Postoperative outcomes in colorectal surgery by day of surgery: A national cohort study.

Aim: Poorer postoperative outcomes have been observed for patients admitted and operated on later in the week and over the weekend. This is thought to be related to temporal fluctuations in the quality of perioperative care. The aim of this work was to identify if the day of surgery influenced outcomes in a national cohort of colorectal cancer (CRC) resections.

Provision and outcomes of publicly funded bariatric surgery in a metropolitan versus a provincial population of New Zealand.

Background: Obesity is an important health problem worldwide. The prevalence of obesity in Aotearoa New Zealand (AoNZ) is the third highest amongst OECD countries. Previous studies have demonstrated inequity in the provision of bariatric and metabolic surgery (BMS) across AoNZ, but detailed data regarding patients and surgical outcomes is lacking.

Barriers for bariatric surgery in provincial New Zealand: a qualitative analysis.

Background: Bariatric surgery is the most effective treatment for people with obesity. It has been shown that there's is a complex psychosocial overlay in the pathophysiology and treatment, which requires specific consideration when delivering care. There is a significant drop out rate for patients accepted on to bariatric programmes in New Zealand, resulting in failure to progress to surgical intervention.

Adherence to national Lynch syndrome testing guidelines for colorectal cancer in an Aotearoa New Zealand hospital-based population.

Aim: Lynch syndrome (LS) is estimated to affect 1-3.9% of patients with colorectal cancer (CRC). Testing for LS is important in determining management and establishing surveillance for "Lynch families".

Protocol for a national, multicentre study of post-endoscopy colorectal and upper gastrointestinal cancers: The POET study.

Aim: The primary aim of the study is to define the post-colonoscopy colorectal cancer (PCCRC) three-year rate and the post-endoscopy upper gastrointestinal cancer (PEUGIC) three-year rate across public hospitals in Aotearoa New Zealand.

Method: This retrospective cohort study will be conducted via the trainee-led STRATA Collaborative network. All public hospitals in Aotearoa New Zealand will be eligible to participate.

Management and outcomes of splenic injuries secondary to blunt trauma in patients presenting to major trauma hospitals in Aotearoa New Zealand.

Background: Non-operative management of splenic injuries has significantly increased in the last decade with an increased emphasis on splenic preservation. This shift was assisted by increased availability of angioembolization, however, potential geographical variability in access exists in Aotearoa New Zealand (AoNZ). The aim of this study was to assess the management of splenic injury across AoNZ.

The impact of delay and prehospital factors on acute appendicitis severity in New Zealand children: a national prospective cohort study.

Background: Appendicitis is the most common reason children undergo acute general surgery but international, population-level disparities exist. This is hypothesised to be caused by preoperative delay and differential access to surgical care. The impact of prehospital factors on paediatric appendicitis severity in New Zealand is unknown.

Incidence and outcomes of major trauma patients with thoracic injuries and rib fractures in Aotearoa New Zealand.

Introduction: Thoracic trauma represents a significant burden of disease in Aotearoa, New Zealand (AoNZ). To date, no study has examined the incidence or outcomes of patients suffering major thoracic trauma, or major trauma and rib fractures in AoNZ.

Methods: A 6 year retrospective study of all major trauma (Injury Severity Score >12) patients in AoNZ was performed.

Colonic Investigation following acute diverticulitis in Northland, New Zealand.

Aim: Diverticulitis is common and increasing in incidence. The risk of malignancy in those with uncomplicated diverticulitis is estimated to be 0.7%, compared with 10% in complicated diverticulitis.

Characterising nationwide reasons for unplanned hospital readmission after colorectal cancer surgery.

Background: Readmissions after colorectal cancer surgery are common, despite advancements in surgical care, and have a significant impact on both individual patients and overall healthcare costs. The aim of this study was to determine the 30-and 90 days readmission rate after colorectal cancer surgery, and to investigate the risk factors and clinical reasons for unplanned readmissions.

Method: A multicenter, population-based study including all patients discharged after index colorectal cancer resection from 2010 to 2020 in Aotearoa New Zealand (AoNZ) was completed.

Trauma Teams in Aotearoa New Zealand-a national survey.

Aims: Improved survival of trauma patients has been shown when a multidisciplinary trauma team is available. The aim of this study is to investigate the composition of trauma teams, trauma call criteria and the role of anaesthetists in trauma care across New Zealand.

Methods: A survey was distributed using the modified Dillman's technique.

Survival of patients with small bowel neuroendocrine neoplasms in Auckland, Aotearoa New Zealand.

Background: Small intestinal Neuroendocrine Neoplasms (SI-NENs) are the most common primary malignancy of the small bowel. The aim of this study is to define the survival of patients with an SI-NEN in Auckland, Aotearoa New Zealand (AoNZ).

Methods: A retrospective study of all patients diagnosed with a jejunal or ileal SI-NEN in the Auckland region between 2000 and 2012 was performed.

The effect of rurality and ethnicity in patients with acute cholecystitis in Northland, New Zealand.

Aim: Acute cholecystitis is a common reason for emergency admission. Rurality and ethnicity are associated with poorer surgical outcomes, but data in benign disease is sparse. This study aims to assess the effect of rurality and ethnicity on the severity, management, and outcomes of acute cholecystitis.

Cost analysis of index versus delayed cholecystectomy for acute cholecystitis in a New Zealand Provincial Centre.

Background: Evidence suggests index cholecystectomy (IC) in patients with acute cholecystitis is safe, has decreased hospital stay and is cheaper than delayed cholecystectomy (DC). Costs of cholecystectomy have not previously been investigated in New Zealand. The aim of this study was to compare cost of IC with DC for patients with acute cholecystitis.

Management and outcomes of rib fractures in patients with isolated blunt thoracic trauma: Results of the Aotearoa New Zealand RiBZ study.

Aim: Rib fractures are common and associated with significant morbidity and mortality. There is limited literature on patient care and outcomes in Aotearoa New Zealand (AoNZ). The aim of this study is to describe key clinical outcomes and management interventions for patients with rib fractures across AoNZ.

Outcomes in patients with fractured ribs: middle aged at same risk of complications as the elderly.

Aims: Rib fractures occur in up to 10% of hospitalised trauma patients and are the most common type of clinically significant blunt injury to the thorax. There is strong evidence that elderly patients have worse outcomes compared with younger patients. Evolving evidence suggests adverse outcomes start at a younger age.

Prehospital barriers for rural New Zealand parents in paediatric appendicitis: a qualitative analysis.

Background: Appendicitis is the most common reason children undergo emergency general surgery. Worse appendicitis outcomes have been demonstrated in rural, lower socioeconomic, and indigenous populations. These findings are hypothesised to be a result of differential access and delay in presentation to hospital.

Incidence, outcomes and effect of delayed intervention in patients with hollow viscus injury due to major trauma in the Northern region of New Zealand.

Background: Patients with hollow viscus injury (HVI) are often a cause for diagnostic uncertainty. The incidence and outcomes of patients suffering hollow viscus injury secondary to major trauma have not been previously described in New Zealand. These metrics are important to guide quality improvement and resource allocation.

Effect of rurality and ethnicity in severity and outcomes in patients with acute pancreatitis.

Background: Previous studies have demonstrated a high incidence of acute pancreatitis (AP) in New Zealand, with Maori having the highest reported incidence worldwide. It is possible that barriers to healthcare exist for rural and Maori patients, leading to poorer outcomes. The aim of this study is to compare differences in severity and outcomes in patients with AP with regards to rurality and ethnicity.

Rate and cost of representation in patients suffering from major trauma in Northland, New Zealand.

Introduction: The published rate of readmission in major trauma patients in New Zealand has been recorded at 11%. The rate of re-attendances to emergency departments (ED) is currently not reported, but potentially adds significant burden to the healthcare system. The rate, costs and resource implications of these representations have not previously been described in New Zealand.

Association between COVID-19 public health interventions and major trauma presentation in the northern region of New Zealand.

Background: The New Zealand government implemented restrictive public health interventions to eradicate Covid-19. Early reports suggest that one downstream ramification is a change in trauma presentations. The aim of this study is to evaluate the effect these public health measures had on major trauma admissions in the Northern Region, New Zealand.

The effect of national public health interventions for COVID-19 on emergency general surgery in Northland, New Zealand.

Background: The New Zealand government instituted escalating public health interventions to prevent the spread of COVID-19. There was concern this would affect health seeking behaviour leading to delayed presentation and worse outcomes. The aim of this study was to examine the effects of these interventions on rate and severity of acute general surgical admissions in Northland, New Zealand.

Surgeon-performed ultrasound-guided fine needle aspiration of thyroid nodules is cost effective and efficient: evaluation of thyroid nodule assessment in a provincial New Zealand hospital.

Aim: Surgeon-performed ultrasound-guided fine needle aspiration cytology (US-FNAC) and radiologist-performed US-FNAC are both accepted forms of thyroid nodule assessment. To date there have been no studies comparing cost of evaluation between these two models. The aim of this study is to compare surgeon-performed thyroid US-FNAC to radiologist-performed US-FNAC.

Cost and resource implications of introducing intensive nodal surveillance for sentinel node positive melanoma in provincial New Zealand.

Aims: Two randomised trials have shown that immediate completion lymphadenectomy for sentinel node positive melanoma provides no long-term survival benefit; compared with a follow up regime of intensive nodal surveillance. The aim of this study was to assess the cost and resource implications of introducing this regime for patients with sentinel node positive melanoma in a provincial New Zealand hospital.

Methods: Patients with cutaneous melanoma presenting to Northland District Health Board between 1 January 2012 and 31 December 2014 were identified.