Mads Marckmann,Nadia A Henriksen,Peter-Martin Krarup,Frederik Helgstrand,Peter Vester-Glowinski,M W Christoffersen,Kristian S Kiim
BACKGROUNDThe benefit of closed incision negative-pressure therapy (ciNPT) after open incisional hernia repair in reducing surgical-site infection (SSI) is uncertain.METHODSThe PROPRESS multicentre RCT was conducted from 1 March 2023 to 25 June 2024 at three Danish hospitals. Patients undergoing elective open incisional hernia repair were randomized to ciNPT or a standard wound dressing (SWD). The primary outcome was the incidence of SSI at 30 days. Secondary outcomes at 30 days included the pooled incidence of surgical-site occurrences (SSOs), patient-reported quality of life (QoL), and patient-reported scar assessment. The last follow-up date was 25 July 2024.RESULTSA total of 110 patients were randomized (54 SWD patients and 56 ciNPT patients; median age of 63.9 (interquartile range 50.7-69.0) years; 45 (40.1%) were female) and 108 (98.2%) completed follow-up at 30 days. In total, 7 of the 110 patients (6.4%) were smokers, the mean(s.d.) BMI was 29.3(4.1) kg/m2, and the mean(s.d.) horizontal defect size was 8.7(4.7) cm. One death in each group was unrelated to the intervention, but surgery and anaesthesia may have been predisposing factors for mortality. There was no difference in SSI rates; 4 of 53 patients (8%) in the SWD group versus 7 of 55 patients (13%) in the ciNPT group (P = 0.673). With regard to SSOs, these affected 12 of 53 patients (23%) in the SWD group versus 14 of 55 patients (26%) in the ciNPT group (P = 0.907). There was no difference in scar scores (equal mean scores of 24; P = 0.892) and overall QoL improved significantly (mean score difference: -12.8 (95% c.i. -15.4 to -10.2); P < 0.001) without a difference between the groups (mean score change: SWD -12.6 versus ciNPT -13.0; P = 0.874).CONCLUSIONciNPT did not reduce SSI after open incisional hernia repair in this RCT, which was limited by the relatively small number of patients.REGISTRATION NUMBERNCT05050786 (http://www.clinicaltrials.gov).
{"title":"Effect of standard wound dressing versus prophylactic closed incision negative-pressure therapy on surgical-site infection after open incisional hernia repair: multicentre randomized clinical trial.","authors":"Mads Marckmann,Nadia A Henriksen,Peter-Martin Krarup,Frederik Helgstrand,Peter Vester-Glowinski,M W Christoffersen,Kristian S Kiim","doi":"10.1093/bjs/znaf230","DOIUrl":"https://doi.org/10.1093/bjs/znaf230","url":null,"abstract":"BACKGROUNDThe benefit of closed incision negative-pressure therapy (ciNPT) after open incisional hernia repair in reducing surgical-site infection (SSI) is uncertain.METHODSThe PROPRESS multicentre RCT was conducted from 1 March 2023 to 25 June 2024 at three Danish hospitals. Patients undergoing elective open incisional hernia repair were randomized to ciNPT or a standard wound dressing (SWD). The primary outcome was the incidence of SSI at 30 days. Secondary outcomes at 30 days included the pooled incidence of surgical-site occurrences (SSOs), patient-reported quality of life (QoL), and patient-reported scar assessment. The last follow-up date was 25 July 2024.RESULTSA total of 110 patients were randomized (54 SWD patients and 56 ciNPT patients; median age of 63.9 (interquartile range 50.7-69.0) years; 45 (40.1%) were female) and 108 (98.2%) completed follow-up at 30 days. In total, 7 of the 110 patients (6.4%) were smokers, the mean(s.d.) BMI was 29.3(4.1) kg/m2, and the mean(s.d.) horizontal defect size was 8.7(4.7) cm. One death in each group was unrelated to the intervention, but surgery and anaesthesia may have been predisposing factors for mortality. There was no difference in SSI rates; 4 of 53 patients (8%) in the SWD group versus 7 of 55 patients (13%) in the ciNPT group (P = 0.673). With regard to SSOs, these affected 12 of 53 patients (23%) in the SWD group versus 14 of 55 patients (26%) in the ciNPT group (P = 0.907). There was no difference in scar scores (equal mean scores of 24; P = 0.892) and overall QoL improved significantly (mean score difference: -12.8 (95% c.i. -15.4 to -10.2); P < 0.001) without a difference between the groups (mean score change: SWD -12.6 versus ciNPT -13.0; P = 0.874).CONCLUSIONciNPT did not reduce SSI after open incisional hernia repair in this RCT, which was limited by the relatively small number of patients.REGISTRATION NUMBERNCT05050786 (http://www.clinicaltrials.gov).","PeriodicalId":136,"journal":{"name":"British Journal of Surgery","volume":"2 1","pages":""},"PeriodicalIF":9.6,"publicationDate":"2025-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145613380","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":"Correction to: Axillary surgery versus no-axillary staging in T1N0 breast cancer: 20-year follow-up of the INT 09/98 randomized clinical trial.","authors":"","doi":"10.1093/bjs/znaf234","DOIUrl":"https://doi.org/10.1093/bjs/znaf234","url":null,"abstract":"","PeriodicalId":136,"journal":{"name":"British Journal of Surgery","volume":"169 1","pages":""},"PeriodicalIF":9.6,"publicationDate":"2025-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145472767","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}
Angus R J Barber,Alexander Dottore,James Leigh,Mark Fear,Fiona Wood
BACKGROUNDRapid evaporative ionization mass spectrometry (REIMS) is an emerging technology facilitating real-time intraoperative tissue identification during surgery. This review aims to discuss the applications and reported outcomes of REIMS technology in a surgical context.METHODSA systematic review was performed using four electronic databases that were searched in August 2025: MEDLINE, Emcare, Embase, and Web of Science. Eligible studies were peer-reviewed, included five or more patients, and evaluated REIMS technology in the context of a surgical specialty or pathology. Two independent reviewers screened studies, extracted data, and assessed risk of bias using the QUADAS-2 tool. The study protocol was registered in the PROSPERO international prospective register of systematic reviews before commencing the review (CRD42024546741).RESULTSA total of 344 records underwent initial screening, with 26 studies included. Included articles originated from seven countries and applied REIMS to eight surgical specialties. Twenty-three of the included articles used REIMS to identify cancerous tissue. All included studies reported both qualitative and quantitative outcomes. Included studies demonstrated a variety of surgical applications with promising results with regard to accuracy, sensitivity, and specificity. Both ex vivo and in vivo applications were explored, but limited in vivo data was reported and logistical limitations were identified.CONCLUSIONMost of the evidence supporting the use of REIMS in surgery originates from an ex vivo environment. Current limitations of the technique include equipment logistics and the complexity of interpretation of data and further in vivo studies with larger patient numbers are required to support more widespread application.
背景：快速蒸发电离质谱法（REIMS）是一种新兴的技术，可以在手术过程中实时识别术中组织。这篇综述旨在讨论REIMS技术在外科领域的应用和报道的结果。方法采用于2025年8月检索的MEDLINE、Emcare、Embase和Web of Science 4个电子数据库进行系统评价。符合条件的研究经过同行评审，包括5名或更多患者，并在外科专科或病理学背景下评估REIMS技术。两名独立审稿人筛选研究，提取数据，并使用QUADAS-2工具评估偏倚风险。在开始审查之前，该研究方案已在普洛斯彼罗国际前瞻性系统评价登记处注册（CRD42024546741）。结果共有344例患者接受了初步筛查，其中26例为研究。纳入来自7个国家的文章，并将REIMS应用于8个外科专科。纳入的文章中有23篇使用rems来识别癌组织。所有纳入的研究均报告了定性和定量结果。纳入的研究证明了各种外科应用，在准确性、敏感性和特异性方面都有很好的结果。研究人员探索了体外和体内的应用，但体内数据有限，并且确定了后勤限制。结论支持rems在手术中应用的证据大多来自离体环境。目前该技术的局限性包括设备后勤和数据解释的复杂性，需要更多患者数量的进一步体内研究来支持更广泛的应用。
{"title":"Rapid evaporative ionization mass spectrometry in surgery: a systematic review.","authors":"Angus R J Barber,Alexander Dottore,James Leigh,Mark Fear,Fiona Wood","doi":"10.1093/bjs/znaf228","DOIUrl":"https://doi.org/10.1093/bjs/znaf228","url":null,"abstract":"BACKGROUNDRapid evaporative ionization mass spectrometry (REIMS) is an emerging technology facilitating real-time intraoperative tissue identification during surgery. This review aims to discuss the applications and reported outcomes of REIMS technology in a surgical context.METHODSA systematic review was performed using four electronic databases that were searched in August 2025: MEDLINE, Emcare, Embase, and Web of Science. Eligible studies were peer-reviewed, included five or more patients, and evaluated REIMS technology in the context of a surgical specialty or pathology. Two independent reviewers screened studies, extracted data, and assessed risk of bias using the QUADAS-2 tool. The study protocol was registered in the PROSPERO international prospective register of systematic reviews before commencing the review (CRD42024546741).RESULTSA total of 344 records underwent initial screening, with 26 studies included. Included articles originated from seven countries and applied REIMS to eight surgical specialties. Twenty-three of the included articles used REIMS to identify cancerous tissue. All included studies reported both qualitative and quantitative outcomes. Included studies demonstrated a variety of surgical applications with promising results with regard to accuracy, sensitivity, and specificity. Both ex vivo and in vivo applications were explored, but limited in vivo data was reported and logistical limitations were identified.CONCLUSIONMost of the evidence supporting the use of REIMS in surgery originates from an ex vivo environment. Current limitations of the technique include equipment logistics and the complexity of interpretation of data and further in vivo studies with larger patient numbers are required to support more widespread application.","PeriodicalId":136,"journal":{"name":"British Journal of Surgery","volume":"11 1","pages":""},"PeriodicalIF":9.6,"publicationDate":"2025-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145491716","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}
Eoin P Kerin,John P M O'Donnell,Sami M Abd Elwahab,Thomas O Butler,Luis Bouz Mkabaah,Angie Fasoula,Giannis Papatrechas,Petros Arvanitis,Luc Duchesne,Michael K Barry,Aoife J Lowery,Michael J Kerin
{"title":"Diagnostic performance of the second-generation Wavelia microwave breast imaging system: a pilot clinical investigation.","authors":"Eoin P Kerin,John P M O'Donnell,Sami M Abd Elwahab,Thomas O Butler,Luis Bouz Mkabaah,Angie Fasoula,Giannis Papatrechas,Petros Arvanitis,Luc Duchesne,Michael K Barry,Aoife J Lowery,Michael J Kerin","doi":"10.1093/bjs/znaf242","DOIUrl":"https://doi.org/10.1093/bjs/znaf242","url":null,"abstract":"","PeriodicalId":136,"journal":{"name":"British Journal of Surgery","volume":"53 1","pages":""},"PeriodicalIF":9.6,"publicationDate":"2025-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145491717","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":"Wearable-supported self-managed rehabilitation after breast cancer surgery: aligning with the NHS 10-year health plan.","authors":"Ahmed Latif,Meera Joshi,Ara Darzi,Daniel R Leff","doi":"10.1093/bjs/znaf235","DOIUrl":"https://doi.org/10.1093/bjs/znaf235","url":null,"abstract":"","PeriodicalId":136,"journal":{"name":"British Journal of Surgery","volume":"39 1","pages":""},"PeriodicalIF":9.6,"publicationDate":"2025-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145472817","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}
Sivesh K Kamarajah,Jugdeep Dhesi,Kamlesh Khunti,Krishnarajah Nirantharakumar,Paul Cockwell,Clare Hughes,Paul Stern,Joyce Yeung,Dion G Morton,Aneel A Bhangu,Shalini Ahuja
BACKGROUNDPeople with multiple long-term conditions (MLTC) commonly undergo elective surgery, yet current pathways remain poorly equipped to meet their complex needs. These pathways present a unique, time-sensitive opportunity to act. The aim of this study was to co-design a feasible intervention that integrates MLTC care into surgical pathways.METHODSThis was a theory-informed mixed-methods co-design study (informed by the National Institute for Health and Care Research (NIHR)/Medical Research Council (MRC) complex intervention framework). Phase 1 involved contextual analysis of current UK pathways (pathway mapping, policy/guideline scan, and national survey) and phase 2 involved multidisciplinary stakeholder workshops to develop a Theory of Change.RESULTSIn phase 1, pathway mapping identified variation and delayed preassessment, resulting in a limited window to optimize chronic diseases. The scoping review found no UK guidance integrating MLTC into surgical pathways. In the survey (73 responses, 51 National Health Service (NHS) Trusts), few services screened at listing and structured pathways were uncommon. Only one-in-ten hospitals had an MLTC-specific care pathway for elective surgical patients, primarily focusing on diabetes or anaemia management. In phase 2, 21 stakeholders agreed upon a pragmatic intervention prioritized on four domains (diabetes, hypertension, weight management, and smoking cessation), with five intervention components: surgeon-led checklist-based early identification at listing; automated referral to primary care/specialist services; patient-activation materials; optimization during waiting time; and structured discharge communication.CONCLUSIONThis study presents a co-designed model that shifts MLTC care upstream to the point of listing, offering the potential to improve short- and long-term health.
{"title":"Integrated care for people with multimorbidity into elective surgical pathways: mixed-methods co-design study.","authors":"Sivesh K Kamarajah,Jugdeep Dhesi,Kamlesh Khunti,Krishnarajah Nirantharakumar,Paul Cockwell,Clare Hughes,Paul Stern,Joyce Yeung,Dion G Morton,Aneel A Bhangu,Shalini Ahuja","doi":"10.1093/bjs/znaf246","DOIUrl":"https://doi.org/10.1093/bjs/znaf246","url":null,"abstract":"BACKGROUNDPeople with multiple long-term conditions (MLTC) commonly undergo elective surgery, yet current pathways remain poorly equipped to meet their complex needs. These pathways present a unique, time-sensitive opportunity to act. The aim of this study was to co-design a feasible intervention that integrates MLTC care into surgical pathways.METHODSThis was a theory-informed mixed-methods co-design study (informed by the National Institute for Health and Care Research (NIHR)/Medical Research Council (MRC) complex intervention framework). Phase 1 involved contextual analysis of current UK pathways (pathway mapping, policy/guideline scan, and national survey) and phase 2 involved multidisciplinary stakeholder workshops to develop a Theory of Change.RESULTSIn phase 1, pathway mapping identified variation and delayed preassessment, resulting in a limited window to optimize chronic diseases. The scoping review found no UK guidance integrating MLTC into surgical pathways. In the survey (73 responses, 51 National Health Service (NHS) Trusts), few services screened at listing and structured pathways were uncommon. Only one-in-ten hospitals had an MLTC-specific care pathway for elective surgical patients, primarily focusing on diabetes or anaemia management. In phase 2, 21 stakeholders agreed upon a pragmatic intervention prioritized on four domains (diabetes, hypertension, weight management, and smoking cessation), with five intervention components: surgeon-led checklist-based early identification at listing; automated referral to primary care/specialist services; patient-activation materials; optimization during waiting time; and structured discharge communication.CONCLUSIONThis study presents a co-designed model that shifts MLTC care upstream to the point of listing, offering the potential to improve short- and long-term health.","PeriodicalId":136,"journal":{"name":"British Journal of Surgery","volume":"16 1","pages":""},"PeriodicalIF":9.6,"publicationDate":"2025-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145491461","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}
Thomas Daoulas,Hugo Mollard-Tanguy,Jean-Christophe Courtil,Christian Lefèvre,Joël Savéan,Muriel Pardon-Labonnelie
{"title":"Critical review of an instrument from the House of the Roman Surgeon in Rimini.","authors":"Thomas Daoulas,Hugo Mollard-Tanguy,Jean-Christophe Courtil,Christian Lefèvre,Joël Savéan,Muriel Pardon-Labonnelie","doi":"10.1093/bjs/znaf229","DOIUrl":"https://doi.org/10.1093/bjs/znaf229","url":null,"abstract":"","PeriodicalId":136,"journal":{"name":"British Journal of Surgery","volume":"82 1","pages":""},"PeriodicalIF":9.6,"publicationDate":"2025-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145472769","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}
Carly N Bisset,Robert Baigrie,Nicola Dames,Stefan Corbett,Susannah Hill,Ewan Macdermid,Vincent Q Sier,Joost R van der Vorst,Umar Rehman,Mohammad S Sarwar,Peter A Brennan,Jennifer Cleland,Ricky Ellis,James E Bryan,Adele Ketley,Jenna L Morgan,Peter Gogalniceanu,Haytham M A Kaafarani,Rhea Liang,Susan J Moug
{"title":"The science and art of decision-making in surgery.","authors":"Carly N Bisset,Robert Baigrie,Nicola Dames,Stefan Corbett,Susannah Hill,Ewan Macdermid,Vincent Q Sier,Joost R van der Vorst,Umar Rehman,Mohammad S Sarwar,Peter A Brennan,Jennifer Cleland,Ricky Ellis,James E Bryan,Adele Ketley,Jenna L Morgan,Peter Gogalniceanu,Haytham M A Kaafarani,Rhea Liang,Susan J Moug","doi":"10.1093/bjs/znaf177","DOIUrl":"https://doi.org/10.1093/bjs/znaf177","url":null,"abstract":"","PeriodicalId":136,"journal":{"name":"British Journal of Surgery","volume":"53 1","pages":""},"PeriodicalIF":9.6,"publicationDate":"2025-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145477603","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}
Ana Manzano Rodriguez,Cees G M Snoek,Marlies P Schijven
{"title":"Bridging the gap: exposing the hidden challenges towards adoption of artificial intelligence in surgery.","authors":"Ana Manzano Rodriguez,Cees G M Snoek,Marlies P Schijven","doi":"10.1093/bjs/znaf217","DOIUrl":"https://doi.org/10.1093/bjs/znaf217","url":null,"abstract":"","PeriodicalId":136,"journal":{"name":"British Journal of Surgery","volume":"71 1","pages":""},"PeriodicalIF":9.6,"publicationDate":"2025-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145472768","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}
Marcin Barczyński,Klaas Van Den Heede,James C Lee,Kerstin Lorenz,Radu Mihai,Olov Norlen,Kepal N Patel,Marco Raffaelli,Rebecca S Sippel,Tracy S Wang,Carmen C Solorzano
{"title":"Standardizing the reporting of postoperative hypoparathyroidism following thyroidectomy: consensus statement from the European Society of Endocrine Surgeons, the American Association of Endocrine Surgeons, and the International Association of Endocrine Surgeons.","authors":"Marcin Barczyński,Klaas Van Den Heede,James C Lee,Kerstin Lorenz,Radu Mihai,Olov Norlen,Kepal N Patel,Marco Raffaelli,Rebecca S Sippel,Tracy S Wang,Carmen C Solorzano","doi":"10.1093/bjs/znaf247","DOIUrl":"https://doi.org/10.1093/bjs/znaf247","url":null,"abstract":"","PeriodicalId":136,"journal":{"name":"British Journal of Surgery","volume":"1 1","pages":""},"PeriodicalIF":9.6,"publicationDate":"2025-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145499514","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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