ANZ journal of surgery
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ANZ journal of surgery · May 2016
Endoscopic cyst-gastrostomy for pancreatic pseudocysts: refining the indications.
Pseudocysts are a common consequence of acute pancreatitis and require intervention if symptomatic. Endoscopic management is emerging as a safe and effective alternative to surgery, although its use is not yet widespread. ⋯ We discuss technical and patient factors which may have contributed to these complications in the context of current literature, and in particular, found that the presence of necrosis was associated with higher morbidity, both in our series and in others. In our experience, endoscopic ultrasound-guided cyst-gastrostomy is best employed in simple, mature pseudocysts without necrotic debris, and we recommend this procedure only after a detailed assessment of the pseudocyst in a specialist hepatobiliary unit.
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On 8 November 2013, Typhoon Haiyan struck the Philippines causing widespread loss of lives and infrastructures. At the request of the Government of the Philippines, the Australian Government deployed a surgical field hospital to the city of Tacloban for 4 weeks. This paper describes the establishment of the hospital, the surgical workload and handover to the local health system upon the end of deployment. ⋯ This paper describes the experience of a trained, equipped and collaborative surgical foreign medical team in Tacloban in the aftermath of Typhoon Haiyan. Sepsis from foot injuries in diabetic patients constituted an unexpected majority of the workload. New presentations of typhoon-related injuries were presented throughout the deployment.
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ANZ journal of surgery · Apr 2016
Randomized Controlled TrialCautery versus scalpel for abdominal skin incisions: a double blind, randomized crossover trial of scar cosmesis.
The purpose of this study was to determine whether there is any difference in cosmetic outcome between using cutting diathermy and using a scalpel to make abdominal skin incisions. ⋯ We found the use of cutting diathermy to make abdominal skin incisions to be cosmetically equivalent to cutting with the scalpel. As previous studies have not shown adverse wound outcomes using this technique, and considering the safety concerns for theatre staff when the scalpel is used, the routine use of cutting diathermy for skin incisions in abdominal surgery is justified.
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ANZ journal of surgery · Apr 2016
Comparative StudyMinimally invasive Ivor-Lewis oesophagectomy is a feasible and safe approach for patients with oesophageal cancer.
Minimally invasive approaches are increasingly being used in oesophagectomy. The aim of this study was to compare the short-term clinical outcomes of the minimally invasive Ivor-Lewis oesophagectomy (MIILE) technique with those of the open Ivor-Lewis oesophagectomy (OILE) technique. ⋯ In this study, we demonstrate that MIILE is a feasible and safe approach for patients with middle or lower oesophageal cancer.
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ANZ journal of surgery · Apr 2016
ReviewChlorhexidine-induced anaphylaxis in surgical patients: a review of the literature.
Chlorhexidine (CHL) has antiseptic and disinfectant properties used to prevent hospital-acquired infections. CHL-induced anaphylaxis is poorly reported in surgical literature despite government warnings and growing recognition. The aim of this review is to increase awareness of CHL-induced anaphylaxis in the surgical population. ⋯ In order to reduce abandoned procedures, unplanned intensive care unit admissions, morbidity and mortality associated with CHL-induced anaphylaxis we recommend the following: rationalization of CHL-containing products, greater vigilance regarding subtle symptoms of CHL allergy, appropriate investigation of these symptoms and a greater awareness of CHL-containing products. Lastly, we outline the appropriate investigations and highlight the need for meticulous documentation in those who are CHL allergic.