ANZ Journal of Surgery最新文献

{"title":"Artificial intelligence and surgical radiology – how it is shaping real-world management","authors":"Victor Chai MBBS(Hons), Lara Wirth, Ke Cao MSc, Lincoln Lim MBBS (Hons), MCHSM, Justin Yeung FRACS","doi":"10.1111/ans.19256","DOIUrl":"10.1111/ans.19256","url":null,"abstract":"","PeriodicalId":8158,"journal":{"name":"ANZ Journal of Surgery","volume":"94 11","pages":"1894-1896"},"PeriodicalIF":1.5,"publicationDate":"2024-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142493546","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":"Small bowel obstruction secondary to barbed sutures: a few more tricks to have fewer complications.","authors":"Guglielmo Stabile, Laura Vona, Stefania Carlucci, Luigi Nappi","doi":"10.1111/ans.19286","DOIUrl":"https://doi.org/10.1111/ans.19286","url":null,"abstract":"","PeriodicalId":8158,"journal":{"name":"ANZ Journal of Surgery","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2024-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142493518","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":"Pneumatosis cystoides intestinalis – an endoscopic rarity","authors":"Wei Ming Ong MBBS (Hons), Suat Chin Ng Masters of Surgery, MBBS and BioMedSc","doi":"10.1111/ans.19217","DOIUrl":"10.1111/ans.19217","url":null,"abstract":"","PeriodicalId":8158,"journal":{"name":"ANZ Journal of Surgery","volume":"94 11","pages":"2073-2074"},"PeriodicalIF":1.5,"publicationDate":"2024-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142493516","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":"Intra-operative neuromonitoring in paediatric spinal deformity surgery: a retrospective single-centre experience.","authors":"Norine Ma, Ann Saunders, Laura Moylan, Michael B Johnson, Monique Ryan, Eppie Yiu, Susan Liew","doi":"10.1111/ans.19279","DOIUrl":"https://doi.org/10.1111/ans.19279","url":null,"abstract":"<p><strong>Introduction: </strong>Intra-operative neuromonitoring including somatosensory evoked potentials, motor evoked potentials, and electromyography, have replaced the Stagnara wake-up test to allow early detection of neurological change during paediatric spinal deformity surgery. It is important for surgeons to recognize alerts triggered by loss of these potentials and act accordingly to prevent iatrogenic neurological damage intra-operatively. This study was conducted to determine the sensitivity and specificity of neuromonitoring alerts in paediatric spinal deformity correction surgery.</p><p><strong>Methods: </strong>A retrospective single-centre study of all patients undergoing spinal deformity surgery at a tertiary paediatric centre between 1 January 2017 and 31 December 2020 (inclusive) was conducted. Neuromonitoring alerts were identified through neurophysiology documentation, and these were correlated with neurological deficits documented in the patient record post-operatively.</p><p><strong>Results: </strong>A total of 399 operations were included in the study, with 147 (35.7%) of these having a motor, or motor and sensory alert triggered. Fifteen (10.2% of alerts) of these patients had a post-operative neurological deficit, compared to seven (2.8% of no alerts) of those that had no neuromonitoring alert. The sensitivity for post-operative neurological deficits not resolving within 3 days was 100%, and the specificity was 65.5%.</p><p><strong>Conclusion: </strong>Intra-operative neuromonitoring is highly sensitive to post-operative neurological deficits lasting longer than 3 days. However, there is still scope for optimization of specificity, with many false positives identified.</p>","PeriodicalId":8158,"journal":{"name":"ANZ Journal of Surgery","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2024-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142493513","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":"Effectiveness of prophylactic central compartment neck dissection following Hemithyroidectomy in papillary thyroid cancer: a meta-analysis.","authors":"P Zhao, L-L Liang, Y-B Luo, Q-K Liang, B-D Xiang","doi":"10.1111/ans.19210","DOIUrl":"10.1111/ans.19210","url":null,"abstract":"<p><strong>Introduction: </strong>In this study, we aimed to assess the effect of prophylactic central compartment neck dissection (pCCND) in conjunction with hemithyroidectomy (HT) for clinically low-risk node-negative (cN0) papillary thyroid carcinoma (PTC).</p><p><strong>Methods: </strong>A thorough literature search was performed utilizing PubMed and EMBASE for articles published until October 2023. Subsequently, a meta-analysis was performed on studies involving patients with cN0 PTC, with postoperative locoregional recurrence (LRR) and survival data, treated with HT + pCCND or HT. The study was registered with PROSPERO (CRD42024560962).</p><p><strong>Results: </strong>We included seven studies in this meta-analysis, including 2132 patients who met the inclusion criteria: six retrospective cohort studies and one randomized controlled trial. The HT + pCCND group consisted of 1090 cases, and the HT group had 1042 cases. The LRR rates after HT with or without pCCND were similar (3.58% vs. 4.51%; odds ratio (OR) = 0.65; 95% confidence interval (CI) = 0.41-1.03). Five of the seven studies provided prognostic and survival data, particularly the log hazard ratio (log HR) of disease-free survival (DFS) between the two groups. There was also no significant difference in terms of DFS between the HT + pCCND and HT groups (OR = 0.67; 95% CI = 0.42-1.07).</p><p><strong>Conclusions: </strong>There was no significant difference in LRR and DFS between the HT + pCCND and HT groups. pCCND did not demonstrate significant efficacy in improving oncological outcomes for low-risk patients with cN0 PTC. Therefore, for patients with low-risk cN0 PTC, thyroid surgeons should make reasonable and individualized decisions regarding the extent of surgical removal.</p>","PeriodicalId":8158,"journal":{"name":"ANZ Journal of Surgery","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2024-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142456688","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":"An invisible knife to add to your toolkit: a narrative review of how podcasts have audibly shaped, styled, and sharpened surgical education","authors":"Kristy Mansour MD, MTrauma,&nbsp;Christopher Neasey MBBS,&nbsp;Jordan Hamilton MBBS, MTrauma,&nbsp;Denna Fryer MChD, MPhil,&nbsp;Caitlin Pailthorpe MBBS, MSurg,&nbsp;Debra Nestel AM, PhD, FSSH","doi":"10.1111/ans.19240","DOIUrl":"10.1111/ans.19240","url":null,"abstract":"<p>Podcasts as a mobile learning platform to augment surgical expertise and dialogue have been embraced by many surgical educators and learners. Podcasts are digital audio files that can be streamed or downloaded from the internet to individual devices. Surgical podcast literature was appraised with a search using the keywords ‘surgery’ AND ‘podcast’ in the PubMed database which found 639 results with titles and abstracts screened to identify and review 28 relevant articles. This narrative review explores podcast origins, aims, structure and availability for diverse surgical audiences. It also appraises quality, strengths and limitations, highlighting optimal surgical podcast features. Finally, it proposes how to better implement podcasts into surgical training and clinical practice.</p>","PeriodicalId":8158,"journal":{"name":"ANZ Journal of Surgery","volume":"94 11","pages":"1935-1941"},"PeriodicalIF":1.5,"publicationDate":"2024-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/ans.19240","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142456684","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Failure to rescue: using consistent longitudinal data to interrogate the nuances of volume outcome relationships?","authors":"Neil Donald Merrett MBBS, FRACS","doi":"10.1111/ans.19215","DOIUrl":"10.1111/ans.19215","url":null,"abstract":"","PeriodicalId":8158,"journal":{"name":"ANZ Journal of Surgery","volume":"94 10","pages":"1672-1673"},"PeriodicalIF":1.5,"publicationDate":"2024-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142456711","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":"Multidisciplinary protocol to reduce surgical readmissions in Australia: American College of Surgeons National Surgical Quality Improvement Program.","authors":"Helen Pham, Kerry Hitos, Rishan Pawaskar, Jane-Louise Sinclair, Hazel Mathuthu, Christopher B Nahm, Tony Pang, Vincent Lam, Arthur Richardson","doi":"10.1111/ans.19252","DOIUrl":"https://doi.org/10.1111/ans.19252","url":null,"abstract":"<p><strong>Introduction: </strong>Unplanned readmissions in general surgery are an important quality indicator of patient care and are associated with increased costs to healthcare services. This study aims to implement a multidisciplinary protocol in a single institution in a tertiary referral hospital to monitor and reduce unplanned readmission rates.</p><p><strong>Methods: </strong>A prospective cohort study using an institution-based protocol was conducted over an 18-month period including patients undergoing a general surgical procedure. The protocol included: (i) implementation of a surgical readmissions nurse-patient liaison; (ii) access to a surgical walk-in clinic; and (iii) early post-discharge phone contact. Data included demographic details, index procedure, hospital length of stay (LOS), and whether contact between patient/nurse occurred upon discharge. The primary outcome was the cause and rate of 30-day readmissions. Secondary outcomes were mortality, use of surgical clinic, emergency department presentations, and complications.</p><p><strong>Results: </strong>After protocol implementation, 874 patients underwent a general surgical procedure, with 354 (49%) being male and an overall median age of 53.0 years (interquartile range: 36.0-67.0). The overall readmission rate was 5.6% (n = 49), with a median LOS after readmission of 4 days. Compared with historical pre-protocol ACS-NSQIP data, this reflects a 30% reduction compared to that of readmission rate of 7.9%, P = 0.03.</p><p><strong>Conclusion: </strong>The multidisciplinary protocol was efficacious in significantly reducing unplanned readmissions. Continued audits and monitoring of factors associated with readmissions are required to help design targeted projects that may lead to improved outcomes, lower costs, increased patient satisfaction, and better efficiency within our healthcare system.</p>","PeriodicalId":8158,"journal":{"name":"ANZ Journal of Surgery","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2024-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142456693","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":"Non-tuberculous mycobacterial bone and joint infections – a case series from a tertiary referral centre in Australia","authors":"Cameron Holscher BSc, MD,&nbsp;Silvia Manzanero PhD,&nbsp;Anna Hume BSc, MBBS,&nbsp;Andrew L. Foster MBBS, PhD,&nbsp;Kevin Tetsworth MD,&nbsp;Paul R. Chapman Bsc, MBBS, MPh, PhD","doi":"10.1111/ans.19268","DOIUrl":"10.1111/ans.19268","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Non-tuberculous mycobacteria (NTM) are rare causes of bone and joint infection (BJI) and there is limited evidence on which to base management decisions. This study describes 1 year of experience from a multi-disciplinary BJI team which collects data on all cases reviewed at a tertiary referral centre in Queensland, Australia.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The database was interrogated for all cases in which NTM were recovered from operative samples. Individual chart review was performed to collect the details of each case.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of seven cases were managed between 1st February 2021 and 28th February 2022, comprising one patient with chronic osteomyelitis, three with fracture-related infections, two with prosthetic joint infections, and one with infection of a synthetic ligament graft. In contrast to pulmonary NTM infections, most patients were clinically well and immunocompetent, and most infections were propagated by direct inoculation. Time to diagnosis was unknown in three patients, with 1, 2, 2, and 5 months for the remaining four. Rapid growing NTM were diagnosed on routine cultures and specific mycobacterial cultures were confirmatory. Management was characterized by multiple stage surgical procedures and prolonged antimicrobial regimens.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Antimicrobial complications were common; however, all patients were infection free at their latest follow up. Despite the inherent limitations, these results suggest that routinely ordering mycobacterial culture is of low yield. There is potential for shorter-term oral antimicrobial treatments. Prospective research is required to optimize treatment regimens and durations.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8158,"journal":{"name":"ANZ Journal of Surgery","volume":"94 11","pages":"1942-1948"},"PeriodicalIF":1.5,"publicationDate":"2024-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/ans.19268","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142456708","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Posterior tibial reperfusion cannula for difficult distal extracorporeal membrane oxygenation access.","authors":"Tin Yau Ngan, Dushan Miladinovic, Timothy J Southwood, Timothy Shiraev","doi":"10.1111/ans.19282","DOIUrl":"https://doi.org/10.1111/ans.19282","url":null,"abstract":"","PeriodicalId":8158,"journal":{"name":"ANZ Journal of Surgery","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2024-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142456709","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}