Jingyun Ning, Cao Dai, Qin Liu, Haoming Lin, Rui Zhang
{"title":"Application of the associating liver partition and portal vein ligation for staged hepatectomy (ALPPS) technique in conversion therapy for hepatocellular carcinoma.","authors":"Jingyun Ning, Cao Dai, Qin Liu, Haoming Lin, Rui Zhang","doi":"10.1093/bjs/znaf067","DOIUrl":"https://doi.org/10.1093/bjs/znaf067","url":null,"abstract":"","PeriodicalId":136,"journal":{"name":"British Journal of Surgery","volume":"112 4","pages":""},"PeriodicalIF":8.6,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143951629","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}
Matthew J Lee,Daniel M Baker,Debby Hawkins,Sue Blackwell,Robert Arnott,Deena Harji,Gabrielle Thorpe,Stephen J Chapman,Georgina L Jones,
BACKGROUNDAfter major abdominal surgery, patients may experience significant gastrointestinal dysfunction, including postoperative ileus. Many clinical tools are used to measure this dysfunction, but there is no patient-reported outcome measure (PROM) specific to this group. The aim of this study was to develop a new PROM for this common condition.METHODSA four-stage approach was undertaken. Stage 1 used semi-structured interviews with 29 patients to explore experiences of gastrointestinal recovery and develop a draft questionnaire. Stage 2 solicited feedback from 18 patients and 15 clinical experts on the face validity of the proposed tool using the Questionnaire on Questionnaires (QQ-10). Stage 3 recruited 297 patients to complete the questionnaire. Principal component analysis reduced the items and identified the domain structure. Test-retest reliability and a pilot assessment of responsiveness were assessed in stage 4 in a sample of 100 patients and in a sample of 68 patients respectively.RESULTSThe interviews generated 26 subthemes across gastrointestinal recovery and general well-being. An initial questionnaire containing 44 items was developed. The QQ-10 demonstrated high value and low burden, supporting face validity. Tests to reduce the items and identify the domain structure resulted in a 15-item questionnaire across four domains (nausea, eating, well-being, and bowels). Test-retest reliability showed intraclass correlation coefficient values ≥0.7 for all domains. Pilot responsiveness was demonstrated through differences in pre- and post-surgical scores.CONCLUSIONPRO-diGI is a PROM for gastrointestinal dysfunction after major abdominal surgery that shows good psychometric properties and demonstrates face validity, reliability, and responsiveness. This now needs external validation to facilitate broader implementation.
{"title":"Development of a patient-reported outcome measure for gastrointestinal recovery after surgery (PRO-diGI).","authors":"Matthew J Lee,Daniel M Baker,Debby Hawkins,Sue Blackwell,Robert Arnott,Deena Harji,Gabrielle Thorpe,Stephen J Chapman,Georgina L Jones,","doi":"10.1093/bjs/znaf055","DOIUrl":"https://doi.org/10.1093/bjs/znaf055","url":null,"abstract":"BACKGROUNDAfter major abdominal surgery, patients may experience significant gastrointestinal dysfunction, including postoperative ileus. Many clinical tools are used to measure this dysfunction, but there is no patient-reported outcome measure (PROM) specific to this group. The aim of this study was to develop a new PROM for this common condition.METHODSA four-stage approach was undertaken. Stage 1 used semi-structured interviews with 29 patients to explore experiences of gastrointestinal recovery and develop a draft questionnaire. Stage 2 solicited feedback from 18 patients and 15 clinical experts on the face validity of the proposed tool using the Questionnaire on Questionnaires (QQ-10). Stage 3 recruited 297 patients to complete the questionnaire. Principal component analysis reduced the items and identified the domain structure. Test-retest reliability and a pilot assessment of responsiveness were assessed in stage 4 in a sample of 100 patients and in a sample of 68 patients respectively.RESULTSThe interviews generated 26 subthemes across gastrointestinal recovery and general well-being. An initial questionnaire containing 44 items was developed. The QQ-10 demonstrated high value and low burden, supporting face validity. Tests to reduce the items and identify the domain structure resulted in a 15-item questionnaire across four domains (nausea, eating, well-being, and bowels). Test-retest reliability showed intraclass correlation coefficient values ≥0.7 for all domains. Pilot responsiveness was demonstrated through differences in pre- and post-surgical scores.CONCLUSIONPRO-diGI is a PROM for gastrointestinal dysfunction after major abdominal surgery that shows good psychometric properties and demonstrates face validity, reliability, and responsiveness. This now needs external validation to facilitate broader implementation.","PeriodicalId":136,"journal":{"name":"British Journal of Surgery","volume":"60 1","pages":""},"PeriodicalIF":9.6,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143819369","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":"Robotic intersphincteric resection with en-bloc prostatectomy for rectal cancer invading the prostate.","authors":"Kenji Kawada,Ryo Iguchi,Hiroya Matsuoka,Yukio Inamura,Mitsuru Yokota,Kazuyuki Kawamoto","doi":"10.1093/bjs/znaf064","DOIUrl":"https://doi.org/10.1093/bjs/znaf064","url":null,"abstract":"","PeriodicalId":136,"journal":{"name":"British Journal of Surgery","volume":"101 1","pages":""},"PeriodicalIF":9.6,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143822671","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":"The future of liver surgery-why it should be minimally invasive.","authors":"Ismaël Chaoui,Mathieu D'Hondt","doi":"10.1093/bjs/znaf053","DOIUrl":"https://doi.org/10.1093/bjs/znaf053","url":null,"abstract":"","PeriodicalId":136,"journal":{"name":"British Journal of Surgery","volume":"60 1","pages":""},"PeriodicalIF":9.6,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143822568","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":"The future of liver surgery-open access should still be the front runner.","authors":"Guido Torzilli","doi":"10.1093/bjs/znaf046","DOIUrl":"https://doi.org/10.1093/bjs/znaf046","url":null,"abstract":"","PeriodicalId":136,"journal":{"name":"British Journal of Surgery","volume":"25 1","pages":""},"PeriodicalIF":9.6,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143822569","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":"Symmetrization in therapeutic mammoplasty for breast cancer: si non nunc quandro.","authors":"Daniel R Leff, Paul T R Thiruchelvam","doi":"10.1093/bjs/znaf060","DOIUrl":"10.1093/bjs/znaf060","url":null,"abstract":"","PeriodicalId":136,"journal":{"name":"British Journal of Surgery","volume":"112 4","pages":""},"PeriodicalIF":8.6,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11962930/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143762686","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":"Correction to: Role of Lugol solution before total thyroidectomy for Graves' disease: randomized clinical trial.","authors":"","doi":"10.1093/bjs/znaf073","DOIUrl":"https://doi.org/10.1093/bjs/znaf073","url":null,"abstract":"","PeriodicalId":136,"journal":{"name":"British Journal of Surgery","volume":"112 4","pages":""},"PeriodicalIF":8.6,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12036522/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143955766","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}
Satoru Matsuda, Pieter van der Sluis, Hiraku Kumamaru, Feike Kingma, Hirofumi Kawakubo, Jelle Ruurda, Masayuki Watanabe, Hiroaki Miyata, Sjoerd Lagarde, Hiroya Takeuchi, Richard van Hillegersberg, Ken Shirabe, Bas P L Wijnhoven, Yuko Kitagawa
{"title":"Oesophagectomy in the East versus the West: comparison of two national audit databases.","authors":"Satoru Matsuda, Pieter van der Sluis, Hiraku Kumamaru, Feike Kingma, Hirofumi Kawakubo, Jelle Ruurda, Masayuki Watanabe, Hiroaki Miyata, Sjoerd Lagarde, Hiroya Takeuchi, Richard van Hillegersberg, Ken Shirabe, Bas P L Wijnhoven, Yuko Kitagawa","doi":"10.1093/bjs/znaf035","DOIUrl":"https://doi.org/10.1093/bjs/znaf035","url":null,"abstract":"","PeriodicalId":136,"journal":{"name":"British Journal of Surgery","volume":"112 4","pages":""},"PeriodicalIF":8.6,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12015469/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143959600","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}
Sander J M van Hootegem, Margrietha van der Linde, Marcel A Schneider, Jeesun Kim, Felix Berlth, Yutaka Sugita, Peter P Grimminger, Gian Luca Baiocchi, Giovanni De Manzoni, Maria Bencivenga, Suzanne Gisbertz, Souya Nunobe, Han-Kwang Yang, Christian A Gutschow, Sjoerd M Lagarde, Hester F Lingsma, Bas P L Wijnhoven
Background: To reduce the clinical and economic burden of complications after gastrectomy for gastric cancer, specific complications should be targeted to effectively allocate healthcare resources for quality improvement and preventive measures. The aim of this study was to assess the impact of complications on clinical outcomes.
Methods: This was a retrospective multicentre study of patients who underwent (sub)total gastrectomy for gastric or junctional adenocarcinoma at 43 centres in 16 countries between 2017 and 2021. Outcomes were escalation of care, reoperation, prolonged hospital stay (greater than the 75th percentile), readmission, and 30-day mortality. Adjusted relative risks and population attributable fractions were estimated for specific complication-outcome pairs. The population attributable fraction represents the percentage reduction in the frequency of an adverse outcome if a complication could be completely prevented in the population.
Results: In total, 7829 patients were included. Postoperative complications occurred in 1884 patients (24.1%). The most frequent complications were pulmonary complications (436 patients (5.6%)), anastomotic leakage (363 patients (4.6%)), and abdominal collection (301 patients (3.8%)). Anastomotic leakage, cardiac complications, and pulmonary complications had the greatest impact on 30-day mortality (population attributable fraction 26.6% (95% c.i. 14.5% to 38.6%), 18.7% (95% c.i. 9.4% to 28.0%), and 15.6% (95% c.i. 12.0% to 30.0%) respectively). Anastomotic leakage and pulmonary complications had the greatest impact on escalation of care (population attributable fraction 26.3% (95% c.i. 20.6% to 32.0%) and 18.4% (95% c.i. 11.7% to 25.2%) respectively), whereas anastomotic leakage and intra-abdominal bleeding had the greatest impact on reoperation (population attributable fraction 31.6% (95% c.i. 26.4% to 36.9%) and 8.5% (95% c.i. 5.5% to 11.5%) respectively). Most of the studied complications contributed to a prolonged hospital stay, whereas the contribution of complications to readmission did not exceed 15.9%. Subgroup analysis showed regional variation in the impact of complications.
Conclusion: Anastomotic leakage had the largest overall negative impact on clinical outcomes after gastrectomy for gastric adenocarcinoma. Reducing the incidence of anastomotic leakage and pulmonary complications would have the most impact on the burden of complications.
{"title":"Impact of postoperative complications on clinical outcomes after gastrectomy for cancer: multicentre study.","authors":"Sander J M van Hootegem, Margrietha van der Linde, Marcel A Schneider, Jeesun Kim, Felix Berlth, Yutaka Sugita, Peter P Grimminger, Gian Luca Baiocchi, Giovanni De Manzoni, Maria Bencivenga, Suzanne Gisbertz, Souya Nunobe, Han-Kwang Yang, Christian A Gutschow, Sjoerd M Lagarde, Hester F Lingsma, Bas P L Wijnhoven","doi":"10.1093/bjs/znaf043","DOIUrl":"10.1093/bjs/znaf043","url":null,"abstract":"<p><strong>Background: </strong>To reduce the clinical and economic burden of complications after gastrectomy for gastric cancer, specific complications should be targeted to effectively allocate healthcare resources for quality improvement and preventive measures. The aim of this study was to assess the impact of complications on clinical outcomes.</p><p><strong>Methods: </strong>This was a retrospective multicentre study of patients who underwent (sub)total gastrectomy for gastric or junctional adenocarcinoma at 43 centres in 16 countries between 2017 and 2021. Outcomes were escalation of care, reoperation, prolonged hospital stay (greater than the 75th percentile), readmission, and 30-day mortality. Adjusted relative risks and population attributable fractions were estimated for specific complication-outcome pairs. The population attributable fraction represents the percentage reduction in the frequency of an adverse outcome if a complication could be completely prevented in the population.</p><p><strong>Results: </strong>In total, 7829 patients were included. Postoperative complications occurred in 1884 patients (24.1%). The most frequent complications were pulmonary complications (436 patients (5.6%)), anastomotic leakage (363 patients (4.6%)), and abdominal collection (301 patients (3.8%)). Anastomotic leakage, cardiac complications, and pulmonary complications had the greatest impact on 30-day mortality (population attributable fraction 26.6% (95% c.i. 14.5% to 38.6%), 18.7% (95% c.i. 9.4% to 28.0%), and 15.6% (95% c.i. 12.0% to 30.0%) respectively). Anastomotic leakage and pulmonary complications had the greatest impact on escalation of care (population attributable fraction 26.3% (95% c.i. 20.6% to 32.0%) and 18.4% (95% c.i. 11.7% to 25.2%) respectively), whereas anastomotic leakage and intra-abdominal bleeding had the greatest impact on reoperation (population attributable fraction 31.6% (95% c.i. 26.4% to 36.9%) and 8.5% (95% c.i. 5.5% to 11.5%) respectively). Most of the studied complications contributed to a prolonged hospital stay, whereas the contribution of complications to readmission did not exceed 15.9%. Subgroup analysis showed regional variation in the impact of complications.</p><p><strong>Conclusion: </strong>Anastomotic leakage had the largest overall negative impact on clinical outcomes after gastrectomy for gastric adenocarcinoma. Reducing the incidence of anastomotic leakage and pulmonary complications would have the most impact on the burden of complications.</p>","PeriodicalId":136,"journal":{"name":"British Journal of Surgery","volume":"112 4","pages":""},"PeriodicalIF":8.6,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11953074/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143741773","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}
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