Surgeon-Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland最新文献

{"title":"The role of gastropexy in paraesophageal hernia repair: A scoping review of current evidence","authors":"Haneen Kamran,&nbsp;Hamza Shafiq,&nbsp;Misha Mansoor,&nbsp;Umm-e-Aimen Minhas,&nbsp;Sameen Tahira,&nbsp;Sameen Shahid,&nbsp;Farah Khan","doi":"10.1016/j.surge.2024.10.001","DOIUrl":"10.1016/j.surge.2024.10.001","url":null,"abstract":"<div><h3>Background</h3><div>Paraesophageal hernias (PEH), involving abdominal components herniating through the esophageal hiatus, pose serious risks like obstruction and perforation, prompting SAGES to recommend repair upon symptom onset in 2013. Despite surgical advancements, high recurrence rates persist post-PEH repair. Gastropexy, securing the stomach to prevent re-herniation, emerges as a potential solution. However, consensus on its application is lacking. This review aims to map existing research, summarize evidence, and identify gaps guiding future gastropexy research in PEH repair.</div></div><div><h3>Methods</h3><div>Following PRISMA guidelines, this scoping review conducted a comprehensive literature search using PubMed, Cochrane, and Embase. Eligible studies, including RCTs, observational, and cohort studies, described gastropexy for PEH treatment in adults published in English after 2013. Articles were rigorously screened, with data extracted and organized into tables detailing study characteristics, conditions, and outcomes.</div></div><div><h3>Results</h3><div>A search yielded 343 studies on gastropexy for PEH, with 17 meeting inclusion criteria. Most were retrospective (47.1 %) or case series (41.2 %). GP, primarily in types III and IV hernias, was mainly performed laparoscopically. Anterior GP was most commonly used (in 64.7 % of included studies), with some studies using additional techniques. Reduced recurrence rates were seen when adjunct procedures such as fundoplication were performed with gastropexy.</div></div><div><h3>Conclusion</h3><div>This review highlights the varied application of gastropexy in PEH repair, aiming to reconcile differing surgeon opinions. The data suggests gastropexy can be safely utilised across different techniques, offering a viable option for addressing PEH and reducing hernia recurrence, particularly in high-risk cases.</div></div>","PeriodicalId":49463,"journal":{"name":"Surgeon-Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland","volume":"23 1","pages":"Pages e21-e31"},"PeriodicalIF":2.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142479006","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparative study of the outcomes of one-stage versus two-stage reconstruction of chronic multiligament knee injury","authors":"S.A. Arojuraye ,&nbsp;Ibrahim Abolaji Alabi ,&nbsp;Ndubuisi Okoh ,&nbsp;Folajuwon Bayode Ayeni ,&nbsp;Musliu Kolawole Odunola ,&nbsp;M.N. Salihu","doi":"10.1016/j.surge.2024.10.004","DOIUrl":"10.1016/j.surge.2024.10.004","url":null,"abstract":"<div><h3>Background</h3><div>Multi-ligament knee injury (MLKI) is a complex orthopaedic knee problem, usually following traumatic knee dislocation. Surgical management is preferred and has resulted in better clinical outcomes. However, the optimal surgical treatment protocol is continuously evolving. This study aimed to compare the outcomes of one-stage versus two-stage reconstruction of MLKI.</div></div><div><h3>Materials and methods</h3><div>This retrospective comparative study was conducted between July 2020 and December 2023 at a government orthopaedic hospital in Nigeria. The inclusion criteria include males and females between 18 and 45 years of age who had one- or two staged knee reconstructions for MLKI and were followed up for a minimum of 12 months. The exclusion criteria were patients below 18 and above 45 years of age, those with previous knee surgery, those associated with femoral or tibia fractures, those with radiological evidence of osteoarthritis, and those with follow-ups less than 12 months. Clinical outcomes using the Lysholm scoring system and complication rate were recorded. The statistical analysis was performed using SPSS version 23.</div></div><div><h3>Results</h3><div>Fifty-one patients (26 in the OS group and 25 in the TS group) were studied. There was a significant difference between the preoperative and postoperative Lysholm scores in the two groups (p = 0.86 and 0.57 for OS and TS, respectively). However, there was no significant difference between the postoperative Lysholm scores in the two groups (p = 0.918).</div></div><div><h3>Conclusion</h3><div>One-stage and two-stage reconstruction of chronic MLKI give similar excellent clinical outcomes.</div></div>","PeriodicalId":49463,"journal":{"name":"Surgeon-Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland","volume":"23 1","pages":"Pages 27-29"},"PeriodicalIF":2.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142523466","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Score card for individual contribution to global and remote surgery","authors":"Rahul M. Jindal","doi":"10.1016/j.surge.2024.11.006","DOIUrl":"10.1016/j.surge.2024.11.006","url":null,"abstract":"","PeriodicalId":49463,"journal":{"name":"Surgeon-Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland","volume":"23 1","pages":"Pages e33-e34"},"PeriodicalIF":2.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142639898","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The prevalence and impact of microaggressions within orthopaedics in the United States of America: A systematic review","authors":"B. Azam ,&nbsp;A. Bakhiet ,&nbsp;W. Moussa ,&nbsp;M.A. Sajid ,&nbsp;M.K. Qureshi ,&nbsp;A. Kumar ,&nbsp;U.A. Halim","doi":"10.1016/j.surge.2024.11.010","DOIUrl":"10.1016/j.surge.2024.11.010","url":null,"abstract":"<div><h3>Background</h3><div>Microaggressions are being increasingly documented within the medical community. With their rising prevalence, there is concern that microaggressions can lead to suboptimal working environments, victim burnout, and compromised patient safety. Orthopaedics, known for macroaggressions like bullying and sexual discrimination, remains the least diverse specialty, potentially predisposing its staff to microaggressions. The aim of this paper was to determine the prevalence of microaggressions within Trauma and Orthopaedics, and ascertain the impact they have within the specialty.</div></div><div><h3>Methods</h3><div>A systematic review was carried out using PRISMA guidelines. Publications pertaining to microaggressions in orthopaedics in the English language were included, with no restrictions relating to study location, date of publication or the victims of microaggressions.</div></div><div><h3>Results</h3><div>29 papers were included in this systematic review, of which 10 papers were eligible for inclusion. The prevalence of microaggressions in orthopaedics based on gender was discussed in 5 papers, whilst microaggressions relating to race/ethnicity were discussed in 2 papers. A further 2 papers discussed microaggressions relating to both race and gender. All were published in the United States of America (USA). It was found that microaggressions are common in orthopaedics, with 80 % of respondents across 3 cross sectional surveys experiencing some form of microaggression.</div></div><div><h3>Conclusion</h3><div>Microaggressions are a significant problem within the American orthopaedic community. They affect surgeons of all grades, and deter medical students from pursuing orthopaedics as a career. It is important to develop mitigating strategies to tackle this behaviour, in the hope that working environments and patient safety improve in orthopaedic departments.</div></div>","PeriodicalId":49463,"journal":{"name":"Surgeon-Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland","volume":"23 1","pages":"Pages 52-60"},"PeriodicalIF":2.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142807343","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"List of editors","authors":"","doi":"10.1016/S1479-666X(25)00018-6","DOIUrl":"10.1016/S1479-666X(25)00018-6","url":null,"abstract":"","PeriodicalId":49463,"journal":{"name":"Surgeon-Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland","volume":"23 1","pages":"Page i"},"PeriodicalIF":2.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143420598","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Research progress in the etiology and minimally invasive therapy of hallux valgus","authors":"YongJia Zhu,&nbsp;Ming Gao,&nbsp;Haowen Tan,&nbsp;JiaPeng Yan,&nbsp;HongFei Zhang","doi":"10.1016/j.surge.2025.01.005","DOIUrl":"10.1016/j.surge.2025.01.005","url":null,"abstract":"<div><div>Hallux valgus (HV) is the most common foot deformity. It has various pathogenic factors that make its pathogenesis challenging to understand. As the disease progresses, patients experience amplified pain and decreased activities, significantly affecting their quality of life.</div><div>At present, clinics offer several conservative and surgical treatments that must be selected based on patient condition and disease progression. Surgical treatment is frequently the only method available to patients with HV to delay disease progression and correct the deformity after conservative treatment fails.</div><div>In recent years, minimally invasive surgical treatments have gained significant attention and developed rapidly due to their well-known advantages, such as safety, efficiency, and quick recovery time. The number of literature that provides a systematic review of the subject must be increased.</div><div>This review tracks recent advancements, summarizing the etiological mechanism, epidemiology, diagnosis, and treatment of HV. In addition, it emphasizes typical surgical therapies and focuses on the progress of minimally invasive treatment from the first generation to the current fourth generation. This review will serve as a systematic basis for the clinical treatment of HV and provide a reference material for future research.</div></div>","PeriodicalId":49463,"journal":{"name":"Surgeon-Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland","volume":"23 1","pages":"Pages e9-e20"},"PeriodicalIF":2.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143043010","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The positive effects of preoperative chlorhexidine rinse to reduce postoperative pneumonia after kidney transplantation surgery","authors":"Murat Ferhat Ferhatoglu ,&nbsp;Osman Z. Sahin ,&nbsp;Taner Kivilcim ,&nbsp;Alp Gurkan","doi":"10.1016/j.surge.2024.07.001","DOIUrl":"10.1016/j.surge.2024.07.001","url":null,"abstract":"<div><h3>Background</h3><div><span><span>Postoperative pneumonia is one of the most observed hospital-acquired infections and increases the postoperative mortality rate. Further, it drives the healthcare systems under a severe financial burden. Preventing postoperative pneumonia is an incredibly challenging issue for clinicians. Since </span>immunosuppression<span><span> therapy, the patients who had kidney transplants are more vulnerable to </span>postoperative infections<span>. There is no data in the scientific literature focusing on the effects of preoperative oral care with chlorhexidine </span></span></span>antiseptic solutions<span> on postoperative pneumonia in kidney transplantation surgery cases. In the present research, we studied this topic.</span></div></div><div><h3>Methods</h3><div><span>A prospective, randomized clinical trial was conducted at our institution between August 2020 and August 2022. </span><strong>Group A</strong>: Received 0.12 % chlorhexidine oral rinse preoperatively; <strong>Group B:</strong> Not received 0.12 % chlorhexidine oral rinse preoperatively. We analyzed the differences between the two trial groups using a chi-square or <em>t</em>-test. The Mann-Whitney <em>U</em> test was used for the categorical data.</div></div><div><h3>Results</h3><div>Nine patients (17.6 %) were diagnosed with postoperative pneumonia in Group A and fourteen (25.9 %) in Group B (p &lt; 0.05). Hospitalization time of Group B was prolonged (p &lt; 0.05). In multivariate analysis<span>, significant risk factors associated with postoperative pneumonia were advanced age, diabetes mellitus, smoking, delayed graft function and not gargling with 0.12 % chlorhexidine (p &lt; 0.05).</span></div></div><div><h3>Conclusions</h3><div>To reduce postoperative pneumonia risk in patients undergoing kidney transplantation surgery, an oral health protocol including 0.12 % chlorhexidine mouth rinse seems beneficial.</div></div>","PeriodicalId":49463,"journal":{"name":"Surgeon-Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland","volume":"23 1","pages":"Pages 18-22"},"PeriodicalIF":2.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141564947","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Tight application of a surgical tourniquet prior to inflation increases venous pressure in the upper limb; Potentially resulting in increased blood loss and poorer visibility","authors":"Ross Condell ,&nbsp;Dhruv Kapoor ,&nbsp;Alexander Price ,&nbsp;David O'Briain","doi":"10.1016/j.surge.2024.08.015","DOIUrl":"10.1016/j.surge.2024.08.015","url":null,"abstract":"<div><h3>Background</h3><div>Tourniquets are commonly used in extremity surgery to help provide a bloodless operative field to improve visibility and reduce length of procedures. With the development of WALANT (wide awake, local anaesthetic, no tourniquet) techniques, many surgeons undertake surgery without tourniquet inflation. The correct technique of pneumatic tourniquet application is poorly understood by healthcare staff. The application of a tight tourniquet when applied for optional use or use for only a portion of a procedure, rather than for inflation throughout can cause venous engorgement of an extremity leading to increased blood loss and reduced operative field visualisation thereby discouraging surgeons from persevering with WALANT strategies.</div></div><div><h3>Aim</h3><div>To determine the effect of tourniquet application tension on limb volume prior to skin incision.</div></div><div><h3>Methods</h3><div>30 volunteers had the volume of their non-dominant forearm measured post-inflation of a surgical tourniquet using two different application techniques. Tight application was defined as the tourniquet fastened using a dynamometer to a tension of 100 N. Loose application was defined as the tourniquet fastened using a dynamometer to a tension of 50 N. The tourniquet was then inflated to 200 mmHg after both application techniques. Exsanguination was performed by elevation of the arm for 1 min prior to tourniquet inflation. At 5 min the forearm volume was measured using a volume displacement technique.</div></div><div><h3>Results</h3><div>93 % of participants (28/30) had a higher volume of water displaced when the tourniquet was applied tightly. The mean difference between the loose and tight applications was 30.06 mls.</div></div><div><h3>Conclusion</h3><div>The increase in volume in tightly applied tourniquets is believed to result from increased intravascular volume. This increase in blood volume can lead to increased intra-operative blood loss and poor intra-operative visualisation when operating without tourniquet inflation. Loose application of the tourniquet pre-inflation appears to prevent sequestration of venous blood in the limb, therefore decreasing operative blood loss and improving view for operating.</div></div><div><h3>Level of evidence</h3><div>Level 1; Symptom Prevalence Study.</div></div>","PeriodicalId":49463,"journal":{"name":"Surgeon-Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland","volume":"23 1","pages":"Pages 23-26"},"PeriodicalIF":2.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142127156","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Supporting trainees in difficulty: A guiding hand through challenging times","authors":"Michael El Boghdady","doi":"10.1016/j.surge.2024.11.013","DOIUrl":"10.1016/j.surge.2024.11.013","url":null,"abstract":"","PeriodicalId":49463,"journal":{"name":"Surgeon-Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland","volume":"23 1","pages":"Pages e35-e36"},"PeriodicalIF":2.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142848198","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Embracing change: The potential of artificial intelligence in transforming surgical practice","authors":"Kaiser O'Sahil Sadiq","doi":"10.1016/j.surge.2025.01.002","DOIUrl":"10.1016/j.surge.2025.01.002","url":null,"abstract":"","PeriodicalId":49463,"journal":{"name":"Surgeon-Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland","volume":"23 1","pages":"Pages e44-e45"},"PeriodicalIF":2.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143015002","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}