British Journal of Surgery最新文献

{"title":"FUT2 and FUT3-specific normalization of DUPAN-2 and carbohydrate antigen 19-9 in preoperative therapy for pancreatic cancer: multicentre retrospective study (GEMINI-PC-01).","authors":"Haruyoshi Tanaka, Ayano Sakai, Masaya Suenaga, Masamichi Hayashi, Tomohisa Otsu, Nobuhiko Nakagawa, Keisuke Kurimoto, Mina Fukasawa, Kazuto Shibuya, Nobuyuki Watanabe, Masaki Sunagawa, Junpei Yamaguchi, Takashi Mizuno, Toshio Kokuryo, Hideki Takami, Tomoki Ebata, Tsutomu Fujii, Yasuhiro Kodera","doi":"10.1093/bjs/znaf049","DOIUrl":"https://doi.org/10.1093/bjs/znaf049","url":null,"abstract":"","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":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12037208/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143955957","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":"Total robotic inter-sphincteric dissection with transanal transection and single stapled anastomosis-a video vignette.","authors":"Chee Hoe Koo,María Sánchez-Rodríguez,Vincent Assenat,Marc-Oliver Francois,Patricia Tejedor,Quentin Denost","doi":"10.1093/bjs/znae308","DOIUrl":"https://doi.org/10.1093/bjs/znae308","url":null,"abstract":"","PeriodicalId":136,"journal":{"name":"British Journal of Surgery","volume":"197 1","pages":""},"PeriodicalIF":9.6,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143819371","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":"Total pelvic exenteration with distal sacrectomy following local recurrence of rectal cancer.","authors":"Maria Jose Gomez-Jurado, Jorge Sancho-Muriel, Filotico Marcello, Hanna Cholewa, Eduardo Álvarez-Sarrado, Matteo Frasson, Blas Flor-Lorente","doi":"10.1093/bjs/znae320","DOIUrl":"https://doi.org/10.1093/bjs/znae320","url":null,"abstract":"","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":"143957655","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":"Cost-effectiveness of immediate versus postponed intervention for infected necrotizing pancreatitis: planned secondary analysis of the POINTER trial.","authors":"Michiel F G Francken, Lotte Boxhoorn, Sven M van Dijk, Janneke van Grinsven, Robert C Verdonk, Marja A Boermeester, Thomas L Bollen, Stefan A W Bouwense, Marco J Bruno, Vincent C Cappendijk, Peter van Duijvendijk, Casper H J van Eijck, Paul Fockens, Harry van Goor, Muhammed Hadithi, Nora D L Hallensleben, Jan Willem Haveman, Maarten A J M Jacobs, Jeroen M Jansen, Marnix P M Kop, Krijn P van Lienden, Eric R Manusama, J Sven D Mieog, I Quintus Molenaar, Vincent B Nieuwenhuijs, Alexander C Poen, Jan-Werner Poley, Marcel van de Poll, Rutger Quispel, Tessa E H Römkens, Matthijs P Schwartz, Tom C Seerden, Martijn W J Stommel, Jan Willem A Straathof, Hester C Timmerhuis, Niels G Venneman, Rogier P Voermans, Wim van de Vrie, Hjalmar C van Santvoort, Marc G Besselink, Marcel G W Dijkgraaf","doi":"10.1093/bjs/znaf071","DOIUrl":"https://doi.org/10.1093/bjs/znaf071","url":null,"abstract":"","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":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12022604/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143952178","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":"Surgery for chronic pancreatitis across Europe (ESCOPA): prospective multicentre study.","authors":"Charlotte L van Veldhuisen, Charlotte A Leseman, Fleur E M De Rijk, Joana Marques-Antunes, Fabio Ausania, Orlin Belyaev, Frederik Berrevoet, Marja A Boermeester, Ugo Boggi, Stefan A Bouwense, Marco J Bruno, Olivier R Busch, Kevin C Conlon, Safi Dokmak, Massimo Falconi, Poya Ghorbani, Filip Gryspeerdt, Roel Haen, Arturan Ibrahimli, Jakob R Izbicki, Christina Krikke, Arto Kokkola, Lancelot Marique, J Sven D Mieog, Gennaro Nappo, Janis Pavulans, Haralds Plaudis, Geert Roeyen, Pasquale Scognamiglio, Domenico Tamburrino, Tore Tholfsen, Marie Toschka, Faik G Uzunoglu, Susan van Dieren, Casper H J Van Eijck, Jeanin E van Hooft, Hjalmar C van Santvoort, Robert C Verdonk, Rogier P Voermans, Anne Waage, Marc G Besselink","doi":"10.1093/bjs/znaf068","DOIUrl":"10.1093/bjs/znaf068","url":null,"abstract":"<p><strong>Background: </strong>Randomized trials have demonstrated the superiority of surgery over endoscopy in patients with symptomatic chronic pancreatitis. However, large international studies quantifying the impact of surgery on chronic pancreatitis are lacking. The aim of this study was to evaluate current practice across Europe regarding indications, surgical techniques, and outcomes of surgery for chronic pancreatitis.</p><p><strong>Methods: </strong>A prospective multicentre study of consecutive patients undergoing surgery for symptomatic chronic pancreatitis from 22 centres in 13 countries from 1 June 2021 to 30 November 2022 was conducted. The outcome of interest in patients with pain as an indication was the Izbicki pain score at 6-month follow-up, with complete pain relief defined as an Izbicki pain score ≤10 and partial pain relief defined as an Izbicki pain score >10, but with a >50% decrease compared with the baseline score. Quality of life was assessed using Pancreatitis Quality of Life Instrument (PANQOLI) and 12-Item Short-Form (SF-12) surveys. Predictors of pain relief were analysed using multivariable analysis.</p><p><strong>Results: </strong>Overall, 207 patients underwent surgery (24.6% underwent surgical drainage procedures, 29.5% underwent duodenum-preserving head resections, and 45.9% underwent formal pancreatic resections). Before surgery, 48.8% used opioids and 51.2% had undergone prior endoscopic treatment. Major morbidity occurred in 14.0% and the 90-day mortality rate was 1.4%. Among 113 patients operated on for pain, the median Izbicki pain score decreased from 61.3 to 19.0 at 6 months (P < 0.001). Pain relief was achieved in 72.6% (43 patients reported complete pain relief and 39 patients reported partial pain relief). PANQOLI and SF-12 Physical Component Summary scores improved significantly (P < 0.001). Longer symptom duration (OR 0.95 (95% c.i. 0.90 to 1.00), P = 0.045) and use of opioids before surgery (OR 3.16 (95% c.i. 1.04 to 9.64), P = 0.043) predicted less pain relief.</p><p><strong>Conclusion: </strong>Surgery for chronic pancreatitis across Europe was performed with low morbidity. Patients reported good pain relief and improvements in quality-of-life scores. Multidisciplinary consultation is recommended for all patients with chronic pancreatitis before undergoing any intervention.</p>","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":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12038157/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143951918","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":"Adjuvant hyperthermic intraperitoneal chemotherapy in patients with colon cancer at high risk of peritoneal metastases: individual patient data meta-analysis.","authors":"Julie J M Hamm, Rudolf van den Berg, Eleni-Rosalina Andrinopoulou, E Sophie Zwanenburg, Gijsbert D Musters, Pieter J Tanis, Alvaro Arjona-Sanchez","doi":"10.1093/bjs/znaf076","DOIUrl":"https://doi.org/10.1093/bjs/znaf076","url":null,"abstract":"<p><strong>Background: </strong>About a quarter of patients with locally advanced colon cancer (pT4) develop locoregional recurrence, including peritoneal metastases. The aim of this individual patient data meta-analysis (IPDMA) was to evaluate the efficacy of adjuvant hyperthermic intraperitoneal chemotherapy (HIPEC) with regard to reducing the locoregional recurrence rate in the overall population and high-risk subgroups of patients with locally advanced colon cancer.</p><p><strong>Methods: </strong>A systematic literature search was conducted in July 2024 to identify RCTs on adjuvant HIPEC in addition to routine adjuvant systemic chemotherapy in locally advanced colon carcinoma. An IPDMA was performed, with the locoregional recurrence rate as the primary endpoint and disease-free survival (DFS) and overall survival (OS) as secondary endpoints.</p><p><strong>Results: </strong>The search identified two trials (COLOPEC and HIPECT4). Individual patient data were pooled for 386 patients, of whom 189 patients received adjuvant HIPEC and 197 patients constituted the control group. The median follow-up was 36 (interquartile range 32-60) months. A modified intention-to-treat analysis showed a 36-month locoregional recurrence rate of 16.0% for HIPEC patients and 21.2% for control patients (P = 0.295). Predefined subgroup analyses revealed a significant reduction in locoregional recurrence after HIPEC in patients with right-sided tumours (HR 0.56 (95% c.i. 0.48 to 0.67)) (P < 0.001). No significant differences in survival were found for the overall study population; low event rates in subgroups did not allow for survival analyses.</p><p><strong>Conclusion: </strong>Adjuvant HIPEC significantly reduced the locoregional recurrence rate in right-sided locally advanced colon cancer, but not in the overall study population. Definitive conclusions on DFS and OS require longer follow-up.</p>","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":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12037274/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143958982","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":"National implementation of Watch-and-Wait in patients with rectal cancer.","authors":"Barbara M Geubels, Brechtje A Grotenhuis, Aart-Jan van den Esschert, Doenja M J Lambregts, Monique Maas, Corrie A M Marijnen, Regina G H Beets-Tan, Geerard L Beets","doi":"10.1093/bjs/znaf040","DOIUrl":"10.1093/bjs/znaf040","url":null,"abstract":"<p><strong>Introduction: </strong>Most reports on the outcome of Watch-and-Wait (W&W) in rectal cancer come from expert centres. This study reports on a broad implementation in the Netherlands.</p><p><strong>Material and methods: </strong>The process of W&W implementation is described and the outcome of patients in a W&W registry between 2004 and 2022 analysed (regrowth, metastases, survival, and organ preservation). Three equally sized chronological cohorts were compared to capture any differences during implementation over time.</p><p><strong>Results: </strong>W&W was gradually implemented in 18 high-volume hospitals coordinated by a single expert centre. One thousand and eighty patients with a clinical good response after (chemo)radiotherapy were included, with a median follow-up of 42 months (95% c.i. 40 to 44). At first response evaluation, 45% had a clinical complete response (cCR) and 55% near-complete reponse (nCR). In patients with nCR, 75% eventually achieved cCR, 14% underwent local excision, 2% received additional contact X-ray brachytherapy, and 10% underwent total mesorectal excision (TME) for persistent residual disease. Three-year actuarial local regrowth incidence was 23%. Three-year organ preservation rate was 76%. The 3-year distant metastases rate and overall survival were 10% and 97%. There were no significant differences in 3-year local regrowth or distant metastases between the three consecutive cohorts. In the two more recent cohorts more patients underwent TME for residual disease (13% versus 3%), likely due to a more liberal inclusion of patients with nCR.</p><p><strong>Conclusion: </strong>The results of W&W in rectal cancer patients in high-volume hospitals mirror those of expert centres.</p>","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":"143771070","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":"Preoperative management and resectability criteria in perihilar cholangiocarcinoma.","authors":"Christian Sturesson,Kjetil Soreide","doi":"10.1093/bjs/znae329","DOIUrl":"https://doi.org/10.1093/bjs/znae329","url":null,"abstract":"","PeriodicalId":136,"journal":{"name":"British Journal of Surgery","volume":"183 1","pages":""},"PeriodicalIF":9.6,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143822672","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":"Robotic right hemicolectomy with D3 lymphadenectomy using the Hugo™ RAS system.","authors":"Juan-Manuel Romero-Marcos, Carlota Cuenca-Gómez, Jaime-Gerardo Sampson-Dávila, Sandra González-Abós, Juan Altet-Torné, Julia Landaluce-Carrilero, Salvadora Delgado-Rivilla","doi":"10.1093/bjs/znaf063","DOIUrl":"https://doi.org/10.1093/bjs/znaf063","url":null,"abstract":"","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":"143762683","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":"Tumour burden predicts outcomes after curative resection of multifocal intrahepatic cholangiocarcinoma.","authors":"Jun Kawashima, Miho Akabane, Mujtaba Khalil, Selamawit Woldesenbet, Yutaka Endo, Kota Sahara, François Cauchy, Federico Aucejo, Hugo P Marques, Rita Lopes, Andreia Rodriguea, Tom Hugh, Feng Shen, Shishir K Maithel, Bas Groot Koerkamp, Irinel Popescu, Minoru Kitago, Matthew J Weiss, Guillaume Martel, Carlo Pulitano, Luca Aldrighetti, George Poultsides, Andrea Ruzzenente, Todd W Bauer, Ana Gleisner, Itaru Endo, Timothy M Pawlik","doi":"10.1093/bjs/znaf050","DOIUrl":"10.1093/bjs/znaf050","url":null,"abstract":"<p><strong>Background: </strong>Liver resection for multifocal intrahepatic cholangiocarcinoma (ICC) remains controversial due to a poor prognosis, driven by aggressive tumour biology. The aim of this study was to stratify multifocal ICC patients to identify those who are likely to benefit from resection.</p><p><strong>Methods: </strong>Patients who underwent upfront curative-intent hepatectomy for ICC were identified from an international multi-institutional database. Among patients with multifocal tumours, overall survival (OS) was analysed using multivariable Cox regression to identify prognostic factors. Tumour burden score (TBS) was used for stratification of multifocal ICC, with the optimal cut-off determined via restricted cubic spline (RCS) analysis.</p><p><strong>Results: </strong>Of 1502 patients, 208 (13.8%) had multifocal ICC. Among them, independent predictors of prognosis included TBS (HR 1.09), ASA grade >II (HR 1.48), cirrhosis (HR 2.05), periductal infiltrating/mass forming plus periductal infiltrating morphological subtype (HR 1.58), and receipt of adjuvant chemotherapy (HR 0.59). RCS analysis identified a TBS of 7.0 as the optimal cut-off. Notably, multifocal ICC patients with a low TBS (<7.0) demonstrated comparable 3-year OS to solitary ICC patients with AJCC stage II/III. In contrast, patients with a high TBS (≥7.0) and multifocal ICC exhibited the worst prognosis (3-year OS: stage I and solitary 67.1%, stage II/III and solitary 43.2%, low TBS and multifocal 43.4%, and high TBS and multifocal 17.8% (P < 0.001)).</p><p><strong>Conclusion: </strong>Whereas patients with high-TBS multifocal ICC had a poor prognosis, individuals with low-TBS multifocal ICC demonstrated survival outcomes comparable to solitary ICC patients. These findings emphasize the importance of stratifying patients by tumour burden to guide surgical decision-making and optimize treatment strategies for multifocal ICC.</p>","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":"143741791","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}