bluuebunny/crossref_metadata_2025_split huggingface dataset:
557 Adherence and Factors Related to Completion of SRS22 PROM Scores in Patients Undergoing Surgical Correction for Adolescent Idiopathic Scoliosis
Authors: Bellamy M , Tung W S , Courtney E , Jayasuriya R , Cole A , Bayley E 
Published: August 2023

Abstract

Aim
The Scoliosis Research Society Health-Related Quality of Life Questionnaire (SRS22) allows clinicians insights into the challenges patients with scoliosis face. This study aims to assess compliance with SRS22 questionnaires, identifying key factors impacting adherence.

Method
This retrospective cohort study of the British Spine Registry included 216 patients who underwent surgery for Adolescent Idiopathic Scoliosis between 2018 and 2022 at a single institution. Completed SRS22s at 5 timepoints were collected with contact and deprivation data.

Results
SRS22 completion averaged 44.0% across time points. Contact information was available in 84.1%. There was a significant drop in completion from 2018 (60.4%) to 2021 (30.6%) at follow up. Binary logistic regression demonstrated preoperative and 6-week SRS22s were significant predictors of completed 6-month and 1-year questionnaires (OR: 2.46; p = 0.037, OR: 3.31; p = 0.0041). Six-month completion and telephone numbers were significant predictors of 1-year completion (OR: 6.29; p &lt; 0.001, OR: 5.55, p = 0.048). One year completion was the only significant predictor for 2-year completion (OR: 10.29; p &lt; 0.001). Index of multiple deprivation was not significant to SRS22 completion.

Conclusions
With lowering rates of engagement, input at the beginning of care may provide an effective strategy to maximise long-term collection. With incomplete preliminary questionnaires, later questionnaire completion is unlikely. Long term completion does not seem to directly correspond to email availability or area deprivation. Clinical initiative and funding, maximising completion at early patient visits, could lead to significantly greater engagement.
608 Oral Antibiotic Bowel Preparation in Elective Anterior Resection
Authors: Newey H 
Published: August 2023

Abstract

Aim
A single centre retrospective cohort study investigating the impact of oral antibiotic prophylaxis (OAP) for lower anterior resections on length of hospital stay and post-operative complications.

Method
The pre-intervention group were all elective anterior resections between 2015 and 2016. They received mechanical bowel preparation only. The intervention group were patients undergoing elective anterior resection between 2020 and 2021. These patients were given OAP in addition to standard mechanical bowel preparation. Outcomes investigated were surgical site infections, overall length of hospital stay, anastomotic leak and return to theatre. These were then compared between the two cohorts and statistical analysis was conducted.

Results
The pre-intervention group consisted of 221 patients and there were 201 patients in the intervention group. 61% of patients were male, whilst other patient demographics were comparable between cohorts. The mean length of hospital stay was reduced by 26.4% (p = 0.002) and the median length of stay was reduced by one day. There was a 1.5% decrease (p = 0.50) in post-operative infections, a decrease of 26.7% (p = 0.25) in anastomotic leaks and a decrease of 45% (p = 0.13) in patients who returned to theatre.

Conclusions
There was a statistically significant reduction in length of hospital stay with OAP alongside mechanical preparation. Although post-operative complications such as anastomotic leaks and return to theatre were reduced, these were not statistically significant, but may still have clinical and economic importance. There is strong evidence towards the benefit of OAP reducing length of stay, which reduces cost and improves patient flow and bed capacity.
743 Intraoperative Outcomes Using Infrahepatic Inferior Vena Cava Clamping During Hepatectomy: A Meta-Analysis
Authors: Tan J , Patel A , Kitching S , Iqbal A , Satyadas T 
Published: August 2023

Abstract

Aim
The aim of this meta-analysis is to determine the effect of infrahepatic inferior vena cava clamping (IIVCC) with Pringle maneuver (PM) compared to only PM during hepatectomy on intraoperative outcomes.

Method
Medline, Cochrane Library, Scopus, Web of Science, and EMBASE were searched from inception till 23.11.2021 using a predefined search strategy. The initial search resulted in 615 unique articles. After screening, eight studies including 755 patients (358 in IIVCC+PM, 397 in PM group) met the inclusion criteria for this meta-analysis. Of these, two were randomized controlled trials, one prospective and five retrospective cohort studies. Data on patient demographics, surgical technique and intraoperative outcomes was collected. Summary estimates using the appropriate effect models were generated with Review Manager 5.0.

Results
Patients who underwent IIVCC + PM during hepatectomies experienced significantly less total intraoperative blood loss (mean difference (MD), 95% confidence interval (CI) = -233.03, -360.48 to -105.58; p = 0.0003), less blood loss during transection (MD, 95% CI = -172.91, -308.94 to -36.88; p = 0.01), and had significantly less intraoperative blood transfusion requirement (Odds ratio, 95% CI = 0.38, 0.25 to 0.57; p&lt;0.0001) compared to patients who had only PM. Additionally, the total operative time was comparable between the two groups (MD, 95% CI = 8.06, 4.29 to 11.82; p&lt;0.0001). There were no difference in the parenchymal transection time and total intraoperative fluid infusion between the two groups.

Conclusions
IIVCC + PM is beneficial in reducing intraoperative blood loss and need for transfusion without significantly affecting operative times in comparison to PM during hepatectomy.
1023 The Changing Indication and Outcomes of Patients Undergoing Pancreatectomy for Malignancy
Authors: Jackson S , Dreyer S , Bryce A , Thomas R , Duthie F , Coats M , Carter R , McKay C , Dickson E , Chang D , Holroyd D , Jamieson N 
Published: August 2023

Abstract

Aim
Pancreatic surgery has evolved significantly in terms of indications and peri-operative management to improve long term outcomes for patients. The aim of this study is to assess the change in indication and long-term outcome for patients undergoing pancreatectomy for malignancy.

Method
Patients who underwent pancreatectomy at the West of Scotland Pancreatic Unit, Glasgow Royal Infirmary between 2000 – 2020 for malignancy were included. Clinicopathological variables, survival and recurrence data were collected from patient notes and electronic patient records.

Results
594 patients were identified. The majority were for pancreatic ductal adenocarcinoma (PDAC) n = 325 (54.7%). There was a significant increase in overall survival for all indications (28.6 months vs 41.8 months, P = 0.001), completion of adjuvant therapy and the use of neoadjuvant therapy (P&lt;0.001) over the first and second decades in the study period. After adopting a neoadjuvant strategy for PDAC in the unit from 2013, the overall median survival increased from 24.6 months to 34.5 months (P&lt;0.001). The overall survival for PDACs was higher for those receiving neoadjuvant chemotherapy compared to upfront resection (41.9 months vs 38.9 months, P = 0.151). For patients with PDAC who received upfront surgery, median survival increased from 24.2 to 40.3 months (P = 0.004) once a neoadjuvant strategy was adopted.

Conclusions
There has been significant changes to the indications and long-term outcomes for patients undergoing pancreatectomy. A neoadjuvant strategy improved survival even in those patients who received upfront surgery.
389 Spinal Fusion in Parkinsons Disease – Surgery, Radiography and Complications
Authors: Toor K 
Published: August 2023

Abstract

Aim
To understand the effectiveness of spinal fusion in PD, this review will focus on the surgical and radiological outcomes of this specific patient group using spinal fusion, within the background of pre- and post-operative complications.

Method
This literature review was conducted using PubMed, Embase and Medline databases. The selection criteria included studies with patients who are undergoing primary spinal fusion surgery, excluding any other neuromuscular disorders. We identified and reviewed twenty-eight studies in which spinal fusion was conducted in PD patients, encompassing clinical, radiographic outcomes and perioperative complications.

Results
A total of 363 patients with PD who underwent primary spinal fusion surgery were reviewed with an average age of 64 and a 3:4 male to female ratio. With average follow up at 52 months, 69 out of 97 patients were judged to have a satisfactory outcome with the remaining 29% reporting worsening Visual Analog Score (VAS) post-surgically. 84 out of 121 patients showed an improved Sagittal Vertical Axis (SVA) at follow up. 134 patients out of 145 displayed greater overall total complications when compared to non-PD patients.

Conclusions
Spinal fusion within PD patients has shown to be of benefit clinically with radiographic measures showing improvement post-surgically which is sustained at follow up. However, what limits its efficacy is the development of complications in this complex patient group. Continued prospective research is required and perhaps the advent of minimally invasive approaches may further benefit these patients and minimise complications.
417 Factors Associated with the Development of Post-Traumatic Hydrocephalus Following a Decompressive Craniectomy: A Single Centre Experience
Authors: Jesuyajolu D , Moti T , Abdulahi Z , Alnaser A , Zanaty A , Grundy T , Evans J 
Published: August 2023

Abstract

Introduction
A decompressive craniectomy (DC) is a surgical procedure sometimes utilised to manage refractory intracranial hypertension following severe traumatic brain injury (sTBI). Previous studies have established a relationship between DC and post-traumatic hydrocephalus (PTH). This study aimed to identify the factors responsible for developing shunt-amenable post-traumatic hydrocephalus in patients who underwent DC following sTBI.

Method
A review of a prospectively collected database of all patients admitted with severe TBI in a tertiary neurosurgical centre in northwest England between January 2012 and May 2022 was performed. Post-traumatic hydrocephalus was defined as evidence of progressive ventricular dilatation, clinical deterioration, and/or the eventual need for CSF diversion (i.e. a ventriculoperitoneal shunt). Statistical analysis was carried out using IBM SPSS vs 28.0.1.

Results
65 patients met the eligibility criteria and were included in the study. The mean age of the PTH group was 31.38+/-14.67, while the mean age of the non-PTH group was slightly higher at 39.96 +/- 14.85. No statistically significant difference was observed between the two groups' mechanisms of traumatic injury (MOI) (P = 0.945). Of the predictors investigated, cerebellar hematoma (and contusions) was significantly associated with post-traumatic hydrocephalus (p = 0.006).

Conclusions
This study concludes that cerebellar hematoma (and contusions) are associated with developing post-traumatic hydrocephalus in patients undergoing decompressive craniectomy.
643 A Review of the Screening Protocols Investigating Intracranial Aneurysms in Polycystic Kidney Disease
Authors: Abualnaja S , Rehman U , McKenna G 
Published: August 2023

Abstract

Aim
Intracranial aneurysms (ICA) are a common complication of polycystic kidney disease (PKD). Due to the lack of screening protocols that exist for PKD patients, without the appropriate preventative measures ICA rupture leads to significant morbidity and mortality. The aim is to analyse existing screening protocols by referencing the lead time between ICA diagnosis and rupture in PKD patients, the purpose and importance of screening, the types of imaging modalities used, and patient outcomes. We will also consider cost-effectiveness and its relation in establishing a screening protocol.

Method
A literature search was conducted in April 2022 for articles published between 1990-2022 with special interest in ICA, PKD, and screening protocols. Only exclusion criteria were patients who were diagnosed with PKD &lt;30 years of age. An independent reviewer screened the relevant full papers prior to inclusion.

Results
Our findings suggest that if a PKD presents with either a positive family history of ICA and/or cerebrovascular events and/or is above 40 years of age, then they should have a magnetic resonance angiography (MRA) scan every 5 years to monitor ICA development with annual follow-ups. This will significantly decrease patient morbidity and mortality in PKD positive patients.

Conclusions
While there is significant evidence proving that screening protocols decrease the morbidity and mortality of PKD patients, none have been suggested. The screening protocol suggested in this review should be used as a guideline for future studies that will try and establish a national or international guidelines that can be used by nephrologists and neurosurgeons worldwide.
1216 Epidemiology, Management, and Outcome of Traumatic Spinal Cord Injury at Two Hospitals in the South-West Region of Cameroon: A Five-Year Retrospective Review
Authors: Takoutsing B D , Esene I , Chichom A M 
Published: August 2023

Abstract

Aim
To determine the prevalence, patterns, management, and outcome of traumatic spinal cord injury (TSCI) at the Buea Regional Hospital (BRH) and Limbe Regional Hospital (LRH).

Method
We performed a descriptive cross-sectional study with a retrospective data collection of cases of TSCI admitted from January 1st, 2017, to December 31st, 2021. Chi-square was used for bivariate analysis assessing correlation between various patterns and outcome of TSCI. The p-value was considered statistically significant if &lt;0.05.

Results
TSCI represented 1% of hospital admissions. The majority were males (79.2%), and within the 25-44 years age group (55.6%). Referred patients represented 48.6% of cases. The most prevalent etiology was falls (43.7%). More than half (66.7%) had an incomplete SCI which correlated with the level of spine injury (p = 0.018). A spine CT scan was the neuroimaging modality of choice (65.3%). The treatment modalities varied, and the majority (92.3%) of those requiring surgery were operated on greater than 48 hours after injury. The morbidity rate was 36.1%, the severity of neurological injury improved in 23.6%, and the mortality rate was 16.9%. The level of spine injury and the initial severity of neurological injury correlated with the neurological outcome (p = 0.017; p = 0.007), and survival post-injury (p = 0.029; p = 0.006).

Conclusions
Males of the working age group are most at risk of TSCI. Most causes of TSCI at the are preventable, and their management deviates from recommendations. Their morbidity and mortality rates are high reflecting the realities of TSCI in sub-Saharan Africa.
1249 A Single Centre Analysis of Cauda Equina Referrals Since the ENTICE National Audit
Authors: Choudhry H , Vasilla A , Richards O , Schramm M , Kalra N , Sheikh A 
Published: August 2023

Abstract

Aim
To analyse changes in the referral patterns of Cauda Equina Syndrome (CES) following the publication of the national ENTICE study.

Method
A retrospective analysis was conducted of all 933 patients referred to Leeds Neurosurgery department in a 6- month period (1st October 2019- 1st February 2020) for suspected CES. The referrals were analysed to assess compliance with the updated national BASS/ SBNS guidelines, primarily to determine if an MRI had been performed prior to referral. This was compared with data prior to the national ENTICE study.

Results
933 patients were referred to Leeds Neurosurgery department for suspected CES in the 6-month period. This is a 31% increase prior to the ENTICE study. Of these referrals, 65 had radiologically confirmed CES. 15% of those referred had an MRI prior to referral. 15.5% of referrals in hours had an accompanying scan compared with 14.5% of referrals out of hours. 8% of referrals from centres with access to out of hours scanning did not have an MRI prior to referral.

Conclusions
Referrals should only be sent after CES has been radiologically confirmed, according to national guidelines. Despite changes in the referral system, the number and quality of referrals has not improved since the ENTICE national audit. A lack of out of hours MRI provision has little effect on referrals without a scan. Only 7% of CES referrals had confirmed CES, thus it is imperative that guidelines are followed to reduce delays in neurosurgical care.
1318 Cross-Sectional Study of Recurrent Disc Herniation Risk Factors and Predictors of Outcomes After Primary Lumbar Discectomy: A STROBE Compliance
Authors: Dokponou Y C H , Obame F L O , Mouhssani M , El Akroud S , Siba Z , Saad M E , Sahri I E , Chandide Tlemcani Z , Imbunhe N , Yero D , Abderrahmane H , Laaguili J , El Kacemi I , Mohcine S , Belhachmi A , El Asri A C , Mostarchid B , Gazzaz M 
Published: August 2023

Abstract

Aim
The purpose of this study is to determine if lifting weight, smoking status, occupational work, and diabetes were predictors for recurrent lumbar disk herniation (rLDH) leading to reoperation and if the outcome can be influenced by the reoperated level and side.

Method
From June 2010 to July 2019, the 2196 consecutive patients who underwent first-time single-level lumbar discectomy at our institution were revised. Data on first and second lumbar spine surgery were brought into the analysis. Multivariate Logistic Regression Analysis was performed to determine whether lifting weight, smoking status, occupational work, and diabetes were predictors for recurrent lumbar disk herniation. Multivariable Cox-regression analysis was performed for repeated lumbar disc herniation excision at the L4L5 and L5S1 levels independently.

Results
From the 101(4.59%) patients that presented with recurrent lumbar disc herniation (rLDH), 75 cases (3.41%) met the inclusion criteria. There were 54 cases of ipsilateral recurrent herniation and 21 contralateral. The group of diabetes patients who smoke was at high risk (Odds 2.77) of rapid recurrence of lumbar disc prolapse. Only the group of patients reoperated on the opposite side at the L4L5 level showed very less recurrence risk (Odd ratio 1.01) for lumbar disc prolapses compared to those reoperated on the same side who are 6.73 times at risk of recurrence.

Conclusions
Coexisting diabetes and smoking status increase the risk of rLDH and the patient’s outcome is favorable with pain-free after reoperation without the need for physiotherapy when the recurrence is on the same level and opposite side.
799 Positive Resected Lymph Nodes, Five-Year Recurrence/survival and Overall Survival After Pancreatoduodenectomy for Ampullary Adenocarcinoma
Authors: Mariathasan M , Grayson N , Ribaud J , Nair A ,   Raw Study Collaborators, Srinivasan P 
Published: August 2023

Abstract

Aim
Pancreatoduodenectomy (PD) is recommended in patients with resectable ampullary adenocarcinoma (AA). This study aimed to quantify the correlation between histologically involved lymph nodes and survival using a large multicentre cohort.

Method
Data were extracted from the Recurrence After Whipple’s (RAW) study, a multicentre retrospective cohort study of outcomes following pancreatoduodenectomy for pancreatic head malignancy (29 centres in 8 countries, n = 1484). Patients with histologically confirmed AA were identified and grouped by their number of positive resected nodes. Five-year survival rates and median estimated survival were compared using Fisher’s exact test, Kaplan-Meier method and the log-rank test.

Results
In total, 394 patients (26.5%) had AA. 212 (55.1%) patients had &lt;2 involved nodes and 173 (44.9%) had ≥2 involved nodes (data unavailable for nine patients). The former had reduced five-year recurrence (29.2% vs 64.2%, p&lt;0.0001) and increased five-year survival (69.8% vs 33.5%, p&lt;0.00001). The number of patients with zero, one and two or more positive nodes was 37 (20.8%), 27 (15.2%) and 114 (64.0%), respectively (patients with missing data were excluded). Median survival was 787 (95% confidence interval: 526-1048), 515 (423-607) and 567 (501-632) days, respectively (p = 0.01).

Conclusions
In our multicentre study, a histological finding of &lt;2 positive lymph nodes was associated with reduced five-year recurrence and increased five-year survival in patients who underwent PD for AA. Patients with positive lymph nodes had reduced median survival when compared to those without positive nodes. However, patients with only one positive node did not survive longer than those with two or more positive nodes.
825 Imaging in Suspected Gallstone Patients: Are We Optimising Resources?
Authors: Lawson R 
Published: August 2023

Abstract

Aim
Suspected biliary pathology necessitates imaging to assess for gallstones. Ultrasound is gold-standard but often limited by bowel gas/body habitus. MRCP has become popular due to superior ability to detect CBD stones. CT is often used with concerns of a wider differential diagnosis. This study aimed to explore the diagnostic journey of suspected gallstone patients, and whether increased imaging furthered patients’ management.

Method
This study used retrospective data collection of 2 months' referrals, October 1st-November 30th 2022 (inclusive), to the QEQM General Surgery team with suspected gallstones. This yielded 76 patients, for which PACS was reviewed to collate imaging performed.

Results
28 patients received 1 scan type (37%) and 41 received 2 types (54%). 7 patients received all 3 of CT, US and MRCP (9%); 100% of these gained new information ranging from ductal stones/dilated CBD, to choledochal cysts.
63%with 2+ scan types obtained new information. An additional 15% of patients with 2+ scan types had the absence of CBD stones confirmed on MRCP, where US couldn't comment.
16 patients (33%) had an US/CT that could not confidently comment on CBD dilation.

Conclusions
Most patients had two or more scans, often CT/US followed by US/MRCP respectively, which typically expanded the clinical picture. Multi-modal imaging certainly proves useful, eradicating the individual limitations of each type as shown in this study. MRCP as first-line would prevent multiple scans for one patient but is much more limited in availability. US therefore continues to have significant value in detecting pathology in practice.