Acute surgical experience of Australian general surgical trainees.

BACKGROUND: A principle of Australian general surgical training is exposure to a variety of operative and clinical experiences. These are potentially being impacted upon by expanding post-fellowship training positions, mandatory reduced working hours, and advances in non-operative care. This study aims to report the recent acute surgical experience of Australian general surgical trainees. METHODS: A de-identified summary of general surgical trainee logbook data was obtained from General Surgeons Australia, over a 6-year period (2009-2014). Case volumes in operative and non-operative acute surgical cases were analysed, encompassing 5307 individual logbooks from 12 consecutive training terms. RESULTS: There was a mean of 112.2 ± 6.8 total major operative cases per trainee per term. There was an increase in case volumes reported from terms 1-8 (from 102.1 to 122.9), with the most recent reported volume being 117.8 cases per trainee in term 12. The total major operative primary operator rate increased from 35.5% in term 1 to 40.6% in term 8, with the most recent reported rate being 41.8% in term 12. Open and laparoscopic colorectal case volumes have remained stable. Operative trauma case volumes have increased. CONCLUSION: The acute surgical operative case experience of general surgical trainees has not declined. However, it should continue to be monitored in view of the changing scope of surgical practice.

A Multifocal Pattern of Neuroendocrine Neoplasms Along the Appendix: A Series of Six Cases.

We present 6 cases with multifocal appendiceal neuroendocrine tumors, including their clinical and histopathological findings. To our knowledge, this is the first description of a multifocal pattern of a neuroendocrine neoplasm arising in the appendix. All patients presented in a setting requiring an acute appendectomy. The number of tumors ranged from 2 to 5. Histopathological examination revealed WHO (World Health Organization) grade 1 tumor in 3 patients and WHO grade 2 in the other 3 patients. The median duration of follow-up in these patients was 70 months (range = 6-192 months). No metastatic disease was observed. According to these findings, a multifocal pattern of neuroendocrine neoplasms along the appendix seems not to be a predictor for local advanced or metastatic disease.