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Author response to: Comment on: Total neoadjuvant therapy versus standard neoadjuvant treatment strategies for the management of locally advanced rectal cancer: network meta-analysis of randomized clinical trials. 作者回复:评论:治疗局部晚期直肠癌的全新术式治疗与标准新术式治疗策略:随机临床试验网络荟萃分析。
IF 8.6 1区 医学 Q1 SURGERY Pub Date : 2024-08-02 DOI: 10.1093/bjs/znae211
Mark Donnelly, Odhrán K Ryan, Éanna J Ryan, Des C Winter
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引用次数: 0
Acute large bowel obstruction. 急性大肠梗阻
IF 8.6 1区 医学 Q1 SURGERY Pub Date : 2024-08-02 DOI: 10.1093/bjs/znae202
Gita Lingham, Michael Okocha, Ben Griffiths
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引用次数: 0
Corrigendum to: Evaluation of a quality improvement intervention to reduce anastomotic leak following right colectomy (EAGLE): pragmatic, batched stepped-wedge, cluster-randomized trial in 64 countries. 更正:减少右结肠切除术后吻合口漏的质量改进干预评估 (EAGLE):在 64 个国家进行的务实、分批阶梯式、分组随机试验。
IF 8.6 1区 医学 Q1 SURGERY Pub Date : 2024-08-02 DOI: 10.1093/bjs/znae032
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引用次数: 0
Penetrating abdominal trauma. 腹部穿透性创伤
IF 8.6 1区 医学 Q1 SURGERY Pub Date : 2024-08-02 DOI: 10.1093/bjs/znae206
Ewan Kyle, Sally Grice, David N Naumann
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引用次数: 0
Effects of limb lengths in gastric bypass surgery. 胃旁路手术中肢体长度的影响。
IF 8.6 1区 医学 Q1 SURGERY Pub Date : 2024-08-02 DOI: 10.1093/bjs/znae220
Adisa Poljo, Ralph Peterli, Marko Kraljević
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引用次数: 0
Ten-year outcomes of a randomized clinical trial of endothermal ablation versus conventional surgery for great saphenous varicose veins. 大隐静脉曲张内热消融术与传统手术随机临床试验的十年疗效。
IF 8.6 1区 医学 Q1 SURGERY Pub Date : 2024-08-02 DOI: 10.1093/bjs/znae195
Abduraheem H Mohamed, Annabel Howitt, Shivani Rae, Paris L Cai, Louise Hitchman, Tom Wallace, Sandip Nandhra, Sean Pymer, Alexander Knighton, George Smith, Ian C Chetter, Daniel Carradice

Background: Surgical ligation and stripping (surgery) and endothermal ablation are both effective treatments for varicose veins, improving quality of life (QoL) up to 5 years. Few data are available on long-term outcomes. The aim of this study was to evaluate the outcomes 10 years after interventions in an RCT. Previously this RCT demonstrated that endothermal ablation is associated with superior postprocedural QoL, more rapid recovery, and lower rates of early clinical recurrence. This analysis reports outcomes at 10 years.

Methods: Patients with symptomatic varicose veins owing to unilateral great saphenous vein reflux were randomized to either surgery or endovenous laser ablation (EVLA). Outcomes at 10 years included clinical recurrence and QoL.

Results: Data were obtained for 206 of 280 patients (73.6%) at 10 years. Both groups retained significant QoL improvement compared with pretreatment levels (Aberdeen Varicose Vein Questionnaire (AVVQ), Short Form 36 (SF-36®), and EQ-5D™; P < 0.001). Clinical disease progression from baseline was observed in only 10.7% of patients. The clinical recurrence rate was lower in the EVLA group (37 versus 59%; P = 0.005). The number needed to treat with EVLA to avoid one clinical recurrence within 10 years was five. This was associated with significantly higher (better) generic QoL scores with EVLA in several SF-36® domains, including bodily pain (median 84 (i.q.r. 51-100) versus 62 (41-84); P = 0.009) and general health (77 (62-87) versus 67 (52-82); P = 0.017). AVVQ scores in the EVLA group were also lower (better) (3.1 (0-7.7) versus 6.3 (0.7-13.3); P = 0.029).

Conclusion: Both surgery and endothermal ablation are effective treatments for varicose veins at 10 years, with durable improvement in QoL and a very low rate of disease progression. However, endothermal ablation was associated with superior clinical and QoL outcomes. Registration number: NCT00759434 (http://www.clinicaltrials.gov).

背景:外科结扎和剥脱术(手术)以及内热消融术都是治疗静脉曲张的有效方法,可改善患者长达 5 年的生活质量(QoL)。但有关长期疗效的数据却很少。本研究旨在评估一项研究性试验中干预10年后的疗效。之前的研究表明,内热消融术具有更高的术后生活质量、更快的恢复速度和更低的早期临床复发率。本分析报告的是 10 年后的结果:方法:因单侧大隐静脉回流而出现症状性静脉曲张的患者被随机分配到手术或静脉腔内激光消融术(EVLA)治疗。10年后的结果包括临床复发率和生活质量:280名患者中有206人(73.6%)获得了10年的数据。与治疗前相比,两组患者的 QoL 均有明显改善(阿伯丁静脉曲张问卷 (AVVQ)、短表 36 (SF-36®) 和 EQ-5D™; P < 0.001)。仅有 10.7% 的患者出现了临床疾病进展。EVLA组的临床复发率较低(37%对59%;P = 0.005)。在10年内避免一次临床复发所需的EVLA治疗人数为5人。这与EVLA在多个SF-36®领域的一般QoL评分明显更高(更好)有关,包括身体疼痛(中位数84(i.q.r. 51-100)对62(41-84);P = 0.009)和一般健康(77(62-87)对67(52-82);P = 0.017)。EVLA组的AVVQ评分也更低(更好)(3.1(0-7.7)对6.3(0.7-13.3);P = 0.029):结论:手术和内热消融术都是治疗静脉曲张的有效方法,可在10年内持久改善患者的生活质量,且疾病进展率极低。然而,内热消融术的临床效果和生活质量都更胜一筹。注册编号NCT00759434 (http://www.clinicaltrials.gov)。
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引用次数: 0
Adrenocortical carcinoma: what you at least should know. 肾上腺皮质癌:你至少应该知道什么?
IF 8.6 1区 医学 Q1 SURGERY Pub Date : 2024-08-02 DOI: 10.1093/bjs/znae177
Charles de Ponthaud, Malanie Roy, Sébastien Gaujoux
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引用次数: 0
Sex-related differences in oncological surgery and postoperative outcomes: comprehensive, nationwide study in France. 肿瘤手术和术后结果的性别差异:法国全国范围内的综合研究。
IF 8.6 1区 医学 Q1 SURGERY Pub Date : 2024-08-02 DOI: 10.1093/bjs/znae179
Floriane Jochum, Anne-Sophie Hamy, Paul Gougis, Élise Dumas, Beatriz Grandal, Mathilde Sauzey, Enora Laas, Jean-Guillaume Feron, Virginie Fourchotte, Thomas Gaillard, Noemie Girard, Lea Pauly, Elodie Gauroy, Lauren Darrigues, Judicael Hotton, Lise Lecointre, Fabien Reyal, Fabrice Lecuru, Cherif Akladios

Background: The main objective of this study was to undertake an exhaustive investigation of sex-related differences in cancer surgery.

Methods: This observational study used data from the French national health insurance system database covering 98.8% of the population. Patients diagnosed with non-sex-specific solid invasive cancers between January 2018 and December 2019 were included. The main outcomes were likelihood of undergoing cancer surgery, type of oncological surgery performed, and associated 30-, 60-, and 90-day postoperative reoperation and mortality rates, by sex.

Results: For the 367 887 patients included, women were 44% more likely than men to undergo cancer surgery (OR 1.44, 95% c.i. 1.31 to 1.59; P < 0.001). However, the likelihood of surgery decreased with advancing age (OR 0.98, 0.98 to 0.98; P < 0.001), and with increasing number of co-morbid conditions (OR 0.95, 0.95 to 0.96; P < 0.001), especially in women. Men had higher 90-day reoperation (21.2 versus 18.8%; P < 0.001) and mortality (1.2 versus 0.9%; P < 0.001) rates than women, overall, and for most cancer types, with the exception of bladder cancer, for which the 90-day mortality rate was higher among women (1.8 versus 1.4%; P < 0.001). After adjustment for age, number of co-morbid conditions, and surgical procedure, 90-day mortality remained higher in men (OR 1.16, 1.07 to 1.26; P < 0.001), and men were 21% more likely than women to undergo reoperation within 90 days (OR 1.21, 1.18 to 1.23; P < 0.001).

Conclusion: Women were much more likely than men to undergo cancer surgery than men, but the likelihood of surgery decreased with advancing age and with increasing number of co-morbid conditions, especially in women. These findings highlight a need for both increased awareness and strategies to ensure gender equality in access to oncological surgical treatment and improved outcomes.

背景:本研究的主要目的是详尽调查癌症手术中与性别有关的差异:本研究的主要目的是对癌症手术中的性别差异进行详尽调查:这项观察性研究使用的数据来自法国国家医疗保险系统数据库,覆盖了98.8%的人口。研究纳入了2018年1月至2019年12月期间诊断为非性别特异性实体侵袭性癌症的患者。主要结果是接受癌症手术的可能性、所实施的肿瘤手术类型,以及相关的术后30天、60天和90天再手术率和死亡率(按性别分列):在纳入的 367 887 名患者中,女性接受癌症手术的可能性比男性高 44%(OR 1.44,95% c.i. 1.31 至 1.59;P <0.001)。然而,随着年龄的增长(OR 0.98,0.98 至 0.98;P <0.001)和并发症数量的增加(OR 0.95,0.95 至 0.96;P <0.001),手术的可能性会降低,尤其是女性。总体而言,男性的90天再次手术率(21.2%对18.8%;P<0.001)和死亡率(1.2%对0.9%;P<0.001)高于女性,大多数癌症类型也是如此,但膀胱癌除外,女性的90天死亡率更高(1.8%对1.4%;P<0.001)。在对年龄、并发症数量和手术方式进行调整后,男性的90天死亡率仍然较高(OR 1.16,1.07至1.26;P <0.001),男性在90天内再次手术的可能性比女性高21%(OR 1.21,1.18至1.23;P <0.001):女性比男性更有可能接受癌症手术,但随着年龄的增长和并发症的增加,手术的可能性会降低,尤其是女性。这些研究结果突出表明,有必要提高人们的认识并制定相关策略,以确保在接受肿瘤外科治疗和改善治疗效果方面实现性别平等。
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引用次数: 0
Toxic megacolon. 中毒性巨结肠
IF 8.6 1区 医学 Q1 SURGERY Pub Date : 2024-08-02 DOI: 10.1093/bjs/znae200
Orestis Argyriou, Gita Lingam, Phil Tozer, Kapil Sahnan
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引用次数: 0
Severe acute pancreatitis. 重症急性胰腺炎
IF 8.6 1区 医学 Q1 SURGERY Pub Date : 2024-08-02 DOI: 10.1093/bjs/znae170
Kjetil Søreide, S George Barreto, Sanjay Pandanaboyana
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引用次数: 0
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British Journal of Surgery
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