ANZ Journal of Surgery最新文献

{"title":"Fostering collaboration: an exploration of knowledge exchange between Rongoā Māori practitioners and surgical clinicians.","authors":"Nasya Thompson, Tamara Glyn, Donna Kerridge, Jonathan Koea","doi":"10.1111/ans.19238","DOIUrl":"https://doi.org/10.1111/ans.19238","url":null,"abstract":"<p><strong>Background: </strong>This research investigates the potential for collaboration of Rongoā Māori, the Indigenous healing practices of Māori, with New Zealand's contemporary healthcare system. It aims to bridge the gap between Rongoā Māori and Western medicine by exploring the perspectives of practitioners from both fields, identifying barriers to integration, and highlighting potential areas for collaboration.</p><p><strong>Methods: </strong>Qualitative interviews were conducted with both Rongoā practitioners and Western surgeons. The data collected were subjected to thematic analysis to extract key themes related to the integration process, challenges faced, and the potential for mutual recognition and respect between the two healing paradigms.</p><p><strong>Results: </strong>The study reveals a deep respect for Rongoā Māori among Western surgeons but identifies significant systemic barriers that impede its integration. These include bureaucratic challenges and the absence of clear referral pathways. Rongoā practitioners express concerns over being overlooked within the healthcare system and highlight a lack of awareness among healthcare professionals about their practices. Despite these challenges, there is a shared interest in collaborative approaches to healthcare that respect and incorporate Rongoā Māori.</p><p><strong>Conclusions: </strong>The findings underscore the need for systemic changes to facilitate the integration of Rongoā Māori into mainstream healthcare, including the development of clear referral pathways and initiatives to raise awareness among healthcare professionals. The study highlights the need for a more collaborative healthcare approach that values the contributions of Rongoā Māori, aiming to improve patient care through holistic practices.</p>","PeriodicalId":8158,"journal":{"name":"ANZ Journal of Surgery","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2024-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142339950","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":"Barriers to clinical audit","authors":"Ian A Harris AM MBBS, MMed, MSc, PhD, FRACS, FAHMS,&nbsp;Jacqueline CT Close MBBS, MD, FRCP, FRACP,&nbsp;Elizabeth Armstrong BAppSci(Phty), MPH","doi":"10.1111/ans.19174","DOIUrl":"10.1111/ans.19174","url":null,"abstract":"","PeriodicalId":8158,"journal":{"name":"ANZ Journal of Surgery","volume":"94 9","pages":"1436"},"PeriodicalIF":1.5,"publicationDate":"2024-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142307019","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":"Power of arthroplasty registries in Orthopaedic surgery","authors":"James D. Stoney FRACS, FAOrthA,&nbsp;Paul N. Smith FRACS, FAOrthA","doi":"10.1111/ans.19205","DOIUrl":"10.1111/ans.19205","url":null,"abstract":"","PeriodicalId":8158,"journal":{"name":"ANZ Journal of Surgery","volume":"94 9","pages":"1437-1438"},"PeriodicalIF":1.5,"publicationDate":"2024-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142307020","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":"Contribution to the variability in the coeliac plexus structure and formation.","authors":"Zora Haviarová, Roman Kuruc, Viktor Matjčík","doi":"10.1111/ans.19234","DOIUrl":"https://doi.org/10.1111/ans.19234","url":null,"abstract":"<p><strong>Background: </strong>The coeliac plexus is often approached due to the diagnosis and treatment of the intractable pain associated with cancerous or non-cancerous pathology of the pancreas or neighbouring organs. Various methods of coeliac plexus blocks are used and the variations in its structure are causes of the failures of such procedures.</p><p><strong>Methods: </strong>Twenty human cadavers (17 male, 3 females, age range 30-86 years, without any abdominal pathology) were dissected in the supine position. The abdominal autonomics was studied bilaterally after the incision of the abdominal wall the peritoneal sac was cut and the abdominal organs were removed. The coeliac plexus becomes visible after removing the hepatogastric and hepatoduodenal ligaments and pulling the stomach to the left and the pancreas downward.</p><p><strong>Results: </strong>The largest coeliac ganglion was 45 mm on the right and 25 mm on the left. The average distance of the ganglia from the coeliac trunks was 6-9 mm from the right and left. The size of coeliac ganglia varies from 5 to 45 mm and their number from 2 to 12. Ganglia can be diffusely or concentrically organized. The coeliac plexus almost always receives the branches from the greater splanchnic and vagus nerves. Sometimes the contributions from the lesser splanchnic nerve, phrenic nerve, and accessory phrenic nerve (60%) were observed. Very rarely are missing both phrenic nerves.</p><p><strong>Conclusion: </strong>Sympathectomy (splanchnicectomy), as well as the coeliac blocks (under US, CT control, or laparotomic) aimed at pain relief usually by pancreatic cancer, should consider these possible variabilities.</p>","PeriodicalId":8158,"journal":{"name":"ANZ Journal of Surgery","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2024-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142279701","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 12-year retrospective analysis of non-operative management for paediatric duodenal hematomas caused by trauma at a single center","authors":"Qiulong Shen PhD,&nbsp;Yi Li PhD,&nbsp;Dayong Wang MS,&nbsp;Li Wang MS,&nbsp;Shuanling Li MBBS,&nbsp;Long Chen MS,&nbsp;Tingting Liu MS","doi":"10.1111/ans.19224","DOIUrl":"10.1111/ans.19224","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Paediatric traumatic duodenal hematoma is a rare type of blunt abdominal injury for which treatment strategies are controversial. This study aimed to evaluate the application value of nonoperative management of paediatric duodenal hematoma caused by trauma.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A retrospective analysis was conducted on patients with duodenal hematoma with a confirmed history of abdominal trauma admitted to our hospital between January 2010 and December 2022. General patient information, including age, sex, cause of injury, clinical manifestations, and treatment outcomes, was recorded.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 11 cases were included in this study, with 6 males and 5 females. School-age children (≥6 years) accounted for 72.7% (8/11) of the cases. Bicycle handlebar injuries accounted for 63.6% (7/11) of cases. Among these cases, 5 (45.5%) were classified as American Association for the Surgery of Trauma grade I, while the remaining were classified as grade II. The median history time was 1 day (range: 2 h–12 days). All patients were successfully treated using non-operative methods. The median time to oral feeding after injury was 17 days (range: 9–32 days). Oral feeding was initiated within 2 weeks in 2 patients (18.2%), within 3 weeks in 6 patients (54.5%), and within 4 weeks in 10 patients (90.9%).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Paediatric traumatic duodenal hematoma is more common in school-aged children, mainly due to bicycle handlebar injuries. Nonoperative treatment is proven to be safe and effective, with duodenal obstruction symptoms typically resolving within 4 weeks.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8158,"journal":{"name":"ANZ Journal of Surgery","volume":"94 11","pages":"1990-1994"},"PeriodicalIF":1.5,"publicationDate":"2024-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142279700","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":"Ileocolic resection with temporary ileostomy for Crohn's disease: does it affect long-term disease recurrence compared with primary anastomosis?","authors":"Michael Goldenshluger, Lior Segev","doi":"10.1111/ans.19237","DOIUrl":"https://doi.org/10.1111/ans.19237","url":null,"abstract":"<p><strong>Background: </strong>We aimed to assess whether the risk of disease recurrence in Crohn's disease (CD) patients that undergone ileocolic resection (ICR) with temporary ileostomy and a later stoma reversal is different compared to patients that underwent a one-stage operation.</p><p><strong>Methods: </strong>A single-center retrospective review of all patients that underwent elective primary ICR for CD between 2010 and 2022 divided into: 2S-ICR group-patients who underwent two-stage ICR. 1S-ICR group-patients who underwent one-stage ICR.</p><p><strong>Results: </strong>The cohort included 191 patients (mean age 33.4, range 15-70), with 40 and 151 patients in the 2S-ICR and 1S-ICR groups, respectively. The 2S-ICR were more comorbid, with a lower mean BMI (18 vs. 21.3, P < 0.001), higher median ASA score (3 vs. 2, P = 0.036), higher percentage on pre-operative total parenteral nutrition (TPN) (62.5% vs. 24.5%, P < 0.001), and lower levels of pre-operative albumin (3.3 g/dL vs. 3.8 g/dL, P < 0.001). There were no significant differences in the overall postoperative complication rate (47.5% vs. 47.7% respectively, P = 1), nor in the rate of severe complications (17.5% vs. 13.2%, P = 0.6), but, the 2S-ICR had a longer post-operative length-of-stay (14 vs. 6 days, P < 0.001) and higher rates of 30-day readmission (30% vs. 13.2%, P = 0.017). After an overall median follow-up of 63 months, the groups showed similar rates of endoscopic, clinical, and surgical recurrence.</p><p><strong>Conclusions: </strong>Two-stage ICR with a temporary ileostomy does not change long-term CD recurrence rates compared with one-stage ICR.</p>","PeriodicalId":8158,"journal":{"name":"ANZ Journal of Surgery","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2024-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142279702","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":"Spontaneous regression of extensive colorectal cancer peritoneal metastases: first you see it, then you do not","authors":"Samuel Pau MBChB,&nbsp;Jesse Fischer MBChB, MMedSc, FRACS,&nbsp;Ian Kennedy MBChB, FRACP, MD","doi":"10.1111/ans.19236","DOIUrl":"10.1111/ans.19236","url":null,"abstract":"","PeriodicalId":8158,"journal":{"name":"ANZ Journal of Surgery","volume":"94 11","pages":"2079-2080"},"PeriodicalIF":1.5,"publicationDate":"2024-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142279703","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":"Gastric cardia submucosal tumours – histopathological diagnosis and challenges in management","authors":"Preekesh Suresh Patel MSc, FRACS,&nbsp;Michael Rodgers MBChB, FRACS,&nbsp;Suheelan Kulasegaran MBChB, FRACS","doi":"10.1111/ans.19233","DOIUrl":"10.1111/ans.19233","url":null,"abstract":"&lt;p&gt;A 74-year-old female presented with epigastric pain. A submucosal lesion of the gastric cardia and small hiatus hernia were identified on gastroscopy (Fig. 1). Superficial biopsies were inconclusive. Endoscopic ultrasound identified a 2 cm, well-defined and lobulated submucosal lesion. Sharkcore deep biopsies confirmed a leiomyoma with spindle cells which were positive for desmin on immunohistochemistry (with absence of CD117 and DOG1). Computed tomography (CT) confirmed a gastric cardia submucosal lesion with adherence to the left diaphragmatic crura &lt;b&gt;(&lt;/b&gt;Fig. 2&lt;b&gt;)&lt;/b&gt;. She underwent laparoscopic enucleation of a 6 × 4 cm gastric leiomyoma with primary repair and achieved a satisfactory functional and histological result. This case underpins the importance of histopathological diagnosis for submucosal lesions and challenges/considerations for those that are near the gastroesophageal junction (GOJ).&lt;/p&gt;&lt;p&gt;Most submucosal tumours are gastrointestinal stromal tumours (GIST) or leiomyomas.&lt;span&gt;&lt;sup&gt;1&lt;/sup&gt;&lt;/span&gt; They are indistinguishable without histological diagnosis as highlighted in Figure 1. Accurate diagnosis is key to applying the correct treatment principles.&lt;span&gt;&lt;sup&gt;2&lt;/sup&gt;&lt;/span&gt; Our patient's symptomatic 2 cm leiomyoma prompted enucleation. This was challenging due to lesion mobility – addressed by approaching the lesion from above and below (two myotomies) and retracting it with a silk stitch. Lesion adherence to the mucosa led to two mucosal breaches, likely related to the multiple preoperative biopsies taken, including superficial biopsies which are often non-diagnostic.&lt;span&gt;&lt;sup&gt;2&lt;/sup&gt;&lt;/span&gt; ≥2 cm GISTs require resection and being near the GOJ, this can be achieved with a laparo-endoscopic extra-gastric or trans-gastric approach.&lt;span&gt;&lt;sup&gt;3, 4&lt;/sup&gt;&lt;/span&gt; There a two key differences between GIST and leiomyoma resectional management. Firstly, the malignant potential of GISTs leads to both a lower threshold for resection and the stronger importance of a clear margin.&lt;span&gt;&lt;sup&gt;5&lt;/sup&gt;&lt;/span&gt; Secondly, the option of tyrosine kinase inhibitors (TKI) for GIST in either the neoadjuvant setting to achieve resectability or the adjuvant setting to reduce the risk of recurrence.&lt;span&gt;&lt;sup&gt;6&lt;/sup&gt;&lt;/span&gt; A laparo-endoscopic resection (not enucleation) would have been utilized if our case was diagnosed preoperatively as a 2 cm GIST.&lt;span&gt;&lt;sup&gt;3, 4&lt;/sup&gt;&lt;/span&gt;&lt;/p&gt;&lt;p&gt;Submucosal tumours near the GOJ are challenging to resect as there is risk of stenosis, reflux and leak.&lt;span&gt;&lt;sup&gt;3&lt;/sup&gt;&lt;/span&gt; Surgical approach is impacted by tumour location, size and pathology. The lesion had more than doubled in size at time of surgery (3 months later). Adherence to the left crus and a concurrent hiatus hernia (Fig. 1) meant hiatal and mediastinal mobilization was required to allow assessment and planning of the surgical approach. Neoadjuvant TKI may have been considered if the lesion was known to be &gt;5 cm and potentially locally invasive.&lt;sp","PeriodicalId":8158,"journal":{"name":"ANZ Journal of Surgery","volume":"94 10","pages":"1869-1870"},"PeriodicalIF":1.5,"publicationDate":"2024-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/ans.19233","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142254848","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":"25, 50 and 75 years ago","authors":"Julian A. Smith MBMS, MSurgEd, FRACS","doi":"10.1111/ans.19232","DOIUrl":"10.1111/ans.19232","url":null,"abstract":"","PeriodicalId":8158,"journal":{"name":"ANZ Journal of Surgery","volume":"94 9","pages":"1460-1461"},"PeriodicalIF":1.5,"publicationDate":"2024-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/ans.19232","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142254851","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":"Correction to Royal Australasian College of Surgeons 92nd Annual Scientific Congress, Õtautahi Christchurch, Aotearoa New Zealand, 6–10 May 2024","authors":"","doi":"10.1111/ans.19239","DOIUrl":"10.1111/ans.19239","url":null,"abstract":"<p>Royal Australasian College of Surgeons 92nd Annual Scientific Congress, Õtautahi Christchurch, Aotearoa New Zealand, 6–10 May 2024. <i>ANZ Journal of Surgery</i> 94 (Suppl. 1) (2024) 5–19. https://onlinelibrary.wiley.com/doi/10.1111/ans.18953</p><p>The abstract “BS023P EFFECT OF BIOPSY MARKING CLIP MIGRATION ON RATE OF RE-EXCISION IN WIDE LOCAL EXCISION OF IMPALPABLE BREAST LESIONS” by Nelson Smith, et al. has been removed from online publication.</p><p>We apologize for this error.</p>","PeriodicalId":8158,"journal":{"name":"ANZ Journal of Surgery","volume":"94 9","pages":"1665"},"PeriodicalIF":1.5,"publicationDate":"2024-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/ans.19239","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142254846","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}