Journal•ISSN: 0007-1323
British Journal of Surgery
Wiley
About: British Journal of Surgery is an academic journal published by Wiley. The journal publishes majorly in the area(s): Medicine & Surgery. It has an ISSN identifier of 0007-1323. Over the lifetime, 27733 publications have been published receiving 906390 citations. The journal is also known as: Br J Surg.
Topics: Medicine, Surgery, Hernia, Cancer, Survival rate
Papers published on a yearly basis
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TL;DR: Emergency ligation of bleeding oesophageal varices using the Milnes Walker technique was performed in 38 patients, and in patients with good preoperative liver function this rose to 71% and the simple scoring system for grading the severity of disturbance of liver function was found to be of value in predicting the outcome of surgery.
Abstract: Emergency ligation of bleeding oesophageal varices using the Milnes Walker technique was performed in 38 patients. Haemorrhage continued or recurred in hospital in 11 patients, all of whom subsequently died. A further 10 patients died in hospital following operation from hepatic failure and a variety of other causes. Five patients were finally considered suitable for elective shunt surgery, but of 12 patients who were discharged without a further operation, only 2 have re-bled. Although the overall 6-month survival was 32 per cent, in patients with good preoperative liver function this rose to 71 per cent, and the simple scoring system for grading the severity of disturbance of liver function was found to be of value in predicting the outcome of surgery.
Since the results of emergency ligation of bleeding oesophageal varices in our hands have been so disappointing we are currently using it less and are trying the mesenteric caval jump graft as an emergency operation for the control of bleeding varices.
7,262 citations
TL;DR: Five cases are described where minute foci of adenocarcinoma have been demonstrated in the mesorectum several centimetres distal to the apparent lower edge of a rectal cancer, and these operations have been carried out as a part of over 100 consecutive anterior resections.
Abstract: Five cases are described where minute foci of adenocarcinoma have been demonstrated in the mesorectum several centimetres distal to the apparent lower edge of a rectal cancer. In 2 of these there was no other evidence of lymphatic spread of the tumour. In orthodox anterior resection much of this tissue remains in the pelvis, and its is suggested that these foci might lead to suture-line or pelvic recurrence. Total excision of the mesorectum has, therefore, been carried out as a part of over 100 consecutive anterior resections. Fifty of these, which were classified as 'curative' or 'conceivably curative' operations, have now been followed for over 2 years with no pelvic or staple-line recurrence.
2,564 citations
TL;DR: This study aimed to compare the reliability of three scoring systems, to compare live and bench formats and to assess construct validity of a test of operative skill.
Abstract: Background The technical skill of surgical trainees is not well assessed. This study aimed (1) to compare the reliability of three scoring systems, (2) to compare live and bench formats and (3) to assess construct validity of a test of operative skill.
Methods Parallel examinations of operative skill, one using live animals and one using simulations, were developed. Performance was graded using operation-specific checklists, detailed global rating forms and pass/fail judgements. Twenty surgical residents each took both formats.
Results Disattenuated correlations between live and bench scores were high (0.69–0.72). Mean inter-rater reliability across stations ranged from 0.64 to 0.72. Internal consistency was moderate to high (α: 0.61–0.74) for the live format using the checklist and for live and bench formats using global ratings. Global ratings discriminated between resident levels for both formats (bench: F(2,17) = 4.45, P < 0.05; live: F(2,17) = 3.5, P < 0.05), checklists did not.
Conclusion This preliminary study suggests that the Objective Structured Assessment of Technical Skill can reliably and validly assess surgical skills. Global ratings are a better method of assessment than task-specific checklists. Bench model simulation gives equivalent results to use of live animals for this test format.
2,160 citations
TL;DR: The scoring system produced assessments for morbidity and mortality rates which did not significantly differ from observed rates and the present paper attempts to validate it prospectively.
Abstract: POSSUM, a Physiological and Operative Severity Score for the enUmeration of Mortality and morbidity, is described. This system has been devised from both a retrospective and prospective analysis and the present paper attempts to validate it prospectively. Logistic regression analysis yielded statistically significant equations for both mortality and morbidity (P less than 0.001). When displayed graphically zones of increasing morbidity and mortality rates could be defined which could be of value in surgical audit. The scoring system produced assessments for morbidity and mortality rates which did not significantly differ from observed rates.
1,579 citations
TL;DR: A classification of anal fistulas is presented, which is the result of an analysis of 400 cases treated over the past IS years, based on the pathogenesis of the disease and the normal muscular anatomy of the pelvic floor.
Abstract: This report contains an analysis of 163 cases of fistula seen and personally treated at St. Mark’s Hospital between the years 1959 and 1968. Details of the anatomy of the tracks of each fistula were carefully recorded. An attempt is made to establish a logical anatomical classification of fistula with special reference to the relationship of the tracks to the sphincter muscles.
1,218 citations