{"title":"Surgical Practice May 2025 CME for Fellows","authors":"","doi":"10.1111/1744-1633.70014","DOIUrl":"https://doi.org/10.1111/1744-1633.70014","url":null,"abstract":"","PeriodicalId":51190,"journal":{"name":"Surgical Practice","volume":"29 2","pages":"121-122"},"PeriodicalIF":0.3,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144309079","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}
Kevin K. F. Wong, Max W. Y. Chung, H. L. Yiu, Carmen Chan
The routine implementation of the SOMIP risk calculator in the Department of Surgery, New Territories West Cluster, is one of the measures aimed at improving SOMIP outcomes. This study sought to investigate the process, efficacy, staff satisfaction, and clinical outcomes associated with this programme. Our experience with using this calculator and the key steps involved are illustrated, including (1) identifying problems and potential solutions, (2) conducting basic research and project planning, (3) implementing changes, and (4) convincing others with evidence. This was the first time the calculator was used routinely in Hong Kong, providing valuable local data and experience for future development. Associated factors, such as increased staff awareness of SOMIP, alignment among different parties, and the provision of a common platform to manage patients through a multidisciplinary team approach, may help improve our service outcomes.
{"title":"Implementation of the SOMIP risk calculator in New Territories West Cluster: A journey of change management","authors":"Kevin K. F. Wong, Max W. Y. Chung, H. L. Yiu, Carmen Chan","doi":"10.1111/1744-1633.70010","DOIUrl":"https://doi.org/10.1111/1744-1633.70010","url":null,"abstract":"<p>The routine implementation of the SOMIP risk calculator in the Department of Surgery, New Territories West Cluster, is one of the measures aimed at improving SOMIP outcomes. This study sought to investigate the process, efficacy, staff satisfaction, and clinical outcomes associated with this programme. Our experience with using this calculator and the key steps involved are illustrated, including (1) identifying problems and potential solutions, (2) conducting basic research and project planning, (3) implementing changes, and (4) convincing others with evidence. This was the first time the calculator was used routinely in Hong Kong, providing valuable local data and experience for future development. Associated factors, such as increased staff awareness of SOMIP, alignment among different parties, and the provision of a common platform to manage patients through a multidisciplinary team approach, may help improve our service outcomes.</p>","PeriodicalId":51190,"journal":{"name":"Surgical Practice","volume":"29 3","pages":"163-168"},"PeriodicalIF":0.2,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144915089","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":"Embedding clinical governance in the artificial intelligence era: Ensuring safe, ethical, and high-quality surgical care","authors":"Paul B. S. Lai","doi":"10.1111/1744-1633.70012","DOIUrl":"https://doi.org/10.1111/1744-1633.70012","url":null,"abstract":"","PeriodicalId":51190,"journal":{"name":"Surgical Practice","volume":"29 2","pages":"66-67"},"PeriodicalIF":0.3,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144309046","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":"Persistent sciatic artery aneurysm repaired by interposition graft—A case report and literature review","authors":"Wai Yin Lai MBBS, Wing Keung Stephen Cheng MS","doi":"10.1111/1744-1633.70011","DOIUrl":"https://doi.org/10.1111/1744-1633.70011","url":null,"abstract":"","PeriodicalId":51190,"journal":{"name":"Surgical Practice","volume":"29 4","pages":"229-230"},"PeriodicalIF":0.2,"publicationDate":"2025-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145595359","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}
Laparoscopic pancreaticoduodenectomy (LPD) is an alternative to the open surgical approach. Several authors have investigated the advantages of LPD over open PD (OPD); this study aims to evaluate the effectiveness of LPD compared with OPD.
Methodology
This study conducted a meta-analysis following the Cochrane Handbook for Systematic Reviews and adhering to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Multiple databases—including PubMed, the Cochrane Trial Register, and Google Scholar—were searched for relevant literature up to April 20, 2024. Studies comparing OPD with LPD were included.
Results
A total of 4 randomized controlled trials and 41 non-randomized comparative trials were analysed. No significant difference in post-operative mortality was found (P = .42). However, there was a significant reduction in overall post-operative complications in the LPD group (P < .002). The length of hospital stay was also significantly shorter in the LPD group (P < .00001). No significant differences were observed between LPD and OPD regarding post-operative pancreatic fistula (P = .93) and post-pancreatectomy haemorrhage (post-pancreatectomy haemorrhage; P = .19). However, the rate of post-operative bile leaks was higher in the LPD group compared with the OPD group (P = .02).
Conclusion
This study concluded that LPD is a safer approach with less post-operative complications, longer operative time, less estimated blood loss, and shorter hospital stays when compared with OPD.
{"title":"Comparison of outcomes of laparoscopic and open pancreaticoduodenectomy: An updated meta-analysis","authors":"Mehreen Ansari, Mishkat Shehzad, Duaa Naveed Choudhry, Sohair Saleem, Muhammad Faizan","doi":"10.1111/1744-1633.70009","DOIUrl":"https://doi.org/10.1111/1744-1633.70009","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>Laparoscopic pancreaticoduodenectomy (LPD) is an alternative to the open surgical approach. Several authors have investigated the advantages of LPD over open PD (OPD); this study aims to evaluate the effectiveness of LPD compared with OPD.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methodology</h3>\u0000 \u0000 <p>This study conducted a meta-analysis following the Cochrane Handbook for Systematic Reviews and adhering to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Multiple databases—including PubMed, the Cochrane Trial Register, and Google Scholar—were searched for relevant literature up to April 20, 2024. Studies comparing OPD with LPD were included.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 4 randomized controlled trials and 41 non-randomized comparative trials were analysed. No significant difference in post-operative mortality was found (<i>P</i> = .42). However, there was a significant reduction in overall post-operative complications in the LPD group (<i>P</i> < .002). The length of hospital stay was also significantly shorter in the LPD group (<i>P</i> < .00001). No significant differences were observed between LPD and OPD regarding post-operative pancreatic fistula (<i>P</i> = .93) and post-pancreatectomy haemorrhage (post-pancreatectomy haemorrhage; <i>P</i> = .19). However, the rate of post-operative bile leaks was higher in the LPD group compared with the OPD group (<i>P</i> = .02).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This study concluded that LPD is a safer approach with less post-operative complications, longer operative time, less estimated blood loss, and shorter hospital stays when compared with OPD.</p>\u0000 </section>\u0000 </div>","PeriodicalId":51190,"journal":{"name":"Surgical Practice","volume":"29 2","pages":"95-110"},"PeriodicalIF":0.3,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144309197","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":"Surgical Practice February 2025 CME for Fellows","authors":"","doi":"10.1111/1744-1633.70007","DOIUrl":"https://doi.org/10.1111/1744-1633.70007","url":null,"abstract":"","PeriodicalId":51190,"journal":{"name":"Surgical Practice","volume":"29 1","pages":"60-61"},"PeriodicalIF":0.3,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143707466","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":"Artificial intelligence in surgical education: Transforming training for the next generation of surgeons","authors":"Paul B. S. Lai","doi":"10.1111/1744-1633.70006","DOIUrl":"https://doi.org/10.1111/1744-1633.70006","url":null,"abstract":"","PeriodicalId":51190,"journal":{"name":"Surgical Practice","volume":"29 1","pages":"3-5"},"PeriodicalIF":0.3,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143707468","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":"Surgical Practice November 2024 CME for Fellows","authors":"","doi":"10.1111/1744-1633.12741","DOIUrl":"https://doi.org/10.1111/1744-1633.12741","url":null,"abstract":"","PeriodicalId":51190,"journal":{"name":"Surgical Practice","volume":"29 1","pages":"58-59"},"PeriodicalIF":0.3,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143707472","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}
Tam-Lin Chow FRCS, FHKAM, Nelly N. L. Mak MSc, BSc
Objective
The latest trend in the surgical management of low-risk differentiated thyroid carcinomas is de-escalation, with lobectomy performed for low-risk cases due to their excellent prognosis. Thyroidectomy for selected nodules under local anaesthesia (LA) is generally safe. This study was undertaken to investigate whether LA thyroidectomy is equally effective for selected cases of papillary thyroid carcinoma (PTC).
Methods
Twenty-five patients with histopathologically verified PTC who underwent LA hemithyroidectomy as initial definite therapy were retrieved from the in-house thyroid cancer registry. Their clinicopathologic data, operation status (day vs inpatient), surgical complications (vocal cord palsy, post-operative haematoma, and wound complications), and oncologic outcomes (tumour recurrence and survival) were evaluated. Post-operative thyroglobulin monitoring and radioactive iodine ablation were not practised after hemithyroidectomy. Propensity score matching was utilised to compare operation outcomes with the general anaesthesia counterpart (N = 112).
Results
The median follow-up was 87.0 months, and the median tumour diameter was 6.0 mm (range 1.0–40.0 mm). Twelve (48%) tumours were incidental, while 13 (52%) were non-incidental. Most patients (84%) were discharged as day cases. Regarding surgical complications, only one case of permanent vocal cord palsy occurred, with no incidence of transient cord palsy, wound swelling, unplanned readmission, or wound infection. Three patients underwent completion thyroidectomy in due course. There was no tumour recurrence or cancer-specific mortality in this series. Length of stay (P = .0002), unplanned readmission (P < .0001), and overall thyroidectomy complications (P < .0001) were significantly lower in the LA arm by propensity score matching analysis.
Conclusions
For low- and selected intermediate-risk PTC, LA hemithyroidectomy appears to be safe in the long run. Its benefits include early recovery, a short hospital stay, the feasibility of day surgery, and simplified post-operative care by eliminating thyroglobulin monitoring and long-term thyroxine usage.
{"title":"Hemithyroidectomy under local anaesthesia as the initial definite treatment for papillary thyroid carcinoma: a propensity score analysis","authors":"Tam-Lin Chow FRCS, FHKAM, Nelly N. L. Mak MSc, BSc","doi":"10.1111/1744-1633.70004","DOIUrl":"https://doi.org/10.1111/1744-1633.70004","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>The latest trend in the surgical management of low-risk differentiated thyroid carcinomas is de-escalation, with lobectomy performed for low-risk cases due to their excellent prognosis. Thyroidectomy for selected nodules under local anaesthesia (LA) is generally safe. This study was undertaken to investigate whether LA thyroidectomy is equally effective for selected cases of papillary thyroid carcinoma (PTC).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Twenty-five patients with histopathologically verified PTC who underwent LA hemithyroidectomy as initial definite therapy were retrieved from the in-house thyroid cancer registry. Their clinicopathologic data, operation status (day vs inpatient), surgical complications (vocal cord palsy, post-operative haematoma, and wound complications), and oncologic outcomes (tumour recurrence and survival) were evaluated. Post-operative thyroglobulin monitoring and radioactive iodine ablation were not practised after hemithyroidectomy. Propensity score matching was utilised to compare operation outcomes with the general anaesthesia counterpart (<i>N</i> = 112).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The median follow-up was 87.0 months, and the median tumour diameter was 6.0 mm (range 1.0–40.0 mm). Twelve (48%) tumours were incidental, while 13 (52%) were non-incidental. Most patients (84%) were discharged as day cases. Regarding surgical complications, only one case of permanent vocal cord palsy occurred, with no incidence of transient cord palsy, wound swelling, unplanned readmission, or wound infection. Three patients underwent completion thyroidectomy in due course. There was no tumour recurrence or cancer-specific mortality in this series. Length of stay (<i>P</i> = .0002), unplanned readmission (<i>P</i> < .0001), and overall thyroidectomy complications (<i>P</i> < .0001) were significantly lower in the LA arm by propensity score matching analysis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>For low- and selected intermediate-risk PTC, LA hemithyroidectomy appears to be safe in the long run. Its benefits include early recovery, a short hospital stay, the feasibility of day surgery, and simplified post-operative care by eliminating thyroglobulin monitoring and long-term thyroxine usage.</p>\u0000 </section>\u0000 </div>","PeriodicalId":51190,"journal":{"name":"Surgical Practice","volume":"29 4","pages":"184-191"},"PeriodicalIF":0.2,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145595287","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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