British Journal of Surgery最新文献

{"title":"Validation of the Swiss-Finnish Bariatric Metabolic Outcome Score within a large prospective registry cohort.","authors":"Floris F E Bruinsma, Saija Hurme, Ralph Peterli, Erik Stenberg, Simon W Nienhuijs, Sofia Grönroos, Villy Våge, Marco Bueter, Johan Ottosson, Ronald S L Liem, Paulina Salminen","doi":"10.1093/bjs/znaf106","DOIUrl":"https://doi.org/10.1093/bjs/znaf106","url":null,"abstract":"<p><strong>Background: </strong>The Swiss-Finnish Bariatric Metabolic Outcome Score (SF-BARI Score), based on merged data of two RCTs, is a composite endpoint designed to evaluate and categorize outcomes after metabolic bariatric surgery (MBS). The aim of this study was to externally validate the score using registry data.</p><p><strong>Methods: </strong>Individual patient data were included from the Dutch Audit for Treatment of Obesity, the Scandinavian Obesity Surgery Registries (SOReg-Sweden and SOReg-Norway), and the merged RCT data used for establishing the SF-BARI Score. All patients undergoing primary MBS from January 2010 to June 2018, with complete baseline characteristics, as well as complete 1- and 5-year follow-up data, were included. The mean total score and distribution were compared between the combined registry and merged RCT data.</p><p><strong>Results: </strong>There was no statistically significant difference in the mean SF-BARI Score between the registries (21 603 patients) and merged RCTs (457 patients) at 5 years (90.9 versus 89.1 points; difference = 1.8 (95% c.i. -1.0 to 4.7); P = 0.212), and the score distribution was similar. Statistically significant differences in baseline characteristics existed regarding sex (male 20.9% versus 29.3%), type 2 diabetes (16.7% versus 33.9%), hypertension (30.4% versus 66.1%), dyslipidaemia (13.7% versus 46.5%), obstructive sleep apnoea syndrome (12.0% versus 17.4%), and sleeve gastrectomy (SG) rate (21.0% versus 49.9%) (P < 0.001). The mean score estimate at 5 years in Roux-en-Y gastric bypass was 11.2 (95% c.i. 10.2 to 12.2) points higher compared with SG (P < 0.001).</p><p><strong>Conclusion: </strong>This study verified the feasibility of the SF-BARI Score, enabling standardized reporting and allowing for comparison of different treatment modalities.</p>","PeriodicalId":136,"journal":{"name":"British Journal of Surgery","volume":"112 6","pages":""},"PeriodicalIF":8.6,"publicationDate":"2025-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144191302","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of virtual reality on pain and stress in children during Kirschner-wire removal after fracture treatment: a randomized clinical trial.","authors":"Kathrin Kelly,Juliane Pretzsch,Lena Altenburger,Julia Siebert,Alexander Tzabazis,Judith Lindert,Reinhard Vonthein,Ludger Tüshaus","doi":"10.1093/bjs/znaf075","DOIUrl":"https://doi.org/10.1093/bjs/znaf075","url":null,"abstract":"BACKGROUNDRemoval of Kirschner wires (K-wires) after fracture treatment in the upper limb is unpleasant for children. The aim of this study was to evaluate whether virtual reality (VR) distraction could improve pain and the overall experience for children.METHODSAn RCT was performed in a single outpatient fracture clinic, where children (aged 6-15 years) were randomized 1 : 1, in three age strata, to additional VR or standard of care. Pain perception was assessed using the Wong-Baker Faces Pain Rating Scale by neutral observers and later by the patients and their guardians. Further measures included the Face/Legs/Activity/Cry/Consolability (FLACC) Pain Scale, the modified Yale Pain Anxiety Scale (mYPAS), and questionnaires, as well as objective data, such as heart rate variability and blood pressure.RESULTSA total of 146 patients were recruited into the trial. The VR group showed significantly less pain on the Wong-Baker Faces Pain Rating Scale (OR 0.23 (95% c.i. 0.12 to 0.43)) compared with the control group. Observers rated the pain >2 for 43% of patients in the VR group and 74% of patients in the control group. Observer scales (the FLACC Pain Scale and the mYPAS) during K-wire removal also indicated less pain (OR 0.36 (95% c.i. 0.19 to 0.24) and 0.29 (95% c.i. 0.16 to 0.52) respectively). The difference in pain rated >2 between the VR and control group was smaller directly after (59% versus 69% respectively) and 2 weeks after (58% versus 70% respectively) K-wire removal. Children in the VR group were less aware of the painful stimulus directly after and 2 weeks after wire extraction.CONCLUSIONVR distraction effectively reduces pain during K-wire removal in children. VR positively impacts the procedural memory of children.REGISTRATION NUMBERDRKS00020229 (Deutsches Register Klinischer Studien (DRKS; that is the German Clinical Trials Register); date of registration 10 December 2019).","PeriodicalId":136,"journal":{"name":"British Journal of Surgery","volume":"30 1","pages":""},"PeriodicalIF":9.6,"publicationDate":"2025-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144311324","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Empty pelvis syndrome as a cause of major morbidity after pelvic exenteration: validation of a core data set.","authors":"Charles T West,Abhinav Tiwari,Julian Smith,Hideaki Yano,Malcolm A West,Alex H Mirnezami,","doi":"10.1093/bjs/znaf070","DOIUrl":"https://doi.org/10.1093/bjs/znaf070","url":null,"abstract":"BACKGROUNDPelvic exenteration (PE) is a potentially curative treatment for advanced pelvic cancers. However, PE procedures are associated with empty pelvis syndrome (EPS), a spectrum of complications including pelvic sepsis, sinus formation, fistulae, and bowel obstruction. Inconsistent reporting has impeded progress in understanding EPS. The PelvEx Collaborative introduced a core data set of descriptors and outcomes to address these issues and the aim of this study was to validate this data set.METHODSAn observational cohort study applied the EPS core data set to a prospectively maintained PE database. Patterns of major and minor manifestations were evaluated; logistic regression was used to explore relationships between descriptors and outcomes, and inter-descriptor correlation was assessed using Cramer's V.RESULTSEPS occurred in 32.1% of patients (105 of 327) and was the leading cause of major morbidity. Infected pelvic collections (occurring in 23.5%) were associated with subsequent chronic sinus formation (OR 3.08, P = 0.01) and fistulae (P = 0.05). The risk of EPS increased with external beam radiotherapy (OR 1.01 per 1 Gy, P = 0.01), sacrectomy (OR 3.78, P < 0.001), total cystectomy (OR 2.46, P = 0.001), internal iliac vessel ligation (unilateral OR 1.94, P = 0.045; bilateral OR 3.65, P < 0.001), and infralevator exenteration (OR 3.69, P < 0.001). Omentoplasty reduced pelvic bowel obstruction (OR 0.27, P = 0.004) and perineal flaps were linked to a higher rate of reconstruction-related major morbidity compared with biological mesh alone (20.8% versus 1.2% respectively, P = 0.002).CONCLUSIONThe PelvEx Collaborative core data set standardizes reporting of EPS, with this study detailing the acute and chronic complications arising as a consequence. Biological mesh was associated with reduced reconstruction-related morbidity compared with perineal flaps. Further validation in additional cohorts is required to address potential confounding factors.","PeriodicalId":136,"journal":{"name":"British Journal of Surgery","volume":"12 1","pages":""},"PeriodicalIF":9.6,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143897321","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Obesity is more than a number: a framework for treatment.","authors":"Ricardo V Cohen,Gerhard Prager,Paulina Salminen","doi":"10.1093/bjs/znaf100","DOIUrl":"https://doi.org/10.1093/bjs/znaf100","url":null,"abstract":"","PeriodicalId":136,"journal":{"name":"British Journal of Surgery","volume":"30 1","pages":""},"PeriodicalIF":9.6,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143903044","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Three-year patient-reported outcomes of the BOOG 2013-08 RCT evaluating omission of sentinel lymph node biopsy in early-stage breast cancer patients treated with breast conserving surgery: Impact of personality traits on health-related quality of life.","authors":"Veerle M Wintraecken,Lori M van Roozendaal,Janine M Simons,Jolanda de Vries,Sander M J van Kuijk,Marissa L G Vane,Thijs van Dalen,Helena Sackey,Jos A van der Hage,Luc J A Strobbe,Sabine C Linn,Marc B I Lobbes,Philip M P Poortmans,Vivianne C G Tjan-Heijnen,Koen K B T van de Vijver,Helen H Westenberg,Carmen D Dirksen,Johan H W de Wilt,Liesbeth J Boersma,Marjolein L Smidt","doi":"10.1093/bjs/znaf031","DOIUrl":"https://doi.org/10.1093/bjs/znaf031","url":null,"abstract":"BACKGROUNDThe non-inferiority randomized controlled trial BOOG 2013-08 investigates the oncological safety and impact on health-related quality of life (HRQoL) of sentinel lymph node biopsy (SNLB) omission in cT1-2 N0 breast cancer. The primary aim of the present study was to compare patient-reported arm function and HRQoL up to 3 years after study inclusion in cT1-2 N0 patients with breast cancer undergoing breast-conserving surgery (BCS) with or without SLNB. The secondary aim was to explore the association between personality traits 'trait anxiety' and 'neuroticism', and perceived arm function and HRQoL.METHODSA total of 1733 women with unilateral cT1-2 N0 invasive breast cancer treated with BCS with or without SLNB were included. The primary outcomes of arm function (assessed using the Lymphoedema Functioning, Disability, and Health Questionnaire) and HRQoL (assessed using the European Organisation for Research and Treatment of Cancer QLQ-C30 and QLQ-BR-23 questionnaires) were analysed.RESULTSAnalyses included 821 patients (383 with SLNB and 438 without SLNB). Those in the SLNB group experienced a slight, temporary decline in arm function (P < 0.025) and reported more HRQoL arm and breast symptoms (P < 0.049). High trait anxiety or neuroticism was associated with significant poorer arm function and lower HRQoL.CONCLUSIONSLNB slightly reduced arm function, temporarily affecting HRQoL arm and breast symptoms. Neuroticism significantly negatively impacted arm function and HRQoL. Measuring and stratifying for personality traits is crucial for interpreting patient-reported outcomes and to identify patients needing additional support after surgery.REGISTRATION NUMBERNCT02271828 (http://www.clinicaltrials.gov).","PeriodicalId":136,"journal":{"name":"British Journal of Surgery","volume":"8 1","pages":""},"PeriodicalIF":9.6,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143945411","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correction to: Endovascular treatment of peripheral arterial disease: Endo-STAR framework for the design, conduct, and reporting of trials.","authors":"","doi":"10.1093/bjs/znaf105","DOIUrl":"https://doi.org/10.1093/bjs/znaf105","url":null,"abstract":"","PeriodicalId":136,"journal":{"name":"British Journal of Surgery","volume":"27 1","pages":""},"PeriodicalIF":9.6,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143915184","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Beyond the operating room: surgeons' perceptions of the environmental footprint of the healthcare sector.","authors":"Russell S Martins,Warda Ahmed,M Umar Mahar,Ayilkin Çelik,Jeffrey Luo,Syed S Razi,Kostantinos Poulikidis,M Jawad Latif,Kyle Tafuri,Mahim A Malik,Faiz Y Bhora,","doi":"10.1093/bjs/znaf088","DOIUrl":"https://doi.org/10.1093/bjs/znaf088","url":null,"abstract":"","PeriodicalId":136,"journal":{"name":"British Journal of Surgery","volume":"53 1","pages":""},"PeriodicalIF":9.6,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143915185","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sigmoid volvulus: outcomes of surgery and conservative management after initial colonoscopic decompression (the VOLVUCOL study).","authors":"Lucie Audeguy,Mattia Stella,Damien Duprez,Astrid Laurent,Fatah Tidadini,Alison Foote,Joey Fournier,Bertrand Trilling,Jean-Luc Faucheron","doi":"10.1093/bjs/znaf085","DOIUrl":"https://doi.org/10.1093/bjs/znaf085","url":null,"abstract":"","PeriodicalId":136,"journal":{"name":"British Journal of Surgery","volume":"109 1","pages":""},"PeriodicalIF":9.6,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143903046","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of revision surgery after implant-based breast reconstruction between smooth, textured, and polyurethane-covered implants: results from the Dutch Breast Implant Registry.","authors":"J Xavier Harmeling,J Juliët Vrolijk,Erik Heeg,Babette E Becherer,Hinne A Rakhorst,Eveline M L Corten,Marta Fiocco,Marc A M Mureau","doi":"10.1093/bjs/znaf082","DOIUrl":"https://doi.org/10.1093/bjs/znaf082","url":null,"abstract":"BACKGROUNDImplant-based breast reconstruction is the most common technique after mastectomy. Breast implants are categorized by surface type as smooth, textured, or polyurethane-covered, each with specific attributed advantages and complication profiles. High-quality comparative studies are, however, limited. This study compared revision incidence and indications for revision among these implant types.METHODSA prospective, nationwide cohort from the Dutch Breast Implant Registry was analysed. Permanent implants used between 2017 and 2022 for direct-to-implant or two-stage reconstruction were included. Surface-related revision was the primary outcome. Cumulative incidences were estimated using a competing risk model. Cause-specific hazard ratios (HRcs) were calculated using univariable and multivariable models, accounting for implant clustering and confounders. Subgroup analyses examined revisions for specific complications.RESULTSOf 3996 implants, 76.9% were textured, 12.4% smooth, and 10.8% polyurethane-covered. At 4 years, the cumulative incidence of revision surgeries did not differ between textured (11.1%; 95% c.i. = 9.9 to 12.5), smooth (13.0%; 95% c.i. = 8.5 to 18.4), and polyurethane-covered (16.1%; 95% c.i. = 12.4 to 20.2) implants. Multivariable analysis found no association between surface type and surface-related revision. Subgroup analysis however revealed that polyurethane-covered implants had increased hazards of revision for capsular contracture (HRcs = 2.49; 95% c.i. = 1.24 to 5.01) and asymmetry (HRcs = 2.31; 95% c.i. = 1.33 to 4.02).CONCLUSIONAfter adjusting for confounders and clustering, surface-related revision in a reconstructive setting did not significantly different among breast implant surface types overall. Polyurethane-covered implants may, however, require more revisions due to capsular contracture and asymmetry.","PeriodicalId":136,"journal":{"name":"British Journal of Surgery","volume":"58 1","pages":""},"PeriodicalIF":9.6,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144083164","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Round ligament coverage with polyglycol acid mesh and fibrin glue on pancreatic stump may decrease postoperative pancreatic fistula in distal pancreatectomy.","authors":"Yuki Adachi,Hirohisa Okabe,Hiromitsu Hayashi,Yoshiyuki Tagayasu,Takumi Tanizaki,Shinsei Yumoto,Kosuke Kanemitsu,Takuya Tajiri,Daisuke Ogawa,Rumi Itoyama,Yuki Kitano,Shigeki Nakagawa,Hidetoshi Nitta,Toshiro Masuda,Hiroki Sugita,Masaaki Iwatsuki","doi":"10.1093/bjs/znaf101","DOIUrl":"https://doi.org/10.1093/bjs/znaf101","url":null,"abstract":"","PeriodicalId":136,"journal":{"name":"British Journal of Surgery","volume":"9 1","pages":""},"PeriodicalIF":9.6,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144083165","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}