ANZ Journal of Surgery最新文献_第7页

Enhancing Organ Availability: Increased DCD Liver Utilization Following Implementation of a Normothermic Machine Perfusion Program. 增强器官可用性：在实施恒温机器灌注程序后增加DCD肝脏利用率。

IF 1.5 4区医学

ANZ Journal of Surgery Pub Date : 2025-05-19 DOI: 10.1111/ans.70176

Marwan T Idrees, Gabriel Land, Nicky Kathuria, Nicholas Butler, Peter Hodgkinson

{"title":"Enhancing Organ Availability: Increased DCD Liver Utilization Following Implementation of a Normothermic Machine Perfusion Program.","authors":"Marwan T Idrees, Gabriel Land, Nicky Kathuria, Nicholas Butler, Peter Hodgkinson","doi":"10.1111/ans.70176","DOIUrl":"https://doi.org/10.1111/ans.70176","url":null,"abstract":"In Australia, donation after circulatory death (DCD) liver utilization remains below that of comparable healthcare systems in the Northern Hemisphere, due to concerns over higher rates of early hepatocellular dysfunction/nonfunction and ischemic cholangiopathy, coupled with limited organ availability and challenging organ transport logistics. To address this, the Queensland Liver Transplant Service introduced the OrganOx Metra normothermic machine perfusion (NMP) device in 2018. Positive outcomes were initially reported for 10 livers, including five DCD livers deemed unsuitable for static cold storage (SCS). This retrospective, historical-control study evaluated whether NMP availability improved DCD liver utilization. The NMP era (June 2018 to June 2021) was compared to the SCS era (June 2015 to June 2018), with all DCD activity included, regardless of the preservation technique. Donor data were sourced from the DonateLife Queensland database, and patient outcome data were gathered from the electronic medical records of Princess Alexandra Hospital, Queensland. The NMP era showed significantly higher rates for medically suitable DCD offers(90.5% vs. 66.1%, p < 0.01), higher rates of formal DCD offers (88.1% vs. 61.0%, p < 0.01), greater DCD planned retrieval rate (56.6% vs. 23.7%, p < 0.01), and higher implantation rate as a proportion of all DCD offers (18.8% vs. 5.9%, p < 0.01). More potentially viable DCD grafts were declined because of the lack of suitable recipients, suggesting an abundance of available livers and reduced waitlist. Despite increased DCD utilization and a higher mean modified UK DCD risk score in the NMP era (1.5 vs. 0, p = 0.05), there was no increase in early allograft dysfunction, primary nonfunction, ischemic cholangiopathy, or re-transplantation.","PeriodicalId":8158,"journal":{"name":"ANZ Journal of Surgery","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144092629","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}

引用次数: 0

Time to Computed Tomography for Major Trauma Patients: 10-Year Trends at a Level-1 Trauma Centre. 重大创伤患者的计算机断层扫描时间：一级创伤中心的10年趋势。

IF 1.5 4区医学

ANZ Journal of Surgery Pub Date : 2025-05-19 DOI: 10.1111/ans.70163

Claudia A Yarad, Daniel Lewis, Benjamin M Hardy, Kate L King, Angela Fischer, Zsolt J Balogh

{"title":"Time to Computed Tomography for Major Trauma Patients: 10-Year Trends at a Level-1 Trauma Centre.","authors":"Claudia A Yarad, Daniel Lewis, Benjamin M Hardy, Kate L King, Angela Fischer, Zsolt J Balogh","doi":"10.1111/ans.70163","DOIUrl":"https://doi.org/10.1111/ans.70163","url":null,"abstract":"Introduction: Computed tomography (CT) is an essential part of trauma patient initial workup. Rapid performance of CT has become the standard of care in most parts of the world. This study aims to assess if the time to CT has changed over a 10-year period at the study centre and examine the potential impact on patient outcomes.Methods: A retrospective audit of prospectively collected trauma registry from 2010 to 2019 was performed, including trauma presentations to John Hunter Hospital (n = 9712) with injury severity score above 15. CT data, including start time, end time, time to CT and body region imaged, were collected from RIS-PACS.Results: Time to CT over the 10-year period ranged from 6 to 299, with a mean of 92 min. Regression analysis showed no overall change in time to CT. Patients who arrived intubated, polytrauma patients and those with isolated head injuries had faster time to CT. Longer time to CT was seen in patients hypotensive on arrival.Conclusions: Time to CT in trauma patients has not changed over a 10-year period, remaining below international standards. In-hospital mortality of major trauma patients at our institution continued to decrease over the study timeframe, resulting in one of the lowest risk-adjusted mortality rates in the country. Development and publication of an Australian KPI for Time to CT in Trauma patients is an important next step in Australian trauma policy and guidelines. This study will serve as a baseline for reassessment of trauma patient initial management workflow within the hospital following the addition of a new acute care services block, protocols for suitable major trauma patients to bypass the emergency resuscitation bay, and a CT hybrid room through our institution's expansion.","PeriodicalId":8158,"journal":{"name":"ANZ Journal of Surgery","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144092633","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}

引用次数: 0

Re: A History of Advocacy in Breast Cancer: Lessons for All of Us in Putting Advocacy to Work-Or 'How to Just Get Things Done!' 乳腺癌倡导的历史：我们所有人在倡导工作中的经验教训——或者“如何把事情做好！”

IF 1.5 4区医学

ANZ Journal of Surgery Pub Date : 2025-05-15 DOI: 10.1111/ans.70177

Emma Charters, Sarah Davies, Chris Milross, Gail O'Brien

引用次数: 0

The Place of Appendicectomy in Inflammatory Bowel Disease-A Review. 阑尾切除术在炎性肠病中的地位——综述。

IF 1.5 4区医学

ANZ Journal of Surgery Pub Date : 2025-05-15 DOI: 10.1111/ans.70157

Krishanth Naidu, Pearl Wong, Pierre H Chapuis, Matthew J F X Rickard, Kheng-Seong Ng

引用次数: 0

Classifying Laparoscopic Variations of the Mesoappendix. Response to: "Anatomical and Clinical Variations in the Mesoappendix and Appendicular Arteries". 腹腔镜阑尾系膜病变分类。对“阑尾系膜和尾动脉的解剖和临床变异”的回应。

IF 1.5 4区医学

ANZ Journal of Surgery Pub Date : 2025-05-15 DOI: 10.1111/ans.70183

Ernest Cheng, Wilson Petrushnko

引用次数: 0

Predictors of Discharge Home Versus Inpatient Rehabilitation Following Total Hip and Knee Arthroplasty-Cohort Study. 全髋关节和膝关节置换术后出院与住院康复的预测因素——队列研究。

IF 1.5 4区医学

ANZ Journal of Surgery Pub Date : 2025-05-15 DOI: 10.1111/ans.70170

Kaka Martina, Michelle M Dowsey, David J Hunter, Justin P Roe, Matthew C Lyons, Michael D O'Sullivan, Benjamin Gooden, Phil Huang, David Carmody, Keran Sundaraj, Leo A Pinczewski, Lucy J Salmon

{"title":"Predictors of Discharge Home Versus Inpatient Rehabilitation Following Total Hip and Knee Arthroplasty-Cohort Study.","authors":"Kaka Martina, Michelle M Dowsey, David J Hunter, Justin P Roe, Matthew C Lyons, Michael D O'Sullivan, Benjamin Gooden, Phil Huang, David Carmody, Keran Sundaraj, Leo A Pinczewski, Lucy J Salmon","doi":"10.1111/ans.70170","DOIUrl":"https://doi.org/10.1111/ans.70170","url":null,"abstract":"Background: This study aims to identify the prevalence of inpatient rehabilitation (IPR) use in an Australian private total joint arthroplasty (TJA) cohort and to identify factors predictive of IPR discharge, including components of the Risk Assessment and Prediction Tool (RAPT).Methods: Primary TJA patients at a Sydney private hospital, between 2021 and 2022 were identified from an institutional arthroplasty database. Variables previously deemed as predictive factors for IPR facility discharge in the literature and components of RAPT were assessed utilising multivariable generalised linear model analysis.Results: Of the 733 total hip arthroplasty (THA) and 776 total knee arthroplasty (TKA) patients included, 46% of THA and 64% of TKA subjects transferred to IPR post-acutely. Bilateral procedure (OR 7.91, p < 0.001), living alone (OR 5.23, p < 0.001), older age groups (66-75 (OR 2.14, p = 0.001)); (> 75 (OR 5.02, p < 0.001)), poorer walking distance (1-2 blocks (OR 1.64, p = 0.023)); (housebound (OR 2.68, p = 0.009)), were significant predictors of IPR following THA. In the TKA cohort, the significant predictors of IPR discharge were female (OR 2.47, p < 0.001), older age (66-75 (OR 1.73, p = 0.021)); (> 75 (OR 4.23, p < 0.001)), bilateral procedure (OR 6.86, p < 0.001), obesity (OR 1.76, p = 0.006), living alone (OR 2.86, p = 0.001) and surgeon (surgeon 3 (OR 2.30, p = 0.024)); (surgeon 4 (OR 3.04, p = 0.003)); (surgeon 5 (OR 2.18, p = 0.046)).Conclusion: The use of IPR following TJA was associated with some clinically justifiable factors, such as bilateral procedure, older age, and living alone. However, other variables may be driven by inappropriate and potentially modifiable societal expectations, such as being female, obesity, treating surgeon, and limited walking distance.","PeriodicalId":8158,"journal":{"name":"ANZ Journal of Surgery","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144075562","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}

引用次数: 0

Surgeons and Their Mental Health: Is There a Problem? 外科医生和他们的心理健康：有问题吗？

IF 1.5 4区医学

ANZ Journal of Surgery Pub Date : 2025-05-15 DOI: 10.1111/ans.70182

Mohamed H Khadra, Nicholas Glozier

引用次数: 0

Traffic Light Coding System for Engaging With AI in Surgery. 在外科手术中与人工智能互动的红绿灯编码系统。

IF 1.5 4区医学

ANZ Journal of Surgery Pub Date : 2025-05-15 DOI: 10.1111/ans.70172

Payal Mukherjee, Amin Beheshti, Shivani Angelique Kumar, Gordon Wallace, Neil Merrett, Jonathan Clark, Simon Kos, Ellen Rawstron, Jian Yang, Stuart Grieve, Amith Shetty, Simon Singer

引用次数: 0

Laboratory Assessment of Anastomotic Configurations Utilized for Intracorporeal Anastomosis in Laparoscopic Right Hemicolectomy. 腹腔镜右半结肠切除术中吻合口形态的实验室评价。

IF 1.5 4区医学

ANZ Journal of Surgery Pub Date : 2025-05-14 DOI: 10.1111/ans.70147

Ali Hooshyari, Sina Karimian, Malsha Kularatna, Mark Omundsen, Benjamin Cribb

{"title":"Laboratory Assessment of Anastomotic Configurations Utilized for Intracorporeal Anastomosis in Laparoscopic Right Hemicolectomy.","authors":"Ali Hooshyari, Sina Karimian, Malsha Kularatna, Mark Omundsen, Benjamin Cribb","doi":"10.1111/ans.70147","DOIUrl":"https://doi.org/10.1111/ans.70147","url":null,"abstract":"Background: An intracorporeal anastomosis for colorectal resections has several advantages over a traditional extracorporeal anastomosis. A double stapled intracorporeal anastomosis compared to a single-stapled technique could reduce operative time and increase uptake of this beneficial technique. However, the patency and calibre of this anastomosis require laboratory assessment.Objective: The aim of the study was to assess and compare the luminal diameter and patency of the double-stapled (intracorporeal type) anastomosis (DICA) with a single-stapled (intracorporeal type) anastomosis (SICA) and a double-stapled (extra-corporeal type) anastomosis (ECA).Methods: Experimental laboratory-based study using fresh bovine intestine. Construction and assessment of two of each of the following anastomotic types: DICA, SICA, and ECA. The primary outcome measure was the luminal diameter of the anastomosis, comparing the ratios of the narrowest point of the anastomosis to the narrowest luminal diameter. Secondary outcome tests were leak and patency testing for each anastomosis.Results: All six anastomoses were found to be patent and without any anastomotic leakage. The ratio of narrowest anastomotic diameter to narrowest luminal diameter for all three anastomoses was comparable (extracorporeal anastomosis 1.16, single-stapled intracorporeal anastomosis 1.0 and double-stapled intracorporeal anastomosis 0.97).Conclusion: This study confirms the in vitro patency and the adequacy of luminal diameter of the double stapled (intracorporeal type) anastomosis.","PeriodicalId":8158,"journal":{"name":"ANZ Journal of Surgery","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143969307","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}

引用次数: 0

3D-reconstruction printed models could enhance understanding of Crohn's disease complex perianal fistulas? 3d重建打印模型能提高对克罗恩病复杂肛周瘘管的认识？

IF 1.5 4区医学

ANZ Journal of Surgery Pub Date : 2025-05-14 DOI: 10.1111/ans.70140

Sebastián Jerí-McFarlane, Álvaro García-Granero, Aina Ochogavía-Seguí, Daniel Ginard-Vicens, Leandro Brogi, Marc Ferrà-Canet, Margarita Gamundí-Cuesta, Francisco Xavier González-Argenté

{"title":"3D-reconstruction printed models could enhance understanding of Crohn's disease complex perianal fistulas?","authors":"Sebastián Jerí-McFarlane, Álvaro García-Granero, Aina Ochogavía-Seguí, Daniel Ginard-Vicens, Leandro Brogi, Marc Ferrà-Canet, Margarita Gamundí-Cuesta, Francisco Xavier González-Argenté","doi":"10.1111/ans.70140","DOIUrl":"https://doi.org/10.1111/ans.70140","url":null,"abstract":"Background: 3D image processing and reconstruction (3D-IPR) is increasingly used in surgical applications for enhanced planning and intraoperative visualization. 3D-printed models, created from 3D-IPR, have the potential to improve understanding of anatomical structures and simulate surgical procedures. However, evidence supporting their educational benefits, particularly for complex perianal Crohn's disease (pCD) fistulas, remains limited.Methods: This study assessed the role of 3D-printed models as teaching tools for general surgery and gastroenterology trainees/attendants. Two courses were developed, incorporating pre-tests, lessons, real case presentations with MRI scans, and discussions using 3D-printed models. Pre- and post-course test scores were analyzed to evaluate learning outcomes.Results: Participants demonstrated significant improvement in post-test scores compared to pre-test scores, highlighting the educational impact of 3D models. Course satisfaction surveys revealed high satisfaction, with most participants likely to recommend the course.Conclusions: 3D-IPR and 3D-printed models hold promise as effective tools for teaching complex pCD anatomy, enhancing surgical education, and improving understanding of 3D structures. These findings enhance the growing importance of integrating 3D technologies into modern surgical training.","PeriodicalId":8158,"journal":{"name":"ANZ Journal of Surgery","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143956919","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}

引用次数: 0