Mishal Javed,Jesse Kigozi,Catherine A Moakes,Gareth R Bate,Jack A Hall,Jon J Deeks,Lisa Kelly,Lewis Meecham,Andrew W Bradbury,Matthew A Popplewell,
{"title":"Plain balloon angioplasty with or without bare-metal stenting versus drug-coated balloon angioplasty with or without bare-metal stenting versus primary drug-eluting stenting in patients requiring femoropopliteal, with or without infrapopliteal, endovascular revascularization for chronic limb-threatening ischaemia: BASIL-3 within-trial health economic analysis.","authors":"Mishal Javed,Jesse Kigozi,Catherine A Moakes,Gareth R Bate,Jack A Hall,Jon J Deeks,Lisa Kelly,Lewis Meecham,Andrew W Bradbury,Matthew A Popplewell, ","doi":"10.1093/bjs/znaf274","DOIUrl":"https://doi.org/10.1093/bjs/znaf274","url":null,"abstract":"BACKGROUNDThe BASIL-3 trial demonstrated that patients with chronic limb-threatening ischaemia secondary to femoropopliteal disease who were randomized to plain balloon angioplasty (PBA) ± bare-metal stenting (BMS), drug-coated balloon angioplasty (DCBA) ± BMS, or drug-eluting stenting (DES) had similar clinical outcomes. Herein, the in-trial health economic analysis is presented.METHODSCost-utility analysis (CUA) and cost-effectiveness analysis (CEA) were conducted from the perspective of the UK National Health Service (NHS) and Personal Social Services Research Unit. Patient-level resource use and health outcome data were collected from the BASIL-3 trial during 2-7 years of follow-up and were utilized to estimate incremental cost-effectiveness ratios expressed as a cost per amputation-free life-year and per quality-adjusted life-year (QALY). EQ-5D-5L was used to generate participant QALYs at baseline and during follow-up.RESULTSIn the CUA, DCBA was associated with slightly lower NHS costs (-£250.71 (95% c.i. -£4630.34 to £3652.10)), but slightly lower QALY gains (-0.007 (95% c.i. -0.116 to 0.097) QALYs) when compared with PBA. When compared with PBA, DES was less costly (-£724.52 (95% c.i. -£4975.04 to £2631.57)) and resulted in an additional 0.048 (95% c.i. -0.060 to 0.148) QALYs.CONCLUSIONIn BASIL-3, the probability of DCBA and of DES being cost-effective at £20 000 per QALY was 52% and 76% respectively. At a higher willingness-to-pay threshold (£30 000 per QALY) DES may be cost-effective and further research is required to explore the economic case.","PeriodicalId":136,"journal":{"name":"British Journal of Surgery","volume":"3 1","pages":""},"PeriodicalIF":9.6,"publicationDate":"2026-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147350520","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}
Seonghye Kim,Kyung-Do Han,Jinhyung Jung,Yun-Mi Song,Jae-Hyun Park,Jong Ho Cho,Dong Wook Shin
{"title":"Retrospective population-based cohort study on the risk of cardiovascular disease among oesophageal cancer survivors.","authors":"Seonghye Kim,Kyung-Do Han,Jinhyung Jung,Yun-Mi Song,Jae-Hyun Park,Jong Ho Cho,Dong Wook Shin","doi":"10.1093/bjs/znaf264","DOIUrl":"https://doi.org/10.1093/bjs/znaf264","url":null,"abstract":"INTRODUCTIONThere is little data on the occurrence of cardiovascular disease (CVD) in oesophageal cancer (OC) survivors. Risk of CVD was investigated as a composite of myocardial infarction (MI), atrial fibrillation (AF), heart failure (HF), and ischaemic stroke (IS), as well as CVD-specific death among OC survivors after surgery.METHODSA population-based retrospective cohort study was performed using the Korean National Health Insurance Service database (2009-2022), including patients who underwent surgery for OC (n = 3996) and 1:3 propensity score-matched non-cancer controls (n = 11 988).RESULTSA total of 3996 OC survivors and 11 988 non-cancer controls were included in this study. Among OC survivors and controls, 492 and 1599 incident CVD cases and 33 and 305 CVD-specific deaths were observed respectively. OC survivors showed a higher risk of CVD (cause-specific hazard ratio (csHR) 1.42, 95% c.i. 1.28 to 1.57) than controls, and patients who underwent chemoradiotherapy plus surgery were at the highest risk. The increased risk was most prominent within the first year after surgery (csHR 3.00, 95% c.i. 2.35 to 3.85), but persisted thereafter (csHR 1.23, 95% c.i. 1.10 to 1.38 at 1-year lag; csHR 1.23, 95% c.i. 1.08 to 1.40 at 3-year lag; csHR 1.34, 95% c.i. 1.14 to 1.57 at 5-year lag). This pattern was evident for MI and AF, but not for HF, IS, or CVD-specific death.DISCUSSIONThere is an increased risk of CVD in OC survivors compared to controls. The risk of CVD varied by the outcome, treatment, and duration after surgery.","PeriodicalId":136,"journal":{"name":"British Journal of Surgery","volume":"13 1","pages":""},"PeriodicalIF":9.6,"publicationDate":"2026-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147350928","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}
Chelsia Gillis,Daniel I McIsaac,Daniel Santa Mina,Stéphanie Chevalier,Gabriele Baldini,Francesco Carli,Celena Scheede-Bergdahl,Linda Edgar,Vanessa Smrk,Leah Avery,Amal Bessissow,Miquel Coca Martinez,Robert Copeland,Susanne Oksbjerg Dalton,Gerad Danjoux,Linda Denehy,Dominique Engel,Chloe Grimmett,Michael P Grocott,Heather L Gill,Sandy Jack,Bente Thoft Jensen,Denny Levett,Graciela Martinez-Palli,Zoe Merchant,John Moore,Nicolò Pecorelli,Ian Randall,Bernhard Riedel,Geoff Schierbeck,Gerrit Slooter,Malcolm West,Julio F Fiore,
{"title":"Standards for reporting research methods, interventions, and Outcomes in Surgical Prehabilitation studies (SOS-Prehab).","authors":"Chelsia Gillis,Daniel I McIsaac,Daniel Santa Mina,Stéphanie Chevalier,Gabriele Baldini,Francesco Carli,Celena Scheede-Bergdahl,Linda Edgar,Vanessa Smrk,Leah Avery,Amal Bessissow,Miquel Coca Martinez,Robert Copeland,Susanne Oksbjerg Dalton,Gerad Danjoux,Linda Denehy,Dominique Engel,Chloe Grimmett,Michael P Grocott,Heather L Gill,Sandy Jack,Bente Thoft Jensen,Denny Levett,Graciela Martinez-Palli,Zoe Merchant,John Moore,Nicolò Pecorelli,Ian Randall,Bernhard Riedel,Geoff Schierbeck,Gerrit Slooter,Malcolm West,Julio F Fiore, ","doi":"10.1093/bjs/znaf302","DOIUrl":"https://doi.org/10.1093/bjs/znaf302","url":null,"abstract":"BACKGROUNDPrehabilitation, a process of building physiological reserve before surgery to improve postoperative outcomes, is a complex, multimodal intervention that requires rigorous evaluation in clinical trials. Incomplete reporting by such trials obscures essential intervention components and delivery contexts, hindering comparability and interpretability. This, in turn, limits clinical implementation and the replication or refinement of interventions by researchers. The aim of this study was to develop a reporting checklist for RCTs of prehabilitation.METHODSA modified two-round Delphi process using the EQUATOR framework with 53 international experts across exercise, nutrition, psychological, and perioperative care disciplines was conducted. An initial checklist of candidate items was adapted from existing reporting standards, contextualized for prehabilitation, and iteratively refined through expert voting. Items rated eight to nine on a nine-point scale by ≥70% of participants in round two were classified as 'essential' and those rated seven were considered 'important'.RESULTSThe final checklist comprised 40 items. Sixteen items were classified as 'essential' and 24 items were classified as 'important' for guiding comprehensive reporting of prehabilitation interventions. These items span key domains including intervention components, delivery methods, adherence, participant characteristics, and outcome measures. High agreement among experts underscores the checklist's relevance and usability.CONCLUSIONAdoption of Standards for reporting research methods, interventions, and Outcomes in Surgical Prehabilitation studies (SOS-Prehab), alongside methodological and outcome-reporting items of CONSORT could improve transparency, completeness, and interpretability of prehabilitation trials. This could enable better reproducibility, robust evidence synthesis, and accelerate translation into clinical practice and policy.","PeriodicalId":136,"journal":{"name":"British Journal of Surgery","volume":"45 1","pages":""},"PeriodicalIF":9.6,"publicationDate":"2026-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147454592","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}
Tara Edwards,Gurinder Rayat,Denny Z H Levett,Malcolm A West
{"title":"Perioperative risk assessment with Cardiopulmonary exercise testing: supporting shared decision making and prehabilitation.","authors":"Tara Edwards,Gurinder Rayat,Denny Z H Levett,Malcolm A West","doi":"10.1093/bjs/znag020","DOIUrl":"https://doi.org/10.1093/bjs/znag020","url":null,"abstract":"","PeriodicalId":136,"journal":{"name":"British Journal of Surgery","volume":"71 1","pages":""},"PeriodicalIF":9.6,"publicationDate":"2026-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147329482","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 mastectomy: the possibility of a scarless future.","authors":"Gordon R Daly,Jennifer L McGarry,Arnold D K Hill","doi":"10.1093/bjs/znag002","DOIUrl":"https://doi.org/10.1093/bjs/znag002","url":null,"abstract":"","PeriodicalId":136,"journal":{"name":"British Journal of Surgery","volume":"32 1","pages":""},"PeriodicalIF":9.6,"publicationDate":"2026-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146021676","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":"Saving the surgeon-scientist: need to build enduring support for surgical science.","authors":"Noémie Villemure-Poliquin,Stephanie Wong,Julie Hallet","doi":"10.1093/bjs/znag003","DOIUrl":"https://doi.org/10.1093/bjs/znag003","url":null,"abstract":"","PeriodicalId":136,"journal":{"name":"British Journal of Surgery","volume":"64 1","pages":""},"PeriodicalIF":9.6,"publicationDate":"2026-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146033618","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}
Julien Hedou,Gwendoline Mendes,Grégoire Bellan,Daniel El Khoury,Franck Verdonk
{"title":"Impact of postoperative complications on cost and length of stay: multicentre prospective clinical study.","authors":"Julien Hedou,Gwendoline Mendes,Grégoire Bellan,Daniel El Khoury,Franck Verdonk","doi":"10.1093/bjs/znaf290","DOIUrl":"https://doi.org/10.1093/bjs/znaf290","url":null,"abstract":"","PeriodicalId":136,"journal":{"name":"British Journal of Surgery","volume":"37 1","pages":""},"PeriodicalIF":9.6,"publicationDate":"2025-12-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145986563","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}
Fiorenzo V Angehrn,Julian Süsstrunk,Romano Schneider,Kaspar Baltzer,Beat P Müller,Johannes Baur,Daniel C Steinemann
{"title":"Robotic versus laparoscopic minimally invasive inguinal hernia repair: randomized clinical trial (the ROGER trial).","authors":"Fiorenzo V Angehrn,Julian Süsstrunk,Romano Schneider,Kaspar Baltzer,Beat P Müller,Johannes Baur,Daniel C Steinemann","doi":"10.1093/bjs/znaf283","DOIUrl":"https://doi.org/10.1093/bjs/znaf283","url":null,"abstract":"BACKGROUNDSuperiority of robotic inguinal hernia repair compared with a laparoscopic minimally invasive approach remains unproven. The aim of this study was to evaluate postoperative pain after laparoscopic totally extraperitoneal repair (TEP) compared with robotic transabdominal preperitoneal repair (rTAPP).METHODSThis was a prospective, patient- and investigator-blinded, two-group, single-centre RCT conducted at a tertiary Swiss healthcare institution including 182 patients undergoing elective primary inguinal hernia repair. Patients were randomized 1 : 1 and stratified according to BMI and unilateral or bilateral hernia to either TEP or rTAPP. Surgery took place between March 2022 and November 2024. The primary endpoint was postoperative pain while coughing 24 h after surgery. Surgical workload (assessed using the National Aeronautics and Space Administration (NASA) Task Load Index (TLX)) was also recorded.RESULTSIn total, 91 patients (93% male, mean(s.d.) age of 56.8(15.2) years, mean(s.d.) BMI of 24.8(3) kg/m2, and 22% with bilateral hernias) were randomized to TEP and 91 patients (95% male, mean(s.d.) age of 55.1(14.5) years, mean(s.d.) BMI of 24.6(2.9) kg/m2, and 21% with bilateral hernias) were randomized to rTAPP. Primary outcome data were available for 90 TEP patients and 88 rTAPP patients. The median postoperative pain while coughing on a numeric rating scale 24 h after surgery was 5 (interquartile range (i.q.r.) 2-7) after TEP and 4 (i.q.r. 2-7) after rTAPP (P = 0.431, Cohen's d = 0.12). The mean(s.d.) operating time for unilateral hernias was 64.2(19.2) min for TEP and 80.3(20.9) min for rTAPP (P < 0.001). Ten (11%) postoperative complications occured after TEP and nine (10%) after rTAPP (P > 0.999). The mean(s.d.) NASA raw TLX score was 34.0(17.2) after TEP and 18.4(10.7) after rTAPP (P < 0.001).CONCLUSIONrTAPP demonstrated no superiority over TEP regarding postoperative pain and complication rates. rTAPP was associated with a reduced surgeon workload at the expense of a longer operating time.REGISTRATION NUMBERNCT05216276 (http://www.clinicaltrials.gov).","PeriodicalId":136,"journal":{"name":"British Journal of Surgery","volume":"28 1","pages":""},"PeriodicalIF":9.6,"publicationDate":"2025-12-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145937839","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}