ANZ journal of surgery
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ANZ journal of surgery · Aug 2006
Diagnostic value of thoracoscopic pleural biopsy for pleurisy under local anaesthesia.
We find pleural effusion in clinical practice frequently. However, it is difficult to make a diagnosis definitively by thoracocentesis or closed pleural biopsy. We directly examine the thoracic cavity by thoracoscopy under local anaesthesia, carry out pleural biopsy and make a definitive pathological diagnosis in pleurisy. ⋯ Pleural biopsy by thoracoscopy under local anaesthesia should be actively carried out in patients with pleurisy, because the technique has a high diagnostic rate and can be easily and safely carried out.
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ANZ journal of surgery · Jul 2006
Multicenter Study Comparative StudyOutcomes of patients with orthopaedic trauma admitted to level 1 trauma centres.
Although orthopaedic trauma results in significant disability and substantial financial cost, there is a paucity of large cohort studies that collectively describe the functional outcomes of a variety of these injuries. The current study aimed to investigate the outcomes of patients admitted with a range of orthopaedic injuries to adult Level 1 trauma centres. ⋯ A large percentage of patients have ongoing pain and disability and a reduced capacity to return to work 6 months after orthopaedic trauma. Further research into the long-term outcomes of patients with orthopaedic injuries is required to identify patient subgroups and specific injuries and procedures that result in high morbidity.
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ANZ journal of surgery · Jul 2006
Comparative StudyAdherence to guidelines for prevention of postsplenectomy sepsis. Age and sex are risk factors: a five-year retrospective review.
Vaccination, education and use of long-term antibiotics are recommended in expert guidelines for the prevention of infectious complications after splenectomy. However, studies outside Australia have shown poor adherence to the guidelines. ⋯ Education for prevention of sepsis after splenectomy is poorly documented and may be incomplete. Older age and male sex are risk factors in non-adherence to guidelines for prevention of postsplenectomy sepsis. Strategies such as alert cards and information brochures may improve adherence to guidelines particularly in older patients.
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ANZ journal of surgery · Jul 2006
Comparative StudyPancreaticoduodenectomy: does preoperative biliary drainage, method of pancreatic reconstruction or age influence perioperative outcome? A retrospective study of 104 consecutive cases.
Whether preoperative biliary drainage (PBD) is beneficial in reducing complications after pancreaticoduodenectomy is controversial. There remains a reluctance to consider pancreaticoduodenectomy in older patients. The major source of morbidity and potential mortality after pancreaticoduodenectomy is pancreatic fistula, which is caused by difficulties associated with the pancreatic anastomosis. The purpose of this study was to examine the effect of PBD, patient age and method of pancreatico-enteric reconstruction on postoperative morbidity and mortality. ⋯ Preoperative biliary drainage was not associated with increased postoperative complications. Pancreaticogastrostomy after pancreaticoduodenectomy is a safe and reliable method of reconstruction. Finally, pancreaticoduodenectomy can be carried out with acceptable rates of postoperative morbidity and mortality in selected patients over 70 years of age.