementation in a Global Context.","authors":"Freya Roberts, Brett McClelland, Ali Gholamrezaei, Dion Sandoz, Elisabet Hagert, Tanya Burgess","doi":"10.1111/ans.70707","DOIUrl":"https://doi.org/10.1111/ans.70707","url":null,"abstract":"<p><strong>Background: </strong>Wide-awake local anaesthesia no tourniquet (WALANT) is increasingly used globally for hand surgery, offering clinical and operational benefits. However, its adoption in Australia remains understudied. This study assessed current WALANT usage among Australian hand surgeons to identify key factors influencing its implementation.</p><p><strong>Methods: </strong>A national cross-sectional survey of all Australian Hand Surgery Society (AHSS) active members (n = 164) was conducted in 2024. The survey examined current WALANT use, perceived benefits and drawbacks, as well as facilitators and barriers of incorporation into practice. Quantitative data were analysed using descriptive and inferential statistics and qualitative data were analysed thematically.</p><p><strong>Results: </strong>Sixty-eight surgeons responded (41% response rate). Seventy percent had performed WALANT at least once, and 50% incorporated it in practice. Current WALANT use was associated with hand surgery fellowship (OR = 8.7), prior WALANT exposure during training (OR = 6.1) and practice in university/teaching hospital (OR = 3.2). Respondents highlighted avoidance of general anaesthesia, shorter recovery, improved patient satisfaction and lower costs as benefits. Conversely, workflow inefficiencies, limited outpatient infrastructure, concerns over anaesthetist scheduling and remuneration and the absence of dedicated billing codes were the dominant barriers. Non-users viewed WALANT as more complex and remained wary of adrenaline safety, whereas users perceived more benefits and reported few technical concerns.</p><p><strong>Conclusion: </strong>WALANT is used by a substantial proportion of Australian hand surgeons, but broader adoption is limited by systemic and institutional barriers contributing to a perception gap. Training, infrastructure, policy reform, appropriate funding mechanisms and interprofessional collaboration may support wider integration of WALANT in Australia.</p>","PeriodicalId":8158,"journal":{"name":"ANZ Journal of Surgery","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2026-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147760291","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":"Assessment of Quality and Content in Hernia-Related Short Videos on TikTok and Bilibili.","authors":"Xiaoyang Shi, Xiangda Meng, Yongqiang Li, Yu-Jun Xiong","doi":"10.1111/ans.70702","DOIUrl":"https://doi.org/10.1111/ans.70702","url":null,"abstract":"<p><strong>Background: </strong>Hernia imposes a growing global and national disease burden, yet public understanding remains limited. Short-video platforms such as TikTok and Bilibili have become major sources of health information in China, but the quality and reliability of hernia-related content have not been systematically evaluated.</p><p><strong>Methods: </strong>Hernia-related videos were retrieved from TikTok and Bilibili between November 15 and 20, 2025. After excluding irrelevant, duplicate, and promotional content, 184 videos were included. Video characteristics, uploader categories, and engagement metrics were collected. Content themes were categorized, and quality was assessed using the Global Quality Score (GQS), modified DISCERN, Patient Education Materials Assessment Tool (PEMAT-U/A), and Journal of the American Medical Association (JAMA) benchmark criteria. Group comparisons were performed using the Mann-Whitney U test, and associations were examined via Spearman correlation.</p><p><strong>Results: </strong>TikTok videos showed significantly higher engagement (likes and comments, both p < 0.01) but were shorter in duration compared with Bilibili. Professional physicians produced 98% of TikTok videos, whereas non-professionals contributed 56% of Bilibili content. TikTok demonstrated higher scores in mDISCERN, PEMAT-A, and JAMA benchmarks (all p < 0.05), though overall GQS scores remained low on both platforms. Longer videos were modestly associated with higher GQS (r = 0.35) and PEMAT-U (r = 0.34). Engagement indicators did not correlate with quality metrics.</p><p><strong>Conclusion: </strong>Hernia-related content on TikTok and Bilibili exhibits a clear trade-off: TikTok achieves greater reach but offers limited educational depth, while Bilibili supports more comprehensive content with lower engagement.</p>","PeriodicalId":8158,"journal":{"name":"ANZ Journal of Surgery","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2026-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147760583","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":"Tale of Two Centres-Exploring Bedside Challenges to Implementing a Clinical Quality Registry for Abdominal Wall Hernias in Metropolitan Australia.","authors":"Edward Young, Doug Fenton-Lee, Julian Süsstrunk, Jorgen Ferguson, Matthew Amprayil, Yijie Yin, Rabieh Abu Assi, Alex Karatassas, Sanjeev Khurana, Chrys Hensman, Andrew Tse, Hamish Urquhart, Reginald V N Lord, Jean Wong, Darren Tonkin, Markus Trochsler, Guy J Maddern","doi":"10.1111/ans.70694","DOIUrl":"https://doi.org/10.1111/ans.70694","url":null,"abstract":"<p><strong>Background: </strong>In an effort to improve hernia care and mesh product surveillance, the Australia and New Zealand Hernia Society (ANZ Hernia) has been setting up a prototype binational learning healthcare system virtual clinical quality registry (CQR) for clinical use. The aim of this study was to assess the feasibility for clinicians to enrol patients for a prototype hernia CQR in a typical clinical environment across two metropolitan centres in Australia.</p><p><strong>Methods: </strong>All English-speaking adult patients with capacity to consent and who were being managed for abdominal wall hernias by participating clinicians at the Queen Elizabeth Hospital (Adelaide) or at St Vincent's Private Hospital (Sydney) during specified periods were eligible for inclusion. Participating clinicians were recruited and encouraged to provide feedback. The total number of eligible patients for each recruitment period was determined from clinical records. The literature was reviewed to summarise existing hernia registries.</p><p><strong>Results: </strong>Over a continuous 6-month recruitment period, the conditional recruitment rate of eligible patients encountered by participating clinicians was 34.7% (25 of 74) at TQEH (07/08/2024-02/02/2025) and 48.7% (58 of 119) at SVPHS (15/08/2025-10/02/2025). In the absence of incentives and sustained funding, clinician goodwill alone was insufficient to achieve the minimal standards required by the Australian Commission on Safety and Quality in Health Care for CQRs. An in-depth analysis of the CQR was conducted.</p><p><strong>Conclusion: </strong>The prototype ANZ Hernia CQR would benefit from a redesign to address the structural issues identified, if meaningful system-wide quality improvement is to be delivered across Australia and New Zealand as envisioned.</p>","PeriodicalId":8158,"journal":{"name":"ANZ Journal of Surgery","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2026-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147760581","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":"Intrahepatic Cholangiocarcinoma Surgery Outcomes and Survival Factors in an Opisthorchis viverrini-Endemic Area.","authors":"Nisit Tongsiri, Rawin Ingsirorat","doi":"10.1111/ans.70704","DOIUrl":"https://doi.org/10.1111/ans.70704","url":null,"abstract":"<p><strong>Background: </strong>Cholangiocarcinoma (CCA) is a malignancy of the bile duct epithelium. Its incidence is highest in Northeast Thailand, where it is strongly associated with Opisthorchis viverrini (OV) infection. The only curative treatment for intrahepatic cholangiocarcinoma (IHCCA), the most common subtype, is surgical resection. This study aimed to investigate survival outcomes and identify factors associated with long-term survival in resectable IHCCA patients in the high-incidence of OV infection.</p><p><strong>Methods: </strong>This retrospective cohort study included all patients who underwent curative-intent hepatic resection for pathologically confirmed IHCCA at Sakon Nakhon Hospital between January 2016 and December 2023. Survival was analysed using Kaplan-Meier method. Univariate and multivariate Cox proportional hazard regression models were used to identify prognosis factors.</p><p><strong>Results: </strong>A total of 63 patients were included. The 30-day and 90-day mortality rate were 1.6% and 6.3%, respectively. The median overall survival was 28.5 months (95% CI: 13.79-43.13). The 1-year, 3-year, and 5-year survival rates were 71.1%, 43.5%, and 30.1%, respectively. In the multivariate analysis, factors significantly associated with poorer survival were advanced disease (Stages III and IV) (adjusted hazard ratios [aHR] = 3.37; 95% CI: 1.63-6.97) and lymphovascular invasion (LVI) (aHR = 2.55; 95% CI: 1.27-5.11).</p><p><strong>Conclusion: </strong>The median survival and 5-year survival in this study are consistent with outcomes from previous studies. Advanced disease stage and the presence of LVI are independent predictors of poor survival.</p>","PeriodicalId":8158,"journal":{"name":"ANZ Journal of Surgery","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2026-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147760558","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":"Re: Cost of Managing Proximal Humerus Fractures in Road Traffic Injuries.","authors":"Malik Zubair Hussain, Majid Khattak, Anas Ahmad, Kumail Abbas","doi":"10.1111/ans.70703","DOIUrl":"https://doi.org/10.1111/ans.70703","url":null,"abstract":"","PeriodicalId":8158,"journal":{"name":"ANZ Journal of Surgery","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2026-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147760588","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 \"Impact of Surgical Approach on Survival and Recurrence in Borderline and Malignant Phyllodes Tumours: A Systematic Review and Meta-Analysis\".","authors":"Shiyuan Li, Weijie Zhou, Yuxin Ye, Ziyi Yu, Ruihang Luo","doi":"10.1111/ans.70701","DOIUrl":"https://doi.org/10.1111/ans.70701","url":null,"abstract":"","PeriodicalId":8158,"journal":{"name":"ANZ Journal of Surgery","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2026-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147760627","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":"Preoperative Frailty Screening in Head and Neck Cancer: A Prospective Comparison of Three Assessment Tools.","authors":"Prithvi Santana, Alec Patfield, Rebecca Venchiarutti, Timothy Manzie, Jonathan R Clark, Tsu-Hui Hubert Low, Michael S Elliott, James Wykes","doi":"10.1111/ans.70693","DOIUrl":"https://doi.org/10.1111/ans.70693","url":null,"abstract":"<p><strong>Background: </strong>Whilst guidelines recommend routine frailty screening for elderly patients with head and neck cancer (HNC), no consensus exists on the preferred tool to predict postoperative morbidity. The aim of this study was to assess the predictive capacity of three validated frailty screening tools for postoperative complications in patients undergoing major ablative and reconstructive head and neck surgery.</p><p><strong>Methods: </strong>A prospective cohort of 50 patients aged ≥ 70 years undergoing major ablative and reconstructive HNC surgery was recruited from a single institution in Sydney, Australia. Patients completed three frailty assessment tools pre-operatively: the Clinical Frailty Scale (CFS), Modified Frailty Index-5 (mFI-5) and Modified Frailty Index-11 (mFI-11). Postoperative complications were recorded using the Clavien-Dindo Classification (CDC) and the Comprehensive Complication Index (CCI). Logistic regression and ROC analysis were used to assess predictive performance.</p><p><strong>Results: </strong>The CFS increased the odds of severe (CDC ≥ 3) complications five-fold (OR 5.16, 95% CI 1.12, 23.69; AUC 0.70; cut-off 5). Age ≥ 86 years was also a significant predictor of severe complications (OR = 9.00, 95% CI: 1.79, 45.19, p = 0.008, AUC = 0.71), though limited by prevalence. The mFI-5 and mFI-11 demonstrated limited predictive utility for severe complications (AUC = 0.30 and 0.58, respectively).</p><p><strong>Conclusion: </strong>CFS provided the greatest accuracy in predicting severe complications after free-flap surgery, with high specificity and negative predictive value. Age ≥ 86 years also confers high risk. Incorporating CFS into preoperative pathways may guide surgical decision-making and perioperative interventions to improve patient outcomes.</p>","PeriodicalId":8158,"journal":{"name":"ANZ Journal of Surgery","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2026-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147760562","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":"Ambient Artificial Intelligence Scribes: A Reality Check-Insights From Two RCTs.","authors":"Nagendra N Dudi-Venkata, Ian Hastie, Satish Warrier, Alexander Heriot, Sandeep Reddy","doi":"10.1111/ans.70699","DOIUrl":"https://doi.org/10.1111/ans.70699","url":null,"abstract":"","PeriodicalId":8158,"journal":{"name":"ANZ Journal of Surgery","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2026-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147760651","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}