ANZ Journal of Surgery最新文献

Objectives: To compare the Article Processing Charges (APCs) and fee transparency between legitimate and potentially predatory urology journals.

Methods: Potentially predatory journals were identified from unsolicited email solicitations sent to an academic urologist between December 2023 and January 2024. APC data were collected from the journals' websites and categorized based on fee transparency: no APC, non-transparent APCs, or transparent APCs. Legitimate journals were identified from the 69 urology journals listed in the Royal Australasian College of Surgeons library. APCs for these journals were similarly collected and analyzed. We conducted a quantitative analysis with Chi-squared testing to compare categorical variables and a Mann-Whitney U-test to assess differences in APC values.

Results: A total of 214 potentially predatory journals were identified from 422 emails, originating from 75 different publishers. Solicitations spanned various disciplines, with only 7.35% from urology journals. Among potentially predatory journals, 3.7% claimed to have no APCs, 21.5% lacked fee transparency, and 74.8% disclosed their APCs, with a mean charge of 2272.50 USD (median 2000 USD; range 150-3690 USD). In contrast, legitimate journals had a mean APC of $3244.51 USD (median 3490 USD; range 635-6950 USD), with 11.6% offering publication without APCs.

Conclusion: Academic urologists often face unsolicited invitations from predatory journals and encounter high APCs from legitimate journals. This dual challenge complicates researchers' decisions and can hinder access to reputable publication avenues. To alleviate this burden, institutions should consider financial support for researchers, and both publishers and researchers must prioritize transparency and caution in the open-access publishing landscape.

Background: Gender diverse people in Australia have higher levels of psychological stress, suicidal ideation and suicide attempts and have poorer self-reported health than cisgender people.

Objectives: To determine if adults who experience gender incongruence have improved health-related quality of life and mental health with gender affirming treatment (hormone therapy and surgery), compared with no treatment.

Data sources: PubMed, Web of Science, Embase and Psych Info.

Review methods: A systematic review of peer-reviewed publications in English from January 2010 to October 2022. Studies were included where: participants were treated with gender affirming surgery or hormone therapy for minimum 3 months and; validated patient reported outcome measures of health-related quality of life or mental health were reported. Quality of evidence assessment was undertaken using the Let Evidence Guide Every New Decision evaluation tool.

Results: Eighty-one publications were included for analysis. The systematic review indicated that there were significant improvements in the domains of mental illness, gender dysphoria, body image and health-related quality of life following gender affirming medical treatment as measured by a variety of patient reported outcomes. Meta-analysis showed significant improvement in body image (z = 4.47, P < 0.001) and health-related quality of life for psychological (z = 1.99, P = 0.047) and social relationships (z = 3.09, P = 0.002) following gender affirming surgery.

Conclusions: There is evidence that hormones and surgery as a collective for adults with gender incongruence has therapeutic value and should be considered for funding within Australia's healthcare systems. The development and implementation of patient-reported outcome tools tailored for purpose (GENDER Q) will facilitate future research.

Background: The operating theatre generates substantial waste, raising environmental concerns. This study quantified the waste generated during four common orthopaedic procedures and identified recyclable materials. It also assessed the associated carbon footprint to highlight opportunities for sustainable waste management.

Methods: This prospective study was conducted at a single regional hospital in New South Wales, Australia, from July to September 2024. Sixty procedures were analysed: 15 total knee arthroplasties (TKA), 15 total hip arthroplasties (THA), 15 ankle fracture fixations, and 15 hand injury surgeries. Waste was categorized as landfill, recyclable, or biohazardous. Landfill waste was further analysed for potentially recyclable components, with data extrapolated to nationwide operation numbers. Carbon dioxide emissions were calculated using the formula tCO₂-e = Q × EF, where Q is waste weight, EF is the emission factor (0.879), and tCO₂-e is tonnes of carbon dioxide emissions.

Results: Across 60 procedures, 425.7 kg of waste was generated, averaging 8.2 kg per case. TKA produced the most waste (11.7 kg per case), while hand injury surgeries generated the least (3.9 kg per case). Potentially recyclable waste constituted 12% of landfill waste, with TKA having the highest recyclable proportion (13%). Recyclable materials comprised 44% of total waste. Proper segregation could reduce up to 75 t of CO₂-emissions annually from TKA alone in Australia.

Conclusions: A significant portion of orthopaedic theatre waste is recyclable, offering opportunities to reduce the carbon footprint of surgeries. Improved staff training and recycling facilities are crucial for optimizing waste management in healthcare.

Background: Pancreas resection for metachronous colorectal cancer metastasis is episodic and the role of surgery in the management of these patients is still debated.

Methods: We recruited seven patients from three different centres and analyzed 30-day morbidity and mortality, oncological outcomes at 6 and 12 months.

Results: There was no postoperative mortality. Complications occurred in two patients (28,6%). All patients completed at least a 12-months follow-up. At 6-month follow-up, only one patient had a recurrence. At 12-month follow-up, no patients died for disease recurrence and one more patient had a new recurrence.

Conclusion: Our series supports the feasibility and safety of pancreas resection in metastatic colorectal cancer suggesting that radical resection may improve the patient's prognosis.

Backgrounds: Oesophageal leiomyoma is the most common benign tumour of the oesophagus, and complete tumour enucleation is the preferred treatment. The aim of this study is to evaluate the clinical application and technical advantages of Robotic-assisted Thoracoscopic Surgery (RATS) during the resection of oesophageal leiomyoma.

Methods: A retrospective study was conducted on patients who underwent robotic surgery for oesophageal diseases at our hospital from September 2017 to December 2023. Demographic statistics and clinical pathological characteristics, intraoperative and postoperative outcomes, immune histopathological staining, tumour pathology diagnosis and follow-up were analyzed.

Results: A total of 57 patients were enrolled in the study, including 42 males and 15 females with an average age of 49 years All patients received surgical treatment, with 54 patients undergoing robot-assisted resection of oesophageal tumour, one patient undergoing conversion to thoracotomy, and two patients undergoing exploratory surgery. The mean surgical time was 130 minutes, and the mean blood loss was 50 mL. Of the 55 patients who underwent tumour resection, 54 were pathologically diagnosed as oesophageal leiomyoma and one as atypical leiomyoma. Only one patient developed pulmonary infection after surgery, and there was no perioperative mortality. The average postoperative hospital stay was 9 days. All patients were followed up for a median time of 16 months (range: 1 to 70 months), and there was no recurrence or long-term complications after surgery.

Conclusion: Robot-assisted resection of oesophageal leiomyoma is safe and feasible, and can provide ideal short-and medium-term results.

Backgrounds: The MIMIC score was designed to predict the likelihood of spontaneous stone passage (SSP) in patients presenting with ureteric colic and given a trial of conservative management. The objective of this study was to determine the external validity of the MIMIC score.

Methods: Cross-sectional, retrospective cohort study that reviewed patients over a 2-year period presenting with ureteric colic who were given a trial of conservative management. Patient-factors were recorded, and their MIMIC score calculated and compared to the observed outcome. Discrimination was determined using an area under the receiver-operating curve with an AUC >0.7 considered validated and calibration using calibration plot.

Results: Three hundred ninety-nine patients were included. The median age was 49 (IQR 37-60). 79% were males. The mean stone size for successful SSP was 3.8 mm compared to 4.8 mm for failed SSP. 88% of stones passed spontaneously. The AUC was 0.68 (95% CI: 0.60-0.77). The calibration plot showed an underestimation of SSP. In the lowest quintile of patients with a mean predicted SSP rate of 46%, the observed SSP rate was 74% (95% CI: 63-83%). With a higher predicted SSP rate, the MIMIC score was accurate. In the highest quintile of patients with a mean predicted SSP rate of 90%, the observed SSP rate was 92% (95% CI: 84-97%).

Conclusion: In this population, the prediction of the MIMIC score were not sufficiently accurate. There was overall an underestimation of SSP. The MIMIC score was accurate for patients who had a higher likelihood of SSP (>83%).

Background: Disease severity and treatment efficacy in salivary gland disorders can be gauged through quality-of-life (QoL) questionnaires. However, limited research has explored patient experience with these questionnaires. This cross-sectional study assessed the usability of, and patient experience with, six validated QoL questionnaires.

Methods: This cross-sectional study assessed the usability of and patient experience with the QoL-15D, Oral Health Impact Profile-14, Manukau Salivary Symptom Score, Chronic Obstructive Sialadenitis Symptoms, Multidisciplinary Salivary Gland Society, and Glasgow Benefit Index questionnaires. We measured the time to complete each questionnaire, patient-perceived questionnaire coverage of symptoms and disease impact using a 5-point Likert scale, patient experience with the questionnaires through open feedback, and which questionnaire patients most preferred. There were 30 participants in this study.

Results: All questionnaires tested could be completed in under 5 min each. The most preferred questionnaire was the Manukau Salivary Symptom Score (43%). Participants raised the following concerns regarding the questionnaires: unclear timeframes (90%), questions not being relevant (67%), initial questions not addressing their primary symptoms (40%), confusing or unclear question wording (37%), inconsistent response scale between questions (27%), and antibiotic use during flare-ups assuming access to primary medical care (7%).

Conclusion: No previous study has measured and analysed patient experience with the currently validated QoL questionnaires used in salivary gland disorders. This study's findings can be used to inform both questionnaire selection as well as the development of future QoL questionnaires for salivary gland disorders in order to achieve a better overall patient experience and reduce unintentional bias.