ANZ Journal of Surgery最新文献

{"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":"https://doi.org/10.1111/ans.70215","url":null,"abstract":"<p><strong>Background and aims: </strong>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><p><strong>Methods: </strong>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><p><strong>Results: </strong>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><p><strong>Conclusions: </strong>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>","PeriodicalId":8158,"journal":{"name":"ANZ Journal of Surgery","volume":" ","pages":""},"PeriodicalIF":1.5,"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}

{"title":"How to Do a Robotic Assisted Prostatectomy in Patients With Pre-Existing Inflatable Penile Prosthesis.","authors":"Hedda Cooper, Jodie McDonald, Emma Clarebrough, Jeremy Goad","doi":"10.1111/ans.70216","DOIUrl":"https://doi.org/10.1111/ans.70216","url":null,"abstract":"","PeriodicalId":8158,"journal":{"name":"ANZ Journal of Surgery","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144265163","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 Double Blind Randomised Controlled Trial Comparing Glenohumeral Cortisone With and Without Hydrodilatation in Patients With Frozen Shoulder.","authors":"Alastair Konarski, Kishen Narayanasamy, Jennifer Coghlan, Timothy Chung, Matthew Andrews, Simon Bell","doi":"10.1111/ans.70200","DOIUrl":"https://doi.org/10.1111/ans.70200","url":null,"abstract":"<p><strong>Background: </strong>Frozen shoulder (FS) is a common condition causing pain and stiffness in the shoulder. There is controversy over whether hydrodilatation (HD) gives improved outcomes compared to corticosteroid injection (CSI) alone. The aim of this study was to investigate if HD improves outcomes compared to CSI alone.</p><p><strong>Methods: </strong>This was a double-blinded RCT. Patients aged 18-90 with FS were included. The CSI group received an injection of contrast followed by local anaesthetic and steroid. The HD group received the same, followed by saline until capsular rupture or severe resistance. The primary outcome was pain-free range of motion (ROM), along with Shoulder Pain and Disability Index (SPADI) 8 weeks post-intervention, and American Shoulder and Elbow Surgeons Score (ASES), Simple Shoulder Test (SST) and Constant score.</p><p><strong>Results: </strong>Seventy-nine patients were included, with a mean age of 54 (29-70), 53% female. The ROM and SPADI improved in both groups (CSI from 57.4 to 35.8, HD from 57.7 to 32.7) along with ASES, SST and Constant. There were no significant differences between the groups at 8 weeks. HD was found to be more painful than CSI. Male patients achieved greater improvement in ER with HD, while females, patients with severe pain at presentation, and symptoms for less than 120 days favoured CSI.</p><p><strong>Conclusion: </strong>Both groups significantly improved, but there were no significant differences between the groups, although there were some differences between subgroups. We recommend tailoring the first-line treatment according to patient symptoms and baseline characteristics.</p>","PeriodicalId":8158,"journal":{"name":"ANZ Journal of Surgery","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144265161","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":"Evaluating Artificial Intelligence in Patient Education: DeepSeek-V3 Versus ChatGPT-4o in Answering Common Questions on Laparoscopic Cholecystectomy.","authors":"Hilmi Anil Dincer, Dogukan Dogu","doi":"10.1111/ans.70198","DOIUrl":"https://doi.org/10.1111/ans.70198","url":null,"abstract":"<p><strong>Background: </strong>Artificial intelligence-based large language models (AI-based LLMs) have gained popularity over traditional search engines for obtaining medical information. However, the accuracy and reliability of these AI-generated medical insights remain a topic of debate. Recently, a new AI-based LLM, DeepSeek-V3, developed in East Asia, has been introduced. The aim of this study is to evaluate the appropriateness, accuracy, and readability of responses and the usability of these answers for patient education provided by ChatGPT-4o and DeepSeek-V3 AI-based LLMs to frequently asked questions by patients regarding laparoscopic cholecystectomy (LC).</p><p><strong>Methods: </strong>The 20 most frequently asked questions by patients regarding LC were presented to the DeepSeek-V3 and ChatGPT-4o chatbots. Before each question, the search history was deleted. The comprehensiveness of the responses was evaluated based on clinical experience by two board-certified general surgeons experienced in hepatobiliary surgery using a Likert scale. Paired sample t-test and Wilcoxon signed rank test were used. Inter-rater reliability was analyzed with Cohen's Kappa test.</p><p><strong>Results: </strong>The DeepSeek-V3 chatbot provided statistically significantly more suitable responses compared to ChatGPT-4o (p = 0.033). On the Likert scale, DeepSeek-V3 received a 5-point rating for 19 out of 20 questions (95%), whereas ChatGPT-4o achieved a 5-point rating for only 13 questions (65%). Based on the evaluation conducted according to the reviewers' clinical experience, DeepSeek-V3 provided statistically significantly more appropriate responses (p = 0.008).</p><p><strong>Conclusion: </strong>Released in January 2025, DeepSeek-V3 provides more suitable responses to patient inquiries regarding LC compared to ChatGPT-4o.</p>","PeriodicalId":8158,"journal":{"name":"ANZ Journal of Surgery","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144265162","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":"Trends and Predictors of Total Neoadjuvant Therapy in Rectal Cancer: A Bi-National Registry Study Across Australia and New Zealand.","authors":"Ishraq Murshed, Sergei Bedrikovetski, Zachary Bunjo, Hidde M Kroon, Michelle Thomas, Tarik Sammour","doi":"10.1111/ans.70218","DOIUrl":"https://doi.org/10.1111/ans.70218","url":null,"abstract":"<p><strong>Background: </strong>Total Neoadjuvant Therapy (TNT) has significantly improved outcomes in locally advanced rectal cancer. Despite rising use and inclusion in international guidelines, adoption patterns in Australia and New Zealand (ANZ) remain unclear. This study determines bi-national patterns and predictors of TNT utilisation over a 6-year period.</p><p><strong>Methods: </strong>A retrospective population-based bi-national registry cohort study analysed data from the ANZ Bowel Cancer Outcome Registry from 2018 to 2024. Patients diagnosed with primary locally advanced rectal cancer (LARC) and treated with standard neoadjuvant therapy (SNT), consisting of long-course chemoradiotherapy or short-course radiotherapy, or TNT were included. The primary outcome was the incidence of TNT utilisation over time and determining pre-treatment predictive factors.</p><p><strong>Results: </strong>Of 33 270 patient entries, 3234 eligible LARC patients were identified, with 706 (21.8%) receiving TNT and 2528 (78.2%) receiving SNT. TNT usage increased from 11% in 2018 to 41% in 2023. On multivariable logistic regression, independent factors associated with decreased TNT use were older age (OR: 0.978, 95% CI: 0.970-0.985, p < 0.001), absence of multidisciplinary team discussion (OR: 0.113, 95% CI: 0.027-0.472, p = 0.003) and private health insurance (OR: 0.619, 95% CI: 0.441-0.869, p = 0.006). Factors associated with increased TNT use were clinical T4 tumours (OR: 2.020, 95% CI: 1.245-3.280, p = 0.004), node-positive status (OR: 1.481, 95% CI: 1.118-1.964, p = 0.006) and diagnosis during the years 2019-2023 (p < 0.05 for all).</p><p><strong>Conclusions: </strong>TNT is increasingly used in surgical rectal cancer patients captured in the BCOR in ANZ. This study provides a baseline for future benchmarking patterns of rectal cancer management.</p>","PeriodicalId":8158,"journal":{"name":"ANZ Journal of Surgery","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144257249","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":"Vision & the Ageing Surgeon: A Review.","authors":"Lloyd R Kopecny, Ashish Agar, Shing Wai Wong","doi":"10.1111/ans.70213","DOIUrl":"https://doi.org/10.1111/ans.70213","url":null,"abstract":"<p><p>Populations in the developed world are ageing and their surgeons are no exception. Accurate vision is essential for the surgeon to operate effectively, yet optimal vision has an expiry date in advancing age. This review examines the effects of ageing on the eye with particular focus on the visual changes of significance to senior surgeons who currently account for 20%-25% of the surgeon workforce. The major age-related diseases of the eye, which include cataracts, glaucoma, age-related macular degeneration and diabetic retinopathy, are surmised; together with physiologic ocular changes that accompany normal ageing, including loss of accommodation (presbyopia), reduced pupil size (senile miosis), reduced contrast sensitivity, and impaired binocular vision, amongst others. The aforementioned conditions may impair operative visualisation in the elderly surgeon and potentially impact surgical performance. Strategies and available technologies that support operative visualisation-particularly magnification aids, illumination systems and fluorescent dyes in surgery-are appraised with consideration to the senior surgeon who may be affected by the aforementioned visual changes associated with ageing. To inform minimum standards of visual function for safe surgical practice, future prospective studies are needed which report on individual surgeon-related measures of visual function together with postoperative outcomes. This vein of future research will allow for an evidence-based evaluation of proposed safety measures for which the data are currently lacking, thereby providing clarity regarding whether requisite age-based visual assessments improve surgical outcomes, and if so, at what age and frequency should such evaluations take place.</p>","PeriodicalId":8158,"journal":{"name":"ANZ Journal of Surgery","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144257250","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":"I Feel It in My Finger: Intraneural Lipoma of the Digital Nerve.","authors":"Brett Sacks, Sally Ng","doi":"10.1111/ans.70209","DOIUrl":"https://doi.org/10.1111/ans.70209","url":null,"abstract":"<p><p>Intraneural lipoma arising from the radial digital nerve of the left index finger.</p>","PeriodicalId":8158,"journal":{"name":"ANZ Journal of Surgery","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144224107","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-Retrieval and Non-Utilisation of Deceased Donor Kidneys for Transplantation: An Australian Cohort Study.","authors":"Rachel B Cutting, Nicole L De La Mata, Animesh Singla, James A Hedley, Helen Opdam, Philip Clayton, Kate Wyburn, Elena Cavazzoni, Paul Robertson, Henry Pleass, Angela C Webster","doi":"10.1111/ans.70208","DOIUrl":"https://doi.org/10.1111/ans.70208","url":null,"abstract":"<p><strong>Background: </strong>An efficient organ donation programme must maximise transplantation following initiation of organ recovery procedures.</p><p><strong>Methods: </strong>We conducted a cohort study of deceased donors in Australia (2014-2021) using Australia and New Zealand Organ Donation Registry data to characterise kidney non-retrieval (post-incision) and non-utilisation (retrieved, not transplanted). Donor characteristics included kidney side (left/right), kidney-only procurement, kidney donor profile index (KDPI), cause of death, resuscitation, donation after circulatory/neurological determination of death (DCDD/DNDD) and donor criteria (standard SCD/extended ECD), year, age, sex, blood group, ethnicity, comorbidities, smoking, BMI, weight, remoteness, occupation and socioeconomic disadvantage. System characteristics included jurisdiction of donor hospital, retrieval team and recipient's hospital.</p><p><strong>Results: </strong>Among 7211 kidneys (3683 donors) accepted for retrieval, 675 (9%) were non-retrieved and 430 (7%) were non-utilised. Crude non-retrieval rates doubled from 5% to 10% between 2014 and 2021 (p = 0.01) while non-utilisation remained around 7% (p = 0.1). After adjustment, non-retrieval was greater among donors with KDPI ≥ 75 (OR: 4.28, 95% CI: 2.08-8.81, p < 0.001), diabetes (OR: 1.74, 95% CI: 1.25-2.43, p = 0.001) and in recent years (annual OR: 1.08, 95% CI: 1.03-1.55, p = 0.002), and lower for ECD DCDD (OR: 0.46, 95% CI: 0.26-0.81, p = 0.01). Non-utilisation was greater for SCD DCDD (OR: 1.90, 95% CI: 1.28-2.82, p < 0.001), blood group AB (OR: 2.05, 95% CI: 1.16-3.64, p = 0.03) and in recent years (annual OR: 1.08, 95% CI: 1.02-1.15, p = 0.01), and lower in Tasmania (OR: 0.28, 95% CI: 0.08-0.97) and Queensland (OR: 0.57, 95% CI: 0.36-0.92, p = 0.03). Documented reasons for non-utilisation lacked transparency but included poor perfusion (17%).</p><p><strong>Conclusion: </strong>Increasing utilisation of higher KDPI kidneys and enhancing perfusion could help maximise kidney transplantation.</p>","PeriodicalId":8158,"journal":{"name":"ANZ Journal of Surgery","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144224108","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":"Correction of Secondary Chest Wall Deformity After Bentall and Sternal Turnover Procedures: Modified Wang and Wenlin Procedures.","authors":"Shaoyi Zheng, Wenlin Wang, Weiguang Long, Yang Liu, Bin Cai, Juan Luo","doi":"10.1111/ans.70210","DOIUrl":"https://doi.org/10.1111/ans.70210","url":null,"abstract":"<p><p>Secondary chest wall deformities are usually more complex and difficult to correct than primary deformities, especially the secondary chest wall deformity after cardiovascular surgery. This occurs because the severe adhesions in the mediastinum, the risk of bleeding, and the complexity of the deformity increase the difficulty of correcting the deformity. However, by combining the modified Wang procedure and Wenlin procedure, we can overcome these shortcomings.</p>","PeriodicalId":8158,"journal":{"name":"ANZ Journal of Surgery","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144224106","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}