The British journal of surgery最新文献

{"title":"Proctalgia fugax.","authors":"Andreia Albuquerque","doi":"10.1093/bjs/znag097","DOIUrl":"10.1093/bjs/znag097","url":null,"abstract":"","PeriodicalId":520792,"journal":{"name":"The British journal of surgery","volume":" ","pages":""},"PeriodicalIF":8.8,"publicationDate":"2026-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148595486","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Restorative resection in robot-assisted versus laparoscopic total mesorectal excision: systematic review and meta-analysis.","authors":"Charlotte M S Genders, Jory Wentink, Ritch T J Geitenbeek, Roel Hompes, Jasper B van Praagh, Esther C J Consten","doi":"10.1093/bjs/znag106","DOIUrl":"10.1093/bjs/znag106","url":null,"abstract":"<p><strong>Background: </strong>The surgical treatment of rectal cancer is based on the principle of total mesorectal excision (TME). Owing to its technological advantages, robot-assisted total mesorectal excision (R-TME) is hypothesized to facilitate primary anastomosis more frequently than laparoscopic total mesorectal excision (L-TME). This systematic review and meta-analysis aimed to investigate whether R-TME is associated with a higher likelihood of restorative surgery compared with L-TME.</p><p><strong>Methods: </strong>This systematic review and meta-analysis was conducted in accordance with PRISMA guidelines. The protocol was prospectively registered in PROSPERO, the international prospective register of systematic reviews (registration number: 1106767). PubMed/MEDLINE, Embase, the Web of Science, and the Cochrane Library were searched for studies from January 2010 to January 2026. Pooled ORs and mean differences were calculated using a random-effects model.</p><p><strong>Results: </strong>Twenty studies were included, reporting on 7133 patients. The pooled analysis demonstrated a significantly higher likelihood of restorative surgery with R-TME compared with L-TME (OR 1.43 (95% c.i. 1.04 to 1.98)). In a subgroup analysis of studies including patients after 2020, a stronger effect was observed (OR 2.86 (95% c.i. 1.80 to 4.53)). No significant differences were observed in anastomotic leakage, postoperative complications, reoperations, and readmissions. R-TME was associated with a lower conversion rate compared with L-TME (OR 0.37 (95% c.i. 0.28 to 0.49)).</p><p><strong>Conclusion: </strong>R-TME is associated with a higher likelihood of primary anastomosis formation while maintaining a comparable safety profile. The more pronounced effect in recent studies likely reflects increasing surgical expertise. Future research should determine whether these advantages translate into measurable improvements in patient quality of life.</p>","PeriodicalId":520792,"journal":{"name":"The British journal of surgery","volume":"113 10","pages":""},"PeriodicalIF":8.8,"publicationDate":"2026-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13640960/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149123040","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Retention risk in European vascular surgery training: workplace conditions outweigh workload.","authors":"David Wippel, Laura Schönherr, Ryan Gouveia E Melo, Juliana Heidler, Alexandre Oliny, Christian Zielasek, Moritz Wegner, Leszek Kukulski, Fabrizio Cecere, Maram Darwish, Vincent Jongkind, Nadia Hakkenbrak, Petar Zlatanovic","doi":"10.1093/bjs/znag126","DOIUrl":"https://doi.org/10.1093/bjs/znag126","url":null,"abstract":"","PeriodicalId":520792,"journal":{"name":"The British journal of surgery","volume":"113 10","pages":""},"PeriodicalIF":8.8,"publicationDate":"2026-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149123030","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Beyond SANO: the future of active surveillance for oesophageal cancer.","authors":"Jun Wang, Fei Liang, Qingsong Pang, Zhouguang Hui","doi":"10.1093/bjs/znag066","DOIUrl":"10.1093/bjs/znag066","url":null,"abstract":"","PeriodicalId":520792,"journal":{"name":"The British journal of surgery","volume":" ","pages":""},"PeriodicalIF":8.8,"publicationDate":"2026-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13637626/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148160392","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Gastrointestinal symptoms and health-related quality of life before and after pancreatectomy for pancreatic cancer (GO-PANC): longitudinal nationwide study.","authors":"Pauline A J Vissers, Annuska Schoorlemmer, Chulja J Pek, Pleun Appelhof, Lieke Baade-Corpelijn, Ellen Betten, Lisa Serlier-Erades, Henriëtte de Groot, Mariska W Hoogendoorn-de Ruiter, Sharon A G Linders, Joanne L Reeves, Annemarie M Roele-de Vreugd, Petra A W Roza-van Os, André L A Sterk, Rosa van der Werf, Marc G H Besselink, Hanneke W M van Laarhoven, Casper H J van Eijck","doi":"10.1093/bjs/znag122","DOIUrl":"10.1093/bjs/znag122","url":null,"abstract":"<p><strong>Background: </strong>Patients undergoing pancreatectomy for pancreatic cancer may experience gastrointestinal symptoms that impair health-related quality of life (HRQoL) before and after pancreatic surgery. The longitudinal course of these symptoms and their association with HRQoL remains unclear as large prospective studies are lacking.</p><p><strong>Methods: </strong>Patients who underwent pancreatectomy for pancreatic cancer and filled out questionnaires of the Dutch Pancreatic Cancer Project were included in this cohort study. Gastrointestinal symptoms and HRQoL were assessed before surgery and 0-3, 3-6, 6-9, and 9-12 months after surgery. Multivariable generalized linear mixed models were applied to evaluate longitudinal changes in gastrointestinal symptoms and their association with HRQoL.</p><p><strong>Results: </strong>After pancreatectomy for pancreatic cancer, overall, 1009 patients were included and 2995 questionnaires were completed. Before surgery, gastrointestinal symptoms were present in 95% of patients; commonly flatulence, dry mouth, problems with taste, and altered bowel habits. Gastrointestinal symptom scores peaked at 0-3 months after surgery and generally returned to preoperative or lower levels at 9-12 months after surgery. Severe gastrointestinal symptoms (defined as 'quite a bit' or 'very much') decreased from 61% of patients before surgery to 52% at 9-12 months after surgery. Patients with two or more severe symptoms had moderate (10-20 points) to large (>20 points) clinically relevant lower scores for HRQoL.</p><p><strong>Conclusion: </strong>Gastrointestinal symptoms in patients undergoing pancreatectomy for pancreatic cancer were highly prevalent and peaked within 3 months after surgery. Severe gastrointestinal symptoms affected more than half of all patients after surgery, which led to substantial declines in HRQoL.</p>","PeriodicalId":520792,"journal":{"name":"The British journal of surgery","volume":"113 10","pages":""},"PeriodicalIF":8.8,"publicationDate":"2026-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13641176/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149123037","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Concise stakeholder-informed tool for reporting modifications to innovative surgical procedures and devices: Surgical ModificAtion Reporting Tool (SMART) checklist.","authors":"James B Olivier, Rhiannon C Macefield, Maeve Coyle, Kerry N L Avery, Natalie S Blencowe, Daisy Elliott","doi":"10.1093/bjs/znag117","DOIUrl":"10.1093/bjs/znag117","url":null,"abstract":"<p><strong>Background: </strong>Modifications to invasive procedures and devices are common during surgical innovation, yet reporting is frequently inconsistent and incomplete. The aim of this study was to develop a concise, stakeholder-informed checklist for reporting modifications in surgical innovation studies.</p><p><strong>Methods: </strong>A provisional checklist was developed from a systematic review of 104 IDEAL (Idea, Development, Exploration, Assessment, and Long-term study) studies, identifying substantial heterogeneity and deficits in modification reporting. Twenty stakeholders were purposively sampled for semi-structured interviews, including clinicians, methodologists, industry representatives, and governance professionals. Interviews explored views and subsequently optimized the checklist's content, wording, layout, scope, and usability. Data were analysed by thematic analysis and iteratively used to refine the checklist until no further required changes were identified.</p><p><strong>Results: </strong>Stakeholders endorsed the need for a dedicated modification reporting tool, emphasizing pragmatism and usability. Interview findings led to clarification of scope, refinement of terminology, and removal of ambiguous items. Greater emphasis was placed on describing the innovation's starting configuration, specifying the IDEAL stage, explicitly reporting both the presence and absence of modifications, and reflecting on procedural stability. Iterations condensed the checklist to a seven-item tool. The final Surgical ModificAtion Reporting Tool (SMART) specifies describing the starting point of the innovation, reporting modifications, and summarizing stability and shared learning.</p><p><strong>Conclusion: </strong>SMART is a concise, stakeholder-informed prepublication tool to guide prospective tracking and consistent reporting of modifications to innovative invasive procedures and devices. Used alongside the IDEAL framework, it has the potential to improve the quality and interpretability of surgical innovation research.</p>","PeriodicalId":520792,"journal":{"name":"The British journal of surgery","volume":"113 10","pages":""},"PeriodicalIF":8.8,"publicationDate":"2026-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13637718/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149122973","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development of an artificial intelligence-based model for anatomical recognition during robotic distal pancreatectomy.","authors":"Koichi Tomita, Masashi Takeuchi, Michael P Kim, Adriana C Gamboa, Jessica E Maxwell, Rebecca A Snyder, Ching-Wei D Tzeng, Matthew H G Katz, Naruhiko Ikoma","doi":"10.1093/bjs/znag115","DOIUrl":"https://doi.org/10.1093/bjs/znag115","url":null,"abstract":"","PeriodicalId":520792,"journal":{"name":"The British journal of surgery","volume":"113 9","pages":""},"PeriodicalIF":8.8,"publicationDate":"2026-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148922633","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Defunctioning stomas and the effect of oral antibiotic bowel preparation in colorectal surgery: a microbiome-based hypothesis.","authors":"Jack A Helliwell, Andrew Kirby, Caroline Chilton, Henry Wood, Philip Quirke, David G Jayne","doi":"10.1093/bjs/znag102","DOIUrl":"10.1093/bjs/znag102","url":null,"abstract":"","PeriodicalId":520792,"journal":{"name":"The British journal of surgery","volume":" ","pages":""},"PeriodicalIF":8.8,"publicationDate":"2026-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148682013","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dehiscence, infection, seroma, haematoma (DISH): development and validation of a new classification of surgical site outcomes.","authors":"Giles Bond-Smith, Marja A Boermeester, David J Leaper, Philip L Russo, Antonia F Chen","doi":"10.1093/bjs/znag112","DOIUrl":"10.1093/bjs/znag112","url":null,"abstract":"<p><strong>Background: </strong>Surgical site outcome (SSO) reporting lacks details of management, focuses on infection, and overlooks dehiscence, seroma, and haematoma. An international, consensus-driven classification system applicable to a diverse range of surgical incisions and outcomes was developed to address this gap and standardize the reporting of SSOs.</p><p><strong>Method: </strong>Concept statements based on a targeted literature review were rated by pan-specialty global experts during a four-round modified Delphi study to create a comprehensive classification of SSOs. Reliability and language validation focused on inter-rater agreement and intra-rater reproducibility by experts applying the classification to case vignettes, created using generative artificial intelligence sampling. Cross-domain agreement was evaluated using a patient-level, double entry, interclass correlation coefficient (DE-ICC).</p><p><strong>Results: </strong>Consensus was achieved on definitions of dehiscence, inflammation/infection, seroma, and haematoma ('DISH') within a new classification, comprising five objectifiable grades of clinical intervention (0-4) and four grades of clinical presentation (a-d) for each domain. The DISH 'score' presents all domains collectively, for example D1a I2b S0 H0; a snapshot of the management and presentation of an incision. Mean patient-level inter-rater DE-ICC was 0.93 (95% c.i. 0.91 to 0.96; median 1.00; very high concordance). Intra-rater DE-ICC was similarly high (mean 0.95; 95% c.i. 0.93 to 0.96; median 1.00).</p><p><strong>Conclusion: </strong>The proposed cross-specialty, global DISH Classification facilitates more comprehensive surveillance and audit of SSOs in clinical practice and research, by standardizing reporting of all relevant grades of clinical presentation and management of SSOs. Very high concordance when applied to case vignettes gives credibility to clinical validation and adoption.</p>","PeriodicalId":520792,"journal":{"name":"The British journal of surgery","volume":" ","pages":""},"PeriodicalIF":8.8,"publicationDate":"2026-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13584926/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148805537","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Futility in cancer surgery: towards consensus and patient-centred decisions.","authors":"Alison Wallace, Campbell S Roxburgh, Colin W Steele, John T Jenkins","doi":"10.1093/bjs/znag091","DOIUrl":"10.1093/bjs/znag091","url":null,"abstract":"","PeriodicalId":520792,"journal":{"name":"The British journal of surgery","volume":"113 9","pages":""},"PeriodicalIF":8.8,"publicationDate":"2026-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13591269/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149013571","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}