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British Journal of Surgery

M Kanapathy, R Simpson, L Madden, C Thrasivoulou, A Mosahebi, D L Becker, T Richards
BACKGROUND: Leg ulceration is a feared complication of venous insufficiency. It is not known whether varicose veins predispose skin to poor wound healing. The expression pattern of gap junctional protein connexin, a known marker of poor wound healing, was investigated across various stages of venous disease. METHODS: Patients undergoing intervention for varicose veins were assessed according to the Clinical Etiologic Anatomic Pathophysiologic (CEAP) classification of varicose veins...
November 16, 2017: British Journal of Surgery
K-J Lundström, H Holmberg, A Montgomery, P Nordin
BACKGROUND: The effectiveness of different procedures in routine surgical practice for hernia repair with respect to chronic postoperative pain and reoperation rates is not clear. METHODS: This was prospective cohort study based on a unique combination of patient-reported outcomes and national registry data. Virtually all patients with a groin hernia repair in Sweden between September 2012 and April 2015 were sent a questionnaire 1 year after surgery. Persistent pain, defined as at least 'pain present, cannot be ignored, and interferes with concentration on everyday activities' in the past week was the primary outcome...
November 15, 2017: British Journal of Surgery
K Mohkam, O Farges, E Vibert, O Soubrane, R Adam, F-R Pruvot, J-M Regimbeau, M Adham, E Boleslawski, J-Y Mabrut
BACKGROUND: Biliary leakage remains a major cause of morbidity after liver resection. Previous prognostic studies of posthepatectomy biliary leakage (PHBL) lacked power, population homogeneity, and model validation. The present study aimed to develop a risk score for predicting severe PHBL. METHODS: In this multicentre observational study, patients who underwent liver resection without hepaticojejunostomy in one of nine tertiary centres between 2012 and 2015 were randomly assigned to a development or validation cohort in a 2 : 1 ratio...
November 13, 2017: British Journal of Surgery
E Omling, A Jarnheimer, J Rose, J Björk, J G Meara, L Hagander
BACKGROUND: The WHO and the World Bank ask countries to report the national volume of surgery. This report describes these data for Sweden, a high-income country. METHODS: In an 8-year population-based observational cohort study, all inpatient and outpatient care in the public and private sectors was detected in the Swedish National Patient Register and screened for the occurrence of surgery. The entire Swedish population was eligible for inclusion. All patients attending healthcare for any disease were included...
November 13, 2017: British Journal of Surgery
Z E Winters, M Afzal, C Rutherford, B Holzner, G Rumpold, R A da Costa Vieira, S Hartup, K Flitcroft, V Bjelic-Radisic, A Oberguggenburger, M Panouilleres, M Mani, G Catanuto, M Douek, J Kokan, P Sinai, M T King
BACKGROUND: The aim was to carry out phase 4 international field-testing of the European Organisation for Research and Treatment of Cancer (EORTC) breast reconstruction (BRECON) module. The primary objective was finalization of its scale structure. Secondary objectives were evaluation of its reliability, validity, responsiveness, acceptability and interpretability in patients with breast cancer undergoing mastectomy and reconstruction. METHODS: The EORTC module development guidelines were followed...
November 8, 2017: British Journal of Surgery
P Giesecke, V Frykman, G Wallin, S Lönn, A Discacciati, O Törring, M Rosenqvist
BACKGROUND: Little is known about the long-term side-effects of different treatments for hyperthyroidism. The few studies previously published on the subject either included only women or focused mainly on cancer outcomes. This register study compared the impact of surgery versus radioiodine on all-cause and cause-specific mortality in a cohort of men and women. METHODS: Healthcare registers were used to find hyperthyroid patients over 35 years of age who were treated with radioiodine or surgery between 1976 and 2000...
November 8, 2017: British Journal of Surgery
S T W van Haelst, C Koopman, H M den Ruijter, F L Moll, F L Visseren, I Vaartjes, G J de Borst
BACKGROUND: The aim of this study was to evaluate absolute mortality risks and to determine whether changes in mortality risk occurred in patients with intermittent claudication (IC) or critical limb ischaemia (CLI) in the Netherlands between 1998 and 2010. METHODS: Data for patients treated between 1998 and 2010 were obtained from Dutch nationwide registers: the Hospital Discharge Register, Population Register and Cause of Death Register. The registers were used to obtain information regarding IC and CLI hospitalizations, co-morbidities, demographic factors, and date and cause of death...
November 8, 2017: British Journal of Surgery
M Xiao, C Lou, H Xiao, Y Yang, X Cai, C Li, S Jia, Y Huang
BACKGROUND: Triple-negative breast cancer (TNBC) is prone to metastasis and has a poor prognosis, with lower survival rates than other breast cancer subtypes. MicroRNAs have recently emerged as powerful regulators of cancer processes and become a promising target in cancer therapy. METHODS: Expression of miR-128 was examined in invasive ductal breast cancer, and its relationship with clinicopathological features analysed. A series of in vitro and in vivo experiments were performed to investigate the function and mechanism of miR-128 in the development of invasive ductal breast cancer...
November 8, 2017: British Journal of Surgery
H T Malik, J Marti, A Darzi, E Mossialos
BACKGROUND: Finding opportunities for improving efficiency is important, given the pressure on national health budgets. Identifying and reducing low-value interventions that deliver little benefit is key. A systematic literature evaluation was done to identify low-value interventions in general surgery, with further assessment of their cost. METHODS: A multiplatform method of identifying low value interventions was undertaken, including a broad literature search, a targeted database search, and opportunistic sampling...
November 8, 2017: British Journal of Surgery
D Verver, M F Madu, C M C Oude Ophuis, M Faut, J H W de Wilt, J J Bonenkamp, D J Grünhagen, A C J van Akkooi, C Verhoef, B L van Leeuwen
BACKGROUND: The optimal extent of groin completion lymph node dissection (CLND) (inguinal or ilioinguinal dissection) in patients with melanoma is controversial. The aim of this study was to evaluate whether the extent of groin CLND after a positive sentinel node biopsy (SNB) is associated with improved outcome. METHODS: Data from all sentinel node-positive patients who underwent groin CLND at four tertiary melanoma referral centres were retrieved retrospectively...
November 2, 2017: British Journal of Surgery
K K C Ng, K S H Chok, A C Y Chan, T T Cheung, T C L Wong, J Y Y Fung, J Yuen, R T P Poon, S T Fan, C M Lo
BACKGROUND: Hepatic resection and radiofrequency ablation (RFA) are treatment options for early-stage hepatocellular carcinoma (HCC). Whether tumour recurrence and long-term survival favour either treatment has not been established. This randomized trial aimed to test the hypothesis that RFA is superior to hepatic resection in terms of lower tumour recurrence rate and better long-term survival. METHODS: Patients with early-stage HCC (solitary tumour no larger than 5 cm; or no more than 3 tumours, each 3 cm or smaller) were randomized into hepatic resection and RFA groups...
November 1, 2017: British Journal of Surgery
K Polom, L Marano, D Marrelli, R De Luca, G Roviello, V Savelli, P Tan, F Roviello
BACKGROUND: Several associations between microsatellite instability (MSI) and other clinicopathological factors have been reported in gastric cancer, but the results have been ambiguous. This systematic review and meta-analysis investigated the relationship between MSI and overall survival and clinicopathological characteristics of patients with gastric cancer. METHODS: A systematic literature search of the PubMed, Cochrane and Ovid databases until 31 January 2016 was performed in accordance with the PRISMA statement...
November 1, 2017: British Journal of Surgery
L Escal, S Nougaret, B Guiu, M M Bertrand, H de Forges, R Tetreau, S Thézenas, P Rouanet
BACKGROUND: Rectal cancer surgery is technically challenging and depends on many factors. This study evaluated the ability of clinical and anatomical factors to predict surgical difficulty in total mesorectal excision. METHODS: Consecutive patients who underwent total mesorectal excision for locally advanced rectal cancer in a laparoscopic, robotic or open procedure after neoadjuvant treatment, between 2005 and 2014, were included in this retrospective study. Preoperative clinical and MRI data were studied to develop a surgical difficulty grade...
October 31, 2017: British Journal of Surgery
U Nitsche, C Stöß, L Stecher, D Wilhelm, H Friess, G O Ceyhan
BACKGROUND: It is not clear whether resection of the primary tumour (when there are metastases) alters survival and/or whether resection is associated with increased morbidity. This systematic review and meta-analysis assessed the prognostic value of primary tumour resection in patients presenting with metastatic colorectal cancer. METHODS: A systematic review of MEDLINE/PubMed was performed on 12 March 2016, with no language or date restrictions, for studies comparing primary tumour resection versus conservative treatment without primary tumour resection for metastatic colorectal cancer...
October 31, 2017: British Journal of Surgery
V Wanjura, E Szabo, J Österberg, J Ottosson, L Enochsson, G Sandblom
BACKGROUND: There is a strong association between obesity and gallstones. However, there is no clear evidence regarding the optimal order of Roux-en-Y gastric bypass (RYGB) and cholecystectomy when both procedures are clinically indicated. METHODS: Based on cross-matched data from the Swedish Register for Cholecystectomy and Endoscopic Retrograde Cholangiopancreatography (GallRiks; 79 386 patients) and the Scandinavian Obesity Surgery Registry (SOReg; 36 098 patients) from 2007 to 2013, complication rates, reoperation rates and operation times related to the timing of RYGB and cholecystectomy were explored...
October 18, 2017: British Journal of Surgery
E O Matthews, S E Rowbotham, J V Moxon, R E Jones, M Vega de Ceniga, J Golledge
BACKGROUND: The role of atherosclerosis in the pathogenesis of abdominal aortic aneurysm (AAA) is controversial. Atherosclerosis-associated peripheral artery disease (PAD) has been reported to be a risk factor for AAA in population screening studies; its relationship with AAA growth is controversial. METHODS: A systematic search of MEDLINE, Scopus, CINAHL and the Cochrane Central Register of Controlled Trials was conducted in April 2016 and repeated in January 2017...
October 17, 2017: British Journal of Surgery
J Deng, J Guo, G Ma, H Zhang, D Sun, Y Hou, X Xie, X Guo, Y Nie, H Liang
BACKGROUND: Kelch-like 6 (KLHL6) is a cancer oncogene previously associated with specific human cancers, such as chronic lymphocytic leukaemia. Here, the mechanisms of KLHL6 function were explored in gastric cancer (GC) cells, in an in vivo experimental tumour model, and the prognostic value of KLHL6 analysis in GC tissue evaluated in a cohort of patients with GC. METHODS: Associations between clinicopathological and survival data and KLHL6 expression in GC tissues were analysed...
October 17, 2017: British Journal of Surgery
C S Palmer, B J Gabbe, P A Cameron
BACKGROUND: Assessment of functional outcomes in survivors of severe injury is an identified priority for trauma systems. The predictive Functional Capacity Index (pFCI) within the 2008 Abbreviated Injury Scale dictionary (pFCI08) offers a widely available tool for predicting functional outcomes without requiring long-term follow-up. This study aimed to assess the 12-month functional outcome predictions of pFCI08 in a major trauma population, and to test the assumptions made by its developers to ensure population homogeneity...
October 12, 2017: British Journal of Surgery
K Westberg, G Palmer, F Hjern, C Nordenvall, H Johansson, T Holm, A Martling
BACKGROUND: Local recurrence of rectal cancer (LRRC) is associated with poor survival unless curative treatment is performed. The aim of this study was to investigate predictive factors for treatment with curative intent in patients with LRRC. METHODS: Population-based data for patients treated for primary rectal cancer between 1995 and 2002, and with LRRC reported as first event were collected from the Swedish Colorectal Cancer Registry and medical records. The associations between patient-, primary tumour- and LRRC-related factors and intention of the treatment for LRRC were determined...
October 12, 2017: British Journal of Surgery
G A Tew, A M Batterham, K Colling, J Gray, K Kerr, E Kothmann, S Nawaz, M Weston, D Yates, G Danjoux
BACKGROUND: This study assessed the feasibility of a preoperative high-intensity interval training (HIT) programme in patients awaiting elective abdominal aortic aneurysm repair. METHODS: In this feasibility trial, participants were allocated by minimization to preoperative HIT or usual care. Patients in the HIT group were offered three exercise sessions per week for 4 weeks, and weekly maintenance sessions if surgery was delayed. Feasibility and acceptability outcomes were: rates of screening, eligibility, recruitment, retention, outcome completion, adverse events and adherence to exercise...
October 9, 2017: British Journal of Surgery
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