ANZ Journal of Surgery最新文献

{"title":"25, 50 and 75 Years Ago","authors":"Julian A. Smith","doi":"10.1111/ans.70267","DOIUrl":"10.1111/ans.70267","url":null,"abstract":"","PeriodicalId":8158,"journal":{"name":"ANZ Journal of Surgery","volume":"95 7-8","pages":"1348-1349"},"PeriodicalIF":1.6,"publicationDate":"2025-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144697493","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":"Management of Acute Gallstone Disease in Older Adults and Associated Outcomes","authors":"Kate Junker,&nbsp;Amanda Foster,&nbsp;Anand Trivedi,&nbsp;Shabnam Islam,&nbsp;Oscar Aldridge,&nbsp;Tristan Gilliland,&nbsp;Anuttara Panchali W. Kumarasinghe","doi":"10.1111/ans.70268","DOIUrl":"10.1111/ans.70268","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Older adults (≥ 65 years) present with complex Acute Gallstone Disease (AGD) and can deteriorate rapidly, necessitating time-critical decision making. We describe AGD presentation, management, and associated outcomes in older adults.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Older adults with AGD between May 2021 and April 2022 were identified from a prospectively maintained dataset, including age, Clinical Frailty Scale (CFS) and co-morbidities. Data pertaining to diagnosis, management, and outcomes (mortality, discharge destination, readmissions) were collected retrospectively.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of 122 older adults with AGD, 63.1% were vulnerable or frail, 80.3% were moderately or severely co-morbid, and 54.1% had Acute Calculous Cholecystitis (ACC). 43.9% were managed with antibiotics alone, 28.8% via Early Cholecystectomy (EC), 21.2% via Percutaneous Cholecystostomy (PC), 4.5% with Endoscopic Retrograde Cholangiography (ERCP), and 1.5% palliated. The EC cohort was less frail and less co-morbid (CFS = 3, CCI = 3, <i>p</i> = 0.05) compared to those managed non-operatively. Inpatient mortality was 13.3% post-PC and 0% post-EC (<i>p</i> = 0.03). 38.5% of those managed with antibiotics alone represented at 90 days, as did 40% post-PC. In contrast, post-EC, 83.3% were discharged directly home, with 4.17% (<i>p</i> ≤ 0.01) readmitted at 90 days.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Older adults presenting with AGD have frailty and co-morbidities, and ACC is the most frequent presentation. 28.8% of ACC was managed via EC, which was safe and effective, with &gt; 80% discharged home, &lt; 5% 90-day readmissions, and no inpatient mortalities. Readmission was highest post PC and antibiotics. Frailty, co-morbidities, procedural and anaesthetic risk, and associated clinical outcomes need to be considered when managing AGD in older adults.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8158,"journal":{"name":"ANZ Journal of Surgery","volume":"95 9","pages":"1750-1757"},"PeriodicalIF":1.6,"publicationDate":"2025-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144697494","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":"Redefining the Impact of Cancer in Aotearoa New Zealand","authors":"Nasya Thompson,&nbsp;John Pearson,&nbsp;Francis Frizelle,&nbsp;Jonathan Koea,&nbsp;Tamara Glyn","doi":"10.1111/ans.70259","DOIUrl":"10.1111/ans.70259","url":null,"abstract":"&lt;p&gt;Globally, there are around 20 million new cancer diagnoses each year, with cancer accounting for approximately 15% of all deaths. In Aotearoa New Zealand (AoNZ), cancer diagnoses are projected to increase from 25 700 per year in 2015–2019 to 45 100 per year by 2040–2044, a 76% increase [&lt;span&gt;1&lt;/span&gt;]. A cancer diagnosis has a profound and often long-lasting impact on patients and their whānau, extending beyond the treatment period to affect many aspects of daily life. These impacts are not limited to health or quality-of-life (QoL) issues but include multidimensional burdens such as financial strain, social disruption, and psychological stress. Despite widespread recognition of these challenges, we lack a comprehensive way to measure the true impact of cancer, particularly in ways that reflect the lived experiences of patients and their whānau. A broader understanding of survivorship is urgently needed to guide meaningful policy, ensure equitable care, and allocate resources where they are most needed. The use of a tool to identify unmet needs may inform resourcing decisions by improving access to funding for transport, accommodation, disability support, rural outreach, hauora navigators, access to Rongoā, and other culturally appropriate support services.&lt;/p&gt;&lt;p&gt;Current tools for measuring the impact of cancer focus on assessing biomedical outcomes, such as survival rates and disease progression, or health-related QoL for cost assessment analyses. These assessments range from generic QoL questionnaires—such as the SF 36, EuroQol-5 dimensions instrument [&lt;span&gt;2&lt;/span&gt;] and the Nottingham Health Profile [&lt;span&gt;3&lt;/span&gt;]—to specialised questionnaires that have been validated in patients with cancer, including the European Organization for Research and Treatment of Cancer QLQ-C30 questionnaire [&lt;span&gt;4&lt;/span&gt;], the Assessing Quality of Life in Adult Cancer Survivors scale [&lt;span&gt;5&lt;/span&gt;] and the Functional Assessment of Cancer Therapy-Br [&lt;span&gt;6&lt;/span&gt;]. Research utilising these tools has demonstrated that cancer survivors suffer from poorer quality of life, experience increased rates of anxiety and depressed mood, have more limitations in their activities of daily living, and report poorer health overall when compared to those without a cancer diagnosis [&lt;span&gt;7&lt;/span&gt;]. These tools are often used in research to assess their relationship to disease outcomes, rather than to support patients' social, economic, and cultural well-being. Furthermore, cancer follow-up is focused on clinical outcomes (e.g., has the cancer returned) and often deprioritised as they are not as financially valuable as new patient appointments. These appointments could be used to measure and support survivorship well-being.&lt;/p&gt;&lt;p&gt;While these instruments provide valuable insights, they fail to capture a more holistic impact of cancer on patients and their whānau (extended whānau and caregivers), particularly across diverse ethnic and social contexts. A broader understand","PeriodicalId":8158,"journal":{"name":"ANZ Journal of Surgery","volume":"95 9","pages":"1660-1662"},"PeriodicalIF":1.6,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/ans.70259","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144688771","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":"Total Neoadjuvant Therapy in Rectal Cancer: A Clinically and Economically Sound Strategy.","authors":"Francesco Fiorica, Elvira Rampello, Jacopo Giuliani, Maria Viviana Candela","doi":"10.1111/ans.70257","DOIUrl":"https://doi.org/10.1111/ans.70257","url":null,"abstract":"","PeriodicalId":8158,"journal":{"name":"ANZ Journal of Surgery","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144688772","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":"Robotic Transabdominal Preperitoneal Inguinal Hernia Repair Is Feasible and Efficient: A Prospective Cohort Study of a Day-Only Protocol From a High-Volume Robotic Surgery Centre Evaluating Short-Term Outcomes.","authors":"Joseph Do Woong Choi, Lauren Bradford, Kim Tang, Mark Bukofzer, Paul Dunkin, Hannah Wong, Ammar Ali-Beck, Andrew Spillane, Jennifer Van Der Heever, Catherine Murphy, Julian Kueh, Rennie Woodman, Aime Needs, Kar Yin Fok, Michelle Chen, Assad Zahid, Jaswinder Samra, Andrew Craig Lynch, Christos Apostolou, Walid Barto, Stephen Pillinger","doi":"10.1111/ans.70263","DOIUrl":"https://doi.org/10.1111/ans.70263","url":null,"abstract":"<p><strong>Background: </strong>Inguinal hernia repair (IHR) is one of the most frequently performed procedures in general surgery. There is clinical equipoise regarding the increasing global adoption of robotic IHR as a safe minimally invasive option. We present the short-term outcomes of robotic transabdominal (R-TAPP) preperitoneal IHR as a protocol-driven day-only procedure within a high-volume centre.</p><p><strong>Methods: </strong>Single institution prospective cohort study of 200 consecutive patients using the da Vinci Xi system from July 2023 to April 2025. Elective adult patients with index or recurrent unilateral or bilateral inguinal hernias were eligible. Postoperative day (POD) 1.7 and 28 pain scores and analgesia use were recorded. Thirty-day operative complications were tabulated.</p><p><strong>Results: </strong>Eighty-nine percent were male and 66% underwent unilateral R-TAPP IHR. Six percent had redo surgery for recurrent inguinal hernia. For unilateral IHR, the median console time was 29 min (IQR: 21-39.5), knife to skin and skin closure time was 49 min (IQR: 37-59.5) and total time into and out (wheels in to wheels out) of theatre was 77 min (IQR: 66.5-88.5). The median length of stay was 0 days (range: 0-2). Median POD 1.7 and 28 pain scores were 4, 2, and 0 (out of 10). Clavien-Dindo 1-2 complications occurred in 4%. There were no hernia recurrences.</p><p><strong>Conclusions: </strong>R-TAPP IHR is feasible and safe, with comparatively lower operative time than the reported literature. Most patients were discharged as a day-only procedure, with minimal postoperative pain. Future studies will investigate the cost and longer-term outcomes.</p>","PeriodicalId":8158,"journal":{"name":"ANZ Journal of Surgery","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144673778","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 Effects of Gum Chewing in the Postoperative-Period: A Systematic Review and Meta-Analysis","authors":"Calandra Li,&nbsp;Akhil Nair,&nbsp;Xi Ming Zhu,&nbsp;Mikaela Leung,&nbsp;Gabrielle Leung,&nbsp;Joseph Catapano,&nbsp;Mark McRae","doi":"10.1111/ans.70238","DOIUrl":"10.1111/ans.70238","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>Postoperative ileus (POI) is a transient impairment of gastrointestinal motility occurring after surgery. Patients with POI can suffer from complications such as increased risk of nosocomial infections, overall mortality risk, and higher overall healthcare costs. This study aims to (a) evaluate the effectiveness of gum chewing on relieving POI symptoms (b) conduct meta-analysis on POI outcome variables to estimate overall effect size.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We searched MEDLINE (Ovid), EMBASE, CINAHL, Web of Science, and Scopus for English language randomized controlled trials (RCTs), evaluating the postoperative effects of gum chewing in adult surgical patients. Two reviewers independently screened titles, abstracts, and full texts, resolving conflicts by discussion. Study quality was assessed using the GRADE system. Meta-analysis was conducted within two surgical specialty subgroups separately.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>From 1925 citations, 714 duplicates were removed. After title/abstract screening, 128 proceeded to full text review, out of which 43 studies met the inclusion criteria. Among RCTs, 69.8% noted statistically significant improvement in at least one of the POI outcomes in the intervention cohort. Meta-analysis showed significant reductions in time to first flatus (−7.4 h; <i>p</i> = 0.0003) and defecation (−18.64 h; <i>p</i> &lt; 0.0001) in general and colorectal surgery. Similar reductions were also observed in the OBGYN and gynecology cohort: flatus (−6.52 h; <i>p</i> &lt; 0.0001) and defecation (−9.71 h; <i>p</i> = 0.003).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Chewing gum is a safe low-cost intervention that has the potential to significantly reduce POI symptoms and hospitalization times. Meta-analysis validated the clinical relevance of the intervention. Standardized protocols are still required to delineate true effect sizes and reduce heterogeneity.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8158,"journal":{"name":"ANZ Journal of Surgery","volume":"95 7-8","pages":"1320-1328"},"PeriodicalIF":1.6,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/ans.70238","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144673788","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":"Effects of Complex Ventral Hernia and Stoma on Body Image and Interpersonal Relationships","authors":"Bing Wang,&nbsp;Sameer Mohammad Khan,&nbsp;Femi E. Ayeni,&nbsp;Anita Jacombs","doi":"10.1111/ans.70264","DOIUrl":"10.1111/ans.70264","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Complex ventral hernias (CVH) are an increasingly prevalent condition. Historically, surgeons have focused on surgical complications and recurrence in assessing the success of hernia repair surgery. In recent years, an increasing focus has been placed on quality-of-life outcomes in patients, with newer questionnaires being developed to assess these outcomes. Despite this, there is limited data available on the effects on body image and interpersonal relationships. Stomas are a similar condition which involves a defect in the abdominal wall, for which body image and relationship impacts have been studied more extensively. The aim of this project was to conduct a narrative review of the literature to determine how body image and interpersonal relationships are affected in complex ventral hernia patients, drawing from the data on stoma patients.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This study was a narrative review, with searches conducted to examine the literature on complex ventral hernia and stoma patients' experiences with body image and interpersonal relationship changes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>We found patients with CVH notice significant impairments to their body image and quality of relationships, with the experience of negative changes to body image, sexual relationships, and social relationships.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The impairments in body image and interpersonal relationships suggest a need to assess these outcomes when considering overall wellbeing in patients with complex ventral hernias. Further research and validation will provide insight into management and outcomes of such patients.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8158,"journal":{"name":"ANZ Journal of Surgery","volume":"95 9","pages":"1687-1693"},"PeriodicalIF":1.6,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/ans.70264","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144658196","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":"A Scoping Review on the Data Utility, Clinical Impact, and Cost of Multidisciplinary Team Meetings for Pancreatic Cancer.","authors":"Que Wuttivat Sabmeethavorn, Amy Sylivris, Rachael Mackie, Geertje Noë, Julie Chu, Belinda Lee, Benjamin Paul Timothy Loveday","doi":"10.1111/ans.70262","DOIUrl":"https://doi.org/10.1111/ans.70262","url":null,"abstract":"<p><strong>Background: </strong>Multidisciplinary Team Meetings (MDMs) are the accepted model for constructing treatment plans for pancreatic cancer (PC). With increasing PC diagnoses and budget constraints, MDMs must undertake cost-effective workflows. We aimed to summarize available evidence on the utility of information collected, their impact on care decisions, and cost burden.</p><p><strong>Methods: </strong>A systematic scoping review was conducted, searching MEDLINE, EMBASE, and CINAHL databases until December 2023. Included studies related to adult PCMDMs, their impact on diagnosis, treatment plans, and costs. Data were deductively and inductively analyzed based on study aims.</p><p><strong>Results: </strong>Exactly 36 studies were included from 3728 identified studies. Information influencing MDM decisions were patient age, alcohol use, comorbidities, CEA/CA19-9, and CT imaging, with structured referral forms reported to improve data collection. PCMDMs changed initial diagnosis in 3.4%-21.7%, resectability assessment in 18.7%-29.7%, and treatment plan in 18.2%-72.2% of patients. PCMDMs increased participation in clinical trials/cancer registries. PCMDMs accrued substantial time (16.5 h weekly preparation per MDM) and financial cost ($240 USD/case).</p><p><strong>Conclusion: </strong>PCMDM best practice should include standardization of collected data, identifying patients for clinical trials/registries, and knowledge of emerging technologies. Further research on PCMDM cost-burden is required to improve its cost-effectiveness.</p>","PeriodicalId":8158,"journal":{"name":"ANZ Journal of Surgery","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144658195","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":"General Surgical Management of Lower Gastrointestinal Bleeding in a Rural Setting-A Case for Establishing a Local Management Guideline.","authors":"Prahalath Sundaram, Alexandra Zalums, Nestor Sabat, Rakin Rahman, Mahanama Dissanayake, Theophilus I Emeto","doi":"10.1111/ans.70260","DOIUrl":"https://doi.org/10.1111/ans.70260","url":null,"abstract":"<p><strong>Background: </strong>Acute lower gastrointestinal bleeding (LGIB) presents a management challenge in regional and rural hospitals due to limited resources and potential delays in accessing specialist care. This study aimed to assess the performance of general surgeons in a rural general hospital in managing patients with acute LGIB using a quality indicator framework.</p><p><strong>Methods: </strong>A single-center retrospective study reviewed the records of adult patients presenting to the emergency department with acute LGIB between January 2017 and June 2022. Data on demographics, clinical and laboratory findings, initial management strategies, and patient outcomes were extracted from electronic medical records (EMR).</p><p><strong>Results: </strong>A total of 145 patients were included. Key findings revealed underutilization of the Oakland score system, inconsistencies in blood product transfusion practices, and inappropriate management of antiplatelet medications. Notably, there was an observed overuse of computed tomography angiography (CTA) despite limited access to interventional radiology services. Endoscopic interventions, however, demonstrated effectiveness in managing acute LGIB at the hospital.</p><p><strong>Conclusion: </strong>This study highlights the need for a locally developed clinical guideline tailored to the specific resource constraints of the hospital. The findings further emphasize the importance of proficiency in endoscopic techniques for rural general surgeons managing patients with acute LGIB. This study can serve as a foundation for the development of a local guideline to optimize the management of acute LGIB in this setting.</p>","PeriodicalId":8158,"journal":{"name":"ANZ Journal of Surgery","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144641605","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 the Impact of Mental Disorders on Outcomes Following Esophagectomy for Cancer: A Systematic Review and Meta-Analysis","authors":"Dimitrios Papaconstantinou,&nbsp;Theano Perri,&nbsp;Nikolaos Christodoulou,&nbsp;Orestis Lyros,&nbsp;Dimosthenis Chrysikos,&nbsp;Efstathia Liatsou,&nbsp;Georgios D. Lianos,&nbsp;Michail Mitsis,&nbsp;Vasileios Tatsis,&nbsp;Ioannis Karavokyros,&nbsp;Dimitrios Schizas","doi":"10.1111/ans.70255","DOIUrl":"10.1111/ans.70255","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Esophageal cancer, the sixth leading cause of cancer-related deaths globally, imposes significant physical and psychological burdens on patients. Psychiatric comorbidities, such as anxiety and depression, are prevalent among esophagectomy patients and may adversely affect postoperative outcomes, quality of life, and survival. However, their clinical impact remains understudied and heterogeneous in existing literature.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>This systematic review and meta-analysis evaluates the prevalence and clinical significance of perioperative mental disorders in esophageal cancer surgery, assessing their association with postoperative outcomes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Data Sources</h3>\u0000 \u0000 <p>A comprehensive search of Medline, Embase, CINAHL, CENTRAL, and Web of Science was conducted from inception to March 2025. (Keywords included “esophageal cancer,” “esophagectomy,” “anxiety,” “depression”).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Review Methods</h3>\u0000 \u0000 <p>PRISMA-guided analysis included 11 studies (<i>n</i> = 24 411 patients). Studies reporting preoperative psychiatric comorbidities or postoperative mental disorders (PMD) were eligible. Risk of bias was assessed using ROBINS-I. Random-effects meta-analyses pooled mortality risk, PMD incidence, and associated risk factors.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Preoperative psychiatric comorbidities (11.8%–28.8%) increased mortality risk by 33% (RR 1.33, 95% CI 1.15–1.55, <i>p</i> &lt; 0.001). PMD incidence was 29.8% (95% CI 21.2%–38.4%), with anxiety being the most common (29.5%). Key risk factors included stage III disease (OR 3.2, 95% CI 1.66–6.2), postoperative complications (OR 2.32, 95% CI 1.55–3.49), female gender (OR 1.35, 95% CI 1.07–1.69), and higher Charlson Comorbidity Index (OR 1.04, 95% CI 1.01–1.06).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Mental disorders significantly impact esophagectomy outcomes, elevating mortality, and complicating recovery. Proactive screening and multidisciplinary mental health support are warranted, particularly for high-risk patients.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8158,"journal":{"name":"ANZ Journal of Surgery","volume":"95 9","pages":"1668-1676"},"PeriodicalIF":1.6,"publicationDate":"2025-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144641604","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}