Secondary lymphoedema remains an incurable long-term complication of breast cancer treatment and prevention is our best chance. This article is a review of current strategies that should be an integral part of all multidisciplinary decision makings to prevent this debilitating condition.

Studies assessing neurosurgical disease incidence and perioperative outcomes for Māori are lacking. Most studies are not responsive to Māori however, most of these studies are dated. Research outlining patient and whānau experiences of neurosurgical disease and care have not yet been conducted and should be considered for future research.

This review synthesizes international studies on day-case laparoscopic cholecystectomy (DCLC), highlighting patient selection criteria, procedural factors, and outcomes. Findings indicate that judicious selection of patients for DCLC can offer a safe alternative to overnight stays, with comparable surgical outcomes and high patient satisfaction. Strict adherence to selection criteria can optimize implementation, reducing unexpected admissions and readmissions, thus providing valuable guidance for establishing DCLC protocols in hospitals.

This systematic review and meta-analysis assesses indocyanine green fluorescence in left-sided colorectal anastomosis, finding a pooled odds ratio of 0.586 (95% CI: 0.434–0.792) from six randomized trials and 1949 patients, suggesting a 4.7% absolute reduction in leak rates with moderate certainty, indicating its potential as a standard of care.

Changes to the tumour bed following oncoplastic surgery complicate the administration of adjuvant radiotherapy. A framework for tumour bed classification is proposed (OPSURGE) to aid communication between oncoplastic surgeons and radiation oncologists, particularly when using a boost dose to the primary tumour site.

Radiation-induced angiosarcoma of the breast is a rare and aggressive form of sarcoma. Extended resection of the majority of irradiated skin and breast tissue provides good oncological outcomes with an acceptable post-operative complication rate.

Retrospective review of invasive breast cancer in women in Australia and New Zealand between 2010 and 2022 using BreastSurgANZ Quality Audit Database to investigate incidence and identify predictors of axillary nodal metastases in early hormone receptor positive breast cancer in women >74 years to inform decision making about sentinel lymph node biopsy in this population. Review of 127 436 cases where 17 599 were over 74 years, two thirds were node negative and in patients >74 years with grade 1–2, T1a-b, ER positive HER2 negative cancers without LVI 94% were node negative. Lymph node status influences adjuvant treatment in this population so we recommend clinicians consider tumour factors and patient fitness in decision making about SLN biopsy in the elderly population with hormone receptor positive early breast cancer.

Surgical management of advanced skull base tumours has evolved over the last few decades at our institution with acceptable survival outcomes and complication rates. Histological diagnosis and margin status are the main predictors of survival.

This study aimed to determine the natural history of untreated chronic otitis media in Indigenous children in remote South Australia. Hearing in Indigenous children with untreated middle ear pathology remains poor at follow-up. Intervention is critical to prevent persisting poor hearing outcomes.

This series confirms the safety and adequacy of more conservative partial parotidectomy for benign tumours, highlighting most tumours are peripherally situated, but not more prone to positive histological margin involvement. Partial parotidectomy with routine intraoperative facial nerve monitoring, is achieved with low facial nerve palsy rates, and low local recurrence.

Appendiceal neuroendocrine tumours are rarely detected after appendicectomies for appendicitis. Our data show that postoperative imaging with DOTATATE PET is often negative and thus, its use should be reserved for patients with high-risk features.

ICC patients who had clinically positive but pathologically negative lymph nodes recorded the highest median OS (52 months) and median DFS (32 months). Conversely, those who were clinically negative but pathologically positive experienced the lowest median OS (16 months) and median DFS (8 months). A comprehensive lymphadenectomy may enhance survival outcomes for ICC patients with clinically positive lymph nodes.

Computed tomography is used to differentiate pyonephrosis from hydronephrosis where the presence of infection increases fluid density. We hypothesized that stones, sludge and infection would all increase the fluid density of the distal bile duct in the setting of choledocholithiasis. The distal bile duct fluid density is significantly higher in patients who have proven choledocholithiasis at ERCP compared to a normal population. Calculation of the distal bile duct fluid density could improve early detection of choledocholithiasis using CT and reduce reliance on MRCP or EUS prior to ERCP.

Post-hepatectomy liver failure is associated with inadequate future liver remnant, which is influenced by liver quality. No significant variances in liver volumetry were found across different ethnic groups in New Zealand. However, the strength of correlation between Body Mass Index and Intra-hepatic fat deposits varied amongst the ethnic cohorts. Consequently, knowledge of liver volumetry is not enough and liver quality and patient ethnicity should be taken into consideration when planning management for hepatic neoplasms.

This retrospective study of emergency laparoscopic cholecystectomies was conducted at Cairns Hospital between 2016 and 2021. Results demonstrate increasing rates of emergency laparoscopic cholecystectomy across the study timeframe and that rates were significantly higher in Indigenous and remote patients.

Intra-operative neuromonitoring during corrective surgery for scoliosis and kyphosis provides an opportunity to prevent iatrogenic injury by detecting changes in motor or sensory function early. Our results highlight that effectiveness in detecting post-operative deficits and provide further confidence in the use of neuromonitoring. However, there are still a high number of false positive alerts which surgeons should be aware of when making decisions.

Private insurance status in patients with proximal periprosthetic femoral fractures was associated with an average 8-day reduction in hospital stay and increased likelihood of discharge to private rehabilitation. Prolonged hospital stays for public patients stem from delays in accessing rehabilitation beds.

This retrospective analysis of 8444 primary elective total hip or knee arthroplasties aimed to identify whether admission to intensive care (ICU) post-total joint arthroplasty was associated with poorer quality of life, pain and functional outcomes for patients 12 months postoperatively, compared to candidates not requiring ICU admission. We found that patients reported similar clinically meaningful improvements in quality of life, pain and function 12 months after surgery, regardless of whether they were admitted to ICU postoperatively.

A thematic analysis of the impact of human capacity and infrastructure upon rural general surgery provision.

This project aims to identify whether the introduction of routine preoperative risk assessment (RPRA) with the ‘National Emergency Laparotomy Audit (NELA) Calculator’ as standard-of-care for emergency major abdominal surgery at a regional Victorian hospital has improved postoperative outcomes and critical care unit (CCU) utilization. An audit was performed including all adult general surgery patients who required EMAS at Bendigo Health between September 2017 and August 2022, comparing outcomes before and after introduction of RPRA. RPRA reduced rate of unplanned CCU admissions but did not impact postoperative mortality or complication rates.

This original article expands the current understanding of horse-related trauma in a regional New South Wales hospital, Australia. Horse-related trauma is a common, significant trauma mechanism and equestrians have a high rate of injuries and consequential hospitalization.

The anatomical relationships and differences between the superior mesenteric vessels were explored by comparing CT three-dimensional angiography with the surgical video of laparoscopic right hemicolectomy.

On 20 human cadavers, the diffuse or concentrically organized coeliac plexus was revealed. The ganglia size, average distance from the celiac trunks, ganglia number, and nervous contributions were documented and compared. The results are important for splanchnicectomy and coeliac blocks.