ANZ journal of surgery
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ANZ journal of surgery · Sep 2012
Appendicectomy at a children's hospital: what has changed over a decade?
Appendicectomy remains the most common abdominal emergency procedure performed by surgeons. We reviewed appendicectomies for the calendar years 1999 and 2009 to assess any changes in the referral, presentation and management at a tertiary paediatric institution. ⋯ Our institution has experienced an extraordinary rise in the number of appendicectomies performed, which cannot be explained by an increase in the local paediatric population alone. There appears to have been dramatic shift in the surgical care of children to our tertiary paediatric centre. The majority of appendicectomies in 2009 were laparoscopic, with a reduced length of stay despite longer operative times.
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ANZ journal of surgery · Sep 2012
Time to computed tomography scanning for major trauma patients: the Australian reality.
Computed tomography (CT) can facilitate the diagnosis of life-threatening injuries in polytrauma patients. Reported times to imaging vary widely, but it has been suggested that rapid whole body scanning improves mortality rates. The aim of this study was to determine the time to CT for severe polytrauma patients presenting to a level I trauma centre in Australia. ⋯ Although 93 min to completion of trauma CT scans is comparable with some international reports, it falls well behind centres who have demonstrated improved outcomes with CT scanning. Our results serve as a baseline to our and potentially other Australasian trauma centres to improve on this surrogate measure of trauma team efficacy.
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ANZ journal of surgery · Sep 2012
Review Comparative StudyPostgraduate surgical education and training in Canada and Australia: each may benefit from the other's experiences.
Canada and Australia share similar cultural origins and current multicultural societies and demographics but there are differences in climate and sporting pursuits. Surgeons and surgeon teachers similarly share many of the same challenges, but the health care and health-care education systems differ in significant ways. The objective of this review is to detail the different postgraduate surgical training programs with a focus on general surgery and how the programs of each country may benefit from appreciating the experiences of the other. ⋯ The Royal Australasian College of Surgeons is unlikely to cede much responsibility to the universities but alternative academic models are emerging. Private health care in the two countries differs, but there are increasing opportunities for training in the private sector in Australia. In spite of the differences, both provide excellent health care and surgical training opportunities in an environment with significant fiscal, technological and societal challenges.
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ANZ journal of surgery · Sep 2012
ReviewAblation of Barrett's oesophagus: towards improved outcomes for oesophageal cancer?
Barrett's oesophagus is the major risk factor for the development of oesophageal adenocarcinoma. The management of Barrett's oesophagus entails treating reflux symptoms with acid-suppressing medication or surgery (fundoplication). However, neither form of anti-reflux therapy produces predictable regression, or prevents cancer development. ⋯ The combination of EMR and radiofrequency ablation has been used for multifocal lesions, but long-term outcomes are unknown. The new endoscopic interventions for Barrett's oesophagus and early oesophageal cancer have the potential to improve clinical outcomes, although evidence that confirms superiority over oesphagectomy is limited. Longer-term outcome data and data from larger cohorts are required to confirm the appropriateness of these procedures.