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Subnormothermic acellular machine perfusion for prolonged preservation of human kidneys. 常温下脱细胞机器灌注用于人体肾脏的长期保存。
IF 9.6 1区 医学 Q1 SURGERY Pub Date : 2025-07-03 DOI: 10.1093/bjs/znaf147
Sara Deffrennes,Serena MacMillan,Anna Paterson,Michael L Nicholson,Sarah A Hosgood
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引用次数: 0
Pancreatectomy in a national universal healthcare system: sex- and age-adjusted resection rates across four health regions related to a composite ideal outcome. 国家全民医疗保健系统中的胰腺切除术:性别和年龄调整的四个健康区域的切除率与复合理想结果相关。
IF 9.6 1区 医学 Q1 SURGERY Pub Date : 2025-07-03 DOI: 10.1093/bjs/znaf148
Marcus T T Roalsø,Linn S Nymo,Dyre Kleive,Kim Waardal,Rachel Dille-Amdam,Jan T Kvaløy,Kjetil Søreide
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引用次数: 0
The spoon of Diocles: a tool for extracting an arrow from a wound in the Graeco-Roman world? 戴可利斯的勺子:希腊罗马时代用来从伤口中拔箭的工具?
IF 9.6 1区 医学 Q1 SURGERY Pub Date : 2025-07-03 DOI: 10.1093/bjs/znaf127
Thomas Daoulas,Giorgio Franchetti,Joel Savéan,Jean-Christophe Courtil,Muriel Pardon-Labonnelie
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引用次数: 0
Prevalence and severity of pain, anxiety, stress, and sleep disturbances among surgical patients: a nationwide single-day multicentre flash mob study. 外科手术患者疼痛、焦虑、压力和睡眠障碍的患病率和严重程度:一项全国性的、为期一天的多中心快闪研究
IF 9.6 1区 医学 Q1 SURGERY Pub Date : 2025-07-03 DOI: 10.1093/bjs/znaf124
Jetske M Stoop,Roos Geensen,Sophie C Adam,Kayleigh A M van Dam,Els van Dessel,Annemarie Dolmans-Zwartjes,Margot Heijmans,Audrey C H M Jongen,Mirjam Kaijser,Chantal A Ten Kate,Joanna Luttikhold,Flores M Metz,Laura van Zeggeren, ,Johannes Jeekel,Markus Klimek
BACKGROUNDPatient-reported outcomes (PROs) are subjective health indicators including pain, anxiety, stress, and sleep disturbances. Despite their frequent occurrence in the perioperative period and potentially severe consequences for postoperative recovery (for example prolonged length of hospital stay, cardiovascular events, development of chronic pain), these are not acknowledged as complications and their exact prevalence remains unclear. This study aims to assess the prevalence and severity of pre- and postoperative pain, anxiety, stress, and sleep disturbances among surgical patients.METHODSA nationwide single-day multicentre cross-sectional flash mob study was conducted in 29 Dutch hospitals. Adult surgical patients with an expected hospital stay of at least one night were included. Patients admitted for neurosurgery, cardiothoracic surgery, or orthopaedic surgery were excluded. Primary outcomes were self-reported pain, anxiety, stress, and sleep disturbances, as assessed with the Numeric Rating Scale, Visual Analogue Scale for Anxiety, Perceived Stress Scale, and the adapted Patient-Reported Outcome Measurement Information System respectively.RESULTSOf the 1077 eligible patients, 733 (68%) patients (mean age of 64 ± 15.9 s.d. years, 51.8% male) completed participation. Moderate to severe pain was prevalent in 509 patients (69.7%) and occurred most frequently post-surgery. Anxiety occurred in 278 patients (38.1%) and was more prevalent preoperatively. Moderate to severe stress was reported by 272 patients (37.8%) with similar findings pre- and post-surgery. Sleep disturbances were prevalent in 440 patients (64.1%). Pain and anxiety were more severe in females. Sleep disturbances were more severe in patients with lower socioeconomic status.CONCLUSIONPain, anxiety, stress, and sleep disturbances are highly frequent complications among surgical patients in Dutch hospitals. Considering the prevalence and severity, we suggest implementing these relevant additional measures for PROs as indicators for routine postoperative evaluation to facilitate their management.
患者报告的结果(PROs)是主观健康指标,包括疼痛、焦虑、压力和睡眠障碍。尽管它们经常发生在围手术期,并可能对术后恢复造成严重后果(例如延长住院时间、心血管事件、慢性疼痛的发展),但这些都不被认为是并发症,其确切的患病率尚不清楚。本研究旨在评估手术患者术前和术后疼痛、焦虑、压力和睡眠障碍的患病率和严重程度。方法在荷兰29家医院进行为期一天的全国性多中心横断面快闪研究。预计住院至少一晚的成年外科患者被纳入研究对象。排除了接受神经外科、心胸外科或骨科手术的患者。主要结局是自我报告的疼痛、焦虑、压力和睡眠障碍,分别用数字评定量表、焦虑视觉模拟量表、感知压力量表和适应的患者报告结果测量信息系统进行评估。结果在1077例符合条件的患者中,733例(68%)患者(平均年龄64±15.9 s.d.年,男性51.8%)完成了参与。509例患者(69.7%)普遍存在中度至重度疼痛,且最常发生在术后。278例患者(38.1%)出现焦虑,且术前更为普遍。272例患者(37.8%)报告了中度至重度压力,手术前后的结果相似。440例(64.1%)患者普遍存在睡眠障碍。疼痛和焦虑在女性中更为严重。社会经济地位较低的患者睡眠障碍更严重。结论疼痛、焦虑、压力和睡眠障碍是荷兰医院外科患者中较为常见的并发症。考虑到pro的患病率和严重程度,我们建议将这些相关的附加措施作为术后常规评估的指标,以方便其管理。
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引用次数: 0
Correction to: Outcomes of elective open surgical repair or fenestrated endovascular aneurysm repair for juxtarenal abdominal aortic aneurysms in Sweden. 修正:瑞典择期切开手术修复或开窗血管内动脉瘤修复术治疗脐旁腹主动脉瘤的结果。
IF 8.8 1区 医学 Q1 SURGERY Pub Date : 2025-07-03 DOI: 10.1093/bjs/znaf167
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引用次数: 0
Birth rates after laparoscopic and open ileal pouch-anal anastomosis for ulcerative colitis: a nationwide population-based cohort study. 溃疡性结肠炎腹腔镜和开放式回肠袋-肛门吻合术后的出生率:一项全国性人群队列研究。
IF 9.6 1区 医学 Q1 SURGERY Pub Date : 2025-07-03 DOI: 10.1093/bjs/znaf136
Anders Mark-Christensen,Anthony Charles Ebert,Kirstine Kirkegaard,Søren Laurberg,Gry Poulsen,Tine Jess,Mette Julsgaard
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引用次数: 0
Early-onset gastrointestinal cancers: comprehensive review and future directions. 早发性胃肠道癌症:综合综述及未来发展方向。
IF 9.6 1区 医学 Q1 SURGERY Pub Date : 2025-07-03 DOI: 10.1093/bjs/znaf102
Sara K Char,Catherine A O'Connor,Kimmie Ng
BACKGROUNDThe incidence of early-onset (EO) gastrointestinal (GI) cancers-commonly defined as being diagnosed in patients <50 years of age-is rising at an alarming rate globally. The rising incidence demonstrates a birth cohort effect, implicating environmental factors, such as diet and lifestyle; however, the drivers behind this trend are not yet known.METHODSA comprehensive narrative review of the literature was conducted, focusing on EO colorectal, oesophagogastric, and pancreatic cancers. Additionally, the literature on less common EO GI cancers, including appendiceal, biliary, and neuroendocrine tumours, was reviewed. Epidemiological trends, risk factors, clinical and molecular characteristics, germline and somatic genetic features, and outcomes across these diseases were examined.RESULTSEO GI cancers have demonstrated a consistent rise in incidence, which disproportionally affects black, Hispanic, and indigenous populations and women. Though germline pathogenic variants are more common in EO GI cancers compared with average-onset GI cancers, most cases occur sporadically. Modifiable risk factors associated with an increased risk of EO GI cancers include obesity, a Western-pattern diet, non-alcoholic fatty liver disease, smoking, and alcohol use, among others. Across GI cancers, younger patients frequently present with more aggressive disease features and receive more intensive treatment compared with older patients. Survival outcomes are inconsistent across studies.CONCLUSIONEO GI cancers represent clinically distinct disease entities that are associated with unique challenges in screening, management, and survivorship. A better understanding of underlying aetiologies, optimized screening strategies, and improved survivorship support are necessary. Meeting the needs of this growing patient population will require a multidisciplinary, equity-based approach in both clinical care and research.
背景:早发性(EO)胃肠道(GI)癌症(通常定义为在50岁以下的患者中被诊断出来)的发病率在全球范围内以惊人的速度上升。发病率的上升表明了出生队列效应,涉及环境因素,如饮食和生活方式;然而,这一趋势背后的驱动因素尚不清楚。方法对EO型结直肠癌、食管胃癌和胰腺癌的相关文献进行综述。此外,对不常见的EO消化道肿瘤,包括阑尾、胆道和神经内分泌肿瘤的文献进行了回顾。研究了这些疾病的流行病学趋势、危险因素、临床和分子特征、种系和体细胞遗传特征以及结果。结果:GI癌症的发病率呈持续上升趋势,黑人、西班牙裔、土著人口和妇女的发病率尤其高。尽管生殖系致病性变异在EO型胃肠道癌症中比平均发病的胃肠道癌症更常见,但大多数病例是零星发生的。与EO - GI癌症风险增加相关的可改变的危险因素包括肥胖、西式饮食、非酒精性脂肪性肝病、吸烟和饮酒等。在胃肠道癌症中,与老年患者相比,年轻患者往往表现出更具侵袭性的疾病特征,并接受更强化的治疗。不同研究的生存结果不一致。结论:胃肠道肿瘤是临床独特的疾病实体,在筛查、管理和生存方面具有独特的挑战。更好地了解潜在的病因,优化筛查策略和改善生存支持是必要的。满足这一不断增长的患者群体的需求将需要在临床护理和研究中采用多学科、基于公平的方法。
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引用次数: 0
Automated surgical phase recognition for robotic pancreatoduodenectomy using artificial intelligence. 基于人工智能的机器人胰十二指肠切除术手术阶段自动识别。
IF 8.8 1区 医学 Q1 SURGERY Pub Date : 2025-07-03 DOI: 10.1093/bjs/znaf160
Koichi Tomita, Masashi Takeuchi, Jessica E Maxwell, Rebecca A Snyder, Michael P Kim, Hop S Tran Cao, Ching-Wei D Tzeng, Jeffrey E Lee, Matthew H G Katz, Naruhiko Ikoma
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引用次数: 0
Information standards for innovative surgery: what patients need to know. 创新手术的信息标准:患者需要知道什么。
IF 9.6 1区 医学 Q1 SURGERY Pub Date : 2025-07-03 DOI: 10.1093/bjs/znaf140
Christin Hoffmann,Daisy Elliott,Leila Rooshenas,Cynthia Ochieng,Barry Main,Pete Wheatstone,Samuel Lawday,Abigail Vallance,Jane M Blazeby,Angus G K McNair,
BACKGROUNDThere are repeated and ongoing failures in shared decision-making and informed consent for innovative surgical procedures. Governments and regulatory bodies internationally recommend establishing information standards to support safe and transparent surgical innovation. The aim of this study was to develop a core information set (CIS) for surgical innovation.METHODSThis was a mixed-method study in three phases: a provisional CIS was generated from multiple data sources (interviews with patients/professionals (44), recorded consultations (34), policy documents (58), and published studies (213)) using qualitative content analysis; the CIS was refined, with input from key stakeholders (patient representatives, surgeon innovators, anaesthetists, lawyers, ethicists, medical directors, academic experts, and regulatory representatives) using a modified nominal group technique; and the CIS was finalized through public consultation.RESULTSThe final CIS comprised seven themes that included: what is 'new' about the procedure; potential conflicts of interest; reasons for the innovation (including why the innovation is believed to be appropriate for the patient); treatment alternatives; unknowns (including uncertain safety/efficacy and that the procedure may be abandoned/modified); expertise with the innovation; and governance, oversight, and accountability (including how safety will be monitored and recompense if anything goes wrong). Two themes require follow-up discussions after the procedure.CONCLUSIONA seven-theme CIS for surgical innovation was co-developed, with input from key stakeholders. International implementation of these information standards may support safe and transparent surgical innovation.
背景在创新外科手术的共同决策和知情同意方面一再出现失败。各国政府和监管机构在国际上建议建立信息标准,以支持安全和透明的外科创新。本研究的目的是为外科创新开发一个核心信息集(CIS)。方法:这是一项分为三个阶段的混合方法研究:使用定性内容分析,从多个数据源(与患者/专业人员的访谈(44)、记录咨询(34)、政策文件(58)和发表的研究(213))生成临时CIS;根据主要利益相关者(患者代表、外科医生创新者、麻醉师、律师、伦理学家、医疗主任、学术专家和监管代表)的意见,使用改进的名义团体技术,对CIS进行了改进;《独联体》是通过公众咨询最后定稿的。最终的CIS包括七个主题,包括:手术的“新”之处;潜在的利益冲突;创新的原因(包括为什么认为该创新适合患者);治疗选择;未知因素(包括不确定的安全性/有效性以及程序可能被放弃/修改);专业与创新;以及治理、监督和问责制(包括如何监控安全以及在出现问题时如何进行补偿)。有两个主题需要在程序之后进行后续讨论。结论在关键利益相关者的参与下,共同制定了外科创新的七大主题CIS。这些信息标准的国际实施可以支持安全和透明的外科创新。
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引用次数: 0
Validation of the Swiss-Finnish Bariatric Metabolic Outcome Score within a large prospective registry cohort. 在一项大型前瞻性登记队列中验证瑞士-芬兰减肥代谢结局评分。
IF 8.6 1区 医学 Q1 SURGERY Pub Date : 2025-05-31 DOI: 10.1093/bjs/znaf106
Floris F E Bruinsma, Saija Hurme, Ralph Peterli, Erik Stenberg, Simon W Nienhuijs, Sofia Grönroos, Villy Våge, Marco Bueter, Johan Ottosson, Ronald S L Liem, Paulina Salminen

Background: The Swiss-Finnish Bariatric Metabolic Outcome Score (SF-BARI Score), based on merged data of two RCTs, is a composite endpoint designed to evaluate and categorize outcomes after metabolic bariatric surgery (MBS). The aim of this study was to externally validate the score using registry data.

Methods: Individual patient data were included from the Dutch Audit for Treatment of Obesity, the Scandinavian Obesity Surgery Registries (SOReg-Sweden and SOReg-Norway), and the merged RCT data used for establishing the SF-BARI Score. All patients undergoing primary MBS from January 2010 to June 2018, with complete baseline characteristics, as well as complete 1- and 5-year follow-up data, were included. The mean total score and distribution were compared between the combined registry and merged RCT data.

Results: There was no statistically significant difference in the mean SF-BARI Score between the registries (21 603 patients) and merged RCTs (457 patients) at 5 years (90.9 versus 89.1 points; difference = 1.8 (95% c.i. -1.0 to 4.7); P = 0.212), and the score distribution was similar. Statistically significant differences in baseline characteristics existed regarding sex (male 20.9% versus 29.3%), type 2 diabetes (16.7% versus 33.9%), hypertension (30.4% versus 66.1%), dyslipidaemia (13.7% versus 46.5%), obstructive sleep apnoea syndrome (12.0% versus 17.4%), and sleeve gastrectomy (SG) rate (21.0% versus 49.9%) (P < 0.001). The mean score estimate at 5 years in Roux-en-Y gastric bypass was 11.2 (95% c.i. 10.2 to 12.2) points higher compared with SG (P < 0.001).

Conclusion: This study verified the feasibility of the SF-BARI Score, enabling standardized reporting and allowing for comparison of different treatment modalities.

背景:瑞士-芬兰减肥代谢结局评分(SF-BARI Score)基于两项随机对照试验的合并数据,是一个复合终点,旨在评估和分类代谢减肥手术(MBS)后的结果。本研究的目的是使用注册表数据对评分进行外部验证。方法:个体患者数据包括来自荷兰肥胖治疗审计、斯堪的纳维亚肥胖手术登记处(soregg -瑞典和soregg -挪威)以及用于建立SF-BARI评分的合并RCT数据。所有2010年1月至2018年6月接受原发性MBS的患者,具有完整的基线特征,以及完整的1年和5年随访数据。比较合并注册表和合并RCT数据的平均总分和分布。结果:注册组(21,603例患者)和合并rct(457例患者)5年时的SF-BARI平均评分无统计学差异(90.9分vs 89.1分;差异= 1.8 (95% ci = -1.0 ~ 4.7);P = 0.212),评分分布相似。基线特征在性别(男性20.9%对29.3%)、2型糖尿病(16.7%对33.9%)、高血压(30.4%对66.1%)、血脂异常(13.7%对46.5%)、阻塞性睡眠呼吸暂停综合征(12.0%对17.4%)和袖胃切除术(SG)率(21.0%对49.9%)方面存在统计学差异(P < 0.001)。Roux-en-Y胃旁路术5年的平均评分比SG高11.2分(95% ci: 10.2 ~ 12.2) (P < 0.001)。结论:本研究验证了SF-BARI评分的可行性,实现了标准化报告,并允许对不同治疗方式进行比较。
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引用次数: 0
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British Journal of Surgery
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