ANZ Journal of Surgery

Publisher: Royal Australasian College of Surgeons, Blackwell Publishing

Description

ANZ Journal of Surgery, established more than 70 years, is the leading surgical journal published in Australia, New Zealand and the South-East Asian region. The Journal is dedicated to the promotion of outstanding surgical practice and research of contemporary and international interest. ANZ Journal of Surgery publishes high-quality papers related to clinical practice and/or research in all fields of surgery and its related disciplines. A programme of continuing education for surgeons at all levels is also provided.

  • Impact factor
    1.50
  • 5-year impact
    1.47
  • Cited half-life
    6.10
  • Immediacy index
    0.31
  • Eigenfactor
    0.01
  • Article influence
    0.47
  • Website
    ANZ Journal of Surgery website
  • Other titles
    ANZ journal of surgery (Online), Australian and New Zealand journal of surgery
  • ISSN
    1445-2197
  • OCLC
    47259969
  • Material type
    Document, Periodical, Internet resource
  • Document type
    Internet Resource, Computer File, Journal / Magazine / Newspaper

Publisher details

Blackwell Publishing

  • Pre-print
    • Author can archive a pre-print version
  • Post-print
    • Author cannot archive a post-print version
  • Restrictions
    • Some journals impose embargoes typically of 6 or 12 months, occasionally of 24 months
    • no listing of affected journals available as yet
  • Conditions
    • See Wiley-Blackwell entry for articles after February 2007
    • Publisher's version/PDF cannot be used
    • On author's server, institutional server or subject-based server
    • Server must be non-commercial
    • Publisher copyright and source must be acknowledged with set statement ("The definitive version is available at www.blackwell-synergy.com")
    • Articles in some journals can be made Open Access on payment of additional charge
    • 'Blackwell Publishing' is an imprint of 'Wiley'
  • Classification
    ​ yellow

Publications in this journal

  • [Show abstract] [Hide abstract]
    ABSTRACT: Background Endovascular interventions are increasingly utilized in managing occlusive peripheral vascular disease. Angioplasty and stenting remain the mainstay of endovascular management; however, newer treatment modalities such as excisional atherectomy provide the clinician with additional treatment options. While demonstrating promising results in available trials, a paucity of data exist regarding peripheral atherectomy. The purpose of this retrospective clinical study was to assess the efficacy and safety of excisional atherectomy with the TurboHawk atherectomy device (Covidien/ev3, Plymouth, MN, USA) in the treatment of lower limb peripheral vascular disease and to evaluate the learning curve involved in the institution of a new treatment modality.MethodsA retrospective analysis was performed on all patients undergoing atherectomy for symptomatic lower limb peripheral vascular disease by a single clinician between November 2011 and June 2013. Forty-seven vessels on 28 legs in 24 patients were treated during the period.ResultsAtherectomy was possible in 98% of cases. The 6- and 12-month primary patency was 72.6 and 58.9%, respectively. The primary-assisted patency was 93.2% at 6 months and 74.6% at 12 months. There were significantly greater patency rates in the TransAtlantic Inter-Society Consensus A + B lesions and a non-significant trend towards improved patency rates in claudicants versus critical limb ischaemia. There were four instances of embolization and four cases of dissection.Conclusion Excisional atherectomy provides a further option for the minimally invasive management of peripheral vascular disease. It has similar patency rates to established endovascular therapies and should be considered among the treatment options in patients with favourable pathology.
    ANZ Journal of Surgery 12/2014;
  • ANZ Journal of Surgery 12/2014;
  • [Show abstract] [Hide abstract]
    ABSTRACT: Background The volume of orthopaedic literature is increasing exponentially, becoming more widely scattered among journals. The rate of increase in orthopaedics is greater than other specialties. We aimed to identify the number of different journals an orthopaedic surgeon would need to read to stay up-to-date with current evidence.Method We searched PubMed for all orthopaedic-related systematic reviews (SR) and randomized controlled trials (RCT) published in 2011 using MESH (Medical Subject Headings) terms. The search was based on the Australian Orthopaedic Association syllabus of March 2011. The results of the search were exported to EndNote, then Microsoft Excel. We then calculated the least number of journals needed to read 25%, 50% and 100% of the articles. This was done separately for SRs and RCTs.ResultsWe found 1400 orthopaedic RCTs spread over 392 journals. Ten journals contained 25% of the articles, 36 journals contained 50% and 114 journals contained 75%. Three hundred journals contained three or fewer RCTs. We found 354 orthopaedic-relevant SRs spread over 152 journals. Six journals contained 25% of the articles, 23 journals contained 50% and 63 journals contained 75%. Ninety-three journals contained only one SR.Conclusion Our results demonstrate the vast scatter of orthopaedic research. Four orthopaedic RCTs are published every day. To read even 25% of the new RCTs and SRs published in orthopaedics, a surgeon would require a subscription to 13 different journals monthly, a costly and time-consuming endeavour.
    ANZ Journal of Surgery 12/2014;
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    ABSTRACT: Background Australian bladder cancer patients especially women are thought to have worse outcomes when compared to the other international series. The objective of this study was to assess the pathological pattern of primary bladder cancer at the time of radical cystectomy as well as assessing the quality of resection in New South Wales.Method Pathology reports of radical cystectomy performed for primary bladder cancer were reviewed for a period of 10 years in a single major pathology centre servicing the state of New South Wales.ResultsTwo hundred one specimens reviewed over 10 years. The tumour stage at the time of cystectomy was: CIS 29 (14%), Tx,a 5 (2%), T1 24 (12%), T2 49 (24%), T3 57 (28%) and T4 37 (18%). Lymphovascular invasion was seen in 94 (47%). Soft tissue margins were positive in 31 (15%), pelvic lymph node dissection was not performed in 64 (32%) of patients and only 32 (16%) of the patients had 10 or more lymph nodes harvested. No significant differences between men and women were noted in tumour stages, soft tissue positive margin rates and performance of pelvic lymph node dissection. Improving trends were noted in rates of negative soft tissue margins and the lymph node count during this period.Conclusion Pattern of disease at the time of cystectomy was similar to the North American and European cohorts. Higher main specimen margin rates as well as lower lymph nodes retrieval rates were observed. No sex discrimination was observed. Further study is recommended to investigate the survival impact of this finding.
    ANZ Journal of Surgery 12/2014;
  • ANZ Journal of Surgery 12/2014;
  • ANZ Journal of Surgery 12/2014;
  • [Show abstract] [Hide abstract]
    ABSTRACT: BackgroundA significant ‘gap’ in life expectancy exists for Australian Aboriginal people. The role of surgical care in this gap has been poorly addressed. This study has compared in-hospital surgical deaths of Aboriginal and non-Aboriginal persons in order to identify patient factors plus deficiencies of care that may have contributed to the gap.Methods This study used retrospective data collection and prospective audit of all in-hospital surgical deaths since commencement of the Northern Territory Audit of Surgical Mortality (NTASM). Outcome measures included causes of death, coexisting factors and deficiencies of care.ResultsBetween June 2010 and June 2013, 190 deaths were audited (96% capture), of which 72 (38%) were Aboriginal. Aboriginal persons were younger at death (53 versus 65 years, P < 0.001) and had a higher incidence of diabetes (odds ratio = 2.8, 95% confidence interval: 1.4–5.6), renal (2.3, 1.1–4.7) and liver disease (5.7, 2.6–12.9). When adjusted for age and gender, serious cofactors were significantly more common in Aboriginal persons (3.8, 1.3–7.1). Rates of infections and all-cause trauma were comparable. There were no significant differences in the rates of complications, unplanned returns to theatre or intensive care unit, delays to surgery or whether in retrospect the surgeon considered management overall could have been improved.ConclusionsA large gap of 12 years exists for age at death between Aboriginal and non-Aboriginal persons admitted as surgical patients in the Northern Territory. Aboriginal persons had significantly more co-morbidities at time of death, particularly diabetes, renal and hepatic disease. No significant discrepancies of surgical care were identified between Aboriginal and non-Aboriginal persons.
    ANZ Journal of Surgery 12/2014;
  • ANZ Journal of Surgery 12/2014;
  • [Show abstract] [Hide abstract]
    ABSTRACT: Background There is no consensus regarding the optimal management of the acutely ruptured Achilles tendon (TA). Functional bracing alone achieves outcomes similar to those of surgical repair. Surgical repair combined with immediate mobilization may improve the clinical outcome further. The purpose of our study was to determine if an accelerated rehabilitation programme following surgical repair of the ruptured TA could improve clinical outcome, relative to the standard protocol.Methods Patients with an acutely ruptured TA were randomly allocated to undergo an accelerated programme (AP) or standard programme (SP), following surgery. Outcome was assessed at 12 months post-surgery using the Achilles tendon Total Rupture Score (ATRS), the heel-raise height and the time taken to return to running.ResultsFifty-one patients completed the study, 25 in the AP group and 26 in the SP group. At 12 months post-surgery, the ATRS results were similar in the two treatment groups (87.46 in AP with standard error (SE) of 0.735 versus 87.12 in SP with SE of 0.75) while the AP group had less lengthening of the TA (0.385 cm, SE 0.166 versus 1.00 cm, SE 0.169) and a more rapid return to running (17.231 weeks, SE 0.401 versus 21.08 weeks, SE 0.409), than the SP group.Conclusion The accelerated rehabilitation programme resulted in less tendon lengthening, more rapid return to running, but similar ATRS relative to the standard rehabilitation. Immobilization following TA repair may prolong recovery.
    ANZ Journal of Surgery 12/2014;
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    ABSTRACT: Background The Stryker Anatomique Benoist Girard (ABG) hip implant system was a commonly used cementless prosthesis in the early 2000s, which fell from favour after several studies emerged implicating the prosthesis in high rates of revision. This retrospective, single-surgeon clinical study examines the fracture rate, revision rate and reasons for revision in 500 consecutive ABG II primary total conventional hip replacements.Methods Follow-up was conducted by audit of patient notes, patient mailout survey, patient phone contact and audit of the Australian National Joint Replacement Registry (NJRR) database to find instances of fracture and revision. End points were periprosthetic fracture and revision for any reason.ResultsFollow-up was 1.2–13.8 years with a mean of 6.58 years. Of the 500 hips, 17 (3.4%) had undergone a revision. Of these, 13 were due to periprosthetic fracture. Four further fractures occurred that were not revised. Eight of these periprosthetic fractures occurred within 1 year post-operatively. There were four revisions for recurrent dislocations. Kaplan–Meier survival curve demonstrates a 93.7% survivorship at 6.58 years for revision for any reason. Multivariate analysis showed the only statistically significant factor for increased risk of revision was smaller stem size.Conclusion Our results were consistent with the literature in that the ABG II system has good medium-term results but is prone to periprosthetic fractures, especially in the early post-operative period. When used as a primary total hip arthroplasty, the ABG II system has an 8-year revision rate of 5.6% compared with the 4.9% of all primary total hip arthroplasties.
    ANZ Journal of Surgery 12/2014;
  • ANZ Journal of Surgery 12/2014;
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    ABSTRACT: Background Routine swab cultures for perianal abscesses remain commonplace in surgical practice. However, patients are often discharged post-operatively prior to the culture results being made available. Consequently, intra-operative swab cultures rarely impact subsequent management and outcomes. Similarly, the use of broad-spectrum antibiotics for perianal abscesses post-drainage also remains prevalent, albeit with questionable benefit.Methods The records of all patients diagnosed with perianal abscess from January 2011 to December 2011 were reviewed. Patients with complicated perianal abscesses or recurrent abscesses previously treated before the study period were excluded. The demographics, medical co-morbidities, intra-operative findings, swab cultures, microbiological results and use of post-operative antibiotics were reviewed. Subsequent wound healing and follow-up were also recorded.ResultsTwo hundred and seven patients were admitted to our institution for perianal abscesses in 2011. After excluding 35, the remaining 172 patients were analysed. One hundred and thirty-four patients (78%) had swab cultures performed intra-operatively but 80% of these were discharged prior to the culture results being available. One hundred and eight (63%) were discharged with outpatient antibiotics. During the index admission and subsequent follow-up, swab culture results were not documented to be reviewed by the attending physician 96.5% of the time. Sixteen patients required repeat surgery for recurrence of anorectal sepsis. We found that the use of antibiotics after the index surgery did not confer a statistically significant benefit.Conclusion Routine swab cultures are unnecessary and do not affect management and outcome. The use of post-operative antibiotics may reduce the rates of recurrence, but this benefit was not found to be statistically significant.
    ANZ Journal of Surgery 12/2014;
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    ABSTRACT: Background Henry Barrett worked as a general surgeon in New Plymouth, New Zealand between 1939 and 1978. In this time, he made significant contributions to the development of paediatric surgery in New Zealand.Methods Henry Barrett's archive and personal papers remain in the possession of his family. These described his pioneering operations first hand.ResultsIn an 18-month period from 1947 to 1948, in New Plymouth small provincial hospital, Henry Barrett successfully completed the first primary repair of an oesophageal atresia with distal tracheoesophageal fistula in the Southern Hemisphere and the second and third successful ligations of patent ductus arteriosus in New Zealand. All three patients survived into adulthood.Conclusion Henry Barrett pioneered the undertaking of two complex paediatric surgical procedures in New Zealand. These operations were performed without specialist paediatric support at a time when procedures for these conditions, particularly patent ductus arteriosus, were viewed with suspicion.
    ANZ Journal of Surgery 12/2014;
  • ANZ Journal of Surgery 12/2014;
  • ANZ Journal of Surgery 11/2014; 84(11).
  • ANZ Journal of Surgery 11/2014; 84(11).
  • ANZ Journal of Surgery 11/2014; 84(11).
  • ANZ Journal of Surgery 11/2014; 84(11).
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    ABSTRACT: Background Insulinoma is a rare functional pancreatic neuroendocrine tumour (NET) believed to have an excellent long-term outcome, but few studies have solely focused on this issue after apparently curative resection. This study aimed to assess post-operative and long-term outcomes after resection of benign insulinomas.Methods From 1998 to 2013, 36 consecutive patients with insulinomas underwent surgery. Three patients had multiple endocrine neoplasia type-1 (MEN-1). Demographics, operative findings, tumour grade (2010 World Health Organization (WHO) NET classification), post-operative pancreatic fistula (POPF) grade (International Study Group of Pancreatic Fistula (ISGPF)), complications and recurrence were analysed.ResultsEighteen (50%) had enucleation while the rest underwent pancreatic resection. The majority (86.1%) of insulinomas belonged to WHO NET grade G1. POPF occurred in 58.3% of patients while clinical fistula (ISGPF grades B and C) occurred in 19.4%. One (2.8%) patient required reoperation. The occurrence of POPF was not related to type of resection or surgical approach. There was no perioperative mortality. After a mean follow-up of 83.6 months, two patients (5.7%) developed disease recurrence at 34.4 and 131.9 months after initial surgery. No patients developed distant metastasis. The 10- and 15-year disease-free rates were 95.6 and 85.4%, respectively.ConclusionPOPF occurred frequently and posed a significant morbidity after resection of insulinoma. However, it occurred independently of type of resection or surgical approach. Although the immediate cure rate after resection was high (100%), long-term disease recurrence in sporadic (non-MEN-1) cases was not insignificant. Regular long-term follow-up is recommended.
    ANZ Journal of Surgery 11/2014;