The British journal of surgery
-
Neoadjuvant chemotherapy (NACT) is a standard treatment option for primary operable breast cancer when adjuvant chemotherapy is indicated. ⋯ Overall, patients do benefit from NACT, especially those with human epidermal growth factor receptor 2-positive and triple-negative breast cancer, but surgical/local procedures need to be adapted.
-
Observational Study
Outcomes after implementation of a multimodal standard care pathway for laparoscopic colorectal surgery.
The aim of the study was to assess which aspects of an enhanced recovery programme are associated with better outcomes following laparoscopic colorectal surgery. ⋯ Compliance with an enhanced recovery pathway was associated with less opiate use, fewer complications and a shorter hospital stay.
-
Trends in surgery for screen-detected and interval breast cancers in a national screening programme.
This population-based study aimed to evaluate trends in surgical approach for screen-detected cancer versus interval breast cancer, and to determine the factors associated with positive resection margins. ⋯ Mastectomy rates doubled during a 14-year period of screening mammography and the proportion of positive resection margins decreased, with variation among hospitals. The latter observation stresses the importance of quality control programmes for hospitals treating women with breast cancer.
-
Peritoneal or thoracoabdominal wall implants from hepatocellular carcinoma (HCC) occur occasionally after biopsy, percutaneous therapy or resection, and spontaneously, with no effective treatment available. The objective of this study was to clarify the indications for, and benefits of, surgical resection of such HCC implants. ⋯ Surgical resection of implanted HCC may improve long-term survival in selected patients as long as intrahepatic disease is absent or well controlled.
-
Observational Study
Influence of body mass index on mortality after surgery for perforated peptic ulcer.
Body mass index (BMI) is a strong predictor of mortality in the general population. In spite of the medical hazards of obesity, a protective effect on mortality has been suggested in surgical patients: the obesity paradox. The aim of the present nationwide cohort study was to examine the association between BMI and mortality in patients treated surgically for perforated peptic ulcer (PPU). ⋯ Being underweight was associated with increased mortality in patients with PPU, whereas being overweight or obese was neither protective nor an adverse prognostic factor.