Malin Sund

Survival After Pathological Complete Response Following Neoadjuvant Chemotherapy vs Chemoradiotherapy in Esophageal Squamous Cell Carcinoma ➡️ doi.org/10.1093/bjs/zn… 📊 Individual patient data from 7 phase III RCTs (n=1,044 ESCC patients, 6 countries) 💊 NAC vs 🔥 NACRT → pCR rates: 6.9% vs 34.2% 🔎 Among patients achieving pCR (n=192):  • 5-year OS: 97.5% (NAC) vs 70.4% (NACRT)  • 5-year RFS: 80.8% (NAC) vs 63.7% (NACRT) 📈 Multivariable analysis confirmed a significant survival advantage for NAC in the pCR subgroup 🎯 Take-home: pCR is not biologically equivalent across modalities. ESCC patients achieving pCR after NAC have an exceptionally favourable prognosis—raising the question of whether this group could be considered for future surgery-avoidance or watch-and-wait strategies. Work by Jun Okui , Satoru Matsuda , Kengo Nagashima , Yasunori Sato , Hirofumi Kawakubo , Thomas Ruhstaller , Peter Thuss-Patience , Magnus Nilsson , Fredrik Klevebro , Lijie Tan , Shaoyuan Zhang , Thomas Aparicio , Guillaume Piessen , Charlène van der Zijden , Bianca Mostert , Bas P L Wijnhoven , Takahiro Tsushima , Hiroya Takeuchi , Ken Kato , Yuko Kitagawa #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 #some4UGI #uppergi #esophagealcancer #gastriccancer #reflux @ISDE_net @Augishealth @roux_group @T4UGIS @SARONG_Trial @YoungIFSO #bariatricsurgery

Major systemic infection following breast cancer surgery and oncological outcomes ➡️ doi.org/10.1093/bjs/zn… 🎗️ Postoperative infections are common after cancer surgery, but their impact on breast cancer recurrence has been unclear 📊 In a nationwide Swedish cohort (n=82,102, 2008–2019), 1.8% developed a major systemic infection within 90 days after surgery 📈 Major systemic infection was associated with a higher risk of distant recurrence (HR 1.23), overall mortality (HR 1.47), and breast cancer–specific death (HR 1.27) 📍 No significant association was seen with locoregional recurrence 🚨 These findings highlight that early recognition and effective treatment of postoperative infections may be critical to improving long-term oncological outcomes Work by Linda Adwall , Irma Fredriksson , Hella Hultin , Peter Stålberg , Maria Mani , Olov Norlén , Helena Sackey #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 #breastcancer #BreastCancerAwareness #breastsurgery

Märket, the world’s smallest island split between two nations, is a 3.3-hectare Baltic islet shared by Sweden and Finland. In 1885, Finland accidentally built a lighthouse on Sweden’s side, but as good friends and allies, they simply redrew the border in 1985 to fix it. 🇫🇮🤝🇸🇪

Long-term mortality rate and clinical outcomes associated with femoro-popliteal drug–coated balloon angioplasty and drug-eluting stents in chronic limb-threatening ischaemia: an analysis of the BASIL-3 RCT ➡️doi.org/10.1093/bjs/zn… 🦵 Paclitaxel-based endovascular devices (drug-coated balloons and drug-eluting stents) are widely used in chronic limb-threatening ischaemia (CLTI), but concerns have persisted about increased mortality 📊 In the BASIL-3 randomized trial (UK, n=481), outcomes with drug technologies were compared against plain balloon angioplasty ± bare metal stents ⏱️ After a median 5.6-year follow-up, overall survival was similar between groups (adjusted HR 0.83, 95% CI 0.64–1.07) 🦶 There were no significant differences in amputation-free survival, major amputations, limb events, cardiovascular events, or reinterventions ✅ These data do not support an increased all-cause mortality risk with paclitaxel drug-eluting technologies in patients with CLTI Work by Matthew Popplewell , Jack Hall , Lewis Meecham , Gareth Bate , Lisa Kelly , Jon J Deeks , Catherine A Moakes , Andrew Bradbury , the BASIL-3 Investigators #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 @VascularSVS

Anatomical basis for sensory preservation in robotic mastectomy ➡️ doi.org/10.1093/bjs/zn… 🎀 Preserving nipple–areolar complex (NAC) sensation is key for physical, psychological, and sexual well-being after mastectomy, and robotic nipple-sparing techniques may offer an advantage. 🧠 In a cadaveric anatomical study (3 donors, 6 breasts) plus a systematic review, the 4th intercostal nerve (ICN)emerged as the main sensory supply to the NAC. 🔬 The anterior cutaneous branch (ACB) of the 4th ICN followed a consistent, superficial subdermal course, while the lateral cutaneous branch (LCB) reached the NAC through deeper breast tissue. 🔀 Additional and variable contributions came from the 2nd, 3rd, and 5th ICNs, highlighting marked inter-individual anatomical variability. 🤖 The superficial and reliable pathway of the ACB of the 4th ICN provides a strong anatomical explanation for better sensory preservation with robotic nipple-sparing mastectomy, supporting refined nerve-preserving surgical strategies. Work by Hunter A Holley , Sandra Hembrecht , Níamh M Smyth , Mathieu Colbert , Fabio Quondamatteo , Arnold D K Hill #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 #breastcancer #BreastCancerAwareness #breastsurgery

Magnetic seed versus guidewire-based breast cancer localization with magnetic lymph node detection: cost-minimization analysis ➡️ doi.org/10.1093/bjs/zn… This predefined economic analysis of the MAGTOTAL #RCT compared magnetic seed with guidewire localization for non-palpable breast cancer in the context of magnetic sentinel node biopsy Despite the higher device cost, magnetic seed localization was associated with lower overall procedural costs due to shorter operating times and streamlined logistics These findings support the cost-efficiency and operational advantages of a totally magnetic surgical approach Work by Eirini Pantiora , Filipa Sampaio , Allan Jazrawi , Fredrik Wärnberg , Staffan Eriksson , Andreas Karakatsanis #SoMe4Surgery #MedTwitter #SurgEd #Surgery @RCPSGTrainees @aecirujanos @SEIQuirurgica @iss_sic #MedicalTechniques @BJSAcademy @young_bjs @BJSOpen @des_winter @evanscolorectal @robhinchliffe1 @bplwijn @MalinASund @nfmkok @TejedorPat @paulo_sutt @PVaughanShaw @JJEarnshaw @juliomayol @ksoreide #breastcancer #BreastCancerAwareness #BreastSurgery

🎇 2025 Highlights: End-of-Year Spotlight: BJS Award Professor James Shapiro 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 through his ground-breaking "Edmonton Protocol" for islet cell transplantation for type 1 diabetes, which has changed clinical practice and improved outcomes for patients around the world. Put your thinking caps on - nominations for the 2027 BJS Award will open in April 2026. #LeadingSurgicalEducation #ThankYou #BJS2025 #TogetherForSurgery #HappyNewYear2026 @bjsurgery @bjsopen #surgery #surgeon

Uunituore @DuodecimFi numero 23 - Teemana: Kohti parempaa kirurgiaa - Suomen Kirurgiyhdistys 100 vuotta. Erikoistoimittajina kanssani @MalinASund ja @AleksiReito. Lue koko lehti: duodecimlehti.fi/lehti/2025/23 Podcast: duodecimlehti.fi/duo19091/ sekä Spotifyssä : open.spotify.com/episode/3skfao…

Standardizing the reporting of postoperative hypoparathyroidism following thyroidectomy: consensus statement from the European Society of Endocrine Surgeons, the American Association of Endocrine Surgeons, and the International Association of Endocrine Surgeons ➡️doi.org/10.1093/bjs/zn… 🎯 Standardise definitions and reporting for postoperative hypoparathyroidism after thyroidectomy. Multinational joint societies (ESES, AAES, IAES). 🧮 Consensus guideline developed through society surveys and General Assembly (GA) votes (May 2025). Outcomes include standardised definitions, core surgical and biochemical variables, reporting framework and quality metrics, and follow-up data elements such as parathyroid hormone (PTH), calcium levels, symptoms, and therapy. 📊 Standardised definitions (biochemical/symptomatic/relative; transient <6 months; permanent ≥12 months); PTH within 24 hours recommended; GA agreement 78.25%; core variables and quality metrics specified; final statement approval 92.93%. 💡 Clear, harmonised definitions and a minimum reporting set (timed PTH/calcium, symptoms, supplementation, key surgical details) enable comparable prevalence estimates, benchmarking of thyroid surgery outcomes, and integration with national/multicentre registries—supporting safer discharges, targeted supplementation, and better identification of true permanent hypoparathyroidism at ≥12 months. Work by Barczyński Marcin, Van Den Heede Klaas, Lee James C., Lorenz Kerstin, Mihai Radu, Norlen Olov, Patel Kepal N., Raffaelli Marco, Sippel Rebecca S., Wang Tracy S., Solorzano Carmen C. #SoMe4Surgery #MedTwitter #SurgEd #Surgery @BJSAcademy @young_bjs @BJSOpen @des_winter @evanscolorectal @robhinchliffe1 @bplwijn @MalinASund @nfmkok @TejedorPat @paulo_sutt @PVaughanShaw @JJEarnshaw @juliomayol @ksoreide @TheAAES @IAESurgeons @eurocrine_eu #EndocrineSurgery #Thyroid #Hypoparathyroidism

@safesurg @villesallinen 🙏 Marja!

@villesallinen @MalinASund Two great leaders !

Today the torch was passed. Thank you @MalinASund for your fantastic leadership as president to Finnish Surgical Society! I’ll humbly take the role and hope to be able to serve surgical community towards unity and collegialism! Thanks to members and council for the support!

Ten steps towards better perioperative intravenous fluid therapy ➡️ doi.org/10.1093/bjs/zn… 💧 IV fluids are drugs — both deficit and overload worsen outcomes, yet perioperative prescribing is often overlooked and delegated to juniors 🩺 The paper stresses ABCDE assessment and clear indication (resuscitation, replacement, maintenance), plus better pre-op hydration with “SipTilSend” ⚖️ Intraoperatively, it advocates balanced crystalloids over 0.9% saline, low-rate background infusions, and goal-directed boluses to avoid salt–water overload 🩸 For bleeding, early 1:1:1 blood product transfusion is advised 🥤 Post-op care focuses on tailored maintenance (≤2–2.5 L/day), early oral intake, and aiming for near-zero or negative fluid balance to reduce complications Work by Michael Ess, Dileep N Lobo @DL08OMD #SoMe4Surgery #MedTwitter #SurgEd #Surgery @RCPSGTrainees @aecirujanos @SEIQuirurgica @iss_sic #MedicalTechniques @BJSAcademy @young_bjs @BJSOpen @des_winter @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 #colorectalsurgery #StepUp4CRC @FightCRC @ACPGBI #ERAS @dice_europe #Crohn #proctology @Dukes_Club @ACPGBI_EduTrain @AECP_FAECP @PelvExGroup @escp_tweets @YouESCP #TeachMeColoproctology #Some4COLoprocto

Quilt technique after mastectomy: stepped-wedge randomized cluster trial showing superior textbook outcome and reduced healthcare utilization ➡️doi.org/10.1093/bjs/zn… 🎯 Assess quilting after mastectomy on textbook outcome versus conventional closure in patients across 12 Dutch hospitals (multicenter stepped-wedge trial). 🧮 Stepped-wedge cluster trial comparing quilting versus conventional closure, assessing textbook outcome (wound complications, readmission, reoperation, unscheduled visits, no increased pain meds at 6 months), healthcare use, and patient satisfaction. 📊 Textbook outcome was higher in the quilted group (65.7% vs 41.3%, P=0.003). Wound complications, including seroma, and unscheduled outpatient visits lower (24.0% vs 55.6%). No difference in pain, satisfaction, shoulder function, or cosmesis. 💡 Quilting after mastectomy improves outcomes and reduces healthcare use without affecting pain, function, satisfaction, or cosmetic results, supporting it as a safe closure method that minimises seroma issues and unplanned care. Work by van Zeelst Lotte J, Plate Joost D J, van Eekeren Ramon R J P, Ten Wolde Britt, Kroeze Evita M A, Schalken Emma C, de Wilt Johannes H W, Strobbe Luc J A #SoMe4Surgery #MedTwitter #SurgEd #Surgery @BJSAcademy @young_bjs @BJSOpen @des_winter @evanscolorectal @robhinchliffe1 @bplwijn @MalinASund @nfmkok @TejedorPat @paulo_sutt @PVaughanShaw @JJEarnshaw @juliomayol @ksoreide @radboudumc @CWZNijmegen @ESSOnews #BreastSurgery #BreastCancer #Mastectomy #Seroma

Impact of postoperative complications and type 2 diabetes on #BreastCancer recurrence and mortality ➡️ doi.org/10.1093/bjs/zn… 📊 Population-based cohort study (58,198 women, Denmark, 1996–2017) 🎯 Objective: Assess if postoperative complications after breast cancer surgery impact recurrence & survival 🔎 Findings: Complications ❌ did not increase recurrence risk ⚠️ But linked to higher mortality, especially in women with type 2 diabetes ✅ Conclusion: Surgical complications affect survival, not recurrence Work by Kasper A Kjærgaard, Peer Christiansen, Signe Borgquist, Deirdre Cronin-Fenton #SoMe4Surgery #MedTwitter #SurgEd #Surgery @RCPSGTrainees @aecirujanos @SEIQuirurgica @iss_sic #MedicalTechniques @BJSAcademy @young_bjs @BJSOpen @des_winter @evanscolorectal @robhinchliffe1 @bplwijn @MalinASund @nfmkok @TejedorPat @paulo_sutt @PVaughanShaw @JJEarnshaw @juliomayol @ksoreide #BreastCancerAwareness #BreastSurgery

Recurrence rate and mesh bulging are reduced with primary fascial closure in ventral hernia repair: the PROSECO randomized clinical trial ➡️doi.org/10.1093/bjs/zn… 🔍 RCT in midline hernia repair: Fascial closure vs bridging during laparoscopic IPOM 📊 No overall difference in hernia site complications, but fascial closure cut recurrence (4% vs 20%) & mesh bulging, and reduced pain at 12 months 👉 Supports fascial closure as standard with IPOM Work by Mikael Lindmark, Jael Tall, Bahman Darkahi, Johanna Österberg, Karin Strigård, Anders Thorell, Ulf Gunnarsson #SoMe4Surgery #MedTwitter #SurgEd #Surgery @RCPSGTrainees @aecirujanos @SEIQuirurgica @iss_sic #MedicalTechniques @BJSAcademy @young_bjs @BJSOpen @des_winter @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 #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

BJS commission on the surgical management of the axilla in breast cancer ➡️doi.org/10.1093/bjs/zn… - The operating room has long been the main place where surgeons in training develop their skills. But in breast cancer surgery, the complexity of modern procedures means this may no longer be enough. - With techniques like ALND, axillary management, nipple-sparing mastectomy, and oncoplastic surgery, the need for highly specialized breast surgeons is greater than ever. - Future training must go beyond the OR: simulators, cadaver labs, hands-on courses, VR/AR, and even AI tools will play a key role in standardizing procedures. - This evolution is not a setback for surgical education — it’s an opportunity to reshape how we train the next generation of breast surgeons. Ultimately, better training means not only improved oncological outcomes but also a better quality of life for breast cancer patients. Work by Michael R Boland, Oreste D Gentilini, G Bruce Mann, Jana de Boniface, Elena Leinert, Christine Obondo, Thorsten Kühn, Anna Weiss, Judy C Boughey, Paul T R Thiruchelvam, Anna Duncan, Meera Joshi, Maria Mani, Isabel T Rubio, Pedro F Gouveia, Malin Sundon behalf of @BJSurgery Editors #SoMe4Surgery #MedTwitter #SurgEd #Surgery @RCPSGTrainees @aecirujanos @SEIQuirurgica @iss_sic #MedicalTechniques @BJSAcademy @young_bjs @BJSOpen @des_winter @evanscolorectal @robhinchliffe1 @bplwijn @MalinASund @nfmkok @TejedorPat @paulo_sutt @PVaughanShaw @JJEarnshaw @juliomayol @ksoreide #breastcancer @YoungIFSO #BreastCancerAwareness #BreastSurgery

📢2024 IF : 4.5!! (up from 3.4 last year)🥳🥳🥳 Thx to all the authors, reviewers and the editorial teams of @BjsOpen, @BJSurgery and @BJSAcademy for your hard work and contributions, which made this fantastic result possible! #SoMe4Surgery #MedTwitter #SurgEd #Surgery @BJSAcademy @BJSurgery @young_bjs @juliomayol @JJEarnshaw @OUPMedicine @villesallinen @Gio_Marchegiani @katydarvall @Mcfark @LauraLorenzonMD @samira_sadowski @wannabehawkeye @MA__Schneider @des_winter @evanscolorectal @robhinchliffe1 @bplwijn @ksoreide @MalinASund @nfmkok @paulo_sutt @rebgross @PVaughanShaw

New Impact Factors are out! JAMA Surgery 14.9 BJS 8.8 Annals of Surgery 6.4 BJS Open 4.5 Dis Col Rectum 3.7 J Trauma 3.7 Ann Surg Oncol 3.5 JACS 3.4 EJSO 2.9 Surgery 2.7 Surg Endosc 2.7 Colorectal Dis 2.7 WJS 2.5 Hernia 2.4 HPB 2.4 JGIS 2.4 Langenbeck’s 1.8 Scand J Surg 1.8

Following a rigorous judging process, Professor James Shapiro has been named the recipient of our 2025 BJS Award. Professor Shapiro has been recognised for pioneering the Edmonton Protocol. Listen to the full announcement and download the press release: ➡️ bjsacademy.com/bjs-academy/ne… Many congratulations from all at the BJS Foundation. We look forward to officially presenting Professor Shapiro with the BJS Award tonight, Friday 13 June. The ceremony will be streamed LIVE from London at 18:15 BST! Watch it here ➡️youtube.com/live/UsLsUsUgi… #ShapingSurgicalScience #LeadingSurgicalEducation @BJSurgery @BjsOpen @UAlbertaSurgery @RCSNews