BJS Open

Quality improvement interventions in surgical oncology: systematic review of international studies ➡️doi.org/10.1093/bjsope… Substantial variation in surgical oncology care and outcomes have been identified and quality improvement interventions have the potential to address this. This systematic review highlights a lack of high-quality evaluations of QI interventions in the literature. Key gaps include interventions aimed at improving equitable access to surgical care. 👏👏👏Adil Rashid , Sugeeta Sukumar , Joanna Dodkins , Georgia Zachou , Nicola S Fearnhead , Kate Walker , @AggarwalOnc #SoMe4Surgery #MedTwitter #SurgEd #Surgery @BJSAcademy @BJSurgery

Surgical innovation and technology ➡️ doi.org/10.1093/bjs/zn… The future of surgery will be more precise, personalized, and technology-enabled—but innovation must be judged by its impact on patient care, not by novelty alone This BJS Commission highlights how surgeons, engineers, scientists, and industry can work together to ensure new tools improve outcomes, equity, and value Work by @JBMatthews, Jelle P Ruurda , Peter G Vaughan-Shaw , Desmond C Winter , Andrew Beggs , Andrew Yiu , Brian Davidson , Barbara Seeliger , Chen Xin , Daniel Stoyanov , Daphne D Rietbergen , Fijs W B van Leeuwen , Gerlof M Kuiper , Guglielmo N Piozzi , Jianing Qiu , James M Kinross , João Ramalhinho , Jim S Khan , Kurinchi Gurusamy , Kyle Lam , Kai F Chan , Li Zhang , Matthew Boal , Matthew J Clarkson , Matthias N van Oosterom , Nader Francis , Neeraj Lal , Philip W Y Chiu , Tessa Buckle , Yafit Shasha , Israa F E Hussein #SoMe4Surgery #MedTwitter #SurgEd #Surgery @RCPSGTrainees @aecirujanos @SEIQuirurgica @iss_sic #MedicalTechniques @BJSAcademy @young_bjs @BJSOpen @evanscolorectal @robhinchliffe1 @bplwijn @MalinASund @nfmkok @TejedorPat @paulo_sutt @PVaughanShaw @JJEarnshaw @juliomayol @ksoreide #some4hpb #some4tpl @DPCG_official @pancreatitis_nl @PancreasClub #PancreasClub2023 #PancreaticCancer #Pancreatitis #HCC @PanCAN #PanCANawareness @EurPancClub @P_C_E_ @dice_europe #PancreaticCancer #cholangiocarcinoma #HPBSurgery #GallbladderCancer #Oncology #LiverSurgery #colorectalsurgery #StepUp4CRC @FightCRC @ACPGBI #ERAS @dice_europe #Crohn #proctology @Dukes_Club @ACPGBI_EduTrain @AECP_FAECP @PelvExGroup @escp_tweets @YouESCP #TeachMeColoproctology #Some4COLoprocto #some4UGI #uppergi #esophagealcancer #gastriccancer #reflux @ISDE_net @Augishealth @roux_group @T4UGIS @SARONG_Trial @YoungIFSO #bariatricsurgery

Presurgical levels of circulating tumour DNA in patients with resectable chemotherapy-naïve colorectal liver metastases: association with multiorgan recurrence and survival in the MIRACLE cohort ➡️ doi.org/10.1093/bjs/zn… 📊 In this cohort of 182 patients undergoing curative-intent treatment for CRLM, 19% were classified as ctDNA-high using the mFast-SeqS aneuploidy assay. ⚠️ ctDNA-high patients had markedly worse outcomes, with 1-year recurrence-free survival of 29% vs 52% and 3-year overall survival of 48% vs 78%. 🌍 Multiorgan recurrence within the first year was significantly more common in ctDNA-high patients. 🔍 The aneuploidy score independently predicted recurrence and survival on multivariable analysis. 🎯 mFast-SeqS may provide a low-cost, minimally invasive strategy to identify patients at high risk of rapid recurrence before treatment. Work by Lissa Wullaert , Lotte van Leeuwen , Vanja de Weerd , Mai Van , Esther Oomen-de Hoop , Jaco Kraan , Maurice P H M Jansen , John W M Martens , Dirk J Grünhagen , Henk M W Verheul , Cornelis Verhoef , Saskia M Wilting #SoMe4Surgery #MedTwitter #SurgEd #Surgery @RCPSGTrainees @aecirujanos @SEIQuirurgica @iss_sic #MedicalTechniques @BJSAcademy @young_bjs @BJSOpen @evanscolorectal @robhinchliffe1 @bplwijn @MalinASund @nfmkok @TejedorPat @paulo_sutt @PVaughanShaw @JJEarnshaw @juliomayol @ksoreide #some4hpb #some4tpl @DPCG_official @pancreatitis_nl @PancreasClub #PancreasClub2023 #PancreaticCancer #Pancreatitis #HCC @PanCAN #PanCANawareness @EurPancClub @P_C_E_ @dice_europe #PancreaticCancer #cholangiocarcinoma #HPBSurgery #GallbladderCancer #Oncology #LiverSurgery

Costs associated with anastomotic leak after left-sided colorectal surgery: retrospective real-world study in England ➡️doi.org/10.1093/bjsope… This retrospective matched cohort study compared healthcare resource utilization and costs between patients with and without anastomotic leak (AL) after left-sided colorectal surgery to highlight the significant burden of AL and to address the evidence gap regarding its economic impact in England. AL was associated with a significantly higher mean all-cause inpatient cost of €11 723 and a significantly higher mean cumulative length of hospital stay of 15.93 days. 👏👏👏Julia Glover-Kirtland , Cindy Tong , Melek Pinar Bosut , Niels-Derrek Schmitz , Sara Joao Carvalho , Caoimhe T Rice , Dion G Morton , Elizabeth Li , Thomas D Pinkney #SoMe4Surgery #MedTwitter #SurgEd #Surgery @BJSAcademy @BJSurgery #colorectalsurgery #colorectalcancer @FightCRC #StepUp4CRC

Negative-pressure wound therapy in thoracic and abdominal surgery: meta-analysis of randomized trials ➡️doi.org/10.1093/bjsope… This systematic review and meta-analysis of 45 randomized trials including over 12 000 patients found that closed-incision negative-pressure wound therapy (NPWT) significantly reduces surgical site infections (SSIs) and shortens hospital stay following open abdominal surgery, with consistent effects across device types. No benefit was observed for organ/space infection, fascial dehiscence or reoperation, and evidence of publication bias suggests that, although the magnitude of benefit may be overestimated, the reduction in SSI remains statistically significant when adjusted for this. These findings support selective use of NPWT in high-risk patients, while underscoring the need for cost-effectiveness analyses and long-term outcome data. 👏👏👏Adil S Lakha , Salma Neves , Younis Alemour , Hannah McGivern , Alex Gordon-Weeks #SoMe4Surgery #MedTwitter #SurgEd #Surgery @BJSAcademy @BJSurgery

Transanal irrigation for low anterior resection syndrome treatment: international multicentre randomized clinical trial ➡️doi.org/10.1093/bjsope… In this multicentre randomized feasibility trial, transanal irrigation (TAI) was evaluated in patients with major low anterior resection syndrome persisting at least 12 months after anterior resection. Compared with best supportive care, TAI significantly improved bowel function and quality of life at 12 months, with markedly lower LARS and Wexner incontinence scores and higher bowel function scores. Treatment adherence was high, with 75% of patients continuing daily irrigation, and patient satisfaction consistently favoured TAI. Only two mild procedure-related adverse events were reported, supporting TAI as a feasible, acceptable, and effective treatment option for severe LARS. 👏👏👏Ignas Civilka , Michail Klimovskij , Andrej Aleinikov , Peter Christensen , Narimantas E Samalavicius , Miglė Sakalauskaitė , Audrius Dulskas #SoMe4Surgery #MedTwitter #SurgEd #Surgery @BJSAcademy @BJSurgery #colorectalsurgery #colorectalcancer @FightCRC #StepUp4CRC

Standards for reporting research methods, interventions, and Outcomes in Surgical Prehabilitation studies (SOS-Prehab) ➡️doi.org/10.1093/bjs/zn… 🏋️ Prehabilitation trials need clearer and more consistent reporting to improve reproducibility and clinical implementation. 🌍 SOS-Prehab was developed through a two-round Delphi process with 53 international experts across exercise, nutrition, psychology, and perioperative care. 📋 The final checklist includes 40 items: 16 essential and 24 important reporting elements. 🔍 Key domains include intervention components, delivery methods, adherence, participant characteristics, and outcome measures. 📊 Used alongside CONSORT, SOS-Prehab may improve transparency, comparability, and evidence synthesis in prehabilitation research. 🎯 Better reporting can help accelerate translation of prehabilitation into clinical practice and policy. Work by Chelsia Gillis , Daniel I McIsaac , Daniel Santa Mina , Stéphanie Chevalier , Gabriele Baldini , Francesco Carli , Celena Scheede-Bergdahl , Linda Edgar , Vanessa Smrk , Leah Avery , Amal Bessissow , Miquel Coca Martinez , Robert Copeland , Susanne Oksbjerg Dalton , Gerad Danjoux , Linda Denehy , Dominique Engel , Chloe Grimmett , Michael P Grocott , Heather L Gill , Sandy Jack , Bente Thoft Jensen , Denny Levett , Graciela Martinez-Palli , Zoe Merchant , John Moore , Nicolò Pecorelli , Ian Randall , Bernhard Riedel , Geoff Schierbeck , Gerrit Slooter , Malcolm West , Julio F Fiore, Jr. , Collaborators #SoMe4Surgery #MedTwitter #SurgEd #Surgery @RCPSGTrainees @aecirujanos @SEIQuirurgica @iss_sic #MedicalTechniques @BJSAcademy @young_bjs @BJSOpen @evanscolorectal @robhinchliffe1 @bplwijn @MalinASund @nfmkok @TejedorPat @paulo_sutt @PVaughanShaw @JJEarnshaw @juliomayol @ksoreide #some4hpb #some4tpl @DPCG_official @pancreatitis_nl @PancreasClub #PancreasClub2023 #PancreaticCancer #Pancreatitis #HCC @PanCAN #PanCANawareness @EurPancClub @P_C_E_ @dice_europe #PancreaticCancer #cholangiocarcinoma #HPBSurgery #GallbladderCancer #Oncology #LiverSurgery #colorectalsurgery #StepUp4CRC @FightCRC @ACPGBI #ERAS @dice_europe #Crohn #proctology @Dukes_Club @ACPGBI_EduTrain @AECP_FAECP @PelvExGroup @escp_tweets @YouESCP #TeachMeColoproctology #Some4COLoprocto #some4UGI #uppergi #esophagealcancer #gastriccancer #reflux @ISDE_net @Augishealth @roux_group @T4UGIS @SARONG_Trial @YoungIFSO #bariatricsurgery @asgbi @ASiTofficial @eurohernias @SEIQuirurgica @ESCP_tweets @YouESCP

Impact of breast cancer characteristics on the development and time to liver metastases: population-based study ➡️doi.org/10.1093/bjsope… The intrinsic breast cancer subtype is correlated with the risk of and time to the development of liver metastasis. Breast cancer liver metastases are common in advanced breast cancer, but isolated oligometastases are rare. 👏👏👏Marcus Sundén , Elin Lindqvist , Ellen Wahlqvist , Ellen Hansson , Charlotta Wadsten , Anne Andersson , Malin Sund , Oskar Hemmingsson #SoMe4Surgery #MedTwitter #SurgEd #Surgery @BJSAcademy @BJSurgery #breastcancer #mastectomy #endocrine

Development of a standard definition of ‘no-option’ and ‘poor-option’ for revascularization in chronic limb-threatening ischemia ➡️ doi.org/10.1093/bjs/zn… This consensus study established a structured, expert-validated definition of no option or poor option for revascularisation of patients with CLTI The multidomain ABRFC framework provides a foundation for standardized clinical assessment, trial design, and future guideline development Work by Mario Alejandro Fabiani , Jos C van den Berg , Oscar A De la Torre , Alfredo Verastegui , Anahita Dua On Behalf of , the International Cooperative Vascular Consortium (ICVC) #SoMe4Surgery #MedTwitter #SurgEd #Surgery @RCPSGTrainees @aecirujanos @SEIQuirurgica @iss_sic #MedicalTechniques @BJSAcademy @young_bjs @BJSOpen @evanscolorectal @robhinchliffe1 @bplwijn @MalinASund @nfmkok @TejedorPat @paulo_sutt @PVaughanShaw @JJEarnshaw @juliomayol @ksoreide #vascularsurgery #vascular #Ischemia @vascularsurgery

Effect of timing on patient-reported outcomes in contralateral symmetrization surgery in autologous breast reconstruction ➡️doi.org/10.1093/bjsope… This cohort study compared patient-reported outcomes between simultaneous and secondary contralateral breast symmetrization in women undergoing unilateral autologous breast reconstruction. Short-term satisfaction was better with simultaneous symmetrization; however, once all patients had undergone symmetrization, the difference in satisfaction was no longer significant. 👏👏👏Rojda Gümüscü , Olivia Sjökvist , Ellen Kragsterman , Johan Svensson , Susanna Kauhanen , Maria Mani , Rebecca Wiberg #SoMe4Surgery #MedTwitter #SurgEd #Surgery @BJSAcademy @BJSurgery #breastcancer #mastectomy #endocrine

Diagnosis of inflammatory bowel disease after symptomatic faecalimmunochemical testing: population-based cohort study ➡️ doi.org/10.1093/bjs/zn… IBD is more common than CRC in patients aged <50 years referred on symptomatic FIT pathways using FIT ≥10 µg Hb/g In a selected cohort of dual-tested patients, FCP results provided additional risk stratification Incorporating routine FCP testing into symptomatic FIT pathways may better target further investigations. Work by James C K Ng , Alastair J Morton , Colin J Crooks , Joe West , Matthew J Grainge , Timothy R Card , David J Humes #SoMe4Surgery #MedTwitter #SurgEd #Surgery @RCPSGTrainees @aecirujanos @SEIQuirurgica @iss_sic #MedicalTechniques @BJSAcademy @young_bjs @BJSOpen @evanscolorectal @robhinchliffe1 @bplwijn @MalinASund @nfmkok @TejedorPat @paulo_sutt @PVaughanShaw @JJEarnshaw @juliomayol @ksoreide #colorectalsurgery #StepUp4CRC @FightCRC @ACPGBI #ERAS @dice_europe #Crohn #proctology @Dukes_Club @ACPGBI_EduTrain @AECP_FAECP @PelvExGroup @escp_tweets @YouESCP #TeachMeColoproctology #Some4COLoprocto

Video-based assessment tool for workflow analysis in minimally invasive colorectal surgery: expert consensus-based development and multicentre validation of ColoWorkflow ➡️doi.org/10.1093/bjsope… ColoWorkflow, the first video-based assessment tool for workflow analysis across minimally invasive colorectal procedures, was based on a modified Delphi process involving over 40 experts from 11 countries. Validation on a multicentre data set demonstrated moderate-to-strong inter-rater reliability and broad applicability across five major colorectal procedures. ColoWorkflow provides a standardized framework for benchmarking surgical workflows, improving training, and developing artificial intelligence-driven workflow recognition in colorectal surgery. 👏👏👏Pooja P Jain , Pietro Mascagni , Giuseppe Massimiani , Nabani Banik , Marta Goglia , Lorenzo Arboit , Britty Baby , Andrea Balla , Ludovica Baldari , Gianfranco Silecchia , Claudio Fiorillo , The CompSurg Colorectal Experts Group , Sergio Alfieri , @smoralesconde , Deborah S Keller , Luigi Boni , Nicolas Padoy #SoMe4Surgery #MedTwitter #SurgEd #Surgery @BJSAcademy @BJSurgery #colorectalsurgery #colorectalcancer @FightCRC #StepUp4CRC @dice_europe

@robhinchliffe1 @asgbi #asgbi2026

👏 Next up for BJS LIVE @evanscolorectal, joint Editor-in-Chief @BJSurgery @asgbi #asgbi2026

Clinical and molecular landscape of surgically resected early onset pancreatic cancer ➡️ doi.org/10.1093/bjs/zn… EOPC is associated with a shorter time to recurrence and more aggressive, adverse molecular pathology. Work by Stephan B Dreyer , Adam Bryce , Fieke Froeling , Shannon Jackson Australian Pancreatic Cancer Genome Initiative , Leonor Santana , Euan J Dickson , Maria Coats , Colin McKay , David Holroyd , Andrew V Biankin , Nigel B Jamieson , David K Chang #SoMe4Surgery #MedTwitter #SurgEd #Surgery @RCPSGTrainees @aecirujanos @SEIQuirurgica @iss_sic #MedicalTechniques @BJSAcademy @young_bjs @BJSOpen @evanscolorectal @robhinchliffe1 @bplwijn @MalinASund @nfmkok @TejedorPat @paulo_sutt @PVaughanShaw @JJEarnshaw @juliomayol @ksoreide #some4hpb #some4tpl @DPCG_official @pancreatitis_nl @PancreasClub #PancreasClub2023 #PancreaticCancer #Pancreatitis #HCC @PanCAN #PanCANawareness @EurPancClub @P_C_E_ @dice_europe #PancreaticCancer #cholangiocarcinoma #HPBSurgery #GallbladderCancer #Oncology #LiverSurgery

📢 Calling trainee organisations, student bodies and organisations that are not a BJS Foundation partner! Interested in applying for funding to support education? 🌍 Explore available opportunities here: ➡️buff.ly/wFId3b8 Application deadline: 1 June! ⏳ #FundingOpportunity #EducationSupport #LeadingSurgicalEducation @BJSurgery @BjsOpen @Young_BJS

In 1985, Erich Mühe performed the first laparoscopic cholecystectomy—and was reprimanded for it. Today, the problem isn’t rejecting innovation. It’s the opposite. A new review shows: ▪️ Median 5-year delay from first procedure to publication ▪️ Only 11% prospectively registered ▪️ 98% high risk of bias We now have the IDEAL framework—but we’re not using it. This article asks a difficult question: Have we learned anything about evaluating surgical innovation? Read it here 👉 buff.ly/TqJseH1 #LeadingSurgicalEducation #SurgicalInnovation #MedEd #Research

Effectiveness of interventions delivered within inpatient perioperative care in adults undergoing surgery: scoping review of systematic reviews ➡️doi.org/10.1093/bjsope… This study provides a contemporary overview of the effectiveness of interventions delivered within inpatient perioperative care to adults undergoing surgery. The scoping review provides much needed clarity in a complex and diverse field, and can valuably inform research priorities to allocate often limited resources and help focus on intervention strategies that are likely to provide the most benefit and have the greatest impact on patients after surgery. 👏👏👏Charlotte Davies , Isobel Read , Penny Sucharitkul , Ronelle Mouton , @robhinchliffe1 #SoMe4Surgery #MedTwitter #SurgEd #Surgery @BJSAcademy @BJSurgery

Quality metrics for perioperative red blood cell transfusion in gastrointestinal cancer surgery: international Delphi consensus ➡️doi.org/10.1093/bjsope… A consensus on quality metrics to assess and monitor the use of perioperative red blood cell transfusion (RBCT) in gastrointestinal cancer surgery was generated through a four-round modified Delphi process with 37 international experts. Consensus was reached on 18 quality metrics across structures, processes, and outcomes of care, reflecting both clinical importance and feasibility. These expert-endorsed metrics can support institutions and health systems in monitoring RBCT practices, with a view to reducing unwarranted variation in RBCT use and improving patient outcomes and blood resource stewardship in gastrointestinal cancer surgery. 👏👏👏@HalletJulie, @jesse_zuckerman , Frances C Wright , Jeannie Callum , Alyson L Mahar , Alexis F Turgeon , Asim Alam , Jessica Armah , @Gio_Marchegiani , David Cavallucci , Guillaume Martel on behalf of , the RBCT Quality Metrics Group #SoMe4Surgery #MedTwitter #SurgEd #Surgery @BJSAcademy @BJSurgery

❓What makes a BJS Award winner?❓ ➡️bjsacademy.com/page/bjs-award… 2023's winner, Professor Henrik Kehlet, described as a “colossus” in the field of research into perioperative care, was selected by a panel of experts from around the global surgical community, in a process similar to that of the selection for Nobel laureates, for his profound impact on patient care. Be sure to check out the citation by Derek Alderson, Professor's Kehlet's moving acceptance speech and more while you consider who you'll be nominating this year! Nomination deadline: 26 June #2027BJSAward #ShapingSurgicalScience #LeadingSurgicalEducation #SoMe4Surgery @BJSurgery @BjsOpen #surgery #surgeon #medical #medicine #2027BJSAward #ShapingSurgicalScience #LeadingSurgicalEducation #SoMe4Surgery @BJSurgery @BjsOpen @asgbi @IfsoSecretariat @ACPGBI @BAETS_UK @Augishealth @OPSORE @amcgmx @spcir @CerrahiTurk @VSGBI @ALRSGBIAcademy @BritishHernia @STARSurgUK @ASiTofficial @roux_group @spigc2018 @_WACS_Surgeons @cosecsa @NIHR_GSU @websurg