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Publisher: John Wiley and Sons   (Total: 1584 journals)

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Showing 1 - 200 of 1584 Journals sorted alphabetically
Abacus     Hybrid Journal   (Followers: 12, SJR: 0.48, h-index: 22)
About Campus     Hybrid Journal   (Followers: 5)
Academic Emergency Medicine     Hybrid Journal   (Followers: 58, SJR: 1.385, h-index: 91)
Accounting & Finance     Hybrid Journal   (Followers: 45, SJR: 0.547, h-index: 30)
ACEP NOW     Free   (Followers: 1)
Acta Anaesthesiologica Scandinavica     Hybrid Journal   (Followers: 51, SJR: 1.02, h-index: 88)
Acta Archaeologica     Hybrid Journal   (Followers: 137, SJR: 0.101, h-index: 9)
Acta Geologica Sinica (English Edition)     Hybrid Journal   (Followers: 3, SJR: 0.552, h-index: 41)
Acta Neurologica Scandinavica     Hybrid Journal   (Followers: 5, SJR: 1.203, h-index: 74)
Acta Obstetricia et Gynecologica Scandinavica     Hybrid Journal   (Followers: 15, SJR: 1.197, h-index: 81)
Acta Ophthalmologica     Hybrid Journal   (Followers: 5, SJR: 0.112, h-index: 1)
Acta Paediatrica     Hybrid Journal   (Followers: 56, SJR: 0.794, h-index: 88)
Acta Physiologica     Hybrid Journal   (Followers: 6, SJR: 1.69, h-index: 88)
Acta Polymerica     Hybrid Journal   (Followers: 9)
Acta Psychiatrica Scandinavica     Hybrid Journal   (Followers: 35, SJR: 2.518, h-index: 113)
Acta Zoologica     Hybrid Journal   (Followers: 6, SJR: 0.459, h-index: 29)
Acute Medicine & Surgery     Hybrid Journal   (Followers: 2)
Addiction     Hybrid Journal   (Followers: 33, SJR: 2.086, h-index: 143)
Addiction Biology     Hybrid Journal   (Followers: 12, SJR: 2.091, h-index: 57)
Adultspan J.     Hybrid Journal   (SJR: 0.127, h-index: 4)
Advanced Energy Materials     Hybrid Journal   (Followers: 24, SJR: 6.411, h-index: 86)
Advanced Engineering Materials     Hybrid Journal   (Followers: 26, SJR: 0.81, h-index: 81)
Advanced Functional Materials     Hybrid Journal   (Followers: 50, SJR: 5.21, h-index: 203)
Advanced Healthcare Materials     Hybrid Journal   (Followers: 13, SJR: 0.232, h-index: 7)
Advanced Materials     Hybrid Journal   (Followers: 249, SJR: 9.021, h-index: 345)
Advanced Materials Interfaces     Hybrid Journal   (Followers: 6, SJR: 1.177, h-index: 10)
Advanced Optical Materials     Hybrid Journal   (Followers: 5, SJR: 2.488, h-index: 21)
Advanced Science     Open Access   (Followers: 5)
Advanced Synthesis & Catalysis     Hybrid Journal   (Followers: 17, SJR: 2.729, h-index: 121)
Advances in Polymer Technology     Hybrid Journal   (Followers: 13, SJR: 0.344, h-index: 31)
Africa Confidential     Hybrid Journal   (Followers: 19)
Africa Research Bulletin: Economic, Financial and Technical Series     Hybrid Journal   (Followers: 12)
Africa Research Bulletin: Political, Social and Cultural Series     Hybrid Journal   (Followers: 9)
African Development Review     Hybrid Journal   (Followers: 35, SJR: 0.275, h-index: 17)
African J. of Ecology     Hybrid Journal   (Followers: 14, SJR: 0.477, h-index: 39)
Aggressive Behavior     Hybrid Journal   (Followers: 15, SJR: 1.391, h-index: 66)
Aging Cell     Open Access   (Followers: 10, SJR: 4.374, h-index: 95)
Agribusiness : an Intl. J.     Hybrid Journal   (Followers: 6, SJR: 0.627, h-index: 14)
Agricultural and Forest Entomology     Hybrid Journal   (Followers: 14, SJR: 0.925, h-index: 43)
Agricultural Economics     Hybrid Journal   (Followers: 44, SJR: 1.099, h-index: 51)
AIChE J.     Hybrid Journal   (Followers: 29, SJR: 1.122, h-index: 120)
Alcoholism and Drug Abuse Weekly     Hybrid Journal   (Followers: 7)
Alcoholism Clinical and Experimental Research     Hybrid Journal   (Followers: 7, SJR: 1.416, h-index: 125)
Alimentary Pharmacology & Therapeutics     Hybrid Journal   (Followers: 35, SJR: 2.833, h-index: 138)
Alimentary Pharmacology & Therapeutics Symposium Series     Hybrid Journal   (Followers: 3)
Allergy     Hybrid Journal   (Followers: 49, SJR: 3.048, h-index: 129)
Alternatives to the High Cost of Litigation     Hybrid Journal   (Followers: 3)
American Anthropologist     Hybrid Journal   (Followers: 128, SJR: 0.951, h-index: 61)
American Business Law J.     Hybrid Journal   (Followers: 24, SJR: 0.205, h-index: 17)
American Ethnologist     Hybrid Journal   (Followers: 91, SJR: 2.325, h-index: 51)
American J. of Economics and Sociology     Hybrid Journal   (Followers: 27, SJR: 0.211, h-index: 26)
American J. of Hematology     Hybrid Journal   (Followers: 31, SJR: 1.761, h-index: 77)
American J. of Human Biology     Hybrid Journal   (Followers: 12, SJR: 1.018, h-index: 58)
American J. of Industrial Medicine     Hybrid Journal   (Followers: 16, SJR: 0.993, h-index: 85)
American J. of Medical Genetics Part A     Hybrid Journal   (Followers: 15, SJR: 1.115, h-index: 61)
American J. of Medical Genetics Part B: Neuropsychiatric Genetics     Hybrid Journal   (Followers: 3, SJR: 1.771, h-index: 107)
American J. of Medical Genetics Part C: Seminars in Medical Genetics     Partially Free   (Followers: 5, SJR: 2.315, h-index: 79)
American J. of Orthopsychiatry     Hybrid Journal   (Followers: 4, SJR: 0.756, h-index: 69)
American J. of Physical Anthropology     Hybrid Journal   (Followers: 36, SJR: 1.41, h-index: 88)
American J. of Political Science     Hybrid Journal   (Followers: 252, SJR: 5.101, h-index: 114)
American J. of Primatology     Hybrid Journal   (Followers: 15, SJR: 1.197, h-index: 63)
American J. of Reproductive Immunology     Hybrid Journal   (Followers: 3, SJR: 1.347, h-index: 75)
American J. of Transplantation     Hybrid Journal   (Followers: 16, SJR: 2.792, h-index: 140)
American J. on Addictions     Hybrid Journal   (Followers: 9, SJR: 0.843, h-index: 57)
Anaesthesia     Hybrid Journal   (Followers: 120, SJR: 1.404, h-index: 88)
Analyses of Social Issues and Public Policy     Hybrid Journal   (Followers: 11, SJR: 0.397, h-index: 18)
Analytic Philosophy     Hybrid Journal   (Followers: 16)
Anatomia, Histologia, Embryologia: J. of Veterinary Medicine Series C     Hybrid Journal   (Followers: 3, SJR: 0.295, h-index: 27)
Anatomical Sciences Education     Hybrid Journal   (Followers: 1, SJR: 0.633, h-index: 24)
Andrologia     Hybrid Journal   (Followers: 2, SJR: 0.528, h-index: 45)
Andrology     Hybrid Journal   (Followers: 2, SJR: 0.979, h-index: 14)
Angewandte Chemie     Hybrid Journal   (Followers: 159)
Angewandte Chemie Intl. Edition     Hybrid Journal   (Followers: 210, SJR: 6.229, h-index: 397)
Animal Conservation     Hybrid Journal   (Followers: 34, SJR: 1.576, h-index: 62)
Animal Genetics     Hybrid Journal   (Followers: 8, SJR: 0.957, h-index: 67)
Animal Science J.     Hybrid Journal   (Followers: 6, SJR: 0.569, h-index: 24)
Annalen der Physik     Hybrid Journal   (Followers: 5, SJR: 1.46, h-index: 40)
Annals of Anthropological Practice     Partially Free   (Followers: 2, SJR: 0.187, h-index: 5)
Annals of Applied Biology     Hybrid Journal   (Followers: 8, SJR: 0.816, h-index: 56)
Annals of Clinical and Translational Neurology     Open Access   (Followers: 1)
Annals of Human Genetics     Hybrid Journal   (Followers: 9, SJR: 1.191, h-index: 67)
Annals of Neurology     Hybrid Journal   (Followers: 44, SJR: 5.584, h-index: 241)
Annals of Noninvasive Electrocardiology     Hybrid Journal   (Followers: 2, SJR: 0.531, h-index: 38)
Annals of Public and Cooperative Economics     Hybrid Journal   (Followers: 9, SJR: 0.336, h-index: 23)
Annals of the New York Academy of Sciences     Hybrid Journal   (Followers: 5, SJR: 2.389, h-index: 189)
Annual Bulletin of Historical Literature     Hybrid Journal   (Followers: 12)
Annual Review of Information Science and Technology     Hybrid Journal   (Followers: 14)
Anthropology & Education Quarterly     Hybrid Journal   (Followers: 24, SJR: 0.72, h-index: 31)
Anthropology & Humanism     Hybrid Journal   (Followers: 16, SJR: 0.137, h-index: 3)
Anthropology News     Hybrid Journal   (Followers: 14)
Anthropology of Consciousness     Hybrid Journal   (Followers: 11, SJR: 0.172, h-index: 5)
Anthropology of Work Review     Hybrid Journal   (Followers: 11, SJR: 0.256, h-index: 5)
Anthropology Today     Hybrid Journal   (Followers: 93, SJR: 0.545, h-index: 15)
Antipode     Hybrid Journal   (Followers: 45, SJR: 2.212, h-index: 69)
Anz J. of Surgery     Hybrid Journal   (Followers: 6, SJR: 0.432, h-index: 59)
Anzeiger für Schädlingskunde     Hybrid Journal   (Followers: 1)
Apmis     Hybrid Journal   (Followers: 1, SJR: 0.855, h-index: 73)
Applied Cognitive Psychology     Hybrid Journal   (Followers: 67, SJR: 0.754, h-index: 69)
Applied Organometallic Chemistry     Hybrid Journal   (Followers: 7, SJR: 0.632, h-index: 58)
Applied Psychology     Hybrid Journal   (Followers: 136, SJR: 1.023, h-index: 64)
Applied Psychology: Health and Well-Being     Hybrid Journal   (Followers: 48, SJR: 0.868, h-index: 13)
Applied Stochastic Models in Business and Industry     Hybrid Journal   (Followers: 5, SJR: 0.613, h-index: 24)
Aquaculture Nutrition     Hybrid Journal   (Followers: 14, SJR: 1.025, h-index: 55)
Aquaculture Research     Hybrid Journal   (Followers: 31, SJR: 0.807, h-index: 60)
Aquatic Conservation Marine and Freshwater Ecosystems     Hybrid Journal   (Followers: 34, SJR: 1.047, h-index: 57)
Arabian Archaeology and Epigraphy     Hybrid Journal   (Followers: 11, SJR: 0.453, h-index: 11)
Archaeological Prospection     Hybrid Journal   (Followers: 12, SJR: 0.922, h-index: 21)
Archaeology in Oceania     Hybrid Journal   (Followers: 13, SJR: 0.745, h-index: 18)
Archaeometry     Hybrid Journal   (Followers: 27, SJR: 0.809, h-index: 48)
Archeological Papers of The American Anthropological Association     Hybrid Journal   (Followers: 14, SJR: 0.156, h-index: 2)
Architectural Design     Hybrid Journal   (Followers: 25, SJR: 0.261, h-index: 9)
Archiv der Pharmazie     Hybrid Journal   (Followers: 4, SJR: 0.628, h-index: 43)
Archives of Drug Information     Hybrid Journal   (Followers: 4)
Archives of Insect Biochemistry and Physiology     Hybrid Journal   (SJR: 0.768, h-index: 54)
Area     Hybrid Journal   (Followers: 12, SJR: 0.938, h-index: 57)
Art History     Hybrid Journal   (Followers: 215, SJR: 0.153, h-index: 13)
Arthritis & Rheumatology     Hybrid Journal   (Followers: 51, SJR: 1.984, h-index: 20)
Arthritis Care & Research     Hybrid Journal   (Followers: 28, SJR: 2.256, h-index: 114)
Artificial Organs     Hybrid Journal   (Followers: 1, SJR: 0.872, h-index: 60)
ASHE Higher Education Reports     Hybrid Journal   (Followers: 14)
Asia & the Pacific Policy Studies     Open Access   (Followers: 14)
Asia Pacific J. of Human Resources     Hybrid Journal   (Followers: 316, SJR: 0.494, h-index: 19)
Asia Pacific Viewpoint     Hybrid Journal   (SJR: 0.616, h-index: 26)
Asia-Pacific J. of Chemical Engineering     Hybrid Journal   (Followers: 7, SJR: 0.345, h-index: 20)
Asia-pacific J. of Clinical Oncology     Hybrid Journal   (Followers: 6, SJR: 0.554, h-index: 14)
Asia-Pacific J. of Financial Studies     Hybrid Journal   (SJR: 0.241, h-index: 7)
Asia-Pacific Psychiatry     Hybrid Journal   (Followers: 3, SJR: 0.377, h-index: 7)
Asian Economic J.     Hybrid Journal   (Followers: 8, SJR: 0.234, h-index: 21)
Asian Economic Policy Review     Hybrid Journal   (Followers: 4, SJR: 0.196, h-index: 12)
Asian J. of Control     Hybrid Journal   (SJR: 0.862, h-index: 34)
Asian J. of Endoscopic Surgery     Hybrid Journal   (SJR: 0.394, h-index: 7)
Asian J. of Organic Chemistry     Hybrid Journal   (Followers: 4, SJR: 1.443, h-index: 19)
Asian J. of Social Psychology     Hybrid Journal   (Followers: 5, SJR: 0.665, h-index: 37)
Asian Politics and Policy     Hybrid Journal   (Followers: 13, SJR: 0.207, h-index: 7)
Asian Social Work and Policy Review     Hybrid Journal   (Followers: 5, SJR: 0.318, h-index: 5)
Asian-pacific Economic Literature     Hybrid Journal   (Followers: 5, SJR: 0.168, h-index: 15)
Assessment Update     Hybrid Journal   (Followers: 4)
Astronomische Nachrichten     Hybrid Journal   (Followers: 2, SJR: 0.701, h-index: 40)
Atmospheric Science Letters     Open Access   (Followers: 29, SJR: 1.332, h-index: 27)
Austral Ecology     Hybrid Journal   (Followers: 12, SJR: 1.095, h-index: 66)
Austral Entomology     Hybrid Journal   (Followers: 10, SJR: 0.524, h-index: 28)
Australasian J. of Dermatology     Hybrid Journal   (Followers: 8, SJR: 0.714, h-index: 40)
Australasian J. On Ageing     Hybrid Journal   (Followers: 7, SJR: 0.39, h-index: 22)
Australian & New Zealand J. of Statistics     Hybrid Journal   (Followers: 13, SJR: 0.275, h-index: 28)
Australian Accounting Review     Hybrid Journal   (Followers: 4, SJR: 0.709, h-index: 14)
Australian and New Zealand J. of Family Therapy (ANZJFT)     Hybrid Journal   (Followers: 3, SJR: 0.382, h-index: 12)
Australian and New Zealand J. of Obstetrics and Gynaecology     Hybrid Journal   (Followers: 43, SJR: 0.814, h-index: 49)
Australian and New Zealand J. of Public Health     Hybrid Journal   (Followers: 11, SJR: 0.82, h-index: 62)
Australian Dental J.     Hybrid Journal   (Followers: 6, SJR: 0.482, h-index: 46)
Australian Economic History Review     Hybrid Journal   (Followers: 4, SJR: 0.171, h-index: 12)
Australian Economic Papers     Hybrid Journal   (Followers: 23, SJR: 0.23, h-index: 9)
Australian Economic Review     Hybrid Journal   (Followers: 6, SJR: 0.357, h-index: 21)
Australian Endodontic J.     Hybrid Journal   (Followers: 3, SJR: 0.513, h-index: 24)
Australian J. of Agricultural and Resource Economics     Hybrid Journal   (Followers: 3, SJR: 0.765, h-index: 36)
Australian J. of Grape and Wine Research     Hybrid Journal   (Followers: 5, SJR: 0.879, h-index: 56)
Australian J. of Politics & History     Hybrid Journal   (Followers: 13, SJR: 0.203, h-index: 14)
Australian J. of Psychology     Hybrid Journal   (Followers: 17, SJR: 0.384, h-index: 30)
Australian J. of Public Administration     Hybrid Journal   (Followers: 388, SJR: 0.418, h-index: 29)
Australian J. of Rural Health     Hybrid Journal   (Followers: 4, SJR: 0.43, h-index: 34)
Australian Occupational Therapy J.     Hybrid Journal   (Followers: 66, SJR: 0.59, h-index: 29)
Australian Psychologist     Hybrid Journal   (Followers: 11, SJR: 0.331, h-index: 31)
Australian Veterinary J.     Hybrid Journal   (Followers: 19, SJR: 0.459, h-index: 45)
Autism Research     Hybrid Journal   (Followers: 31, SJR: 2.126, h-index: 39)
Autonomic & Autacoid Pharmacology     Hybrid Journal   (SJR: 0.371, h-index: 29)
Banks in Insurance Report     Hybrid Journal   (Followers: 1)
Basic & Clinical Pharmacology & Toxicology     Hybrid Journal   (Followers: 10, SJR: 0.539, h-index: 70)
Basic and Applied Pathology     Open Access   (Followers: 2, SJR: 0.113, h-index: 4)
Basin Research     Hybrid Journal   (Followers: 3, SJR: 1.54, h-index: 60)
Bauphysik     Hybrid Journal   (Followers: 2, SJR: 0.194, h-index: 5)
Bauregelliste A, Bauregelliste B Und Liste C     Hybrid Journal  
Bautechnik     Hybrid Journal   (Followers: 1, SJR: 0.321, h-index: 11)
Behavioral Interventions     Hybrid Journal   (Followers: 9, SJR: 0.297, h-index: 23)
Behavioral Sciences & the Law     Hybrid Journal   (Followers: 23, SJR: 0.736, h-index: 57)
Berichte Zur Wissenschaftsgeschichte     Hybrid Journal   (Followers: 9, SJR: 0.11, h-index: 5)
Beton- und Stahlbetonbau     Hybrid Journal   (Followers: 2, SJR: 0.493, h-index: 14)
Biochemistry and Molecular Biology Education     Hybrid Journal   (Followers: 6, SJR: 0.311, h-index: 26)
Bioelectromagnetics     Hybrid Journal   (Followers: 1, SJR: 0.568, h-index: 64)
Bioengineering & Translational Medicine     Open Access  
BioEssays     Hybrid Journal   (Followers: 10, SJR: 3.104, h-index: 155)
Bioethics     Hybrid Journal   (Followers: 14, SJR: 0.686, h-index: 39)
Biofuels, Bioproducts and Biorefining     Hybrid Journal   (Followers: 1, SJR: 1.725, h-index: 56)
Biological J. of the Linnean Society     Hybrid Journal   (Followers: 14, SJR: 1.172, h-index: 90)
Biological Reviews     Hybrid Journal   (Followers: 3, SJR: 6.469, h-index: 114)
Biologie in Unserer Zeit (Biuz)     Hybrid Journal   (Followers: 42, SJR: 0.12, h-index: 1)
Biology of the Cell     Full-text available via subscription   (Followers: 9, SJR: 1.812, h-index: 69)
Biomedical Chromatography     Hybrid Journal   (Followers: 6, SJR: 0.572, h-index: 49)
Biometrical J.     Hybrid Journal   (Followers: 5, SJR: 0.784, h-index: 44)
Biometrics     Hybrid Journal   (Followers: 36, SJR: 1.906, h-index: 96)
Biopharmaceutics and Drug Disposition     Hybrid Journal   (Followers: 10, SJR: 0.715, h-index: 44)
Biopolymers     Hybrid Journal   (Followers: 18, SJR: 1.199, h-index: 104)
Biotechnology and Applied Biochemistry     Hybrid Journal   (Followers: 45, SJR: 0.415, h-index: 55)
Biotechnology and Bioengineering     Hybrid Journal   (Followers: 135, SJR: 1.633, h-index: 146)
Biotechnology J.     Hybrid Journal   (Followers: 13, SJR: 1.185, h-index: 51)
Biotechnology Progress     Hybrid Journal   (Followers: 39, SJR: 0.736, h-index: 101)
Biotropica     Hybrid Journal   (Followers: 18, SJR: 1.374, h-index: 71)
Bipolar Disorders     Hybrid Journal   (Followers: 10, SJR: 2.592, h-index: 100)
Birth     Hybrid Journal   (Followers: 34, SJR: 0.763, h-index: 64)
Birth Defects Research Part A : Clinical and Molecular Teratology     Hybrid Journal   (Followers: 2, SJR: 0.727, h-index: 77)
Birth Defects Research Part B: Developmental and Reproductive Toxicology     Hybrid Journal   (Followers: 5, SJR: 0.468, h-index: 47)
Birth Defects Research Part C : Embryo Today : Reviews     Hybrid Journal   (SJR: 1.513, h-index: 55)

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Journal Cover Anz Journal of Surgery
  [SJR: 0.432]   [H-I: 59]   [6 followers]  Follow
    
   Hybrid Journal Hybrid journal (It can contain Open Access articles)
   ISSN (Print) 1445-1433 - ISSN (Online) 1445-2197
   Published by John Wiley and Sons Homepage  [1584 journals]
  • Laparoscopic repair of a left paraduodenal hernia
    • Authors: Krish Kulendran; Cian Keogh, Heng-Chin Chiam
      PubDate: 2017-07-21T02:06:07.068381-05:
      DOI: 10.1111/ans.14172
       
  • Hartmann's reversal: a comparative study between laparoscopic and open
           approaches
    • Authors: Han Deok Kwak; Jin Kim, Dong Woo Kang, Se-Jin Baek, Jung Myun Kwak, Seon-Hahn Kim
      Abstract: BackgroundA reversal of Hartmann's procedure can be performed using either a laparoscopic or open approach. However, laparoscopic reversal (LR) of Hartmann's procedure is challenging. This study was designed to compare the results between open and laparoscopic approaches.MethodsThis was a retrospective study of prospectively collected data. We analysed 29 patients who received Hartmann's reversal at Korea University Anam Hospital between April 2007 and September 2014. All patients underwent either LR (n = 17) or open reversal (OR, n = 12).ResultsPatient characteristics were similar between the LR and OR groups. There was also no difference in mean operation time (212.5 versus 251.8 min), diversion ileostomy, length of hospital stay, postoperative analgesic days, time to diet resumption (3.9 versus 6.2 days) or complication rate. Although the time to resuming a solid diet was not different between the two groups (P = 0.053), bowel movement occurred faster in LR patients (LR versus OR, 1.8 versus 2.8 days, P = 0.020). Patients in the LR group also had less blood loss during surgery (114.1 versus 594.2 mL, P = 0.026). There were no mortalities in this study.ConclusionLR of Hartmann's procedure resulted in faster bowel function recovery than the open method. Laparoscopic approaches are feasible even for patients who received an open Hartmann's procedure.
      PubDate: 2017-07-21T02:05:22.604638-05:
      DOI: 10.1111/ans.13979
       
  • Pre-hydrated sterile acellular dermal matrix allograft in breast
           reconstruction: review of a single unit's experience
    • Authors: Justin James; Brigid Corrigan, Christobel Saunders
      Abstract: BackgroundThe acellular dermal matrix (Flex HD) (FHD) became available for use in Western Australia in 2014 to aid prosthetic breast reconstruction and this descriptive study aims to review and discuss a single institution's experience since its introduction.MethodsBy retrospective case note, review data were collected for all patients who underwent prosthetic breast reconstruction with the aid of FHD between January 2014 and August 2015 in our institution. Data on basic demographic parameters, risk factors, surgery-related factors, post-operative factors and follow-up information were collected. All complications were recorded and described in detail.ResultsFHD was used in 42 breast reconstructions in 26 patients. Procedure-related complications were seen in 26% (n = 11) of cases. A major complication requiring return to theatre was seen in 11% (n = 5) of cases. Cellulitis of the reconstructed breast (red breast syndrome) was seen in 16.67% (n = 7) cases. Overall implant loss was 2.4% (n = 1). Of the six possible risk factors for any complication, only current smoking was found to increase the risk of complications (odds ratio = 9.667, 95% confidence interval = 1.429–65.377).ConclusionFHD is associated with a relatively high overall complication rate. Use of this optional expensive material has to be carefully selected balancing its perceived advantages against this possible risk. The red breast syndrome merits further studies considering its frequent occurrence with FHD use.
      PubDate: 2017-07-20T05:12:48.917436-05:
      DOI: 10.1111/ans.13857
       
  • Re: Review of knee arthroscopic practice and coding at a major
           metropolitan centre
    • Authors: Chris Dalton; Emma Blanusa, Martin Anfinsen
      PubDate: 2017-07-17T22:50:32.931033-05:
      DOI: 10.1111/ans.14167
       
  • Predictive factors for publication of abstracts at the Royal Australasian
           College of Surgeons Annual Scientific Congress
    • Authors: Cristian Udovicich; Bryan Soh, Sam Law, Venetia Hoe, Dion Lanfranco, Kalpa Perera, Cuong Duong, Steven Chan
      Abstract: BackgroundA key metric of the research quality of medical conferences is the publication rate of abstracts. The study objective was to determine the publication rate of abstracts presented at the Royal Australasian College of Surgeons Annual Scientific Congress (RACS ASC) and to examine for any predictive factors associated with publication.Methods s presented at the RACS ASC from 2011 to 2013 were analysed. characteristics such as presentation format, study type, study design, study site, cohort size and author origin were recorded. s published were identified by a PubMed search using a strict algorithm. Univariate and multivariable logistic regressions were used to analyse for predictive factors of publication.ResultsOverall, 1438 abstracts were presented and 423 abstracts (29%) were published. The median time to publication was 15.2 months (interquartile range: 8–26) with 110 in Australasian journals (26%). The median number of citations for published abstracts was 6 (interquartile range: 2–16). After multivariable analysis, publication was significantly associated with prospective study design (odds ratio (OR) = 1.34, P = 0.02), multicentre study site (OR = 1.43, P = 0.02), cohort size ≥100 (OR = 2.00, P 
      PubDate: 2017-07-13T19:30:38.339702-05:
      DOI: 10.1111/ans.14108
       
  • Impact of pre-operative health-related quality of life on outcomes after
           heart surgery
    • Authors: Ieva Norkienė; Indre Urbanaviciute, Greta Kezyte, Vaidas Vicka, Tomas Jovaisa
      Abstract: BackgroundLong-term improvement in health-related quality of life (HRQOL) is one of the most important outcomes of cardiac surgery. The aim of this study is to define the impact of perioperative patient and procedural variables on HRQOL dynamics, a year after cardiac surgery.MethodsConsecutive patients undergoing elective on-pump cardiac surgery were enrolled in this prospective observational cohort study. Patients completed the Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36) questionnaire a day before surgery and once again a year after surgery. The effect size method was used to determine whether treatment resulted in the improvement of HRQOL.ResultsA total of 67.3% of patients achieved long-term improvement in HRQOL. Significant negative association was identified between Physical and Mental Component Summary scores (PCS/MCS) and long-term outcomes. Pre-operative PCS were 40.7 ± 13.7 for improvers and 56.6 ± 14.4 for non-improvers; MCS were 45.8 ± 12.1 and 65.2 ± 13.7, respectively (P 
      PubDate: 2017-07-12T20:11:46.654769-05:
      DOI: 10.1111/ans.14061
       
  • Pathological prognostic factors of recurrence in early stage lung
           adenocarcinoma
    • Authors: Eunjue Yi; Mi-Kyeong Bae, Sukki Cho, Jin-Haeng Chung, Sanghoon Jheon, Kwhanmien Kim
      Abstract: BackgroundHistological heterogeneity is thought to be important for prognosis of lung adenocarcinoma. We investigated to determine pathological features with prognostic value for recurrence of early stage lung cancer.MethodsA total of 368 patients who underwent curative surgical resection for early stage lung adenocarcinoma between 2009 and 2012 were enrolled. Pathologic characteristics including the presence of visceral pleural invasion, micropapillary patterns, aerogenous spread, lymphovascular invasion, perineural invasion and necrosis were examined. The correlations between pathological factors and clinical outcomes were analysed to determine prognostic significance.ResultsMean follow-up was 43.0 months (±14.56, ranging from 0.0 to 73.9 months). Three-year overall survival was 95.2% and disease-free survival was 89.8%. The recurrence rate was 9.0% (33 patients) and the mortality rate was 6.0% (22 patients). The presence of a micropapillary pattern (P 
      PubDate: 2017-07-12T20:11:36.12553-05:0
      DOI: 10.1111/ans.14033
       
  • Gender, ethnicity and smoking affect pain and function in patients with
           rotator cuff tears
    • Authors: Anthony Maher; Warren Leigh, Matt Brick, Simon Young, James Millar, Cameron Walker, Michael Caughey
      Abstract: BackgroundThis study is a collation of baseline demographic characteristics of those presenting for rotator cuff repair in New Zealand, and exploration of associations with preoperative function and pain. Data were obtained from the New Zealand Rotator Cuff Registry; a multicentre, nationwide prospective cohort of rotator cuff repairs undertaken from 1 March 2009 until 31 December 2010.MethodsA total of 1383 patients were included in the study. This required complete demographic information, preoperative Flex-SF (functional score) and pain scores. Following univariate analysis, a multivariate model was used.ResultsThe average age was 58 years (69% males and 11% smokers). New Zealand Europeans made up 90% and Maori 5%. The average preoperative Flex-SF was significantly lower (poorer function) in those over 65 years, females, smokers and Maori, in the non-dominant patients, using a multivariate model. Average preoperative pain scores were significantly worse (higher scores) in females, Maori, Polynesians, smokers, using a multivariate model.ConclusionThis is the largest reported prospective cohort of patients presenting for rotator cuff surgery. Results can be used to understand the effect of rotator cuff tears on the different patients, for example Maori patients who are under-represented, present younger, with more pain and poorer function.
      PubDate: 2017-07-12T20:11:33.633154-05:
      DOI: 10.1111/ans.13921
       
  • Suprascapular artery pseudoaneurysm
    • Authors: Rachel Falconer; Euan N. Munro, Russell W. Jamieson
      PubDate: 2017-07-11T04:17:50.096584-05:
      DOI: 10.1111/ans.14102
       
  • Fitness plus American Society of Anesthesiologists grade improve outcome
           prediction after endovascular aneurysm repair
    • Authors: Margaret Boult; Prue Cowled, Mary Barnes, Robert A. Fitridge
      Abstract: BackgroundAlthough the American Society of Anesthesiologists (ASA) grade was established for statistical purposes, it is often used prognostically. However, older patients undergoing elective surgery are typically ASA III, which limits patient stratification. We look at the prognostic effect on early complications and survival of using ASA and self-reported physical fitness to stratify patients undergoing endovascular repair of abdominal aortic aneurysms.MethodsData were extracted from a trial database. All patients were assigned a fitness level (A (fit) or B (unfit)) based on their self-reported ability to walk briskly for 1 km or climb two flights of stairs. Fitness was used to stratify ASA III patients, with fitter patients assigned ASA IIIA and less fit patients ASA IIIB. Outcomes assessed included survival, reinterventions, endoleak, all early and late complications and early operative complications.ResultsA combined ASA/fitness scale (II, IIIA, IIIB and IV) correlated with 1- and 3-year survival (1-year P = 0.001, 3-year P = 0.001) and early and late complications (P = 0.001 and P = 0.05). On its own, ASA predicted early complications (P = 0.0004) and survival (1-year P = 0.01, 3-year P = 0.01). Fitness alone was predictive for survival (1-year P = 0.001, 3-year P = 0.001) and late complications (P = 0.009).ConclusionThis study shows that even a superficial assessment of fitness is reflected in surgical outcomes, with fitter ASA III patients showing survival patterns similar to ASA II patients. Physicians should be alert to differences in fitness between patients in the ASA III group, despite similarities based on preexisting severe systemic disease.
      PubDate: 2017-07-10T03:05:26.250957-05:
      DOI: 10.1111/ans.14106
       
  • Brain metastases from colorectal cancer: characteristics and management
    • Authors: Diane Mege; Arnaud Sans, Mehdi Ouaissi, Antonio Iannelli, Igor Sielezneff
      Abstract: BackgroundBrain metastases (BMs) are the most common intracranial neoplasms in adults, but they rarely arise from colorectal cancer (CRC). The objective of this study was to report an overview of the characteristics and current management of CRC BMs.MethodsA systematic review on CRC BMs was performed using Medline database from 1983 to 2015. The search was limited to studies published in English. Review articles, not relevant case report or studies or studies relating to animal and in vitro experiments were excluded.ResultsBMs occurred in 0.06–4% of patients with CRC. Most BMs were metachronous and were associated with lung (27–92%) and liver (12–80%) metastases. Treatment options depended on the number of BMs, the general conditions of the patient and the presence of other metastases. Most frequent treatment was whole-brain radiotherapy (WBRT) alone (36%), with median overall survival comprised between 2 and 9 months. Median overall survival was better after surgery alone (from 3 to 16.2 months), or combined with WBRT (from 7.6 to 14 months). After stereotactic radiosurgery alone, overall survival could reach 9.5 months. Many favourable prognostic factors were identified, such as high Karnofsky performance status, low recursive partitioning analysis classes, lack of extracranial disease, low number of BMs and possibility to perform surgical treatment.ConclusionBMs from CRC are rare. In the presence of favourable prognostic factors, an aggressive management including surgical resection with or without WBRT or stereotactic radiosurgery can improve the overall survival.
      PubDate: 2017-07-07T18:55:40.572885-05:
      DOI: 10.1111/ans.14107
       
  • Prognostic value of positron emission tomography/computed tomography for
           adjuvant chemotherapy of colon cancer
    • Authors: HyungJoo Baik; Seok Mo Lee, Sang Hyuk Seo, Min Sung An, Kwang Hee Kim, Ki Beom Bae, Min Kyung Oh, Kwan Hee Hong
      Abstract: BackgroundTo assess the prognostic value of preoperative 18F-fluorodeoxyglucose positron emission tomography/computed tomography in patients with high-risk stage II or stage III colon cancer who underwent FOLFOX chemotherapy.MethodsThe study included 166 patients with high-risk stage II or stage III colon cancer who received FOLFOX4 chemotherapy. Retrospective patient data were analysed including pathological stage, histology, disease-free survival (DFS) and the maximum standardized uptake value (SUVmax) of the primary tumour on 18F-fluorodeoxyglucose positron emission tomography/computed tomography. The primary end point was DFS.ResultsThere were recurrences in 29 of the 166 patients (17.4%). Measuring the area under the receiver operating characteristic curve, the cut-off value of SUVmax with maximum sensitivity and specificity was 10.95. Using the Kaplan–Meier method, the DFS of the patients categorized by SUVmax tended to differ (P = 0.055). In univariate analyses, the risk factors for DFS were age over 70 years, higher N stage and neural invasion. SUVmax ≤ 10.95 showed a tendency, but was not significant (P = 0.0604). In multivariate analyses, the risk factors for DFS were age over 70 and neural invasion.ConclusionsThe results of this study suggest that high fluorodeoxyglucose uptake of the primary mass in high-risk stage II and stage III colon cancer does not significantly correlate with DFS.
      PubDate: 2017-07-07T18:55:37.929868-05:
      DOI: 10.1111/ans.14098
       
  • Emergency appendicectomy in Australia: findings from a multicentre,
           prospective study
    • Authors: Thomas Arthur; Richard Gartrell, Bavahuna Manoharan, David Parker,
      Abstract: BackgroundEmergency appendicectomy is the most common emergency surgical procedure performed in Australia. Despite this frequency, there is a relative paucity of contemporary, broad-based, local data that examine how emergency appendicectomies are currently performed and what are the outcomes from these operations.MethodsA multicentre, prospective, observational study was performed. Patients were recruited by local investigators for a period of 2 months with 30-day follow-up. Patients were eligible for study inclusion if they underwent an emergency appendicectomy for suspected acute appendicitis. The primary outcome of the study was the negative appendicectomy rate (NAR), with secondary outcomes including 30-day complication rates, method of operation and conversion rates.ResultsA total of 1189 patients were recruited across 27 centres. The NAR across all centres was 19.0%. 98.2% of appendicectomies were performed with a laparoscopic-first approach. The rate of conversion from laparoscopy to open operation was 2.4%. 9.4% of patients were recorded as having one or more of the following complications: readmission (6.6%), surgical site infection (1.9%), intra-abdominal abscess (2.7%) or further intervention (1.5%). Patients who had an open operation had higher rates of readmission and surgical site infection.ConclusionThe NAR found in this study is within the traditional measures of acceptance; however, this rate is high when measured against modern international benchmarks.
      PubDate: 2017-07-07T18:55:34.447636-05:
      DOI: 10.1111/ans.14088
       
  • Adrenalectomy for incidentaloma: lessons learned from a single-centre
           series of 274 patients
    • Authors: Sébastien Gaujoux; Adeline Aimé, Guillaume Assié, Roberto Ciuni, Stéphane Bonnet, Florence Tenenbaum, Jérome Bertherat, Bertrand Dousset
      Abstract: BackgroundAdrenal incidentalomas are increasingly diagnosed and include a wide spectrum of lesions from benign adenomas to secreting or malignant lesions. The aim of the present study is to report a large single-institution experience of patients undergoing surgery for adrenal incidentaloma with particular attention to their diagnosis and post-operative course and the evolution of surgical practice over time.MethodsFrom 1993 to 2013, 274 patients underwent adrenalectomy for incidentaloma. All patients underwent standardized clinical, hormonal and imaging assessments.ResultsPatients were mainly female (63.1%; n = 173), and the median age of patients was 56.5 years. After a complete hormonal evaluation, 47.9% (n = 129) of incidentalomas were classified as secreting tumours, including 24.4% (n = 67) subclinical cortisol-secreting adenomas and 18.9% (n = 52) pheochromocytomas. Adrenocortical carcinomas represented 9.5% (n = 26) of incidentalomas, and the risk of malignancy was significantly correlated with tumour size. The conversion rate after laparoscopic adrenalectomy (90.9%; n = 249) was 3.2% (n = 8). The overall morbidity rate was 13.9%, which included a 4.4% rate of severe morbidity (Clavien–Dindo ≥3). From 2008 onwards, there was a significant decrease (P 
      PubDate: 2017-07-07T18:55:32.639475-05:
      DOI: 10.1111/ans.14095
       
  • Publication rate of General Surgery abstracts presented at the Royal
           Australasian College of Surgeons Annual Scientific Congress
    • Authors: Masoomeh Khajehnoori; Douglas Stupart, David Watters
      Abstract: BackgroundA commonly used metric for evaluating the quality and impact of presentations at a scientific meeting is the frequency with which the findings presented are published as full research papers in peer-reviewed journals. The purpose of this study was to determine the full article publication rates of abstract presentations for General Surgery and related sub-specialities at the Royal Australasian College of Surgeons Annual Scientific Congress (RACS ASC) from 2010 to 2014.MethodsAll General Surgical (including its sub-speciality groups) abstracts presented at the RACS ASC from 2010 to 2014 were identified from the ANZ Journal of Surgery. We determined the rates of full paper publication, time to publication, journals of publication and specialty rates of conversion. Full article publications were identified using the PubMed, MEDLINE and Google Scholar databases.ResultsA total of 1386 abstracts were identified, of which 356 (26%) were converted to full paper publications. The number of abstracts presented annually increased from 206 in 2010 to 386 in 2014, but the percentage of abstracts converted to full paper publications did not follow any temporal trend. The majority (74%) of full papers were published within 2 years of the abstract presentation.ConclusionIn total, 26% of General Surgery abstracts presented at the RACS ASC from 2010 to 2014 were converted to full paper publications. This could provide a baseline against which to judge the quality of presentations at other national General Surgical congresses, as well as at future RACS ASC meetings.
      PubDate: 2017-07-06T06:31:27.817091-05:
      DOI: 10.1111/ans.14103
       
  • Extravasation injury in a paediatric population
    • Authors: Adrian D. Murphy; Robert F. Gilmour, Chris J. Coombs
      Abstract: BackgroundExtravasation occurs when a drug is inadvertently administered outside of the vein. Depending on the substance involved, this may lead to tissue necrosis with significant long-term morbidity. Children, particularly neonates, are particularly susceptible to extravasation with up to 70% of children in neonatal intensive care unit having some form of extravasation injury. These injuries are commonly referred to plastic surgeons for ongoing management.MethodsWe prospectively collected information on all extravasation injuries referred to the plastic surgery department in a children's hospital over an 18-month period. Data collected included the agent involved in the extravasation, treatment and outcomes.ResultsIn total, there were 43 extravasation injuries recorded on the hospital risk management system during the period of this study. All of these were referred to the plastic surgery team for ongoing management. Five patients (11%) underwent washout of their injuries. Three patients (7%) suffered injuries, which led to significant tissue necrosis, delayed healing and prolonged morbidity.ConclusionSmaller infants, particularly those being cared for in an intensive care setting, are at increased risk for extravasation injury. Early referral and treatment of high-risk extravasation injuries may reduce the incidence of tissue loss and morbidity.
      PubDate: 2017-07-06T06:31:25.553236-05:
      DOI: 10.1111/ans.14104
       
  • Impact of an acute surgical unit on patient outcomes in South Australia
    • Authors: Ned Kinnear; Philip Britten-Jones, Derek Hennessey, Diwei Lin, Darren Lituri, Subhita Prasannan, Greg Otto
      Abstract: BackgroundCompared with traditional (Trad) systems of managing emergency surgical presentations, the acute surgical unit (ASU) model provides an on-site registrar, on-call surgeon and dedicated emergency theatre, 24 h/day. To date, there have been no Australasian ASU studies of>3000 patients, nor from South Australia.MethodsA retrospective historical control study compared the outcomes of adults admitted to the Lyell McEwin Hospital in the Trad (1 February 2010 to 31 July 2012) and ASU periods (1 August 2012 to 31 January 2015), who underwent an emergency general surgical procedure.ResultsA total of 4074 patients met inclusion criteria; 1688 and 2386 patients during the Trad and ASU periods, respectively. The cohorts were not significantly different in median age, gender or American Society of Anesthesiologists scores. Compared with the Trad period, improved median time from emergency department referral to theatre start (19.4 h versus 17.9 h, P 
      PubDate: 2017-07-06T06:31:13.854838-05:
      DOI: 10.1111/ans.14100
       
  • Inguinal lymph node metastases from rectal adenocarcinoma
    • Authors: Thamer Bin Traiki; Amirala Khalessi, Kim-Chi Phan-Thien
      PubDate: 2017-07-06T06:31:08.887703-05:
      DOI: 10.1111/ans.14091
       
  • Predictive factors for lymph node metastasis in early gastric cancer with
           signet ring cell histology: a meta-analysis
    • Authors: Xudong Zhao; Aizhen Cai, Hongqing Xi, Yanjing Song, Yi Wang, Hua Li, Peiyu Li, Lin Chen
      Abstract: BackgroundLess invasive surgery is widely used in the treatment of early gastric cancer; however, no definite guidelines exist regarding indications for less invasive surgery to treat early gastric cancer with signet ring cell histology. The aim of this study was to identify risk factors for lymph node metastasis (LNM) in early signet ring cell carcinoma (SRC). An extensive search of PubMed, Embase and the Cochrane library was performed for pertinent articles involving early SRC and LNM.MethodsEligible data (gender, depth of invasion, lymphovascular invasion, size, ulceration, macroscopic type and location) were extracted from the included studies and systematically reviewed via a meta-analysis. Review Manager version 5.3 was used to perform the data processing. The Newcastle–Ottawa Scale was utilized to evaluate the quality of the included articles.ResultsFourteen studies were included in the final analysis. After meta-analysis, female gender, submucosal invasion, lymphovascular invasion and size >20 mm were associated with LNM in early SRC.ConclusionFour variables were identified as risk factors for LNM in early SRC. The significance of the results of the present study should be further confirmed in more early SRC patients for future clinical use.
      PubDate: 2017-07-06T06:30:36.223532-05:
      DOI: 10.1111/ans.14089
       
  • Caecal volvulus post-appendicectomy in pregnancy: a case report
    • Authors: Baillie W. C. Ferris; Garry Dyke
      PubDate: 2017-07-05T19:46:01.300411-05:
      DOI: 10.1111/ans.14099
       
  • Massive arteriovenous air embolism after computed tomography-guided lung
           tumour biopsy
    • Authors: Andrei M. Beliaev; David Milne, Chris Sames, Bruce O'Brien, Tharumenthiran Ramanathan
      PubDate: 2017-07-05T19:45:50.345881-05:
      DOI: 10.1111/ans.14101
       
  • How to do it: use of the Alexis wound protector as a laparostomy device
    • Authors: Alison Rutledge; Georgia Carroll, Stephen Smith, Jonathan Gani
      PubDate: 2017-07-05T05:21:21.75549-05:0
      DOI: 10.1111/ans.14097
       
  • Intravenous lignocaine in colorectal surgery: a systematic review
    • Authors: Wiremu S. MacFater; Jamie-Lee Rahiri, Melanie Lauti, Bruce Su'a, Andrew G. Hill
      Abstract: BackgroundColorectal surgery leads to morbidity during recovery including pain and fatigue. Intravenous (IV) lignocaine (IVL) has both analgesic and anti-inflammatory effects that may improve post-operative pain and recovery. The aim of this review is to compare the effectiveness of IVL to other perioperative analgesia regimens for reducing pain and opioid consumption following colorectal surgery.MethodsUsing the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) statement, a literature search was conducted to identify randomized clinical trials that compared IVL with IV placebo or epidural anaesthesia in open or laparoscopic colorectal surgery. The primary outcomes were opioid requirements and pain scores assessed by visual analogue score. Data were entered into pre-designed electronic spreadsheets.ResultsThe literature search identified 2707 studies. A total of nine randomized clinical trials met the inclusion criteria. Five studies investigated IVL compared with IV placebo and four studies investigated IVL compared with epidural anaesthesia. Two out of the five studies comparing IVL and placebo showed statistically significant reductions in opioid consumption with IVL. There was a variable degree of improvement in pain scores when IVL was compared with epidural. Two studies showed a significant difference, with lower opioid consumption and pain scores in the epidural group. Laparoscopic and open procedures could not be compared between the IVL and placebo group.ConclusionIVL has shown limited benefit towards reducing early pain and morphine consumption when compared with placebo in colorectal surgery. However, IVL did not show any significant reduction in pain or opioid consumption when compared with epidural. Further research investigating IVL combined with intraperitoneal local anaesthetic is warranted.
      PubDate: 2017-07-05T05:20:29.597601-05:
      DOI: 10.1111/ans.14084
       
  • Faecaloma causing large bowel obstruction: a case report and review of
           literature
    • Authors: Zi Qin Ng; Willy Low, Pradeep Subramanian, Joel Stein
      PubDate: 2017-07-01T01:52:12.593377-05:
      DOI: 10.1111/ans.14085
       
  • Is cystic artery lymph node excision during laparoscopic cholecystectomy a
           marker of technique'
    • Authors: Arkadiusz P. Wysocki; Skyle Murphy, Robert S. Ware
      Abstract: BackgroundIn order to minimize bile duct injury, experts suggest that dissection during laparoscopic cholecystectomy (LC) should be performed lateral to the lymph node (LN). This study aims to determine whether the frequency of excision of the LN is related to patient factors, disease severity or surgical difficulty.MethodsAll LCs performed or supervised by one surgeon were identified from a prospective database. The presence of LN was retrospectively determined by reviewing the gallbladder histology report.ResultsThe LN was identified in 10.4% of 1332 cholecystectomies. The American Society of Anesthesiologists class 3 was associated with a lower rate of LN excision compared with class 1 (odds ratio: 0.36; P = 0.049) as was the presence of a senior surgical trainee (odds ratio: 0.18; P < 0.001). Rate of LN excision was independent of patient demographic and clinical characteristics, including indication for cholecystectomy, conversion to open, gallbladder perforation, cholangiography, bile duct exploration and overall surgical difficulty.ConclusionsThe frequency with which the LN is excised during LC by the one surgeon is independent of the majority of clinical and surgical factors and may represent a surrogate marker of surgical technique. Whether this is related to the rate of bile duct injury remains to be determined.
      PubDate: 2017-07-01T01:51:49.96677-05:0
      DOI: 10.1111/ans.14087
       
  • Treatment of peritoneal carcinomatosis with hyperthermic intraperitoneal
           chemotherapy in colorectal cancer
    • Authors: Corina Behrenbruch; Frédéric Hollande, Benjamin Thomson, Michael Michael, Satish K. Warrier, Craig Lynch, Alexander Heriot
      Abstract: The peritoneum is the second most common site of metastasis after the liver and the only site of metastatic disease in approximately 25% of patients with colorectal cancer (CRC). In the past, peritoneal carcinomatosis in CRC was thought to be equivalent to distant metastasis; however, the transcoelomic spread of malignant cells is an acknowledged alternative pathway. Metastasectomy with curative intent is well accepted in patients with liver metastasis in CRC despite the paucity of randomized trials. Therefore, there is rationale for local treatment with peritonectomy to eliminate macroscopic disease, followed by hyperthermic intraperitoneal chemotherapy to destroy any residual free tumour cells within the peritoneal cavity. The aim of this paper is to summarize the current evidence for cytoreduction and hyperthermic intraperitoneal chemotherapy in the treatment of peritoneal carcinomatosis in CRC.
      PubDate: 2017-06-30T01:50:58.850941-05:
      DOI: 10.1111/ans.14077
       
  • Unusual case of ventral liver herniation
    • Authors: Shaveen D. Kanakaratne; Gayatri Asokan, Chandika Liyanage
      PubDate: 2017-06-30T01:50:50.827197-05:
      DOI: 10.1111/ans.14082
       
  • Management of pancreaticojejunal strictures after pancreaticoduodenectomy:
           clinical experience and review of literature
    • Authors: Mudassar A. Ghazanfar; Zahir Soonawalla, Michael A. Silva, Srikanth Reddy
      Abstract: BackgroundSymptomatic pancreaticojejunal anastomotic stricture (PJS) is a rare complication following pancreaticoduodenectomy. The incidence, presentation and management of this condition are infrequently reported in the literature. Revision surgery is thought to be an effective treatment. Recent literature shows some success from endoscopic management.MethodsThe patients treated for symptomatic PJS from January 2005 to June 2014 were identified. Their clinical presentation and management was retrospectively reviewed. Patients were followed up in clinic or by telephonic interviews to assess their symptoms.ResultsThree patients (two females and one male) had symptomatic PJS out of 314 who underwent pancreaticoduodenectomy (0.9%). Main presentating symptom was intermittent abdominal pain. The diagnosis was confirmed by computed tomography scan and/or magnetic resonance cholangiopancreatography. One patient underwent a failed endoscopic retrograde cholangiopancreatography attempt to dilate the stricture. A redo-pancreaticojejunostomy was performed in all patients. At a mean follow-up of 8 months, two patients had complete resolution of symptoms and one patient had partial benefit. Five out of seven case series in literature support surgical management.ConclusionSymptomatic PJS can be successfully treated with redo-pancreaticojejunostomy, with good medium-term outcomes. Although endoscopic intervention has been described, review of the literature shows that success rates are low and the long-term results are unknown.
      PubDate: 2017-06-27T03:12:49.821235-05:
      DOI: 10.1111/ans.14073
       
  • Colonic lipoma causing intussusception: a case for colonoscopic
           surveillance'
    • Authors: Sherman Siu; Raymond Oliphant, Simon Benstock, Anil Keshava, Matthew J. F. X. Rickard
      PubDate: 2017-06-23T04:16:29.281431-05:
      DOI: 10.1111/ans.14080
       
  • Ileocolic intussusception from an inflammatory fibroid polyp: a rare cause
           of adult small bowel obstruction
    • Authors: Sabrina Mader; Joseph Ting, Hajir Nabi
      PubDate: 2017-06-23T04:16:17.245177-05:
      DOI: 10.1111/ans.14086
       
  • Cutaneous angiosarcoma: a rare complication post-male breast cancer
           radiotherapy
    • Authors: Aaron Lim; Corina Preda, Jason Stone, Andreas L. Lambrianides
      PubDate: 2017-06-23T04:16:05.091018-05:
      DOI: 10.1111/ans.14075
       
  • A case of an incidental primary adrenal lymphoma in a patient with newly
           diagnosed human immunodeficiency virus
    • Authors: Maneka M. Britto; Matthew J. Y. Kang, Stephanie Goare, Alan Pham, Jason T. Hong, Jonathan Serpell, Simon Grodski
      PubDate: 2017-06-23T04:15:44.634472-05:
      DOI: 10.1111/ans.14078
       
  • Coding in surgery: impact of a specialized coding proforma in
           hepato-pancreato-biliary surgery
    • Authors: Jennifer Murphy; Charlotte May, Sara Di Carlo, Ian Beckingham, Iain C. Cameron, Dhanny Gomez
      Abstract: BackgroundCoding inaccuracies in surgery misrepresent the productivity of hospitals and outcome data of surgeons. The aim of this study was to audit the extent of coding inaccuracies in hepato-pancreato-biliary (HPB) surgery and assess the financial impact of introducing a coding proforma.MethodsCoding of patients who underwent elective HPB surgery over a 3-month period was audited. Codes were based on International Classification of Diseases 10 and Office of Population and Census Surveys-4 codes. A coding proforma was introduced and assessed. New human resource group codes were re-assigned and new tariffs calculated. A cost analysis was also performed.ResultsPrior to the introduction of the coding proforma, 42.0% of patients had the incorrect diagnosis and 48.5% had missing co-morbidities. In addition, 14.5% of primary procedures were incorrect and 37.6% had additional procedures that were not coded for at all. Following the introduction of the coding proforma, there was a 27.5% improvement in the accuracy of primary diagnosis (P 
      PubDate: 2017-06-23T04:15:27.411917-05:
      DOI: 10.1111/ans.14076
       
  • Rare complication of gastrojejunostomy
    • Authors: Hobia Gole; Thomas Arthur, Hajir Nabi
      PubDate: 2017-06-22T11:10:54.141832-05:
      DOI: 10.1111/ans.14071
       
  • Is it right to ignore learning-curve patients' Laparoscopic colorectal
           trials
    • Authors: Alan P. Meagher; Shi Yang, Shuyuan Li
      Abstract: BackgroundIncreasingly complex, technically demanding surgical procedures utilizing emerging technologies have developed over recent decades and are recognized as having long ‘learning curves’. This raises significant new issues. Ethically and scientifically, the outcome of a patient in the learning curve is as important as the outcome of a patient outside the learning curve. The aim of this study is to highlight just one aspect of our approach to learning-curve patients that should change.MethodsThe protocols of multicentre, prospective, randomized trials of patients undergoing either traditional open or laparoscopic surgery for colorectal cancer were reviewed. The number of patients excluded from the published trial results because they were in surgeons’ learning curves was calculated. The seven editorials accompanying these publications were also examined for any mention of these patients.ResultsThe eight studies identified had similar designs. All patients in the surgeons’ laparoscopic learning curves, which were often several years long, were excluded from the actual trials. The total number of patients included in the trial publications was 5680. The number of patients excluded because they were in the surgeons’ laparoscopic learning curves was>10 605. In none of the studies or accompanying editorials is there any mention of the total number of patients in the surgeons’ learning curves, these patients’ outcomes or how inclusion of their outcomes might have affected the overall results.ConclusionLearning curves are inescapable in modern medicine. Our recognition of patients in these curves should evolve, with more data about them included in trial publications.
      PubDate: 2017-06-22T11:10:32.6641-05:00
      DOI: 10.1111/ans.14070
       
  • Enhanced recovery programme following laparoscopic colorectal resection
           for elderly patients
    • Authors: Wei Gen Zeng; Meng Jia Liu, Zhi Xiang Zhou, Zhen Jun Wang
      Abstract: BackgroundThe aim of this study was to investigate the feasibility and safety of an enhanced recovery programme (ERP) in patients aged ≥75 years who undergo laparoscopic surgery for colorectal cancer.MethodsPatients were divided into two groups according to perioperative management: the ERP group (Group A, n = 94) and the conventional perioperative care group (Group B, n = 157). The postoperative outcomes were compared between two groups.ResultsThere were no differences in terms of age, gender, American Society of Anesthesiologists score, operative time or blood loss between two groups. Postoperative return of gastrointestinal function was significantly faster in Group A compared to Group B, including time to first flatus (2 versus 3 days, P < 0.001), first stool (3 versus 4 days, P = 0.001) and oral intake (1 versus 4 days, P < 0.001). Group A was associated with lower overall postoperative complication rate (26.6% versus 44.6%, P = 0.004) and general complication rate (14.9% versus 31.2%, P = 0.004). The median postoperative hospital stay was 6 days in Group A and 8 days in Group B (P < 0.001), respectively.ConclusionsERP following laparoscopic colorectal resection for elderly patients is associated with faster postoperative recovery, shorter postoperative hospital stay and fewer complications compared with conventional perioperative care.
      PubDate: 2017-06-22T11:10:27.63164-05:0
      DOI: 10.1111/ans.14074
       
  • Gastric outlet obstruction secondary to parastomal hernia: case report and
           literature review
    • Authors: Nicholas Bull; Daniel L. Chan, Praveen Ravindran, Suzanne D. Sano, Stephen I. White
      PubDate: 2017-06-13T00:30:41.352665-05:
      DOI: 10.1111/ans.14066
       
  • Portomesenteric thrombosis post laparoscopic cholecystectomy: a case
           report
    • Authors: Marianna Zukiwskyj; Benjamin McDonald, Michael Auld
      PubDate: 2017-06-13T00:30:35.363191-05:
      DOI: 10.1111/ans.14059
       
  • Systematic differences between ultrasound and pathological evaluation of
           thyroid nodules: a method comparison study
    • Authors: Carolyn R. Chew; Tracey Lam, Steven T. F. Chan, Laura Chin-Lenn
      Abstract: BackgroundThe size of thyroid nodules as measured by ultrasound (ultrasound size, USS) is routinely used in clinical decision-making. Reports of discrepancy between USS and pathological size (PS) evaluation have not analysed their systematic differences. The objective of this study was to uncover the lack of agreement (bias) between USS and PS measurements.MethodsA retrospective study was performed on 121 patients who had a total or hemi-thyroidectomy for a solitary nodule. Ordinary least product regression was used to detect and distinguish constant and proportional bias in unidimensional size measurements between USS and PS evaluation. Three-dimensional volume measurements were compared in a subgroup of 31 patients. Pre-specified acceptable limits of interchange were defined as 20% difference.ResultsOrdinary least product regression demonstrated no constant or proportional bias between the two methods; regression equation: USS = (0.863) + (1.040) × PS. When nodules were grouped by size, discrepancies between the two methods were observed in nodules 10 mm but PS 
      PubDate: 2017-06-13T00:30:27.054456-05:
      DOI: 10.1111/ans.14045
       
  • Intramuscular myxoma and fibrous dysplasia of bone presents as Mazabraud's
           syndrome
    • Authors: Benny Yau; Hock W. Kua, Michael F. Lo
      PubDate: 2017-06-13T00:30:24.98949-05:0
      DOI: 10.1111/ans.13951
       
  • Dental extraction from an appendix: a case report and review of the
           literature
    • Authors: Aaron Smith; Omar Mouline, Tony Mallet, Gael Phillips, Merwe Hartslief
      PubDate: 2017-06-12T19:20:54.769619-05:
      DOI: 10.1111/ans.14065
       
  • Out-of-office hours’ elective surgical intensive care admissions and
           their associated complications
    • Authors: David J. R. Morgan; Kwok Ming Ho, Yang Jian Ong, Marlene L. Kolybaba
      Abstract: BackgroundThe ‘weekend’ effect is a controversial theory that links reduced staffing levels, staffing seniority and supportive services at hospitals during ‘out-of-office hours’ time periods with worsening patient outcomes. It is uncertain whether admitting elective surgery patients to intensive care units (ICU) during ‘out-of-office hours’ time periods mitigates this affect through higher staffing ratios and seniority.MethodsOver a 3-year period in Western Australia's largest private hospital, this retrospective nested-cohort study compared all elective surgical patients admitted to the ICU based on whether their admission occurred ‘in-office hours’ (Monday–Friday 08.00–18.00 hours) or ‘out-of-office hours’ (all other times). The main outcomes were surgical complications using the Dindo-Clavien classification and length-of-stay data.ResultsOf the total 4363 ICU admissions, 3584 ICU admissions were planned following elective surgery resulting in 2515 (70.2%) in-office hours and 1069 (29.8%) out-of-office hours elective ICU surgical admissions. Out-of-office hours ICU admissions following elective surgery were associated with an increased risk of infection (P = 0.029), blood transfusion (P = 0.020), total parental nutrition (P 
      PubDate: 2017-06-12T19:20:48.363357-05:
      DOI: 10.1111/ans.14027
       
  • Does the ileal brake mechanism contribute to sustained weight loss after
           bariatric surgery'
    • Authors: Savio G. Barreto; Stijn Soenen, Jacob Chisholm, Ian Chapman, Lilian Kow
      Abstract: Bariatric surgery is currently the most effective strategy for treating morbid obesity. Weight regain following significant weight loss, however, remains a problem, with the outcome proportional to the period of follow-up. This review revisits a well-established physiological neurohormonally-mediated feedback loop, the so called ileal brake mechanism, with a special emphasis on the gut hormone peptide tyrosine tyrosine. The manuscript not only highlights the potential role of the ileal brake mechanism in weight loss and weight maintenance thereafter following obesity surgery, it also provides a compelling argument for using this appetite suppressing feedback loop to enable sustained long-term weight loss in patients undergoing surgery for morbid obesity.
      PubDate: 2017-06-08T01:45:21.258405-05:
      DOI: 10.1111/ans.14062
       
  • It's worth the wait: optimizing questioning methods for effective
           intraoperative teaching
    • Authors: Meredith Barrett; Christopher P. Magas, Larry D. Gruppen, Priya H. Dedhia, Gurjit Sandhu
      Abstract: BackgroundThe use of questioning to engage learners is critical to furthering resident education intraoperatively. Previous studies have demonstrated that higher level questioning and optimal wait times (>3 s) result in learner responses reflective of higher cognition and retention. Given the importance of intraoperative learning, we investigated question delivery in the operating room.MethodsA total of 12 laparoscopic cholecystectomies were observed and recorded. All questions were transcribed and classified using Bloom's Taxonomy, a framework associated with hierarchical levels of learning outcomes. Wait time between question end and response was recorded.ResultsSix faculty attendings and seven house officers at our institution were observed. A total of 133 questions were recorded with an average number of questions per case of 11.2. The majority of questions 112 out of 133 (84%) were classified as Bloom's levels 1–3, with only 6% of questions of the highest level. The wait time before the resident answered the question averaged 1.75 s, with attendings interceding after 2.50 s. Question complexity and wait time did not vary based on resident postgraduate year level suggesting limited tailoring of question to learner.ConclusionsIntraoperative questioning is not aligned with higher level thinking. The majority of questions were Bloom's level 3 or below, limiting the complexity of answer formulation. Most responses were given within 2 s, hindering opportunity to pursue higher-order thinking. This suggests including higher level questions and tailoring questions to learner level may improve retention and maximize gains. In addition, with attendings answering 20% of their own questions, increasing their wait time offers another area for teaching development.
      PubDate: 2017-06-07T23:50:32.890623-05:
      DOI: 10.1111/ans.14046
       
  • Age 80 years and over is not associated with increased morbidity and
           mortality following pancreaticoduodenectomy
    • Authors: Sandy Y. Kim; Michael A. Fink, Marcos Perini, Nezor Houli, Laurence Weinberg, Vijayaragavan Muralidharan, Graham Starkey, Robert M. Jones, Christopher Christophi, Mehrdad Nikfarjam
      Abstract: BackgroundPancreaticoduodenectomy (PD) is associated with high morbidity, which is perceived to be increased in the elderly. To our knowledge there have been no Australian series that have compared outcomes of patients over the age of 80 undergoing PD to those who are younger.MethodsPatients who underwent PD between January 2008 and November 2015 were identified from a prospectively maintained database.ResultsA total of 165 patients underwent PD of whom 17 (10.3%) were aged 80 or over. The pre-operative health status, according to American Society of Anesthesiologists class was similar between the groups (P = 0.420). The 90-day mortality rates (5.9% in the elderly and 2% in the younger group; P = 0.355) and the post-operative complication rates (64.7% in the elderly versus 62.8% in the younger group; P = 0.88) were similar. Overall median length of hospital stay was also similar between the groups, but older patients were far more likely to be discharged to a rehabilitation facility than younger patients (47.1 versus 12.8%; P 
      PubDate: 2017-06-07T23:50:29.661319-05:
      DOI: 10.1111/ans.14039
       
  • Impact of atrial fibrillation on long-term survival following
           oesophagectomy: a 21-year observational study
    • Authors: Cameron I. Wells; Jason P. Robertson, Sandra Campbell, Fadhel Al-Herz, Bruce Rhind, Mike Young
      Abstract: BackgroundPost-operative atrial fibrillation (AF) is a common complication of oesophagectomy and thought to signal a complicated post-operative course. AF is associated with prolonged admissions, increased healthcare costs and inpatient mortality. However, the impact of post-operative AF on long-term outcomes remains uncertain.MethodsPatients undergoing open Ivor-Lewis oesophagectomy from 1994 to 2014 at Palmerston North Hospital, New Zealand, were retrospectively evaluated. Demographic, perioperative and tumour variables were collected. Regression models were used to identify independent predictors of AF and assess post-discharge survival following oesophagectomy.ResultsIn total, 89 patients were included. New-onset AF developed post-operatively in 27 patients (30%). Median follow-up was 6.3 years. Logistic regression identified volume of intravenous fluid in the first 24 h post-operatively as a predictor of AF. Post-discharge survival was predicted by AF occurrence (hazard ratio (HR): 2.99, 95% confidence interval (CI): 1.37–6.53, P = 0.006), preoperative chemoradiotherapy (HR: 0.43, 95% CI: 0.20–0.91, P = 0.03), 1–4 positive lymph nodes (HR: 2.29, 95% CI: 1.06–4.96, P = 0.04), ≥5 positive nodes (HR: 2.95, 95% CI: 1.25–6.94, P = 0.01) and year of operation from 2008 to 2014 (HR: 0.30, 95% CI: 0.12–0.75, P = 0.01).ConclusionPost-operative AF was associated with poorer long-term survival following oesophagectomy in this cohort. Further research should evaluate the influence of AF on cardiovascular and oncological outcomes following oesophagectomy.
      PubDate: 2017-06-07T23:50:25.268546-05:
      DOI: 10.1111/ans.14054
       
  • Index cholecystectomy in a rural hospital: it can be done
    • Authors: Jay Maloney; Alice McLachlan, Melissa Welch, Emily Davenport
      Abstract: BackgroundIndex cholecystectomy (IC) refers to an operation during a patient's first hospital admission with symptomatic gallstone (GS) disease. There are proven reductions in cost, hospital bed days and GS-related complications while awaiting elective surgery. IC has not been universally adopted, particularly in smaller centres where logistics can present a barrier. The aim of this paper is to describe the introduction of routine IC at Hastings Hospital and the effects in terms of waiting time until surgery; GS-related re-presentations and complications while awaiting surgery; operative complications and overall hospital stay.MethodsData were collected for all patients who underwent cholecystectomy in the year following the introduction of IC (2015/2016). The results were compared with data from the year 2009/2010.ResultsA total of 259 cholecystectomies were performed over the 2015/2016 study period compared with 186 in the 2009/2010 study period. The IC rate increased from 9.89% in 2009 to 75.4% in 2015 (P 
      PubDate: 2017-06-06T19:20:24.669116-05:
      DOI: 10.1111/ans.14072
       
  • Sentinel node biopsy for early breast cancer in Queensland, Australia,
           during 2008–2012
    • Authors: Paramita Dasgupta; Philippa H. Youl, Christopher Pyke, Joanne F. Aitken, Peter D. Baade
      Abstract: BackgroundSentinel node biopsy (SNB) is now the standard of care for women with early-stage breast cancer. Despite lower morbidity than axillary lymph node dissection, widespread variation in SNB rates by non-clinical factors persists. We explored the factors associated with SNB usage and changes in those associations over time for recently diagnosed women.MethodsWe report here on a linked population-based cancer registry and hospital inpatient admission data set for 5577 women aged at least 20 years diagnosed with a first primary invasive early-stage node-negative breast cancer from July 2008 to 2012 in Queensland, Australia, who underwent breast cancer-related surgery within 2 years of diagnosis. Multivariate logistic regression was used to model predictors of SNB separately for 5172 women with ≤30 mm tumours and 405 with 31 to ≤50 mm tumours.ResultsOverall, 3972 (77%) women with ≤30 mm tumours and 221 (55%) of those with larger tumours underwent SNB. Usage increased over time for both cohorts but was consistently lower among those with larger tumours. A more recent diagnosis, having breast-conserving surgery, living in more accessible areas and attending a private or high-volume hospital independently increased the odds of SNB for both cohorts. There was no evidence that the geographical disparity had reduced over the study period for either cohort.ConclusionGeographical disparities to accessing SNB persist. Efforts to promote multidisciplinary care and facilitate education in healthcare changes through innovative solutions using emerging technologies as well as targeted research to identify the barriers to equitable access remain critical.
      PubDate: 2017-06-06T05:42:23.930248-05:
      DOI: 10.1111/ans.14047
       
  • Do the nodules detected in chest X-rays always indicate a disease of lung
           parenchyma'
    • Authors: Sami Karapolat; Atila Turkyilmaz, Alaaddin Buran, Celal Tekinbas
      PubDate: 2017-05-29T20:40:28.555061-05:
      DOI: 10.1111/ans.14055
       
  • Effect of magnesium on arrhythmia incidence in patients undergoing
           coronary artery bypass grafting
    • Authors: Alireza Mohammadzadeh; Farshad Towfighi, Naser Jafari
      Abstract: BackgroundCardiac arrhythmia after coronary artery bypass grafting (CABG) surgery is a common complication of cardiac surgery. The effect of serum magnesium, hypomagnesaemia treatment and prophylactic administration of magnesium in the development and prevention of arrhythmias is controversial and there are many different ideas. This study evaluates the therapeutic effects of magnesium in cardiac arrhythmia after CABG surgery.MethodsThe clinical trial enrolled 250 patients who underwent CABG. Based on the initial serum levels of magnesium, patients were divided into two groups: hypomagnesium and normomagnesium. Based on bioethics committee requirements, patients in the hypo-magnesium group received magnesium treatments until they attained normal magnesium blood levels. Both groups underwent CABG with normal blood levels of magnesium. After surgery, each group was randomly divided into two subgroups: one subgroup received a bolus dose of magnesium sulphate (30 mg/kg in 5 min) and the other subgroup received a placebo. Subgroups were under observation in the intensive care unit for 3 days and arrhythmias were recorded. Data from all four subgroups were analysed statistically and interpreted.ResultsThe results of this study showed that the occurrence of arrhythmia was not significantly different among subgroups (P > 0.05). There was no significant relationship between blood levels of magnesium and arrhythmia during the 3 days post-surgery (P > 0.05).ConclusionThe results of this study showed that magnesium sulphate administration did not significantly improve the incidence of arrhythmias in hypo- and normo-magnesium patients after CABG. There was no significant correlation between post-operative serum levels of magnesium and arrhythmia during 3 days.
      PubDate: 2017-05-22T00:55:26.924966-05:
      DOI: 10.1111/ans.14056
       
  • Multidisciplinary management of metastatic melanoma to the inter-atrial
           septum
    • Authors: Andrei M. Beliaev; Peter N. Ruygrok, Rosalie Stephens, David A. Haydock
      PubDate: 2017-05-21T22:45:34.863373-05:
      DOI: 10.1111/ans.14057
       
  • Comparison of 5-year oncological outcomes of breast cancer based on
           surgery type
    • Authors: Jeeyeon Lee; Jin Hyang Jung, Wan Wook Kim, Yee Soo Chae, Soo Jung Lee, Ho Yong Park
      Abstract: BackgroundA standardized classification system for breast surgery that incorporates oncoplastic techniques is needed. We classified the surgical techniques for breast cancer treatment into five groups according to the extent of surgery and reconstructive methods, i.e. conventional breast-conserving surgery, partial mastectomy with volume displacement, partial mastectomy with volume replacement, simple mastectomy and total mastectomy with immediate reconstruction. We then evaluated the oncological outcomes for each of the five groups.MethodsWe analysed clinical data and 5-year oncological results from patients with breast cancer who underwent breast surgery with reconstruction between 2008 and 2013. Local recurrence, distant metastasis and overall survival were investigated.ResultsIn total, 1469 patients had 1504 breast surgeries performed with a mean follow-up of 72.40 ± 16.76 months. There were 35 cases (2.3%) of locoregional recurrence and 85 cases (5.7%) of distant metastasis, and the 5-year overall survival rate was 98.6%. No statistically significant differences were observed in local recurrence, distant metastasis or death among the five surgical technique groups (P = 0.218, 0.518 and 0.450, respectively).ConclusionOncological outcomes among all patients and within each surgical technique group were excellent during the 5-year follow-up period. No significant differences in oncological results were observed among the five surgical technique groups.
      PubDate: 2017-05-21T22:45:32.09464-05:0
      DOI: 10.1111/ans.14017
       
  • Medial sural artery perforator free flap for the reconstruction of leg,
           foot and ankle defect: an excellent option
    • Authors: Jyoshid R. Balan
      Abstract: BackgroundThe defects over the leg, foot and ankle are best covered with a thin pliable flap. The use of muscle flap for the reconstruction of these defects leaves a grafted, aesthetically inferior result. The medial sural artery perforator (MSAP) free flap gives a thin pliable tissue for the reconstruction with better aesthesis.MethodsThe study design was retrospective case analysis over a period of 2 years. All the patients who underwent flap for leg, foot and ankle defect reconstruction in the form of MSAP free flap were included in the study. The flap characteristics and aesthesis were assessed along with the patient satisfaction. The flap complication and donor site morbidity were also analysed.ResultsA total of seven MSAP free flaps were done for leg, foot and ankle reconstruction. The mean flap size was 14.29 × 6.6 cm and mean pedicle length was 9.71 cm. One flap had venous congestion post-operatively resulting in marginal flap loss. All the flaps had acceptable aesthesis with good patient satisfaction. There was donor site morbidity in two patients, in the form of wound dehiscence.ConclusionMSAP free flap is a reliable choice for leg, foot and ankle defect reconstruction.
      PubDate: 2017-05-16T19:56:42.669124-05:
      DOI: 10.1111/ans.14050
       
  • Predict pancreatic fistula after pancreaticoduodenectomy: ratio body
           thickness/main duct
    • Authors: Louise Barbier; Diane Mège, Anthony Reyre, Vincent M. Moutardier, Jacques A. Ewald, Jean-Robert Delpero
      Abstract: BackgroundThe occurrence of post-operative pancreatic fistula (POPF) after pancreaticoduodenectomy is a challenging issue. The aim was to identify variables on preoperative computed tomography (CT) scan, useful to predict clinically significant POPF (grades B–C) after pancreaticoduodenectomy.MethodsPatients presented POPF after pancreaticoduodenectomy were included from two tertiary referral centres. B/W ratio was defined by ratio of pancreas body thickness (B) to main pancreatic duct (W). The predictive parameters of POPF on CT scan were assessed with a receiving operator characteristics (ROC) curve and intrinsic characteristics.ResultsBetween 2010 and 2013, 186 patients who underwent pancreaticoduodenectomy were included. POPF occurred in 25% of them, and was clinically significant in 13%. After univariate analysis, endocrine tumours (P = 0.03), main pancreatic duct size (P 3.8 increased the rates of post-operative haemorrhage (odds ratio = 4.3 (1.4–13.2), P = 0.01), and reintervention (odds ratio = 3.4 (1.2–9.6), P = 0.02).ConclusionsB/W ratio superior to 3.8 assessed on preoperative CT scan may be an easy tool to predict clinically significant POPF after pancreaticoduodenectomy.
      PubDate: 2017-05-16T19:56:29.950201-05:
      DOI: 10.1111/ans.14048
       
  • Dermatofibrosarcoma protuberans of the scalp: therapeutic challenges
    • Authors: Davendran Kanesen; Zaitun Zakaria, Ewe S. Ch'ng, Puneet Nandrajog, Regunath Kandasamy
      PubDate: 2017-05-16T19:56:27.227606-05:
      DOI: 10.1111/ans.14040
       
  • Cholecystitis in situs inversus totalis
    • Authors: Nicolas J. Copertino; David Grieve
      PubDate: 2017-05-16T19:56:17.78255-05:0
      DOI: 10.1111/ans.14037
       
  • Extramedullary leukaemia presenting as cardiac myeloid sarcoma
    • Authors: Monica Peravali; Kartik R. Kumar, Jayadev R. Mettu, Nour Abd Almohsen, Anupama R. Kottam, Frank A. Baciewicz, Luis Afonso
      PubDate: 2017-05-16T19:56:12.44881-05:0
      DOI: 10.1111/ans.14036
       
  • The Australian laparoscopic radical prostatectomy learning curve
    • Authors: Marcus Handmer; Charles Chabert, Ronald Cohen, Troy Gianduzzo, Paul Kearns, Daniel Moon, Jason Ooi, Tom Shannon, David Sofield, Andrew Tan, Mark Louie-Johnsun
      Abstract: BackgroundInternational estimates of the laparoscopic radical prostatectomy (LRP) learning curve extend to as many as 1000 cases, but is unknown for Fellowship-trained Australian surgeons.MethodsProspectively collected data from nine Australian surgeons who performed 2943 consecutive LRP cases was retrospectively reviewed. Their combined initial 100 cases (F100, n = 900) were compared to their second 100 cases (S100, n = 782) with two of nine surgeons completing fewer than 200 cases.ResultsThe mean age (61.1 versus 61.1 years) and prostate specific antigen (7.4 versus 7.8 ng/mL) were similar between F100 and S100. D'Amico's high-, intermediate- and low-risk cases were 15, 59 and 26% for the F100 versus 20, 59 and 21% for the S100, respectively. Blood transfusions (2.4 versus 0.8%), mean blood loss (413 versus 378 mL), mean operating time (193 versus 163 min) and length of stay (2.7 versus 2.4 days) were all lower in the S100. Histopathology was organ confined (pT2) in 76% of F100 and 71% of S100. Positive surgical margin (PSM) rate was 18.4% in F100 versus 17.5% in the S100 (P = 0.62). F100 and S100 PSM rates by pathological stage were similar with pT2 PSM 12.2 versus 9.5% (P = 0.13), pT3a PSM 34.8 versus 40.5% (P = 0.29) and pT3b PSM 52.9 versus 36.4% (P = 0.14).ConclusionThere was no significant improvement in PSM rate between F100 and S100 cases. Perioperative outcomes were acceptable in F100 and further improved with experience in S100. Mentoring can minimize the LRP learning curve, and it remains a valid minimally invasive surgical treatment for prostate cancer in Australia even in early practice.
      PubDate: 2017-05-16T19:56:06.022534-05:
      DOI: 10.1111/ans.14025
       
  • Mucinous non-neoplastic cyst of the pancreas: is surgical resection
           avoidable'
    • Authors: Shefali Agrawal; Munita Bal
      PubDate: 2017-05-16T19:56:04.925467-05:
      DOI: 10.1111/ans.14028
       
  • Aortocoronary artery dissection: a partial aortic root remodelling, aortic
           valve repair and coronary artery bypass
    • Authors: Andrei M. Beliaev; Jeevesh J. Thomas, Peter N. Ruygrok, Colleen Bergin, Sara J. Allen, Sophie E. Gormack, Jens Lund
      PubDate: 2017-05-16T19:55:56.845017-05:
      DOI: 10.1111/ans.14026
       
  • Causes of pain and loss of function in rotator cuff disease: analysis of
           1383 cases
    • Authors: Anthony Maher; Warren Leigh, Matt Brick, Simon Young, Michael Caughey
      Abstract: BackgroundThe New Zealand Rotator Cuff Registry is a multicentre, nationwide prospective study of rotator cuff repairs established in March 2009.MethodsA total of 1383 rotator cuff repairs were included in this study, all with completed baseline Flex-SF scores, pain scores and standardized operative forms.ResultsIncreasing tear size and tear retraction, over 4 cm, were associated with decreasing Flex-SF scores but not pain. Tear area (a composite of tear size and retraction) is increased with advancing age, male gender and a traumatic history but not with smoking. Increased pain scores were associated with supraspinatus (SS) single tears, compared to subscapularis tears, and with labral tears. SS/infraspinatus tears had lower Flex-SF scores compared to subscapularis/SS.ConclusionThis study presents the relationship between baseline function, pain and tear characteristics in symptomatic rotator cuff tears. Increasing tear size and retraction are related to a loss of function but have minimal effect upon pain. Pain generators included labral pathology, and the involvement of SS. The intraoperative appearance of the long head of biceps pathology did not predict baseline pain and function.
      PubDate: 2017-03-17T06:21:09.674199-05:
      DOI: 10.1111/ans.13870
       
  • Issue information - JEB
    • Pages: 423 - 423
      PubDate: 2017-06-06T06:42:12.810236-05:
      DOI: 10.1111/ans.14093
       
  • Issue information - TOC
    • Pages: 424 - 425
      PubDate: 2017-06-06T06:42:12.050066-05:
      DOI: 10.1111/ans.13778
       
  • Capacity building in Timor Leste: a work in progress
    • Authors: Philip G. Truskett
      Pages: 427 - 427
      PubDate: 2017-06-06T06:42:16.969956-05:
      DOI: 10.1111/ans.13938
       
  • Management of patients with polyposis
    • Authors: Allan D. Spigelman
      Pages: 427 - 428
      PubDate: 2017-06-06T06:42:12.130894-05:
      DOI: 10.1111/ans.13941
       
  • Surgical research in the public hospital
    • Authors: Kamran Zargar-Shoshtari; Andrew G. Hill
      Pages: 428 - 429
      PubDate: 2017-06-06T06:42:16.132875-05:
      DOI: 10.1111/ans.13975
       
  • Challenges and next steps in teaching professionalism in surgical training
    • Authors: James A. Churchill; Prem Rashid
      Pages: 430 - 431
      PubDate: 2017-06-06T06:42:16.243518-05:
      DOI: 10.1111/ans.14016
       
  • Enhancing surgical research at the hospital level: a new model
    • Authors: Kate E. McBride; Michael J. Solomon, Paul G. Bannon, Jane M. Young
      Pages: 431 - 432
      PubDate: 2017-06-06T06:42:15.907497-05:
      DOI: 10.1111/ans.13949
       
  • Medicine in small doses
    • Authors: Bruce P. Waxman
      Pages: 433 - 433
      PubDate: 2017-06-06T06:42:12.889245-05:
      DOI: 10.1111/ans.14034
       
  • 25, 50 & 75 years ago
    • Authors: John P. Harris
      Pages: 434 - 435
      PubDate: 2017-06-06T06:42:13.776806-05:
      DOI: 10.1111/ans.14021
       
  • Dispelling misconceptions in the management of familial adenomatous
           polyposis
    • Authors: Timothy J. Chittleborough; Satish K. Warrier, Alexander G. Heriot, Matthew Kalady, James Church
      Pages: 441 - 445
      Abstract: Patients with familial adenomatous polyposis require surgical intervention at some point in their lives. The diagnosis is often apparent from their phenotype and family history, however, this is not always the case. Many factors can influence the surgical strategy although the polyposis burden and distribution remain the main consideration. While prophylactic removal of the rectum and colon is often required, sparing the rectum at the index surgery is safe in select patients. This article aims to dispel misconceptions in the diagnosis and treatment of patients with familial adenomatous polyposis.
      PubDate: 2017-03-07T01:00:34.000934-05:
      DOI: 10.1111/ans.13919
       
  • Efficacy of dermal substitute on deep dermal to full thickness burn
           injury: a systematic review
    • Authors: Winy Widjaja; Juen Tan, Peter K. M. Maitz
      Pages: 446 - 452
      Abstract: BackgroundThe study aims to systematically examine the efficacy of dermal regeneration templates (DRTs) in comparison to split thickness skin grafting (STSG) in the management of acute burn injuries post-excision and debridement.MethodsSystematic literature search was conducted by two independent reviewers from the following databases: MEDLINE, EMBASE and Cochrane Library with selection criteria set a priori. Only randomized controlled trials (RCTs) were included. Main outcomes extracted were percent of STSG take, infection rate and scar quality.ResultsSeven studies were included. Three of the seven studies reported no significant difference in STSG take between burn wounds treated with dermal substitute and or STSG only. Three of the seven studies reported either low rates of infection or no significant difference in infection rates between dermal substitute and control. Four of the seven studies reported no significant difference in scar quality. Statistical pooling of data was not performed due to heterogeneity of the studies.ConclusionCurrent RCTs available are generally of small sample size with poor methodological reporting. Given the results of more recent RCTs, the risk associated with DRTs is low and it can be a useful alternative for immediate wound coverage post-burn excision. However, there is still no strong evidence to support that DRTs have significant impact on scaring.
      PubDate: 2017-03-17T04:52:51.506556-05:
      DOI: 10.1111/ans.13920
       
  • Association of waist circumference with outcomes in an acute general
           surgical unit
    • Authors: Thomas Ryan; Preet Gosal, Alexa Seal, Joe McGirr, Nicholas Williams
      First page: 453
      Abstract: BackgroundObesity prevalence is increasing in Australia, particularly in non-metropolitan areas. The effect of obesity on acute surgical outcomes is not known. We aimed to record waist circumference (WC) (surrogate for obesity) amongst acute surgical unit (ASU) patients in a New South Wales regional hospital, and compare outcome measures (length of stay (LOS), unplanned return to theatre, readmission rates, intensive care unit (ICU) admission and mortality).MethodsRetrospective cohort study of 4 months of consecutive ASU admissions, excluding age
      PubDate: 2017-04-24T04:35:01.404064-05:
      DOI: 10.1111/ans.13962
       
  • Developing models to predict early postoperative patient deterioration and
           adverse events
    • Authors: Mitchell K. Petersen Tym; Guy L. Ludbrook, Arthas Flabouris, Richard Seglenieks, Thomas W. Painter
      Pages: 457 - 461
      Abstract: BackgroundAccurate identification of patients at risk of early postoperative deterioration allows needs-based allocation of patients to appropriate levels of care. This study aimed to record the incidence of early postoperative deterioration and identify factors predictive of at-risk patients. Doing so may assist future evidence-based perioperative planning and allocation of patients to high-acuity facilities.MethodsWith ethical approval, data from elective non-cardiac surgical patients were collected between May and August 2013. Patient and surgical factors potentially related to postoperative deterioration were collected from preoperative assessment records. Data on deterioration in the postanaesthesia care unit (PACU), and on the wards were collected prospectively for a period of 72 h postoperatively. Patient factors, surgical factors and PACU events were compared with ward events using binomial logistic regression analysis.ResultsOf the 747 patients, postoperative deterioration was common both in PACU (155 (20.1%) patients) and on the wards (125 (16.7%)). Common ward events included hypotension (64 (8.2%)) and desaturation (59 (6.2%)). A rapid response team call occurred for 33 (4.4%) patients and an unplanned ICU admission for seven (0.9%) patients. A history of atrial fibrillation and chronic liver disease, duration of surgery and excessive sedation in PACU, among others, were strongly associated with subsequent ward deterioration. However, measures of surgical complexity were not.ConclusionsPatient factors, duration of surgery and events in PACU can be predictive of subsequent early postoperative ward clinical deterioration. Such information may aid appropriate perioperative decision-making with respect to postoperative utilization of high-acuity facilities.
      PubDate: 2017-02-01T19:40:50.270761-05:
      DOI: 10.1111/ans.13874
       
  • Load response and gap formation in a single-row cruciate suture rotator
           cuff repair
    • Authors: Lachlan Huntington; Martin Richardson, Tony Sobol, Jonathon Caldow, David C. Ackland
      Pages: 483 - 487
      Abstract: BackgroundDouble-row rotator cuff tendon repair techniques may provide superior contact area and strength compared with single-row repairs, but are associated with higher material expenses and prolonged operating time. The purpose of this study was to evaluate gap formation, ultimate tensile strength and stiffness of a single-row cruciate suture rotator cuff repair construct, and to compare these results with those of the Mason-Allen and SutureBridge repair constructs.MethodsInfraspinatus tendons from 24 spring lamb shoulders were harvested and allocated to cruciate suture, Mason-Allen and SutureBridge repair groups. Specimens were loaded cyclically between 10 and 62 N for 200 cycles, and gap formation simultaneously measured using a high-speed digital camera. Specimens were then loaded in uniaxial tension to failure, and construct stiffness and repair strength were evaluated.ResultsGap formation in the cruciate suture repair was significantly lower than that of the Mason-Allen repair (mean difference = 0.6 mm, P = 0.009) and no different from that of the SutureBridge repair (P> 0.05). Both the cruciate suture repair (mean difference = 15.7 N/mm, P = 0.002) and SutureBridge repair (mean difference = 15.8 N/mm, P = 0.034) were significantly stiffer than that of the Mason-Allen repair; however, no significant differences in ultimate tensile strength between repair groups were discerned (P> 0.05).ConclusionThe cruciate suture repair construct, which may represent a simple and cost-effective alternative to double-row and double-row equivalent rotator cuff repairs, has comparable biomechanical strength and integrity with that of the SutureBridge repair, and may result in improved construct longevity and tendon healing compared with the Mason-Allen repair.
      PubDate: 2017-01-26T04:10:36.257381-05:
      DOI: 10.1111/ans.13875
       
  • Comparison of cost of care for tethered versus non-tethered ureteric
           stents in the management of uncomplicated upper urinary tract stones
    • Authors: Alfin Okullo; Yuigi Yuminaga, William Ziaziaris, David Ende, Howard Lau, Andrew Brooks, Manish I. Patel, Simon Bariol
      First page: 505
      Abstract: BackgroundMany surgeons use a stent after ureteroscopic lithotripsy (URSL). For short-term stenting purposes, a surgeon has the choice of either a tethered or a non-tethered stent. Stents may be associated with complications that entail an additional cost to their use. There is a paucity of data on the direct healthcare cost of using stent type after either primary or secondary URSL.MethodsWe retrospectively reviewed medical records for patients who underwent URSL for uncomplicated urolithiasis between January 2013 and December 2013 at two tertiary referral hospitals. Costs data was sourced from the costing department with complete data available for 134 patients. The overall medical care cost was estimated by computing the cost of surgery, stent-related emergency department presentations, re-admissions and stent removal.ResultsA total of 113 patients had tethered stents and 21 had non-tethered stents, with similar age and gender composition between the two groups and complications rates. The mean cost of URSL and stent placement was A$3071.7 ± A$906.8 versus A$3423.8 ± A$808.4 (P = 0.049), mean cost of managing complications was A$309.4 ± A$1744.8 versus A$31.3 ± A$98.9 (P = 0.096), mean cost of out-patient clinic stent removal was A$222.5 ± A$60 versus A$1013.6 ± A$75.4 (P 
      PubDate: 2017-03-30T19:50:33.41967-05:0
      DOI: 10.1111/ans.13945
       
  • Tablespoons and corkscrew: a culinary solution for retrieval of a rectal
           foreign body
    • Authors: Mudassar Ali Ghazanfar; Richard Guy
      Pages: 523 - 523
      PubDate: 2017-06-06T06:42:15.365374-05:
      DOI: 10.1111/ans.14019
       
  • Re: Interns’ perceptions of exposure to urology during medical school
           education in Victoria, Australia
    • Authors: Mark Louie-Johnsun; Jinna Yao
      Pages: 523 - 524
      PubDate: 2017-06-06T06:42:12.463793-05:
      DOI: 10.1111/ans.13982
       
  • Response to Re: Interns’ perceptions of exposure to urology during
           medical school education in Victoria, Australia
    • Authors: Sarah Azer; Munad Khan, Nathan Hoag, Riteesh Bookun, Nathan Lawrentschuk, Richard Grills, Damien Bolton
      Pages: 524 - 524
      PubDate: 2017-06-06T06:42:15.451612-05:
      DOI: 10.1111/ans.14029
       
 
 
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