{"title":"Acute pancreatitis national audit of practice: a national prospective audit of acute pancreatitis in the era of GLP-1 agonists-the PANDORA audit protocol.","authors":" ","doi":"10.1093/bjs/znaf214","DOIUrl":"https://doi.org/10.1093/bjs/znaf214","url":null,"abstract":"","PeriodicalId":136,"journal":{"name":"British Journal of Surgery","volume":"115 1","pages":""},"PeriodicalIF":9.6,"publicationDate":"2025-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145261504","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}
Connor P Boyle,James Crichton,Alessandro Sgrò,Sarah H Michael,Stephen J Wigmore,Richard J E Skipworth,Steven Yule
{"title":"'Play to the conditions': optimizing the operating theatre environment through lessons from elite performance domains.","authors":"Connor P Boyle,James Crichton,Alessandro Sgrò,Sarah H Michael,Stephen J Wigmore,Richard J E Skipworth,Steven Yule","doi":"10.1093/bjs/znaf181","DOIUrl":"https://doi.org/10.1093/bjs/znaf181","url":null,"abstract":"","PeriodicalId":136,"journal":{"name":"British Journal of Surgery","volume":"11 1","pages":""},"PeriodicalIF":9.6,"publicationDate":"2025-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145296201","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}
Ricardo V Cohen,Mohammad Kermansaravi,Randy Levinson,Muffazal Lakdawala,Chetan Parmar,Yosuke Seki,Gerhard Prager,Paulina Salminen,
{"title":"International Federation for the Surgery and Other Therapies for Obesity (IFSO) global consensus recommendations for optimizing outcomes after sleeve gastrectomy.","authors":"Ricardo V Cohen,Mohammad Kermansaravi,Randy Levinson,Muffazal Lakdawala,Chetan Parmar,Yosuke Seki,Gerhard Prager,Paulina Salminen, ","doi":"10.1093/bjs/znaf188","DOIUrl":"https://doi.org/10.1093/bjs/znaf188","url":null,"abstract":"","PeriodicalId":136,"journal":{"name":"British Journal of Surgery","volume":"64 1","pages":""},"PeriodicalIF":9.6,"publicationDate":"2025-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145296203","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}
Floris F E Bruinsma,Simon W Nienhuijs,Ronald S L Liem,Jan Willem M Greve,Perla J Marang-van de Mheen,
BACKGROUNDMetabolic bariatric surgery (MBS) quality registries monitor various outcomes, enabling the assessment of hospital performance in comparison with national benchmarks. However, if there is considerable between-surgeon outcome variation, surgeon-level feedback may be better suited. The aim of this study was to assess the extent to which patient-, surgeon-, and hospital-level factors contribute to the variation in outcomes after MBS.METHODSAll primary procedures registered in the Dutch MBS quality registry between 1 January 2020 and 31 December 2023 were included. Outcomes included severe postoperative complications, reoperation, prolonged length of stay (LOS), readmission, textbook outcome, and achieving ≥25% total weight loss within 1 year. Multilevel logistic regression models were built for each outcome, including all available patient characteristics, operating surgeon, and hospital, to determine the variance explained by patient-, surgeon-, and hospital-level factors.RESULTSIn total, 30 610 patients were included, operated on by 144 surgeons in 19 hospitals. Hospital-level factors contributed most to the explained variance for all outcomes, ranging from 59.6% for reoperation to 90.3% for prolonged LOS. Surgeon-level factors explained less variance, ranging from 3.2% for prolonged LOS to 28.2% for reoperation. Patient characteristics explained the least, ranging from 4.4% for textbook outcome to 13.1% for severe postoperative complications.CONCLUSIONVariation in outcomes is mostly explained by hospital factors, rather than surgeon factors, supporting hospital-based performance feedback. The results suggest that the pre- and postoperative trajectory and perioperative care may affect MBS outcomes more than patient characteristics or surgical team performance.
{"title":"Variation in outcomes after metabolic bariatric surgery: multilevel analysis to assess the contribution of patient, surgeon, and hospital factors.","authors":"Floris F E Bruinsma,Simon W Nienhuijs,Ronald S L Liem,Jan Willem M Greve,Perla J Marang-van de Mheen, ","doi":"10.1093/bjs/znaf186","DOIUrl":"https://doi.org/10.1093/bjs/znaf186","url":null,"abstract":"BACKGROUNDMetabolic bariatric surgery (MBS) quality registries monitor various outcomes, enabling the assessment of hospital performance in comparison with national benchmarks. However, if there is considerable between-surgeon outcome variation, surgeon-level feedback may be better suited. The aim of this study was to assess the extent to which patient-, surgeon-, and hospital-level factors contribute to the variation in outcomes after MBS.METHODSAll primary procedures registered in the Dutch MBS quality registry between 1 January 2020 and 31 December 2023 were included. Outcomes included severe postoperative complications, reoperation, prolonged length of stay (LOS), readmission, textbook outcome, and achieving ≥25% total weight loss within 1 year. Multilevel logistic regression models were built for each outcome, including all available patient characteristics, operating surgeon, and hospital, to determine the variance explained by patient-, surgeon-, and hospital-level factors.RESULTSIn total, 30 610 patients were included, operated on by 144 surgeons in 19 hospitals. Hospital-level factors contributed most to the explained variance for all outcomes, ranging from 59.6% for reoperation to 90.3% for prolonged LOS. Surgeon-level factors explained less variance, ranging from 3.2% for prolonged LOS to 28.2% for reoperation. Patient characteristics explained the least, ranging from 4.4% for textbook outcome to 13.1% for severe postoperative complications.CONCLUSIONVariation in outcomes is mostly explained by hospital factors, rather than surgeon factors, supporting hospital-based performance feedback. The results suggest that the pre- and postoperative trajectory and perioperative care may affect MBS outcomes more than patient characteristics or surgical team performance.","PeriodicalId":136,"journal":{"name":"British Journal of Surgery","volume":"8 1","pages":""},"PeriodicalIF":9.6,"publicationDate":"2025-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145215795","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}
Justin C R Wormald,Matthew D Gardiner,Christina Jerosch-Herold,Jonathan Cook,Rafael Pinedo Villanueva,Ciaron O'Hanlon,Naomi Vides,Gianluca Fabiano,Scott Parsons,Loretta Davies,Heidi Fletcher,Molly Glaze,Cushla Cooper,Dominic Power,Abhilash Jain,David Beard,
BACKGROUNDDigital nerves provide sensibility to the fingers. They are commonly injured through accidental sharp laceration. The aim of the NEON (Nerve rEpair Or Not) study was to investigate whether microsurgical suture repair of lacerated digital nerves is superior to nerve alignment alone without suture repair.METHODSA two-arm, parallel group, double-blind, multicentre RCT was undertaken over 2 years. Participants with suspected unilateral digital nerve injury underwent surgical exploration and were randomized to microsurgical suture repair or nerve alignment alone. The primary outcome was the Impact of Hand Nerve Disorders (I-HaND v2) patient-reported outcome measure (PROM) at 12 months post-randomization. Secondary outcomes assessed were: objective neurosensory and functional recovery; health-related quality of life to examine cost-effectiveness; complications of surgery and clinically problematic neuroma rates (Elliot score). Both participants and assessors were blind to allocation.RESULTSA total of 122 adults were randomized to microsurgical suture repair (n = 61) or nerve alignment alone (n = 61). Primary outcome data using the I-HaND (v2) were available for 106 participants (87%) at 12 months. There were no statistically significant differences in I-HaND scores at all time points, including the 12-month primary end point (15.9 versus 20.2, P = 0.09; 95% c.i. [-0.9, 10.8]). There were also no differences in all secondary outcome measures, including Patient Evaluation Measure and EQ-5D-5L scores at 12 months. Complications were similar at 6 weeks and 12 months. The trial was closed early by the funder owing to slow recruitment and did not reach the intended sample size.CONCLUSIONBased on the available data from the NEON trial, there is no evidence to support the beneficial effect of suture repair over nerve alignment alone for isolated digital nerve injury. This multicentre RCT can be used to inform future trials, inform patients and guide clinical practice.FUNDINGNIHR Health Technology Assessment (NIHR127807-18/37).TRIAL REGISTRATION NUMBERISRCTN16211574.
{"title":"The NEON (Nerve rEpair Or Not) trial: a randomized controlled trial of microsurgical repair versus nerve alignment for digital nerve injury.","authors":"Justin C R Wormald,Matthew D Gardiner,Christina Jerosch-Herold,Jonathan Cook,Rafael Pinedo Villanueva,Ciaron O'Hanlon,Naomi Vides,Gianluca Fabiano,Scott Parsons,Loretta Davies,Heidi Fletcher,Molly Glaze,Cushla Cooper,Dominic Power,Abhilash Jain,David Beard, ","doi":"10.1093/bjs/znaf174","DOIUrl":"https://doi.org/10.1093/bjs/znaf174","url":null,"abstract":"BACKGROUNDDigital nerves provide sensibility to the fingers. They are commonly injured through accidental sharp laceration. The aim of the NEON (Nerve rEpair Or Not) study was to investigate whether microsurgical suture repair of lacerated digital nerves is superior to nerve alignment alone without suture repair.METHODSA two-arm, parallel group, double-blind, multicentre RCT was undertaken over 2 years. Participants with suspected unilateral digital nerve injury underwent surgical exploration and were randomized to microsurgical suture repair or nerve alignment alone. The primary outcome was the Impact of Hand Nerve Disorders (I-HaND v2) patient-reported outcome measure (PROM) at 12 months post-randomization. Secondary outcomes assessed were: objective neurosensory and functional recovery; health-related quality of life to examine cost-effectiveness; complications of surgery and clinically problematic neuroma rates (Elliot score). Both participants and assessors were blind to allocation.RESULTSA total of 122 adults were randomized to microsurgical suture repair (n = 61) or nerve alignment alone (n = 61). Primary outcome data using the I-HaND (v2) were available for 106 participants (87%) at 12 months. There were no statistically significant differences in I-HaND scores at all time points, including the 12-month primary end point (15.9 versus 20.2, P = 0.09; 95% c.i. [-0.9, 10.8]). There were also no differences in all secondary outcome measures, including Patient Evaluation Measure and EQ-5D-5L scores at 12 months. Complications were similar at 6 weeks and 12 months. The trial was closed early by the funder owing to slow recruitment and did not reach the intended sample size.CONCLUSIONBased on the available data from the NEON trial, there is no evidence to support the beneficial effect of suture repair over nerve alignment alone for isolated digital nerve injury. This multicentre RCT can be used to inform future trials, inform patients and guide clinical practice.FUNDINGNIHR Health Technology Assessment (NIHR127807-18/37).TRIAL REGISTRATION NUMBERISRCTN16211574.","PeriodicalId":136,"journal":{"name":"British Journal of Surgery","volume":"24 1","pages":""},"PeriodicalIF":9.6,"publicationDate":"2025-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144962635","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":"Target trial emulation: harnessing real-world data to evaluate surgery and perioperative care interventions.","authors":"Kitty H F Wong,Robert J Hinchliffe","doi":"10.1093/bjs/znaf182","DOIUrl":"https://doi.org/10.1093/bjs/znaf182","url":null,"abstract":"","PeriodicalId":136,"journal":{"name":"British Journal of Surgery","volume":"35 1","pages":""},"PeriodicalIF":9.6,"publicationDate":"2025-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144959987","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}
Mwayi Kachapila,Stephen Tabiri,Mark Monahan,Francis A Abantanga,Anita Eseenam Agbeko,Fareeda Agyei,Aneel Bhangu,Dion G Morton,Tracy E Roberts,Virginia Ledda,Mike Ohene-Yeboah,Raymond Oppong
{"title":"Task sharing in elective inguinal hernia surgery in Ghana: a workforce model comparing surgeons and physicians.","authors":"Mwayi Kachapila,Stephen Tabiri,Mark Monahan,Francis A Abantanga,Anita Eseenam Agbeko,Fareeda Agyei,Aneel Bhangu,Dion G Morton,Tracy E Roberts,Virginia Ledda,Mike Ohene-Yeboah,Raymond Oppong","doi":"10.1093/bjs/znaf173","DOIUrl":"https://doi.org/10.1093/bjs/znaf173","url":null,"abstract":"","PeriodicalId":136,"journal":{"name":"British Journal of Surgery","volume":"35 1","pages":""},"PeriodicalIF":9.6,"publicationDate":"2025-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144962707","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}
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