Improving patient and staff safety by minimising radiation exposure during trauma surgery: A simple and validated predictive model
Publication date: Available online 14 August 2019Source: The SurgeonAuthor(s): Osman Riaz, Raees Vanker, Nayef Aslam-Pervez, Vivek Balachandar, Adeel AqilAbstractIntroductionMinimising radiation exposure, from fluoroscopic equipment during trauma surgery is crucial to safe-guarding patients and staff. This aim of this study was to identify variables associated with increased radiation exposure for 3 of the most common trauma procedures. Secondly, we aimed to derive an internally and externally validated mathematical model for predicting radiation exposure for these procedures.Materials and methodsWe prospectively recorded ...
Source: The Surgeon - August 14, 2019 Category: Surgery Source Type: research

The effect of tranexamic acid on wound complications in primary total Hip Arthroplasty: A meta-analysis
ConclusionTXA reduced blood loss and transfusion rates after primary THA surgery. It also reduced wound complication rates but the clinical significance of this needs further investigation through well designed and adequately powered RCTs. (Source: The Surgeon)
Source: The Surgeon - August 11, 2019 Category: Surgery Source Type: research

Prognosis following surgical resection versus local excision of stage pT1 colorectal cancer: A population-based cohort study
ConclusionsPatients with stage pT1 CRC undergoing formal surgery had a reduced risk of all-cause mortality compared with those treated by local excision only. However, this was not explained by a reduced risk of recurrence/disease-free survival or CRC death, and suggests that the observed benefits may simply reflect selection of a healthier patient population in the formal surgery group. (Source: The Surgeon)
Source: The Surgeon - August 10, 2019 Category: Surgery Source Type: research

A systematic review of the safety and efficacy of non-operative management in patients with high grade liver injury
ConclusionNon-operative management of liver trauma is safe and effective in hemodynamically stable patients with high-grade liver injury. It is associated with significantly lower mortality compared with operative management. More studies are required to evaluate complications of non-operative management in high-grade liver injury. (Source: The Surgeon)
Source: The Surgeon - August 7, 2019 Category: Surgery Source Type: research

Emergency laparotomy research methodology: A systematic review
ConclusionThe heterogeneity in EL research, demonstrated by this review must be considered when EL outcomes are compared. A standardized approach with respect to case definition, outcome measurement, and data analysis would provide for more valid and comparable evaluation of EL outcomes. Future EL research should include more patient centred outcomes (Source: The Surgeon)
Source: The Surgeon - July 23, 2019 Category: Surgery Source Type: research

Aberrant left hepatic arteries arising from left gastric arteries and their clinical importance
DiscussionSome of the studies included did not distinguish between the ‘‘replaced’’ and ‘‘accessory’’ ALHA (34.25%). Some surgical dissection techniques proved insufficient for the localization of other hepatic arteries. These results suggest that an accurate preoperative radiological evaluation is needed to localize replaced arteries. (Source: The Surgeon)
Source: The Surgeon - July 21, 2019 Category: Surgery Source Type: research

What can we learn from the last 20 years: A review of litigation trends in otolaryngology
ConclusionThese results highlight areas that local units can focus on to reduce their litigation burden. Targeted initiatives aimed at improving patient-clinician communication, the consent process and improving local organisational efficiency will address a significant proportion of claims. Re-examination of this data on a regular basis can serve as a useful adjunct in assessing the impact of quality improvement initiatives and implementation of best practiseswithin the speciality. (Source: The Surgeon)
Source: The Surgeon - July 20, 2019 Category: Surgery Source Type: research

Factors affecting the number of lymph nodes retrieved after colo-rectal cancer surgery: A prospective single-centre study
Publication date: Available online 16 July 2019Source: The SurgeonAuthor(s): Valeria Tonini, Arianna Birindelli, Stefania Bianchini, Maurizio Cervellera, Maria Letizia Bacchi Reggiani, James Wheeler, Salomone Di SaverioAbstractBackgroundThe number of harvested lymph nodes (LNs) in colorectal cancer surgery relates to oncologic radicality and accuracy of staging. In addition, it affects the choice of adjuvant therapy, as well as prognosis. The American Joint Committee on Cancer defines at least 12 LNs harvested as adequate in colorectal cancer resections. Despite the importance of the topic, even in high-volume colorectal c...
Source: The Surgeon - July 17, 2019 Category: Surgery Source Type: research

List of editors
Publication date: August 2019Source: The Surgeon, Volume 17, Issue 4Author(s): (Source: The Surgeon)
Source: The Surgeon - July 13, 2019 Category: Surgery Source Type: research

Contents list
Publication date: August 2019Source: The Surgeon, Volume 17, Issue 4Author(s): (Source: The Surgeon)
Source: The Surgeon - July 13, 2019 Category: Surgery Source Type: research

In response: Long-term outcomes of en-bloc renal transplantation from paediatric donors into adult recipients S.W. Considine*, N.F. Davis, L.C. McLoughlin, P. Mohan, J.C. Forde, R. Power, G. Smyth, D.M. Little Surgeon 2019 Feb; 17(1):1–5
Publication date: Available online 15 June 2019Source: The SurgeonAuthor(s): Ming He, David Talbot (Source: The Surgeon)
Source: The Surgeon - June 16, 2019 Category: Surgery Source Type: research

Letter to authors of article: Mode of presentation rather than the 'weekend effect' is a major determinant of in-hospital mortality
Publication date: Available online 13 June 2019Source: The SurgeonAuthor(s): Ross C. McLean, Leo R. Brown, Iain JD. McCallum (Source: The Surgeon)
Source: The Surgeon - June 13, 2019 Category: Surgery Source Type: research

A systematic review of the presentation of scan-negative suspected cauda equina syndrome
ConclusionA psychogenic hypothesis is plausible and warrants further investigation. The need for additional studies is essential to scheming a potential treatment protocol for the scan-negative population, which currently does not exist. (Source: The Surgeon)
Source: The Surgeon - June 12, 2019 Category: Surgery Source Type: research

A growing challenge: The rise of femoral periprosthetic fractures – An 11-year observational study
ConclusionsPPF occur in an elderly comorbid cohort of patients. Care of these patients now makes up a considerable part of the orthopaedic workload and consumes a significant portion of healthcare resources. Patients should be treated in tertiary referral centres with surgeons skilled in their management. Better access to rehabilitation is needed. (Source: The Surgeon)
Source: The Surgeon - June 12, 2019 Category: Surgery Source Type: research

List of editors
Publication date: June 2019Source: The Surgeon, Volume 17, Issue 3Author(s): (Source: The Surgeon)
Source: The Surgeon - May 25, 2019 Category: Surgery Source Type: research

Contents list
Publication date: June 2019Source: The Surgeon, Volume 17, Issue 3Author(s): (Source: The Surgeon)
Source: The Surgeon - May 25, 2019 Category: Surgery Source Type: research

Breast infections – Microbiology and treatment in an era of antibiotic resistance
Publication date: Available online 7 May 2019Source: The SurgeonAuthor(s): S.P. Russell, C. Neary, S. Abd Elwahab, J. Powell, N. O'Connell, L. Power, S. Tormey, B.A. Merrigan, A.J. LoweryAbstractIntroductionPrimary breast abscesses occur in
Source: The Surgeon - May 8, 2019 Category: Surgery Source Type: research

Timing of surgical fixation in traumatic spinal fractures: A systematic review
ConclusionDue to limited studies and a small overall cohort, the authors would cautiously recommend the early surgical fixation of unstable spine fractures in the stable trauma patient. For severely injured patients, the discordance among literature warrants the need for further investigation. (Source: The Surgeon)
Source: The Surgeon - May 5, 2019 Category: Surgery Source Type: research

Predictors of discharge against medical advice in adult trauma patients
Publication date: Available online 2 May 2019Source: The SurgeonAuthor(s): Nathan Jasperse, Areg Grigorian, Patrick Delaplain, Zeljka Jutric, Sebastian D. Schubl, Catherine M. Kuza, Jeffry NahmiasAbstractBackgroundPatients who leave against medical advice (AMA) have higher readmission rates and mortality. However, little is known about the characteristics of trauma patients that leave AMA. The purpose of this study was to identify predictors for leaving AMA in adult trauma patients.MethodsThe Trauma Quality Improvement Program database was queried between 2010 and 2016 for patients ≥18 years of age presenting after trau...
Source: The Surgeon - May 4, 2019 Category: Surgery Source Type: research

Dubious answers to unimportant questions in the treatment of perforated diverticular disease
Publication date: Available online 2 May 2019Source: The SurgeonAuthor(s): Darren Leonard Scroggie (Source: The Surgeon)
Source: The Surgeon - May 4, 2019 Category: Surgery Source Type: research

Understanding primary parotid squamous cell carcinoma – A systematic review
ConclusionPrimary parotid SCC is rare and it is currently a diagnosis of exclusion. Thorough clinical assessment including endoscopy, preoperative imaging and the scrutiny of histopathological findings allow for differentiation between primary and secondary SCC within the parotid. This thus affects both initial treatment and subsequent follow-up. (Source: The Surgeon)
Source: The Surgeon - April 29, 2019 Category: Surgery Source Type: research

Are we neglecting sexual function assessment in suspected cauda equina syndrome?
Publication date: Available online 26 April 2019Source: The SurgeonAuthor(s): Savva Pronin, Ingrid Hoeritzauer, Patrick F. Statham, Andreas K. DemetriadesAbstractObjectivesWe assessed the documentation rates of signs and symptoms, including sexual function, in patients with suspected cauda equina syndrome and whether they can be improved by increasing local awareness.Patients and methodsWe reviewed all electronic records of patients referred with suspected CES who required urgent MRI to our regional service over a 2 month period. We recorded the documentation rates of clinical signs and symptoms. The results were presented...
Source: The Surgeon - April 28, 2019 Category: Surgery Source Type: research

NT-proBNP incorporated in prediction rule of major peri-operative adverse cardiac event in non-cardiac surgery
ConclusionsHigher preoperative NT-proBNP level leads to the increased risk of PMCE in patients undergoing non-cardiac surgery. Compared to NT-proBNP alone, the combination of NT-proBNP with the RCRI and other factors does not improve the accuracy in predicting PMCE. Future large studies are required to build a more accurate risk score. (Source: The Surgeon)
Source: The Surgeon - April 17, 2019 Category: Surgery Source Type: research

The absence of the common hepatic artery and its implications for surgical practice: Results of a systematic review and meta-analysis
ConclusionsThe overall PPE of an absent CHA was 3.1%, a result representing a significant, common anatomical variation. Our study revealed that an absence of a CHA was associated with a replaced CHA. The most common arterial variant was a replaced CHA originating from the Superior Mesenteric Artery and running across the anterior or posterior side of the pancreas (i.e., Types I and II). (Source: The Surgeon)
Source: The Surgeon - April 2, 2019 Category: Surgery Source Type: research

Does using anatomical models improve patient satisfaction in orthopaedic consenting? Single-blinded randomised controlled trial
Publication date: Available online 1 April 2019Source: The SurgeonAuthor(s): K. Sugand, H.H. Malik, S. Newman, D. Spicer, P. Reilly, C.M. GupteAbstractBackgroundPatient satisfaction in consenting is a major pillar of clinical governance and healthcare quality assessment. The purpose was to observe the effect of using 3D anatomical models of knee and shoulder joints on patient satisfaction during informed consent in the largest single-blinded randomised controlled trial in this field.Methods52 patients undergoing elective knee or shoulder surgery were randomised into two groups when being consented. The intervention group (...
Source: The Surgeon - April 2, 2019 Category: Surgery Source Type: research

Management of genetically determined colorectal cancer
Publication date: Available online 29 March 2019Source: The SurgeonAuthor(s): S.K. ClarkAbstractSurgeons are increasingly treating patients for colorectal cancer who are known to have a genetic predisposition to develop the disease; this may modify the surgical and oncological management of the patient.In this review the approach to the patient with colorectal cancer on a background of Lynch syndrome or familial adenomatous polyposis is explored. (Source: The Surgeon)
Source: The Surgeon - March 30, 2019 Category: Surgery Source Type: research

Can we accurately predict nerve conduction study outcome using a carpal tunnel syndrome questionnaire?
Publication date: Available online 29 March 2019Source: The SurgeonAuthor(s): Belagodu S. Sangram, Alistair I.W. Mayne, Arpit C. JariwalaAbstractNCS are often routinely performed for CTS despite recommendations from the BOA, BSSH and NICE that they are associated with increased costs and prolonged waiting times. This prospective study aimed to assess if the Kamath and Stothard clinical questionnaire could accurately predict nerve conduction study (NCS) results when diagnosing carpal tunnel syndrome (CTS).Eighty-eight patients referred with signs and symptoms of CTS from September 2016 to February 2017 were included. All pa...
Source: The Surgeon - March 30, 2019 Category: Surgery Source Type: research

Education website and social media to increase video-based learning of surgical trainees
Publication date: Available online 29 March 2019Source: The SurgeonAuthor(s): Aashish Rajesh, Mohamed S. Baloul, Nizamuddin Shaikh, Rafael U. de Azevedo, David R. Farley (Source: The Surgeon)
Source: The Surgeon - March 30, 2019 Category: Surgery Source Type: research

List of editors
Publication date: April 2019Source: The Surgeon, Volume 17, Issue 2Author(s): (Source: The Surgeon)
Source: The Surgeon - March 9, 2019 Category: Surgery Source Type: research

Contents list
Publication date: April 2019Source: The Surgeon, Volume 17, Issue 2Author(s): (Source: The Surgeon)
Source: The Surgeon - March 9, 2019 Category: Surgery Source Type: research

Penetrating head & neck trauma – Epidemiology and injury characteristics in terror-related violence, interpersonal violence and deliberate self-harm at a level 1 trauma centre
ConclusionViolent crime is increasing. Overall penetrating injury has more than doubled in 6 years. The injury characteristics observed are distinct depending on the assailants and motives. Head and neck trauma requires a multidisciplinary approach, with an understanding of the care needs of patients. Interpersonal violence is the most common aetiology and as such efforts to tackle rising violent crime must involve police and the community. In addition, terror-related violence is evolving in the United Kingdom and globally, and as such healthcare professionals must understand differences in aetiologies to promote optimal p...
Source: The Surgeon - February 25, 2019 Category: Surgery Source Type: research

Letter to the editors in response to the article: Facial restoration by transplantation, B. Kolar, B Pomahac. The surgeon 16 (2018) 245–249
Publication date: Available online 14 February 2019Source: The SurgeonAuthor(s): J.V. Sullivan, Q. Frew, N. Fox, P. Dziewulski (Source: The Surgeon)
Source: The Surgeon - February 14, 2019 Category: Surgery Source Type: research

Exploring geographical variation in access to general surgery in Ireland: Evidence from a national study
ConclusionVariations stemming from inefficient and unequal access are important components and markers of modern health systems and should be minimal. County of residence appears to have a clear influence on a patients' inaccessibility to certain interventions. Our findings imply a need for improved access at a regional level by facilitating the integration of public policies and promoting services at the appropriate settings. (Source: The Surgeon)
Source: The Surgeon - January 30, 2019 Category: Surgery Source Type: research

A review of forehead lipomas: Important tips for the training surgeon
ConclusionImportant differential diagnoses must be excluded prior to attempted surgical excision of forehead lipomas. Surgeons must also be aware that the correct anatomical plane for these lesions is often beneath the frontalis muscle. (Source: The Surgeon)
Source: The Surgeon - January 30, 2019 Category: Surgery Source Type: research

Single-stage approach for the management of choledocolithiasis with concomitant cholelithiasis. Implementation of a protocol in a secondary hospital
ConclusionsSingle-stage approach is a safe and effective management option for concomitant cholelithiasis and choledocolithiasis. Furthermore, a significant number of common bile duct stones pass spontaneously to duodenum or can benefit from a transcystic approach, with presumable low morbidity and cost-efficiency. (Source: The Surgeon)
Source: The Surgeon - January 29, 2019 Category: Surgery Source Type: research

List of editors
Publication date: February 2019Source: The Surgeon, Volume 17, Issue 1Author(s): (Source: The Surgeon)
Source: The Surgeon - January 26, 2019 Category: Surgery Source Type: research

Contents list
Publication date: February 2019Source: The Surgeon, Volume 17, Issue 1Author(s): (Source: The Surgeon)
Source: The Surgeon - January 26, 2019 Category: Surgery Source Type: research

Psychology input to an orthognathic clinic: Patients' perception of service quality
ConclusionsThe group of orthognathic patients studied found the pre-treatment psychology assessment, provided for them through the combined clinic, to be very acceptable and beneficial. Some suggested that further appointments, throughout the treatment journey, as well as supportive literature, might also have been helpful. (Source: The Surgeon)
Source: The Surgeon - January 18, 2019 Category: Surgery Source Type: research

Peri-operative outcomes for ORIF of acetabular fracture in the elderly: Comparison with displaced intracapsular hip fractures in a national pelvic and acetabular referral centre over 5 years
ConclusionsOur paper supports the concept that acute ORIF of acetabular fractures, with appropriate peri-operative support, can be undertaken safely. There is no difference in the major peri-operative outcomes of mortality or infection when compared with hip fracture patients requiring hemiarthroplasty. (Source: The Surgeon)
Source: The Surgeon - January 12, 2019 Category: Surgery Source Type: research

Hip hemiarthroplasty for fractured neck of femur; a freedom of information study to assess national variation in implant selection and procurement
ConclusionsThis article demonstrates a requirement for rationalisation of implant usage and procurement in order to potentially improve patient outcomes and provide opportunities for significant cost saving in an already overstretched health service. (Source: The Surgeon)
Source: The Surgeon - January 12, 2019 Category: Surgery Source Type: research

Alshryda S et al. Evidence based treatment for unstable slipped upper femoral epiphysis: Systematic review and exploratory patient level analysis. The Surgeon. 2018; 16: 46–54
Publication date: Available online 2 December 2018Source: The SurgeonAuthor(s): Reinhold Ganz (Source: The Surgeon)
Source: The Surgeon - December 2, 2018 Category: Surgery Source Type: research

Use of laparoscopic videos amongst surgical trainees in the United Kingdom
ConclusionsSurgical trainees consider videos a useful adjunct in laparoscopic surgery training, with preference for open access sources. Trainees value highly informative videos with supplementary educational content. (Source: The Surgeon)
Source: The Surgeon - November 11, 2018 Category: Surgery Source Type: research

List of editors
Publication date: December 2018Source: The Surgeon, Volume 16, Issue 6Author(s): (Source: The Surgeon)
Source: The Surgeon - November 9, 2018 Category: Surgery Source Type: research

Contents list
Publication date: December 2018Source: The Surgeon, Volume 16, Issue 6Author(s): (Source: The Surgeon)
Source: The Surgeon - November 9, 2018 Category: Surgery Source Type: research

Management of post cholecystectomy vascular injuries
ConclusionVascular injury is an uncommon complication of cholecystectomy with catastrophic outcome if not managed timely and properly. Adequate surgeon training, keeping the possibility of aberrant vasculobiliary anatomy in all cases, and proper surgical technique is crucial for prevention of such injuries. However in such an event, proper documentation and referral to tertiary centre will help in decreasing morbidity and further litigation. (Source: The Surgeon)
Source: The Surgeon - November 3, 2018 Category: Surgery Source Type: research

Meta-analysis of the effect of sarcopenia in predicting postoperative mortality in emergency and elective abdominal surgery
Publication date: Available online 30 October 2018Source: The SurgeonAuthor(s): Shahab Hajibandeh, Shahin Hajibandeh, Ross Jarvis, Talvinder Bhogal, Sanjush DalmiaAbstractsObjectivesTo investigate the effect of sarcopenia on postoperative mortality in patients undergoing emergency abdominal procedures and to compare postoperative mortality in patients with sarcopenia undergoing emergency abdominal procedures with those undergoing elective abdominal procedures.MethodsA search of electronic information sources was conducted to identify all observational studies comparing sarcopenia with no sarcopenia in a) emergency abdomina...
Source: The Surgeon - October 31, 2018 Category: Surgery Source Type: research

Provision of simulation-based training (SBT) within UK vascular surgery training programmes
ConclusionsThe provision of SBT within regional vascular surgical training programmes is variable and hindered by insufficient resources and funding. A uniform policy for the provision of SBT is required to address these regional disparities. (Source: The Surgeon)
Source: The Surgeon - October 27, 2018 Category: Surgery Source Type: research

Mesh fixation technique in totally extraperitoneal inguinal hernia repair – A network meta-analysis
Publication date: Available online 27 October 2018Source: The SurgeonAuthor(s): Suphakarn Techapongsatorn, Amarit Tansawet, Wisit Kasetsermwiriya, Mark McEvoy, John Attia, Chumpon Wilasrusmee, Ammarin ThakkinstianAbstractLaparoscopic totally extra-peritoneal inguinal hernia repair is the standard option for inguinal hernia treatment. However, there are various types of mesh fixation and their relative uses are still controversial. This network meta-analysis was conducted to compare and rank the different fixations available for TEP. Medline and Scopus databases were search until February 1, 2017 and using randomized contro...
Source: The Surgeon - October 27, 2018 Category: Surgery Source Type: research

A meta-analysis comparing the direct anterior with other approaches in primary total hip arthroplasty
Publication date: Available online 22 October 2018Source: The SurgeonAuthor(s): Fatih Kucukdurmaz, Mohamed Sukeik, Javad ParviziAbstractBackgroundProponents of the direct anterior approach (DAA) for THAs suggest earlier recovery with no increased complications whereas opponents suggest higher complication rates.MethodsWe conducted a meta-analysis of randomized controlled trials (RCTs) to compare the outcomes of the DAA versus other surgical approaches in primary THAs.ResultsWe identified 18 RCTs suitable for detailed extraction of the data. The RCTs included a total of 1661 patients with a mean age of 62 years (range 55&nd...
Source: The Surgeon - October 23, 2018 Category: Surgery Source Type: research

Association between sarcopaenia and outcomes in a vascular surgical patient cohort
Publication date: Available online 15 October 2018Source: The SurgeonAuthor(s): Ju-Dong Li, Xin-Fei Xu, Jiong-Jie Yu, Tian Yang (Source: The Surgeon)
Source: The Surgeon - October 16, 2018 Category: Surgery Source Type: research