Abstract:
BACKGROUND:Patients taking warfarin are often given interim anticoagulation in the perioperative period. Institutional guidelines that use low-molecular-weight heparin (LMWH) 'bridging' while the international normalized ratio (INR) is sub-therapeutic are often based on the American College of Chest Physicians Anticoagulation Guidelines. PURPOSE:This study aims to identify if patients at a tertiary referral hospital were anticoagulated in line with these guidelines, and the incidence and nature of bleeding and thromboembolic complications. METHODS:A retrospective review of the Alfred Hospital General Surgical and 'Hospital at Home' databases was conducted, identifying patients who underwent elective general surgical procedures and received bridging anticoagulation with enoxaparin. Demographics, indication for anticoagulation, bleeding and thromboembolism rates were recorded. Thromboembolic risk was estimated. RESULTS:The study identified 108 patients. Three-quarters of all patients were anticoagulated with LMWH doses in accordance with the guidelines. Thirty of the 108 patients suffered bleeding complications. This group was younger, weighed less, received higher doses of enoxaparin and were at higher predicted risk of thromboembolism than non-bleeding patients. Wound haematoma, rectal bleeding and intra-abdominal bleeding were the most frequent complications. The peak time of bleeding was 3.5 days after surgery. Twelve patients returned to theatre, 13 were readmitted and 3 received blood transfusion. One patient suffered pulmonary emboli on the first post-operative day. CONCLUSION:LMWH bridging therapy when prescribed appropriately is associated with low rates of inpatient thromboembolism in elective general surgical patients within our institution, but an unexpectedly high rate of bleeding complications.
journal_name
ANZ J Surgjournal_title
ANZ journal of surgeryauthors
Breen DT,Chavalertsakul N,Paul E,Gruen RL,Serpell Jdoi
10.1111/ans.12070subject
Has Abstractpub_date
2016-03-01 00:00:00pages
167-72issue
3eissn
1445-1433issn
1445-2197journal_volume
86pub_type
杂志文章abstract:BACKGROUND:To evaluate the initial results of laparoscopic radical prostatectomy at this institution. METHODS:Between January 2000 and September 2003, 30 patients underwent laparoscopic radical prostatectomy. Peri- and postoperative data were accumulated prospectively and maintained in a database. All patients have a ...
journal_title:ANZ journal of surgery
pub_type: 杂志文章
doi:10.1111/j.1445-1433.2004.03269.x
更新日期:2004-12-01 00:00:00
abstract:BACKGROUND:Treatment decisions for metastatic spine disease are complex and depend on prognosis. Four prognostic systems in use are the Oswestry Risk Index, modified Bauer score (MBS), van der Linden score and New England Spinal Metastasis Score (NESMS). We aimed to determine the performance of these scoring systems in...
journal_title:ANZ journal of surgery
pub_type: 杂志文章
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更新日期:2020-06-01 00:00:00
abstract:BACKGROUND:We assessed the accuracy of three different methods measuring the angle between two fixed Kirschner wires for the potential purpose of determining correction during rotational osteotomy of long bones. METHODS:Thirty-one orthopaedic consultants and registrars were prospectively asked to measure the angle bet...
journal_title:ANZ journal of surgery
pub_type: 杂志文章
doi:10.1111/ans.12371
更新日期:2013-12-01 00:00:00
abstract::The original description by Morgagni of the anterior diaphragmatic defect that bears his name implies a paramedian defect and this may be true when acquired in adulthood. In contrast, the anterior diaphragmatic defect that is observed in children is central rather than paramedian, as is often assumed. Its central retr...
journal_title:ANZ journal of surgery
pub_type: 传,历史文章,杂志文章
doi:10.1111/j.1445-2197.2008.04641.x
更新日期:2008-09-01 00:00:00
abstract:BACKGROUND:Several ways of performing laparoscopic right hemicolectomy (RHC) have evolved. The vascular pedicle can be divided into extracorporeal (RHC-EC) or intracorporeal (RHC-IC). It is not known whether vessel ligation during RHC-EC is as central as during RHC-IC. We compare these approaches in terms of pathologic...
journal_title:ANZ journal of surgery
pub_type: 杂志文章
doi:10.1111/ans.14504
更新日期:2018-10-01 00:00:00
abstract::Achalasia is a motility disorder encountered by surgeons during the investigation and treatment of dysphagia. Recent advances in manometry technology, a widely accepted new classification system and a new treatment rapidly gaining international acceptance, have changed the working knowledge required to successfully ma...
journal_title:ANZ journal of surgery
pub_type: 杂志文章,评审
doi:10.1111/ans.13497
更新日期:2016-07-01 00:00:00
abstract:AIM:To examine the outcomes and complications of surgery for recurrent carotid stenosis. METHODS:From 1974 to 2000, 1922 carotid endarterectomies were performed in our unit. A retrospective cohort analysis of these records identified 24 patients (1.2%) who underwent surgery for recurrent stenosis. RESULTS:There were ...
journal_title:ANZ journal of surgery
pub_type: 杂志文章
doi:10.1046/j.1445-2197.2003.t01-8-.x
更新日期:2003-12-01 00:00:00
abstract::Adequate hepatopetal portal vein blood flow is obligatory to ensure proper liver function after liver transplantation. Large collateral veins as shunts impair portal vein flow and even cause hepatofugal blood flow and portal steal syndrome. In particular, splenorenal shunts in liver transplant recipients can lead to a...
journal_title:ANZ journal of surgery
pub_type: 杂志文章,评审
doi:10.1111/ans.14044
更新日期:2017-10-01 00:00:00
abstract:BACKGROUND:Implant-based breast reconstruction is becoming increasingly popular because of the widespread adoption of acellular dermal matrix (ADM), which allows surgeons to obtain good aesthetic results with fewer operations. To develop more conservative surgical techniques, a retrospective, three-centre, proof-of-con...
journal_title:ANZ journal of surgery
pub_type: 杂志文章
doi:10.1111/ans.12849
更新日期:2017-06-01 00:00:00
abstract::Patients on haemodialysis are susceptible for central vein occlusions, which can result in debilitating clinical consequences. These may be resistant to conventional revascularization with guidewire and catheter technique. Value-driven sharp recanalization of central vein occlusion is depicted as a safe and affordable...
journal_title:ANZ journal of surgery
pub_type: 杂志文章
doi:10.1111/ans.15599
更新日期:2020-03-01 00:00:00
abstract:BACKGROUND:The isolated limb infusion (ILI) technique is a simpler and less invasive alternative to isolated limb perfusion, which allows regional administration of high-dose chemotherapy to patients with advanced melanoma and other malignancies restricted to a limb. METHODS:Patients from two institutions, treated by ...
journal_title:ANZ journal of surgery
pub_type: 杂志文章,多中心研究
doi:10.1111/j.1445-2197.2012.06249.x
更新日期:2014-09-01 00:00:00
abstract:BACKGROUND:Intraoperative nerve monitoring (IONM) has increasingly been used in thyroid surgery by general, endocrine and head and neck surgeons. The purpose of this paper was to explore the prevalence and reasons for the usage of IONM in endocrine surgery in Australia and New Zealand. METHODS:A survey was sent to gen...
journal_title:ANZ journal of surgery
pub_type: 杂志文章
doi:10.1111/ans.15536
更新日期:2020-05-01 00:00:00
abstract:BACKGROUND:Dermatofibrosarcoma protuberans (DFSP) is a rare locally advanced soft-tissue tumour that is often misdiagnosed at presentation, resulting in inadequate initial resection, requiring multiple resections and reconstructive procedures. We reviewed our experience and treatment outcomes with this tumour and propo...
journal_title:ANZ journal of surgery
pub_type: 杂志文章
doi:10.1111/ans.13276
更新日期:2016-05-01 00:00:00
abstract:BACKGROUND:Splenectomy is a surgical procedure indicated in a variety of medical conditions including trauma. Post-operatively, there is a lifelong risk of developing overwhelming sepsis from encapsulated bacteria, most commonly due to Streptococcus pneumoniae. Splenic autotransplantation has been proposed as a method ...
journal_title:ANZ journal of surgery
pub_type: 杂志文章,评审
doi:10.1111/ans.15383
更新日期:2020-04-01 00:00:00
abstract::Skull base surgery has gone through significant changes with the development of extended endoscopic endonasal approaches over the last decade. Initially used for the transphenoidal removal of hypophyseal adenomas, the endoscopic transnasal approach gradually evolved into a way of accessing the whole ventral skull base...
journal_title:ANZ journal of surgery
pub_type: 杂志文章,评审
doi:10.1111/j.1445-2197.2011.05971.x
更新日期:2012-03-01 00:00:00
abstract:BACKGROUND:In addition to conventional breast-conserving surgery (BCS), oncoplastic breast surgery (OBS) is an operation technique that strives simultaneously to increase oncological safety and patient's satisfaction. It is the combination of the best-proven techniques in plastic surgery with surgery for breast cancer....
journal_title:ANZ journal of surgery
pub_type: 杂志文章
doi:10.1111/ans.15245
更新日期:2019-10-01 00:00:00
abstract::Laparoscopic adrenalectomy is the operation of choice for benign adrenal lesions. During laparoscopic surgery, vessels are usually ligated with diathermy, ligaclips, staplers or ultrasonic coagulators. Use of the electrothermal bipolar vessel sealer (LigaSure; Valleylab, Boulder, CO, USA) has recently been described i...
journal_title:ANZ journal of surgery
pub_type: 杂志文章
doi:10.1111/j.1445-2197.2006.03881.x
更新日期:2006-09-01 00:00:00
abstract:BACKGROUND:Data on the effect of laparoscopic cholecystectomy (LC) on bowel function are controversial. The aim of this study was to determine the incidence of postcholecystectomy diarrhoea (PCD) and to identify patient characteristics that can be used as predictors in daily practice. METHODS:In 100 consecutive patien...
journal_title:ANZ journal of surgery
pub_type: 杂志文章
doi:10.1111/j.1445-2197.2008.04539.x
更新日期:2008-06-01 00:00:00
abstract:BACKGROUND:Intraoperative blood loss and transfusion are known determinants of mortality and morbidity of elective abdominal aortic aneurysm (AAA) repair. The present study analysed the pattern of blood loss and transfusion and evaluated the risk factors of blood loss during open repair of infrarenal AAA. METHODS:Bloo...
journal_title:ANZ journal of surgery
pub_type: 杂志文章
doi:10.1111/j.1445-1433.2004.03117.x
更新日期:2004-08-01 00:00:00
abstract:BACKGROUND:Most studies available on laparoscopic colorectal surgery focus on highly selected patient groups. The aim of the present study was to review short- and long-term outcome of everyday patients treated in a general surgery department. METHODS:Retrospective review was carried out of a prospective database of a...
journal_title:ANZ journal of surgery
pub_type: 杂志文章
doi:10.1111/j.1445-2197.2006.03551.x
更新日期:2006-01-01 00:00:00
abstract:BACKGROUND:Many haemodialysis patients are unable to have or maintain distal upper limb arteriovenous (AV) fistulas because of inadequate veins or arteries and therefore require more proximal access. We have reviewed our experience with a two-stage brachiobasilic AV haemodialysis fistula fashioned in the arm. METHODS:...
journal_title:ANZ journal of surgery
pub_type: 杂志文章
doi:10.1111/j.1445-2197.2006.03996.x
更新日期:2007-03-01 00:00:00
abstract:BACKGROUND:Patients may present with a resectable pancreatic tumour in the context of a concurrent primary extra-pancreatic malignancy. These patients pose a dilemma regarding their suitability for surgery. We evaluated our experience with such patients who underwent pancreatic resection with curative intent and detail...
journal_title:ANZ journal of surgery
pub_type: 杂志文章
doi:10.1111/ans.15651
更新日期:2020-03-01 00:00:00
abstract:BACKGROUND:Pseudocysts are a common consequence of acute pancreatitis and require intervention if symptomatic. Endoscopic management is emerging as a safe and effective alternative to surgery, although its use is not yet widespread. METHODS:We describe our experience of 10 consecutive unselected patients who underwent...
journal_title:ANZ journal of surgery
pub_type: 杂志文章
doi:10.1111/ans.12648
更新日期:2016-05-01 00:00:00
abstract:AIM:To identify the outcome of laparoscopic revision of gastric band surgery with respect to percentage of excess weight lost (%EWL). METHODS:Analysis of a prospective database was then performed and %EWL was plotted with respect to time from initial procedure and also time from revision procedure. RESULTS:All revisi...
journal_title:ANZ journal of surgery
pub_type: 杂志文章
doi:10.1111/j.1445-2197.2009.05088.x
更新日期:2010-05-01 00:00:00
abstract:BACKGROUND:Gastrointestinal stromal tumours (GISTs) are the most common mesenchymal tumours of the gastrointestinal tract and make up 1-2% of all gastrointestinal malignancies. Traditionally, the treatment of choice for primary disease is surgical resection; however, no single surgeon or institution gets extensive expo...
journal_title:ANZ journal of surgery
pub_type: 杂志文章
doi:10.1111/ans.12429
更新日期:2016-03-01 00:00:00
abstract:BACKGROUND: The purpose of credentialing is to ensure that clinicians provide safe, high-quality health-care services in accordance with good practice and legal requirements. This review assessed the institutional credentialing processes and governance structures required to support credentialing processes at an insti...
journal_title:ANZ journal of surgery
pub_type: 杂志文章,评审
doi:10.1111/j.1445-2197.2012.06115.x
更新日期:2012-07-01 00:00:00
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 curr...
journal_title:ANZ journal of surgery
pub_type: 杂志文章
doi:10.1111/ans.12902
更新日期:2015-06-01 00:00:00
abstract::Technical improvements, equipment to minimize bleeding and standardizing setup positions have allowed shoulder arthroscopy to become more user friendly in diagnosis and treatment of disorders of this joint complex. ...
journal_title:ANZ journal of surgery
pub_type: 杂志文章
doi:10.1111/j.1445-2197.2008.04758.x
更新日期:2008-12-01 00:00:00
abstract:BACKGROUND:Some authors, either with anatomical studies or Doppler laser flowmetric investigations have shown the blood flow to the posterior midline of the anus to be potentially deficient. This relative local ischaemia might explain pathogenesis of anal fissure, which is often located posteriorly. The aim of this stu...
journal_title:ANZ journal of surgery
pub_type: 杂志文章
doi:10.1111/ans.15143
更新日期:2019-07-01 00:00:00
abstract:BACKGROUND:Single-incision laparoscopic cholecystectomy (SILC) is a common procedure performed worldwide. In this study, we evaluated the safety and efficacy of SILC for acute cholecystitis. METHODS:Patients who underwent SILC between September 2012 and December 2016 were retrospectively enrolled and divided into acut...
journal_title:ANZ journal of surgery
pub_type: 杂志文章
doi:10.1111/ans.14246
更新日期:2018-07-01 00:00:00