British Journal of Surgery最新文献

{"title":"Contemporary management of phyllodes tumours of the breast: proposal for recommendations from the UK Association of Breast Surgery.","authors":"Mai K Bishr, Alex Humphreys, Mahbubl Ahmed, Karina Cox, Adam Hughes, Jennifer Isherwood, Sarah Pinder, Dionysios Dennis Remoundos, Elinor Sawyer, Muhammad Sarmad Tamimy, Lisa Whisker","doi":"10.1093/bjs/znae277","DOIUrl":"https://doi.org/10.1093/bjs/znae277","url":null,"abstract":"<p><p>Phyllodes tumours of the breast are rare fibroepithelial neoplasms classified histologically into benign, borderline, or malignant; each requiring different treatment strategies. The infrequency of presentation can result in diagnostic and management variability. The aim is to provide evidence-based or expert consensus recommendations for multidisciplinary teams managing patients with phyllodes tumours.</p>","PeriodicalId":136,"journal":{"name":"British Journal of Surgery","volume":"112 1","pages":""},"PeriodicalIF":8.6,"publicationDate":"2024-12-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142996842","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":"Metagenomic next-generation sequencing for the detection of bacterial translocation in the blood of patients following liver, biliary tract or pancreatic surgery.","authors":"Zhenfeng Deng, Zhujing Lan, Huaitao Zhu, Hongbing Ren, Zongrui Jin, Jiajun Jiang, Tiansheng Lan, Jinyuan Zhou, Jilong Wang, Peiqi Wan, Ya Guo, Banghao Xu, Hai Zhu, Zhang Wen","doi":"10.1093/bjs/znae326","DOIUrl":"10.1093/bjs/znae326","url":null,"abstract":"","PeriodicalId":136,"journal":{"name":"British Journal of Surgery","volume":"112 1","pages":""},"PeriodicalIF":8.6,"publicationDate":"2024-12-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11756384/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143021252","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":"Results of the Breast Surgery Training Opportunities National Collaborative Audit: BreaST ONCA.","authors":"Alona Courtney, Natasha Jiwa, Alex Humphreys, Jenna Morgan, Louise Merker, Rachel X N Lee, Katherine Fairhurst, Thomas Hubbard, Rajiv Dave","doi":"10.1093/bjs/znae310","DOIUrl":"https://doi.org/10.1093/bjs/znae310","url":null,"abstract":"","PeriodicalId":136,"journal":{"name":"British Journal of Surgery","volume":"112 1","pages":""},"PeriodicalIF":8.6,"publicationDate":"2024-12-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142884887","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":"WHO Disability Assessment Schedule 2.0: responsiveness in detecting long-term functional disability after surgery.","authors":"Yoko Yabuno, Yusuke Naito, Mitsuru Ida, Soshiro Ogata, Masahiko Kawaguchi","doi":"10.1093/bjs/znaf002","DOIUrl":"https://doi.org/10.1093/bjs/znaf002","url":null,"abstract":"<p><strong>Background: </strong>The WHO Disability Assessment Schedule (WHODAS) 2.0 is widely used for detecting postoperative functional disability. Its responsiveness for detecting disability has been evaluated at 1 year after surgery, with no long-term evaluation. The aim of this study was to examine the responsiveness of the WHO Disability Assessment Schedule in detecting functional disability at 5 years after surgery.</p><p><strong>Methods: </strong>This study was a secondary analysis of a prospective observational study. Patients were enrolled who were aged 55 years or older and underwent elective non-cardiac surgery under general anaesthesia. They were asked to complete the 12-item WHO Disability Assessment Schedule and the Medical Outcome Study Short Form questionnaires before surgery and at 5 years after surgery. The correlation between changes in WHO Disability Assessment Schedule score and Medical Outcome Study Short Form physical score (change in physical component score) was evaluated using the Spearman rank correlation coefficient (ρ). The standardized response means were also calculated for typical subgroups for which functional disability was predicted to improve or decline and compared with the overall standardized response mean.</p><p><strong>Results: </strong>In the analysis, 2596 patients were included. A moderate correlation (ρ = -0.47) existed between changes in WHO Disability Assessment Schedule and physical Medical Outcome Study Short Form scores. The overall standardized response mean was 0.17. The standardized response means for the patients with functional disability predicted to improve ranged from -0.45 to -0.67, whereas those for patients predicted to decline ranged from 0.17 to 0.56. These findings indicated high responsiveness.</p><p><strong>Conclusion: </strong>The WHO Disability Assessment Schedule 2.0 has a high responsiveness at 5 years after surgery. It can be used to detect functional disability at 5 years after surgery.</p>","PeriodicalId":136,"journal":{"name":"British Journal of Surgery","volume":"112 1","pages":""},"PeriodicalIF":8.6,"publicationDate":"2024-12-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143021254","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":"Clinical and patient-reported outcomes in women offered oncoplastic breast-conserving surgery as an alternative to mastectomy: ANTHEM multicentre prospective cohort study.","authors":"Charlotte Davies, Leigh Johnson, Carmel Conefrey, Nicola Mills, Patricia Fairbrother, Chris Holcombe, Lisa Whisker, William Hollingworth, Joanna Skillman, Paul White, Douglas Macmillan, Charles Comins, Shelley Potter","doi":"10.1093/bjs/znae306","DOIUrl":"10.1093/bjs/znae306","url":null,"abstract":"<p><strong>Background: </strong>Oncoplastic breast-conserving surgery may be a better option than mastectomy, but high-quality comparative evidence is lacking. The aim of the ANTHEM study (ISRCTN18238549) was to explore clinical and patient-reported outcomes in a multicentre cohort of women offered oncoplastic breast-conserving surgery as an alternative to mastectomy with or without immediate breast reconstruction.</p><p><strong>Methods: </strong>Women with invasive/pre-invasive breast cancer who were offered oncoplastic breast-conserving surgery with volume replacement or displacement techniques to avoid mastectomy were recruited prospectively. Demographic, operative, oncological, and 3- and 12-month complication data were collected. The proportion of women choosing oncoplastic breast-conserving surgery and the proportion in whom breast conservation was successful were calculated. Participants completed the validated BREAST-Q questionnaire at baseline, 3 months after surgery, and 12 months after surgery. Questionnaires were scored according to the developers' instructions and scores for each group were compared over time.</p><p><strong>Results: </strong>In total, 362 women from 32 UK breast units participated, of whom 294 (81.2%) chose oncoplastic breast-conserving surgery. Of the oncoplastic breast-conserving surgery patients in whom postoperative margin status was reported, 210 of 255 (82.4%) had clear margins after initial surgery and only 10 (3.9%) required completion mastectomy. Major complications were significantly more likely after immediate breast reconstruction. Women having oncoplastic breast-conserving surgery with volume displacement techniques reported significant improvements in baseline 'satisfaction with breasts' and 'psychosocial well-being' scores at 3 and 12 months, but both oncoplastic breast-conserving surgery groups reported significant decreases in 'physical well-being: chest' at 3 and 12 months.</p><p><strong>Conclusion: </strong>Oncoplastic breast-conserving surgery allows greater than 95% of women to avoid mastectomy, with lower major complication rates than immediate breast reconstruction, and may improve satisfaction with outcome. Oncoplastic breast-conserving surgery should be offered as an alternative to mastectomy in all women in whom it is technically feasible.</p>","PeriodicalId":136,"journal":{"name":"British Journal of Surgery","volume":"112 1","pages":""},"PeriodicalIF":8.6,"publicationDate":"2024-12-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11668256/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142884867","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":"Ethics of training surgeons.","authors":"Natasha Houghton, Apostolos Prionas, Roger Kneebone, Vassilios Papalois","doi":"10.1093/bjs/znae252","DOIUrl":"10.1093/bjs/znae252","url":null,"abstract":"","PeriodicalId":136,"journal":{"name":"British Journal of Surgery","volume":"111 12","pages":""},"PeriodicalIF":8.6,"publicationDate":"2024-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11631360/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142805610","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":"Priority outcomes of pelvic exenteration for rectal cancer: a patient, carer, and clinician consensus.","authors":"Kilian G M Brown, James Morkaya, Michael J Solomon, Kheng-Seong Ng, Kate White, Paul Sutton, Desmond C Winter, Daniel Steffens","doi":"10.1093/bjs/znae298","DOIUrl":"10.1093/bjs/znae298","url":null,"abstract":"","PeriodicalId":136,"journal":{"name":"British Journal of Surgery","volume":"111 12","pages":""},"PeriodicalIF":8.6,"publicationDate":"2024-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11631376/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142826807","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":"Global collaboration between platform trials in surgery and anaesthesia.","authors":"James Glasbey, Steve A Webb, Trisha Peel, Thomas D Pinkney, Paul S Myles","doi":"10.1093/bjs/znae262","DOIUrl":"10.1093/bjs/znae262","url":null,"abstract":"<p><p>Large, randomized trials are the bedrock of evidence-based medicine, but the resources required to complete such trials greatly limit the number of important clinical questions that can be addressed within a reasonable period of time. Adaptive platform trials can identify effective, ineffective, or harmful treatments faster. These trials have been shown to deliver rapid evidence through the COVID-19 pandemic and are now being adopted across surgery and anaesthesia, with many opportunities for surgeons, anaesthetists, and other perioperative physicians to conduct and collaborate in platform trials.</p>","PeriodicalId":136,"journal":{"name":"British Journal of Surgery","volume":"111 12","pages":""},"PeriodicalIF":8.6,"publicationDate":"2024-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11658830/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142862640","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":"Pain management after abdominal surgery: requiem for epidural analgesia?","authors":"Dileep N Lobo, Girish P Joshi","doi":"10.1093/bjs/znae299","DOIUrl":"10.1093/bjs/znae299","url":null,"abstract":"","PeriodicalId":136,"journal":{"name":"British Journal of Surgery","volume":"111 12","pages":""},"PeriodicalIF":8.6,"publicationDate":"2024-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11602154/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142737750","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":"Role of obesity-management medications before and after metabolic bariatric surgery: a systematic review.","authors":"Ricardo V Cohen, Ji Yeon Park, Gerhard Prager, Marco Bueter, Carel W le Roux, Chetan Parmar, Mohammad Kermansaravi, Paulina Salminen, Alexander D Miras","doi":"10.1093/bjs/znae284","DOIUrl":"10.1093/bjs/znae284","url":null,"abstract":"","PeriodicalId":136,"journal":{"name":"British Journal of Surgery","volume":"111 12","pages":""},"PeriodicalIF":8.6,"publicationDate":"2024-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142754378","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}