Victa Vinay Kumar, Claudia Paterson, Andrew Hill, Vikash Sharma
{"title":"Efficacy of 'Triple Therapy' in Eradicating Ulcer Related Helicobacter pylori Infection at a Tertiary Hospital in Fiji-A Pilot Study.","authors":"Victa Vinay Kumar, Claudia Paterson, Andrew Hill, Vikash Sharma","doi":"10.1111/ans.70231","DOIUrl":"https://doi.org/10.1111/ans.70231","url":null,"abstract":"<p><strong>Background: </strong>Fiji currently uses a seven-day Clarithromycin based triple therapy regimen for Heliobacter pylori (H. pylori) eradication, and the local eradication rate is unknown. H. pylori testing is performed using a rapid urease test (RUT) during gastroscopy in Fiji.</p><p><strong>Methods: </strong>A year-long prospective observational study was undertaken at the Colonial War Memorial Hospital in Fiji. Eligible participants included patients who had peptic ulcer disease (PUD) on gastroscopy and a positive RUT. Consenting participants were prescribed Clarithromycin based triple therapy for 7 days, and underwent a second gastroscopy with RUT after 6 to 8 weeks. Participants who tested positive on a repeat RUT received Clarithromycin based triple therapy for 14 days, and underwent a third gastroscopy and RUT. Participants who remained positive for H. pylori were prescribed quadruple therapy for 14 days.</p><p><strong>Results: </strong>Forty-nine patients were enrolled in the study. Thirty-six (73.5%) had a negative RUT after a seven-day Clarithromycin-based regimen. Eleven of the 13 participants who remained positive eradicated H. pylori after being given another course of the same regimen for 14 days, resulting in a final eradication rate of 95.9%. The remaining two participants received quadruple therapy for 14 days.</p><p><strong>Conclusion: </strong>This study demonstrates an eradication rate of 73.5% using a seven-day Clarithromycin-based regimen in Fiji among H. pylori positive patients with PUD on gastroscopy. This was significantly improved using a 14-day regimen. H. pylori has reduced susceptibility to the current seven-day Clarithromycin based regimen. Future local guidelines should extend to 14 days to achieve a greater eradication rate.</p>","PeriodicalId":8158,"journal":{"name":"ANZ Journal of Surgery","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144473854","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}
Marcos Vinicius Perini, Eunice Lee, Michael Fink, Graham Starkey, Osamu Yoshino, Bartholomew McKay, Ruelan Furtado, Enes Makalic, Robert Jones
{"title":"To Stent or Not to Stent: Is It a Question? Routine Trans-Cystic Stenting Does Not Reduce Biliary Anastomotic Strictures Post-Liver Transplantation.","authors":"Marcos Vinicius Perini, Eunice Lee, Michael Fink, Graham Starkey, Osamu Yoshino, Bartholomew McKay, Ruelan Furtado, Enes Makalic, Robert Jones","doi":"10.1111/ans.70224","DOIUrl":"https://doi.org/10.1111/ans.70224","url":null,"abstract":"<p><strong>Background: </strong>We aim to compare the incidence and risk factors for biliary anastomotic stricture (BAS) in patients undergoing orthotopic liver transplant (OLT) with and without transcystic externalised trans-anastomotic biliary stenting.</p><p><strong>Methods: </strong>A retrospective analysis was performed of a prospective database focused on 836 cadaveric OLT. Primary outcome measures were the incidence of BAS and risk factors related to its development.</p><p><strong>Results: </strong>Duct-to-duct anastomosis was the most commonly performed biliary reconstruction (90.5%). Transcystic externalised trans-anastomotic biliary stenting was performed in 420 patients (62.0%), being mostly used in patients having a duct-to-duct anastomosis (63.6%). BAS was seen in 222 (32.8%) patients, with a median time to diagnosis of 145.5 days (IQR 50.3-370.5). BAS was higher in patients with a duct-to-duct reconstruction when compared to those having a bilio-enteric reconstruction (34.3% vs. 18.7%, p = 0.02). The prevalence of BAS was not significantly different between patients who were stented and those who were not (34.5% vs. 30.0% respectively, p = 0.25). Multivariable analysis showed that older donor age, transplants performed earlier in the study period, higher MELD score, and type of biliary reconstruction (duct-to-duct) were independently associated with a higher risk of BAS.</p><p><strong>Conclusion: </strong>Transcystic externalised biliary anastomotic stenting is not associated with a reduced biliary stricture incidence in OLT.</p>","PeriodicalId":8158,"journal":{"name":"ANZ Journal of Surgery","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144473858","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}
Harleen Kaur, Margarita-Chrissi Litinas, Christoper Lauder, Nigel Da Silva, Emma L Bradshaw, Timothy Price, Markus Trochsler, Josephine Wright, Susan Lesley Woods, Peter Hewett
{"title":"Long-Term Survival Following Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy (HIPEC) for Pseudomyxoma Peritonei: A 22-Year Single Institution Experience.","authors":"Harleen Kaur, Margarita-Chrissi Litinas, Christoper Lauder, Nigel Da Silva, Emma L Bradshaw, Timothy Price, Markus Trochsler, Josephine Wright, Susan Lesley Woods, Peter Hewett","doi":"10.1111/ans.70214","DOIUrl":"10.1111/ans.70214","url":null,"abstract":"<p><strong>Background: </strong>Pseudomyxoma peritonei (PMP) is a rare condition, often associated with a poor prognosis if left untreated. Cytoreductive surgery (CRS) and heated intraperitoneal chemotherapy (HIPEC), have emerged as the preferred treatment for this condition. The aim of this study was to report 22-year single centre outcomes for PMP following CRS and HIPEC.</p><p><strong>Methods: </strong>A retrospective analysis of a prospectively maintained database (CALHN reference number: Q20160412) from 2002-2024 was conducted on all patients that underwent CRS and HIPEC for PMP at The Queen Elizabeth Hospital, Adelaide, South Australia (TQEH).</p><p><strong>Results: </strong>One hundred and twenty one CRS procedures were performed on 108 patients. Complete cytoreduction (CC0-1) was achieved in 85.9% cases. The overall median 3, 5 and 10-year survival rate for patients with PMP managed at TQEH was 70%, 55% and 23%, respectively. Among those who underwent HIPEC alongside CRS, the median survival was 92 months, with a 5-year survival rate of 62%. Median RFS was 109 months, with 61% 5-year RFS and 54% 10-year RFS. The 5-year survival rates for low-grade PMP and high-grade PMP without signet cells was 64.0% and 30.0%, respectively.</p><p><strong>Conclusion: </strong>CRS and HIPEC is a safe and effective treatment for patients with PMP, demonstrating a 62% survival at 5 years. High-grade PMP histology and CEA ≥ 5 were independent predictors of worse OS. Our results demonstrate that comparable survival rates and recurrence free intervals to those reported by high-volume centres can be achieved, reinforcing the potential for successful outcomes in lower-volume settings while maintaining treatment quality and patient safety.</p>","PeriodicalId":8158,"journal":{"name":"ANZ Journal of Surgery","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144332376","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}
Rathin Gosavi, Charlotte Keung, Gregory Moore, T C Nguyen, William Teoh, Raymond Yap, Paul McMurrick, Vignesh Narasimhan
{"title":"Mesenchymal Stem Cell Therapy for Perianal Crohn's Disease: Surgical Appraisal of Evidence and Translational Potential.","authors":"Rathin Gosavi, Charlotte Keung, Gregory Moore, T C Nguyen, William Teoh, Raymond Yap, Paul McMurrick, Vignesh Narasimhan","doi":"10.1111/ans.70225","DOIUrl":"https://doi.org/10.1111/ans.70225","url":null,"abstract":"","PeriodicalId":8158,"journal":{"name":"ANZ Journal of Surgery","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144324296","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}
Joel Ern Zher Chan, Kate S. Olakkengil, Shantanu Bhattacharjya, Santosh Antony Olakkengil
{"title":"Autosomal Dominant Polycystic Kidney Disease Patients Requiring Nephrectomy: Characteristics and Surgical Considerations","authors":"Joel Ern Zher Chan, Kate S. Olakkengil, Shantanu Bhattacharjya, Santosh Antony Olakkengil","doi":"10.1111/ans.70192","DOIUrl":"10.1111/ans.70192","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Nephrectomies are major surgeries often required in ADPKD for symptom control, removal of septic/malignant foci, and to create space for renal transplantation. Whether ADPKD patients should proceed with nephrectomy/ies should be guided by patient characteristics, technical considerations and anticipated risks and benefits.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A retrospective review of prospectively collected data for all patients who underwent nephrectomy/ies between 1 January 1995 and 31 December 2021, comparing ADPKD patients to patients with alternative primary nephrological conditions. Patient characteristics, technical aspects, and outcomes informing the risks and benefits of nephrectomies were examined. Statistical analyses included descriptive statistics, <i>χ</i>\u0000 <sup>2</sup>/Fisher's exact test and independent samples Mann–Whitney U test, as appropriate.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>At the time of first nephrectomy, ADPKD patients were older and more likely to have end-stage renal failure, hypertension, gastro-oesophageal reflux disease, and hernia compared to non-ADPKD patients. They were more likely to require bilateral nephrectomies, open nephrectomies, and, where transplanted, receive donation after circulatory death. They were at higher risk of post-operative hypotension, anaemia, and more likely to require blood transfusions. Otherwise, nephrectomies achieved their indications in our ADPKD cohort with no apparent increase in adverse events. Renal cell carcinoma appears to be of higher incidence in our cohort, with a high proportion of multifocality and bilaterality, advanced staging at diagnosis and incidental diagnoses on histopathology.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Overall, in our ADPKD patients who received nephrectomy/ies, the procedure appeared to be safe and effective, with benefits outweighing risks. RCC exclusion is a prudent consideration especially for ADPKD patients on dialysis awaiting transplantation.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8158,"journal":{"name":"ANZ Journal of Surgery","volume":"95 7-8","pages":"1605-1616"},"PeriodicalIF":1.6,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/ans.70192","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144324295","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}
Frances Graham, Wanyu Chu, Helena Rodi, Paul Cashin, David S Liu, Norah Finn, Tommy Hon Ting Wong, Linda Nolte
{"title":"Understanding Unwarranted Variation in Care for Victorian Oesophagogastric Cancer Patients Using Linked Data: A Comparative Analysis Between 2012-2016 and 2017-2021.","authors":"Frances Graham, Wanyu Chu, Helena Rodi, Paul Cashin, David S Liu, Norah Finn, Tommy Hon Ting Wong, Linda Nolte","doi":"10.1111/ans.70196","DOIUrl":"https://doi.org/10.1111/ans.70196","url":null,"abstract":"<p><strong>Background: </strong>The Victorian Integrated Cancer Services convened the second Oesophagogastric (OG) Cancer Optimal Care Summit to determine unwarranted variation in care between 2017 and 2021 and compare trends with the first summit (reporting 2012-2016). Statewide administrative datasets were assessed retrospectively at the population level in alignment with the optimal care pathway steps for OG.</p><p><strong>Methods: </strong>Victorians with a primary diagnosis of OG cancer were identified via the Victorian Cancer Registry dataset and linked to various administrative datasets to identify unwarranted variations.</p><p><strong>Results: </strong>Of the 9868 Victorians diagnosed with OG cancer between 2012 and 2021, 39.4% were metastatic at diagnosis. Improved outcomes between time periods included reduced mortality for OG cancer and post-surgical mortality 1 year post gastrectomy. Patient multidisciplinary meeting presentation increased from 74% to 86%. Unwarranted variations included time from diagnosis to any treatment within 6 weeks for non-metastatic gastric cancer (64%, 2012-2016 and 60%, 2017-2021) and for oesophageal cancer patients (58%, 2012-2016 and 60%, 2017-2021). One regional Integrated Cancer Service (ICS) demonstrated statistically lower survival compared to the statewide average for gastric cancer in 2017-2021. There was greater variation in survival for gastric cancer for 2017-2021 compared to 2012-2016. Rates of dietitian and/or physiotherapist involvement within 3 months of diagnosis for OG cancer surgical and/or chemotherapy patients were low across all ICS and both time periods.</p><p><strong>Conclusions: </strong>The Victorian cancer system demonstrates improved survival outcomes for OG cancer patients between the two time periods. Time between diagnosis and treatment, lower survival rates in some ICS, and access to supportive care (e.g., dietetics and physiotherapy) remain areas of deficiency.</p>","PeriodicalId":8158,"journal":{"name":"ANZ Journal of Surgery","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144324298","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":"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":"<p><strong>Background: </strong>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.</p><p><strong>Objective: </strong>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.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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.</p><p><strong>Conclusions: </strong>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.</p>","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}
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":"10.1111/ans.70220","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>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.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>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.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>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, <i>p</i> < 0.001) and CRP (OR1.01, <i>p</i> < 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%, <i>p</i> < 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).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>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.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8158,"journal":{"name":"ANZ Journal of Surgery","volume":"95 7-8","pages":"1532-1539"},"PeriodicalIF":1.6,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/ans.70220","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":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Adult Caecal Intussusception: Diagnosis and Management Insights.","authors":"Mira M Sobhy, John Woodfield","doi":"10.1111/ans.70217","DOIUrl":"https://doi.org/10.1111/ans.70217","url":null,"abstract":"<p><p>Caecal mass with 34 mm lead intussusception point (yellow x) seen inside splenic flexure, with the ascending colon, neurovasulature, and mesentery inside the transverse colon.</p>","PeriodicalId":8158,"journal":{"name":"ANZ Journal of Surgery","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144274097","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":"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":"10.1111/ans.70215","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background and Aims</h3>\u0000 \u0000 <p>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.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>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.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>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.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>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.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8158,"journal":{"name":"ANZ Journal of Surgery","volume":"95 7-8","pages":"1546-1552"},"PeriodicalIF":1.6,"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}