ORCID Profile
0000-0002-4511-0727
Current Organisation
Westmead Hospital
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Publisher: Wiley
Date: 12-05-2020
DOI: 10.1111/ANS.15958
Publisher: Wiley
Date: 28-06-2021
DOI: 10.1111/ANS.17029
Publisher: Wiley
Date: 14-05-2019
DOI: 10.1111/ANS.14561
Publisher: Oxford University Press (OUP)
Date: 08-2020
DOI: 10.1093/JSCR/RJAA239
Abstract: Small bowel obstruction (SBO) following intraperitoneal renal transplantation, either solitary or due to simultaneous pancreas-kidney transplantation, is a known complication. While SBO is most commonly due to adhesions, there have been documented cases of internal herniation following simultaneous pancreas-kidney transplantation with enteric drainage due to the formation of a mesenteric defect. We present a unique complication in which the transplant ureter has caused strangulation and necrosis of a length of small intestine. The transplant ureter was mistaken for a band adhesion and ided. Post-operative anuria signalled this difficult diagnosis. Subsequent re-look laparotomy and ureteric reimplantation with Boari flap were required. Therefore, it is important to consider the ureter as a cause of internal herniation in kidney transplant patients and recognize that a band adhesion within the pelvis may in fact be the transplant ureter, obstructing a loop of small intestine beneath its course.
Publisher: SAGE Publications
Date: 14-05-2018
Abstract: To compare the total initial treatment costs for open surgery, endovascular revascularization, and primary major utation within a single-payer healthcare system. A multicenter, retrospective analysis was undertaken to evaluate 1138 patients with symptomatic peripheral artery disease (PAD) who underwent 1017 endovascular procedures, 86 open surgeries, and 35 major utations between 2013 and 2016. A cost-mix analysis was performed on in idual patient data generated for selected diagnosis-related groups. Mean costs are presented with the 95% confidence interval (CI). There was no intergroup difference in demographics or private health insurance status. However, the utation group had a higher proportion of emergency procedures (68.6% vs 13.3% vs 27.9%, p<0.001) and critical limb ischemia (88.6% vs 35.9% vs 37.2%, p<0.001) compared with the endovascular therapy and open surgery groups, respectively. The endovascular revascularization group spent less time in hospital and used fewer intensive care unit (ICU) resources compared with the open surgery and major utation groups (hospital length of stay: 3.4 vs 10.0 vs 20.2 days, p<0.01 ICU: 2.4 vs 22.6 vs 54.6 hours, p<0.01), respectively. While mean prosthetic and device costs were higher in the endovascular group [AUD$2770 vs AUD$1658 (open) and AUD$1219 ( utation), p<0.01], substantial disparities were observed in costs associated with longer operating theater times, length of stay, and ICU utilization, which resulted in significantly higher costs in the open and utation groups. After adjusting for confounders, the AUD$18,396 (95% CI AUD$16,436 to AUD$20,356) mean cost per admission for the endovascular revascularization group was significantly less (p<0.001) than the open surgery (AUD$31,908, 95% CI AUD$28,285 to AUD$35,530) and major utation groups (AUD$43,033, 95% CI AUD$37,706 to AUD$48,361). Endovascular revascularization procedures for PAD cost the health payer less compared with open surgery and primary utation. While devices used to deliver contemporary endovascular therapy are more expensive, the reduction in bed days, ICU utilization, and related hospital resources results in a significantly lower mean total cost per admission for the initial treatment.
Publisher: Wiley
Date: 05-2021
DOI: 10.1111/ANS.16605
Publisher: Wiley
Date: 09-11-2021
DOI: 10.1111/ANS.17271
Abstract: Renal allograft compartment syndrome (RACS) is the result of extrinsic compression resulting in graft dysfunction and loss due to ischaemia. A literature review was performed by computerized searches from the following data sources Medline, EMBASE, PubMed and Cochrane Library databases. Risk factors include size mismatch between graft and recipient. Intraoperative suspicion should be exercised if there is poor tissue turgor, cyanosis and loss of urine output upon fascial closure. Doppler ultrasound is the modality of choice amongst the literature to aid in diagnosis of RACS. From our study, the accepted form of treatment is early detection and appropriate surgical intervention. Nevertheless, it is clear from the paucity of literature that further investigation into this area of transplantation is necessary.
No related grants have been discovered for Linda Tang.