There was an increased risk of CRC among patients diagnosed with IBS, primarily in the first year after IBS diagnosis. The prevalence was lowest in the constipation-predominant IBS subtype.

15–20% of patients present with near obstructing left-sided colorectal cancer. CT colonography (CTC) or PET-CT has been used to detect synchronous lesions, which may alter preoperative planning of colonic resection. By means of a systematic review, we demonstrate that CTC is an effective and useful adjunct to colonoscopy in assessing the proximal colon when colonoscopy fails to do so.

Immune mediate colitis management has largely been under the purview of medical specialties. This review explores the current landscape of managing immune mediated colitis from a surgical perspective and highlights key areas in which surgeons can engage in the multidisciplinary care of this condition. To facilitate prompt diagnosis and management of immune-mediated colitis, there is an increasing necessity for surgeons to become familiar with the latest multidisciplinary approaches and recommendations.

Long-term complication rates and functional outcomes of ileoanal pouch procedures in the biologic era have not been well defined. This review primarily aims to provide an update on these outcomes. Secondarily, risk factors associated with chronic pouchitis and pouch failure are explored.

For inpatients with diabetes-related foot ulceration (DFU) the incidence of minor amputation was 34% and major amputation was 8% over four years. Most amputations occurred during the patient's index DFU-related hospital admission. Minor amputation during the patient's index DFU-related admission was associated with requiring revascularisation, while major amputation during the patient's index DFU-related admission was associated with having more comorbidities and receiving care for a mental health condition. Minor or major amputation according to DFU-related hospital admission sequence

Over a 15-year period survival to discharge increased for patients admitted to ICU following vascular surgery in 179 units across Australia and New Zealand. During the same period ICU bed-use by vascular surgery patients decreased.

With increase endovascular training in vascular surgery, assessment methods need to shift to capture these nuanced skills. A high-fidelity simulator was set up to capture raw metric data and compared to a standardized assessment method. There were significant correlations between some metric scores and an artificial intelligence model had moderate correlation with these score.

This audit aims to determine differences between two port device insertion techniques employed at Cairns Hospital in a 3 year period in decreasing complication rates and increasing tip accuracy.

COVID-19 caused significant delays in access to lung cancer surgery. This resulted in pathological upstaging and decreased access to surgery. These changes will have significant effects on long term survival and cancer recurrence for years to come.

Lung neuroendocrine tumours are currently staged using the same staging system as all non-small cell lung cancer, despite significant differences in outcomes. We have found that prognosis is significantly driven by histological subtype, however, were not able to independently validate an alternate – proposed – lung neuroendocrine-specific staging system.

This study aimed to compare the clinical effects of lobectomy and sublobar resection in the treatment of lung metastasis and to analyze the factors affecting patient prognosis.

There was no study on use/feasibility of concurrent VATS resections or how grueling performing concurrent lower lobectomies are. We intended to demonstrate that performing a concurrent lower lobectomy via VATS assistance makes it feasible as a concurrent upper lobectomy.

Given the ageing population and uptake of transcatheter approaches for treating aortic stenosis (AS), a renewed evaluation of outcomes after surgical aortic valve replacement (SAVR) is warranted. With guidelines recommending age-based indications for surgical and transcatheter approaches, this study critically evaluates outcomes in age-based subgroups, with the aim to refine management of AS in the elderly, where there is often no clear consensus.

Our study aims to determine the impact of low socioeconomic status and road distance to hospital on the rates of perforated appendicitis at a rural referral centre. Contrary to existing studies, our results demonstrate that socioeconomic status and road distance to hospital do not have a significant impact on perforated appendicitis. In our study, indigenous patients have lower socioeconomic status and longer road distance to hospital than non-indigenous patients, but do not have higher rates of appendiceal perforation.

High-quality healthcare of patients with UGIB is delivered by general surgeons in a rural hospital and can be further improved by local multidisciplinary protocols including risk assessment scores which expedite endoscopy by identifying low risk patients unlikely to require therapy. Guidelines would protocolize resuscitation, management, appropriate medication administration, thereby preventing delays to endoscopy. Despite these nuisances, the time to endoscopy, endoscopic intervention, and patient outcomes were largely in line with international quality assurance and safety targets.

Unplanned return to theatre (URTT) is associated with longer hospital stay, higher mortality rates, and extra burden on hospital resources which is already limited in rural hospitals. There is a lack of literature analysing causes of URTT in a rural general surgery department. This study aims to identify causes of URTT in rural general surgical patients.

The Acute Surgical Unit (ASU) model of emergency general surgical care is a deviation from the traditional model and has demonstrated improved efficiency and patient outcomes This study evaluates the implementation of the ASU model in a major tertiary trauma centre with average review times of 40 min. The results demonstrate that with review times close to the benchmark of 30 min, the ASU model is effective, and with emergency department wait times of close to 5 h prior to review, delays in cares of surgical patients is likely external to the surgical unit.

Seromas refer to collections of fluid secreted into the so-called dead spaces when extensive dissection takes place. In the short-term results, we demonstrated that intraoperative hypertonic saline irrigation significantly decreased the amount of the drained fluid and shortened the length of hospital stay.

The utilization of non-contrast computer tomography imaging to diagnose the acute abdomen during the global contrast shortage.

Sexual abuse is prevalent in the Australian community. Studies report that 12%–23% of patients with functional anorectal disorders have a history of sexual abuse. We have conducted a retrospective study to compare symptom severity, quality of life and anorectal physiology in female patients presenting with defaecatory dysfunction to a colorectal pelvic floor unit with or without a history of penetrative sexual abuse. We found no objective difference in symptomatology or physiology between female patients with a history of sexual abuse compared to those without. Our findings should empower clinicians to employ standard management principles to those presenting with defaecatory dysfunction who have a history of sexual abuse.

Our study investigated how many patients presenting with pelvic floor dysfunction were undergoing colonoscopy and if this investigation yielded useful results in their initial workup. Patients presenting to pelvic floor clinics often have erratic bowel habits and vague symptoms, and it can be difficult to tease out the presence or absence of red flag symptoms such as change in bowel habit. Our findings showed similar adenoma detection rate to the general population, low yield for detecting any serious pathology, and support for current guidelines for colonoscopy in the workup of pelvic floor dysfunction.

This study found there was no statistically significant impact on the overall accuracy of MRI rectal cancer staging between patient groups who received IV hyoscine butylbromide and groups who did not receive IV hyoscine butylbromide. Given the potential side effects and adverse outcomes of IV anti-spasmodic agents, department protocols may need to be re-assessed regarding the prescription of these medications for MRI rectal cancer staging.

IBD patients undergoing surgery are at increased risk of VTE. This risk increases exponentially with risk factors.

Robotic surgery for diverticular disease has become increasingly prominent worldwide with a paucity of Australasian data. Forty-one patients undergoing robotic resection of diverticular disease across three healthcare centres in Victoria were analysed in this series. Robotic resection in this series was considered feasible, with a 2.4% conversion to open surgery rate, and safe, with a low complication rate similar to other robotic diverticular studies and laparoscopic resection studies.

Long-term results of rectal cancer patients undergoing curative resection are affected by their preoperative skeletal muscle status. Larger studies including comprehensive data on muscle strength along with skeletal muscle index are awaited to confirm these results on both Eastern and Western rectal cancer patient populations before strategies to reverse muscle depletion can be extensively applied.

This study compares laparoscopic to open resection for right-sided colorectal cancer for the whole state of Victoria. It uses advanced biostatistics to account for confounders.

This study documents the experience of right hemicolectomy in Australia and New Zealand over the last 15 years. It details current binational clinical practice, and significant patient and operative risk factors for anastomotic leak were identified.

The detection of screw protrusion is imperative intraoperatively so that its correction can prevent damage to the adjacent chondral surfaces that occur with carpal motion. The quadrant of interest is first identified, and fluoroscopic assessment for screw protrusion should be performed with the forearm in pronation, supination or in the mid-pronation position and with the wrist in neutral or 20° ulnar deviated positions.

The rates of unplanned reoperation after lumbar degenerative surgery increased at first and then decreased. Wound infection was the major reason for unplanned reoperation. 2-segment surgery and surgeon's surgical skill were related to the reoperation rate.

For patients undergoing THA or TKA, higher BMI was associated with lower pre-operative expectations, poorer well-being before surgery, and worse scores after surgery. Patients who were obese demonstrated comparable satisfaction with their operated joint, compared with non-obese patients. BMI was associated with greater pre- to post-operative improvements in outcome scores for EQ-5D, VAS knee, OHS/OKS and joint pain.

Facial reanimation with multiple neural inputs and concurrent static strategies allow for effective static and dynamic facial function with little synkinesis and no gross morbidity. By drawing on the relative strengths of each neural input and tailoring the approach to the patient, robust clinician-graded and objective outcomes are able to be achieved.

The aim of the study was to determine the risk of lymph node recurrence in levels IV and V after tumor resection and neck dissection of level I–III and level I–V. Neck dissection of levels I–III seems to be sufficient treatment in cases of unsuspicious lymph nodes in levels IV and V, even in cases of positive nodes in levels I–III if adjuvant radiation therapy is applied.

Here, we offer a step-by-step description of the technique for a Delorme's mucosectomy and muscular plication in our favoured prone jack-knife position, which is our preferred approach in patients who are frail, and unable to tolerate the pneumoperitoneum required for minimally invasive surgery. The principles of this technique are to reduce the prolapse, relieve incontinence and prevent obstructive defecation. This article is supplemented by a series of high-quality clinical images.

Perineal hernias are rare complications of surgeries like abdominoperineal resections. This submission is an educational piece outlining the steps to completing a posterior perineal hernia repair with mesh.