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British Journal of Surgery

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https://www.readbyqxmd.com/read/30588613/ethical-considerations-in-global-surgery
#1
E Steyn, J Edge
No abstract text is available yet for this article.
December 26, 2018: British Journal of Surgery
https://www.readbyqxmd.com/read/30570764/evaluating-the-collection-comparability-and-findings-of-six-global-surgery-indicators
#2
H Holmer, A Bekele, L Hagander, E M Harrison, P Kamali, J S Ng-Kamstra, M A Khan, L Knowlton, A J M Leather, I H Marks, J G Meara, M G Shrime, M Smith, K Søreide, T G Weiser, J Davies
BACKGROUND: In 2015, six indicators were proposed to evaluate global progress towards access to safe, affordable and timely surgical and anaesthesia care. Although some have been adopted as core global health indicators, none has been evaluated systematically. The aims of this study were to assess the availability, comparability and utility of the indicators, and to present available data and updated estimates. METHODS: Nationally representative data were compiled for all WHO member states from 2010 to 2016 through contacts with official bodies and review of the published and grey literature, and available databases...
December 20, 2018: British Journal of Surgery
https://www.readbyqxmd.com/read/30566245/cost-effectiveness-analysis-of-a-multicentre-randomized-clinical-trial-comparing-surgery-with-conservative-management-for-recurrent-and-ongoing-diverticulitis-direct-trial
#3
H E Bolkenstein, G A de Wit, E C J Consten, B J M Van de Wall, I A M J Broeders, W A Draaisma
BACKGROUND: The results of the DIRECT trial, an RCT comparing conservative management with elective sigmoid resection in patients with recurrent diverticulitis or persistent complaints, showed that elective sigmoid resection leads to higher quality of life. The aim of this study is to determine the cost-effectiveness of surgical treatment at 1- and 5-year follow-up from a societal perspective. METHODS: Clinical effectiveness and resource use were derived from the DIRECT trial...
December 19, 2018: British Journal of Surgery
https://www.readbyqxmd.com/read/30566233/patient-level-costs-in-margin-re-excision-for-breast-conserving-surgery
#4
Y Grant, R Al-Khudairi, E St John, M Barschkett, D Cunningham, R Al-Mufti, K Hogben, P Thiruchelvam, D J Hadjiminas, A Darzi, A W Carter, D R Leff
BACKGROUND: High rates of reoperation following breast-conserving surgery (BCS) for positive margins are associated with costs to healthcare providers. The aim was to assess the quality of evidence on reported re-excision costs and compare the direct patient-level costs between patients undergoing successful BCS versus reoperations after BCS. METHODS: The study used data from women who had BCS with or without reoperation at a single institution between April 2015 and March 2016...
December 19, 2018: British Journal of Surgery
https://www.readbyqxmd.com/read/30556594/validation-of-the-bluebelle-wound-healing-questionnaire-for-assessment-of-surgical-site-infection-in-closed-primary-wounds-after-hospital-discharge
#5
(no author information available yet)
BACKGROUND: Accurate assessment of surgical-site infection (SSI) is crucial for surveillance and research. Self-reporting patient measures are needed because current SSI tools are limited for assessing patients after leaving hospital. The Bluebelle Wound Healing Questionnaire (WHQ) was developed for patient or observer completion; this study tested its acceptability, scale structure, reliability and validity in patients with closed primary wounds after abdominal surgery. METHODS: Patients completed the WHQ (self-assessment) within 30 days after leaving hospital and returned it by post...
December 17, 2018: British Journal of Surgery
https://www.readbyqxmd.com/read/30548590/global-surgery-in-an-ecosystem-for-worldwide-health
#6
K Søreide, D C Winter
No abstract text is available yet for this article.
December 13, 2018: British Journal of Surgery
https://www.readbyqxmd.com/read/30507040/relationship-between-r1-resection-tumour-rupture-and-recurrence-in-resected-gastrointestinal-stromal-tumour
#7
T Hølmebakk, B Bjerkehagen, I Hompland, S Stoldt, K Boye
BACKGROUND: According to guidelines, adjuvant treatment or re-excision should be considered after R1 resection of gastrointestinal stromal tumours (GISTs). However, the prognostic significance of R1 resection is uncertain and tumour rupture confounds its assessment. Here, the impact of positive margins was examined and related to rupture in a population-based cohort. METHODS: Patients undergoing surgery for non-metastatic GIST since 2000 were identified in the sarcoma database of Oslo University Hospital...
December 3, 2018: British Journal of Surgery
https://www.readbyqxmd.com/read/30507039/randomized-trial-of-two-types-of-gastrojejunostomy-after-pancreatoduodenectomy-and-risk-of-delayed-gastric-emptying-pauda-trial
#8
J Busquets, S Martín, J Fabregat, L Secanella, N Pelaez, E Ramos
BACKGROUND: Delayed gastric emptying (DGE) is the most important cause of an extended hospital stay after pancreatoduodenectomy. Reports suggest that a Roux-en-Y gastroenteric anastomosis may have lower incidence of DGE than a Billroth II reconstruction. The primary aim of this RCT was to compare Billroth II (single loop) and Roux-en-Y (double loop) after pancreatoduodenectomy to determine whether Roux-en-Y reconstruction is associated with a lower incidence of DGE. Secondary endpoints were postoperative complications...
December 3, 2018: British Journal of Surgery
https://www.readbyqxmd.com/read/30485405/improving-surgical-outcomes-through-benchmarking
#9
R D Staiger, H Schwandt, M A Puhan, P-A Clavien
Benchmarking is a popular quality-improvement tool in economic practice. Its basic principle consists of identifying the best (the benchmark), then comparing with the best, and learning from the best. In healthcare, the concept of benchmarking or establishing benchmarks has been less specific, where comparisons often do not target the best, but the average results. The goal, however, remains improvement in patient outcome. This article outlines the application of benchmarking and proposes a standard approach of benchmark determination in surgery, including the establishment of best achievable real-world postoperative outcomes...
November 28, 2018: British Journal of Surgery
https://www.readbyqxmd.com/read/30460999/sex-differences-in-faecal-occult-blood-test-screening-for-colorectal-cancer
#10
L Koskenvuo, N Malila, J Pitkäniemi, J Miettinen, S Heikkinen, V Sallinen
BACKGROUND: This analysis of patients in a randomized population-based health services study was done to determine the effects of faecal occult blood test (FOBT) screening of colorectal cancer (CRC) in outcomes beyond mortality, and to obtain explanations for potential sex differences in screening effectiveness. METHODS: In the Finnish FOBT screening programme (2004-2011), people aged 60-69 years were randomized into the screening and control arms. Differences in incidence, symptoms, tumour location, TNM categories, non-vital outcomes and survival in the screening and control arms were analysed...
November 21, 2018: British Journal of Surgery
https://www.readbyqxmd.com/read/30395362/survival-after-neoadjuvant-chemoradiotherapy-and-oesophagectomy-versus-definitive-chemoradiotherapy-for-patients-with-oesophageal-squamous-cell-carcinoma
#11
B-Y Wang, S-C Wu, H-C Chen, W-H Hung, C-H Lin, C-L Huang, H-S Chen
BACKGROUND: Whether there is a difference in survival after neoadjuvant chemoradiotherapy plus surgery (CRT-S) compared with definitive chemoradiotherapy (dCRT) in patients with locally advanced oesophageal squamous cell carcinoma (SCC) remains controversial. METHODS: Patients with SCC who underwent curative treatment from 2008 to 2014 were identified from the Taiwan Cancer Registry. Propensity score matching was undertaken to balance pretreatment clinical variables...
November 5, 2018: British Journal of Surgery
https://www.readbyqxmd.com/read/30395361/sex-differences-in-national-rates-of-repair-of-emergency-abdominal-aortic-aneurysm
#12
A Aber, T S Tong, J Chilcott, P Thokala, R Maheswaran, S M Thomas, S Nawaz, S Walters, J Michaels
BACKGROUND: The aim of this study was to assess the sex differences in both the rate and type of repair for emergency abdominal aortic aneurysm (AAA) in England. METHODS: Hospital Episode Statistics (HES) data sets from April 2002 to February 2015 were obtained. Clinical and administrative codes were used to identify patients who underwent primary emergency definitive repair of ruptured or intact AAA, and patients with a diagnosis of AAA who died in hospital without repair...
November 5, 2018: British Journal of Surgery
https://www.readbyqxmd.com/read/30395349/effect-of-preoperative-biliary-drainage-on-cholestasis-associated-inflammatory-and-fibrotic-gene-signatures-in-perihilar-cholangiocarcinoma
#13
M J Reiniers, L de Haan, R Weijer, J K Wiggers, A Jongejan, P D Moerland, L K Alles, A H C van Kampen, T M van Gulik, M Heger, R F van Golen
Preoperative biliary drainage (PBD) is used routinely in the evaluation of patients with potentially resectable perihilar cholangiocarcinoma to relieve cholestasis and improve the liver's resilience to surgery. Little preclinical or translatational data are, however, currently available to guide the use of PBD in this patient group. The effect of PBD on hepatic gene expression profiles was therefore studied by microarray analysis. Drainage affects inflammatory and fibrotic gene signatures.
November 5, 2018: British Journal of Surgery
https://www.readbyqxmd.com/read/30370938/impact-of-postoperative-complications-on-outcomes-after-oesophagectomy-for-cancer
#14
L Goense, J Meziani, J P Ruurda, R van Hillegersberg
BACKGROUND: To allocate healthcare resources optimally, complication-related quality initiatives should target complications that have the greatest overall impact on outcomes after surgery. The aim of this study was to identify the most clinically relevant complications after oesophagectomy for cancer in a nationwide cohort study. METHODS: Consecutive patients who underwent oesophagectomy for cancer between January 2011 and December 2016 were identified from the Dutch Upper Gastrointestinal Cancer Audit...
October 29, 2018: British Journal of Surgery
https://www.readbyqxmd.com/read/30357815/systematic-review-of-shared-decision-making-in-surgery
#15
REVIEW
S M L de Mik, F E Stubenrouch, R Balm, D T Ubbink
BACKGROUND: Multiple treatment options are generally available for most diseases. Shared decision-making (SDM) helps patients and physicians choose the treatment option that best fits a patient's preferences. This review aimed to assess the extent to which SDM is applied during surgical consultations, and the metrics used to measure SDM and SDM-related outcomes. METHODS: This was a systematic review of observational studies and clinical trials that measured SDM during consultations in which surgery was a treatment option...
October 25, 2018: British Journal of Surgery
https://www.readbyqxmd.com/read/30353920/diffusion-weighted-mri-assessment-of-the-peritoneal-cancer-index-before-cytoreductive-surgery
#16
I van 't Sant, W J van Eden, M P Engbersen, N F M Kok, K Woensdregt, D M J Lambregts, S Shanmuganathan, R G H Beets-Tan, A G J Aalbers, M J Lahaye
BACKGROUND: Patients with limited peritoneal metastases from colorectal cancer may be candidates for an aggressive surgical approach including cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (CRS-HIPEC). Selection is based on surgical inspection during laparoscopy or laparotomy. The aim of this study was to investigate whether diffusion-weighted MRI (DW-MRI) can be used to select patients for CRS-HIPEC. METHODS: This was a prospective study at a tertiary referral centre...
October 24, 2018: British Journal of Surgery
https://www.readbyqxmd.com/read/30346041/risk-factors-for-transplant-renal-artery-stenosis-after-live-donor-transplantation
#17
M L Nicholson, C Yong, P B Trotter, L Grant, S A Hosgood
BACKGROUND: Renal transplant surgeons are making increasing use of live donor kidneys with multiple renal arteries. This study aimed to identify independent risk factors for the development of transplant renal artery stenosis (TRAS) in the modern era of complex arterial reconstruction for multiple vessels. METHODS: Multivariable logistic regression analysis with a stepwise variable deletion model was used to identify risk factors for the development of TRAS in a consecutive series of live donor kidney transplants...
October 22, 2018: British Journal of Surgery
https://www.readbyqxmd.com/read/30620076/implementation-and-evaluation-of-nationwide-scale-up-of-the-surgical-safety-checklist
#18
M C White, K Randall, N F E Capo-Chichi, F Sodogas, S Quenum, K Wright, K L Close, S Russ, N Sevdalis, A J M Leather
BACKGROUND: The WHO Surgical Safety Checklist improves surgical outcomes, but evidence and theoretical frameworks for successful implementation in low-income countries remain lacking. Based on previous research in Madagascar, a nationwide checklist implementation in Benin was designed and evaluated longitudinally. METHODS: This study had a longitudinal embedded mixed-methods design. The well validated Consolidated Framework for Implementation Research (CFIR) was used to structure the approach and evaluate the implementation...
January 2019: British Journal of Surgery
https://www.readbyqxmd.com/read/30620075/systematic-review-of-the-use-of-big-data-to-improve-surgery-in-low-and-middle-income-countries
#19
REVIEW
S R Knight, R Ots, M Maimbo, T M Drake, C J Fairfield, E M Harrison
BACKGROUND: Technological advances have led to the generation of large amounts of data, both in surgical research and practice. Despite this, it is unclear how much originates in low- and middle-income countries (LMICs) and what barriers exist to the use of such data in improving surgical care. The aim of this review was to capture the extent and impact of programmes that use large volumes of patient data on surgical care in LMICs. METHODS: A PRISMA-compliant systematic literature review of PubMed, Embase and Google Scholar was performed in August 2018...
January 2019: British Journal of Surgery
https://www.readbyqxmd.com/read/30620074/training-and-accrediting-international-surgeons
#20
REVIEW
S P Stawicki, B C Nwomeh, G L Peck, Z C Sifri, M Garg, J V Sakran, T J Papadimos, H L Anderson, M S Firstenberg, V H Gracias, J A Asensio
BACKGROUND: Formal international medical programmes (IMPs) represent an evolution away from traditional medical volunteerism, and are based on the foundation of bidirectional exchange of knowledge, experience and organizational expertise. The intent is to develop multidirectional collaborations and local capacity that is resilient in the face of limited resources. Training and accreditation of surgeons continues to be a challenge to IMPs, including the need for mutual recognition of competencies and professional certification...
January 2019: British Journal of Surgery
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