ANZ Journal of Surgery最新文献

{"title":"30 years of history, evolution, and surgical outcomes of pancreas transplants in a single Australian national pancreatic transplant unit","authors":"David S. C. Soon MBBS (Hons), MSc, FRACS,&nbsp;Dennison Cheung MD, BPharm (Hons),&nbsp;David Scott MD, MS, FRACS,&nbsp;Erwin Yii MD, MS,&nbsp;Alan Saunder MBBS, FRACS,&nbsp;Roger Bell MBBS, FRACS,&nbsp;Stephen Thwaites MBBS, FRACS,&nbsp;William Mulley MBBS, PhD, FRACP,&nbsp;John Kanellis MBBS, PhD, FRACP,&nbsp;Ming Kon Yii MBBS, MPH, FRACS","doi":"10.1111/ans.70059","DOIUrl":"10.1111/ans.70059","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>The first pancreas transplant in Australia was performed at Prince Henry's Hospital in 1984 (which subsequently relocated to Monash Medical Centre in 1992) in the setting of a successful pancreas transplant reported from the University of Minnesota in 1966.¹ This study is aimed at reviewing the evolution of surgical technique in pancreas transplants and the surgical outcomes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>All pancreas transplants were reviewed from 1992 to 2022. The evolution of surgical technique for pancreas transplants were collected. Outcomes include graft associated complications such as graft thrombosis rate, pancreas graft survival rate, and length of stay.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Forty-four pancreas transplants were done from 1992 to 2001, following that from 2002 to 2022 that number increased to 236 transplants. Venous drainage went from systemic to portal and subsequently reverted to systemic with modification, directly into the inferior vena cava (IVC). The rate of Early pancreatic allograft thrombosis (EPAT) in the institution was (3/18, 17% Common iliac vein (CIV), 3/19, 16% External iliac vein (EIV) and 1/7, 14% Superior Mesenteric Vein (SMV) from 1992 to 2001 and subsequently reduced to 7/119, 5.9% (IVC.) 5/19, 23.3% (CIV), 6/23, 26.1% (EIV), and 10/75, 13.3% (SMV) after modification. The average length of stay of patients in the first cohort was 18.1 days and the subsequent group was 15.5 days. Finally, pancreatic graft survival rates were 77.3% 1-year graft survival and 54.6% 5-year graft survival from 1992 to 2001 and 93.5% 1-year graft survival and 80.6% 5-year graft survival from 2002 to 2022.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Pancreas transplants are complex and technically demanding procedures that should be performed within a specialized unit.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8158,"journal":{"name":"ANZ Journal of Surgery","volume":"95 4","pages":"795-800"},"PeriodicalIF":1.5,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143623315","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":"25, 50 and 75 years ago","authors":"Julian A. Smith MBMS, MSurgEd, FRACS","doi":"10.1111/ans.70094","DOIUrl":"10.1111/ans.70094","url":null,"abstract":"","PeriodicalId":8158,"journal":{"name":"ANZ Journal of Surgery","volume":"95 4","pages":"635-636"},"PeriodicalIF":1.5,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/ans.70094","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143633227","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":"Safety and efficacy of a surgical ambulatory care pathway for superficial abscesses.","authors":"Thomas Coates, Raelene Y M Tan, Yat Cheung Chung, Andrew Gray, Suellyn Centauri, Sarah Martin","doi":"10.1111/ans.70050","DOIUrl":"https://doi.org/10.1111/ans.70050","url":null,"abstract":"<p><strong>Background: </strong>Superficial abscess of the skin is a common emergency presentation often requiring surgical management. Ambulatory Care Pathways (ACPs) are a method that can reduce the burden of this disease on hospital bed pressure by treating patients with superficial abscesses as day cases. We conducted a prospective cohort study to assess the safety and effectiveness of an ACP for patients meeting strict criteria with a superficial abscess.</p><p><strong>Methods: </strong>Data on a new ACP for the management of superficial abscesses was collected for 12 months from June 20th, 2021 and compared to a retrospective control cohort of patients managed on an inpatient care pathway. Primary outcomes were length of inpatient stay and cost of admission, secondary outcomes were delays to theatre, complications, hospital or theatre readmission within 30 days.</p><p><strong>Results: </strong>In total, 151 patient presentations were assessed, 79 in the ACP and 72 in the retrospective cohort. The mean age in our retrospective cohort was 36.3 ± 14.2 years, which was similar to our ACP cohort at 33.2 ± 12.5 (P = 0.16). Both cohorts had similar patient demographics. Inpatient bed days were significantly shorter for ACP patients with a median of 0.30 (IQR 0.20-0.95) days, compared to 1.53 (IQR 1.06-1.70) days for the retrospective cohort (P < 0.001). Both corhorts had similar postoperative complication rates (P > 0.4).</p><p><strong>Conclusion: </strong>Managing selected patients who present out of hours with a superficial abscess using an ambulatory care pathway reduced cumulative inpatient length of stay and resulted in no increase in patient morbidity.</p>","PeriodicalId":8158,"journal":{"name":"ANZ Journal of Surgery","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143603677","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":"Systemic lupus erythematosus and the risk of thyroid surgery: lessons from tracheal injury.","authors":"Jiahua Chen, Mi Zhang","doi":"10.1111/ans.70051","DOIUrl":"https://doi.org/10.1111/ans.70051","url":null,"abstract":"","PeriodicalId":8158,"journal":{"name":"ANZ Journal of Surgery","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143603681","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":"3D reconstruction of resected retroperitoneal sarcoma tumour bed and ex vivo specimen.","authors":"Eyal Mor, Danielle Mor-Hadar, Michael A Henderson, Hayden Snow, David E Gyorki","doi":"10.1111/ans.70089","DOIUrl":"https://doi.org/10.1111/ans.70089","url":null,"abstract":"<p><strong>Purpose: </strong>Retroperitoneal sarcomas (RPS) present a surgical challenge due to their complex anatomical relationships to organs and vascular structures. In this limited case series, we reconstructed the tumour beds of four cases of RPS and their ex vivo specimens.</p><p><strong>Methods: </strong>Four patients underwent surgical resection of their retroperitoneal sarcoma at our centre in 2023-2024. After completing the tumour resection, a smartphone was utilized to capture images of both the tumour bed and the resected specimen. Images were imported into 3D reconstruction programs, which used artificial intelligence (AI) to reconstruct the 3D model, available to explore from various angles and sizes by the surgical team.</p><p><strong>Results: </strong>Four patients were treated at our centre: two left-sided and two right-sided RPS. Pathology was liposarcoma in two patients and leiomyosarcoma in the other two. After the resection was completed, a smartphone was used to create the 3D model. A total of nine models were created, five models of the tumour bed and four models of the ex vivo specimen. Fixed structures present in both the tumour bed and the resected specimen were labelled in both models to allow orientation. These included the ureteric stump, the divided peritoneal reflection and the divided renal pedicle.</p><p><strong>Conclusions: </strong>This technology has great potential for use in education, surgical quality control and other applications in surgical oncology.</p>","PeriodicalId":8158,"journal":{"name":"ANZ Journal of Surgery","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143603664","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":"ACCORD study: a national multi-centre study of the watch and wait approach in patients with rectal cancer in Aotearoa New Zealand","authors":"STRATA Collaborative","doi":"10.1111/ans.19415","DOIUrl":"10.1111/ans.19415","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>The adoption of a watch and wait (W&amp;W) approach in patients with rectal cancer, and a complete clinical response (cCR) following neoadjuvant therapy, is increasing worldwide. Despite this, pragmatic unbiased outcome data is limited. This study aimed to investigate national outcomes associated with W&amp;W in Aotearoa New Zealand (AoNZ).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A national retrospective study of patients with adenocarcinoma of the rectum managed with a W&amp;W approach between January 2015 and December 2022 in AoNZ was performed by STRATA, a student and trainee led collaborative network. The Cancer Registry and the New Zealand Ministry of Health National Minimum Data Set were linked to identify patients who had rectal cancer and who were treated with neoadjuvant therapy but not rectal resection. Research teams across 17 AoNZ hospitals then screened these patients for inclusion and data collection.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>One thousand five hundred and eighteen patients were screened across 17 hospitals, 133 met inclusion criteria. Median age was 71 years. Median follow-up was 2.2 years. The 2-year cumulative incidence of local regrowth was 18.2% (95% CI 10.7%–25.1%), of which 92% was present in the bowel wall, and 68% underwent surgery, all with curative intent. The 2-year cumulative distant metastasis rate was 8.8% (95% CI 3.0%–14.2%) and the 2-year overall survival was 94.8% (95% CI 90.4%–99.4%).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This nationwide study of a W&amp;W approach has clinical outcomes similar to the international literature. This data will help guide further implementation of a W&amp;W approach in the management of patients with rectal cancer and inform both clinicians and patients.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8158,"journal":{"name":"ANZ Journal of Surgery","volume":"95 3","pages":"440-449"},"PeriodicalIF":1.5,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143603665","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":"Gastroesophageal reflux disease symptoms after sleeve gastrectomy with anterior hemifundoplication: a pilot study.","authors":"Justin Shaw, Justin Eltenn, Jorgen Ferguson, Helena Obermaier, Reginald V Lord","doi":"10.1111/ans.70041","DOIUrl":"https://doi.org/10.1111/ans.70041","url":null,"abstract":"<p><strong>Background: </strong>Gastroesophageal reflux disease (GORD) is a significant problem after laparoscopic sleeve gastrectomy (SG). This study aimed to assess the long-term effect of SG with an anterior fundoplication on GORD symptoms.</p><p><strong>Methods: </strong>A single-centre cohort study of all patients who underwent SG with anterior hemifundoplication (SGAF), with a 2:1 SG only comparison group. GORD symptoms were assessed using a structured symptom questionnaire.</p><p><strong>Results: </strong>SGAF was performed in 36 patients between 2010 and 2015; 26 patients were available for follow-up and 17 of these were followed up for more than 6 years. The comparison group included 53 consecutive contactable patients who underwent SG without fundoplication during the same period. The two patient groups were similar with regard to pre-operative factors, weight loss, and weight regain. After 6 years, 12 (71%) of SGAF patients reported no GORD symptoms compared to 9 (17%) of SG patients. GORD symptoms were no worse in 21 (81%) following SGAF, whereas GORD symptoms worsened (worse or new symptoms) in 22 (58.5%) of patients after SG. PPI use was similar in both groups. Eight of 26 (31%) SGAF patients had some degree of fundoplication dilatation and underwent conversion to SG or RYGB.</p><p><strong>Conclusions: </strong>SGAF provided superior control of symptomatic GORD than SG in this study. Fundoplication dilatation treated by conversion to standard SG was not uncommon and was the reason for suspending this series. Reducing intragastric pressure and reducing fundoplication volume may alleviate this problem, which may also be overestimated in this pilot study.</p>","PeriodicalId":8158,"journal":{"name":"ANZ Journal of Surgery","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143603667","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":"Optimizing outcomes in acute type a aortic dissection: a call for specialized care.","authors":"George Matalanis","doi":"10.1111/ans.70088","DOIUrl":"https://doi.org/10.1111/ans.70088","url":null,"abstract":"","PeriodicalId":8158,"journal":{"name":"ANZ Journal of Surgery","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143584469","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":"Abstracts to articles: Examining the publication of presentations at the New Zealand Association of Plastic Surgeons Annual Scientific Meetings","authors":"Daniel Wen MBChB,&nbsp;Hyok Jun Kwon MBChB, PGDipSurgAnat, FRACS (Pl Rec Surg)","doi":"10.1111/ans.70026","DOIUrl":"10.1111/ans.70026","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>The New Zealand Association of Plastic Surgeons (NZAPS) hosts an annual scientific meeting (ASM) to bring clinicians and researchers together to discuss the latest advancements in plastic surgery and showcase the results of up-to-date research through podium and poster presentations. However, it is unclear if these presentations ultimately achieve publication into a peer-reviewed journal. This study aimed to identify the proportion of conference abstracts which are successfully converted to formal journal articles and specifically investigating the effect of variables such as the presenter's training level and country of origin, presentation type and topic, and time to publication.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>NZAPS ASM conference programmes from 2016 to 2021 were reviewed to identify all research presentations. Desired information was extracted such as presentation type, presenting author, the presentation sub-specialty topic and presenting author country of origin.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Out of the 252 abstracts, 24.6% of abstracts had an associated publication with a statistically significant variation depending on the training level of the presenter. Out of the 62 published abstracts, 33.9% were published prior to conference presentation. Accounting for this, the true conversion rate of abstracts to publication after conference presentation was 16.3%.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Abstracts presented at the NZAPS ASM have a modest publication and conversion rate after presentation. The multi-ethnic populations in Australia and New Zealand produce studies that may not be directly applicable to overseas populations; however, this underscores the importance of establishing and maintaining regional journals to facilitate the publication of local research.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8158,"journal":{"name":"ANZ Journal of Surgery","volume":"95 3","pages":"523-526"},"PeriodicalIF":1.5,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143584467","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":"How to perform laparoscopic left hepatectomy with a dorsal approach based on the AHM triangle.","authors":"Yi Zhou, Jinliang Ma, Chuanhai Zhang","doi":"10.1111/ans.70057","DOIUrl":"https://doi.org/10.1111/ans.70057","url":null,"abstract":"<p><p>(a) Diagram of trocar placement. (b) Diagram of the AHM triangle.</p>","PeriodicalId":8158,"journal":{"name":"ANZ Journal of Surgery","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143555694","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}