ANZ journal of surgery
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ANZ journal of surgery · Apr 2007
ReviewUnicompartmental knee arthroplasty for the treatment of unicompartmental osteoarthritis: a systematic study.
Unicompartmental knee arthroplasty (UKA), total knee arthroplasty (TKA) and high tibial osteotomy (HTO) may all be used to treat unicompartmental osteoarthritis, but they are often used for different patient groups. However, there is considerable overlap in indications for all three options. The aim of this review was to assess the safety and efficacy of UKA compared with TKA and HTO in unicompartmental osteoarthritis. ⋯ UKA is considered at least as safe as TKA and HTO. For function, UKA appears to be at least as efficacious as TKA and HTO. The survival of UKA compared with TKA and HTO cannot be determined based on the available evidence.
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ANZ journal of surgery · Apr 2007
Can serum inflammatory parameters estimate outcome of pleurodesis in mesothelioma?
As pleurodesis causes systemic inflammation and is associated with considerable cost and morbidity during long-term follow up, the identification of patients who will experience an unsuccessful pleurodesis would be desirable. This study was aimed to investigate whether systemic inflammatory reaction induced by insuflation of talc into the pleura can predict the outcome of pleurodesis. ⋯ Serum levels of inflammatory parameters (C-reactive protein and erythrocyte sedimentation rate) may be used to predict the success of pleurodesis in patients with malign mesothelioma who underwent thoracoscopic talc poudrage.
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This study presents an audit of the first 50 elective laparoscopic assisted colorectal resections carried out at the Launceston General Hospital, Tasmania, particularly in comparison with the 33 elective open resections carried out in the same 18-month period. ⋯ Laparoscopic colectomy allowed early postoperative recovery and shorter hospital stay. This was at the expense of a longer operation. It can be taken up by relatively laparoscopically naive surgeons without extra major morbidity/mortality associated with the learning curve. It is technically feasible and safe in small centres.
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ANZ journal of surgery · Apr 2007
Scoring systems do not accurately predict outcome following abdominal aortic aneurysm repair.
Abdominal aortic aneurysm repair is associated with significant morbidity and mortality. This study aims to evaluate the efficiency of scoring systems in a group of patients undergoing abdominal aortic aneurysm repair. ⋯ In this study, all systems showed significant errors when predicting mortality. Therefore, although useful as an audit tool, scoring systems should not be used on an individual basis to guide treatment and assess prognosis after surgery.
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A policy of mandatory neck exploration for zone II injuries deep to platysma was promoted in the 1950s and was associated with a reduction in mortality when compared with expectant or delayed exploration. Recently many trauma centres have been practising selective neck exploration using physical examination and imaging to stratify patients to different management strategies. In the Auckland region, patients with penetrating zone II injury deep to platysma have been managed with mandatory neck exploration. As penetrating injuries in the Auckland region are caused by a range of sharp objects, with gunshot wounds rare, outcomes of management of zone II neck injuries in this population warrant investigation. The aim of this study was to determine the rate of therapeutic neck exploration in patients with penetrating zone II neck injury in the Auckland region and to suggest optimum management strategies for such injuries. ⋯ In the Auckland setting, physical examination would appear to be a safe and reliable method for the stratification of patients for either operative or conservative management.