Andrew I Smith

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Transoral incisionless fundoplication (TIF) using the EsophyX™ system has been introduced as a possible alternative for the treatment of gastroesophageal reflux disease (GERD). The efficacy of this procedure in our centers was evaluated. Patients were selected for treatment if they had typical GERD symptoms, failed management with proton pump inhibitors(More)
Of 62 patients with homozygous sickle cell disease subjected to open cholecystectomy for symptomatic gallstones over a 12-year period at the University Hospital of the West Indies, 25 were males and 37 were females. Of these, 27 were paediatric patients aged 18 years or less, and 35 were adults. Preoperative transfusion was selectively administered. All(More)
OBJECTIVE As the number of obese people in Australia continues to increase, laparoscopic adjustable gastric banding (LAGB) surgery will become increasingly common. It is important for practitioners involved in the care of such patients to be able to accurately diagnose, and initially manage, pathology relating to the LAGB. METHODS A retrospective review(More)
We report a historic nosocomial outbreak of Salmonella enteritidis affecting 4 inpatients who underwent endoscopic retrograde cholangiopancreatography. The cause was attributed to inadequate decontamination of an on-loan endoscope used over a weekend. This report highlights the risks of using on-loan endoscopes, particularly regarding their commissioning(More)
BACKGROUND Outcomes of oesophago-gastric cancer are poor and highly variable between centres. It is important that complex multimodal treatments are applied optimally. Low case volumes at Australian centres mean that the analysis of crude outcomes is an inadequate assessment of overall quality of care. Detailed analysis across a range of quality domains(More)
Use of purified water for the final rinse stage of disinfected endoscopes is an important element of quality control. We describe the detection and management of Aspergillus fumigatus contamination of a new reverse osmosis unit supplying 10 automated endoscope reprocessor basins. Prompt detection and reaction to this contaminant were possible because of the(More)
Oesophageal cancer following bariatric surgery adds significant complexity to an already challenging disease. There is limited data on the diagnosis, presentation and management in these complex cases. A retrospective cohort study on prospectively collected data over 10 years was conducted. The oesophago-gastric cancer database was searched for patients(More)
BACKGROUND Bariatric surgery has not been widely used in the Australian public health system. As obesity is strongly associated with socio-economic status, excluding its use from the public system will deny many of the most in-need access to a potentially very effective treatment. Alternatively, with rigorous follow-up and behavioural change requirements,(More)
BACKGROUND Retrieval and analysis of an adequate number of lymph nodes is critical for accurate staging of oesophageal and gastric cancer. Higher total node counts reported by pathologists are associated with improved survival. A prospective study was undertaken to understand the factors contributing to variability in lymph node counts after(More)
Accepted 27 June 1996 A 50-year-old man presented with a three-week history of abdominal pain and constipation. For three days prior to presentation he complained of increasing colicky abdominal pain with distension, anorexia, nausea and vomiting. The constipation was not absolute and there was no rectal bleeding. For two weeks prior to his presentation he(More)