Background Core outcome sets are an established method for standardising the collection, measurement and reporting of treatment outcomes in effectiveness trials. Using Delphi survey methodology, core ...

Objectives The Idea, Development, Evaluation, Assessment and Long-term follow-up (IDEAL) framework was designed to improve the quality of surgical research and evaluation of surgical innovation. It ha...

Background Individualized management of early fluid therapy in acute pancreatitis (AP) remains challenging. Traditional studies primarily focus on static fluid balance, overlooking the heterogeneity of dynamic trajectories. Methods Based on a single-center retrospective cohort, 3,142 AP patients admitted within 72 h of onset were included. Daily fluid therapy-to-body weight ratio (FWR) and CumFWR (trapezoidal AUC) were calculated. Latent Class Growth Modeling (LCGM) identified dynamic FWR trajectories within 72 h. Multivariate Cox regression analyzed the relationship between FWR and in-hospital mortality risk. Three-dimensional fitted surface plot analysis evaluated interactions between CumFWR and hematocrit. Results LCGM successfully identified five distinct dynamic fluid therapy trajectories within 72 h, showing significant clinical differences: Low Stable Group (LSG1, n = 229, 7.3%), Low-Moderate Sustained Group (LMSG2, n = 340, 10.8%), Moderate Stable Group (MSG3, n = 2073, 66.0%), Moderate-High Fluctuating Group (MHFG4, n = 231, 7.4%), and High Sustained Group (HSG5, n = 269, 8.6%). Multivariate Cox regression revealed significantly increased in-hospital mortality risk compared to MSG3 for both MHFG4 (adjusted HR = 2.08, 95%CI 1.15–3.78) and HSG5 (adjusted HR = 2.91, 95%CI 1.77–4.79). Furthermore, each 1 standard deviation increase in CumFWR was associated with a 47% increased mortality risk (HR = 1.47, 95%CI 1.26–1.72). Three-dimensional fitted surface plot demonstrated high mortality risk between high CumFWR and abnormal hematocrit (low/high HCT), particularly prominent in the HSG5 group (p < 0.001). Conclusion This study reveals five distinct dynamic trajectory patterns of early fluid therapy in AP. High-load sustained or fluctuating therapy significantly increases mortality risk. Dynamic monitoring of HCT (within a 35–44% safety window) and therapy trajectories offers a potential strategy to optimize fluid management.

British Journal of Cancer - Development and application of quality assurance methods for interventions in randomised controlled trials of surgical oncology: the ROMIO study (a comparison of...

The University of the West of England (UWE) are excited to announce the launch of their first ‘Ethnic inequality conference’ on 4 November 2025 at UWE, Bristol. The aim of this conference is to create...

The By-Band-Sleeve trial, which recently found gastric bypass is the most clinically and cost-effective form of interventional surgery for people living with severe obesity, has been presented to poli...

Minimally invasive surgery (MIS) utilization in elective inguinal hernia repair varies significantly across Europe. In this analysis of 8355 patients from

Over 3 million adults in the UK are living with severe obesity (BMI ≥40, or ≥35 with comorbidities), which raises the risk of diabetes, heart disease, cancer, poor mental health, time off work, and early death. These individuals need effective, evidence-based support. New weight loss medicines show promise, but important questions remain about long term results and value for money. For those with severe obesity, surgery is a proven and effective intervention. Until recently, it was unclear which operation offered the best outcomes for patients and the NHS, and there was no national policy on which procedure to prioritise. The landmark By-Band-Sleeve trial compared three surgical procedures—gastric bypass, sleeve gastrectomy, and adjustable gastric banding. The results are unequivocal: at three years, the Roux en Y version of gastric bypass delivered the best weight loss, the greatest health gains, and the best value for money. Smaller European studies report similar patterns, supporting these findings.

When innovation skips safeguards, the fallout is significant. Here’s how to protect patients, surgeons and the system.

Discover which surgery is most effective for weight loss and best value for the NHS Tuesday, 4 November, 12:30 to 16:00, Jubilee Room, Westminster Book an appointment Over 3 million adults in the UK a...

Discover which surgery is most effective for weight loss and best value for the NHS Tuesday, 4 November, 12:30 to 16:00, Jubilee Room, Westminster Book an appointment Over 3 million adults in the UK a...

Discover which surgery is most effective for weight loss and best value for the NHS Tuesday, 4 November, 12:30 to 16:00, Jubilee Room, Westminster Book an appointment Over 3 million adults in the UK a...

Discover which surgery is most effective for weight loss and best value for the NHS Tuesday, 4 November, 12:30 to 16:00, Jubilee Room, Westminster Book an appointment Over 3 million adults in the UK a...

Published vacancies that are available for applicants to apply to. This includes key information suchs as the training programme(s), post type(s), advert information and duration.

Background Consistent outcome assessment in surgical research, from early phase studies (during introduction and refinement of new procedures) to late phase studies (to establish comparative effectiveness) needs improvement to ensure efficient and safe surgical care. This study explored the potential continuity of outcome domain assessment throughout the evaluation lifecycle of surgical interventions. Methods Core outcome sets (COS) for late phase studies of surgical interventions were identified through COMET database searches. Core outcomes/outcome domains were extracted and mapped to core domains of a COS developed specifically for evaluating surgical innovation (COHESIVE COS). Outcomes/domains were categorised as “definite match” (clear similarity), “possible match” (potential similarity) and “no match” (no similarity) COHESIVE domain based on similarity in wording or meaning. Results A total of 54 COS studies were included, yielding 573 core outcomes/domains. Most late phase core outcomes/domains (N = 519, 91%) showed clear or possible similarity. All late phase COS studies recommended measurement of COHESIVE domains ‘Intended benefits’ and ‘Expected and unexpected disadvantages’. Some late phase outcomes/domains also showed similarity with early phase COHESIVE domains, including ‘Problems with the device working’, ‘Patients’ experience’ and ‘Operators’/surgeons’ experience’. A minority of late phase outcomes/domains showed no similarity with COHESIVE domains (n = 54, 9%). Conclusion High similarity between outcome domains recommended in early and late phase evaluations of surgical interventions demonstrates continuity of outcome domain assessment throughout the surgical innovation lifecycle is possible. Harmonising outcome measurement throughout the research pathway can streamline evaluation, enhancing access to beneficial treatment and improving early detection of harms.

Published vacancies that are available for applicants to apply to. This includes key information suchs as the training programme(s), post type(s), advert information and duration.

ALT: a congratulations card with snoopy in front of fireworks

About the event We’re looking into why some young people from ethnic minority backgrounds with type 1 diabetes may find it harder to be physically active. In our earlier research with white adolescent...

International public inquiries into patient safety with regard to surgical innovation identified deficiencies in information provision and informed consent

Robotic-assisted surgery (RAS) is increasingly used in clinical practice, but training opportunities for residents vary widely. This multicenter, mixed-methods study assessed Dutch residents’ exposure to RAS, identified their training needs, and explored their perspectives on the future of RAS through a survey (n = 148) and groups interviews (n = 20). Informed consent was obtained. While 69.6% of the residents had RAS experience, only 14.2% had operated as console surgeon. Despite robots being available in 75.7% of hospitals, hands-on training remained limited. Most residents (77.7%) expressed interest in a national RAS curriculum. Qualitative data revealed four major themes: needs and experiences, training requirements, the role of the OR team and industry, and assessment and feedback, with residents advocating for early exposure and holistic feedback. There is a clear need for a formalized RAS training program. Future research should focus on structured curricula, tailored to resident needs, including possible barriers and facilitators.

There is a growing body of research investigating the ability of artificial intelligence to improve the quality of surgical healthcare, specifically via th