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Annals of the Royal College of Surgeons of England

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https://www.readbyqxmd.com/read/28071952/the-decline-of-elective-operating-at-major-trauma-centres
#1
A Memarzadeh, H Taki, E K Tissingh, P Hull
INTRODUCTION Major trauma is a leading cause of death in those aged under 40 years. In order to improve the care for multiply injured patients, the major trauma network was activated in April 2012 in England. Its goal was to link all district hospitals to major trauma centres (MTCs) and allow for rapid transfer of patients. Anecdotally, this has affected elective orthopaedic operating at MTCs. The aim of this study was to compare the number of lower limb arthroplasty procedures performed before and after the establishment of the trauma network...
January 10, 2017: Annals of the Royal College of Surgeons of England
https://www.readbyqxmd.com/read/28071951/spontaneous-extrusion-of-gallstones-after-percutaneous-drainage
#2
D Hariharan, D N Lobo
There have been reports of late discharge of gallstones through operative wounds after spillage into the peritoneal cavity during laparoscopic cholecystectomy and after the development of spontaneous cholecystocutaneous fistulae. However, spontaneous discharge of gallstones from the tract of a percutaneous cholecystostomy or percutaneous drainage of a perforated gall bladder has not, to the best of our knowledge, been reported previously. We report a case in which a patient who had a percutaneous drain inserted for a perforated gall bladder discharged 34 gallstones from the tract after removal of the 7-F pigtail catheter...
January 10, 2017: Annals of the Royal College of Surgeons of England
https://www.readbyqxmd.com/read/28071950/reporting-individual-surgeon-outcomes-does-not-lead-to-risk-aversion-in-abdominal-aortic-aneurysm-surgery
#3
A Saratzis, A Thatcher, M F Bath, D A Sidloff, M J Bown, J Shakespeare, R D Sayers, C Imray
INTRODUCTION Reporting surgeons' outcomes has recently been introduced in the UK. This has the potential to result in surgeons becoming risk averse. The aim of this study was to investigate whether reporting outcomes for abdominal aortic aneurysm (AAA) surgery impacts on the number and risk profile (level of fitness) of patients offered elective treatment. METHODS Publically available National Vascular Registry data were used to compare the number of AAAs treated in those centres across the UK that reported outcomes for the periods 2008-2012, 2009-2013 and 2010-2014...
January 10, 2017: Annals of the Royal College of Surgeons of England
https://www.readbyqxmd.com/read/28071949/lateral-thyroid-cartilage-thyrotomy-approach-to-an-embedded-paraglottic-fishbone
#4
H T Wong, S Y Tham, K Elangkumaran, Wsj Ng, K J Sia
Fishbones are of particular interest to otolaryngologists. Most fishbones can be removed transorally or via endoscopic guidance. Transcervical neck exploration is occasionally necessary, especially in cases of an embedded foreign body. Computed tomography is the most sensitive and specific imaging modality for identifying embedded fishbones. To our knowledge, this is the first reported case of a laryngeal foreign body embedded in the paraglottic space that was removed using an open approach via a lateral thyroid cartilage window...
January 10, 2017: Annals of the Royal College of Surgeons of England
https://www.readbyqxmd.com/read/28071948/current-practice-of-antibiotic-prophylaxis-during-elective-laparoscopic-cholecystectomy
#5
Caw Macano, E A Griffiths, R S Vohra
INTRODUCTION Current guidelines do not recommend antibiotic prophylaxis in elective laparoscopic cholecystectomy. Despite this, there is wide variation in antibiotic prophylaxis during cholecystectomy in population-based studies. The aim of this survey was to establish the current rationale for antibiotic prophylaxis in elective laparoscopic cholecystectomy. METHODS A short questionnaire was designed and disseminated across collaborators for a population-based study investigating outcomes following cholecystectomy and via the Association of Upper Gastrointestinal Surgeons, Researchgate and Surginet membership...
January 10, 2017: Annals of the Royal College of Surgeons of England
https://www.readbyqxmd.com/read/28071947/presacral-abscess-as-a-rare-complication-of-sacral-nerve-stimulator-implantation
#6
A Gumber, S Ayyar, H Varia, S Pettit
A 50-year-old man with intractable anal pain attributed to proctalgia fugax underwent insertion of a sacral nerve stimulator via the right S3 vertebral foramen for pain control with good symptomatic relief. Thirteen months later, he presented with signs of sepsis. Computed tomography (CT) and magnetic resonance imaging (MRI) showed a large presacral abscess. MRI demonstrated increased enhancement along the pathway of the stimulator electrode, indicating that the abscess was caused by infection introduced at the time of sacral nerve stimulator placement...
January 10, 2017: Annals of the Royal College of Surgeons of England
https://www.readbyqxmd.com/read/28052686/henoch-sch%C3%A3-nlein-purpura-as-a-rare-cause-of-an-acute-abdomen
#7
M Davies, M Nanda Kumar, V Shetty, P Mitchell
A 52-year-old man presented with a purpuric rash affecting his legs and hypertension. He was diagnosed with Henoch-Schönlein purpura and discharged with non-steroidal anti-inflammatory drugs. Three weeks later, he presented again with loss of appetite and vomiting before developing abdominal pain with pyrexia of 38.5°C and rigors. On examination, he was hypotensive with a distended abdomen and a national early warning score of 6. Computed tomography revealed enteropathy of Henoch-Schönlein purpura. The patient deteriorated and went for an emergency laparotomy, where 30cm of ischaemic small bowel was resected...
January 4, 2017: Annals of the Royal College of Surgeons of England
https://www.readbyqxmd.com/read/27976915/closed-reduction-of-femoral-fractures-using-an-l-shaped-arm-retainer
#8
S D Brookes-Fazakerley, D M Wharton
No abstract text is available yet for this article.
December 15, 2016: Annals of the Royal College of Surgeons of England
https://www.readbyqxmd.com/read/27976914/using-a-surgical-spoon-for-safe-thoracotomy-closure-in-minimally-invasive-direct-coronary-artery-bypass-surgery
#9
M N Acharya, C Uchimie, T Bahrami
No abstract text is available yet for this article.
December 15, 2016: Annals of the Royal College of Surgeons of England
https://www.readbyqxmd.com/read/27917670/neuroendocrine-tumour-arising-inside-a-tailgut-cyst
#10
I Mora-Guzmán, A Alonso-Casado, A Rodríguez Sánchez, E Bermejo Marcos
Tailgut cysts are rare benign retrorectal cysts arising from persistent remnants of an embryonic hindgut. Malignant transformation inside this lesion is very uncommon and occurrence of neuroendocrine tumours in this context is extremely rare. We report the case of a 56-year-old woman who underwent surgical excision of a presacral tailgut cyst, which was found incidentally to include a neuroendocrine tumour.
December 5, 2016: Annals of the Royal College of Surgeons of England
https://www.readbyqxmd.com/read/27917669/use-of-core-biopsy-in-diagnosing-cervical-lymphadenopathy-a-viable-alternative-to-surgical-excisional-biopsy-of-lymph-nodes
#11
D Allin, S David, A Jacob, N Mir, A Giles, N Gibbins
OBJECTIVES Lymphoma often presents with a neck mass and while fine-needle aspiration cytology may be suggestive, tissue biopsy is required for reliable diagnosis and classification of a lymphoma that is sufficient to deliver the correct treatment for the patient. Traditionally, excisional biopsy of a lymph node has been the standard method of tissue sampling, providing ample tissue for assessment. However, this requires theatre time, and preceding fine-needle aspiration cytology, which may incur a delay. With careful use of tissue, coupled with advances in immunohistochemical and molecular investigative techniques, core biopsy provides a possible alternative to traditional fine-needle aspiration and excisional biopsy...
December 5, 2016: Annals of the Royal College of Surgeons of England
https://www.readbyqxmd.com/read/27917668/recognising-and-dealing-with-complications-in-orthopaedic-surgery
#12
D Ricketts, R A Rogers, T Roper, X Ge
Orthopaedic surgeons need information about the complications they are likely to encounter. The literature on complications is difficult to interpret owing to a lack of agreed definitions, problems with collecting accurate data and with data interpretation. We suggest a role for the Royal College of Surgeons and specialist societies in collecting and interpreting complications data.
December 5, 2016: Annals of the Royal College of Surgeons of England
https://www.readbyqxmd.com/read/27917667/prophylactic-antibiotics-in-acute-pancreatitis-endless-debate
#13
M M Mourad, Rpt Evans, V Kalidindi, R Navaratnam, L Dvorkin, S R Bramhall
INTRODUCTION The development of pancreatic infection is associated with the development of a deteriorating disease with subsequent high morbidity and mortality. There is agreement that in mild pancreatitis there is no need to use antibiotics; in severe pancreatitis it would appear to be a logical choice to use antibiotics to prevent secondary pancreatic infection and decrease associated mortality. MATERIALS AND METHODS A non-systematic review of current evidence, meta-analyses and randomized controlled trials was conducted to assess the role of prophylactic antibiotics in acute pancreatitis and whether it might improve morbidity and mortality in pancreatitis...
December 5, 2016: Annals of the Royal College of Surgeons of England
https://www.readbyqxmd.com/read/27917666/safety-of-out-of-hours-operating-in-trauma-and-orthopaedics-at-a-district-general-hospital
#14
M A Gulamhussein, S Chaudhry, S Noor, T Chaudhry, A Guha, R Knebel
INTRODUCTION According to the National Confidential Enquiry into Perioperative Deaths (NCEPOD), out-of-hours operating in trauma and orthopaedics should be reserved for life or limb threatening cases only. The aim of our study was to determine the nature of non-emergency work carried out in our trust at night in 2015. The overall efficacy and clinical safety of the services provided was evaluated. METHODS Surgical activity undertaken after 9pm was reviewed along with patient ASA (American Society of Anesthesiologists) grade, grade of operating surgeon and any complications that occurred following the procedure...
December 5, 2016: Annals of the Royal College of Surgeons of England
https://www.readbyqxmd.com/read/27917665/the-potential-effect-of-biological-sealants-on-colorectal-anastomosis-healing-in-experimental-research-involving-severe-diabetes
#15
K Stergios, K Kontzoglou, V Pergialiotis, L M Korou, M Frountzas, O Lalude, N Nikiteas, D N Perrea
Colorectal anastomoses continuous to pose a significant challenge in current surgical practice. Anastomotic leakage remains one of the most frequent and dramatic complications of colorectal surgery, even in centres of high specialisation. Diabetes is a well-established independent factor which results in higher anastomotic leakage rates. Fibrin sealants have been applied in experimental and clinical studies for the prevention of anastomotic dehiscence. However, little is known regarding their impact on diabetic patients...
December 5, 2016: Annals of the Royal College of Surgeons of England
https://www.readbyqxmd.com/read/27917664/abdominal-wall-ectopic-testis-torsion-mimicking-a-spigelian-hernia-in-an-adult
#16
M Natarajan, H M Alnajjar, C I Woodward, M Tshuma, T Marshall, M Rochester
We report an unusual case of an ectopic testis identified in a 37-year-old man presenting with acute severe right iliac fossa pain and an irreducible mass. Initially diagnosed as a Spigelian hernia, computed tomography and ultrasonography identified the presence of an ectopic testis in the abdominal wall. Interparietal testicular ectopia is an extremely rare condition. We present and discuss the first case in the literature of an ectopic testis located between the internal and external oblique muscle layers of the anterior abdominal wall in an adult...
December 5, 2016: Annals of the Royal College of Surgeons of England
https://www.readbyqxmd.com/read/27917663/endovascular-treatment-of-an-arterioportal-fistula-following-pancreaticoduodenectomy
#17
J P Taylor, A Akinkuotu, M A Makary
We present a rare case of an arterioportal fistula that formed between the superior mesenteric artery and portal vein 30 days following a pancreaticoduodenectomy, which was successfully managed with endovascular procedures.
December 5, 2016: Annals of the Royal College of Surgeons of England
https://www.readbyqxmd.com/read/27917662/validating-a-benchmarking-tool-for-audit-of-early-outcomes-after-operations-for-head-and-neck-cancer
#18
D Tighe, I Sassoon, M McGurk
INTRODUCTION In 2013 all UK surgical specialties, with the exception of head and neck surgery, published outcome data adjusted for case mix for indicator operations. This paper reports a pilot study to validate a previously published risk adjustment score on patients from separate UK cancer centres. METHODS A case note audit was performed of 1,075 patients undergoing 1,218 operations for head and neck squamous cell carcinoma under general anaesthesia in 4 surgical centres. A logistic regression equation predicting for all complications, previously validated internally at sites A-C, was tested on a fourth external validation sample (site D, 172 operations) using receiver operating characteristic curves, Hosmer-Lemeshow goodness of fit analysis and Brier scores...
December 5, 2016: Annals of the Royal College of Surgeons of England
https://www.readbyqxmd.com/read/27917661/a-technique-for-minimising-the-redundant-skin-of-a-mastectomy-scar-and-improving-cosmesis-for-delayed-reconstruction
#19
H Tuffaha, M Hussien
No abstract text is available yet for this article.
December 5, 2016: Annals of the Royal College of Surgeons of England
https://www.readbyqxmd.com/read/27869497/appendicular-abscess-as-an-unprecedented-cause-of-an-inferior-lumbar-hernia
#20
S M Ali, S Subramaniam
Inferior lumbar hernias are uncommon hernias resulting from a defect in the abdominal wall. They can occur during infancy (congenital defect), albeit less frequently, or spontaneously after trauma or surgery with a lumbar incision. With fewer than 300 cases reported over the past 3 centuries, clinical diagnosis is often confusing owing to non-specific symptoms, relating to the gastrointestinal, genitourinary or musculoskeletal systems. We present a case of an inferior lumbar hernia following spontaneous rupture of a retrocaecally tracked appendicular abscess and a brief literature review...
November 21, 2016: Annals of the Royal College of Surgeons of England
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