ANZ Journal of Surgery

Publisher: Royal Australasian College of Surgeons, Wiley

Journal 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.

Current impact factor: 1.12

Impact Factor Rankings

2015 Impact Factor Available summer 2016
2014 Impact Factor 1.122
2013 Impact Factor 1.118
2012 Impact Factor 1.5
2011 Impact Factor 1.248
2010 Impact Factor 1.098
2009 Impact Factor 1.344
2008 Impact Factor 1.388
2007 Impact Factor 0.998
2006 Impact Factor 0.881
2005 Impact Factor 0.783
2004 Impact Factor 0.742
2003 Impact Factor 0.599
2002 Impact Factor 0.916

Impact factor over time

Impact factor

Additional details

5-year impact 1.40
Cited half-life 7.30
Immediacy index 0.57
Eigenfactor 0.01
Article influence 0.45
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


  • Pre-print
    • Author can archive a pre-print version
  • Post-print
    • Author cannot archive a post-print version
  • Restrictions
    • 12 months embargo
  • Conditions
    • Some journals have separate policies, please check with each journal directly
    • On author's personal website, institutional repositories, arXiv, AgEcon, PhilPapers, PubMed Central, RePEc or Social Science Research Network
    • Author's pre-print may not be updated with Publisher's Version/PDF
    • Author's pre-print must acknowledge acceptance for publication
    • Non-Commercial
    • Publisher's version/PDF cannot be used
    • Publisher source must be acknowledged with citation
    • Must link to publisher version with set statement (see policy)
    • If OnlineOpen is available, BBSRC, EPSRC, MRC, NERC and STFC authors, may self-archive after 12 months
    • If OnlineOpen is available, AHRC and ESRC authors, may self-archive after 24 months
    • Publisher last contacted on 07/08/2014
    • This policy is an exception to the default policies of 'Wiley'
  • Classification
    ​ yellow

Publications in this journal

  • ANZ Journal of Surgery 10/2015; DOI:10.1111/ans.13219
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    ABSTRACT: Background Management of renal cell carcinoma (RCC) with inferior vena cava thrombus (IVCT) is associated with high morbidity. Chronic kidney disease (CKD) is a known risk factor for perioperative complications in many surgical procedures. The objective of this study was to review the association between preoperative CKD (eGFR < 60 mL/min) and post-operative outcomes in patients with RCC and IVCT undergoing radical nephrectomy (RN) and tumour thrombectomy (TT).MethodsA retrospective review of patients with RCC and IVCT treated with RN and TT was carried out. Complications were recorded according to the Clavien-Dindo classification. Multivariable models were fitted using logistic regression analyses for high-grade complications and salvage therapies and linear-regression for intraoperative blood loss (IBL).ResultsOne hundred and one patients with RCC and IVCT, treated with RN and TT, were identified. Forty per cent of patients had preoperative CKD. Median IBL was higher in CKD arm (2.5 versus 1.6 L, P = 0.04). In a multivariate linear regression analysis, CKD (beta 1.34, P = 0.01) remained an independent predictor of IBL. High-grade complications were more frequent in the CKD group (34% versus 16%, P = 0.09) and in logistic regression analysis, CKD was an independent predictor of high-grade complications (OR 3.33, 95% CI 1.01–10.9). Furthermore, CKD patients were less likely to be considered for salvage therapies (62% versus 38%, P = 0.02).Conclusions In patients treated with RN and TT, CKD is an independent predictor of perioperative morbidity. This clinical variable should be considered when selecting patients and subsequent efforts should be made to optimize other competing risk factors in order to reduce the incidence of perioperative adverse events in this patient population.
    ANZ Journal of Surgery 10/2015; DOI:10.1111/ans.13272
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    ABSTRACT: No abstract is available for this article.
    ANZ Journal of Surgery 10/2015; DOI:10.1111/ans.13325
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    ABSTRACT: Background: Both laparoscopic and robotic hepatectomy have been adopted in our centre for selected patients with benign or malignant liver diseases. This article reports the perioperative outcomes of these two approaches and tries to determine any difference between them. Methods: A retrospective review of prospectively collected data was performed for all patients who underwent laparoscopic hepatectomy (LH) and robotic hepatectomy (RH) in our institute. The perioperative results were reported and compared. In order to standardise the type of liver resection performed, a subgroup analysis was made for laparoscopic left lateral sectionectomy (LS) and robotic left lateral sectionectomy (RS). Results: Sixty-six LH and 70 RH were performed between November 2003 and January 2015. The two groups were comparable in demographic data and disease characteristics except more patient with recurrent pyogenic cholangitis (RPC) occurred in RH group. More major hepatectomies were performed in RH (20.0% versus 3.0%, P = 0.002). There was no mortality. No difference was noted in morbidity (LH 4.5%, RH 11.4%), conversion rate (LH 12.1%, RH 5.7%), median blood loss (both 100 mL) and median length of post-operative hospital stay (both 5 days) but operative time was longer in RH (251.5 min versus 215 min, P = 0.008). There were 29 LS and 38 RS, no difference was noted in all perioperative outcomes between the two groups. Conclusion: Both laparoscopic and robotic hepatectomy are safe and their perioperative outcomes are comparable and favourable.
    ANZ Journal of Surgery 10/2015; DOI:10.1111/ans.13339
  • ANZ Journal of Surgery 10/2015; 85(10). DOI:10.1111/ans.13260
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    ABSTRACT: No abstract is available for this article.
    ANZ Journal of Surgery 10/2015; DOI:10.1111/ans.13318
  • ANZ Journal of Surgery 10/2015; DOI:10.1111/ans.13328
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    ABSTRACT: Background Oztag is an Australian tag rugby code in which opponents are ‘tackled’ by removing Velcro tabs from their shorts. It is assumed to be safer than other higher-contact rugby codes.Methods Oztag-related hand injuries were identified by a word search of the electronic emergency department records of Concord Repatriation General Hospital from January 2011 to October 2013. Clinical records were retrospectively reviewed.ResultsTwenty-eight presentations were identified. Mean age of patients was 24 years (range 13–38). Injuries included fractures, dislocations and ligamentous injuries, in isolation or combination. The most common injuries were middle phalangeal fractures (six), all of which required operative fixation. No tendon avulsions were identified. The most common mechanism of injury was attempted tackle, which was much more likely to require operative management than any other mechanism (70% versus 14%, P = 0.010).Conclusions While the prevalence of Oztag-related hand injuries may be low, the occurrence of potentially debilitating injuries in a young, working population raises concern. The ‘tag’ tackle, which involves players running at speed with outstretched fingers, is particularly high risk. Prospective audit of injuries is required and players and organizers should be made aware of the dangers of this ‘low-contact’ sport.
    ANZ Journal of Surgery 10/2015; DOI:10.1111/ans.13245
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    ABSTRACT: No abstract is available for this article.
    ANZ Journal of Surgery 10/2015; DOI:10.1111/ans.13319
  • ANZ Journal of Surgery 10/2015; DOI:10.1111/ans.13322
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    ABSTRACT: Background: Studies show increased rates of mortality for admissions on the weekend (WE) versus the weekday (WD). However, scepticism exists of this so-called 'weekend effect' on patient outcome. It remains poorly investigated, particularly the timing of the day of surgery and post-operative outcomes. A UK study found higher odds of death when operated on Friday and the WE, versus WD. This relationship was investigated by interrogating the Australian and New Zealand Audit of Surgical Mortality database. Methods: A standardized tool is used to collect data after every surgical death. Data in this retrospective cohort study from participating private and public hospitals in Australia on elective and emergency operations were extracted and included 7718 patients who had a surgical procedure within 30 days of admission and who subsequently died. A proxy measure of early surgical mortality, namely odds of dying within the first 48 h following surgery, was used to compare surgical mortality across days of the week. Results: Unadjusted and adjusted odds of early surgical mortality were higher on the WE compared to WD, unadjusted and adjusted OR 1.30 (P < 0.001) and 1.19 (P = 0.026), respectively. When separated by day of week, there was a trend for higher surgical mortality on Friday, Saturday and Sunday versus all other days, although this did not reach statistical significance. ASA grade and specialty of surgery were important predictors of outcome. Conclusion: There appears to be an association between day of surgery and surgical outcome. The exact cause and contributing factors requires further investigation.
    ANZ Journal of Surgery 10/2015; DOI:10.1111/ans.13315
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    ABSTRACT: Background: Botulinum toxin (Botox) injection for chronic anal fissure (CAF) is commonly performed, yet there remains no consensus on optimal dosage or frequency of injections required to achieve complete resolution of anal fissure. The aim of this study was to determine the effectiveness of Botox and side-effect profile in the management of CAF. Methods: A retrospective clinical study of patients between 2010 and 2014 who underwent a Botox injection for CAF at a tertiary centre was performed. The effectiveness of Botox was measured using standardized outcomes including overall healing rate, presence of anal pain, recurrence and need for repeat botulinum injection. Binary outcomes were assessed using logistic regression model. The analysis was performed using Stata version 13 (StataCorp, College Station, TX, USA). Results: One hundred and one patients underwent 126 Botox injections within the study period. The mean first post-operative visit was at 1 month. The overall recurrence rate was 32%. The majority of patients were given 33 U. No statistically significant relationship between dose and recurrence was identified. The presence of pain at the first post-operative visit was a predictor of future recurrence (odds ratio 3.92, confidence interval 1.58-9.74, P = 0.003). Conclusion: Botox is an effective strategy for CAF. Low doses can be given with good efficacy as highlighted by our audit and has the potential for great cost saving. The best predictor of recurrence is the presence of pain at the first post-procedure visit.
    ANZ Journal of Surgery 10/2015; DOI:10.1111/ans.13329
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    ABSTRACT: Background Chlorhexidine (CHL) has antiseptic and disinfectant properties used to prevent hospital-acquired infections. CHL-induced anaphylaxis is poorly reported in surgical literature despite government warnings and growing recognition. The aim of this review is to increase awareness of CHL-induced anaphylaxis in the surgical population.Methods Literature review of Embase, Medline, PubMed and the Cochrane library using ‘anaphylaxis (and) chlorhexidine’ search terms.ResultsThirty-six articles were published on surgical patients suffering anaphylaxis to CHL. Within these, seven patients had two proven separate anaphylactic reactions and one had three separate proven anaphylactic reactions. The most commonly affected speciality was urology. The majority occurred during elective procedures. A history of atopy was surprisingly uncommon as was bronchospasm. Six patients required active chest compressions and 39.71% of patients had their surgical procedure abandoned. Unplanned intensive care admissions occurred in 27.94%.DiscussionIn order to reduce abandoned procedures, unplanned intensive care unit admissions, morbidity and mortality associated with CHL-induced anaphylaxis we recommend the following: rationalization of CHL-containing products, greater vigilance regarding subtle symptoms of CHL allergy, appropriate investigation of these symptoms and a greater awareness of CHL-containing products. Lastly, we outline the appropriate investigations and highlight the need for meticulous documentation in those who are CHL allergic.
    ANZ Journal of Surgery 10/2015; DOI:10.1111/ans.13269
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    ABSTRACT: No abstract is available for this article.
    ANZ Journal of Surgery 10/2015; DOI:10.1111/ans.13324
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    ABSTRACT: Background: Acute pancreatitis (AP) is a common acute surgical presentation with evidence-based guidelines for early management. The aim of this study was to assess the compliance to the published guidelines in patients presenting with AP in Western Sydney. Methods: A retrospective case note audit was conducted for all patients with a confirmed diagnosis of AP from 2008 to 2011 in Western Sydney. Results: There were 932 patients. The mortality was low for mild (0.7%) and severe (1.2%) AP. There was an under-utilization of ultrasound (U/S) with 239 (25.6%) patients not having a U/S. There was an over-utilization of early (within 72 h) computed tomography scanning for diagnosis (31.1%), assessment of severity (16.1%) and assessment for the presence of complications (7.3%). Inappropriate prophylactic antibiotic usage occurred in 15.3% patients. Of 373 cases of gallstone pancreatitis, only 231 (69.1%) had a cholecystectomy within 4 weeks of presentation. There was an under-utilization of early endoscopic retrograde cholangiopancreatography for associated cholangitis (12.5%). Only 16 (18.8%) patients with severe pancreatitis received enteric feeding. In patients with pancreatic necrosis, 50% had invasive intervention delayed beyond 4 weeks and 69% had minimally invasive procedures performed prior to necrosectomy. Patients having a minimally invasive procedure initially showed an improvement in mortality compared with those who had primary necrosectomy (0 versus 40%, P = 0.025). Conclusions: Although morbidity and mortality were acceptable, there was a failure to comply with evidence-based guidelines for the early management of pancreatitis. The results support for the development and auditing of protocols for the early assessment and treatment of AP in all hospitals.
    ANZ Journal of Surgery 09/2015; DOI:10.1111/ans.13330
  • ANZ Journal of Surgery 09/2015; DOI:10.1111/ans.13317
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    ABSTRACT: Background: Acute appendicitis is one of the most common emergency requiring operation. As the first discovered coagulation factor, plasma fibrinogen frequently increases with inflammation due to the activation of coagulation. The aim of this retrospective study was to investigate the diagnostic value of hyperfibrinogenemia as a preoperative laboratory marker for appendiceal perforation in patients with acute appendicitis. Materials and methods: We identified 455 patients (202 females, 253 males; mean age, 31.7 years) with histologically confirmed acute appendicitis who underwent laparoscopic or open appendectomy. Results of preoperative laboratory values and post-operative histologic results were analysed retrospectively. A multivariate logistic regression model was performed to determine patient's age and laboratory tests associated with perforated appendicitis. Result: Mean plasma fibrinogen level of all patients was 3.99 g/L (1.41 SD; range, 1.73-10.6 g/L; median, 3.69 g/L). Patients with appendiceal perforation had a mean fibrinogen level of 5.72 g/L (1.52 SD; range, 3.38-10.04 g/L; median, 5.28 g/L), which was significantly higher than those with nonperforated groups (P = 0.001). Multivariate analysis showed fibrinogen and D-dimer were associated with perforation (P = 0.001, P = 0.014, respectively). Areas under the receiver operating characteristic curve of fibrinogen for discriminating acute perforated appendicitis from non-perforated groups were larger than white blood cell and D-dimer. Conclusions: Hyperfibrinogenemia was common in patients with acute appendicitis and fibrinogen may be useful as a predictive factor for appendiceal perforation.
    ANZ Journal of Surgery 09/2015; DOI:10.1111/ans.13316
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    ABSTRACT: No abstract is available for this article.
    ANZ Journal of Surgery 09/2015; DOI:10.1111/ans.13313
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    ABSTRACT: Sentinel node biopsy (SNB) is recommended for selected melanoma patients in many parts of the world. This review examines the evidence surrounding the accuracy and prognostic value of SNB and completion neck dissection in head and neck melanoma. Sentinel nodes were identified in an average of 94.7% of head and neck cases compared with 95.3-100% in all melanoma cases. More false-negative sentinel nodes were found in head and neck cases. A positive sentinel node was associated with both lower disease-free survival (53.4 versus 83.2%) and overall survival (40 versus 84%). We conclude that SNB should be offered to all patients with intermediate and high-risk melanomas in the head and neck area. To date, evidence does not exist to demonstrate the safety of avoiding completion lymph node dissection in sentinel node-positive patients with head and neck melanoma.
    ANZ Journal of Surgery 09/2015; DOI:10.1111/ans.13286