ANZ journal of surgery
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ANZ journal of surgery · Jan 2014
Clinical TrialCan POSSUM accurately predict post-operative complications risk in patients with abdominal Crohn's disease?
Although the majority of patients with Crohn's disease (CD) are young, they are often seriously ill when surgery is required. The Physiological and Operative Severity Score for the enUmeration of Mortality and morbidity (POSSUM) is a risk prediction scoring system estimating 30-day complications. The primary endpoint was to evaluate POSSUM efficacy in this subgroup. The secondary endpoint was to determine any potential correlation between POSSUM, Harvey-Bradshaw Index (HBI), length of stay (LOS) and anastomotic leak. ⋯ POSSUM is precise in predicting post-operative complications in patients with abdominal CD. POSSUM correlates with HBI.
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ANZ journal of surgery · Jan 2014
Randomized Controlled TrialPre-emptive intraperitoneal local anaesthesia: an effective method in immediate post-operative pain management and metabolic stress response in laparoscopic appendicectomy, a randomized, double-blinded, placebo-controlled study.
Although laparoscopic surgeries are associated with reduced surgical stress response and shortened post-operative recovery, intense pain and high analgesia requirements in the immediate post-operative period are often the chief complaints. ⋯ Pre-emptive intraperitoneal local anaesthesia in laparoscopy surgery is a safe, non-invasive procedure that can benefit patients by reducing the immediate post-operative pain intensity and metabolic stress response of the body.
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ANZ journal of surgery · Jan 2014
Comparative StudyIncreasing breast reconstruction rates by offering more women a choice.
Breast reconstruction (BR) following mastectomy for breast cancer is safe and has high rates of patient satisfaction, yet only around 12% of Australian women undergo BR. This study presents BR rates and outcomes from a specialist practice that discusses reconstruction options with all women medically suitable for BR. ⋯ A BR rate of 41%, over three times the national average, was achieved when BR was discussed with all patients. This significant gain in BR rate was not accompanied by a commensurate increase in adverse outcomes, providing evidence that expanding the indications for BR to women who were previously not considered eligible is a valid option.
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ANZ journal of surgery · Jan 2014
Practice GuidelineEvidence-based review for patients undergoing elective hip and knee replacement.
The objective of this study was to evaluate the evidence for different interventions in the preoperative, perioperative and post-operative care for people undergoing elective total hip (THR) and knee (TKR) replacement surgery. ⋯ There was a deficiency in the quality of the evidence supporting key aspects of the continuum of care for primary THR/TKR surgery. Consequently, recommendations were limited. Prioritization and funding for research into areas likely to impact clinical practice and patient outcomes after elective joint replacement surgery are the next important steps.
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ANZ journal of surgery · Jan 2014
Does moderate tricuspid regurgitation require attention during mitral valve surgery?
This study aims to determine whether tricuspid regurgitation (TR) ≥ 2+ requires attention during mitral valve surgery. ⋯ Preoperative TR ≥ 2+, non-TVR group had more favourable functional class and mid-term survival with comparable QOL and echocardiographic parameters to the TVR group.