Abstract:
OBJECTIVES:To provide guidance about the risks which should be disclosed to patients and documented during the consent process. METHODS:The Delphi Consensus Technique was used to decide what constitutes mandatory risk disclosure for three index procedures. Documentation of risk on consent forms was audited and compared to these locally agreed standards. A four stage strategy for change was undertaken following which practice was reviewed. RESULTS:Mean mandatory risk documentation rose from 61.2% (95% CI: 58.1-64.4) pre-intervention, to 78.1% (95% CI: 72.6-83.6) post-intervention (ccc2; P < 0.001). CONCLUSIONS:Although we demonstrated some benefit from this simple approach, the need for pragmatic means of achieving and sustaining complete discussion and documentation of risks across all surgical interventions based on universally accepted standards remains.
journal_name
Ann R Coll Surg Engljournal_title
Annals of the Royal College of Surgeons of Englandauthors
Edwards TJ,Finlay I,Wilkins DC,Lambert AWdoi
10.1308/1478708041118subject
Has Abstractpub_date
2004-11-01 00:00:00pages
458-62issue
6eissn
0035-8843issn
1478-7083journal_volume
86pub_type
杂志文章abstract:INTRODUCTION:The correction of anaemia prior to total hip arthroplasty reduces surgical risk, hospital stay and cost. This study considers the benefits of implementing a protocol of identifying and treating pre-operative anaemia whilst the patient is on the waiting list for surgery. PATIENTS AND METHODS:From a prospec...
journal_title:Annals of the Royal College of Surgeons of England
pub_type: 杂志文章
doi:10.1308/003588408X301163
更新日期:2008-09-01 00:00:00
abstract::We describe the case of an 89-year old Caucasian woman admitted with confusion and severe clinical manifestations of acute hypercalcaemia. There was no history suggestive of any malignancy and initial management included correction of the hypercalcaemia with intravenous fluid therapy. Sestamibi parathyroid scintigraph...
journal_title:Annals of the Royal College of Surgeons of England
pub_type: 杂志文章
doi:10.1308/rcsann.2020.0101
更新日期:2020-10-01 00:00:00
abstract::Eleven patients underwent primary mandibular reconstruction following resection of a head and neck squamous cell carcinoma. Reconstruction consisted of a free rib graft and a pectoralis major myocutaneous flap. One rib graft failed and one graft, although successful, required removal during a wider resection for tumou...
journal_title:Annals of the Royal College of Surgeons of England
pub_type: 杂志文章
doi:
更新日期:1995-07-01 00:00:00
abstract:INTRODUCTION:Gastric neuromodulation (GNM) has been advocated for the treatment of drug refractory gastroparesis or persistent nausea and vomiting in the absence of a mechanical bowel obstruction. There is, however, little in the way of objective data to support its use, particularly with regards to its effects on gas...
journal_title:Annals of the Royal College of Surgeons of England
pub_type: 杂志文章
doi:10.1308/003588411X13165261994157
更新日期:2011-11-01 00:00:00
abstract::The indications for removal of tonsils and/or adenoids are discussed, along with preoperative assessment, operative technique, treatment of postoperative haemorrhage, aftercare, and results. ...
journal_title:Annals of the Royal College of Surgeons of England
pub_type: 杂志文章
doi:
更新日期:1977-03-01 00:00:00
abstract::The salient steps of a 20-year programme of research into the nature of burn disease are described. By burn disease we mean the late mortality and morbidity following burns. We have isolated a burn toxin which is derived from a thermal polymerization of cell membrane lipoproteins within the dermis and have studied its...
journal_title:Annals of the Royal College of Surgeons of England
pub_type: 杂志文章
doi:
更新日期:1974-11-01 00:00:00
abstract:INTRODUCTION:Despite an increasing emphasis on data-driven quality improvement, few validated quality indicators for emergency surgical services have been published. The aims of this study therefore were: 1) to investigate whether the acute cholecystectomy rate is a valid process indicator; and 2) to use this rate to e...
journal_title:Annals of the Royal College of Surgeons of England
pub_type: 杂志文章
doi:10.1308/rcsann.2019.0042
更新日期:2019-07-01 00:00:00
abstract::A previously fit 37-year-old man developed superior mesenteric venous thrombosis after undergoing a laparoscopic Nissen fundoplication. Despite receiving thrombo-embolic prophylaxis on postoperative day 16, he presented with a gradual onset of vague, but severe, umbilical and epigastric pains. Laboratory tests, abdomi...
journal_title:Annals of the Royal College of Surgeons of England
pub_type: 杂志文章
doi:
更新日期:2002-05-01 00:00:00
abstract::In spite of the suitability of the day surgery environment for most patients undergoing elective plastic surgery, day plastic surgery has not been universally adopted in the United Kingdom. The experience of one plastic surgeon gained in treating 5970 patients as day cases out of a total of 12,461 patients over 10 yea...
journal_title:Annals of the Royal College of Surgeons of England
pub_type: 杂志文章
doi:
更新日期:1994-03-01 00:00:00
abstract:INTRODUCTION:The equivalence of breast-conserving surgery followed by postoperative radiotherapy against mastectomy is now firmly established in patients with early breast cancer. The results of surgery in large-breasted women can be poor, with radiation-induced fibrosis, chronic pain and poor cosmesis contributing to ...
journal_title:Annals of the Royal College of Surgeons of England
pub_type: 杂志文章
doi:10.1308/003588413X13511609958091
更新日期:2013-04-01 00:00:00
abstract::Introduction Emergency general surgery services in England are undergoing rapid structural change with the aim of improving care. In our centre, the key issues identified were high numbers of admissions, inappropriate referrals, prolonged waiting times, delayed senior input and poor patient satisfaction. A new model w...
journal_title:Annals of the Royal College of Surgeons of England
pub_type: 杂志文章
doi:10.1308/rcsann.2017.0081
更新日期:2017-09-01 00:00:00
abstract::Pancreatic injuries are uncommon, difficult to diagnose and there is no uniform standard for treatment. The purpose of this study was to audit the management of pancreatic injuries in our practice. Equally important is to attempt to find out a simple management plan particularly in the era of increasing conservative t...
journal_title:Annals of the Royal College of Surgeons of England
pub_type: 杂志文章
doi:
更新日期:2000-07-01 00:00:00
abstract:INTRODUCTION:Intraoperative neural monitoring of the recurrent laryngeal nerve has been widely used to avoid nerve injury during thyroidectomy. We discuss the results of the change in surgical strategy after unilateral signal loss surgeries using intermittent intraoperative neural monitoring in a high-volume referral c...
journal_title:Annals of the Royal College of Surgeons of England
pub_type: 杂志文章
doi:10.1308/rcsann.2019.0087
更新日期:2019-11-01 00:00:00
abstract::Circumcision is one of the commonest operations performed throughout the world for ritual, traditional or medical reasons. Self-circumcision may lead to disastrous complications. There have been reports of the complications following use of the constricting devices for improved sexual performance and for auto-erotic i...
journal_title:Annals of the Royal College of Surgeons of England
pub_type: 杂志文章
doi:10.1308/147870805X50690
更新日期:2005-07-01 00:00:00
abstract:INTRODUCTION:More aesthetically acceptable treatment options have been sought to minimise the morbidity associated with open surgery for gynaecomastia. This study investigated the use of a vacuum-assisted biopsy device (VABD) and liposuction to provide minimally invasive approach. PATIENTS AND METHODS:Patients diagnos...
journal_title:Annals of the Royal College of Surgeons of England
pub_type: 杂志文章
doi:10.1308/003588410X12628812458815
更新日期:2010-04-01 00:00:00
abstract::Necrotising enterocolitis (NEC) is a rare cause of the acute abdomen in adults and carries one of the highest mortality rates in gastroenterology. However, its rarity confines research to small case reports. Both its pathogenesis and aetiology remain enigmatic in adult patients, proving timely diagnosis and management...
journal_title:Annals of the Royal College of Surgeons of England
pub_type: 杂志文章,评审
doi:10.1308/rcsann.2020.0075
更新日期:2020-10-01 00:00:00
abstract::We present the case of a 27-year-old man who underwent percutaneous atrial septal defect (ASD) repair using the Amplatzer(®) (St Jude Medical, St Paul, MN, US) septal occluder (ASO). Six weeks later, he presented with heart failure and was found to have an aorto-right atrial fistulation. He required urgent surgical de...
journal_title:Annals of the Royal College of Surgeons of England
pub_type: 杂志文章
doi:10.1308/003588414X13814021679591
更新日期:2014-07-01 00:00:00
abstract::Sixty patients scheduled for vaginal surgery under lumbar epidural block were randomly allocated into two groups, one of which received ethamsylate intravenously prior to induction of anaesthesia. Ethamsylate did not reduce the blood loss at operation in these patients. The possible factors underlying this observation...
journal_title:Annals of the Royal College of Surgeons of England
pub_type: 临床试验,杂志文章,随机对照试验
doi:
更新日期:1983-03-01 00:00:00
abstract::John Hunter's observations on dental caries are described and various early speculative theories of its nature and causation are mentioned. With the demonstration in the late 19th century of the chemicoparasitic nature of the late 19th century of the chemicoparasitic nature of the disease attention focused on dietary ...
journal_title:Annals of the Royal College of Surgeons of England
pub_type: 历史文章,杂志文章
doi:
更新日期:1982-11-01 00:00:00
abstract::To assess the efficacy of emergency thoracotomy performed for thoracic trauma in the accident and emergency department, a retrospective analysis of patients who underwent this procedure and were brought to hospital by the Helicopter Emergency Medical Service was carried out. Between 1991 and 1994, 16 patients had emer...
journal_title:Annals of the Royal College of Surgeons of England
pub_type: 杂志文章
doi:
更新日期:1996-05-01 00:00:00
abstract:INTRODUCTION:As a result of a single spinal injury seen at Frimley Park Hospital, we reviewed the injuries recorded at the Army School of Physical Training since December 1996. PATIENTS AND METHODS:This was a retrospective review of all acute accidents and injuries recorded in the Accident Book since its inception. R...
journal_title:Annals of the Royal College of Surgeons of England
pub_type: 杂志文章
doi:10.1308/003588406X114721
更新日期:2006-09-01 00:00:00
abstract::Adult ingestion of caustic substances is an unusual but serious surgical problem, with injuries likely to be more extensive than those in the corresponding paediatric population. After initial stabilisation and airway management, clinicians are presented with a complex multisystemic problem, frequently requiring a mul...
journal_title:Annals of the Royal College of Surgeons of England
pub_type: 杂志文章
doi:10.1308/003588415X14181254789286
更新日期:2015-05-01 00:00:00
abstract::Despite the widespread use of the EEA stapling device, little is known about the eventual fate of the stapled anastomosis. In a study of 38 stapled colonic anastomoses the staples were found to have passed out rectally in 11 patients (29%) within 6 months of surgery. Staple loss occurred only when the small or medium ...
journal_title:Annals of the Royal College of Surgeons of England
pub_type: 杂志文章
doi:
更新日期:1985-01-01 00:00:00
abstract::In the past few years, minimally invasive oesophagectomy has become an increasingly popular approach for oesophagectomy showing advantages in terms of fewer postoperative complications, shorter hospital stay and faster recovery. We present the case of a 60-year-old man with a lesion of the distal third of the oesophag...
journal_title:Annals of the Royal College of Surgeons of England
pub_type: 杂志文章
doi:10.1308/rcsann.2020.0182
更新日期:2021-01-01 00:00:00
abstract::Carcinoma of the oral cavity occurring in Africans is poorly documented. Although oral cancer is considered rare in Africa approximately 40 cases of intraoral carcinoma are seen yearly at the Maxillofacial Clinic, Kaduna. This paper reviews 137 cases of malignant disease in the oral cavity and compares the results wit...
journal_title:Annals of the Royal College of Surgeons of England
pub_type: 杂志文章
doi:
更新日期:1985-05-01 00:00:00
abstract::Colorectal cancer is the second most common cancer in the Western world, and yet the survival after potentially curative excisional surgery has improved little over the last half century. Newer tumour prognostic markers are not superior to conventional Dukes' staging and there are currently no markers which predict re...
journal_title:Annals of the Royal College of Surgeons of England
pub_type: 杂志文章,评审
doi:
更新日期:1995-03-01 00:00:00
abstract::We have reviewed the results of treatment of 159 consecutive limbs presenting with a clinical diagnosis of venous ulcer in 140 patients (70 male, aged 28-90 years, median 66 years). Of the patients, 61% were referred because of severe pain and 53% of the ulcers had been present > 2 years. Patients were evaluated clini...
journal_title:Annals of the Royal College of Surgeons of England
pub_type: 杂志文章
doi:
更新日期:1995-11-01 00:00:00
abstract:INTRODUCTION:Nicorandil is a commonly prescribed antianginal medication that has been found to be associated with painful anal ulceration. The incidence of this complication is unknown. We have used the best data available to us to make an estimate of this figure in a health district with a remarkably stable populatio...
journal_title:Annals of the Royal College of Surgeons of England
pub_type: 杂志文章
doi:10.1308/003588412X13171221501573
更新日期:2012-04-01 00:00:00
abstract::Research performed in the late 1960s, using 24Na, suggested that the perfusion of skin and subcutaneous tissues is critically dependent on the relationship between capillary (Pc) and tissue pressures (Pt). Perfusion changes differed significantly between controls and patients with venous disease and the differences co...
journal_title:Annals of the Royal College of Surgeons of England
pub_type: 杂志文章
doi:
更新日期:1999-03-01 00:00:00
abstract::The 'beehive' sign on the bladder as seen in cystograms is valuable in diagnosing the presence of colovesical fistula and is invariably associated with the vesical end of the fistulous tract. ...
journal_title:Annals of the Royal College of Surgeons of England
pub_type: 杂志文章
doi:
更新日期:1981-05-01 00:00:00