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Surgeon: Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland

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https://www.readbyqxmd.com/read/28522270/lumbar-microdiscectomy-as-a-day-case-procedure-scope-for-improvement
#1
Neeraj Ahuja, Himanshu Sharma
BACKGROUND AND PURPOSE: There are no significant differences in outcomes between patients receiving inpatient and day-case lumbar microdiscectomy, but the latter is still underused in the NHS. Here we aimed to identify factors contributing to successful same-day discharge in day-case patients. METHODS: This was a retrospective observational study of patients undergoing elective lumbar microdiscectomy between August 2012 and December 2014. Age, gender, day of surgery, distance to hospital, ASA grade, regular opiate use, smoking status, order on the operating list, and side and level of surgery were examined by logistic regression to assess their influence on same-day discharge...
May 15, 2017: Surgeon: Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland
https://www.readbyqxmd.com/read/28476310/intra-operative-techniques-to-reduce-the-risk-of-capsular-contracture-in-patients-undergoing-aesthetic-breast-augmentation-a-review
#2
REVIEW
J D Horsnell, A E Searle, P A Harris
BACKGROUND: Capsular contracture is a significant complication following aesthetic breast augmentation. Efforts to reduce this incidence have focused on the surgical approach, implant selection and IV antibiotics. Intra-operative methods to reduce the risk have had less investigation. This review focuses on these interventions and will document evidence to support pocket irrigation, nipple shields, drains and the use of an implant insertion funnel. METHODS: A comprehensive review of Pubmed, Scopus and Embase was performed to identify relevant papers published since 2000...
May 2, 2017: Surgeon: Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland
https://www.readbyqxmd.com/read/28366493/re-lateral-x-ray-for-proximal-femoral-fractures-is-it-really-necessary-riaz-et%C3%A2-al
#3
LETTER
M Gillespie, N Skipper, M Johnstone, D Skipsey, A Johnston
No abstract text is available yet for this article.
March 30, 2017: Surgeon: Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland
https://www.readbyqxmd.com/read/28341407/comparison-of-endoscopic-laser-therapy-and-self-expanding-metal-stents-for-palliation-in-patients-with-non-resectable-oesophageal-carcinoma
#4
R J Drummond, D G Vass, K Robertson, C Sharp, S Gibson
BACKGROUND: There are currently limited data on the comparative success of endoscopic laser therapy (NLT) and self expanding metal stents (SEMS) as palliative measures in patients with non-resectable oesophageal cancer. This study aims to assess and compare the outcomes of these methods of endoscopic palliation. METHODS: Patients with non-curative oesophageal/gastro-oesophageal cancers with dysphagia were identified prospectively and consented to swallow assessment and follow-up...
March 21, 2017: Surgeon: Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland
https://www.readbyqxmd.com/read/28284517/antibiotics-first-strategy-for-uncomplicated-acute-appendicitis-in-adults-is-associated-with-increased-rates-of-peritonitis-at-surgery-a-systematic-review-with-meta-analysis-of-randomized-controlled-trials-comparing-appendectomy-and-non-operative-management
#5
REVIEW
Mauro Podda, Nicola Cillara, Salomone Di Saverio, Antonio Lai, Francesco Feroci, Gianluigi Luridiana, Ferdinando Agresta, Nereo Vettoretto
BACKGROUND: Acute appendicitis is the most common surgical diagnosis in young patients, with lifetime prevalence of about 7%. Debate remains on whether uncomplicated AA should be operated or not. Aim of this meta-analysis of randomized controlled trials was to assess current evidence on antibiotic treatment for uncomplicated AA compared to standard surgical treatment. METHODS: Systematic literature search was performed using PubMed, EMBASE, Medline, Google Scholar and Cochrane Central Register of Controlled Trials databases for randomized controlled trials comparing antibiotic therapy (AT) and surgical therapy-appendectomy (ST) for uncomplicated AA...
March 8, 2017: Surgeon: Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland
https://www.readbyqxmd.com/read/27815046/the-impact-of-the-biomolecular-era-on-breast-cancer-surgery
#6
REVIEW
T P McVeigh, M R Boland, A J Lowery
Surgery has always played a central role in the management of breast cancer, with local control via complete tumour resection long established as the cornerstone of effective breast cancer therapy. While extensive surgical resection in the form of the Halstead radical mastectomy dominated treatment up until at least the 1970s, the advent of adjuvant loco-regional and systemic therapies has resulted in a decrease in the magnitude of surgical intervention in recent decades. The Biomolecular or "-omics" era initiated with the discovery of the DNA double helix in 1953 and intensified by the completion of the human genome project in 2003 has seen an unprecedented expansion in our understanding of the molecular and genetic heterogeneity of cancer...
June 2017: Surgeon: Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland
https://www.readbyqxmd.com/read/27742406/role-of-transoral-robotic-surgery-in-current-head%C3%A2-%C3%A2-neck-practice
#7
REVIEW
David Hamilton, Vinidh Paleri
Morbidity and mortality associated with increasingly radical doses of chemoradiotherapy have led many to question the current standard of care in head and neck cancer. Recently, surgeons have developed minimally invasive, transoral techniques which have demonstrated excellent survival and favourable functional outcomes. Transoral robotic surgery (TORS) is the most recent, cutting edge in the evolution of transoral techniques; TORS allows surgeons unprecedented access to and visualisation of the upper aerodigestive tract...
June 2017: Surgeon: Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland
https://www.readbyqxmd.com/read/27720666/primary-repair-of-the-anterior-cruciate-ligament-a-paradigm-shift
#8
REVIEW
Jelle P van der List, Gregory S DiFelice
Over the last century, many surgical treatments have been developed in the orthopedic field, including treatments of anterior cruciate ligament (ACL) injuries. These treatments ideally evolve in a process of trial and error with prospective comparison of new treatments to the current treatment standard. However, these evolutions are sometimes not linear and periodically undergo paradigm shifts. In this article, we review the evolution of ACL treatment and explain how it underwent a paradigm shift. Open primary ACL repair was the most common treatment in the 1970s and 1980s, but because multiple studies noted deterioration of outcomes at mid-term follow-up, in addition to several randomized clinical trials (RCTs) that noted better outcomes following ACL reconstruction, the open primary repair technique was abandoned...
June 2017: Surgeon: Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland
https://www.readbyqxmd.com/read/27720167/coronary-artery-bypass-grafting-for-left-main-disease-and-the-risk-of-stroke-incidence-aetiology-and-prevention
#9
REVIEW
Ana-Catarina Pinho-Gomes, David P Taggart
This review explores the association between left main disease and the increased risk of perioperative stroke following coronary artery bypass grafting, specifically addressing the potential underlying mechanisms and its potential prevention. In particular, this correlation appears stronger for patients with left main disease when compared to patients with isolated triple vessel disease. Even though evidence on this topic is limited and of modest quality, there appears to be a significant association between ascending aorta atherosclerosis and coronary artery disease...
June 2017: Surgeon: Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland
https://www.readbyqxmd.com/read/26688059/size-of-common-bile-duct-stones-on-mrcp-predicts-likelihood-of-positive-findings-at-ercp
#10
J Reid, R Dolan, M Patel, R Fleming, D Young, A Hair
OBJECTIVE: To ascertain if direct measurement of the size of common bile duct stones (CBD) on magnetic resonance cholangio-pancreatography (MRCP) can be used to predict the likelihood of a positive endoscopic retrograde cholangio-pancreatography (ERCP) result. Should we be carrying out ERCPs on all patients with CBD stones? METHODS: We retrospectively analysed the records of 1812 consecutive patients undergoing MRCP between November 2009 and November 2014 at the Victoria Infirmary...
June 2017: Surgeon: Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland
https://www.readbyqxmd.com/read/26482084/post-traumatic-stress-disorder-amongst-surgical-trainees-an-unrecognised-risk
#11
Christopher V Thompson, David N Naumann, Jodie L Fellows, Douglas M Bowley, Nigel Suggett
BACKGROUND: Experiences of actual/threatened death or serious injury to patients are commonplace in surgery. Pathological symptoms following stress may lead to Acute Stress Reaction (ASR) and Post-Traumatic Stress Disorder (PTSD). PTSD symptoms of insomnia, anger, poor concentration, hyper-vigilance and exaggerated startle have implications for patient safety. The current study investigates the prevalence of occult, untreated psychological morbidity amongst surgical trainees. METHODS: A web-based survey of UK surgical trainees based upon the Impact of Events Scale-Revised (IES-R) was distributed using social media platforms and email...
June 2017: Surgeon: Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland
https://www.readbyqxmd.com/read/26283303/postoperative-exercise-training-is-associated-with-reduced-respiratory-infection-rates-and-early-discharge-a-case-control-study
#12
N R Bhatt, G Sheridan, M Connolly, S Kelly, A Gillis, K C Conlon, S Lane, E Shanahan, P F Ridgway
INTRODUCTION: Pulmonary complications are a significant cause of morbidity, mortality and increased hospital stay following complex abdominal surgery. We investigated whether postoperative early aerobic activity with a pedal exerciser reduced respiratory morbidity and length of stay and improved pulmonary function. METHODS: A prospective case-control study on 30 cases and 30 case matched controls aged 18 years or more who underwent major surgery was conducted. Controls were case-mix matched prospectively from a similar general surgical service not utilising postoperative exercising...
June 2017: Surgeon: Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland
https://www.readbyqxmd.com/read/26210939/endovascular-conversion-into-aorto-uniiliac-configuration-of-acute-failed-endovascular-aneurysm-repair-is-associated-with-better-one-year-survival-rates-compared-to-open-conversion
#13
Alexander M Prusa, Andreas G Wibmer, Richard Nolz, Maria Schoder, Harald Teufelsbauer
BACKGROUND: Open conversions (OC) due to failed endovascular repair of infrarenal abdominal aortic aneurysms (EVAR) are technically demanding because of preexisting prostheses and advanced aortic disease. This study evaluates the feasibility and outcomes of aorto-uniiliac endografting (AUI) as an alternative treatment option in acute failed EVAR. METHODS: From March 1995 through February 2012, 26 patients underwent acute conversion of failed EVAR at our tertiary care university center...
June 2017: Surgeon: Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland
https://www.readbyqxmd.com/read/27729210/reply-trauma-networks-and-rural-trauma
#14
LETTER
Jan O Jansen, Jonathan J Morrison
No abstract text is available yet for this article.
April 2017: Surgeon: Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland
https://www.readbyqxmd.com/read/27612947/the-evolving-management-of-the-appendix-mass-in-the-era-of-laparoscopy-and-interventional-radiology
#15
REVIEW
James Forsyth, Konstantinos Lasithiotakis, Mark Peter
AIM: An appendix mass is the result of a walled-off perforation of the appendix which localises, resulting in a mass and it is encountered in up to 7% of patients presenting with acute appendicitis. However, its management is controversial due to the lack of high level evidence. This review article sets out a rationale diagnostic and therapeutic strategy for the appendix mass based upon up-to-date available evidence. METHODS: A literature review of the investigation and management of appendix mass/complicated appendicitis was undertaken using PubMed, EMBASE and Google Scholar...
April 2017: Surgeon: Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland
https://www.readbyqxmd.com/read/27520332/retrievable-ivc-filters-friend-or-foe
#16
REVIEW
E Ryan, H K Kok, M J Lee
Venous thromboembolism is a common condition with widely varied outcomes. Pulmonary embolism is associated with a case-fatality rate of up to 8%, increasing up to 18-fold in massive PE. Pharmacological treatment of VTE with anticoagulant medication (AC) is the first line therapy of choice. Retrievable inferior vena cava filters (IVCF) are indicated as a short-term replacement for AC in certain circumstances. Most of the evidence concerning IVCF pertains to permanent filters and older filter models. Limited evidence for retrievable IVCF results in poor consensus regarding indications, follow-up and retrieval...
April 2017: Surgeon: Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland
https://www.readbyqxmd.com/read/27396932/predictive-models-in-cancer-management-a-guide-for-clinicians
#17
REVIEW
Mohammed Ali Kazem
BACKGROUND: Predictive tools in cancer management are used to predict different outcomes including survival probability or risk of recurrence. The uptake of these tools by clinicians involved in cancer management has not been as common as other clinical tools, which may be due to the complexity of some of these tools or a lack of understanding of how they can aid decision-making in particular clinical situations. AIMS: The aim of this article is to improve clinicians' knowledge and understanding of predictive tools used in cancer management, including how they are built, how they can be applied to medical practice, and what their limitations may be...
April 2017: Surgeon: Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland
https://www.readbyqxmd.com/read/27346244/management-of-acute-periprosthetic-joint-infection-of-the-knee-algorithms-for-the-on-call-surgeon
#18
REVIEW
Robert Petretta, Jonathan Phillips, Andrew Toms
Periprosthetic joint infection (PJI) remains a serious complication following a total knee replacement. Infections rates following arthroplasty range from 0.5% to 3%. The acutely infected knee replacement often presents to the on call Orthopaedic Surgeon who can often lack the expertise or resources for the definitive management. However, obtaining an early and accurate diagnosis and potentially performing an early treatment such as irrigation and debridement may be required by the on call surgeon. Management of these patients should include a team of specialists including Medical or Intensive Care, and Infectious Disease...
April 2017: Surgeon: Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland
https://www.readbyqxmd.com/read/27167904/the-effect-of-deprivation-on-the-incidence-of-mandibular-fractures-in-a-british-city
#19
M H Wilson, J P Robinson, R T Sisson, P J Revington, S J Thomas
AIM: To examine the relationship between social and material deprivation and mandibular fractures. METHOD: Three hundred and forty three consecutive patients who underwent mandibular fracture fixation were selected for the study. After exclusions, 290 were divided into age groups and ranked according to their Index of Multiple Deprivation (IMD) score. Rankings were determined using postcodes, and divided into quintiles for statistical analysis. RESULTS: Ages ranged from 7 to 82 with 146 (50%) patients aged between 20 and 29...
April 2017: Surgeon: Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland
https://www.readbyqxmd.com/read/26530998/vacuum-assisted-biopsy-is-a-viable-alternative-to-surgical-biopsy-in-the-investigation-of-breast-lesions-of-uncertain-malignant-potential
#20
Andrew Pieri, Diane Hemming, Jackie Westgarth, Linsley Lunt
AIMS: In patients presenting with a breast lesion, when initial core biopsy histology falls into the category of "uncertain malignant potential" (i.e. a B3 lesion), the next line of investigation has traditionally been a surgical biopsy (SBx). Vacuum-assisted biopsy (VAB) may be a viable minimally invasive alternative to SBx for B3 lesions. The primary aims of this study were to establish whether VAB reduces the need for surgical biopsy and determine VAB sensitivity for carcinoma following initial B3 histology...
April 2017: Surgeon: Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland
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