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Several abstracts are presented which includes one on Compliance Audit in Day Surgery Unit (DSU), the other on improving postoperative information transfer and the third on the use of "Hip Precautions" after hip hemiarthroplasty.

Several abstracts related to perioperative care and clinical science are presented including effect of beta-blockade on physical fitness physical fitness in patients with abdominal aortic aneurysms, tumour pathology in Colorectal Cancer and study of surgical care in an African District Hospital.

Background: Incisional hernia is a frequent complication of abdominal wall incision. Surgical technique is an important risk factor for the development of incisional hernia. The aim of these updated guidelines was to provide recommendations to decrease the incidence of incisional hernia. Methods: A systematic literature search of MEDLINE, Embase, and Cochrane CENTRAL was performed on 22 January 2022. The Scottish Intercollegiate Guidelines Network instrument was used to evaluate systematic reviews and meta-analyses, RCTs, and cohort studies. The GRADE approach (Grading of Recommendations, Assessment, Development and Evaluation) was used to appraise the certainty of the evidence. The guidelines group consisted of surgical specialists, a biomedical information specialist, certified guideline methodologist, and patient representative. Results: Thirty-nine papers were included covering seven key questions, and weak recommendations were made for all of these. Laparoscopic surgery and non-midline incisions are suggested to be preferred when safe and feasible. In laparoscopic surgery, suturing the fascial defect of trocar sites of 10 mm and larger is advised, especially after single-incision laparoscopic surgery and at the umbilicus. For closure of an elective midline laparotomy, a continuous small-bites suturing technique with a slowly absorbable suture is suggested. Prophylactic mesh augmentation after elective midline laparotomy can be considered to reduce the risk of incisional hernia; a permanent synthetic mesh in either the onlay or retromuscular position is advised. Conclusion: These updated guidelines may help surgeons in selecting the optimal approach and location of abdominal wall incisions. [ABSTRACT FROM AUTHOR]

The Annual Meeting of the Society of Academic and Research Surgery was held at the University of Nottingham Medical School, Nottingham, on Wednesday 4th and Thursday 5th January 2012 under the Presidency of Professor J Andrew Bradley. The Patey Prize was awarded to Miss M Mallik from the University Department of Surgery, Addenbrooke's Hospital, Cambridge Biomedical Research Centre, Cambridge, for her presentation entitled REGULATORY B CELLS INDUCE LONG-TERM ALLOGRAFT SURVIVAL IN A MOUSE MODEL OF CHRONIC REJECTION. The Norman Williams Prize for the best clinical paper was awarded to Miss S A Hosgood from University of Leicester, Department of 31s, Transplant Group for her presentation entitled PLACEBO CONTROLLED DOUBLE BLIND RANDOMISED CLINICAL TRIAL OF TRANSVERSUS ABDOMINIS PLANE BLOCK IN LIVE DONOR NEPHRECTOMY. The Kevin Burnand Prize for the best experimental/basic science paper was awarded to Mr S Buczacki from Cancer Research UK, Cambridge Research Institute, Cambridge, for his presentation entitled CHARACTERISATION OF QUIESCENT INTESTINAL STEM AND CANCER STEM CELLS. The President's Poster Prize was awarded to Mr S Awad from Division of Gastrointestinal Surgery, Nottingham University Hospitals, Queen's Medical Centre, Nottingham for his poster presentation entitled PREOPERATIVE ORAL CARBOHYDRATE LOADING IN ELECTIVE SURGERY: A META-ANALYSIS. Copyright © 2012 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

Background: Postresection liver failure (PLF) is the major cause of death following liver resection. However, there is no unified definition, the pathophysiology is understood poorly and there are few controlled trials to optimize its management. The aim of this review article is to present strategies to predict, prevent and manage PLF. Methods: The Web of Science, MEDLINE, PubMed, Google Scholar and Cochrane Library databases were searched for studies using the terms 'liver resection', 'partial hepatectomy', 'liver dysfunction' and 'liver failure' for relevant studies from the 15 years preceding May 2011. Key papers published more than 15 years ago were included if more recent data were not available. Papers published in languages other than English were excluded. Results: The incidence of PLF ranges from 0 to 13 per cent. The absence of a unified definition prevents direct comparison between studies. The major risk factors are the extent of resection and the presence of underlying parenchymal disease. Small-for-size syndrome, sepsis and ischaemia-reperfusion injury are key mechanisms in the pathophysiology of PLF. Jaundice is the most sensitive predictor of outcome. An evidence-based approach to the prevention and management of PLF is presented. Conclusion: PLF is the major cause of morbidity and mortality after liver resection. There is a need for a unified definition and improved strategies to treat it. Copyright © 2011 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

Background: Since 1977, restorative proctocolectomy with ileoanal anastomosis (IAA) has evolved into the surgical treatment of choice for most patients with intractable ulcerative colitis. Construction of an ileal pouch reservoir is now standard, usually in the form of a J pouch (IPAA). The aim of this report is to review selection criteria for, and functional outcomes, follow-up and management of complications of IPAA after 30 years of widespread clinical application. Methods and results: Literature published in English on the clinical indications, surgical technique, morbidity, complications and outcome following IAA and IPAA was sourced by electronic search, performed independently by two reviewers who selected potentially relevant papers based on title and abstract. Additional articles were identified by cross-referencing from papers retrieved in the initial search. Conclusion: The functional results of IPAA are good. Pouchitis, irritable pouch syndrome and cuffitis are specific long-term complications but rarely result in failure. Pouch salvage is possible in selected patients with poor functional outcomes. One-stage operations are increasingly performed. [ABSTRACT FROM AUTHOR]

Background Surgical interventions are complex, with multiple components that require consideration in trial reporting. This review examines the reporting of details of surgical interventions in randomized clinical trials ( RCTs) within the context of explanatory and pragmatic study designs. Methods Systematic searches identified RCTs of surgical interventions published in 2010 and 2011. Included studies were categorized as predominantly explanatory or pragmatic. The extent of intervention details in the reports were compared with the CONSORT statement for reporting trials of non-pharmacological treatments ( CONSORT-NPT). CONSORT-NPT recommends reporting the descriptions of surgical interventions, whether they were standardized and adhered to (items 4a, 4b and 4c). Reporting of the context of intervention delivery (items 3 and 15) and operator expertise (item 15) were assessed. Results Of 4541 abstracts and 131 full-text articles, 80 were included (of which 39 were classified as predominantly pragmatic), reporting 160 interventions. Descriptions of 129 interventions (80·6 per cent) were provided. Standardization was mentioned for 47 (29·4 per cent) of the 160 interventions, and 22 articles (28 per cent) reported measurement of adherence to at least one aspect of the intervention. Seventy-one papers (89 per cent) provided some information about context. For one-third of interventions (55, 34·4 per cent), some data were provided regarding the expertise of personnel involved. Reporting standards were similar in trials classified as pragmatic or explanatory. Conclusion The lack of detail in trial reports about surgical interventions creates difficulties in understanding which operations were actually evaluated. Methods for designing and reporting surgical interventions in RCTs, contributing to the quality of the overall study design, are required. This should allow better implementation of trial results into practice. [ABSTRACT FROM AUTHOR]

Background The Physiological and Operative Severity Score for the enUmeration of Mortality and morbidity ( POSSUM) is a well validated model for the prediction of perioperative mortality and morbidity with application to surgery and intensive care medicine. The outcome measure calculations are time-consuming, complex and potentially error-prone. Nomograms are low-cost easy-to-use graphic devices that can be used to make repeated calculations to an acceptable level of accuracy for most clinical purposes. This paper describes a nomogram to aid calculation of POSSUM scores. Methods This graphic solution consists of two sections: a tally sheet to calculate physiological and operative severity scores ( PS and OS), and a nomogram to calculate mortality and morbidity. The latter was designed using standard mathematical methods, and drafted with the aid of commercially available software. Accuracy was confirmed by using a spreadsheet to generate 120 random sets of simulated values for PS and OS, and corresponding calculated values for predicted mortality and morbidity. The outcome values in each case were derived using the nomogram and compared with the spreadsheet values using Bland-Altman analysis. Results Bland-Altman analysis showed close agreement between nomogram and spreadsheet. Bias of the nomogram was −0·1 percentage points for mortality and 0·1 percentage points for morbidity, with limits of agreement of −2·1 to +1·9 and −1·4 to +1·6 percentage points for mortality and morbidity respectively. Correlation coefficients were r > 0·999 and P < 0·001 for both mortality and morbidity. Conclusion The nomogram provides a rapid, accurate, low-cost means of performing, visualizing and cross-checking POSSUM calculations. [ABSTRACT FROM AUTHOR]

Background Experimental studies and small anecdotal reports have documented the potential and feasibility of transgastric appendicectomy. This paper reports the results of the new technique in a selected group of patients. Methods From April 2010 transgastric appendicectomy was offered to all patients with acute appendicitis, but without generalized peritonitis or local contraindications. Results Of 111 eligible patients 15 agreed to undergo the transgastric operation. After conversion of the first case to laparoscopy because of severe inflammation and adhesions, the following 14 consecutive transgastric procedures were completed. Two patients with initial peritonitis required laparoscopic lavage 4 days after transgastric appendicectomy, but no leaks were detected at the appendiceal stump or stomach. Conclusion These preliminary results have shown the feasibility of this innovative procedure. Additional studies, however, are required to demonstrate the specific advantages and disadvantages of this approach, and define its role in clinical surgery. [ABSTRACT FROM AUTHOR]

I Editor i We read with interest the paper of Lehrskov I et al i .[1] analysing the non-inferiority of intraoperative fluorescence cholangiography compared with X-ray cholangiography during elective laparoscopic cholecystectomy for complicated gallstone disease[1]. Acute cholecystitis was an exclusion criterion, but the authors conclude intraoperative fluorescence cholangiography may be beneficial in patients with acute cholecystitis. In addition to 15 per cent of patients in whom X-ray cholangiography was not performed, intraoperative fluorescence cholangiography was not able to identify the "critical junction" in 18 per cent (11 of 60), so neither of these methods can be an alternative to meticulous surgical preparation and conversion, if necessary. [Extracted from the article]

The article presents biographies of several speakers related surgical field of medicine including Sam Alberti, Robert D. Madoff and A. Darzi. It informs about Alberti who is director of Museums and Archives at the Royal College of Surgeons of England and organizes exhibitions on race, museum history and the Hunterian Museum's bicentenary. It mentions about Madoff who is a professor of Surgery at the University of Minnesota and has published academic research papers in medical journals.