British Journal of Surgery最新文献

Empty pelvis syndrome as a cause of major morbidity after pelvic exenteration: validation of a core data set. 骨盆空综合征是骨盆切除后主要发病的原因：对核心数据集的验证。

IF 9.6 1区医学

British Journal of Surgery Pub Date : 2025-04-30 DOI: 10.1093/bjs/znaf070

Charles T West,Abhinav Tiwari,Julian Smith,Hideaki Yano,Malcolm A West,Alex H Mirnezami,

{"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}

引用次数: 0

Obesity is more than a number: a framework for treatment. 肥胖不仅仅是一个数字，而是一个治疗框架。

IF 9.6 1区医学

British Journal of Surgery Pub Date : 2025-04-30 DOI: 10.1093/bjs/znaf100

Ricardo V Cohen,Gerhard Prager,Paulina Salminen

引用次数: 0

Correction to: Endovascular treatment of peripheral arterial disease: Endo-STAR framework for the design, conduct, and reporting of trials. 外周动脉疾病的血管内治疗：试验设计、实施和报告的Endo-STAR框架。

IF 9.6 1区医学

British Journal of Surgery Pub Date : 2025-04-30 DOI: 10.1093/bjs/znaf105

引用次数: 0

Beyond the operating room: surgeons' perceptions of the environmental footprint of the healthcare sector. 手术室之外：外科医生对医疗保健行业环境足迹的看法。

IF 9.6 1区医学

British Journal of Surgery Pub Date : 2025-04-30 DOI: 10.1093/bjs/znaf088

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,

引用次数: 0

Sigmoid volvulus: outcomes of surgery and conservative management after initial colonoscopic decompression (the VOLVUCOL study). 乙状结肠扭转：初始结肠镜减压后手术和保守治疗的结果（VOLVUCOL研究）。

IF 9.6 1区医学

British Journal of Surgery Pub Date : 2025-04-30 DOI: 10.1093/bjs/znaf085

Lucie Audeguy,Mattia Stella,Damien Duprez,Astrid Laurent,Fatah Tidadini,Alison Foote,Joey Fournier,Bertrand Trilling,Jean-Luc Faucheron

引用次数: 0

Negative pressure wound therapy: does it suck? 负压伤口治疗：吸吗？

IF 9.6 1区医学

British Journal of Surgery Pub Date : 2025-04-30 DOI: 10.1093/bjs/znaf093

Matthew J Lee,Thomas D Pinkney

引用次数: 0

Consensus classification of biliary complications after liver transplantation: guidelines from the BileducTx meeting. 肝移植术后胆道并发症的共识分类：BileducTx会议指南。

IF 9.6 1区医学

British Journal of Surgery Pub Date : 2025-04-30 DOI: 10.1093/bjs/znae321

Hannah Esser,Iris E M de Jong,Floris M Roos,Christina Bogensperger,Stefan M Brunner,Benno Cardini,Philipp Dutkowski,Hasan Eker,Sofia Ferreira-Gonzalez,Stuart J Forbes,Peter J Friend,Yiliam Fundora,Henrik Junger,Felix J Krendl,Paulo N Martins,Vincent E de Meijer,Rupert Oberhuber,Gabriel C Oniscu,Damiano Patrono,Robert J Porte,Thomas Resch,Hatem Sadik,Andrea Schlegel,Nicola De Stefano,Mathias Vidgren,Christopher J E Watson,Annemarie Weißenbacher,Stefan Schneeberger

引用次数: 0

Abdominal aortic aneurysm screening: current effectiveness and future perspectives. 腹主动脉瘤筛查：当前有效性和未来展望。

IF 9.6 1区医学

British Journal of Surgery Pub Date : 2025-04-30 DOI: 10.1093/bjs/znaf094

Jonothan J Earnshaw,Sophie Mitra,Harriet Strachan,Philip Gardner,

引用次数: 0

Negative pressure wound therapy for surgical wounds healing by secondary intention is not cost-effective. 负压创面治疗对外科创面的二次创面愈合不具有成本效益。

IF 9.6 1区医学

British Journal of Surgery Pub Date : 2025-04-30 DOI: 10.1093/bjs/znaf077

Pedro Saramago,Athanasios Gkekas,Catherine E Arundel,Ian C Chetter,

{"title":"Negative pressure wound therapy for surgical wounds healing by secondary intention is not cost-effective.","authors":"Pedro Saramago,Athanasios Gkekas,Catherine E Arundel,Ian C Chetter,","doi":"10.1093/bjs/znaf077","DOIUrl":"https://doi.org/10.1093/bjs/znaf077","url":null,"abstract":"BACKGROUNDNegative pressure wound therapy (NPWT) has been used in clinical practice for surgical wounds healing by secondary intention (SWHSI), despite limited evidence regarding its clinical effectiveness and cost-effectiveness. The aim of this study was to evaluate the cost-effectiveness of NPWT for SWHSI, compared with standard dressings, from the perspective of the UK healthcare system.METHODSAn economic model was used to extrapolate the effectiveness results of a meta-analysis over a patient's lifetime and estimate the costs and outcomes (quality-adjusted life-years (QALYs)) of NPWT and standard dressings. The probability of NPWT being cost-effective was estimated, with extensive scenario analyses conducted to evaluate the robustness of results and the degree of uncertainty.RESULTSOn average, NPWT was associated with higher costs and marginally higher QALYs than standard dressings. The cost difference was mainly driven by the additional intervention costs associated with NPWT. The estimated probability of NPWT being cost-effective was <30%. There was considerable uncertainty in the findings, driven largely by uncertainty in the estimated pooled relative effect from the meta-analysis. Results were robust to different scenario analyses.CONCLUSIONNo evidence was found demonstrating that NPWT was a cost-effective alternative to standard dressings for SWHSI.","PeriodicalId":136,"journal":{"name":"British Journal of Surgery","volume":"100 1","pages":""},"PeriodicalIF":9.6,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143914869","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}

引用次数: 0

Optimizing ward rounds: systematic review and meta-analysis of interventions to enhance patient safety. 优化查房：加强患者安全的干预措施的系统回顾和荟萃分析。

IF 8.6 1区医学

British Journal of Surgery Pub Date : 2025-03-28 DOI: 10.1093/bjs/znaf041

Ellie C Treloar, Jesse D Ey, Matheesha Herath, Nicholas P R Edwardes, Suzanne Edwards, Martin H Bruening, Guy J Maddern

{"title":"Optimizing ward rounds: systematic review and meta-analysis of interventions to enhance patient safety.","authors":"Ellie C Treloar, Jesse D Ey, Matheesha Herath, Nicholas P R Edwardes, Suzanne Edwards, Martin H Bruening, Guy J Maddern","doi":"10.1093/bjs/znaf041","DOIUrl":"https://doi.org/10.1093/bjs/znaf041","url":null,"abstract":"Background: Poor quality ward rounds contribute to a large proportion of patient complications, delayed discharge, and increased hospital cost. This systematic review investigated all interventions aiming to improve patient and process-based outcomes in ward rounds.Methods: This systematic review was prospectively registered in PROSPERO, the international prospective register of systematic reviews (CRD42023394325). MEDLINE, Embase, Emcare, and PsycInfo were searched for studies with interventions aiming to improve ward round processes or patient outcomes in hospital settings. Studies were excluded if there was no baseline comparator or they were not in the ward round setting. Interventions were coded as checklist interventions (that is electronic or paper-based pro formas, templates, and checklists), structure interventions (that is defined rules or protocol to guide or standardize conduct), or other interventions. Outcomes were assessed via meta-analyses using the I2 statistic, Cochran's Q P value, and random-effects models. Risk of bias was assessed using the Cochrane Risk of Bias 2 tool for RCTs and the Newcastle-Ottawa scale for non-randomized studies.Results: This review included 84 studies, from 18 countries, in 23 specialties, involving 43 570 patients. Checklist interventions significantly reduced ICU length of stay, improved overall documentation, and did not increase ward round duration. Structure interventions did not increase the time spent per patient or impact 30-day readmission rates or patient length of stay.Conclusion: This is the first systematic review with meta-analyses synthesizing the evidence of all ward round interventions targeted at improving patient and process outcomes. Results from this review should be used to inform guidelines for the 'ideal ward round'.","PeriodicalId":136,"journal":{"name":"British Journal of Surgery","volume":"112 4","pages":""},"PeriodicalIF":8.6,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143810271","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}

引用次数: 0