British Journal of Surgery最新文献

{"title":"Prevalence and severity of pain, anxiety, stress, and sleep disturbances among surgical patients: a nationwide single-day multicentre flash mob study.","authors":"Jetske M Stoop,Roos Geensen,Sophie C Adam,Kayleigh A M van Dam,Els van Dessel,Annemarie Dolmans-Zwartjes,Margot Heijmans,Audrey C H M Jongen,Mirjam Kaijser,Chantal A Ten Kate,Joanna Luttikhold,Flores M Metz,Laura van Zeggeren, ,Johannes Jeekel,Markus Klimek","doi":"10.1093/bjs/znaf124","DOIUrl":"https://doi.org/10.1093/bjs/znaf124","url":null,"abstract":"BACKGROUNDPatient-reported outcomes (PROs) are subjective health indicators including pain, anxiety, stress, and sleep disturbances. Despite their frequent occurrence in the perioperative period and potentially severe consequences for postoperative recovery (for example prolonged length of hospital stay, cardiovascular events, development of chronic pain), these are not acknowledged as complications and their exact prevalence remains unclear. This study aims to assess the prevalence and severity of pre- and postoperative pain, anxiety, stress, and sleep disturbances among surgical patients.METHODSA nationwide single-day multicentre cross-sectional flash mob study was conducted in 29 Dutch hospitals. Adult surgical patients with an expected hospital stay of at least one night were included. Patients admitted for neurosurgery, cardiothoracic surgery, or orthopaedic surgery were excluded. Primary outcomes were self-reported pain, anxiety, stress, and sleep disturbances, as assessed with the Numeric Rating Scale, Visual Analogue Scale for Anxiety, Perceived Stress Scale, and the adapted Patient-Reported Outcome Measurement Information System respectively.RESULTSOf the 1077 eligible patients, 733 (68%) patients (mean age of 64 ± 15.9 s.d. years, 51.8% male) completed participation. Moderate to severe pain was prevalent in 509 patients (69.7%) and occurred most frequently post-surgery. Anxiety occurred in 278 patients (38.1%) and was more prevalent preoperatively. Moderate to severe stress was reported by 272 patients (37.8%) with similar findings pre- and post-surgery. Sleep disturbances were prevalent in 440 patients (64.1%). Pain and anxiety were more severe in females. Sleep disturbances were more severe in patients with lower socioeconomic status.CONCLUSIONPain, anxiety, stress, and sleep disturbances are highly frequent complications among surgical patients in Dutch hospitals. Considering the prevalence and severity, we suggest implementing these relevant additional measures for PROs as indicators for routine postoperative evaluation to facilitate their management.","PeriodicalId":136,"journal":{"name":"British Journal of Surgery","volume":"9 1","pages":""},"PeriodicalIF":9.6,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144645943","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: Outcomes of elective open surgical repair or fenestrated endovascular aneurysm repair for juxtarenal abdominal aortic aneurysms in Sweden.","authors":"","doi":"10.1093/bjs/znaf167","DOIUrl":"10.1093/bjs/znaf167","url":null,"abstract":"","PeriodicalId":136,"journal":{"name":"British Journal of Surgery","volume":"112 7","pages":""},"PeriodicalIF":8.8,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12305533/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144726194","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":"Birth rates after laparoscopic and open ileal pouch-anal anastomosis for ulcerative colitis: a nationwide population-based cohort study.","authors":"Anders Mark-Christensen,Anthony Charles Ebert,Kirstine Kirkegaard,Søren Laurberg,Gry Poulsen,Tine Jess,Mette Julsgaard","doi":"10.1093/bjs/znaf136","DOIUrl":"https://doi.org/10.1093/bjs/znaf136","url":null,"abstract":"","PeriodicalId":136,"journal":{"name":"British Journal of Surgery","volume":"81 1","pages":""},"PeriodicalIF":9.6,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144603975","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":"Early-onset gastrointestinal cancers: comprehensive review and future directions.","authors":"Sara K Char,Catherine A O'Connor,Kimmie Ng","doi":"10.1093/bjs/znaf102","DOIUrl":"https://doi.org/10.1093/bjs/znaf102","url":null,"abstract":"BACKGROUNDThe incidence of early-onset (EO) gastrointestinal (GI) cancers-commonly defined as being diagnosed in patients <50 years of age-is rising at an alarming rate globally. The rising incidence demonstrates a birth cohort effect, implicating environmental factors, such as diet and lifestyle; however, the drivers behind this trend are not yet known.METHODSA comprehensive narrative review of the literature was conducted, focusing on EO colorectal, oesophagogastric, and pancreatic cancers. Additionally, the literature on less common EO GI cancers, including appendiceal, biliary, and neuroendocrine tumours, was reviewed. Epidemiological trends, risk factors, clinical and molecular characteristics, germline and somatic genetic features, and outcomes across these diseases were examined.RESULTSEO GI cancers have demonstrated a consistent rise in incidence, which disproportionally affects black, Hispanic, and indigenous populations and women. Though germline pathogenic variants are more common in EO GI cancers compared with average-onset GI cancers, most cases occur sporadically. Modifiable risk factors associated with an increased risk of EO GI cancers include obesity, a Western-pattern diet, non-alcoholic fatty liver disease, smoking, and alcohol use, among others. Across GI cancers, younger patients frequently present with more aggressive disease features and receive more intensive treatment compared with older patients. Survival outcomes are inconsistent across studies.CONCLUSIONEO GI cancers represent clinically distinct disease entities that are associated with unique challenges in screening, management, and survivorship. A better understanding of underlying aetiologies, optimized screening strategies, and improved survivorship support are necessary. Meeting the needs of this growing patient population will require a multidisciplinary, equity-based approach in both clinical care and research.","PeriodicalId":136,"journal":{"name":"British Journal of Surgery","volume":"21 1","pages":""},"PeriodicalIF":9.6,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144578720","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":"Automated surgical phase recognition for robotic pancreatoduodenectomy using artificial intelligence.","authors":"Koichi Tomita, Masashi Takeuchi, Jessica E Maxwell, Rebecca A Snyder, Michael P Kim, Hop S Tran Cao, Ching-Wei D Tzeng, Jeffrey E Lee, Matthew H G Katz, Naruhiko Ikoma","doi":"10.1093/bjs/znaf160","DOIUrl":"10.1093/bjs/znaf160","url":null,"abstract":"","PeriodicalId":136,"journal":{"name":"British Journal of Surgery","volume":"112 7","pages":""},"PeriodicalIF":8.8,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144726192","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":"Information standards for innovative surgery: what patients need to know.","authors":"Christin Hoffmann,Daisy Elliott,Leila Rooshenas,Cynthia Ochieng,Barry Main,Pete Wheatstone,Samuel Lawday,Abigail Vallance,Jane M Blazeby,Angus G K McNair, ","doi":"10.1093/bjs/znaf140","DOIUrl":"https://doi.org/10.1093/bjs/znaf140","url":null,"abstract":"BACKGROUNDThere are repeated and ongoing failures in shared decision-making and informed consent for innovative surgical procedures. Governments and regulatory bodies internationally recommend establishing information standards to support safe and transparent surgical innovation. The aim of this study was to develop a core information set (CIS) for surgical innovation.METHODSThis was a mixed-method study in three phases: a provisional CIS was generated from multiple data sources (interviews with patients/professionals (44), recorded consultations (34), policy documents (58), and published studies (213)) using qualitative content analysis; the CIS was refined, with input from key stakeholders (patient representatives, surgeon innovators, anaesthetists, lawyers, ethicists, medical directors, academic experts, and regulatory representatives) using a modified nominal group technique; and the CIS was finalized through public consultation.RESULTSThe final CIS comprised seven themes that included: what is 'new' about the procedure; potential conflicts of interest; reasons for the innovation (including why the innovation is believed to be appropriate for the patient); treatment alternatives; unknowns (including uncertain safety/efficacy and that the procedure may be abandoned/modified); expertise with the innovation; and governance, oversight, and accountability (including how safety will be monitored and recompense if anything goes wrong). Two themes require follow-up discussions after the procedure.CONCLUSIONA seven-theme CIS for surgical innovation was co-developed, with input from key stakeholders. International implementation of these information standards may support safe and transparent surgical innovation.","PeriodicalId":136,"journal":{"name":"British Journal of Surgery","volume":"12 1","pages":""},"PeriodicalIF":9.6,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144578719","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":"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}