Synchronous symptomatic parathyroid carcinoma and parathyroid adenoma with incidental follicular thyroid carcinoma.
We describe the case of an 89-year old Caucasian woman admitted with confusion and severe clinical manifestations of acute hypercalcaemia. There was no history suggestive of any malignancy and initial management included correction of the hypercalcaemia with intravenous fluid therapy. Sestamibi parathyroid scintigraphy and neck ultrasonography demonstrated a 4cm left-sided thyroid lesion and a nearly 2cm right-sided thyroid lesion. The patient underwent a total thyroidectomy and parathyroidectomy. Histology confirmed a concomitant parathyroid adenoma, parathyroid carcinoma and follicular thyroid carcinoma. To our knowledge...
Source: Annals of the Royal College of Surgeons of England - May 21, 2020 Category: Surgery Authors: D'cruz RT, Seet JE, Parameswaran R Tags: Ann R Coll Surg Engl Source Type: research

Aortocaval fistula, a potentially favourable complication of abdominal aortic aneurysm rupture in endovascular repair.
We present a case of ruptured abdominal aortic aneurysm with an aortocaval fistula that was successfully treated with percutaneous endovascular aneurysm repair under local anaesthesia. Despite a persistent type 2 endoleak the aneurysm sack shrank from 8.4cm to 4.8cm in 12 months. The presence of an aortocaval fistula may have depressurised the aneurysm, resulting in less bleeding retroperitoneally and may have promoted rapid shrinkage of the sac despite the presence of a persistent type 2 endoleak. PMID: 32436721 [PubMed - as supplied by publisher] (Source: Annals of the Royal College of Surgeons of England)
Source: Annals of the Royal College of Surgeons of England - May 21, 2020 Category: Surgery Authors: Greenfield S, Martin G, Malina M, Theivacumar NS Tags: Ann R Coll Surg Engl Source Type: research

Impact of family history risk assessment on surgical decisions and imaging surveillance at breast cancer diagnosis.
CONCLUSIONS: A proportion of women diagnosed with BC would fall into the MR or HR categories as defined in the NICE FH guidance. Inadequate recording of FH could result in inadequate FUI surveillance and in some cases missing the opportunity for a genetic referral to assess suitability for gene testing. PMID: 32436722 [PubMed - as supplied by publisher] (Source: Annals of the Royal College of Surgeons of England)
Source: Annals of the Royal College of Surgeons of England - May 21, 2020 Category: Surgery Authors: Jones S, Turton P, Achuthan R Tags: Ann R Coll Surg Engl Source Type: research

Oncological outcomes in patients undergoing major glossectomy for advanced carcinoma of the oral tongue.
CONCLUSIONS: Node positivity and multiple node involvement were associated with poor outcomes. Major glossectomy may be offered as a curative option for selected patients with advanced carcinoma of the oral tongue with node negative or limited neck nodal disease (N1). PMID: 32436723 [PubMed - as supplied by publisher] (Source: Annals of the Royal College of Surgeons of England)
Source: Annals of the Royal College of Surgeons of England - May 21, 2020 Category: Surgery Authors: Katna R, Bhosale B, Sharma R, Singh S, Deshpande A, Kalyani N Tags: Ann R Coll Surg Engl Source Type: research

Haematuria caused by bladder cancer in the paediatric setting.
We present the case of bladder cancer in a boy who presented to the primary care practitioner with visible haematuria. This case highlights the need for clinicians to consider malignancy as a possible cause for haematuria when assessing and investigating children with this presenting complaint. PMID: 32436735 [PubMed - as supplied by publisher] (Source: Annals of the Royal College of Surgeons of England)
Source: Annals of the Royal College of Surgeons of England - May 21, 2020 Category: Surgery Authors: Jones P, Eldakhakhny M, Hawary A Tags: Ann R Coll Surg Engl Source Type: research

Repair of oesophageal atresia by consultants and supervised trainees results in similar outcomes.
CONCLUSIONS: Surgical outcomes for repair of OA/TOF are not adversely affected by trainee operating. Trainees with appropriate skills should perform supervised OA/TOF repair. These data are important for understanding the interrelationship between provision of training and surgical outcomes. PMID: 32436786 [PubMed - as supplied by publisher] (Source: Annals of the Royal College of Surgeons of England)
Source: Annals of the Royal College of Surgeons of England - May 21, 2020 Category: Surgery Authors: Jones CE, Smyth R, Keys SC, Ron O, Stanton MP, Kitteringham L, Wheeler RA, Hall NJ Tags: Ann R Coll Surg Engl Source Type: research

Ipsilateral Spigelian hernia: just an infrequent variant?
We describe an unusual case of Spigelian herniation previously unreported and possibly previously unrecognised. PMID: 32389026 [PubMed - as supplied by publisher] (Source: Annals of the Royal College of Surgeons of England)
Source: Annals of the Royal College of Surgeons of England - May 11, 2020 Category: Surgery Authors: Singh R, Jayamanne H, Stephenson BM Tags: Ann R Coll Surg Engl Source Type: research

ANCA-associated vasculitis causing nasopalatal destruction.
Abstract Autoimmune disorders and their manifestations can be very problematic to diagnose and manage. The symptoms can be ambiguous and debilitating. Early intervention is necessary to counter the unforgiving consequences of delayed intervention, such as loss of sight or hearing and destruction of affected tissues. Vasculitis in the head and neck region is rare. A case of ANCA-associated vasculitis causing extensive destruction is presented to enhance our understanding of this devastating multisystem disorder. PMID: 32374179 [PubMed - as supplied by publisher] (Source: Annals of the Royal College of Surgeons of England)
Source: Annals of the Royal College of Surgeons of England - May 6, 2020 Category: Surgery Authors: Mumtaz S, Navaee S, Singh M Tags: Ann R Coll Surg Engl Source Type: research

Portal venous gas as a radiological sign in a sigmoid diverticular abscess and its non-surgical management: a case report.
Abstract A 62-year old man who presented unwell with no specific symptoms or signs was found to have portal venous circulation gas complicating a small diverticular abscess. He was successfully managed with a course of antibiotics and had full resolution of symptoms, therefore avoiding the need for surgical intervention. While most commonly associated with bowel ischaemia and therefore often warranting emergency laparotomy, portal venous gas within the context of other underlying pathology often presents opportunities for delayed surgery or more conservative management options. PMID: 32374180 [PubMed - as sup...
Source: Annals of the Royal College of Surgeons of England - May 6, 2020 Category: Surgery Authors: Kong CY, Goh HL, Anderson JE Tags: Ann R Coll Surg Engl Source Type: research

Tumour-to-tumour metastasis: breast carcinoma to an olfactory neuroblastoma.
We present a case of a 66-year-old woman with known breast cancer who presented with one-sided nasal symptoms. Examination and imaging revealed a unilateral polyp arising from the skull base. She underwent endoscopic polypectomy with the histology demonstrating tumour-to-tumour metastasis from a breast carcinoma to an olfactory neuroblastoma, a rare sinonasal tumour. Clinicians should be cautious of distant metastases in any patient presenting with head and neck symptoms and a known primary tumour. This is the first documented case of this type. PMID: 32374183 [PubMed - as supplied by publisher] (Source: Annals of the...
Source: Annals of the Royal College of Surgeons of England - May 6, 2020 Category: Surgery Authors: Bashyam A, Grammatopoulou V, Crook T, Di Palma S, Sunkaraneni VS Tags: Ann R Coll Surg Engl Source Type: research

Does declared surgeon specialist interest influence the outcome of emergency laparotomy?
CONCLUSION: Surgeon-declared specialty does not impact emergency laparotomy outcomes in this cohort of undifferentiated emergency laparotomies. This may reflect the on-call structure at Birmingham Heartlands Hospital, where a colorectal and oesophagogastric consultant are paired on call and provide cross-cover when needed. PMID: 32374217 [PubMed - as supplied by publisher] (Source: Annals of the Royal College of Surgeons of England)
Source: Annals of the Royal College of Surgeons of England - May 6, 2020 Category: Surgery Authors: Hallam S, Bickley M, Phelan L, Dilworth M, Bowley DM Tags: Ann R Coll Surg Engl Source Type: research

Primary colorectal linitis plastica presenting as rapid acute deterioration: a diagnostic dilemma.
We present a rare case of primary colorectal linitis plastica presenting as an acute admission to hospital with a wide range of systemic symptoms, sudden rapid deterioration and subsequent mortality. A postmortem examination revealed a primary linitis plastica of the colon and rectum with diffuse metastatic disease. To our knowledge, this is the first report of primary colorectal linitis plastica presenting as an acute deterioration as a result of extensive metastatic disease. PMID: 32374219 [PubMed - as supplied by publisher] (Source: Annals of the Royal College of Surgeons of England)
Source: Annals of the Royal College of Surgeons of England - May 6, 2020 Category: Surgery Authors: Brosnan C, Hannan E, Duggan W, Mullen D, Buckley M, Stafford AT Tags: Ann R Coll Surg Engl Source Type: research

Radiographic examination of the chest and COVID-19.
zhan MH PMID: 32357307 [PubMed - as supplied by publisher] (Source: Annals of the Royal College of Surgeons of England)
Source: Annals of the Royal College of Surgeons of England - May 1, 2020 Category: Surgery Authors: Sayiner A, Cinkooglu A, Tasbakan MS, Basoglu ÖK, Ceylan N, Savas R, Bayraktaroglu S, Özhan MH Tags: Ann R Coll Surg Engl Source Type: research

Emergency surgery during the COVID-19 pandemic: what you need to know for practice.
CONCLUSIONS: During the COVID-19 pandemic, all efforts should be deployed in order to evaluate the feasibility of postponing surgery until the patient is no longer considered potentially infectious or at risk of perioperative complications. If surgery is deemed necessary, the emergency surgeon must minimise the risk of exposure to the virus by involving a minimal number of healthcare staff and shortening the occupation of the operating theatre. In case of a lack of security measures to enable safe laparoscopy, open surgery should be considered. PMID: 32352836 [PubMed - as supplied by publisher] (Source: Annals of the ...
Source: Annals of the Royal College of Surgeons of England - May 1, 2020 Category: Surgery Authors: De Simone B, Chouillard E, Di Saverio S, Pagani L, Sartelli M, Biffl WL, Coccolini F, Pieri A, Khan M, Borzellino G, Campanile FC, Ansaloni L, Catena F Tags: Ann R Coll Surg Engl Source Type: research

Commentary.
PMID: 32352839 [PubMed - as supplied by publisher] (Source: Annals of the Royal College of Surgeons of England)
Source: Annals of the Royal College of Surgeons of England - May 1, 2020 Category: Surgery Authors: Williams G Tags: Ann R Coll Surg Engl Source Type: research

Hydrocolloid dressing strip over bridge of nose to relieve pain and pressure from Filtered Face Piece (FFP) masks during the coronavirus (COVID-19) pandemic.
PMID: 32352852 [PubMed - as supplied by publisher] (Source: Annals of the Royal College of Surgeons of England)
Source: Annals of the Royal College of Surgeons of England - May 1, 2020 Category: Surgery Authors: Field MH, Rashbrook JP, Rodrigues JN Tags: Ann R Coll Surg Engl Source Type: research

When infection isn't infection.
Abstract Following open reduction and internal fixation for a proximal humerus fracture a 71-year-old man re-presented with wound changes consistent with infection and elevated inflammatory markers. No significant improvement was seen with concomitant intravenous antibiotics and multiple debridement procedures. This case was further complicated by soft tissue breakdown at the site of a left thigh haematoma also requiring debridement. Surgical site infections represent the most common cause of morbidity postoperatively. This case highlights the importance of considering a number of differential diagnoses. A diagnos...
Source: Annals of the Royal College of Surgeons of England - April 29, 2020 Category: Surgery Authors: Franklin S, Sabharwal S, Hettiaratchy S, Reilly P Tags: Ann R Coll Surg Engl Source Type: research

Colorectal stenting in England: a cross-sectional study of practice.
CONCLUSIONS: All responding hospitals in England consider the use of SEMS in colonic obstruction. Nevertheless, there is great variation in stenting practices, and challenges in terms of access and expertise. Centralisation and regional referral networks may help maximise availability and expertise but more work is needed to support this. PMID: 32347738 [PubMed - as supplied by publisher] (Source: Annals of the Royal College of Surgeons of England)
Source: Annals of the Royal College of Surgeons of England - April 29, 2020 Category: Surgery Authors: Lam J, Chauhan V, Lam I, Kannappa L, Salama Y Tags: Ann R Coll Surg Engl Source Type: research

Axillary lymphadenopathy in a pregnant woman: a case report.
Abstract Lymphadenopathy is a common presentation in surgical assessment units and has numerous differential diagnoses. In one-stop breast clinics, its discovery often raises concerns of malignancy. This case report focuses on the case of a 33-year-old pregnant woman presenting to the breast clinic with a right axillary lump, which was found to be the result of toxoplasmosis. PMID: 32347740 [PubMed - as supplied by publisher] (Source: Annals of the Royal College of Surgeons of England)
Source: Annals of the Royal College of Surgeons of England - April 29, 2020 Category: Surgery Authors: Jalilzadeh Afshari S, Saad Abdalla Al-Zawi A, Idaewor P, Chicken DW Tags: Ann R Coll Surg Engl Source Type: research

Rare case of venous tumour thrombus from acinic cell carcinoma of the parotid gland.
We report a case of an 81-year-old man with an acinic cell carcinoma of the left parotid and an intravenous tumour thrombus extending from the retromandibular vein into the internal jugular vein. This case also highlights the importance of radiological imaging in the management of tumour thrombus. PMID: 32347741 [PubMed - as supplied by publisher] (Source: Annals of the Royal College of Surgeons of England)
Source: Annals of the Royal College of Surgeons of England - April 29, 2020 Category: Surgery Authors: Yap D, Dragan A, Weller A, Tatla T Tags: Ann R Coll Surg Engl Source Type: research

Transoral robotic surgery for the benefit of patients with head and neck cancer of unknown primary: our experience at St George's University Hospital, London.
CONCLUSION: Transoral robotic base of tongue mucosectomy (or lingual tonsillectomy) is a promising technique that offers a high yield of positive identification for the primary tumour. It is well tolerated with minimal associated morbidity. Our findings are comparable with those in the current literature. PMID: 32347742 [PubMed - as supplied by publisher] (Source: Annals of the Royal College of Surgeons of England)
Source: Annals of the Royal College of Surgeons of England - April 29, 2020 Category: Surgery Authors: Mistry R, Walker A, Kim D, Ofo E Tags: Ann R Coll Surg Engl Source Type: research

Necrotising enterocolitis in an adult with anorexia nervosa.
Abstract Necrotising enterocolitis (NEC) is a rare cause of the acute abdomen in adults and carries one of the highest mortality rates in gastroenterology. However, its rarity confines research to small case reports. Both its pathogenesis and aetiology remain enigmatic in adult patients, proving timely diagnosis and management a challenge. This paper reports on one case of NEC in an adult patient with underlying anorexia nervosa, following a seven-day period of starvation. She underwent emergency laparotomy for resection of necrotic bowel and subsequently made a good recovery. To date, there have only been eight r...
Source: Annals of the Royal College of Surgeons of England - April 24, 2020 Category: Surgery Authors: Schapira B, Nazarian S, Thanapal M, Parmar C, Mukhtar H Tags: Ann R Coll Surg Engl Source Type: research

An alternative source of cancellous bone graft in the volar approach to the scaphoid.
PMID: 32326721 [PubMed - as supplied by publisher] (Source: Annals of the Royal College of Surgeons of England)
Source: Annals of the Royal College of Surgeons of England - April 24, 2020 Category: Surgery Authors: Bolt AM, McNab I Tags: Ann R Coll Surg Engl Source Type: research

Long-term survival after endoscopic vein harvest for coronary artery bypass grafting.
CONCLUSION: Endoscopic vein harvest does not affect long-term survival in an unselected population. The contraindications for minimally invasive vein harvest in coronary artery bypass grafting are increasingly diminishing. PMID: 32326723 [PubMed - as supplied by publisher] (Source: Annals of the Royal College of Surgeons of England)
Source: Annals of the Royal College of Surgeons of England - April 24, 2020 Category: Surgery Authors: Kirmani BH, Power S, Zacharias J Tags: Ann R Coll Surg Engl Source Type: research

Small bowel obstruction caused by pericaecal hernia resolved with a laparoscopic approach.
We report a case of an 84-year-old woman with no previous history of abdominal surgery who came to our hospital having endured 6 hours of abdominal pain and vomiting. Following physical examination and computed tomography, a diagnosis of small bowel obstruction caused by pericaecal hernia was made and emergency surgery was performed. The hernia was successfully reduced with a laparoscopic approach. Although pericaecal hernia is a rare disease, surgeons should bear it in mind as a differential diagnosis in small bowel obstruction. PMID: 32326724 [PubMed - as supplied by publisher] (Source: Annals of the Royal College o...
Source: Annals of the Royal College of Surgeons of England - April 24, 2020 Category: Surgery Authors: Plua-Muñiz K, Sanchez-Gonzalez J, Bailon-Cuadrado M, Pacheco-Sanchez D Tags: Ann R Coll Surg Engl Source Type: research

Dulce et decorum est.
PMID: 32326725 [PubMed - as supplied by publisher] (Source: Annals of the Royal College of Surgeons of England)
Source: Annals of the Royal College of Surgeons of England - April 24, 2020 Category: Surgery Authors: Lane T Tags: Ann R Coll Surg Engl Source Type: research

Significance of a positive sentinel lymph node biopsy in staging for distant metastasis in breast cancer: are current guidelines relevant?
This study investigates whether current guidelines adequately identify distant metastasis in a positive sentinel lymph node biopsy population that had radiological staging. MATERIALS AND METHODS: Patients diagnosed with primary breast cancer between 1 January 2013 and 1 October 2017 with a positive sentinel lymph node biopsy and subsequent radiological staging from a single unit were included. A systematic search identified relevant guideline criteria, against which patients were audited. RESULTS: A total of 330 patients with positive sentinel lymph node biopsy were identified; 227 (69%) had radiological staging ...
Source: Annals of the Royal College of Surgeons of England - April 24, 2020 Category: Surgery Authors: Hubbard T, Ives C Tags: Ann R Coll Surg Engl Source Type: research

A novel, inexpensive and reliable K-wire management technique in minimally invasive spine surgery.
PMID: 32326729 [PubMed - as supplied by publisher] (Source: Annals of the Royal College of Surgeons of England)
Source: Annals of the Royal College of Surgeons of England - April 24, 2020 Category: Surgery Authors: Lim YG, Ouyang Y, Soh R Tags: Ann R Coll Surg Engl Source Type: research

Deep venous thrombosis manifestation of common femoral vein leiomyoma.
Abstract Deep vein thrombosis is a common clinical condition, with well-known risk factors. An unusual case of venous leiomyoma manifesting as a deep vein thrombosis in the left femoral vein of a 55-year-old man was managed successfully at our institution with anticoagulation, en-bloc excision and reconstruction of the femoral vein with spiral vein graft. PMID: 32326731 [PubMed - as supplied by publisher] (Source: Annals of the Royal College of Surgeons of England)
Source: Annals of the Royal College of Surgeons of England - April 24, 2020 Category: Surgery Authors: Reddy A, Savlania A, Naik A, Rastogi P, Gorsi U Tags: Ann R Coll Surg Engl Source Type: research

Recurrent acromioclavicular joint dislocation with an associated coracoid fracture following acromioclavicular joint reconstruction.
We report the case of a patient with an iatrogenic coracoid fracture following two failed acromioclavicular joint resuspensory reconstructions using a synthetic ligament. This injury was successfully treated with an autologous hamstring graft reconstruction, initially protected with a hook plate. PMID: 32326733 [PubMed - as supplied by publisher] (Source: Annals of the Royal College of Surgeons of England)
Source: Annals of the Royal College of Surgeons of England - April 24, 2020 Category: Surgery Authors: Karia M, Al-Hadithy N, Tytherleigh-Strong G Tags: Ann R Coll Surg Engl Source Type: research

Factors associated with burnout syndrome in surgeons: a systematic review.
CONCLUSIONS: Workload and work environment are areas that could be looked at to reduce job demands that lead to burnout. Intervening in certain psychological factors such as emotional intelligence, resilience and mindfulness may help to reduce burnout. Promoting physical and mental health is important in alleviating burnout, and these factors likely have a complex interplay. PMID: 32326734 [PubMed - as supplied by publisher] (Source: Annals of the Royal College of Surgeons of England)
Source: Annals of the Royal College of Surgeons of England - April 24, 2020 Category: Surgery Authors: Galaiya R, Kinross J, Arulampalam T Tags: Ann R Coll Surg Engl Source Type: research

Analysis of risk factors of stage IV gastric cancer from the SEER database.
CONCLUSIONS: In patients with stage IV gastric cancer, gastrectomy (partial, subtotal or hemi) should be selected when surgery is necessary. The number of regional lymph node metastasis could be considered as a prognostic factor for patients with stage IV gastric cancer and lymph node dissection could reduce the risk of patients undergoing surgery. PMID: 32326735 [PubMed - as supplied by publisher] (Source: Annals of the Royal College of Surgeons of England)
Source: Annals of the Royal College of Surgeons of England - April 24, 2020 Category: Surgery Authors: Ge XY, Ge F, Wang Z, Wang YL, Lei LW, Liu QR, Sun XY, Jiang X Tags: Ann R Coll Surg Engl Source Type: research

Variations in the management of adolescents with blunt splenic trauma in England and Wales: are we preserving enough?
This study assessed management of splenic injuries in UK adolescents. MATERIALS AND METHODS: Data were acquired from the Trauma Audit and Research Network on isolated blunt splenic injuries reported 2006-2015. Adolescents were divided into age groups of 11-15 years and 16-20 years, and injuries classified as minor (grades 1/2) or major (3+). Primary outcomes were needed for splenectomy and blood transfusion. RESULTS: A total of 445 adolescents suffered isolated blunt splenic injuries. Road traffic collisions were the most common mechanism. There were no deaths as a result of isolated blunt splenic injuries, but 4...
Source: Annals of the Royal College of Surgeons of England - April 24, 2020 Category: Surgery Authors: Green PA, Wilkinson DJ, Bouamra O, Fragoso M, Farrelly PJ Tags: Ann R Coll Surg Engl Source Type: research

Laparoscopic repair of a giant hiatal hernia after minimally invasive oesophagectomy.
Abstract Minimally invasive oesophagectomy has become popular, but studies showed a higher rate of postoperative hiatus hernia compared with open oesophagectomy. Our video presents the laparoscopic biosynthetic mesh repair of a symptomatic giant hiatus hernia in a 71-year-old man who had undergone minimally invasive oesophagectomy one year earlier for distal adenocarcinoma of the oesophagus. The operative time was 120 minutes. The patient started oral intake on postoperative day one and was discharged on postoperative day three. Postoperative computed tomography at six months showed no signs of recurrence. In the ...
Source: Annals of the Royal College of Surgeons of England - April 24, 2020 Category: Surgery Authors: Marchesi F, Dalmonte G, Morini A, Annicchiarico A Tags: Ann R Coll Surg Engl Source Type: research

Immediate unilateral breast reconstruction and contralateral breast augmentation with bilateral free deep inferior epigastric perforator flaps.
Abstract A 42-year-old woman was referred for consideration of left-sided mastectomy and immediate reconstruction. She previously had a bilateral breast augmentation using silicone implants. She desired to maintain her breast size and natural appearance. Owing to the availability of sufficient abdominal tissue, the option of an immediate unilateral breast reconstruction and contralateral augmentation with a differentially split deep inferior epigastric perforator flaps was offered to the patient. The patient had a successful reconstructive and contralateral symmetrising procedure with an uneventful postoperative r...
Source: Annals of the Royal College of Surgeons of England - April 24, 2020 Category: Surgery Authors: Khatib M, Wong KY, Elfaki A, Haywood RM, Masud D Tags: Ann R Coll Surg Engl Source Type: research

Nasal fractures: a dedicated clinic providing reduction under local anaesthesia improves time to manipulation.
DISCUSSION: Implementation of a nasal fracture clinic providing reduction under local anaesthesia reduced the time to assessment and manipulation. The incidence of septorhinoplasty is low following reduction under general or local anaesthesia. Assessment earlier than seven days is feasible and advice for referral can be changed accordingly. PMID: 32326744 [PubMed - as supplied by publisher] (Source: Annals of the Royal College of Surgeons of England)
Source: Annals of the Royal College of Surgeons of England - April 24, 2020 Category: Surgery Authors: Pinto R, Wright R, Ghosh S Tags: Ann R Coll Surg Engl Source Type: research

THE LAST GENERAL SURGEON?: Everything you wanted to know about surgical life but were afraid to ask.
PMID: 32324043 [PubMed - as supplied by publisher] (Source: Annals of the Royal College of Surgeons of England)
Source: Annals of the Royal College of Surgeons of England - April 23, 2020 Category: Surgery Authors: Loony AS Tags: Ann R Coll Surg Engl Source Type: research

Scottsdale Wound Management Guide: A Comprehensive Guide for the Wound Care Clinician, 3rd edn.
PMID: 32324051 [PubMed - as supplied by publisher] (Source: Annals of the Royal College of Surgeons of England)
Source: Annals of the Royal College of Surgeons of England - April 23, 2020 Category: Surgery Authors: Livingstone M, Wolvos T Tags: Ann R Coll Surg Engl Source Type: research

Mechanical dilatation of vein graft in vascular anastomosis: how to 'Jimmy' the vessel.
PMID: 32324053 [PubMed - as supplied by publisher] (Source: Annals of the Royal College of Surgeons of England)
Source: Annals of the Royal College of Surgeons of England - April 23, 2020 Category: Surgery Authors: Ramdas M Tags: Ann R Coll Surg Engl Source Type: research

Mitigating the risk of aerosol generation from power tools during the COVID-19 pandemic.
PMID: 32324054 [PubMed - as supplied by publisher] (Source: Annals of the Royal College of Surgeons of England)
Source: Annals of the Royal College of Surgeons of England - April 23, 2020 Category: Surgery Authors: Williams M, Blake S, Matthews H Tags: Ann R Coll Surg Engl Source Type: research

A safe method to evacuate pneumoperitoneum during laparoscopic surgery in suspected COVID-19 patients.
PMID: 32324055 [PubMed - as supplied by publisher] (Source: Annals of the Royal College of Surgeons of England)
Source: Annals of the Royal College of Surgeons of England - April 23, 2020 Category: Surgery Authors: Hanbali N, Herrod P, Patterson J Tags: Ann R Coll Surg Engl Source Type: research

Giant solitary fibrous tumour: an uncommon approach for an uncommon tumour.
We describe our technique for dealing with one such tumour. A clamshell incision proved inadequate for visualising the extent of the tumour. An additional lower sternotomy incision was then made, which significantly improved exposure. With the aid of cardiopulmonary bypass, it was then possible to mobilise and completely excise the tumour. Complete resection remains the mainstay of treatment for such pleural-based tumours. Every attempt must be made to achieve this, including any modification of the traditional approach if required. PMID: 32324056 [PubMed - as supplied by publisher] (Source: Annals of the Royal Colleg...
Source: Annals of the Royal College of Surgeons of England - April 23, 2020 Category: Surgery Authors: Birla R, Clark S, Beattie A, Agarwal D Tags: Ann R Coll Surg Engl Source Type: research

A seven-month-old with chronic intermittent biphasic stridor.
We report on a chronic presentation of paediatric stridor, discuss the workup, management and lessons learned. A seven-month-old boy presented with chronic intermittent biphasic stridor for the previous five months. Diagnostic microlaryngoscopy and bronchoscopy revealed significant localised tracheomalacia. Urgent chest computed tomography was performed to investigate further. Radiological findings revealed an oesophageal foreign body prompting immediate rigid oesophagoscopy and removal of an embedded pistachio shell. The patient had an uneventful recovery. Foreign bodies in the airway and oesophagus are quite common in ch...
Source: Annals of the Royal College of Surgeons of England - April 22, 2020 Category: Surgery Authors: Tsagkovits A, Hariri A, Bhalla S, Taghi A Tags: Ann R Coll Surg Engl Source Type: research

Adult cavernous haemangioma of the vocal cords with a unique presentation of acute respiratory distress: a case report.
In this study, we explore the unusual case of a previously well 71-year-old gentleman presenting to the Emergency Department, with worsening shortness of breath as his primary complaint. Uniquely, in this case, an awake fibre-optic intubation was undertaken to manage the difficult airway and a microlaryngoscopy was performed. A 20x10x15mm lesion was excised, which had characteristics in keeping with a cavernous haemangioma on microscopic examination. PMID: 32306741 [PubMed - as supplied by publisher] (Source: Annals of the Royal College of Surgeons of England)
Source: Annals of the Royal College of Surgeons of England - April 20, 2020 Category: Surgery Authors: Rafie A, Jolly K, Darr A, Thompson S Tags: Ann R Coll Surg Engl Source Type: research

A 'hot clinic' for cold limbs: the benefit of urgent clinics for patients with critical limb ischaemia.
Abstract INTRODUCTION: The national reconfiguration of vascular surgery means that arterial centres serve larger populations with increased demand on resources. Emergency general surgery ambulatory clinics facilitate timely review and intervention, avoiding admission; a critical limb ischaemia (CLI) 'hot clinic' (HC) was implemented to achieve similar for vascular patients. The aim of the study was to determine HC efficacy. METHODS: This was a prospective cohort study comparing HC patients with emergency admission (EA) patients between 1 May and 1 December 2017. Age, sex, comorbidities, CLI severity and smoki...
Source: Annals of the Royal College of Surgeons of England - April 20, 2020 Category: Surgery Authors: Khan A, Hughes M, Ting M, Riding G, Simpson J, Egun A, Banihani M Tags: Ann R Coll Surg Engl Source Type: research

Laser depilation as adjuvant therapy in prevention of recurrence of pilonidal sinus disease: initial experience of a district general hospital in the UK.
CONCLUSION: Laser depilation is a safe and effective adjunct to surgery in minimising the recurrence of pilonidal disease. Patients with primary pilonidal disease and those who are undergoing minimally invasive surgery may also benefit from adjuvant laser depilation. Further high-quality control trials are required to assess its efficacy and safety. PMID: 32302208 [PubMed - as supplied by publisher] (Source: Annals of the Royal College of Surgeons of England)
Source: Annals of the Royal College of Surgeons of England - April 17, 2020 Category: Surgery Authors: Liyanage A, Woods Y, Javed MA, Deftly C, Shaban H, Kalaiselvan R, Rajaganeshan R Tags: Ann R Coll Surg Engl Source Type: research

Self-retaining retractor and bone reduction forceps to manage a mandibular fracture.
PMID: 32302211 [PubMed - as supplied by publisher] (Source: Annals of the Royal College of Surgeons of England)
Source: Annals of the Royal College of Surgeons of England - April 17, 2020 Category: Surgery Authors: Tebbutt JE, Markose G, Graham RM Tags: Ann R Coll Surg Engl Source Type: research

Use of diathermy needle tips in orthognathic surgical bone marking.
PMID: 32302214 [PubMed - as supplied by publisher] (Source: Annals of the Royal College of Surgeons of England)
Source: Annals of the Royal College of Surgeons of England - April 17, 2020 Category: Surgery Authors: Tebbutt JE, Markose G, Graham RM Tags: Ann R Coll Surg Engl Source Type: research

Predictors of length of stay following shoulder arthroplasty in a high-volume UK centre.
This study analyses the length of inpatient stay following shoulder arthroplasty in a high-volume UK centre and identifies predictors of prolonged inpatient stay. MATERIALS AND METHODS: All shoulder arthroplasty cases performed between 2012 and 2018 were identified. A review of case notes and electronic patient records was completed to identify demographic data, Charlson comorbidity score, length of inpatient stay and factors associated with length of stay. Multiple linear regression analysis was conducted to determine which factors were independently associated with length of inpatient stay. RESULTS: A total of ...
Source: Annals of the Royal College of Surgeons of England - April 17, 2020 Category: Surgery Authors: Dacombe P, Harries L, McCann P, Crowther M, Packham I, Sarangi P, Whitehouse MR Tags: Ann R Coll Surg Engl Source Type: research

Symptomatic malunion after midshaft clavicle fracture in an adolescent patient: a case report of surgical deformity correction using a 3D printed model.
Abstract A 14-year-old boy underwent surgery for symptomatic malunion of the clavicle. This complication, which is uncommon in adults and adolescents, occurred after a displaced midshaft clavicle fracture that had been treated conservatively. Surgery may be considered if functional impairment, pain, weakness, fatigability and neurological symptoms persist in the presence of significant clavicular deformity. Our case was unusual because the patient had a symptomatic malunion and lost range of movement of his shoulder despite a minor degree of clavicular shortening. We adopted an approach used in lower limb deformit...
Source: Annals of the Royal College of Surgeons of England - April 1, 2020 Category: Surgery Authors: Consigliere P, Tyler J, Tennent D, Pearse E Tags: Ann R Coll Surg Engl Source Type: research