• Issue

    ANZ Journal of Surgery: Volume 92, Issue 4

    638-935
    April 2022

ISSUE INFORMATION

Free Access

Issue Information

  • Pages: 638-641
  • First Published: 18 April 2022

REVIEW ARTICLES

Re-fractures of the paediatric radius and/or ulna: A systematic review

  • Pages: 666-673
  • First Published: 22 September 2021
Re-fractures of the paediatric radius and/or ulna: A systematic review

This study is a systematic review of the risk factors for refracture after a fracture of the radius and/or ulna in children. Parents may be counselled about several risk factors identified in this study. Further case-controlled studies are still required to fully investigate the topic.

Optimal screw length in volar locking plate osteosynthesis for distal radius fractures: a systematic review

  • Pages: 674-684
  • First Published: 25 November 2021
Optimal screw length in volar locking plate osteosynthesis for distal radius fractures: a systematic review

This systematic review determines and presents evidence that unicortical locking fixation in distal radius fractures at least 75% of the depth of the distal radius or 2 mm short of the distal cortex, provides equivalent stability to bi-cortical fixation. Certain fluoroscopic images are recommended to confirm if penetration of the dorsal cortex has occurred to lower complication rates.

The surgical management of spinal disorders in lysosomal storage diseases: a systematic review

  • Pages: 685-690
  • First Published: 04 January 2022
The surgical management of spinal disorders in lysosomal storage diseases: a systematic review

The spinal disorders of lysosomal storage diseases are refractory to current available systemic therapies. This systematic review aimed to synthesise the literature to establish the proposed surgical indications, and the recommended surgical management of these spinal disorders.

Open Access

Metastatic giant cell tumour of bone: a narrative review of management options and approaches

  • Pages: 691-696
  • First Published: 10 February 2022
Metastatic giant cell tumour of bone: a narrative review of management options and approaches

The management of metastatic giant cell tumour of bone (metGCTB) is controversial. Asymptomatic patients can be monitored radiologically and undergo treatment only when disease progression occurs. Surgery is recommended for resectable metGCTB and denosumab is recommended for unresectable metGCTB.

GENERAL SURGERY

How do New Zealand-trained general surgeons secure a SMO job? Are we effectively retaining our trainees?

  • Pages: 697-702
  • First Published: 02 December 2021
How do New Zealand-trained general surgeons secure a SMO job? Are we effectively retaining our trainees?

Projections for general surgeon workforce in New Zealand. Provided courtesy of Emmanuel Jo, Manager Analytics and Intelligence, Health Workforce New Zealand, Ministry of Health, School of Medicine, University of Auckland.

Individualised, targeted step count intervention following gastrointestinal cancer surgery: The Fit-4-Home randomised clinical trial

  • Pages: 703-711
  • First Published: 22 September 2021
Individualised, targeted step count intervention following gastrointestinal cancer surgery: The Fit-4-Home randomised clinical trial

An individualised, daily targeted step count intervention and usual care did not confer additional benefits in reducing the length of stay in the ward compared to usual care alone for patients undergoing gastrointestinal cancer surgery.

Open Access

The impact of acute surgical unit rostering on National Emergency Access Targets during the COVID-19 pandemic: a single hospital experience

  • Pages: 712-717
  • First Published: 18 January 2022
The impact of acute surgical unit rostering on National Emergency Access Targets during the COVID-19 pandemic: a single hospital experience

This study determined that after restructuring our surgical department to an ASU roster during mid-COVID-19, our National Emergency Access Target (NEAT) times improved, but not enough to meet national standards and there was no change in patient outcomes. Our results again indicate that any significant change to services requires a coordinated hospital-wide approach, as well as highlight whether achieving NEAT times is actually feasible and safe.

Trends in publication of general surgery research in Australia, 2000–2020

  • Pages: 718-722
  • First Published: 26 February 2022
Trends in publication of general surgery research in Australia, 2000–2020

The significance of evidence-based surgery has resulted in a shift towards producing high-quality surgical research. This study demonstrates there is a trend towards increased quantity, quality and diversity in Australian general surgery publications, which is indicative of the progression and importance of robust modern surgical research.

VASCULAR SURGERY

Pressure relieving interventions for the management of diabetes-related foot ulcers: a study from the Northern Territory of Australia

  • Pages: 723-729
  • First Published: 18 January 2022
Pressure relieving interventions for the management of diabetes-related foot ulcers: a study from the Northern Territory of Australia

Offloading was an effective intervention for the management of diabetes-related foot ulcer (DFU), despite the unique nature of the NT population and the distinctive challenges in our geographical area. In line with the IWGDF guidelines, a non-removable knee-high offloading device was the most effective in healing DFU, which in our study was the total contact cast.

Has EVAR changed the outcomes of ruptured abdominal aortic aneurysms? A decades worth of experience in an Australian Teaching Hospital

  • Pages: 730-735
  • First Published: 15 February 2022
Has EVAR changed the outcomes of ruptured abdominal aortic aneurysms? A decades worth of experience in an Australian Teaching Hospital

A review of the outcomes of patients presenting with ruptured abdominal aortic aneurysms to a tertiary Australian centre, with subgroup analysis of patients undergoing Endovascular repair compared to open repair methods.

PAEDIATRIC SURGERY

Impact of COVID-19 on appendicitis presentations in children in Australia and New Zealand

  • Pages: 736-741
  • First Published: 13 March 2022
Impact of COVID-19 on appendicitis presentations in children in Australia and New Zealand

A secondary effect of the COVID-19 pandemic in some countries has been delayed presentation to hospital with other emergent conditions. We reviewed presentations of paediatric appendicitis early in the COVID-19 pandemic in comparison to previous years in Australia and New Zealand. During 2020, we did not demonstrate prolonged duration of symptoms prior to presentation or increase in other markers of disease severity.

Paediatric appendiceal neuroendocrine tumours: a review of 33 cases from a single center

  • Pages: 742-746
  • First Published: 18 October 2021
Paediatric appendiceal neuroendocrine tumours: a review of 33 cases from a single center

Paediatric appendiceal neurendocrine tumours are quite rare. These tumours do not behave aggressively in children and appendectomy alone is sufficient for most tumours regardless of local invasion. The need for further extensive surgery in tumours >2 cm also remains controversial.

Hyponatremia an indicator of complicated appendicitis in children: Starship experience

  • Pages: 747-752
  • First Published: 19 December 2021
Hyponatremia an indicator of complicated appendicitis in children: Starship experience

Retrospective review of paediatric patients (≤15 years) undergoing acute appendicectomy at Starship Hospital. Investigating the relationship between hyponatremia and complicated appendicitis.

Variation in burn wound management approaches for paediatric burn patients in Australia and New Zealand

  • Pages: 753-758
  • First Published: 17 January 2022
Variation in burn wound management approaches for paediatric burn patients in Australia and New Zealand

We performed a retrospective review of all paediatric patients (ages <16 years) who sustained a burn injury between July 2016 and June 2019 and underwent a burn wound management procedure in theatre, using data from the Burns Registry of Australia New Zealand. Differences in the patient profile and clinical practices were observed among burn services, particularly with regard to time from injury to admission and the proportion of patients who received skin grafts. Further research into best practice around paediatric burn wound management procedures in theatre is essential for greater consistency in treatment. A greater understanding of the factors underlying the variations at each particular service will also be helpful.

UPPER GUT

Transgastric laparoendoscopic approach to tumours of the stomach

  • Pages: 759-763
  • First Published: 26 October 2021
Transgastric laparoendoscopic approach to tumours of the stomach

In this large single centre study, the largest series to date, we demonstrate that transgastric laparo-endoscopic tumoural resection is technically feasible, oncologically safe, with acceptable perioperative and longer-term outcomes.

Failed fundoplication with delayed gastric emptying: efficacy of subtotal gastrectomy

  • Pages: 764-768
  • First Published: 06 January 2022
Failed fundoplication with delayed gastric emptying: efficacy of subtotal gastrectomy

Patients with gastroparesis and recurrent reflux after failed fundoplication are a complex and select patient cohort. Subtotal gastrectomy with RY reconstruction represents a moderately safe and effective salvage option for the management of such patients.

HEPATOPANCREATICOBILIARY SURGERY

Impact of establishing a specialized hepatobiliary unit on liver resections in a non-specialized tertiary centre in regional Australia

  • Pages: 769-773
  • First Published: 24 November 2021
Impact of establishing a specialized hepatobiliary unit on liver resections in a non-specialized tertiary centre in regional Australia

Outcomes after elective liver resection were compared before and after establishment of a dedicated hepatobiliary unit, in a regional centre where such procedures were previously performed by non-specialist general surgeons. We found that a centralised, subspecialty unit resulted in increased surgical volume and case complexity, with no change in early outcomes after liver resection. This unit improved the accessibility of a subspecialty service in regional Australia.

Clinical utility of stimulated cholescintigraphy using a standardized Ensure-Plus fatty meal protocol in patients with suspected functional gallbladder disorder: a retrospective study of seven-years clinical experience

  • Pages: 774-780
  • First Published: 30 November 2021
Clinical utility of stimulated cholescintigraphy using a standardized Ensure-Plus fatty meal protocol in patients with suspected functional gallbladder disorder: a retrospective study of seven-years clinical experience

Retrospective study assessing 173 patients that underwent Ensure-plus stimulated cholescintigraphy for functional gallbladder disorder. We found this imaging investigation offers important supportive value to the clinical decision making process, in particular, identifying patients who can benefit from cholecystectomy.

Pre-operative predictive factors for gangrenous cholecystitis at an Australian quaternary cardiothoracic centre

  • Pages: 781-786
  • First Published: 13 December 2021
Pre-operative predictive factors for gangrenous cholecystitis at an Australian quaternary cardiothoracic centre

Our article looks at pre-operative predictive factors to allow for earlier recognition and diagnosis of gangrenous cholecystitis, to guide prompt surgical intervention. Our study was performed at a large quaternary centre with a large number of patients with pre-existing medical comorbidities. Our study is one of the largest to date, confirmed findings from other literature and identified a number of novel findings.

Management and outcomes of patients for non-functioning pancreatic neuroendocrine tumours: a multi-institutional analysis

  • Pages: 787-793
  • First Published: 01 November 2021
Management and outcomes of patients for non-functioning pancreatic neuroendocrine tumours: a multi-institutional analysis

This study aimed to analyzed the short- and long-term outcomes of patients who underwent surgical resection for non-functioning pancreatic neuroendocrine tumours (NF-PNETs) to gain insights into potential strategies for this rare and heterogeneous entity. We found that positive lymph nodes, vascular/peripheral invasion and pathology grade G3 were related to recurrence of NF-PNETs. Lymph node resection is recommend when FNA biopsy indicates pathology grade G3 for patients with NF-PNETs.

COLORECTAL SURGERY

PCR-based quantitative detection of intraperitoneal free cancer cells for predicting locoregional recurrence after rectal cancer resection

  • Pages: 794-800
  • First Published: 11 January 2022
PCR-based quantitative detection of intraperitoneal free cancer cells for predicting locoregional recurrence after rectal cancer resection

Peritoneal lavage fluid of consecutive 95 patients with Stage I–III CRC were analyzed. Overall and in rectal cancer patients, the 3-year cumulative risk of locoregional recurrence was significantly higher than PCR- patients (1.3% and 0%, P < 0.001 and P = 0.001, respectively). Intraperitoneal free cancer cells can serve as a sensitive predictor of locoregional recurrence after rectal cancer resection.

Open Access

The management of asymptomatic radiological anastomotic leakage following anterior resection

  • Pages: 801-805
  • First Published: 06 January 2022
The management of asymptomatic radiological anastomotic leakage following anterior resection

This article reports the outcomes of the conservative management of asymptomatic radiological leakage following anterior resection in a teaching hospital in the UK.

Surgical management and long-term functional outcomes after anastomotic leak in patients undergoing minimally invasive restorative rectal resection and without a diverting ileostomy

  • Pages: 806-812
  • First Published: 24 January 2022
Surgical management and long-term functional outcomes after anastomotic leak in patients undergoing minimally invasive restorative rectal resection and without a diverting ileostomy

A minimally invasive approach to low pelvic colorectal resections without diversion may lead to early detection of anastomotic leak and an opportunity for earlier, often minimally invasive, intervention with low morbidity and mortality. Subsequent long-term quality of life (QoL) and functional outcomes are more dependent on the extent of resection rather than the occurrence of anastomotic leak.

ORTHOPAEDIC SURGERY

Informed consent: perceptions and practice of orthopaedic trainees

  • Pages: 819-824
  • First Published: 04 February 2022

The purpose of informed consent is to provide the patient with adequate information about a proposed plan or intervention, including the benefits and risks, so that they can make an informed decision about their medical treatment. The aim of this study was to determine the extent Australian orthopaedic surgical trainees have been exposed to education about the informed consent, their perceived ability to obtain consent effectively, and the frequency with which they routinely address essential elements of the process when consenting patients.

Mobile data security: instant messaging in orthopaedics

  • Pages: 825-829
  • First Published: 22 February 2022
Mobile data security: instant messaging in orthopaedics

This article explores the use of WhatsApp instant group messaging amongst surgical teams, with a particular focus on data security. The aim of the study was to implement a practical guideline for clinicians when using WhatsApp in the work place.

Open Access

A 2-year prospective clinical and bone density evaluation, with a subset undergoing radiostereometric analysis, using the Absolut cemented stem

  • Pages: 830-836
  • First Published: 02 February 2022
A 2-year prospective clinical and bone density evaluation, with a subset undergoing radiostereometric analysis, using the Absolut cemented stem

Total hip arthroplasty (THA) is common though the investigation of new prostheses requires a practical, step-wise introduction. In the current study, the Absolut cemented prosthesis, a highly polished, double tapered, collarless femoral stem (Absolut), demonstrated good outcomes, periprosthetic bone mineral density changes consistent with sound prosthesis integration and patterns of post-operative micromotion observed in other successful cemented stems.

NEUROSURGERY

Evaluation of readability and reliability of online patient information for intracranial aneurysms

  • Pages: 843-847
  • First Published: 29 December 2021
Evaluation of readability and reliability of online patient information for intracranial aneurysms

This research was completed to investigate the readability and reliability of online information about intracranial aneurysms that patients will encounter. Overall, the readability and reliability of online information on this topic was poor. Interestingly, there was a statistically significant difference in readability depending on search terms used, with the search term 'brain aneurysm' providing better readability than 'intracranial aneurysm.'

Characterization of volumetric growth of intracranial meningiomas in Māori and Pasifika populations in New Zealand

  • Pages: 848-855
  • First Published: 28 February 2022
Characterization of volumetric growth of intracranial meningiomas in Māori and Pasifika populations in New Zealand

A single centre retrospective cohort analysis studying the growth rates of 408 intracranial meningiomas with ethnic subgroup analysis. We report increased growth rates of intracranial meningiomas in Maori and Pasifika populations compared to a control population.

HOW TO DO IT

How to isolate and manage a colo-atmospheric fistula in a wound requiring negative pressure dressing: a novel technique using a plastic syringe

  • Pages: 856-858
  • First Published: 07 March 2022
How to isolate and manage a colo-atmospheric fistula in a wound requiring negative pressure dressing: a novel technique using a plastic syringe

We describe the management of a colo-atmospheric fistula following extensive debridement for abdominal wall necrotising fasciitis. This was a novel technique performed with VAC dressing and a plastic syringe to isolate the fistula from the surround tissue.

IMAGES FOR SURGEONS