Surgeon-Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland最新文献

{"title":"Personality traits and surgical performance: A human factors perspective.","authors":"Michael El Boghdady, Joris J Blok","doi":"10.1016/j.surge.2025.07.008","DOIUrl":"https://doi.org/10.1016/j.surge.2025.07.008","url":null,"abstract":"","PeriodicalId":49463,"journal":{"name":"Surgeon-Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145281480","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lymphoedema: a current real world prospective evaluation.","authors":"Angus J Lloyd, Alison Johnston, Geraldine MacGregor, Nicola Kelly, Magda Bucholc, Manvydas Varzgalis, Michael Sugrue","doi":"10.1016/j.surge.2025.09.003","DOIUrl":"https://doi.org/10.1016/j.surge.2025.09.003","url":null,"abstract":"<p><strong>Introduction: </strong>Breast-cancer-related-lymphoedema (BCRL) remains problematic clinically. A recent meta-analysis showed a pooled incidence of 21.9 %. Greater lymph node dissection increases BCRL incidence with a pooled average of 5.9 % for sentinel lymph node biopsy (SLNB) versus 23.6 % for axillary lymph node dissection (ALND). The primary aim was to assess the BCRL incidence in symptomatic breast cancer patients undergoing axillary surgery.</p><p><strong>Methods: </strong>A prospective, single centre study was carried out whereby included patients had limb volumes assessed pre-operatively and at 1 and 2 years post-operatively between January 2016 and July 2019. Assessment involved two standardised methods; arm circumference measurement and water displacement.</p><p><strong>Results: </strong>147 patients, mean age 56.4 years (±sd 14.0, range 28-86) were included. 97/147(66 %) of patients underwent SLNB, with 50/147(34 %) undergoing ALND. 70/97(72.2 %) of the SLNB group had a wide local excision versus 24/50(48.0 %) in the ALND group (p = 0.004). Mean lymph nodes excised was 8.0(±sd 7.4, range 1-30) for all patients, 3.3(±sd 2.2, range 1-11) for SLNB and 17.1(±sd 5.1, range 9-30) for ALND (p < 0.001). Overall incidence of BCRL was 6.1 %(9/147) using arm circumference measurement and 15.7 %(23/147) with water displacement at 2 year follow-up. BCRL incidence determined using arm circumference measurement was found to be 4.3 % (4/94), 33.3 % (1/33), 11.5 % (3/26) and 4.2 % (1/24) for SLNB alone, SLNB + RLNR, ALND alone and ALND + RLNR respectively. Using water displacement, BCRL incidence in the SLNB alone, SLNB + RLNR, ALND alone and ALND + RLNR groups was 10.6 % (10/94), 33.3 % (1/3), 15.4 % (4/26), and 33.3 % (8/24) respectively.</p><p><strong>Conclusion: </strong>This study gives a real world perspective on the diagnosis, incidence and subsequent management of BCRL whilst showing that the incidence of BCRL is low at our institution by international standards.</p>","PeriodicalId":49463,"journal":{"name":"Surgeon-Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145201895","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Digital twins assisted surgery: A conceptual framework for transforming surgical training and navigation.","authors":"Justicia Kyeremeh, Lisa Asciak, James P Blackmur, Xichun Luo, Frederic Picard, Wenmiao Shu, Grant D Stewart","doi":"10.1016/j.surge.2025.09.007","DOIUrl":"https://doi.org/10.1016/j.surge.2025.09.007","url":null,"abstract":"<p><strong>Background: </strong>Given the complexity and evolution of modern surgical procedures, there is a need for training methods to develop and keep pace. Digital Twins Assisted Surgery (DTAS) offers a novel opportunity to enhance both surgical education and intraoperative decision-making.</p><p><strong>Patients and methods: </strong>We propose a conceptual framework for integrating DTAS into surgical education. Hypothetical case examples are presented to illustrate how DTAS could be utilized for preoperative planning, intraoperative guidance, and individualized skill development in surgical trainees.</p><p><strong>Results: </strong>DTAS demonstrates potential for improving surgical precision, skill acquisition, and patient safety. By integrating real-time data, 3D modelling, and predictive analytics, DTAS holds promise for improving surgical outcomes and facilitating skill acquisition in complex procedures.</p><p><strong>Conclusions: </strong>DTAS could transform surgical training and navigation. Pilot studies and validation trials are needed to assess its integration into curricula and its impact on clinical outcomes.</p>","PeriodicalId":49463,"journal":{"name":"Surgeon-Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145139232","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A systematic review of surgeon-anesthesiologist relationship in the operating room.","authors":"Iris Wang, Yao Zhang, Yuan Yuan Yao, Bin Zheng","doi":"10.1016/j.surge.2025.09.006","DOIUrl":"https://doi.org/10.1016/j.surge.2025.09.006","url":null,"abstract":"<p><strong>Introduction: </strong>Effective collaboration between surgeons and anesthesiologists is critical to managing intraoperative challenges and ensuring patient safety. Despite its importance, the specific dynamics of this relationship remain underexplored, with few studies providing quantitative assessments.</p><p><strong>Methods: </strong>A structured literature review was conducted following PRISMA guidelines, focusing on studies that examined the surgeon-anesthesiologist relationship and its impact on surgical outcomes. Data were extracted on measurement methodologies, relationship indicators, reported outcome effects, identified barriers, and proposed interventions.</p><p><strong>Results: </strong>Eleven papers met inclusion criteria, all employing surveys or field observations to evaluate communication frequency, content, and patterns. Methods were similar to general team collaboration assessments, lacking multidimensional measures. Potential complementary metrics include collaborative behaviors such as anticipatory movements and eye-tracking to assess shared visual attention. Evidence linking relationship quality to patient outcomes was limited and inconsistent. Reported barriers included operating room culture, negative perceptions, and communication gaps. Suggested interventions included pre-surgical briefings, debriefings, and enhanced visualization of patient and surgical information.</p><p><strong>Discussion: </strong>Current evidence on the surgeon-anesthesiologist relationship is sparse and methodologically limited. Future research should incorporate advanced behavioral and technological metrics to enable robust quantification, inform targeted interventions, and strengthen interprofessional collaboration to improve patient safety and surgical performance.</p>","PeriodicalId":49463,"journal":{"name":"Surgeon-Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145132202","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Beyond structural outcomes: functional and biomechanical considerations in partial foot amputations.","authors":"Mingxuan Liu, Hanjun Ma, Ju Liao, Qunqiang Luo","doi":"10.1016/j.surge.2025.09.004","DOIUrl":"https://doi.org/10.1016/j.surge.2025.09.004","url":null,"abstract":"","PeriodicalId":49463,"journal":{"name":"Surgeon-Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145132247","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Letter to editor on \"Primary closure versus Graham patch omentopexy in perforated peptic ulcer: A systematic review and meta-analysis\".","authors":"Timotius Ivan Hariyanto","doi":"10.1016/j.surge.2025.09.005","DOIUrl":"https://doi.org/10.1016/j.surge.2025.09.005","url":null,"abstract":"","PeriodicalId":49463,"journal":{"name":"Surgeon-Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145132186","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lumbar decompression surgery for cauda equina syndrome: A meta-analysis and systematic review of the safety of operating out of hours.","authors":"Henry A Crouch-Smith, Iain Feeley, Margaret K Lee, Nicholas Carleton-Bland, Simon Clark, Matthew Wilby","doi":"10.1016/j.surge.2025.08.003","DOIUrl":"https://doi.org/10.1016/j.surge.2025.08.003","url":null,"abstract":"<p><strong>Objectives: </strong>We conduct a systematic review and meta-analysis of the published literature regarding the impact of performing lumbar decompression for cauda equina syndrome (CES) out of hours compared to regular operating hours.</p><p><strong>Methods: </strong>A search of databases including Medline, EMBASE and Cochrane Library was performed with two independent reviewers per the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. A senior author arbitrated in event of disagreement. MeSH terms [((cauda equina) OR (CES)) AND ((hours) OR OOH)] were used. Filters including date range (from January 01, 1990 to November 01, 2022) and the English language were applied. Inclusion criteria consisted of retrospective or prospective cohort studies, English or full translation available, surgical complication as primary or secondary outcome and out of hours surgery as an independent variable. Case reports and studies without complication frequency were excluded. There were no additional studies identified through a snowballing secondary search through references of identified articles. Operative metrics were compiled into ad-hoc tables. Statistical analysis was performed using RevMan 5.4. A difference in complication rates with a P value of < .05 was deemed statistically significant. Heterogeneity was reported using I². Study quality was assessed using the Newcastle Ottawa Score (NOS).</p><p><strong>Results: </strong>The search strategy yielded 363 articles. After duplicate removal and application of inclusion/exclusion criteria, 15 studies were sought for retrieval and full text review. Of these, 5 studies were included for qualitative synthesis. Of these, 4 studies underwent quantitative analysis with 581 datasets. Meta-analysis was undertaken on 3 studies comprising 495 datasets. A dichotomous outcome was modelled using the Mantel-Haenszel statistical method with fixed effect which demonstrated an odds ratio (OR) of 2.38 (95 % CI 1.39-4.07) for sustaining an adverse event from out of hours surgery compared to routine operative hours. I² = 12 %, suggesting homogeneity between studies analysed.</p><p><strong>Conclusions: </strong>This study provides clinical evidence that out of hours surgery for lumbar decompression for CES is associated with a higher rate of surgical complications. The spinal surgeon should appropriately counsel the patient with CES that while it is important to do the surgery as soon as possible, operating out of hours carries a higher risk of surgical complications.</p>","PeriodicalId":49463,"journal":{"name":"Surgeon-Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145087831","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"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 Cerament® (Antibiotic impregnated bone void filler) in lower limb salvage for diabetic foot patients with osteomyelitis, a scoping review.","authors":"Ramy Elkady, Seamus McHugh, Elrasheid Kheirelseid, Peter Naughton, Daragh Moneley, Sayed Aly, Stewart Redmond Walsh","doi":"10.1016/j.surge.2025.09.001","DOIUrl":"https://doi.org/10.1016/j.surge.2025.09.001","url":null,"abstract":"<p><strong>Background: </strong>Diabetic foot osteomyelitis (DFO) is a principal cause of non-traumatic lower limb amputation, contributing substantially to morbidity, healthcare costs, and reduced quality of life. Salvage optimization strategies have included the use of local antibiotic carriers to promote healing and reduce infection recurrence. Cerament, either G (gentamicin) or V (vancomycin), resorbable antibiotic-loaded bone graft substitute, has shown potential, but evidence has not been systematically mapped.</p><p><strong>Objective: </strong>This scoping review aimed to map and summarize the available literature on the role of Cerament G and V in lower limb salvage among patients with DFO.</p><p><strong>Methods: </strong>A systematic search of PubMed, Embase, the Cochrane library, and Google scholar [December 2024]. Studies reporting outcomes of Cerament G or V in the management of DFO were eligible. Data were charted according to PRISMA-ScR guidelines, focusing on study design, intervention details, and key findings.</p><p><strong>Results: </strong>A total of 20 studies were identified, including [case reports, case series, retrospective reviews, and prospective cohorts]. Population within the studies ranged from 1 to 136. Reported outcomes included wound healing, eradication of infection, weight bearing, new bone formation and high antibiotic concentration without systemic toxicity. Amputation rates ranged from 2.6 % to 25 %. Evidence is limited by small sample sizes, heterogeneity in outcome reporting, and lack of randomized controlled trials.</p><p><strong>Conclusion: </strong>Current evidence suggests that Cerament G and V may be safe and effective adjuncts for limb salvage in DFO, but high-quality comparative studies are lacking. Further research is needed to support its broader use in daily practice.</p>","PeriodicalId":49463,"journal":{"name":"Surgeon-Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145082347","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Are pelvic binders an effective measure to lower mortality and decrease blood loss after high energy pelvic ring injuries? A systematic review.","authors":"Andreas Papaleontiou, Andréa M Poupard, Paul Parker","doi":"10.1016/j.surge.2025.08.002","DOIUrl":"https://doi.org/10.1016/j.surge.2025.08.002","url":null,"abstract":"<p><strong>Introduction: </strong>Pelvic binders are routinely used in the pre-hospital management of high energy pelvic ring injuries with a low threshold for utilisation. Current literature is inconclusive regarding the effectiveness of pelvic binders in controlling haemorrhage and decreasing mortality. The aim of this study is to investigate whether using such devices decrease mortality, blood loss, pain and complications.</p><p><strong>Method: </strong>A systematic review was carried out using modern era articles published between January 2016 and May 2024 on two databases, investigating the effectiveness of pelvic binders in trauma patients in decreasing mortality, blood product requirement, pain level and complication rate.</p><p><strong>Results: </strong>Five retrospective cohort studies, one interventional study with retrospective control and one RCT compared early binder application to late/no application and were included for analysis. were included. No clear superiority of pelvic binder application, regarding blood product requirements, mortality, pain and complications was demonstrated. Overall mortality in binder groups was 17.4 % and 15.7 % in the no/late binder groups. Only one study found a statistically significant superiority of pelvic binders regarding mortality when adjusted for confounding variables. Overall patients transfused were 35.6 % in the binder group and 25 % in the no/late binder group. Three out of seven studies reported a significantly lower blood product requirement in pelvic binder groups.</p><p><strong>Conclusion: </strong>There is no clear superiority of early pelvic binder application over no/late binder use. The evidence is limited and lacks larger RCTs. Current widespread use of pelvic binders should be reevaluated, and alternative/adjunct devices should be further investigated for their effectiveness.</p>","PeriodicalId":49463,"journal":{"name":"Surgeon-Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145076454","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diversity in core surgical training: Trends between 2012 and 2022.","authors":"Matthew Newman, Neil Scott, Phyo Kyaw Myint, Ricky Ellis","doi":"10.1016/j.surge.2025.09.002","DOIUrl":"https://doi.org/10.1016/j.surge.2025.09.002","url":null,"abstract":"<p><strong>Background and purpose: </strong>A diverse healthcare workforce is an important goal in ensuring that services reflect and meet the needs of a diverse population. Core Surgical Training (CST) is the first stage of surgical training in the UK, but diversity trends at this level have not been previously described. We aim to describe trends in gender, ethnicity, disability, and sexuality among successful CST applicants between 2012 and 2022.</p><p><strong>Methods: </strong>A retrospective cohort study was conducted using anonymised data from the UK Medical Education Database (UKMED) for all successful CST applicants between 2012 and 2022. Chi-squared tests for trend were used to assess statistically significant changes in demographic characteristics over time. Data were categorised and missing data excluded as per pre-specified protocols.</p><p><strong>Results: </strong>The proportion of Non-White CST entrants rose from 36.5 % in 2012 to 54.3 % in 2022 (X² = 124.421, p < 0.001). Entrants declaring a disability increased from 4.8 % in 2016 to 10.4 % in 2019 (X² = 22.225, p = 0.014). No significant trends were observed for gender (X² = 15.338, p = 0.120) or sexuality (X² = 9.880, p = 0.451).</p><p><strong>Conclusions: </strong>This study highlights positive trends in the ethnic and disability diversity of successful CST applicants over the past decade. However, gender and sexuality diversity showed no significant change. Further research is needed to explore barriers to entry and ensure continued progress towards an inclusive surgical workforce.</p>","PeriodicalId":49463,"journal":{"name":"Surgeon-Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145076477","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}