Annals of the Royal College of Surgeons of England

INTRODUCTION: The aim of this study was to investigate comparative outcomes of laparoscopic and open repair for peptic ulcer perforation (PUP). METHODS: A PRISMA-compliant systematic review with a PROSPERO-registered protocol (registration number CRD42024529286) was conducted. All randomised controlled trials (RCTs) involving PUP patients managed by laparoscopic or open repair were identified and their risk of bias assessed. Outcome syntheses for perioperative mortality and morbidities, need for reoperation, procedure time and length of hospital stay were conducted using random-effects modelling to calculate risk ratios (RR) or mean difference (MD) with 95% confidence intervals (CI)...

INTRODUCTION: Consent forms play an active role in the consent process with generic, handwritten consent forms (GCF) often the standard across the National Health Service. Increasingly, procedure-specific consent forms (PSCF) are being used as an alternative. However, concerns remain about whether they meet the standard for consent. We therefore conducted a systematic review with the objectives of investigating evidence for PSCF, study methodology and medicolegal criteria. METHODS: This systematic review was prospectively registered on PROSPERO (CRD42023392693) and conducted from 1 January 1990 to 17 March 2023 using the MEDLINE, Embase, CINAHL, CENTRAL and Emcare databases...

INTRODUCTION: Parathyroid localisation is now routine before first-time surgery for patients with primary hyperparathyroidism (PHPT). The aim of this study was to investigate the contribution of intraoperative parathyroid hormone (PTH) (ioPTH) in patients in whom localisation was either not undertaken or negative for a tumour. METHODS: This was a retrospective study of patients undergoing first-time parathyroidectomy for PHPT in a regional endocrine centre. Data were collected prospectively (Microsoft Excel) and the all-Wales electronic patient record portal was used to retrieve missing data...

INTRODUCTION: Literature data indicate a correlation between vitamin D deficiency and thyroid cancer (TC). We conducted this observational study to test this hypothesis. METHODS: We studied 327 consecutive thyroidectomy cases, and compared patients with TC and those who had benign thyroid disease (BTD). In total, 183 cases with well-differentiated TC (group B) were compared with 144 cases of BTD (group A). We defined 25-hydroxyvitamin D (25(OH)VitD) values <10ng/ml as severe vitamin D deficiency (15...

INTRODUCTION: Simulation training can develop surgical procedural skills in a safe environment. Able to offer high-intensity exposure, simulation is increasingly important as working time for surgeons becomes more protected. Materials used in simulated tendon repair play a critical role in the fidelity and face validity of the model. Although organic materials like porcine tendon are commonly used, non-organic materials offer advantages such as accessibility, reproducibility, cost-effectiveness and ease of use without the need for special licences or facilities...

Following renal transplant, ureteral stents aim to minimise ureteroneocystostomy anastomotic complications. Although there is no specified timing for stent removal after transplantation, these are ideally removed at between 2 and 4 weeks. However, forgotten stents can adversely affect renal allograft function and contribute to obstructive uropathy. We present a 59-year-old man with a retained ureteral stent for more than 19 years with an absence of encrustations, fragmentation, migration and stone formation...

INTRODUCTION: Septorhinoplasty addresses both functional and cosmetic concerns with the nose and has been shown to have consistent, long-term benefits for patients. Nasal irrigation and medication such as antimicrobials are prescribed postoperatively to improve outcomes. Patient compliance with these interventions and outcomes of surgery have not been described. We aim to describe what the effects of compliance with these interventions may be in long-term follow-up. METHODS: Patients undergoing septorhinoplasty were reviewed prospectively from 2015 to 2022...

INTRODUCTION: Anastomotic leak is a relatively common and debilitating complication. Colorectal leak rates vary widely in the literature, ranging from 1% to 20%. In modern surgical practice, there is much emphasis on the use of indocyanine green (ICG). This is a fluorescent dye administered intravenously to locate and predict an adequate line of anastomosis. We sought to analyse the current literature and supporting evidence behind the use of ICG in the context of elective colorectal surgery...

INTRODUCTION: This study aimed to report the proportion of children requiring subsequent surgical intervention, rate of complications and radiologic outcomes following collar and cuff immobilisation with high elbow flexion (>90°) for Gartland type II supracondylar fractures. METHODS: A retrospective case series of consecutive patients aged <18 years with Gartland type II fractures treated at a level 1 trauma centre from December 2020 to April 2023 was conducted...

BACKGROUND: Best practice pathways for common surgical procedures, including total knee arthroplasty (TKA), have the potential to improve patient outcomes and reduce carbon emissions. We aimed to estimate the reduction in carbon emissions due to changing trends in the care of patients undergoing TKA in England. METHODS: This was a retrospective analysis of Hospital Episode Statistics data from 1 April 2013 to 31 March 2022 on adults undergoing elective primary TKA in England...

INTRODUCTION: The aim of this study was to explore whether there were any differences in consultant colorectal surgeon training and adjusted 90-day postoperative colorectal cancer mortality rates (AMR). METHODS: We undertook a retrospective analysis of outcomes data published on the Association of Coloproctology of Great Britain and Ireland (ACPGBI) website. A total of 51,562 procedures for patients in England diagnosed with large bowel cancer between 2010 and 2015, registered under 551 consultants were included...

INTRODUCTION: The Scoliosis Research Society 22r (SRS-22r) questionnaire is a proven tool in assessing healthcare-related quality of life (HRQoL) in idiopathic scoliosis and is the adopted patient-reported outcome measure for the deformity pathway recorded into the British Spinal Registry (BSR). Surgery for adolescent idiopathic scoliosis (AIS) is performed frequently in teenagers; however, patients also present with curves in the surgical range into adulthood. This work aimed to assess HRQoL differences between patients following surgery for AIS performed in adolescence and adulthood using SRS-22r data collected from the BSR...

No abstract text is available yet for this article.

INTRODUCTION: The aim of this study was to investigate the effect of body mass index (BMI, kg/m2 ) on outcomes of high-volume low-complexity (HVLC) general surgery procedures and to determine critical values for BMI when selecting patients into HVLC programmes. METHODS: A systematic review was conducted of studies looking at patients in different BMI categories undergoing HVLC general surgery procedures (laparoscopic cholecystectomy, inguinal hernia repair and umbilical or paraumbilical hernia repair), in accordance with the PRISMA (Preferred Reporting Items for Systematic reviews and Meta-Analyses) guidelines...

No abstract text is available yet for this article.

Rhabdomyosarcoma (RMS) is a form of soft tissue sarcoma that can arise from muscle or fibrous tissue almost anywhere in the body. The two major subtypes of RMS are alveolar and embryonal, whereas the two rarer subtypes are pleomorphic, which typically occurs in adults, and the spindle cell/sclerosing variant, typically seen in children. RMS usually involves the extremities, the head and neck or the genitourinary system. Although it can arise from anywhere in the body, other sites of involvement are rare and usually present only at an advanced stage owing to a mass effect on surrounding tissues and organs...

INTRODUCTION: The number of bariatric operations is increasing each year. Sleeve gastrectomy is the most popular procedure; however, it often requires revision surgery because of insufficient weight loss, weight regain or gastro-oesophageal reflux disease (GORD). The most popular revisional procedures are Roux-en-Y gastric bypass (RYGB) and one anastomosis gastric bypass (OAGB). The primary outcome of this meta-analysis was weight loss after revisional surgery following laparoscopic sleeve gastrectomy and the secondary outcomes were gastro-oesophageal reflux, BMI difference, operative time, bleeding and anastomotic leak...

No abstract text is available yet for this article.

INTRODUCTION: Up to 30% of patients with colorectal cancer present as an emergency and have worse outcomes than elective patients. Compared with left-sided cancers, malignancies arising in the right colon are significantly under-researched. We sought to compare cancer care quality and clinical outcomes between emergency and elective presentations of right-sided colon cancer (RCC). METHODS: This multicentre, retrospective study included all patients who underwent operative management for a RCC, from 1 April 2017 to 31 March 2022...

INTRODUCTION: A multidisciplinary team (MDT) approach to polytrauma patients minimises morbidity and mortality. This project assesses the extent to which British Orthopaedic Association Standards for Trauma guidelines for the management of the frail Orthopaedic patient are currently being met. METHODS: A retrospective analysis was performed of all Trauma and Orthopaedic patients in multiple medical institutions over a 2-week capture period from 1 March 2022 until 14 March 2022 inclusive...