ANZ journal of surgery
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ANZ journal of surgery · Jul 2006
Comparative StudyAnastomotic leakage after lower gastrointestinal anastomosis: men are at a higher risk.
Anastomotic leakage is the most important complication specific to intestinal surgery. The aim of this study was to review the anastomotic leakage rates in a single Colorectal Unit and to evaluate the risk factors for anastomotic leakage after lower gastrointestinal anastomosis. ⋯ Male gender, previous abdominal surgery and low rectal cancer are associated with increased anastomotic leakage rates. These have important implications during preoperative patient counselling and decision-making regarding defunctioning stoma formation.
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ANZ journal of surgery · Jul 2006
Historical ArticleFifty years of vascular surgery in australia and new zealand.
Over the 50 years that vascular surgery has been practised in Australia and New Zealand there have been major advances and refinements of surgical techniques, particularly with the advent of endovascular surgery, spurred on especially with the introduction of endovascular aortic aneurysm stent grafting. At the same time, there has been a revolution in medical imaging, with the introduction of ultrasound, computed tomography scanning and magnetic resonance scanning. Vascular surgery in Australia and New Zealand was initially an interest of either general or cardiothoracic surgeons, but was recognized as a subspecialty of general surgery with the formation of the Section of Vascular Surgery within the Division of General Surgery of the Royal Australasian College of Surgeons in 1972. ⋯ In 1995, vascular surgery was recognized as a specialty in its own right with the formation of the Division of Vascular Surgery within the College. There has been a separate examination for Fellowship of the Royal Australasian College of Surgeons (Vascular) since 1997. In 2001, the Chapter changed its name to The Australian and New Zealand Society for Vascular Surgery and in 2002 it amalgamated with and took over the functions of the Division of Vascular Surgery, which was formally dissolved.
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The Parkland formula is established as the "gold standard" for initial fluid resuscitation for major burns. The purpose of this study was to review our fluid resuscitation practice for major burns to determine whether anecdotal observations of significant variations from the Parkland formula were wide spread and whether any difference could be used as a basis for a revision of fluid resuscitation in major burns. ⋯ Fluid resuscitation volumes significantly higher than those predicted by the Parkland formula were given, without adverse consequences. This retrospective review supports a prospective, multicentre, randomized, controlled study comparing this study with the Parkland formula, resulting in a better guide to initial fluid resuscitation in major burns.
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ANZ journal of surgery · Nov 2005
Small bowel tumours in emergency surgery: specificity of clinical presentation.
Despite advances in diagnostic modalities, small bowel tumours are notoriously difficult to diagnose and are often advanced at the time of definitive treatment. These malignancies can cause insidious abdominal pain and weight loss, or create surgical emergencies including haemorrhage, obstruction or perforation. The aim of the present study was to describe the clinical presentation, diagnostic work-up, surgical therapy and short-term outcome of 34 patients with primary and secondary small bowel tumours submitted for surgical procedures in an emergency setting and to look for a correlation between clinical presentation and the type of tumours. ⋯ The present study shows that there is a correlation between small bowel tumours and clinical emergency presentation: gastrointestinal stromal tumours (GIST) mostly bleed; carcinoids make an obstruction; lymphomas cause a perforation; and melanoma metastasis causes intussusception.