ANZ Journal of Surgery最新文献

{"title":"Do hormones and surgery improve the health of adults with gender incongruence? A systematic review of patient reported outcomes.","authors":"Kelsey Ireland, Madeleine Hughes, Nicola R Dean","doi":"10.1111/ans.70028","DOIUrl":"https://doi.org/10.1111/ans.70028","url":null,"abstract":"<p><strong>Background: </strong>Gender diverse people in Australia have higher levels of psychological stress, suicidal ideation and suicide attempts and have poorer self-reported health than cisgender people.</p><p><strong>Objectives: </strong>To determine if adults who experience gender incongruence have improved health-related quality of life and mental health with gender affirming treatment (hormone therapy and surgery), compared with no treatment.</p><p><strong>Data sources: </strong>PubMed, Web of Science, Embase and Psych Info.</p><p><strong>Review methods: </strong>A systematic review of peer-reviewed publications in English from January 2010 to October 2022. Studies were included where: participants were treated with gender affirming surgery or hormone therapy for minimum 3 months and; validated patient reported outcome measures of health-related quality of life or mental health were reported. Quality of evidence assessment was undertaken using the Let Evidence Guide Every New Decision evaluation tool.</p><p><strong>Results: </strong>Eighty-one publications were included for analysis. The systematic review indicated that there were significant improvements in the domains of mental illness, gender dysphoria, body image and health-related quality of life following gender affirming medical treatment as measured by a variety of patient reported outcomes. Meta-analysis showed significant improvement in body image (z = 4.47, P < 0.001) and health-related quality of life for psychological (z = 1.99, P = 0.047) and social relationships (z = 3.09, P = 0.002) following gender affirming surgery.</p><p><strong>Conclusions: </strong>There is evidence that hormones and surgery as a collective for adults with gender incongruence has therapeutic value and should be considered for funding within Australia's healthcare systems. The development and implementation of patient-reported outcome tools tailored for purpose (GENDER Q) will facilitate future research.</p>","PeriodicalId":8158,"journal":{"name":"ANZ Journal of Surgery","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143456845","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":"Pancreatic resection for metachronous colorectal cancer metastases: a case series multicenter study.","authors":"Francesco Palmieri, Francesco Lancellotti, Francesco Ferrara, Thomas Satyadas, Davide Gobatti, Luis Felipe Abreu de Carvalho, Filip Gryspeerdt, Grazia Conte, Federico Mocchegiani, Roberto Sampietro, Pierpaolo Sileri","doi":"10.1111/ans.70027","DOIUrl":"https://doi.org/10.1111/ans.70027","url":null,"abstract":"<p><strong>Background: </strong>Pancreas resection for metachronous colorectal cancer metastasis is episodic and the role of surgery in the management of these patients is still debated.</p><p><strong>Methods: </strong>We recruited seven patients from three different centres and analyzed 30-day morbidity and mortality, oncological outcomes at 6 and 12 months.</p><p><strong>Results: </strong>There was no postoperative mortality. Complications occurred in two patients (28,6%). All patients completed at least a 12-months follow-up. At 6-month follow-up, only one patient had a recurrence. At 12-month follow-up, no patients died for disease recurrence and one more patient had a new recurrence.</p><p><strong>Conclusion: </strong>Our series supports the feasibility and safety of pancreas resection in metastatic colorectal cancer suggesting that radical resection may improve the patient's prognosis.</p>","PeriodicalId":8158,"journal":{"name":"ANZ Journal of Surgery","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143456848","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":"Less trash, more treasure. Waste production and reduction in Orthopaedic surgery","authors":"Nikolas Drobetz BMedSt,&nbsp;Joshua Xu MD, MS (Orth),&nbsp;David Chang MD,&nbsp;Daniel Hazan MBBS,&nbsp;William Collins MD,&nbsp;Herwig Drobetz MD, PhD, FRACS","doi":"10.1111/ans.70018","DOIUrl":"10.1111/ans.70018","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>The operating theatre generates substantial waste, raising environmental concerns. This study quantified the waste generated during four common orthopaedic procedures and identified recyclable materials. It also assessed the associated carbon footprint to highlight opportunities for sustainable waste management.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This prospective study was conducted at a single regional hospital in New South Wales, Australia, from July to September 2024. Sixty procedures were analysed: 15 total knee arthroplasties (TKA), 15 total hip arthroplasties (THA), 15 ankle fracture fixations, and 15 hand injury surgeries. Waste was categorized as landfill, recyclable, or biohazardous. Landfill waste was further analysed for potentially recyclable components, with data extrapolated to nationwide operation numbers. Carbon dioxide emissions were calculated using the formula tCO₂-e = Q × EF, where Q is waste weight, EF is the emission factor (0.879), and tCO₂-e is tonnes of carbon dioxide emissions.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Across 60 procedures, 425.7 kg of waste was generated, averaging 8.2 kg per case. TKA produced the most waste (11.7 kg per case), while hand injury surgeries generated the least (3.9 kg per case). Potentially recyclable waste constituted 12% of landfill waste, with TKA having the highest recyclable proportion (13%). Recyclable materials comprised 44% of total waste. Proper segregation could reduce up to 75 t of CO₂-emissions annually from TKA alone in Australia.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>A significant portion of orthopaedic theatre waste is recyclable, offering opportunities to reduce the carbon footprint of surgeries. Improved staff training and recycling facilities are crucial for optimizing waste management in healthcare.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8158,"journal":{"name":"ANZ Journal of Surgery","volume":"95 3","pages":"539-543"},"PeriodicalIF":1.5,"publicationDate":"2025-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/ans.70018","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143456846","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":"Robot-assisted resection of oesophageal leiomyoma: a single-centre retrospective analysis of 57 cases","authors":"Ruizhen Wang MD,&nbsp;Yuhang Guo MD,&nbsp;Xiaofeng Duan MD, PhD,&nbsp;Hongjing Jiang MD, PhD","doi":"10.1111/ans.70022","DOIUrl":"10.1111/ans.70022","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Backgrounds</h3>\u0000 \u0000 <p>Oesophageal leiomyoma is the most common benign tumour of the oesophagus, and complete tumour enucleation is the preferred treatment. The aim of this study is to evaluate the clinical application and technical advantages of Robotic-assisted Thoracoscopic Surgery (RATS) during the resection of oesophageal leiomyoma.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A retrospective study was conducted on patients who underwent robotic surgery for oesophageal diseases at our hospital from September 2017 to December 2023. Demographic statistics and clinical pathological characteristics, intraoperative and postoperative outcomes, immune histopathological staining, tumour pathology diagnosis and follow-up were analyzed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 57 patients were enrolled in the study, including 42 males and 15 females with an average age of 49 years All patients received surgical treatment, with 54 patients undergoing robot-assisted resection of oesophageal tumour, one patient undergoing conversion to thoracotomy, and two patients undergoing exploratory surgery. The mean surgical time was 130 minutes, and the mean blood loss was 50 mL. Of the 55 patients who underwent tumour resection, 54 were pathologically diagnosed as oesophageal leiomyoma and one as atypical leiomyoma. Only one patient developed pulmonary infection after surgery, and there was no perioperative mortality. The average postoperative hospital stay was 9 days. All patients were followed up for a median time of 16 months (range: 1 to 70 months), and there was no recurrence or long-term complications after surgery.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Robot-assisted resection of oesophageal leiomyoma is safe and feasible, and can provide ideal short-and medium-term results.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8158,"journal":{"name":"ANZ Journal of Surgery","volume":"95 3","pages":"356-362"},"PeriodicalIF":1.5,"publicationDate":"2025-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143456849","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":"Specialist sarcoma centres in Australia and New Zealand – addressing equity of access and ensuring best practice through centralization","authors":"David J. Coker FRACS,&nbsp;Kilian G. M. Brown FRACS,&nbsp;Richard Boyle FRACS","doi":"10.1111/ans.70003","DOIUrl":"10.1111/ans.70003","url":null,"abstract":"&lt;p&gt;Centralization of cancer services within Australia remains controversial and challenging, within a number of domains, including the management of bone and soft tissue sarcoma of the extremities, abdomen and retroperitoneum. In this issue of the Journal, the Australia and New Zealand Sarcoma Association (ANZSA) Working Group led by Gyorki and Hong present a summary of recently published guidelines, including the role of specialist centres in the management of sarcoma.&lt;span&gt;&lt;sup&gt;1&lt;/sup&gt;&lt;/span&gt; Following systematic review, the ANZSA guidelines recommend that both radiotherapy and surgery occur within specialized sarcoma centres.&lt;/p&gt;&lt;p&gt;The development and publication of the ANZSA guidelines, coincided with the release of an Australian Senate inquiry into rare and less common cancers. This inquiry concluded that patients with rare cancers do not receive the same level of support, or have access to the same diagnostic and treatment options, as those with more common cancers.&lt;span&gt;&lt;sup&gt;2&lt;/sup&gt;&lt;/span&gt; Sarcoma undoubtedly represents a rare malignancy (1.5% of all new cancer diagnoses) for which the argument for centralization of management is obvious. Standardizing treatment strategies for patients with sarcoma is made all the more challenging by the heterogenous nature of the disease, which comprises over 120 subtypes. As these diverse tumours are better understood on a molecular level, individual patients require a tailored, histology-specific treatment approach developed by an experienced multi-disciplinary team, as well as access to complex surgery, novel systemic treatments and clinical trials. Such tailored treatment can only be achieved consistently at centres with the necessary experience and expertise.&lt;/p&gt;&lt;p&gt;One of the challenges in recommending treatment at a specialist sarcoma centre, is in defining a specialist centre. ANZSA defines specialist sarcoma centres as those which have a tumour-specific multidisciplinary team (MDT) meetings, and actively participate in clinical trials. An issue is to what extent this is standardized or ratified, where ANZSA is not a regulatory body, and centres would seem to be able to self-determine their status somewhat. This compares to Europe, where the European Reference Network (EUROCAN), is not only far more prescriptive in setting out specific standards for MDTs, but establishes recommended thresholds with 100 new patients managed per year, against which centres can be benchmarked.&lt;span&gt;&lt;sup&gt;3&lt;/sup&gt;&lt;/span&gt;&lt;/p&gt;&lt;p&gt;While volume-based assessment has always been a controversial metric in surgery, the findings of the systematic review regarding surgery at specialized sarcoma centres conducted by the ANZSA working group would support that morbidity, local recurrence and overall recurrence are all improved where sarcoma surgery, including pre-operative work-up, occurs at a specialized centre.&lt;span&gt;&lt;sup&gt;4&lt;/sup&gt;&lt;/span&gt; The literature in retroperitoneal and extremity sarcoma sets the relatively low threshold of 10 ca","PeriodicalId":8158,"journal":{"name":"ANZ Journal of Surgery","volume":"95 3","pages":"271-272"},"PeriodicalIF":1.5,"publicationDate":"2025-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/ans.70003","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143447781","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":"Validating the MIMIC score as a predictor of successful spontaneous stone passage in patients managed conservatively for ureteric colic.","authors":"T M Milton, D N Noll, P S Stapleton, P Z Zhang, J C Chieng, J C Chow, J H Hewitt, L S Stroman, S V Van Beek, R S Steele","doi":"10.1111/ans.70033","DOIUrl":"https://doi.org/10.1111/ans.70033","url":null,"abstract":"<p><strong>Backgrounds: </strong>The MIMIC score was designed to predict the likelihood of spontaneous stone passage (SSP) in patients presenting with ureteric colic and given a trial of conservative management. The objective of this study was to determine the external validity of the MIMIC score.</p><p><strong>Methods: </strong>Cross-sectional, retrospective cohort study that reviewed patients over a 2-year period presenting with ureteric colic who were given a trial of conservative management. Patient-factors were recorded, and their MIMIC score calculated and compared to the observed outcome. Discrimination was determined using an area under the receiver-operating curve with an AUC >0.7 considered validated and calibration using calibration plot.</p><p><strong>Results: </strong>Three hundred ninety-nine patients were included. The median age was 49 (IQR 37-60). 79% were males. The mean stone size for successful SSP was 3.8 mm compared to 4.8 mm for failed SSP. 88% of stones passed spontaneously. The AUC was 0.68 (95% CI: 0.60-0.77). The calibration plot showed an underestimation of SSP. In the lowest quintile of patients with a mean predicted SSP rate of 46%, the observed SSP rate was 74% (95% CI: 63-83%). With a higher predicted SSP rate, the MIMIC score was accurate. In the highest quintile of patients with a mean predicted SSP rate of 90%, the observed SSP rate was 92% (95% CI: 84-97%).</p><p><strong>Conclusion: </strong>In this population, the prediction of the MIMIC score were not sufficiently accurate. There was overall an underestimation of SSP. The MIMIC score was accurate for patients who had a higher likelihood of SSP (>83%).</p>","PeriodicalId":8158,"journal":{"name":"ANZ Journal of Surgery","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143439300","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":"Synchronous acute internal hernia and marginal ulceration with bleeding causing acute abdominal pain","authors":"Preekesh Suresh Patel MBChB, MSc, FRACS,&nbsp;Michael Booth MBChB, FRACS","doi":"10.1111/ans.70013","DOIUrl":"10.1111/ans.70013","url":null,"abstract":"","PeriodicalId":8158,"journal":{"name":"ANZ Journal of Surgery","volume":"95 3","pages":"594"},"PeriodicalIF":1.5,"publicationDate":"2025-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143439297","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":"Patient experience with quality-of-life questionnaires for obstructive salivary gland disorders: a cross-sectional study.","authors":"Saskia Boogaard, Naveed Basheeth","doi":"10.1111/ans.19403","DOIUrl":"https://doi.org/10.1111/ans.19403","url":null,"abstract":"<p><strong>Background: </strong>Disease severity and treatment efficacy in salivary gland disorders can be gauged through quality-of-life (QoL) questionnaires. However, limited research has explored patient experience with these questionnaires. This cross-sectional study assessed the usability of, and patient experience with, six validated QoL questionnaires.</p><p><strong>Methods: </strong>This cross-sectional study assessed the usability of and patient experience with the QoL-15D, Oral Health Impact Profile-14, Manukau Salivary Symptom Score, Chronic Obstructive Sialadenitis Symptoms, Multidisciplinary Salivary Gland Society, and Glasgow Benefit Index questionnaires. We measured the time to complete each questionnaire, patient-perceived questionnaire coverage of symptoms and disease impact using a 5-point Likert scale, patient experience with the questionnaires through open feedback, and which questionnaire patients most preferred. There were 30 participants in this study.</p><p><strong>Results: </strong>All questionnaires tested could be completed in under 5 min each. The most preferred questionnaire was the Manukau Salivary Symptom Score (43%). Participants raised the following concerns regarding the questionnaires: unclear timeframes (90%), questions not being relevant (67%), initial questions not addressing their primary symptoms (40%), confusing or unclear question wording (37%), inconsistent response scale between questions (27%), and antibiotic use during flare-ups assuming access to primary medical care (7%).</p><p><strong>Conclusion: </strong>No previous study has measured and analysed patient experience with the currently validated QoL questionnaires used in salivary gland disorders. This study's findings can be used to inform both questionnaire selection as well as the development of future QoL questionnaires for salivary gland disorders in order to achieve a better overall patient experience and reduce unintentional bias.</p>","PeriodicalId":8158,"journal":{"name":"ANZ Journal of Surgery","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143439348","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":"Surgical trainee research collaboratives – here to stay?","authors":"Claudia Paterson MBChB,&nbsp;Andrew Hill MBChB, MD, FRACS, FRSNZ","doi":"10.1111/ans.70036","DOIUrl":"10.1111/ans.70036","url":null,"abstract":"&lt;p&gt;In this issue of the journal, the results from the ACCORD (Aotearoa New Zealand (AoNZ) Complete Clinical Response Database) study conducted by the STRATA (Surgical Trainee Research, Audit and Trials, Aotearoa) Collaborative are published. This national, retrospective cohort study investigated patients diagnosed with rectal cancer across 17 New Zealand hospitals over an 8-year period who were managed using a watch and wait (W&amp;W) approach.&lt;span&gt;&lt;sup&gt;1&lt;/sup&gt;&lt;/span&gt; W&amp;W is a relatively new concept that has gained traction in the past decade, where rectal resection is deferred in patients achieving a complete clinical response (cCR) after total neoadjuvant therapy (TNT), providing the patient with a chance of organ preservation.&lt;span&gt;&lt;sup&gt;1&lt;/sup&gt;&lt;/span&gt;&lt;/p&gt;&lt;p&gt;This work identified 133 patients managed with W&amp;W between 2015 and 2022 in AoNZ. Over time, the use of W&amp;W increased, with two-thirds of patients managed with W&amp;W by 2022.&lt;span&gt;&lt;sup&gt;1&lt;/sup&gt;&lt;/span&gt; The 2-year cumulative regrowth rate was 18.2%, and the 2-year cumulative rate of metastatic disease was 8.8%. The 2-year overall survival was 94.8%.&lt;span&gt;&lt;sup&gt;1&lt;/sup&gt;&lt;/span&gt; Encouragingly, these results show that AoNZ outcomes align with international data.&lt;span&gt;&lt;sup&gt;1&lt;/sup&gt;&lt;/span&gt;&lt;/p&gt;&lt;p&gt;This study by the STRATA Collaborative is an excellent example of how trainee-led collaborative research can produce results that are relevant and current. Trainee-led collaborative research networks are relatively new, with the first being the West Midlands Research Collaborative formed in the United Kingdom in 2007.&lt;span&gt;&lt;sup&gt;2&lt;/sup&gt;&lt;/span&gt; The STRATA Collaborative is a New Zealand example, formed in 2018.&lt;span&gt;&lt;sup&gt;2&lt;/sup&gt;&lt;/span&gt; More Australasian collaborative networks can be found on the RACS website and are supported by CTANZ (Clinical Trials Network Australia and New Zealand).&lt;span&gt;&lt;sup&gt;3, 4&lt;/sup&gt;&lt;/span&gt;&lt;/p&gt;&lt;p&gt;Trainee-led collaborative research has advantages for researchers and patients alike. Structured research programmes provide an opportunity for learning and upskilling beginner researchers, developing mentorship relationships, fostering an ongoing interest in research, and creating a sustainable pipeline for ongoing research.&lt;span&gt;&lt;sup&gt;5, 6&lt;/sup&gt;&lt;/span&gt; Expanding these opportunities to researchers in low- and middle-income countries should be a priority, and this has been mentioned as a goal in previous publications from collaborative groups.&lt;span&gt;&lt;sup&gt;2&lt;/sup&gt;&lt;/span&gt;&lt;/p&gt;&lt;p&gt;Protocol development, ethics applications and locality approvals are time-intensive and can be daunting, particularly for doctors balancing clinical demands with research. The development of proformas for common or similar processes allows for streamlining efforts for future projects.&lt;span&gt;&lt;sup&gt;5&lt;/sup&gt;&lt;/span&gt; Research waste has been identified as a major issue in surgical clinical trials and ensuring high-quality research at all stages is crucial for investment to result in better patient care.&lt;span&gt;&lt;sup&gt;7&lt;/sup&gt;&lt;/s","PeriodicalId":8158,"journal":{"name":"ANZ Journal of Surgery","volume":"95 3","pages":"273-274"},"PeriodicalIF":1.5,"publicationDate":"2025-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/ans.70036","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143413172","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":"Improving access for adult cochlear implantation.","authors":"Robert J S Briggs, Robert S C Cowan","doi":"10.1111/ans.70023","DOIUrl":"https://doi.org/10.1111/ans.70023","url":null,"abstract":"","PeriodicalId":8158,"journal":{"name":"ANZ Journal of Surgery","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143413155","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}