Understanding unplanned return to theatre in rural South Australia general surgery: review of four major hospitals over a six-year period.

Background: Unplanned return to theatre (URTT) is associated with longer hospital stay and higher mortality rates, placing extra burden on hospital resources. There is a lack of literature analysing causes of URTT in a rural general surgery department. This knowledge may be important to help identify patients at risk of URTT.

Extended scope of practice needed for Australian rural general surgeons: a review of South Australia's rural general surgical caseload and case mix.

Background: There is a shortage of surgeons caring for the 33% of Australians residing in rural and regional areas. In order to help appreciate what rural general surgery entails and optimize training for aspiring rural surgeons, the aim of this study was to analyse the general surgical departments' procedural caseload and casemix in four rural South Australian hospitals.

Methods: This is a retrospective multi-centre study involving four rural surgical centres in South Australia (Mt Gambier, Whyalla, Port Augusta, and Port Lincoln).

Analysis of surgical mortality in rural South Australia: a review of four major rural hospital in South Australia.

Background: One-third of Australia's population reside in rural and remote areas. This audit aims to describe all-causes of mortality in rural general surgical patients, and identify areas of improvement.

Methods: This is a retrospective multi-centre study involving four South Australian hospitals (Mt Gambier, Whyalla, Port Augusta, and Port Lincoln).

In-hospital survival after pancreatoduodenectomy is greater in high-volume hospitals versus lower-volume hospitals: a meta-analysis.

Background: Variation in cut-off values for what is considered a high volume (HV) hospital has made assessments of volume-outcome relationships for pancreaticoduodenectomy (PD) challenging. Accordingly, we performed a systematic review and meta-analysis comparing in-hospital mortality after PD in hospitals above and below HV thresholds of various cut-off values.

Method: PubMed/MEDLINE, Embase and Cochrane Library were searched to 4 January 2021 for studies comparing in-hospital mortality after PD in hospitals above and below defined HV thresholds.

Gastrointestinal recovery after surgery: protocol for a systematic review.

Introduction: Gastrointestinal recovery after surgery is of worldwide significance. Postoperative gastrointestinal dysfunction is multifaceted and known to represent a major source of postoperative morbidity, however, its significance to postoperative care across all surgical procedures is unknown. The complexity of postoperative gastrointestinal recovery is poorly defined within gastrointestinal surgery, and even less so outside this field.

Five myths about unacceptable behaviour in surgical education.

Recent evidence of the occurrence of discrimination, bullying and sexual harassment in surgery and more generally within healthcare has led to widespread discussion about the effects of unacceptable behaviour in surgical education and practice. Despite accumulating evidence of the adverse effects of unacceptable behaviour in clinical practice, not only on health care professionals but on patient care and outcomes, many surgeons and other health care professionals continue to embrace false perceptions about appropriate professional behaviour, interactions and approaches to teaching within surgical departments and more generally within healthcare institutions. This article explores five misperceptions about unacceptable behaviour in surgical education and provides evidence that supports a change in practice.

Correlation of selection scores with subsequent assessment scores during surgical training.

Background: Determining admission criteria to select candidates most likely to succeed in surgical training in Australia and New Zealand has been an imprecise art with little empirical evidence informing decisions. Selection to the Royal Australasian College of Surgeons' Surgical Education and Training programme is based entirely on applicants' performance in structured curriculum vitae (CV), referees' reports and interviews. This retrospective review compared General Surgery (GS) trainees' performance in selection with subsequent performance in assessments during training.

Learning surgical communication, leadership and teamwork through simulation.

Background: In Australia and New Zealand, surgical trainees are expected to develop competencies across 9 domains. Although structured training is provided in several domains, there is little or no formal program for professionalism, communication, collaboration, and management and leadership. The Australian federal Department of Health and Aging funded a pilot course in simulation-based education to address these competencies for surgical trainees.

Surgical simulation: a systematic review.

Objective: To evaluate the effectiveness of surgical simulation compared with other methods of surgical training.

Summary Background Data: Surgical simulation (with or without computers) is attractive because it avoids the use of patients for skills practice and provides relevant technical training for trainees before they operate on humans.

Methods: Studies were identified through searches of MEDLINE, EMBASE, the Cochrane Library, and other databases until April 2005.

The use of a "liquid" electrode in hepatic electrolysis.

Background: The use of direct current electrolysis as a local nonthermal ablative technique for colorectal liver metastases promises to be a simple, safe, and effective therapy. Under general anesthesia, electrolysis is presently limited to tumors smaller than 5 cm, due to the protracted nature of its administration. In an attempt to enhance the effect of electrolysis, a direct current was passed through a preinjected bolus of acetic acid.

Endoscopic modified Lothrop procedure for the treatment of chronic frontal sinusitis: a systematic review.

Objective: We sought to assess the safety and efficacy of the endoscopic modified Lothrop procedure (EMLP), performed either wholly intranasally or in combination with an external approach, against the osteoplastic flap (OPF) procedure with or without fat obliteration.

Methods: All original, published studies on the EMLP and the OPF, with or without fat obliteration, were identified by searching Current Contents, Embase, MEDLINE, and The Cochrane Library. The search strategy for OPF was date-restricted to articles published after 1979 until February 2001.

Surgical rotations in provincial South Australia: the trainees' perspective.

Background: Rural general surgery is faced with a shortage of resident surgeons in many parts of Australia. Although it is accepted that an undergraduate rural exposure favourably influences graduates to undertake rural practice, it is not known whether postgraduate terms exert a similar effect.

Method: Advanced general surgical trainees in 2000 were rotated for 1-month terms to Whyalla, a major provincial centre in South Australia.

Liver electrolysis: pH can reliably monitor the extent of hepatic ablation in pigs.

Electrolysis is a method of tissue ablation that creates chemical species and a pH gradient in response to direct current. Initial studies of electrolysis in animal models and humans have shown that it is a safe, predictable and effective process for destroying normal and tumour-bearing liver in a linear, dose-dependent manner. Presently, the amount of current that is applied (in coulombs) has to be calculated using historical data, with inherent inaccuracy.