The Surgical Sisterhood - The Experiences of wahine Maori and Pasifika Aspiring Surgeons.

The establishment of a culturally diverse surgical workforce, largely on the basis of gender, has been highly promoted in Australasia in the last decade. Despite this, discussions of gender diversity in surgery have largely excluded Indigenous women. This study presents the experiences of wahine Maori and Pasifika doctors in Aotearoa, who formed a surgical sisterhood to support them towards applying for advanced surgical training. Utilising mana wahine and Masi methodologies, semi-structured interpersonal interviews were undertaken with five wahine who formed the surgical sisterhood. Following transcription and analysis of all interviews, four key themes were identified. These were mana wahine, unity, our why and change on the horizon. These themes illustrate the complex and varied experiences of wahine Maori and Pasifika and how they have navigated their surgical pathways amidst multiple layers of discrimination towards being in a position to apply for advanced surgical training.

Diagnostic accuracy of procalcitonin for the early diagnosis of anastomotic leakage after colorectal surgery: a meta-analysis.

BACKGROUND: Anastomotic leakage (AL) is a dreaded complication following colorectal surgery. Procalcitonin is one of many biomarkers studied and research has suggested that it has improved accuracy for the diagnosis of AL compared with other inflammatory biomarkers such as C-reactive protein. This meta-analysis was conducted to evaluate the accuracy of procalcitonin in the early diagnosis of AL following colorectal surgery. METHODS: MEDLINE, Embase and PubMed were searched for studies evaluating procalcitonin in the context of AL following colorectal surgery in the elective setting. The literature was reviewed using the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) statement. Quality of the studies was assessed using the Quality Assessment Diagnostic Accuracy Studies (QUADAS)-2 tool. Meta analyses were conducted using area under the receiver operating characteristic curves for day 3, 4 and 5 post-surgery as a diagnostic test to detect AL. RESULTS: A total of eight studies were analysed. Results showed that the highest diagnostic accuracy for procalcitonin is on day 5 post surgery. The reported optimal cut-off values ranged from 0.25 to 680 ng/mL from postoperative day 3 to 5, with reported negative predictive values ranging from 95% to 100%, and positive predictive values of up to 34%. The highest area under the receiver operating characteristic curve was 0.88 on postoperative day 5. CONCLUSION: Procalcitonin is a useful negative test for AL following elective colorectal surgery. However, as an isolated test, it is not useful in detecting AL.