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Papers by Martin Corbally
Springer Surgery Atlas Series, 2006
Bahrain Medical Bulletin
INFORMED CONSENT INVOLVES GIVING THE PATIENT ALL INFORMATION THAT ENABLES THEM TO MAKE A BALANCED... more INFORMED CONSENT INVOLVES GIVING THE PATIENT ALL INFORMATION THAT ENABLES THEM TO MAKE A BALANCED DECISION ABOUT THEIR PLANNED CARE. INCREASINGLY TAUGHT TO UNDERGRADUATES ALL DOCTORS MUST BE FAMILIAR WITH IT AND THE INEVITABILITY OF OCCASIONAL CULTURAL ISSUES AROUND IT.
Frontiers in Pediatrics, 2014
Despite greater awareness of patient safety issues especially in the operating room and the wides... more Despite greater awareness of patient safety issues especially in the operating room and the widespread implementation of surgical time out World Health Organization (WHO), errors, especially wrong site surgery, continue. Most such errors are due to lapses in communication where decision makers fail to consult or confirm operative findings but worryingly where parental concerns over the planned procedure are ignored or not followed through. The WHO Surgical Pause/Time Out aims to capture these errors and prevent them, but the combination of human error and complex hospital environments can overwhelm even robust safety structures and simple common sense. Parents are the ultimate repository of information on their child's condition and planned surgery but are traditionally excluded from the process of Surgical Pause and Time Out, perhaps to avoid additional stress. In addition, surgeons, like pilots, are subject to the phenomenon of "plan-continue-fail" with potentially disastrous outcomes. If we wish to improve patient safety during surgery and avoid wrong site errors then we must include parents in the Surgical Pause/Time Out. A recent pilot study has shown that neither staff nor parents found it added to their stress, but, moreover, 100% of parents considered that it should be a mandatory component of the Surgical Pause nor does it add to the stress of surgery. Surgeons should be required to confirm that the planned procedure is in keeping with the operative findings especially in extirpative surgery and this "step back" should be incorporated into the standard Surgical Pause. It is clear that we must improve patient safety further and these simple measures should add to that potential. Keywords: patient safety,WHO Surgical Pause/Time Out, parental involvement in Surgical Pause/Time Out, surgeon step back and confirm
Pediatric Surgery International, 1992
ABSTRACT
Pediatric Surgery International, 1990
ABSTRACT
Pediatric Surgery International, 2009
Seminars in Surgical Oncology, 1993
Cytotoxic therapy for paediatric malignancy continues to be associated with significant mortality... more Cytotoxic therapy for paediatric malignancy continues to be associated with significant mortality and morbidity. However, survival figures continue to improve despite increasingly toxic treatment protocols. Aggressive supportive care, more than any other modality, has produced a dramatic reduction in mortality during the past 30 years, and includes the appropriate management of infection, provision of adequate nutrition, and proper use of blood and blood products. The paediatric surgeon plays an integral role in the multidisciplinary team of cancer management and together with other team specialists is responsible for the planning of surgical intervention and also ensuring the safe passage of immunologically impaired patients through the additional stress of surgery. This paper details essential aspects of supportive care as commonly practiced in paediatric patients undergoing therapy and surgery.
Journal of Pediatric Surgery, 2003
Broviac catheters are in common use for administration of parenteral nutrition, cancer chemothera... more Broviac catheters are in common use for administration of parenteral nutrition, cancer chemotherapy, and antibiotic therapy within the paediatric population. Inadvertent dislodgement of these catheters is common during the initial weeks before the Dacron cuff is anchored by the ingrowth of fibrous tissue. The authors describe a technique in which an internal fixation suture is placed to prevent dislodgement or migration.
Journal of Pediatric Surgery, 1992
Journal of Pediatric Surgery, 1996
Journal of Pediatric Surgery, 1996
Journal of Pediatric Surgery, 1993
9 Problems with loss of correct orientation of the pullthrough rectal pouch during posterior sagi... more 9 Problems with loss of correct orientation of the pullthrough rectal pouch during posterior sagittal anorectoplasty (PSARP) for high imperforate anus can occur during laparotomy after perineal closure is complete. A simple modification of the de Vries-Pefia technique is described that facilitates preservation of orientation and precise anatomical neomuscle construction. A slotted rubber tube preserves correct anatomical orientation of the neorectal pouch and allows accurate construction of the muscle complex around the tube.
Irish Journal of Medical Science, 2000
British Journal of Surgery, 1992
Archives of Surgery, 1989
Journal of Pediatric Surgery, 2008
Vascular access in paediatric patients with chronic and/or life-threatening illness is crucial to... more Vascular access in paediatric patients with chronic and/or life-threatening illness is crucial to survival. Access is frequently lost in this group because of thrombosis, infection, or displacement, and vascular options can quickly be exhausted. The last resort access procedure is generally a direct atrial catheter inserted via a thoracotomy. A viable alternative is the percutaneous transhepatic Broviac catheter (Bard Access Systems, Salt Lake City, UT). We retrospectively reviewed the charts of 5 patients who underwent percutaneous transhepatic Broviac insertion for long-term access over a 4-year period in a single institution. Four of the patients (80%) had a significant cardiac abnormality, with 1 patient requiring long-term parenteral nutrition after complicated necrotizing enterocolitis. All patients had significant caval thrombosis, which precluded them having placement of a standard percutaneous or openly placed central catheter. Of the 5 patients, 2 (40%) died of cardiac-related illnesses. Of the 3 surviving patients, 2 had functioning catheters electively removed because they were no longer required. One catheter was removed at thoracotomy for right atrial perforation because of catheter erosion. Vascular access in paediatric patients with chronic and/or life-threatening illness is crucial to survival. Transhepatic central venous catheters are a feasible, reliable, and relatively easily placed form of central access in patients with multiple venous thromboses requiring long-term access. This route should be considered in paediatric patients requiring central access in preference to a thoracotomy.
Archives of Surgery
A retrospective study of 19 patients with pancreatic cystadenoma included 15 patients with microc... more A retrospective study of 19 patients with pancreatic cystadenoma included 15 patients with microcystic and 4 with mucinous cystadenomas. The typical clinical presentation was that of an elderly woman with an upper abdominal mass. An association with diabetes mellitus and extrapancreatic malignant disease was noted. Total tumor resection provided the best chance of cure and removed the risk of compression of adjacent organs and, in mucinous cystadenomas, the risk of malignant transformation.
Springer Surgery Atlas Series, 2006
Bahrain Medical Bulletin
INFORMED CONSENT INVOLVES GIVING THE PATIENT ALL INFORMATION THAT ENABLES THEM TO MAKE A BALANCED... more INFORMED CONSENT INVOLVES GIVING THE PATIENT ALL INFORMATION THAT ENABLES THEM TO MAKE A BALANCED DECISION ABOUT THEIR PLANNED CARE. INCREASINGLY TAUGHT TO UNDERGRADUATES ALL DOCTORS MUST BE FAMILIAR WITH IT AND THE INEVITABILITY OF OCCASIONAL CULTURAL ISSUES AROUND IT.
Frontiers in Pediatrics, 2014
Despite greater awareness of patient safety issues especially in the operating room and the wides... more Despite greater awareness of patient safety issues especially in the operating room and the widespread implementation of surgical time out World Health Organization (WHO), errors, especially wrong site surgery, continue. Most such errors are due to lapses in communication where decision makers fail to consult or confirm operative findings but worryingly where parental concerns over the planned procedure are ignored or not followed through. The WHO Surgical Pause/Time Out aims to capture these errors and prevent them, but the combination of human error and complex hospital environments can overwhelm even robust safety structures and simple common sense. Parents are the ultimate repository of information on their child's condition and planned surgery but are traditionally excluded from the process of Surgical Pause and Time Out, perhaps to avoid additional stress. In addition, surgeons, like pilots, are subject to the phenomenon of "plan-continue-fail" with potentially disastrous outcomes. If we wish to improve patient safety during surgery and avoid wrong site errors then we must include parents in the Surgical Pause/Time Out. A recent pilot study has shown that neither staff nor parents found it added to their stress, but, moreover, 100% of parents considered that it should be a mandatory component of the Surgical Pause nor does it add to the stress of surgery. Surgeons should be required to confirm that the planned procedure is in keeping with the operative findings especially in extirpative surgery and this "step back" should be incorporated into the standard Surgical Pause. It is clear that we must improve patient safety further and these simple measures should add to that potential. Keywords: patient safety,WHO Surgical Pause/Time Out, parental involvement in Surgical Pause/Time Out, surgeon step back and confirm
Pediatric Surgery International, 1992
ABSTRACT
Pediatric Surgery International, 1990
ABSTRACT
Pediatric Surgery International, 2009
Seminars in Surgical Oncology, 1993
Cytotoxic therapy for paediatric malignancy continues to be associated with significant mortality... more Cytotoxic therapy for paediatric malignancy continues to be associated with significant mortality and morbidity. However, survival figures continue to improve despite increasingly toxic treatment protocols. Aggressive supportive care, more than any other modality, has produced a dramatic reduction in mortality during the past 30 years, and includes the appropriate management of infection, provision of adequate nutrition, and proper use of blood and blood products. The paediatric surgeon plays an integral role in the multidisciplinary team of cancer management and together with other team specialists is responsible for the planning of surgical intervention and also ensuring the safe passage of immunologically impaired patients through the additional stress of surgery. This paper details essential aspects of supportive care as commonly practiced in paediatric patients undergoing therapy and surgery.
Journal of Pediatric Surgery, 2003
Broviac catheters are in common use for administration of parenteral nutrition, cancer chemothera... more Broviac catheters are in common use for administration of parenteral nutrition, cancer chemotherapy, and antibiotic therapy within the paediatric population. Inadvertent dislodgement of these catheters is common during the initial weeks before the Dacron cuff is anchored by the ingrowth of fibrous tissue. The authors describe a technique in which an internal fixation suture is placed to prevent dislodgement or migration.
Journal of Pediatric Surgery, 1992
Journal of Pediatric Surgery, 1996
Journal of Pediatric Surgery, 1996
Journal of Pediatric Surgery, 1993
9 Problems with loss of correct orientation of the pullthrough rectal pouch during posterior sagi... more 9 Problems with loss of correct orientation of the pullthrough rectal pouch during posterior sagittal anorectoplasty (PSARP) for high imperforate anus can occur during laparotomy after perineal closure is complete. A simple modification of the de Vries-Pefia technique is described that facilitates preservation of orientation and precise anatomical neomuscle construction. A slotted rubber tube preserves correct anatomical orientation of the neorectal pouch and allows accurate construction of the muscle complex around the tube.
Irish Journal of Medical Science, 2000
British Journal of Surgery, 1992
Archives of Surgery, 1989
Journal of Pediatric Surgery, 2008
Vascular access in paediatric patients with chronic and/or life-threatening illness is crucial to... more Vascular access in paediatric patients with chronic and/or life-threatening illness is crucial to survival. Access is frequently lost in this group because of thrombosis, infection, or displacement, and vascular options can quickly be exhausted. The last resort access procedure is generally a direct atrial catheter inserted via a thoracotomy. A viable alternative is the percutaneous transhepatic Broviac catheter (Bard Access Systems, Salt Lake City, UT). We retrospectively reviewed the charts of 5 patients who underwent percutaneous transhepatic Broviac insertion for long-term access over a 4-year period in a single institution. Four of the patients (80%) had a significant cardiac abnormality, with 1 patient requiring long-term parenteral nutrition after complicated necrotizing enterocolitis. All patients had significant caval thrombosis, which precluded them having placement of a standard percutaneous or openly placed central catheter. Of the 5 patients, 2 (40%) died of cardiac-related illnesses. Of the 3 surviving patients, 2 had functioning catheters electively removed because they were no longer required. One catheter was removed at thoracotomy for right atrial perforation because of catheter erosion. Vascular access in paediatric patients with chronic and/or life-threatening illness is crucial to survival. Transhepatic central venous catheters are a feasible, reliable, and relatively easily placed form of central access in patients with multiple venous thromboses requiring long-term access. This route should be considered in paediatric patients requiring central access in preference to a thoracotomy.
Archives of Surgery
A retrospective study of 19 patients with pancreatic cystadenoma included 15 patients with microc... more A retrospective study of 19 patients with pancreatic cystadenoma included 15 patients with microcystic and 4 with mucinous cystadenomas. The typical clinical presentation was that of an elderly woman with an upper abdominal mass. An association with diabetes mellitus and extrapancreatic malignant disease was noted. Total tumor resection provided the best chance of cure and removed the risk of compression of adjacent organs and, in mucinous cystadenomas, the risk of malignant transformation.