British Journal of Surgery最新文献

{"title":"Perforated peptic ulcer.","authors":"Gunnar Velde, Warsan Ismail, Kenneth Thorsen","doi":"10.1093/bjs/znae224","DOIUrl":"10.1093/bjs/znae224","url":null,"abstract":"","PeriodicalId":136,"journal":{"name":"British Journal of Surgery","volume":"111 9","pages":""},"PeriodicalIF":8.6,"publicationDate":"2024-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142138753","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":"Assessment and management of necrotizing fasciitis.","authors":"Elizabeth J Jones, Peter J Drew","doi":"10.1093/bjs/znae204","DOIUrl":"https://doi.org/10.1093/bjs/znae204","url":null,"abstract":"","PeriodicalId":136,"journal":{"name":"British Journal of Surgery","volume":"111 9","pages":""},"PeriodicalIF":8.6,"publicationDate":"2024-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142277511","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":"Disease extent according to baseline [18F]fluorodeoxyglucose PET/CT and molecular subtype: prediction of axillary treatment response after neoadjuvant systemic therapy for breast cancer.","authors":"Florien J G van Amstel, Cornelis M de Mooij, Janine M Simons, Cristina Mitea, Paul J van Diest, Patty J Nelemans, Carmen C van der Pol, Ernest J T Luiten, Linetta B Koppert, Marjolein L Smidt, Thiemo J A van Nijnatten","doi":"10.1093/bjs/znae203","DOIUrl":"10.1093/bjs/znae203","url":null,"abstract":"<p><strong>Background: </strong>Axillary disease extent according to baseline [18F]fluorodeoxyglucose PET/CT combined with pathological axillary treatment response has been proposed to guide de-escalation of axillary treatment for clinically node-positive breast cancer patients treated with neoadjuvant systemic therapy. The aim of this study was to assess whether axillary disease extent according to baseline [18F]fluorodeoxyglucose PET/CT and breast cancer molecular subtype are predictors of axillary pCR.</p><p><strong>Methods: </strong>This study included clinically node-positive patients treated with neoadjuvant systemic therapy in the prospective Radioactive Iodine Seed placement in the Axilla with Sentinel lymph node biopsy ('RISAS') trial (NCT02800317) with baseline [18F]fluorodeoxyglucose PET/CT imaging available. The predictive value of axillary disease extent according to baseline [18F]fluorodeoxyglucose PET/CT and breast cancer molecular subtype to estimate axillary pCR was evaluated using logistic regression analysis. Discriminative ability is expressed using ORs with 95% confidence intervals.</p><p><strong>Results: </strong>Overall, 185 patients were included, with an axillary pCR rate of 29.7%. The axillary pCR rate for patients with limited versus advanced baseline axillary disease according to [18F]fluorodeoxyglucose PET/CT was 31.9% versus 26.1% respectively. Axillary disease extent was not a significant predictor of axillary pCR (OR 0.75 (95% c.i. 0.38 to 1.46) (P = 0.404)). There were significant differences in axillary pCR rates between breast cancer molecular subtypes. The lowest probability (7%) was found for hormone receptor+/human epidermal growth factor receptor 2- tumours. Using this category as a reference group, significantly increased ORs of 14.82 for hormone receptor+/human epidermal growth factor receptor 2+ tumours, 40 for hormone receptor-/human epidermal growth factor receptor 2+ tumours, and 6.91 for triple-negative tumours were found (P < 0.001).</p><p><strong>Conclusion: </strong>Molecular subtype is a significant predictor of axillary pCR after neoadjuvant systemic therapy, whereas axillary disease extent according to baseline [18F]fluorodeoxyglucose PET/CT is not.</p>","PeriodicalId":136,"journal":{"name":"British Journal of Surgery","volume":"111 9","pages":""},"PeriodicalIF":8.6,"publicationDate":"2024-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11414043/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142277512","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":"Neoadjuvant 177Lu-DOTATATE for non-functioning pancreatic neuroendocrine tumours (NEOLUPANET): multicentre phase II study.","authors":"Stefano Partelli, Luca Landoni, Mirco Bartolomei, Alessandro Zerbi, Chiara Maria Grana, Ugo Boggi, Giovanni Butturini, Riccardo Casadei, Roberto Salvia, Massimo Falconi","doi":"10.1093/bjs/znae178","DOIUrl":"10.1093/bjs/znae178","url":null,"abstract":"<p><strong>Background: </strong>Resection of non-functioning pancreatic neuroendocrine tumours (NF-PanNETs) is curative in most patients. The potential benefits of neoadjuvant treatments have, however, never been explored. The primary aim of this study was to evaluate the safety of neoadjuvant 177Lu-labelled DOTA0-octreotate (177Lu-DOTATATE) followed by surgery in patients with NF-PanNETs.</p><p><strong>Methods: </strong>NEOLUPANET was a multicentre, single-arm, phase II trial of patients with sporadic, resectable or potentially resectable NF-PanNETs at high-risk of recurrence; those with positive 68Ga-labelled DOTA PET were eligible. All patients were candidates for neoadjuvant 177Lu-DOTATATE followed by surgery. A sample size of 30 patients was calculated to test postoperative complication rates against predefined cut-offs. The primary endpoint was safety, reflected by postoperative morbidity and mortality within 90 days. Secondary endpoints included rate of objective radiological response and quality of life.</p><p><strong>Results: </strong>From March 2020 to February 2023, 31 patients were enrolled, of whom 26 completed 4 cycles of 177Lu-DOTATATE. A partial radiological response was observed in 18 of 31 patients, and 13 patients had stable disease. Disease progression was not observed. Twenty-four R0 resections and 4 R1 resections were performed in 29 patients who underwent surgery. One tumour was unresectable owing to vascular involvement. There was no postoperative death. Postoperative complications occurred in 21 of 29 patients. Severe complications were observed in seven patients. Quality of life remained stable after 177Lu-DOTATATE and decreased after surgery.</p><p><strong>Conclusion: </strong>Neoadjuvant treatment with 177Lu-DOTATATE is safe and effective for patients with NF-PanNETs.</p>","PeriodicalId":136,"journal":{"name":"British Journal of Surgery","volume":"111 9","pages":""},"PeriodicalIF":8.6,"publicationDate":"2024-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11364141/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142102528","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":"Anorectal auto transplantation in swine: an experimental model.","authors":"Juliana B Salem, Daniel R Waisberg, Paola S E Alvarez, Cinthia L Ferreira, Júlia B Guarana, Matheus C Galvao, Anderson C L Costa, Eduardo Pompeu, Jun Araki, Luiz A Carneiro D'albuquerque, Flavio H F Galvao","doi":"10.1093/bjs/znae245","DOIUrl":"https://doi.org/10.1093/bjs/znae245","url":null,"abstract":"","PeriodicalId":136,"journal":{"name":"British Journal of Surgery","volume":"111 9","pages":""},"PeriodicalIF":8.6,"publicationDate":"2024-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142277510","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":"Timing and type of breast reconstruction in SweBRO 3: long-term outcomes.","authors":"Rojda Gümüscü, Fredrik Wärnberg, Jana de Boniface, Malin Sund, Kristina Åhsberg, Emma Hansson, Folke Folkvaljon, Dmytro Unukovych, Maria Mani","doi":"10.1093/bjs/znae240","DOIUrl":"https://doi.org/10.1093/bjs/znae240","url":null,"abstract":"<p><strong>Background: </strong>Breast reconstruction after mastectomy helps women with breast cancer feel better about their bodies and lives. There is debate about the best time and type of reconstruction (immediate versus delayed, and using own tissue versus implants). Long-term studies are rare.</p><p><strong>Aim: </strong>This study looked at long-term results of different breast reconstruction methods and timings in Swedish women who had mastectomies in 2000, 2005 or 2010. It focused on how satisfied the women were with their surgeries and their quality of life.</p><p><strong>Method: </strong>The study included 5853 women from the Swedish National Breast Cancer Registry who had mastectomies in 2000, 2005 or 2010. Of these, 2904 women answered the survey, and 895 had breast reconstruction. Satisfaction and quality of life were measured using two surveys: EORTC QLQ-BRECON23 and BREAST-Q.</p><p><strong>Results: </strong>Of the women who answered the survey, 895 (31%) had breast reconstruction. Of these, 176 (20%) had immediate reconstruction, and 719 (80%) had delayed reconstruction; 58% had implant-based reconstructions, 31% had reconstructions using their own tissue, 2% had both types and 9% did not report the type of reconstruction. There were no major differences in satisfaction between immediate and delayed reconstruction. Women who used their own tissue were more satisfied with their results and breast appearance than those with implants.</p><p><strong>Conclusion: </strong>Autologous reconstruction leads to better satisfaction and outcomes than implants. The timing of reconstruction (immediate versus delayed) was less of an influence on quality of life.</p>","PeriodicalId":136,"journal":{"name":"British Journal of Surgery","volume":"111 9","pages":""},"PeriodicalIF":8.6,"publicationDate":"2024-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11421470/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142337734","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":"Identification of A0 minimum ablative margins for colorectal liver metastases: multicentre, retrospective study using deformable CT registration and artificial intelligence-based autosegmentation.","authors":"Iwan Paolucci, Jessica Albuquerque Marques Silva, Yuan-Mao Lin, Gregor Laimer, Valentina Cignini, Francesca Menchini, Marcio Meira, Alexander Shieh, Caleb O'Connor, Kyle A Jones, Carlo Gazzera, Paolo Fonio, Kristy K Brock, Marco Calandri, Marcos Menezes, Reto Bale, Bruno C Odisio","doi":"10.1093/bjs/znae165","DOIUrl":"10.1093/bjs/znae165","url":null,"abstract":"<p><strong>Background: </strong>Several ablation confirmation software methods for minimum ablative margin assessment have recently been developed to improve local outcomes for patients undergoing thermal ablation of colorectal liver metastases. Previous assessments were limited to single institutions mostly at the place of development. The aim of this study was to validate the previously identified 5 mm minimum ablative margin (A0) using autosegmentation and biomechanical deformable image registration in a multi-institutional setting.</p><p><strong>Methods: </strong>This was a multicentre, retrospective study including patients with colorectal liver metastases undergoing CT- or ultrasound-guided microwave or radiofrequency ablation during 2009-2022, reporting 3-year local disease progression (residual unablated tumour or local tumour progression) rates by minimum ablative margin across all institutions and identifying an intraprocedural contrast-enhanced CT-based minimum ablative margin associated with a 3-year local disease progression rate of less than 1%.</p><p><strong>Results: </strong>A total of 400 ablated colorectal liver metastases (median diameter of 1.5 cm) in 243 patients (145 men; median age of 62 [interquartile range 54-70] years) were evaluated, with a median follow-up of 26 (interquartile range 17-40) months. A total of 119 (48.9%) patients with 186 (46.5%) colorectal liver metastases were from international institutions B, C, and D that were not involved in the software development. Three-year local disease progression rates for 0 mm, >0 and <5 mm, and 5 mm or larger minimum ablative margins were 79%, 15%, and 0% respectively for institution A (where the software was developed) and 34%, 19%, and 2% respectively for institutions B, C, and D combined. Local disease progression risk decreased to less than 1% with an intraprocedurally confirmed minimum ablative margin greater than 4.6 mm.</p><p><strong>Conclusion: </strong>A minimum ablative margin of 5 mm or larger demonstrates optimal local oncological outcomes. It is proposed that an intraprocedural minimum ablative margin of 5 mm or larger, confirmed using biomechanical deformable image registration, serves as the A0 for colorectal liver metastasis thermal ablation.</p>","PeriodicalId":136,"journal":{"name":"British Journal of Surgery","volume":"111 9","pages":""},"PeriodicalIF":8.6,"publicationDate":"2024-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11364140/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142102485","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":"Surgical outcomes following total neoadjuvant therapy in rectal cancer with short-course radiotherapy using protons or photons: initial safety data from the PRORECT randomized trial.","authors":"Alexander Valdman,Richard Marsk,Masoud Karimi,Daniel Asklid,Daniel Brattström,Joanna Östling Palme,Anna Martling,Per Johan Nilsson","doi":"10.1093/bjs/znae241","DOIUrl":"https://doi.org/10.1093/bjs/znae241","url":null,"abstract":"","PeriodicalId":136,"journal":{"name":"British Journal of Surgery","volume":"212 1","pages":""},"PeriodicalIF":9.6,"publicationDate":"2024-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142268111","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":"Erratum to: Acute large bowel obstruction.","authors":"","doi":"10.1093/bjs/znae249","DOIUrl":"https://doi.org/10.1093/bjs/znae249","url":null,"abstract":"","PeriodicalId":136,"journal":{"name":"British Journal of Surgery","volume":"111 9","pages":""},"PeriodicalIF":8.6,"publicationDate":"2024-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142277513","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":"Risk factor-targeted abdominal aortic aneurysm screening: systematic review of risk prediction for abdominal aortic aneurysm.","authors":"Liam Musto,Aiden Smith,Coral Pepper,Sylwia Bujkiewicz,Matthew Bown","doi":"10.1093/bjs/znae239","DOIUrl":"https://doi.org/10.1093/bjs/znae239","url":null,"abstract":"BACKGROUNDThis systematic review aimed to investigate the current state of risk prediction for abdominal aortic aneurysm in the literature, identifying and comparing published models and describing their performance and applicability to a population-based targeted screening strategy.METHODSElectronic databases MEDLINE (via Ovid), Embase (via Ovid), MedRxiv, Web of Science, and the Cochrane Library were searched for papers reporting or validating risk prediction models for abdominal aortic aneurysm. Studies were included only if they were developed on a cohort or study group derived from the general population and used multiple variables with at least one modifiable risk factor. Risk of bias was assessed using the Prediction model Risk Of Bias ASsessment Tool. A synthesis and comparison of the identified models was undertaken.RESULTSThe search identified 4813 articles. After full-text review, 37 prediction models were identified, of which 4 were unique predictive models that were reported in full. Applicability was poor when considering targeted screening strategies using electronic health record-based populations. Common risk factors used for the predictive models were explored across all 37 models; the most common risk factors in predictive models for abdominal aortic aneurysm were: age, sex, biometrics (such as height, weight, or BMI), smoking, hypertension, hypercholesterolaemia, and history of heart disease. Few models had undergone standardized model development, adequate external validation, or impact evaluation.CONCLUSIONThis study identified four risk models that can be replicated and used to predict abdominal aortic aneurysm with acceptable levels of discrimination. None of the models have been validated externally.","PeriodicalId":136,"journal":{"name":"British Journal of Surgery","volume":"24 1","pages":""},"PeriodicalIF":9.6,"publicationDate":"2024-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142249981","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}