ANZ journal of surgery
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ANZ journal of surgery · Jan 2020
Hidden blood loss and the influencing factors after laparoscopic cholecystectomy.
A small amount of bleeding usually occurs during laparoscopic cholecystectomy (LC), but the occurrence of perioperative hidden blood loss (HBL) is ignored. So our objective is to investigate the amount of HBL and find out the influential factors in LC. ⋯ HBL should not be overlooked during the perioperative period of LC, especially in patients with hypertension, gallbladder bed >50% gallbladder surface or operation time >60 min.
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ANZ journal of surgery · Jan 2020
Minimally invasive Venetian blinds ventral hernia repair with botulinum toxin chemical component separation.
Laparoscopic ventral repair is safe, with lower wound infection rates compared with open repair. 'Venetian blinds' technique of plication in combination with mesh reinforcement, is totally intra-corporeal, with hernia defect and sac plication to reduce seroma formation. While laparoscopic suturing of the abdominal wall can represent a technical challenge, pre-operative botulinum toxin A (BTA) injections as an adjunct can assist. This study aims to demonstrate feasibility and efficacy of this technique in abdominal wall hernia repair, with BTA adjunct in midline hernias. ⋯ Minimally invasive 'Venetian blinds' technique has promising early results with both midline and non-midline ventral hernias. The addition of BTA is a novel and feasible combination for repair of midline ventral hernias.
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ANZ journal of surgery · Dec 2019
Health economic implications of postoperative complications following liver resection surgery: a systematic review.
Limited data exists concerning the health economics of liver resection, with even less information on the costs emerging from complications, despite this remaining an important target from a health economic perspective. Our objective was to describe the financial burden of complications following liver resection. ⋯ The presence and grade of complications increase hospital cost across diverse settings. The costing methodology should be transparent and complication grading systems should be consistent in future studies.
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ANZ journal of surgery · Dec 2019
Clinical state of the paediatric acute scrotum in south-eastern Victoria.
Acute scrotal pain is a common paediatric surgical presentation. Delays in treatment can result in testicular loss from torsion. It is unclear where delays occur. We aimed to investigate presentations with an acute scrotum to identify any potential areas of delay. ⋯ Delays in assessment and treatment of acute scrotal pain occur from the time parents are aware of symptoms to seeking medical opinion. Education to increase awareness may reduce time delays. GPs should refer patients directly to a paediatric ED. Local EDs should manage paediatric cases as per the local surgeons' skill base.
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ANZ journal of surgery · Nov 2019
Ten-year evolution of a massive transfusion protocol in a level 1 trauma centre: have outcomes improved?
We aimed to evaluate the evolution and implementation of the massive transfusion protocol (MTP) in an urban level 1 trauma centre. Most data on this topic comes from trauma centres with high exposure to life-threatening haemorrhage. This study examines the effect of the introduction of an MTP in an Australian level 1 trauma centre. ⋯ Introduction of an MTP-II in our level 1 civilian trauma centre significantly reduced the amount of PRBC and platelets used during damage control resuscitation. Introduction of the MTP did not directly impact survival or the incidence of complications. Nevertheless, this study reflects the complexity of real-life medical care in a level 1 civilian trauma centre.