ANZ journal of surgery
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ANZ journal of surgery · Jul 2018
Meta AnalysisSystematic review of disparities in surgical care for Māori in New Zealand.
Health equity for Indigenous peoples in the context of surgery has recently become topical amongst surgeons in Australasia. Health inequities are amongst the most consistent and compelling disparities between Māori and New Zealand Europeans (NZE) in New Zealand (NZ). We aimed to investigate where ethnic disparities in surgical care may occur and highlight some of the potential contributing factors, over all surgical specialties, between Māori and NZE adults in NZ. ⋯ Despite the significant variation in the types of diseases, procedures and indicators of surgical care of the included studies, consistent findings are that disparities in different aspects of surgical care exist between Māori and NZE in NZ. This review highlights the need to better quantify the important issue of health equity for Māori in surgery given the lack of studies over the majority of surgical specialties.
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ANZ journal of surgery · Jun 2018
Comparison of lipase and amylase for diagnosing post-operative pancreatic fistulae.
To ascertain if post-operative drain fluid lipase is superior to amylase in routinely detecting clinically significant post-operative pancreatic fistulae (POPF). ⋯ Our experience suggests drain fluid amylase or lipase results are not sufficiently sensitive or specific to reassure clinicians and rule out clinically significant POPF. However, if biochemical tests are used to aid decision-making, then lipase is a more sensitive biochemical marker than amylase for the routine detection of clinically significant POPF.
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ANZ journal of surgery · Jun 2018
Comparative StudyLower risk of pelvic metalware infection with operative repair of concurrent bladder rupture.
Patients with traumatic bladder rupture frequently have associated pelvic fracture. With increasing numbers of pelvic fractures fixed internally, there are concerns that conservative management of bladder rupture may increase the risk of pelvic metalware infection. This study aims to determine if operative repair of bladder rupture in comparison to conservative management with catheter drainage alone is associated with a lower rate of infection of internal fixation device for concurrent pelvic fracture. ⋯ Operative repair of bladder rupture is associated with a lower rate of pelvic orthopaedic hardware infection in the presence of concurrent pelvic fracture requiring internal fixation.
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ANZ journal of surgery · Jun 2018
Comparative StudyCost-effective imaging for resectability of liver lesions in colorectal cancer: an economic decision model.
This study aimed to determine the cost-effectiveness of contrast-enhanced magnetic resonance imaging (CE-MRI) compared with multiphase CE computed tomography (CE-CT) scan to characterize suspected liver lesions in patients with known colorectal carcinoma. ⋯ The results provide evidence of the potential cost-effectiveness associated with CE-MRI for the diagnosis of liver metastases in patients with identified colorectal carcinoma. CE-MRI can be recommended as cost-effective provided it replaces CE-CT and that improved diagnostic accuracy results in earlier, curative, disease management.