Management of acute sigmoid volvulus in a provincial centre-a 20-year experience.

Aim: At our institution there has been a long-standing early operative approach to large bowel volvulus as well as initial decompression with rigid sigmoidoscopy. The primary aim of this study was to investigate the safety and efficacy of this approach on reducing readmissions and complications. Secondary aims were to investigate the safety and efficacy of bedside rigid sigmoidoscopy in decompression of sigmoid volvulus and investigate the sensitivity of abdominal x-ray in the diagnosis of acute large bowel volvulus.

Outcomes of endoscopic retrograde cholangiopancreatography: a series from a provincial New Zealand hospital.

Background: Endoscopic retrograde cholangiopancreatography (ERCP) is an essential tool in the management of pancreaticobiliary pathology. It is technically demanding and has the potential to cause significant morbidity and mortality. Several trials have identified small centres and lower hospital volume as risk factors for lower success rates and higher complication rates.

The incidence and risk factors for lower limb skin graft failure.

Lower limb skin grafts are thought to have higher failure rates than skin grafts in other sites of the body. Currently, there is a paucity of literature on specific factors associated with lower limb skin graft failure. We present a series of 70 lower limb skin grafts in 50 patients with outcomes at 6 weeks.

Time delays in presentation and treatment of acute scrotal pain in a provincial hospital.

Background: Acute scrotal pain is a urological emergency due to the possibility of testicular torsion and subsequent testicular loss if correction is not carried out in a timely manner.

Methods: We conducted a retrospective review of all patients who underwent surgical exploration for acute scrotal pain in a provincial hospital in New Zealand between 1 January 2001 and 31 December 2010.

Results: A total of 91 cases were identified.

Interhospital transfer of acute general surgical patients in the Taranaki region of New Zealand.

Aim: 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.

Omental torsion: a rare cause of acute abdomen.

Omental torsion is a rare cause of acute abdomen which often required surgical intervention. Preoperative diagnosis by clinical examination alone is almost never possible. Increasing use of CT is making it possible to diagnose this preoperatively.

Why Taranaki women choose to have a mastectomy when suitable for breast conservation treatment.

Background: Breast conservation treatment (BCT) rate is recognized as a marker of surgical practice. An historically low BCT rate may reflect the requirement for Taranaki women to travel for adjuvant radiotherapy. The aim of this study was to determine the reasons Taranaki women with breast cancer choose mastectomy or BCT.

Skin grafts: a rural general surgical perspective.

Background: Skin grafts are a common method of closing skin defects. The literature comparing methods of graft application and subsequent outcomes is poor, but reports indicate a graft failure rate between 2 and 30%. The aim of this study was to audit our current skin graft practice.

Risk-adjusted general surgical audit in octogenarians.

Background: Surgical admissions in patients more than the age of 80 years are increasing. Age-related comorbidities place this group at particular risk of complications and death. The aim of this study was to specifically document our current outcomes in patients more than 80 years old admitted to a surgical unit, in particular, to assess the risk-adjusted scoring tool used to predict outcomes in this patient population for operative and non-operative patients.

Paediatric surgery carried out by general surgeons: a rural New Zealand experience.

Background: There are increasing moves towards centralization in paediatric surgery. With only four paediatric tertiary centres in New Zealand, many general surgeons still routinely carry out paediatric surgery. We present an audit of paediatric surgical patients admitted to our general surgical unit.

Prospective audit of colorectal resections in a peripheral public hospital.

Background: Colorectal disease requiring surgery is common in New Zealand where there is no established national colorectal screening programme. We established an audit to review our current practice in colorectal surgery.

Methods: Prospective audit data were collected on consecutive patients undergoing colorectal resection between April 2003 and December 2004, using a standardized pro forma.