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.

Ureteric Injury due to the Use of LigaSure.

Background. LigaSure is a bipolar clamping device used in open and laparoscopic surgeries for producing haemostasis in vascular pedicles up to 7 mm in diameter ("Covidien LigaSure technology: consistent, reliable, trusted vessel sealing," 2012). The use of LigaSure has made securing haemostasis and tissue dissection relatively easy especially in laparoscopic surgery; however, if not used with care it can cause damage to the surrounding structures through lateral spread of energy.

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.

Sentinel lymph node biopsy experience in Taranaki: a prospective audit in a provincial New Zealand hospital.

Aim: Sentinel lymph node biopsy has been rapidly incorporated into the management of early stage invasive breast cancer. The aim of this study was to review the adoption of sentinel lymph node biopsy at a provincial centre in New Zealand and compare markers of performance against established standards.

Methods: The Taranaki Breast Database was created in 2002 and prospectively records data from all breast cancer patients in the Taranaki area.

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.

Quality of life assessment in patients with inguinal hernia.

Background: The natural history of untreated inguinal hernia (IH) is poorly understood. Whether a delay in operative repair of IH leads to excessive physical suffering or significant psychosocial impairment is not known. This study attempts to quantify the morbidity of patients with IH by assessing their quality of life (QOL) while on a waiting list for IH surgery.