On the basis of a rapid review of the literature and advice from a clinical expert working group containing seven senior surgeons and a senior medical virologist, evidence-based recommendations have been produced along with a proposed schema for the preoperative screening of surgical patients suspected of having active COVID-19. A printable questionnaire has also been developed for verbally screening patients for COVID-19 during either face-to-face or telemedicine consultations.

There is concern regarding the risk of viral transmission via surgical smoke. We performed a systematic scoping review and found that there is little evidence that virus particles can be transmitted via surgical plumes during intra-abdominal surgery.

Meta-analysis of 17 147 patients from 11 eligible studies provided a pooled diverticula of the appendix (DA) prevalence of 1.74%. Presence of neoplasia in DA specimens was 26.94% versus 1.28% in appendicectomy specimens without DA. Random-effects model demonstrated that pooled risk ratio was 25.46 (95% confidence interval 12.77–50.75, P < 0.00001). The strong association with neoplasia in this meta-analysis reinforces the clinical significance of DA to surgeons, pathologists and radiologists.

We have conducted a systematic review of case reports of fistulae involving the appendix and identified 301 unique case reports, with a range of different sites and aetiologies.

• Mucinous appendiceal neoplasms warrant from the simplest to the most complicated surgery.• The updated histopathological classification is the cornerstone of decision making.• Advanced appendiceal tumours that have spread to the peritoneum are potentially curable by surgery.• Standard treatment is cytoreductive surgery and hyperthermic intraperitoneal chemotherapy.• Better surgical technique and perioperative care greatly diminished the morbidity of CRS + HIPEC.

Several preoperative factors influence outcomes from emergency laparotomy. Multiple physiological derangements and comorbidity factors worsen mortality post-operatively. Increased body mass index (obese and overweight categories) are the only factors found to be protective against post-operative death following emergency laparotomy.

This paper addresses the surgical metrics for a region and Bellwether capable hospital in Papua New Guinea. It is, in having real patient studies of access (metric 1) and financial out of pocket expenses, the first paper from this region to address all the indicators.

Currently the South Pacific experience about 750 postoperative deaths per year, representing 1% of crude mortality in the region. Given that more than 400 000 procedures are needed in these countries to reach the Lancet Commission of Global Surgery target of 5000/100 000, surgical scale up would result in perioperative mortality contributing on average 3.3% of all national crude mortality, assuming the POMR stays the same which is challenging to predict. Although postoperative mortality as a proportion of all mortality may increase with surgical scale up, we feel that the POMR is likely to decrease as Lancet Commission of Global Surgery targets for surgical volume are reached.

A retrospective quantitative case–control study of breast-related presentation for 1 year was conducted at Hospital Nationale Guido Valadares (sole tertiary hospital) in Dili. This study was conducted to determine the burden of breast disease and to inform public health measures to address early detection, diagnosis and management.

Overview of a simulation-based medical education paediatric surgical programme in Myanmar.

We describe the establishment of a sustainable mesh hernia repair service in a resource-poor setting. The service will now be replicated across hospitals in Tanzania. If successful, the training model could be reproduced for other surgically treatable diseases.

There is a concerningly high burden of potentially hazardous medical waste dumped in surgical changing rooms. We hope that the current study will raise awareness of the need for appropriate disposal of medical equipment before entering changing rooms and leads to formal evaluation and initiatives to mitigate medical waste and the associated cost in our healthcare system.

There is a growing opioid crisis in the Western world. Addiction to opioids often starts with prescriptions after a hospital admission. We evaluated the feasibility of an opioid-scarce Enhanced Recovery After Surgery (ERAS) protocol after colorectal surgery and found that opioid use was significantly reduced when this new protocol was implemented.

We determined pre- and peri-operative parameters with significant predictive value for post-operative outcomes in patients with recurrent colorectal cancer presenting as peritoneal carcinomatosis undergoing Cytoreductive surgery and hyperthermic intraperitoneal chemotherapy. Our prognostic models provide an objective and simple risk stratification system for accurately prognosticating patients following cytoreductive surgery and hyperthermic intraperitoneal chemotherapy.

Our unit undertook a 11-year review of all hypopharyngeal squamous cell carcinomas treated with primary total pharyngolaryngectomy aiming to provide an update on survival outcomes, morbidity, post-operative complications and evolving management strategies. We report one of the largest single-centre series to date.

There is little published data on the non-operative management of small post-appendicectomy intra-abdominal abscesses. Twenty-six small (<4 cm diameter) post-appendicectomy intra-abdominal abscesses were all successfully managed non-operatively.

In this study, we detected the changes of C-reactive protein, interleukin-1β, interleukin-6 and tumour necrosis factor-alpha in serum and enterocoelia perioperatively. Moreover, in order to investigate the value of inflammatory markers for the prediction of small bowel obstruction, we analysed the correlation between the small bowel obstruction occurrence and the level of inflammatory markers.

Hypertriglyceridaemia is a rare cause of acute pancreatitis. Successful management involves the treatment of acute pancreatitis in conjunction with long-term anti-lipid therapy and optimisation of associated risk factors.

This article aims to describe the glycaemic status of patients pre- and post-pancreatectomy, compare patient's clinical characteristics, group according to pre- and post-pancreatectomy diabetes mellitus (DM) status and identify predictors of post-operative pancreatogenic DM. The development or continuance of DM within 30 days post-pancreatectomy occurs in approximately one in seven persons. No patients with pre-existing DM demonstrated a remission of DM post-pancreatectomy. All patients should be screened for diabetes pre-operatively and followed up post-operatively, particularly those with pre-existing impaired renal function.

Gallstone pancreatitis has evidence-based guidelines which recommend index admission cholecystectomy in patients with mild disease. A retrospective chart audit within the Sunshine Coast Health District found a 69.5% compliance rate to the guidelines. There was a 17% readmission rate in patients not receiving index cholecystectomy reinforcing the importance of guideline adherence.

Patients with acute pancreatitis were who were referred from other hospitals a tertiary care centre were studied and their outcomes were analysed. Subgroup analysis of patients between those referred early (7 days) versus those referred late (>7 days) was done. Patients referred 7 days of pain onset had higher rates of organ failure (P = 0.007), including acute lung injury (P = 0.008) and acute kidney injury (P = 0.026) whereas those referred late had higher infected necrosis (P < 0.0001), requirement of endoscopic/percutaneous drainage (P < 0.001) and need for surgery (P < 0.02).

Our aim was to evaluate the outcome by comparing video-assisted retroperitoneal debridement (VARD) and small incision pancreatic necrosectomy (SIPN) for infected pancreatic necrosis. SIPN and VARD are both an effective treatment for infected pancreatic necrosis with acceptable mortality and complication rates. SIPN can reduce the rate of reinterventions due to poor clinical improvement with a shorter hospital stay and a lower total cost compared with VARD.

This study aimed to show the surgical outcomes of the non-functional pancreatic neuroendocrine tumours (NF-PNETs) and evaluate the factors predicting disease-specific survival for well-differentiated NF-PNETs (grade G1 and G2 tumours without synchronous distant metastasis). A total of 103 NF-PNETs (40%) were identified for analysis. Age >52 years and tumour grade G2 might be independent predictors of poor disease-specific survival for patients with well-differentiated NF-PNETs.

Acute diverticulitis is a common surgical condition, the risk of which has been shown to be increased in obese patients. The risk of recurrent diverticulitis in obese patients has not been well demonstrated previously. We found obesity did not significantly affect the risk of recurrent acute diverticulitis in a cohort of over 1000 patients.

This paper demonstrates the utility of a dynamic assessment of C-reactive protein in predicting the failure of conservative management of acute diverticulitis in patients not needing immediate surgery or radiological intervention. If the C-reactive protein is persistently high or is rising in the first 2 days of admission, then there is a higher risk of intervention during the hospital admission. This is the first time such a dynamic assessment is performed in patients with acute diverticulitis.

High neutrophil-to-lymphocyte ratio (NLR)/platelet-to-lymphocyte ratio (PLR) is associated with complicated diverticulitis. High NLR/PLR is associated with higher rate of recurrence of acute diverticulitis. High NLR/PLR is associated with longer length of stay when adding all of the hospitalizations for acute diverticulitis.

This study provides an accurate estimate of the overall healthcare cost of acute diverticulitis and its sequelae. There are considerable long-term costs associated with the index episode of diverticulitis with only 57% of the cost occurred at initial admission. A large proportion of the expenditure is incurred by a small group that included those with complicated disease. These findings are important for healthcare resource allocation and for targeting health research funding.

A 10-year retrospective review of prospectively recorded data extracted from a single hospital registry was performed to compare the incidence of early surgical complications in total hip arthroplasty related to approach. No approach was associated with the primary outcome measure of return to theatre in 1 year on unadjusted analyses or multivariate modelling.

By comparing reversed hypothyroid patients with euthyroid patients, we found well-controlled overt hypothyroidism did not increase the risk of total knee arthroplasty (TKA), except for perioperative blood loss. Surgeons should be aware that even if hypothyroidism is reversed, the risk of more perioperative blood loss still exists and consequently, perioperative blood management is still essential in this population.

This article looks at comparing the revision rates of fully stabilized and hinged total knee arthroplasty, when used in either primary or first revision procedures.

The use of accelerometer-based navigation in total knee arthroplasties in the treatment of osteoarthritis for the restoration of alignment with increased precision and accuracy. Accelerometer-based navigation provides a suitable alternative to computer-assisted surgery and patient-specific instrumentation while maintaining a similar feel and feedback to conventional systems. In addition, there are limited increases in operative times without compromise of blood loss, complications or functional outcomes to date in the published literature.

Aerosolization during laparoscopy poses a theoretical risk of infection to healthcare providers by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). A simple, low-cost method of controlled abdominal desufflation during laparoscopy is described.

During deceased donor procurement, the heart procurement team may cut the supra-hepatic inferior vena cava (IVC) too close to the liver surface, depriving the liver allograft from having enough supra-hepatic IVC to perform the anastomosis with the recipient's IVC or hepatic veins. In such instances, liver grafts usually are deemed as non-appropriate for transplantation, being discarded. Here we report a technique for reconstruction of damaged supra-hepatic IVCs through the use of a segment of the infra-hepatic IVC of the liver graft.