ANZ Journal of Surgery最新文献

{"title":"Strangulated hernias and eventrations: prosthesis versus simple suture repair.","authors":"Sahar Sallemi, Zied Hadrich, Hamadi Ben Chaabane, Rached Bayar, Sahir Omrani","doi":"10.1111/ans.70105","DOIUrl":"https://doi.org/10.1111/ans.70105","url":null,"abstract":"<p><strong>Purpose: </strong>Despite the established position of prosthetic repair as the standard for the planned cure of abdominal hernias and eventrations, its application in cases of strangulation remains limited, mainly due to the risk of infection. The primary aim of our study was to compare prosthesis and stent cure for strangulated hernias and eventrations in terms of surgical site infection. The secondary objectives were to compare the two techniques in terms of length of hospital stay, non-specific surgical and medical morbidity, recurrence and death.</p><p><strong>Methods: </strong>We conducted a retrospective comparative study of 194 patients operated on for strangulated hernia or eventration, aged over 18 years and with an ASA score of 1 or 2. Patients who required bowel resection were excluded.</p><p><strong>Results: </strong>The two populations were comparable in terms of preoperative data (age (P = 0.15), gender (P = 0.07), medical and surgical history (P = 0.3 and 0.55) and ASA score (P = 0.17)) and intraoperative data (type of eventration (P = 0.69), contents of the sac (P = 0.56), vitality of the contents (P = 0.25), intraperitoneal effusion (P = 0.39), intraoperative incident (P = 0.49)). Our study showed that there was no significant difference between the two groups in terms of suppuration of the surgical site (P = 0.26). Furthermore, there was no significant difference in terms of length of hospital stay (P = 0.4), scrotal haematoma for patients operated on for groin hernia (P = 0.68), non-specific surgical complications (P = 0.37) or medical complications (P = 0.26) and death (P = 0.58). Recurrence was less frequent in patients who had had a prosthesis (P = 0.044).</p><p><strong>Conclusion: </strong>We can confirm that the cure of strangulated hernias and eventrations by prosthesis is safe and effective, and gives similar results to the cure by raphia in terms of suppuration of the surgical site.</p>","PeriodicalId":8158,"journal":{"name":"ANZ Journal of Surgery","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143699510","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":"Combination of Lenvatinib and pembrolizumab as neoadjuvant treatment for BRAF negative anaplastic thyroid cancer.","authors":"Zhao Jie, Bella Nguyen, Dean Lisewski","doi":"10.1111/ans.70104","DOIUrl":"https://doi.org/10.1111/ans.70104","url":null,"abstract":"","PeriodicalId":8158,"journal":{"name":"ANZ Journal of Surgery","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143690773","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":"Impact of COVID-19 on elective general surgery cancellations and emergency presentations.","authors":"Kai Yun Jodene Tay, Evangeline Woodford, Jingyi Cao","doi":"10.1111/ans.70108","DOIUrl":"https://doi.org/10.1111/ans.70108","url":null,"abstract":"<p><strong>Background: </strong>Following the declaration of the COVID-19 pandemic by the World Health Organization, many measures to contain its spread were applied in Australia, including the cancellation and postponement of elective procedures. This study aims to explore the impact of these delays to elective surgery on emergency department (ED) presentations and post-operative outcomes.</p><p><strong>Methods: </strong>This was a single-centre retrospective cohort study comparing waitlisted elective general surgical patients presenting to ED between 2021 and 2023 to a pre-COVID cohort presenting between 2017 and 2019. The primary outcome was the incidence and proportion of ED presentations for waitlisted patients, with secondary outcomes of emergency surgical intervention and post-operative morbidity. SPSS Statistics version 24.0 (IBM SPSS Statistics for Windows, Amonk, NY, USA) was used for statistical analysis.</p><p><strong>Results: </strong>No significant difference in incidence of related ED presentations was found between the two groups (22.1% v 21.4%, P = 0.610). A significant increase in average waitlist time was seen in the post-COVID period, with delays to procedures for 51.5% of patients compared to 9.2% pre-COVID (<0.001). Average waitlist time for category 1 & 2 procedures in the post-COVID period was notably higher than the recommended category wait-time (category 1, 50.3 ± 43.1 days; category 2, 124.5 ± 106.8 days).</p><p><strong>Conclusion: </strong>Significant delays to surgery and an increase in waitlist time were apparent in the post-COVID period despite no significant difference in emergency presentation incidence for waitlisted elective general surgical patients.</p>","PeriodicalId":8158,"journal":{"name":"ANZ Journal of Surgery","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143690818","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":"Radical resections of hepatopancreatobiliary cancers: balancing surgical innovation, evidence, and societal impact.","authors":"Thomas J Hugh, Saxon Connor","doi":"10.1111/ans.70099","DOIUrl":"https://doi.org/10.1111/ans.70099","url":null,"abstract":"","PeriodicalId":8158,"journal":{"name":"ANZ Journal of Surgery","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143690868","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":"Portal annular pancreas: a rare surgical challenge.","authors":"Ferhat Arabaci, Mehrdad Nikfarjam","doi":"10.1111/ans.70098","DOIUrl":"https://doi.org/10.1111/ans.70098","url":null,"abstract":"","PeriodicalId":8158,"journal":{"name":"ANZ Journal of Surgery","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143690861","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":"Fistulotomy versus fistulectomy for simple fistula-in-ano: a systematic review and meta-analysis of randomized controlled trials.","authors":"Rakesh Quinn, Alexandra Peacock, Rebecca J Lendzion","doi":"10.1111/ans.70095","DOIUrl":"https://doi.org/10.1111/ans.70095","url":null,"abstract":"<p><strong>Background: </strong>Perianal fistulas are a common anorectal pathology. The sphincter-cutting techniques of fistulectomy and fistulotomy are associated with high cure rates for low or simple fistula-in-ano, with negligible risk of incontinence. However, the superiority of either technique has not previously been conclusively demonstrated. The aim of this systematic review is to compare the outcomes of the two surgical techniques for the management of simple fistula-in-ano.</p><p><strong>Methods: </strong>A search of MEDLINE, EMBASE and Cochrane Databases for randomized controlled trials (RCT) comparing fistulotomy to fistulectomy for simple fistula-in-ano was conducted. The primary outcome was healing time; secondary outcomes included operative time, length of hospital stay, post-operative pain score, post-operative complications and fistula recurrence.</p><p><strong>Results: </strong>Thirteen RCTs meet inclusion criteria, comprising a total of 685 fistulectomy and 688 fistulotomy patients. There was no significant difference between the techniques for healing time (P = 0.15), operative time (P = 0.13), length of stay (P = 0.05), wound infection (P = 0.97), flatus or faecal incontinence (P = 0.35 and P = 0.70, respectively) or recurrence (P = 0.19). Post-operative pain at 24 h, assessed using a visual analogue scale, was significantly lower in the fistulectomy group (MD-0.49, 95% CI: -0.90, -0.08; P = 0.02), and we found significantly fewer post-operative bleeding complications in the fistulotomy group (OR: 3.81, 95% CI: 1.23, 11.80; P = 0.02).</p><p><strong>Conclusion: </strong>This systematic review did not find conclusive evidence of the superiority of either fistulectomy or fistulotomy in terms of healing time. The two statistically significant findings were lower post-operative pain scores with fistulectomy and reduced post-operative bleeding with fistulotomy.</p>","PeriodicalId":8158,"journal":{"name":"ANZ Journal of Surgery","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143690779","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":"Telehealth for vascular outpatients may help combat rising healthcare pressures with high levels of patient satisfaction.","authors":"Philip Allan, Finn Roberts-Craig, Richard Evans, Anantha Narayanan","doi":"10.1111/ans.70049","DOIUrl":"https://doi.org/10.1111/ans.70049","url":null,"abstract":"","PeriodicalId":8158,"journal":{"name":"ANZ Journal of Surgery","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143662344","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":"Enteral nutrition versus parenteral nutrition in the management of postoperative pancreatic fistula following pancreaticoduodenectomy: a prospective observational study.","authors":"Rohith Kodali, Kunal Parasar, Utpal Anand, Saad Anwar, Bijit Saha, Basant Narayan Singh, Kislay Kant, Venkatesh Karthikeyan","doi":"10.1111/ans.70096","DOIUrl":"https://doi.org/10.1111/ans.70096","url":null,"abstract":"<p><strong>Background: </strong>Postoperative pancreatic fistula (POPF) presents a significant challenge to oral intake after pancreaticoduodenectomy (PD). Strategies such as enteral feeding via nasojejunal tube, feeding jejunostomy (FJ), and total parenteral nutrition (TPN) are commonly used to optimize postoperative nutrition. However, the routine use of FJ in PD remains controversial. This study assesses the effectiveness of enteral feeding versus TPN in the management of POPF.</p><p><strong>Methods: </strong>A prospective observational study was conducted on 100 patients undergoing classical PD at a tertiary care centre in eastern India between July 2019 and July 2024. Patients were randomly allocated to FJ and non-FJ groups in a 1:1 ratio. The primary endpoints were procedure-related complications (POPF, delayed gastric emptying (DGE), post-pancreatectomy haemorrhage, bile leak, Clavien-Dindo grade ≥ 3), hospital stay, additional costs and 30-day mortality in patients with clinically relevant POPF.</p><p><strong>Results: </strong>Of the 100 patients, 50 underwent routine FJ placement, and 50 did not. Most POPF cases were Grade B (34% versus 24%). Subgroup analysis of patients with clinically relevant POPF revealed that FJ placement significantly reduced fistula duration (3.8 versus 5.2 weeks, P < 0.001), intra-abdominal drain duration (26.4 versus 34.9 days, P < 0.001), hospital stay (7.9 versus 9.9 days, P < 0.001) and cost expenses (1301 ± 524 versus 1982 ± 441, P < 0.001). There were no differences in complication rates, reoperations, readmissions or 30-day mortality. FJ placement was not associated with adverse events.</p><p><strong>Conclusion: </strong>Routine FJ is a safe and cost-effective strategy for PD patients requiring prolonged nutritional support.</p>","PeriodicalId":8158,"journal":{"name":"ANZ Journal of Surgery","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143656053","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":"Impact of Magseed® localization on re-excision rates of non-palpable breast cancers in an Australian regional hospital","authors":"Madison Bowles MBBS,&nbsp;Su Su Naing MBBS,&nbsp;Guat Shi Ng MBChB, MSc,&nbsp;Emilia Dauway MD, FRACS","doi":"10.1111/ans.70009","DOIUrl":"10.1111/ans.70009","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Impalpable breast cancers have traditionally been localized under hook-wire guidance. Magseed® is an innovative method of breast cancer localization that consists of a tiny paramagnetic seed designed to enable more precise tumour localization and greater scheduling flexibility by decoupling the timing of radiological insertion and surgery. The primary outcome of this study was to evaluate whether the implementation of the Magseed® localization technique in our healthcare facility led to a reduction in re-excision rates.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A single institution retrospective evaluation was carried out for 96 women who underwent Magseed® localization (MSL) between 01 August 2020 and 30 April 2022. To allow direct comparison to the hospitals wire-guided localization (WGL) re-excision rates, data was collected from the Queensland Cancer Registry for patients who underwent WGL excision at our hospital between 01 January 2015 and 30 June 2020.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 105 Magseeds® were inserted in 96 patients with 95% placed within 1 mm of the target lesion. All Magseeds® markers were successfully retrieved. Re-excision rates were 14% and of the re-excisions only 24% (<i>n</i> = 3) had residual tumour in the re-excision specimen. In the preceding 5 years when hook-wires were used as the localization technique, the re-excision rate was 38%.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Magseed® technology is a safe and effective pre-operative localization method that has the potential to reduce re-excision rates for non-palpable breast lesions.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8158,"journal":{"name":"ANZ Journal of Surgery","volume":"95 3","pages":"512-516"},"PeriodicalIF":1.5,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143646821","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":"Professional indemnity insurance rates for metabolic bariatric surgeons in Australia: survey results.","authors":"Jacob Chisholm, Lilian Kow, Adam Skidmore, Nicholas Williams","doi":"10.1111/ans.70087","DOIUrl":"https://doi.org/10.1111/ans.70087","url":null,"abstract":"","PeriodicalId":8158,"journal":{"name":"ANZ Journal of Surgery","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143623318","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}