Gaps in emergency surgical coverage in regional and rural locations are managed with interhospital transfers, despite inferior outcomes. A systematic review of the contemporary literature was performed and identified a paucity of knowledge on factors influencing interhospital transfer delays. More robust prospective cohort studies were recommended.

Surgical admissions between 01/01/2010 and 18/08/2020 were extracted from the Australian and New Zealand Audit of Surgical Mortality database and association between transfer type (delayed/prompt) and various predictors were investigated. Modifiable predictors of transfer delay identified were inadequate clinical assessment, poor communication and multiple transfers.

The RIPC group had significantly lower postoperative ALT, AST and bilirubin level than the control group. The RIPC was evaluated to have a strong hepatoprotective effect from ischemia-reperfusion injury in the liver related surgery.

Postoperative pancreatic fistula (POPF) remains a significant complication of pancreatic resection with recent evidence showing a strong association between perioperative pancreatitis and the subsequent development of POPF. We present a systematic literature review and meta-analysis of the prophylactic treatment with corticosteroids or n-acetyl cysteine (NAC) of induced pancreatitis in animal models.

This article consolidates the recent evidence on the incidence of, and risk factors for, preselected procedure-specific complications of pancreatoduodenectomy. An in-depth understanding of these will guide the consenting process and allow surgeons to consider their operative technique.

A systematic review was undertaken to define the optimal surveillance protocol for metachronous cancer following choledochal cyst resection. We propose annual liver function tests, Ca 19-9 measurement and two yearly ultrasound assessment for 20 years post cyst resection, with two yearly liver function testing, Ca 19-9 measurement and three yearly ultrasound assessment thereafter.

There are considerable advantages and opportunities for surgeons and trainee surgeons in conducting a period of research allied with basic scientists. Such clinicians are well placed to define relevant clinical questions, provide human material and translate the techniques derived in experimental animals to human subjects. This is review illustrates how this has been achieved in the study of the nervous system that controls gut motility.

This is a review of a Queensland-based novel patient-initiated escalation process on surgical patients. The study demonstrates that poor communication is the underlying cause of the majority of patient escalations and that the majority of case are resolved with consultation between patient and surgical teams.

Alcohol withdrawal scales are commonly used in hospitalized inpatients for diagnosing and managing alcohol withdrawal. These scales have only ever been validated in acute detoxification units. Our investigation shows a false positive rate of 18% for the commonly used CIWA-Ar scale based on a prospective study of symptoms in patients at no significant risk of alcohol withdrawal. We call for caution in using alcohol withdrawal scales on surgical wards.

Clinical characteristics of the cohort pre-ERAS and post-ERAS implementation.

Number and percentages of consultations where the 10 most-commonly asked questions were asked by patient (number of consultations = 182) or companion (number of consultations = 48)

Historically patients have often been followed up routinely for benign anorectal conditions, which places a large strain on outpatient clinic resources. Patient initiated follow up instead puts the onus on the patient to arrange further appointments if they need further input. Protocolising clinic visits allows for guidelines to follow so that every patient gets equal and quality care.

Flowchart of patients and complications in this patient cohort.

HN-AS is a slowly progressive disease with poor survival. Patients treated with surgery and adjuvant radiotherapy in this series had better outcomes compared with those treated with chemoradiotherapy alone.

This study demonstrated an overwhelming satisfaction and support for the use of telemedicine appointments in the head and neck surgical oncology setting. This should reassure clinicians that telemedicine is feasible, acceptable and accessible. Telemedicine has benefits in combating COVID-19 as well as increasing accessibility for regional and rural patients, potentially reducing the burden on patients, families and health systems.

Patients presenting for thyroidectomy may have an unrecognised pre-existing vocal cord palsy (VCP) which raises the danger of bilateral VCP if such a patient sustains an injury to the RLN on the sole functioning side. Part of the rationale for routine preoperative laryngoscopy is to eliminate such a risk. This article endeavours to quantify the potential risk so surgeons can decide if preoperative laryngoscopy is warranted, either routinely or selectively.

Medullary thyroid cancer is a challenging and rare diagnosis. There are conflicting recommendations as to the use of sCT between different guidelines and so we hoped to identify the utility of serum calcitonin as a biomarker for possible MTC.

Overall survival of MBC patients.

Flow diagram of patients.

The optimal distal resection margin (DRM) has been debated in sphincter-saving surgery for patients with low-lying rectal cancers. We analysed the impact of a DRM of 1 cm on local recurrence and long-term survival for patients who underwent sphincter-preserving surgery. No matter whether patients received neoadjuvant therapy, a DRM of 1 cm may be acceptable.

A decompressing stoma can be constructed as bridge to elective surgery in left-sided obstructive colon cancer. Simultaneous tumour resection and stoma reversal carries a higher rate of wound complication compared with tumour resection followed by stoma reversal in separate surgeries. However, issues such as the location of the tumour and diverting stoma, along with the need to resect other upper abdominal organs, should all be considered when deciding the stages of operation.

This study aimed to investigate whether an extracorporeal side-to-side (SS) or end-to-side (ES) stapled anastomosis impacts short- and long-term outcomes after an oncological laparoscopic right hemicolectomy. In a 1040 patient cohort, the type of extracorporeal stapled anastomosis had minimal impact on morbidity and survival outcomes; however, a side to side stapled anastomosis is more likely to be a faster operation with a higher postoperative ileus rate.

Transperineal prostate biopsies can be performed under local anaesthesia safely with excellent patient tolerability. Patient rated pain scores were rated the highest during infiltration of local anaesthetic agent with a median score of 5, dropping to a median pain score of 1 at conclusion of the procedure. Vast majority of patients (85.4%) would opt for a repeat TPB under local anaesthesia should the need for prostate biopsy arise again.

In-bore MRI guided biopsy of the prostate gland provides accurate is safe and feasible method to investigate suspicions of prostate cancer.

This study assesses the feasibility of a novel intra-operative void scoring technique (Chambers Test). Chambers Test during TURP is simple, reproducible, fast and requires minimal resources. In TURP it may predict successful outcomes by identifying patients who will be catheter free post-operatively as opposed to those who will be catheter dependent despite the procedure.

We present a modified technique called noninflated intracorporeal ileocolic anastomosis, which maintains the benefits of the intracorporeal technique, but has the advantages of no requirement for laparoscopic suturing.

Accessing the transversus abdominis plane during midline laparotomy