ANZ Journal Of Surgery[JOURNAL]
Sun
200 papers
Prognostic Factors and Predictive Models for Rates of Mortality and Morbidity Following Percutaneous Cholecystostomy: A Retrospective Cohort Study at Counties Manukau Between 2022 and 2024.
Wei Y, Ramson DM, Smith JA … +3 more , Hawkins SP, Biggar MA, Rahman H
ANZ J Surg · 2026 Jun · PMID 42290247 · Publisher ↗
BACKGROUND: Percutaneous cholecystostomy is a critical intervention for patients with acute cholecystitis who are unsuitable for immediate surgery, yet long-term outcomes and prognostic indicators remain poorly defined....
BACKGROUND: Percutaneous cholecystostomy is a critical intervention for patients with acute cholecystitis who are unsuitable for immediate surgery, yet long-term outcomes and prognostic indicators remain poorly defined. This largest single-centre study in New Zealand has been performed to evaluate percutaneous cholecystotomy outcomes and to investigate key predictors of mortality and morbidity. METHODS: A retrospective cohort study of all patients undergoing percutaneous cholecystostomy between January 2022 and December 2024 was performed. Clinical, radiological and procedural variables were analysed. Primary outcomes were 30-day, 90-day and 1-year mortality; secondary outcomes included sepsis resolution, readmissions, drain-related complications and subsequent completion cholecystectomy. RESULTS: Among 115 patients, mortality was 7.8% at 30 days, 11.3% at 90 days and 25.2% at 1 year. Acute acalculous cholecystitis conferred a fourfold greater 1-year mortality compared with calculous disease. Acute kidney injury predicted early mortality, while cardiovascular comorbidities predicted late mortality. Sepsis resolved within 72 h in 81.7% of patients, though after-hours procedures were associated with lower success rates. Readmissions and drain-related complications occurred in over half of patients. CONCLUSIONS: Patients undergoing percutaneous cholecystostomy face a substantial disease burden, with high rates of complications, readmissions and late mortality. Percutaneous cholecystostomy should be framed as a palliative or temporising measure rather than definitive therapy and patients must be counselled accordingly so expectations are realistic. In suitable candidates, interval cholecystectomy remains essential for definitive treatment. In acute acalculous cholecystitis, percutaneous cholecystostomy should not be the main treatment; priority must instead be given to addressing the underlying systemic illness.
Socioeconomic Disadvantage, but Not Remote Location, Is Associated With Poorer Survival After Resection of Colon Cancer in Queensland Patients: A Population-Based Retrospective Cohort Study.
Lonne MLR, Cao AMY, Jenkin A … +1 more , Clark DA
ANZ J Surg · 2026 Jun · PMID 42290018 · Publisher ↗
BACKGROUND: Previous studies have demonstrated a social gradient in survival outcomes for colorectal cancer. The aim of this study was to determine the effect of socioeconomic status and geographic remoteness on overall...
BACKGROUND: Previous studies have demonstrated a social gradient in survival outcomes for colorectal cancer. The aim of this study was to determine the effect of socioeconomic status and geographic remoteness on overall (OS) and cancer-specific survival (CSS) for patients with non-metastatic colon cancer in Queensland. METHODS: A population-based retrospective cohort study between 1 January 2001 and 30 December 2021 utilising data from the Queensland Oncology Repository. RESULTS: A total of 29 749 patients met the inclusion criteria, with a median follow up time of 71 months. Both OS and CSS for those that were socioeconomically disadvantaged were significantly lower than those who were middle SES and affluent at all-time points (p < 0.001). In multivariate Cox proportional hazards analysis, after accounting for age, stage, sex, ASA and geographic remoteness, the hazard ratio (HR) for overall and cancer-specific death in those that were disadvantaged compared to those that were affluent and middle SES was 1.13 (95% 1.01-1.25, p = 0.03) and 1.18 (95% CI 1.01-1.39, p = 0.04), respectively. Patients who were socioeconomically disadvantaged were less likely to be from a major city than those who were middle SES and affluent (32.8% vs. 70.2% and 97.1%, respectively, p < 0.001). Geographic remoteness itself had no effect on OS or CSS in multivariate analysis. CONCLUSION: Despite significant advances in healthcare, socioeconomic disadvantage remains a predictor of poor prognosis for patients with non-metastatic colon cancer in Queensland. Further efforts are needed to ensure equitable provision of services to improve outcomes in this vulnerable population.
An Unexpected Finding of Palmaris Profundus in the Carpal Tunnel.
Gilroy DA, Rooke GMJ
ANZ J Surg · 2026 Jun · PMID 42286855 · Publisher ↗
Abstract loading — click title to view on PubMed.
External Validation of Adult Prediction Models for Complicated Appendicitis After Contrast-Enhanced Computed Tomography: A Single-Centre Study.
Le KL, Nguyen DA, Pham TN … +5 more , Trinh MT, Tran MQ, Pham PC, Nguyen NT, Le NK
ANZ J Surg · 2026 Jun · PMID 42286846 · Publisher ↗
BACKGROUND: Preoperative distinction between uncomplicated and complicated appendicitis is important when treatment pathways diverge, including non-operative management for adults. Several adult prediction models exist,...
BACKGROUND: Preoperative distinction between uncomplicated and complicated appendicitis is important when treatment pathways diverge, including non-operative management for adults. Several adult prediction models exist, but validation remains limited. METHODS: We performed a single-centre validation study using a dataset from Nhan Dan Gia Dinh Hospital. Adults undergoing appendectomy after contrast-enhanced computed tomography were included. Complicated appendicitis was the primary outcome. Atema 2015, the Appendicitis Severity Index and Mori 2024 were prespecified for formal external validation. Because the pain score was unavailable, SAS 2.0 was not formally validated; instead, a modified SAS 2.0 using a surrogate abdominal examination variable was explored. Discrimination was assessed with area under the receiver operating characteristic curve, and threshold metrics at cut-offs. RESULTS: The cohort comprised 496 adults; 200 (40.3%) had complicated appendicitis. Mori 2024 showed the highest discrimination (area under the receiver operating characteristic curve 0.783, 95% confidence interval: 0.741-0.826), followed by Atema 2015 (0.760, 0.715-0.804) and the Appendicitis Severity Index (0.731, 0.686-0.776). Mori outperformed the Appendicitis Severity Index (p = 0.0146). At published cut-offs, sensitivity/specificity were 51.6%/89.7% for Atema, 22.0%/98.6% for the Appendicitis Severity Index and 75.0%/65.4% for Mori. In 474 complete cases, modified SAS 2.0 achieved an apparent area under the receiver operating characteristic curve of 0.850 and optimism-corrected area under the curve of 0.833. CONCLUSION: In this restricted-spectrum cohort, Mori performed best among the formal models, whereas the Appendicitis Severity Index was most specific but poorly sensitive. None of the formal models should be used alone to exclude complicated appendicitis in this setting.
A Systematic Scoping Review of Participant Descriptor, Diversity and Inclusivity Data Reported in Randomised Studies of Post-Operative Ileus.
Khalil M, Roberts E, Jayne DG … +1 more , Chapman SJ
ANZ J Surg · 2026 Jun · PMID 42281225 · Publisher ↗
BACKGROUND: Poor reporting of baseline descriptor, diversity and inclusion data is a barrier in surgical research for drawing generalisable conclusions across diverse populations. Post-operative ileus was used as an exem...
BACKGROUND: Poor reporting of baseline descriptor, diversity and inclusion data is a barrier in surgical research for drawing generalisable conclusions across diverse populations. Post-operative ileus was used as an exemplar surgical condition to quantify the variation in baseline descriptor, inclusivity and diversity data in randomised controlled trials and to identify targets for improved reporting for baseline descriptors. METHODS: A systematic search of MEDLINE, EMBASE and CENTRAL databases was performed to identify randomised controlled trials (RCTs) in the context of post-operative ileus after abdominal surgery. Two assessors independently screened studies. Baseline descriptors, including diversity and inclusion descriptors, were extracted and summarised. A narrative synthesis quantified variation and explored targets for improvement. RESULTS: Of 4887 studies initially identified, 211 met inclusion criteria, and 184 were accessible for inclusion. A total of 92 unique descriptors were identified. The median number of descriptors per RCT was 6 (IQR: 4-8). Characteristics known to predispose patients to ileus, including baseline opioids (n = 4/184; 2.2%) and previous surgery (n = 38/184; 20.7%), were uncommonly reported. The most common characteristics were age (n = 181/184; 98.4%) and one of either sex or gender (n = 152/184; 82.6%). A total of 18 (9.8%) RCTs reported participants' ethnic group, described variably as 'race' or 'ethnicity'. No studies reported physical disability. CONCLUSIONS: Substantial heterogeneity exists in the reporting of baseline participant descriptors in the common surgical context of post-operative ileus. Data relating to diversity and inclusion is seldom reported and difficult to interpret. Homogenising the reporting of these data will improve the comparability and representativeness of future results.
Prognostic Implications of Chronic Kidney Disease in Colorectal Cancer Surgery: A Propensity Score-Matched Analysis.
Gojayev A, Ismayilov R, Erkent M … +2 more , Ertekin I, Yildirim S
ANZ J Surg · 2026 Jun · PMID 42281220 · Publisher ↗
BACKGROUND: Chronic kidney disease (CKD) is a common comorbidity that may impact surgical outcomes in colorectal cancer (CRC). OBJECTIVE: This study evaluated the prognostic significance of CKD on postoperative complicat...
BACKGROUND: Chronic kidney disease (CKD) is a common comorbidity that may impact surgical outcomes in colorectal cancer (CRC). OBJECTIVE: This study evaluated the prognostic significance of CKD on postoperative complications and survival in CRC patients undergoing curative surgery. METHODS: This retrospective cohort study included 510 patients with stage I-III CRC who underwent surgery between 2011 and 2023. Patients were categorized into CKD (n = 32, 81.3% had end-stage renal disease) and non-CKD (n = 478) groups. Propensity score matching (PSM) was performed to adjust for confounders. Short-term outcomes, including postoperative morbidity, in-hospital mortality, and hospital stay, were analyzed alongside long-term survival. RESULTS: Patients with CKD exhibited significantly higher rates of surgical site infections (p = 0.031), intra-abdominal abscesses (p = 0.047), pulmonary thromboembolism (p = 0.021), and stroke (p = 0.003). CKD was associated with an increased risk of severe complications (50% vs. 17.2%, p < 0.001) and higher in-hospital mortality (18.8% vs. 0.8%, p < 0.001). After PSM, in-hospital mortality (p = 0.024) and Clavien-Dindo grade ≥ 3 morbidity (p = 0.001) remained significantly higher in CKD patients. CKD did not impact disease-free survival, but it was independently associated with mortality (HR: 3.262, 95% CI: 1.535-6.930, p = 0.002) CONCLUSIONS: CKD, particularly in dialysis-dependent patients, significantly increases postoperative morbidity and mortality following CRC surgery. Although oncologically appropriate surgery is feasible in CKD patients, their reduced OS underscores the need for meticulous perioperative management and individualized treatment strategies.
Facilitators, Barriers and Reported Implementation Outcomes of Wide-Awake Local Anaesthesia No Tourniquet in Hand Surgery Practice: A Systematic Scoping Review.
Roberts F, Gholamrezaei A, McClelland B … +2 more , Sandoz D, Burgess T
ANZ J Surg · 2026 Jun · PMID 42281211 · Publisher ↗
BACKGROUND: Wide-Awake Local Anaesthesia No Tourniquet (WALANT) is increasingly being used by hand surgeons. This systematic scoping review aims to identify and collate existing evidence on the reported implementation ou...
BACKGROUND: Wide-Awake Local Anaesthesia No Tourniquet (WALANT) is increasingly being used by hand surgeons. This systematic scoping review aims to identify and collate existing evidence on the reported implementation outcomes, barriers, facilitators and implementation strategies relevant to WALANT in hand surgery practice. METHODS: A systematic search was conducted across major medical databases as well as grey literature from inception to 13 February 2025. Studies were included if they reported on implementation outcomes, implementation strategies and/or the perspectives and experiences of clinicians, patients and other stakeholders. Included records were independently reviewed, with the data extracted and analysed narratively. RESULTS: Forty-five studies were included: mostly observational, orthopaedic-focused, hospital-based, from North America and Europe. The evidence base was dominated by the outcomes of acceptability and cost, with little or no explicit reporting of feasibility, adoption, or penetration. Common barriers included patient anxiety, lack of knowledge and training, persistent misconceptions about safety, departmental and anaesthetist attitudes and limited resources. Key facilitators included positive patient experiences and feedback, the presence of surgical and departmental champions, educational resources and cost savings. Strategies assisting uptake included patient education, financial incentives and dedicated WALANT facilities. CONCLUSION: WALANT implementation in hand surgery is influenced by a combination of perceived advantages, organisational and system-level conditions, individual knowledge and beliefs and the presence of supportive champions and leadership. Future research should more explicitly evaluate how WALANT is implemented, sustained and scaled across different health care contexts.
Stakeholder Consensus Selection of Data Elements and Indicators for a Pancreatic Cancer Surgical Outcomes Registry in Australia and Aotearoa New Zealand: Modified Delphi Process.
Lockie E, Skandarajah A, Zalcberg J … +8 more , Brown K, Chandrasegaram M, Koea J, Kuri E, Watters D, Metz A, Loveday BPT, PaCaSO Consensus Group
ANZ J Surg · 2026 Jun · PMID 42274276 · Publisher ↗
BACKGROUND: The data elements and indicators in a clinical quality registry (CQR) contribute towards the utility of its output and should be informed by stakeholder input. In Australia and Aotearoa New Zealand (AANZ), th...
BACKGROUND: The data elements and indicators in a clinical quality registry (CQR) contribute towards the utility of its output and should be informed by stakeholder input. In Australia and Aotearoa New Zealand (AANZ), there is no CQR for pancreatic cancer surgery. This study aimed to select data elements and registry aims with stakeholder input. METHODS: A three-round modified Delphi consensus process was conducted involving clinicians and consumers. An initial list of data elements was generated through a review of literature, existing international registries, and guidelines. Participants rated the importance of each element using the RAND/UCLA method. In the final round, ≥ 75% consensus was needed for an element to be accepted. Participants rated potential registry aims. RESULTS: Consumers and clinicians from across AANZ were involved. A total of 66 participants were involved asynchronously across the three rounds (Round 1, n = 33; Round 2, n = 40; Round 3, n = 63), with representatives from consumers, surgery, medical oncology, nutrition, nursing, public health and a consumer organisation. After three rounds, 121 data elements were accepted, and all 9 registry aims were rated with high importance. Of these elements, 54 were classified as quality indicators (structure n = 3, process n = 11, outcome n = 40). CONCLUSION: The utility of a registry relies on having meaningful and feasible data elements and indicators. Through involvement of key stakeholders in a systematic process, this study has selected data elements and indicators for a proposed AANZ pancreatic cancer surgery CQR. This is an essential step towards establishing such a registry. The next steps will be to pilot the dataset with pancreatic surgery centres across the region, and to establish baseline benchmarks.
Potentially-Preventable Deaths Following Colorectal Surgery: A National Retrospective Cohort Study of Surgical Mortality.
Wells CI, McLaughlin SJP, McGuiness MJ … +4 more , Joret MO, Baraza W, O'Grady G, Bissett IP
ANZ J Surg · 2026 Jun · PMID 42274274 · Publisher ↗
BACKGROUND: Many deaths after colorectal resection may be preventable, but administrative datasets provide limited insights into the clinical processes leading to mortality. We used the Australian and New Zealand Audit o...
BACKGROUND: Many deaths after colorectal resection may be preventable, but administrative datasets provide limited insights into the clinical processes leading to mortality. We used the Australian and New Zealand Audit of Surgical Mortality (ANZASM) to quantify potentially preventable deaths after colorectal surgery and describe modifiable clinical management issues (CMI) in contemporary Australasian practice. METHODS: Retrospective cohort study of prospectively collected ANZASM data. Adults who died after elective or emergency colorectal resection between 2010 and 2023 were included. Potentially preventable mortality was defined as at least one CMI assessed as definitely or potentially preventable and contributing to death. CMIs were summarised by phase of care and thematically analysed. RESULTS: Among 1058 deaths after colorectal resection, 321 (30.3%) were classified as potentially preventable. Potentially preventable deaths were more frequent after elective than emergency surgery (35.3 vs. 27.8%, p = 0.01). Leading causes of death were sepsis, multiorgan failure and aspiration/pneumonia. Anastomotic leak was the most common postoperative complication, implicated in 19.6% of deaths. Preventable mortality was independently associated with lower estimated operative risk, postoperative complications, unplanned ICU admission and rural hospital care. Common themes included suboptimal patient selection, physiological optimisation, anastomotic decision-making and delayed recognition or escalation of deterioration. CONCLUSIONS: Nearly one third of audited deaths after colorectal surgery were potentially preventable, most arising from failures of selection, optimisation or rescue rather than technical errors. Strengthening preoperative triage, multidisciplinary decision-making and improving postoperative surveillance and escalation systems offer the greatest opportunities to reduce preventable mortality in colorectal surgery.
Characteristics of Surgical Patients at Risk of Adverse Outcomes After Medical Emergency Team Call: A Single Centre Experience.
Dunduru CC, Castelino C, Wood A … +6 more , Zdral A, Adeniyi T, Majumdar M, Skinner I, Douglas NWR, Lange PW
ANZ J Surg · 2026 Jun · PMID 42272117 · Publisher ↗
BACKGROUND: As volume and complexity of surgical procedures increase, there is increased likelihood of perioperative physiological deterioration needing activation of Medical Emergency Team (MET) calls. AIMS: We aimed to...
BACKGROUND: As volume and complexity of surgical procedures increase, there is increased likelihood of perioperative physiological deterioration needing activation of Medical Emergency Team (MET) calls. AIMS: We aimed to estimate rate of MET calls in patients admitted for surgery and identify risk factors for perioperative activation of MET calls in a metropolitan teaching hospital with growing surgical acuity. METHODS: We identified risk factors for MET activation in a retrospective cohort study of a convenience sample of patients admitted under surgical services over a 3-month period and compared perioperative outcomes of patients who experienced MET call activation with those who did not. RESULTS: Thirty-three (7%, 95% CI: 5%-9.9%) patients required perioperative MET call activation. Patients needing MET activation were older (71 years vs. 49 years, p < 0.001), had higher Charlson Comorbidity Index (CCI) (median CCI 3 vs. 1, p < 0.001) and were more likely to be on five or more medications, polypharmacy, pre-operatively (58% vs. 21%, p < 0.001). MET call patients were more likely to require ICU admission (49% vs. 3% respectively, p < 0.001) and had a longer median length of hospital stay (median 10 days vs. 2 days, p < 0.001). CONCLUSIONS: The rate of MET call activation in patients admitted for surgery was 7%. Age, CCI and polypharmacy were significant predictors of need for MET activation (associated with need for escalation of care and poorer hospital outcomes). Since risk factors for MET activation were identifiable from data available at admission, there is potential to identify and intervene early in the perioperative period. Further work will determine whether intervention based on these can improve outcomes.
Risk Factors for Complications Following Paediatric Neuromuscular and Syndromic Scoliosis Correction Surgery: A Systematic Review.
Pham M, Percival MA, Vandeleur M … +2 more , Antolovich G, Lundine K
ANZ J Surg · 2026 Jun · PMID 42272087 · Publisher ↗
BACKGROUND: Paediatric neuromuscular and syndromic scoliosis patients have multiple medical comorbidities that increase the risk of postoperative complications. There is a lack of consistent literature assessing the spec...
BACKGROUND: Paediatric neuromuscular and syndromic scoliosis patients have multiple medical comorbidities that increase the risk of postoperative complications. There is a lack of consistent literature assessing the specific risk factors for complications following scoliosis correction surgery in this high-risk cohort. This review aims to systematically examine the existing literature and synthesise the risk factors for postoperative complications to better inform perioperative planning and patient management. METHODS: A comprehensive search strategy identified existing literature from three databases (OVID Medline, Embase and Web of Science). A total of 1306 articles were identified, and 27 were deemed eligible for inclusion. RESULTS: A total of 21 290 patients were included across all the included studies. There were differences between definitions and reporting of risk factors and complications. There were 13 instances of conflicting findings between studies, and most risk factors were only assessed by one study for a specific complication. CONCLUSION: This review identified several potential risk factors for postoperative complications following neuromuscular scoliosis correction surgery. However, the existing literature is heterogeneous, and there is a lack of consensus regarding the most important risk factors.
A Novel Blood-Based Screening Test for Colorectal Cancer Using Raman Spectroscopy.
Karolewski J, Carroll G, Carroll R … +3 more , Scott RJ, Smith S, Petit J
ANZ J Surg · 2026 Jun · PMID 42265893 · Publisher ↗
BACKGROUND: Label-free vibrational spectroscopic techniques (Raman spectroscopy) combined with machine learning (ML) methodologies have huge potential for the development of screening and diagnostic tests in oncology. Tr...
BACKGROUND: Label-free vibrational spectroscopic techniques (Raman spectroscopy) combined with machine learning (ML) methodologies have huge potential for the development of screening and diagnostic tests in oncology. Traditionally, screening for colorectal cancer (CRC) has relied on immunochemical faecal occult blood (iFOBT) testing; however, this has shown to have low compliance in the Australian setting. The aim of this study was to assess the efficacy of Raman spectroscopy for the detection of CRC and potential screening for CRC. METHODS: Plasma samples were analysed from a total of 370 participants; 117 CRC patients and 253 iFOBT positive control participants. 8 of the CRC patients were from the iFOBT cohort. The control cohort had either advanced adenomas (n = 81), non-advanced adenomas (n = 76), colitis (n = 2) or no evidence of disease (n = 94). The Raman spectra of these plasma samples were analysed using ML algorithms in separate training (n = 222) and validation (n = 148) cohorts. RESULTS: A sensitivity of 84% and specificity of 93% was achieved for the detection of CRC in the validation cohort. When analysed in subcategories, 95% of people with CRC would receive a colonoscopy and 42% of FIT positive people could potentially be spared a colonoscopy. CONCLUSION: This exploratory study demonstrated a high level of accuracy for the detection of CRC using a Raman spectroscopy-based ML model and has the potential to be used for CRC screening.
Clinical Outcomes of Patients Submitted to Pelvic Exenteration With Major Vascular Resection and Reconstruction: A Systematic Review of the Literature.
Perivoliotis K, Tekkis P, Sukha A … +4 more , Frountzas M, Qiu S, Kontovounisios C, Rasheed S
ANZ J Surg · 2026 Jun · PMID 42265890 · Publisher ↗
AIM: The present study aims to evaluate the current data regarding the clinical outcomes of patients undergoing pelvic exenteration with major vascular resection and reconstruction. METHODS: This study was conducted acco...
AIM: The present study aims to evaluate the current data regarding the clinical outcomes of patients undergoing pelvic exenteration with major vascular resection and reconstruction. METHODS: This study was conducted according to the PRISMA guidelines and the Cochrane handbook. Scholar databases were systematically screened. The last search date was March 2026. The primary endpoint was the overall complications rate. Secondary endpoints included specific postoperative complications, oncological outcomes of interest, and perioperative efficacy metrics. Random Effects (RE) models were reported. RESULTS: Overall, 6 studies and 69 patients were included in this study. Pooled complications rate was 57.9% (95% CI: 32.2%-83.6%, p = 0.003). Overall vessel thrombosis and reoperation rates were estimated to be 16.5% (p = 0.008) and 21.7% (p = 0.011). The reported reoperated cases included hemostasis n:13, stent placement n:3, thrombectomy n:2, fasciotomies n:2 and amputation n:1. R0 resection margin was achieved in 58.2% (p = 0.002) of patients. It was shown that in cases with a primary tumor R0 rate was 50% (p = 0.295), while in the recurrent malignancies this dropped to 42% (p = 0.364). Two patients had local relapse at 15 and 25 months while distal metastasis related mortality developed in two patients at 14 and 22 months after surgery. In total, the pooled local recurrence rate was 20% (p = 0.002). CONCLUSION: We estimated a significant overall morbidity burden with increased risk for loss of vascular patency and reoperation and suboptimal oncological outcomes. Despite this, cases with pelvic confined disease that require vascular reconstruction can still be amendable in curative surgery following multidisciplinary assessment.
Hand-Assisted Laparoscopic Donor Nephrectomy-A Decade's Experience in an Australian Transplant Centre.
Peng CC, Tully EK, Furlong T … +3 more , Millar R, Robertson A, Suh N
ANZ J Surg · 2026 Jun · PMID 42265870 · Publisher ↗
AIMS: Hand-assisted laparoscopic donor nephrectomy (HALDN) is an internationally accepted technique to safely retrieve kidneys for live kidney donor transplantation. Locally published data regarding outcomes in the donor...
AIMS: Hand-assisted laparoscopic donor nephrectomy (HALDN) is an internationally accepted technique to safely retrieve kidneys for live kidney donor transplantation. Locally published data regarding outcomes in the donors is lacking. This study aims to assess outcomes after HALDN in the Australian setting. METHODS: A retrospective review of all patients undergoing HALDN was conducted at Royal Melbourne Hospital and Melbourne Private Hospital between 24 March 2011 and 31 December 2022. Patients were identified and information collected from surgical and renal databases which collect data prospectively. The primary outcomes of interest were peri-operative complications (type and Clavien-Dindo classification). Secondary outcomes include length of stay, rate of conversion to open operation and readmission to hospital. RESULTS: A total of 387 patients (55.6% female) underwent HALDN during the study period. The median age of donors was 58 years (range 29-75) and median body mass index was 26.7 kg/m (range 18.6-39.8). The left kidney was donated in 85.3% of patients. The post-operative complication rate was 11.6% (n = 45), and most complications (27/45) were classified as Clavien-Dindo II. Eight patients (1.9%) required return to the operating theatre, and one procedure (0.25%) converted to open operation due to bleeding from stapler malfunction. Median length of stay in hospital was 5 days (range 3-24) and the hospital readmission rate was 3.6%. Median donor creatinine was 69 μmol/L pre-operatively and 99 μmol/L at discharge. CONCLUSION: HALDN is a safe method of kidney donation, with low rates of conversion to open, post-operative complications and hospital readmission.
An Aberrant Right Colic Artery Arising From the Right Gastroepiploic Artery.
Triantafyllou G, Paschopoulos I, Tsakotos G … +3 more , Lyros O, Kokoropoulos P, Piagkou M
ANZ J Surg · 2026 Jun · PMID 42265854 · Publisher ↗
Abstract loading — click title to view on PubMed.
Emergency Laparotomy in Regional New Zealand: Outcomes and Benchmarking Against NELA Standards.
Yong LN, Leung E
ANZ J Surg · 2026 Jun · PMID 42265853 · Publisher ↗
BACKGROUND: Emergency laparotomy is associated with substantial morbidity and mortality. While national audits such as ANZELA-QI have driven quality improvement across Australia and New Zealand, data from regional New Ze...
BACKGROUND: Emergency laparotomy is associated with substantial morbidity and mortality. While national audits such as ANZELA-QI have driven quality improvement across Australia and New Zealand, data from regional New Zealand centres remain limited. This study audited emergency laparotomy outcomes and processes of care at a regional New Zealand hospital and compared them with ANZELA-QI benchmarks. METHODS: A retrospective audit was conducted of all adult patients undergoing emergency laparotomy or laparoscopy at Taranaki Base Hospital between September 2023 and September 2025. Inclusion and exclusion criteria mirrored those of ANZELA-QI. Data collected included demographics, operative details, consultant involvement, radiology, timeliness to theatre, postoperative outcomes, and 30-day mortality. Outcomes were compared descriptively with ANZELA-QI benchmarks. RESULTS: A total of 126 patients were included (median age 67 years; 50.8% female). Preoperative CT scanning was performed in 96% of cases, with 95.2% reported by a consultant radiologist. Surgery occurred within the assigned urgency timeframe in 86.3% of cases. Consultant surgeons were present in 88.9% of operations and consultant anaesthetists in 100%. Preoperative risk assessment was documented in only 4% of patients. Postoperatively, 42.9% were admitted to critical care and 7.1% returned to theatre. Overall 30-day mortality was 10.3%. Of those alive at discharge, 92.9% returned to their prehospital residence. Only 17.1% of patients aged ≥ 65 years received geriatric assessment. CONCLUSION: Emergency laparotomy outcomes at this regional New Zealand hospital were comparable to national and international benchmarks, with strong performance in radiology access, consultant involvement, and timeliness to theatre. Key areas for improvement include routine documentation of preoperative risk assessment and increased geriatric involvement for older patients. Regional-specific audits remain essential to inform equitable, high-quality surgical care.
Developing an Intervention Framework to Prevent Surgical Complications in Patients With Metabolic Syndrome: A Qualitative Study of Health Professional Perspectives on Barriers and Enablers.
Norris P, Gow J, Arthur T … +5 more , Rodda D, Coory J, Oprescu F, Neville S, Ralph N
ANZ J Surg · 2026 Jun · PMID 42260900 · Publisher ↗
BACKGROUND: Metabolic syndrome (MetS) is a cluster of risk factors, including cardiovascular disease, diabetes, chronic hypertension, obesity, and hypercholesterolemia, which collectively increase the risk of chronic dis...
BACKGROUND: Metabolic syndrome (MetS) is a cluster of risk factors, including cardiovascular disease, diabetes, chronic hypertension, obesity, and hypercholesterolemia, which collectively increase the risk of chronic diseases and adverse health outcomes. Affecting up to 30% of the global population, MetS poses significant challenges for surgical patients, with emerging evidence indicating poorer postoperative outcomes compared to nonaffected populations. Despite its growing prevalence, there is a lack of dedicated interventions to address the specific needs of this group. This study aims to explore the barriers and facilitators influencing the management of MetS in surgical patients, with the goal of informing intervention development. METHODS: A qualitative, exploratory study was conducted using the Theoretical Domains Framework (TDF) to guide data collection and analysis. Semi-structured interviews were conducted with clinicians involved in the perioperative care of patients with MetS, focusing on their perspectives on barriers and facilitators to effective management. Data were analyzed thematically and mapped to the 14 TDF domains. RESULTS: Clinicians identified significant barriers, including resource constraints, fragmented care pathways, and variability in team roles. Facilitators included peer validation, multidisciplinary collaboration, and the integration of decision-support tools. Emotional and motivational factors also emerged as critical determinants of engagement. CONCLUSION: This study underscores the need for targeted interventions to address the unique challenges of managing MetS in surgical contexts. The findings provide a foundation for developing behaviorally informed frameworks, with implications for improving surgical outcomes and reducing healthcare costs.
Endoscopic and Radiological Outcomes of Strictureplasty in Patients With Small Bowel Stricturing Crohn's Disease.
Zhang X, Yang R, Wu E … +5 more , Zhang H, Zhang Z, Duan M, Zhu W, Li Y
ANZ J Surg · 2026 Jun · PMID 42253164 · Publisher ↗
PURPOSE: Endoscopic and radiologic changes following strictureplasty for Crohn's disease (CD) remain largely unknown. This study aimed to evaluate postoperative mucosal and transmural healing at strictureplasty sites. ME...
PURPOSE: Endoscopic and radiologic changes following strictureplasty for Crohn's disease (CD) remain largely unknown. This study aimed to evaluate postoperative mucosal and transmural healing at strictureplasty sites. METHODS: A retrospective cohort study using a prospectively maintained database of patients undergoing surgery for small-bowel stricturing CD between October 2014 and January 2024 was conducted. Propensity score matching was performed to generate a contextual comparison group of patients undergoing intestinal resection. Endoscopic and radiological outcomes were evaluated using postoperative computed tomography enterography (CTE) and enteroscopy. RESULTS: 59 patients undergoing strictureplasty were included. Postoperative endoscopy showed mucosal healing at the primary strictureplasty site in 46 of 59 patients (78%, Median follow-up 8 months). CTE showed a marked reduction in bowel wall thickness compared to preoperative measurements (8.25 mm vs. 5.6 mm, p < 0.001) (Median follow-up 7 months). At the final follow-up (median follow-up 12 months), clinical recurrence requiring treatment escalation, was observed in 38/51 (75%) patients, and 23 (61%) of these recurrences were due to new sites rather than the strictureplasty site. No statistically significant difference in clinical recurrence was observed between the strictureplasty and matched resection cohorts (p = 0.74). CONCLUSIONS: Significant mucosal and transmural healing occurred at the site of the primary stricture within approximately 1 year of strictureplasty. Preservation of diseased bowel did not appear to increase short-term clinical recurrence in this cohort.
Artificial Intelligence-Enhanced Dictation Improves Efficiency in a Regional General Surgery Clinic: A Quasi-Experimental Pilot Study.
Carmichael GJ, Di Tano V, Wright C … +4 more , Al-Sharea A, Kovoor JG, Gonzalez-Chica D, Jacob MO
ANZ J Surg · 2026 Jun · PMID 42253160 · Publisher ↗
INTRODUCTION: Rural surgical services face increasing clinical demand and administrative burden, often exacerbated by limited workforce and support infrastructure. Artificial intelligence (AI) scribes may improve documen...
INTRODUCTION: Rural surgical services face increasing clinical demand and administrative burden, often exacerbated by limited workforce and support infrastructure. Artificial intelligence (AI) scribes may improve documentation efficiency, yet evidence from surgical and rural or regional outpatient settings remains scarce. The study aimed to determine whether AI-assisted documentation could reduce total documentation time relative to traditional dictation methods. METHODS: A quasi-experimental pilot study was conducted in a private colorectal and general surgery clinic in regional Victoria. Consecutive consultations were documented either using traditional dictation with human transcription or AI-assisted scribing (Lyrebird Health) according to an alternating-day schedule. Total clinician-facing documentation time, consultation duration and type (initial vs. review) were recorded by an observer. Group comparisons used non-parametric tests, and a multiple linear regression model adjusted for consultation duration and type. RESULTS: A total of 119 consultations were analysed (60 traditional, 59 AI-assisted). Median documentation time was significantly shorter with AI assistance (0.71 [0.37-1.10] min) compared with traditional dictation (2.28 [1.94-2.78] min; p < 0.001). Regression analysis confirmed that AI-assisted documentation was associated with a mean reduction of 1.35 min in documentation time (β = -1.35; 95% CI -1.75 to -0.95; p < 0.001), independent of consultation duration or type. Consultation duration did not differ significantly between methods (p = 0.59). CONCLUSION: In this pilot proof-of-concept study, AI-assisted documentation was associated with shorter clinician-facing documentation time in one regional surgical outpatient practice without prolonging consultation duration. These findings support further evaluation of AI scribes in surgical settings, but broader assessment of documentation quality, cost, governance, and downstream workforce effects is required before wider implementation.
Timing of Curative Resection in Incidental Carcinoma of the Gall Bladder: Does It Really Matter?
Chowdhury S, Aggarwal A, Lahiri A … +2 more , Goel S, Singh S
ANZ J Surg · 2026 Jun · PMID 42253122 · Publisher ↗
PURPOSE: There is conflicting data in the literature regarding the optimal timing of curative surgery in incidental gallbladder cancer (IGBC). The aim of this study was to assess the impact of the timing of surgery in IG...
PURPOSE: There is conflicting data in the literature regarding the optimal timing of curative surgery in incidental gallbladder cancer (IGBC). The aim of this study was to assess the impact of the timing of surgery in IGBC on disease-free (DFS) and overall survival (OS). METHODS: Data of all patients of IGBC who underwent completion radical cholecystectomy from January 2012 to December 2022 was retrieved from a prospectively maintained electronic database. Patients were divided into two groups based on the interval between the cholecystectomy and completion radical cholecystectomy: early (≤ 4 weeks) and late (> 4 weeks). The groups were compared using appropriate statistical methods. RESULTS: There were 44 and 47 patients in early and late groups respectively. Both groups were comparable in all demographic, preoperative, operative, postoperative, and histopathological characteristics. At a median follow-up of 36 months, median DFS and OS were not reached. There was no difference in early and late groups in mean DFS (41 vs. 43 months) and OS (47 vs. 46 months). CONCLUSION: Timing of curative surgery did not have any impact on intraoperative blood loss, duration of surgery, hospital stay, complication rates, and lymph node retrieval. Early surgery was associated with better adjuvant therapy completion rates (95% vs. 77%, p = 0.04). Mean DFS and OS were similar in both groups. So timing of surgery in IGBC did not have any impact on short term and long term outcomes.
About
- Frequency
- Sun
- Papers found
- 200
- RSS feed
- Subscribe