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British Journal of Surgery

G Gui, A Agusti, D Twelves, S Tang, M Kabir, C Montgomery, A Nerurkar, P Osin, C Isacke
BACKGROUND: The majority of lesions resulting in pathological nipple discharge are benign. Conventional surgery is undirected and targeting the causative lesion by duct endoscopy may enable more accurate surgery with fewer complications. METHODS: Patients requiring microdochectomy and/or major duct excision were randomized to duct endoscopy or no duct endoscopy before surgery. Primary endpoints were successful visualization of the pathological lesion in patients randomized to duct endoscopy, and a comparison of the causative pathology between the two groups...
September 20, 2018: British Journal of Surgery
A Storesund, A S Haugen, M Hjortås, M W Nortvedt, H Flaatten, G E Eide, M A Boermeester, N Sevdalis, E Søfteland
BACKGROUND: The ICD-10 codes are used globally for comparison of diagnoses and complications, and are an important tool for the development of patient safety, healthcare policies and the health economy. The aim of this study was to investigate the accuracy of verified complication rates in surgical admissions identified by ICD-10 codes and to validate these estimates against complications identified using the established Global Trigger Tool (GTT) methodology. METHODS: This was a prospective observational study of a sample of surgical admissions in two Norwegian hospitals...
September 18, 2018: British Journal of Surgery
O Uleberg, K Pape, T Kristiansen, P R Romundstad, P Klepstad
BACKGROUND: Functional outcome measures are important as most patients survive trauma. The aim of this study was to describe the long-term impact of trauma within a healthcare region from a social perspective. METHODS: People active in work or education and admitted to hospitals in Central Norway in the interval 1 June 2007 to 31 May 2010 after sustaining trauma were included in the study. Clinical data were linked to Norwegian national registers of cause of death, sickness and disability benefits, employment and education...
September 17, 2018: British Journal of Surgery
H Elfeki, H M Larsen, K J Emmertsen, P Christensen, M Youssef, W Khafagy, W Omar, S Laurberg
BACKGROUND: Several studies have explored functional outcomes after rectal cancer surgery, but bowel dysfunction after sigmoid resection for cancer has hardly been considered. The aim of this study was to identify the prevalence and pattern of bowel dysfunction after resection for sigmoid cancer, and the impact of bowel function on quality of life (QoL) by comparison with patients who had polypectomy for cancer. METHODS: This was a national cross-sectional study...
September 13, 2018: British Journal of Surgery
J J Yu, F Shen, T H Chen, L Liang, J Han, H Xing, Y H Zhou, H Wang, W M Gu, W Y Lau, T Yang
BACKGROUND: Whether preoperative bodyweight is associated with long-term prognosis in patients after liver resection for hepatocellular carcinoma (HCC) is controversial. This study aimed to investigate the relationship of patient weight with long-term recurrence and overall survival (OS) after curative liver resection for HCC. METHODS: Data for patients with HCC who underwent curative liver resection between 2000 and 2015 in five centres in China were analysed retrospectively in three groups according to their preoperative BMI: underweight (BMI 18·4 kg/m2 or less), normal weight (BMI 18·5-24·9 kg/m2 ) and overweight (BMI 25·0 kg/m2 or above)...
September 10, 2018: British Journal of Surgery
G Polychronidis, F J Hüttner, P Contin, K Goossen, L Uhlmann, M Heidmann, P Knebel, M K Diener, M W Büchler, P Probst
BACKGROUND: The objective of this study was to investigate the potential benefit of local haemostatic agents for the prevention of postoperative bleeding after thyroidectomy. METHODS: A systematic literature search was performed, and RCTs involving adult patients who underwent thyroid surgery using either active (AHA) or passive (PHA) haemostatic agents were included in the review. The main outcome was the rate of cervical haematoma that required reoperation. A Bayesian random-effects model was used for network meta-analysis with minimally informative prior distributions...
September 10, 2018: British Journal of Surgery
C Dahlbäck, A Ringberg, J Manjer
BACKGROUND: The aim of this study was to compare the agreement between three different methods for evaluation of aesthetic outcome following breast-conserving surgery and adjuvant radiotherapy: a patient questionnaire, panel evaluation of photographs and the software BCCT.core. A further aim was to examine how these modalities predict health-related quality of life as measured by the validated Breast-Q™ questionnaire. METHODS: At 1-year follow-up after breast-conserving surgery, patients completed a study-specific questionnaire...
August 30, 2018: British Journal of Surgery
E Akgun, C Caliskan, O Bozbiyik, T Yoldas, M Sezak, S Ozkok, T Kose, B Karabulut, M Harman, O Ozutemiz
BACKGROUND: The optimal timing of surgery following preoperative chemoradiotherapy (CRT) is controversial. This trial aimed to compare pathological complete response (pCR) rates obtained after an interval of 8 weeks or less versus more than 8 weeks. METHODS: Patients with locally advanced rectal adenocarcinoma situated within 12 cm of the anal verge (T3-4 or N+ disease) were randomized to undergo total mesorectal excision (TME) within 8 weeks (classical interval, CI group) or after 8 weeks (long interval, LI group) following CRT...
August 29, 2018: British Journal of Surgery
R Mouton, C A Rogers, R A Harris, R J Hinchliffe
BACKGROUND: Case series and a post hoc subgroup analysis of a large randomized trial have suggested a potential benefit in treating ruptured abdominal aortic aneurysms (rAAAs) using endovascular aneurysm repair (EVAR) with local anaesthesia (LA) rather than general anaesthesia (GA). The uptake and outcomes of LA in clinical practice remain unknown. METHODS: The UK National Vascular Registry was interrogated for patients presenting with rAAA managed with EVAR under different modes of anaesthesia between 1 January 2014 and 31 December 2016...
August 23, 2018: British Journal of Surgery
H Shiwani, P Baxter, E Taylor, M A Bailey, D J A Scott
BACKGROUND: Popliteal artery aneurysms (PAAs) comprise up to 85 per cent of all peripheral aneurysms. Few longitudinal studies track their progression. This study aimed to track the growth of asymptomatic PAAs in a hospital-based ultrasound service, and compare models of aneurysm growth. METHODS: This retrospective single-centre cohort study included patients who had a PAA on arterial duplex ultrasound imaging of the lower limbs between 1 January 2011 and 1 January 2016...
August 23, 2018: British Journal of Surgery
R L O'Connell, E Baker, A Trickey, T Rattay, L Whisker, R D Macmillan, S Potter
BACKGROUND: Therapeutic mammaplasty, which combines breast reduction and mastopexy techniques with tumour excision, may extend the boundaries of breast-conserving surgery and improve outcomes for patients, but current practice is unknown and high-quality outcome data are lacking. This prospective multicentre cohort study aimed to explore the practice and short-term outcomes of the technique. METHODS: Consecutive patients undergoing therapeutic mammaplasty at participating centres between 1 September 2016 and 30 June 2017 were recruited to the study...
August 22, 2018: British Journal of Surgery
T Wallace, J El-Sheikha, S Nandhra, C Leung, A Mohamed, A Harwood, G Smith, D Carradice, I Chetter
BACKGROUND: Clinical guidelines recommend endovenous laser ablation (EVLA) over surgery based on short-term evidence, yet there are few studies reporting mid- to long-term outcomes. The aim of this study was to report the 5-year outcomes from an RCT of surgery versus EVLA for treatment of symptomatic great saphenous varicose veins. METHODS: Patients with symptomatic varicose veins due to great saphenous vein (GSV) incompetence were followed up 5 years after enrolment in a randomized trial of either surgery (saphenofemoral junction ligation, GSV strip to the knee and multiple avulsions of varicosities) or EVLA plus multiple avulsions...
August 22, 2018: British Journal of Surgery
M van Putten, S D Nelen, V E P P Lemmens, J H M B Stoot, H H Hartgrink, S S Gisbertz, E J Spillenaar Bilgen, J Heisterkamp, R H A Verhoeven, G A P Nieuwenhuijzen
BACKGROUND: Centralization of surgery has been shown to improve outcomes for oesophageal and pancreatic cancer, and has been implemented for gastric cancer since 2012 in the Netherlands. This study evaluated the impact of centralizing gastric cancer surgery on outcomes for all patients with gastric cancer. METHODS: Patients diagnosed with non-cardia gastric adenocarcinoma in the intervals 2009-2011 and 2013-2015 were selected from the Netherlands Cancer Registry...
August 22, 2018: British Journal of Surgery
G Marchegiani, S Andrianello, G Morbin, E Secchettin, M D'Onofrio, R De Robertis, G Malleo, C Bassi, R Salvia
BACKGROUND: The association between risk of pancreatic cancer and a dilated main pancreatic duct (MPD) in intraductal papillary mucinous neoplasm (IPMN) is debated. The aim of this study was to assess the role of MPD size in predicting pancreatic cancer in resected IPMNs and those kept under surveillance. METHODS: All patients with IPMN referred to the Pancreas Institute, University of Verona Hospital Trust, from 2006 to 2016 were included. The primary endpoint was the occurrence of malignancy detected at surgery or during follow-up...
August 14, 2018: British Journal of Surgery
S Mine, M Watanabe, K Kumagai, A Okamura, K Yamashita, M Hayami, M Yuda, Y Imamura, N Ishizuka
BACKGROUND: Treatment of supraclavicular nodes remains controversial among patients with oesophageal squamous cell carcinoma. This study assessed the outcomes of patients who underwent oesophagectomy with or without supraclavicular lymphadenectomy after neoadjuvant treatment. METHODS: This was a single-centre retrospective cohort study. Patients with oesophageal squamous cell carcinoma and clinically negative supraclavicular nodes who underwent oesophagectomy after neoadjuvant treatment between January 2005 and December 2015 were included...
August 14, 2018: British Journal of Surgery
M Baré, L Mora, N Torà, M J Gil, I Barrio, P Collera, D Suárez, M Redondo, A Escobar, N Fernández de Larrea, J M Quintana
BACKGROUND: The aim of this study was to assess factors associated with outcomes after surgery for colorectal cancer and to design and internally validate a simple score for predicting perioperative mortality. METHODS: Patients undergoing surgery for primary invasive colorectal cancer in 22 centres in Spain between June 2010 and December 2012 were included. Clinical variables up to 30 days were collected prospectively. Multiple logistic regression techniques were applied and a risk score was developed...
August 13, 2018: British Journal of Surgery
M C van Maaren, L J A Strobbe, L B Koppert, P M P Poortmans, S Siesling
BACKGROUND: Landmark trials have shown breast-conserving surgery (BCS) combined with radiotherapy to be as safe as mastectomy in breast cancer treatment. This population-based study aimed to evaluate trends in BCS from 1989 to 2015 in nine geographical regions in the Netherlands. METHODS: All women diagnosed between 1989 and 2015 with primary T1-2 N0-1 breast cancer, treated with BCS or mastectomy, were identified from the Netherlands Cancer Registry. Crude and case mix-adjusted rates of BCS were evaluated and compared between nine Dutch regions for two time intervals: 1989-2002 and 2003-2015...
August 9, 2018: British Journal of Surgery
M Ishimaru, H Matsui, S Ono, Y Hagiwara, K Morita, H Yasunaga
BACKGROUND: Improving patients' oral hygiene is an option for preventing postoperative pneumonia that may be caused by aspiration of oral and pharyngeal secretions. Whether preoperative oral care by a dentist can decrease postoperative complications remains controversial. A retrospective cohort study was undertaken to assess the association between preoperative oral care and postoperative complications among patients who underwent major cancer surgery. METHODS: The nationwide administrative claims database in Japan was analysed...
August 8, 2018: British Journal of Surgery
D P Schaap, A Ogura, J Nederend, M Maas, J S Cnossen, G J Creemers, I van Lijnschoten, G A P Nieuwenhuijzen, H J T Rutten, M Kusters
BACKGROUND: Lateral nodal disease in rectal cancer remains a subject of debate and is treated differently in the East and the West. The predictive value of lateral lymph node and MRI-detected extramural vascular invasion (mrEMVI) features on oncological outcomes was assessed in this study. METHODS: In this retrospective cohort study, data on patients with cT3-4 rectal cancer within 8 cm from the anal verge were considered over a 5-year period (2009-2013). Lateral lymph node size, malignant features and mrEMVI features were evaluated and related to oncological outcomes...
August 6, 2018: British Journal of Surgery
J Zheng, S-H Xie, G Santoni, J Lagergren
BACKGROUND: Gastric adenocarcinoma is a common cause of cancer death globally. It remains unclear whether coexisting diabetes mellitus influences survival in patients with this tumour. A cohort study was conducted to determine whether coexisting diabetes increases mortality in gastric adenocarcinoma. METHODS: This nationwide population-based cohort study included all patients diagnosed with gastric adenocarcinoma in Sweden between 1990 and 2014. Cox proportional hazards regression and competing risks regression were used to assess the influence of coexisting diabetes on disease-specific mortality in gastric adenocarcinoma with adjustment for sex, age, calendar year and co-morbidity (Charlson Co-morbidity Index score excluding diabetes)...
July 27, 2018: British Journal of Surgery
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