Contents
Publication date: October 2019Source: Surgery (Oxford), Volume 37, Issue 10Author(s): (Source: Surgery (Oxford))
Source: Surgery (Oxford) - October 10, 2019 Category: Surgery Source Type: research

Editorial Board
Publication date: October 2019Source: Surgery (Oxford), Volume 37, Issue 10Author(s): (Source: Surgery (Oxford))
Source: Surgery (Oxford) - October 10, 2019 Category: Surgery Source Type: research

MCQ and single best answer
Publication date: Available online 26 September 2019Source: Surgery (Oxford)Author(s): Adrian Ben Cresswell (Source: Surgery (Oxford))
Source: Surgery (Oxford) - September 27, 2019 Category: Surgery Source Type: research

Contents
Publication date: September 2019Source: Surgery (Oxford), Volume 37, Issue 9Author(s): (Source: Surgery (Oxford))
Source: Surgery (Oxford) - September 18, 2019 Category: Surgery Source Type: research

“Erratum to Imaging the spine” [Surgery 36/7 (2018) 370–382]
Publication date: September 2019Source: Surgery (Oxford), Volume 37, Issue 9Author(s): Jenn S. Wong, Priya Suresh (Source: Surgery (Oxford))
Source: Surgery (Oxford) - September 18, 2019 Category: Surgery Source Type: research

Editorial Board
Publication date: September 2019Source: Surgery (Oxford), Volume 37, Issue 9Author(s): (Source: Surgery (Oxford))
Source: Surgery (Oxford) - September 18, 2019 Category: Surgery Source Type: research

Trauma laparotomy and damage control surgery
This article discusses the different mechanisms of injury, early assessment and investigations. It goes on to highlight the features of a trauma laparotomy, its preparation, management and the systematic approach for damage control surgery. The main abdominal organs are outlined in more detail to describe the individual approach to them in trauma. (Source: Surgery (Oxford))
Source: Surgery (Oxford) - September 13, 2019 Category: Surgery Source Type: research

Laparoscopic management of acute abdominal emergencies
Publication date: Available online 12 September 2019Source: Surgery (Oxford)Author(s): Rishabh Singh, Andrea ScalaAbstractUse of minimally invasive approaches to acute abdominal surgical emergencies has increased in recent decades. Uptake has been slower than for elective surgery, however, with concerns regarding inadvertent injury and operative time being most frequently cited. Laparoscopy for abdominal pain has shown to be safe and is a useful diagnostic procedure in the context of unexplained abdominal pain. Minimally invasive surgery has also been shown to be the approach of choice in appendicitis and cholecystitis. La...
Source: Surgery (Oxford) - September 13, 2019 Category: Surgery Source Type: research

Physiology of shock and volume resuscitation
This article therefore focuses on the pathophysiology of hypovolaemic shock, volume resuscitation, haemostasis and approaches to management. Fluid resuscitation saves lives but considerable debate remains regarding the ideal fluid type and strategy to use. Blood transfusion is also a critical therapy in the shocked, bleeding patient with a lower threshold for transfusion being appropriate in the elderly patient with less physiological reserve. Reversal of anticoagulant medications and the administration of coagulation products should support both fluid and red cell therapy to counteract the multifactorial coagulopathy that...
Source: Surgery (Oxford) - September 10, 2019 Category: Surgery Source Type: research

The management of bariatric surgery complications
Publication date: Available online 7 September 2019Source: Surgery (Oxford)Author(s): William Hawkins, Ian MaheswaranAbstractBariatric surgery is now commonplace in the UK and has been demonstrated to be safe and effective. Complications that present as an emergency are unusual but will be seen more frequently as the number of patients who have undergone weight loss surgery rises. The optimal management encompasses a low threshold of suspicion and early diagnosis of complications, coupled with expertise to deal with them. It is therefore important for a general surgeon to have an understanding of the common bariatric proce...
Source: Surgery (Oxford) - September 8, 2019 Category: Surgery Source Type: research

Management of massive gastrointestinal haemorrhage
Publication date: Available online 7 September 2019Source: Surgery (Oxford)Author(s): Paul D. Mackenzie, Matthew Rogers, Michelle Gallagher, Timothy RockallAbstractAcute gastrointestinal bleeding is a common medical emergency, accounting for approximately 85,000 admissions in the United Kingdom per annum. It is associated with significant morbidity and mortality. GI haemorrhage is commonly categorized according to source of blood loss; either upper GI (above the ligament of Treitz) or lower GI (below the ligament of Treitz). Rapid assessment, resuscitation and correction of coagulopathy should be undertaken to stabilize th...
Source: Surgery (Oxford) - September 8, 2019 Category: Surgery Source Type: research

The detection and management of complications following the treatment of liver metastases
This article will describe the current common liver-directed therapies and outline the presentation and management of their complications. (Source: Surgery (Oxford))
Source: Surgery (Oxford) - September 7, 2019 Category: Surgery Source Type: research

Abdominal compartment syndrome
Publication date: Available online 6 September 2019Source: Surgery (Oxford)Author(s): Alicia Skervin, Mohammad MobasheriAbstractAbdominal compartment syndrome (ACS) is a devastating condition for the critically unwell patient. Initially described as solely affecting surgical patients, ACS is now also recognized in the medical intensive care setting. Without prompt and definitive treatment, mortality rates approach 70% as multiorgan failure develops. Over the past decade our understanding, recognition and management of ACS has evolved. The World Society of Abdominal Compartment Syndrome published updated guidelines in 2012 ...
Source: Surgery (Oxford) - September 7, 2019 Category: Surgery Source Type: research

Visceral volvulae and management
This article will summarize current evidence for management of the most common sources of volvulus; gastric, small bowel, and colonic. (Source: Surgery (Oxford))
Source: Surgery (Oxford) - September 7, 2019 Category: Surgery Source Type: research

Pathology of tumours of the kidney and urinary tract
Publication date: Available online 30 August 2019Source: Surgery (Oxford)Author(s): Jonathan M. SalmondAbstractThe urinary tract encompasses the kidney and the urinary collecting system, ureter, bladder and urethra. Benign lesions of the kidney include angiomyolipoma and renal oncocytoma. The main subtypes of renal cell carcinoma include clear cell, papillary and chromophobe variants. Prognostic factors reported by pathologists are reviewed, including the current grading and staging systems. Urothelial tumours include urothelial carcinoma in situ, papillary urothelial carcinoma and invasive urothelial carcinoma. Aspects of...
Source: Surgery (Oxford) - September 1, 2019 Category: Surgery Source Type: research

The management of testis cancer
Publication date: Available online 28 August 2019Source: Surgery (Oxford)Author(s): Noel W. Clarke, Áine M. HaranAbstractTestis cancer is the most common solid malignancy in young men and represents a clinically and pathologically diverse disease. Between 90% and 95% of tumours are germ cell tumours (GCTs) that are categorized into seminoma and non-seminomatous germ cell tumours (NGSCTs). Testis cancer typically presents as a painless testicular mass and must be investigated with ultrasound imaging and tumour marker assay before being treated urgently with radical inguinal orchidectomy if suspicion persists. Disease...
Source: Surgery (Oxford) - August 29, 2019 Category: Surgery Source Type: research

Renal cancer
Publication date: Available online 21 August 2019Source: Surgery (Oxford)Author(s): Gideon Blecher, Kara McDermott, Benjamin ChallacombeAbstractRenal carcinoma is a reasonably common cancer in the UK. Fortunately, its diagnosis is nowadays much earlier due to the increased utilization of radiological imaging. While surveillance is an option, particularly in older/comorbid patients, nephron-sparing surgery remains the gold standard treatment for small renal masses. Laparoscopic, robotic or open partial nephrectomy have excellent cure rates. For larger tumours, radical nephrectomy may be required. This again can be performed...
Source: Surgery (Oxford) - August 21, 2019 Category: Surgery Source Type: research

Bladder cancer
Publication date: Available online 17 August 2019Source: Surgery (Oxford)Author(s): Jameel Mushtaq, Ramesh Thurairaja, Rajesh NairAbstractUrothelial carcinoma of the bladder is the most common malignancy affecting the urinary tract. This review examines the current standards in the diagnosis and management of this disease. Cystoscopy and urine cytology remain important tools in the diagnosis and follow-up of bladder cancer. Alternatives include photodynamic diagnosis, narrow band imaging and professional image enhancement which may improve detection of tumours. En-bloc resection using either laser or electrocautery shows p...
Source: Surgery (Oxford) - August 18, 2019 Category: Surgery Source Type: research

Prostate cancer
This article aims to summarize the current knowledge of prostate cancer and treatment options available. (Source: Surgery (Oxford))
Source: Surgery (Oxford) - August 18, 2019 Category: Surgery Source Type: research

Upper tract urothelial cancer
Publication date: Available online 17 August 2019Source: Surgery (Oxford)Author(s): Tim LaneAbstractUpper tract transitional cell carcinoma is a lethal disease with half the patients dead within 5 years of diagnosis. Unlike urothelial tumours arising in the bladder, the disease is more likely to be invasive at the time of diagnosis and in part reflects the poorer prognosis. It is a biologically aggressive disease with a high chance of recurrence even after local control. Diagnosis is made by a combination of upper tract imaging, urine cytology and ureteroscopic biopsy. Organ-confined disease is amenable to radical surgery,...
Source: Surgery (Oxford) - August 18, 2019 Category: Surgery Source Type: research

Tumours of the male genital tract
This article discusses pathological features of tumours of the male genital tract. Carcinoma of the prostate is common and represents an increasing burden to the NHS in terms of management and treatment. We focus on recent changes to grading and discuss issues around pathological diagnosis. Tumours of the testes represent the greatest success story of cancer treatment over the past several decades. We review the pathological features of the commonest tumours focusing on prognostic features. Carcinoma of the penis is rare but appears to be increasing in incidence. It requires more awareness amongst the public and general pr...
Source: Surgery (Oxford) - August 17, 2019 Category: Surgery Source Type: research

Haematuria
This article provides a clear framework to help decide which patients have significant haematuria and which patients are suitable for urological referral; a decision algorithm is also included. We discuss how to investigate such patients further, including points not to forget when taking a history or conducting physical examination. Explanations are provided as to why current management strategies exist and what the potential flaws are of each method, including the ubiquitous urine dipstick test, urine cytology, cystoscopy and the modern radiological techniques used in everyday clinical practice. We provide guidance on wh...
Source: Surgery (Oxford) - August 15, 2019 Category: Surgery Source Type: research

Test yourself: MCQs
Publication date: Available online 14 August 2019Source: Surgery (Oxford)Author(s): Adrian Ben Cresswell (Source: Surgery (Oxford))
Source: Surgery (Oxford) - August 14, 2019 Category: Surgery Source Type: research

Contents
Publication date: August 2019Source: Surgery (Oxford), Volume 37, Issue 8Author(s): (Source: Surgery (Oxford))
Source: Surgery (Oxford) - July 25, 2019 Category: Surgery Source Type: research

Editorial Board
Publication date: August 2019Source: Surgery (Oxford), Volume 37, Issue 8Author(s): (Source: Surgery (Oxford))
Source: Surgery (Oxford) - July 25, 2019 Category: Surgery Source Type: research

Contents
Publication date: July 2019Source: Surgery (Oxford), Volume 37, Issue 7Author(s): (Source: Surgery (Oxford))
Source: Surgery (Oxford) - July 3, 2019 Category: Surgery Source Type: research

Editorial Board
Publication date: July 2019Source: Surgery (Oxford), Volume 37, Issue 7Author(s): (Source: Surgery (Oxford))
Source: Surgery (Oxford) - July 3, 2019 Category: Surgery Source Type: research

Surgical management for chronic pain
Publication date: Available online 27 June 2019Source: Surgery (Oxford)Author(s): Robert Lyons, Kiran K. KonetiAbstractChronic pain in the UK affects up to 43% of the population. The consequences include physical and psychological distress, loss of function, employment, family and social strain and increased utilisation of healthcare services. Modern pain management services operate across primary, secondary and tertiary care and incorporate general practitioners, psychologists, physiotherapists, pharmacists, specialist nurses, pain physicians and surgeons. This allows for a coordinated approach to chronic pain, engaging t...
Source: Surgery (Oxford) - June 28, 2019 Category: Surgery Source Type: research

Consent: assessing and communicating risk
Publication date: Available online 27 June 2019Source: Surgery (Oxford)Author(s): Rachel Horner, Catherine RimmerAbstractThe consent process is a cornerstone of the patient–doctor relationship. It can be a complex process presenting challenges to both doctor and patients due to the interaction of multiple different factors, including ethical and legal considerations. Ensuring the patient has informed consent requires a through understanding of the risks of an intervention for a particular patient; therefore risk assessment is of fundamental importance. Accurate risk assessment can be done through assessment of indivi...
Source: Surgery (Oxford) - June 27, 2019 Category: Surgery Source Type: research

Anaemia and blood transfusion: incorporating patient blood management
Publication date: Available online 13 June 2019Source: Surgery (Oxford)Author(s): Sean R. Bennett, Mahasen Al HarbiAbstractBoth red blood cell (RBC) transfusion and anaemia or low haematocrit increase morbidity and mortality associated with surgery. Chronic anaemia in the elective patient carries a small risk in non-haemorrhagic surgery. Where bleeding is anticipated anaemia should be treated medically to avoid (RBC) transfusion which will increase the risk to the patient. Major bleeding (MB) has the biggest impact on adverse outcomes. Acute anaemia is caused by surgical bleeding and requires RBC transfusion to keep the ha...
Source: Surgery (Oxford) - June 13, 2019 Category: Surgery Source Type: research

Premedication and management of concomitant therapy
This article summarizes current recommendations with regard to premedication and concomitant medication. (Source: Surgery (Oxford))
Source: Surgery (Oxford) - June 13, 2019 Category: Surgery Source Type: research

Management of acute pain
Publication date: Available online 7 June 2019Source: Surgery (Oxford)Author(s): David Hay, Vanessa NesbittAbstractAcute pain is a common feature in the presentation of surgical and traumatic pathology and in postoperative patients. In pathological presentations acute pain may have a protective role serving as a warning sign, with muscle spasm helping to limit movement and prevent further injury. Acute postoperative pain can hinder recovery due to limited mobility and may lead to a range of complications, increasing patient morbidity and mortality. Timely and effective management of acute pain is therefore imperative. An a...
Source: Surgery (Oxford) - June 9, 2019 Category: Surgery Source Type: research

Chronic pain management after surgery
Publication date: Available online 7 June 2019Source: Surgery (Oxford)Author(s): Kiran K. Koneti, Joel S. PerfittAbstractChronic post-surgical pain is a common problem affecting between 2% and 10% of adults after surgery and a significant health burden. The development of chronic post-surgical pain involves multiple mechanisms including peripheral and central sensitization and nerve injury, thought to be the most significant factor. There are many risk factors including preoperative pain, chemo/radiotherapy, surgical, psychological and genetic factors. The prevention of chronic post-surgical pain is challenging but progres...
Source: Surgery (Oxford) - June 9, 2019 Category: Surgery Source Type: research

Fluid management
This article reviews some of the basic concepts underpinning the use of fluid therapy, associated physiology, clinical application and evidence base in the perioperative setting. Suggested further reading is also provided. (Source: Surgery (Oxford))
Source: Surgery (Oxford) - June 9, 2019 Category: Surgery Source Type: research

Patient monitoring techniques
This article reviews the basic components of any monitoring device, and its importance in relation to improving patient safety. Issues related to increasing complexity of monitoring devices are also discussed. Basic monitoring modalities are described including pulse oximetry, non-invasive blood pressure, electrocardiography, temperature and capnography. Advanced cardiovascular monitoring is also discussed including invasive pressure monitoring, and invasive and non-invasive cardiac output monitoring devices. Neurological monitoring systems which evaluate intracranial pressure, cerebral blood flow and brain electrical...
Source: Surgery (Oxford) - June 9, 2019 Category: Surgery Source Type: research

The principles and conduct of anaesthesia
Publication date: Available online 8 June 2019Source: Surgery (Oxford)Author(s): Anurag Vats, Monalisa J. MarbaniangAbstractAnaesthesia is one of the younger specialties of medicine and has made immense advancement since its inception. The development of modern anaesthesia techniques, drugs, and monitoring methods has facilitated the development and advancement of surgical practice, which benefits patients. In this article, we provide an overview of the pharmacology and the conduct of a general anaesthetic. Regional anaesthesia has always been an integral part of the practice of anaesthesia and surgery. We discuss the esse...
Source: Surgery (Oxford) - June 9, 2019 Category: Surgery Source Type: research

Test yourself: MCQ and extended matching
Publication date: Available online 6 June 2019Source: Surgery (Oxford)Author(s): Adrian Ben Cresswell (Source: Surgery (Oxford))
Source: Surgery (Oxford) - June 7, 2019 Category: Surgery Source Type: research

Nocturia
Publication date: Available online 5 June 2019Source: Surgery (Oxford)Author(s): Tim LaneAbstractNocturia is a poorly understood symptom complex. It is seldom the result of obstructive lower urinary tract symptoms alone. Its association with multiple medical comorbidities and nocturnal polyuria explains the generally poor response to interventions aimed at improving outflow obstruction or lessening the impact of bladder instability. Nocturia is increasingly recognized as a surrogate marker for poor health and one that carries with it an increased risk of mortality. The management of nocturia needs to address not only the u...
Source: Surgery (Oxford) - June 7, 2019 Category: Surgery Source Type: research

Anatomy of the lower urinary tract
Publication date: Available online 29 May 2019Source: Surgery (Oxford)Author(s): Vishy MahadevanAbstractFor descriptive purposes the urinary tract is divided into two parts: the upper urinary tract and the lower urinary tract. The former comprises the kidneys and ureters, while the lower urinary tract consists of the urinary bladder and the urethra. In this article, a detailed description of the surgical and functional anatomy of the urinary bladder is followed by a description of the clinical anatomy of the female and male urethra. There then follows a brief description of the relevant anatomy of the prostate and seminal ...
Source: Surgery (Oxford) - May 31, 2019 Category: Surgery Source Type: research

Anatomy of the kidney and ureter
Publication date: Available online 29 May 2019Source: Surgery (Oxford)Author(s): Vishy MahadevanAbstractThe urinary tract is divided into upper and lower parts. The kidneys and ureters make up the upper urinary tract while the urinary bladder and urethra constitute the lower urinary tract. This classification while somewhat arbitrary is nevertheless useful and convenient for descriptive purposes. In this article, a detailed description of the topographical and vascular anatomy of the kidney and ureter is followed by a brief account of the anatomy of the suprarenal gland. (Source: Surgery (Oxford))
Source: Surgery (Oxford) - May 31, 2019 Category: Surgery Source Type: research

Test yourself: MCQ and extended matching
Publication date: Available online 29 May 2019Source: Surgery (Oxford)Author(s): Adrian Ben Cresswell (Source: Surgery (Oxford))
Source: Surgery (Oxford) - May 31, 2019 Category: Surgery Source Type: research

Contents
Publication date: June 2019Source: Surgery (Oxford), Volume 37, Issue 6Author(s): (Source: Surgery (Oxford))
Source: Surgery (Oxford) - May 25, 2019 Category: Surgery Source Type: research

Editorial Board
Publication date: June 2019Source: Surgery (Oxford), Volume 37, Issue 6Author(s): (Source: Surgery (Oxford))
Source: Surgery (Oxford) - May 25, 2019 Category: Surgery Source Type: research

Assessment of lower urinary tract symptoms
Publication date: Available online 16 May 2019Source: Surgery (Oxford)Author(s): Jay KhastgirAbstractLower urinary tract symptoms (LUTS) encompass a range of symptoms commonly experienced by both men and women, and encountered by a wide range of healthcare practitioners (HCPs). This review summarizes the basic terminology and assessment that HCPs should be aware of, regardless of their professional discipline. Apart from emphasizing the need for standardization in terminology, there is a need to avoid misleading terms that suggest a causative mechanism until the mechanism has been identified by investigation. HCPs should a...
Source: Surgery (Oxford) - May 17, 2019 Category: Surgery Source Type: research

Contents
Publication date: May 2019Source: Surgery (Oxford), Volume 37, Issue 5Author(s): (Source: Surgery (Oxford))
Source: Surgery (Oxford) - May 17, 2019 Category: Surgery Source Type: research

Editorial Board
Publication date: May 2019Source: Surgery (Oxford), Volume 37, Issue 5Author(s): (Source: Surgery (Oxford))
Source: Surgery (Oxford) - May 17, 2019 Category: Surgery Source Type: research

The practical assessment and management of bladder outflow obstruction
Publication date: Available online 15 May 2019Source: Surgery (Oxford)Author(s): Narin Suleyman, Freddie CL. BanksAbstractThe initial management of bladder outflow obstruction typically related to benign prostatic hyperplasia (BPH) falls to a large extent within the remit of general practice. Referral onwards to secondary care typically arises following the failure to respond to conservative measures or when complications have supervened; the most significant of which is urinary retention. In the hospital setting, anaesthesia, constipation and immobility are the common precipitants. What follows is a practical guide to the...
Source: Surgery (Oxford) - May 17, 2019 Category: Surgery Source Type: research

Genitourinary trauma
Publication date: Available online 15 May 2019Source: Surgery (Oxford)Author(s): Keval M. Patel, Martin C. NuttallAbstractGenitourinary (GU) organs are commonly injured in trauma patients. Although the kidney is the most commonly injured organ, other GU structures such as the bladder and urethra are also susceptible to injury. GU trauma is broadly divided into blunt and penetrative and based on the mechanism of injury. Prompt diagnosis and recognition of iatrogenic GU injury is also paramount. A delay in diagnosis and treatment can have significant consequences (e.g. abscess formation, fistulae and permanent renal impairme...
Source: Surgery (Oxford) - May 17, 2019 Category: Surgery Source Type: research

The physiology and pharmacology of the lower urinary tract
Publication date: Available online 16 May 2019Source: Surgery (Oxford)Author(s): Chandran Tanabalan, Andrew BallaroAbstractThe lower urinary tract comprises the urinary bladder, the urethra and prostate in men, and is concerned with the storage of urine and its voluntary expulsion from the body when socially convenient. These mutually exclusive states are mediated by complex neural networks that when dysfunctional generate bothersome and highly prevalent lower urinary tract symptoms (LUTS). Lower urinary tract symptoms are often idiopathic and not pathology specific and most result from bladder outflow obstruction, disorde...
Source: Surgery (Oxford) - May 17, 2019 Category: Surgery Source Type: research

The management of urolithiasis
Publication date: Available online 16 May 2019Source: Surgery (Oxford)Author(s): Vimoshan Arumuham, Andrew Brodie, John BycroftAbstractThe incidence and prevalence of urolithiasis is on the rise; though inevitably the increasing availability of cross-sectional imaging has some contribution to this rise in diagnoses, it cannot take all the blame. Urolithiasis is now more commonly being recognized as a symptom of a more systemic disease which has a constellation of presenting signs and complaints. The authors aim to outline the precipitating causes of urolithiasis, along with a comprehensive discussion of the current operati...
Source: Surgery (Oxford) - May 17, 2019 Category: Surgery Source Type: research