Atypical case of Crohn's colitis in a patient with adult-onset Still's disease.

A 65-year-old woman with a background of adult-onset Still's disease (AOSD) presented acutely to a general surgical unit with signs of bowel obstruction and sepsis. A CT scan was indicative of a mesenteric lymphadenopathy suspicious of malignancy. At the time of the surgery, a clinical diagnosis of lymphoma was made given the large number of lymph nodes; however, histological diagnosis was resulted as Crohn's colitis.

A survey of neurosurgical management and prognostication of traumatic brain injury following the RESCUEicp trial.

Purpose: Decompressive craniectomy remains controversial because of uncertainty regarding its benefit to patients; this study aimed to explore current practice following the RESCUEicp Trial, an important study in the evolving literature on decompressive craniectomies.

Materials And Methods: Neurosurgeons in New Zealand, Australia, USA and Nepal were sent a survey consisting of two case scenarios and several multi-choice questions exploring their utilisation of decompressive craniectomy following the RESCUEicp Trial.

Results: One in ten neurosurgeons (n=6, 10.

Reducing length of stay for patients presenting to general surgery with acute non-surgical abdominal pain.

Background: Acute abdominal pain is a common surgical presentation. We previously found that over the last decade, more patients were admitted to hospital with non-surgical diagnoses (e.g.

Circulating Extracellular Vesicle MicroRNA as Diagnostic Biomarkers in Early Colorectal Cancer-A Review.

Colorectal cancer (CRC) is one of the most common malignancies in the developed world, with global deaths expected to double in the next decade. Disease stage at diagnosis is the single greatest prognostic indicator for long-term survival. Unfortunately, early stage CRC is often asymptomatic and diagnosis frequently occurs at an advanced stage, where long-term survival can be as low as 14%.

Can Surgical Registrars Accurately Identify the Urgent from the Non-Urgent Patient Presenting with Acute Abdominal Pain?

Background: Acute abdominal pain is a common surgical presentation with a wide range of causes. Differentiating urgent patients from non-urgent patients is important to optimise patient outcomes and the use of hospital resources. The aim of this study was to determine how accurately urgent and non-urgent patients presenting with abdominal pain can be identified.

Neoadjuvant therapy in rectal cancer: how are we choosing?

Background: Neoadjuvant therapy has revolutionized the management of rectal cancer; however, there is a need to examine the factors driving neoadjuvant treatment allocation. This study aimed to describe patterns of treatment allocation for patients with rectal cancer at our institution and identify predictors for receiving neoadjuvant therapy, and for choice of short- or long-course therapy.

Methods: A retrospective review of a prospectively maintained database of 122 patients undergoing surgical resection for rectal cancer with curative intent, between 1 November 2012 and 31 October 2017.

Patients requiring an acute operation: where are the delays in the process?

Background: Delays to surgery for patients requiring an acute operation are associated with increased morbidity and mortality. A recent study from our institution observed long waiting times for patients booked for an acute operation. The aim of this study was to evaluate the patient's progress from presentation to arrival in the operating theatre and to identify where delays occurred.

Appropriateness of CT scans for patients with non-traumatic acute abdominal pain.

Objective: Acute abdominal pain is the most common reason for surgical admission. CT scans are increasingly used to aid early diagnosis. Excessive use of CT scans is associated with increased length of stay, healthcare costs and radiation.

Systematic review of diagnostic pathways for patients presenting with acute abdominal pain.

Purpose: Abdominal pain is the most common reason for surgical referral. Imaging, aids early diagnosis and treatment. However unnecessary requests are associated with increased costs, radiation exposure and increased length of stay.

Review of appendicectomies over a decade in a tertiary hospital in New Zealand.

Background: Acute appendicectomy is the most common emergency operation for patients with abdominal pain. In the last decade, computed tomography (CT) scans have increasingly been used to aid in the diagnosis in order to reduce the negative appendicectomy rate. The aim of this study was to evaluate our institution's negative appendicectomy rate and the use of pre-operative imaging.

The incidence of metastasis from cutaneous squamous cell carcinoma and the impact of its risk factors.

Background: Cutaneous squamous cell carcinoma (cSCC), the most common cancer capable of metastasis, has variable reported metastatic rates and the impact of individual risk factors for metastasis is unknown.

Methods: This study examined pathology records of excised cSCC over a 10-year period. Uni-variate and multi-variate analyses including patient demographics, maximum clinical diameter (MCD), anatomical sub-site, histological differentiation, perineural invasion (PNI), and lymphovascular invasion (LVI) of the lesion were performed.

Trends in colorectal cancer incidence rates in New Zealand, 1981-2004.

Background: Incidence rates of colorectal cancer (CRC) in New Zealand rank among the highest worldwide. Internationally, there has been evidence of a shift in colon cancer from left- to right-sided. The objective of this study was to determine trends in left- and right-sided colon and rectal cancers incidence by sex, age and ethnicity.

Changing incidence of non-melanoma skin cancer in New Zealand.

Background: Basal cell carcinoma (BCC) and squamous cell carcinoma (SCC) are the commonest types of non-melanoma skin cancer (NMSC). The incidence of NMSC has been increasing globally with Australia recording a 1.5-fold increase over the last 17 years.

Non-melanoma skin cancers in New Zealand--a neglected problem.

Basal cell carcinoma (BCC) and squamous cell carcinoma (SCC) are the commonest types of non-melanoma skin cancer (NMSC). The incidence of NMSC has been increasing globally with Australia recording a 1.5-fold increase over the last 17 years.

Immunohistochemical testing for colon cancer--what do New Zealand surgeons know?

Aim: 8-12% of colorectal cancers are associated with genetic syndromes. The most common of these is Lynch syndrome (also known as Hereditary Non-Polyposis Colorectal Cancer). Clinical criteria (Besthesda criteria) exist that can be used to identify colorectal cancer patients who may benefit from immunohistochemical screening of their tumour for Lynch syndrome.

Development of metachronous neoplasms after colorectal cancer resection: absence of synchronous neoplasms predicts a lower risk.

Aim: The appropriate interval for performing surveillance colonoscopy following curative resection for colorectal cancer is unclear. The high demand for colonoscopy in New Zealand's public health system requires careful prioritisation according to clinical urgency. The aim of the study was to identify a group of patients at lower risk for the development of metachronous neoplasms (cancer or adenoma) for which a less intensive surveillance programme may be appropriate.

A study into external rectal anatomy: improving patient selection for radiotherapy for rectal cancer.

Purpose: This study was designed to determine the distance from the anal verge to the anterior peritoneal reflection in vivo, thereby improving the selection of patients for preoperative radiotherapy.

Methods: Measurement of the distance from the anal verge to the anterior peritoneal reflection, confluence of the taenia, and the origin of the sigmoid mesentery in 50 patients in the lithotomy position.

Results: The mean distance from the anal verge to the anterior peritoneal reflection was 11.

Prognostic significance of occult metastases in colon cancer.

Purpose: The purpose of this study was to determine the prognostic significance of occult lymph node metastases in colon cancer detected by cytokeratin 20 reverse transcription polymerase chain reaction.

Methods: Two hundred patients undergoing elective colonic resections were enrolled in the study. Lymph nodes from resected specimens were dissected fresh and assessed by both reverse transcription polymerase chain reaction and histopathology.