Pub Date : 2024-05-13DOI: 10.1016/j.surge.2024.04.015
Background
This study aims to shed light on the profound ramifications of the military conflict that started in April 2023 on surgical practice in Sudan.
Methods
This is a survey-based study. The survey link was disseminated to Sudanese medical practitioners via various social media (WhatsApp, Telegram, X (previously twitter) and Facebook) channels. We included only responses from medical practitioners working in the surgical specialities.
Results
A total of 90 responses have been collected. All participants were working in surgical service provision institutes. Sixty per cent of the responses were from the age group 25–35 years old, and two-thirds of the total cohort either left Sudan or was internally displaced because of the conflict. Moreover, 51% are no longer practising because they had to flee the conflict area (75%) or because the hospital is out of service (20%). There was a significant drop in the average number of emergency and elective lists.
Conclusion
The military conflict affected Sudan's already strained health system. There was a significant drop in the average number of emergency and elective lists with surgeons out of practice because they had to flee the conflict area and hospitals were out of service.
{"title":"Scalpel and strife: Assessing the impact of Sudan's ongoing civil war on surgical practice and healthcare delivery","authors":"","doi":"10.1016/j.surge.2024.04.015","DOIUrl":"10.1016/j.surge.2024.04.015","url":null,"abstract":"<div><h3>Background</h3><p>This study aims to shed light on the profound ramifications of the military conflict that started in April 2023 on surgical practice in Sudan.</p></div><div><h3>Methods</h3><p>This is a survey-based study. The survey link was disseminated to Sudanese medical practitioners via various social media (WhatsApp, Telegram, X (previously twitter) and Facebook) channels. We included only responses from medical practitioners working in the surgical specialities.</p></div><div><h3>Results</h3><p>A total of 90 responses have been collected. All participants were working in surgical service provision institutes. Sixty per cent of the responses were from the age group 25–35 years old, and two-thirds of the total cohort either left Sudan or was internally displaced because of the conflict. Moreover, 51% are no longer practising because they had to flee the conflict area (75%) or because the hospital is out of service (20%). There was a significant drop in the average number of emergency and elective lists.</p></div><div><h3>Conclusion</h3><p>The military conflict affected Sudan's already strained health system. There was a significant drop in the average number of emergency and elective lists with surgeons out of practice because they had to flee the conflict area and hospitals were out of service.</p></div>","PeriodicalId":49463,"journal":{"name":"Surgeon-Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140923664","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}
Pub Date : 2024-05-11DOI: 10.1016/j.surge.2024.04.011
Jessica M Ryan, Anastasija Simiceva, Conor Toale, Walter Eppich, Dara O Kavanagh, Deborah A McNamara
Background: Handovers of care are potentially hazardous moments in the patient journey and can lead to harm if conducted poorly. Through a national survey of surgical doctors in Ireland, this paper assesses contemporary surgical handover practices and evaluates barriers and facilitators of effective handover.
Methods: After ethical approval and pre-testing with a representative sample, a cross-sectional, online survey was distributed to non-consultant hospital doctors (NCHDs) working in the Republic of Ireland. A mixed-methods approach was used, combining data using triangulation design.
Main findings: A total of 201 responses were received (18.5%). Most participants were senior house officers or senior registrars (49.7% and 37.3%). Most people (85.1%) reported that information received during handover was missing or incorrect at least some of the time. One-third of respondents reported that a near-miss had occurred as a result of handover within the past three months, and handover-related errors resulted in minor (16.9%), moderate (4.9%), or major (1.5%) harm. Only 11.4% had received any formal training. Reported barriers to handover included negative attitudes, a lack of institutional support, and competing clinical activities. Facilitators included process standardisation, improved access to resources, and staff engagement.
Conclusions: Surgical NCHDs working in Irish hospitals reported poor compliance with international best practice for handover and identified potential harms. Process standardisation, appropriate staff training, and the provision of necessary handover-related resources is required at a national level to address this significant patient safety concern.
{"title":"Assessing current handover practices in surgery: A survey of non-consultant hospital doctors in Ireland.","authors":"Jessica M Ryan, Anastasija Simiceva, Conor Toale, Walter Eppich, Dara O Kavanagh, Deborah A McNamara","doi":"10.1016/j.surge.2024.04.011","DOIUrl":"https://doi.org/10.1016/j.surge.2024.04.011","url":null,"abstract":"<p><strong>Background: </strong>Handovers of care are potentially hazardous moments in the patient journey and can lead to harm if conducted poorly. Through a national survey of surgical doctors in Ireland, this paper assesses contemporary surgical handover practices and evaluates barriers and facilitators of effective handover.</p><p><strong>Methods: </strong>After ethical approval and pre-testing with a representative sample, a cross-sectional, online survey was distributed to non-consultant hospital doctors (NCHDs) working in the Republic of Ireland. A mixed-methods approach was used, combining data using triangulation design.</p><p><strong>Main findings: </strong>A total of 201 responses were received (18.5%). Most participants were senior house officers or senior registrars (49.7% and 37.3%). Most people (85.1%) reported that information received during handover was missing or incorrect at least some of the time. One-third of respondents reported that a near-miss had occurred as a result of handover within the past three months, and handover-related errors resulted in minor (16.9%), moderate (4.9%), or major (1.5%) harm. Only 11.4% had received any formal training. Reported barriers to handover included negative attitudes, a lack of institutional support, and competing clinical activities. Facilitators included process standardisation, improved access to resources, and staff engagement.</p><p><strong>Conclusions: </strong>Surgical NCHDs working in Irish hospitals reported poor compliance with international best practice for handover and identified potential harms. Process standardisation, appropriate staff training, and the provision of necessary handover-related resources is required at a national level to address this significant patient safety concern.</p>","PeriodicalId":49463,"journal":{"name":"Surgeon-Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2024-05-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140912969","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}
Pub Date : 2024-04-30DOI: 10.1016/j.surge.2024.04.003
K. O'Reilly , J.M. McDonnell , S. Ibrahim , J.S. Butler , J.D. Martin-Smith , J.B. O'Sullivan , R.T. Dolan
Introduction
Surgeons are at high risk of developing musculoskeletal symptoms due to a range of factors including, maladaptive positioning and surgical ergonomics. Cervical muscle strain and biomechanical load is most prevalent due to repetitive motions and prolonged static neck positioning. This issue is apparent through reports of prevalence between 10 and 74.4% among surgeons. The aim of this systematic review is to provide an objective assessment of the clinical evidence available and a descriptive analysis of the effects of kinematics and surgical ergonomics on the prevalence of surgeons' cervical musculoskeletal pain.
Methods
This is PRISMA-compliant systematic review of clinical studies assessing the prevalence of cervical musculoskeletal dysfunction in surgeons by searching PUBMED and Ovid EMBASE databases from inception to 19th October 2023. Study quality was graded according to the National Institutes of Health study quality assessment tools.
Results
A total of 9 studies were included in the final qualitative analysis. The use of loupes, open surgery and excessive neck flexion (>30°) were associated with cervical dysfunction. Comparison of study outcomes was challenging due to heterogeneity within study methods and the paucity of methodological quality.
Conclusion
The current literature assessing ergonomic and biomechanical factors predisposing surgeons to cervical musculoskeletal dysfunction is insufficient to provide reliable guidance for clinicians. Although the literature identifies factors contributing to work-related cervical dysfunction, few attempt to evaluate interventions for improved surgical ergonomics. An objective assessment of interventions that prompt postural correction with the aim to improve neck pain in surgeon cohorts is warranted.
{"title":"Biomechanical and ergonomic risks associated with cervical musculoskeletal dysfunction amongst surgeons: A systematic review","authors":"K. O'Reilly , J.M. McDonnell , S. Ibrahim , J.S. Butler , J.D. Martin-Smith , J.B. O'Sullivan , R.T. Dolan","doi":"10.1016/j.surge.2024.04.003","DOIUrl":"10.1016/j.surge.2024.04.003","url":null,"abstract":"<div><h3>Introduction</h3><p>Surgeons are at high risk of developing musculoskeletal symptoms due to a range of factors including, maladaptive positioning and surgical ergonomics. Cervical muscle strain and biomechanical load is most prevalent due to repetitive motions and prolonged static neck positioning. This issue is apparent through reports of prevalence between 10 and 74.4% among surgeons. The aim of this systematic review is to provide an objective assessment of the clinical evidence available and a descriptive analysis of the effects of kinematics and surgical ergonomics on the prevalence of surgeons' cervical musculoskeletal pain.</p></div><div><h3>Methods</h3><p>This is PRISMA-compliant systematic review of clinical studies assessing the prevalence of cervical musculoskeletal dysfunction in surgeons by searching PUBMED and Ovid EMBASE databases from inception to 19th October 2023. Study quality was graded according to the National Institutes of Health study quality assessment tools.</p></div><div><h3>Results</h3><p>A total of 9 studies were included in the final qualitative analysis. The use of loupes, open surgery and excessive neck flexion (>30°) were associated with cervical dysfunction. Comparison of study outcomes was challenging due to heterogeneity within study methods and the paucity of methodological quality.</p></div><div><h3>Conclusion</h3><p>The current literature assessing ergonomic and biomechanical factors predisposing surgeons to cervical musculoskeletal dysfunction is insufficient to provide reliable guidance for clinicians. Although the literature identifies factors contributing to work-related cervical dysfunction, few attempt to evaluate interventions for improved surgical ergonomics. An objective assessment of interventions that prompt postural correction with the aim to improve neck pain in surgeon cohorts is warranted.</p></div>","PeriodicalId":49463,"journal":{"name":"Surgeon-Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2024-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1479666X24000350/pdfft?md5=277b08e910101ec5a0cbfb46ff7fb4bd&pid=1-s2.0-S1479666X24000350-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140859249","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-04-30DOI: 10.1016/j.surge.2024.04.008
Elena Artioli , Antonio Mazzotti , Simone Ottavio Zielli , Alberto Arceri , Edoardo Cassanelli , Federico Pilla , Cesare Faldini
Purpose
Arthroscopy of the first metatarsophalangeal joint (1 MTP) has gained increasing attention in the last two decades. Despite numerous studies describing the surgical technique, only a few provide clinical or radiological outcome data. This systematic review aimed to analyze studies presenting objectively measurable clinical outcomes of patients who underwent 1 MTP arthroscopy as the primary procedure, categorizing results by indication pathology.
Methods
Following PRISMA guidelines, PubMed and Cochrane databases were searched for studies reporting outcomes of primary 1 MTP arthroscopy, regardless of underlying pathology. The selected articles were thoroughly assessed to extract data regarding the demographics of included patients, pathology, preoperative and postoperative clinical and radiological outcomes, complications, and reinterventions.
Results
Fourteen articles, involving 405 patients (419 halluces), were included. Common indications were hallux valgus and hallux rigidus. Notably, Hallux Valgus Angle improved from 28.9° to 12.7°, and Intermetatarsal Angle improved from 13.8° to 9.2°, where reported. In hallux rigidus patients, range of motion increased from 25.15° to 71.3° post-surgery. Temporary or permanent sensory loss occurred in 3% of treated halluces, with 4.28% requiring reoperation.
Conclusions
Evidence on 1 MTP arthroscopy as the primary procedure is limited. It is most effective for hallux rigidus, while in hallux valgus cases, it can achieve satisfactory angular corrections but has a relatively high recurrence and reoperation rate. Although this technique is generally safe, further research should compare it with traditional surgical approaches to provide comprehensive insights.
{"title":"First metatarsophalangeal joint arthroscopy: Unearthing clinical evidence – A systematic review","authors":"Elena Artioli , Antonio Mazzotti , Simone Ottavio Zielli , Alberto Arceri , Edoardo Cassanelli , Federico Pilla , Cesare Faldini","doi":"10.1016/j.surge.2024.04.008","DOIUrl":"10.1016/j.surge.2024.04.008","url":null,"abstract":"<div><h3>Purpose</h3><p>Arthroscopy of the first metatarsophalangeal joint (1 MTP) has gained increasing attention in the last two decades. Despite numerous studies describing the surgical technique, only a few provide clinical or radiological outcome data. This systematic review aimed to analyze studies presenting objectively measurable clinical outcomes of patients who underwent 1 MTP arthroscopy as the primary procedure, categorizing results by indication pathology.</p></div><div><h3>Methods</h3><p>Following PRISMA guidelines, PubMed and Cochrane databases were searched for studies reporting outcomes of primary 1 MTP arthroscopy, regardless of underlying pathology. The selected articles were thoroughly assessed to extract data regarding the demographics of included patients, pathology, preoperative and postoperative clinical and radiological outcomes, complications, and reinterventions.</p></div><div><h3>Results</h3><p>Fourteen articles, involving 405 patients (419 halluces), were included. Common indications were hallux valgus and hallux rigidus. Notably, Hallux Valgus Angle improved from 28.9° to 12.7°, and Intermetatarsal Angle improved from 13.8° to 9.2°, where reported. In hallux rigidus patients, range of motion increased from 25.15° to 71.3° post-surgery. Temporary or permanent sensory loss occurred in 3% of treated halluces, with 4.28% requiring reoperation.</p></div><div><h3>Conclusions</h3><p>Evidence on 1 MTP arthroscopy as the primary procedure is limited. It is most effective for hallux rigidus, while in hallux valgus cases, it can achieve satisfactory angular corrections but has a relatively high recurrence and reoperation rate. Although this technique is generally safe, further research should compare it with traditional surgical approaches to provide comprehensive insights.</p></div><div><h3>Level of evidence</h3><p>IV</p></div>","PeriodicalId":49463,"journal":{"name":"Surgeon-Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2024-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140868663","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}
Pub Date : 2024-04-26DOI: 10.1016/j.surge.2024.04.009
Objectives/aims
The primary aim of this study was to assess the current standard of shoulder radiographs in Ireland. The secondary aim of this study was to determine whether orthopaedic surgeons in Ireland are of the opinion that a national protocol is required, and what this protocol should consist of.
Methods
A national audit of shoulder trauma series x-rays performed in emergency departments was conducted. The number and type of views performed was recorded. The anteroposterior (AP) and axillary or Velpeau views were assessed to determine if they met pre-defined audit criteria. Consultant orthopaedic surgeons working in public trauma hospitals were invited to participate in an online survey by email.
Results
The number of shoulder trauma series included in this audit was 789. The majority of patients had two views performed (75.92%, n = 599) and 21.17% (n = 167) had an axillary or Velpeau view. The AP view met the audit criteria in 23.09% (n = 181) of cases. The survey response rate was 70.8% (n = 17). 88.2% (n = 15) of surgeons agreed that three views should be performed for a shoulder trauma series and 94.12% (n = 16) agreed that an axillary or Velpeau view should be included. The majority of surgeons surveyed (94%, n = 16) are in favour of establishing a national protocol.
Conclusion
The current standard shoulder trauma series in Irish hospitals consists of two views, most frequently a thoracic AP and a scapular Y view. We propose the introduction of a national protocol consisting of three views: Grashey AP, Scapular Y, and an axillary or Velpeau view.
目的/宗旨：本研究的主要目的是评估爱尔兰目前的肩部放射摄影标准。研究的次要目的是确定爱尔兰的骨科医生是否认为需要制定一项全国性协议，以及该协议应包括哪些内容：方法：对急诊科进行的肩部创伤系列 X 光片进行全国性审核。方法：对急诊科进行的肩部外伤系列 X 光片进行了一次全国性审计，记录了所做切面的数量和类型。对前正位（AP）切面、腋窝切面或维尔普切面进行评估，以确定其是否符合预先设定的审核标准。通过电子邮件邀请在公立创伤医院工作的骨科顾问外科医生参与在线调查：结果：本次审核共纳入 789 例肩部创伤病例。大多数患者都进行了两种视图检查（75.92%，n = 599），21.17%的患者（n = 167）进行了腋窝或Velpeau视图检查。有 23.09% 的病例（n = 181）的 AP 切面符合审计标准。调查回复率为 70.8%（n = 17）。88.2%（n = 15）的外科医生同意在肩部创伤系列手术中应进行三视图检查，94.12%（n = 16）的外科医生同意应包括腋窝或Velpeau视图。接受调查的大多数外科医生（94%，n = 16）都赞成制定一项国家协议：结论：爱尔兰医院目前的标准肩部创伤系列包括两个切面，最常见的是胸AP切面和肩胛Y切面。我们建议采用由三个切面组成的全国性方案：Grashey AP 切面、肩胛 Y 切面和腋窝或 Velpeau 切面。
{"title":"The current standard of the shoulder trauma series in Ireland – A national audit","authors":"","doi":"10.1016/j.surge.2024.04.009","DOIUrl":"10.1016/j.surge.2024.04.009","url":null,"abstract":"<div><h3>Objectives/aims</h3><p>The primary aim of this study was to assess the current standard of shoulder radiographs in Ireland. The secondary aim of this study was to determine whether orthopaedic surgeons in Ireland are of the opinion that a national protocol is required, and what this protocol should consist of.</p></div><div><h3>Methods</h3><p>A national audit of shoulder trauma series x-rays performed in emergency departments was conducted. The number and type of views performed was recorded. The anteroposterior (AP) and axillary or Velpeau views were assessed to determine if they met pre-defined audit criteria. Consultant orthopaedic surgeons working in public trauma hospitals were invited to participate in an online survey by email.</p></div><div><h3>Results</h3><p>The number of shoulder trauma series included in this audit was 789. The majority of patients had two views performed (75.92%, n = 599) and 21.17% (n = 167) had an axillary or Velpeau view. The AP view met the audit criteria in 23.09% (n = 181) of cases. The survey response rate was 70.8% (n = 17). 88.2% (n = 15) of surgeons agreed that three views should be performed for a shoulder trauma series and 94.12% (n = 16) agreed that an axillary or Velpeau view should be included. The majority of surgeons surveyed (94%, n = 16) are in favour of establishing a national protocol.</p></div><div><h3>Conclusion</h3><p>The current standard shoulder trauma series in Irish hospitals consists of two views, most frequently a thoracic AP and a scapular Y view. We propose the introduction of a national protocol consisting of three views: Grashey AP, Scapular Y, and an axillary or Velpeau view.</p></div>","PeriodicalId":49463,"journal":{"name":"Surgeon-Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-04-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140868669","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}
Pub Date : 2024-04-26DOI: 10.1016/j.surge.2024.04.006
Andrew R. Grant , Ruijia Niu , Abigail Smith , Elisabeth R. Grant , Eric L. Smith
Introduction
The physician–patient interaction now begins before patients arrive in the office. Online ratings, social media profiles, and online award status are all components of physician online reputation which contributes to the patient's initial impressions. Therefore, it is important to understand the interplay of these factors and determine if there is a consistent trend indicating the value of this information.
Methods
We Identified all (N = 160) registered American Association of Hip and Knee Surgeons (AAHKS) in New England using the https://findadoctor.aahks.net/tool for Massachusetts (MA), Connecticut (CT), Rhode Island (RI), Vermont (VT), New Hampshire (NH), and Maine (ME) on 6/26/2023. We collected surgeon age, fellowship graduation year, and practice type (i.e. Academic or Private). The average 5-star rating and number of ratings were collected from four websites. Any professional-use Facebook, Instagram, Twitter, LinkedIn, YouTube Channel, Personal Websites, or Institutional Websites were identified and a modified SMI Score was calculated. Finally, Castle Connolly Top Doctor, Local Magazine (e.g. Boston Magazine) Top Doctor, or the presence of having any award was noted for each surgeon.
Results
We identified several significant trends indicating that online awards were associated with higher online ratings. Social media presence, as determined by SMI Score, was also correlated with higher ratings overall and a higher likelihood of having an online award.
Conclusion
Given the observed trends and reported importance patients place on ratings and awards, surgeons may consider increasing online engagement via social media and encouraging patients to share their experience via online ratings.
{"title":"Do social media use and patient satisfaction scores correlate with online award recognition among hip and knee arthroplasty specialists?","authors":"Andrew R. Grant , Ruijia Niu , Abigail Smith , Elisabeth R. Grant , Eric L. Smith","doi":"10.1016/j.surge.2024.04.006","DOIUrl":"10.1016/j.surge.2024.04.006","url":null,"abstract":"<div><h3>Introduction</h3><p>The physician–patient interaction now begins before patients arrive in the office. Online ratings, social media profiles, and online award status are all components of physician online reputation which contributes to the patient's initial impressions. Therefore, it is important to understand the interplay of these factors and determine if there is a consistent trend indicating the value of this information.</p></div><div><h3>Methods</h3><p>We Identified all (N = 160) registered American Association of Hip and Knee Surgeons (AAHKS) in New England using the <span>https://findadoctor.aahks.net/</span><svg><path></path></svg>tool for Massachusetts (MA), Connecticut (CT), Rhode Island (RI), Vermont (VT), New Hampshire (NH), and Maine (ME) on 6/26/2023. We collected surgeon age, fellowship graduation year, and practice type (i.e. Academic or Private). The average 5-star rating and number of ratings were collected from four websites. Any professional-use Facebook, Instagram, Twitter, LinkedIn, YouTube Channel, Personal Websites, or Institutional Websites were identified and a modified SMI Score was calculated. Finally, Castle Connolly Top Doctor, Local Magazine (e.g. Boston Magazine) Top Doctor, or the presence of having any award was noted for each surgeon.</p></div><div><h3>Results</h3><p>We identified several significant trends indicating that online awards were associated with higher online ratings. Social media presence, as determined by SMI Score, was also correlated with higher ratings overall and a higher likelihood of having an online award.</p></div><div><h3>Conclusion</h3><p>Given the observed trends and reported importance patients place on ratings and awards, surgeons may consider increasing online engagement via social media and encouraging patients to share their experience via online ratings.</p></div>","PeriodicalId":49463,"journal":{"name":"Surgeon-Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2024-04-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140873909","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}
Pub Date : 2024-04-22DOI: 10.1016/j.surge.2024.04.005
Shahab Hajibandeh , Iain Gilham , Winnie Tam , Emma Kirby , Adetona Obaloluwa Babs-Osibodu , William Jones , George A. Rose , Damian M. Bailey , Christopher Morris , Rachel Hargest , Amy Clayton , Richard G. Davies
Objectives
To evaluate whether computed tomography (CT)-derived psoas major muscle measurements could predict preoperative cardiopulmonary exercise testing (CPET) performance and long-term mortality in patients undergoing major colorectal surgery and to compare predictive performance of psoas muscle measurements using 2D approach and 3D approach.
Methods
A retrospective cohort study compliant with STROCSS standards was conducted. Consecutive patients undergoing major colorectal surgery between January 2011 and January 2017 following CPET as part of their preoperative assessment were included. Regression analyses were modelled to investigate association between the CT-derived psoas major muscle mass variables [total psoas muscle area (TPMA), total psoas muscle volume (TPMV) and psoas muscle index (PMI)] and CPET performance and mortality (1-year and 5-year). Discriminative performances of the variables were evaluated using Receiver Operating Characteristic (ROC) curve analysis.
Results
A total of 457 eligible patients were included. The median TPMA and TPMV were 21 cm2 (IQR: 15–27) and 274 cm3 (IQR: 201–362), respectively. The median PMI measured via 2D and 3D approaches were 7 cm2/m2 (IQR: 6–9) and 99 cm3/m2 (IQR: 76–120), respectively. The risks of 1-year and 5-year mortality were 7.4% and 27.1%, respectively. Regression analyses showed TPMA, TPMV, and PMI can predict preoperative CPET performance and long-term mortality. However, ROC curve analyses showed no significant difference in predictive performance amongst TPMA, TPMV, and PMI.
Conclusion
Radiologically-measured psoas muscle mass variables may predict preoperative CPET performance and may be helpful with informing more objective selection of patients for preoperative CPET and prehabilitation.
{"title":"Association between psoas major muscle mass and CPET performance and long-term survival following major colorectal surgery: A retrospective cohort study","authors":"Shahab Hajibandeh , Iain Gilham , Winnie Tam , Emma Kirby , Adetona Obaloluwa Babs-Osibodu , William Jones , George A. Rose , Damian M. Bailey , Christopher Morris , Rachel Hargest , Amy Clayton , Richard G. Davies","doi":"10.1016/j.surge.2024.04.005","DOIUrl":"10.1016/j.surge.2024.04.005","url":null,"abstract":"<div><h3>Objectives</h3><p>To evaluate whether computed tomography (CT)-derived psoas major muscle measurements could predict preoperative cardiopulmonary exercise testing (CPET) performance and long-term mortality in patients undergoing major colorectal surgery and to compare predictive performance of psoas muscle measurements using 2D approach and 3D approach.</p></div><div><h3>Methods</h3><p>A retrospective cohort study compliant with STROCSS standards was conducted. Consecutive patients undergoing major colorectal surgery between January 2011 and January 2017 following CPET as part of their preoperative assessment were included. Regression analyses were modelled to investigate association between the CT-derived psoas major muscle mass variables [total psoas muscle area (TPMA), total psoas muscle volume (TPMV) and psoas muscle index (PMI)] and CPET performance and mortality (1-year and 5-year). Discriminative performances of the variables were evaluated using Receiver Operating Characteristic (ROC) curve analysis.</p></div><div><h3>Results</h3><p>A total of 457 eligible patients were included. The median TPMA and TPMV were 21 cm<sup>2</sup> (IQR: 15–27) and 274 cm<sup>3</sup> (IQR: 201–362), respectively. The median PMI measured via 2D and 3D approaches were 7 cm<sup>2</sup>/m<sup>2</sup> (IQR: 6–9) and 99 cm<sup>3</sup>/m<sup>2</sup> (IQR: 76–120), respectively. The risks of 1-year and 5-year mortality were 7.4% and 27.1%, respectively. Regression analyses showed TPMA, TPMV, and PMI can predict preoperative CPET performance and long-term mortality. However, ROC curve analyses showed no significant difference in predictive performance amongst TPMA, TPMV, and PMI.</p></div><div><h3>Conclusion</h3><p>Radiologically-measured psoas muscle mass variables may predict preoperative CPET performance and may be helpful with informing more objective selection of patients for preoperative CPET and prehabilitation.</p></div>","PeriodicalId":49463,"journal":{"name":"Surgeon-Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2024-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140773576","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}
Pub Date : 2024-04-17DOI: 10.1016/j.surge.2024.04.001
Eimear M. Phoenix, Jake M. McDonnell, Joseph S. Butler, Colm Fuller, Colin M. Morrison, Roisin T. Dolan
{"title":"‘Barbie Tox’ – A cosmetic trend with potential functional implications","authors":"Eimear M. Phoenix, Jake M. McDonnell, Joseph S. Butler, Colm Fuller, Colin M. Morrison, Roisin T. Dolan","doi":"10.1016/j.surge.2024.04.001","DOIUrl":"10.1016/j.surge.2024.04.001","url":null,"abstract":"","PeriodicalId":49463,"journal":{"name":"Surgeon-Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2024-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140861185","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}
Pub Date : 2024-04-16DOI: 10.1016/j.surge.2024.03.005
Kathryn Fu, James Walmsley, Mohamed Abdelrahman, David S.Y. Chan
Background
As waiting lists for elective surgery grow, there seems to be a disconnect between the public's expectations on the amount of time surgeons spend operating compared with reality. On average, a surgeon in the NHS spends one day a week performing elective surgery. We aimed to investigate the public's perception on the amount of time surgeons spend performing elective surgery and what they would desire.
Methods
Members of the public in the UK were approached randomly either on-line or in-person to complete an anonymised 6-question survey. The questionnaire included demographic details, surgical history, occupational experience in the healthcare sector, the number of days a week they believe and wish for surgeons to be performing elective surgery.
Results
252 members of the public responded to the survey (150 females, 102 males). 38.5% have experience working in the healthcare sector and 58.5% have had surgery in the past. 83.7% believe surgeons spend at least 3 days a week performing elective surgery [3–4 days (43.2%), 5–7 days (40.5%)]. 45.7% of respondents want their surgeon to operate between 5 and 7 days per week.
Conclusion
The public appears to overestimate the amount of time that surgeons spend performing elective surgery and have unrealistic expectations of how much they want their surgeons to operate.
{"title":"The public's perspective on the amount of time surgeons spend operating","authors":"Kathryn Fu, James Walmsley, Mohamed Abdelrahman, David S.Y. Chan","doi":"10.1016/j.surge.2024.03.005","DOIUrl":"10.1016/j.surge.2024.03.005","url":null,"abstract":"<div><h3>Background</h3><p>As waiting lists for elective surgery grow, there seems to be a disconnect between the public's expectations on the amount of time surgeons spend operating compared with reality. On average, a surgeon in the NHS spends one day a week performing elective surgery. We aimed to investigate the public's perception on the amount of time surgeons spend performing elective surgery and what they would desire.</p></div><div><h3>Methods</h3><p>Members of the public in the UK were approached randomly either on-line or in-person to complete an anonymised 6-question survey. The questionnaire included demographic details, surgical history, occupational experience in the healthcare sector, the number of days a week they believe and wish for surgeons to be performing elective surgery.</p></div><div><h3>Results</h3><p>252 members of the public responded to the survey (150 females, 102 males). 38.5% have experience working in the healthcare sector and 58.5% have had surgery in the past. 83.7% believe surgeons spend at least 3 days a week performing elective surgery [3–4 days (43.2%), 5–7 days (40.5%)]. 45.7% of respondents want their surgeon to operate between 5 and 7 days per week.</p></div><div><h3>Conclusion</h3><p>The public appears to overestimate the amount of time that surgeons spend performing elective surgery and have unrealistic expectations of how much they want their surgeons to operate.</p></div>","PeriodicalId":49463,"journal":{"name":"Surgeon-Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2024-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140781449","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}
Pub Date : 2024-04-16DOI: 10.1016/j.surge.2024.04.004
Kelvin Jeason Yang , Huey-Shiuan Kuo , Nai-Hsin Chi , Hsi-Yu Yu , Shoei-Shen Wang , I-Hui Wu
Objectives
Best medical therapy (BMT) for acute uncomplicated type B intramural hematoma (TBIMH) is the current treatment guideline, but there is considerable controversy about subsequent clinical course and outcome, which may be associated with a significant failure rate. The purpose of this study was to identify potential risk factors for BMT failure and to develop a risk score to guide clinical decision making.
Methods
Patients with acute uncomplicated TBIMH between 2011 January and 2020 December were retrospectively studied. Logistic regression was applied to univariately assess potential risk predictors, and multivariable model results were then used to formulate a simplified predictive model for BMT failure.
Results
In a total of 61 patients, the overall rate of BMT failure was 57.4% (35/61), of which 48.6% (17/35) occurred within 28 days of onset. Logistic regression identified maximum descending aortic diameter (HR = 1.99 CI = 1.16–3.40, p = 0.012), initial IMH thickness (HR = 3.29, CI = 1.28–8.46, p = 0.013) and presence of focal contrast enhancement (HR = 3.12, CI = 1.49–6.54, p = 0.003) as potential risk predictors of BMT failure. A risk score was calculated as follows: [Max DTA diameter (mm)∗0.6876 + Max IMH thickness (mm)∗1.1918 + PAU/ULP ∗1.1369]. Freedom from BMT failure at 1 year was 72% in patients with a risk score < 4.12, compared with only 35.1% in those with a risk score ≧ 4.12.
Conclusions
In a substantial proportion of patients with acute uncomplicated TBIMH, initial BMT failed. Based on the three initial computed tomographic imaging variables, this risk score could help stratify patients at high or low risk for BMT failure and provided additional information for early intervention.
{"title":"Risk stratification of best medical therapy for acute uncomplicated type B intramural hematoma","authors":"Kelvin Jeason Yang , Huey-Shiuan Kuo , Nai-Hsin Chi , Hsi-Yu Yu , Shoei-Shen Wang , I-Hui Wu","doi":"10.1016/j.surge.2024.04.004","DOIUrl":"10.1016/j.surge.2024.04.004","url":null,"abstract":"<div><h3>Objectives</h3><p>Best medical therapy (BMT) for acute uncomplicated type B intramural hematoma (TBIMH) is the current treatment guideline, but there is considerable controversy about subsequent clinical course and outcome, which may be associated with a significant failure rate. The purpose of this study was to identify potential risk factors for BMT failure and to develop a risk score to guide clinical decision making.</p></div><div><h3>Methods</h3><p>Patients with acute uncomplicated TBIMH between 2011 January and 2020 December were retrospectively studied. Logistic regression was applied to univariately assess potential risk predictors, and multivariable model results were then used to formulate a simplified predictive model for BMT failure.</p></div><div><h3>Results</h3><p>In a total of 61 patients, the overall rate of BMT failure was 57.4% (35/61), of which 48.6% (17/35) occurred within 28 days of onset. Logistic regression identified maximum descending aortic diameter (HR = 1.99 CI = 1.16–3.40, p = 0.012), initial IMH thickness (HR = 3.29, CI = 1.28–8.46, p = 0.013) and presence of focal contrast enhancement (HR = 3.12, CI = 1.49–6.54, p = 0.003) as potential risk predictors of BMT failure. A risk score was calculated as follows: [Max DTA diameter (mm)∗0.6876 + Max IMH thickness (mm)∗1.1918 + PAU/ULP ∗1.1369]. Freedom from BMT failure at 1 year was 72% in patients with a risk score < 4.12, compared with only 35.1% in those with a risk score ≧ 4.12.</p></div><div><h3>Conclusions</h3><p>In a substantial proportion of patients with acute uncomplicated TBIMH, initial BMT failed. Based on the three initial computed tomographic imaging variables, this risk score could help stratify patients at high or low risk for BMT failure and provided additional information for early intervention.</p></div>","PeriodicalId":49463,"journal":{"name":"Surgeon-Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2024-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140776799","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}
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