A technique for retrieving misplaced intramedullary metalwork during total knee replacement.
PMID: 31232605 [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 - June 24, 2019 Category: Surgery Authors: Holmes B, Wheelton A Tags: Ann R Coll Surg Engl Source Type: research

Abscess of the anterior belly of the digastric muscle: a case report.
Abstract Abscess of the anterior belly of the digastric muscle has not been previously described and could pose a diagnostic and interventional dilemma. This case summarises the clinical, microbiological, radiological and surgical issues encountered and suggests learning points for clinicians posed with similar presentations. We recommend timely assessment by an appropriately trained clinician in either ear, nose and throat or oral and maxillofacial surgery, admission to a closely observable environment with airway-trained nursing staff and with potential for escalation to high dependency or intensive care in the ...
Source: Annals of the Royal College of Surgeons of England - June 24, 2019 Category: Surgery Authors: Thompson A, Pankhania M Tags: Ann R Coll Surg Engl Source Type: research

A multicentre, prospective, observational cohort study of variation in practice in perioperative analgesia strategies in elective laparoscopic colorectal surgery (the LapCoGesic study).
Abstract INTRODUCTION: Enhanced recovery programmes are established as an essential part of laparoscopic colorectal surgery. Optimal pain management is central to the success of an enhanced recovery programme and is acknowledged to be an important patient reported outcome measure. A variety of analgesia strategies are employed in elective laparoscopic colorectal surgery ranging from patient-controlled analgesia to local anaesthetic wound infiltration catheters. However, there is little evidence regarding the optimal analgesia strategy in this cohort of patients. The LapCoGesic study aimed to explore differences in...
Source: Annals of the Royal College of Surgeons of England - June 24, 2019 Category: Surgery Authors: Brown L, Gray M, Griffiths B, Jones M, Madhavan A, Naru K, Shaban F, Somnath S, Harji D, NoSTRA (Northern Surgical Trainees Reseach Association) Tags: Ann R Coll Surg Engl Source Type: research

Tape to view: novel technique to improve axillary access.
PMID: 31232621 [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 - June 24, 2019 Category: Surgery Authors: Dalal A, Ives C Tags: Ann R Coll Surg Engl Source Type: research

Validation of the size morphology site access score in endoscopic mucosal resection of large polyps in a district general hospital.
CONCLUSIONS: Many patients with large polyps can be managed outside of specialist units. This study has validated that the SMSA score was associated with incomplete endoscopic mucosal resection for large polyps in a district general hospital setting. PMID: 31233327 [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 - June 24, 2019 Category: Surgery Authors: Currie AC, Merriman H, Nadia Shah Gilani S, Mackenzie P, McFall MR, Baig MK Tags: Ann R Coll Surg Engl Source Type: research

Retrospective analysis of 73 cases of elastofibroma.
CONCLUSIONS: A correct diagnosis of elastofibroma can be made prior to surgical resection by examining typical clinical features and characteristic imaging findings. Short- and long-term outcomes of local excision are good, with no further recurrence. PMID: 31233334 [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 - June 24, 2019 Category: Surgery Authors: Haihua R, Xiaobing W, Jie P, Xinxin H Tags: Ann R Coll Surg Engl Source Type: research

Factors affecting patient flow in a neurosurgery department.
The objectives of this study were to implement and evaluate the NHS Improvement SAFER patient flow bundle, evaluate the impact of the Red2Green initiative, and assess the impact of frailty on patient flow. MATERIALS AND METHODS: All patients admitted to a neurosurgery unit from 1 September to 30 November 2017 were included. Using guidance set out by NHS, data were prospectively collected from daily ward lists and patient notes, including demographics, admission and discharge details, length of stay, anticipated discharge date, red days with reasons and frailty (Rockwood Clinical Frailty Scale). NHS reference costs wer...
Source: Annals of the Royal College of Surgeons of England - June 24, 2019 Category: Surgery Authors: Irvine S, Awan M, Chharawala F, Bhagawati D, Lawrance N, Peck G, Peterson D, Banerjee S, Camp S Tags: Ann R Coll Surg Engl Source Type: research

Laparoscopic mesh repair of obturator hernia causing small bowel obstruction.
PMID: 31219305 [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 - June 20, 2019 Category: Surgery Authors: Loizides S, Read J Tags: Ann R Coll Surg Engl Source Type: research

Angioleiomyoma of the inferior turbinate: a rare cause of isolated facial pain.
We describe the first documented presentation of angioleiomyoma as a cause of isolated, unilateral facial pain; a very common presentation to the otorhinolaryngology clinic. We promote consideration of angioleiomyoma as a different diagnosis in the presence of facial pain and a unilateral sinonasal lesion. Endoscopic resection provides complete symptomatic resolution. PMID: 31219307 [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 - June 20, 2019 Category: Surgery Authors: Heyman J, Jones LM, Hilton JM, Cooke JS, Viswanathan H, Hayes SM Tags: Ann R Coll Surg Engl Source Type: research

Novel technique using tensor fascia lata graft to reconstruct a floor of mouth postablative defect from invasive ectopic papillary carcinoma of the thyroglossal duct tract.
We describe a rare case of ectopic papillary thyroid cancer in the thyroglossal duct tract invading the floor-of-mouth musculature. The postablative defect was reconstructed with a bone-anchored tensor fascia lata graft to resuspend the floor of mouth to the mandible as a neogeniohyoid sling, enabling maintenance of a functional tongue position for normal speech and swallowing. This reconstruction should be considered when suprahyoid musculature is resected without breaching the oral lining. PMID: 31219312 [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 - June 20, 2019 Category: Surgery Authors: Izadi D, Al-Zahid S, Smith J, Wallace CG Tags: Ann R Coll Surg Engl Source Type: research

A feasibility randomised controlled trial to evaluate the role of computed tomography in adults with atypical right iliac fossa pain.
CONCLUSION: A large randomised trial to evaluate the use of unenhanced computed tomography in atypical right iliac fossa pain appears feasible and justified. PMID: 31219315 [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 - June 20, 2019 Category: Surgery Authors: Jones R, Olatunbode D, Dean J, Hall B, Harji D, Davis P Tags: Ann R Coll Surg Engl Source Type: research

The effect of Oncotype DX ® on adjuvant chemotherapy treatment decisions in early breast cancer.
CONCLUSIONS: In intermediate risk patients with breast cancer, the results of the ODX gene assay may change the decision for adjuvant treatment. It represents a valuable tool to assist patients' and clinicians' decision making regarding adjuvant chemotherapy. PMID: 31219316 [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 - June 20, 2019 Category: Surgery Authors: Rabie MA, Rankin A, Burger A, Youssef M Tags: Ann R Coll Surg Engl Source Type: research

Enhanced recovery after anterior resection: earlier leak diagnosis and low mortality in a case series.
This study aimed to determine when leaks are diagnosed in enhanced recovery, and whether the choice of intervention affects outcomes. MATERIALS AND METHODS: We conducted a retrospective study of a prospectively maintained database of complications of anterior resections for rectal cancer in a district general hospital in the UK. Data were extracted on day of leak diagnosis, length of stay, intensive care admission, mortality and ileostomy reversal rate. Statistical analysis was performed using Student's t, Mann-Whitney U and chi square tests. RESULTS: A total of 323 patients underwent anterior resection for color...
Source: Annals of the Royal College of Surgeons of England - June 20, 2019 Category: Surgery Authors: D'Souza N, Robinson PD, Branagan G, Chave H Tags: Ann R Coll Surg Engl Source Type: research

Ergonomic handling of electric pen drill for passing K-wires.
PMID: 31219320 [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 - June 20, 2019 Category: Surgery Authors: Rodrigues JN, Halsey T Tags: Ann R Coll Surg Engl Source Type: research

Isolated free fluid on computed tomography for blunt abdominal trauma.
DISCUSSION: In patients with blunt abdominal trauma, the finding of isolated free fluid on abdominal CT alone is no longer an indication for laparotomy. Other clinical factors must be taken into account when deciding on the need for laparotomy, such as haemodynamic status, clinical abdominal findings and the ability to reliably assess the abdomen. In the absence of a clinical indication for urgent laparotomy, patients with isolated free fluid may be observed. PMID: 31219321 [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 - June 20, 2019 Category: Surgery Authors: Bekker W, Kong VY, Bruce JL, Laing G, Manchev V, Clarke DL Tags: Ann R Coll Surg Engl Source Type: research

Intraoperative nerve monitoring during thyroidectomy: evaluation of signal loss, prognostic value and surgical strategy.
CONCLUSIONS: Intraoperative neural monitoring can be used safely in thyroid surgery to avoid recurrent laryngeal nerve injury. It enables the surgeon to diagnose recurrent laryngeal nerve injury intraoperatively to estimate the postoperative nerve function and to modify the surgical strategy to avoid bilateral vocal cord paralysis. PMID: 31219340 [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 - June 20, 2019 Category: Surgery Authors: Gür EO, Haciyanli M, Karaisli S, Haciyanli S, Kamer E, Acar T, Kumkumoglu Y Tags: Ann R Coll Surg Engl Source Type: research

The helicopter technique: a technique for removing cold-welded titanium plates.
PMID: 31155883 [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 - June 3, 2019 Category: Surgery Authors: Dimock R, Newman K, Elliott D Tags: Ann R Coll Surg Engl Source Type: research

Appendicovesical fistula presenting as hypokalaemic hyperchloraemic metabolic acidosis: a case report.
Abstract A 52-year-old man was admitted with diarrhoea and faecaluria and referred recurrent urinary tract infections for over 20 years. He also reported a two-week hospital admission more than 20 years ago for right iliac fossa pain, which was managed conservatively. Computed tomography showed a fistulous tract extending from the bladder with an unclear connection to the bowel. Cystoscopy confirmed the presence of a vesical fistula and biopsy of the tract confirmed colonic mucosa. Flexible sigmoidoscopy was negative. A cystogram was requested as an outpatient procedure and the patient was discharged after antibio...
Source: Annals of the Royal College of Surgeons of England - June 3, 2019 Category: Surgery Authors: Keane S, Tebala GD Tags: Ann R Coll Surg Engl Source Type: research

Patient-reported functional outcomes and health-related quality of life following fractures of the talus.
Abstract INTRODUCTION: The primary aim of this study was to investigate patient-reported outcomes following talar fractures. Secondary aims were to investigate health-related quality of life and to determine whether it is influenced by functional outcome. MATERIALS AND METHODS: This retrospective study identified 56 talar fractures over eight years. Patients were contacted by post and the Olerud and Molander score (OMS), Manchester-Oxford Foot and Ankle scores (MOXFQ) and Euroqol-5D-3L collected. RESULTS: The mean age was 35.2 years (range 13-78 years). There were four cases (7.1%) of avascular necrosis ...
Source: Annals of the Royal College of Surgeons of England - June 3, 2019 Category: Surgery Authors: Stirling P, MacKenzie SP, Maempel JF, McCann C, Ray R, Clement ND, White TO, Keating JF Tags: Ann R Coll Surg Engl Source Type: research

Does the source of referral affect outcomes for paediatric testicular torsion?
CONCLUSIONS: Boys undergoing emergency scrotal exploration had a higher orchidectomy rate when transferred from other hospitals to our unit. This difference was statistically significant when compared with boys presenting directly to our ED. This supports advice from The Royal College of Surgeons of England for undertaking paediatric scrotal explorations in the presenting hospital when safe to do so rather than delaying the care of these patients by transferring them to a tertiary paediatric surgical unit. PMID: 31155886 [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 - June 3, 2019 Category: Surgery Authors: Peeraully R, Jancauskaite M, Dawes S, Green S, Fraser N Tags: Ann R Coll Surg Engl Source Type: research

Surgical treatment of type III temporomandibular joint ankylosis with a lateral arthroplasty while retaining the medially displaced condyle.
CONCLUSIONS: The released medially residual condyle can still function normally in temporomandibular joint movement and without reankylosis after a bone fusion resection. The displaced condyle should thus be preserved instead of being removed during the treatment of type III temporomandibular joint ankylosis. PMID: 31155887 [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 - June 3, 2019 Category: Surgery Authors: Lin X, Li HY, Xie QT, Zhang T, Huang XP, Zhou N Tags: Ann R Coll Surg Engl Source Type: research

Comparison of gait kinematics in total and unicondylar knee replacement surgery.
CONCLUSIONS: The UKA knees moved more physiologically in the sagittal plane with a greater range of motion during gait. Despite having a stiff gait pattern, the patients undergoing TKA demonstrated a more neutral alignment in the coronal plane. Neither type of knee arthroplasty restored knee kinematics to those of the non-operated side. PMID: 31155888 [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 - June 3, 2019 Category: Surgery Authors: Agarwal A, Miller S, Hadden W, Johnston L, Wang W, Arnold G, Abboud RJ Tags: Ann R Coll Surg Engl Source Type: research

Distinguishing bone and soft tissue infections mimicking sarcomas requires multimodal multidisciplinary team assessment.
CONCLUSIONS: This study has highlighted that infection is frequently clinically indistinguishable from sarcoma and remains a principle non-neoplastic differential diagnosis. When patients are investigated for suspected sarcoma, infections can be missed due to falsely negative radiological investigations and percutaneous biopsy. As no single clinical, biochemical or radiological feature or investigation can be relied upon for diagnosis, clinicians should have a low threshold for tissue biopsy and discussion in a sarcoma multidisciplinary team meeting. PMID: 31155889 [PubMed - as supplied by publisher] (Source: Annals o...
Source: Annals of the Royal College of Surgeons of England - June 3, 2019 Category: Surgery Authors: Lex JR, Gregory J, Allen C, Reid JP, Stevenson JD Tags: Ann R Coll Surg Engl Source Type: research

Validation of the acute cholecystectomy rate as a quality indicator for emergency general surgery using the SWORD database.
CONCLUSIONS: The acute cholecystectomy rate is easily measurable using routine administrative datasets, modifiable by local services and has a strong evidence base linking it to patient outcomes. We therefore advocate that it is an ideal process indicator that should be used in quality monitoring and improvement. Using it, we identified significant variation in the quality of care for acute biliary disease in England. PMID: 31155890 [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 - June 3, 2019 Category: Surgery Authors: Palser TR, Navarro AP, Swift S, Beckingham IJ Tags: Ann R Coll Surg Engl Source Type: research

Technique for contouring the cut end of infix bars and external fixator pins.
PMID: 31155891 [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 - June 3, 2019 Category: Surgery Authors: Stevens JM, Shiels S, Chesser T Tags: Ann R Coll Surg Engl Source Type: research

Improvised 'suture passer': an easy and cost-effective tool for transcorporeal suturing.
PMID: 31155892 [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 - June 3, 2019 Category: Surgery Authors: Ray K Tags: Ann R Coll Surg Engl Source Type: research

Continuous intraoperative nerve monitoring in thyroidectomy using automatic periodic stimulation in 256 at-risk nerves.
Abstract INTRODUCTION: Automatic periodic stimulation of the vagal nerve during thyroidectomy provides real-time feedback of recurrent laryngeal nerve function intraoperatively. To assess the validity of this device, the ability of monitoring to predict recurrent laryngeal nerve palsy was determined and the incidence of recurrent laryngeal nerve palsy recorded. MATERIALS AND METHODS: All thyroidectomies using APS® (Automatic Periodic Stimulation, Medtronic) nerve monitoring were reviewed over a 27-month period. Changes in signal amplitude and latency during thyroidectomy were recorded from saved data. Pos...
Source: Annals of the Royal College of Surgeons of England - June 3, 2019 Category: Surgery Authors: Hamilton N, Morley H, Haywood M, Arman S, Mochloulis G Tags: Ann R Coll Surg Engl Source Type: research

Fixation of ankle fractures - a major trauma centre's experience in improving quality.
CONCLUSIONS: By recognising and addressing the need to improve the quality of ankle fracture fixation, we have made significant improvements in radiological outcomes. Education alone, without system change, was not successful in our department in achieving improved outcomes. PMID: 31155894 [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 - June 3, 2019 Category: Surgery Authors: Whitehouse S, Mason LW, Jayatilaka L, Molloy AP Tags: Ann R Coll Surg Engl Source Type: research

Percutaneous hook wire assistance during laparoscopic excision of an intrarenal mass.
Abstract Completely endophytic renal tumours pose challenges in laparoscopic nephron-sparing tumour excisions, with the use of intraoperative imaging techniques (e.g. ultrasound) being crucial when managing such tumours. The use of a percutaneous hookwire for tumour localisations are in use in several other surgical fields, such as breast surgery. An asymptomatic 52-year-old man presented with an incidental small right sided solid 33-mm interpolar renal mass identified on computed tomography. A guided insertion of a percutaneous localisation wire was carried out prior to a laparoscopic partial nephrectomy to assis...
Source: Annals of the Royal College of Surgeons of England - June 3, 2019 Category: Surgery Authors: Kouriefs C, Georgiades F, Michaelides M, Ioannides K, Kouriefs A, Grange P Tags: Ann R Coll Surg Engl Source Type: research

Fistulotomy with or without marsupialisation of wound edges in treatment of simple anal fistula: a randomised controlled trial.
Abstract BACKGROUND: Promotion of healing of the anal wound after fistulotomy may help accelerate recovery and return to work. The present study aimed to assess the effect of marsupialisation of the edges of the laid open fistula track on wound healing after anal fistulotomy for simple anal fistula. METHODS: This was a prospective randomised trial on patients with simple anal fistula. Patients were randomly assigned to one of two groups; group I underwent anal fistulotomy and group II underwent anal fistulotomy and marsupialisation of the edges of the laid open track. Outcomes of the study were time to achiev...
Source: Annals of the Royal College of Surgeons of England - June 3, 2019 Category: Surgery Authors: Anan M, Emile SH, Elgendy H, Shalaby M, Elshobaky A, Abdel-Razik MA, Elbaz SA, Farid M Tags: Ann R Coll Surg Engl Source Type: research

The role of intraoperative cholangiography in patients undergoing laparoscopic cholecystectomy for acute gallstone pancreatitis: is magnetic resonance cholangiopancreatography needed?
CONCLUSIONS: In patients diagnosed with acute gallstone pancreatitis, it is reasonable to proceed directly to surgery using intraoperative cholangiography on the same admission as the definitive assessment of the common bile duct. This negates the need for magnetic resonance cholangiopancreatography and can translate into cost savings and reduced length of stay. PMID: 31155897 [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 - June 3, 2019 Category: Surgery Authors: Thacoor A, Pike TW, Pathak S, Dixon J, Macutkiewicz C, Smith AM Tags: Ann R Coll Surg Engl Source Type: research

Daycase trauma list: a safe and cost-effective service delivery.
CONCLUSION: We conclude that a daycase trauma service is safe, cost effective, and yields high patient satisfaction. It reduces the burden on hospital beds and a wide range of upper- and lower-limb cases can be performed as daycase trauma surgery with adequate planning and teamwork. PMID: 31155898 [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 - June 3, 2019 Category: Surgery Authors: Athar MS, Fazal MA, Ashwood N, Arealis G, Buchanan D, Okoth FH Tags: Ann R Coll Surg Engl Source Type: research

Arthroplasty infection rates in fractured neck of femur: single vs dual antibiotic cement.
CONCLUSION: Dual antibiotic cement reduced the rate of deep surgical site infection compared with conventional single antibiotic cement in arthroplasty for fractured neck of femur. Only a marginal difference in superficial surgical site infection was observed. PMID: 31155899 [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 - June 3, 2019 Category: Surgery Authors: Savage P, McCormick M, Al-Dadah O Tags: Ann R Coll Surg Engl Source Type: research

Symptomatic trochanteric non-union following total hip replacement treated with reattachment combined with two-stage revision surgery of the femoral stem.
We present a case of symptomatic trochanteric non-union following total hip replacement treated initially with a Dall-Miles grip plate. After failure of this treatment, the patient had a two-stage revision. Trochanteric non-union is one of the well-described complications after total hip replacement. It is frequently difficult to treat, while potentially causing weakness, altered gait and instability of the artificial joint. We believe that reattachment of the trochanter combined with a staged revision of the femoral stem using a posterior approach for the second stage could be a valuable technique to be added to the ortho...
Source: Annals of the Royal College of Surgeons of England - June 3, 2019 Category: Surgery Authors: Drampalos E, Bayam L, Oakley J, Hemmady M, Hodgkinson J Tags: Ann R Coll Surg Engl Source Type: research

Enhancing the emergency general surgical service: an example of the aggregation of marginal gains.
Abstract INTRODUCTION: We aimed to enhance the emergency general surgical service in our high-volume centre in order to reduce four-hour target breaches, to expedite senior decision making and to avoid unnecessary admissions. MATERIALS AND METHODS: The aggregation of marginal gains theory was applied. A dual consultant on-call system was established by the incremental employment of five emergency general surgeons with a specialist interest in colorectal or oesophagogastric surgery. A surgical ambulatory care unit, which combines consultant-led clinical review with dedicated next-day radiology slots, and a ded...
Source: Annals of the Royal College of Surgeons of England - June 3, 2019 Category: Surgery Authors: Panagiotopoulou IG, Bennett J, Tweedle EM, Di Saverio S, Gourgiotis S, Hardwick RH, Wheeler J, Justin Davies R Tags: Ann R Coll Surg Engl Source Type: research

Novel method to create a bespoke cement spacer for use in the management of segmental long-bone defects.
PMID: 31155902 [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 - June 3, 2019 Category: Surgery Authors: Silk Z, Vris A Tags: Ann R Coll Surg Engl Source Type: research

A rare case of thoracic spinal intradural extramedullary enterogenous cyst with acute onset: case report and literature review.
We report a rare case of thoracic spinal intradural extramedullary enterogenous cyst with rapidly progressive weakness of both lower extremities. Additionally, we analysed the literature concerning the clinical features, diagnosis and prognosis of this disease. PMID: 31155903 [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 - June 3, 2019 Category: Surgery Authors: Liu CX, Meng B, Li YB, Bai H, Wu ZX Tags: Ann R Coll Surg Engl Source Type: research

A rare case of unilateral hemifacial spasm and facial palsy associated with an abnormal anatomical variant of the posterior basilar circulation.
We present a rare case of facial spasm along with facial palsy in a 67-year-old woman who was found to have an anatomical variant in the posterior basilar circulation with an ectatic basilar artery and significantly displaced posterior vertebral artery impinging on the facial nerve. PMID: 31155905 [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 - June 3, 2019 Category: Surgery Authors: Chan J, Jolly K, Darr A, Bowyer DJ Tags: Ann R Coll Surg Engl Source Type: research

Giant anterior urethra stones combined with a diverticulum: a case report.
We report a case of giant anterior urethra stones combined with a diverticulum with no lower urinary tract symptoms. We believe that this case is extremely rare, and the process of diagnosis and treatment is of great significance in clinical practice. PMID: 31155906 [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 - June 3, 2019 Category: Surgery Authors: Chen S, Su X, Jiang M, Mi H Tags: Ann R Coll Surg Engl Source Type: research

Femoral hernia containing the right fallopian tube: chronic pain with menstruation.
Abstract Femoral hernias represent less than 10% of groin hernias and appear mainly in adult women; incarceration is more usual than in other hernias. Content found within the sac is commonly small bowel or omentum. Other anatomical structures, such as appendix, bladder, Meckel's diverticulum, ectopic testis, stomach and gynaecological organs are extremely unusual. A 48-year-old woman presented with intense right groin pain over 48 hours. Her past medical history revealed periodical moderate right groin pain coincident with her menstrual cycles, usually self-limited. No abdominal symptoms or fever were present. On...
Source: Annals of the Royal College of Surgeons of England - June 3, 2019 Category: Surgery Authors: Marcos-Santos P, Bailon-Cuadrado M, Choolani-Bhojwani E, Pacheco-Sanchez D Tags: Ann R Coll Surg Engl Source Type: research

Day of surgery: the impact on patient length of stay in a tertiary vascular unit.
This study aimed to assess whether there is a significant difference in postoperative length of hospital stay between the groups with secondary assessment by operation subtype. METHODS: We identified all patients admitted for vascular surgery in 2015 from a prospectively collected database and divided the week into Monday to Wednesday and Thursday to Friday. Endovascular cases were included but day cases were excluded. Further analysis was performed with a breakdown in both groups by operation type. Statistical analysis was performed using SPSS version 16.0. RESULTS: We identified 652 patients who met our criteri...
Source: Annals of the Royal College of Surgeons of England - June 3, 2019 Category: Surgery Authors: Holford NC, Ní Ghuidhir C, Hands L Tags: Ann R Coll Surg Engl Source Type: research

Reverse Wilson's framing for lumbar spinal surgery in patients with stiff shoulders.
PMID: 31155909 [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 - June 3, 2019 Category: Surgery Authors: Yuen J, Sharma H Tags: Ann R Coll Surg Engl Source Type: research

Carotid artery stenosis, an underestimated cause of stroke recurrence in patients with ischaemic monocular visual loss.
CONCLUSIONS: Carotid stenosis ≥ 50% is present in patients with ocular ischaemia in approximately 20% of those with persistent visual loss and in 10% with transient visual loss. Those with carotid stenosis have a higher risk of stroke recurrence and should be considered urgent surgical intervention as other forms of stroke. PMID: 31155910 [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 - June 3, 2019 Category: Surgery Authors: Cheng SF, Zarkali A, Richards T, Simister R, Chandratheva A Tags: Ann R Coll Surg Engl Source Type: research

Cadaveric allograft implantation to maintain limb viability in a case of traumatic pseudoaneurysm and poor native vessels.
We report a case of cadaveric allografting of the common femoral artery in a patient with a traumatic, infected pseudoaneurysm, who was taking immunosuppressive therapy for a liver transplant. The patient was followed up with ultrasound at 12 months and was found to have a significant graft stenosis, which was treated successfully with angioplasty. At 18 months, the patient remained well. This case describes the successful implantation of a cadaveric allograft into a patient with an infected pseudoaneurysm, negating the for need primary ligation. PMID: 31155912 [PubMed - as supplied by publisher] (Source: Annals of th...
Source: Annals of the Royal College of Surgeons of England - June 3, 2019 Category: Surgery Authors: Wall J, Waduud MA, Scott D Tags: Ann R Coll Surg Engl Source Type: research

Revascularisation through the obturator foramen of lower limbs with a compromised ipsilateral groin due to infection.
CONCLUSION: The transobturator approach could be considered as a chance for lower limb revascularisation in case of ipsilateral groin infection. Moreover, avoiding the infected site allowed us to focus separately and safely on the treatment of the inguinal wound. PMID: 31155915 [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 - June 3, 2019 Category: Surgery Authors: Zenunaj G, Traina L, Acciarri P, Spataro C, Gasbarro V Tags: Ann R Coll Surg Engl Source Type: research

The anatomical relationship between the axillary arch of Langer and sentinel lymph node in breast cancer surgery.
PMID: 31155917 [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 - June 3, 2019 Category: Surgery Authors: Abudhaise H, Merh R, Devalia H Tags: Ann R Coll Surg Engl Source Type: research

Use of an automated knot fastener shortens operative times in minimally invasive mitral valve repair.
Abstract INTRODUCTION: Longer durations of cardiopulmonary bypass and aortic cross clamp are associated with increased morbidity and mortality. Little is known about the effect of automated knot fasteners (Cor-Knot®) in minimally invasive mitral valve repair on operative times and outcomes. The aim of this study was to evaluate whether these devices shortened cardiopulmonary bypass and aortic cross clamp times and whether this impacted on postoperative outcomes. MATERIALS AND METHODS: All patients undergoing isolated minimally invasive mitral valve repair by a single surgeon between March 2011 and March 2...
Source: Annals of the Royal College of Surgeons of England - June 3, 2019 Category: Surgery Authors: Perin G, Shaw M, Pingle V, Palmer K, Al-Rawi O, Ridgway T, Pousios D, Modi P Tags: Ann R Coll Surg Engl Source Type: research

Getting It Right First Time: the national survey of surgical site infection rates in NHS trusts in England.
CONCLUSION: The Getting It Right First Time surgical site infection programme has introduced a different approach to infection surveillance in England. Results of the survey has demonstrated variation in surgical site infection rates among surgical units, raised the importance in addressing these issues for better patient outcomes and to reduce the financial burden on the NHS. Much work remains to be done to improve surgical site infection surveillance across surgical units and trusts in England. PMID: 31155919 [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 - June 3, 2019 Category: Surgery Authors: Wong J, Ho C, Scott G, Machin JT, Briggs T Tags: Ann R Coll Surg Engl Source Type: research

Conservative management of diffuse cavernous haemangioma of the sigmoid and rectum.
Abstract Diffuse cavernous haemangioma is a rare disease of the rectum. It usually presents with a history of rectal bleeding in children and young adults. When conservative methods fail to control bleeding, traditionally resection is recommended. A 50-year-old man presented with per rectal bleeding and was diagnosed with diffuse cavernous haemangioma of the sigmoid and rectum extending up to 40 cm in the left colon through endoscopy, magnetic resonance imaging and computed tomography. The diagnosis was confirmed by biopsy. This patient was successful managed conservatively with tranexamic acid as needed, avoiding...
Source: Annals of the Royal College of Surgeons of England - June 3, 2019 Category: Surgery Authors: Cotzias E, Rehman SF, Arsalani Zadeh R, Smith D Tags: Ann R Coll Surg Engl Source Type: research

Perforated diverticulitis in the North of England: trends in patient outcomes, management approach and the influence of subspecialisation.
Abstract INTRODUCTION: In recent years, several management options have been used in the management of perforated diverticulitis, ranging from conservative treatment to laparotomy. General surgery has also become increasingly specialised over time. This retrospective cohort study investigated changes in patient outcomes following perforated diverticulitis, management approach and the influence of consultant subspecialisation over time. MATERIALS AND METHODS: Data was collected on patients admitted with perforated diverticulitis in the North of England between 2002 and 2016. Subspecialisation was categorised a...
Source: Annals of the Royal College of Surgeons of England - June 3, 2019 Category: Surgery Authors: Baldock TE, Brown LR, McLean RC Tags: Ann R Coll Surg Engl Source Type: research