British Journal of Surgery最新文献

{"title":"The changing landscape of multimodal treatment for locally advanced oesophageal and junctional adenocarcinoma.","authors":"Sander J M van Hootegem, Bas P L Wijnhoven","doi":"10.1093/bjs/znaf010","DOIUrl":"https://doi.org/10.1093/bjs/znaf010","url":null,"abstract":"","PeriodicalId":136,"journal":{"name":"British Journal of Surgery","volume":"112 2","pages":""},"PeriodicalIF":8.6,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143363326","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":"Decellularized dermis allograft for the treatment of venous leg ulceration: the DAVE RCT.","authors":"Sarah Onida, Matthew Tan, Valeria Balan, Francine Heatley, Sarrah Peerbux, Layla Bolton-Saghdaoui, Tristan Lane, David Epstein, Manjit Gohel, John Norrie, Robert Lee, Richard Lomas, Alun H Davies","doi":"10.1093/bjs/znae330","DOIUrl":"10.1093/bjs/znae330","url":null,"abstract":"<p><strong>Background: </strong>Venous leg ulcers (VLUs) cause significant impairment to patients' quality of life (QoL) and up to 30% do not heal at 6 months. Decellularized dermis (DCD) allografts have been shown to be effective in improving healing rates of diabetic foot ulcers in RCTs. The DAVE RCT aimed to determine whether DCD is an effective, safe, and cost-effective treatment adjunct for VLUs.</p><p><strong>Methods: </strong>This was a multicentre RCT performed in the UK. Patients with lower limb ulcers ≥18 years with VLU, venous incompetence on duplex ultrasound, an ankle : brachial pressure index ≥ 0.8 and an index VLU present for at least 3 months and ≥2 cm2 in size were included. Patients were randomized to either the intervention (DCD graft and standard of care) or control arm (standard of care alone). The primary outcome was the proportion of patients with a healed index ulcer at 12 weeks.</p><p><strong>Results: </strong>From October 2019 to October 2022, 36 and 35 participants were randomized into the intervention and control arms respectively. Patient characteristics at baseline were similar between groups. Healing was recorded in 5.7% of the intervention group and 15.2% in the control group (OR 0.34, 95% c.i. 0.03 to 2.31). There were no significant differences in the secondary outcomes including the percentage change in ulcer area, time to healing, recurrence rates, and QoL. There were five serious adverse events attributed to DCD application. Early trial termination was advised after the interim data analysis due to a lower-than-expected primary outcome rate (11.3%).</p><p><strong>Conclusions: </strong>Decellularized dermis grafts did not improve healing rates of venous leg ulcers, although the trial was terminated early due to poor healing rates in both the intervention and control arms. Important clinical benefits or harms of decellularized dermis grafts could not be excluded due to the small sample size.</p><p><strong>Trial registration: </strong>ISRCTN 21541209.</p>","PeriodicalId":136,"journal":{"name":"British Journal of Surgery","volume":"112 2","pages":""},"PeriodicalIF":8.6,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11831364/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143439284","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patient-reported outcomes 3 and 18 months after mastectomy and immediate prepectoral implant-based breast reconstruction in the UK Pre-BRA prospective multicentre cohort study.","authors":"Kate L Harvey, Leigh Johnson, Parisa Sinai, Nicola Mills, Paul White, Christopher Holcombe, Shelley Potter","doi":"10.1093/bjs/znaf032","DOIUrl":"10.1093/bjs/znaf032","url":null,"abstract":"<p><strong>Introduction: </strong>Prepectoral techniques are becoming standard of care for implant-based breast reconstruction due to reduced impact on chest wall function and improved patient satisfaction. Evidence to support these benefits, however, is lacking. Here, patient-reported outcomes (PROs) of prepectoral breast reconstruction (PPBR) in the Pre-BRA cohort are reported.</p><p><strong>Methods: </strong>Women undergoing PPBR after mastectomy for breast cancer or risk reduction between July 2019 and December 2020 were recruited. Participants completed the BREAST-Q preoperatively and at 3 and 18 months following surgery together with a single item evaluating overall satisfaction at 18 months. Women completing at least one BREAST-Q scale at any timepoint were eligible for inclusion. Questionnaires were scored according to the developers' instructions and scores compared over time. Exploratory analysis, adjusting for baseline scores was performed to explore factors impacting PROs.</p><p><strong>Results: </strong>In total 338 of 343 (98.5%) women undergoing PPBR at 40 UK centres were included in the analysis. Compared with baseline scores, women reported statistically significant and clinically meaningful decreases in both 'Physical' and 'Sexual well-being' at 3 and 18 months. Adjusting for baseline, at 18 months, those experiencing implant loss or having surgery for malignancy reported lower scores in all BREAST-Q domains. Overall, two-thirds of women (167/251) rated the outcome of their reconstruction as 'excellent/very good', but experiencing major complications, implant loss, and being dissatisfied with wrinkling/rippling in the reconstructed breast were associated with reduced satisfaction.</p><p><strong>Conclusions: </strong>PPBR impacts postoperative physical well-being and PROs are variable. These findings should be discussed with patients to support informed decision-making based on realistic expectations of outcome.</p><p><strong>Study registration: </strong>ISRCTN11898000.</p>","PeriodicalId":136,"journal":{"name":"British Journal of Surgery","volume":"112 2","pages":""},"PeriodicalIF":8.6,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11851068/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143490226","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correction to: Disease-specific survival outcomes for patients after locoregional treatment for ductal carcinoma in situ: observational cohort study.","authors":"","doi":"10.1093/bjs/znaf045","DOIUrl":"10.1093/bjs/znaf045","url":null,"abstract":"","PeriodicalId":136,"journal":{"name":"British Journal of Surgery","volume":"112 2","pages":""},"PeriodicalIF":8.6,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12187505/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143476170","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Paying homage to all our ancestors: an analytical review of the contributions that shaped modern spinal surgery.","authors":"Baptiste Boukebous, Joseph F Baker, Julia Fanchette, Marc Antoine Rousseau","doi":"10.1093/bjs/znaf009","DOIUrl":"https://doi.org/10.1093/bjs/znaf009","url":null,"abstract":"","PeriodicalId":136,"journal":{"name":"British Journal of Surgery","volume":"112 2","pages":""},"PeriodicalIF":8.6,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143655701","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":"Reducing pancreatic fistula after left-sided pancreatectomy-the search continues.","authors":"Dyre Kleive","doi":"10.1093/bjs/znaf033","DOIUrl":"10.1093/bjs/znaf033","url":null,"abstract":"","PeriodicalId":136,"journal":{"name":"British Journal of Surgery","volume":"112 2","pages":""},"PeriodicalIF":8.6,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11851102/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143490229","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk of lymph node metastasis in pT2 rectal cancer: a nationwide retrospective analysis.","authors":"Sander C Albers, Ritchie T J Geitenbeek, Eline G M van Geffen, Tania C Sluckin, Sanne-Marije J A Hazen, Miranda Kusters, Pieter J Tanis, Esther C J Consten, Evelien Dekker, Barbara A J Bastiaansen, Jimme K Wiggers, Roel Hompes","doi":"10.1093/bjs/znaf028","DOIUrl":"https://doi.org/10.1093/bjs/znaf028","url":null,"abstract":"","PeriodicalId":136,"journal":{"name":"British Journal of Surgery","volume":"112 2","pages":""},"PeriodicalIF":8.6,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143466689","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":"Compression hosiery to avoid post-thrombotic syndrome: CHAPS randomized clinical trial.","authors":"Ankur Thapar, Rebecca Lawton, Andrew Bradbury, Nicky Cullum, Manjit Gohel, Robert Horne, Beverley J Hunt, John Norrie, Joseph Shalhoub, Alun H Davies","doi":"10.1093/bjs/znaf018","DOIUrl":"https://doi.org/10.1093/bjs/znaf018","url":null,"abstract":"","PeriodicalId":136,"journal":{"name":"British Journal of Surgery","volume":"112 2","pages":""},"PeriodicalIF":8.6,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143439281","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":"LAsting Symptoms after Oesophageal Resectional Surgery (LASORS): multicentre validation cohort study.","authors":"Heidi Paine, Swathikan Chidambaram, Asif Johar, Nick Maynard, Pernilla Lagergren, Ewen A Griffiths, Paul Behrens, Pritam Singh, Nima Abbassi-Ghadi, Shaun R Preston, Ravinder S Vohra, James Gossage, Tim Underwood, Nick Dai, J Robert O'Neill, Sherif Awad, Borzoueh Mohammadi, Khaled Dawas, Yassar Qureshi, Bilal Alkhaffaf, Rhys Jones, George B Hanna, Sheraz R Markar","doi":"10.1093/bjs/znae319","DOIUrl":"10.1093/bjs/znae319","url":null,"abstract":"<p><strong>Background: </strong>Long-term symptom burden and health-related quality-of-life outcomes after curative oesophageal cancer treatment are poorly understood. Existing tools are cumbersome and do not address the post-treatment population specifically. The aim of this study was to validate the six-symptom LASORS tool for identifying patients after curative oesophageal cancer treatment with poor health-related quality of life and to assess its clinical utility.</p><p><strong>Methods: </strong>Between 2015 and 2019, patients from 15 UK centres who underwent curative-intent oesophageal cancer treatment, and were disease-free at least 1 year after surgery, were invited to participate in the study and complete LASORS and European Organisation for Research and Treatment of Cancer QLQ-C30 and QLQ-OG25 questionnaires. Receiver operating characteristic curve analysis was used to examine the accuracy of the LASORS tool for identifying patients with poor health-related quality of life.</p><p><strong>Results: </strong>A total of 263 patients completed the questionnaire. Four of the six LASORS symptoms were associated with poor health-related quality of life: reduced energy (OR 2.13 (95% c.i. 1.45 to 3.13)); low mood (OR 1.86 (95% c.i. 1.20 to 2.88)); diarrhoea more than three times a day unrelated to eating (OR 1.48 (95% c.i. 1.06 to 2.07)); and bloating or cramping after eating (OR 1.35 (95% c.i. 1.03 to 1.77)). The LASORS tool showed good diagnostic accuracy with an area under the receiver operating characteristic curve of 0.858 for identifying patients with poor health-related quality of life.</p><p><strong>Conclusion: </strong>The six-symptom LASORS tool generated a reliable model for identification of patients with poor health-related quality of life after curative treatment for oesophageal cancer. This is the first tool of its kind to be prospectively validated in the post-esophagectomy population. Clinical utility lies in identification of patients at risk of poor health-related quality of life, ease of use of the tool, and in planning survivorship services.</p>","PeriodicalId":136,"journal":{"name":"British Journal of Surgery","volume":"112 2","pages":""},"PeriodicalIF":8.6,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11843645/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143466688","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Anterior component separation. Carbonell-Bonafé modified technique.","authors":"Isabel Sierra Fernández, Christian Esteo Verdú, Rafael Sellés Dechent","doi":"10.1093/bjs/znae328","DOIUrl":"https://doi.org/10.1093/bjs/znae328","url":null,"abstract":"","PeriodicalId":136,"journal":{"name":"British Journal of Surgery","volume":"112 2","pages":""},"PeriodicalIF":8.6,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143481807","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}