Background: Lymph node status is a well-established prognostic factor for colon cancer, but the optimal number of nodes for accurate staging remains unclear. This study explored the relationship between lymph node yield (LNY) and 5-year mortality rates in colon cancer patients in New Zealand.
Methods: Data from the New Zealand Cancer Registry were retrospectively analyzed for patients with TNM stage I, II, and III colon cancer between August 2003 and December 2021, with follow-up until January 2024.
Background: C-reactive protein (CRP) is a useful negative predictor of infectious complications following colorectal surgery. Whilst a CRP level below reported cut-offs on postoperative day (POD) 3 to 5 can be reassuring, it can be difficult to interpret an elevated CRP above these cut-offs. This study evaluated whether investigating an elevated CRP on POD 3-5 allows earlier detection of infectious complications.
View Article and Find Full Text PDFBackground: Postoperative pain remains the greatest problem after hemorrhoidectomy. Pain is hypothesized to arise from bacterial infection, sphincter spasm, and local inflammation.
Objective: This trial was conducted to assess the effects of metronidazole, diltiazem, and lidocaine on posthemorrhoidectomy pain.
J Med Case Rep
November 2022
Background: Colopleural fistulas are mostly left-sided and related to trauma, Crohn's disease, or gastrointestinal malignancy. However, a diverticular fistula between the colon and right pleural space has not been reported and is rare considering the liver forms a natural anatomical barrier on this side. Colopleural fistulas often present with respiratory symptoms ranging from mild cough and dyspnea to sepsis from empyema caused by the leakage of gastrointestinal content into the pleural space.
View Article and Find Full Text PDFBackground: Anal fissure is a common condition that can be treated medically or surgically. Chemical sphincterotomy is often used before surgical intervention. This study aims to evaluate the effectiveness of topical agents for chemical sphincterotomy on healing of anal fissures and side-effects.
View Article and Find Full Text PDFBackground: To investigate whether a text message intervention improves adherence to preoperative exercise advice prior to laparoscopic sleeve gastrectomy (LSG).
Methods: A single-blinded parallel design 1:1 ratio randomized controlled trial was performed in patients undergoing LSG as a single-stage bariatric procedure for morbid obesity. The intervention group received preoperative daily text messages.
Background: Studies conducted in animal models have shown that statins (3-hydroxy-3-methylglutaryl-coenzyme A reductase inhibitors) reduce adhesion formation by upregulating fibrinolysis. The aim of this study was to determine the effect of orally administered statins on the promoters and inhibitors of the fibrinolytic pathway.
Methods: In a previously described double-blinded clinical trial, 144 patients undergoing elective colorectal resection, or reversal of Hartmann's procedure were randomized to receive 40 mg once daily oral simvastatin 3-7 d before surgery or placebo.
Background: Statins have numerous potential benefits relevant to abdominal surgery, and their use has been associated with a reduction in the systemic inflammatory response syndrome, wound infection, and anastomotic leak after colorectal surgery. However, this clinical evidence is limited to retrospective studies. The aim of this study was to prospectively investigate whether perioperative statin therapy can decrease the incidence of complications after major colorectal surgery.
View Article and Find Full Text PDFBackground: Diverticulitis is a common condition with a broad spectrum of disease severity. A scoring system has been proposed for diagnosing diverticulitis, and a number of scoring systems exist for predicting prognosis associated with severe complications of diverticulitis such as peritonitis. However, predicting disease severity has not received as much attention.
View Article and Find Full Text PDFBackground: Whilst the early to mid-term efficacy of laparoscopic sleeve gastrectomy (SG) is well established, there is comparatively less detailing of long-term efficacy. The objectives of this study were to evaluate the long-term outcomes of patients undergoing SG at the authors' institution.
Methods: All patients undergoing SG during the past 5 or more years were eligible.
Introduction: Goal-Directed Fluid Therapy (GDFT) has been previously shown to decrease complications and hospital length of stay in major colorectal surgery but the data are not specific to rectal surgery and may be potentially outdated. This study investigated whether GDFT provides clinical benefits in patients undergoing major elective rectal surgery.
Methods: There were 81 consecutive patients in this cohort study.
A systematic review was conducted to determine the relationship between academic assessment and medical student psychological distress with the aim of informing assessment practices. A systematic literature search of six electronic databases (Medline, Medline IN PROCESS, PubMed, EMBASE, Psychinfo, ERIC) from 1991 to May 2014 was completed. Articles focusing on academic assessment and its relation to stress or anxiety of medical students were included.
View Article and Find Full Text PDFBackground: General practitioners with specialty interests (GPwSIs) have been an emerging entity in the last decade or so and aim to improve patient's access to specialist level care in the primary care setting. This is achieved by them providing equivalent quality and outcomes to secondary consultant-led services, while not necessarily providing the same breadth of clinical care as them. In this systematic review, we attempt to address their efficacy for surgical procedures and specialties.
View Article and Find Full Text PDFAim: This study investigated the transfer of acute general surgical patients from HPH to TBH in order to evaluate Interhospital transfer time in a rural New Zealand setting. It specifically investigates the prioritisation and time to transfer of unwell patients who required ICU/HDU admission following transfer.
Method: 9 months case-control retrospective study based on review of ambulance' "patient transfer sheets" and patients' medical records.
Background: Diabetes mellitus (DM) is common in the general population and it poses a heavy burden to society in the form of long-term disability, healthcare use and costs. The pancreas is a key player in glucose homeostasis, but the occurrence of newly diagnosed DM after acute pancreatitis (AP), the most frequent disease of the pancreas, has never been assessed systematically. The aim of this study was to conduct a systematic literature review to determine the prevalence and time course of DM and related conditions after the first attack of AP as well as the impact of covariates.
View Article and Find Full Text PDFAims: In 2005, the senior author (AGH) initiated an Enhanced Recovery After Surgery (ERAS) or 'fast-track' programme for elective colonic surgery at the Manukau Surgery Centre aimed at improving perioperative care. We reviewed the senior author's experience of elective colectomy conducted within the ERAS programme and evaluated clinical outcomes.
Methods: Using a prospectively maintained database, consecutive patients who underwent elective colonic resection by the senior author within the ERAS programme at the Manukau Surgery Centre between December 2005 and March 2012 were reviewed.
Background: The Surgical Recovery Score (SRS) is a validated, comprehensive recovery assessment tool used to measure functional recovery after major surgery. To further evaluate its clinical applicability, this study investigated whether the SRS correlates with clinical outcomes and the occurrence of complications after elective colectomy.
Materials And Methods: We conducted a retrospective review of prospectively collected data for consecutive patients undergoing elective colonic resection within an enhanced recovery program at our institution from September 2008 to September 2011.
Background: This systematic review aims to investigate the extent to which preoperative conditioning (PREHAB) improves physiologic function and whether it correlates with improved recovery after major surgery.
Methods: An electronic database search identified randomized controlled trials (RCTs) investigating the safety and efficacy of PREHAB. The outcomes studied were changes in cardiorespiratory physiologic function, clinical outcomes (including length of hospital stay and rates of postoperative complications), and measures of changes in functional capacity (physical and psychological).
Background: Preoperative glucocorticoid (GC) administration attenuates the physiological response to surgery and improves clinical outcomes. However, GC use is not yet universally implemented. A propensity score analysis was performed to evaluate preoperative GC use in elective colectomy.
View Article and Find Full Text PDFEnhanced recovery after surgery (ERAS) programs have been shown to minimise morbidity in other types of surgery, but comparatively less data exist investigating ERAS in bariatric surgery. This article reviews the existing literature to identify interventions which may be included in an ERAS program for bariatric surgery. A narrative literature review was conducted.
View Article and Find Full Text PDFBackground: Laparoscopic sleeve gastrectomy (LSG) is increasingly used as a single-stage bariatric procedure. However, its safety and efficacy in super-obese patients (body mass index [BMI] > 50 kg/m(2)) is less well defined. This series reports on 400 consecutive patients who underwent LSG at our institution, to evaluate safety and efficacy in the super-obese.
View Article and Find Full Text PDFBackground: Statins have many beneficial effects and may attenuate the proinflammatory and metabolic stress response to surgery and consequently reduce postoperative morbidity.
Objective: This study investigated whether perioperative use of statins improved short-term outcomes after elective colectomy.
Design: This study is a retrospective review of prospectively collected data.