British Journal of Surgery最新文献

{"title":"Variation in surgery postponement rates in the NHS in England.","authors":"Emma McCone, Chris Snowden, Michael Swart, Tim W R Briggs, William K Gray","doi":"10.1093/bjs/znae280","DOIUrl":"10.1093/bjs/znae280","url":null,"abstract":"<p><strong>Introduction: </strong>Postponement of surgery at preoperative assessment in the days or weeks before the patient is admitted for surgery, as distinct from cancellation on the planned day of surgery, can be devastating for patients and an inefficient use of finite resources. However, postponements are often poorly recorded. The primary aim of this pilot study was to investigate elective surgical postponement rates during or after preoperative assessment across England, and the reasons for postponement for patients on an elective surgical pathway.</p><p><strong>Methods: </strong>A retrospective analysis of clinical audit data from 16 National Health Service (NHS) trusts in England was undertaken. Data were collected during a two-week period in March 2024 on all postponements within a service. The primary outcome of interest was the postponement rate.</p><p><strong>Results: </strong>Some 8000 case notes were reviewed. There were 583 (7.3%) postponements. Postponement rates across trusts varied from 31.9% to 1.0%. Significantly shorter time from referral to preoperative assessment was observed for day-case patients, urgent patients, patients without early screening and patients without a 'to come in' date in place. Of the 342 routine patients, 293 (85.7%) had postponements for medical rather than pathways or process reasons. Half of all routine patients waited over 94 days and a quarter of patients waited 198 days from being added to a patient tracking list to preoperative assessment.</p><p><strong>Conclusions: </strong>Minimizing postponements and improving preoperative assessment efficiency should be part of wider initiatives to streamline perioperative pathways.</p>","PeriodicalId":136,"journal":{"name":"British Journal of Surgery","volume":"111 11","pages":""},"PeriodicalIF":8.6,"publicationDate":"2024-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142613349","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":"Infrapyloric and gastroepiploic lymph node metastasis in right transverse colon cancer (InCLART study): multicentre, prospective, observational study.","authors":"Zheng-Hao Cai, Yin-Cong Guo, Kai Ye, Yi Xiao, Abraham Fingerhut, Wei-Dong Zang, Jun You, Xiao-Hui Du, Lin Fan, De-Qing Wu, En Li, Chun Zhuang, Su Yan, Chang-Qing Jing, Jia-Ming Zhu, Jian Zhang, Xin-Chun Liu, Ai-Wen Wu, Ying-Chi Yang, Feng-Lin Liu, Zheng Lou, Min-Zhe Li, Jun-Jun Ma, Quan Wang, Lu Zang","doi":"10.1093/bjs/znae272","DOIUrl":"https://doi.org/10.1093/bjs/znae272","url":null,"abstract":"","PeriodicalId":136,"journal":{"name":"British Journal of Surgery","volume":"111 11","pages":""},"PeriodicalIF":8.6,"publicationDate":"2024-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142562613","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":"Assessing diversity among consultant paediatric surgeons in the UK: open science, education, and academic achievement.","authors":"Marianna Evangelia Kapsetaki","doi":"10.1093/bjs/znae261","DOIUrl":"https://doi.org/10.1093/bjs/znae261","url":null,"abstract":"","PeriodicalId":136,"journal":{"name":"British Journal of Surgery","volume":"111 11","pages":""},"PeriodicalIF":8.6,"publicationDate":"2024-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142542321","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":"Achievements and challenges after a century of parathyroid surgery.","authors":"Radu Mihai","doi":"10.1093/bjs/znae268","DOIUrl":"https://doi.org/10.1093/bjs/znae268","url":null,"abstract":"","PeriodicalId":136,"journal":{"name":"British Journal of Surgery","volume":"111 11","pages":""},"PeriodicalIF":8.6,"publicationDate":"2024-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142643522","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":"Prevention of surgical-site infections: paradoxes in surgical dogma and sustainability.","authors":"Hilary Humphreys, Arnold D K Hill","doi":"10.1093/bjs/znae285","DOIUrl":"10.1093/bjs/znae285","url":null,"abstract":"","PeriodicalId":136,"journal":{"name":"British Journal of Surgery","volume":"111 11","pages":""},"PeriodicalIF":8.6,"publicationDate":"2024-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142589563","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":"The role of yellow enhancement in laparoscopy.","authors":"Reuben C Suherman, Harpreet Singh, Darius K L Aw, Cheryl X Z Chong, Jia-Lin Ng, Sharmini Sivarajah, Winson J Tan, Fung-Joon Foo, Jasmine Ladlad, Nathanelle Khoo, Cheryl H M Tan, Frederick H Koh","doi":"10.1093/bjs/znae288","DOIUrl":"10.1093/bjs/znae288","url":null,"abstract":"","PeriodicalId":136,"journal":{"name":"British Journal of Surgery","volume":"111 11","pages":""},"PeriodicalIF":8.6,"publicationDate":"2024-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142666495","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":"Combined pedicled and free omentum flaps for chronic lower limb lymphoedema: novel approach with robotic surgery.","authors":"María Sánchez-Rodríguez, Patricia Tejedor, Jose Manuel Asencio, Adnan Alsourani, Álvaro García-Cañal, Yue Chen, Jose María Lasso-Vázquez","doi":"10.1093/bjs/znae276","DOIUrl":"https://doi.org/10.1093/bjs/znae276","url":null,"abstract":"","PeriodicalId":136,"journal":{"name":"British Journal of Surgery","volume":"111 11","pages":""},"PeriodicalIF":8.6,"publicationDate":"2024-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142714780","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":"Can rotational thromboelastometry predict venous thromboembolism in patients with peritoneal metastases?","authors":"Mina Sarofim, Assad Zahid, Ruwanthi Wijayawardana, Nima Ahmadi, David L Morris","doi":"10.1093/bjs/znae301","DOIUrl":"https://doi.org/10.1093/bjs/znae301","url":null,"abstract":"","PeriodicalId":136,"journal":{"name":"British Journal of Surgery","volume":"111 11","pages":""},"PeriodicalIF":8.6,"publicationDate":"2024-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142714767","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":"Chest wall perforator flaps are safe and can decrease mastectomy rates in breast cancer surgery: multicentre cohort study.","authors":"Andreas Karakatsanis, Farid Meybodi, Eirini Pantiora, Elisabeth Elder, Faustine Cabel, Jeremy Hsu, James French, Iliana Aristokleous, Olivia Sjökvist, Daniel Önefäldt, Jaime Navia, Rachel L O'Connell, Jennifer E Rusby, Peter A Barry","doi":"10.1093/bjs/znae266","DOIUrl":"10.1093/bjs/znae266","url":null,"abstract":"<p><strong>Background: </strong>Chest wall perforator flaps are emerging in oncoplastic breast conservation, mostly as an alternative to mastectomy. However, standardization and consensus on patient selection, techniques, and outcomes have not yet been reached. The aim of this international multicentre collaborative study was to explore practice patterns and outcomes in high-volume centres from different countries.</p><p><strong>Methods: </strong>Patients with both pre-invasive and invasive breast cancer treated at the Uppsala University Hospital in Uppsala, Sweden, the Royal Marsden Hospital in London, UK, and the Westmead Breast Cancer Institute in Sydney, Australia, were included in this study. The rationale for offering chest wall perforator flaps and surgical outcomes were prospectively documented.</p><p><strong>Results: </strong>In total, 603 patients were analysed median age of 54 (interquartile range (i.q.r.) 48-63) years, median BMI of 25.0 (i.q.r. 22.5-28.1) kg/m2, median tumour extent of 30 (IQR 19-45) mm, median breast volume of 280 (i.q.r. 216-430) ml, and median calculated resection ratio of 16% (i.q.r. 9%-28%). In 67.7%, the treating surgeon had offered chest wall perforator flaps to avoid mastectomy. The procedure was performed as day surgery in 69.5% of patients, with an overall complication rate of 8.6% and the majority of complications being classified as Clavien-Dindo grade I (5.3% of patients). The re-excision rate was 15.9%, with only 1.5% of patients converting to a mastectomy. There were no flap losses. At a median follow-up of 22 (range 12 to 98) months, rates of local recurrence, distant recurrence, and breast cancer-related mortality were 1.9%, 4.9%, and 1.7% respectively.</p><p><strong>Conclusion: </strong>Chest wall perforator flaps are a useful option to allow more women to avoid mastectomy. In experienced hands, the procedure is safe and should be offered to suitable patients.</p>","PeriodicalId":136,"journal":{"name":"British Journal of Surgery","volume":"111 11","pages":""},"PeriodicalIF":8.6,"publicationDate":"2024-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11529790/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142562611","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":"Surgeon factors and their association with operating room turnover time.","authors":"Kshitij Pandit, Luke Wang, Joel Rosenberg, Nicole Goldhaber, Jill C Buckley, Sonia Ramamoorthy, Kristin L Mekeel, Aditya Bagrodia","doi":"10.1093/bjs/znae273","DOIUrl":"https://doi.org/10.1093/bjs/znae273","url":null,"abstract":"","PeriodicalId":136,"journal":{"name":"British Journal of Surgery","volume":"111 11","pages":""},"PeriodicalIF":8.6,"publicationDate":"2024-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142542322","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}