ANZ Journal of Surgery最新文献_第4页

A Retrospective Cohort Study to Predict Early Recurrence in Colorectal Liver Metastases Using a Nomogram Model. 使用Nomogram模型预测结直肠肝转移早期复发的回顾性队列研究。

IF 1.5 4区医学

ANZ Journal of Surgery Pub Date : 2025-06-16 DOI: 10.1111/ans.70195

Deng Zhao Wu, Zan Zhang, Joseph Mugaanyi

{"title":"A Retrospective Cohort Study to Predict Early Recurrence in Colorectal Liver Metastases Using a Nomogram Model.","authors":"Deng Zhao Wu, Zan Zhang, Joseph Mugaanyi","doi":"10.1111/ans.70195","DOIUrl":"https://doi.org/10.1111/ans.70195","url":null,"abstract":"Background: The incidence of colorectal liver metastases (CRLM) is rising, with only a subset of patients eligible for intent-to-cure treatment. Among these, up to 67% experience recurrence, with a worse prognosis for those with early recurrence. Reliable predictive models for early recurrence are needed.Objective: To identify predictive factors for early recurrence in CRLM patients, construct a nomogram, and compare its predictive performance against a clinical risk score (CRS) model.Methods: This study analyzed 240 CRLM patients who underwent intent-to-cure treatment at our center between January 2019 and August 2024. After applying inclusion and exclusion criteria, 198 patients were included. CRSs were calculated, and independent predictors of early recurrence were identified using univariate and multivariate Cox regression analyses. The nomogram model was evaluated using receiver operating characteristic (ROC) analysis, calibration, and decision curve analysis.Results: Significant predictors of early recurrence included primary tumor location (p = 0.0014), primary tumor T stage (p = 0.0015), M stage (p = 0.0298), number of liver metastases (p = 0.003), metastatic tumor size (p = 0.0041), efficacy of neoadjuvant chemotherapy (p = 0.0043), and RAS mutation (p < 0.001). Independent predictors were primary tumor location, RAS mutation, number of metastases, and metastatic tumor size (p = 0.0047, p = 0.0116, p = 0.0423, and p < 0.0001, respectively). The nomogram model significantly outperformed the CRS model (AUC 0.790 vs. 0.604, p < 0.0001) and demonstrated superior clinical utility in decision curve analysis.Conclusions: Primary tumor location, RAS mutation, and the extent of liver metastases are independent predictors of early recurrence in CRLM patients post-treatment. A nomogram integrating these factors demonstrated strong predictive performance, making it a practical tool for clinicians.","PeriodicalId":8158,"journal":{"name":"ANZ Journal of Surgery","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144301072","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

A Retrospective Study on Use of Neutrophil-Lymphocyte Ratio as a Prognostic Measurement to Assess Acute Diverticulitis. 中性粒细胞-淋巴细胞比值作为评估急性憩室炎预后指标的回顾性研究。

IF 1.5 4区医学

ANZ Journal of Surgery Pub Date : 2025-06-13 DOI: 10.1111/ans.70220

Yam Ting Ho, Omattage M Perera, Femi E Ayeni, Harrison Gregory, Hugh McMahon, Punkaja M S Amarasekera, Yi-Che Chan, Jia Han Chang, Tzu Yi Chuang, Peter J Coverdale

{"title":"A Retrospective Study on Use of Neutrophil-Lymphocyte Ratio as a Prognostic Measurement to Assess Acute Diverticulitis.","authors":"Yam Ting Ho, Omattage M Perera, Femi E Ayeni, Harrison Gregory, Hugh McMahon, Punkaja M S Amarasekera, Yi-Che Chan, Jia Han Chang, Tzu Yi Chuang, Peter J Coverdale","doi":"10.1111/ans.70220","DOIUrl":"https://doi.org/10.1111/ans.70220","url":null,"abstract":"Background: Acute diverticulitis (AD) is a common surgical condition and the Neutrophil-lymphocyte ratio (NLR) is an emerging biomarker ratio used to guide its management. The aim of this study is to validate and assess the utility of the NLR in AD in the Australian population.Methods: This is a single centre retrospective observational study of patients who presented to the emergency department with the diagnosis of AD between September 2018 and September 2023, in Ipswich, Queensland. One thousand five hundred and forty patients were screened against exclusion/inclusion criteria and 634 patients were available for analysis.Results: The study identified NLR, CRP (C-reactive protein) and age to be significant coefficients in predicting length of stay (LOS) in regression analysis. NLR (OR1.06, p < 0.001) and CRP (OR1.01, p < 0.001) were significant predictors for surgical management of diverticulitis. NLR was found to be superior predictor of surgical management in ROC analysis (AUC 0.75, sensitivity 65%, specificity 75%, p < 0.001) compared to CRP, but both were equivalent in predicting for diverticulitis severity and percutaneous drainage. Further analysis revealed NLR between those receiving surgery, percutaneous drainage and readmission (One-way ANOVA) and NLR between modified Hinchey classifications were also significantly different (Mann-Whitney U).Conclusion: In this study, we have further validated the effectiveness of NLR as a diagnostic marker. In particular, NLR is superior to CRP in predicting surgical management. It has also proven useful to predict for LOS, disease severity and percutaneous drainage. NLR usage should be encouraged in the clinical setting as it is simple and effective.","PeriodicalId":8158,"journal":{"name":"ANZ Journal of Surgery","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144282261","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

Adult Caecal Intussusception: Diagnosis and Management Insights. 成人盲肠肠套叠：诊断和管理见解。

IF 1.5 4区医学

ANZ Journal of Surgery Pub Date : 2025-06-12 DOI: 10.1111/ans.70217

Mira M Sobhy, John Woodfield

引用次数: 0

Treatment of Abductor Deficiency Post Total Hip Arthroplasty Using Gluteus Maximus Transfer and Cortical Button Fixation. 臀大肌转移和皮质钮扣固定治疗全髋关节置换术后外展肌缺损。

IF 1.5 4区医学

ANZ Journal of Surgery Pub Date : 2025-06-11 DOI: 10.1111/ans.70215

Marc-James Friso, Jitendara Balakumar, Lachlan Milne

{"title":"Treatment of Abductor Deficiency Post Total Hip Arthroplasty Using Gluteus Maximus Transfer and Cortical Button Fixation.","authors":"Marc-James Friso, Jitendara Balakumar, Lachlan Milne","doi":"10.1111/ans.70215","DOIUrl":"https://doi.org/10.1111/ans.70215","url":null,"abstract":"Background and aims: Abductor deficiency in the setting of total hip arthroplasty (THA) can cause pain, poor function, and instability. Multiple treatment approaches exist for each stage of muscle and tendon disease. Transfer of a portion of gluteus maximus to the greater trochanter is a burgeoning procedure for irreparable gluteal deficiency. Described techniques for securing the flap to the trochanter can be compromised in the setting of bone loss and can contribute to bone loss themselves. This study aimed to describe the use of a polyethylene suture tape and cortical button for fixation of a gluteus maximus flap and provide early evidence for its equivalence to published techniques.Methods: The surgical technique is described. A consecutive series of patients undergoing gluteus maximus transfer for abductor deficiency in the setting of total hip arthroplasty were assessed using visual analog scales (VAS) for pain, patient satisfaction, gait parameters, and magnetic resonance imaging (MRI) assessment of flap healing.Results: There were five patients available for review at an average of 9 months post surgery. Mean VAS pain improved from 8 to 3. The majority would have the procedure performed again. Use of a gait aid improved in the patients that required one. All MRIs demonstrated graft incorporation.Conclusions: Securing the transfer of the anterior third of gluteus maximus using polyethylene suture tape and cortical button suspensory fixation results in flap healing to the recipient site. Clinical results obtained in patients undergoing this modified technique are consistent with the published results, supporting its use.","PeriodicalId":8158,"journal":{"name":"ANZ Journal of Surgery","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144265164","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

How to Do a Robotic Assisted Prostatectomy in Patients With Pre-Existing Inflatable Penile Prosthesis. 如何在已有充气阴茎假体的患者中进行机器人辅助前列腺切除术。

IF 1.5 4区医学

ANZ Journal of Surgery Pub Date : 2025-06-11 DOI: 10.1111/ans.70216

Hedda Cooper, Jodie McDonald, Emma Clarebrough, Jeremy Goad

引用次数: 0

A Double Blind Randomised Controlled Trial Comparing Glenohumeral Cortisone With and Without Hydrodilatation in Patients With Frozen Shoulder. 一项双盲随机对照试验比较肩关节可的松在肩周炎患者中的应用。

IF 1.5 4区医学

ANZ Journal of Surgery Pub Date : 2025-06-11 DOI: 10.1111/ans.70200

Alastair Konarski, Kishen Narayanasamy, Jennifer Coghlan, Timothy Chung, Matthew Andrews, Simon Bell

{"title":"A Double Blind Randomised Controlled Trial Comparing Glenohumeral Cortisone With and Without Hydrodilatation in Patients With Frozen Shoulder.","authors":"Alastair Konarski, Kishen Narayanasamy, Jennifer Coghlan, Timothy Chung, Matthew Andrews, Simon Bell","doi":"10.1111/ans.70200","DOIUrl":"https://doi.org/10.1111/ans.70200","url":null,"abstract":"Background: Frozen shoulder (FS) is a common condition causing pain and stiffness in the shoulder. There is controversy over whether hydrodilatation (HD) gives improved outcomes compared to corticosteroid injection (CSI) alone. The aim of this study was to investigate if HD improves outcomes compared to CSI alone.Methods: This was a double-blinded RCT. Patients aged 18-90 with FS were included. The CSI group received an injection of contrast followed by local anaesthetic and steroid. The HD group received the same, followed by saline until capsular rupture or severe resistance. The primary outcome was pain-free range of motion (ROM), along with Shoulder Pain and Disability Index (SPADI) 8 weeks post-intervention, and American Shoulder and Elbow Surgeons Score (ASES), Simple Shoulder Test (SST) and Constant score.Results: Seventy-nine patients were included, with a mean age of 54 (29-70), 53% female. The ROM and SPADI improved in both groups (CSI from 57.4 to 35.8, HD from 57.7 to 32.7) along with ASES, SST and Constant. There were no significant differences between the groups at 8 weeks. HD was found to be more painful than CSI. Male patients achieved greater improvement in ER with HD, while females, patients with severe pain at presentation, and symptoms for less than 120 days favoured CSI.Conclusion: Both groups significantly improved, but there were no significant differences between the groups, although there were some differences between subgroups. We recommend tailoring the first-line treatment according to patient symptoms and baseline characteristics.","PeriodicalId":8158,"journal":{"name":"ANZ Journal of Surgery","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144265161","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

Evaluating Artificial Intelligence in Patient Education: DeepSeek-V3 Versus ChatGPT-4o in Answering Common Questions on Laparoscopic Cholecystectomy. 评估患者教育中的人工智能：DeepSeek-V3与chatgpt - 40在回答腹腔镜胆囊切除术中的常见问题

IF 1.5 4区医学

ANZ Journal of Surgery Pub Date : 2025-06-11 DOI: 10.1111/ans.70198

Hilmi Anil Dincer, Dogukan Dogu

{"title":"Evaluating Artificial Intelligence in Patient Education: DeepSeek-V3 Versus ChatGPT-4o in Answering Common Questions on Laparoscopic Cholecystectomy.","authors":"Hilmi Anil Dincer, Dogukan Dogu","doi":"10.1111/ans.70198","DOIUrl":"https://doi.org/10.1111/ans.70198","url":null,"abstract":"Background: Artificial intelligence-based large language models (AI-based LLMs) have gained popularity over traditional search engines for obtaining medical information. However, the accuracy and reliability of these AI-generated medical insights remain a topic of debate. Recently, a new AI-based LLM, DeepSeek-V3, developed in East Asia, has been introduced. The aim of this study is to evaluate the appropriateness, accuracy, and readability of responses and the usability of these answers for patient education provided by ChatGPT-4o and DeepSeek-V3 AI-based LLMs to frequently asked questions by patients regarding laparoscopic cholecystectomy (LC).Methods: The 20 most frequently asked questions by patients regarding LC were presented to the DeepSeek-V3 and ChatGPT-4o chatbots. Before each question, the search history was deleted. The comprehensiveness of the responses was evaluated based on clinical experience by two board-certified general surgeons experienced in hepatobiliary surgery using a Likert scale. Paired sample t-test and Wilcoxon signed rank test were used. Inter-rater reliability was analyzed with Cohen's Kappa test.Results: The DeepSeek-V3 chatbot provided statistically significantly more suitable responses compared to ChatGPT-4o (p = 0.033). On the Likert scale, DeepSeek-V3 received a 5-point rating for 19 out of 20 questions (95%), whereas ChatGPT-4o achieved a 5-point rating for only 13 questions (65%). Based on the evaluation conducted according to the reviewers' clinical experience, DeepSeek-V3 provided statistically significantly more appropriate responses (p = 0.008).Conclusion: Released in January 2025, DeepSeek-V3 provides more suitable responses to patient inquiries regarding LC compared to ChatGPT-4o.","PeriodicalId":8158,"journal":{"name":"ANZ Journal of Surgery","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144265162","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

Trends and Predictors of Total Neoadjuvant Therapy in Rectal Cancer: A Bi-National Registry Study Across Australia and New Zealand. 直肠癌新辅助治疗的趋势和预测因素：澳大利亚和新西兰的两国注册研究。

IF 1.5 4区医学

ANZ Journal of Surgery Pub Date : 2025-06-10 DOI: 10.1111/ans.70218

Ishraq Murshed, Sergei Bedrikovetski, Zachary Bunjo, Hidde M Kroon, Michelle Thomas, Tarik Sammour

{"title":"Trends and Predictors of Total Neoadjuvant Therapy in Rectal Cancer: A Bi-National Registry Study Across Australia and New Zealand.","authors":"Ishraq Murshed, Sergei Bedrikovetski, Zachary Bunjo, Hidde M Kroon, Michelle Thomas, Tarik Sammour","doi":"10.1111/ans.70218","DOIUrl":"https://doi.org/10.1111/ans.70218","url":null,"abstract":"Background: Total Neoadjuvant Therapy (TNT) has significantly improved outcomes in locally advanced rectal cancer. Despite rising use and inclusion in international guidelines, adoption patterns in Australia and New Zealand (ANZ) remain unclear. This study determines bi-national patterns and predictors of TNT utilisation over a 6-year period.Methods: A retrospective population-based bi-national registry cohort study analysed data from the ANZ Bowel Cancer Outcome Registry from 2018 to 2024. Patients diagnosed with primary locally advanced rectal cancer (LARC) and treated with standard neoadjuvant therapy (SNT), consisting of long-course chemoradiotherapy or short-course radiotherapy, or TNT were included. The primary outcome was the incidence of TNT utilisation over time and determining pre-treatment predictive factors.Results: Of 33 270 patient entries, 3234 eligible LARC patients were identified, with 706 (21.8%) receiving TNT and 2528 (78.2%) receiving SNT. TNT usage increased from 11% in 2018 to 41% in 2023. On multivariable logistic regression, independent factors associated with decreased TNT use were older age (OR: 0.978, 95% CI: 0.970-0.985, p < 0.001), absence of multidisciplinary team discussion (OR: 0.113, 95% CI: 0.027-0.472, p = 0.003) and private health insurance (OR: 0.619, 95% CI: 0.441-0.869, p = 0.006). Factors associated with increased TNT use were clinical T4 tumours (OR: 2.020, 95% CI: 1.245-3.280, p = 0.004), node-positive status (OR: 1.481, 95% CI: 1.118-1.964, p = 0.006) and diagnosis during the years 2019-2023 (p < 0.05 for all).Conclusions: TNT is increasingly used in surgical rectal cancer patients captured in the BCOR in ANZ. This study provides a baseline for future benchmarking patterns of rectal cancer management.","PeriodicalId":8158,"journal":{"name":"ANZ Journal of Surgery","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144257249","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

Vision & the Ageing Surgeon: A Review. 视力与老年外科医生：综述。

IF 1.5 4区医学

ANZ Journal of Surgery Pub Date : 2025-06-10 DOI: 10.1111/ans.70213

Lloyd R Kopecny, Ashish Agar, Shing Wai Wong

{"title":"Vision & the Ageing Surgeon: A Review.","authors":"Lloyd R Kopecny, Ashish Agar, Shing Wai Wong","doi":"10.1111/ans.70213","DOIUrl":"https://doi.org/10.1111/ans.70213","url":null,"abstract":"Populations in the developed world are ageing and their surgeons are no exception. Accurate vision is essential for the surgeon to operate effectively, yet optimal vision has an expiry date in advancing age. This review examines the effects of ageing on the eye with particular focus on the visual changes of significance to senior surgeons who currently account for 20%-25% of the surgeon workforce. The major age-related diseases of the eye, which include cataracts, glaucoma, age-related macular degeneration and diabetic retinopathy, are surmised; together with physiologic ocular changes that accompany normal ageing, including loss of accommodation (presbyopia), reduced pupil size (senile miosis), reduced contrast sensitivity, and impaired binocular vision, amongst others. The aforementioned conditions may impair operative visualisation in the elderly surgeon and potentially impact surgical performance. Strategies and available technologies that support operative visualisation-particularly magnification aids, illumination systems and fluorescent dyes in surgery-are appraised with consideration to the senior surgeon who may be affected by the aforementioned visual changes associated with ageing. To inform minimum standards of visual function for safe surgical practice, future prospective studies are needed which report on individual surgeon-related measures of visual function together with postoperative outcomes. This vein of future research will allow for an evidence-based evaluation of proposed safety measures for which the data are currently lacking, thereby providing clarity regarding whether requisite age-based visual assessments improve surgical outcomes, and if so, at what age and frequency should such evaluations take place.","PeriodicalId":8158,"journal":{"name":"ANZ Journal of Surgery","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144257250","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

I Feel It in My Finger: Intraneural Lipoma of the Digital Nerve. 我感觉它在我的手指：指神经神经内脂肪瘤。

IF 1.5 4区医学

ANZ Journal of Surgery Pub Date : 2025-06-05 DOI: 10.1111/ans.70209

Brett Sacks, Sally Ng

引用次数: 0