Search

Only 8 patients (5.9%) had a new finding on second or subsequent visits (colonic polyp in 6 patients, renal cancer in one patient and benign adrenal adenoma in one patient). For patient with screen and surveillance detected AAA the median times from diagnosis to first clinic review was 8-days and 17-days; and from diagnosis to surgery 43-days (7 [59%] of patients were operated on within 40-days) and 76-days (only 20 [30%] of patients were operated on within 40-days) respectively. WS 6.3 Patient reported surgical site infection after elective colorectal surgery - patient reported... Lydia Newton, Ffion Dewi, Harry Dean, Cara Swain, Dawn Gane, Anne Pullyblank North Bristol NHS Trust Aims: 30-day surgical site infection (SSI) after colorectal resection is difficult to measure as patients are discharged quickly within enhanced recovery programmes. WS 13.3 Z-Plasty is an effective management for colostomy stenosis in high risk patients Judith Johnston, Mohamed Basheer Midyorkshire Hospital Trust Aims: To ascertain which patients are managed with Z-plasty for stomal stenosis To assess the effectiveness of using Z-plasty in treating stomal stenosis Methods: Operative information around all patients from 2010-2019 who underwent Z-plasty for stomal stenosis was collected and analysed on Excel. [Extracted from the article]

Methods: Electronic patient records of 1088 patients who underwent ANC Patients had their USS the same day and 26% of patients had to return the Cases, 6 patients developed septicemia, 2 patients developed ARF, 2 patients Vital role in providing treatment services to patients, Patient reported outcome Timeline of each case from the time the patient was sent for till the patient goes. [Extracted from the article]

Background: Small bowel neuroendocrine tumours often present with locally advanced or metastatic disease. The aim of this paper is to provide evidence-based recommendations regarding (controversial) topics in the surgical management of advanced small bowel neuroendocrine tumours. Methods: A working group of experts was formed by the European Society of Endocrine Surgeons. The group addressed 11 clinically relevant questions regarding surgery for advanced disease, including the benefit of primary tumour resection, the role of cytoreduction, the extent of lymph node clearance, and the management of an unknown primary tumour. A systematic literature search was performed in MEDLINE to identify papers addressing the research questions. Final recommendations were presented and voted upon by European Society of Endocrine Surgeons members at the European Society of Endocrine Surgeons Conference in Mainz in 2023. Results: The literature review yielded 1223 papers, of which 84 were included. There were no randomized controlled trials to address any of the research questions and therefore conclusions were based on the available case series, cohort studies, and systematic reviews/meta-analyses of the available non-randomized studies. The proposed recommendations were scored by 38–51 members and rated 'strongly agree' or 'agree' by 64–96% of participants. Conclusion: This paper provides recommendations based on the best available evidence and expert opinion on the surgical management of locally advanced and metastatic small bowel neuroendocrine tumours. This paper provides evidence-based recommendations on the surgical management of locally advanced and metastatic small bowel neuroendocrine tumours, primary tumour resections in the setting of metastatic disease, and surgical indications for grade 3 small bowel neuroendocrine tumours and small bowel neuroendocrine carcinomas. The recommendations are the result of a working group of experts, created by the European Society of Endocrine Surgeons. The group addressed 11 relevant clinical questions regarding surgery for advanced disease, emphasizing and confirming the key role of the surgeon for advanced small bowel neuroendocrine tumours. [ABSTRACT FROM AUTHOR]

Several abstracts are presented which includes one on Compliance Audit in Day Surgery Unit (DSU), the other on improving postoperative information transfer and the third on the use of "Hip Precautions" after hip hemiarthroplasty.

The article presents abstracts of articles on surgery topics including one on the relationship between disease severity and Aberdeen varicose vein questionnaire (AVVQ), another on influence of obesity on insulin resistance, and the effects of genetic polymorphisms on aortic growth.

Several abstracts are presented related to non-profit organization Association Of Surgeons Of Great Britain & Ireland (ASGBI) including analysis of surgical competence, using social media to share surgical evidence and using simulation with Frozen Cadaveric model for training medical students.

Several abstracts related to trauma and military surgery are presented including surgical options to control laparotomy, study on electrolyte variability in military trauma patients and psychological effects of extracorporeal hemofiltration in hind limb ischemia-reperfusion injury in Sus scrofa.

Several abstracts related to perioperative care and clinical science are presented including effect of beta-blockade on physical fitness physical fitness in patients with abdominal aortic aneurysms, tumour pathology in Colorectal Cancer and study of surgical care in an African District Hospital.

The article presents abstracts on medical topics which include the Great Britain higher surgical training, the Laparoscopic adrenal contouring using fluorescence imaging and validation of Microrna Signatures for detecting pancreatic malignant transformation.

The article presents abstracts on medical topics which include an audit to identify factors involved in making recommendations to decrease unplanned readmissions, study to determine safety profile following gastrointestinal surgery and thromboprophylaxis after major abdominal cancer surgery.

Several abstracts on surgery are presented which includes one on the use of serum osteonectin for screening pancreatic cancer, the other on appendectomy and the third on post -traumatic stress disorder.

The article presents abstracts on medical topics including the use of localised full thickness colonic resection approach as hemicolectomy's alternative, the effect of analgesia on stress response after laparoscopic colorectal surgery, and the high-risk emergency surgical admission mortality.

The article presents abstracts on medical topics including the pre-operative score of pancreatic fistula, the effect of breast screening protocol on the presentation of symptomatic breast cancer, and the oncological results of vertical scar therapeutic mammaplasty.

Ambulatory Management of Right Iliac Fossa Pain: A Five-year Review Dale Thompson, Sarah Richards Royal United Hospitals, Bath Aim: Acute appendicitis is the most common indication for emergency surgery. The investigation and management of patients presenting with right iliac fossa (RIF) pain is usually on an in-patient basis in the UK. We present a 5-year experience of managing patients with RIF pain on an ambulatory basis in Emergency Surgical Ambulatory Care (ESAC). [Extracted from the article]

To FLOT chemotherapy in a cohort of patients treated with radical intent. Methods: Patients receiving perioperative FLOT for oesophagogastric ade- Chemotherapy-related toxicity was encountered in 6/24 (25%) patients Chemotherapy was completed in 9/17 (52.9%) patients. [Extracted from the article]

Background: Australia's unique national surgical mortality audit has had a long-term focus on the avoidance of futile surgery. The 30-day mortality rate after emergency laparotomy in Australia is lower than in other countries. Early death (within 72 h) after emergency laparotomy may reflect futile surgery. This paper considers whether Australia's national mortality audit is the reason for its lower mortality rate after emergency laparotomy. Methods: Data were extracted from the Australia and New Zealand Emergency Laparotomy Audit--Quality Improvement (ANZELA-QI) from 2018 to 2022. The time elapsed from emergency laparotomy to death was determined for each patient. The cumulative daily mortality rate was calculated for the first 30 days and expressed as a proportion of all emergency laparotomies, and 30-day and inhospital mortality. Mortality data were compared with those in the only three similar overseas studies. The mortality rate after emergency laparotomy for patients who required but did not undergo surgery was calculated for each hospital. The proportion of patients with high-risk characteristics was compared with that in the National Emergency Laparotomy Audit (NELA). Results: Compared with overseas studies, there was a lower early (within 72 h) mortality rate in ANZELA-QI. Although the lower mortality rate in ANZELA-QI persisted to 30 days, there was a relative increase after 14 days that likely reflected known poor compliance with care standards. Australian patients had fewer high-risk characteristics than those in NELA. Conclusion: The present findings support the hypothesis that the lower mortality rate after emergency laparotomy in Australia is likely a consequence of its national mortality audit and the avoidance of futile surgery. [ABSTRACT FROM AUTHOR]

Presents correspondence discussing various aspects related to the use of polytetrafluoroethylene patch saphenoplasty to treat varicose veins. Safety parameters of patch saphenoplasty; Patient satisfaction; Duration of hospital stay.

Presents letters from readers relating to articles published in the 'British Journal of Surgery.' Letter written by R.M. Jindal regarding patients with chronic pancreatitis; References used by Jindal; Correspondence sent by C. Palmieri on the significance of estrogen receptor beta in breast cancer.

The article presents abstracts on medical topics which include risk associated with management of patients with intermittent claudication, a study on abdominal aortic aneurysms via modulation of glucose transporters, and analysis of human venous valve in patients with lymphoedema.

The article presents abstracts on medical topics which include prediction of autogenous Arterio-venous fistula maturity, a study on the use of pragmatic structured education programme to increase walking in people with intermittent claudication, and thrombolysis in vascular patients.

The article presents abstracts on medical topics which include identification of abdominal aortic aneurysm, a study on implementation of dual anti-platelet therapy to reduce recurrent neurological events prior to surgery, and duplex ultrasound surveillance to maintain stent patency.

Focuses on the number of centers involved in kidney donor programs in Great Britain. Basis of donor assessment guidelines; Consequences of associated physiological, ethical and clinical implications; Number of renal transplants performed annually.

The author comments on the ethical publishing behavior violated by the authors of three papers published in the German language publication "Zentralblatt fur Chirurgie," in "Surgery" and then in the "British Journal Surgery." The author highlights the failure of the authors to present an honest representation of clinical findings and their failure to acknowledge republication of the paper. The author emphasizes the responsibility of authors to adhere to principles regarding publications in scientific journals.

Presents letters relating to medical articles published in the periodical 'British Jurnal of Surgery.' Techniques for healing venous ulcers; Comaprison of cognitive function of quality of life after endovascular aortic aneurysm repair.

Presents a list of reviewers of articles on surgery published in the 1998 volume of the periodical 'British Journal of Surgery.'

Background: The Clinical Treatment Score post-5 years (CTS5) integrates four clinicopathological variables to estimate the residual disease recurrence risk in hormone receptor-positive breast cancer patients who have been treated with five years of adjuvant endocrine therapy. This study aimed to determine the accuracy of the CTS5. Methods: A systematic review was performed in accordance with the PRISMA statement. Studies relevant for inclusion in the current review were identified from The Cochrane Library, EBSCO, Ovid, PubMed, and Embase. Results: Six papers reported on 30 354 postmenopausal patients (age range 42 to 91 years). The pooled hazard ratio (HR) of distant recurrence relative to the low-risk CTS5 category was 5.41 (95% c.i. 4.50 to 6.51; P,0.05) for the high-risk CTS5 category and 2.32 (95% c.i. 1.90-2.84; P,0.05) for the intermediate CTS5 category. Three papers reported on 10 425 premenopausal patients (age range 18 to 54 years). The pooled HR of distant recurrence relative to the low-risk CTS5 category was 5.42 (95% c.i. 2.26 to 13.01; P, 0.05) for the high-risk CTS5 category and 2.82 (95% c.i. 1.35 to 5.88; P,0.05) for the intermediate CTS5 category. Relative to highrisk postmenopausal patients, the mean observed 10-year distant recurrence risk for the high CTS5 category was 13.83 per cent, which differs significantly from the CTS5 estimation of 10-year distant recurrence risk (20.3 per cent, 95% c.i. 17.2 to 24; P=0.000). Conclusion: The CTS5 can predict late distant recurrence risk in pre- and postmenopausal hormone receptor-positive breast cancer patients. CTS5 overestimates the risk for high-risk patients and thus, its use in these patients warrants caution. [ABSTRACT FROM AUTHOR]

Background: Incisional hernia is a frequent complication of abdominal wall incision. Surgical technique is an important risk factor for the development of incisional hernia. The aim of these updated guidelines was to provide recommendations to decrease the incidence of incisional hernia. Methods: A systematic literature search of MEDLINE, Embase, and Cochrane CENTRAL was performed on 22 January 2022. The Scottish Intercollegiate Guidelines Network instrument was used to evaluate systematic reviews and meta-analyses, RCTs, and cohort studies. The GRADE approach (Grading of Recommendations, Assessment, Development and Evaluation) was used to appraise the certainty of the evidence. The guidelines group consisted of surgical specialists, a biomedical information specialist, certified guideline methodologist, and patient representative. Results: Thirty-nine papers were included covering seven key questions, and weak recommendations were made for all of these. Laparoscopic surgery and non-midline incisions are suggested to be preferred when safe and feasible. In laparoscopic surgery, suturing the fascial defect of trocar sites of 10 mm and larger is advised, especially after single-incision laparoscopic surgery and at the umbilicus. For closure of an elective midline laparotomy, a continuous small-bites suturing technique with a slowly absorbable suture is suggested. Prophylactic mesh augmentation after elective midline laparotomy can be considered to reduce the risk of incisional hernia; a permanent synthetic mesh in either the onlay or retromuscular position is advised. Conclusion: These updated guidelines may help surgeons in selecting the optimal approach and location of abdominal wall incisions. [ABSTRACT FROM AUTHOR]

Background: Tissue adhesive, adhesive tape, and sutures are used to close surgical incisions. However, it is unclear which produces the best results in children, and whether combination wound closure is better than sutures alone. Methods: In this parallel randomised controlled trial (ANZCTR: ACTRN12617000158369), children (aged 18 years or less) undergoing elective general surgical or urological procedures were randomized to skin closure with sutures alone, sutures and adhesive tape, or sutures and tissue adhesive. Participants were assessed 2 weeks, 6 weeks, and more than 6 months after operation. Outcomes included wound cosmesis (clinician- and parent-rated) assessed using four validated scales, parental satisfaction, and wound complication rates. Results: 295 patients (333 wounds) were recruited and 277 patients (314 wounds) were included in the analysis. Tissue adhesive wounds had poorer cosmesis at 6 weeks: median 10-point VAS score 7.7 with sutures alone, 7.5 with adhesive tape, and 7.0 with tissue adhesive (P=0.014). Respective median scores on a 100-point VAS were 80.0, 77.2, and 73.8 (P=0.010). This difference was not sustained at over 6 months. There was no difference in parent-rated wound cosmesis at 6 weeks (P=0.690) and more than 6 months (P=0.167): median score 9.0 with sutures alone, 10.0 with adhesive tape, and 10.0 with tissue adhesive at both stages. Parental satisfaction was similar at all points, with a median score of 5 (very satisfied) for all groups. There was one instance of wound dehiscence in the tissue adhesive group and no wound infections. Conclusion: Short-term wound cosmesis was poorer with tissue adhesive although it is unclear whether this difference is sustained in the long-term. There were no differences between techniques for the study outcomes. [ABSTRACT FROM AUTHOR]

Background: Enhanced Recovery After Surgery (ERAS) protocols are now widely practiced in major surgery, improving postsurgical outcomes. Uptake of these programmes have been slow in kidney transplantation due to challenges in evaluating their safety and efficacy in this high-risk cohort. To date, there are no unified guidance and protocols specific to ERAS in kidney transplantation surgery. This paper aims to summarise current evidence in the literature and develop ERAS protocol recommendations for kidney transplantation recipients. Methods: PubMed, Cochrane, Embase and Medline databases were screened for studies relevant to ERAS protocols in kidney transplantation, up to August 2021. A secondary search was repeated for each ERAS recommendation to explore the specific evidence base available for each section of the protocol. Randomised controlled trials, case-control and cohort studies were included. The Grading of Recommendations, Assessment, Development and Evaluations (GRADE) framework was used to evaluate the quality of evidence available and recommendations. Results: We identified six eligible studies with a total of 1225 participants. All studies found a reduction in length of hospital stay without affecting readmission rates. The evidence behind specific pre-operative, intra-operative and post-operative interventions included in current ERAS protocols are reviewed and discussed. Conclusion: Compared to other surgical specialties, the evidence base for ERAS in kidney transplantation remains lacking, with further room for research and development. However, significant improvements to patient outcomes are already possible with application of the currently available evidence. This has shown that ERAS in kidney transplantation surgery is safe and feasible, with improved postoperative outcomes. [ABSTRACT FROM AUTHOR]

Presents correspondence on the attenuation of pancreatic and end-stage injury by hypertonic saline in an experimental model of acute pancreatitis. Therapeutic potential of hypertonic saline in individuals with severe acute pancreatitis.

Presents letters to the editor of the 2001 issue of the 'British Journal of Surgery.' Effect of colectomy on gastric emptying in idiopathic slow-transit constipation; Causes of polytetrafluoroethylene patch saphenoplasty re-recurrence; Factors influencing the outcome after surgery for fecal incontinence.

The Annual Scientific Meeting of the Association of Surgeons of Great Britain and Ireland takes place this year at the Scottish Exhibition and Conference Centre, Glasgow, UK (13th-15th May 2009), under the presidency of Professor Michael Horrocks. To view the abstracts from this meeting, please click the pdf link on this page. Copyright © 2009 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

The Annual Scientific Meeting of the Association of Surgeons of Great Britain and Ireland takes place this year at the Scottish Exhibition and Conference Centre, Glasgow, UK (13th-15th May 2009), under the presidency of Professor Michael Horrocks. To view the abstracts from this meeting, please click the pdf link on this page. Copyright © 2009 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

The Annual Scientific Meeting of the Association of Surgeons of Great Britain and Ireland takes place this year at Bournemouth International Centre, Bournemouth, UK (14th - 16th May 2008), under the presidency of Professor Brian J Rowlands. To view all abstracts of oral presentations from this meeting, please click the pdf link on this page. Copyright © 2008 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

The Annual Scientific Meeting of the Association of Surgeons of Great Britain and Ireland takes place this year at Bournemouth International Centre, Bournemouth, UK (14th - 16th May 2008), under the presidency of Professor Brian J Rowlands. To view all abstracts of poster presentations from this meeting, please click the pdf link on this page. Copyright © 2008 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

The Annual Scientific Meeting of the Association of Surgeons of Great Britain and Ireland takes place this year at Manchester Central (18th - 20th April 2007), under the presidency of Professor Brian J Rowlands. To view all abstracts of oral presentations from this meeting, please click the pdf link on this page. [ABSTRACT FROM AUTHOR]

The Annual Scientific Meeting of the Association of Surgeons of Great Britain and Ireland takes place this year at Manchester Central (18th - 20th April 2007), under the presidency of Professor Brian J Rowlands. To view all abstracts of poster presentations from this meeting, please click the pdf link on this page. [ABSTRACT FROM AUTHOR]

The 41st Annual Scientific Meeting of the Vascular Society of Great Britain and Ireland was held in Edinburgh, UK 22nd - 24th November 2006. The prize abstracts from this meeting are published in the print edition of BJS (vol 94: issue 2, February 2007). To view all other abstracts from this meeting, please click the pdf link on this page. Copyright © 2007 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

The Vascular Society AGM was held at the Bournemouth International Centre, Bournemouth, UK 23rd - 25th November 2005. To view all abstracts from this meeting, please click the pdf link on this page. [ABSTRACT FROM AUTHOR]

Background: Breast angiosarcomas are rare tumours of vascular origin. Secondary angiosarcoma occurs following radiotherapy for breast cancer. Angiosarcomas have high recurrence and poor survival rates. This is concerning owing to the increasing use of adjuvant radiotherapy for the treatment of invasive breast cancer and ductal cancer in situ (DCIS), which could explain the rising incidence of angiosarcoma. Outcome data are limited and provide a poor evidence base for treatment. This paper presents a national, trainee-led, retrospective, multicentre study of a large angiosarcoma cohort. Methods: Data for patients with a diagnosis of breast/chest wall angiosarcoma between 2000 and 2015 were collected retrospectively from 15 centres. Results: The cohort included 183 patients with 34 primary and 149 secondary angiosarcomas. Median latency from breast cancer to secondary angiosarcoma was 6 years. Only 78.9 per cent of patients were discussed at a sarcoma multidisciplinary team meeting. Rates of recurrence were high with 14 of 28 (50 per cent) recurrences in patients with primary and 80 of 124 (64.5 per cent) in those with secondary angiosarcoma at 5 years. Many patients had multiple recurrences: total of 94 recurrences in 162 patients (58.0 per cent). Median survival was 5 (range 0-16) years for patients with primary and 5 (0-15) years for those with secondary angiosarcoma. Development of secondary angiosarcoma had a negative impact on predicted breast cancer survival, with a median 10-year PREDICT prognostic rate of 69.6 per cent, compared with 54.0 per cent in the observed cohort. Conclusion: A detrimental impact of secondary angiosarcoma on breast cancer survival has been demonstrated. Although not statistically significant, almost all excess deaths were attributable to angiosarcoma. The increased use of adjuvant radiotherapy to treat low-risk breast cancer and DCIS is a cause for concern and warrants further study. [ABSTRACT FROM AUTHOR]

Background: Global surgery research is often generated through collaborative partnerships between researchers from both low‐ and middle‐income countries (LMICs) and high‐income countries (HICs). Inequitable engagement of LMIC collaborators can limit the impact of the research. Methods: This article describes evidence of inequities in the conduct of global surgery research and outlines reasons why the inequities in this research field may be more acute than in other global health research disciplines. The paper goes on to describe activities for building a collaborative research portfolio in rural Rwanda. Results: Inequities in global surgery research collaborations can be attributed to: a limited number and experience of researchers working in this field; time constraints on both HIC and LMIC global surgery researchers; and surgical journal policies. Approaches to build a robust, collaborative research portfolio in Rwanda include leading research trainings focused on global surgery projects, embedding surgical fellows in Rwanda to provide bidirectional research training and outlining all research products, ensuring that all who are engaged have opportunities to grow in capacities, including leading research, and that collaborators share opportunities equitably. Of the 22 published or planned papers, half are led by Rwandan researchers, and the research now has independent research funding. Conclusion: It is unacceptable to gather data from an LMIC without meaningful engagement in all aspects of the research and sharing opportunities with local collaborators. The strategies outlined here can help research teams build global surgery research portfolios that optimize the potential for equitable engagement. Power dynamics in the field of global surgery research lead to inequitable opportunities for researchers in low‐ and middle‐income countries. This paper describes the authors' own experiences in Rwanda, and outlines strategies to develop a strong global surgery research portfolio and fair partnerships. Probity is key [ABSTRACT FROM AUTHOR]