The aim of this study was to evaluate the safety and efficacy of low-molecular weight heparin in the prevention of portal vein system thrombosis after splenectomy.

Best management in acute uncomplicated disease is ambiguous. Medical management is currently favoured, but endovascular management may have better outcomes. Surgical decisions can be supported by clinical and anatomical risk predictors identified through registries.

Our meta-analysis found equivalent outcomes between left heart bypass and hypothermic circulatory arrest for open repair of thoracic aortic and thoracoabdominal aortic pathologies. Clinical outcomes evaluated were 30-day mortality, post-operative stroke, spinal cord deficit, renal failure and respiratory failure.

This multicentre study analysed 6628 elective major procedures across all general surgical specialties. Significant variations in practice of perioperative thromboprophylaxis were identified. These included: (i) use of chemoprophylaxis, (ii) timing of its initiation, (iii) type of anticoagulant administered and (iv) application of extended chemoprophylaxis. These variations were seen within the same procedure, and between different surgeries and subspecialties. The inherent bleeding and venous thromboembolism risks of common procedures are also described. Our findings enable surgeons to compare their practices, and provide baseline data to inform efforts towards optimizing thromboprophylaxis for general surgical patients.

PROTECTinG (Perioperative Timing of Elective Chemical Thromboprophylaxis in General surgery) is a multicentre cohort study which has demonstrated that perioperative chemical thromboprophylaxis usage is variable among patients undergoing elective cholecystectomy. The rate of clinical venous thromboembolism post-cholecystectomy is low. Early chemoprophylaxis increases bleeding risk without an appreciable additional protection from venous thromboembolism.

The management of an open abdomen in critically ill patients remains an evolving field because of its relative rarity. We describe our experience with the Abdominal Re-approximation Anchor device in the emergency and elective setting at a tertiary hospital in Queensland, Australia. Primary fascial closure was achieved in 100% of patients demonstrating that the Abdominal Re-approximation Anchor device is an important tool for the general surgeon in managing these complex cases.

Bedside ultrasound performed by surgical registrars and emergency medicine physicians is accurate for finding the presence or absence of gallstones, but less so for an imaging diagnosis of acute cholecystitis. This has the potential to improve the efficiency of surgical assessment of patients.

Laparoscopic total mesorectal excision combined with intersphincteric resection is technically safe and feasible for the treatment of ultra-low rectal cancer. The curative effect is encouraging, but surgical indications should be determined.

In Australia, colorectal cancer (CRC) is the third most common cancer and the second leading cause of cancer death. Recent Australian and International studies have shown an increase in CRC incidence in patients under 50 years of age. The main aim of this study was to analyse the incidence of CRC in patients under 50 in our facility and in doing so, determine if CRC screening would have been beneficial in this population.

This is a large, contemporary, Australian study of the recurrence rates in stage I–III rectal cancer. Recurrence occurred in 24.2%, being predominantly distant, and independent associated with higher grade, stage and distal tumour location.

This article describes a novel technique using the AFX stent to treat the aortic bifurcation with occlusive atherosclerotic disease. It is the largest single-centre case series published to date. The minimally invasive technique preserves a future cross-over approach and is a safe and durable method for the treatment of aorto-iliac occlusive disease.

This study analysed the ureteric complications of four patients and also discussed the time of onset of symptoms, treatment and outcome.

Thromboangiitis obliterans typically affects the medium- and small-sized extremity vessels, making arterial revascularization difficult. However, in this study involving 83 patients with thromboangiitis obliterans who underwent angiography, 79.5% of patients had at least one or more target artery feasible for revascularization. The patients who underwent revascularization had a patency rate of 64.8% and limb salvage rate of 80.9%.

This study demonstrates the performance characteristics and efficiency of the sentinel node and occult lesion localization technique in localizing non-palpable breast cancer and successful identification and removal of sentinel nodes. The results are compared to the literature for wire-guided localization techniques, the most common form of lesion localization.

It has been suggested that Chinese patients with breast cancer present at a younger age compared to the general Australian population, with tumour pathological characteristics that carry less favourable outcomes. This study was aimed to investigate if a substantial difference in breast cancer subtypes exists between the Australian Chinese population and the general Australian population.

Vacuum-assisted excisional biopsy may be appropriate for low malignant risk lesions, such as papillary lesion without atypia, mucocoele-like lesion and radial scar lesion without atypia. Open-surgical-excisional biopsy remains essential for high upgrade lesions such as flat epithelial atypia, atypical ductal hyperplasia, papillary lesion with atypia and classical lobular carcinoma in situ with calcification.

Significant health disparities exist between Māori and non-Māori patients in New Zealand. This study aims to assess the differences in ethnic representation for thyroid surgery.

A 10-year series of 608 children undergoing subtotal or total tonsillectomy were studied for bleeding and return to normal activity. Subtotal tonsil surgery was associated with less bleeding and a much faster return to normal activity.

Nodal metastatic size significantly predicts disease-free survival on multivariate analysis, with the prognostic impact predominantly occurring in parotid metastases. Each 1 cm increase in the size of nodal metastasis increased the risk of recurrence or death by 27%. Parotid nodal metastasis size thresholds of <3, 3–4.5 and > 4.5 cm optimized prognostic discrimination.

Clinical coding of arthroplasty procedures by hospitals may be inaccurate. In contrast, the New Zealand Joint Registry has high completeness and records >95% of knee and hip arthroplasty procedures.

The consent process is complex and somewhat of an artform for procedural specialties. Readability of consent forms was objectively examined. The objective readability of the texts exceeds local and international recommendations.

We investigated the use of Denosumab in the treatment of primary giant cell tumour of bone. Denosumab has been an increasingly utilized treatment option in managing giant cell tumour of bone. However, much is still unknown about its current indications, long-term effects and the potential risk for rapid relapse and sarcomatous transformation. In this manuscript, we highlight the clinical, radiological and pathological outcomes following treatment with Denosumab and of concern we noted a trend towards increasing recurrence rates with the potential risk for rapid relapse and sarcomatous transformation.

We describe a safe technique for controlled deflation of pneumoperitoneum to facilitate safe laparoscopic surgery in the coronavirus disease 2019 (COVID-19) era.

This study describes how to do safe intracorporeal marking of structures during minimally invasive surgery by simple modification of a skin marking pen. We wish to publicize the use of a skin marking pen tip held within laparoscopic graspers as an effective, simple and cheap method to mark intracorporeal structures, avoiding tissue damage.

The article proposes an image classification with four types according to the relationship between a tumor and the splenic vein. We establish a scoring system by combining two parameters (that are the image classification and tumor size), which are helpful in making a spleen-preservation strategy during laparoscopic spleen preserving distal pancreatectomy.

This study aimed to evaluate the clinical features and outcomes of patients who experienced PA bleeding after pancreaticoduodenectomy. In patients with suspected PA, urgent angiography should be considered immediately for diagnosis and treatment. The stent-graft placement can be performed first if it is technically feasible in PA bleeding. However, TAE is also a safe and effective treatment in patient intact portal flow, as well as those who do not have disrupted collateral pathways because of previous surgery, such as hepatectomy.

In our propensity score match analysis of patients with rectal neuroendocrine tumours, we show that radical resection may not be associated with improved overall survival and that local excision is a reasonable treatment option for patients.

Routine performance of random colonic biopsies should be questioned. These should be performed in selected patients only with a high degree of suspicion of an organic cause of their chronic non-bloody watery diarrhoea as they otherwise have low yield and are of significant cost. All random colonic biopsies should be placed in one specimen pot when submitted for histopathology analysis as a cost saving measure.

Surgical outcomes of laparoscopic total mesorectal excision combined with en-bloc seminal vesicle and prostate resection for locally advanced rectal cancer after chemoradiotherapy.

A retrospective assessment of the utility of selective intra-arterial calcium stimulation test to correctly localize insulinoma and a comparison to newer modalities such as endoscopic ultrasound or functional imaging was conducted.

Use of validated quality of life questionnaire (ThyPRO) to assess quality of life following benign thyroid surgery in an Australian population.