iiinova — where your digital self keeps evolving

🎯 Future prevention will likely require personalized risk stratification and targeted interventions rather than a one-size-fits-all approach Work by Jack A Helliwell , Aaron Quyn , David G Jayne

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💡 ICG fluorescence angiography may improve perfusion assessment, particularly in rectal cancer surgery, but standardized quantitative thresholds are still needed 🦠 The microbiome is emerging as a key contributor, with collagenase-producing bacteria potentially weakening the anastomosis

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📊 Leak rates remain substantial despite modern care: 3–6% after ileocolic anastomoses and up to 10–20% after low colorectal anastomoses 🧬 Anastomotic healing is multifactorial, involving surgical technique, perfusion, host immune response, and the gut microbiome

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BJS @bjsurgery.bsky.social · 30/05/2026

🔗 Anastomotic leak remains one of the most feared complications after colorectal surgery, with major consequences including sepsis, reoperation, permanent stoma, and poorer oncological outcomes

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Work by Maurits J C A M Gielen , Ahmed M Chaoui , Samantha Schoenmakers , Bas Vreugdenhil , Tim Lubbers , Richard P G Ten Broek , Rudi M H Roumen , Nicole D Bouvy , Willem A R Zwaans

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BJS @bjsurgery.bsky.social · 30/05/2026

In a nationwide Dutch cohort, polypropylene mesh implantation was not associated with an increased medium-term risk of autoimmune disease New autoimmune disease occurred at similar rates after mesh hernia repair and control surgery (1.1% vs 1.5%)

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BJS @bjsurgery.bsky.social · 30/05/2026

Incidence of autoimmune disease after hernia surgery with a mesh implant: national retrospective cohort study ➡️ doi.org/10.1093/bjs/...

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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)

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🔍 “Poor-option” CLTI reflects combined factors such as severe infection, lack of autologous vein, or treatment non-compliance. 🎯 This framework can standardize clinical assessment, trial design, reporting, and future guideline development.

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📊 Consensus supported a multidomain ABRFC framework: arterial anatomy, biology, risk, function, and context. ⚠️ “No-option” CLTI includes desert foot, prohibitive medical risk, non-functional limb, or patient refusal of revascularization.

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🦵 How should we define “no-option” or “poor-option” CLTI? 🌍 This modified Delphi study brought together 164 vascular specialists from 30 countries to develop an expert-validated definition.

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Development of a standard definition of ‘no-option’ and ‘poor-option’ for revascularization in chronic limb-threatening ischemia ➡️https://doi.org/10.1093/bjs/znag040

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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

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🎯 mFast-SeqS may provide a low-cost, minimally invasive strategy to identify patients at high risk of rapid recurrence before treatment.

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🌍 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.

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📊 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%.

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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/...

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... Bernhard Riedel , Geoff Schierbeck , Gerrit Slooter , Malcolm West , Julio F Fiore, Jr. , Collaborators

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... 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 , ...

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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 ,...

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📊 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.

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📋 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.

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🏋️ 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.

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BJS @bjsurgery.bsky.social · 17/05/2026

Standards for reporting research methods, interventions, and Outcomes in Surgical Prehabilitation studies (SOS-Prehab) ➡️https://doi.org/10.1093/bjs/znaf302

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Wprk 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)

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BJS @bjsurgery.bsky.social · 17/05/2026

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

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BJS @bjsurgery.bsky.social · 17/05/2026

Development of a standard definition of ‘no-option’ and ‘poor-option’ for revascularization in chronic limb-threatening ischemia ➡️ doi.org/10.1093/bjs/...

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BJS @bjsurgery.bsky.social · 16/05/2026

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

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BJS @bjsurgery.bsky.social · 16/05/2026

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

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BJS @bjsurgery.bsky.social · 16/05/2026

Diagnosis of inflammatory bowel disease after symptomatic faecalimmunochemical testing: population-based cohort study ➡️ doi.org/10.1093/bjs/...

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BJS @bjsurgery.bsky.social · 10/05/2026

Clinical and molecular landscape of surgically resected early onset pancreatic cancer ➡️ doi.org/10.1093/bjs/...

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⚠️ Advanced tumour stage (T3–T4) and nodal metastases independently predicted worse survival outcomes. 🎯 These findings reinforce the importance of aggressive multimodal management and careful pathological staging in incidental GBC. Work by the UK HPB Research Collaborative Group, United Kingdom

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💊 Completion of adjuvant chemotherapy was also associated with better survival (OS 47 vs 26 months). 📊 Most resections involved segment 4B/5, highlighting current surgical practice patterns across UK centres.

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🟡 Incidental gallbladder cancer remains a challenging diagnosis, with 5-year DFS and OS of 41.5% and 45.1% in this UK multicentre cohort (n=285). 🔪 Patients undergoing liver resection had significantly improved outcomes, with median OS of 72 vs 26 months compared with no further surgery.

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