BJS Open最新文献

{"title":"Video-based coaching for surgeons in the UK: consensus on essential elements.","authors":"Eilidh G M Gunn, Adam P Johnson, Riinu Pius, Douglas S Smink, Andrew L Tambyraja, Steven Yule","doi":"10.1093/bjsopen/zraf006","DOIUrl":"10.1093/bjsopen/zraf006","url":null,"abstract":"","PeriodicalId":9028,"journal":{"name":"BJS Open","volume":"9 2","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11914973/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143655997","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Short disease-specific quality of life questionnaire for patients with uncomplicated symptomatic cholecystolithiasis: Gall-Questionnaire.","authors":"Floris M Thunnissen, Daan J Comes, Verena N N Kornmann, Lindsey C F de Nes, Frans T W E van Workum, Sarah Z Wennmacker, Jose A E Custers, Philip R de Reuver","doi":"10.1093/bjsopen/zraf025","DOIUrl":"https://doi.org/10.1093/bjsopen/zraf025","url":null,"abstract":"","PeriodicalId":9028,"journal":{"name":"BJS Open","volume":"9 2","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143810437","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Regional variation in non-traumatic major lower limb amputation in England: observational study of linked primary and secondary care data.","authors":"Anna Meffen, Mark J Rutherford, Rob D Sayers, John S M Houghton, Naomi Bradbury, Laura J Gray","doi":"10.1093/bjsopen/zraf004","DOIUrl":"10.1093/bjsopen/zraf004","url":null,"abstract":"<p><strong>Background: </strong>Peripheral artery disease and diabetes are the main primary risk factors for non-traumatic major lower limb amputation. Regional variation in incidence of major lower limb amputation has yet to be fully described in terms of these risk factors and explained. The aim of this study was to estimate yearly incidence of major lower limb amputation over a 10-year interval (2010-2019) across England, by related condition and by region and, additionally, to investigate reasons for regional variation.</p><p><strong>Methods: </strong>This observational study utilized primary care (Clinical Practice Research Datalink Aurum), secondary care (Hospital Episode Statistics), death and demographic data in England. Adults registered with a practice using Clinical Practice Research Datalink Aurum and with Hospital Episode Statistics linkage were included. Patients with a record of major lower limb amputation during the interval 1 January 2010 to 31 December 2019 were identified and yearly incidence rates of major lower limb amputation were calculated. Co-morbidities analysed were cardiovascular disease (including coronary artery disease, peripheral artery disease and cerebrovascular disease), diabetes (of any type) and cancer. Demographic and socioeconomic covariates analysed were age, sex, ethnicity, deprivation level, region and urban/rural categorization.</p><p><strong>Results: </strong>The study included 18 397 483 individuals, 8584 of which had a record of major lower limb amputation. The age-standardized yearly incidence rate of major lower limb amputation in England decreased by 30% from 11.2 per 100 000 person-years in 2010 to 7.8 in 2019. The incidence rate in those with diabetes fell by 30% over the 10-year interval, rose by 20% for those with both diabetes and cardiovascular disease, and changed little in those with cardiovascular disease. In 2019, the age-standardized incidence rate was highest in the North East (14.8 per 100 000 person-years) and lowest in the East of England (4.5 per 100 000 person-years). Between 2010 and 1019, incidence rates decreased across all regions, the largest decrease of 56% in the East Midlands and the smallest of 8% in the North East. Statistically significant regional variation remained after full adjustment for demographic, socioeconomic data and related conditions.</p><p><strong>Conclusion: </strong>Whilst the incidence of major lower limb amputation is decreasing overall, significant regional variation in major lower limb amputation exists and is unexplained by demographic, socioeconomic and health data. Regional differences in service provision and accessibility should be investigated to provide further explanation.</p>","PeriodicalId":9028,"journal":{"name":"BJS Open","volume":"9 2","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11938355/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143728382","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Omental preservation versus omentectomy in curative-intent gastrectomy for gastric cancer: Swedish population-based cohort study.","authors":"Biying Huang, Chih-Han Kung, Andrianos Tsekrekos, Fredrik Klevebro, Raphaela Mayerhofer, Laura Vossen Engblom, Mats Lindblad, Jakob Hedberg, Eva Szabo, David Edholm, Ulrika Smedh, Jan Johansson, Ioannis Rouvelas, Magnus Nilsson","doi":"10.1093/bjsopen/zraf012","DOIUrl":"10.1093/bjsopen/zraf012","url":null,"abstract":"<p><strong>Background: </strong>Omentectomy has traditionally been performed in gastric cancer surgery, but omental preservation has become increasingly common. It is unclear whether omentectomy leads to additional survival benefit compared with omental preservation. This nationwide population-based cohort study aimed to assess survival and surgical outcomes comparing omental preservation to omentectomy in curative-intent gastrectomy.</p><p><strong>Methods: </strong>Patients were identified from the Swedish National Registry for Oesophageal and Gastric Cancer with inclusion between 2006 and 2022. The primary endpoint was overall survival assessed by a multivariable Cox proportional hazards model, adjusted for age, sex, American Society of Anesthesiologists physical status score, clinical T and N stage, type of gastrectomy, surgical approach, extent of lymphadenectomy, neoadjuvant chemotherapy, surgery year and regional cancer centre. Secondary endpoints were surgical outcomes including tumour-free resection margins, lymph node yield and postoperative complications.</p><p><strong>Results: </strong>A total of 1615 patients were included, 517 (32.0%) underwent gastrectomy with omental preservation, and 1098 (68.0%) underwent gastrectomy with omentectomy. Overall survival after omental preservation was similar compared with omentectomy in the multivariable Cox model (HR 1.00, 95% c.i. 0.83 to 1.20; P = 0.967). Omental preservation also had similar surgical outcomes including lymph node yield and postoperative morbidity rate, compared with omentectomy.</p><p><strong>Conclusions: </strong>Omental preservation was similar to omentectomy in terms of overall survival and surgical outcomes. The results suggest that omentectomy can safely be omitted in curative-intent gastrectomy for gastric cancer.</p>","PeriodicalId":9028,"journal":{"name":"BJS Open","volume":"9 2","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143802321","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Relationship between pancreatic cancer resection rate and survival at population level: systematic review.","authors":"Elizabeth B Lockie, Amy Sylivris, Sanjay Pandanaboyana, John Zalcberg, Anita Skandarajah, Benjamin P Loveday","doi":"10.1093/bjsopen/zraf007","DOIUrl":"10.1093/bjsopen/zraf007","url":null,"abstract":"<p><strong>Background: </strong>Surgery combined with chemotherapy provides the best chance of survival in pancreatic cancer. This study investigated whether increasing the resection rate at a population level improves overall survival and modelled the interaction between resection rate, perioperative mortality rate, and population survival.</p><p><strong>Methods: </strong>A systematic review was conducted on studies reporting resection rate and survival outcomes in patients with pancreatic cancer at a population level. MEDLINE, Embase and Evidence-Based Medicine Reviews were searched up to February 2024. The primary outcome was overall population-level survival. A model for 1-year survival incorporating varying resection and perioperative mortality rates was developed.</p><p><strong>Results: </strong>The search identified 3967 studies; 19 were eligible (516 789 patients). A significant association was observed between resection rate and pancreatic cancer population survival at 1 year (r2 = 0.46, P = 0.001). A weak but significant association was noted between resection rate and (neo)adjuvant chemotherapy (r2 = 0.26, P = 0.03). One-year pancreatic cancer population survival was significantly associated with chemotherapy (r2 = 0.63; P = 0.004), but the effect was weaker than for resection rate (regression slope 0.26 versus 0.94 respectively). According to the developed model, for example, increasing the resection rate from 10 to 15% and perioperative mortality rate from 2 to 3% would lead to a 1-year survival increase from 17.6% to 22.1%.</p><p><strong>Conclusion: </strong>A higher resection rate at a population level was associated with improved survival of the pancreatic cancer population. While some of this benefit was linked to increasing (neo)adjuvant chemotherapy use, the effect of resection rate was stronger. Strategies to enhance the resection rate at national and regional levels should be explored. Establishing a benchmark for resection rate could support patient-centred healthcare and promote equitable access to high-quality pancreatic cancer care.</p>","PeriodicalId":9028,"journal":{"name":"BJS Open","volume":"9 2","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11934921/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143708365","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Colonic resection and stoma formation due to chronic diverticular disease: nationwide population-based cohort study.","authors":"Helene Rask Dalby, Rune Erichsen, Kåre Andersson Gotschalck, Katrine Jøssing Emmertsen","doi":"10.1093/bjsopen/zraf008","DOIUrl":"10.1093/bjsopen/zraf008","url":null,"abstract":"<p><strong>Background: </strong>Consensus on patient selection for elective colonic resection in patients with chronic diverticular disease is lacking. Early identification of patients who require surgery eventually enables timely elective resection, which could decrease the chronic diverticular disease burden. This register-based nationwide cohort study aimed to investigate the incidence of emergency and elective colonic resections or stoma formation in patients with chronic diverticular disease and explore predictors for surgery.</p><p><strong>Methods: </strong>The study included all patients with chronic diverticular disease in Denmark from 1996 to 2020, defined as patients with two or more hospital contacts due to diverticular disease. The incidence of surgery due to chronic diverticular disease was calculated as cumulative incidence proportions. Predictors for surgery were explored in a Cox proportional hazard model.</p><p><strong>Results: </strong>A total of 33 951 patients with chronic diverticular disease were included. The overall 5-year cumulative incidence proportion of surgery was 13.9% (elective surgery 9.8%, emergency surgery 4.2%). Patients with complicated chronic diverticular disease, including fistula, stenosis or perforation, had a three- to six-fold higher incidence of surgery overall than patients with uncomplicated chronic diverticular disease. The incidence of elective surgery decreased with age and co-morbidity and increased with the number of emergency admissions, even more pronounced if the emergency admissions accumulated within a shorter interval.</p><p><strong>Conclusion: </strong>Patients with chronic diverticular disease should be considered for elective colonic resection if they have complicated disease or several hospital contacts as they are likely to undergo surgery eventually.</p>","PeriodicalId":9028,"journal":{"name":"BJS Open","volume":"9 2","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11879527/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143555720","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Preventing thromboembolism-another benefit of ERAS.","authors":"David A Watters","doi":"10.1093/bjsopen/zraf035","DOIUrl":"https://doi.org/10.1093/bjsopen/zraf035","url":null,"abstract":"","PeriodicalId":9028,"journal":{"name":"BJS Open","volume":"9 2","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143810436","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Healthcare metaverse in surgery: scoping review.","authors":"Benoit Jauniaux, Joshua Burke, Deena Harji","doi":"10.1093/bjsopen/zrae155","DOIUrl":"10.1093/bjsopen/zrae155","url":null,"abstract":"<p><strong>Background: </strong>The metaverse is an emerging concept in surgery, with much interest in its highly immersive and interactive virtual environment. Despite the growing interest and importance in healthcare, the metaverse is still very much in its early phase of evolution and adoption in surgery, with debate on its definition and components. This scoping review provides a summary of the evidence and current understanding for the use of the metaverse in surgery.</p><p><strong>Methods: </strong>Embase and MEDLINE were searched using scoping review methodology with a systematic search strategy, identifying any study examining the role of the metaverse in surgery without time limitation. After data extraction, a narrative synthesis was conducted to identify the components of the metaverse employed within surgery and the domains in which they were applied.</p><p><strong>Results: </strong>Of 97 articles found through the initial search, 15 studies were eligible for inclusion. Most of the studies were expert opinion pieces (46.6%), urology was the most common specialty (33.3%), and all studies were published after 2020. Studies were widely heterogeneous in study design and outcomes varied. The surgical metaverse was used across four main domains: education (53%), training (80%), operations (67%), and surgical care (53%).</p><p><strong>Conclusion: </strong>Surgery is rapidly moving towards the age of the metaverse. There is great potential; however, evidence is lacking on its effectiveness and there are risks associated with its implementation. Institutions must learn how to understand and safely adopt the metaverse into their domains of education, training, operations, and surgical care.</p>","PeriodicalId":9028,"journal":{"name":"BJS Open","volume":"9 2","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11886832/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143571957","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of a transition of care bundle on health-related quality of life after major emergency abdominal surgery: before-and-after study.","authors":"Dunja Kokotovic, Liv Í Soylu, Therese L Hansen, Julie B Knoblauch, Camilla B Balle, Lisbeth Jensen, Andrea Kiørboe, Simon Amled, Thomas K Jensen, Jakob Burcharth","doi":"10.1093/bjsopen/zraf020","DOIUrl":"10.1093/bjsopen/zraf020","url":null,"abstract":"<p><strong>Introduction: </strong>The transition from hospital to home can be challenging. This study investigated whether a standardized transition of care bundle could enhance health-related quality of life (HRQoL), reduce readmission rates, and increase days alive and out of hospital after major emergency abdominal surgery.</p><p><strong>Methods: </strong>A single-centre before-and-after study including consecutive patients undergoing major emergency abdominal surgery was conducted at Copenhagen University Hospital Herlev from 1 January 2022 to 31 December 2023. A transition of care bundle including standardized discharge coordination, written material, and multidisciplinary information meetings for patients and relatives was implemented on 1 January 2023. Patients were followed up by phone interviews and hospital records. HRQoL was assessed by the EQ-5D-5L questionnaire.</p><p><strong>Results: </strong>A total of 667 patients were included (before group 333 patients (median age 70.9), after group 335 patients (median age 72.2)). The predominant surgical procedure was emergency laparotomy for bowel obstruction (before group: n = 187, 56.2%, after group: n = 171, 51.5%). HRQoL was significantly higher in the after group compared with the before group at postoperative day (POD) 30 (0.846 versus 0.750, P < 0.001), postoperative day 90 (0.925 versus 0.847, P < 0.001), and at postoperative day 180 (0.907 versus 0.875, P = 0.039). No difference in days alive and out of hospital or readmission was found between the groups. A significant reduction in patients transitioning to a rehabilitation facility at discharge was found in the after group versus before group (12.5% versus 23.3%).</p><p><strong>Conclusions: </strong>A transition of care bundle with coordination, written material, and multidisciplinary efforts increased HRQoL up to 180 days after major emergency abdominal surgery.</p>","PeriodicalId":9028,"journal":{"name":"BJS Open","volume":"9 2","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11914972/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143655979","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of Enhanced Recovery After Surgery compliance on postoperative venous thromboembolism.","authors":"Kristin A Black, Abby Thomas, Khara M Sauro, Gregg Nelson","doi":"10.1093/bjsopen/zraf018","DOIUrl":"https://doi.org/10.1093/bjsopen/zraf018","url":null,"abstract":"<p><strong>Background: </strong>Implementing Enhanced Recovery After Surgery (ERAS) guidelines has been demonstrated to reduce complications; however, it is unknown if ERAS may influence incidence of postoperative venous thromboembolism, a particularly challenging complication. The objective of this study was to examine the association between ERAS compliance and venous thromboembolism across multiple surgery types.</p><p><strong>Methods: </strong>This retrospective cohort study included adult patients undergoing one of seven ERAS-guided surgeries between 2017 and 2021 at nine hospitals in Alberta, Canada, that implemented ERAS guidelines. The exposure was overall ERAS compliance (categorized as low, moderate, high) and compliance with each ERAS element. The primary outcome was venous thromboembolism within 30 days of surgery. Secondary outcomes included 30-day hospital readmission, emergency department visits and healthcare costs.</p><p><strong>Results: </strong>Of the 8118 included patients, most had colorectal (52.8%) and gynaecologic (26.1%) surgery. There were 118 (1.5%) patients who experienced a postoperative venous thromboembolism. ERAS compliance was associated with developing a venous thromboembolism; each unit increase in the ERAS compliance score was associated with a 23% decrease in the occurrence of venous thromboembolism. More patients with venous thromboembolism had low (11.0%) or moderate (44.1%) overall ERAS compliance compared with those with no venous thromboembolism (5.6% and 34.5% respectively, P = 0.001). Using logistic regression analysis, the overall ERAS compliance score and American Society of Anesthesiologists class remained significant risk factors for developing a venous thromboembolism.</p><p><strong>Conclusions: </strong>ERAS compliance was associated with decreased odds of postoperative venous thromboembolism across multiple surgical disciplines, highlighting the importance of improving ERAS compliance to decrease postoperative venous thromboembolism.</p>","PeriodicalId":9028,"journal":{"name":"BJS Open","volume":"9 2","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143810435","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}