ANZ journal of surgery
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ANZ journal of surgery · Aug 2004
Blood loss and transfusion in elective abdominal aortic aneurysm surgery.
Intraoperative blood loss and transfusion are known determinants of mortality and morbidity of elective abdominal aortic aneurysm (AAA) repair. The present study analysed the pattern of blood loss and transfusion and evaluated the risk factors of blood loss during open repair of infrarenal AAA. ⋯ Intraoperative blood loss in elective infrarenal aneurysm surgery is influenced by patients' haematological parameters, distal involvement of aneurysm and degree of difficulty of operation.
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ANZ journal of surgery · Aug 2004
Highly symptomatic adult polycystic liver disease: options and results of surgical management.
The majority of patients afflicted with adult polycystic liver disease (APLD) are asymptomatic. For those who are symptomatic, there are a variety of treatment procedures that have been proposed but these lack verification through long-term studies with respect to safety and long-term effectiveness. Choice of surgical procedure is related to the severity of APLD and morphology of the cysts within the liver. The aim of the present study was to analyse the immediate and long-term results of fenestration and combined resection-fenestration at Singapore General Hospital. ⋯ Treatment for symptomatic APLD should be based on the morphology of the liver cysts. Fenestration is a safe and acceptable procedure for patients with a dominant cyst pattern where liver size can be reduced after the cysts collapse. A combination of resection-fenestration is suitable for those with a diffuse cyst pattern where grossly affected segments are resected in combination with fenestration to allow for reduction in liver size.
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ANZ journal of surgery · Jul 2004
ReviewGuidelines for the management of haemodynamically unstable pelvic fracture patients.
Haemodynamically unstable pelvic fracture patients have a high mortality, and decision-making is crucial. The present article discusses key clinical practice guidelines and options in the early management of these challenging patients. ⋯ The consensus committee successfully developed best evidence recommendations identifying the issues and providing guidelines and options for this challenging condition.
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ANZ journal of surgery · Jul 2004
Randomized Controlled Trial Comparative Study Clinical TrialComparison of the effect of diclofenac with hyoscine-N-butylbromide in the symptomatic treatment of acute biliary colic.
Although non-steroidal anti-inflammatory drugs (NSAID) and spasmolytics have been used to relieve biliary colic, the role of these drugs in the natural history of biliary colic has not been clarified. The objective of the present study is to compare the efficacy of intramuscular diclofenac with intramuscular hyoscine in the treatment of pain of acute biliary colic, and to study their role in the natural history of biliary colic and in the prevention of cholelithiasis-related complications. ⋯ In patients with biliary colic, diclofenac gives much faster and more effective pain relief in a significantly larger number of patients as compared with hyoscine. Most remarkably, diclofenac can prevent progression of biliary colic to acute cholecystitis in a significant number of patients.