ANZ Journal of Surgery最新文献

{"title":"The Evolution of Aspirin in Colorectal Cancer Chemoprophylaxis.","authors":"L V O'Connell, J McCafferty, H M Mohan, A G Heriot, S K Warrier","doi":"10.1111/ans.70883","DOIUrl":"https://doi.org/10.1111/ans.70883","url":null,"abstract":"","PeriodicalId":8158,"journal":{"name":"ANZ Journal of Surgery","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2026-08-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148663304","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":"The Impact of Intraoperative Facial Nerve Monitoring During Parotidectomy on Postoperative Facial Nerve Function: A Systematic Review and Meta-Analysis.","authors":"H Buntain, M Thompson, C F Perry, O Hunter, S F Zahir, B Basu","doi":"10.1111/ans.70861","DOIUrl":"https://doi.org/10.1111/ans.70861","url":null,"abstract":"<p><strong>Background: </strong>Facial nerve dysfunction (FND) remains a key complication of parotidectomy. Intraoperative facial nerve monitoring (IOFNM) aims to assist facial nerve identification and preservation; however, its effect on postoperative FND remains unclear. This systematic review and meta-analysis evaluated the effect of IOFNM on facial nerve outcomes post-parotidectomy.</p><p><strong>Methods: </strong>PubMed, Embase, MEDLINE (Ovid) and CINAHL were searched from inception to August 22nd, 2025. Primary outcomes were immediate and permanent FND, assessed using the House-Brackmann grading system. Retrospective and prospective double-arm studies were included. Screening, data extraction and risk of bias assessment (ROBINS-I/RoB-2) were performed independently. Random-effects meta-analyses were conducted using restricted maximum likelihood. Certainty of evidence was assessed using GRADE.</p><p><strong>Results: </strong>Twelve studies (n = 2401) met inclusion criteria. Meta-analysis of ten studies (n = 2042) demonstrated significantly lower odds of immediate FND with IOFNM (OR 0.48; 95% CI: 0.31-0.72). This reduction occurred in superficial (OR 0.51; 95% CI: 0.30-0.87), but not total parotidectomy (OR 0.93; 95% CI: 0.42-2.08). Analysis of six studies (n = 981) found no significant difference in permanent FND (OR 0.84; 95% CI: 0.44-1.60). Four studies (n = 1369) reported operative time, with a non-significant reduction using IOFNM (MD -8.82 min; 95% CI: -18.78 to +1.13).</p><p><strong>Conclusion: </strong>IOFNM is associated with lower odds of immediate postoperative FND, particularly in superficial parotidectomy, but its effect on permanent FND and total parotidectomy remains uncertain. IOFNM use should be tailored to surgical complexity and surgeon experience, with high-quality prospective studies needed to clarify its clinical utility.</p>","PeriodicalId":8158,"journal":{"name":"ANZ Journal of Surgery","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2026-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148629109","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":"Omental Flaps: A Dependable Flap's Moment of Independence?","authors":"David Lee, Fiona Wee, Daniel Reilly, David Wardill","doi":"10.1111/ans.70890","DOIUrl":"https://doi.org/10.1111/ans.70890","url":null,"abstract":"","PeriodicalId":8158,"journal":{"name":"ANZ Journal of Surgery","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2026-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148617997","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":"Complications Following Abdominal-Based Microsurgical Breast Reconstruction.","authors":"Nicholas Savage, Jackson Catalano, Jieyun Zhou, Zakary Doherty, Shiba Sinha, William Blake","doi":"10.1111/ans.70882","DOIUrl":"https://doi.org/10.1111/ans.70882","url":null,"abstract":"<p><strong>Background: </strong>Microsurgical breast reconstruction is the gold standard for patients after a mastectomy. Despite the benefits associated with microsurgical reconstruction, there remain considerable challenges at the level of both patient and health service. This study aimed to uncover variables associated with post-surgical complications following microsurgical autologous reconstruction in a single centre Australian cohort with the aim of informing future strategies to reduce risk and cost.</p><p><strong>Methods: </strong>We conducted a retrospective cohort analysis utilising data from the electronic medical records of a tertiary breast reconstruction service in Melbourne, Australia between August 2022 and February 2024. Data on post-surgical complications were collected, with a particular focus on respiratory and wound complications.</p><p><strong>Results: </strong>A total of 204 women, with a mean age of 49.8 years, were included. Multivariate logistic analysis found that for every kg/m² point increase in BMI, respiratory complications increased by 8%. Respiratory comorbidities and operative duration were also associated with respiratory complications. For every kg/m² point increase in BMI, wound complications increased by 11%. Respiratory comorbidities and intra-operative fluid volume were also associated with wound complications.</p><p><strong>Conclusions: </strong>We identified several pre- and intra-operative risk factors that may assist in informing changes to standard clinical practice, in the hopes of optimising the overall experience for a patient undergoing microsurgical breast reconstruction. These quantified risks may also enable better patient education or institutional decisions to offer alternative pathways to high-risk patients.</p>","PeriodicalId":8158,"journal":{"name":"ANZ Journal of Surgery","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2026-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148618050","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":"Factors Influencing the Mental Health Status of Hepatocellular Carcinoma Patients Undergoing Hepatectomy.","authors":"Zhanchang Xie, Chunlong Liu, Shouge Zang, Panpan Wu, Rui Yang, Jiangtao Yu","doi":"10.1111/ans.70762","DOIUrl":"https://doi.org/10.1111/ans.70762","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the psychological status of patients with hepatocellular carcinoma (HCC) undergoing hepatectomy, analyze risk factors for anxiety and depression, and provide a theoretical basis for individualized mental intervention strategies.</p><p><strong>Methods: </strong>A total of 412 HCC patients who underwent hepatectomy at Fuyang People's Hospital from January 2022 to January 2026 were enrolled. The Hospital Anxiety and Depression Scale (HADS) and FRAIL scale were used to assess psychological status and frailty, respectively. Univariate ANOVA and linear regression were performed to analyze relationships between anxiety, depression, and perioperative factors.</p><p><strong>Results: </strong>Of 456 distributed questionnaires, 412 were valid (response rate: 90.35%). Mean HADS-A (anxiety) score was 8.34 ± 2.79: 130 asymptomatic, 192 doubtful, and 90 definite cases. Mean HADS-D (depression) score was 8.68 ± 2.75: 187 asymptomatic, 96 doubtful, and 129 definite cases. Univariate analysis showed associations between anxiety/depression and family income, open surgery, FRAIL score, and complications. Multivariate analysis identified open surgery, FRAIL score, and complications as independent risk factors (p < 0.05).</p><p><strong>Conclusion: </strong>Patients with HCC undergoing hepatectomy exhibited significant anxiety and depression symptoms. FRAIL score, open surgery, and complication severity were risk factors, warranting attention to postoperative negative emotions and timely intervention.</p>","PeriodicalId":8158,"journal":{"name":"ANZ Journal of Surgery","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2026-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148598054","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":"Status Quo Bias: An Overlooked Barrier to Sustainable Surgical Care.","authors":"Chen Lew, Arun Dhir, Ben Dunne, Eugenie Kayak, Robert Hoffmann","doi":"10.1111/ans.70887","DOIUrl":"https://doi.org/10.1111/ans.70887","url":null,"abstract":"<p><p>Healthcare contributes to the climate change, with operating theatres among the most resource-intensive environments. Although technological solutions to mitigate this exist, behavioural factors remain under-recognised barriers to sustainable surgical practice. This perspective examines status quo bias as a driver of reliance on single-use devices in surgery, one of the contributors to the carbon footprint of operating rooms. Drawing on behavioural economics, historical examples, and surgical data, we explore how entrenched defaults, training culture, and lack of feedback perpetuate waste without improving outcomes. Addressing status quo bias through redesigned defaults, feedback mechanisms, and cultural change is essential to advancing responsible surgical care.</p>","PeriodicalId":8158,"journal":{"name":"ANZ Journal of Surgery","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2026-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148598078","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":"Routine Preoperative Coagulation Screening in Elective Surgery: Time to Choose Wisely.","authors":"Kirollos Salah Kamel, Khalid Al-Azri","doi":"10.1111/ans.70886","DOIUrl":"https://doi.org/10.1111/ans.70886","url":null,"abstract":"","PeriodicalId":8158,"journal":{"name":"ANZ Journal of Surgery","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2026-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148590152","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":"Effectiveness of an Interdisciplinary Integrated Care Model on Perioperative Outcomes in Patients Undergoing Lung Cancer Surgery: A Randomized Controlled Trial.","authors":"Xingu Chen, Nili Zhang, Xiaohong Zhang, Shuping Liang, Shuting Liu, Ying Liu, Yan Yu","doi":"10.1111/ans.70841","DOIUrl":"https://doi.org/10.1111/ans.70841","url":null,"abstract":"<p><strong>Background: </strong>Lung cancer surgery is associated with significant perioperative morbidity, including pulmonary complications and psychological distress. The effectiveness of comprehensive interdisciplinary care models in improving outcomes remains insufficiently studied.</p><p><strong>Methods: </strong>This single-center randomized controlled trial enrolled 240 patients undergoing lung cancer surgery between March 2021 and December 2023. Patients were randomized 1:1 to receive either an interdisciplinary integrated care intervention (n = 120) or standard care (n = 120). The intervention included preoperative pulmonary rehabilitation, psychological support, nutritional optimization, and enhanced postoperative recovery protocols. The primary outcome was postoperative length of hospital stay (LOS). Secondary outcomes included postoperative pulmonary complications (PPCs), pain scores, functional recovery (6-min walk distance), psychological status (HADS), and quality of life (QLQ-C30). Intention-to-treat analysis was performed as the primary analysis.</p><p><strong>Results: </strong>In the ITT analysis, the intervention group had significantly shorter LOS compared to control (7.43 ± 1.94 vs. 9.02 ± 2.30 days; mean difference 1.59 days, 95% CI: 1.07-2.12; p < 0.001; Cohen's d = 0.75). After adjusting for baseline FEV1 imbalance, the difference remained significant (adjusted mean difference 1.54 days, 95% CI: 1.02-2.06; p < 0.001). PPCs were significantly lower in the intervention group (12.0% vs. 26.1%; RR = 0.46, 95% CI: 0.26-0.81; p = 0.008). The intervention group demonstrated superior functional recovery, with 6-min walk distance differences of 57.77 m at 1 month and 61.97 m at 3 months, both exceeding the minimal clinically important difference of 22-42 m. Psychological outcomes (HADS-anxiety: 4.19 ± 2.55 vs. 6.48 ± 3.22; HADS-Depression: 3.57 ± 1.97 vs. 5.19 ± 2.89 at 3 months; both p < 0.001) and quality of life were significantly improved.</p><p><strong>Conclusions: </strong>An interdisciplinary integrated care model significantly reduces hospital stay, decreases pulmonary complications, and improves functional and psychological outcomes in patients undergoing lung cancer surgery. These findings support the implementation of comprehensive perioperative care programs.</p>","PeriodicalId":8158,"journal":{"name":"ANZ Journal of Surgery","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2026-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148590218","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":"Clinical Relevance of the SOUND and INSEMA Trials in Women With Early Breast Cancer in Australia and New Zealand.","authors":"Matea Dominkovic, Kerry Hitos, Wei Wang, T Michael Hughes, James French, Nicholas Ngui","doi":"10.1111/ans.70879","DOIUrl":"https://doi.org/10.1111/ans.70879","url":null,"abstract":"<p><strong>Background: </strong>Axillary surgery in breast cancer has undergone progressive de-escalation. The recent Sentinel Node versus Observation after Axillary Ultrasound (SOUND) and Intergroup Sentinel Mamma (INSEMA) trials have demonstrated that sentinel lymph node biopsy may be safely omitted in selected patients. This study aimed to evaluate the clinical relevance and applicability of the SOUND and INSEMA trial criteria within the Australian and New Zealand context.</p><p><strong>Methods: </strong>Prospectively maintained data from the BreastSurgANZ Quality Audit (BQA) was analysed. Patients with invasive breast cancer treated between 2019 and 2023 who met the inclusion criteria of the SOUND and INSEMA trials were identified.</p><p><strong>Results: </strong>A total of 69 122 patients were treated for invasive breast cancer over the five-year study period, of whom 30 822 fulfilled the inclusion criteria of either the SOUND or INSEMA trials. Overall, 34.0% and 44.6% of patients with invasive breast cancer in Australia and New Zealand met the SOUND and INSEMA eligibility criteria, respectively. Tumour characteristics of BQA patients were more closely aligned with those reported in the SOUND trial than the INSEMA trial, although key differences in other clinicopathological features were observed.</p><p><strong>Conclusions: </strong>The SOUND and INSEMA trial criteria are applicable to over one-third of patients with invasive breast cancer in Australia and New Zealand, supporting the potential relevance of axillary surgery de-escalation in this population.</p>","PeriodicalId":8158,"journal":{"name":"ANZ Journal of Surgery","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2026-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148590200","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":"Point-of-View Video Recording Devices in Plastic Surgery: Educational Utility and Medicolegal Documentation Potential.","authors":"Frank Bevacqua, Emma Choong, Nelson Low","doi":"10.1111/ans.70876","DOIUrl":"https://doi.org/10.1111/ans.70876","url":null,"abstract":"<p><strong>Introduction: </strong>Operative video supports performance review and education, but consistent surgeon point-of-view (POV) capture in plastic and reconstructive surgery is challenging. We assessed the perceived educational effectiveness of a smart-glasses POV system and documentation/implementation considerations, including medicolegal use.</p><p><strong>Methods: </strong>De-identified operative segments were recorded using second-generation Meta AI Glasses. Curated videos/stills were shown to consultants, trainees, and medical students, who completed an anonymous questionnaire with optional free-text.</p><p><strong>Results: </strong>Thirty-five respondents participated (17 students, 12 junior doctors/registrars, 6 consultants); 24/35 (68.6%) provided free-text. Video quality and clarity/stability were rated good/excellent by 35/35 (100%); field of view and audio by 31/35 (88.6%) and 29/35 (82.9%). Documentation quality and clinically relevant detail were rated good/excellent by 33/35 (94.3%), and the added value of commentary was rated good/excellent by 32/35 (91.4%); 29/35 (82.9%) would recommend using POV recording for documentation. Educational value was strongly endorsed (34/35, 97.1% agreed POV recordings effectively teach/review technique). Patient-facing and medicolegal-related items were endorsed less consistently (22/35-30/35, 62.9%-85.7%). Consultants were more critical of the field-of-view/audio (good/excellent 50% each) and less likely than non-consultants to recommend routine documentation (1/6, 16.7% vs. 28/29, 96.6%). Free-text prioritised zoom/loupe compatibility, audio/lighting and alignment improvements, and governance around consent, privacy, storage, and access.</p><p><strong>Conclusion: </strong>Smart-glasses POV recording was considered a feasible, high-value adjunct to surgical education, especially when accompanied by narration. Wider adoption for routine documentation and medicolegal utility depends less on conceptual acceptance and more on resolving current technical limits and establishing robust consent, privacy, storage, access, and governance.</p>","PeriodicalId":8158,"journal":{"name":"ANZ Journal of Surgery","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2026-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148590144","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}