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Coccolini F, Sartelli M, Sawyer R, Rasa K, Viaggi B, Abu-Zidan F, Soreide K, Hardcastle T, Gupta D, Bendinelli C, Ceresoli M, Shelat VG, Broek RT, Baiocchi GL, Moore EE, Sall I, Podda M, Bonavina L, Kryvoruchko IA, Stahel P, Inaba K, Montravers P, Sakakushev B, Sganga G, Ballestracci P, Malbrain MLNG, Vincent JL, Pikoulis M, Beka SG, Doklestic K, Chiarugi M, Falcone M, Bignami E, Reva V, Demetrashvili Z, Di Saverio S, Tolonen M, Navsaria P, Bala M, Balogh Z, Litvin A, Hecker A, Wani I, Fette A, De Simone B, Ivatury R, Picetti E, Khokha V, Tan E, Ball C, Tascini C, Cui Y, Coimbra R, Kelly M, Martino C, Agnoletti V, Boermeester MA, De'Angelis N, Chirica M, Biffl WL, Ansaloni L, Kluger Y, Catena F, Kirkpatrick AW. Source control in emergency general surgery: WSES, GAIS, SIS-E, SIS-A guidelines. World J Emerg Surg 2023; 18:41. [PMID: 37480129 PMCID: PMC10362628 DOI: 10.1186/s13017-023-00509-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2022] [Accepted: 06/30/2023] [Indexed: 07/23/2023] [Imported: 10/13/2023] Open
Abstract
Intra-abdominal infections (IAI) are among the most common global healthcare challenges and they are usually precipitated by disruption to the gastrointestinal (GI) tract. Their successful management typically requires intensive resource utilization, and despite the best therapies, morbidity and mortality remain high. One of the main issues required to appropriately treat IAI that differs from the other etiologies of sepsis is the frequent requirement to provide physical source control. Fortunately, dramatic advances have been made in this aspect of treatment. Historically, source control was left to surgeons only. With new technologies non-surgical less invasive interventional procedures have been introduced. Alternatively, in addition to formal surgery open abdomen techniques have long been proposed as aiding source control in severe intra-abdominal sepsis. It is ironic that while a lack or even delay regarding source control clearly associates with death, it is a concept that remains poorly described. For example, no conclusive definition of source control technique or even adequacy has been universally accepted. Practically, source control involves a complex definition encompassing several factors including the causative event, source of infection bacteria, local bacterial flora, patient condition, and his/her eventual comorbidities. With greater understanding of the systemic pathobiology of sepsis and the profound implications of the human microbiome, adequate source control is no longer only a surgical issue but one that requires a multidisciplinary, multimodality approach. Thus, while any breach in the GI tract must be controlled, source control should also attempt to control the generation and propagation of the systemic biomediators and dysbiotic influences on the microbiome that perpetuate multi-system organ failure and death. Given these increased complexities, the present paper represents the current opinions and recommendations for future research of the World Society of Emergency Surgery, of the Global Alliance for Infections in Surgery of Surgical Infection Society Europe and Surgical Infection Society America regarding the concepts and operational adequacy of source control in intra-abdominal infections.
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Affiliation(s)
- Federico Coccolini
- General, Emergency and Trauma Surgery Dept., Pisa University Hospital, Via Paradisia, 56124, Pisa, Italy.
| | | | - Robert Sawyer
- Department of Surgery, Western Michigan University Homer Stryker MD School of Medicine, Kalamazoo, MI, USA
| | | | - Bruno Viaggi
- ICU Dept., Careggi University Hospital, Florence, Italy
| | - Fikri Abu-Zidan
- Department of Surgery, College of Medicine and Health Sciences, United Arab Emirates University, Al-Ain, United Arab Emirates
| | - Kjetil Soreide
- Department of Gastrointestinal Surgery, Stavanger University Hospital, University of Bergen, Bergen, Norway
| | - Timothy Hardcastle
- Dept. of Health - KwaZulu-Natal, Surgery, University of KwaZulu-Natal and Inkosi Albert Luthuli Central Hospital, Durban, South Africa
| | - Deepak Gupta
- All India Institute of Medical Sciences, New Delhi, India
| | - Cino Bendinelli
- Department of Surgery, John Hunter Hospital, Newcastle, Australia
| | - Marco Ceresoli
- General Surgery Dept., Monza University Hospital, Monza, Italy
| | - Vishal G Shelat
- Department of General Surgery, Tan Tock Seng Hospital, Singapore, Singapore
| | - Richard Ten Broek
- Department of Surgery, Radboud University Medical Center, Njmegen, The Netherlands
| | | | | | - Ibrahima Sall
- Département de Chirurgie, Hôpital Principal de Dakar, Hôpital d'Instruction des Armées, Dakar, Senegal
| | - Mauro Podda
- Department of Surgical Science, University of Cagliari, Cagliari, Italy
| | | | - Igor A Kryvoruchko
- Department of Surgery No. 2, Kharkiv National Medical University, Kharkiv, Ukraine
| | - Philip Stahel
- Department of Surgery, East Carolina University, Brody School of Medicine, Greenville, NC, USA
| | - Kenji Inaba
- LAC+USC Medical Center, Los Angeles, CA, USA
| | - Philippe Montravers
- Département d'Anesthésie-Réanimation CHU Bichat Claude Bernard, Paris, France
| | - Boris Sakakushev
- Research Institute of Medical, University Plovdiv/University Hospital St. George, Plovdiv, Bulgaria
| | - Gabriele Sganga
- Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Paolo Ballestracci
- General, Emergency and Trauma Surgery Dept., Pisa University Hospital, Via Paradisia, 56124, Pisa, Italy
| | - Manu L N G Malbrain
- First Department of Anaesthesiology and Intensive Therapy, Medical University of Lublin, Lublin, Poland
| | | | - Manos Pikoulis
- General Surgery, Hospital, National and Kapodistrian University of Athens (NKUA), Athens, Greece
| | | | - Krstina Doklestic
- Clinic of Emergency Surgery, University Clinical Center of Serbia, Belgrade, Serbia
| | - Massimo Chiarugi
- General, Emergency and Trauma Surgery Dept., Pisa University Hospital, Via Paradisia, 56124, Pisa, Italy
| | - Marco Falcone
- Infectious Disease Dept., Pisa University Hospital, Pisa, Italy
| | - Elena Bignami
- Anesthesiology, Critical Care and Pain Medicine Division, Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - Viktor Reva
- Department of War Surgery, Kirov Military Medical Academy, Saint-Petersburg, Russia
| | | | - Salomone Di Saverio
- General Surgery Dept, San Benedetto del Tronto Hospital, San Benedetto del Tronto, Italy
| | - Matti Tolonen
- Emergency Surgery, Meilahti Tower Hospital, Helsinki, Finland
| | - Pradeep Navsaria
- Groote Schuur Hospital and University of Cape Town, Cape Town, South Africa
| | - Miklosh Bala
- Trauma and Acute Care Surgery Unit, Hadassah - Hebrew University Medical Center, Jerusalem, Israel
| | - Zsolt Balogh
- Department of Traumatology, John Hunter Hospital and University of Newcastle, Newcastle, NSW, Australia
| | - Andrey Litvin
- Department of Surgical Disciplines, Immanuel Kant Baltic Federal University, Regional Clinical Hospital, Kaliningrad, Russia
| | | | - Imtiaz Wani
- Government Gousia Hospital, Srinagar, Kashmir, India
| | | | - Belinda De Simone
- Department of Emergency Surgery, Centre Hospitalier Intercommunal de Villeneuve-Saint-Georges, Villeneuve-Saint-Georges, France
| | - Rao Ivatury
- Virginia Commonwealth University, Richmond, VA, USA
| | | | | | - Edward Tan
- Emergency Department, Radboud University Medical Center, Njmegen, The Netherlands
| | - Chad Ball
- Trauma and Acute Care Surgery, Foothills Medical Center, Calgary, AB, Canada
| | - Carlo Tascini
- Infectious Disease Dept., Udine University Hospital, Udine, Italy
| | - Yunfeng Cui
- Tianjin Nankai Hospital, Tianjin Medical University, Tianjin, China
| | - Raul Coimbra
- Riverside University Health System Medical Center, Riverside, CA, USA
- Loma Linda University School of Medicine, Loma Linda, CA, USA
| | - Michael Kelly
- Department of General Surgery, Albury Hospital, Albury, Australia
| | | | | | | | - Nicola De'Angelis
- Service de Chirurgie Digestive et Hépato-Bilio-Pancréatique, Hôpital Henri Mondor, Université Paris Est, Créteil, France
| | - Mircea Chirica
- Centre Hospitalier Universitaire Grenoble Alpes, Grenoble, France
| | - Walt L Biffl
- Trauma and Emergency Surgery, Scripss Memorial Hospital, La Jolla, CA, USA
| | - Luca Ansaloni
- General Surgery, Pavia University Hospital, Pavia, Italy
| | - Yoram Kluger
- General Surgery, Rambam Medical Centre, Haifa, Israel
| | - Fausto Catena
- General, Emergency and Trauma Surgery Dept, Bufalini Hospital, Cesena, Italy
| | - Andrew W Kirkpatrick
- General, Acute Care, Abdominal Wall Reconstruction, and Trauma Surgery, Foothills Medical Centre, Calgary, AB, Canada
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Balogh ZJ. Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries. Br J Surg 2023; 110:804-817. [PMID: 37079880 PMCID: PMC10364528 DOI: 10.1093/bjs/znad092] [Citation(s) in RCA: 14] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Revised: 03/03/2023] [Accepted: 03/06/2023] [Indexed: 04/22/2023] [Imported: 10/13/2023]
Abstract
BACKGROUND Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. METHODS This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low-middle-income countries. RESULTS In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of 'single-use' consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low-middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. CONCLUSION This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high- and low-middle-income countries.
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Sartelli M, Boermeester MA, Cainzos M, Coccolini F, de Jonge SW, Rasa K, Dellinger EP, McNamara DA, Fry DE, Cui Y, Delibegovic S, Demetrashvili Z, De Simone B, Gkiokas G, Hardcastle TC, Itani KMF, Isik A, Labricciosa FM, Lohsiriwat V, Marwah S, Pintar T, Rickard J, Shelat VG, Catena F, Barie PS. Six Long-Standing Questions about Antibiotic Prophylaxis in Surgery. Antibiotics (Basel) 2023; 12:antibiotics12050908. [PMID: 37237811 DOI: 10.3390/antibiotics12050908] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Revised: 05/10/2023] [Accepted: 05/11/2023] [Indexed: 05/28/2023] [Imported: 10/13/2023] Open
Abstract
Surgical site infections (SSIs) are the most common adverse event occurring in surgical patients. Optimal prevention of SSIs requires the bundled integration of a variety of measures before, during, and after surgery. Surgical antibiotic prophylaxis (SAP) is an effective measure for preventing SSIs. It aims to counteract the inevitable introduction of bacteria that colonize skin or mucosa into the surgical site during the intervention. This document aims to guide surgeons in appropriate administration of SAP by addressing six key questions. The expert panel identifies a list of principles in response to these questions that every surgeon around the world should always respect in administering SAP.
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Affiliation(s)
| | - Marja A Boermeester
- Department of Surgery, Amsterdam University Medical Center, University of Amsterdam, 1105AZ Amsterdam, The Netherlands
| | - Miguel Cainzos
- Department of Surgery, Hospital Clínico Universitario, 15706 Santiago de Compostela, Spain
| | - Federico Coccolini
- Department of Emergency and Trauma Surgery, Pisa University Hospital, University of Pisa, 55126 Pisa, Italy
| | - Stijn W de Jonge
- Department of Surgery, Amsterdam University Medical Center, University of Amsterdam, 1105AZ Amsterdam, The Netherlands
| | - Kemal Rasa
- Department of Surgery, Anadolu Medical Center, 41200 Kocaeli, Turkey
| | | | - Deborah A McNamara
- Department of Colorectal Surgery, Beaumont Hospital, D09V2N0 Dublin, Ireland
| | - Donald E Fry
- Department of Surgery, Northwestern University, Chicago, IL 60208, USA
| | - Yunfeng Cui
- Department of Surgery, Tianjin Nankai Hospital, Nankai Clinical School of Medicine, Tianjin Medical University, Tianjin 300100, China
| | - Samir Delibegovic
- Department of Surgery, University Clinical Center of Tuzla, 75000 Tuzla, Bosnia and Herzegovina
| | - Zaza Demetrashvili
- Department General Surgery, Kipshidze Central University Hospital, Tbilisi 0162, Georgia
| | - Belinda De Simone
- Department of Emergency and Metabolic Minimally Invasive Surgery, Centre Hospitalier Intercommunal de Poissy/Saint Germain en Laye, 78300 Poissy CEDEX, France
| | - George Gkiokas
- Second Department of Surgery, Aretaieion University Hospital, National and Kapodistrian University of Athens, 10679 Athens, Greece
| | - Timothy C Hardcastle
- Department of Surgery, Nelson R. Mandela School of Clinical Medicine, University of KwaZulu-Natal, Mayville 4058, South Africa
| | - Kamal M F Itani
- Department of Surgery, VA Boston Health Care System, Boston University and Harvard Medical School, Boston, MA 02118, USA
| | - Arda Isik
- Division of General Surgery, School of Medicine, Istanbul Medeniyet University, 34700 Istanbul, Turkey
| | | | - Varut Lohsiriwat
- Department of Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand
| | - Sanjay Marwah
- Department of Surgery, BDS Post-Graduate Institute of Medical Sciences, Rohtak 124001, India
| | - Tadeja Pintar
- Department of Abdominal Surgery, University Medical Centre Ljubljana, 1000 Ljubljana, Slovenia
| | - Jennifer Rickard
- Department of Surgery, University of Minnesota, Minneapolis, MN 55455, USA
| | - Vishal G Shelat
- Department of Hepato-Pancreatic-Biliary Surgery, Tan Tok Seng Hospital, Singapore 308433, Singapore
| | - Fausto Catena
- Department of Surgery, "Bufalini" Hospital, 47023 Cesena, Italy
| | - Philip S Barie
- Department of Surgery, Weill Cornell Medicine, E. Northport, New York, NY 11731, USA
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4
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Podda M, Pellino G, Di Saverio S, Coccolini F, Pacella D, Cioffi SPB, Virdis F, Balla A, Ielpo B, Pata F, Poillucci G, Ortenzi M, Damaskos D, De Simone B, Sartelli M, Leppaniemi A, Jayant K, Catena F, Giuliani A, Di Martino M, Pisanu A. Infected pancreatic necrosis: outcomes and clinical predictors of mortality. A post hoc analysis of the MANCTRA-1 international study. Updates Surg 2023; 75:493-522. [PMID: 36899292 PMCID: PMC10005914 DOI: 10.1007/s13304-023-01488-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Accepted: 02/24/2023] [Indexed: 03/12/2023] [Imported: 10/13/2023]
Abstract
The identification of high-risk patients in the early stages of infected pancreatic necrosis (IPN) is critical, because it could help the clinicians to adopt more effective management strategies. We conducted a post hoc analysis of the MANCTRA-1 international study to assess the association between clinical risk factors and mortality among adult patients with IPN. Univariable and multivariable logistic regression models were used to identify prognostic factors of mortality. We identified 247 consecutive patients with IPN hospitalised between January 2019 and December 2020. History of uncontrolled arterial hypertension (p = 0.032; 95% CI 1.135-15.882; aOR 4.245), qSOFA (p = 0.005; 95% CI 1.359-5.879; aOR 2.828), renal failure (p = 0.022; 95% CI 1.138-5.442; aOR 2.489), and haemodynamic failure (p = 0.018; 95% CI 1.184-5.978; aOR 2.661), were identified as independent predictors of mortality in IPN patients. Cholangitis (p = 0.003; 95% CI 1.598-9.930; aOR 3.983), abdominal compartment syndrome (p = 0.032; 95% CI 1.090-6.967; aOR 2.735), and gastrointestinal/intra-abdominal bleeding (p = 0.009; 95% CI 1.286-5.712; aOR 2.710) were independently associated with the risk of mortality. Upfront open surgical necrosectomy was strongly associated with the risk of mortality (p < 0.001; 95% CI 1.912-7.442; aOR 3.772), whereas endoscopic drainage of pancreatic necrosis (p = 0.018; 95% CI 0.138-0.834; aOR 0.339) and enteral nutrition (p = 0.003; 95% CI 0.143-0.716; aOR 0.320) were found as protective factors. Organ failure, acute cholangitis, and upfront open surgical necrosectomy were the most significant predictors of mortality. Our study confirmed that, even in a subgroup of particularly ill patients such as those with IPN, upfront open surgery should be avoided as much as possible. Study protocol registered in ClinicalTrials.Gov (I.D. Number NCT04747990).
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Affiliation(s)
- Mauro Podda
- Emergency Surgery Unit, Department of Surgical Science, Policlinico Universitario "D. Casula", Azienda Ospedaliero-Universitaria di Cagliari, University of Cagliari, SS 554, Km 4,500, Monserrato, 09042, Cagliari, Italy.
| | - Gianluca Pellino
- Department of Advanced Medical and Surgical Sciences, Università degli Studi della Campania "Luigi Vanvitelli", Naples, Italy
- Colorectal Surgery Unit, Vall d'Hebron University Hospital, Barcelona, Spain
| | - Salomone Di Saverio
- Department of Surgery, "Madonna del Soccorso" Hospital, San Benedetto del Tronto, Italy
| | - Federico Coccolini
- General, Emergency and Trauma Surgery Unit, Pisa University Hospital, Pisa, Italy
| | - Daniela Pacella
- Department of Public Health, University of Naples Federico II, Naples, Italy
| | | | - Francesco Virdis
- Trauma and Acute Care Surgery Unit, "Niguarda Ca Granda" Hospital, Milan, Italy
| | - Andrea Balla
- General and Minimally-Invasive Surgery Unit, "San Paolo" Hospital, Civitavecchia, Rome, Italy
| | | | - Francesco Pata
- General Surgery Unit, "Nicola Giannettasio" Hospital, Corigliano-Rossano, Italy
| | - Gaetano Poillucci
- Department of General Surgery, Policlinico Umberto I, La Sapienza University of Rome, Rome, Italy
| | - Monica Ortenzi
- Department of General and Emergency Surgery, Marche Polytechnic University, Ancona, Italy
| | - Dimitrios Damaskos
- Department of Upper G.I. Surgery, Royal Infirmary of Edinburgh, Edinburgh, Scotland, UK
| | - Belinda De Simone
- Department of Emergency and Metabolic Minimally Invasive Surgery, Centre Hospitalier Intercommunal de Poissy/Saint Germain en Laye, Poissy Cedex, France
| | | | - Ari Leppaniemi
- Department of Abdominal Surgery, Abdominal Center, University of Helsinki and Helsinki University Central Hospital, Helsinki, Finland
| | - Kumar Jayant
- Department of Surgery & Cancer, Imperial College London, Du Cane Road, London, UK
| | - Fausto Catena
- Department of Emergency and Trauma Surgery, "Bufalini" Hospital, Cesena, Italy
| | - Antonio Giuliani
- General and Emergency Surgery Unit, San Carlo Hospital, Potenza, Italy
| | - Marcello Di Martino
- Division of Hepatobiliary and Liver Transplantation Surgery, "A.O.R.N. Cardarelli", Naples, Italy
| | - Adolfo Pisanu
- Emergency Surgery Unit, Department of Surgical Science, Policlinico Universitario "D. Casula", Azienda Ospedaliero-Universitaria di Cagliari, University of Cagliari, SS 554, Km 4,500, Monserrato, 09042, Cagliari, Italy
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5
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Hess B, Cahenzli M, Forbes A, Burgos R, Coccolini F, Corcos O, Holst M, Irtun Ø, Klek S, Pironi L, Rasmussen HH, Serlie MJ, Thibault R, Gabe S, Reintam Blaser A. Management of acute mesenteric ischaemia: Results of a worldwide survey. Clin Nutr ESPEN 2023; 54:194-205. [PMID: 36963863 DOI: 10.1016/j.clnesp.2022.12.022] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2022] [Revised: 12/16/2022] [Accepted: 12/19/2022] [Indexed: 01/06/2023] [Imported: 10/13/2023]
Abstract
BACKGROUND Acute mesenteric ischaemia (AMI) is a condition with high mortality. This survey assesses current attitudes and practices to manage AMI worldwide. METHODS A questionnaire survey about the practices of diagnosing and managing AMI, endorsed by several specialist societies, was sent to different medical specialists and hospitals worldwide. Data from individual health care professionals and from medical teams were collected. RESULTS We collected 493 individual forms from 71 countries and 94 team forms from 34 countries. Almost half of respondents were surgeons, and most of the responding teams (70%) were led by surgeons. Most of the respondents indicated that diagnosis of AMI is often delayed but rarely missed. Emergency revascularisation is often considered for patients with AMI but rarely in cases of transmural ischaemia (intestinal infarction). Responses from team hospitals with a dedicated special unit (14 team forms) indicated more aggressive revascularisation. Abdominopelvic CT-scan with intravenous contrast was suggested as the most useful diagnostic test, indicated by approximately 90% of respondents. Medical history and risk factors were thought to be more important in diagnosis of AMI without transmural ischaemia, whereas for intestinal infarction, plasma lactate concentrations and surgical exploration were considered more useful. In elderly patients, a palliative approach is often chosen over extensive bowel resection. There was a large variability in anticoagulant treatment, as well as in timing of surgery to restore bowel continuity. CONCLUSIONS Delayed diagnosis of AMI is common despite wide availability of an adequate imaging modality, i.e. CT-scan. Large variability in treatment approaches exists, indicating the need for updated guidelines. Increased awareness and knowledge of AMI may improve current practice until more robust evidence becomes available. Adherence to the existing guidelines may help in improving differences in treatment and outcomes.
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Affiliation(s)
- Benjamin Hess
- Department of Intensive Care Medicine, Lucerne Cantonal Hospital, Lucerne, Switzerland.
| | - Martin Cahenzli
- Department of Intensive Care Medicine, Lucerne Cantonal Hospital, Lucerne, Switzerland
| | - Alastair Forbes
- Department of Anaesthesiology and Intensive Care, University of Tartu, Tartu, Estonia
| | - Rosa Burgos
- Nutritional Support Unit, University Hospital Vall D'Hebron, Barcelona, Spain
| | - Federico Coccolini
- General, Emergency and Trauma Surgery Department, Pisa University Hospital, Pisa, Italy
| | - Olivier Corcos
- Intestinal Vascular Emergencies Structure (SURVI), Beaujon Hospital/Assistance Publique, Hopitaux de Paris, France
| | - Mette Holst
- Centre for Nutrition and Intestinal Failure, Aalborg University Hospital, Denmark; Department of Clinical Medicine, Aalborg University, Denmark
| | - Øivind Irtun
- Department of Gastrointestinal Surgery, University Hospital North Norway, Norway
| | - Stanislaw Klek
- Surgical Oncology Clinic, The Maria Sklodowska-Curie Reseach Institute of Oncology, Krakow, Poland
| | - Loris Pironi
- Department of Medical and Surgical Sciences, University of Bologna, Italy; Centre for Chronic Intestinal Failure - Clinical Nutrition and Metabolism Unit, IRCCS AOUBO, Bologna, Italy
| | - Henrik Højgaard Rasmussen
- Centre for Nutrition and Intestinal Failure, Aalborg University Hospital, Denmark; Department of Clinical Medicine, Aalborg University, Denmark
| | - Mireille J Serlie
- Department of Endocrinology & Metabolism, Amsterdam University Medical Center, Amsterdam Gastroenterology, Endocrinology and Metabolism, Amsterdam, the Netherlands
| | - Ronan Thibault
- Unité de Nutrition, CHU Rennes, INRAE, INSERM, Univ Rennes, Nutrition Metabolisms and Cancer Institute, NuMeCan, Rennes, France
| | - Simon Gabe
- Lennard Jones Intestinal Rehabilitation Unit, St Mark's Hospital, London, England
| | - Annika Reintam Blaser
- Department of Intensive Care Medicine, Lucerne Cantonal Hospital, Lucerne, Switzerland; Department of Anaesthesiology and Intensive Care, University of Tartu, Tartu, Estonia
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6
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Cobianchi L, Piccolo D, Dal Mas F, Agnoletti V, Ansaloni L, Balch J, Biffl W, Butturini G, Catena F, Coccolini F, Denicolai S, De Simone B, Frigerio I, Fugazzola P, Marseglia G, Marseglia GR, Martellucci J, Modenese M, Previtali P, Ruta F, Venturi A, Kaafarani HM, Loftus TJ. Correction: Surgeons' perspectives on artificial intelligence to support clinical decision-making in trauma and emergency contexts: results from an international survey. World J Emerg Surg 2023; 18:22. [PMID: 36959605 PMCID: PMC10037845 DOI: 10.1186/s13017-023-00493-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/18/2023] [Indexed: 03/25/2023] [Imported: 10/13/2023] Open
Affiliation(s)
- Lorenzo Cobianchi
- Department of Clinical, Diagnostic and Pediatric Sciences, University of Pavia, Via Alessandro Brambilla, 74, 27100, Pavia, PV, Italy.
- General Surgery, IRCCS Policlinico San Matteo Foundation, Pavia, Italy.
- ITIR - Institute for Transformative Innovation Research, University of Pavia, Pavia, Italy.
| | - Daniele Piccolo
- Department of Clinical, Diagnostic and Pediatric Sciences, University of Pavia, Via Alessandro Brambilla, 74, 27100, Pavia, PV, Italy
- Department of Neurosurgery, ASUFC Santa Maria Della Misericordia, Udine, Italy
| | - Francesca Dal Mas
- Department of Management, Ca' Foscari University of Venice, Venice, Italy
| | | | - Luca Ansaloni
- Department of Clinical, Diagnostic and Pediatric Sciences, University of Pavia, Via Alessandro Brambilla, 74, 27100, Pavia, PV, Italy
- General Surgery, IRCCS Policlinico San Matteo Foundation, Pavia, Italy
| | - Jeremy Balch
- Department of Surgery, University of Florida Health, Gainesville, FL, USA
| | - Walter Biffl
- Division of Trauma and Acute Care Surgery, Scripps Memorial Hospital La Jolla, La Jolla, CA, USA
| | - Giovanni Butturini
- Department of HPB Surgery, Pederzoli Hospital, Peschiera del Garda, Italy
| | | | - Federico Coccolini
- General, Emergency and Trauma Surgery Department, Pisa University Hospital Pisa, Pisa, Italy
| | - Stefano Denicolai
- ITIR - Institute for Transformative Innovation Research, University of Pavia, Pavia, Italy
- Department of Economics and Management, University of Pavia, Pavia, Italy
| | - Belinda De Simone
- Department of Emergency, Digestive and Metabolic Minimally Invasive Surgery, Poissy and Saint Germain en Laye Hospitals, Poissy, France
| | - Isabella Frigerio
- Department of HPB Surgery, Pederzoli Hospital, Peschiera del Garda, Italy
| | - Paola Fugazzola
- Department of Clinical, Diagnostic and Pediatric Sciences, University of Pavia, Via Alessandro Brambilla, 74, 27100, Pavia, PV, Italy
- General Surgery, IRCCS Policlinico San Matteo Foundation, Pavia, Italy
| | - Gianluigi Marseglia
- Department of Clinical, Diagnostic and Pediatric Sciences, University of Pavia, Via Alessandro Brambilla, 74, 27100, Pavia, PV, Italy
- IRCCS Policlinico San Matteo Foundation, Pediatric Clinic., Pavia, Italy
| | | | | | | | - Pietro Previtali
- ITIR - Institute for Transformative Innovation Research, University of Pavia, Pavia, Italy
- Department of Economics and Management, University of Pavia, Pavia, Italy
| | - Federico Ruta
- General Direction, ASL BAT (Health Agency), Andria, Italy
| | - Alessandro Venturi
- ITIR - Institute for Transformative Innovation Research, University of Pavia, Pavia, Italy
- Department of Political and Social Sciences, University of Pavia, Pavia, Italy
- Bureau of the Presidency, IRCCS Policlinico San Matteo Foundation, Pavia, Italy
| | - Haytham M Kaafarani
- Harvard Medical School, Boston, MA, USA
- Division of Trauma, Emergency Surgery, and Surgical Critical Care, Massachusetts General Hospital, Boston, MA, USA
| | - Tyler J Loftus
- Department of Surgery, University of Florida Health, Gainesville, FL, USA
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7
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Fugazzola P, Cobianchi L, Di Martino M, Tomasoni M, Dal Mas F, Abu-Zidan FM, Agnoletti V, Ceresoli M, Coccolini F, Di Saverio S, Dominioni T, Farè CN, Frassini S, Gambini G, Leppäniemi A, Maestri M, Martín-Pérez E, Moore EE, Musella V, Peitzman AB, de la Hoz Rodríguez Á, Sargenti B, Sartelli M, Viganò J, Anderloni A, Biffl W, Catena F, Ansaloni L. Prediction of morbidity and mortality after early cholecystectomy for acute calculous cholecystitis: results of the S.P.Ri.M.A.C.C. study. World J Emerg Surg 2023; 18:20. [PMID: 36934276 PMCID: PMC10024826 DOI: 10.1186/s13017-023-00488-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Accepted: 03/04/2023] [Indexed: 03/20/2023] [Imported: 10/13/2023] Open
Abstract
BACKGROUND Less invasive alternatives than early cholecystectomy (EC) for acute calculous cholecystitis (ACC) treatment have been spreading in recent years. We still lack a reliable tool to select high-risk patients who could benefit from these alternatives. Our study aimed to prospectively validate the Chole-risk score in predicting postoperative complications in patients undergoing EC for ACC compared with other preoperative risk prediction models. METHOD The S.P.Ri.M.A.C.C. study is a World Society of Emergency Surgery prospective multicenter observational study. From 1st September 2021 to 1st September 2022, 1253 consecutive patients admitted in 79 centers were included. The inclusion criteria were a diagnosis of ACC and to be a candidate for EC. A Cochran-Armitage test of the trend was run to determine whether a linear correlation existed between the Chole-risk score and a complicated postoperative course. To assess the accuracy of the analyzed prediction models-POSSUM Physiological Score (PS), modified Frailty Index, Charlson Comorbidity Index, American Society of Anesthesiologist score (ASA), APACHE II score, and ACC severity grade-receiver operating characteristic (ROC) curves were generated. The area under the ROC curve (AUC) was used to compare the diagnostic abilities. RESULTS A 30-day major morbidity of 6.6% and 30-day mortality of 1.1% were found. Chole-risk was validated, but POSSUM PS was the best risk prediction model for a complicated course after EC for ACC (in-hospital mortality: AUC 0.94, p < 0.001; 30-day mortality: AUC 0.94, p < 0.001; in-hospital major morbidity: AUC 0.73, p < 0.001; 30-day major morbidity: AUC 0.70, p < 0.001). POSSUM PS with a cutoff of 25 (defined in our study as a 'Chole-POSSUM' score) was then validated in a separate cohort of patients. It showed a 100% sensitivity and a 100% negative predictive value for mortality and a 96-97% negative predictive value for major complications. CONCLUSIONS The Chole-risk score was externally validated, but the CHOLE-POSSUM stands as a more accurate prediction model. CHOLE-POSSUM is a reliable tool to stratify patients with ACC into a low-risk group that may represent a safe EC candidate, and a high-risk group, where new minimally invasive endoscopic techniques may find the most useful field of action. TRIAL REGISTRATION ClinicalTrial.gov NCT04995380.
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Affiliation(s)
- Paola Fugazzola
- Division of General Surgery, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Lorenzo Cobianchi
- Division of General Surgery, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy.
- Department of Clinical, Diagnostic and Pediatric Sciences, University of Pavia, Via Alessandro Brambilla, 74, 27100, Pavia, PV, Italy.
| | - Marcello Di Martino
- Hepato-Biliary and Liver Transplantation Department, AORN Cardarelli, Napoli, Italy
| | - Matteo Tomasoni
- Division of General Surgery, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Francesca Dal Mas
- Department of Management, Ca' Foscari University of Venice, Venice, Italy
| | - Fikri M Abu-Zidan
- The Research Office, College of Medicine and Health Sciences, United Arab Emirates University, Al-Ain, United Arab Emirates
| | | | - Marco Ceresoli
- General and Emergency Surgery, School of Medicine and Surgery, Milano-Bicocca University, Monza, Italy
| | - Federico Coccolini
- Department of Emergency and Trauma Surgery, Pisa University Hospital, University of Pisa, Pisa, Italy
| | - Salomone Di Saverio
- Department of Surgery, Madonna Del Soccorso Hospital, San Benedetto del Tronto, Italy
| | - Tommaso Dominioni
- Division of General Surgery, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Camilla Nikita Farè
- Division of General Surgery, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Simone Frassini
- Division of General Surgery, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Giulia Gambini
- Unit of Clinical Epidemiology and Biometry, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Ari Leppäniemi
- Abdominal Center, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Marcello Maestri
- Division of General Surgery, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Elena Martín-Pérez
- Department of General and Digestive Surgery, Hospital Universitario La Princesa, Instituto de Investigación Sanitaria Princesa (IIS-IP), Universidad Autónoma de Madrid (UAM), Madrid, Spain
| | - Ernest E Moore
- Denver Health System - Denver Health Medical Center, Denver, USA
| | - Valeria Musella
- Unit of Clinical Epidemiology and Biometry, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Andrew B Peitzman
- Department of Surgery, University of Pittsburgh School of Medicine, UPMC-Presbyterian, Pittsburgh, USA
| | - Ángela de la Hoz Rodríguez
- Department of General and Digestive Surgery, Hospital Universitario La Princesa, Instituto de Investigación Sanitaria Princesa (IIS-IP), Universidad Autónoma de Madrid (UAM), Madrid, Spain
| | - Benedetta Sargenti
- Division of General Surgery, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Massimo Sartelli
- Department of Surgery, Macerata Hospital, 62100, Macerata, Italy
| | - Jacopo Viganò
- Division of General Surgery, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Andrea Anderloni
- Gastroenterology and Digestive Endoscopy Unit, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Walter Biffl
- Division of Trauma/Acute Care Surgery, Scripps Clinic Medical Group, La Jolla, CA, USA
| | - Fausto Catena
- General and Emergency Surgery, Bufalini Hospital, Cesena, Italy
| | - Luca Ansaloni
- Division of General Surgery, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
- Department of Clinical, Diagnostic and Pediatric Sciences, University of Pavia, Via Alessandro Brambilla, 74, 27100, Pavia, PV, Italy
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Cobianchi L, Dal Mas F, Agnoletti V, Ansaloni L, Biffl W, Butturini G, Campostrini S, Catena F, Denicolai S, Fugazzola P, Martellucci J, Massaro M, Previtali P, Ruta F, Venturi A, Woltz S, Kaafarani HM, Loftus TJ, Aapoäÿlu R, Abbott KL, Abdelmalik A, Abebe NS, Abu-Zidan F, Adam YAY, Adamou H, Adamovich DM, Agresta F, Agrusa A, Akin E, Alessiani M, Alexandrino H, Bidoli C, Ali SM, Mihai VA, Almeida PM, Al-Shehari MM, Altomare M, Amico F, Ammendola M, Andreuccetti J, Anestiadou E, Annicchiarico A, Antonelli A, Aparicio-Sanchez D, Ardito A, Argenio G, Arvieux CC, Arvieux C, Askevold IH, Atanasov BT, Augustin G, Awad SS, Bacchiocchi G, Bagnoli C, Bahouth H, Baili E, Bains L, Baiocchi GL, Bala M, Balaguà© C, Balalis D, Baldini E, Baraket O, Baral S, Barone M, Gonzãlez Barranquero A, Barreras JA, Bass GA, Bayhan Z, Bellanova G, Ben-Ishay O, Bert F, Bianchi V, Biancuzzi H, Radulescu RB, Bignell MB, Biloslavo A, Bini R, Bissacco D, Boati P, Boddaert G, Bogdanic B, Bombardini C, Bonavina L, Bonomo L, Bottari A, Bouliaris K, Brachini G, Brillantino A, Brisinda G, Bulanauca MM, Buonomo LA, Burcharth J, Buscemi S, Calabretto F, Calini G, Calu V, Campanile FC, Campo Dall’Orto R, Campos-Serra A, Carvas JM, Cascella M, Pattacini GC, Celentano V, Centonze DC, Ceresoli M, Chatzipetris D, Chessa A, Chiarello MM, Chirica M, Chooklin S, Chouliaras C, Chowdhury S, Cianci P, Cillara N, Cimbanassi S, Cioffi SPB, Colãis-Ruiz E, Colak E, Conti L, Coppola A, de Sa TC, Costa SD, Cozza V, Curro’ G, Dabekaussen KFASA, D’acapito F, Damaskos D, D’Ambrosio G, Das K, Davies RJ, de Beaux AC, De Lebrusant Fernandez SP, De Luca A, De Simone B, De Stefano F, Degrate L, Demetrashvili Z, Demetriades AK, Detanac DS, Dezi A, Di Buono G, Carlo IDI, Di Lascio P, Di Martino M, Di Saverio S, Diaconescu B, Diaz JJ, Dibra R, Dimitrov EN, Dinuzzi VP, Dios-Barbeito S, Diyani JFA, Dogjani A, Domanin M, D’Oria M, Munoz-Cruzado VD, East B, Ekelund M, Ekwen GT, Elbaih AH, Elhadi M, Enninghorst N, Ernisova M, Escalera-Antezana JP, Esposito S, Esposito G, Estaire-Gãmez M, Farã CN, Farre R, Favi F, Ferrario L, Ferrario di Tor Vajana A, Filisetti C, Fleres F, Fonseca VC, Forero-Torres A, Forfori F, Fortuna L, Fradelos E, Fraga GP, Fransvea P, Frassini S, Frazzetta G, Frigerio I, Frountzas M, Gachabayov M, Galeiras R, Garcãa BM, Garcia Vazquez A, Gargarella S, Garzali IU, Ghannam WM, Ghazi FN, Gillman LM, Gioco R, Giordano A, Giordano L, Giove C, Giraudo G, Giuffrida M, Capponi MG, Gois E, Gomes CA, Gomes FC, Gonsaga RAT, Gonullu E, Goosen J, Goranovic T, Gracia-Roman R, Graziano GMP, Griffiths EA, Guagni T, Hadzhiev DB, Haidar MG, Hamid HKS, Hardcastle TC, Hayati F, Healey AJ, Hecker A, Hecker M, Garcia EFH, hodonou AM, huaman EC, Huerta M, Ibrahim AF, Ibrahim BMS, Ietto G, Inama M, Ioannidis O, Isik A, Ismail N, Ismail AMH, Jailani RUHIF, Jang JY, Kalfountzos C, Kalipershad SNR, Kaouras E, Kaplan LJ, Kara Y, Karamagioli E, Karamarkovia A, Katsaros I, Kavalakat AJ, Kechagias A, Kenig J, Kessel BJ, Khan JS, Khokha V, Kim JI, Kirkpatrick AW, Klappenbach R, Kobe Y, Lymperis EK, Kok KYY, Kong V, Korkolis DP, Koukoulis G, Kovacevic B, Kruger VF, Kryvoruchko IA, Kurihara H, Kuriyama A, Landaluce-Olavarria A, Lapolla P, Licari L, Lisi G, Litvin A, Lizarazu A, Bayo HL, Lohsiriwat V, Moreira CCL, Lostoridis E, Luna AT, Luppi D, V. GMM, Maegele M, Maggiore D, Magnone S, Maier RV, Maier RV, Major P, Manangi M, manetti A, Mantoglu B, Marafante C, Mariani F, Marinis A, Mariot ES, Marseglia GR, Martãnez-Pãrez A, Martines G, Perez AM, Martino C, Mascagni P, Massalou D, Matãas-Garcãa B, Mazzarella G, Mazzarolo G, Melo RB, Mendoza-Moreno F, Meric S, Meyer J, Miceli L, Michalopoulos NV, Milana F, Mingoli A, Mishra TS, Mohamed M, Mohamed MIEA, Mohamedahmed AY, Mohammed MJS, Mohan R, Moore EE, Morales-Garcia D, Muhrbeck M, Mulita F, Mustafa SMS, Muttillo EM, Naimzada MD, Navsaria PH, Negoi I, Nespoli L, Nguyen C, Nidaw MK, Nigri G, Nikolopoulos I, O’Connor DB, Ogundipe HD, Oliveri C, Olmi S, Ong ECW, Orecchia L, Osipov AV, Othman MF, Pace M, Pacilli M, Pagani L, Palomba G, Pantalone D, Panyko A, Paolillo C, Papa MV, Papaconstantinou D, Papadoliopoulou M, Papadopoulos A, Papis D, Pararas N, Parreira JG, Parry NG, Pata F, Patel T, Paterson-Brown S, Pavone G, Pecchini F, Pellino G, Pelloni M, Peloso A, del Pozo EP, Pereira RG, Pereira BM, perez AL, Perra T, Perrone G, Pesce A, Petagna L, Petracca G, Phupong V, Picardi B, Picciariello A, Piccoli M, Piccolo D, Picetti E, Pikoulis Pikoulis E, Pintar T, Pirozzolo G, Piscioneri F, Podda M, Porcu A, Privitera F, Punzo C, Quaresima S, Quiodettis MA, Qvist N, Rahim R, de Almeida FR, Ramely RB, Rasa HK, Reichert M, Reinisch-Liese A, Renne A, Riccetti C, Rodriguez-Luna MR, Roizblatt D, Romanzi A, Romeo L, Roscio FPM, Rosnelifaizur RB, Rossi S, Rubiano AM, Ruiz-Úcar E, Sakakushev BE, Salamea JC, Sall I, Samarakoon LB, Sammartano F, Arteaga AS, Sanchez-Cordero S, Santoanastaso DPM, Sasia D, Sato N, Savchuk A, Sawyer RG, Scaioli G, Schizas D, Sebastiani S, Seeliger B, Lohse HAS, Seretis C, Sermonesi G, Serradilla-Martin M, Shelat VG, Shlyapnikov S, Sidiropoulos T, Simoes RL, Siragusa L, Siribumrungwong B, Slavchev M, Solaini L, soldini G, Sopuev A, Soreide K, Sovatzidis A, Stahel PF, Strickland M, Sultan MAH, Sydorchuk R, Sydorchuk L, Syed SMAM, Syed AM, Tallon-Aguilar L, Tamburini AM, Tamini N, Tan ECTH, Tan JH, Tarasconi A, Tartaglia N, Tartaglia G, Tartaglia D, Taylor JV, Tebala GD, Gonsaga RAT, Teuben M, Theodorou A, Tolonen M, Tomasicchio G, Toro A, Torre B, Triantafyllou T, Trigiante Trigiante G, Tripepi M, Trostchansky J, Tsekouras K, Turrado-Rodriguez V, Tutino R, Uccelli M, Uchikov PA, Ugarte-Sierra B, Ukkonen MT, Vailas M, Vassiliu PG, Vazquez AG, Vazquez RG, Verde JE, Verde JM, Veroux M, Viganò J, Vilallonga R, Visconti D, Vittori A, Waledziak M, Wannatoop T, Widmer LW, Wilson MSJ, Wong TH, Xenaki S, Yu B, Yule S, Zachariah SK, Zacharis G, Zaghi C, Zakaria AD, Zambrano DA, Zampitis N, Zampogna B, Zanghã S, Zapsalis K, Zattoni F, Zese M, Farre SP, Atanasov BT, Pegoraro V, Zantedeschi M, Reitano E, Pizzocaro E. Time for a paradigm shift in shared decision-making in trauma and emergency surgery? Results from an international survey. World J Emerg Surg 2023; 18:14. [PMID: 36803568 PMCID: PMC9936681 DOI: 10.1186/s13017-022-00464-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2022] [Accepted: 11/02/2022] [Indexed: 02/19/2023] [Imported: 10/13/2023] Open
Abstract
BACKGROUND Shared decision-making (SDM) between clinicians and patients is one of the pillars of the modern patient-centric philosophy of care. This study aims to explore SDM in the discipline of trauma and emergency surgery, investigating its interpretation as well as the barriers and facilitators for its implementation among surgeons. METHODS Grounding on the literature on the topics of the understanding, barriers, and facilitators of SDM in trauma and emergency surgery, a survey was created by a multidisciplinary committee and endorsed by the World Society of Emergency Surgery (WSES). The survey was sent to all 917 WSES members, advertised through the society's website, and shared on the society's Twitter profile. RESULTS A total of 650 trauma and emergency surgeons from 71 countries in five continents participated in the initiative. Less than half of the surgeons understood SDM, and 30% still saw the value in exclusively engaging multidisciplinary provider teams without involving the patient. Several barriers to effectively partnering with the patient in the decision-making process were identified, such as the lack of time and the need to concentrate on making medical teams work smoothly. DISCUSSION Our investigation underlines how only a minority of trauma and emergency surgeons understand SDM, and perhaps, the value of SDM is not fully accepted in trauma and emergency situations. The inclusion of SDM practices in clinical guidelines may represent the most feasible and advocated solutions.
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Affiliation(s)
- Lorenzo Cobianchi
- Department of Clinical, Diagnostic and Pediatric Sciences, University of Pavia, Via Alessandro Brambilla, 74, 27100, Pavia, PV, Italy. .,IRCCS Policlinico San Matteo Foundation, General Surgery, Pavia, Italy.
| | - Francesca Dal Mas
- grid.7240.10000 0004 1763 0578Department of Management, Ca’ Foscari University of Venice, Venice, Italy
| | - Vanni Agnoletti
- grid.414682.d0000 0004 1758 8744Bufalini Hospital, AUSL Romagna, Cesena, Italy
| | - Luca Ansaloni
- grid.8982.b0000 0004 1762 5736Department of Clinical, Diagnostic and Pediatric Sciences, University of Pavia, Via Alessandro Brambilla, 74, 27100 Pavia, PV Italy ,grid.419425.f0000 0004 1760 3027IRCCS Policlinico San Matteo Foundation, General Surgery, Pavia, Italy
| | - Walter Biffl
- grid.415402.60000 0004 0449 3295Division of Trauma and Acute Care Surgery, Scripps Memorial Hospital La Jolla, La Jolla, CA USA
| | - Giovanni Butturini
- grid.513352.3Department of HPB Surgery, Pederzoli Hospital, Peschiera del Garda, Italy
| | - Stefano Campostrini
- grid.7240.10000 0004 1763 0578Department of Economics, Ca’ Foscari University of Venice, Venice, Italy
| | - Fausto Catena
- grid.414682.d0000 0004 1758 8744Bufalini Hospital, AUSL Romagna, Cesena, Italy
| | - Stefano Denicolai
- grid.8982.b0000 0004 1762 5736Department of Economics and Management, University of Pavia, Pavia, Italy
| | - Paola Fugazzola
- grid.419425.f0000 0004 1760 3027IRCCS Policlinico San Matteo Foundation, General Surgery, Pavia, Italy
| | - Jacopo Martellucci
- grid.24704.350000 0004 1759 9494Department of Surgery, Careggi University Hospital, Florence, Italy
| | - Maurizio Massaro
- grid.7240.10000 0004 1763 0578Department of Management, Ca’ Foscari University of Venice, Venice, Italy
| | - Pietro Previtali
- grid.8982.b0000 0004 1762 5736Department of Economics and Management, University of Pavia, Pavia, Italy
| | - Federico Ruta
- General Direction, ASL BAT (Health Agency), Andria, Italy
| | - Alessandro Venturi
- grid.8982.b0000 0004 1762 5736Department of Political and Social Sciences, University of Pavia, Pavia, Italy ,grid.419425.f0000 0004 1760 3027Bureau of the Presidency, IRCCS Policlinico San Matteo Foundation, Pavia, Italy
| | - Sarah Woltz
- grid.416219.90000 0004 0568 6419Department of Surgery, Spaarne Gasthuis, Hoofddorp, The Netherlands
| | - Haytham M. Kaafarani
- grid.38142.3c000000041936754XHarvard Medical School, Boston, MA USA ,grid.32224.350000 0004 0386 9924Division of Trauma, Emergency Surgery, and Surgical Critical Care, Massachusetts General Hospital, Boston, MA USA
| | - Tyler J. Loftus
- grid.430508.a0000 0004 4911 114XDepartment of Surgery, University of Florida Health, Gainesville, FL USA
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Cobianchi L, Piccolo D, Dal Mas F, Agnoletti V, Ansaloni L, Balch J, Biffl W, Butturini G, Catena F, Coccolini F, Denicolai S, De Simone B, Frigerio I, Fugazzola P, Marseglia G, Marseglia GR, Martellucci J, Modenese M, Previtali P, Ruta F, Venturi A, Kaafarani HM, Loftus TJ. Surgeons' perspectives on artificial intelligence to support clinical decision-making in trauma and emergency contexts: results from an international survey. World J Emerg Surg 2023; 18:1. [PMID: 36597105 PMCID: PMC9811693 DOI: 10.1186/s13017-022-00467-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Accepted: 11/28/2022] [Indexed: 01/05/2023] [Imported: 10/13/2023] Open
Abstract
BACKGROUND Artificial intelligence (AI) is gaining traction in medicine and surgery. AI-based applications can offer tools to examine high-volume data to inform predictive analytics that supports complex decision-making processes. Time-sensitive trauma and emergency contexts are often challenging. The study aims to investigate trauma and emergency surgeons' knowledge and perception of using AI-based tools in clinical decision-making processes. METHODS An online survey grounded on literature regarding AI-enabled surgical decision-making aids was created by a multidisciplinary committee and endorsed by the World Society of Emergency Surgery (WSES). The survey was advertised to 917 WSES members through the society's website and Twitter profile. RESULTS 650 surgeons from 71 countries in five continents participated in the survey. Results depict the presence of technology enthusiasts and skeptics and surgeons' preference toward more classical decision-making aids like clinical guidelines, traditional training, and the support of their multidisciplinary colleagues. A lack of knowledge about several AI-related aspects emerges and is associated with mistrust. DISCUSSION The trauma and emergency surgical community is divided into those who firmly believe in the potential of AI and those who do not understand or trust AI-enabled surgical decision-making aids. Academic societies and surgical training programs should promote a foundational, working knowledge of clinical AI.
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Affiliation(s)
- Lorenzo Cobianchi
- Department of Clinical, Diagnostic and Pediatric Sciences, University of Pavia, Via Alessandro Brambilla, 74, 27100, Pavia, PV, Italy.
- General Surgery, IRCCS Policlinico San Matteo Foundation, Pavia, Italy.
- ITIR - Institute for Transformative Innovation Research, University of Pavia, Pavia, Italy.
| | - Daniele Piccolo
- Department of Clinical, Diagnostic and Pediatric Sciences, University of Pavia, Via Alessandro Brambilla, 74, 27100, Pavia, PV, Italy
- Department of Neurosurgery, ASUFC Santa Maria Della Misericordia, Udine, Italy
| | - Francesca Dal Mas
- Department of Management, Ca' Foscari University of Venice, Venice, Italy
| | | | - Luca Ansaloni
- Department of Clinical, Diagnostic and Pediatric Sciences, University of Pavia, Via Alessandro Brambilla, 74, 27100, Pavia, PV, Italy
- General Surgery, IRCCS Policlinico San Matteo Foundation, Pavia, Italy
| | - Jeremy Balch
- Department of Surgery, University of Florida Health, Gainesville, FL, USA
| | - Walter Biffl
- Division of Trauma and Acute Care Surgery, Scripps Memorial Hospital La Jolla, La Jolla, CA, USA
| | - Giovanni Butturini
- Department of HPB Surgery, Pederzoli Hospital, Peschiera del Garda, Italy
| | | | - Federico Coccolini
- General, Emergency and Trauma Surgery Department, Pisa University Hospital Pisa, Pisa, Italy
| | - Stefano Denicolai
- ITIR - Institute for Transformative Innovation Research, University of Pavia, Pavia, Italy
- Department of Economics and Management, University of Pavia, Pavia, Italy
| | - Belinda De Simone
- Department of Emergency, Digestive and Metabolic Minimally Invasive Surgery, Poissy and Saint Germain en Laye Hospitals, Poissy, France
| | - Isabella Frigerio
- Department of HPB Surgery, Pederzoli Hospital, Peschiera del Garda, Italy
| | - Paola Fugazzola
- Department of Clinical, Diagnostic and Pediatric Sciences, University of Pavia, Via Alessandro Brambilla, 74, 27100, Pavia, PV, Italy
- General Surgery, IRCCS Policlinico San Matteo Foundation, Pavia, Italy
| | - Gianluigi Marseglia
- Department of Clinical, Diagnostic and Pediatric Sciences, University of Pavia, Via Alessandro Brambilla, 74, 27100, Pavia, PV, Italy
- IRCCS Policlinico San Matteo Foundation, Pediatric Clinic., Pavia, Italy
| | | | | | | | - Pietro Previtali
- ITIR - Institute for Transformative Innovation Research, University of Pavia, Pavia, Italy
- Department of Economics and Management, University of Pavia, Pavia, Italy
| | - Federico Ruta
- General Direction, ASL BAT (Health Agency), Andria, Italy
| | - Alessandro Venturi
- ITIR - Institute for Transformative Innovation Research, University of Pavia, Pavia, Italy
- Department of Political and Social Sciences, University of Pavia, Pavia, Italy
- Bureau of the Presidency, IRCCS Policlinico San Matteo Foundation, Pavia, Italy
| | - Haytham M Kaafarani
- Harvard Medical School, Boston, MA, USA
- Division of Trauma, Emergency Surgery, and Surgical Critical Care, Massachusetts General Hospital, Boston, MA, USA
| | - Tyler J Loftus
- Department of Surgery, University of Florida Health, Gainesville, FL, USA
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Sibilla MG, Cremonini C, Portinari M, Carcoforo P, Tartaglia D, Cicuttin E, Musetti S, Strambi S, Sartelli M, Radica MK, Catena F, Chiarugi M, Coccolini F, Salvetti F, Negoi I, Zese M, Occhionorelli S, Shlyapnikov S, Sugrue M, Demetrashvili Z, Dondossola D, Ioannidis O, Novelli G, Frattini C, Nacoti M, Khor D, Inaba K, Demetriades D, Kaussen T, Jusoh AC, Ghannam W, Sakakushev B, Guetta O, Dogjani A, Costa S, Singh S, Damaskos D, Isik A, Yuan KC, Trotta F, Rausei S, Martinez-Perez A, Bellanova G, Fonseca VC, Hernández F, Marinis A, Fernandes W, Quiodettis M, Bala M, Vereczkei A, Curado R, Fraga GP, Pereira BM, Gachabayov M, Chagerben GP, Arellano ML, Ozyazici S, Costa G, Tezcaner T, Porta M, Li Y, Karateke F, Manatakis D, Mariani F, Lora F, Sahderov I, Atanasov B, Zegarra S, Fattori L, Ivatury R, Xiao J, Ben-Ishay O, Zharikov A, Dubuisson V. Patients with an Open Abdomen in Asian, American and European Continents: A Comparative Analysis from the International Register of Open Abdomen (IROA). World J Surg 2023; 47:142-151. [PMID: 36326921 PMCID: PMC9726668 DOI: 10.1007/s00268-022-06733-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/16/2022] [Indexed: 11/06/2022] [Imported: 10/13/2023]
Abstract
BACKGROUND International register of open abdomen (IROA) enrolls patients from several centers in American, European, and Asiatic continent. The aim of our study is to compare the characteristics, management and clinical outcome of adult patients treated with OA in the three continents. MATERIAL AND METHODS A prospective analysis of adult patients enrolled in the international register of open abdomen (IROA). TRIAL REGISTRATION NCT02382770. RESULTS 1183 patients were enrolled from American, European and Asiatic Continent. Median age was 63 years (IQR 49-74) and was higher in the European continent (65 years, p < 0.001); 57% were male. The main indication for OA was peritonitis (50.6%) followed by trauma (15.4%) and vascular emergency (13.5%) with differences among the continents (p < 0.001). Commercial NPWT was preferred in America and Europe (77.4% and 52.3% of cases) while Barker vacuum pack (48.2%) was the preferred temporary abdominal closure technique in Asia (p < 0.001). Definitive abdominal closure was achieved in 82.3% of cases in America (fascial closure in 90.2% of cases) and in 56.4% of cases in Asia (p < 0.001). Prosthesis were mostly used in Europe (17.3%, p < 0.001). The overall entero-atmospheric fistula rate 2.5%. Median open abdomen duration was 4 days (IQR 2-7). The overall intensive care unit and hospital length-of-stay were, respectively, 8 and 11 days (no differences between continents). The overall morbidity and mortality rates for America, Europe, and Asia were, respectively, 75.8%, 75.3%, 91.8% (p = 0.001) and 31.9%, 51.6%, 56.9% (p < 0.001). CONCLUSION There is no uniformity in OA management in the different continents. Heterogeneous adherence to international guidelines application is evident. Different temporary abdominal closure techniques in relation to indications led to different outcomes across the continents. Adherence to guidelines, combined with more consistent data, will ultimately allow to improving knowledge and outcome.
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Affiliation(s)
- Maria Grazia Sibilla
- Department of Surgery, Unit of General Surgery, University Hospital of Ferrara and University of Ferrara, Ferrara, Italy
| | - Camilla Cremonini
- General Emergency and Trauma Surgery, Pisa University Hospital, Via Paradisia,1, 56124 Pisa, Italy
| | - Mattia Portinari
- Department of Surgery, Unit of General Surgery, University Hospital of Ferrara and University of Ferrara, Ferrara, Italy
| | - Paolo Carcoforo
- Department of Surgery, Unit of General Surgery, University Hospital of Ferrara and University of Ferrara, Ferrara, Italy
| | - Dario Tartaglia
- General Emergency and Trauma Surgery, Pisa University Hospital, Via Paradisia,1, 56124 Pisa, Italy
| | - Enrico Cicuttin
- General Emergency and Trauma Surgery, Pisa University Hospital, Via Paradisia,1, 56124 Pisa, Italy
| | - Serena Musetti
- General Emergency and Trauma Surgery, Pisa University Hospital, Via Paradisia,1, 56124 Pisa, Italy
| | - Silvia Strambi
- General Emergency and Trauma Surgery, Pisa University Hospital, Via Paradisia,1, 56124 Pisa, Italy
| | | | - Margherita Koleva Radica
- Department of Surgery, Unit of General Surgery, University Hospital of Ferrara and University of Ferrara, Ferrara, Italy
| | - Fausto Catena
- Emergency Surgery, Parma University Hospital, Parma, Italy
| | - Massimo Chiarugi
- General Emergency and Trauma Surgery, Pisa University Hospital, Via Paradisia,1, 56124 Pisa, Italy
| | - Federico Coccolini
- General Emergency and Trauma Surgery, Pisa University Hospital, Via Paradisia,1, 56124, Pisa, Italy.
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De Simone B, Abu-Zidan FM, Chouillard E, Di Saverio S, Sartelli M, Podda M, Gomes CA, Moore EE, Moug SJ, Ansaloni L, Kluger Y, Coccolini F, Landaluce-Olavarria A, Estraviz-Mateos B, Uriguen-Etxeberria A, Giordano A, Luna AP, Amín LAH, Hernández AMP, Shabana A, Dzulkarnaen ZA, Othman MA, Sani MI, Balla A, Scaramuzzo R, Lepiane P, Bottari A, Staderini F, Cianchi F, Cavallaro A, Zanghì A, Cappellani A, Campagnacci R, Maurizi A, Martinotti M, Ruggieri A, Jusoh AC, Rahman KA, Zulkifli ASM, Petronio B, Matías-García B, Quiroga-Valcárcel A, Mendoza-Moreno F, Atanasov B, Campanile FC, Vecchioni I, Cardinali L, Travaglini G, Sebastiani E, Chooklin S, Chuklin S, Cianci P, Restini E, Capuzzolo S, Currò G, Filippo R, Rispoli M, Aparicio-Sánchez D, Muñóz-Cruzado VD, Barbeito SD, Delibegovic S, Kesetovic A, Sasia D, Borghi F, Giraudo G, Visconti D, Doria E, Santarelli M, Luppi D, Bonilauri S, Grossi U, Zanus G, Sartori A, Piatto G, De Luca M, Vita D, Conti L, Capelli P, Cattaneo GM, Marinis A, Vederaki SA, Bayrak M, Altıntas Y, Uzunoglu MY, Demirbas IE, Altinel Y, Meric S, Aktimur YE, Uymaz DS, Omarov N, Azamat I, Lostoridis E, Nagorni EA, Pujante A, Anania G, Bombardini C, Bagolini F, Gonullu E, Mantoglu B, Capoglu R, Cappato S, Muzio E, Colak E, Polat S, Koylu ZA, Altintoprak F, Bayhan Z, Akin E, Andolfi E, Rezart S, Kim JI, Jung SW, Shin YC, Enciu O, Toma EA, Medas F, Canu GL, Cappellacci F, D’Acapito F, Ercolani G, Solaini L, Roscio F, Clerici F, Gelmini R, Serra F, Rossi EG, Fleres F, Clarizia G, Spolini A, Ferrara F, Nita G, Sarnari J, Gachabayov M, Abdullaev A, Poillucci G, Palini GM, Veneroni S, Garulli G, Piccoli M, Pattacini GC, Pecchini F, Argenio G, Armellino MF, Brisinda G, Tedesco S, Fransvea P, Ietto G, Franchi C, Carcano G, Martines G, Trigiante G, Negro G, Vega GM, González AR, Ojeda L, Piccolo G, Bondurri A, Maffioli A, Guerci C, Sin BH, Zuhdi Z, Azman A, Mousa H, al Bahri S, Augustin G, Romic I, Moric T, Nikolopoulos I, Andreuccetti J, Pignata G, D’Alessio R, Kenig J, Skorus U, Fraga GP, Hirano ES, de Lima Bertuol JV, Isik A, Kurnaz E, Asghar MS, Afzal A, Akbar A, Nikolouzakis TK, Lasithiotakis K, Chrysos E, Das K, Özer N, Seker A, Ibrahim M, Hamid HKS, Babiker A, Bouliaris K, Koukoulis G, Kolla CC, Lucchi A, Agostinelli L, Taddei A, Fortuna L, Agostini C, Licari L, Viola S, Callari C, Laface L, Abate E, Casati M, Anastasi A, Canonico G, Gabellini L, Tosi L, Guariniello A, Zanzi F, Bains L, Sydorchuk L, Iftoda O, Sydorchuk A, Malerba M, Costanzo F, Galleano R, Monteleone M, Costanzi A, Riva C, Walędziak M, Kwiatkowski A, Czyżykowski Ł, Major P, Strzałka M, Matyja M, Natkaniec M, Valenti MR, Di Vita MDP, Sotiropoulou M, Kapiris S, Massalou D, Veroux M, Volpicelli A, Gioco R, Uccelli M, Bonaldi M, Olmi S, Nardi M, Livadoti G, Mesina C, Dumitrescu TV, Ciorbagiu MC, Ammendola M, Ammerata G, Romano R, Slavchev M, Misiakos EP, Pikoulis E, Papaconstantinou D, Elbahnasawy M, Abdel-elsalam S, Felsenreich DM, Jedamzik J, Michalopoulos NV, Sidiropoulos TA, Papadoliopoulou M, Cillara N, Deserra A, Cannavera A, Negoi I, Schizas D, Syllaios A, Vagios I, Gourgiotis S, Dai N, Gurung R, Norrey M, Pesce A, Feo CV, Fabbri N, Machairas N, Dorovinis P, Keramida MD, Mulita F, Verras GI, Vailas M, Yalkin O, Iflazoglu N, Yigit D, Baraket O, Ayed K, Ghalloussi MH, Patias P, Ntokos G, Rahim R, Bala M, Kedar A, Sawyer RG, Trinh A, Miller K, Sydorchuk R, Knut R, Plehutsa O, Liman RK, Ozkan Z, Kader SA, Gupta S, Gureh M, Saeidi S, Aliakbarian M, Dalili A, Shoko T, Kojima M, Nakamoto R, Atici SD, Tuncer GK, Kaya T, Delis SG, Rossi S, Picardi B, del Monte SR, Triantafyllou T, Theodorou D, Pintar T, Salobir J, Manatakis DK, Tasis N, Acheimastos V, Ioannidis O, Loutzidou L, Symeonidis S, de Sá TC, Rocha M, Guagni T, Pantalone D, Maltinti G, Khokha V, Abdel-elsalam W, Ghoneim B, López-Ruiz JA, Kara Y, Zainudin S, Hayati F, Azizan N, Khei VTP, Yi RCX, Sellappan H, Demetrashvili Z, Lekiashvili N, Tvaladze A, Froiio C, Bernardi D, Bonavina L, Gil-Olarte A, Grassia S, Romero-Vargas E, Bianco F, Gumbs AA, Dogjani A, Agresta F, Litvin A, Balogh ZJ, Gendrikson G, Martino C, Damaskos D, Pararas N, Kirkpatrick A, Kurtenkov M, Gomes FC, Pisanu A, Nardello O, Gambarini F, Aref H, Angelis ND, Agnoletti V, Biondi A, Vacante M, Griggio G, Tutino R, Massani M, Bisetto G, Occhionorelli S, Andreotti D, Lacavalla D, Biffl WL, Catena F. The ChoCO-W prospective observational global study: Does COVID-19 increase gangrenous cholecystitis? World J Emerg Surg 2022; 17:61. [PMID: 36527038 PMCID: PMC9755784 DOI: 10.1186/s13017-022-00466-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2022] [Accepted: 10/15/2022] [Indexed: 12/23/2022] [Imported: 10/13/2023] Open
Abstract
BACKGROUND The incidence of the highly morbid and potentially lethal gangrenous cholecystitis was reportedly increased during the COVID-19 pandemic. The aim of the ChoCO-W study was to compare the clinical findings and outcomes of acute cholecystitis in patients who had COVID-19 disease with those who did not. METHODS Data were prospectively collected over 6 months (October 1, 2020, to April 30, 2021) with 1-month follow-up. In October 2020, Delta variant of SARS CoV-2 was isolated for the first time. Demographic and clinical data were analyzed and reported according to the STROBE guidelines. Baseline characteristics and clinical outcomes of patients who had COVID-19 were compared with those who did not. RESULTS A total of 2893 patients, from 42 countries, 218 centers, involved, with a median age of 61.3 (SD: 17.39) years were prospectively enrolled in this study; 1481 (51%) patients were males. One hundred and eighty (6.9%) patients were COVID-19 positive, while 2412 (93.1%) were negative. Concomitant preexisting diseases including cardiovascular diseases (p < 0.0001), diabetes (p < 0.0001), and severe chronic obstructive airway disease (p = 0.005) were significantly more frequent in the COVID-19 group. Markers of sepsis severity including ARDS (p < 0.0001), PIPAS score (p < 0.0001), WSES sepsis score (p < 0.0001), qSOFA (p < 0.0001), and Tokyo classification of severity of acute cholecystitis (p < 0.0001) were significantly higher in the COVID-19 group. The COVID-19 group had significantly higher postoperative complications (32.2% compared with 11.7%, p < 0.0001), longer mean hospital stay (13.21 compared with 6.51 days, p < 0.0001), and mortality rate (13.4% compared with 1.7%, p < 0.0001). The incidence of gangrenous cholecystitis was doubled in the COVID-19 group (40.7% compared with 22.3%). The mean wall thickness of the gallbladder was significantly higher in the COVID-19 group [6.32 (SD: 2.44) mm compared with 5.4 (SD: 3.45) mm; p < 0.0001]. CONCLUSIONS The incidence of gangrenous cholecystitis is higher in COVID patients compared with non-COVID patients admitted to the emergency department with acute cholecystitis. Gangrenous cholecystitis in COVID patients is associated with high-grade Clavien-Dindo postoperative complications, longer hospital stay and higher mortality rate. The open cholecystectomy rate is higher in COVID compared with non -COVID patients. It is recommended to delay the surgical treatment in COVID patients, when it is possible, to decrease morbidity and mortality rates. COVID-19 infection and gangrenous cholecystistis are not absolute contraindications to perform laparoscopic cholecystectomy, in a case by case evaluation, in expert hands.
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Affiliation(s)
- Belinda De Simone
- Department of Emergency, Digestive and Metabolic Minimally Invasive Surgery, Poissy and Saint Germain en Laye Hospitals, Poissy, France
| | - Fikri M. Abu-Zidan
- grid.43519.3a0000 0001 2193 6666The Research Office, College of Medicine and Health Sciences, United Arab Emirates University, Al-Ain, United Arab Emirates., United Arab Emirates University, Al-Ain, UAE
| | - Elie Chouillard
- Department of Emergency, Digestive and Metabolic Minimally Invasive Surgery, Poissy and Saint Germain en Laye Hospitals, Poissy, France
| | - Salomone Di Saverio
- Department of General Surgery, Santa Maria del Soccorso Hospital, San Benedetto del Tronto, Ascoli Piceno, Italy
| | - Massimo Sartelli
- Department of General Surgery, Macerata Hospital, Macerata, Italy
| | - Mauro Podda
- grid.7763.50000 0004 1755 3242Department of Surgical Science, University of Cagliari, Cagliari, Italy
| | - Carlos Augusto Gomes
- Faculdade de Ciência Médicas e da Saúde de Juiz de Fora, Hospital Universitario Terezinha de Jesus (SUPREMA), Juiz de Fora, Brazil
| | - Ernest E. Moore
- grid.239638.50000 0001 0369 638XErnest E. Moore Shock Trauma Center at Denver Health, Denver, CO USA
| | - Susan J. Moug
- grid.8756.c0000 0001 2193 314XDepartment of Surgery, Royal Alexandra Hospital, Paisley and Golden Jubilee National Hospital, University of Glasgow, Glasgow, Scotland
| | - Luca Ansaloni
- grid.18887.3e0000000417581884Department of General Surgery, University Hospital of Pavia, Pavia, Italy
| | - Yoram Kluger
- Department of General Surgery, The Rambam Academic Hospital, Haifa, Israel
| | - Federico Coccolini
- grid.144189.10000 0004 1756 8209Department of General and Emergency Surgery, University Hospital of Pisa, Pisa, Italy
| | | | | | | | - Alessio Giordano
- General Surgery Unit ASL Toscana Centro, Santo Stefano Hospital, Prato, Italy
| | | | | | | | - Amanda Shabana
- grid.8348.70000 0001 2306 7492Emergency Surgery Department, John Radcliffe Hospital, Oxford, UK
| | - Zakaria Andee Dzulkarnaen
- grid.11875.3a0000 0001 2294 3534Department of Surgery, School of Medical Sciences and Hospital USM, Universiti Sains Malaysia, Kubang Kerian, Kelantan Malaysia
| | - Muhammad Asyraf Othman
- grid.11875.3a0000 0001 2294 3534Department of Surgery, School of Medical Sciences and Hospital USM, Universiti Sains Malaysia, Kubang Kerian, Kelantan Malaysia
| | - Mohamad Ikhwan Sani
- grid.11875.3a0000 0001 2294 3534Department of Surgery, School of Medical Sciences and Hospital USM, Universiti Sains Malaysia, Kubang Kerian, Kelantan Malaysia
| | - Andrea Balla
- UOC of General and Minimally Invasive Surgery, Hospital “San Paolo”, Largo Donatori del Sangue 1, 00053 Civitavecchia, Rome, Italy
| | - Rosa Scaramuzzo
- UOC of General and Minimally Invasive Surgery, Hospital “San Paolo”, Largo Donatori del Sangue 1, 00053 Civitavecchia, Rome, Italy
| | - Pasquale Lepiane
- UOC of General and Minimally Invasive Surgery, Hospital “San Paolo”, Largo Donatori del Sangue 1, 00053 Civitavecchia, Rome, Italy
| | - Andrea Bottari
- grid.24704.350000 0004 1759 9494SOD Chirurgia dell’Apparato Digerente, AOU Careggi, Florence, Italy
| | - Fabio Staderini
- grid.24704.350000 0004 1759 9494SOD Chirurgia dell’Apparato Digerente, AOU Careggi, Florence, Italy
| | - Fabio Cianchi
- grid.24704.350000 0004 1759 9494SOD Chirurgia dell’Apparato Digerente, AOU Careggi, Florence, Italy
| | - Andrea Cavallaro
- grid.8158.40000 0004 1757 1969Department of Surgery, University of Catania, Policlinico “G. Rodolico - San Marco” Hospital, Catania, Italy
| | - Antonio Zanghì
- grid.8158.40000 0004 1757 1969Department of Surgery, University of Catania, Policlinico “G. Rodolico - San Marco” Hospital, Catania, Italy
| | - Alessandro Cappellani
- grid.8158.40000 0004 1757 1969Department of Surgery, University of Catania, Policlinico “G. Rodolico - San Marco” Hospital, Catania, Italy
| | | | - Angela Maurizi
- U.O.C. of General Surgery, “Carlo Urbani” Hospital, Jesi, AN Italy
| | | | | | - Asri Che Jusoh
- Department of General Surgery, Hospital Sultan Ismail Petra, 18000 Kuala Krai, Kelantan Malaysia
| | - Karim Abdul Rahman
- Department of General Surgery, Hospital Sultan Ismail Petra, 18000 Kuala Krai, Kelantan Malaysia
| | - Anis Suraya M. Zulkifli
- Department of General Surgery, Hospital Sultan Ismail Petra, 18000 Kuala Krai, Kelantan Malaysia
| | - Barbara Petronio
- Chirurgia Generale e Mininvasiva, San Polo Monfalcone, Monfalcone, GO Italy
| | - Belén Matías-García
- grid.411336.20000 0004 1765 5855Hospital Universitario Príncipe de Asturias, Alcalá de Henares, Spain
| | - Ana Quiroga-Valcárcel
- grid.411336.20000 0004 1765 5855Hospital Universitario Príncipe de Asturias, Alcalá de Henares, Spain
| | - Fernando Mendoza-Moreno
- grid.411336.20000 0004 1765 5855Hospital Universitario Príncipe de Asturias, Alcalá de Henares, Spain
| | - Boyko Atanasov
- grid.35371.330000 0001 0726 0380RIMU, Medical University of Plovdiv, UMHAT Eurohospital, Plovdiv, Bulgaria
| | | | - Ilaria Vecchioni
- Ospedale San Giovanni Decollato Andosilla – ASL, Civita Castellana, Viterbo, VT Italy
| | - Luca Cardinali
- UOC Chirurgia Generale, Ospedale “Madonna del Soccorso”, San Benedetto del Tronto, AP Italy
| | - Grazia Travaglini
- UOC Chirurgia Generale, Ospedale “Madonna del Soccorso”, San Benedetto del Tronto, AP Italy
| | - Elisa Sebastiani
- UOC Chirurgia Generale, Ospedale “Madonna del Soccorso”, San Benedetto del Tronto, AP Italy
| | | | | | - Pasquale Cianci
- grid.416083.80000 0004 1768 5712Lorenzo Bonomo Hospital, ASL BAT, Andria, Puglia Italy
| | - Enrico Restini
- grid.416083.80000 0004 1768 5712Lorenzo Bonomo Hospital, ASL BAT, Andria, Puglia Italy
| | - Sabino Capuzzolo
- grid.416083.80000 0004 1768 5712Lorenzo Bonomo Hospital, ASL BAT, Andria, Puglia Italy
| | - Giuseppe Currò
- grid.411489.10000 0001 2168 2547Generall Surgery Unit, Science of Health Department, “Mater Domini” Hospital, University “Magna Graecia” Medical School, Viale Europa, 88100 Germaneto, Catanzaro Italy
| | - Rosalinda Filippo
- grid.411489.10000 0001 2168 2547Generall Surgery Unit, Science of Health Department, “Mater Domini” Hospital, University “Magna Graecia” Medical School, Viale Europa, 88100 Germaneto, Catanzaro Italy
| | - Michele Rispoli
- grid.411489.10000 0001 2168 2547Generall Surgery Unit, Science of Health Department, “Mater Domini” Hospital, University “Magna Graecia” Medical School, Viale Europa, 88100 Germaneto, Catanzaro Italy
| | - Daniel Aparicio-Sánchez
- grid.411109.c0000 0000 9542 1158Emergency Surgery Unit, Hospital Virgen del Rocío, Seville, Spain
| | | | - Sandra Dios Barbeito
- grid.411109.c0000 0000 9542 1158Emergency Surgery Unit, Hospital Virgen del Rocío, Seville, Spain
| | - Samir Delibegovic
- grid.412410.20000 0001 0682 9061Clinic for Surgery, University Clinical Center Tuzla, Tuzla, Bosnia and Herzegovina
| | - Amar Kesetovic
- grid.412410.20000 0001 0682 9061Clinic for Surgery, University Clinical Center Tuzla, Tuzla, Bosnia and Herzegovina
| | - Diego Sasia
- grid.413179.90000 0004 0486 1959Santa Croce and Carle Hospital, Cuneo, Italy
| | - Felice Borghi
- grid.413179.90000 0004 0486 1959Santa Croce and Carle Hospital, Cuneo, Italy
| | - Giorgio Giraudo
- grid.413179.90000 0004 0486 1959Santa Croce and Carle Hospital, Cuneo, Italy
| | - Diego Visconti
- Chirurgia Generale d’Urgenza e PS - AOU Cittá della Salute e della Scienza, Turin, Italy
| | - Emanuele Doria
- Chirurgia Generale d’Urgenza e PS - AOU Cittá della Salute e della Scienza, Turin, Italy
| | - Mauro Santarelli
- Chirurgia Generale d’Urgenza e PS - AOU Cittá della Salute e della Scienza, Turin, Italy
| | - Davide Luppi
- General and Emergency Surgery, ASMN IRCCS REGGIO EMILIA, Reggio Emilia, Italy
| | - Stefano Bonilauri
- General and Emergency Surgery, ASMN IRCCS REGGIO EMILIA, Reggio Emilia, Italy
| | - Ugo Grossi
- grid.5608.b0000 0004 1757 3470Surgery Unit 2, Regional Hospital Treviso, DISCOG, University of Padua, Treviso, Italy
| | - Giacomo Zanus
- grid.5608.b0000 0004 1757 3470Surgery Unit 2, Regional Hospital Treviso, DISCOG, University of Padua, Treviso, Italy
| | - Alberto Sartori
- U.O. Chirurgia Generale e d’Urgenza Ospedale San Valentino, Montebelluna, Treviso, Italy
| | - Giacomo Piatto
- U.O. Chirurgia Generale e d’Urgenza Ospedale San Valentino, Montebelluna, Treviso, Italy
| | - Maurizio De Luca
- U.O. Chirurgia Generale e d’Urgenza Ospedale San Valentino, Montebelluna, Treviso, Italy
| | - Domenico Vita
- grid.5608.b0000 0004 1757 3470Surgery Unit 2, Regional Hospital Treviso, DISCOG, University of Padua, Treviso, Italy
| | - Luigi Conti
- grid.476050.0Department of Surgery, G. Da Saliceto Hospital, AUSL Piacenza, Piacenza, Italy
| | - Patrizio Capelli
- grid.476050.0Department of Surgery, G. Da Saliceto Hospital, AUSL Piacenza, Piacenza, Italy
| | - Gaetano Maria Cattaneo
- grid.476050.0Department of Surgery, G. Da Saliceto Hospital, AUSL Piacenza, Piacenza, Italy
| | - Athanasios Marinis
- grid.414012.20000 0004 0622 6596Styliani-Aikaterini Vederaki, Third Department of Surgery, “Tzaneio” General Hospital, Piraeus, Greece
| | - Styliani-Aikaterini Vederaki
- grid.414012.20000 0004 0622 6596Styliani-Aikaterini Vederaki, Third Department of Surgery, “Tzaneio” General Hospital, Piraeus, Greece
| | - Mehmet Bayrak
- Mehmet Bayrak, Clinic for Surgery, Private Ortadogu Hospital, Adana, Turkey
| | | | | | | | - Yuksel Altinel
- grid.488643.50000 0004 5894 3909Department of General Surgery, Bagcilar Training and Research Hospital, University of Health Science, Istanbul, Turkey
| | - Serhat Meric
- grid.488643.50000 0004 5894 3909Department of General Surgery, Bagcilar Training and Research Hospital, University of Health Science, Istanbul, Turkey
| | - Yunus Emre Aktimur
- grid.488643.50000 0004 5894 3909Department of General Surgery, Bagcilar Training and Research Hospital, University of Health Science, Istanbul, Turkey
| | - Derya Salim Uymaz
- grid.15876.3d0000000106887552General Surgery Department, Faculty of Medicine, Koc University, Istanbul, Turkey
| | - Nail Omarov
- grid.15876.3d0000000106887552General Surgery Department, Faculty of Medicine, Koc University, Istanbul, Turkey
| | - Ibrahim Azamat
- grid.15876.3d0000000106887552General Surgery Department, Faculty of Medicine, Koc University, Istanbul, Turkey
| | - Eftychios Lostoridis
- grid.513828.50000 0004 0623 027X1St Department of Surgery, Kavala General Hospital, Kavala, Greece
| | - Eleni-Aikaterini Nagorni
- grid.513828.50000 0004 0623 027X1St Department of Surgery, Kavala General Hospital, Kavala, Greece
| | - Antonio Pujante
- grid.513828.50000 0004 0623 027X1St Department of Surgery, Kavala General Hospital, Kavala, Greece
| | - Gabriele Anania
- grid.416315.4UO Chirurgia 1, Dipartimento Chirurgico, Arcispedale Sant’Anna, Azienda Ospedaliero-Universitaria’di Ferrara, Ferrara, Italy
| | - Cristina Bombardini
- grid.416315.4UO Chirurgia 1, Dipartimento Chirurgico, Arcispedale Sant’Anna, Azienda Ospedaliero-Universitaria’di Ferrara, Ferrara, Italy
| | - Francesco Bagolini
- grid.416315.4UO Chirurgia 1, Dipartimento Chirurgico, Arcispedale Sant’Anna, Azienda Ospedaliero-Universitaria’di Ferrara, Ferrara, Italy
| | - Emre Gonullu
- grid.459902.30000 0004 0386 5536Sakarya Training and Research Hospital, Sakarya, Turkey
| | - Baris Mantoglu
- grid.459902.30000 0004 0386 5536Sakarya Training and Research Hospital, Sakarya, Turkey
| | - Recayi Capoglu
- grid.459902.30000 0004 0386 5536Sakarya Training and Research Hospital, Sakarya, Turkey
| | - Stefano Cappato
- Department of General Surgery ASL 4, Lavagna Hospital, Genoa, Italy
| | - Elena Muzio
- Department of General Surgery ASL 4, Lavagna Hospital, Genoa, Italy
| | - Elif Colak
- grid.510471.60000 0004 7684 9991Samsun Training and Research Hospital, University of Samsun, Samsun, Turkey
| | - Suleyman Polat
- grid.510471.60000 0004 7684 9991Samsun Training and Research Hospital, University of Samsun, Samsun, Turkey
| | - Zehra Alan Koylu
- grid.510471.60000 0004 7684 9991Samsun Training and Research Hospital, University of Samsun, Samsun, Turkey
| | - Fatih Altintoprak
- grid.49746.380000 0001 0682 3030Department of General Surgery, Faculty of Medicine, Sakarya University, Serdivan, Turkey
| | - Zülfü Bayhan
- grid.49746.380000 0001 0682 3030Department of General Surgery, Faculty of Medicine, Sakarya University, Serdivan, Turkey
| | - Emrah Akin
- grid.49746.380000 0001 0682 3030Department of General Surgery, Faculty of Medicine, Sakarya University, Serdivan, Turkey
| | - Enrico Andolfi
- grid.416351.40000 0004 1789 6237General and Emergency Surgery Unit, San Donato Hospital, Arezzo, Italy
| | - Sulce Rezart
- grid.416351.40000 0004 1789 6237General and Emergency Surgery Unit, San Donato Hospital, Arezzo, Italy
| | - Jae Il Kim
- grid.411633.20000 0004 0371 8173Department of Surgery, Inje University Ilsan Paik Hospital, Goyang, South Korea
| | - Sung Won Jung
- grid.411633.20000 0004 0371 8173Department of Surgery, Inje University Ilsan Paik Hospital, Goyang, South Korea
| | - Yong Chan Shin
- grid.411633.20000 0004 0371 8173Department of Surgery, Inje University Ilsan Paik Hospital, Goyang, South Korea
| | - Octavian Enciu
- grid.8194.40000 0000 9828 7548Elias University Emergency Hospital, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
| | - Elena Adelina Toma
- grid.8194.40000 0000 9828 7548Elias University Emergency Hospital, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
| | - Fabio Medas
- grid.7763.50000 0004 1755 3242Department of Surgical Science, University of Cagliari, Cagliari, Italy
| | - Gian Luigi Canu
- grid.7763.50000 0004 1755 3242Department of Surgical Science, University of Cagliari, Cagliari, Italy
| | - Federico Cappellacci
- grid.7763.50000 0004 1755 3242Department of Surgical Science, University of Cagliari, Cagliari, Italy
| | - Fabrizio D’Acapito
- grid.415079.e0000 0004 1759 989XGeneral and Oncologic Surgery, Morgagni-Pierantoni Hospital, AUSL Romagna, Via C. Forlanini 34, 47121 Forlì, Italy
| | - Giorgio Ercolani
- grid.415079.e0000 0004 1759 989XGeneral and Oncologic Surgery, Morgagni-Pierantoni Hospital, AUSL Romagna, Via C. Forlanini 34, 47121 Forlì, Italy
| | - Leonardo Solaini
- grid.415079.e0000 0004 1759 989XGeneral and Oncologic Surgery, Morgagni-Pierantoni Hospital, AUSL Romagna, Via C. Forlanini 34, 47121 Forlì, Italy
| | | | | | - Roberta Gelmini
- grid.7548.e0000000121697570Department of Medical and Surgical Sciences for Children and Adults, University of Modena and Reggio Emilia School of Medicine AOU Policlinico Di Modena, Modena, Italy
| | - Francesco Serra
- grid.7548.e0000000121697570Department of Medical and Surgical Sciences for Children and Adults, University of Modena and Reggio Emilia School of Medicine AOU Policlinico Di Modena, Modena, Italy
| | - Elena Giulia Rossi
- grid.7548.e0000000121697570Department of Medical and Surgical Sciences for Children and Adults, University of Modena and Reggio Emilia School of Medicine AOU Policlinico Di Modena, Modena, Italy
| | - Francesco Fleres
- UOC General Surgery, Hospital Civil of Sondrio, ASST Valtellina e Alto Lario, Sondrio, Italy
| | - Guglielmo Clarizia
- UOC General Surgery, Hospital Civil of Sondrio, ASST Valtellina e Alto Lario, Sondrio, Italy
| | - Alessandro Spolini
- UOC General Surgery, Hospital Civil of Sondrio, ASST Valtellina e Alto Lario, Sondrio, Italy
| | - Francesco Ferrara
- grid.414126.40000 0004 1760 1507Department of Surgery, San Carlo Borromeo Hospital, ASST Santi Paolo e Carlo, Milan, Italy
| | - Gabriela Nita
- grid.458453.b0000 0004 1756 7652AUSL Reggio Emilia, Ospedale Sant’Anna, Castelnuovo ne Monti, Reggio Emilia, Italy
| | - Jlenia Sarnari
- grid.458453.b0000 0004 1756 7652AUSL Reggio Emilia, Ospedale Sant’Anna, Castelnuovo ne Monti, Reggio Emilia, Italy
| | - Mahir Gachabayov
- Department of Abdominal Surgery, Vladimir City Emergency Hospital, Vladimir, Russia
| | - Abakar Abdullaev
- Department of Abdominal Surgery, Vladimir City Emergency Hospital, Vladimir, Russia
| | | | - Gian Marco Palini
- grid.414614.2Chirurgia generale e d’urgenza, Ospedale Infermi di Rimini, AUSL Romagna, Rimini, Italy
| | - Simone Veneroni
- grid.414614.2Chirurgia generale e d’urgenza, Ospedale Infermi di Rimini, AUSL Romagna, Rimini, Italy
| | - Gianluca Garulli
- grid.414614.2Chirurgia generale e d’urgenza, Ospedale Infermi di Rimini, AUSL Romagna, Rimini, Italy
| | - Micaela Piccoli
- Department of General Surgery, Emergencies and New Technologies, Baggiovara Civil Hospital, Modena, Italy
| | - Gianmaria Casoni Pattacini
- Department of General Surgery, Emergencies and New Technologies, Baggiovara Civil Hospital, Modena, Italy
| | - Francesca Pecchini
- Department of General Surgery, Emergencies and New Technologies, Baggiovara Civil Hospital, Modena, Italy
| | - Giulio Argenio
- UOC Chirurgia d’Urgenza, AOU San Giovanni di Dio e Ruggi d’Aragona, Salerno, Italy
| | | | - Giuseppe Brisinda
- grid.414603.4Department of Medical and Surgical Sciences, Fondazione Policlinico Universitario A Gemelli IRCCS, Rome, Italy
| | - Silvia Tedesco
- grid.414603.4Department of Medical and Surgical Sciences, Fondazione Policlinico Universitario A Gemelli IRCCS, Rome, Italy
| | - Pietro Fransvea
- grid.414603.4Department of Medical and Surgical Sciences, Fondazione Policlinico Universitario A Gemelli IRCCS, Rome, Italy
| | - Giuseppe Ietto
- grid.18147.3b0000000121724807General, Emergency and Transplant Surgery Department, ASST-Settelaghi and University of Insubria, Varese, Italy
| | - Caterina Franchi
- grid.18147.3b0000000121724807General, Emergency and Transplant Surgery Department, ASST-Settelaghi and University of Insubria, Varese, Italy
| | - Giulio Carcano
- grid.18147.3b0000000121724807General, Emergency and Transplant Surgery Department, ASST-Settelaghi and University of Insubria, Varese, Italy
| | - Gennaro Martines
- General Surgery Unit, Azienda Ospedaliero Universitaria Policlinico Bari - Italy, Bari, Italy
| | - Giuseppe Trigiante
- General Surgery Unit, Azienda Ospedaliero Universitaria Policlinico Bari - Italy, Bari, Italy
| | - Giulia Negro
- General Surgery Unit, Azienda Ospedaliero Universitaria Policlinico Bari - Italy, Bari, Italy
| | - Gustavo Machain Vega
- grid.412213.70000 0001 2289 5077Department of Surgery, Hospital de Clinicas, Universidad Nacional de Asunción, San Lorenzo, Paraguay
| | - Agustín Rodríguez González
- grid.412213.70000 0001 2289 5077Department of Surgery, Hospital de Clinicas, Universidad Nacional de Asunción, San Lorenzo, Paraguay
| | - Leonardo Ojeda
- grid.412213.70000 0001 2289 5077Department of Surgery, Hospital de Clinicas, Universidad Nacional de Asunción, San Lorenzo, Paraguay
| | - Gaetano Piccolo
- grid.4708.b0000 0004 1757 2822Unit of HepatoBilioPancreatic and Digestive Surgery, Department of Health Sciences, San Paolo Hospital, University of Milan, Via Di Rudinì 8, 20142 Milan, Italy
| | - Andrea Bondurri
- grid.4708.b0000 0004 1757 2822Department of General Surgery, Department of Biomedical and Clinical Sciences Luigi Sacco, Luigi Sacco University Hospital, Università degli Studi di Milano, Milan, Italy
| | - Anna Maffioli
- grid.4708.b0000 0004 1757 2822Department of General Surgery, Department of Biomedical and Clinical Sciences Luigi Sacco, Luigi Sacco University Hospital, Università degli Studi di Milano, Milan, Italy
| | - Claudio Guerci
- grid.4708.b0000 0004 1757 2822Department of General Surgery, Department of Biomedical and Clinical Sciences Luigi Sacco, Luigi Sacco University Hospital, Università degli Studi di Milano, Milan, Italy
| | - Boo Han Sin
- HPB Unit, Department of Surgery, Hospital Canselor Tuanku Muhriz, Kuala Lumpur, Malaysia
| | - Zamri Zuhdi
- HPB Unit, Department of Surgery, Hospital Canselor Tuanku Muhriz, Kuala Lumpur, Malaysia
| | - Azlanudin Azman
- HPB Unit, Department of Surgery, Hospital Canselor Tuanku Muhriz, Kuala Lumpur, Malaysia
| | - Hussam Mousa
- grid.43519.3a0000 0001 2193 6666College of Medicine, Tawam Hospital, UAE University, Al-Ain, UAE
| | - Shadi al Bahri
- grid.43519.3a0000 0001 2193 6666College of Medicine, Tawam Hospital, UAE University, Al-Ain, UAE
| | - Goran Augustin
- grid.412688.10000 0004 0397 9648Department of Surgery, University Hospital Centre, Zagreb, Croatia
| | - Ivan Romic
- grid.412688.10000 0004 0397 9648Department of Surgery, University Hospital Centre, Zagreb, Croatia
| | - Trpimir Moric
- grid.412688.10000 0004 0397 9648Department of Surgery, University Hospital Centre, Zagreb, Croatia
| | | | - Jacopo Andreuccetti
- grid.412725.72nd Department of General Surgery, ASST Spedali Civili of Brescia, Brescia, Italy
| | - Giusto Pignata
- grid.412725.72nd Department of General Surgery, ASST Spedali Civili of Brescia, Brescia, Italy
| | - Rossella D’Alessio
- grid.412725.72nd Department of General Surgery, ASST Spedali Civili of Brescia, Brescia, Italy
| | - Jakub Kenig
- grid.5522.00000 0001 2162 9631Department of General, Gastrointestinal, Oncologic Surgery and Transplantology, Jagiellonian University Medical College, Kraków, Poland
| | - Urszula Skorus
- grid.5522.00000 0001 2162 9631Department of General, Gastrointestinal, Oncologic Surgery and Transplantology, Jagiellonian University Medical College, Kraków, Poland
| | - Gustavo Pereira Fraga
- grid.411087.b0000 0001 0723 2494Division of Trauma Surgery, School of Medical Sciences, University of Campinas (Unicamp), Campinas, Brazil
| | - Elcio Shiyoiti Hirano
- grid.411087.b0000 0001 0723 2494Division of Trauma Surgery, School of Medical Sciences, University of Campinas (Unicamp), Campinas, Brazil
| | | | - Arda Isik
- grid.412176.70000 0001 1498 7262School of Medicine, Erzincan University, Erzincan, Turkey
| | - Eray Kurnaz
- grid.412176.70000 0001 1498 7262School of Medicine, Erzincan University, Erzincan, Turkey
| | | | - Ameer Afzal
- grid.412129.d0000 0004 0608 7688King Edward Medical University, Lahore, Pakistan
| | - Ali Akbar
- grid.412129.d0000 0004 0608 7688King Edward Medical University, Lahore, Pakistan
| | | | - Konstantinos Lasithiotakis
- grid.412481.a0000 0004 0576 5678Department of General Surgery, University General Hospital of Heraklion, 71110 Heraklion, Crete, Greece
| | - Emmanuel Chrysos
- grid.412481.a0000 0004 0576 5678Department of General Surgery, University General Hospital of Heraklion, 71110 Heraklion, Crete, Greece
| | - Koray Das
- Department of General Surgery, Adana City Training and Research Hospital, University of Health Sciences, Adana, Turkey
| | - Nazmi Özer
- Department of General Surgery, Adana City Training and Research Hospital, University of Health Sciences, Adana, Turkey
| | - Ahmet Seker
- Department of General Surgery, Adana City Training and Research Hospital, University of Health Sciences, Adana, Turkey
| | | | | | | | - Konstantinos Bouliaris
- Surgical Department, Koutlimbaneio and Triantafylleio General Hospital of Larissa, Larisa, Greece
| | - George Koukoulis
- Surgical Department, Koutlimbaneio and Triantafylleio General Hospital of Larissa, Larisa, Greece
| | | | - Andrea Lucchi
- U.O. Chirurgia Generale Ospedale “Ceccarini” Riccione, Riccione, Italy
| | - Laura Agostinelli
- U.O. Chirurgia Generale Ospedale “Ceccarini” Riccione, Riccione, Italy
| | - Antonio Taddei
- grid.24704.350000 0004 1759 9494Hepatobiliary Surgery, Department of Clinical and Experimental Medicine, University of Florence, AOU Careggi, Florence, Italy
| | - Laura Fortuna
- grid.24704.350000 0004 1759 9494Hepatobiliary Surgery, Department of Clinical and Experimental Medicine, University of Florence, AOU Careggi, Florence, Italy
| | - Carlotta Agostini
- grid.24704.350000 0004 1759 9494Hepatobiliary Surgery, Department of Clinical and Experimental Medicine, University of Florence, AOU Careggi, Florence, Italy
| | - Leo Licari
- grid.10776.370000 0004 1762 5517Department of Surgical, Oncological and Oral Sciences (DICHIRONS), Policlinico P. Giaccone, University of Palermo, Via Liborio Giuffré 5, 90127 Palermo, Italy
| | - Simona Viola
- grid.10776.370000 0004 1762 5517University of Palermo, Palermo, Italy
| | - Cosimo Callari
- Department of Surgery, Buccheri La Ferla Hospital, Via Messina Marine, 197, 90123 Palermo, Italy
| | - Letizia Laface
- Department of General Surgery, Vittorio Emanuele III Hospital, Carate Brianza - ASST Brianza, Carate Brianza, Italy
| | - Emmanuele Abate
- Department of General Surgery, Vittorio Emanuele III Hospital, Carate Brianza - ASST Brianza, Carate Brianza, Italy
| | - Massimiliano Casati
- Department of General Surgery, Vittorio Emanuele III Hospital, Carate Brianza - ASST Brianza, Carate Brianza, Italy
| | | | | | - Linda Gabellini
- Chirurgia Generale, Ospedale San Giovanni Di Dio, Florence, Italy
| | - Lorenzo Tosi
- grid.6292.f0000 0004 1757 1758Residency Program in General Surgery, University of Bologna, Bologna, Italy
| | - Anna Guariniello
- grid.415207.50000 0004 1760 3756Section of Emergency Surgery, Department of Surgery, S.Maria delle Croci Hospital Ravenna, Ravenna, Italy
| | - Federico Zanzi
- grid.415207.50000 0004 1760 3756Section of Emergency Surgery, Department of Surgery, S.Maria delle Croci Hospital Ravenna, Ravenna, Italy
| | - Lovenish Bains
- grid.414698.60000 0004 1767 743XDepartment of Surgery, Maulana Azad Medical College and Nayak Hospital, New Delhi, 110002 India
| | - Larysa Sydorchuk
- grid.445372.30000 0004 4906 2392Bukovinian State Medical University, Chernivtsi, Ukraine
| | - Oksana Iftoda
- grid.445372.30000 0004 4906 2392Bukovinian State Medical University, Chernivtsi, Ukraine
| | - Andrii Sydorchuk
- grid.445372.30000 0004 4906 2392Bukovinian State Medical University, Chernivtsi, Ukraine
| | | | | | | | - Michela Monteleone
- Andrea Costanzi, Carlo Riva, O.U. of General Surgery, San Leopoldo Mandic Hospital, Merate, ASST, Lecco, Italy
| | - Andrea Costanzi
- Andrea Costanzi, Carlo Riva, O.U. of General Surgery, San Leopoldo Mandic Hospital, Merate, ASST, Lecco, Italy
| | - Carlo Riva
- Andrea Costanzi, Carlo Riva, O.U. of General Surgery, San Leopoldo Mandic Hospital, Merate, ASST, Lecco, Italy
| | - Maciej Walędziak
- grid.415641.30000 0004 0620 0839Department of General, Oncological, Metabolic and Thoracic Surgery, Military Institute of Medicine, Warsaw, Poland
| | - Andrzej Kwiatkowski
- grid.415641.30000 0004 0620 0839Department of General, Oncological, Metabolic and Thoracic Surgery, Military Institute of Medicine, Warsaw, Poland
| | - Łukasz Czyżykowski
- grid.415641.30000 0004 0620 0839Department of General, Oncological, Metabolic and Thoracic Surgery, Military Institute of Medicine, Warsaw, Poland
| | - Piotr Major
- grid.5522.00000 0001 2162 9631Department of General and Emergency Surgery, Faculty of Medicine, Jagiellonian University Medical College, Kraków, Poland
| | - Marcin Strzałka
- grid.5522.00000 0001 2162 9631Department of General and Emergency Surgery, Faculty of Medicine, Jagiellonian University Medical College, Kraków, Poland
| | - Maciej Matyja
- grid.5522.00000 0001 2162 9631Department of General and Emergency Surgery, Faculty of Medicine, Jagiellonian University Medical College, Kraków, Poland
| | - Michal Natkaniec
- grid.5522.00000 0001 2162 9631Department of General and Emergency Surgery, Faculty of Medicine, Jagiellonian University Medical College, Kraków, Poland
| | - Maria Rosaria Valenti
- U.O. General Surgery, Azienda Ospedaliera Universitaria “Policlinico - San Marco”, Catania, Italy
| | | | - Maria Sotiropoulou
- grid.414655.70000 0004 4670 43293Rd Surgical Department, Evangelismos General Hospital, Athens, Greece
| | - Stylianos Kapiris
- grid.414655.70000 0004 4670 43293Rd Surgical Department, Evangelismos General Hospital, Athens, Greece
| | - Damien Massalou
- grid.410528.a0000 0001 2322 4179Department of Emergency Surgery, Centre Hospitalier Universitaire de Nice (CHU de Nice), Université Côte d’Azur, Nice, France
| | | | | | - Rossella Gioco
- General Surgery, Azienda Policlinico San Marco, Catania, Italy
| | - Matteo Uccelli
- General and Oncological Surgery Department, San Marco Hospital GSD, Zingonia, BG Italy
| | - Marta Bonaldi
- General and Oncological Surgery Department, San Marco Hospital GSD, Zingonia, BG Italy
| | - Stefano Olmi
- General and Oncological Surgery Department, San Marco Hospital GSD, Zingonia, BG Italy
| | - Matteo Nardi
- San Giovanni Calibita Hospital- Fondazione Fatebenefratelli, Rome, Italy
| | - Giada Livadoti
- San Giovanni Calibita Hospital- Fondazione Fatebenefratelli, Rome, Italy
| | - Cristian Mesina
- grid.452359.c0000 0004 4690 999XDepartment of Surgery, Emergency County Hospital of Craiova, Craiova, Romania
| | - Theodor Viorel Dumitrescu
- grid.452359.c0000 0004 4690 999XDepartment of Surgery, Emergency County Hospital of Craiova, Craiova, Romania
| | - Mihai Calin Ciorbagiu
- grid.452359.c0000 0004 4690 999XDepartment of Surgery, Emergency County Hospital of Craiova, Craiova, Romania
| | - Michele Ammendola
- grid.411489.10000 0001 2168 2547Science of Health Department, Digestive Surgery Unit, “Mater Domini” Hospital, University “Magna Graecia” Medical School, Viale Europa, 88100 Germaneto, Catanzaro Italy
| | - Giorgio Ammerata
- grid.411489.10000 0001 2168 2547Science of Health Department, Digestive Surgery Unit, “Mater Domini” Hospital, University “Magna Graecia” Medical School, Viale Europa, 88100 Germaneto, Catanzaro Italy
| | - Roberto Romano
- grid.411489.10000 0001 2168 2547Science of Health Department, Digestive Surgery Unit, “Mater Domini” Hospital, University “Magna Graecia” Medical School, Viale Europa, 88100 Germaneto, Catanzaro Italy
| | - Mihail Slavchev
- Department of General Surgery, University Hospital Eurohospital, Plovdiv, Bulgaria
| | - Evangelos P. Misiakos
- grid.5216.00000 0001 2155 08003Rd Department of Surgery, Attikon University Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Emmanouil Pikoulis
- grid.5216.00000 0001 2155 08003Rd Department of Surgery, Attikon University Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Dimitrios Papaconstantinou
- grid.5216.00000 0001 2155 08003Rd Department of Surgery, Attikon University Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Mohamed Elbahnasawy
- grid.412258.80000 0000 9477 7793Emergency Medicine and Traumatology Department, Tanta University Faculty of Medicine, Tanta, Egypt
| | - Sherief Abdel-elsalam
- grid.412258.80000 0000 9477 7793Tropical Medicine and Infectious Diseases, Faculty of Medicine, Tanta University, Tanta, Egypt
| | - Daniel M. Felsenreich
- grid.22937.3d0000 0000 9259 8492Division of Visceral Surgery, Department of General Surgery, Medical University of Vienna, Vienna, Austria
| | - Julia Jedamzik
- grid.22937.3d0000 0000 9259 8492Division of Visceral Surgery, Department of General Surgery, Medical University of Vienna, Vienna, Austria
| | - Nikolaos V. Michalopoulos
- grid.5216.00000 0001 2155 08004Rd Department of Surgery Attikon University Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Theodoros A. Sidiropoulos
- grid.5216.00000 0001 2155 08004Rd Department of Surgery Attikon University Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Maria Papadoliopoulou
- grid.5216.00000 0001 2155 08004Rd Department of Surgery Attikon University Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Nicola Cillara
- grid.459832.1Surgery Department, Santissima Trinità Hospital, Cagliari, Italy
| | - Antonello Deserra
- grid.459832.1Surgery Department, Santissima Trinità Hospital, Cagliari, Italy
| | | | - Ionuţ Negoi
- grid.8194.40000 0000 9828 7548General Surgery Department, Carol Davila University of Medicine and Pharmacy, Emergency Hospital of Bucharest, Bucharest, Romania
| | - Dimitrios Schizas
- grid.411565.20000 0004 0621 2848First Department of Surgery, National and Kapodistrian University of Athens, Laiko General Hospital, 11527 Athens, Greece
| | - Athanasios Syllaios
- grid.411565.20000 0004 0621 2848First Department of Surgery, National and Kapodistrian University of Athens, Laiko General Hospital, 11527 Athens, Greece
| | - Ilias Vagios
- grid.411565.20000 0004 0621 2848First Department of Surgery, National and Kapodistrian University of Athens, Laiko General Hospital, 11527 Athens, Greece
| | - Stavros Gourgiotis
- grid.5335.00000000121885934Addenbrooke’s Hospital, Cambridge University, Cambridge, UK
| | - Nick Dai
- grid.5335.00000000121885934Addenbrooke’s Hospital, Cambridge University, Cambridge, UK
| | - Rekha Gurung
- grid.5335.00000000121885934Addenbrooke’s Hospital, Cambridge University, Cambridge, UK
| | - Marcus Norrey
- grid.5335.00000000121885934Addenbrooke’s Hospital, Cambridge University, Cambridge, UK
| | - Antonio Pesce
- grid.8484.00000 0004 1757 2064Department of Surgery, Delta Hospital, Azienda USL of Ferrara, University of Ferrara, Ferrara, Italy
| | - Carlo Vittorio Feo
- grid.8484.00000 0004 1757 2064Department of Surgery, Delta Hospital, Azienda USL of Ferrara, University of Ferrara, Ferrara, Italy
| | - Nicolo’ Fabbri
- grid.8484.00000 0004 1757 2064Department of Surgery, Delta Hospital, Azienda USL of Ferrara, University of Ferrara, Ferrara, Italy
| | - Nikolaos Machairas
- grid.5216.00000 0001 2155 08002Nd Department of Propaedeutic Surgery, National and Kapodistrian University of Athens, General Hospital Laiko, Athens, Greece
| | - Panagiotis Dorovinis
- grid.5216.00000 0001 2155 08002Nd Department of Propaedeutic Surgery, National and Kapodistrian University of Athens, General Hospital Laiko, Athens, Greece
| | - Myrto D. Keramida
- grid.5216.00000 0001 2155 08002Nd Department of Propaedeutic Surgery, National and Kapodistrian University of Athens, General Hospital Laiko, Athens, Greece
| | - Francesk Mulita
- grid.412458.eDepartment of Surgery, General University Hospital of Patras, Patras, Greece
| | | | - Michail Vailas
- grid.412458.eDepartment of Surgery, General University Hospital of Patras, Patras, Greece
| | - Omer Yalkin
- Department of Surgical Oncology and Gastroenterological Surgery, Bursa City Hospital, Bursa, Turkey
| | - Nidal Iflazoglu
- Department of Surgical Oncology and Gastroenterological Surgery, Bursa City Hospital, Bursa, Turkey
| | - Direnc Yigit
- Department of Surgical Oncology and Gastroenterological Surgery, Bursa City Hospital, Bursa, Turkey
| | - Oussama Baraket
- grid.265234.40000 0001 2177 9066Department of General Surgery, Habib Bougatfa Hospital, University Tunis El Manar, Bizerte, Tunisia
| | - Karim Ayed
- grid.265234.40000 0001 2177 9066Department of General Surgery, Habib Bougatfa Hospital, University Tunis El Manar, Bizerte, Tunisia
| | - Mohamed hedi Ghalloussi
- grid.265234.40000 0001 2177 9066Department of General Surgery, Habib Bougatfa Hospital, University Tunis El Manar, Bizerte, Tunisia
| | - Parmenion Patias
- grid.414012.20000 0004 0622 65962nd Department of Surgery, General Hospital of Athens “G.Gennimatas”, Athens, Greece
| | - Georgios Ntokos
- grid.414012.20000 0004 0622 65962nd Department of Surgery, General Hospital of Athens “G.Gennimatas”, Athens, Greece
| | - Razrim Rahim
- grid.462995.50000 0001 2218 9236Department of Surgery, Universiti Sains Islam Malaysia, Nilai, Malaysia
| | - Miklosh Bala
- grid.9619.70000 0004 1937 0538Department of General Surgery and Trauma, Hadassah Medical Center and Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Asaf Kedar
- grid.9619.70000 0004 1937 0538Department of General Surgery and Trauma, Hadassah Medical Center and Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Robert G. Sawyer
- grid.268187.20000 0001 0672 1122Western Michigan University School of Medicine, Kalamazoo, USA
| | - Anna Trinh
- grid.268187.20000 0001 0672 1122Western Michigan University School of Medicine, Kalamazoo, USA
| | - Kelsey Miller
- grid.268187.20000 0001 0672 1122Western Michigan University School of Medicine, Kalamazoo, USA
| | | | - Ruslan Knut
- Regional Emergency Hospital, Chernivtsi, Ukraine
| | | | | | - Zeynep Ozkan
- General Surgery Clinic, Elazig Fethi Sekin City Hospital, Elazig, Turkey
| | - Saleh Abdel Kader
- Egypt and NMC Specialty Hospital Al Ain, Ain Shams University, Al-Ain, UAE
| | - Sanjay Gupta
- grid.413220.60000 0004 1767 2831Government Medical College and Hospital, Chandigarh, India
| | - Monika Gureh
- grid.413220.60000 0004 1767 2831Government Medical College and Hospital, Chandigarh, India
| | - Sara Saeidi
- grid.411583.a0000 0001 2198 6209Surgical Oncology Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mohsen Aliakbarian
- grid.411583.a0000 0001 2198 6209Surgical Oncology Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Amin Dalili
- grid.411583.a0000 0001 2198 6209Surgical Oncology Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Tomohisa Shoko
- grid.410818.40000 0001 0720 6587Department of Emergency and Critical Care Medicine, Department of Acute Care Surgery Center, Adachi Medical Center, Tokyo Women’s Medical University, Tokyo, Japan
| | - Mitsuaki Kojima
- grid.410818.40000 0001 0720 6587Department of Emergency and Critical Care Medicine, Department of Acute Care Surgery Center, Adachi Medical Center, Tokyo Women’s Medical University, Tokyo, Japan
| | - Raira Nakamoto
- grid.410818.40000 0001 0720 6587Department of Emergency and Critical Care Medicine, Department of Acute Care Surgery Center, Adachi Medical Center, Tokyo Women’s Medical University, Tokyo, Japan
| | - Semra Demirli Atici
- grid.414882.30000 0004 0643 0132Department of General Surgery, University of Health Sciences Tepecik Training and Research Hospital, Izmir, Turkey
| | - Gizem Kilinc Tuncer
- grid.414882.30000 0004 0643 0132Department of General Surgery, University of Health Sciences Tepecik Training and Research Hospital, Izmir, Turkey
| | - Tayfun Kaya
- grid.414882.30000 0004 0643 0132Department of General Surgery, University of Health Sciences Tepecik Training and Research Hospital, Izmir, Turkey
| | | | - Stefano Rossi
- grid.416357.2Department of General and Emergency Surgery, San Filippo Neri Hospital, ASL Roma 1, Rome, Italy
| | - Biagio Picardi
- grid.416357.2Department of General and Emergency Surgery, San Filippo Neri Hospital, ASL Roma 1, Rome, Italy
| | - Simone Rossi del Monte
- grid.416357.2Department of General and Emergency Surgery, San Filippo Neri Hospital, ASL Roma 1, Rome, Italy
| | - Tania Triantafyllou
- grid.5216.00000 0001 2155 0800Department of Surgery, Hippocration General Hospital of Athens, University of Athens, Athens, Greece
| | - Dimitrios Theodorou
- grid.5216.00000 0001 2155 0800Department of Surgery, Hippocration General Hospital of Athens, University of Athens, Athens, Greece
| | - Tadeja Pintar
- grid.29524.380000 0004 0571 7705Department of Abdominal Surgery, University Medical Center Ljubljana, Ljubljana, Slovenia
| | - Jure Salobir
- grid.29524.380000 0004 0571 7705Department of Abdominal Surgery, University Medical Center Ljubljana, Ljubljana, Slovenia
| | - Dimitrios K. Manatakis
- grid.414025.60000 0004 0638 8093Vasileios Acheimastos, Athens Naval and Veterans Hospital, Athens, Greece
| | - Nikolaos Tasis
- grid.414025.60000 0004 0638 8093Vasileios Acheimastos, Athens Naval and Veterans Hospital, Athens, Greece
| | - Vasileios Acheimastos
- grid.414025.60000 0004 0638 8093Vasileios Acheimastos, Athens Naval and Veterans Hospital, Athens, Greece
| | - Orestis Ioannidis
- grid.414012.20000 0004 0622 65964Th Department of Surgery, Medical School Aristotle University of Thessaloniki, General Hospital “George Papanikolaou”, Thessaloniki, Greece
| | - Lydia Loutzidou
- grid.414012.20000 0004 0622 65964Th Department of Surgery, Medical School Aristotle University of Thessaloniki, General Hospital “George Papanikolaou”, Thessaloniki, Greece
| | - Savvas Symeonidis
- grid.414012.20000 0004 0622 65964Th Department of Surgery, Medical School Aristotle University of Thessaloniki, General Hospital “George Papanikolaou”, Thessaloniki, Greece
| | - Tiago Correia de Sá
- grid.466592.aGeneral Surgery Department, Centro Hospitalar Do Tâmega e Sousa Penafiel, Penafiel, Portugal
| | - Mónica Rocha
- grid.466592.aGeneral Surgery Department, Centro Hospitalar Do Tâmega e Sousa Penafiel, Penafiel, Portugal
| | - Tommaso Guagni
- grid.24704.350000 0004 1759 9494Department of general surgery, Careggi University Hospital, Florence, Italy
| | - Desiré Pantalone
- grid.24704.350000 0004 1759 9494Department of general surgery, Careggi University Hospital, Florence, Italy
| | - Gherardo Maltinti
- grid.24704.350000 0004 1759 9494Department of general surgery, Careggi University Hospital, Florence, Italy
| | | | - Wafaa Abdel-elsalam
- grid.411978.20000 0004 0578 3577Anesthesia and Surgical Intensive Care Department, Faculty of Medicine, Kafrelsheikh University, Kafrelsheikh, Egypt
| | - Basma Ghoneim
- grid.411978.20000 0004 0578 3577Anesthesia and Surgical Intensive Care Department, Faculty of Medicine, Kafrelsheikh University, Kafrelsheikh, Egypt
| | - José Antonio López-Ruiz
- grid.411375.50000 0004 1768 164XAngeles Gil-Olarte, Estela Romero-Vargas, Hospital Universitario Virgen Macarena, Seville, Spain
| | - Yasin Kara
- grid.414850.c0000 0004 0642 8921General Surgery Clinic Health Sciences University Kanuni Sultan Süleyman Training and Research Hospital, Istanbul, Turkey
| | - Syaza Zainudin
- grid.265727.30000 0001 0417 0814Faculty of Medicine and Health Sciences, Queen Elisabeth Hospital, Universiti Malaysia Sabah, Kota Kinabalu, Malaysia
| | - Firdaus Hayati
- grid.265727.30000 0001 0417 0814Faculty of Medicine and Health Sciences, Queen Elisabeth Hospital, Universiti Malaysia Sabah, Kota Kinabalu, Malaysia
| | - Nornazirah Azizan
- grid.265727.30000 0001 0417 0814Faculty of Medicine and Health Sciences, Queen Elisabeth Hospital, Universiti Malaysia Sabah, Kota Kinabalu, Malaysia
| | - Victoria Tan Phooi Khei
- grid.265727.30000 0001 0417 0814Department of Surgery, Queen Elizabeth Hospital, Universiti Malaysia Sabah, Kota Kinabalu, Malaysia
| | - Rebecca Choy Xin Yi
- grid.265727.30000 0001 0417 0814Department of Surgery, Queen Elizabeth Hospital, Universiti Malaysia Sabah, Kota Kinabalu, Malaysia
| | - Harivinthan Sellappan
- grid.265727.30000 0001 0417 0814Department of Surgery, Queen Elizabeth Hospital, Universiti Malaysia Sabah, Kota Kinabalu, Malaysia
| | | | | | - Ana Tvaladze
- N.Kipshidze Central University Hospital, Tbilisi, Georgia
| | - Caterina Froiio
- grid.4708.b0000 0004 1757 2822IRCCS Policlinico San Donato, University of Milan, Milan, Italy
| | - Daniele Bernardi
- grid.4708.b0000 0004 1757 2822IRCCS Policlinico San Donato, University of Milan, Milan, Italy
| | - Luigi Bonavina
- grid.4708.b0000 0004 1757 2822IRCCS Policlinico San Donato, University of Milan, Milan, Italy
| | - Angeles Gil-Olarte
- grid.411375.50000 0004 1768 164XAngeles Gil-Olarte, Estela Romero-Vargas, Hospital Universitario Virgen Macarena, Seville, Spain
| | - Sebastiano Grassia
- General Surgery Unit, S. Leonardo Hospital, Castellammare Di Stabia, Naples, Italy
| | - Estela Romero-Vargas
- grid.411375.50000 0004 1768 164XAngeles Gil-Olarte, Estela Romero-Vargas, Hospital Universitario Virgen Macarena, Seville, Spain
| | - Francesco Bianco
- General Surgery Unit, S. Leonardo Hospital, Castellammare Di Stabia, Naples, Italy
| | - Andrew A. Gumbs
- Department of Emergency, Digestive and Metabolic Minimally Invasive Surgery, Poissy and Saint Germain en Laye Hospitals, Poissy, France
| | - Agron Dogjani
- Department of General Surgery, University Hospital of Tirana, Tirana, Albania
| | - Ferdinando Agresta
- Department of General Surgery, AULSS2 Trevigiana del Veneto, Ospedale di Vittorio Veneto, Vittorio Veneto, TV Italy
| | - Andrey Litvin
- grid.410686.d0000 0001 1018 9204Department of Surgical Disciplines, Immanuel Kant Baltic Federal University, Regional Clinical Hospital, Kalingrad, Russia
| | - Zsolt J. Balogh
- grid.414724.00000 0004 0577 6676Department of Traumatology, John Hunter Hospital and University of Newcastle, Newcastle, NSW Australia
| | - George Gendrikson
- grid.410686.d0000 0001 1018 9204Department of Surgical Disciplines, Immanuel Kant Baltic Federal University, Regional Clinical Hospital, Kalingrad, Russia
| | - Costanza Martino
- Anesthesia and Intensive Care Unit, Umberto I Hospital, AUSL Romagna, Lugo, Italy
| | - Dimitrios Damaskos
- grid.4305.20000 0004 1936 7988Department of General and Emergency Surgery, Royal Infirmary of Edinburgh, University of Edinburgh, Edinburgh, UK
| | - Nikolaos Pararas
- grid.411335.10000 0004 1758 7207Department of General Surgery, Dr. Sulaiman Al Habib Hospital, Alfaisal University, Riyadh, Saudi Arabia
| | - Andrew Kirkpatrick
- grid.414959.40000 0004 0469 2139General, Acute Care, Abdominal Wall Reconstruction, and Trauma Surgery, Foothills Medical Centre, Calgary, AB Canada
| | - Mikhail Kurtenkov
- grid.410686.d0000 0001 1018 9204Department of Surgical Disciplines, Immanuel Kant Baltic Federal University, Regional Clinical Hospital, Kalingrad, Russia
| | - Felipe Couto Gomes
- Faculdade de Ciência Médicas e da Saúde de Juiz de Fora, Hospital Universitario Terezinha de Jesus (SUPREMA), Juiz de Fora, Brazil
| | - Adolfo Pisanu
- grid.7763.50000 0004 1755 3242Department of Surgical Science, University of Cagliari, Cagliari, Italy
| | - Oreste Nardello
- grid.7763.50000 0004 1755 3242Department of Surgical Science, University of Cagliari, Cagliari, Italy
| | | | - Hager Aref
- Department of Emergency, Digestive and Metabolic Minimally Invasive Surgery, Poissy and Saint Germain en Laye Hospitals, Poissy, France
| | - Nicola de’ Angelis
- grid.412116.10000 0004 1799 3934Unit of Digestive and HPB Surgery, CARE Department, Henri Mondor Hospital and University Paris-Est, Creteil, France
| | - Vanni Agnoletti
- grid.414682.d0000 0004 1758 8744Department of General and Trauma Surgery, Bufalini Hospital, Cesena, Italy
| | - Antonio Biondi
- grid.8158.40000 0004 1757 1969Department of General Surgery and Medical-Surgical Specialties, University of Catania, Catania, Italy
| | - Marco Vacante
- grid.8158.40000 0004 1757 1969Department of General Surgery and Medical-Surgical Specialties, University of Catania, Catania, Italy
| | - Giulia Griggio
- grid.8158.40000 0004 1757 1969Department of General Surgery and Medical-Surgical Specialties, University of Catania, Catania, Italy
| | - Roberta Tutino
- grid.10776.370000 0004 1762 5517Chirurgia 1; Dipartimento di Discipline Chirurgiche , Oncologiche e Stomatologiche (DI.CHIR.ON.S), Ospedale “Ca’Foncell”; Univerità degli studi di Palermo, Treviso; Palermo, Italy
| | - Marco Massani
- grid.10776.370000 0004 1762 5517Chirurgia 1; Dipartimento di Discipline Chirurgiche , Oncologiche e Stomatologiche (DI.CHIR.ON.S), Ospedale “Ca’Foncell”; Univerità degli studi di Palermo, Treviso; Palermo, Italy
| | - Giovanni Bisetto
- grid.5608.b0000 0004 1757 3470Dipartimento di Scienze Chirurgiche, Oncologiche e Gastroenterologica (DI.SC.O.G.), Chirurgia 1-Ospedale “Ca Foncello”- Treviso, Università degli Studi di Padova, Padua, Italy
| | - Savino Occhionorelli
- grid.8484.00000 0004 1757 2064Department of General Surgery, Arcispedale Sant’Anna-University of Ferrara, Ferrara, Italy
| | - Dario Andreotti
- grid.8484.00000 0004 1757 2064Department of General Surgery, Arcispedale Sant’Anna-University of Ferrara, Ferrara, Italy
| | - Domenico Lacavalla
- grid.8484.00000 0004 1757 2064Department of General Surgery, Arcispedale Sant’Anna-University of Ferrara, Ferrara, Italy
| | - Walter L. Biffl
- grid.415401.5Department of Emergency and Trauma Surgery, Scripps Clinic Medical Group, La Jolla, CA USA
| | - Fausto Catena
- grid.414682.d0000 0004 1758 8744Department of General and Trauma Surgery, Bufalini Hospital, Cesena, Italy
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NIHR Global Health Unit on Global Surgery, COVIDSurg Collaborative. Elective surgery system strengthening: development, measurement, and validation of the surgical preparedness index across 1632 hospitals in 119 countries. Lancet 2022; 400:1607-17. [PMID: 36328042 DOI: 10.1016/S0140-6736(22)01846-3] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2022] [Revised: 08/18/2022] [Accepted: 09/20/2022] [Indexed: 11/06/2022] [Imported: 10/13/2023]
Abstract
BACKGROUND The 2015 Lancet Commission on global surgery identified surgery and anaesthesia as indispensable parts of holistic health-care systems. However, COVID-19 exposed the fragility of planned surgical services around the world, which have also been neglected in pandemic recovery planning. This study aimed to develop and validate a novel index to support local elective surgical system strengthening and address growing backlogs. METHODS First, we performed an international consultation through a four-stage consensus process to develop a multidomain index for hospital-level assessment (surgical preparedness index; SPI). Second, we measured surgical preparedness across a global network of hospitals in high-income countries (HICs), middle-income countries (MICs), and low-income countries (LICs) to explore the distribution of the SPI at national, subnational, and hospital levels. Finally, using COVID-19 as an example of an external system shock, we compared hospitals' SPI to their planned surgical volume ratio (SVR; ie, operations for which the decision for surgery was made before hospital admission), calculated as the ratio of the observed surgical volume over a 1-month assessment period between June 6 and Aug 5, 2021, against the expected surgical volume based on hospital administrative data from the same period in 2019 (ie, a pre-pandemic baseline). A linear mixed-effects regression model was used to determine the effect of increasing SPI score. FINDINGS In the first phase, from a longlist of 103 candidate indicators, 23 were prioritised as core indicators of elective surgical system preparedness by 69 clinicians (23 [33%] women; 46 [67%] men; 41 from HICs, 22 from MICs, and six from LICs) from 32 countries. The multidomain SPI included 11 indicators on facilities and consumables, two on staffing, two on prioritisation, and eight on systems. Hospitals were scored from 23 (least prepared) to 115 points (most prepared). In the second phase, surgical preparedness was measured in 1632 hospitals by 4714 clinicians from 119 countries. 745 (45·6%) of 1632 hospitals were in MICs or LICs. The mean SPI score was 84·5 (95% CI 84·1-84·9), which varied between HIC (88·5 [89·0-88·0]), MIC (81·8 [82·5-81·1]), and LIC (66·8 [64·9-68·7]) settings. In the third phase, 1217 (74·6%) hospitals did not maintain their expected SVR during the COVID-19 pandemic, of which 625 (51·4%) were from HIC, 538 (44·2%) from MIC, and 54 (4·4%) from LIC settings. In the mixed-effects model, a 10-point increase in SPI corresponded to a 3·6% (95% CI 3·0-4·1; p<0·0001) increase in SVR. This was consistent in HIC (4·8% [4·1-5·5]; p<0·0001), MIC (2·8 [2·0-3·7]; p<0·0001), and LIC (3·8 [1·3-6·7%]; p<0·0001) settings. INTERPRETATION The SPI contains 23 indicators that are globally applicable, relevant across different system stressors, vary at a subnational level, and are collectable by front-line teams. In the case study of COVID-19, a higher SPI was associated with an increased planned surgical volume ratio independent of country income status, COVID-19 burden, and hospital type. Hospitals should perform annual self-assessment of their surgical preparedness to identify areas that can be improved, create resilience in local surgical systems, and upscale capacity to address elective surgery backlogs. FUNDING National Institute for Health Research (NIHR) Global Health Research Unit on Global Surgery, NIHR Academy, Association of Coloproctology of Great Britain and Ireland, Bowel Research UK, British Association of Surgical Oncology, British Gynaecological Cancer Society, and Medtronic.
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13
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Podda M, Pacella D, Pellino G, Coccolini F, Giordano A, Di Saverio S, Pata F, Ielpo B, Virdis F, Damaskos D, De Simone B, Agresta F, Sartelli M, Leppaniemi A, Riboni C, Agnoletti V, Mole D, Kluger Y, Catena F, Pisanu A. coMpliAnce with evideNce-based cliniCal guidelines in the managemenT of acute biliaRy pancreAtitis): The MANCTRA-1 international audit. Pancreatology 2022; 22:902-916. [PMID: 35963665 DOI: 10.1016/j.pan.2022.07.007] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Revised: 06/24/2022] [Accepted: 07/12/2022] [Indexed: 12/11/2022] [Imported: 10/13/2023]
Abstract
BACKGROUND/OBJECTIVES Reports about the implementation of recommendations from acute pancreatitis guidelines are scant. This study aimed to evaluate, on a patient-data basis, the contemporary practice patterns of management of biliary acute pancreatitis and to compare these practices with the recommendations by the most updated guidelines. METHODS All consecutive patients admitted to any of the 150 participating general surgery (GS), hepatopancreatobiliary surgery (HPB), internal medicine (IM) and gastroenterology (GA) departments with a diagnosis of biliary acute pancreatitis between 01/01/2019 and 31/12/2020 were included in the study. Categorical data were reported as percentages representing the proportion of all study patients or different and well-defined cohorts for each variable. Continuous data were expressed as mean and standard deviation. Differences between the compliance obtained in the four different subgroups were compared using the Mann-Whitney U, Student's t, ANOVA or Kruskal-Wallis tests for continuous data, and the Chi-square test or the Fisher's exact test for categorical data. RESULTS Complete data were available for 5275 patients. The most commonly discordant gaps between daily clinical practice and recommendations included the optimal timing for the index CT scan (6.1%, χ2 6.71, P = 0.081), use of prophylactic antibiotics (44.2%, χ2 221.05, P < 0.00001), early enteral feeding (33.2%, χ2 11.51, P = 0.009), and the implementation of early cholecystectomy strategies (29%, χ2 354.64, P < 0.00001), with wide variability based on the admitting speciality. CONCLUSIONS The results of this study showed an overall poor compliance with evidence-based guidelines in the management of ABP, with wide variability based on the admitting speciality. Study protocol registered in ClinicalTrials.Gov (ID Number NCT04747990).
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Affiliation(s)
- Mauro Podda
- Department of Surgical Science, Emergency Surgery Unit, University of Cagliari, Cagliari, Italy.
| | - Daniela Pacella
- University of Naples Federico II, Department of Public Health, Naples, Italy
| | - Gianluca Pellino
- 'Luigi Vanvitelli' University of Campania, Naples, Italy; Colorectal Surgery, Vall d'Hebron University Hospital, Barcelona, Spain
| | - Federico Coccolini
- General, Emergency and Trauma Surgery Unit, Pisa University Hospital, Pisa, Italy
| | - Alessio Giordano
- Department of General Surgery, Santo Stefano Hospital, Prato, Italy
| | - Salomone Di Saverio
- Department of Surgery, Madonna del Soccorso Hospital, San Benedetto del Tronto, Italy
| | - Francesco Pata
- General Surgery Unit, Nicola Giannettasio Hospital, Corigliano-Rossano, Italy
| | | | - Francesco Virdis
- Trauma and Acute Care Surgery Unit, Niguarda Ca Granda Hospital, Milan, Italy
| | - Dimitrios Damaskos
- Department of Upper GI Surgery, Royal Infirmary of Edinburgh, Edinburgh, Scotland, UK
| | - Belinda De Simone
- Department of Emergency and Metabolic Minimally Invasive Surgery, Centre Hospitalier Intercommunal de Poissy/Saint Germain en Laye, Poissy Cedex, France
| | - Ferdinando Agresta
- Department of Surgery, Vittorio Veneto Civil Hospital, Vittorio Veneto, Italy
| | | | - Ari Leppaniemi
- Department of Abdominal Surgery, Abdominal Center, University of Helsinki and Helsinki University Central Hospital, Helsinki, Finland
| | - Cristiana Riboni
- Department of Surgery, EOC Regional Hospital, Lugano, Switzerland
| | | | - Damian Mole
- Centre for Inflammation Research, Clinical Surgery, University of Edinburgh, Edinburgh, Scotland, UK
| | - Yoram Kluger
- Division of General Surgery, Rambam Health Care Campus, Haifa, Israel
| | - Fausto Catena
- Department of Emergency and Trauma Surgery, Bufalini Hospital, Cesena, Italy
| | - Adolfo Pisanu
- Department of Surgical Science, Emergency Surgery Unit, University of Cagliari, Cagliari, Italy
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14
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Cobianchi L, Dal Mas F, Massaro M, Biffl W, Catena F, Coccolini F, Dionigi B, Dionigi P, Di Saverio S, Fugazzola P, Kluger Y, Leppäniemi A, Moore EE, Sartelli M, Velmahos G, Woltz S, Angelos P, Ansaloni L. Diversity and ethics in trauma and acute care surgery teams: results from an international survey. World J Emerg Surg 2022; 17:44. [PMID: 35948947 PMCID: PMC9364511 DOI: 10.1186/s13017-022-00446-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Accepted: 07/11/2022] [Indexed: 02/08/2023] [Imported: 10/13/2023] Open
Abstract
BACKGROUND Investigating the context of trauma and acute care surgery, the article aims at understanding the factors that can enhance some ethical aspects, namely the importance of patient consent, the perceptiveness of the ethical role of the trauma leader, and the perceived importance of ethics as an educational subject. METHODS The article employs an international questionnaire promoted by the World Society of Emergency Surgery. RESULTS Through the analysis of 402 fully filled questionnaires by surgeons from 72 different countries, the three main ethical topics are investigated through the lens of gender, membership of an academic or non-academic institution, an official trauma team, and a diverse group. In general terms, results highlight greater attention paid by surgeons belonging to academic institutions, official trauma teams, and diverse groups. CONCLUSIONS Our results underline that some organizational factors (e.g., the fact that the team belongs to a university context or is more diverse) might lead to the development of a higher sensibility on ethical matters. Embracing cultural diversity forces trauma teams to deal with different mindsets. Organizations should, therefore, consider those elements in defining their organizational procedures. LEVEL OF EVIDENCE Trauma and acute care teams work under tremendous pressure and complex circumstances, with their members needing to make ethical decisions quickly. The international survey allowed to shed light on how team assembly decisions might represent an opportunity to coordinate team member actions and increase performance.
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Affiliation(s)
- Lorenzo Cobianchi
- Department of Clinical, Diagnostic and Pediatric Sciences, University of Pavia, Via Alessandro Brambilla, 74, 27100, Pavia, PV, Italy.
- Department of General Surgery, IRCCS Policlinico San Matteo Foundation, Pavia, Italy.
| | - Francesca Dal Mas
- Department of Management, Ca' Foscari University of Venice, Venice, Italy
| | - Maurizio Massaro
- Department of Management, Ca' Foscari University of Venice, Venice, Italy
| | - Walter Biffl
- Division of Trauma and Acute Care Surgery, Scripps Memorial Hospital La Jolla, La Jolla, CA, USA
| | | | - Federico Coccolini
- General, Emergency and Trauma Surgery Departmrnt, Pisa University Hospital Pisa, Pisa, Italy
| | - Beatrice Dionigi
- New York Presbyterian Columbia University Irvine Medical Center, Irvine, NY, USA
| | - Paolo Dionigi
- Department of Clinical, Diagnostic and Pediatric Sciences, University of Pavia, Via Alessandro Brambilla, 74, 27100, Pavia, PV, Italy
| | - Salomone Di Saverio
- ASUR Marche 5, San Benedetto del Tronto General Hospital, San Benedetto del Tronto, Italy
| | - Paola Fugazzola
- Department of General Surgery, IRCCS Policlinico San Matteo Foundation, Pavia, Italy
| | - Yoram Kluger
- Division of General Surgery, Rambam Health Care Campus, Haifa, Israel
| | - Ari Leppäniemi
- Abdominal Center, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Ernest E Moore
- Department of Surgery, Denver Health Medical Center, Denver, CO, USA
| | | | - George Velmahos
- Harvard Medical School, Boston, MA, USA
- Division of Trauma, Emergency Surgery, and Surgical Critical Care, Massachusetts General Hospital, Boston, MA, USA
| | - Sarah Woltz
- Department of Surgery, Spaarne Gasthuis, Hoofddorp, The Netherlands
| | - Peter Angelos
- Department of Surgery and MacLean Center for Clinical Medical Ethics, The University of Chicago, Chicago, IL, USA
| | - Luca Ansaloni
- Department of Clinical, Diagnostic and Pediatric Sciences, University of Pavia, Via Alessandro Brambilla, 74, 27100, Pavia, PV, Italy
- Department of General Surgery, IRCCS Policlinico San Matteo Foundation, Pavia, Italy
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15
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Coccolini F, Sartelli M, Kluger Y, Osipov A, Cui Y, Beka SG, Kirkpatrick A, Sall I, Moore EE, Biffl WL, Litvin A, Pisano M, Magnone S, Picetti E, de Angelis N, Stahel P, Ansaloni L, Tan E, Abu-Zidan F, Ceresoli M, Hecker A, Chiara O, Sganga G, Khokha V, di Saverio S, Sakakushev B, Campanelli G, Fraga G, Wani I, Broek RT, Cicuttin E, Cremonini C, Tartaglia D, Soreide K, Galante J, de Moya M, Koike K, De Simone B, Balogh Z, Amico F, Shelat V, Pikoulis E, Di Carlo I, Bonavina L, Leppaniemi A, Marzi I, Ivatury R, Khan J, Maier RV, Hardcastle TC, Isik A, Podda M, Tolonen M, Rasa K, Navsaria PH, Demetrashvili Z, Tarasconi A, Carcoforo P, Sibilla MG, Baiocchi GL, Pararas N, Weber D, Chiarugi M, Catena F. The LIFE TRIAD of emergency general surgery. World J Emerg Surg 2022; 17:41. [PMID: 35879801 PMCID: PMC9317062 DOI: 10.1186/s13017-022-00447-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Accepted: 06/17/2022] [Indexed: 02/08/2023] [Imported: 10/13/2023] Open
Abstract
Emergency General Surgery (EGS) was identified as multidisciplinary surgery performed for traumatic and non-traumatic acute conditions during the same admission in the hospital by general emergency surgeons and other specialists. It is the most diffused surgical discipline in the world. To live and grow strong EGS necessitates three fundamental parts: emergency and elective continuous surgical practice, evidence generation through clinical registries and data accrual, and indications and guidelines production: the LIFE TRIAD.
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Affiliation(s)
- Federico Coccolini
- General, Emergency and Trauma Surgery, Pisa University Hospital, Via Paradisia 1, 56100, Pisa, Italy.
| | - Massimo Sartelli
- General and Emergency Surgery, Macerata Hospital, Macerata, Italy
| | - Yoram Kluger
- Division of General Surgery, Rambam Health Care Campus, Haifa, Israel
| | - Aleksei Osipov
- Emergency Surgery, Emergency Surgery of the Research Institute of Emergency Medicine Named After I.I. Dzhanelidze, St. Petersburg, Russia
| | - Yunfeng Cui
- Department of Surgery, Tianjin Nankai Hospital, Nankai Clinical School of Medicine, Tianjin Medical University, Tianjin, China
| | - Solomon Gurmu Beka
- General Surgery, Ethiopian Air Force Hospital, Bishoftu, Oromia, Ethiopia
| | - Andrew Kirkpatrick
- General, Acute Care, Abdominal Wall Reconstruction, and Trauma Surgery Foothills Medical Centre, Calgary, AB, Canada
| | - Ibrahima Sall
- Department of General Surgery, Hôpital Principal de Dakar Military Teaching Hospital, Dakar, Sénégal
| | - Ernest E Moore
- Ernest E. Moore Shock Trauma Center at Denver Health, Denver, CO, USA
| | - Walter L Biffl
- Trauma Surgery Department, Scripps Memorial Hospital, La Jolla, CA, USA
| | - Andrey Litvin
- Department of Surgical Disciplines, Immanuel Kant Baltic Federal University, Regional Clinical Hospital, Kaliningrad, Russia
| | - Michele Pisano
- Emergency and Trauma Surgery, Papa Giovanni XXIII Hospital, Bergamo, Italy
| | - Stefano Magnone
- Emergency and Trauma Surgery, Papa Giovanni XXIII Hospital, Bergamo, Italy
| | | | - Nicola de Angelis
- Unit of General Surgery, CARE Department Henri Mondor University Hospital (AP-HP), Faculty of Medicine, University of Paris Est, UPEC, Créteil, France
| | - Philip Stahel
- College of Osteopathic Medicine, Rocky Vista University, Parker, CO, 80134, USA
| | - Luca Ansaloni
- General Surgery, Pavia University Hospital, Pavia, Italy
| | - Edward Tan
- Emergency Medicine Department, Radboud Universitair Medisch Centrum, Nijmegen, The Netherlands
| | - Fikri Abu-Zidan
- Department of Surgery, College of Medicine and Health Sciences, UAE University, Al-Ain, UAE
| | - Marco Ceresoli
- General Surgery Department, Monza University Hospital, Monza, Italy
| | - Andreas Hecker
- Department of General and Thoracic Surgery, University Hospital of Giessen, Giessen, Germany
| | - Osvaldo Chiara
- Emergency and Trauma Surgery, Niguarda Hospital, Milan, Italy
| | - Gabriele Sganga
- Emergency and Trauma Surgery, Gemelli University Hospital, Rome, Italy
| | | | - Salomone di Saverio
- ASUR Marche, AV5, Hospital of San Benedetto del Tronto, San Benedetto del Tronto, Italy.,Dipartimento Di Chirurgia Generale E Specialistica "Paride Stefanini", La Sapienza University of Rome, Rome, Italy
| | - Boris Sakakushev
- General Surgery Department, Plovdiv University Hospital, Plovdiv, Bulgaria
| | | | - Gustavo Fraga
- General Surgery Department, Campinas University, Campinas, Brazil
| | - Imtiaz Wani
- Department of Minimal Access and General Surgery, Government Gousia Hospital, Srinagar, Jammu and Kashmir, India
| | - Richard Ten Broek
- Surgery Department, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Enrico Cicuttin
- General, Emergency and Trauma Surgery, Pisa University Hospital, Via Paradisia 1, 56100, Pisa, Italy
| | - Camilla Cremonini
- General, Emergency and Trauma Surgery, Pisa University Hospital, Via Paradisia 1, 56100, Pisa, Italy
| | - Dario Tartaglia
- General, Emergency and Trauma Surgery, Pisa University Hospital, Via Paradisia 1, 56100, Pisa, Italy
| | - Kjetil Soreide
- Department of Gastrointestinal Surgery, Stavanger University Hospital, Stavanger, Norway
| | - Joseph Galante
- Trauma Department, University of California, Davis, Sacramento, CA, USA
| | - Marc de Moya
- Trauma/Acute Care Surgery, Department of Surgery, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Kaoru Koike
- Department of Traumatology and Critical Care Medicine, National Hospital Organization Kyoto Medical Center, Kyoto, Japan
| | - Belinda De Simone
- Visceral and Metabolic Minimally Invasive Surgery, Centre Hospitalier Intercommunal de Poissy/Saint Germain en Laye, Saint Germain en Laye, France
| | - Zsolt Balogh
- Department of Traumatology, John Hunter Hospital and University of Newcastle, Newcastle, NSW, Australia
| | - Francesco Amico
- Department of Traumatology, John Hunter Hospital and University of Newcastle, Newcastle, NSW, Australia
| | - Vishal Shelat
- HPB Surgery, Tan Tock Seng Hospital, Tan Tock Seng, Singapore
| | - Emmanouil Pikoulis
- General Surgery, Hospital, National and Kapodistrian University of Athens (NKUA), Athens, Greece
| | - Isidoro Di Carlo
- Department of Surgical Sciences and Advanced Technologies, University of Catania, Catania, Italy
| | | | - Ari Leppaniemi
- Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Ingo Marzi
- Department of Trauma, Hand-, and Reconstructive Surgery, University Hospital Frankfurt, Goethe-University, Frankfurt am Main, Germany
| | - Rao Ivatury
- Department of Surgery, Virginia Commonwealth University School of Medicine, Richmond, VA, USA
| | - Jim Khan
- University of Portsmouth UK & Portsmouth Hospitals University NHS Trust UK, Portsmouth, UK
| | - Ronald V Maier
- Department of Surgery, University of Washington School of Medicine, Harborview Medical Center, Seattle, USA
| | - Timothy C Hardcastle
- Department of Surgery, Nelson R. Mandela School of Clinical Medicine, University of KwaZulu-Natal, Durban, South Africa.,Trauma and Burns Service, Inkosi Albert Luthuli Central Hospital, Department of Health, KwaZulu-Natal, Mayville, Durban, South Africa
| | - Arda Isik
- Division of General Surgery, School of Medicine, Istanbul Medeniyet University, Kadıkoy/Istambul, Turkey
| | - Mauro Podda
- Department of Surgical Science, University of Cagliari, Cagliari, Italy
| | - Matti Tolonen
- HUS Abdominal Center, Emergency Surgery, Meilahti Tower Hospital, Helsinki, Finland
| | - Kemal Rasa
- Department of General Surgery, Anadolu Medical Center, Kocaeli, Turkey
| | - Pradeep H Navsaria
- Trauma Center, Groote Schuur Hospital and University of Cape Town, Cape Town, South Africa
| | | | - Antonio Tarasconi
- Emergency Surgery Department, Parma University Hospital, Parma, Italy
| | - Paolo Carcoforo
- Department of Morphology, Surgery and Experimental Medicine, University Hospital of Ferrara and University of Ferrara, Ferrara, Italy
| | - Maria Grazia Sibilla
- Department of Morphology, Surgery and Experimental Medicine, University Hospital of Ferrara and University of Ferrara, Ferrara, Italy
| | - Gian Luca Baiocchi
- General Surgery, Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
| | - Nikolaos Pararas
- General Surgery, Hospital, National and Kapodistrian University of Athens (NKUA), Athens, Greece
| | - Dieter Weber
- Department of General Surgery, Royal Perth Hospital, Division of Surgery, School of Medicine, The University of Western Australia, Perth, Australia
| | - Massimo Chiarugi
- General, Emergency and Trauma Surgery, Pisa University Hospital, Via Paradisia 1, 56100, Pisa, Italy
| | - Fausto Catena
- Emergency and Trauma Surgery, Bufalini Hospital, Cesena, Italy
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Reichert M, Sartelli M, Weigand MA, Hecker M, Oppelt PU, Noll J, Askevold IH, Liese J, Padberg W, Coccolini F, Catena F, Hecker A. Correction to: Two years later: Is the SARS-CoV-2 pandemic still having an impact on emergency surgery? An international cross-sectional survey among WSES members. World J Emerg Surg 2022; 17:39. [PMID: 35804425 PMCID: PMC9270731 DOI: 10.1186/s13017-022-00442-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/30/2022] [Indexed: 02/08/2023] [Imported: 10/13/2023] Open
Affiliation(s)
- Martin Reichert
- Department of General, Visceral, Thoracic, Transplant and Pediatric Surgery, University Hospital of Giessen, Rudolf-Buchheim-Strasse 7, 35392, Giessen, Germany.
| | | | - Markus A Weigand
- Department of Anesthesiology, Heidelberg University Hospital, Heidelberg, Germany
| | - Matthias Hecker
- Department of Pulmonary and Critical Care Medicine, University Hospital of Giessen and Marburg Lung Center (UGMLC), University Hospital of Giessen, Giessen, Germany
| | - Philip U Oppelt
- Department of General, Visceral, Thoracic, Transplant and Pediatric Surgery, University Hospital of Giessen, Rudolf-Buchheim-Strasse 7, 35392, Giessen, Germany
| | - Julia Noll
- Department of General, Visceral, Thoracic, Transplant and Pediatric Surgery, University Hospital of Giessen, Rudolf-Buchheim-Strasse 7, 35392, Giessen, Germany
| | - Ingolf H Askevold
- Department of General, Visceral, Thoracic, Transplant and Pediatric Surgery, University Hospital of Giessen, Rudolf-Buchheim-Strasse 7, 35392, Giessen, Germany
| | - Juliane Liese
- Department of General, Visceral, Thoracic, Transplant and Pediatric Surgery, University Hospital of Giessen, Rudolf-Buchheim-Strasse 7, 35392, Giessen, Germany
| | - Winfried Padberg
- Department of General, Visceral, Thoracic, Transplant and Pediatric Surgery, University Hospital of Giessen, Rudolf-Buchheim-Strasse 7, 35392, Giessen, Germany
| | - Federico Coccolini
- Department of General, Emergency and Trauma Surgery, Pisa University Hospital, Pisa, Italy
| | - Fausto Catena
- Department of Emergency Surgery, Parma Maggiore Hospital, Parma, Italy
| | - Andreas Hecker
- Department of General, Visceral, Thoracic, Transplant and Pediatric Surgery, University Hospital of Giessen, Rudolf-Buchheim-Strasse 7, 35392, Giessen, Germany
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Reichert M, Sartelli M, Weigand MA, Hecker M, Oppelt PU, Noll J, Askevold IH, Liese J, Padberg W, Coccolini F, Catena F, Hecker A. Two years later: Is the SARS-CoV-2 pandemic still having an impact on emergency surgery? An international cross-sectional survey among WSES members. World J Emerg Surg 2022; 17:34. [PMID: 35710386 PMCID: PMC9202986 DOI: 10.1186/s13017-022-00424-0] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2022] [Accepted: 04/15/2022] [Indexed: 02/08/2023] [Imported: 10/13/2023] Open
Abstract
BACKGROUND The SARS-CoV-2 pandemic is still ongoing and a major challenge for health care services worldwide. In the first WSES COVID-19 emergency surgery survey, a strong negative impact on emergency surgery (ES) had been described already early in the pandemic situation. However, the knowledge is limited about current effects of the pandemic on patient flow through emergency rooms, daily routine and decision making in ES as well as their changes over time during the last two pandemic years. This second WSES COVID-19 emergency surgery survey investigates the impact of the SARS-CoV-2 pandemic on ES during the course of the pandemic. METHODS A web survey had been distributed to medical specialists in ES during a four-week period from January 2022, investigating the impact of the pandemic on patients and septic diseases both requiring ES, structural problems due to the pandemic and time-to-intervention in ES routine. RESULTS 367 collaborators from 59 countries responded to the survey. The majority indicated that the pandemic still significantly impacts on treatment and outcome of surgical emergency patients (83.1% and 78.5%, respectively). As reasons, the collaborators reported decreased case load in ES (44.7%), but patients presenting with more prolonged and severe diseases, especially concerning perforated appendicitis (62.1%) and diverticulitis (57.5%). Otherwise, approximately 50% of the participants still observe a delay in time-to-intervention in ES compared with the situation before the pandemic. Relevant causes leading to enlarged time-to-intervention in ES during the pandemic are persistent problems with in-hospital logistics, lacks in medical staff as well as operating room and intensive care capacities during the pandemic. This leads not only to the need for triage or transferring of ES patients to other hospitals, reported by 64.0% and 48.8% of the collaborators, respectively, but also to paradigm shifts in treatment modalities to non-operative approaches reported by 67.3% of the participants, especially in uncomplicated appendicitis, cholecystitis and multiple-recurrent diverticulitis. CONCLUSIONS The SARS-CoV-2 pandemic still significantly impacts on care and outcome of patients in ES. Well-known problems with in-hospital logistics are not sufficiently resolved by now; however, medical staff shortages and reduced capacities have been dramatically aggravated over last two pandemic years.
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Affiliation(s)
- Martin Reichert
- Department of General, Visceral, Thoracic, Transplant and Pediatric Surgery, University Hospital of Giessen, Rudolf-Buchheim-Strasse 7, 35392, Giessen, Germany.
| | | | - Markus A Weigand
- Department of Anesthesiology, Heidelberg University Hospital, Heidelberg, Germany
| | - Matthias Hecker
- Department of Pulmonary and Critical Care Medicine, University Hospital of Giessen and Marburg Lung Center (UGMLC), University Hospital of Giessen, Giessen, Germany
| | - Philip U Oppelt
- Department of General, Visceral, Thoracic, Transplant and Pediatric Surgery, University Hospital of Giessen, Rudolf-Buchheim-Strasse 7, 35392, Giessen, Germany
| | - Julia Noll
- Department of General, Visceral, Thoracic, Transplant and Pediatric Surgery, University Hospital of Giessen, Rudolf-Buchheim-Strasse 7, 35392, Giessen, Germany
| | - Ingolf H Askevold
- Department of General, Visceral, Thoracic, Transplant and Pediatric Surgery, University Hospital of Giessen, Rudolf-Buchheim-Strasse 7, 35392, Giessen, Germany
| | - Juliane Liese
- Department of General, Visceral, Thoracic, Transplant and Pediatric Surgery, University Hospital of Giessen, Rudolf-Buchheim-Strasse 7, 35392, Giessen, Germany
| | - Winfried Padberg
- Department of General, Visceral, Thoracic, Transplant and Pediatric Surgery, University Hospital of Giessen, Rudolf-Buchheim-Strasse 7, 35392, Giessen, Germany
| | - Federico Coccolini
- Department of General, Emergency and Trauma Surgery, Pisa University Hospital, Pisa, Italy
| | - Fausto Catena
- Department of Emergency Surgery, Parma Maggiore Hospital, Parma, Italy
| | - Andreas Hecker
- Department of General, Visceral, Thoracic, Transplant and Pediatric Surgery, University Hospital of Giessen, Rudolf-Buchheim-Strasse 7, 35392, Giessen, Germany
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Lamidi S, Williams KM, Hind D, Peckham-Cooper A, Miller AS, Smith AM, Saha A, Macutkiewicz C, Griffiths EA, Catena F, Coccolini F, Toogood G, Tierney GM, Boyd-Carson H, Sartelli M, Blencowe NS, Lockwood S, Coe PO, Lee MJ, Barreto SG, Drake T, Gachabayov M, Hill J, Ioannidis O, Lostoridis E, Mehraj A, Negoi I, Pata F, Steenkamp C, Ahmed S, Alin V, Al-Rashedy M, Atici SD, Bains L, Bandyopadhyay SK, Baraket O, Bates T, Beral D, Brown L, Buonomo L, Burke D, Caravaglios G, Ceresoli M, Chapman SJ, Cillara N, Clarke R, Colak E, Daniels S, Demetrashvili Z, Di Carlo I, Duff S, Dziakova J, Elliott JA, El Zalabany T, Engledow A, Ewnte B, Fraga GP, George R, Giuffrida M, Glasbey J, Isik A, Kechagias A, Kenington C, Kessel B, Khokha V, Kong V, Laloë P, Litvin A, Lostoridis E, Marinis A, Martínez-Pérez A, Menzies D, Mills R, Monzon BI, Morgan R, Neri V, Nita GE, Perra T, Perrone G, Porcu A, Poskus T, Premnath S, Sall I, Sarma DR, Slavchev M, Spence G, Tarasconi A, Tolonen M, Toro A, Venn ML, Vimalachandran D, Wheldon L, Zakaria AD. Defining core patient descriptors for perforated peptic ulcer research: international Delphi. Br J Surg 2022; 109:603-609. [PMID: 35467718 DOI: 10.1093/bjs/znac096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Revised: 02/09/2022] [Accepted: 03/08/2022] [Indexed: 10/13/2023] [Imported: 10/13/2023]
Abstract
BACKGROUND Perforated peptic ulcer (PPU) remains a common condition globally with significant morbidity and mortality. Previous work has demonstrated variation in reporting of patient characteristics in PPU studies, making comparison of studies and outcomes difficult. The aim of this study was to standardize the reporting of patient characteristics, by creating a core descriptor set (CDS) of important descriptors that should be consistently reported in PPU research. METHODS Candidate descriptors were identified through systematic review and stakeholder proposals. An international Delphi exercise involving three survey rounds was undertaken to obtain consensus on key patient characteristics for future research. Participants rated items on a scale of 1-9 with respect to their importance. Items meeting a predetermined threshold (rated 7-9 by over 70 per cent of stakeholders) were included in the final set and ratified at a consensus meeting. Feedback was provided between rounds to allow refinement of ratings. RESULTS Some 116 clinicians were recruited from 29 countries. A total of 63 descriptors were longlisted from the literature, and 27 were proposed by stakeholders. After three survey rounds and a consensus meeting, 27 descriptors were included in the CDS. These covered demographic variables and co-morbidities, risk factors for PPU, presentation and pathway factors, need for organ support, biochemical parameters, prognostic tools, perforation details, and surgical history. CONCLUSION This study defines the core descriptive items for PPU research, which will allow more robust synthesis of studies.
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Merabishvili G, Mosidze B, Demetrashvili Z, Agdgomelashvili I. Comparison of hartmann's procedure versus resection with primary anastomosis in management of left sided colon cancer obstruction: A prospective cohort study. Georgian Med News 2022:21-25. [PMID: 35417858 DOI: pmid/35417858] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
The aim of our prospective study is to compare and analyze the results of two treatment methods of left-sided malignant colon obstruction: Hartmann's procedure (HP) and Resection with primary anastomosis (RPA). 90 Patients with diagnosis of left-sided malignant colon obstructions were enrolled in this study. The patients were assigned into two groups: Hartmann's procedure (HP) group and Resection and Primary anastomosis group (RPA). Several clinical characteristics were determined and compared between the groups: hospital stay days, duration of the surgery, postoperative complications (during 30 days after surgery) and mortality was assessed. 37 patients were enrolled in the Hartmann's procedure (HP) group and 53 patients were enrolled in the Primary anastomosis (RPA) group and had undergone different types of colon resections with primary anastomosis. There was 1mortality in HP group and 1 in RPA group. In RPA group, there were 7 complications (13.2%). 1 intraabdominal abscess after colorectal anastomosis, which was cured with antibiotic therapy and percutaneous drainage; 5 cases of wound infections, 1- leak of colorectal anastomosis and in Hartmann's procedure group there were 8 (21.6%) complications (7 - wound infections, 1-necrosis of colostomy). But this difference is not statistically reliable (p=0.110). In stenting RPA stay were - 6 days and in HP group, it was 8 days. This difference is statistically reliable (P=0.02). In case of left-sided malignant colon obstructions, Primary anastomosis intervention should be preferred, rather than Hartmann's procedure. In the future it's needed to perform the randomized trials, which will study the long-term outcomes (recurrence of cancer, survival rate) of this treatment method.
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Affiliation(s)
- G Merabishvili
- Tbilisi State Medical University; High Technology Medical Center, University Clinic, Georgia
| | - B Mosidze
- Tbilisi State Medical University; High Technology Medical Center, University Clinic, Georgia
| | - Z Demetrashvili
- Tbilisi State Medical University; High Technology Medical Center, University Clinic, Georgia
| | - I Agdgomelashvili
- Tbilisi State Medical University; High Technology Medical Center, University Clinic, Georgia
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20
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Sartelli M, Labricciosa FM, Coccolini F, Coimbra R, Abu-Zidan FM, Ansaloni L, Al-Hasan MN, Ansari S, Barie PS, Caínzos MA, Ceresoli M, Chiarugi M, Claridge JA, Cicuttin E, Dellinger EP, Fry DE, Guirao X, Hardcastle TC, Hecker A, Leppäniemi AK, Litvin A, Marwah S, Maseda E, Mazuski JE, Memish ZA, Kirkpatrick AW, Pagani L, Podda M, Rasa HK, Sakakushev BE, Sawyer RG, Tumietto F, Xiao Y, Aboubreeg WF, Adamou H, Akhmeteli L, Akin E, Alberio MG, Alconchel F, Magagi IA, Araúz AB, Argenio G, Atanasov BC, Atici SD, Awad SS, Baili E, Bains L, Bala M, Baraket O, Baral S, Belskii VA, Benboubker M, Ben-Ishay O, Bordoni P, Boumédiène A, Brisinda G, Cavazzuti L, Chandy SJ, Chiarello MM, Cillara N, Clarizia G, Cocuz ME, Cocuz IG, Conti L, Coppola R, Cui Y, Czepiel J, D'Acapito F, Damaskos D, Das K, De Simone B, Delibegovic S, Demetrashvili Z, Detanac DS, Dhingra S, Di Bella S, Dimitrov EN, Dogjani A, D'Oria M, Dumitru IM, Elmangory MM, Enciu O, Fantoni M, Filipescu D, Fleres F, Foghetti D, Fransvea P, Gachabayov M, Galeiras R, Gattuso G, Ghannam WM, Ghisetti V, Giraudo G, Gonfa KB, Gonullu E, Hamad YTEY, Hecker M, Isik A, Ismail N, Ismail A, Jain SA, Kanj SS, Kapoor G, Karaiskos I, Kavalakat AJ, Kenig J, Khamis F, Khokha V, Kiguba R, Kim JI, Kobe Y, Kok KYY, Kovacevic BM, Kryvoruchko IA, Kuriyama A, Landaluce-Olavarria A, Lasithiotakis K, Lohsiriwat V, Lostoridis E, Luppi D, Vega GMM, Maegele M, Marinis A, Martines G, Martínez-Pérez A, Massalou D, Mesina C, Metan G, Miranda-Novales MG, Mishra SK, Mohamed MIH, Mohamedahmed AYY, Mora-Guzmán I, Mulita F, Musina AM, Navsaria PH, Negoi I, Nita GE, O'Connor DB, Ordoñez CA, Pantalone D, Panyko A, Papadopoulos A, Pararas N, Pata F, Patel T, Pellino G, Perra T, Perrone G, Pesce A, Pintar T, Popivanov GI, Porcu A, Quiodettis MA, Rahim R, Mitul AR, Reichert M, Rems M, Campbell GYR, Rocha-Pereira N, Rodrigues G, Villamil GER, Rossi S, Sall I, Kafil HS, Sasia D, Seni J, Seretis C, Serradilla-Martín M, Shelat VG, Siribumrungwong B, Slavchev M, Solaini L, Tan BK, Tarasconi A, Tartaglia D, Toma EA, Tomadze G, Toro A, Tovani-Palone MR, van Goor H, Vasilescu A, Vereczkei A, Veroux M, Weckmann SA, Widmer LW, Yahya A, Zachariah SK, Zakaria AD, Zubareva N, Zuidema WP, Di Carlo I, Cortese F, Baiocchi GL, Maier RV, Catena F. It is time to define an organizational model for the prevention and management of infections along the surgical pathway: a worldwide cross-sectional survey. World J Emerg Surg 2022; 17:17. [PMID: 35300731 PMCID: PMC8928018 DOI: 10.1186/s13017-022-00420-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Accepted: 02/28/2022] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND The objectives of the study were to investigate the organizational characteristics of acute care facilities worldwide in preventing and managing infections in surgery; assess participants' perception regarding infection prevention and control (IPC) measures, antibiotic prescribing practices, and source control; describe awareness about the global burden of antimicrobial resistance (AMR) and IPC measures; and determine the role of the Coronavirus Disease 2019 pandemic on said awareness. METHODS A cross-sectional web-based survey was conducted contacting 1432 health care workers (HCWs) belonging to a mailing list provided by the Global Alliance for Infections in Surgery. The self-administered questionnaire was developed by a multidisciplinary team. The survey was open from May 22, 2021, and June 22, 2021. Three reminders were sent, after 7, 14, and 21 days. RESULTS Three hundred four respondents from 72 countries returned a questionnaire, with an overall response rate of 21.2%. Respectively, 90.4% and 68.8% of participants stated their hospital had a multidisciplinary IPC team or a multidisciplinary antimicrobial stewardship team. Local protocols for antimicrobial therapy of surgical infections and protocols for surgical antibiotic prophylaxis were present in 76.6% and 90.8% of hospitals, respectively. In 23.4% and 24.0% of hospitals no surveillance systems for surgical site infections and no monitoring systems of used antimicrobials were implemented. Patient and family involvement in IPC management was considered to be slightly or not important in their hospital by the majority of respondents (65.1%). Awareness of the global burden of AMR among HCWs was considered very important or important by 54.6% of participants. The COVID-19 pandemic was considered by 80.3% of respondents as a very important or important factor in raising HCWs awareness of the IPC programs in their hospital. Based on the survey results, the authors developed 15 statements for several questions regarding the prevention and management of infections in surgery. The statements may be the starting point for designing future evidence-based recommendations. CONCLUSION Adequacy of prevention and management of infections in acute care facilities depends on HCWs behaviours and on the organizational characteristics of acute health care facilities to support best practices and promote behavioural change. Patient involvement in the implementation of IPC is still little considered. A debate on how operationalising a fundamental change to IPC, from being solely the HCWs responsibility to one that involves a collaborative relationship between HCWs and patients, should be opened.
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Affiliation(s)
| | | | - Federico Coccolini
- General, Emergency and Trauma Surgery Department, Pisa University Hospital, Pisa, Italy
| | - Raul Coimbra
- Comparative Effectiveness and Clinical Outcomes Research Center, Riverside University Health System Medical Center, Riverside, USA
| | - Fikri M Abu-Zidan
- Department of Surgery, College of Medicine and Health Sciences, UAE University, Al-Ain, United Arab Emirates
| | - Luca Ansaloni
- Department of Surgery, Fondazione IRCCS Policlinico San Matteo, University of Pavia, Pavia, Italy
| | - Majdi N Al-Hasan
- Department of Internal Medicine, University of South Carolina School of Medicine, Columbia, USA
| | - Shamshul Ansari
- Department of Microbiology, Chitwan Medical College and Teaching Hospital, Bharatpur, Chitwan, Nepal
| | - Philip S Barie
- Department of Surgery, Weill Cornell Medicine, New York, USA
| | | | - Marco Ceresoli
- Department of General and Emergency Surgery, Milano-Bicocca University, School of Medicine and Surgery, Milan, Italy
| | - Massimo Chiarugi
- General, Emergency and Trauma Surgery Department, Pisa University Hospital, Pisa, Italy
| | - Jeffrey A Claridge
- MetroHealth Medical Center, Case Western Reserve University, Cleveland, OH, USA
| | - Enrico Cicuttin
- General, Emergency and Trauma Surgery Department, Pisa University Hospital, Pisa, Italy
| | | | - Donald E Fry
- Department of Surgery, Northwestern University Feinberg School of Medicine, Chicago, USA
| | - Xavier Guirao
- Surgical Endocrine Head and Neck Unit, Department of General Surgery, Parc Tauli, Hospital Universitari, Sabadell, Spain
| | - Timothy Craig Hardcastle
- Trauma and Burn Service, Department of Surgery, University of KwaZulu-Natal, Durban, South Africa
| | - Andreas Hecker
- Department of Surgery, University Hospital of Giessen, Giessen, Germany
| | - Ari K Leppäniemi
- Abdominal Surgery, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Andrey Litvin
- Department of Surgical Disciplines, Immanuel Kant Baltic Federal University, Regional Clinic Hospital, Kaliningrad, Russia
| | - Sanjay Marwah
- Department of Surgery, BDS Post-Graduate Institute of Medical Sciences, Rohtak, India
| | - Emilio Maseda
- Surgical Critical Care, Department of Anesthesia, Hospital Valdecilla, Santander, Spain
| | - John E Mazuski
- Department of Surgery, Washington University in Saint Louis, Saint Louis, USA
| | - Ziad Ahmed Memish
- Research and Innovation Center, King Saud Medical City, College of Medicine, Alfaisal University, Riyadh, Kingdom of Saudi Arabia
| | - Andrew W Kirkpatrick
- General, Acute Care, Abdominal Wall Reconstruction, and Trauma Surgery, Foothills Medical Centre, Calgary, Canada
| | - Leonardo Pagani
- Antimicrobial Stewardship Program, Bolzano Central Hospital, Bolzano, Italy
| | - Mauro Podda
- Department of Emergency Surgery, Cagliari University Hospital "D. Casula", AOU Cagliari, Cagliari, Italy
| | | | - Boris E Sakakushev
- General Surgery, UMHAT St George Plovdiv, RIMU/Research Institute at Medical University of Plovdiv, Plovdiv, Bulgaria
| | - Robert G Sawyer
- Department of Surgery, Homer Stryker, M.D., School of Medicine, Western Michigan University, Kalamazoo, USA
| | - Fabio Tumietto
- Infectious Diseases Unit, IRCCS Azienda Ospedaliero Universitaria di Bologna, Bologna, Italy
| | - Yonghong Xiao
- State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | | | | | - Lali Akhmeteli
- Department of Surgery, TSMU First University Clinic, Tbilisi, Georgia
| | - Emrah Akin
- Department of Surgery, Sakarya University Educational and Research Hospital, Sakarya, Turkey
| | | | - Felipe Alconchel
- Department of Surgery and Transplantation, Virgen de La Arrixaca University Hospital, El Palmar, Spain
| | | | - Ana Belén Araúz
- Infectious Diseases Unit, Hospital Santo Tomás, Panama City, Panama
| | - Giulio Argenio
- Emergency Surgery Unit, AOU San Giovanni di Dio e Ruggi d'Aragona, University of Salerno, Salerno, Italy
| | - Boyko C Atanasov
- Department of Surgery, UMHAT Eurohospital Plovdiv, RIMU/Research Institute at Medical University of Plovdiv, Plovdiv, Bulgaria
| | - Semra Demirli Atici
- Department of Surgery, University of Health Sciences Tepecik Training and Research Hospital, Izmir, Turkey
| | - Selmy Sabry Awad
- Department of Trauma and Acute Care Surgery, Mansoura University Hospital, Mansoura University, Mansoura, Egypt
| | - Efstratia Baili
- Second Department of Surgery, IASO General Hospital, Athens, Greece
| | - Lovenish Bains
- Department of Surgery, Maulana Azad Medical College, New Delhi, India
| | - Miklosh Bala
- Department of Surgery, Hadassah Hebrew University Medical Center, Jerusalem, Israel
| | - Oussama Baraket
- Department of Surgery, Department of Surgery, Bizerte Hospital, Tunis El Manar University, Tunis, Tunisia
| | - Suman Baral
- Department of Surgery, Dirghayu Pokhara Hospital, Pokhara, Nepal
| | - Vladislav A Belskii
- Department of Anesthesiology and Intensive Care, Privolzhskiy District Medical Center, Nizhny Novgorod, Russia
| | - Moussa Benboubker
- HAIs Control Committee, HASSAN II University Hospital Fez, Fez, Morocco
| | - Offir Ben-Ishay
- Department of Surgery, Rambam Health Care Campus, Haifa, Israel
| | - Pierpaolo Bordoni
- Department of Surgery, ASST Valtellina e Alto Lario, Sondrio Hospital, Sondrio, Italy
| | | | - Giuseppe Brisinda
- Medical and Surgical Sciences Department, Fondazione Policlinico Universitario "A. Gemelli" IRCCS, Rome, Italy
| | - Laura Cavazzuti
- Medical Directorate, Arcispedale Santa Maria Nuova Hospital, Local Health Authority-IRCSS of Reggio Emilia, Reggio Emilia, Italy
| | - Sujith J Chandy
- Department of Pharmacology and Clinical Pharmacology, Christian Medical College, Vellore, India
| | - Maria Michela Chiarello
- Department of Surgery, Ospedale San Giovanni di Dio, Azienda Sanitaria Provinciale, Crotone, Italy
| | - Nicola Cillara
- Department of Surgery, PO Santissima Trinità ASSL Cagliari, Cagliari, Italy
| | - Guglielmo Clarizia
- Department of Surgery, ASST Valtellina e Alto Lario, Sondrio Hospital, Sondrio, Italy
| | - Maria-Elena Cocuz
- Faculty of Medicine, University Transilvania of Brasov, Brasov, Romania
| | - Iuliu Gabriel Cocuz
- Pathophysiology Department, George Emil Palade University of Medicine, Pharmacy, Sciences and Technology, George Emil Palade of Targu Mures, Targu Mures, Romania
| | - Luigi Conti
- Department of Surgery, Ospedale G. Da Saliceto, AUSL Piacenza, Piacenza, Italy
| | | | - Yunfeng Cui
- Department of Surgery, Tianjin Nankai Hospital, Nankai Clinical School of Medicine, Tianjin Medical University, Tianjin, China
| | - Jacek Czepiel
- Department of Infectious and Tropical Diseases, Jagiellonian University Medical College, Krakaw, Poland
| | - Fabrizio D'Acapito
- Department of Surgery, Forlì Morgagni-Pierantoni Hospital, AUSL Romagna, Forlì, Italy
| | | | - Koray Das
- Department of Surgery, University of Health Sciences, Adana City Training and Research Hospital, Adana, Turkey
| | - Belinda De Simone
- Emergency and Metabolic Minimally Invasive Surgery, Poissy-Saint-Germain-en-Laye Hospital, Yvelines, France
| | - Samir Delibegovic
- Department of Surgery, University Clinical Center Tuzla, Tuzla, Bosnia and Herzegovina
| | - Zaza Demetrashvili
- Department of Surgery, Kipshidze Central University Hospital, Tbilisi, Georgia
| | - Dzemail S Detanac
- Department of Surgery, General Hospital Novi Pazar, Novi Pazar, Serbia
| | - Sameer Dhingra
- Department of Pharmacy Practice, National Institute of Pharmaceutical Education and Research (NIPER), Hajipur, Bihar, India
| | - Stefano Di Bella
- Clinical Department of Medical, Surgical and Health Sciences, Trieste University, Trieste, Italy
| | - Evgeni N Dimitrov
- Department of Surgical Diseases, University Hospital "Prof. Dr. Stoyan Kirkovich", Stara Zagora, Bulgaria
| | - Agron Dogjani
- Department of Surgery, University of Medicine of Tirana, Tirana, Albania
| | - Mario D'Oria
- Division of Vascular and Endovascular Surgery, Cardiovascular Department, University Hospital of Trieste, Trieste, Italy
| | | | | | - Octavian Enciu
- Department of Surgery, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
| | - Massimo Fantoni
- Dipartimento Di Scienze Di Laboratorio E Infettivologiche, Fondazione Policlinico Gemelli IRCCS, Rome, Italy
| | - Daniela Filipescu
- Cardiac Anaesthesia and Intensive Care 2, Emergency Institute of Cardiovascular Diseases, University of Medicine and Pharmacy Carol Davila, Bucharest, Romania
| | - Francesco Fleres
- Department of Surgery, ASST Valtellina e Alto Lario, Sondrio Hospital, Sondrio, Italy
| | | | - Pietro Fransvea
- Medical and Surgical Sciences Department, Fondazione Policlinico Universitario "A. Gemelli" IRCCS, Rome, Italy
| | - Mahir Gachabayov
- Department of Abdominal Surgery, Vladimir City Emergency Hospital, Vladimir, Russia
| | - Rita Galeiras
- Critical Care Unit, Complexo Hospitalario Universitario, La Coruna, Spain
| | - Gianni Gattuso
- Department of Infectious Diseases, Carlo Poma" Hospital ASST, Mantova, Italy
| | - Wagih M Ghannam
- Department of Surgery, Mansoura Faculty of Medicine, Mansoura, Egypt
| | - Valeria Ghisetti
- Laboratory of Microbiology and Virology, Amedeo di Savoia Hospital and ASL Città di Torino, Turin, Italy
| | - Giorgio Giraudo
- Department of Surgery, Aso Santa Croce e Carle, Cuneo, Italy
| | - Kebebe Bekele Gonfa
- Department of Surgery, Madda Walabu University Goba Referral Hospital, Bala-Robe, Ethiopia
| | - Emre Gonullu
- Department of Surgery, Sakarya University, Adapazarı, Turkey
| | | | - Matthias Hecker
- Medical Clinic II, University Hospital Giessen, Glessen, Germany
| | - Arda Isik
- Department of Surgery, Istanbul Medeniyet University, Istanbul, Turkey
| | - Nizar Ismail
- Trauma and Orthopaedics, Stoke Mandeville Hospital, Aylesbury, UK
| | - Azzain Ismail
- Trauma and Orthopaedics Woodend Hospital, Aberdeen, UK
| | | | - Souha S Kanj
- Infectious Diseases Division, American University of Beirut Medical Center, Beirut, Lebanon
| | - Garima Kapoor
- Department of Microbiology, Gandhi Medical College, Bhopal, India
| | - Ilias Karaiskos
- 1St Department of Internal Medicine-Infectious Diseases, Hygeia Hospital, Marousi, Greece
| | - Alfie J Kavalakat
- Department of Surgery, Jubilee Mission Medical College and RI, Thrissur, India
| | - Jakub Kenig
- Department of General Surgery, Jagiellonian University Medical College, Kraków, Poland
| | - Faryal Khamis
- Infectious Diseases and Internal Medicine Department, Royal Hospital, Muscat, Oman
| | - Vladimir Khokha
- Department of Emergency Surgery, City Hospital, Mozyr, Belarus
| | - Ronald Kiguba
- Pharmacology and Therapeutics, College of Health Sciences, Makerere University, Kampala, Uganda
| | - Jae Il Kim
- Department of Surgery, Inje University Ilsan Paik Hospital, Goyang, South Korea
| | - Yoshiro Kobe
- Department of Surgery, Chiba Emergency Medical Center, Chiba, Japan
| | - Kenneth Yuh Yen Kok
- Discipline of Medicine, Pengiran Anak Puteri Rashidah Sa'adatul Bolkiah Institute of Health Sciences, Brunei Darussalam University, Darussalam, Brunei
| | | | | | - Akira Kuriyama
- Emergency and Critical Care Center, Kurashiki Central Hospital, Kurashiki, Japan
| | | | | | - Varut Lohsiriwat
- Department of Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | | | - Davide Luppi
- Department of Surgery, ASMN IRCCS, Reggio Emilia, Italy
| | - Gustavo Miguel Machain Vega
- General Surgery, Universidad Nacional de Asunción-Facultad de Ciencias Medicas, Hospital de Clínicas, Asuncion, Paraguay
| | - Marc Maegele
- Department of Trauma and Orthopedic Surgery, Cologne-Merheim Medical Center (CMMC), University Witten/Herdecke, Cologne, Germany
| | | | - Gennaro Martines
- Department of Surgery, Azienda Ospedaliero Universitaria Policlinico, Bari, Italy
| | - Aleix Martínez-Pérez
- Department of General and Digestive Surgery, Hospital Universitario Doctor Peset, Valencia, Spain
| | - Damien Massalou
- Acute Care Surgery, Centre Hospitalier Universitaire de Nice, Nice University Hospital, Nice, France
| | - Cristian Mesina
- Department of Surgery, Emergency County Hospital of Craiova, Craiova, Romania
| | - Gökhan Metan
- Infectious Diseases and Clinical Microbiology, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - María Guadalupe Miranda-Novales
- Infectious Diseases Department, Paediatric Hospital, Analysis and Synthesis Research Unit, Social Security Mexican Institute, Mexico City, Mexico
| | - Shyam Kumar Mishra
- Clinical Microbiology, Tribhuvan University Teaching Hospital, Institute of Medicine, Kathmandu, Nepal
| | | | | | - Ismael Mora-Guzmán
- Department of Surgery, Hospital General La Mancha Centro, Alcazar de San Juan, Spain
| | - Francesk Mulita
- Department of Surgery, General University Hospital of Patras, Rio, Greece
| | - Ana-Maria Musina
- Department of Surgery, University of Medicine and Pharmacy Grigore T Popa, Iasi, Romania
| | - Pradeep H Navsaria
- Trauma Centre, Groote Schuur Hospital and University of Cape Town, Cape Town, South Africa
| | - Ionut Negoi
- Department of Surgery, Emergency Hospital of Bucharest, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
| | | | | | | | - Desiré Pantalone
- Emergency Surgery Department, AOU Careggi-Università di Firenze, Florence, Italy
| | - Arpád Panyko
- IVth Department of Surgery, Faculty of Medicine, Comenius University, Bratislava, Slovakia
| | | | - Nikolaos Pararas
- Surgical Department, Dr. Sulaiman Al Habib Hospital, Alfaisal University, Riyadh, Saudi Arabia
| | - Francesco Pata
- Department of Surgery, Nicola Giannettasio Hospital, Corigliano-Rossano, Italy
| | - Tapan Patel
- Department of Surgery, Baroda Medical College, Vadodara, India
| | - Gianluca Pellino
- Department of Advanced Medical and Surgical Sciences, Università degli Studi della Campania "Luigi Vanvitelli", Naples, Italy
| | - Teresa Perra
- Department of Medical, Surgical and Experimental Sciences, University of Sassari, Azienda Ospedaliero Universitaria di Sassari, Sassari, Italy
| | - Gennaro Perrone
- Department of Emergency Surgery, Parma University Hospital, Parma, Italy
| | - Antonio Pesce
- Department of Surgery, Azienda USL of Ferrara-University of Ferrara, Ferrara, Italy
| | - Tadeja Pintar
- Abdominal Surgery Department, UMC Ljubljana, Ljubljana, Slovenia
| | | | - Alberto Porcu
- Department of Medical, Surgical and Experimental Sciences, University of Sassari, Azienda Ospedaliero Universitaria di Sassari, Sassari, Italy
| | | | - Razrim Rahim
- Department of Surgery, Universiti Sains Islam Malaysia, Nilai, Malaysia
| | - Ashrarur Rahman Mitul
- Unit of Pediatric Surgery, Bangladesh Shishu Hospital and Institute, Dhaka, Bangladesh
| | - Martin Reichert
- Department of Surgery, University Hospital of Giessen, Giessen, Germany
| | - Miran Rems
- Department for General and Abdominal Surgery, General Hospital Jesenice, Jesenice, Slovenia
| | | | | | - Gabriel Rodrigues
- Department of Surgery, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, India
| | - Gustavo Eduardo Roncancio Villamil
- Department of Medicine, Division of Infectious Diseases, Universidad Pontificia Bolivariana, Medellín, Colombia
- Research Group on Cardiovascular and Pulmonary Diseases, Clínica Cardio VID, Medellín, Colombia
| | - Stefano Rossi
- Emergency Surgery Department, San Filippo Neri Hospital, Rome, Italy
| | - Ibrahima Sall
- Department of Surgery, Military Teaching Hospital, Hôpital Principal de Dakar, Dakar, Senegal
| | - Hossein Samadi Kafil
- Drug Applied Research Center, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Diego Sasia
- Department of Surgery, Aso Santa Croce e Carle, Cuneo, Italy
| | - Jeremiah Seni
- Department of Microbiology and Immunology, Weill Bugando School of Medicine, Catholic University of Health and Allied Sciences, Mwanza, Tanzania
| | | | - Mario Serradilla-Martín
- Department of Surgery, Instituto de Investigación Sanitaria Aragón, Miguel Servet University Hospital, Zaragoza, Spain
| | - Vishal G Shelat
- Department of Surgery, Tan Tock Seng Hospital, Novena, Singapore
| | | | - Mihail Slavchev
- Department of Surgery, University Hospital Eurohospital, Plovdiv, Bulgaria
| | - Leonardo Solaini
- Department of Medical and Surgical Sciences, University of Bologna, Forlì, Italy
| | - Boun Kim Tan
- Infection Prevention and Control Unit, Centre des Massues, French Red Cross, Lyon, France
| | - Antonio Tarasconi
- Department of Emergency Surgery, Parma University Hospital, Parma, Italy
| | - Dario Tartaglia
- General, Emergency and Trauma Surgery Department, Pisa University Hospital, Pisa, Italy
| | - Elena Adelina Toma
- Department of Surgery, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
| | - Gia Tomadze
- Department of Surgery, Tbilisi State Medical University, Tbilisi, Georgia
| | - Adriana Toro
- Department of General Surgery, E. Muscatello Augusta Hospital, Augusta, Italy
| | - Marcos Roberto Tovani-Palone
- Department of Pathology and Legal Medicine, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil
| | - Harry van Goor
- Department of Surgery, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Alin Vasilescu
- Department of Surgery, St. Spiridon University Hospital "Grigore T Popa" University of Medicine and Pharmacy, Iasi, Romania
| | - Andras Vereczkei
- Department of Surgery, Medical Center University of Pécs, Pécs, Hungary
| | - Massimiliano Veroux
- Department of Medical and Surgical Sciences and Advanced Technologies, University of Catania, Catania, Italy
| | | | - Lukas Werner Widmer
- Department of Visceral Surgery and Medicine, Bern University Hospital, Bern, Switzerland
| | | | - Sanoop K Zachariah
- Department of Surgery, Kerala Institute of Medical Sciences, Thiruvananthapuram, Kerala, India
| | - Andee Dzulkarnaen Zakaria
- Department of Surgery, School of Medical Sciences and University Hospital Sains Malaysia, Sains Malaysia University, Penang, Malaysia
| | - Nadezhda Zubareva
- Department of General Surgery, Perm State Medical University N.a. Academician E.A. Wagner, Perm, Russia
| | - Wietse P Zuidema
- Department of Surgery, Amsterdam University Medical Center, Amsterdam, The Netherlands
| | - Isidoro Di Carlo
- Department of Medical and Surgical Sciences and Advanced Technologies, University of Catania, Catania, Italy
| | - Francesco Cortese
- Emergency Surgery Department, San Filippo Neri Hospital, ASL Roma 1, Rome, Italy
| | - Gian Luca Baiocchi
- Department of Surgery, AAST Cremona, Cremona, Italy
- Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
| | - Ronald V Maier
- Harborview Medical Center, Department of Surgery, University of Washington, Seattle, WA, USA
| | - Fausto Catena
- Department of Surgery, Bufalini" Hospital, Cesena, Italy
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21
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Sartelli M, Coccolini F, Kluger Y, Agastra E, Abu-Zidan FM, Abbas AES, Ansaloni L, Adesunkanmi AK, Augustin G, Bala M, Baraket O, Biffl WL, Ceresoli M, Cerutti E, Chiara O, Cicuttin E, Chiarugi M, Coimbra R, Corsi D, Cortese F, Cui Y, Damaskos D, de’Angelis N, Delibegovic S, Demetrashvili Z, De Simone B, de Jonge SW, Di Bella S, Di Saverio S, Duane TM, Fugazzola P, Galante JM, Ghnnam W, Gkiokas G, Gomes CA, Griffiths EA, Hardcastle TC, Hecker A, Herzog T, Karamarkovic A, Khokha V, Kim PK, Kim JI, Kirkpatrick AW, Kong V, Koshy RM, Inaba K, Isik A, Ivatury R, Labricciosa FM, Lee YY, Leppäniemi A, Litvin A, Luppi D, Maier RV, Marinis A, Marwah S, Mesina C, Moore EE, Moore FA, Negoi I, Olaoye I, Ordoñez CA, Ouadii M, Peitzman AB, Perrone G, Pintar T, Pipitone G, Podda M, Raşa K, Ribeiro J, Rodrigues G, Rubio-Perez I, Sall I, Sato N, Sawyer RG, Shelat VG, Sugrue M, Tarasconi A, Tolonen M, Viaggi B, Celotti A, Casella C, Pagani L, Dhingra S, Baiocchi GL, Catena F. WSES/GAIS/WSIS/SIS-E/AAST global clinical pathways for patients with skin and soft tissue infections. World J Emerg Surg 2022; 17:3. [PMID: 35033131 PMCID: PMC8761341 DOI: 10.1186/s13017-022-00406-2] [Citation(s) in RCA: 26] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2021] [Accepted: 01/04/2022] [Indexed: 02/08/2023] Open
Abstract
Skin and soft-tissue infections (SSTIs) encompass a variety of pathological conditions that involve the skin and underlying subcutaneous tissue, fascia, or muscle, ranging from simple superficial infections to severe necrotizing infections. Together, the World Society of Emergency Surgery, the Global Alliance for Infections in Surgery, the Surgical Infection Society-Europe, The World Surgical Infection Society, and the American Association for the Surgery of Trauma have jointly completed an international multi-society document to promote global standards of care in SSTIs guiding clinicians by describing reasonable approaches to the management of SSTIs. An extensive non-systematic review was conducted using the PubMed and MEDLINE databases, limited to the English language. The resulting evidence was shared by an international task force with different clinical backgrounds.
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Affiliation(s)
| | - Federico Coccolini
- grid.144189.10000 0004 1756 8209Department of General, Emergency and Trauma Surgery, Pisa University Hospital, Pisa, Italy
| | - Yoram Kluger
- grid.413731.30000 0000 9950 8111Department of General Surgery, Rambam Health Care Campus, Haifa, Israel
| | - Ervis Agastra
- General Surgery Department, Regional Hospital of Durres, Durres, Albania
| | - Fikri M. Abu-Zidan
- grid.43519.3a0000 0001 2193 6666Department of Surgery, College of Medicine and Health Sciences, UAE University, Al-Ain, United Arab Emirates
| | - Ashraf El Sayed Abbas
- grid.469958.fDepartment of General and Emergency Surgery Faculty of Medicine, Mansoura University Hospital, Mansoura, Egypt
| | - Luca Ansaloni
- grid.8982.b0000 0004 1762 5736Department of Surgery, Fondazione IRCCS Policlinico San Matteo, University of Pavia, Pavia, Italy
| | - Abdulrashid Kayode Adesunkanmi
- grid.10824.3f0000 0001 2183 9444Department of Surgery, Faculty of Clinical Sciences, College of Health Sciences, Obafemi Awolowo University, Ile-Ife, Osun State Nigeria
| | - Goran Augustin
- grid.412688.10000 0004 0397 9648Department of Surgery, University Hospital Centre Zagreb, Zagreb, Croatia
| | - Miklosh Bala
- grid.17788.310000 0001 2221 2926Trauma and Acute Care Surgery Unit, Hadassah Hebrew University Medical Center, Jerusalem, Israel
| | - Oussama Baraket
- grid.12574.350000000122959819Department of General Surgery Bizerte Hospital, Faculty of Medicine of Tunis, University Tunis El Manar, Tunis, Tunisia
| | - Walter L. Biffl
- grid.415401.5Division of Trauma/Acute Care Surgery, Scripps Clinic Medical Group, La Jolla, CA USA
| | - Marco Ceresoli
- grid.7563.70000 0001 2174 1754Emergency and General Surgery Department, University of Milan-Bicocca, Milan, Italy
| | - Elisabetta Cerutti
- grid.415845.9Anesthesia and Transplant Surgical Intensive Care Unit, Ospedali Riuniti, Ancona, Italy
| | - Osvaldo Chiara
- grid.4708.b0000 0004 1757 2822Department of Pathophysiology, ASST Niguarda Ca’Granda Hospital, University of Milano, Milan, Italy
| | - Enrico Cicuttin
- grid.144189.10000 0004 1756 8209Department of General, Emergency and Trauma Surgery, Pisa University Hospital, Pisa, Italy
| | - Massimo Chiarugi
- grid.144189.10000 0004 1756 8209Department of General, Emergency and Trauma Surgery, Pisa University Hospital, Pisa, Italy
| | - Raul Coimbra
- grid.43582.380000 0000 9852 649XRiverside University Health System, CECORC Research Center, Loma Linda University, Loma Linda, USA
| | - Daniela Corsi
- General Direction, Area Vasta 3, ASUR Marche, Macerata, Italy
| | | | - Yunfeng Cui
- grid.265021.20000 0000 9792 1228Department of Surgery, Tianjin Nankai Hospital, Nankai Clinical School of Medicine, Tianjin Medical University, Tianjin, China
| | - Dimitris Damaskos
- grid.418716.d0000 0001 0709 1919Department of Surgery, Royal Infirmary of Edinburgh, Edinburgh, UK
| | - Nicola de’Angelis
- Minimally Invasive and Robotic Digestive Surgery Unit, Regional General Hospital F. Miulli, Bari, Italy
- grid.410511.00000 0001 2149 7878Université Paris Est, UPEC, Creteil, France
| | - Samir Delibegovic
- grid.412410.20000 0001 0682 9061Department of Surgery, University Clinical Center of Tuzla, Tuzla, Bosnia and Herzegovina
| | - Zaza Demetrashvili
- Department General Surgery, Kipshidze Central University Hospital, Tbilisi, Georgia
| | - Belinda De Simone
- grid.418056.e0000 0004 1765 2558Department of General, Digestive and Metabolic Minimally Invasive Surgery, Centre Hospitalier Intercommunal De Poissy/St Germain en Laye, Poissy, France
| | - Stijn W. de Jonge
- grid.7177.60000000084992262Department of Surgery, Academic Medical Center, University of Amsterdam, Amsterdam, Netherlands
| | - Stefano Di Bella
- grid.5133.40000 0001 1941 4308Clinical Department of Medical, Surgical and Health Sciences, Trieste University, Trieste, Italy
| | - Salomone Di Saverio
- Department of General Surgery, “Madonna del Soccorso” San Benedetto del Tronto Hospital, San Benedetto del Tronto, Italy
| | - Therese M. Duane
- grid.429044.f0000 0004 0402 1407Department of Surgery, Texas Health Resources, Ft Worth, TX USA
| | - Paola Fugazzola
- grid.8982.b0000 0004 1762 5736Department of Surgery, Fondazione IRCCS Policlinico San Matteo, University of Pavia, Pavia, Italy
| | - Joseph M. Galante
- grid.27860.3b0000 0004 1936 9684Division of Trauma and Acute Care Surgery, Department of Surgery, University of California Davis, Sacramento, CA USA
| | - Wagih Ghnnam
- grid.10251.370000000103426662Department of General Surgery, Mansoura Faculty of Medicine, Mansoura University, Mansoura, Egypt
| | - George Gkiokas
- grid.5216.00000 0001 2155 0800Second Department of Surgery, Aretaieion University Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Carlos Augusto Gomes
- Department of Surgery, Hospital Universitário Terezinha de Jesus, Faculdade de Ciências Médicas E da Saúde de Juiz de Fora, Juiz de Fora, Brazil
| | - Ewen A. Griffiths
- grid.415490.d0000 0001 2177 007XDepartment of Upper GI Surgery, Queen Elizabeth Hospital, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
| | - Timothy C. Hardcastle
- Trauma Service, Inkosi Albert Luthuli Central Hospital and Department of Surgery, Nelson R Mandela School of Clinical Medicine, Durban, South Africa
| | - Andreas Hecker
- grid.411067.50000 0000 8584 9230Department of General and Thoracic Surgery, University Hospital Giessen, Giessen, Germany
| | - Torsten Herzog
- grid.416438.cDepartment of Surgery, St. Josef Hospital, Ruhr University Bochum, Bochum, Germany
| | - Aleksandar Karamarkovic
- grid.7149.b0000 0001 2166 9385Surgical Clinic “Nikola Spasic”, Faculty of Medicine University of Belgrade, Belgrade, Serbia
| | - Vladimir Khokha
- Department of Emergency Surgery, City Hospital, Mozyr, Belarus
| | - Peter K. Kim
- grid.251993.50000000121791997Department of Surgery, Jacobi Medical Center, Albert Einstein College of Medicine, Bronx, NY USA
| | - Jae Il Kim
- grid.411633.20000 0004 0371 8173Department of Surgery, Ilsan Paik Hospital, Inje University College of Medicine, Goyang, Republic of Korea
| | - Andrew W. Kirkpatrick
- grid.414959.40000 0004 0469 2139General, Acute Care, Abdominal Wall Reconstruction, and Trauma Surgery, Foothills Medical Centre, Calgary, AB Canada
| | - Victor Kong
- grid.414386.c0000 0004 0576 7753Department of Surgery, Edendale Hospital, Pietermaritzburg, South Africa
| | - Renol M. Koshy
- grid.412570.50000 0004 0400 5079Department of General Surgery, University Hospital of Coventry and Warwickshire, Coventry, UK
| | - Kenji Inaba
- grid.42505.360000 0001 2156 6853Division of Trauma and Surgical Critical Care, Department of Surgery, University of Southern California, Los Angeles, CA USA
| | - Arda Isik
- grid.411776.20000 0004 0454 921XDepartment of General Surgery, School of Medicine, Istanbul Medeniyet University, Istanbul, Turkey
| | - Rao Ivatury
- grid.224260.00000 0004 0458 8737Department of Surgery, Virginia Commonwealth University School of Medicine, Richmond, VA USA
| | | | - Yeong Yeh Lee
- grid.11875.3a0000 0001 2294 3534School of Medical Sciences, Universitiy Sains Malaysia, Kota Bharu, Kelantan Malaysia
| | - Ari Leppäniemi
- grid.15485.3d0000 0000 9950 5666Abdominal Center, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Andrey Litvin
- grid.410686.d0000 0001 1018 9204Department of Surgical Disciplines, Immanuel Kant Baltic Federal University, Regional Clinical Hospital, Kaliningrad, Russia
| | - Davide Luppi
- Department of General and Emergency Surgery, ASMN, Reggio Emilia, Italy
| | - Ronald V. Maier
- grid.34477.330000000122986657Department of Surgery, University of Washington, Seattle, WA USA
| | - Athanasios Marinis
- grid.417374.2First Department of Surgery, Tzaneion General Hospital, Piraeus, Greece
| | - Sanjay Marwah
- grid.412572.70000 0004 1771 1642Department of Surgery, Post-Graduate Institute of Medical Sciences, Rohtak, India
| | - Cristian Mesina
- Second Surgical Clinic, Emergency Hospital of Craiova, Craiova, Romania
| | - Ernest E. Moore
- grid.239638.50000 0001 0369 638XErnest E Moore Shock Trauma Center at Denver Health, Denver, USA
| | - Frederick A. Moore
- grid.15276.370000 0004 1936 8091Department of Surgery, Division of Acute Care Surgery, and Center for Sepsis and Critical Illness Research, University of Florida College of Medicine, Gainesville, FL USA
| | - Ionut Negoi
- Department of Surgery, Emergency Hospital of Bucharest, Bucharest, Romania
| | - Iyiade Olaoye
- grid.412975.c0000 0000 8878 5287Department of Surgery, University of Ilorin Teaching Hospital, Ilorin, Nigeria
| | - Carlos A. Ordoñez
- grid.477264.4Division of Trauma and Acute Care Surgery, Fundacion Valle del Lili, Cali, Colombia
- grid.8271.c0000 0001 2295 7397Department of Surgery, Universidad del Valle, Cali, Colombia
| | - Mouaqit Ouadii
- grid.412817.90000 0004 5938 8644Department of Surgery, Hassan II University Hospital, Medical School of Fez, Sidi Mohamed Benabdellah University, Fez, Morocco
| | - Andrew B. Peitzman
- grid.21925.3d0000 0004 1936 9000Department of Surgery, University of Pittsburgh School of Medicine, UPMC-Presbyterian, Pittsburgh, USA
| | - Gennaro Perrone
- Department of Emergency Surgery, Parma Maggiore Hospital, Parma, Italy
| | - Tadeja Pintar
- grid.29524.380000 0004 0571 7705Department of Surgery, UMC Ljubljana, Ljubljana, Slovenia
| | - Giuseppe Pipitone
- grid.419995.9Department of Internal Medicine, Division of Infectious Disease, ARNAS Civico-Di Cristina Hospital, Palermo, Italy
| | - Mauro Podda
- grid.7763.50000 0004 1755 3242Department of General and Emergency Surgery, Cagliari University Hospital, Cagliari, Italy
| | - Kemal Raşa
- Department of Surgery, Anadolu Medical Center, Kocaeli, Turkey
| | - Julival Ribeiro
- grid.414433.5Infection Control, Hospital de Base, Brasília, DF Brazil
| | - Gabriel Rodrigues
- grid.411639.80000 0001 0571 5193Department of General Surgery, Kasturba Medical College and Hospital, Manipal Academy of Higher Education, Manipal, India
| | - Ines Rubio-Perez
- grid.81821.320000 0000 8970 9163General Surgery Department, Colorectal Surgery Unit, La Paz University Hospital, Madrid, Spain
| | - Ibrahima Sall
- General Surgery Department, Military Teaching Hospital, Dakar, Senegal
| | - Norio Sato
- grid.255464.40000 0001 1011 3808Department of Aeromedical Services for Emergency and Trauma Care, Ehime University Graduate School of Medicine, Ehime, Japan
| | - Robert G. Sawyer
- grid.268187.20000 0001 0672 1122Department of Surgery, Western Michigan University School of Medicine, Kalamazoo, MI USA
| | - Vishal G. Shelat
- grid.240988.f0000 0001 0298 8161Department of General Surgery, Tan Tock Seng Hospital, Singapore, Singapore
| | - Michael Sugrue
- grid.415900.90000 0004 0617 6488Donegal Clinical Research Academy Emergency Surgery Outcome Project, Letterkenny University Hospital, Donegal, Ireland
| | - Antonio Tarasconi
- Department of Emergency Surgery, Parma Maggiore Hospital, Parma, Italy
| | - Matti Tolonen
- grid.15485.3d0000 0000 9950 5666Abdominal Center, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Bruno Viaggi
- grid.24704.350000 0004 1759 9494Department of Anesthesiology, Neuro Intensive Care Unit, Florence Careggi University Hospital, Florence, Italy
| | | | - Claudio Casella
- grid.7637.50000000417571846Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
| | - Leonardo Pagani
- Department of Infectious Diseases, Bolzano Hospital, Bolzano, Italy
| | - Sameer Dhingra
- grid.464629.b0000 0004 1775 2698Department of Pharmacy Practice, National Institute of Pharmaceutical Education and Research (NIPER), Hajipur, Bihar India
| | - Gian Luca Baiocchi
- Department of Surgery, AAST Cremona, Cremona, Italy
- grid.7637.50000000417571846Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
| | - Fausto Catena
- grid.414682.d0000 0004 1758 8744Department of Surgery, “Bufalini” Hospital, Cesena, Italy
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22
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Agdgomelashvili I, Mosidze B, Merabishvili G, Demetrashvili Z. Comparison of the patient-controlled epidural and intravenous analgesia after open colorectal surgery: A randomized controlled trial. Georgian Med News 2021:19-23. [PMID: 34628372 DOI: pmid/34628372] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
The goal of this study was to evaluate the efficacy of two common analgesic techniques: patient-controlled epidural analgesia (PCEA) and patient-controlled intravenous analgesia (IVPCA) in patients undergoing open colorectal surgeries. 130 patients were randomized in two groups: group I - n=65 (27 males, 38 females, age range 23-75) - whose postoperative period and pain was managed with PCEA; group II - n=65 (31 male, 34 female, age range 23-75) - whose postoperative period and pain was managed with IVPCA. There were no significant differences by demographic and preoperative factors between the groups. The study demonstrates, that both analgesia techniques in colorectal surgery patients, IVPCA and PCEA, resulted in high levels of satisfaction (as reflected by a median score of 4 on the 1-5 scale), and provided effective management of postoperative pain. There were no differences in the pain scores on the postoperative visual analogue scales, analgesic requirements and satisfaction score between groups. This indicates that IVPCA and Epidural PCA are equally effective to control the postoperative pain after open colorectal surgery.
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Affiliation(s)
- I Agdgomelashvili
- Tbilisi State Medical University; High Technology Medical Center, University Clinic, Georgia
| | - B Mosidze
- Tbilisi State Medical University; High Technology Medical Center, University Clinic, Georgia
| | - G Merabishvili
- Tbilisi State Medical University; High Technology Medical Center, University Clinic, Georgia
| | - Z Demetrashvili
- Tbilisi State Medical University; High Technology Medical Center, University Clinic, Georgia
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23
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COVIDSurg Collaborative, GlobalSurg Collaborative. SARS-CoV-2 vaccination modelling for safe surgery to save lives: data from an international prospective cohort study. Br J Surg 2021; 108:1056-63. [PMID: 33761533 DOI: 10.1093/bjs/znab101] [Citation(s) in RCA: 155] [Impact Index Per Article: 51.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2021] [Accepted: 02/12/2021] [Indexed: 02/07/2023] [Imported: 10/13/2023]
Abstract
BACKGROUND Preoperative SARS-CoV-2 vaccination could support safer elective surgery. Vaccine numbers are limited so this study aimed to inform their prioritization by modelling. METHODS The primary outcome was the number needed to vaccinate (NNV) to prevent one COVID-19-related death in 1 year. NNVs were based on postoperative SARS-CoV-2 rates and mortality in an international cohort study (surgical patients), and community SARS-CoV-2 incidence and case fatality data (general population). NNV estimates were stratified by age (18-49, 50-69, 70 or more years) and type of surgery. Best- and worst-case scenarios were used to describe uncertainty. RESULTS NNVs were more favourable in surgical patients than the general population. The most favourable NNVs were in patients aged 70 years or more needing cancer surgery (351; best case 196, worst case 816) or non-cancer surgery (733; best case 407, worst case 1664). Both exceeded the NNV in the general population (1840; best case 1196, worst case 3066). NNVs for surgical patients remained favourable at a range of SARS-CoV-2 incidence rates in sensitivity analysis modelling. Globally, prioritizing preoperative vaccination of patients needing elective surgery ahead of the general population could prevent an additional 58 687 (best case 115 007, worst case 20 177) COVID-19-related deaths in 1 year. CONCLUSION As global roll out of SARS-CoV-2 vaccination proceeds, patients needing elective surgery should be prioritized ahead of the general population.
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24
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Sartelli M, Coccolini F, Kluger Y, Agastra E, Abu-Zidan FM, Abbas AES, Ansaloni L, Adesunkanmi AK, Atanasov B, Augustin G, Bala M, Baraket O, Baral S, Biffl WL, Boermeester MA, Ceresoli M, Cerutti E, Chiara O, Cicuttin E, Chiarugi M, Coimbra R, Colak E, Corsi D, Cortese F, Cui Y, Damaskos D, de’ Angelis N, Delibegovic S, Demetrashvili Z, De Simone B, de Jonge SW, Dhingra S, Di Bella S, Di Marzo F, Di Saverio S, Dogjani A, Duane TM, Enani MA, Fugazzola P, Galante JM, Gachabayov M, Ghnnam W, Gkiokas G, Gomes CA, Griffiths EA, Hardcastle TC, Hecker A, Herzog T, Kabir SMU, Karamarkovic A, Khokha V, Kim PK, Kim JI, Kirkpatrick AW, Kong V, Koshy RM, Kryvoruchko IA, Inaba K, Isik A, Iskandar K, Ivatury R, Labricciosa FM, Lee YY, Leppäniemi A, Litvin A, Luppi D, Machain GM, Maier RV, Marinis A, Marmorale C, Marwah S, Mesina C, Moore EE, Moore FA, Negoi I, Olaoye I, Ordoñez CA, Ouadii M, Peitzman AB, Perrone G, Pikoulis M, Pintar T, Pipitone G, Podda M, Raşa K, Ribeiro J, Rodrigues G, Rubio-Perez I, Sall I, Sato N, Sawyer RG, Segovia Lohse H, Sganga G, Shelat VG, Stephens I, Sugrue M, Tarasconi A, Tochie JN, Tolonen M, Tomadze G, Ulrych J, Vereczkei A, Viaggi B, Gurioli C, Casella C, Pagani L, Baiocchi GL, Catena F. WSES/GAIS/SIS-E/WSIS/AAST global clinical pathways for patients with intra-abdominal infections. World J Emerg Surg 2021; 16:49. [PMID: 34563232 PMCID: PMC8467193 DOI: 10.1186/s13017-021-00387-8] [Citation(s) in RCA: 37] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2021] [Accepted: 08/05/2021] [Indexed: 02/08/2023] Open
Abstract
Intra-abdominal infections (IAIs) are common surgical emergencies and have been reported as major contributors to non-trauma deaths in hospitals worldwide. The cornerstones of effective treatment of IAIs include early recognition, adequate source control, appropriate antimicrobial therapy, and prompt physiologic stabilization using a critical care environment, combined with an optimal surgical approach. Together, the World Society of Emergency Surgery (WSES), the Global Alliance for Infections in Surgery (GAIS), the Surgical Infection Society-Europe (SIS-E), the World Surgical Infection Society (WSIS), and the American Association for the Surgery of Trauma (AAST) have jointly completed an international multi-society document in order to facilitate clinical management of patients with IAIs worldwide building evidence-based clinical pathways for the most common IAIs. An extensive non-systematic review was conducted using the PubMed and MEDLINE databases, limited to the English language. The resulting information was shared by an international task force from 46 countries with different clinical backgrounds. The aim of the document is to promote global standards of care in IAIs providing guidance to clinicians by describing reasonable approaches to the management of IAIs.
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Affiliation(s)
- Massimo Sartelli
- Department of Surgery Department of Surgery, Macerata Hospital, Macerata, Italy
| | - Federico Coccolini
- grid.144189.10000 0004 1756 8209Department of General, Emergency and Trauma Surgery, Pisa University Hospital, Pisa, Italy
| | - Yoram Kluger
- grid.413731.30000 0000 9950 8111Department of General Surgery, Rambam Health Care Campus, Haifa, Israel
| | - Ervis Agastra
- General Surgery Department, Regional Hospital of Durres, Durres, Albania
| | - Fikri M. Abu-Zidan
- grid.43519.3a0000 0001 2193 6666Department of Surgery, College of Medicine and Health Sciences, UAE University, Al-Ain, United Arab Emirates
| | - Ashraf El Sayed Abbas
- grid.469958.fDepartment of General and Emergency Surgery Faculty of Medicine, Mansoura University Hospital, Mansoura, Egypt
| | - Luca Ansaloni
- grid.8982.b0000 0004 1762 5736Department of Surgery, Fondazione IRCCS Policlinico San Matteo, University of Pavia, Pavia, Italy
| | - Abdulrashid Kayode Adesunkanmi
- grid.10824.3f0000 0001 2183 9444Department of Surgery, Faculty of Clinical Sciences, College of Health Sciences, Obafemi Awolowo University, Osun State, Ile-Ife, Nigeria
| | - Boyko Atanasov
- grid.35371.330000 0001 0726 0380Department of General Surgery, Medical University of Plovdiv, UMHAT Eurohospital, Plovdiv, Bulgaria
| | - Goran Augustin
- grid.412688.10000 0004 0397 9648Department of Surgery, University Hospital Centre Zagreb, Zagreb, Croatia
| | - Miklosh Bala
- grid.17788.310000 0001 2221 2926Trauma and Acute Care Surgery Unit, Hadassah Hebrew University Medical Center, Jerusalem, Israel
| | - Oussama Baraket
- grid.12574.350000000122959819Department of general surgery Bizerte hospital, Faculty of Medicine of Tunis, University Tunis El Manar, Tunis, Tunisia
| | - Suman Baral
- Department of Surgery, Lumbini Medical College and Teaching Hospital Ltd., Palpa, Tansen, Nepal
| | - Walter L. Biffl
- grid.415401.5Division of Trauma/Acute Care Surgery, Scripps Clinic Medical Group, La Jolla, CA USA
| | - Marja A. Boermeester
- grid.509540.d0000 0004 6880 3010Department of Surgery, Amsterdam University Medical Centers, location AMC, Amsterdam Gastroenterology Endocrinology Metabolism Research Institute, Amsterdam, The Netherlands
| | - Marco Ceresoli
- grid.7563.70000 0001 2174 1754Emergency and General Surgery Department, University of Milan-Bicocca, Milan, Italy
| | - Elisabetta Cerutti
- grid.415845.9Anesthesia and Transplant Surgical Intensive Care Unit, Ospedali Riuniti, Ancona, Italy
| | - Osvaldo Chiara
- grid.416200.1Emergency Department, Niguarda Ca’Granda Hospital, Milan, Italy
| | - Enrico Cicuttin
- grid.144189.10000 0004 1756 8209Department of General, Emergency and Trauma Surgery, Pisa University Hospital, Pisa, Italy
| | - Massimo Chiarugi
- grid.144189.10000 0004 1756 8209Department of General, Emergency and Trauma Surgery, Pisa University Hospital, Pisa, Italy
| | - Raul Coimbra
- grid.43582.380000 0000 9852 649XRiverside University Health System, CECORC Research Center, Loma Linda University, Loma Linda, USA
| | - Elif Colak
- Department of General Surgery, Health Sciences University, Samsun Training and Research Hospital, Samsun, Turkey
| | - Daniela Corsi
- General Direction, Area Vasta 3, ASUR Marche, Macerata, Italy
| | | | - Yunfeng Cui
- grid.265021.20000 0000 9792 1228Department of Surgery, Tianjin Nankai Hospital, Nankai Clinical School of Medicine, Tianjin Medical University, Tianjin, China
| | - Dimitris Damaskos
- grid.418716.d0000 0001 0709 1919Department of Surgery, Royal Infirmary of Edinburgh, Edinburgh, UK
| | - Nicola de’ Angelis
- Minimally Invasive and Robotic Digestive Surgery Unit, Regional General Hospital F. Miulli, Bari, Italy
- grid.410511.00000 0001 2149 7878Université Paris Est, UPEC, Creteil, France
| | - Samir Delibegovic
- grid.412410.20000 0001 0682 9061Department of Surgery, University Clinical Center of Tuzla, Tuzla, Bosnia and Herzegovina
| | - Zaza Demetrashvili
- Department General Surgery, Kipshidze Central University Hospital, Tbilisi, Georgia
| | - Belinda De Simone
- grid.418056.e0000 0004 1765 2558Department of general, Digestive and Metabolic Minimally Invasive Surgery, Centre Hospitalier Intercommunal De Poissy/St Germain en Laye, Poissy, France
| | - Stijn W. de Jonge
- grid.415401.5Division of Trauma/Acute Care Surgery, Scripps Clinic Medical Group, La Jolla, CA USA
| | - Sameer Dhingra
- grid.464629.b0000 0004 1775 2698Department of Pharmacy Practice, National Institute of Pharmaceutical Education and Research (NIPER), Hajipur, Bihar India
| | - Stefano Di Bella
- grid.5133.40000 0001 1941 4308Clinical Department of Medical, Surgical and Health sciences, Trieste University, Trieste, Italy
| | | | - Salomone Di Saverio
- grid.412972.bDepartment of General Surgery, University of Insubria, University Hospital of Varese, ASST Sette Laghi, Regione Lombardia, Varese, Italy
| | - Agron Dogjani
- Department of Surgery, University Hospital of Trauma, Tirana, Albania
| | - Therese M. Duane
- grid.429044.f0000 0004 0402 1407Department of Surgery, Texas Health Resources, Fort Worth, TX USA
| | - Mushira Abdulaziz Enani
- grid.415277.20000 0004 0593 1832Department of Medicine, Infectious Disease Division, King Fahad Medical City, Riyadh, Saudi Arabia
| | - Paola Fugazzola
- grid.8982.b0000 0004 1762 5736Department of Surgery, Fondazione IRCCS Policlinico San Matteo, University of Pavia, Pavia, Italy
| | - Joseph M. Galante
- grid.27860.3b0000 0004 1936 9684Division of Trauma and Acute Care Surgery, Department of Surgery, University of California Davis, Sacramento, CA USA
| | - Mahir Gachabayov
- Department of Abdominal Surgery, Vladimir City Clinical Hospital of Emergency Medicine, Vladimir, Russia
| | - Wagih Ghnnam
- grid.10251.370000000103426662Department of General Surgery, Mansoura Faculty of Medicine, Mansoura University, Mansoura, Egypt
| | - George Gkiokas
- grid.5216.00000 0001 2155 0800Second Department of Surgery, Aretaieion University Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Carlos Augusto Gomes
- Department of Surgery, Hospital Universitário Terezinha de Jesus, Faculdade de Ciências Médicas e da Saúde de Juiz de Fora, Juiz de Fora, Brazil
| | - Ewen A. Griffiths
- grid.412563.70000 0004 0376 6589Department of Upper GI Surgery, Queen Elizabeth Hospital, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
| | - Timothy C. Hardcastle
- Trauma Service, Inkosi Albert Luthuli Central Hospital and Department of Surgery, Nelson R Mandela School of Clinical Medicine, Durban, South Africa
| | - Andreas Hecker
- grid.411067.50000 0000 8584 9230Department of General and Thoracic Surgery, University Hospital Giessen, Giessen, Germany
| | - Torsten Herzog
- grid.5570.70000 0004 0490 981XDepartment of Surgery, St. Josef Hospital, Ruhr University Bochum, Bochum, Germany
| | - Syed Mohammad Umar Kabir
- grid.415900.90000 0004 0617 6488Donegal Clinical Research Academy Emergency Surgery Outcome Project, Letterkenny University Hospital, Donegal, Ireland
| | - Aleksandar Karamarkovic
- grid.7149.b0000 0001 2166 9385Surgical Clinic “Nikola Spasic”, Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | - Vladimir Khokha
- Department of Emergency Surgery, City Hospital, Mozyr, Belarus
| | - Peter K. Kim
- grid.251993.50000000121791997Department of Surgery, Jacobi Medical Center, Albert Einstein College of Medicine, Bronx, NY USA
| | - Jae Il Kim
- grid.411612.10000 0004 0470 5112Department of Surgery, Ilsan Paik Hospital, Inje University College of Medicine, Goyang, Republic of Korea
| | - Andrew W. Kirkpatrick
- grid.414959.40000 0004 0469 2139General, Acute Care, Abdominal Wall Reconstruction, and Trauma Surgery, Foothills Medical Centre, Calgary, AB Canada
| | - Victor Kong
- grid.414386.c0000 0004 0576 7753Department of Surgery, Edendale Hospital, Pietermaritzburg, South Africa
| | - Renol M. Koshy
- grid.412570.50000 0004 0400 5079Department of General Surgery, University Hospital of Coventry & Warwickshire, Coventry, UK
| | - Igor A. Kryvoruchko
- grid.412081.eDepartment of Surgery #2, National Medical University, Kharkiv, Ukraine
| | - Kenji Inaba
- grid.42505.360000 0001 2156 6853Division of Trauma and Surgical Critical Care, Department of Surgery, University of Southern California, Los Angeles, CA USA
| | - Arda Isik
- grid.411776.20000 0004 0454 921XDepartment of General Surgery, School of Medicine, Istanbul Medeniyet University, Istanbul, Turkey
| | - Katia Iskandar
- grid.444421.30000 0004 0417 6142Department of Pharmacy, Lebanese International University, Beirut, Lebanon
| | - Rao Ivatury
- grid.224260.00000 0004 0458 8737Department of Surgery, Virginia Commonwealth University School of Medicine, Richmond, VA USA
| | | | - Yeong Yeh Lee
- grid.11875.3a0000 0001 2294 3534School of Medical Sciences, Universitiy Sains Malaysia, Kota Bharu, Kelantan Malaysia
| | - Ari Leppäniemi
- grid.15485.3d0000 0000 9950 5666Abdominal Center, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Andrey Litvin
- grid.410686.d0000 0001 1018 9204Department of Surgical Disciplines, Immanuel Kant Baltic Federal University, Regional Clinical Hospital, Kaliningrad, Russia
| | - Davide Luppi
- Department of General and Emergency Surgery, ASMN, Reggio Emilia, Italy
| | - Gustavo M. Machain
- grid.412213.70000 0001 2289 5077Department of Surgery, Universidad Nacional de Asuncion, Asuncion, Paraguay
| | - Ronald V. Maier
- grid.34477.330000000122986657Department of Surgery, University of Washington, Seattle, WA USA
| | - Athanasios Marinis
- grid.417374.2First Department of Surgery, Tzaneion General Hospital, Piraeus, Greece
| | - Cristina Marmorale
- grid.7010.60000 0001 1017 3210Department of Surgery, Università Politecnica delle Marche, Ancona, Italy
| | - Sanjay Marwah
- grid.412572.70000 0004 1771 1642Department of Surgery, Post-Graduate Institute of Medical Sciences, Rohtak, India
| | - Cristian Mesina
- Second Surgical Clinic, Emergency Hospital of Craiova, Craiova, Romania
| | - Ernest E. Moore
- grid.239638.50000 0001 0369 638XErnest E Moore Shock Trauma Center at Denver Health, Denver, USA
| | - Frederick A. Moore
- grid.15276.370000 0004 1936 8091Department of Surgery, Division of Acute Care Surgery, and Center for Sepsis and Critical Illness Research, University of Florida College of Medicine, Gainesville, FL USA
| | - Ionut Negoi
- Department of Surgery, Emergency Hospital of Bucharest, Bucharest, Romania
| | - Iyiade Olaoye
- grid.412975.c0000 0000 8878 5287Department of Surgery, University of Ilorin Teaching Hospital, Ilorin, Nigeria
| | - Carlos A. Ordoñez
- grid.477264.4Division of Trauma and Acute Care Surgery, Fundacion Valle del Lili, Cali, Colombia
- grid.8271.c0000 0001 2295 7397Department of Surgery, Universidad del Valle, Cali, Colombia
| | - Mouaqit Ouadii
- grid.412817.9Department of Surgery, Hassan II University Hospital, Medical School of Fez, Sidi Mohamed Benabdellah University, Fez, Morocco
| | - Andrew B. Peitzman
- grid.21925.3d0000 0004 1936 9000Department of Surgery, University of Pittsburgh School of Medicine, UPMC-Presbyterian, Pittsburgh, USA
| | - Gennaro Perrone
- Department of Emergency Surgery, Parma Maggiore Hospital, Parma, Italy
| | - Manos Pikoulis
- grid.5216.00000 0001 2155 08003rd Department of Surgery, Attiko Hospital, MSc “Global Health-Disaster Medicine”, National and Kapodistrian University of Athens (NKUA), Athens, Greece
| | - Tadeja Pintar
- grid.29524.380000 0004 0571 7705Department of Surgery, UMC Ljubljana, Ljubljana, Slovenia
| | - Giuseppe Pipitone
- National Institute for Infectious Diseases - INMI - Lazzaro Spallanzani IRCCS, Rome, Italy
| | - Mauro Podda
- grid.7763.50000 0004 1755 3242Department of General and Emergency Surgery, Cagliari University Hospital, Cagliari, Italy
| | - Kemal Raşa
- Department of Surgery, Anadolu Medical Center, Kocaeli, Turkey
| | - Julival Ribeiro
- grid.414433.5Infection Control, Hospital de Base, Brasília, DF Brazil
| | - Gabriel Rodrigues
- grid.411639.80000 0001 0571 5193Department of General Surgery, Kasturba Medical College & Hospital, Manipal Academy of Higher Education, Manipal, India
| | - Ines Rubio-Perez
- grid.81821.320000 0000 8970 9163General Surgery Department, Colorectal Surgery Unit, La Paz University Hospital, Madrid, Spain
| | - Ibrahima Sall
- General Surgery Department, Military Teaching Hospital, Dakar, Senegal
| | - Norio Sato
- grid.255464.40000 0001 1011 3808Department of Aeromedical Services for Emergency and Trauma Care, Ehime University Graduate School of Medicine, Ehime, Japan
| | - Robert G. Sawyer
- grid.268187.20000 0001 0672 1122Department of Surgery, Western Michigan University School of Medicine, Kalamazoo, MI USA
| | - Helmut Segovia Lohse
- grid.412213.70000 0001 2289 5077Department of Surgery, Universidad Nacional de Asuncion, Asuncion, Paraguay
| | - Gabriele Sganga
- grid.414603.4Department of Medical and Surgical Sciences, Emergency Surgery & Trauma, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Vishal G. Shelat
- grid.240988.fDepartment of General Surgery, Tan Tock Seng Hospital, Singapore, Singapore
| | - Ian Stephens
- grid.415900.90000 0004 0617 6488Donegal Clinical Research Academy Emergency Surgery Outcome Project, Letterkenny University Hospital, Donegal, Ireland
| | - Michael Sugrue
- grid.415900.90000 0004 0617 6488Donegal Clinical Research Academy Emergency Surgery Outcome Project, Letterkenny University Hospital, Donegal, Ireland
| | - Antonio Tarasconi
- Department of Emergency Surgery, Parma Maggiore Hospital, Parma, Italy
| | - Joel Noutakdie Tochie
- grid.412661.60000 0001 2173 8504Department of Emergency medicine, Anesthesiology and critical care, Faculty of Medicine and Biomedical Sciences, University of Yaoundé I, Yaoundé, Cameroon
| | - Matti Tolonen
- grid.15485.3d0000 0000 9950 5666Abdominal Center, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Gia Tomadze
- grid.412274.60000 0004 0428 8304Surgery Department, Tbilisi State Medical University, Tbilisi, Georgia
| | - Jan Ulrych
- grid.411798.20000 0000 9100 9940First Department of Surgery, Department of Abdominal, Thoracic Surgery and Traumatology, First Faculty of Medicine, Charles University and General University Hospital, Prague, Czech Republic
| | - Andras Vereczkei
- grid.9679.10000 0001 0663 9479Department of Surgery, Clinical Center University of Pecs, Pecs, Hungary
| | - Bruno Viaggi
- grid.24704.350000 0004 1759 9494Department of Anesthesiology, Neuro Intensive Care Unit, Florence Careggi University Hospital, Florence, Italy
| | - Chiara Gurioli
- Department of Surgery, Camerino Hospital, Macerata, Italy
| | - Claudio Casella
- grid.7637.50000000417571846Department of Molecular and Translational Medicine, University of Brescia, Brescia, Italy
| | - Leonardo Pagani
- Department of Infectious Diseases, Bolzano Hospital, Bolzano, Italy
| | - Gian Luca Baiocchi
- Department of Surgery, AAST Cremona, Cremona, Italy
- grid.7637.50000000417571846Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
| | - Fausto Catena
- Department of Emergency Surgery, Parma Maggiore Hospital, Parma, Italy
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25
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Cobianchi L, Dal Mas F, Massaro M, Fugazzola P, Coccolini F, Kluger Y, Leppäniemi A, Moore EE, Sartelli M, Angelos P, Catena F, Ansaloni L. Team dynamics in emergency surgery teams: results from a first international survey. World J Emerg Surg 2021; 16:47. [PMID: 34530891 PMCID: PMC8443910 DOI: 10.1186/s13017-021-00389-6] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Accepted: 08/20/2021] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Emergency surgery represents a unique context. Trauma teams are often multidisciplinary and need to operate under extreme stress and time constraints, sometimes with no awareness of the trauma's causes or the patient's personal and clinical information. In this perspective, the dynamics of how trauma teams function is fundamental to ensuring the best performance and outcomes. METHODS An online survey was conducted among the World Society of Emergency Surgery members in early 2021. 402 fully filled questionnaires on the topics of knowledge translation dynamics and tools, non-technical skills, and difficulties in teamwork were collected. Data were analyzed using the software R, and reported following the Checklist for Reporting Results of Internet E-Surveys (CHERRIES). RESULTS Findings highlight how several surgeons are still unsure about the meaning and potential of knowledge translation and its mechanisms. Tools like training, clinical guidelines, and non-technical skills are recognized and used in clinical practice. Others, like patients' and stakeholders' engagement, are hardly implemented, despite their increasing importance in the modern healthcare scenario. Several difficulties in working as a team are described, including the lack of time, communication, training, trust, and ego. DISCUSSION Scientific societies should take the lead in offering training and support about the abovementioned topics. Dedicated educational initiatives, practical cases and experiences, workshops and symposia may allow mitigating the difficulties highlighted by the survey's participants, boosting the performance of emergency teams. Additional investigation of the survey results and its characteristics may lead to more further specific suggestions and potential solutions.
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Affiliation(s)
- Lorenzo Cobianchi
- Department of Clinical, Diagnostic and Pediatric Sciences, University of Pavia, Polo Didattico "Cesare Brusotti" Viale Brambilla, 74, 27100, Pavia, Italy.
- IRCCS Policlinico San Matteo Foundation, General Surgery, Viale Camillo Golgi, 19, 27100, Pavia, Italy.
| | - Francesca Dal Mas
- Department of Management, Lincoln International Business School, University of Lincoln, Lincoln, UK
| | | | - Paola Fugazzola
- IRCCS Policlinico San Matteo Foundation, General Surgery, Viale Camillo Golgi, 19, 27100, Pavia, Italy
| | - Federico Coccolini
- Department of Surgery, University of Pisa, Pisa, Italy
- General, Emergency and Trauma Surgery, Pisa University Hospital, Pisa, Italy
| | - Yoram Kluger
- Department of General Surgery, Rambam Health Care Campus, Haifa, Israel
| | - Ari Leppäniemi
- Abdominal Center, University Hospital Meilahti, Helsinki, Finland
| | | | - Massimo Sartelli
- Department of General Surgery, Macerata's Hospital, Macerata, Italy
| | - Peter Angelos
- Department of Surgery and MacLean Center for Clinical Medical Ethics, The University of Chicago, Chicago, IL, USA
| | - Fausto Catena
- General and Emergency Surgery, Bufalini Hospital, Cesena, Italy
| | - Luca Ansaloni
- Department of Clinical, Diagnostic and Pediatric Sciences, University of Pavia, Polo Didattico "Cesare Brusotti" Viale Brambilla, 74, 27100, Pavia, Italy
- IRCCS Policlinico San Matteo Foundation, General Surgery, Viale Camillo Golgi, 19, 27100, Pavia, Italy
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26
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Coccolini F, Cicuttin E, Cremonini C, Tartaglia D, Viaggi B, Kuriyama A, Picetti E, Ball C, Abu-Zidan F, Ceresoli M, Turri B, Jain S, Palombo C, Guirao X, Rodrigues G, Gachabayov M, Machado F, Eftychios L, Kanj SS, Di Carlo I, Di Saverio S, Khokha V, Kirkpatrick A, Massalou D, Forfori F, Corradi F, Delibegovic S, Machain Vega GM, Fantoni M, Demetriades D, Kapoor G, Kluger Y, Ansari S, Maier R, Leppaniemi A, Hardcastle T, Vereczkei A, Karamagioli E, Pikoulis E, Pistello M, Sakakushev BE, Navsaria PH, Galeiras R, Yahya AI, Osipov AV, Dimitrov E, Doklestić K, Pisano M, Malacarne P, Carcoforo P, Sibilla MG, Kryvoruchko IA, Bonavina L, Kim JI, Shelat VG, Czepiel J, Maseda E, Marwah S, Chirica M, Biancofiore G, Podda M, Cobianchi L, Ansaloni L, Fugazzola P, Seretis C, Gomez CA, Tumietto F, Malbrain M, Reichert M, Augustin G, Amato B, Puzziello A, Hecker A, Gemignani A, Isik A, Cucchetti A, Nacoti M, Kopelman D, Mesina C, Ghannam W, Ben-Ishay O, Dhingra S, Coimbra R, Moore EE, Cui Y, Quiodettis MA, Bala M, Testini M, Diaz J, Girardis M, Biffl WL, Hecker M, Sall I, Boggi U, Materazzi G, Ghiadoni L, Matsumoto J, Zuidema WP, Ivatury R, Enani MA, Litvin A, Al-Hasan MN, Demetrashvili Z, Baraket O, Ordoñez CA, Negoi I, Kiguba R, Memish ZA, Elmangory MM, Tolonen M, Das K, Ribeiro J, O’Connor DB, Tan BK, Van Goor H, Baral S, De Simone B, Corbella D, Brambillasca P, Scaglione M, Basolo F, De’Angelis N, Bendinelli C, Weber D, Pagani L, Monti C, Baiocchi G, Chiarugi M, Catena F, Sartelli M. A pandemic recap: lessons we have learned. World J Emerg Surg 2021; 16:46. [PMID: 34507603 PMCID: PMC8430288 DOI: 10.1186/s13017-021-00393-w] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2021] [Accepted: 08/29/2021] [Indexed: 02/08/2023] Open
Abstract
On January 2020, the WHO Director General declared that the outbreak constitutes a Public Health Emergency of International Concern. The world has faced a worldwide spread crisis and is still dealing with it. The present paper represents a white paper concerning the tough lessons we have learned from the COVID-19 pandemic. Thus, an international and heterogenous multidisciplinary panel of very differentiated people would like to share global experiences and lessons with all interested and especially those responsible for future healthcare decision making. With the present paper, international and heterogenous multidisciplinary panel of very differentiated people would like to share global experiences and lessons with all interested and especially those responsible for future healthcare decision making.
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Affiliation(s)
- Federico Coccolini
- grid.144189.10000 0004 1756 8209General, Emergency and Trauma Surgery Department, Pisa University Hospital, Via Paradisa, 2, 56124 Pisa, Italy
| | - Enrico Cicuttin
- grid.144189.10000 0004 1756 8209General, Emergency and Trauma Surgery Department, Pisa University Hospital, Via Paradisa, 2, 56124 Pisa, Italy
| | - Camilla Cremonini
- grid.144189.10000 0004 1756 8209General, Emergency and Trauma Surgery Department, Pisa University Hospital, Via Paradisa, 2, 56124 Pisa, Italy
| | - Dario Tartaglia
- grid.144189.10000 0004 1756 8209General, Emergency and Trauma Surgery Department, Pisa University Hospital, Via Paradisa, 2, 56124 Pisa, Italy
| | - Bruno Viaggi
- grid.24704.350000 0004 1759 9494Infectious Disease Department, Careggi Hospital, Florence, Italy
| | - Akira Kuriyama
- grid.415565.60000 0001 0688 6269Emergency and Critical Care Center, Kurashiki Central Hospital, Kurashiki, Japan
| | - Edoardo Picetti
- grid.411482.aDepartment of Anesthesia and Intensive Care, Parma University Hospital, Parma, Italy
| | - Chad Ball
- grid.414959.40000 0004 0469 2139Hepatobiliary and Pancreatic Surgery Trauma and Acute Care Surgery, Foothills Medical Center, Calgary, AB Canada
| | - Fikri Abu-Zidan
- grid.43519.3a0000 0001 2193 6666Department of Surgery, College of Medicine and Health Sciences, UAE University, Al-Ain, UAE
| | - Marco Ceresoli
- grid.18887.3e0000000417581884General Surgery Department, Monza University Hospital, Monza, Italy
| | - Bruno Turri
- grid.414682.d0000 0004 1758 8744General Emergency and Trauma Surgery Department, Bufalini Hospital, Cesena, Italy
| | - Sumita Jain
- grid.416077.30000 0004 1767 3615Department of Surgery, SMS Medical College and Hospital, Jaipur, India
| | - Carlo Palombo
- grid.5395.a0000 0004 1757 3729Cardiology Division 1, Department of Surgical, Medical, Molecular Pathology, and Critical Medicine, School of Medicine, University of Pisa, Pisa, Italy
| | - Xavier Guirao
- grid.428313.f0000 0000 9238 6887Department of Surgery, Parc Tauli, Hospital Universitari, Sabadell, Spain
| | - Gabriel Rodrigues
- grid.415066.00000 0004 1805 8200Department of General Surgery, Kasturba Medical College and Hospital, Manipal, Karnataka India
| | - Mahir Gachabayov
- Department of Abdominal Surgery, Vladimir City Emergency Hospital, Vladimir City, Russia
| | - Fernando Machado
- General Surgery Department, Montevideo Hospital, Montevideo, Paraguay
| | | | - Souha S. Kanj
- grid.411654.30000 0004 0581 3406Antimicrobial Stewardship Program, American University of Beirut Medical Center, Beirut, Lebanon
| | - Isidoro Di Carlo
- grid.8158.40000 0004 1757 1969Department of Surgical Sciences and Advanced Technologies, General Surgery, University of Catania, Cannizzaro Hospital, Catania, Italy
| | - Salomone Di Saverio
- General Surgery, ASUR Marche 5, San Benedetto del Tronto General Hospital, San Benedetto del Tronto, Italy
| | | | - Andrew Kirkpatrick
- grid.414959.40000 0004 0469 2139General, Acute Care, Abdominal Wall Reconstruction, and Trauma Surgery, Foothills Medical Centre, Calgary, AB Canada
| | - Damien Massalou
- grid.410528.a0000 0001 2322 4179Acute Care Surgery, University Hospital of Nice (CHU de Nice)/Université Côte d’Azur, Nice, France
| | - Francesco Forfori
- grid.144189.10000 0004 1756 8209ICU Department, Pisa University Hospital, Pisa, Italy
| | - Francesco Corradi
- grid.144189.10000 0004 1756 8209ICU Department, Pisa University Hospital, Pisa, Italy
| | - Samir Delibegovic
- grid.412410.20000 0001 0682 9061General Surgery, University Clinical Center Tuzla, Tuzla, Bosnia and Herzegovina
| | - Gustavo M. Machain Vega
- grid.412213.70000 0001 2289 5077Servicio de Cirugia General, Universidad Nacional de Asuncion, Hospital de Clinicas Ii Cátedra de Clinica Quirúrgica, Asunción, Paraguay
| | - Massimo Fantoni
- grid.411075.60000 0004 1760 4193Dipartimento Di Scienze Di Laboratorio E Infettivologiche, Fondazione Policlinico Universitario Agostino Gemelli Irccs, Roma, Italy
| | - Demetrios Demetriades
- grid.411409.90000 0001 0084 1895Division of Trauma, Emergency Surgery, and Surgical Critical Care, LAC+USC Medical Center, Los Angeles, USA
| | - Garima Kapoor
- grid.415285.fDepartment of Microbiology, Gandhi Medical College, Bhopal, India
| | - Yoram Kluger
- General Surgery Department, Rambam Medical Centre, Tel Aviv, Israel
| | - Shamshul Ansari
- grid.488411.00000 0004 5998 7153Department of Microbiology, Chitwan Medical College and Teaching Hospital, Bharatpur, Chitwan, Nepal
| | - Ron Maier
- grid.34477.330000000122986657Harborview Medical Center, University of Washington, Seattle, WA USA
| | - Ari Leppaniemi
- grid.15485.3d0000 0000 9950 5666HUS Abdominal Center, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Timothy Hardcastle
- Trauma and Burns, Inkosi Albert Luthuli Central Hospital and DoH-KZN, Mayville, South Africa
| | - Andras Vereczkei
- grid.9679.10000 0001 0663 9479Department of Surgery, Medical School, University of Pécs, Pecs, Hungary
| | - Evika Karamagioli
- grid.5216.00000 0001 2155 0800Medical School, National and Kapodistrian University of Athens, (NKUA), Athens, Greece
| | - Emmanouil Pikoulis
- grid.5216.00000 0001 2155 0800Medical School, National and Kapodistrian University of Athens, (NKUA), Athens, Greece
| | - Mauro Pistello
- grid.5395.a0000 0004 1757 3729Department of Translational Research, University of Pisa, Pisa, Italy
| | - Boris E. Sakakushev
- grid.35371.330000 0001 0726 0380Research Institute at Medical University Plovdiv/University Hospital St George, Plovdiv, Bulgaria
| | - Pradeep H. Navsaria
- grid.7836.a0000 0004 1937 1151Trauma Center, Groote Schuur Hospital, Faculty of Health Sciences, University of Cape Town, Cape Town, 7925 South Africa
| | - Rita Galeiras
- grid.488921.eCritical Care Unit, Complexo Hospitalario Universitario A Coruña, Instituto de Investigación Biomédica de A Coruña, A Coruña, Spain
| | - Ali I. Yahya
- General Surgery Department, Zliten Medical Center, Zliten, Libya
| | - Aleksei V. Osipov
- Division of Emergency Surgery, Saint-Petersburg Research Institute of Emergency Medicine, Saint-Petersburg, Russian Federation
| | - Evgeni Dimitrov
- Department of Surgical Diseases, University Hospital “Prof. Dr. Stoyan Kirkovich”, 2A Gen. Stoletov Str., 6000 Stara Zagora, Bulgaria
| | | | - Michele Pisano
- 1St General Surgery Unit, Department of Emergency, ASST Papa Giovanni, Bergamo, Italy
| | - Paolo Malacarne
- grid.144189.10000 0004 1756 8209Department of Anaesthesia and Critical Care Medicine, Azienda Ospedaliera Universitaria Pisana, Pisa, Italy
| | - Paolo Carcoforo
- grid.416315.4General and Emergency Surgery Unit, Sant’Anna University-Hospital, Ferrara, Italy
| | - Maria Grazia Sibilla
- grid.416315.4General and Emergency Surgery Unit, Sant’Anna University-Hospital, Ferrara, Italy
| | - Igor A. Kryvoruchko
- grid.445504.40000 0004 0529 6576Department of Surgery No2, Kharkiv National Medical University, Kharkiv, Ukraine
| | - Luigi Bonavina
- grid.4708.b0000 0004 1757 2822Division of General and Foregut Surgery, University of Milan, IRCCS Policlinico San Donato, Milan, Italy
| | - Jae Il Kim
- grid.411633.20000 0004 0371 8173Department of Surgery, Inje University, Ilsan Paik Hospital, Goyang-si, South Korea
| | - Vishal G. Shelat
- grid.240988.fDepartment of General Surgery, Tan Tock Seng Hospital, Singapore, Singapore
| | - Jacek Czepiel
- grid.5522.00000 0001 2162 9631Department of Infectious and Tropical Diseases, Jagiellonian University Medical College, Kraków, Poland
| | - Emilio Maseda
- Surgical Critical Care, Department of Anesthesia, Hospital Valdecilla Santander, Santander, Spain
| | - Sanjay Marwah
- grid.412572.70000 0004 1771 1642Post-Graduate Institute of Medical Sciences, Rohtak, 124001 India
| | - Mircea Chirica
- grid.410529.b0000 0001 0792 4829Department of Digestive Surgery, Centre Hospitalier Universitaire Grenoble Alpes, La Tronche, France
| | - Giandomenico Biancofiore
- grid.5395.a0000 0004 1757 3729Operative Unit of Anesthesia and Transplant Resuscitation, University of Pisa, Pisa, Italy
| | - Mauro Podda
- grid.7763.50000 0004 1755 3242Department of Emergency Surgery, Cagliari University Hospital, Cagliari, Italy
| | - Lorenzo Cobianchi
- grid.419425.f0000 0004 1760 3027Department of Clinical, IRCCS Policlinico San Matteo Foundation, Pavia, Italy
- grid.8982.b0000 0004 1762 5736Department of Clinical, Diagnostic, and Pediatric Sciences, University of Pavia, Pavia, Italy
| | - Luca Ansaloni
- grid.419425.f0000 0004 1760 3027Department of Clinical, IRCCS Policlinico San Matteo Foundation, Pavia, Italy
- grid.8982.b0000 0004 1762 5736Department of Clinical, Diagnostic, and Pediatric Sciences, University of Pavia, Pavia, Italy
| | - Paola Fugazzola
- grid.419425.f0000 0004 1760 3027Department of Clinical, IRCCS Policlinico San Matteo Foundation, Pavia, Italy
- grid.8982.b0000 0004 1762 5736Department of Clinical, Diagnostic, and Pediatric Sciences, University of Pavia, Pavia, Italy
| | - Charalampos Seretis
- grid.412924.80000 0004 0446 0530Department of General Surgery, George Eliot Hospital NHS Trust, Warwickshire, UK
| | | | - Fabio Tumietto
- Azienda Ospedaliero Universitaria Di Bologna, Unità Operativa Malattie Infettive, Bologna, Italy
| | - Manu Malbrain
- Internal Medicine – Intensive Care, AZ Jan Palfijn Gent, Gent, Belgium
- grid.411484.c0000 0001 1033 7158First Department of Anaesthesia and Intensive Therapy, Medical University of Lublin, Lublin, Poland
| | - Martin Reichert
- grid.411067.50000 0000 8584 9230Department of General, Visceral, Thoracic, Transplant and Pediatric Surgery, University Hospital of Giessen, Giessen, Germany
| | - Goran Augustin
- grid.412688.10000 0004 0397 9648Department of Surgery, University Hospital Centre Zagreb, Zagreb, Croatia
| | - Bruno Amato
- grid.4691.a0000 0001 0790 385XDepartment of Public Health, Medical School, University of Naples Federico II, Naples, Italy
| | - Alessandro Puzziello
- grid.11780.3f0000 0004 1937 0335Dipartimento Di Medicina, Chirurgia E Odontoiatria, Campus Universitario di Baronissi - Università Di Salerno, Salerno, Italy
| | - Andreas Hecker
- grid.411067.50000 0000 8584 9230Department of General and Thoracic Surgery, University Hospital of Giessen, Marburg, Germany
| | - Angelo Gemignani
- grid.5395.a0000 0004 1757 3729Department of Surgical, Medical and Molecular Pathology and Critical Care Medicine, University of Pisa, Pisa, Italy
| | - Arda Isik
- grid.411776.20000 0004 0454 921XGeneral Surgery Department, Istanbul Medeniyet University, Istanbul, Turkey
| | - Alessandro Cucchetti
- grid.6292.f0000 0004 1757 1758Department of Medical and Surgical Sciences – DIMEC, Alma Mater Studiorum - University of Bologna, Bologna, Italy
- grid.415079.e0000 0004 1759 989XGeneral Surgery of the Morgagni - Pierantoni Hospital, Forlì, Italy
| | - Mirco Nacoti
- grid.460094.f0000 0004 1757 8431Pediatric Intensive Care Unit, Department of Anesthesia and Intensive Care, ASST Papa Giovanni XXIII, Bergamo, Italy
| | - Doron Kopelman
- grid.469889.20000 0004 0497 6510Hepato-Billiary-Pancreatic (HPB) Surgery Center, Emek Medical Center, Afula, Israel
| | - Cristian Mesina
- grid.452359.cEmergency County Hospital of Craiova, Craiova, Romania
| | - Wagih Ghannam
- grid.10251.370000000103426662Mansoura Faculty of Medicine, Mansoura University, Mansoura, Egypt
| | - Offir Ben-Ishay
- grid.6451.60000000121102151The Ruth and Bruce Rappaport Faculty of Medicine, Technion – Israel Institute of Technology, Rambam Health Care Campus, Haifa, Israel
| | - Sameer Dhingra
- grid.419631.80000 0000 8877 852XDepartment of Pharmacy Practice, National Institute of Pharmaceutical Education and Research (NIPER), Hajipur Vaishali, Bihar, India
| | - Raul Coimbra
- grid.488519.90000 0004 5946 0028Department of Surgery, Riverside University Health System, Moreno Valley, CA USA
- grid.43582.380000 0000 9852 649XSchool of Medicine, Loma Linda University, Loma Linda, CA USA
| | - Ernest E. Moore
- grid.239638.50000 0001 0369 638XShock Trauma Center at Denver Health, Denver, CO USA
| | - Yunfeng Cui
- grid.265021.20000 0000 9792 1228Department of Surgery, Tianjin Nankai Hospital, Nankai Clinical School of Medicine, Tianjin Medical University, Tianjin, China
| | | | - Miklosh Bala
- grid.17788.310000 0001 2221 2926Trauma and Acute Care Surgery Unit, Hadassah - Hebrew University Medical Center, Jerusalem, Israel
| | - Mario Testini
- grid.7644.10000 0001 0120 3326Department of Biomedical Sciences and Human Oncology, University of Bari, Bari, Italy
| | - Jose Diaz
- grid.411024.20000 0001 2175 4264University of Maryland School of Medicine, Baltimore, MD USA
| | - Massimo Girardis
- grid.413363.00000 0004 1769 5275Intensive Care Unit, University Hospital of Modena, Modena, Italy
| | | | - Matthias Hecker
- grid.411067.50000 0000 8584 9230Department of Respiratory and Critical Care Medicine, University Hospital Giessen, Giessen, Germany
| | - Ibrahima Sall
- grid.414281.aDepartment of General Surgery, Military Teaching Hospital, Hôpital Principal de Dakar, Dakar, Senegal
| | - Ugo Boggi
- grid.5395.a0000 0004 1757 3729Division of General and Transplant Surgery, University of Pisa, Pisa, Italy
| | - Gabriele Materazzi
- grid.5395.a0000 0004 1757 3729Department of Surgical, Medical and Molecular Pathology and Critical Care Medicine, University of Pisa, Pisa, Italy
| | - Lorenzo Ghiadoni
- grid.144189.10000 0004 1756 8209Emergency Medical Department, Pisa University Hospital, Pisa, Italy
| | - Junichi Matsumoto
- grid.412764.20000 0004 0372 3116Department of Emergency and Critical Care Medicine, Saint-Marianna University School of Medicine, Kawasaki, Japan
| | - Wietse P. Zuidema
- grid.509540.d0000 0004 6880 3010Department of Surgery, Amsterdam University Medical Center, Amsterdam, The Netherlands
| | - Rao Ivatury
- grid.224260.00000 0004 0458 8737Professor Emeritus, Virginia Commonwealth University, Richmond, VA USA
| | - Mushira A. Enani
- grid.415277.20000 0004 0593 1832Infectious Diseases Section, King Fahad Medical City, Riyadh, Kingdom of Saudi Arabia
| | - Andrey Litvin
- grid.410686.d0000 0001 1018 9204Immanuel Kant Baltic Federal University, Regional Clinic Hospital, Kaliningrad, Russia
| | - Majdi N. Al-Hasan
- grid.254567.70000 0000 9075 106XDepartment of Internal Medicine, University of South Carolina School of Medicine, Prisma Health-Midlands, Columbia, SC USA
| | - Zaza Demetrashvili
- grid.412274.60000 0004 0428 8304Department of Surgery, Tbilisi State Medical University, Kipshidze Central University Hospital, Tbilisi, Georgia
| | - Oussama Baraket
- Department of Surgery, Bizerte Hospital, Bizerte, Tunisia
- grid.265234.40000 0001 2177 9066Faculty of Medicine, Tunis University, Tunis ElManar, Tunisia
| | - Carlos A. Ordoñez
- grid.8271.c0000 0001 2295 7397Division of Trauma and Acute Care Surgery, Department of Surgery, Universidad del Valle, Cali, Colombia
| | - Ionut Negoi
- grid.8194.40000 0000 9828 7548General Surgery Department, Emergency Hospital of Bucharest, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
| | - Ronald Kiguba
- grid.11194.3c0000 0004 0620 0548Department of Pharmacology and Therapeutics, College of Health Sciences, Makerere University, Kampala, Uganda
| | - Ziad A. Memish
- grid.411335.10000 0004 1758 7207King Saud Medical City, Ministry of Health and College of Medicine, AlFaisal University, Riyadh, Kingdom of Saudi Arabia
| | | | - Matti Tolonen
- grid.15485.3d0000 0000 9950 5666HUS Abdominal Center, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Korey Das
- General Surgery, University of Health Sciences, Adana City Training and Research Hospital, Adana, Turkey
| | - Julival Ribeiro
- grid.414433.5Infection Control Coordinator, Hospital de Base Do Distrito Federal /IGESDF, Brasilia, Brazil
| | - Donal B. O’Connor
- grid.8217.c0000 0004 1936 9705Department of Surgery, Trinity College Dublin, Dublin, Ireland
| | - Boun Kim Tan
- Infection Prevention and Control Unit, Centre des Massues, French-Red Cross, Lyon, France
| | - Harry Van Goor
- grid.10417.330000 0004 0444 9382Department of Surgery, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Suman Baral
- General Surgery, Dirghayu Pokhara Hospital, Pokhara, Nepal
| | - Belinda De Simone
- grid.418056.e0000 0004 1765 2558Department of Emergency, Digestive and Metabolic Minimally Invasive Surgery, Centre Hospitalier Intercommunal de Poissy, Saint Germain en Laye, France
| | | | | | - Michelangelo Scaglione
- grid.144189.10000 0004 1756 8209Orthopedic and Traumatology Department, Pisa University Hospital, Pisa, Italy
| | - Fulvio Basolo
- grid.5395.a0000 0004 1757 3729Department of Surgical, Medical and Molecular Pathology and Critical Care Medicine, University of Pisa, Pisa, Italy
| | - Nicola De’Angelis
- grid.412116.10000 0001 2292 1474General Surgery, Department, Henri Mondor Hospital, Paris, France
| | - Cino Bendinelli
- grid.414724.00000 0004 0577 6676Department of Surgery, John Hunter Hospital, Newcastle, Australia
- grid.266842.c0000 0000 8831 109XUniversity of Newcastle, Callaghan, Australia
| | - Dieter Weber
- grid.1012.20000 0004 1936 7910General Surgery, Royal Perth Hospital, The University of Western Australia, Perth, Australia
| | - Leonardo Pagani
- grid.415844.8Infectious Diseases Unit, Bolzano Central Hospital, Bolzano, Italy
| | - Cinzia Monti
- Radiology Department, Gavazzeni Hospital, Bergamo, Italy
| | - Gianluca Baiocchi
- grid.419450.dGeneral Surgery Department, Cremona Hospital, Cremona, Italy
| | - Massimo Chiarugi
- grid.144189.10000 0004 1756 8209General, Emergency and Trauma Surgery Department, Pisa University Hospital, Via Paradisa, 2, 56124 Pisa, Italy
| | - Fausto Catena
- grid.414682.d0000 0004 1758 8744General Emergency and Trauma Surgery Department, Bufalini Hospital, Cesena, Italy
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Coccolini F, Improta M, Sartelli M, Rasa K, Sawyer R, Coimbra R, Chiarugi M, Litvin A, Hardcastle T, Forfori F, Vincent JL, Hecker A, Ten Broek R, Bonavina L, Chirica M, Boggi U, Pikoulis E, Di Saverio S, Montravers P, Augustin G, Tartaglia D, Cicuttin E, Cremonini C, Viaggi B, De Simone B, Malbrain M, Shelat VG, Fugazzola P, Ansaloni L, Isik A, Rubio I, Kamal I, Corradi F, Tarasconi A, Gitto S, Podda M, Pikoulis A, Leppaniemi A, Ceresoli M, Romeo O, Moore EE, Demetrashvili Z, Biffl WL, Wani I, Tolonen M, Duane T, Dhingra S, DeAngelis N, Tan E, Abu-Zidan F, Ordonez C, Cui Y, Labricciosa F, Perrone G, Di Marzo F, Peitzman A, Sakakushev B, Sugrue M, Boermeester M, Nunez RM, Gomes CA, Bala M, Kluger Y, Catena F. Acute abdomen in the immunocompromised patient: WSES, SIS-E, WSIS, AAST, and GAIS guidelines. World J Emerg Surg 2021; 16:40. [PMID: 34372902 PMCID: PMC8352154 DOI: 10.1186/s13017-021-00380-1] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2021] [Accepted: 06/18/2021] [Indexed: 02/08/2023] Open
Abstract
Immunocompromised patients are a heterogeneous and diffuse category frequently presenting to the emergency department with acute surgical diseases. Diagnosis and treatment in immunocompromised patients are often complex and must be multidisciplinary. Misdiagnosis of an acute surgical disease may be followed by increased morbidity and mortality. Delayed diagnosis and treatment of surgical disease occur; these patients may seek medical assistance late because their symptoms are often ambiguous. Also, they develop unique surgical problems that do not affect the general population. Management of this population must be multidisciplinary.This paper presents the World Society of Emergency Surgery (WSES), Surgical Infection Society Europe (SIS-E), World Surgical Infection Society (WSIS), American Association for the Surgery of Trauma (AAST), and Global Alliance for Infection in Surgery (GAIS) joined guidelines about the management of acute abdomen in immunocompromised patients.
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Affiliation(s)
- Federico Coccolini
- grid.144189.10000 0004 1756 8209General, Emergency and Trauma Surgery Department, Pisa University Hospital, Via Paradisa, 2, 56124 Pisa, Italy
| | - Mario Improta
- grid.8982.b0000 0004 1762 5736Emergency Department, Pavia University Hospital, Pavia, Italy
| | | | - Kemal Rasa
- Department of Surgery, Anadolu Medical Center, Kocaali, Turkey
| | - Robert Sawyer
- grid.268187.20000 0001 0672 1122General Surgery Department, Western Michigan University, Kalamazoo, MI USA
| | - Raul Coimbra
- grid.488519.90000 0004 5946 0028Department of General Surgery, Riverside University Health System Medical Center, Moreno Valley, CA USA
| | - Massimo Chiarugi
- grid.144189.10000 0004 1756 8209General, Emergency and Trauma Surgery Department, Pisa University Hospital, Via Paradisa, 2, 56124 Pisa, Italy
| | - Andrey Litvin
- grid.410686.d0000 0001 1018 9204Department of Surgical Disciplines, Immanuel Kant Baltic Federal University, Kaliningrad, Russia
| | - Timothy Hardcastle
- Emergency and Trauma Surgery, Inkosi Albert Luthuli Central Hospital, Mayville, South Africa
| | - Francesco Forfori
- grid.144189.10000 0004 1756 8209Intensive Care Unit, Pisa University Hospital, Pisa, Italy
| | - Jean-Louis Vincent
- grid.4989.c0000 0001 2348 0746Departement of Intensive Care, Erasme Univ Hospital, Université Libre de Bruxelles, Bruxelles, Belgium
| | - Andreas Hecker
- grid.411067.50000 0000 8584 9230Departementof General and Thoracic Surgery, University Hospital of Giessen, Giessen, Germany
| | - Richard Ten Broek
- grid.10417.330000 0004 0444 9382General Surgery, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Luigi Bonavina
- grid.416351.40000 0004 1789 6237General Surgery, San Donato Hospital, Milano, Italy
| | - Mircea Chirica
- grid.450307.5General Surgery, CHUGA-CHU Grenoble Alpes UGA-Université Grenoble Alpes, Grenoble, France
| | - Ugo Boggi
- grid.144189.10000 0004 1756 8209General Surgery, Pisa University Hospital, Pisa, Italy
| | - Emmanuil Pikoulis
- grid.5216.00000 0001 2155 08003rd Department of Surgery, Attiko Hospital, National & Kapodistrian University of Athens, Athens, Greece
| | - Salomone Di Saverio
- grid.18887.3e0000000417581884General Surgery, Varese University Hospital, Varese, Italy
| | - Philippe Montravers
- grid.411119.d0000 0000 8588 831XDépartement d’Anesthésie-Réanimation, CHU Bichat Claude Bernard, Paris, France
| | - Goran Augustin
- grid.4808.40000 0001 0657 4636Department of Surgery, Zagreb University Hospital Centre and School of Medicine, University of Zagreb, Zagreb, Croatia
| | - Dario Tartaglia
- grid.144189.10000 0004 1756 8209General, Emergency and Trauma Surgery Department, Pisa University Hospital, Via Paradisa, 2, 56124 Pisa, Italy
| | - Enrico Cicuttin
- grid.144189.10000 0004 1756 8209General, Emergency and Trauma Surgery Department, Pisa University Hospital, Via Paradisa, 2, 56124 Pisa, Italy
| | - Camilla Cremonini
- grid.144189.10000 0004 1756 8209General, Emergency and Trauma Surgery Department, Pisa University Hospital, Via Paradisa, 2, 56124 Pisa, Italy
| | - Bruno Viaggi
- grid.24704.350000 0004 1759 9494ICU Department, Careggi University Hospital, Firenze, Italy
| | - Belinda De Simone
- grid.418056.e0000 0004 1765 2558Department of Digestive, Metabolic and Emergency Minimally Invasive Surgery, Centre Hospitalier Intercommunal de Poissy/Saint Germain en Laye, Saint Germain en Laye, France
| | - Manu Malbrain
- grid.8767.e0000 0001 2290 8069Faculty of Engineering, Department of Electronics and Informatics, Vrije Universiteit Brussel, Brussels, Belgium
| | - Vishal G. Shelat
- General and Emergency Surgery, Tan Tock Seng Hospital, Kuala Lumpur, Malaysia
| | - Paola Fugazzola
- grid.8982.b0000 0004 1762 5736General and Emergency Surgery, Pavia University Hospital, Pavia, Italy
| | - Luca Ansaloni
- grid.8982.b0000 0004 1762 5736General and Emergency Surgery, Pavia University Hospital, Pavia, Italy
| | - Arda Isik
- grid.411776.20000 0004 0454 921XGeneral Surgery, School of Medicine, Istanbul Medeniyet University, Istanbul, Turkey
| | - Ines Rubio
- grid.81821.320000 0000 8970 9163Department of General Surgery, La Paz University Hospital, Madrid, Spain
| | - Itani Kamal
- grid.38142.3c000000041936754XGeneral Surgery, VA Boston Health Care System, Boston University, Harvard Medical School, Boston, MA USA
| | - Francesco Corradi
- grid.144189.10000 0004 1756 8209Intensive Care Unit, Pisa University Hospital, Pisa, Italy
| | - Antonio Tarasconi
- grid.411482.aGeneral Surgery, Parma University Hospital, Parma, Italy
| | - Stefano Gitto
- grid.8404.80000 0004 1757 2304Gastroenterology and Transplant Unit, Firenze University Hospital, Firenze, Italy
| | - Mauro Podda
- grid.7763.50000 0004 1755 3242General and Emergency Surgery, Cagliari University Hospital, Cagliari, Italy
| | - Anastasia Pikoulis
- grid.5216.00000 0001 2155 0800Medical Department, National & Kapodistrian University of Athens, Athens, Greece
| | - Ari Leppaniemi
- grid.15485.3d0000 0000 9950 5666Abdominal Center, Helsinki University and Helsinki University Hospital, Helsinki, Finland
| | - Marco Ceresoli
- grid.18887.3e0000000417581884General Surgery, Monza University Hospital, Monza, Italy
| | - Oreste Romeo
- grid.268187.20000 0001 0672 1122Department of Surgery, Western Michigan University School of Medicine, Kalamazoo, MI USA
| | - Ernest E. Moore
- grid.239638.50000 0001 0369 638XTrauma Surgery, Denver Health, Denver, CL USA
| | - Zaza Demetrashvili
- grid.412274.60000 0004 0428 8304General Surgery, Tbilisi State Medical University, Tbilisi, Georgia
| | - Walter L. Biffl
- grid.415402.60000 0004 0449 3295Emergency and Trauma Surgery, Scripps Memorial Hospital La Jolla, La Jolla, CA USA
| | - Imitiaz Wani
- General Surgery, Government Gousia Hospital, Srinagar, Kashmir India
| | - Matti Tolonen
- grid.15485.3d0000 0000 9950 5666Abdominal Center, Helsinki University and Helsinki University Hospital, Helsinki, Finland
| | | | - Sameer Dhingra
- National Institute of Pharmaceutical Education and Research, Hajipur (NIPER-H), Vaishali, Bihar India
| | - Nicola DeAngelis
- grid.50550.350000 0001 2175 4109General Surgery Department, Henry Mondor University Hospital, Paris, France
| | - Edward Tan
- grid.10417.330000 0004 0444 9382Emergency Medicine, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Fikri Abu-Zidan
- General Surgery, UAE University Hospital, Sharjah, United Arab Emirates
| | - Carlos Ordonez
- grid.8271.c0000 0001 2295 7397Division of Trauma and Acute Care Surgery, Department of Surgery, Fundación Valle del Lili, Universidad del Valle, Cali, Colombia
| | - Yunfeng Cui
- grid.265021.20000 0000 9792 1228Department of Surgery, Tianjin Nankai Hospital, Nankai Clinical School of Medicine, Tianjin Medical University, Tianjin, China
| | | | - Gennaro Perrone
- grid.411482.aGeneral Surgery, Parma University Hospital, Parma, Italy
| | | | - Andrew Peitzman
- grid.21925.3d0000 0004 1936 9000General Surgery, University of Pittsburgh School of Medicine, Pittsburgh, USA
| | - Boris Sakakushev
- First Clinic of General Surgery, University Hospital St George Plovdiv, Plovdiv, Bulgaria
| | - Michael Sugrue
- General Surgery, Letterkenny Hospital, Letterkenny, Ireland
| | - Marja Boermeester
- grid.5650.60000000404654431Department of Surgery, Academic Medical Center, Amsterdam, Netherlands
| | | | - Carlos Augusto Gomes
- Department of Surgery, Faculdade de Ciências Médicas e da Saúde de Juiz de Fora, Hospital Universitário Terezinha de Jesus, Juiz de Fora, Brazil
| | - Miklosh Bala
- grid.17788.310000 0001 2221 2926General Surgery, Hadassah Hospital, Jerusalem, Israel
| | - Yoram Kluger
- General Sugery, Ramabam Medical Centre, Tel Aviv, Israel
| | - Fausto Catena
- grid.411482.aGeneral Surgery, Parma University Hospital, Parma, Italy
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Agdgomelashvili I, Mosidze B, Merabishvili G, Demetrashvili Z. Enhanced recovery after surgery vs traditional care in elective colorectal surgery: A retrospective cohort study. Georgian Med News 2021:17-21. [PMID: 33814383 DOI: pmid/33814383] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
The objective and the goal of this study was to determine how ERAS guidelines affected on hospital stay days and other complications rates in case of elective colorectal surgery in our clinic, compared to traditional care methods. First of all, all team members including surgeons, anesthetists, nurses were being trained in ERAS guidelines principals during two months and we started active implementation process after this. 87 patients, who were needed to be done colorectal surgery treatment, were actively treated according to ERAS guidelines and these patients were gathered in experimental group. At the same time, we started to collect data retrospectively from last 2 years elective colorectal surgery cases and sorted them according to preoperative, intraoperative surgical and anesthesia data, postoperative analgesia, all type of complications. 120 patients were placed in traditional care group (control group). In traditional care group open colorectal surgery was associated with long length of stay 8-10 days. High rates of surgical site infection-24.2%, readmission rate during 30 days-30.8%, PONV-44.2%, respiratory complication-6.7%, deep vein thrombosis-3.3%, urinary retention-2.5%, prolonged postoperative ileus 16.7%. We included 87 patients in ERAS care group during 2 years. In this group our study showed big reduction of hospital stay days and it was average 5 days. Compared to traditional care group incidence of respiratory complications was 0, postoperative PONV- 6.9%, postoperative ileus-5.7%, deep vein thrombosis-0, urinary retention-0, readmission rate-0, surgical site infection-3.4%.
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Affiliation(s)
- I Agdgomelashvili
- Tbilisi State Medical University; High Technology Medical Center, University Clinic, Georgia
| | - B Mosidze
- Tbilisi State Medical University; High Technology Medical Center, University Clinic, Georgia
| | - G Merabishvili
- Tbilisi State Medical University; High Technology Medical Center, University Clinic, Georgia
| | - Z Demetrashvili
- Tbilisi State Medical University; High Technology Medical Center, University Clinic, Georgia
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29
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Coccolini F, Kluger Y, Moore EE, Maier RV, Coimbra R, Ordoñez C, Ivatury R, Kirkpatrick AW, Biffl W, Sartelli M, Hecker A, Ansaloni L, Leppaniemi A, Reva V, Civil I, Vega F, Chiarugi M, Chichom-Mefire A, Sakakushev B, Peitzman A, Chiara O, Abu-Zidan F, Maegele M, Miccoli M, Chirica M, Khokha V, Sugrue M, Fraga GP, Otomo Y, Baiocchi GL, Catena F. Trauma quality indicators: internationally approved core factors for trauma management quality evaluation. World J Emerg Surg 2021; 16:6. [PMID: 33622373 PMCID: PMC7901006 DOI: 10.1186/s13017-021-00350-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2020] [Accepted: 02/10/2021] [Indexed: 02/07/2023] Open
Abstract
INTRODUCTION Quality in medical care must be measured in order to be improved. Trauma management is part of health care, and by definition, it must be checked constantly. The only way to measure quality and outcomes is to systematically accrue data and analyze them. MATERIAL AND METHODS A systematic revision of the literature about quality indicators in trauma associated to an international consensus conference RESULTS: An internationally approved base core set of 82 trauma quality indicators was obtained: Indicators were divided into 6 fields: prevention, structure, process, outcome, post-traumatic management, and society integrational effects. CONCLUSION Present trauma quality indicator core set represents the result of an international effort aiming to provide a useful tool in quality evaluation and improvement. Further improvement may only be possible through international trauma registry development. This will allow for huge international data accrual permitting to evaluate results and compare outcomes.
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Affiliation(s)
- Federico Coccolini
- grid.144189.10000 0004 1756 8209General Emergency and Trauma Surgery Department, Pisa University Hospital, Via Paradisa, 2, 56124 Pisa, Italy
| | - Yoram Kluger
- grid.413731.30000 0000 9950 8111Division of General Surgery, Rambam Health Care Campus, Haifa, Israel
| | - Ernest E. Moore
- grid.239638.50000 0001 0369 638XErnest E Moore Shock Trauma Center, Denver Health, Denver, CO USA
| | - Ronald V. Maier
- grid.34477.330000000122986657Department of Surgery, Harborview Medical Center, University of Washington, Seattle, WA USA
| | - Raul Coimbra
- grid.412489.20000 0004 0608 2801Riverside University Health System, Riverside, CA USA
| | - Carlos Ordoñez
- grid.477264.4Division of Trauma and Acute Care Surgery, Fundación Valle del Lili, Cali, Colombia
| | - Rao Ivatury
- grid.417264.20000 0001 2194 2791VCU Medical Center, Richmond, VA USA
| | - Andrew W. Kirkpatrick
- grid.414959.40000 0004 0469 2139General, Acute Care, Abdominal Wall Reconstruction, and Trauma Surgery, Foothills Medical Centre, Calgary, Canada
| | - Walter Biffl
- grid.415402.60000 0004 0449 3295Department of Trauma and Acute Care Surgery, Scripps Memorial Hospital La Jolla, La Jolla, San Diego, CA USA
| | - Massimo Sartelli
- General and Emergency Surgery, Macerata Hospital, Macerata, Italy
| | - Andreas Hecker
- grid.411067.50000 0000 8584 9230Department of General and Thoracic Surgery, University Hospital of Giessen, Giessen, Germany
| | - Luca Ansaloni
- grid.414682.d0000 0004 1758 8744General, Emergency and Trauma Surgery Department, Bufalini Hospital, Cesena, Italy
| | - Ari Leppaniemi
- grid.15485.3d0000 0000 9950 5666Abdominal Center, Helsinki University Hospital, Helsinki, Finland
| | - Viktor Reva
- grid.415628.c0000 0004 0562 6029Department of War Surgery, Kirov Military Medical Academy, Saint-Petersburg, Russia
| | - Ian Civil
- grid.414055.10000 0000 9027 2851General and Emergency Surgery Dept., Auckland City Hospital, Auckland, New Zealand
| | - Felipe Vega
- Department of Surgery, Hospital Angeles Lomas, Mexico City, Mexico
| | - Massimo Chiarugi
- grid.144189.10000 0004 1756 8209General Emergency and Trauma Surgery Department, Pisa University Hospital, Via Paradisa, 2, 56124 Pisa, Italy
| | - Alain Chichom-Mefire
- grid.29273.3d0000 0001 2288 3199Faculty of Health Sciences, University of Buea, Buea, Cameroon
- Douala Gynaeco-Obstetric and Pediatric Hospital, Douala, Cameroon
| | - Boris Sakakushev
- General Surgery Department, University Hospital St George, Plovdiv, Bulgaria
| | - Andrew Peitzman
- grid.21925.3d0000 0004 1936 9000Department of Surgery, University of Pittsburgh School of Medicine, Pittsburgh, USA
| | - Osvaldo Chiara
- Trauma Team and General Surgery, ASST Niguarda, Milan, Italy
| | - Fikri Abu-Zidan
- grid.43519.3a0000 0001 2193 6666Department of Surgery, College of Medicine and Health Sciences, UAE University, Al-Ain, United Arab Emirates
| | - Marc Maegele
- grid.412581.b0000 0000 9024 6397Department of Trauma and Orthopedic Surgery, Cologne-Merheim Medical Center (CMMC), University Witten/Herdecke (UW/H), Cologne, Germany
| | - Mario Miccoli
- grid.5395.a0000 0004 1757 3729Statistic Dept., Pisa University, Pisa, Italy
| | - Mircea Chirica
- grid.410529.b0000 0001 0792 4829Centre Hospitalier Universitaire Grenoble Alpes, Grenoble, France
| | - Vladimir Khokha
- Department of Emergency Surgery, City Hospital, Mozyr, Belarus
| | - Michael Sugrue
- General Surgery Dept., Letterkenny Hospital, Letterkenny, Ireland
| | - Gustavo P. Fraga
- grid.411087.b0000 0001 0723 2494Division of Trauma Surgery, School of Medical Sciences, University of Campinas, Campinas, Brazil
| | - Yasuhiro Otomo
- grid.474906.8Trauma and Acute Critical Care Center, Tokyo Medical and Dental University Hospital, Tokyo, Japan
| | - Gian Luca Baiocchi
- grid.7637.50000000417571846General Surgery, Brescia University Hospital, Brescia, Italy
| | - Fausto Catena
- grid.411482.aEmergency and Trauma Surgery, Parma University Hospital, Parma, Italy
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30
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Reichert M, Sartelli M, Weigand MA, Doppstadt C, Hecker M, Reinisch-Liese A, Bender F, Askevold I, Padberg W, Coccolini F, Catena F, Hecker A. Impact of the SARS-CoV-2 pandemic on emergency surgery services-a multi-national survey among WSES members. World J Emerg Surg 2020; 15:64. [PMID: 33298131 PMCID: PMC7724441 DOI: 10.1186/s13017-020-00341-0] [Citation(s) in RCA: 36] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2020] [Accepted: 11/02/2020] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND The SARS-CoV-2 pandemic is a major challenge for health care services worldwide. It's impact on oncologic therapies and elective surgery has been described recently, and the literature provides guidelines regarding appropriate elective patient treatment during the pandemic. However, the impact of SARS-CoV-2 pandemic on emergency surgery services has been poorly investigated up to now. METHODS A 17-item web survey had been distributed to emergency surgeons in June 2020 around the world, investigating the impact of SARS-CoV-2 pandemic on patients and septic diseases both requiring emergency surgery and the time-to-intervention in emergency surgery routine, as well as experiences with surgery in COVID-19 patients. RESULTS Ninety-eight collaborators from 31 countries responded to the survey. The majority (65.3%) estimated the impact of the SARS-CoV-2 pandemic on emergency surgical patient care as being strong or very strong. Due to the pandemic, 87.8% reported a decrease in the total number of patients undergoing emergency surgery and approximately 25% estimated a delay of more than 2 h in the time-to-diagnosis and another 2 h in the time-to-intervention. Fifty percent make structural problems with in-hospital logistics (e.g. transport of patients, closed normal wards etc.) mainly responsible for delayed emergency surgery and the frequent need (56.1%) for a triage of emergency surgical patients. 56.1% of the collaborators observed more severe septic abdominal diseases during the pandemic, especially for perforated appendicitis and severe septic cholecystitis (41.8% and 40.2%, respectively). 62.2% had experiences with surgery in COVID-19-infected patients. CONCLUSIONS The results of The WSES COVID-19 emergency surgery survey are alarming. The combination of an estimated decrease in numbers of emergency surgical patients and an observed increase in more severe septic diseases may be a result of the fear of patients from infection with COVID-19 and a consecutive delayed hospital admission and diagnosis. A critical delay in time-to-diagnosis and time-to-intervention may be a result of changes in in-hospital logistics and operating room as well as intensive care capacities. Both reflect the potentially harmful impact of SARS-CoV-2 pandemic on emergency surgery services.
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Affiliation(s)
- Martin Reichert
- Department of General, Visceral, Thoracic, Transplant and Pediatric Surgery, University Hospital of Giessen, Giessen, Germany
| | | | - Markus A Weigand
- Department of Anesthesiology, University Hospital of Heidelberg, Heidelberg, Germany
| | - Christoph Doppstadt
- Department of General, Visceral, Thoracic, Transplant and Pediatric Surgery, University Hospital of Giessen, Giessen, Germany
| | - Matthias Hecker
- Department of Pulmonary and Critical Care Medicine, University Hospital of Giessen and Marburg Lung Center (UGMLC), University Hospital of Giessen, Giessen, Germany
| | - Alexander Reinisch-Liese
- Department of General, Visceral and Oncologic Surgery, Hospital and Clinics Wetzlar, Wetzlar, Germany
| | - Fabienne Bender
- Department of General, Visceral, Thoracic, Transplant and Pediatric Surgery, University Hospital of Giessen, Giessen, Germany
| | - Ingolf Askevold
- Department of General, Visceral, Thoracic, Transplant and Pediatric Surgery, University Hospital of Giessen, Giessen, Germany
| | - Winfried Padberg
- Department of General, Visceral, Thoracic, Transplant and Pediatric Surgery, University Hospital of Giessen, Giessen, Germany
| | - Federico Coccolini
- Department of General, Emergency and Trauma Surgery, Pisa University Hospital, Pisa, Italy
| | - Fausto Catena
- Department of Emergency Surgery, Parma Maggiore Hospital, Parma, Italy
| | - Andreas Hecker
- Department of General, Visceral, Thoracic, Transplant and Pediatric Surgery, University Hospital of Giessen, Giessen, Germany.
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31
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Rausei S, Pappalardo V, Ceresoli M, Catena F, Sartelli M, Chiarugi M, Kluger Y, Kirkpatrick A, Ansaloni L, Coccolini F. Open abdomen management for severe peritonitis in elderly. Results from the prospective International Register of Open Abdomen (IROA): Cohort study. Int J Surg 2020; 82:240-244. [PMID: 32891828 DOI: 10.1016/j.ijsu.2020.08.030] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Revised: 07/09/2020] [Accepted: 08/11/2020] [Indexed: 02/05/2023]
Abstract
BACKGROUND Analyzing the data of the International Register of Open Abdomen (IROA), the feasibility of open abdomen treatment has been demonstrated at every age. This new analysis on the IROA database investigates the risk factors for mortality in elderly patients treated with open abdomen for intra-abdominal infection. METHODS Data were derived from the IROA, a prospective observational international cohort study that enrolled patients treated with open abdomen worldwide. A univariate analysis of potential risk factors was performed. Inclusion criteria were patients older than 65 years and treated with open abdomen for intra-abdominal infection. End point was overall mortality, calculated within 30 days after open abdomen management, after 1-month and 1-year follow-up. RESULTS A total of 116 patients was analyzed with mean age of 76 ± 7 years. Definitive closure was achieved in 93 patients (93/116, 80.2%) for a mean open abdomen duration of 5.0 ± 5.0 days. Complicated patients were 101 (101/116, 87.1%) for a total of 201 complications. Overall, 62 out of 116 patients (53.4%) died: 23 patients (23/62, 37.1%) during open abdomen management, 29 patients (46.8%) within 30 days after abdominal closure, 9 patients (14.5%) after 1-month follow-up, and 1 patient (1.6%) after 1-year follow-up. Age did not affect mortality (75 ± 6 years in alive patients versus 77 ± 7 years in dead patients, p = 0.773). Definitive abdominal closure was the most important factor to prevent mortality. CONCLUSIONS This study confirmed that age alone cannot be considered a determinant for death, even in elderly patients managed with open abdomen for severe intra-abdominal infection.
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Affiliation(s)
- Stefano Rausei
- Department of Surgery, ASST Valle Olona, Gallarate, Varese, Italy.
| | | | - Marco Ceresoli
- Emergency and General Surgery Department, University of Milan-Bicocca, Milan, Italy
| | - Fausto Catena
- General Surgery Department, Ospedale Maggiore, Parma, Italy
| | - Massimo Sartelli
- General and Emergency Surgery, Macerata Hospital, Macerata, Italy
| | - Massimo Chiarugi
- General, Emergency and Trauma Surgery Department, Pisa University Hospital, Pisa, Italy
| | - Yoram Kluger
- Division of General Surgery, Rambam Health Care Campus, Haifa, Israel
| | - Andrew Kirkpatrick
- General, Acute Care, Abdominal Wall Reconstruction, and Trauma Surgery, Foothills Medical Centre, Calgary, Alberta, Canada
| | - Luca Ansaloni
- General, Emergency and Trauma Surgery Department, Bufalini Hospital, Cesena, Italy
| | - Federico Coccolini
- General, Emergency and Trauma Surgery Department, Pisa University Hospital, Pisa, Italy
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32
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Coccolini F, Gubbiotti F, Ceresoli M, Tartaglia D, Fugazzola P, Ansaloni L, Sartelli M, Kluger Y, Kirkpatrick A, Amico F, Catena F, Chiarugi M. Open Abdomen and Fluid Instillation in the Septic Abdomen: Results from the IROA Study. World J Surg 2020; 44:4032-4040. [PMID: 32833107 PMCID: PMC7599169 DOI: 10.1007/s00268-020-05728-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/01/2020] [Indexed: 02/05/2023]
Abstract
Background Open abdomen (OA) is a surgical option that can be used in patients with severe peritonitis. Few evidences exist to recommend the use of intraperitoneal fluid instillation associated with OA in managing septic abdomen. Materials and methods A prospective analysis of adult patients enrolled in the International Register of Open Abdomen (trial registration: NCT02382770) was performed. Results A total of 387 patients were enrolled in two groups: 84 with peritoneal fluid instillation (FI) and 303 without (NFI). The groups were homogeneous for baseline characteristics. Overall complications were 92.9% in FI and 86.3% in NFI (p = 0.106). Complications during OA were 72.6% in FI and 59.9% in NFI (p = 0.034). Complications after definitive closure were 70.8% in FI and 61.1% in NFI (p = 0.133). Entero-atmospheric fistula was 13.1% in FI and 12% in NFI (p = 0.828). Fascial closure was 78.6% in FI and 63.7% in NFI (p = 0.02). Analysis of FI in negative pressure wound therapy (NPWT) showed: Overall morbidity in NPWT was 94% and in non-NPWT 91.2% (p = 0.622) and morbidity during OA was 68% and 79.4% (p = 0.25), respectively. Definitive fascial closure in NPWT was 87.8% and 96.8% in non-NPWT (p = 0.173). Overall mortality was 40% in NPWT and 29.4% in non-NPWT (p = 0.32) and morality during OA period was 18% and 8.8% (p = 0.238), respectively. Conclusion We found intraperitoneal fluid instillation during open abdomen in peritonitic patients to increase the complication rate during the open abdomen period, with no impact on mortality, entero-atmospheric fistula rate and opening time. Fascial closure rate is increased by instillation. Fluid instillation is feasible even when associated with nonnegative pressure temporary abdominal closure techniques.
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Affiliation(s)
- Federico Coccolini
- General Emergency and Trauma Surgery Department, Pisa University Hospital, Via Paradisia, 1, 56124, Pisa, Italy.
| | | | - Marco Ceresoli
- General and Emergency Surgery Department, Milano-Bicocca University Hospital, Monza, Italy
| | - Dario Tartaglia
- General Emergency and Trauma Surgery Department, Pisa University Hospital, Via Paradisia, 1, 56124, Pisa, Italy
| | - Paola Fugazzola
- General, Emergency and Trauma Surgery Department, Bufalini Hospital, Cesena, Italy
| | - Luca Ansaloni
- General, Emergency and Trauma Surgery Department, Bufalini Hospital, Cesena, Italy
| | - Massimo Sartelli
- General and Emergency Surgery Department, Macerata Hospital, Macerata, Italy
| | - Yoram Kluger
- General Surgery Department, Rambam Medical Centre, Tel Aviv, Israel
| | | | - Francesco Amico
- Department of Surgery, Trauma Service, John Hunter Hospital, University of Newcastle, Newcastle, Australia
| | - Fausto Catena
- Emergency Surgery Department, Parma University Hospital, Parma, Italy
| | - Massimo Chiarugi
- General Emergency and Trauma Surgery Department, Pisa University Hospital, Via Paradisia, 1, 56124, Pisa, Italy
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33
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Perrone G, Sartelli M, Mario G, Chichom-Mefire A, Labricciosa FM, Abu-Zidan FM, Ansaloni L, Biffl WL, Ceresoli M, Coccolini F, Coimbra R, Demetrashvili Z, Di Saverio S, Fraga GP, Khokha V, Kirkpatrick AW, Kluger Y, Leppaniemi A, Maier RV, Moore EE, Negoi I, Ordonez CA, Sakakushev B, Lohse HAS, Velmahos GC, Wani I, Weber DG, Bonati E, Catena F. Management of intra-abdominal-infections: 2017 World Society of Emergency Surgery guidelines summary focused on remote areas and low-income nations. Int J Infect Dis 2020; 99:140-148. [PMID: 32739433 DOI: 10.1016/j.ijid.2020.07.046] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2020] [Revised: 07/23/2020] [Accepted: 07/26/2020] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND Most remote areas have restricted access to healthcare services and are too small and remote to sustain specialist services. In 2017, the World Society of Emergency Surgery (WSES) published guidelines for the management of intra-abdominal infections. Many hospitals, especially those in remote areas, continue to face logistical barriers, leading to an overall poorer adherence to international guidelines. METHODS The aim of this paper is to report and amend the 2017 WSES guidelines for the management of intra-abdominal infections, extending these recommendations for remote areas and low-income countries. A literature search of the PubMed/MEDLINE databases was conducted covering the period up until June 2020. RESULTS The critical shortages of healthcare workers and material resources in remote areas require the use of a robust triage system. A combination of abdominal signs and symptoms with early warning signs may be used to screen patients needing immediate acute care surgery. A tailored diagnostic step-up approach based on the hospital's resources is recommended. Ultrasound and plain X-ray may be useful diagnostic tools in remote areas. The source of infection should be totally controlled as soon as possible. CONCLUSIONS The cornerstones of effective treatment for intra-abdominal infections in remote areas include early diagnosis, prompt resuscitation, early source control, and appropriate antimicrobial therapy. Standardization in applying the guidelines is mandatory to adequately manage intra-abdominal infections.
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Affiliation(s)
- Gennaro Perrone
- Department of Emergency Surgery, Maggiore Hospital, Parma, Italy
| | | | - Giuffrida Mario
- Department of General Surgery, Maggiore Hospital, Parma, Italy.
| | - Alain Chichom-Mefire
- Department of Surgery and Obstetrics/Gynaecology, Regional Hospital, Limbe, Cameroon
| | - Francesco Maria Labricciosa
- Department of Biomedical Sciences and Public Health, Unit of Hygiene, Preventive Medicine and Public Health, Università Politecnica delle Marche, Ancona, Italy
| | - Fikri M Abu-Zidan
- Department of Surgery, College of Medicine and Health Sciences, UAE University, Al-Ain, United Arab Emirates
| | - Luca Ansaloni
- General Surgery Department, Papa Giovanni XXIII Hospital, Bergamo, Italy
| | - Walter L Biffl
- Acute Care Surgery at The Queen's Medical Center, John A. Burns School of Medicine, University of Hawai'i, Honolulu, USA
| | - Marco Ceresoli
- General Surgery Department, Papa Giovanni XXIII Hospital, Bergamo, Italy
| | - Federico Coccolini
- General, Emergency and Trauma Surgery Department, Pisa University Hospital, Pisa, Italy
| | - Raul Coimbra
- Department of Surgery, UC San Diego Medical Center, San Diego, CA, USA
| | - Zaza Demetrashvili
- Department of Surgery, Tbilisi State Medical University, Kipshidze Central University Hospital, Tbilisi, Georgia
| | - Salomone Di Saverio
- Department of General Surgery, University Hospital of Varese, University of Insubria, Varese, Italy
| | - Gustavo Pereira Fraga
- Division of Trauma Surgery, Department of Surgery, School of Medical Sciences, University of Campinas (Unicamp), Campinas, SP, Brazil
| | - Vladimir Khokha
- Department of Emergency Surgery, Mozyr City Hospital, Mozyr, Belarus
| | - Andrew W Kirkpatrick
- Departments of Surgery, Critical Care Medicine, and the Regional Trauma Service, Foothills Medical Centre, Calgary, Alberta, Canada
| | - Yoram Kluger
- Department of General Surgery, Division of Surgery, Rambam Health Care Campus, Haifa, Israel
| | - Ari Leppaniemi
- Abdominal Center, University Hospital Meilahti, Helsinki, Finland
| | - Ronald V Maier
- Department of Surgery, University of Washington, Seattle, WA, USA
| | - Ernest Eugene Moore
- Department of Surgery, University of Colorado, Denver Health Medical Center, Denver, CO, USA
| | - Ionut Negoi
- Department of Surgery, Emergency Hospital of Bucharest, Bucharest, Romania
| | - Carlos A Ordonez
- Department of Surgery and Critical Care, Universidad del Valle, Fundación Valle del Lili, Cali, Colombia
| | - Boris Sakakushev
- General Surgery Department, Medical University, University Hospital St George, Plovdiv, Bulgaria
| | - Helmut A Segovia Lohse
- II Cátedra de Clínica Quirúrgica, Hospital de Clínicas, Facultad de Ciencias Medicas, Universidad Nacional de Asuncion, Asuncion, Paraguay
| | - George C Velmahos
- Trauma, Emergency Surgery, and Surgical Critical Care Harvard Medical School, Massachusetts General Hospital, Boston, USA
| | - Imtaz Wani
- Department of Surgery, Sheri-Kashmir Institute of Medical Sciences, Srinagar, India
| | - Dieter G Weber
- Department of Trauma Surgery, Royal Perth Hospital, Perth, Australia
| | - Elena Bonati
- Department of General Surgery, Maggiore Hospital, Parma, Italy
| | - Fausto Catena
- Department of Emergency Surgery, Maggiore Hospital, Parma, Italy
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Sartelli M, Weber DG, Kluger Y, Ansaloni L, Coccolini F, Abu-Zidan F, Augustin G, Ben-Ishay O, Biffl WL, Bouliaris K, Catena R, Ceresoli M, Chiara O, Chiarugi M, Coimbra R, Cortese F, Cui Y, Damaskos D, De' Angelis GL, Delibegovic S, Demetrashvili Z, De Simone B, Di Marzo F, Di Saverio S, Duane TM, Faro MP, Fraga GP, Gkiokas G, Gomes CA, Hardcastle TC, Hecker A, Karamarkovic A, Kashuk J, Khokha V, Kirkpatrick AW, Kok KYY, Inaba K, Isik A, Labricciosa FM, Latifi R, Leppäniemi A, Litvin A, Mazuski JE, Maier RV, Marwah S, McFarlane M, Moore EE, Moore FA, Negoi I, Pagani L, Rasa K, Rubio-Perez I, Sakakushev B, Sato N, Sganga G, Siquini W, Tarasconi A, Tolonen M, Ulrych J, Zachariah SK, Catena F. 2020 update of the WSES guidelines for the management of acute colonic diverticulitis in the emergency setting. World J Emerg Surg 2020; 15:32. [PMID: 32381121 PMCID: PMC7206757 DOI: 10.1186/s13017-020-00313-4] [Citation(s) in RCA: 128] [Impact Index Per Article: 32.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2020] [Accepted: 04/29/2020] [Indexed: 02/08/2023] Open
Abstract
Acute colonic diverticulitis is one of the most common clinical conditions encountered by surgeons in the acute setting. An international multidisciplinary panel of experts from the World Society of Emergency Surgery (WSES) updated its guidelines for management of acute left-sided colonic diverticulitis (ALCD) according to the most recent available literature. The update includes recent changes introduced in the management of ALCD. The new update has been further integrated with advances in acute right-sided colonic diverticulitis (ARCD) that is more common than ALCD in select regions of the world.
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Affiliation(s)
| | - Dieter G Weber
- Department of General Surgery, Royal Perth Hospital, The University of Western Australia, Perth, Australia
| | - Yoram Kluger
- Department of General Surgery, Division of Surgery, Rambam Health Care Campus, Haifa, Israel
| | - Luca Ansaloni
- General Surgery Department, Bufalini Hospital Hospital, Cesena, Italy
| | - Federico Coccolini
- General, Emergency and Trauma Surgery Department, Pisa University Hospital, Pisa, Italy
| | - Fikri Abu-Zidan
- Department of Surgery, College of Medicine and Health Sciences, UAE University, Al-Ain, United Arab Emirates
| | - Goran Augustin
- Department of Surgery, University Hospital Centre Zagreb, Zagreb, Croatia
| | - Offir Ben-Ishay
- Department of General Surgery, Division of Surgery, Rambam Health Care Campus, Haifa, Israel
| | - Walter L Biffl
- Trauma Surgery Department, Scripps Memorial Hospital, La Jolla, CA, USA
| | | | - Rodolfo Catena
- Department of Emergency Surgery, Parma Maggiore Hospital, Parma, Italy
| | - Marco Ceresoli
- Department of General and Emergency Surgery, ASST, San Gerardo Hospital, Monza, Italy.,School of Medicine and Surgery, University of Milan-Bicocca, Milan, Italy
| | - Osvaldo Chiara
- General Surgery and Trauma Team, University of Milano, ASST Niguarda Milano, Milan, Italy
| | - Massimo Chiarugi
- General, Emergency and Trauma Surgery Department, Pisa University Hospital, Pisa, Italy
| | - Raul Coimbra
- Riverside University Health System Medical Center, Loma Linda University School of Medicine, Moreno Valley, CA, USA
| | | | - Yunfeng Cui
- Department of Surgery, Tianjin Nankai Hospital, Nankai Clinical School of Medicine, Tianjin Medical University, Tianjin, China
| | | | | | - Samir Delibegovic
- Department of Surgery, University Clinical Center of Tuzla, Tuzla, Bosnia and Herzegovina
| | - Zaza Demetrashvili
- Department General Surgery, Kipshidze Central University Hospital, Tbilisi, Georgia
| | - Belinda De Simone
- Department of Digestive Surgery, Guastalla Hospital, Reggio Emilia, Italy
| | | | - Salomone Di Saverio
- Colorectal Unit, Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | | | - Mario Paulo Faro
- Department of General Surgery, Trauma and Emergency Surgery Division, ABC Medical School, Santo André, SP, Brazil
| | - Gustavo P Fraga
- Trauma/Acute Care Surgery & Surgical Critical Care, University of Campinas, Campinas, Brazil
| | - George Gkiokas
- Second Department of Surgery, Aretaieion University Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Carlos Augusto Gomes
- Department of Surgery, Hospital Universitário Terezinha de Jesus, Faculdade de Ciências Médicas e da Saúde de Juiz de Fora, Juiz de Fora, Brazil
| | - Timothy C Hardcastle
- Trauma Service, Inkosi Albert Luthuli Central Hospital and Department of Surgery, Nelson R Mandela School of Clinical Medicine, Durban, South Africa
| | - Andreas Hecker
- Department of General and Thoracic Surgery, University Hospital Giessen, Giessen, Germany
| | | | - Jeffry Kashuk
- Department of Surgery, Assia Medical Group, Tel Aviv University Sackler School of Medicine, Tel Aviv, Israel
| | - Vladimir Khokha
- Department of Emergency Surgery, City Hospital, Mozyr, Belarus
| | - Andrew W Kirkpatrick
- General, Acute Care, Abdominal Wall Reconstruction, and Trauma Surgery, Foothills Medical Centre, Calgary, AB, Canada
| | - Kenneth Y Y Kok
- Department of Surgery, The Brunei Cancer Centre, Jerudong Park, Brunei
| | - Kenji Inaba
- Division of Acute Care Surgery and Surgical Critical Care, Department of Surgery, Los Angeles County and University of Southern California Medical Center, University of Southern California, Los Angeles, CA, USA
| | - Arda Isik
- Department of General Surgery, Faculty of Medicine, Erzincan University, Erzincan, Turkey
| | | | - Rifat Latifi
- Department of Surgery, Westchester Medical Center, New York Medical College, Valhalla, NY, USA
| | - Ari Leppäniemi
- Abdominal Center, University Hospital Meilahti, Helsinki, Finland
| | - Andrey Litvin
- Surgical Disciplines, Immanuel Kant Baltic Federal University/Regional Clinical Hospital, Kaliningrad, Russian Federation
| | - John E Mazuski
- Department of Surgery, School of Medicine, Washington University, Saint Louis, USA
| | - Ronald V Maier
- Department of Surgery, University of Washington, Seattle, WA, USA
| | - Sanjay Marwah
- Department of Surgery, Post-Graduate Institute of Medical Sciences, Rohtak, India
| | - Michael McFarlane
- Department of Surgery, Radiology, University Hospital of the West Indies, Kingston, Jamaica
| | - Ernest E Moore
- Department of Surgery, Denver Health Medical Center, University of Colorado, Denver, CO, USA
| | - Frederick A Moore
- Department of Surgery, Division of Acute Care Surgery, and Center for Sepsis and Critical Illness Research, University of Florida College of Medicine, Gainesville, FL, USA
| | - Ionut Negoi
- Department of Surgery, Emergency Hospital of Bucharest, Bucharest, Romania
| | - Leonardo Pagani
- Infectious Diseases Unit, Bolzano Central Hospital, Bolzano, Italy
| | - Kemal Rasa
- Department of Surgery, Anadolu Medical Center, Kocaali, Turkey
| | - Ines Rubio-Perez
- General Surgery Department, Colorectal Surgery Unit, La Paz University Hospital, Madrid, Spain
| | - Boris Sakakushev
- General Surgery Department, Medical University, University Hospital St George, Plovdiv, Bulgaria
| | - Norio Sato
- Department of Aeromedical Services for Emergency and Trauma Care, Ehime University Graduate School of Medicine, Ehime, Japan
| | - Gabriele Sganga
- Emergency Surgery, Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Walter Siquini
- Department of Surgery, Macerata Hospital, Macerata, Italy
| | - Antonio Tarasconi
- Department of Emergency Surgery, Parma Maggiore Hospital, Parma, Italy
| | - Matti Tolonen
- Abdominal Center, University Hospital Meilahti, Helsinki, Finland
| | - Jan Ulrych
- First Department of Surgery, First Faculty of Medicine, Charles University in Prague and General University Hospital in Prague, Prague, Czech Republic
| | | | - Fausto Catena
- Department of Emergency Surgery, Parma Maggiore Hospital, Parma, Italy
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Di Saverio S, Podda M, De Simone B, Ceresoli M, Augustin G, Gori A, Boermeester M, Sartelli M, Coccolini F, Tarasconi A, De' Angelis N, Weber DG, Tolonen M, Birindelli A, Biffl W, Moore EE, Kelly M, Soreide K, Kashuk J, Ten Broek R, Gomes CA, Sugrue M, Davies RJ, Damaskos D, Leppäniemi A, Kirkpatrick A, Peitzman AB, Fraga GP, Maier RV, Coimbra R, Chiarugi M, Sganga G, Pisanu A, De' Angelis GL, Tan E, Van Goor H, Pata F, Di Carlo I, Chiara O, Litvin A, Campanile FC, Sakakushev B, Tomadze G, Demetrashvili Z, Latifi R, Abu-Zidan F, Romeo O, Segovia-Lohse H, Baiocchi G, Costa D, Rizoli S, Balogh ZJ, Bendinelli C, Scalea T, Ivatury R, Velmahos G, Andersson R, Kluger Y, Ansaloni L, Catena F. Diagnosis and treatment of acute appendicitis: 2020 update of the WSES Jerusalem guidelines. World J Emerg Surg 2020; 15:27. [PMID: 32295644 PMCID: PMC7386163 DOI: 10.1186/s13017-020-00306-3] [Citation(s) in RCA: 399] [Impact Index Per Article: 99.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2020] [Accepted: 03/30/2020] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND AND AIMS Acute appendicitis (AA) is among the most common causes of acute abdominal pain. Diagnosis of AA is still challenging and some controversies on its management are still present among different settings and practice patterns worldwide. In July 2015, the World Society of Emergency Surgery (WSES) organized in Jerusalem the first consensus conference on the diagnosis and treatment of AA in adult patients with the intention of producing evidence-based guidelines. An updated consensus conference took place in Nijemegen in June 2019 and the guidelines have now been updated in order to provide evidence-based statements and recommendations in keeping with varying clinical practice: use of clinical scores and imaging in diagnosing AA, indications and timing for surgery, use of non-operative management and antibiotics, laparoscopy and surgical techniques, intra-operative scoring, and peri-operative antibiotic therapy. METHODS This executive manuscript summarizes the WSES guidelines for the diagnosis and treatment of AA. Literature search has been updated up to 2019 and statements and recommendations have been developed according to the GRADE methodology. The statements were voted, eventually modified, and finally approved by the participants to the consensus conference and by the board of co-authors, using a Delphi methodology for voting whenever there was controversy on a statement or a recommendation. Several tables highlighting the research topics and questions, search syntaxes, and the statements and the WSES evidence-based recommendations are provided. Finally, two different practical clinical algorithms are provided in the form of a flow chart for both adults and pediatric (< 16 years old) patients. CONCLUSIONS The 2020 WSES guidelines on AA aim to provide updated evidence-based statements and recommendations on each of the following topics: (1) diagnosis, (2) non-operative management for uncomplicated AA, (3) timing of appendectomy and in-hospital delay, (4) surgical treatment, (5) intra-operative grading of AA, (6) ,management of perforated AA with phlegmon or abscess, and (7) peri-operative antibiotic therapy.
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Affiliation(s)
- Salomone Di Saverio
- Cambridge Colorectal Unit, Cambridge University Hospitals NHS Foundation Trust, Addenbrooke's Hospital, Cambridge Biomedical Campus, Hills Road, Cambridge, CB2 0QQ, UK.
- Department of General Surgery, University of Insubria, University Hospital of Varese, ASST Sette Laghi, Regione Lombardia, Varese, Italy.
| | - Mauro Podda
- Department of General and Emergency Surgery, Cagliari University Hospital, Cagliari, Italy
| | - Belinda De Simone
- Emergency and Trauma Surgery Department, Maggiore Hospital of Parma, Parma, Italy
| | - Marco Ceresoli
- Emergency and General Surgery Department, University of Milan-Bicocca, Milan, Italy
| | - Goran Augustin
- Department of Surgery, University Hospital Centre of Zagreb, Zagreb, Croatia
| | - Alice Gori
- Maggiore Hospital Regional Emergency Surgery and Trauma Center, Bologna Local Health District, Bologna, Italy
| | - Marja Boermeester
- Department of Surgery, University of Amsterdam, Amsterdam, The Netherlands
| | | | - Federico Coccolini
- General, Emergency and Trauma Surgery, Pisa University Hospital, Pisa, Italy
| | - Antonio Tarasconi
- Emergency and Trauma Surgery Department, Maggiore Hospital of Parma, Parma, Italy
| | - Nicola De' Angelis
- Department of Digestive, Hepato-Pancreato-Biliary Surgery and Liver Transplantation, Henri Mondor University Hospital, Paris, France
| | - Dieter G Weber
- Trauma and General Surgeon Royal Perth Hospital & The University of Western Australia, Perth, Australia
| | - Matti Tolonen
- Department of Abdominal Surgery, Abdominal Center, University of Helsinki and Helsinki University Central Hospital, Helsinki, Finland
| | - Arianna Birindelli
- Department of General Surgery, Azienda Socio Sanitaria Territoriale, di Valle Camonica, Italy
| | - Walter Biffl
- Queen's Medical Center, University of Hawaii, Honolulu, HI, USA
| | - Ernest E Moore
- Denver Health System - Denver Health Medical Center, Denver, USA
| | - Michael Kelly
- Acute Surgical Unit, Canberra Hospital, ACT, Canberra, Australia
| | - Kjetil Soreide
- Department of Gastrointestinal Surgery, Stavanger University Hospital, Stavanger, Norway
| | - Jeffry Kashuk
- Department of Surgery, University of Jerusalem, Jerusalem, Israel
| | - Richard Ten Broek
- Department of Surgery, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Carlos Augusto Gomes
- Department of Surgery Hospital Universitario, Universidade General de Juiz de Fora, Juiz de Fora, Brazil
| | | | - Richard Justin Davies
- Cambridge Colorectal Unit, Cambridge University Hospitals NHS Foundation Trust, Addenbrooke's Hospital, Cambridge Biomedical Campus, Hills Road, Cambridge, CB2 0QQ, UK
| | - Dimitrios Damaskos
- Department of Upper GI Surgery, Royal Infirmary of Edinburgh, Edinburgh, Scotland, UK
| | - Ari Leppäniemi
- Department of Abdominal Surgery, Abdominal Center, University of Helsinki and Helsinki University Central Hospital, Helsinki, Finland
| | - Andrew Kirkpatrick
- General, Acute Care, Abdominal Wall Reconstruction, and Trauma Surgery, Foothills Medical Centre, Calgary, Alberta, Canada
| | - Andrew B Peitzman
- Department of Surgery, University of Pittsburgh School of Medicine, UPMC-Presbyterian, Pittsburgh, USA
| | - Gustavo P Fraga
- Faculdade de Ciências Médicas (FCM) - Unicamp, Campinas, SP, Brazil
| | - Ronald V Maier
- Department of Surgery, University of Washington, Harborview Medical Center, Seattle, WA, USA
| | - Raul Coimbra
- UCSD Health System - Hillcrest Campus Department of Surgery Chief Division of Trauma, Surgical Critical Care, Burns, and Acute Care Surgery, San Diego, CA, USA
| | - Massimo Chiarugi
- General, Emergency and Trauma Surgery, Pisa University Hospital, Pisa, Italy
| | - Gabriele Sganga
- Department of Emergency Surgery, "A. Gemelli Hospital", Catholic University of Rome, Rome, Italy
| | - Adolfo Pisanu
- Department of General and Emergency Surgery, Cagliari University Hospital, Cagliari, Italy
| | - Gian Luigi De' Angelis
- Gastroenterology and Endoscopy Unit, University Hospital of Parma, University of Parma, Parma, Italy
| | - Edward Tan
- Department of Surgery, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Harry Van Goor
- Department of Surgery, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Francesco Pata
- Department of Surgery, Nicola Giannettasio Hospital, Corigliano-Rossano, and La Sapienza University of Rome, Rome, Italy
| | - Isidoro Di Carlo
- Department of Surgical Sciences and Advanced Technologies "GF Ingrassia", Cannizzaro Hospital, University of Catania, Catania, Italy
| | | | - Andrey Litvin
- Department of Surgery, Immanuel Kant Baltic Federal University, Kaliningrad, Russia
| | - Fabio C Campanile
- Department of Surgery, San Giovanni Decollato Andosilla Hospital, Viterbo, Italy
| | - Boris Sakakushev
- General Surgery Department, Medical University, University Hospital St George, Plovdiv, Bulgaria
| | - Gia Tomadze
- Department of Surgery, Tbilisi State Medical University, TSMU, Tbilisi, Georgia
| | - Zaza Demetrashvili
- Department of Surgery, Tbilisi State Medical University, TSMU, Tbilisi, Georgia
| | - Rifat Latifi
- Section of Acute Care Surgery, Westchester Medical Center, Department of Surgery, New York Medical College, Valhalla, NY, USA
| | - Fakri Abu-Zidan
- Department of Surgery, College of Medicine and Health Sciences, UAE University, Al-Ain, United Arab Emirates
| | | | | | - Gianluca Baiocchi
- Surgical Clinic, Department of Experimental and Clinical Sciences, University of Brescia, Brescia, Italy
| | - David Costa
- Hospital universitario de Alicante, departamento de Cirugia General, Alicante, Spain
| | - Sandro Rizoli
- Department of Surgery, St. Michael Hospital, University of Toronto, Toronto, Canada
| | - Zsolt J Balogh
- Department of Traumatology, John Hunter Hospital and University of Newcastle, Newcastle, NSW, Australia
| | - Cino Bendinelli
- Department of Traumatology, John Hunter Hospital and University of Newcastle, Newcastle, NSW, Australia
| | | | - Rao Ivatury
- Professor Emeritus Virginia Commonwealth University, Richmond, VA, USA
| | - George Velmahos
- Harvard Medical School, Massachusetts General Hospital, Boston, USA
| | | | - Yoram Kluger
- Division of General Surgery, Rambam Health Care Campus, Haifa, Israel
| | - Luca Ansaloni
- Department of General Surgery and Trauma, Bufalini Hospital, Cesena, Italy
| | - Fausto Catena
- Emergency and Trauma Surgery Department, Maggiore Hospital of Parma, Parma, Italy
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Coccolini F, Coimbra R, Ordonez C, Kluger Y, Vega F, Moore EE, Biffl W, Peitzman A, Horer T, Abu-Zidan FM, Sartelli M, Fraga GP, Cicuttin E, Ansaloni L, Parra MW, Millán M, DeAngelis N, Inaba K, Velmahos G, Maier R, Khokha V, Sakakushev B, Augustin G, di Saverio S, Pikoulis E, Chirica M, Reva V, Leppaniemi A, Manchev V, Chiarugi M, Damaskos D, Weber D, Parry N, Demetrashvili Z, Civil I, Napolitano L, Corbella D, Catena F. Liver trauma: WSES 2020 guidelines. World J Emerg Surg 2020; 15:24. [PMID: 32228707 PMCID: PMC7106618 DOI: 10.1186/s13017-020-00302-7] [Citation(s) in RCA: 105] [Impact Index Per Article: 26.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2020] [Accepted: 03/06/2020] [Indexed: 02/06/2023] Open
Abstract
Liver injuries represent one of the most frequent life-threatening injuries in trauma patients. In determining the optimal management strategy, the anatomic injury, the hemodynamic status, and the associated injuries should be taken into consideration. Liver trauma approach may require non-operative or operative management with the intent to restore the homeostasis and the normal physiology. The management of liver trauma should be multidisciplinary including trauma surgeons, interventional radiologists, and emergency and ICU physicians. The aim of this paper is to present the World Society of Emergency Surgery (WSES) liver trauma management guidelines.
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Affiliation(s)
- Federico Coccolini
- General, Emergency and Trauma Surgery Department, Pisa University Hospital, Via Paradisia 1, 56100, Pisa, Italy.
| | - Raul Coimbra
- Riverside University Health System, CECORC Research Center, Loma Linda University, Loma Linda, USA
| | - Carlos Ordonez
- Division of Trauma and Acute Care Surgery, Fundación Valle del Lili, Cali, Colombia
| | - Yoram Kluger
- Division of General Surgery, Rambam Health Care Campus Haifa, Haifa, Israel
| | - Felipe Vega
- Department of Surgery, Hospital Angeles Lomas, Huixquilucan, Mexico
| | | | - Walt Biffl
- Trauma Surgery Department, Scripps Memorial Hospital La Jolla, San Diego, CA, USA
| | - Andrew Peitzman
- Surgery Department, University of Pittsburgh, Pittsburgh, PA, USA
| | - Tal Horer
- Department of Cardiothoracic and Vascular Surgery, Örebro University Hospital, Örebro University, Örebro, Sweden.,Department of Surgery, Örebro University Hospital, Örebro University, Örebro, Sweden
| | - Fikri M Abu-Zidan
- Department of Surgery, College of Medicine and Health Sciences, UAE University, Al-Ain, United Arab Emirates
| | - Massimo Sartelli
- General and Emergency Surgery, Macerata Hospital, Macerata, Italy
| | - Gustavo P Fraga
- Trauma/Acute Care Surgery & Surgical Critical Care, University of Campinas, Campinas, Brazil
| | - Enrico Cicuttin
- General, Emergency and Trauma Surgery Department, Pisa University Hospital, Via Paradisia 1, 56100, Pisa, Italy
| | - Luca Ansaloni
- General, Emergency and Trauma Surgery Department, Bufalini Hospital, Cesena, Italy
| | - Michael W Parra
- Department of Trauma Critical Care, Broward General Level I Trauma Center, Fort Lauderdale, FL, USA
| | - Mauricio Millán
- Division of Trauma and Acute Care Surgery, Fundación Valle del Lili, Cali, Colombia
| | - Nicola DeAngelis
- Unit of Digestive Surgery, HPB Surgery and Liver Transplant, Henri Mondor Hospital, Créteil, France
| | - Kenji Inaba
- General and Trauma Surgery, LAC+USC Medical Center, Los Angeles, CA, USA
| | - George Velmahos
- General and Emergency Surgery, Massachusetts General Hospital, Boston, MA, USA
| | - Ron Maier
- Department of Surgery, Harborview Medical Centre, Seattle, USA
| | - Vladimir Khokha
- General Surgery Department, Mozir City Hospital, Mozir, Belarus
| | - Boris Sakakushev
- General Surgery Department, Medical University, University Hospital St George, Plovdiv, Bulgaria
| | - Goran Augustin
- Department of Surgery, Zagreb University Hospital Centre and School of Medicine, University of Zagreb, Zagreb, Croatia
| | - Salomone di Saverio
- General and Trauma Surgery Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | - Emanuil Pikoulis
- 3rd Department of Surgery, Attiko Hospital, National & Kapodistrian University of Athens, Athens, Greece
| | - Mircea Chirica
- Chirurgie Digestive, CHUGA-CHU Grenoble Alpes, Grenoble, France
| | - Viktor Reva
- General and Emergency Surgery, Sergei Kirov Military Academy, Saint Petersburg, Russia
| | - Ari Leppaniemi
- General Surgery Department, Mehilati Hospital, Helsinki, Finland
| | - Vassil Manchev
- General and Trauma Surgery Department, Pietermaritzburg Hospital, Pietermaritzburg, South Africa
| | - Massimo Chiarugi
- General, Emergency and Trauma Surgery Department, Pisa University Hospital, Via Paradisia 1, 56100, Pisa, Italy
| | | | - Dieter Weber
- Department of General Surgery, Royal Perth Hospital, Perth, Australia
| | - Neil Parry
- General and Trauma Surgery Department, London Health Sciences Centre, Victoria Hospital, London, ON, Canada
| | | | - Ian Civil
- Trauma Surgery, Auckland University Hospital, Auckland, New Zealand
| | - Lena Napolitano
- Division of Acute Care Surgery, University of Michigan Health System, Ann Arbor, MI, USA
| | | | - Fausto Catena
- Emergency and Trauma Surgery, Maggiore Hospital, Parma, Italy
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De Simone B, Ansaloni L, Sartelli M, Kluger Y, Abu-Zidan FM, Biffl WL, Heyer A, Coccolini F, Baiocchi GL, Catena F. Correction to: The Operative management in Bariatric Acute abdomen (OBA) Survey: long-term complications of bariatric surgery and the emergency surgeon’s point of view. World J Emerg Surg 2020. [PMCID: PMC7001328 DOI: 10.1186/s13017-020-0292-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023] Open
Abstract
The original article [1] contained an error in authorship whereby author, Fausto Catena was mistakenly listed as part of the institutional authorship of the OBA trial supporters instead of in the correct position of final author.
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De Simone B, Ansaloni L, Sartelli M, Kluger Y, Abu-Zidan FM, Biffl WL, Heyer A, Coccolini F, Baiocchi GL, Catena F. The Operative management in Bariatric Acute abdomen (OBA) Survey: long-term complications of bariatric surgery and the emergency surgeon's point of view. World J Emerg Surg 2020; 15:2. [PMID: 32005129 PMCID: PMC6945511 DOI: 10.1186/s13017-019-0281-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2019] [Accepted: 12/16/2019] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND The number of bariatric procedures is increasing worldwide. No consensus or guidelines about the emergency management of long-term complications following bariatric surgery are currently available. The aim of this study is to investigate by a web survey how an emergency surgeon approaches this unique group of patients in an emergency medical scenario and to report their personal experience. METHOD An international web survey was sent to 197 emergency surgeons with the aim to collect data about emergency surgeons' experience in the management of patients admitted in the emergency department for acute abdominal pain after bariatric surgery. The survey was conceived as a questionnaire composed by 26 (multiple choice and open) questions and approved by a steering committee. RESULTS One hundred seventeen international emergency surgeons decided to join the project and answered to the web survey with a response rate of 59.39%. CONCLUSIONS The aim of this WSES web survey was to highlight the current management of patients previously submitted to bariatric surgical procedures by ES. Emergency surgeons must be mindful of postoperative bariatric surgery complications. CT scan with oral intestinal opacification may be useful in making a diagnosis if carefully interpreted by the radiologist and the surgeon. In case of inconclusive clinical and radiological findings, when symptoms fail to improve, surgical exploration for bariatric patients presenting acute abdominal pain, by laparoscopy if expertise is available, is mandatory in the first 12-24 h, to have good outcomes and decrease morbidity rate.
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Affiliation(s)
- Belinda De Simone
- Department of General and Emergency Surgery, Azienda Usl Reggio Emilia IRCCS, Reggio Emilia, Italy
| | - Luca Ansaloni
- Department of Emergency and Trauma Surgery, Bufalini Hospital, Cesena, Italy
| | - Massimo Sartelli
- Department of General Surgery, Macerata’s Hospital, Macerata, Italy
| | - Yoram Kluger
- Department of Emergency and Trauma Surgery, Rambam Health Campus, Haifa, Israel
| | - Fikri M. Abu-Zidan
- Department of Surgery, College of Medicine and Health Sciences, UAE University, Al-Ain, United Arab Emirates
| | - Walter L. Biffl
- Department of Trauma and Acute Care Surgery, Scripps Memorial Hospital, La Jolla, California USA
| | - Arianna Heyer
- Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania USA
| | | | | | - Fausto Catena
- Department of Emergency and Trauma Surgery, Parma University Hospital, Parma, Italy
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39
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Demetrashvili Z, Kenchadze G, Pipia I, Khutsishvili K, Loladze D, Ekaladze E, Merabishvili G, Kamkamidze G. Comparison of treatment methods of appendiceal mass and abscess: A prospective Cohort Study. Ann Med Surg (Lond) 2019; 48:48-52. [PMID: 31719976 DOI: 10.1016/j.amsu.2019.10.016] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2019] [Revised: 10/09/2019] [Accepted: 10/19/2019] [Indexed: 02/05/2023] Open
Abstract
Background The aim of our prospective study is to compare and analyze the results of two treatment methods of appendiceal mass and abscess: emergency surgery and conservative treatment with and without interval surgery. Materials and methods 74 Patients with the diagnosis of appendiceal mass or abscess were enrolled in this study. The patients were assigned into two groups: the emergency surgery group and the conservative management group. The conservative management group was subdivided into two groups: interval surgery group and the ambulatory follow-up observation group without interval surgery. Several clinical characteristics were determined and compared between the groups. Among patients who underwent surgery, the surgical methods, operation time, postoperative hospitalization period, and post-surgical complications were analyzed. In the ambulatory follow-up observation group, recurrence of appendicitis was assessed. Results Comparison of the emergency surgery group and interval surgery group revealed that the interval surgery group was characterized by shorter operation time (P = 0.008), a smallernumber of postoperative complications (P = 0.02) and also shorter postoperative hospital stay (P = 0.009). In the ambulatory follow-up observation group, recurrence of appendicitis developed in 3 (13%) patients. US or CT-guided PCD was performed in all 3 patients on the conservative treatment stage. Comparing the interval surgery and recurrent appendicitis groups revealed statistically significant difference: operation time (P = 0.04) as well as postoperative hospital stay (P = 0.04) were shorter in recurrent appendicitis group. In 3 (4.1%) patients, the cause of the appendiceal mass was caecal cancer (2 cases) and Crohn's disease. Conclusion Conservative treatment without interval surgery seems to be the preferred method for treatment of appendiceal mass and abscess. Patients can be operated on only in case of recurrence of appendicitis. US or CT PCD of appendiceal abscess presents the risk-factor for the development of recurrence of appendicitis. CT and colonoscopy within 4–6 weeks after completing the conservative treatment is recommended to be performed in all patients. Conservative treatment without interval surgery should be the method of choice for treatment of appendiceal mass and abscess. Patients should be operated only in case of recurrence of appendicitis. US or CT PCD of appendiceal abscess present the risk-factor for the development of recurrence of appendicitis. All patients should be performed CT and colonoscopy in 4–6 weeks after completing the conservative treatment.
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40
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Ceresoli M, Salvetti F, Kluger Y, Braga M, Viganò J, Fugazzola P, Sartelli M, Ansaloni L, Catena F, Coccolini F. Open Abdomen in Obese Patients: Pay Attention! New Evidences from IROA, the International Register of Open Abdomen. World J Surg 2019; 44:53-62. [PMID: 31602518 DOI: 10.1007/s00268-019-05209-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
BACKGROUND Open abdomen is the cornerstone of damage control strategies in acute care and trauma surgery. The role of BMI has not been well investigated. The aim of the study was to assess the role of BMI in determining outcomes after open abdomen. METHODS This is an analysis of patients recorded into the International Register of Open Abdomen; patients were classified in two groups according to BMI using a cutoff of 30 kg/m2. The primary outcome was in-hospital mortality; secondary outcomes were primary fascia closure rate, length of treatment, complication rate, entero-atmospheric fistula rate and length of ICU stay. RESULTS A total of 591 patients were enrolled from 57 centers, and obese patients were 127 (21.5%). There was no difference in mortality between the two groups; complications developed during the open treatment were higher in obese patients (63.8% vs. 53.4%, p = 0.038) while post-closure complications rate was similar. Obese patients had a significantly longer duration of the open treatment (9.1 ± 11.5 days vs. 6.3 ± 7.5 days; p = 0,002) and lower primary fascia closure rate (75.5% vs. 89.5%; p < 0,001). No differences in fistula rate were found. There was a linear correlation between the duration of open abdomen and the BMI (Pearson's linear correlation coefficient = 0,201; p < 0,001). CONCLUSIONS Open abdomen in obese patients seems to be safe as in non-obese patients with similar mortality; however, in obese patients the length of open abdomen is significantly higher with higher complication rate, longer ICU length of stay and lower primary fascia closure rate. TRIAL REGISTRATION NUMBER ClinicalTrials.gov, Identifier: NCT02382770.
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Affiliation(s)
- Marco Ceresoli
- School of Medicine and Surgery, Milano-Bicocca University, Monza, Italy. .,General and Emergency Surgery Department, ASST Monza, Via Pergolesi 33, 20900, Monza, Italy.
| | - Francesco Salvetti
- General and Emergency Surgery Department, Papa Giovanni XXIII Hospital, Bergamo, Italy.,Internal Medicine and Medical Therapy Department, School of Medicine and Surgery, University of Pavia, Pavia, Italy
| | - Yoram Kluger
- Division of General Surgery, Rambam Health Care Campus, Haifa, Israel
| | - Marco Braga
- School of Medicine and Surgery, Milano-Bicocca University, Monza, Italy.,General and Emergency Surgery Department, ASST Monza, Via Pergolesi 33, 20900, Monza, Italy
| | - Jacopo Viganò
- Internal Medicine and Medical Therapy Department, School of Medicine and Surgery, University of Pavia, Pavia, Italy.,General Surgery I, Surgery Department, Fondazione IRCCS Policlinico S. Matteo, Pavia, Italy
| | - Paola Fugazzola
- General, Emergency and Trauma Surgery Department, Bufalini Hospital, Cesena, Italy
| | - Massimo Sartelli
- General and Emergency Surgery, Macerata Hospital, Macerata, Italy
| | - Luca Ansaloni
- General, Emergency and Trauma Surgery Department, Bufalini Hospital, Cesena, Italy
| | - Fausto Catena
- Emergency Surgery Department, Parma University Hospital, Parma, Italy
| | - Federico Coccolini
- General, Emergency and Trauma Surgery Department, Bufalini Hospital, Cesena, Italy
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41
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Sartelli M, Di Bella S, McFarland LV, Khanna S, Furuya-Kanamori L, Abuzeid N, Abu-Zidan FM, Ansaloni L, Augustin G, Bala M, Ben-Ishay O, Biffl WL, Brecher SM, Camacho-Ortiz A, Caínzos MA, Chan S, Cherry-Bukowiec JR, Clanton J, Coccolini F, Cocuz ME, Coimbra R, Cortese F, Cui Y, Czepiel J, Demetrashvili Z, Di Carlo I, Di Saverio S, Dumitru IM, Eckmann C, Eiland EH, Forrester JD, Fraga GP, Frossard JL, Fry DE, Galeiras R, Ghnnam W, Gomes CA, Griffiths EA, Guirao X, Ahmed MH, Herzog T, Kim JI, Iqbal T, Isik A, Itani KMF, Labricciosa FM, Lee YY, Juang P, Karamarkovic A, Kim PK, Kluger Y, Leppaniemi A, Lohsiriwat V, Machain GM, Marwah S, Mazuski JE, Metan G, Moore EE, Moore FA, Ordoñez CA, Pagani L, Petrosillo N, Portela F, Rasa K, Rems M, Sakakushev BE, Segovia-Lohse H, Sganga G, Shelat VG, Spigaglia P, Tattevin P, Tranà C, Urbánek L, Ulrych J, Viale P, Baiocchi GL, Catena F. 2019 update of the WSES guidelines for management of Clostridioides ( Clostridium) difficile infection in surgical patients. World J Emerg Surg 2019. [PMID: 30858872 DOI: 10.1186/s13017-19-0228-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] [Imported: 10/13/2023] Open
Abstract
In the last three decades, Clostridium difficile infection (CDI) has increased in incidence and severity in many countries worldwide. The increase in CDI incidence has been particularly apparent among surgical patients. Therefore, prevention of CDI and optimization of management in the surgical patient are paramount. An international multidisciplinary panel of experts from the World Society of Emergency Surgery (WSES) updated its guidelines for management of CDI in surgical patients according to the most recent available literature. The update includes recent changes introduced in the management of this infection.
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Affiliation(s)
- Massimo Sartelli
- Department of Surgery, Macerata Hospital, Via Santa Lucia 2, 62100 Macerata, Italy
| | - Stefano Di Bella
- 2Infectious Diseases Department, Trieste University Hospital, Trieste, Italy
| | - Lynne V McFarland
- 3Medicinal Chemistry, School of Pharmacy, University of Washington, Seattle, WA USA
| | - Sahil Khanna
- 4Division of Gastroenterology and Hepatology, Department of Medicine, Mayo Clinic, Rochester, MN USA
| | - Luis Furuya-Kanamori
- 5Research School of Population Health, Australian National University, Acton, ACT Australia
| | - Nadir Abuzeid
- 6Department of Microbiology, Faculty of Medical Laboratory Sciences, Omdurman Islamic University, Khartoum, Sudan
| | - Fikri M Abu-Zidan
- 7Department of Surgery, College of Medicine and Health Sciences, UAE University, Al-Ain, United Arab Emirates
| | - Luca Ansaloni
- 8Department of General Surgery, Bufalini Hospital, Cesena, Italy
| | - Goran Augustin
- 9Department of Surgery, University Hospital Centre Zagreb and School of Medicine, University of Zagreb, Zagreb, Croatia
| | - Miklosh Bala
- 10Trauma and Acute Care Surgery Unit, Hadassah Hebrew University Medical Center, Jerusalem, Israel
| | - Offir Ben-Ishay
- 11Department of General Surgery, Rambam Health Care Campus, Haifa, Israel
| | - Walter L Biffl
- 12Trauma and Acute Care Surgery, Scripps Memorial Hospital La Jolla, La Jolla, CA USA
| | - Stephen M Brecher
- 13Pathology and Laboratory Medicine, VA Boston Healthcare System, West Roxbury MA and BU School of Medicine, Boston, MA USA
| | - Adrián Camacho-Ortiz
- Department of Internal Medicine, University Hospital, Dr. José E. González, Monterrey, Mexico
| | - Miguel A Caínzos
- 15Department of Surgery, University of Santiago de Compostela, A Coruña, Spain
| | - Shirley Chan
- 16Department of General Surgery, Medway Maritime Hospital, Gillingham, Kent UK
| | - Jill R Cherry-Bukowiec
- 17Department of Surgery, Division of Acute Care Surgery, University of Michigan, Ann Arbor, MI USA
| | - Jesse Clanton
- 18Department of Surgery, West Virginia University Charleston Division, Charleston, WV USA
| | | | - Maria E Cocuz
- 19Faculty of Medicine, Transilvania University, Infectious Diseases Hospital, Brasov, Romania
| | - Raul Coimbra
- 20Riverside University Health System Medical Center and Loma Linda University School of Medicine, Moreno Valley, CA USA
| | | | - Yunfeng Cui
- Department of Surgery, Tianjin Nankai Hospital, Nankai Clinical School of Medicine, Tianjin Medical University, Tianjin, China
| | - Jacek Czepiel
- 23Department of Infectious Diseases, Jagiellonian University, Medical College, Kraków, Poland
| | - Zaza Demetrashvili
- 24Department of Surgery, Tbilisi State Medical University, Kipshidze Central University Hospital, Tbilisi, Georgia
| | - Isidoro Di Carlo
- 25Department of Surgical Sciences, Cannizzaro Hospital, University of Catania, Catania, Italy
| | - Salomone Di Saverio
- 26Department of Surgery, Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | - Irina M Dumitru
- 27Clinical Infectious Diseases Hospital, Ovidius University, Constanta, Romania
| | - Christian Eckmann
- Department of General, Visceral and Thoracic Surgery, Klinikum Peine, Hospital of Medical University Hannover, Peine, Germany
| | | | | | - Gustavo P Fraga
- 31Division of Trauma Surgery, Hospital de Clinicas, School of Medical Sciences, University of Campinas, Campinas, Brazil
| | - Jean L Frossard
- 32Service of Gastroenterology and Hepatology, Geneva University Hospital, Genève, Switzerland
| | - Donald E Fry
- 33Department of Surgery, Northwestern University Feinberg School of Medicine, Chicago, IL USA.,34University of New Mexico School of Medicine, Albuquerque, NM USA
| | - Rita Galeiras
- 35Critical Care Unit, Instituto de Investigación Biomédica de A Coruña (INIBIC), Complexo Hospitalario Universitario de A Coruña (CHUAC), Sergas, Universidade da Coruña (UDC), A Coruña, Spain
| | - Wagih Ghnnam
- 36Department of Surgery Mansoura, Faculty of Medicine, Mansoura University, Mansoura, Egypt
| | - Carlos A Gomes
- 37Surgery Department, Hospital Universitario (HU) Terezinha de Jesus da Faculdade de Ciencias Medicas e da Saude de Juiz de Fora (SUPREMA), Hospital Universitario (HU) Universidade Federal de Juiz de Fora (UFJF), Juiz de Fora, Brazil
| | - Ewen A Griffiths
- 38Department of Surgery, Queen Elizabeth Hospital, Birmingham, UK
| | - Xavier Guirao
- Unit of Endocrine, Head, and Neck Surgery and Unit of Surgical Infections Support, Department of General Surgery, Parc Taulí, Hospital Universitari, Sabadell, Spain
| | - Mohamed H Ahmed
- 40Department of Medicine, Milton Keynes University Hospital NHS Foundation Trust, Milton Keynes, Buckinghamshire UK
| | - Torsten Herzog
- 41Department of Surgery, St. Josef Hospital, Ruhr University Bochum, Bochum, Germany
| | - Jae Il Kim
- 42Department of Surgery, Ilsan Paik Hospital, Inje University College of Medicine, Goyang, Republic of Korea
| | - Tariq Iqbal
- 43Department of Gastroenterology, Queen Elizabeth Hospital, Birmingham, UK
| | - Arda Isik
- 44General Surgery Department, Magee Womens Hospital, UPMC, Pittsburgh, USA
| | - Kamal M F Itani
- 45Department of Surgery, VA Boston Health Care System, Boston University and Harvard Medical School, Boston, MA USA
| | | | - Yeong Y Lee
- 47School of Medical Sciences, University Sains Malaysia, Kota Bharu, Kelantan Malaysia
| | - Paul Juang
- 48Department of Pharmacy Practice, St Louis College of Pharmacy, St Louis, MO USA
| | - Aleksandar Karamarkovic
- Faculty of Mediine University of Belgrade Clinic for Surgery "Nikola Spasic", University Clinical Center "Zvezdara" Belgrade, Belgrade, Serbia
| | - Peter K Kim
- 50Department of Surgery, Jacobi Medical Center, Albert Einstein College of Medicine, Bronx, NY USA
| | - Yoram Kluger
- 11Department of General Surgery, Rambam Health Care Campus, Haifa, Israel
| | - Ari Leppaniemi
- 51Abdominal Center, Helsinki University Hospital Meilahti, Helsinki, Finland
| | - Varut Lohsiriwat
- 52Department of Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Gustavo M Machain
- 53Department of Surgery, Universidad Nacional de Asuncion, Asuncion, Paraguay
| | - Sanjay Marwah
- 54Department of Surgery, Post-Graduate Institute of Medical Sciences, Rohtak, India
| | - John E Mazuski
- 55Department of Surgery, Washington University School of Medicine, Saint Louis, USA
| | - Gokhan Metan
- 56Department of Infectious Diseases and Clinical Microbiology, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Ernest E Moore
- Department of Surgery, University of Colorado, Denver Health Medical Center, Denver, CO USA
| | | | - Carlos A Ordoñez
- 59Department of Surgery, Fundación Valle del Lili, Hospital Universitario del Valle, Universidad del Valle, Cali, Colombia
| | - Leonardo Pagani
- Infectious Diseases Unit, Bolzano Central Hospital, Bolzano, Italy
| | - Nicola Petrosillo
- National Institute for Infectious Diseases - INMI - Lazzaro Spallanzani IRCCS, Rome, Italy
| | - Francisco Portela
- 62Gastroenterology Department, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - Kemal Rasa
- Department of Surgery, Anadolu Medical Center, Kocaali, Turkey
| | - Miran Rems
- Department of Abdominal and General Surgery, General Hospital Jesenice, Jesenice, Slovenia
| | - Boris E Sakakushev
- 65Department of Surgery, Medical University of Plovdiv, Plovdiv, Bulgaria
| | | | - Gabriele Sganga
- 66Division of Emergency Surgery, Department of Surgery, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Vishal G Shelat
- 67Department of Surgery, Tan Tock Seng Hospital, Singapore, Singapore
| | - Patrizia Spigaglia
- 68Department of Infectious Diseases, Istituto Superiore di Sanità, Rome, Italy
| | - Pierre Tattevin
- 69Infectious Diseases and Intensive Care Unit, Pontchaillou University Hospital, Rennes, France
| | - Cristian Tranà
- Department of Surgery, Macerata Hospital, Via Santa Lucia 2, 62100 Macerata, Italy
| | - Libor Urbánek
- 70First Department of Surgery, Faculty of Medicine, Masaryk University Brno and University Hospital of St. Ann Brno, Brno, Czech Republic
| | - Jan Ulrych
- 71First Department of Surgery, First Faculty of Medicine, Charles University in Prague and General University Hospital in Prague, Prague, Czech Republic
| | - Pierluigi Viale
- 72Clinic of Infectious Diseases, St Orsola-Malpighi University Hospital, Bologna, Italy
| | - Gian L Baiocchi
- 73Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
| | - Fausto Catena
- 74Emergency Surgery Department, Maggiore Parma Hospital, Parma, Italy
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42
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Sartelli M, Di Bella S, McFarland LV, Khanna S, Furuya-Kanamori L, Abuzeid N, Abu-Zidan FM, Ansaloni L, Augustin G, Bala M, Ben-Ishay O, Biffl WL, Brecher SM, Camacho-Ortiz A, Caínzos MA, Chan S, Cherry-Bukowiec JR, Clanton J, Coccolini F, Cocuz ME, Coimbra R, Cortese F, Cui Y, Czepiel J, Demetrashvili Z, Di Carlo I, Di Saverio S, Dumitru IM, Eckmann C, Eiland EH, Forrester JD, Fraga GP, Frossard JL, Fry DE, Galeiras R, Ghnnam W, Gomes CA, Griffiths EA, Guirao X, Ahmed MH, Herzog T, Kim JI, Iqbal T, Isik A, Itani KMF, Labricciosa FM, Lee YY, Juang P, Karamarkovic A, Kim PK, Kluger Y, Leppaniemi A, Lohsiriwat V, Machain GM, Marwah S, Mazuski JE, Metan G, Moore EE, Moore FA, Ordoñez CA, Pagani L, Petrosillo N, Portela F, Rasa K, Rems M, Sakakushev BE, Segovia-Lohse H, Sganga G, Shelat VG, Spigaglia P, Tattevin P, Tranà C, Urbánek L, Ulrych J, Viale P, Baiocchi GL, Catena F. 2019 update of the WSES guidelines for management of Clostridioides ( Clostridium) difficile infection in surgical patients. World J Emerg Surg 2019; 14:8. [PMID: 30858872 PMCID: PMC6394026 DOI: 10.1186/s13017-019-0228-3] [Citation(s) in RCA: 75] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2019] [Accepted: 02/17/2019] [Indexed: 02/08/2023] Open
Abstract
In the last three decades, Clostridium difficile infection (CDI) has increased in incidence and severity in many countries worldwide. The increase in CDI incidence has been particularly apparent among surgical patients. Therefore, prevention of CDI and optimization of management in the surgical patient are paramount. An international multidisciplinary panel of experts from the World Society of Emergency Surgery (WSES) updated its guidelines for management of CDI in surgical patients according to the most recent available literature. The update includes recent changes introduced in the management of this infection.
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Affiliation(s)
- Massimo Sartelli
- Department of Surgery, Macerata Hospital, Via Santa Lucia 2, 62100 Macerata, Italy
| | - Stefano Di Bella
- 0000000459364044grid.460062.6Infectious Diseases Department, Trieste University Hospital, Trieste, Italy
| | - Lynne V. McFarland
- 0000000122986657grid.34477.33Medicinal Chemistry, School of Pharmacy, University of Washington, Seattle, WA USA
| | - Sahil Khanna
- 0000 0004 0459 167Xgrid.66875.3aDivision of Gastroenterology and Hepatology, Department of Medicine, Mayo Clinic, Rochester, MN USA
| | - Luis Furuya-Kanamori
- 0000 0001 2180 7477grid.1001.0Research School of Population Health, Australian National University, Acton, ACT Australia
| | - Nadir Abuzeid
- grid.442422.6Department of Microbiology, Faculty of Medical Laboratory Sciences, Omdurman Islamic University, Khartoum, Sudan
| | - Fikri M. Abu-Zidan
- 0000 0001 2193 6666grid.43519.3aDepartment of Surgery, College of Medicine and Health Sciences, UAE University, Al-Ain, United Arab Emirates
| | - Luca Ansaloni
- 0000 0004 1758 8744grid.414682.dDepartment of General Surgery, Bufalini Hospital, Cesena, Italy
| | - Goran Augustin
- 0000 0001 0657 4636grid.4808.4Department of Surgery, University Hospital Centre Zagreb and School of Medicine, University of Zagreb, Zagreb, Croatia
| | - Miklosh Bala
- 0000 0001 2221 2926grid.17788.31Trauma and Acute Care Surgery Unit, Hadassah Hebrew University Medical Center, Jerusalem, Israel
| | - Offir Ben-Ishay
- 0000 0000 9950 8111grid.413731.3Department of General Surgery, Rambam Health Care Campus, Haifa, Israel
| | - Walter L. Biffl
- 0000 0004 0449 3295grid.415402.6Trauma and Acute Care Surgery, Scripps Memorial Hospital La Jolla, La Jolla, CA USA
| | - Stephen M. Brecher
- 0000 0004 0367 5222grid.475010.7Pathology and Laboratory Medicine, VA Boston Healthcare System, West Roxbury MA and BU School of Medicine, Boston, MA USA
| | - Adrián Camacho-Ortiz
- Department of Internal Medicine, University Hospital, Dr. José E. González, Monterrey, Mexico
| | - Miguel A. Caínzos
- 0000000109410645grid.11794.3aDepartment of Surgery, University of Santiago de Compostela, A Coruña, Spain
| | - Shirley Chan
- grid.439210.dDepartment of General Surgery, Medway Maritime Hospital, Gillingham, Kent UK
| | - Jill R. Cherry-Bukowiec
- 0000000086837370grid.214458.eDepartment of Surgery, Division of Acute Care Surgery, University of Michigan, Ann Arbor, MI USA
| | - Jesse Clanton
- 0000 0001 2156 6140grid.268154.cDepartment of Surgery, West Virginia University Charleston Division, Charleston, WV USA
| | - Federico Coccolini
- 0000 0004 1758 8744grid.414682.dDepartment of General Surgery, Bufalini Hospital, Cesena, Italy
| | - Maria E. Cocuz
- 0000 0001 2159 8361grid.5120.6Faculty of Medicine, Transilvania University, Infectious Diseases Hospital, Brasov, Romania
| | - Raul Coimbra
- 0000 0000 9852 649Xgrid.43582.38Riverside University Health System Medical Center and Loma Linda University School of Medicine, Moreno Valley, CA USA
| | | | - Yunfeng Cui
- Department of Surgery, Tianjin Nankai Hospital, Nankai Clinical School of Medicine, Tianjin Medical University, Tianjin, China
| | - Jacek Czepiel
- 0000 0001 2162 9631grid.5522.0Department of Infectious Diseases, Jagiellonian University, Medical College, Kraków, Poland
| | - Zaza Demetrashvili
- 0000 0004 0428 8304grid.412274.6Department of Surgery, Tbilisi State Medical University, Kipshidze Central University Hospital, Tbilisi, Georgia
| | - Isidoro Di Carlo
- 0000 0004 1757 1969grid.8158.4Department of Surgical Sciences, Cannizzaro Hospital, University of Catania, Catania, Italy
| | - Salomone Di Saverio
- 0000 0004 0622 5016grid.120073.7Department of Surgery, Addenbrooke’s Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | - Irina M. Dumitru
- 0000 0001 1089 1079grid.412430.0Clinical Infectious Diseases Hospital, Ovidius University, Constanta, Romania
| | - Christian Eckmann
- Department of General, Visceral and Thoracic Surgery, Klinikum Peine, Hospital of Medical University Hannover, Peine, Germany
| | | | - Joseph D. Forrester
- 0000000419368956grid.168010.eDepartment of Surgery, Stanford University, Stanford, CA USA
| | - Gustavo P. Fraga
- 0000 0001 0723 2494grid.411087.bDivision of Trauma Surgery, Hospital de Clinicas, School of Medical Sciences, University of Campinas, Campinas, Brazil
| | - Jean L. Frossard
- 0000 0001 0721 9812grid.150338.cService of Gastroenterology and Hepatology, Geneva University Hospital, Genève, Switzerland
| | - Donald E. Fry
- 0000 0001 2299 3507grid.16753.36Department of Surgery, Northwestern University Feinberg School of Medicine, Chicago, IL USA
- 0000 0001 2188 8502grid.266832.bUniversity of New Mexico School of Medicine, Albuquerque, NM USA
| | - Rita Galeiras
- 0000 0001 2176 8535grid.8073.cCritical Care Unit, Instituto de Investigación Biomédica de A Coruña (INIBIC), Complexo Hospitalario Universitario de A Coruña (CHUAC), Sergas, Universidade da Coruña (UDC), A Coruña, Spain
| | - Wagih Ghnnam
- 0000000103426662grid.10251.37Department of Surgery Mansoura, Faculty of Medicine, Mansoura University, Mansoura, Egypt
| | - Carlos A. Gomes
- 0000 0001 2170 9332grid.411198.4Surgery Department, Hospital Universitario (HU) Terezinha de Jesus da Faculdade de Ciencias Medicas e da Saude de Juiz de Fora (SUPREMA), Hospital Universitario (HU) Universidade Federal de Juiz de Fora (UFJF), Juiz de Fora, Brazil
| | - Ewen A. Griffiths
- 0000 0001 2177 007Xgrid.415490.dDepartment of Surgery, Queen Elizabeth Hospital, Birmingham, UK
| | - Xavier Guirao
- Unit of Endocrine, Head, and Neck Surgery and Unit of Surgical Infections Support, Department of General Surgery, Parc Taulí, Hospital Universitari, Sabadell, Spain
| | - Mohamed H. Ahmed
- grid.415667.7Department of Medicine, Milton Keynes University Hospital NHS Foundation Trust, Milton Keynes, Buckinghamshire UK
| | - Torsten Herzog
- grid.416438.cDepartment of Surgery, St. Josef Hospital, Ruhr University Bochum, Bochum, Germany
| | - Jae Il Kim
- 0000 0004 0371 8173grid.411633.2Department of Surgery, Ilsan Paik Hospital, Inje University College of Medicine, Goyang, Republic of Korea
| | - Tariq Iqbal
- 0000 0001 2177 007Xgrid.415490.dDepartment of Gastroenterology, Queen Elizabeth Hospital, Birmingham, UK
| | - Arda Isik
- 0000 0004 0455 1723grid.411487.fGeneral Surgery Department, Magee Womens Hospital, UPMC, Pittsburgh, USA
| | - Kamal M. F. Itani
- 000000041936754Xgrid.38142.3cDepartment of Surgery, VA Boston Health Care System, Boston University and Harvard Medical School, Boston, MA USA
| | | | - Yeong Y. Lee
- 0000 0001 2294 3534grid.11875.3aSchool of Medical Sciences, University Sains Malaysia, Kota Bharu, Kelantan Malaysia
| | - Paul Juang
- 0000 0000 8660 3507grid.419579.7Department of Pharmacy Practice, St Louis College of Pharmacy, St Louis, MO USA
| | - Aleksandar Karamarkovic
- Faculty of Mediine University of Belgrade Clinic for Surgery “Nikola Spasic”, University Clinical Center “Zvezdara” Belgrade, Belgrade, Serbia
| | - Peter K. Kim
- 0000000121791997grid.251993.5Department of Surgery, Jacobi Medical Center, Albert Einstein College of Medicine, Bronx, NY USA
| | - Yoram Kluger
- 0000 0000 9950 8111grid.413731.3Department of General Surgery, Rambam Health Care Campus, Haifa, Israel
| | - Ari Leppaniemi
- 0000 0000 9950 5666grid.15485.3dAbdominal Center, Helsinki University Hospital Meilahti, Helsinki, Finland
| | - Varut Lohsiriwat
- 0000 0004 1937 0490grid.10223.32Department of Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Gustavo M. Machain
- 0000 0001 2289 5077grid.412213.7Department of Surgery, Universidad Nacional de Asuncion, Asuncion, Paraguay
| | - Sanjay Marwah
- 0000 0004 1771 1642grid.412572.7Department of Surgery, Post-Graduate Institute of Medical Sciences, Rohtak, India
| | - John E. Mazuski
- 0000 0001 2355 7002grid.4367.6Department of Surgery, Washington University School of Medicine, Saint Louis, USA
| | - Gokhan Metan
- 0000 0001 2342 7339grid.14442.37Department of Infectious Diseases and Clinical Microbiology, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Ernest E. Moore
- Department of Surgery, University of Colorado, Denver Health Medical Center, Denver, CO USA
| | - Frederick A. Moore
- 0000 0004 1936 8091grid.15276.37Department of Surgery, University of Florida, Gainesville, FL USA
| | - Carlos A. Ordoñez
- 0000 0001 2295 7397grid.8271.cDepartment of Surgery, Fundación Valle del Lili, Hospital Universitario del Valle, Universidad del Valle, Cali, Colombia
| | - Leonardo Pagani
- Infectious Diseases Unit, Bolzano Central Hospital, Bolzano, Italy
| | - Nicola Petrosillo
- National Institute for Infectious Diseases - INMI - Lazzaro Spallanzani IRCCS, Rome, Italy
| | - Francisco Portela
- 0000000106861985grid.28911.33Gastroenterology Department, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - Kemal Rasa
- Department of Surgery, Anadolu Medical Center, Kocaali, Turkey
| | - Miran Rems
- Department of Abdominal and General Surgery, General Hospital Jesenice, Jesenice, Slovenia
| | - Boris E. Sakakushev
- 0000 0001 0726 0380grid.35371.33Department of Surgery, Medical University of Plovdiv, Plovdiv, Bulgaria
| | - Helmut Segovia-Lohse
- 0000 0001 2289 5077grid.412213.7Department of Surgery, Universidad Nacional de Asuncion, Asuncion, Paraguay
| | - Gabriele Sganga
- grid.414603.4Division of Emergency Surgery, Department of Surgery, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Vishal G. Shelat
- grid.240988.fDepartment of Surgery, Tan Tock Seng Hospital, Singapore, Singapore
| | - Patrizia Spigaglia
- 0000 0000 9120 6856grid.416651.1Department of Infectious Diseases, Istituto Superiore di Sanità, Rome, Italy
| | - Pierre Tattevin
- grid.414271.5Infectious Diseases and Intensive Care Unit, Pontchaillou University Hospital, Rennes, France
| | - Cristian Tranà
- Department of Surgery, Macerata Hospital, Via Santa Lucia 2, 62100 Macerata, Italy
| | - Libor Urbánek
- 0000 0001 2194 0956grid.10267.32First Department of Surgery, Faculty of Medicine, Masaryk University Brno and University Hospital of St. Ann Brno, Brno, Czech Republic
| | - Jan Ulrych
- 0000 0000 9100 9940grid.411798.2First Department of Surgery, First Faculty of Medicine, Charles University in Prague and General University Hospital in Prague, Prague, Czech Republic
| | - Pierluigi Viale
- grid.412311.4Clinic of Infectious Diseases, St Orsola-Malpighi University Hospital, Bologna, Italy
| | - Gian L. Baiocchi
- 0000000417571846grid.7637.5Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
| | - Fausto Catena
- grid.411482.aEmergency Surgery Department, Maggiore Parma Hospital, Parma, Italy
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Sartelli M, Abu-Zidan FM, Labricciosa FM, Kluger Y, Coccolini F, Ansaloni L, Leppäniemi A, Kirkpatrick AW, Tolonen M, Tranà C, Regimbeau JM, Hardcastle T, Koshy RM, Abbas A, Aday U, Adesunkanmi ARK, Ajibade A, Akhmeteli L, Akın E, Akkapulu N, Alotaibi A, Altintoprak F, Anyfantakis D, Atanasov B, Augustin G, Azevedo C, Bala M, Balalis D, Baraket O, Baral S, Barkai O, Beltran M, Bini R, Bouliaris K, Caballero AB, Calu V, Catani M, Ceresoli M, Charalampakis V, Jusoh AC, Chiarugi M, Cillara N, Cuesta RC, Cobuccio L, Cocorullo G, Colak E, Conti L, Cui Y, De Simone B, Delibegovic S, Demetrashvili Z, Demetriades D, Dimova A, Dogjani A, Enani M, Farina F, Ferrara F, Foghetti D, Fontana T, Fraga GP, Gachabayov M, Gérard G, Ghnnam W, Maurel TG, Gkiokas G, Gomes CA, Guner A, Gupta S, Hecker A, Hirano ES, Hodonou A, Hutan M, Ilaschuk I, Ioannidis O, Isik A, Ivakhov G, Jain S, Jokubauskas M, Karamarkovic A, Kaushik R, Kenig J, Khokha V, Khokha D, Kim JI, Kong V, Korkolis D, Kruger VF, Kshirsagar A, Simões RL, Lanaia A, Lasithiotakis K, Leão P, Arellano ML, Listle H, Litvin A, Lizarazu Pérez A, Lopez-Tomassetti Fernandez E, Lostoridis E, Luppi D, Machain V GM, Major P, Manatakis D, Reitz MM, Marinis A, Marrelli D, Martínez-Pérez A, Marwah S, McFarlane M, Mesic M, Mesina C, Michalopoulos N, Misiakos E, Moreira FG, Mouaqit O, Muhtaroglu A, Naidoo N, Negoi I, Nikitina Z, Nikolopoulos I, Nita GE, Occhionorelli S, Olaoye I, Ordoñez CA, Ozkan Z, Pal A, Palini GM, Papageorgiou K, Papagoras D, Pata F, Pędziwiatr M, Pereira J, Pereira Junior GA, Perrone G, Pintar T, Pisarska M, Plehutsa O, Podda M, Poillucci G, Quiodettis M, Rahim T, Rios-Cruz D, Rodrigues G, Rozov D, Sakakushev B, Sall I, Sazhin A, Semião M, Sharda T, Shelat V, Sinibaldi G, Skicko D, Skrovina M, Stamatiou D, Stella M, Strzałka M, Sydorchuk R, Teixeira Gonsaga RA, Tochie JN, Tomadze G, Ugoletti L, Ulrych J, Ümarik T, Uzunoglu MY, Vasilescu A, Vaz O, Vereczkei A, Vlad N, Walędziak M, Yahya AI, Yalkin O, Yilmaz TU, Ünal AE, Yuan KC, Zachariah SK, Žilinskas J, Zizzo M, Pattonieri V, Baiocchi GL, Catena F. Physiological parameters for Prognosis in Abdominal Sepsis (PIPAS) Study: a WSES observational study. World J Emerg Surg 2019; 14:34. [PMID: 31341511 PMCID: PMC6631509 DOI: 10.1186/s13017-019-0253-2] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2019] [Accepted: 07/03/2019] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND Timing and adequacy of peritoneal source control are the most important pillars in the management of patients with acute peritonitis. Therefore, early prognostic evaluation of acute peritonitis is paramount to assess the severity and establish a prompt and appropriate treatment. The objectives of this study were to identify clinical and laboratory predictors for in-hospital mortality in patients with acute peritonitis and to develop a warning score system, based on easily recognizable and assessable variables, globally accepted. METHODS This worldwide multicentre observational study included 153 surgical departments across 56 countries over a 4-month study period between February 1, 2018, and May 31, 2018. RESULTS A total of 3137 patients were included, with 1815 (57.9%) men and 1322 (42.1%) women, with a median age of 47 years (interquartile range [IQR] 28-66). The overall in-hospital mortality rate was 8.9%, with a median length of stay of 6 days (IQR 4-10). Using multivariable logistic regression, independent variables associated with in-hospital mortality were identified: age > 80 years, malignancy, severe cardiovascular disease, severe chronic kidney disease, respiratory rate ≥ 22 breaths/min, systolic blood pressure < 100 mmHg, AVPU responsiveness scale (voice and unresponsive), blood oxygen saturation level (SpO2) < 90% in air, platelet count < 50,000 cells/mm3, and lactate > 4 mmol/l. These variables were used to create the PIPAS Severity Score, a bedside early warning score for patients with acute peritonitis. The overall mortality was 2.9% for patients who had scores of 0-1, 22.7% for those who had scores of 2-3, 46.8% for those who had scores of 4-5, and 86.7% for those who have scores of 7-8. CONCLUSIONS The simple PIPAS Severity Score can be used on a global level and can help clinicians to identify patients at high risk for treatment failure and mortality.
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Affiliation(s)
| | - Fikri M. Abu-Zidan
- 0000 0001 2193 6666grid.43519.3aDepartment of Surgery, College of Medicine and Health Sciences, UAE University, Al-Ain, United Arab Emirates
| | | | - Yoram Kluger
- 0000 0000 9950 8111grid.413731.3Department of General Surgery, Rambam Health Care Campus, Haifa, Israel
| | - Federico Coccolini
- 0000 0004 1758 8744grid.414682.dDepartment of Emergency Surgery, Bufalini Hospital, Cesena, Italy
| | - Luca Ansaloni
- 0000 0004 1758 8744grid.414682.dDepartment of Emergency Surgery, Bufalini Hospital, Cesena, Italy
| | - Ari Leppäniemi
- 0000 0004 0410 2071grid.7737.4Abdominal Center, Department of Abdominal Surgery, Helsinki University Hospital Meilahti and University of Helsinki, Helsinki, Finland
| | - Andrew W. Kirkpatrick
- 0000 0004 0469 2139grid.414959.4General, Acute Care, Abdominal Wall Reconstruction, and Trauma Surgery, Foothills Medical Centre, Calgary, AB Canada
| | - Matti Tolonen
- 0000 0004 0410 2071grid.7737.4Abdominal Center, Department of Abdominal Surgery, Helsinki University Hospital Meilahti and University of Helsinki, Helsinki, Finland
| | - Cristian Tranà
- Department of Surgery, Macerata Hospital, Macerata, Italy
| | - Jean-Marc Regimbeau
- 0000 0004 0593 702Xgrid.134996.0Department of Digestive Surgery and SSPC Research Unit, CHU Amiens-Picardie, Amiens, France
| | - Timothy Hardcastle
- 0000 0001 0723 4123grid.16463.36Department of Trauma ICU, IALCH, University of KwaZulu-Natal, Durban, South Africa
| | - Renol M. Koshy
- 0000 0004 0400 5079grid.412570.5Department of General Surgery, University Hospital of Coventry & Warwickshire, Coventry, UK
| | - Ashraf Abbas
- 0000000103426662grid.10251.37Department of Surgery, Mansoura University and Emergency Hospital, Mansoura, Egypt
| | - Ulaş Aday
- Department of Gastrointestinal Surgery, University of Health Sciences, Elazig Training and Research Hospital, Elazig, Turkey
| | - A. R. K. Adesunkanmi
- 0000 0001 2183 9444grid.10824.3fDepartment of Surgery, College of Health Sciences, Obafemi Awolowo University, Ile-Ife, Nigeria
| | - Adesina Ajibade
- 0000 0001 0583 749Xgrid.411274.5Department of Surgery, LAUTECH Teaching Hospital, Osogbo, Nigeria
| | - Lali Akhmeteli
- 0000 0004 0428 8304grid.412274.6Department of Surgery, TSMU First University Clinic, Tbilisi, Georgia
| | - Emrah Akın
- 0000 0001 0682 3030grid.49746.38Department of General Surgery, Sakarya University Research and Educational Hospital, Sakarya, Turkey
| | - Nezih Akkapulu
- 0000 0004 0642 1084grid.411920.fDepartment of General Surgery, Hacettepe University Hospital, Ankara, Turkey
| | - Alhenouf Alotaibi
- 0000 0004 0593 1832grid.415277.2Department of Surgical Oncology, King Fahad Medical City, Riyadh, Saudi Arabia
| | - Fatih Altintoprak
- Department of General Surgery, Istinye University Faculty of Medicine, Istanbul, Turkey
| | | | - Boyko Atanasov
- 0000 0001 0726 0380grid.35371.33Surgical Department, UMHAT “Eurohospital”, Medical University, Plovdiv, Bulgaria
| | - Goran Augustin
- 0000 0004 0397 9648grid.412688.1Department of Surgery, University Hospital Centre Zagreb, Zagreb, Croatia
| | - Constança Azevedo
- Cirurgia Geral, Centro Hospitalar Universitário da Cova da Beira, Covilhã, Portugal
| | - Miklosh Bala
- 0000 0001 2221 2926grid.17788.31Department of General Surgery, Hadassah Medical Center, Jerusalem, Israel
| | - Dimitrios Balalis
- Department of Surgery, Saint Savvas Anticancer Hospital, Athens, Greece
| | | | - Suman Baral
- Department of Surgery, Lumbini Medical College and Teaching Hospital Ltd., Tansen, Palpa Nepal
| | - Or Barkai
- 0000 0000 9950 8111grid.413731.3Department of General Surgery, Rambam Health Care Campus, Haifa, Israel
| | - Marcelo Beltran
- Department of Surgery, Hospital San Juan de Dios de La Serena, La Serena, Chile
| | - Roberto Bini
- Emergency and General Surgery, SG Bosco, Torino, Italy
| | | | - Ana B. Caballero
- 0000 0004 0465 2778grid.461067.2General Surgery, Hospital Santo Tomas, Panama, Panama
| | - Valentin Calu
- Department of Surgery, Elias Emergency Hospital, Bucharest, Romania
| | - Marco Catani
- grid.417007.5Dipartimento Emergenza e Accettazione, Policlinico Umberto I, Roma, Italy
| | - Marco Ceresoli
- 0000 0004 1756 8604grid.415025.7Department of General and Emergency Surgery, ASST Monza - Ospedale San Gerardo, Monza, Italy
| | - Vasileios Charalampakis
- 0000 0004 0478 4463grid.440196.eGeneral Surgery, South Warwickshire NHS Foundation Trust, Warwick, UK
| | - Asri Che Jusoh
- Department of General Surgery, Kuala Krai Hospital, Kuala Krai, Malaysia
| | - Massimo Chiarugi
- 0000 0004 1756 8209grid.144189.1U.O. Chirurgia d’Urgenza Universitaria, Azienda Ospedaliero-Universitaria Pisana, Pisa, Italy
| | - Nicola Cillara
- grid.459832.1U.O.C. Chirurgia Generale, PO Santissima Trinità, Cagliari, Italia
| | - Raquel Cobos Cuesta
- 0000 0004 1771 208Xgrid.418878.aUGC Cirugía General, Complejo Hospitalario de Jaén, Jaén, Spain
| | - Luigi Cobuccio
- 0000 0004 1756 8209grid.144189.1U.O. Chirurgia d’Urgenza Universitaria, Azienda Ospedaliero-Universitaria Pisana, Pisa, Italy
| | - Gianfranco Cocorullo
- Department of General and Emergency Surgery, Azienda Ospedaliera Policlinico Universitario Palermo “Paolo Giaccone”, Palermo, Italy
| | - Elif Colak
- General Surgery, University of Health Sciences, Samsun Training and Research Hospital, Samsun, Turkey
| | - Luigi Conti
- Department of Surgery, G. Da Saliceto Hospital, Piacenza, Italy
| | - Yunfeng Cui
- grid.417036.7Department of Surgery, Tianjin Nankai Hospital, Tianjin, China
| | - Belinda De Simone
- Chirurgie Viscerale et d’Urgence, Centre Hospitalier Regional de Perpignan, Perpignan, France
| | - Samir Delibegovic
- 0000 0001 0682 9061grid.412410.2Department of Surgery, University Clinical Center Tuzla, Tuzla, Bosnia and Herzegovina
| | - Zaza Demetrashvili
- Department of Surgery, Kipshidze Central University Hospital, Tbilisi, Georgia
| | - Demetrios Demetriades
- 0000 0001 0084 1895grid.411409.9Division of Trauma and Acute Care Surgery, LAC+USC Medical Center, Los Angeles, USA
| | - Ana Dimova
- 0000 0004 0397 9648grid.412688.1Department of Surgery, University Hospital Centre Zagreb, Zagreb, Croatia
| | - Agron Dogjani
- Department of General Surgery, University Hospital of Trauma, Tirana, Albania
| | - Mushira Enani
- 0000 0004 0593 1832grid.415277.2Department of Infectious Diseases, King Fahad Medical City, Riyadh, Saudi Arabia
| | - Federica Farina
- 0000 0004 0625 0318grid.459640.aChirurgia Generale, Ospedale Versilia, La Spezia, Italy
| | - Francesco Ferrara
- grid.414126.4Department of Surgery, San Carlo Borromeo Hospital, Milan, Italy
| | - Domitilla Foghetti
- grid.415103.2Department of General Surgery, San Salvatore, Pesaro, Italy
| | - Tommaso Fontana
- Department of General and Emergency Surgery, Azienda Ospedaliera Policlinico Universitario Palermo “Paolo Giaccone”, Palermo, Italy
| | - Gustavo P. Fraga
- 0000 0001 0723 2494grid.411087.bDivision of Trauma Surgery, Hospital de Clinicas, University of Campinas, Campinas, Brazil
| | - Mahir Gachabayov
- Department of Abdominal Surgery, Vladimir City Clinical Hospital of Emergency Medicine, Vladimir, Russia
| | - Grelpois Gérard
- 0000 0004 0593 702Xgrid.134996.0Department of Surgery, University hospital, Amiens, France
| | - Wagih Ghnnam
- grid.469958.fDepartment of General Surgery, Mansoura University Hospital, Mansoura, Egypt
| | - Teresa Giménez Maurel
- 0000 0000 9854 2756grid.411106.3Department of General Surgery, Miguel Servet, Zaragoza, Spain
| | - Georgios Gkiokas
- 0000 0001 2155 0800grid.5216.02nd Department of Surgery, Aretaieion University Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Carlos A. Gomes
- Department of Surgery, Hospital Universitário Terezinha de Jesus, Faculdade de Ciências Médicas e da Saúde de Juiz de Fora (SUPREMA), Juiz de Fora, Brazil
| | - Ali Guner
- 0000 0001 2186 0630grid.31564.35Department of General Surgery, Karadeniz Technical University, Trabzon, Turkey
| | - Sanjay Gupta
- 0000 0004 1767 2831grid.413220.6Department of General Surgery, Government Medical College and Hospital, Chandigarh, India
| | - Andreas Hecker
- 0000 0000 8584 9230grid.411067.5Department of General and Thoracic Surgery, University Hospital of Giessen, Giessen, Germany
| | - Elcio S. Hirano
- 0000 0001 0723 2494grid.411087.bDivision of Trauma Surgery, Hospital de Clinicas, University of Campinas, Campinas, Brazil
| | - Adrien Hodonou
- Department of General Surgery, University and Regional Hospital Center of Borgou, Parakou, Republic of Benin
| | - Martin Hutan
- Chirurgische Abteilung, Landesklinikum Hainburg, Hainburg an der Donau, Austria
| | - Igor Ilaschuk
- Intensive Care Unit, Chernivtsi City Emergency Hospital, Chernivtsi, Ukraine
| | - Orestis Ioannidis
- 0000000109457005grid.4793.94th Surgical Department, Medical School, Aristotle University of Thessaloniki, General Hospital “G. Papanikolaou”, Thessaloniki, Greece
| | - Arda Isik
- 0000 0001 1498 7262grid.412176.7Department of General Surgery, Erzincan University Hospital, Erzincan, Turkey
| | - Georgy Ivakhov
- 0000 0000 9559 0613grid.78028.35Department of Faculty Surgery #1, Pirogov Russian National Research Medical University, Moscow, Russia
| | - Sumita Jain
- grid.416065.0Department of Surgery, SMS Hospital, Jaipur, India
| | - Mantas Jokubauskas
- 0000 0004 0575 8750grid.48349.32Department of Surgery, Hospital of Lithuanian University of Health Sciences Kaunas Clinics, Kaunas, Lithuania
| | - Aleksandar Karamarkovic
- Faculty of Medicine University of Belgrade Clinic for Surgery, University Clinical Center “Zvezdara”, Belgrade, Serbia
| | - Robin Kaushik
- 0000 0004 1767 2831grid.413220.6Department of General Surgery, Government Medical College and Hospital, Chandigarh, India
| | - Jakub Kenig
- 0000 0001 2162 9631grid.5522.0Department of General, Oncologic and Geriatric Surgery, Jagiellonian University Collegium Medicum, Kraków, Poland
| | - Vladimir Khokha
- Department of Emergency Surgery, City Hospital, Mozyr, Belarus
| | - Denis Khokha
- Department of Vascular Surgery, City Hospital, Mozyr, Belarus
| | - Jae Il Kim
- 0000 0004 0371 8173grid.411633.2Department of Surgery, Inje University Ilsan Paik Hospital, Goyang, Republic of Korea
| | - Victor Kong
- 0000 0004 0576 7753grid.414386.cTrauma and Acute Care Surgery, Edendale Hospital, Pietermaritzburg, South Africa
| | - Dimitris Korkolis
- Department of Surgery, Saint Savvas Anticancer Hospital, Athens, Greece
| | - Vitor F. Kruger
- 0000 0001 0723 2494grid.411087.bDivision of Trauma Surgery, Hospital de Clinicas, University of Campinas, Campinas, Brazil
| | - Ashok Kshirsagar
- Department of Surgery, Krishna Hospital and Medical Research University Karad, Karad, India
| | - Romeo Lages Simões
- Departament of General Surgery, Hospital Municipal de Governador Valadares, Vale do Rio Doce University, Governador Valadares, Brazil
| | - Andrea Lanaia
- Chirurgia d’Urgenza, Arcispedale Santa Maria Nuova IRCCS, Reggio Emilia, Italy
| | | | - Pedro Leão
- 0000 0001 2159 175Xgrid.10328.38Cirurgia Geral, Hospital de Braga, Life and Health Sciences Research Institute, ICVS/3Bs, Universidade do Minho, Braga, Portugal
| | - Miguel León Arellano
- grid.419651.eGeneral and Digestive Surgery, Hospital Fundación Jimenez Diaz, Madrid, Spain
| | - Holger Listle
- 0000 0000 9116 8976grid.412469.cGeneral, Visceral, Thoracic and Vascular Surgery, University Hospital Greifswald, Greifswald, Germany
| | - Andrey Litvin
- 0000 0001 1018 9204grid.410686.dDepartment of Surgical Disciplines, Regional Clinical Hospital, Immanuel Kant Baltic Federal University, Kaliningrad, Russia
| | - Aintzane Lizarazu Pérez
- grid.414651.3Cirugía general y del aparato digestivo, Hospital Universitario Donostia, Donostia, Spain
| | | | | | - Davide Luppi
- Department of General and Emergency Surgery, ASMN Reggio Emilia, Modena, Italy
| | - Gustavo M. Machain V
- 0000 0001 2289 5077grid.412213.7II Catedra de Clinica Quirúrgica, Hospital de Clinicas, Facultad de Ciencias Médicas, Universidad Nacional de Asunción, Asunción, Paraguay
| | - Piotr Major
- 0000 0001 2162 9631grid.5522.02nd Department of General Surgery, Jagiellonian University Medical College, Kraków, Poland
| | - Dimitrios Manatakis
- 0000 0004 0638 8093grid.414025.6Department of Surgery, Athens Naval and Veterans Hospital, Athens, Greece
| | - Marianne Marchini Reitz
- 0000 0001 0084 1895grid.411409.9Division of Trauma and Acute Care Surgery, LAC+USC Medical Center, Los Angeles, USA
| | - Athanasios Marinis
- grid.417374.2First Department of Surgery, Tzaneio General Hospital, Piraeus, Greece
| | - Daniele Marrelli
- 0000 0004 1757 4641grid.9024.fDepartment of General Surgery and Surgical Oncology, Policlinico Le Scotte, University of Siena, Siena, Italy
| | - Aleix Martínez-Pérez
- 0000 0004 1770 9825grid.411289.7Department of General and Digestive Surgery, Hospital Universitario Doctor Peset, Valencia, Spain
| | - Sanjay Marwah
- 0000 0004 1771 1642grid.412572.7Department of General Surgery, Post-graduate Institute of Medical Sciences, Rohtak, India
| | - Michael McFarlane
- 0000 0004 0500 5353grid.412963.bDepartment of Surgery, Radiology, Anaesthesia and Intensive Care, University Hospital of the West Indies, Kingston, Jamaica
| | - Mirza Mesic
- 0000 0001 0682 9061grid.412410.2Department of Surgery, University Clinical Center Tuzla, Tuzla, Bosnia and Herzegovina
| | - Cristian Mesina
- grid.452359.cSecond Surgical Clinic, Emergency County Hospital of Craiova, Craiova, Romania
| | - Nickos Michalopoulos
- 0000 0004 0576 4544grid.411222.63rd Department of Surgery, Ahepa University Hospital, Thessaloniki, Greece
| | - Evangelos Misiakos
- 0000 0004 0622 4662grid.411449.d3rd Department of Surgery, Attikon University Hospital, Athens, Greece
| | - Felipe Gonçalves Moreira
- Departament of General Surgery, Hospital Municipal de Governador Valadares, Vale do Rio Doce University, Governador Valadares, Brazil
| | - Ouadii Mouaqit
- grid.412817.9Department of Surgery, Hassan II, Fez, Morocco
| | - Ali Muhtaroglu
- 0000 0001 0682 3030grid.49746.38Department of General Surgery, Sakarya University Research and Educational Hospital, Sakarya, Turkey
| | - Noel Naidoo
- Department of Specialist Surgery, Port Shepstone Regional Hospital, Port Shepstone, Republic of South Africa
| | - Ionut Negoi
- General Surgery Department, Emergency Hospital of Bucharest, Bucharest, Romania
| | - Zane Nikitina
- 0000 0004 0375 2558grid.488518.8Toxicology and Sepsis, Riga East University Hospital, Riga, Latvia
| | - Ioannis Nikolopoulos
- grid.439484.6Department of General Surgery, Queen Elizabeth Hospital, London, UK
| | - Gabriela-Elisa Nita
- grid.458453.bChirurgia generale, Sant’Anna (AUSL Reggio Emilia), Castelnovo ne’ Monti, Italy
| | | | - Iyiade Olaoye
- 0000 0000 8878 5287grid.412975.cDepartment of Surgery, University of Ilorin Teaching Hospital, Ilorin, Nigeria
| | - Carlos A. Ordoñez
- 0000 0001 2295 7397grid.8271.cDepartment of Surgery, Fundacion Valle del Lili - Universidad del Valle, Cali, Colombia
| | - Zeynep Ozkan
- Department of General Surgery, University of Health Sciences, Elazig Training and Research Hospital, Elazig, Turkey
| | - Ajay Pal
- 0000 0004 0645 6578grid.411275.4Department of Surgery, King George’s Medical University, Lucknow, India
| | - Gian M. Palini
- grid.414614.2Chirurgia Generale e d’Urgenza, Ospedale Infermi, Rimini, Italy
| | | | - Dimitris Papagoras
- Department of General Surgery, General Hospital of Trikala, Trikala, Greece
| | - Francesco Pata
- Department of Surgery, Sant’Antonio Abate Hospital, Gallarate, Italy
| | - Michał Pędziwiatr
- 0000 0001 1216 0093grid.412700.0Department of General and Emergency Surgery, University Hospital, University Hospital Kraków, Kraków, Poland
| | - Jorge Pereira
- 0000 0004 5914 1131grid.489946.eCirurgia Geral, Centro Hospitalar Tondela-Viseu, Viseu, Portugal
| | | | - Gennaro Perrone
- Chirurgia d’Urgenza – Dipartimento Urgenza/Emergenza, AOU Parma, Parma, Italy
| | - Tadeja Pintar
- 0000 0004 0571 7705grid.29524.38Department of Abdominal Surgery, UMC Ljubljana, Ljubljana, Slovenia
| | - Magdalena Pisarska
- 0000 0001 1216 0093grid.412700.0Department of Endoscopic, Metabolic and Soft Tissue Tumors Surgery, University Hospital, Kraków, Poland
| | - Oleksandr Plehutsa
- Surgery Department, Chernivtsi City Emergency Hospital, Chernivtsi, Ukraine
| | - Mauro Podda
- Department of General, Emergency and Robotic Surgery, San Francesco Hospital, Nuoro, Italy
| | | | - Martha Quiodettis
- 0000 0004 0465 2778grid.461067.2Department of Surgery/Trauma, Hospital Santo Tomás, Panama, Panama
| | - Tuba Rahim
- 0000 0001 0723 4123grid.16463.36Department of Trauma ICU, IALCH, University of KwaZulu-Natal, Durban, South Africa
| | - Daniel Rios-Cruz
- Department of Gastrointestinal Surgery, HGR1 IMSS, Cuernavaca, Mexico
| | - Gabriel Rodrigues
- 0000 0001 0571 5193grid.411639.8Department of General Surgery, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, India
| | - Dmytry Rozov
- 0000 0000 9950 8111grid.413731.3Department of General Surgery, Rambam Health Care Campus, Haifa, Israel
| | - Boris Sakakushev
- 0000 0001 1014 775Xgrid.11187.3eFirst Clinic of General Surgery, University Hospital St George/Medical University Plovdiv, Plovdiv, Bulgaria
| | - Ibrahima Sall
- grid.414281.aChirurgie Générale et Viscérale, Hôpital d’instruction des Armées, Hôpital Principal de Dakar, Dakar, Senegal
| | - Alexander Sazhin
- 0000 0000 9559 0613grid.78028.35Department of Faculty Surgery #1, Pirogov Russian National Research Medical University, Moscow, Russia
| | - Miguel Semião
- Cirurgia Geral, Centro Hospitalar Universitário da Cova da Beira, Covilhã, Portugal
| | - Taanya Sharda
- 0000 0004 1767 2831grid.413220.6Department of General Surgery, Government Medical College and Hospital, Chandigarh, India
| | - Vishal Shelat
- grid.240988.fDepartment of General Surgery, Tan Tock Seng Hospital, Singapore, Singapore
| | - Giovanni Sinibaldi
- Department of Surgery, Fatebbenefratelli Hospital, Isola Tiberina, Rome, Italy
| | - Dmitrijs Skicko
- 0000 0004 0375 2558grid.488518.8Department of Surgery (Department No. 10), Riga East Clinical University Hospital “Gaiļezers”, Riga, Latvia
| | - Matej Skrovina
- Department of Surgery, Hospital and Oncological Centre Novy Jicin, Novy Jicin, Czech Republic
| | - Dimitrios Stamatiou
- 0000 0004 0399 7344grid.413964.dGeneral Surgery, Heartlands Hospital, Birmingham, UK
| | - Marco Stella
- grid.414126.4Department of Surgery, San Carlo Borromeo Hospital, Milan, Italy
| | - Marcin Strzałka
- 0000 0001 2162 9631grid.5522.0Department of General Surgery, Polytrauma and Emergency Medicine, University Hospital of the Jagiellonian University Medical College, Kraków, Poland
| | - Ruslan Sydorchuk
- 0000 0004 4906 2392grid.445372.3General Surgery Department, Bukovinian State Medical University, Chernivtsi, Ukraine
| | | | - Joel Noutakdie Tochie
- 0000 0001 2173 8504grid.412661.6Faculty of Medicine and Biomedical Sciences, University of Yaounde I, Yaounde, Cameroon and Department of Surgery and Anaesthesiology, Yaounde Central Hospital, Yaounde, Cameroon
| | - Gia Tomadze
- 0000 0004 0428 8304grid.412274.6Surgery Department, Tbilisi State Medical University, Tbilisi, Georgia
| | - Lara Ugoletti
- Chirurgia Generale, Ospedale Civile di Guastalla, Reggio Emilia, Italy
| | - Jan Ulrych
- 0000 0000 9100 9940grid.411798.2First Department of Surgery, Department of Abdominal, Thoracic Surgery and Traumatology, First Faculty of Medicine, Charles University and General University Hospital, Prague, Czech Republic
| | - Toomas Ümarik
- 0000 0004 0631 377Xgrid.454953.aUpper Gastrointestinal Tract Surgery Department, North Estonia Medical Centre, Tallinn, Estonia
| | | | - Alin Vasilescu
- First Surgical Unit, “St. Spiridon” University Hospital Iasi, University of Medicine and Pharmacy “Grigore T. Popa”, Iasi, Romania
| | - Osborne Vaz
- 0000 0004 0641 2823grid.419319.7Renal Transplant and General Surgery, Manchester Royal Infirmary, Manchester, UK
| | - Andras Vereczkei
- 0000 0001 0663 9479grid.9679.1Department of Surgery, Clinical Center University of Pecs, Pecs, Hungary
| | - Nutu Vlad
- First Surgical Unit, “St. Spiridon” University Hospital Iasi, University of Medicine and Pharmacy “Grigore T. Popa”, Iasi, Romania
| | - Maciej Walędziak
- 0000 0004 0620 0839grid.415641.3Department of General, Oncological, Metabolic and Thoracic Surgery, Military Institute of Medicine, Warsaw, Poland
| | - Ali I. Yahya
- Department of Surgey, Zliten Teaching Hospital, Zliten, Libya
| | - Omer Yalkin
- 0000000109409118grid.7256.6Department of General Surgery, Ankara University School of Medicine, Ankara, Turkey
| | - Tonguç U. Yilmaz
- grid.488402.2Transplantation Unıt, Acibadem Atakent Hospital, İstanbul, Turkey
| | - Ali Ekrem Ünal
- 0000000109409118grid.7256.6Department of General Surgery, Ankara University School of Medicine, Ankara, Turkey
| | - Kuo-Ching Yuan
- 0000 0004 0639 0994grid.412897.1Department of Surgery, Taipei Medical University Hospital, Taipei, Taiwan
| | - Sanoop K. Zachariah
- 0000 0004 1766 361Xgrid.464618.9Department of Surgery, Mosc Medical College, Kolenchery, Cochin, India
| | - Justas Žilinskas
- Faculty of Medicine University of Belgrade Clinic for Surgery, University Clinical Center “Zvezdara”, Belgrade, Serbia
| | - Maurizio Zizzo
- Surgical Oncology Unit, Azienda Unità Sanitaria Locale - IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Vittoria Pattonieri
- grid.411482.aEmergency Surgery Department, Maggiore Parma Hospital, Parma, Italy
| | - Gian Luca Baiocchi
- 0000000417571846grid.7637.5Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
| | - Fausto Catena
- grid.411482.aEmergency Surgery Department, Maggiore Parma Hospital, Parma, Italy
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Coccolini F, Ceresoli M, Kluger Y, Kirkpatrick A, Montori G, Salvetti F, Fugazzola P, Tomasoni M, Sartelli M, Ansaloni L, Catena F, Negoi I, Zese M, Occhionorelli S, Shlyapnikov S, Galatioto C, Chiarugi M, Demetrashvili Z, Dondossola D, Ioannidis O, Novelli G, Nacoti M, Khor D, Inaba K, Demetriades D, Kaussen T, Jusoh AC, Ghannam W, Sakakushev B, Guetta O, Dogjani A, Costa S, Singh S, Damaskos D, Isik A, Yuan KC, Trotta F, Rausei S, Martinez-Perez A, Bellanova G, Fonseca V, Hernández F, Marinis A, Fernandes W, Quiodettis M, Bala M, Vereczkei A, Curado R, Fraga GP, Pereira BM, Gachabayov M, Chagerben GP, Arellano ML, Ozyazici S, Costa G, Tezcaner T, Porta M, Li Y, Karateke F, Manatakis D, Mariani F, Lora F, Sahderov I, Atanasov B, Zegarra S, Gianotti L, Fattori L, Ivatury R. Open abdomen and entero-atmospheric fistulae: An interim analysis from the International Register of Open Abdomen (IROA). Injury 2019; 50:160-166. [PMID: 30274755 DOI: 10.1016/j.injury.2018.09.040] [Citation(s) in RCA: 40] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2018] [Revised: 08/26/2018] [Accepted: 09/20/2018] [Indexed: 02/08/2023]
Abstract
INTRODUCTION No definitive data describing associations between cases of Open Abdomen (OA) and Entero-atmospheric fistulae (EAF) exist. The World Society of Emergency Surgery (WSES) and the Panamerican Trauma Society (PTS) thus analyzed the International Register of Open Abdomen (IROA) to assess this question. MATERIAL AND METHODS A prospective analysis of adult patients enrolled in the IROA. RESULTS Among 649 adult patients with OA 58 (8.9%) developed EAF. Indications for OA were peritonitis (51.2%) and traumatic-injury (16.8%). The most frequently utilized temporary abdominal closure techniques were Commercial-NPWT (46.8%) and Bogotà-bag (21.9%). Mean OA days were 7.9 ± 18.22. Overall mortality rate was 29.7%, with EAF having no impact on mortality. Multivariate analysis associated cancer (p = 0.018), days of OA (p = 0.003) and time to provision-of-nutrition (p = 0.016) with EAF occurrence. CONCLUSION Entero-atmospheric fistulas are influenced by the duration of open abdomen treatment and by the nutritional status of the patient. Peritonitis, intestinal anastomosis, negative pressure and oral or enteral nutrition were not risk factors for EAF during OA treatment.
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Affiliation(s)
- Federico Coccolini
- General, Emergency and Trauma Surgery Dept., Bufalini Hospital, Cesena, Italy.
| | - Marco Ceresoli
- General and Emergency Surgery, Milano-Bicocca University, School of Medicine and Surgery, Monza, Italy.
| | - Yoram Kluger
- Division of General Surgery Rambam Health Care Campus Haifa, Israel.
| | | | - Giulia Montori
- General Surgery, San Giovanni Bianco Hospital, Bergamo, Italy.
| | - Fracensco Salvetti
- General, Emergency and Trauma Surgery Dept., Bufalini Hospital, Cesena, Italy.
| | - Paola Fugazzola
- General, Emergency and Trauma Surgery Dept., Bufalini Hospital, Cesena, Italy.
| | - Matteo Tomasoni
- General, Emergency and Trauma Surgery Dept., Bufalini Hospital, Cesena, Italy.
| | - Massimo Sartelli
- General and Emergency Surgery, Macerata Hospital, Macerata, Italy.
| | - Luca Ansaloni
- General, Emergency and Trauma Surgery Dept., Bufalini Hospital, Cesena, Italy.
| | - Fausto Catena
- Emergency Surgery dept., Parma University Hospital, Parma, Italy.
| | - Ionut Negoi
- Emergency Surgery Hospital, Bucharest, Romania
| | - Monica Zese
- Emergency Surgery dept. Ferrara University Hospital, Ferrara, Italy
| | | | | | | | | | | | - Daniele Dondossola
- HPB Surgery, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, Milano, Italy
| | - Orestis Ioannidis
- Fourth Surgical dept. Hospital George Papanikolau, Aristotle University, Thessaloniki, Greece
| | | | - Mirco Nacoti
- Pediatric Intensive Care Unit, Papa Giovanni XXIII Hospital, Bergamo, Italy
| | | | - Kenji Inaba
- LAS+USC Medical Centre, Los Angeles, California
| | | | - Torsten Kaussen
- Pediatric Intensive Care Unit, Hannover University Hospital, Hannover, Germany
| | | | | | | | | | | | - Stefano Costa
- Emergency and General Surgery, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, Milano, Italy
| | | | | | - Arda Isik
- Erzincan University Faculty Of Medicine MengucekGazi Training Research Hospital Erzincan, Turkey
| | | | | | - Stefano Rausei
- Ospedale di Circolo e Fondazione Macchi, University of Insubria, Varese, Italy
| | | | | | | | | | | | | | | | - Miklosh Bala
- Hadassah Hebrew University Medical Center, Jerusalem, Israel
| | | | | | | | | | | | | | | | - Sefa Ozyazici
- Adana Numune Training and Research Hospital, Department of Surgery, Adana, Turkey
| | - Gianluca Costa
- Ospedale Sant'Andrea University Hospital Sapienza, Rome, Italy
| | | | - Matteo Porta
- General Surgery, IRCCS Policlinico San Donato, Milano, Italy
| | - Yousheng Li
- Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, China
| | - Faruk Karateke
- Numune Training and Research Hospital, Department of Surgery, Numune, Turkey
| | | | - Federico Mariani
- General Surgery, Santa Maria alleScotteUniversitary Hospital Siena, Italy
| | - Federic Lora
- General Surgery, Cittàdella Salute e dellascienza, Torino, Italy
| | - Ivan Sahderov
- General Surgery, Krasnoyarsk Regional Hospital, Krasnoyarsk, Russia
| | | | | | - Luca Gianotti
- General and Emergency Surgery, Milano-Bicocca University School of Medicine and surgery, Monza, Italy
| | - Luca Fattori
- General and Emergency Surgery, Milano-Bicocca University School of Medicine and surgery, Monza, Italy
| | - Rao Ivatury
- Virginia Commonwealth University, Richmond, Virginia, USA
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Pipia I, Kenchadze G, Demetrashvili Z, Nemsadze G, Jamburia L, Zamtaradze T, Abiatari I. Gallbladder agenesis: A case report and review of the literature. Int J Surg Case Rep 2018; 53:235-237. [PMID: 30428439 PMCID: PMC6232615 DOI: 10.1016/j.ijscr.2018.10.061] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2018] [Revised: 10/02/2018] [Accepted: 10/09/2018] [Indexed: 02/08/2023] Open
Abstract
Gallbladder agenesis presented with symptoms similar to biliary colic can be diagnosed without the need for surgical intervention. MRCP is considered a test of choice for diagnosis of gallbladder agenesis. If gallbladder agenesis is discovered during laparoscopy no conversion to laparotomy is needed.
Introduction Gallbladder agenesis is a rare congenital abnormality with an incidence of 10–65 per 100,000. Approximately half of these patients are surgically operated on because of the symptoms similar to biliary colic, and correct diagnosis is established intra-operatively. We present a clinical case of gallbladder agenesis from our practice. Presentation of case A 49 (forty-nine) - year- old women was admitted in the Emergency Department of our clinic. Symptoms were similar to the biliary colic. Ultrasonography showed hyperechogenic acoustic shadow on the projection of the gallbladder which was considered as constricted gallbladder and cholecystolithiasis was diagnosed. Laparoscopic cholecystectomy was considered. During laparoscopy gallbladder could not be found. Surgical operation was completed without conversion. Postoperative treatment included analgesics and antispasmodics. Pre-operative symptoms disappeared. One month later magnetic resonance cholangiopancreatography (MRCP) confirmed gallbladder agenesis diagnosis. Health condition of the patient is satisfactory, without any complications after a year of surgery. Discussion Gallbladder agenesis presented with symptoms similar to biliary colic can be diagnosed without surgical intervention. Conservative treatment consists of antispasmodic drugs. Conclusion If the shrunken gallbladder is detected on the ultrasound, additional radiological examinations are required. MRCP is considered as a test of choice among the radiological investigations. If gallbladder agenesis is identified on laparoscopy, there is no need for further conversion. For postoperative follow up examination MRCP investigation is recommended.
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Affiliation(s)
- Irakli Pipia
- Institute of Medical Research, Ilia State University, 3/5, Cholokashvili Ave., 0162, Tbilisi, Georgia; Department of Surgery, Kipshidze Central University Hospital, 29, Vazha-Pshavela Ave., 0160, Tbilisi, Georgia.
| | - George Kenchadze
- Institute of Medical Research, Ilia State University, 3/5, Cholokashvili Ave., 0162, Tbilisi, Georgia; Department of Surgery, Kipshidze Central University Hospital, 29, Vazha-Pshavela Ave., 0160, Tbilisi, Georgia.
| | - Zaza Demetrashvili
- Department of Surgery, Kipshidze Central University Hospital, 29, Vazha-Pshavela Ave., 0160, Tbilisi, Georgia; Department of Surgery, Tbilisi State Medical University, 33, Vazha-Pshavela Ave., 0177, Tbilisi, Georgia.
| | - Grigol Nemsadze
- Department of Radiology, Tbilisi State Medical University, 33, Vazha-Pshavela Ave., 0177, Tbilisi, Georgia; Department of Radiology, Kipshidze Central University Hospital, 29, Vazha-Pshavela Ave., 0160, Tbilisi, Georgia.
| | - Lika Jamburia
- Department of Radiology, Kipshidze Central University Hospital, 29, Vazha-Pshavela Ave., 0160, Tbilisi, Georgia.
| | - Tamari Zamtaradze
- Department of Surgery, Tbilisi State Medical University, 33, Vazha-Pshavela Ave., 0177, Tbilisi, Georgia.
| | - Ivane Abiatari
- Institute of Medical Research, Ilia State University, 3/5, Cholokashvili Ave., 0162, Tbilisi, Georgia.
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Sartelli M, Kluger Y, Ansaloni L, Coccolini F, Baiocchi GL, Hardcastle TC, Moore EE, May AK, Itani KMF, Fry DE, Boermeester MA, Guirao X, Napolitano L, Sawyer RG, Rasa K, Abu-Zidan FM, Adesunkanmi AK, Atanasov B, Augustin G, Bala M, Cainzos MA, Chichom-Mefire A, Cortese F, Damaskos D, Delibegovic S, Demetrashvili Z, De Simone B, Duane TM, Ghnnam W, Gkiokas G, Gomes CA, Hecker A, Karamarkovic A, Kenig J, Khokha V, Kong V, Isik A, Leppäniemi A, Litvin A, Lostoridis E, Machain GM, Marwah S, McFarlane M, Mesina C, Negoi I, Olaoye I, Pintar T, Pupelis G, Rems M, Rubio-Perez I, Sakakushev B, Segovia-Lohse H, Siribumrungwong B, Talving P, Ulrych J, Vereczkei AG, Labricciosa FM, Catena F. Knowledge, awareness, and attitude towards infection prevention and management among surgeons: identifying the surgeon champion. World J Emerg Surg 2018; 13:37. [PMID: 30140304 PMCID: PMC6098571 DOI: 10.1186/s13017-018-0198-x] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2018] [Accepted: 08/08/2018] [Indexed: 02/08/2023] Open
Abstract
Despite evidence supporting the effectiveness of best practices of infection prevention and management, many surgeons worldwide fail to implement them. Evidence-based practices tend to be underused in routine practice. Surgeons with knowledge in surgical infections should provide feedback to prescribers and integrate best practices among surgeons and implement changes within their team. Identifying a local opinion leader to serve as a champion within the surgical department may be important. The “surgeon champion” can integrate best clinical practices of infection prevention and management, drive behavior change in their colleagues, and interact with both infection control teams in promoting antimicrobial stewardship.
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Affiliation(s)
- Massimo Sartelli
- Department of Surgery, Macerata Hospital, Via Santa Lucia, 62100 Macerata, Italy
| | - Yoram Kluger
- 2Department of General Surgery, Division of Surgery, Rambam Health Care Campus, Haifa, Israel
| | - Luca Ansaloni
- General Surgery Department, "M. Bufalini" Cesena Hospital, Cesena, Italy
| | - Federico Coccolini
- General Surgery Department, "M. Bufalini" Cesena Hospital, Cesena, Italy
| | - Gian Luca Baiocchi
- 4Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
| | - Timothy C Hardcastle
- Department of Surgery, Trauma Service, Inkosi Albert Luthuli Central Hospital, Nelson R Mandela School of Clinical Medicine, Durban, South Africa
| | - Ernest E Moore
- 6Department of Surgery, Denver Health Medical Center, University of Colorado, Denver, CO USA
| | - Addison K May
- 7Division of Trauma and Surgical Critical Care, Vanderbilt University Medical Center, Nashville, TN USA
| | - Kamal M F Itani
- Department of Surgery, VA Boston Health Care System, Boston University, Harvard Medical School, Boston, MA USA
| | - Donald E Fry
- 9Department of Surgery, Northwestern University Feinberg School of Medicine, Chicago, IL USA.,10University of New Mexico School of Medicine, Albuquerque, NM USA
| | | | - Xavier Guirao
- Unit of Endocrine, Head, and Neck Surgery and Unit of Surgical Infections Support, Department of General Surgery, ParcTaulí, Hospital University, Sabadell, Spain
| | - Lena Napolitano
- 13Department of Surgery, University of Michigan, Ann Arbor, MI USA
| | - Robert G Sawyer
- 14Department of Surgery, Western Michigan University School of Medicine, Kalamazoo, MI USA
| | - Kemal Rasa
- Department of Surgery, Anadolu Medical Center, Kocaali, Turkey
| | - Fikri M Abu-Zidan
- 16Department of Surgery, College of Medicine and Health Sciences, UAE University, Al-Ain, United Arab Emirates
| | | | - Boyko Atanasov
- 18Department of General Surgery, Medical University of Plovdiv, UMHAT Eurohospital, Plovdiv, Bulgaria
| | - Goran Augustin
- 19Department of Surgery, University Hospital Centre Zagreb, Zagreb, Croatia
| | - Miklosh Bala
- 20Trauma and Acute Care Surgery Unit, Hadassah Hebrew University Medical Center, Jerusalem, Israel
| | - Miguel A Cainzos
- 21Department of Surgery, Hospital Clínico Universitario, Santiago de Compostela, Spain
| | - Alain Chichom-Mefire
- Department of Surgery and Obstetrics/Gynaecology, Regional Hospital, Limbe, Cameroon
| | | | - Dimitris Damaskos
- 24Department of Surgery, Royal Infirmary of Edinburgh, Edinburgh, UK
| | - Samir Delibegovic
- 25Department of Surgery, University Clinical Center of Tuzla, Tuzla, Bosnia and Herzegovina
| | - Zaza Demetrashvili
- Department General Surgery, Kipshidze Central University Hospital, Tbilisi, Georgia
| | | | - Therese M Duane
- Department of Surgery, John Peter Smith Health Network, Fort Worth, TX USA
| | - Wagih Ghnnam
- 29Department of General Surgery, Mansoura Faculty of Medicine, Mansoura University, Mansoura, Egypt
| | - George Gkiokas
- 30Second Department of Surgery, Aretaieion University Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Carlos A Gomes
- Faculdade de Ciências Médicas e da Saúde de Juiz de Fora, Department of Surgery, Hospital Universitário Terezinha de Jesus, Juiz de Fora, Brazil
| | - Andreas Hecker
- 32Department of General and Thoracic Surgery, University Hospital Giessen, Giessen, Germany
| | | | - Jakub Kenig
- 34Third Department of General Surgery, Jagiellonian University Medical College, Krakow, Poland
| | - Vladimir Khokha
- Department of Emergency Surgery, City Hospital, Mozyr, Belarus
| | - Victor Kong
- 36Department of Surgery, Edendale Hospital, Pietermaritzburg, South Africa
| | - Arda Isik
- 37General Surgery Department, Magee Womens Hospital, UPMC, Pittsburgh, USA
| | - Ari Leppäniemi
- Abdominal Center, University Hospital Meilahti, Helsinki, Finland
| | - Andrey Litvin
- 39Surgical Disciplines, Immanuel Kant Baltic Federal University/Regional Clinical Hospital, Kaliningrad, Russian Federation
| | | | - Gustavo M Machain
- 41Department of Surgery, II Cátedra de Clínica Quirúrgica, Universidad Nacional de Asunción, San Lorenzo, Paraguay
| | - Sanjay Marwah
- 42Department of Surgery, Post-Graduate Institute of Medical Sciences, Rohtak, India
| | - Michael McFarlane
- 43Department of Surgery, Radiology, University Hospital of the West Indies, Kingston, Jamaica
| | - Cristian Mesina
- Second Surgical Clinic, Emergency Hospital of Craiova, Craiova, Romania
| | - Ionut Negoi
- Department of Surgery, Emergency Hospital of Bucharest, Bucharest, Romania
| | - Iyiade Olaoye
- 46Department of Surgery, University of Ilorin Teaching Hospital, Ilorin, Nigeria
| | - Tadeja Pintar
- 47Department of Surgery, UMC Ljubljana, Ljubljana, Slovenia
| | - Guntars Pupelis
- 48Department of General and Emergency Surgery, Riga East University Hospital "Gailezers", Riga, Latvia
| | - Miran Rems
- Department of General Surgery, Jesenice General Hospital, Jesenice, Slovenia
| | - Ines Rubio-Perez
- 50Colorectal Surgery Unit, General Surgery Department, La Paz University Hospital, Madrid, Spain
| | - Boris Sakakushev
- General Surgery Department, Medical University, University Hospital St George, Plovdiv, Bulgaria
| | - Helmut Segovia-Lohse
- 41Department of Surgery, II Cátedra de Clínica Quirúrgica, Universidad Nacional de Asunción, San Lorenzo, Paraguay
| | - Boonying Siribumrungwong
- 52Faculty of Medicine, Department of Surgery, Thammasat University Hospital, Thammasat University, Amphoe Khlong Luang, Pathum Thani Thailand
| | - Peep Talving
- Department of Surgery, North Estonia Medical Center, Tallinn, Estonia
| | - Jan Ulrych
- 54First Department of Surgery-Department of Abdominal, Thoracic Surgery and Traumatology, General University Hospital, Prague, Czech Republic
| | - András G Vereczkei
- 55Department of Surgery, Medical School University of Pécs, Pécs, Hungary
| | | | - Fausto Catena
- Department of Emergency Surgery, Maggiore Hospital, Parma, Italy
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47
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Coccolini F, Roberts D, Ansaloni L, Ivatury R, Gamberini E, Kluger Y, Moore EE, Coimbra R, Kirkpatrick AW, Pereira BM, Montori G, Ceresoli M, Abu-Zidan FM, Sartelli M, Velmahos G, Fraga GP, Leppaniemi A, Tolonen M, Galante J, Razek T, Maier R, Bala M, Sakakushev B, Khokha V, Malbrain M, Agnoletti V, Peitzman A, Demetrashvili Z, Sugrue M, Di Saverio S, Martzi I, Soreide K, Biffl W, Ferrada P, Parry N, Montravers P, Melotti RM, Salvetti F, Valetti TM, Scalea T, Chiara O, Cimbanassi S, Kashuk JL, Larrea M, Hernandez JAM, Lin HF, Chirica M, Arvieux C, Bing C, Horer T, De Simone B, Masiakos P, Reva V, DeAngelis N, Kike K, Balogh ZJ, Fugazzola P, Tomasoni M, Latifi R, Naidoo N, Weber D, Handolin L, Inaba K, Hecker A, Kuo-Ching Y, Ordoñez CA, Rizoli S, Gomes CA, De Moya M, Wani I, Mefire AC, Boffard K, Napolitano L, Catena F. The open abdomen in trauma and non-trauma patients: WSES guidelines. World J Emerg Surg 2018; 13:7. [PMID: 29434652 PMCID: PMC5797335 DOI: 10.1186/s13017-018-0167-4] [Citation(s) in RCA: 142] [Impact Index Per Article: 23.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2018] [Accepted: 01/18/2018] [Indexed: 02/08/2023] Open
Abstract
Damage control resuscitation may lead to postoperative intra-abdominal hypertension or abdominal compartment syndrome. These conditions may result in a vicious, self-perpetuating cycle leading to severe physiologic derangements and multiorgan failure unless interrupted by abdominal (surgical or other) decompression. Further, in some clinical situations, the abdomen cannot be closed due to the visceral edema, the inability to control the compelling source of infection or the necessity to re-explore (as a "planned second-look" laparotomy) or complete previously initiated damage control procedures or in cases of abdominal wall disruption. The open abdomen in trauma and non-trauma patients has been proposed to be effective in preventing or treating deranged physiology in patients with severe injuries or critical illness when no other perceived options exist. Its use, however, remains controversial as it is resource consuming and represents a non-anatomic situation with the potential for severe adverse effects. Its use, therefore, should only be considered in patients who would most benefit from it. Abdominal fascia-to-fascia closure should be done as soon as the patient can physiologically tolerate it. All precautions to minimize complications should be implemented.
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Affiliation(s)
- Federico Coccolini
- General Emergency and Trauma Surgery, Bufalini Hospital, Viale Giovanni Ghirotti, 286, 47521 Cesena, Italy
| | - Derek Roberts
- Department of Surgery, Foothills Medical Centre, Calgary, Canada
| | - Luca Ansaloni
- General Emergency and Trauma Surgery, Bufalini Hospital, Viale Giovanni Ghirotti, 286, 47521 Cesena, Italy
| | - Rao Ivatury
- Virginia Commonwealth University, Richmond, VA USA
| | | | - Yoram Kluger
- Division of General Surgery, Rambam Health Care Campus, Haifa, Israel
| | | | - Raul Coimbra
- Department of Surgery, UC San Diego Health System, San Diego, USA
| | | | - Bruno M. Pereira
- Faculdade de Ciências Médicas (FCM)–Unicamp Campinas, Campinas, SP Brazil
| | - Giulia Montori
- General Emergency and Trauma Surgery, Bufalini Hospital, Viale Giovanni Ghirotti, 286, 47521 Cesena, Italy
| | - Marco Ceresoli
- General Emergency and Trauma Surgery, Bufalini Hospital, Viale Giovanni Ghirotti, 286, 47521 Cesena, Italy
| | - Fikri M. Abu-Zidan
- Department of Surgery, College of Medicine and Health Sciences, UAE University, Al-Ain, United Arab Emirates
| | | | - George Velmahos
- Department of Trauma, Emergency Surgery and Surgical Critical Care, Massachusetts General Hospital, Boston, MA USA
| | | | - Ari Leppaniemi
- Second Department of Surgery, Meilahti Hospital, Helsinki, Finland
| | - Matti Tolonen
- Second Department of Surgery, Meilahti Hospital, Helsinki, Finland
| | - Joseph Galante
- Trauma and Acute Care Surgery and Surgical Critical Care Trauma, Department of Surgery, University of California, Davis, USA
| | - Tarek Razek
- General and Emergency Surgery, McGill University Health Centre, Montréal, QC Canada
| | - Ron Maier
- Department of Surgery, Harborview Medical Centre, Seattle, USA
| | - Miklosh Bala
- General Surgery Department, Hadassah Medical Centre, Jerusalem, Israel
| | - Boris Sakakushev
- First Clinic of General Surgery, University Hospital/UMBAL/St George Plovdiv, Plovdiv, Bulgaria
| | | | - Manu Malbrain
- ICU and High Care Burn Unit, Ziekenhius Netwerk Antwerpen, Antwerpen, Belgium
| | | | - Andrew Peitzman
- Department of Surgery, Trauma and Surgical Services, University of Pittsburgh School of Medicine, Pittsburgh, USA
| | - Zaza Demetrashvili
- Department of Surgery, Tbilisi State Medical University, Kipshidze Central University Hospital, Tbilisi, Georgia
| | - Michael Sugrue
- General Surgery Department, Letterkenny Hospital, Letterkenny, Ireland
| | | | - Ingo Martzi
- Klinik für Unfall-, Hand- und Wiederherstellungschirurgie Universitätsklinikum Goethe-Universität Frankfurt, Frankfurt, Germany
| | - Kjetil Soreide
- Department of Clinical Medicine, University of Bergen, Bergen, Norway
- Department of Gastrointestinal Surgery, Stavanger University Hospital, Stavanger, Norway
| | - Walter Biffl
- Acute Care Surgery, The Queen’s Medical Center, Honolulu, HI USA
| | | | - Neil Parry
- General and Trauma Surgery Department, London Health Sciences Centre, Victoria Hospital, London, ON Canada
| | - Philippe Montravers
- Département d’Anesthésie-Réanimation, CHU Bichat Claude-Bernard-HUPNVS, Assistance Publique-Hôpitaux de Paris, University Denis Diderot, Paris, France
| | - Rita Maria Melotti
- ICU Department, Sant’Orsola-Malpighi University Hospital, Bologna, Italy
| | - Francesco Salvetti
- General Emergency and Trauma Surgery, Bufalini Hospital, Viale Giovanni Ghirotti, 286, 47521 Cesena, Italy
| | - Tino M. Valetti
- ICU Department, Papa Giovanni XXIII Hospital, Bergamo, Italy
| | - Thomas Scalea
- Surgery Department, University of Maryland School of Medicine, Baltimore, MD USA
| | - Osvaldo Chiara
- Emergency and Trauma Surgery Department, Niguarda Hospital, Milano, Italy
| | | | - Jeffry L. Kashuk
- General Surgery Department, Assuta Medical Centers, Tel Aviv, Israel
| | - Martha Larrea
- General Surgery, “General Calixto García”, Habana Medicine University, Havana, Cuba
| | | | - Heng-Fu Lin
- Division of Trauma, Department of Surgery, Far-Eastern Memorial Hospital, New Taipei City, Taiwan, Republic of China
| | - Mircea Chirica
- Clin. Univ. de Chirurgie Digestive et de l’Urgence, CHUGA-CHU Grenoble Alpes UGA-Université Grenoble Alpes, Grenoble, France
| | - Catherine Arvieux
- Clin. Univ. de Chirurgie Digestive et de l’Urgence, CHUGA-CHU Grenoble Alpes UGA-Université Grenoble Alpes, Grenoble, France
| | - Camilla Bing
- General and Emergency Surgery Department, Empoli Hospital, Empoli, Italy
| | - Tal Horer
- Department of Cardiothoracic and Vascular Surgery, Örebro University Hospital and Örebro University, Orebro, Sweden
| | | | - Peter Masiakos
- Pediatric Trauma Service, Massachusetts General Hospital, Boston, MA USA
| | - Viktor Reva
- General and Emergency Surgery, Sergei Kirov Military Academy, Saint Petersburg, Russia
| | - Nicola DeAngelis
- Unit of Digestive Surgery, HPB Surgery and Liver Transplant, Henri Mondor Hospital, Créteil, France
| | - Kaoru Kike
- Department of Primary Care and Emergency Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Zsolt J. Balogh
- Department of Traumatology, John Hunter Hospital and University of Newcastle, Newcastle, NSW Australia
| | - Paola Fugazzola
- General Emergency and Trauma Surgery, Bufalini Hospital, Viale Giovanni Ghirotti, 286, 47521 Cesena, Italy
| | - Matteo Tomasoni
- General Emergency and Trauma Surgery, Bufalini Hospital, Viale Giovanni Ghirotti, 286, 47521 Cesena, Italy
| | - Rifat Latifi
- General Surgery Department, Westchester Medical Center, Westchester, NY USA
| | - Noel Naidoo
- Department of Surgery, University of KwaZulu-Natal, Durban, South Africa
| | - Dieter Weber
- Department of General Surgery, Royal Perth Hospital, The University of Western Australia & The University of Newcastle, Perth, Australia
| | - Lauri Handolin
- Trauma Unit, Helsinki University Hospital, Helsinki, Finland
| | - Kenji Inaba
- Division of Trauma and Critical Care, LAC+USC Medical Center, University of Southern California, California, Los Angeles USA
| | - Andreas Hecker
- General and Thoracic Surgery, Giessen Hospital, Giessen, Germany
| | - Yuan Kuo-Ching
- Acute Care Surgery and Traumatology, Taipei Medical University Hospital, Taipei City, Taiwan, Republic of China
| | - Carlos A. Ordoñez
- Trauma and Acute Care Surgery, Fundacion Valle del Lili, Cali, Colombia
| | - Sandro Rizoli
- Trauma and Acute Care Service, St Michael’s Hospital, Toronto, ON Canada
| | - Carlos Augusto Gomes
- Hospital Universitário Terezinha de Jesus, Faculdade de Ciências Médicas e da Saúde de Juiz de Fora (SUPREMA), Juiz de Fora, Brazil
| | - Marc De Moya
- Trauma, Acute Care Surgery, Medical College of Wisconsin/Froedtert Trauma Center, Milwaukee, WI USA
| | - Imtiaz Wani
- Department of Surgery, Sheri-Kashmir Institute of Medical Sciences, Srinagar, India
| | - Alain Chichom Mefire
- Department of Surgery and Obs/Gyn, Faculty of Health Sciences, University of Buea, Buea, Cameroon
| | - Ken Boffard
- Milpark Hospital Academic Trauma Center, University of the Witwatersrand, Johannesburg, South Africa
| | - Lena Napolitano
- Acute Care Surgery, Department of Surgery, University of Michigan Health System, Ann Arbor, MI USA
| | - Fausto Catena
- Emergency and Trauma Surgery, Parma Maggiore Hospital, Parma, Italy
| |
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48
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Sartelli M, Kluger Y, Ansaloni L, Hardcastle TC, Rello J, Watkins RR, Bassetti M, Giamarellou E, Coccolini F, Abu-Zidan FM, Adesunkanmi AK, Augustin G, Baiocchi GL, Bala M, Baraket O, Beltran MA, Jusoh AC, Demetrashvili Z, De Simone B, de Souza HP, Cui Y, Davies RJ, Dhingra S, Diaz JJ, Di Saverio S, Dogjani A, Elmangory MM, Enani MA, Ferrada P, Fraga GP, Frattima S, Ghnnam W, Gomes CA, Kanj SS, Karamarkovic A, Kenig J, Khamis F, Khokha V, Koike K, Kok KYY, Isik A, Labricciosa FM, Latifi R, Lee JG, Litvin A, Machain GM, Manzano-Nunez R, Major P, Marwah S, McFarlane M, Memish ZA, Mesina C, Moore EE, Moore FA, Naidoo N, Negoi I, Ofori-Asenso R, Olaoye I, Ordoñez CA, Ouadii M, Paolillo C, Picetti E, Pintar T, Ponce-de-Leon A, Pupelis G, Reis T, Sakakushev B, Kafil HS, Sato N, Shah JN, Siribumrungwong B, Talving P, Tranà C, Ulrych J, Yuan KC, Catena F. Raising concerns about the Sepsis-3 definitions. World J Emerg Surg 2018; 13:6. [PMID: 29416555 PMCID: PMC5784683 DOI: 10.1186/s13017-018-0165-6] [Citation(s) in RCA: 63] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2017] [Accepted: 01/17/2018] [Indexed: 02/08/2023] Open
Abstract
The Global Alliance for Infections in Surgery appreciates the great effort of the task force who derived and validated the Sepsis-3 definitions and considers the new definitions an important step forward in the evolution of our understanding of sepsis. Nevertheless, more than a year after their publication, we have a few concerns regarding the use of the Sepsis-3 definitions.
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Affiliation(s)
| | - Yoram Kluger
- 2Department of General Surgery, Division of Surgery, Rambam Health Care Campus, Haifa, Israel
| | - Luca Ansaloni
- 3General Surgery Department, Bufalini Hospital, Cesena, Italy
| | - Timothy C Hardcastle
- Trauma Service, Inkosi Albert Luthuli Central Hospital, Durban, South Africa.,Department of Surgery, Nelson R Mandela School of Clinical Medicine, Durban, South Africa
| | - Jordi Rello
- 5Department of Clinical Research & Innovation in Pneumonia and Sepsis, Vall d'Hebron Institute of Research (VHIR), Barcelona, Spain
| | - Richard R Watkins
- 6Division of Infectious Diseases, Cleveland Clinic Akron General, Akron, OH USA.,7Department of Medicine, Northeast Ohio Medical University, Rootstown, OH USA
| | - Matteo Bassetti
- 8Infectious Diseases Division, Santa Maria Misericordia University Hospital, Udine, Italy
| | - Eleni Giamarellou
- 96th Department of Internal Medicine, Hygeia General Hospital, Athens, Greece
| | | | - Fikri M Abu-Zidan
- 10Department of Surgery, College of Medicine and Health Sciences, UAE University, Al-Ain, United Arab Emirates
| | | | - Goran Augustin
- 12Department of Surgery, University Hospital Centre, Zagreb, Croatia
| | - Gian L Baiocchi
- 13Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
| | - Miklosh Bala
- 14Trauma and Acute Care Surgery Unit, Hadassah Hebrew University Medical Center, Jerusalem, Israel
| | | | - Marcelo A Beltran
- Department of General Surgery, Hospital San Juan de Dios de La Serena, La Serena, Chile
| | - Asri Che Jusoh
- Department of General Surgery, Kuala Krai Hospital, Kelantan, Malaysia
| | - Zaza Demetrashvili
- Department General Surgery, Kipshidze Central University Hospital, Tbilisi, Georgia
| | | | - Hamilton P de Souza
- 20Department of Surgery, School of Medicine, Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS), Porto Alegre, Brazil
| | - Yunfeng Cui
- 21Department of Surgery, Tianjin Nankai Hospital, Nankai Clinical School of Medicine, Tianjin Medical University, Tianjin, China
| | - R Justin Davies
- 22Colorectal Unit, Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | - Sameer Dhingra
- 23School of Pharmacy, Faculty of Medical Sciences, The University of the West Indies, St. Augustine, Eric Williams Medical Sciences Complex, Uriah Butler Highway, Champ Fleurs, Trinidad and Tobago
| | - Jose J Diaz
- 24Division of Acute Care Surgery, Program in Trauma, R Adams Cowley Shock Trauma Center, University of Maryland, Baltimore, MD USA
| | - Salomone Di Saverio
- 22Colorectal Unit, Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | - Agron Dogjani
- Department of Surgery, University Hospital of Trauma, Tirana, Albania
| | - Mutasim M Elmangory
- 26Sudan National Public Health Laboratory, Federal Ministry of Health, Khartoum, Sudan
| | - Mushira A Enani
- 27Department of Medicine, Infectious Disease Division, King Fahad Medical City, Riyadh, Saudi Arabia
| | - Paula Ferrada
- 28Department of Surgery, Virginia Commonwealth University, Richmond, VA USA
| | - Gustavo P Fraga
- 29Division of Trauma Surgery, Department of Surgery, School of Medical Sciences, University of Campinas (Unicamp), Campinas, SP Brazil
| | | | - Wagih Ghnnam
- 31Department of General Surgery, Mansoura Faculty of Medicine, Mansoura University, Mansoura, Egypt
| | - Carlos A Gomes
- Department of Surgery, Hospital Universitário Terezinha de Jesus, Faculdade de Ciências Médicas e da Saúde de Juiz de Fora, Juiz de Fora, Brazil
| | - Souha S Kanj
- 33Division of Infectious Diseases, Department of Internal Medicine, American University of Beirut, Beirut, Lebanon
| | | | - Jakub Kenig
- 35Third Department of General Surgery, Jagiellonian University Medical College, Krakow, Poland
| | - Faryal Khamis
- 36Department of Internal Medicine, Royal Hospital, Muscat, Oman
| | - Vladimir Khokha
- Department of Emergency Surgery, City Hospital, Mozyr, Belarus
| | - Kaoru Koike
- 38Department of Primary Care and Emergency Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Kenneth Y Y Kok
- Department of Surgery, The Brunei Cancer Centre, Jerudong Park, Jerudong, Brunei
| | - Arda Isik
- 40Department of General Surgery, Faculty of Medicine, Erzincan University, Erzincan, Turkey
| | | | - Rifat Latifi
- 42Department of Surgery, Division of Trauma, University of Arizona, Tucson, AZ USA
| | - Jae G Lee
- 43Department of Surgery, College of Medicine, Yonsei University, Seoul, South Korea
| | - Andrey Litvin
- 44Surgical Disciplines, Immanuel Kant Baltic Federal University/Regional Clinical Hospital, Kaliningrad, Russian Federation
| | - Gustavo M Machain
- 45Department of Surgery, Universidad Nacional de Asuncion, Asuncion, Paraguay
| | | | - Piotr Major
- 472nd Department of General Surgery, Jagiellonian University Medical College, Krakow, Poland
| | - Sanjay Marwah
- 48Department of Surgery, Post-Graduate Institute of Medical Sciences, Rohtak, India
| | - Michael McFarlane
- 49Department of Surgery, Radiology, University Hospital of the West Indies, Kingston, Jamaica
| | - Ziad A Memish
- 50Infectious Diseases Division, Department of Medicine, Prince Mohamed Bin Abdulaziz Hospital, Ministry of Health, Riyadh, Saudi Arabia.,76College of Medicine, Alfaisal University, Riyadh, Saudi Arabia
| | - Cristian Mesina
- Second Surgical Clinic, Emergency Hospital of Craiova, Craiova, Romania
| | - Ernest E Moore
- 52Department of Surgery, Denver Health Medical Center, University of Colorado, Denver, CO USA
| | - Frederick A Moore
- 53Department of Surgery, Division of Acute Care Surgery, and Center for Sepsis and Critical Illness Research, College of Medicine, University of Florida, Gainesville, FL USA
| | - Noel Naidoo
- 54Department of Surgery, University of KwaZulu-Natal, Durban, South Africa
| | - Ionut Negoi
- Department of Surgery, Emergency Hospital of Bucharest, Bucharest, Romania
| | | | - Iyiade Olaoye
- 57Department of Surgery, University of Ilorin, Teaching Hospital, Ilorin, Nigeria
| | - Carlos A Ordoñez
- 58Department of Surgery and Critical Care, Universidad del Valle, Fundación Valle del Lili, Cali, Colombia
| | - Mouaqit Ouadii
- Department of Surgery, Hassan II University Hospital, Medical School of Fez, Sidi Mohamed Benabdellah University, Fez, Morocco
| | - Ciro Paolillo
- 60Department of Emergency Medicine, Santa Maria Misericordia University Hospital, Udine, Italy
| | - Edoardo Picetti
- 61Department of Anesthesia and Intensive Care, Azienda Ospedaliero-Universitaria Parma, Parma, Italy
| | - Tadeja Pintar
- 62Department of Surgery, UMC Ljubljana, Ljubljana, Slovenia
| | - Alfredo Ponce-de-Leon
- 63Laboratory of Clinical Microbiology, Department of Infectious Diseases, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
| | - Guntars Pupelis
- 64Department of General and Emergency Surgery, Riga East University Hospital "Gailezers", Riga, Latvia
| | - Tarcisio Reis
- Emergency Post-Operative Department, Otavio De Freitas Hospital, Recife, Brazil.,Osvaldo Cruz Hospital Recife, Recife, Brazil
| | - Boris Sakakushev
- General Surgery Department, Medical University, University Hospital St George, Plovdiv, Bulgaria
| | - Hossein Samadi Kafil
- 67Drug Applied Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Norio Sato
- 68Department of Aeromedical Services for Emergency and Trauma Care, Graduate School of Medicine, Ehime University, Ehime, Japan
| | - Jay N Shah
- 69Department of Surgery, Patan Hospital, Patan Academy of Health Sciences Lalitpur, Kathmandu, Nepal
| | - Boonying Siribumrungwong
- 70Department of Surgery, Faculty of Medicine, Thammasat University Hospital, Thammasat University, Rangsit, Pathum Thani Thailand
| | - Peep Talving
- Department of Surgery, North Estonia Medical Center, Tallinn, Estonia
| | - Cristian Tranà
- Department of Surgery, Macerata Hospital, Macerata, Italy
| | - Jan Ulrych
- 72First Department of Surgery, First Faculty of Medicine, Charles University in Prague, Prague, Czech Republic.,78General University Hospital in Prague, Prague, Czech Republic
| | - Kuo-Ching Yuan
- 73Department of Emergency and Critical Care Medicine, Taipei Medical University Hospital, Taipei, Taiwan
| | - Fausto Catena
- Department of Emergency Surgery, Parma Maggiore Hospital, Parma, Italy
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49
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Sartelli M, Baiocchi GL, Di Saverio S, Ferrara F, Labricciosa FM, Ansaloni L, Coccolini F, Vijayan D, Abbas A, Abongwa HK, Agboola J, Ahmed A, Akhmeteli L, Akkapulu N, Akkucuk S, Altintoprak F, Andreiev AL, Anyfantakis D, Atanasov B, Bala M, Balalis D, Baraket O, Bellanova G, Beltran M, Melo RB, Bini R, Bouliaris K, Brunelli D, Castillo A, Catani M, Che Jusoh A, Chichom-Mefire A, Cocorullo G, Coimbra R, Colak E, Costa S, Das K, Delibegovic S, Demetrashvili Z, Di Carlo I, Kiseleva N, El Zalabany T, Faro M, Ferreira M, Fraga GP, Gachabayov M, Ghnnam WM, Giménez Maurel T, Gkiokas G, Gomes CA, Griffiths E, Guner A, Gupta S, Hecker A, Hirano ES, Hodonou A, Hutan M, Ioannidis O, Isik A, Ivakhov G, Jain S, Jokubauskas M, Karamarkovic A, Kauhanen S, Kaushik R, Kavalakat A, Kenig J, Khokha V, Khor D, Kim D, Kim JI, Kong V, Lasithiotakis K, Leão P, Leon M, Litvin A, Lohsiriwat V, López-Tomassetti Fernandez E, Lostoridis E, Maciel J, Major P, Dimova A, Manatakis D, Marinis A, Martinez-Perez A, Marwah S, McFarlane M, Mesina C, Pędziwiatr M, Michalopoulos N, Misiakos E, Mohamedahmed A, Moldovanu R, Montori G, Mysore Narayana R, Negoi I, Nikolopoulos I, Novelli G, Novikovs V, Olaoye I, Omari A, Ordoñez CA, Ouadii M, Ozkan Z, Pal A, Palini GM, Partecke LI, Pata F, Pędziwiatr M, Pereira Júnior GA, Pintar T, Pisarska M, Ploneda-Valencia CF, Pouggouras K, Prabhu V, Ramakrishnapillai P, Regimbeau JM, Reitz M, Rios-Cruz D, Saar S, Sakakushev B, Seretis C, Sazhin A, Shelat V, Skrovina M, Smirnov D, Spyropoulos C, Strzałka M, Talving P, Teixeira Gonsaga RA, Theobald G, Tomadze G, Torba M, Tranà C, Ulrych J, Uzunoğlu MY, Vasilescu A, Occhionorelli S, Venara A, Vereczkei A, Vettoretto N, Vlad N, Walędziak M, Yilmaz TU, Yuan KC, Yunfeng C, Zilinskas J, Grelpois G, Catena F. Prospective Observational Study on acute Appendicitis Worldwide (POSAW). World J Emerg Surg 2018; 13:19. [PMID: 29686725 PMCID: PMC5902943 DOI: 10.1186/s13017-018-0179-0] [Citation(s) in RCA: 99] [Impact Index Per Article: 16.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2017] [Accepted: 04/04/2018] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Acute appendicitis (AA) is the most common surgical disease, and appendectomy is the treatment of choice in the majority of cases. A correct diagnosis is key for decreasing the negative appendectomy rate. The management can become difficult in case of complicated appendicitis. The aim of this study is to describe the worldwide clinical and diagnostic work-up and management of AA in surgical departments. METHODS This prospective multicenter observational study was performed in 116 worldwide surgical departments from 44 countries over a 6-month period (April 1, 2016-September 30, 2016). All consecutive patients admitted to surgical departments with a clinical diagnosis of AA were included in the study. RESULTS A total of 4282 patients were enrolled in the POSAW study, 1928 (45%) women and 2354 (55%) men, with a median age of 29 years. Nine hundred and seven (21.2%) patients underwent an abdominal CT scan, 1856 (43.3%) patients an US, and 285 (6.7%) patients both CT scan and US. A total of 4097 (95.7%) patients underwent surgery; 1809 (42.2%) underwent open appendectomy and 2215 (51.7%) had laparoscopic appendectomy. One hundred eighty-five (4.3%) patients were managed conservatively. Major complications occurred in 199 patients (4.6%). The overall mortality rate was 0.28%. CONCLUSIONS The results of the present study confirm the clinical value of imaging techniques and prognostic scores. Appendectomy remains the most effective treatment of acute appendicitis. Mortality rate is low.
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Affiliation(s)
| | - Gian L. Baiocchi
- 0000000417571846grid.7637.5Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
| | - Salomone Di Saverio
- 0000 0004 1759 7093grid.416290.8Emergency Surgery, Maggiore Hospital, Bologna, Italy
| | - Francesco Ferrara
- grid.414126.4General Surgery and Polytrauma, San Carlo Borromeo Hospital, Milan, Italy
| | - Francesco M. Labricciosa
- Department of Biomedical Sciences and Public Health, Unit of Hygiene, Preventive Medicine and Public Health, UNIVPM, Ancona, Italy
| | - Luca Ansaloni
- 0000 0004 1758 8744grid.414682.dDepartment of Surgery, Bufalini Hospital, Cesena, Italy
| | - Federico Coccolini
- 0000 0004 1758 8744grid.414682.dDepartment of Surgery, Bufalini Hospital, Cesena, Italy
| | - Deepak Vijayan
- 0000 0004 0376 6589grid.412563.7General Surgery, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
| | - Ashraf Abbas
- grid.469958.fEmergency Surgery, Mansoura University Hospital, Mansoura, Egypt
| | | | - John Agboola
- Surgery, Kwara State General Hospital, Ilorin, Kwara Nigeria
| | - Adamu Ahmed
- 0000 0004 4688 7583grid.413221.7Surgery, Ahmadu Bello University Teaching Hospital Zaria, Zaria, Nigeria
| | | | - Nezih Akkapulu
- 0000 0001 1457 1144grid.411548.dGeneral Surgery, Baskent Universitesi Adana Eğitim ve Uygulama Hastanesi, Adana, Turkey
| | - Seckin Akkucuk
- 0000 0001 0680 7823grid.14352.31General Surgery, Training and Research Hospital of Mustafa Kemal University, Hatay, Turkey
| | - Fatih Altintoprak
- 0000 0001 0682 3030grid.49746.38General Surgery, Sakarya University School of Medicine, Sakarya, Turkey
| | - Aurelia L. Andreiev
- 0000 0004 0376 6589grid.412563.7General Surgery, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
| | | | - Boiko Atanasov
- 0000 0001 0726 0380grid.35371.33Department of General Surgery, Medical University of Plovdiv, UMHAT Eurohospital, Plovdiv, Bulgaria
| | - Miklosh Bala
- 0000 0001 2221 2926grid.17788.31General Surgery, Hadassah Medical Center, Jerusalem, Israel
| | - Dimitrios Balalis
- Surgical Department, Agios Savvas Anticaner Hospital, Athens, Greece
| | - Oussama Baraket
- General Surgery, Hospital Habib Bouguefa de Bizerte, Bizerte, Tunisia
| | | | - Marcelo Beltran
- Surgery, Hospital San Juan de Dios de La Serena, La Serena, Chile
| | - Renato Bessa Melo
- 0000 0000 9375 4688grid.414556.7General Surgery, Centro Hospitalar São João, Porto, Portugal
| | - Roberto Bini
- 0000 0004 1760 7116grid.415044.0General and Emergency Surgery, San Giovanni Bosco Hospital, Turin, Italy
| | | | | | - Adrian Castillo
- 0000 0001 0157 6501grid.239844.0Department of Surgery, Harbor-UCLA Medical Center, Torrance, USA
| | - Marco Catani
- grid.7841.aDEA, La Sapienza Università di Roma, Policlinico Umberto I, Rome, Italy
| | - Asri Che Jusoh
- General Surgery, Kuala Krai Hospital, Kuala Krai, Kelantan Malaysia
| | | | - Gianfranco Cocorullo
- 0000 0004 1756 3088grid.412510.3Emergency Surgery, Azienda Ospedaliera Universitaria Policlinico Paolo Giaccone, Palermo, Italy
| | - Raul Coimbra
- 0000 0001 2107 4242grid.266100.3Trauma/Acute Care Surgery, University of California San Diego, San Diego, USA
| | - Elif Colak
- General Surgery, Samsun Training and Research Hospital, Samsun, Turkey
| | - Silvia Costa
- 0000 0000 8902 4519grid.418336.bSurgery, CHVNG/E, EPE, Vila Nova de Gaia, Portugal
| | - Koray Das
- 0000 0004 0642 7670grid.413791.9General Surgery, Numune Training and Research Hospital, Adana, Turkey
| | - Samir Delibegovic
- 0000 0001 0682 9061grid.412410.2Colorectal Surgery, Clinic for Surgery, University Clinical Center Tuzla, Tuzla, Bosnia and Herzegovina
| | | | - Isidoro Di Carlo
- 0000 0004 0637 437Xgrid.413542.5Surgery, Hamad General Hospital, Doha, Qatar
| | - Nadezda Kiseleva
- 0000 0004 0375 2558grid.488518.8General and Emergency Surgery, Riga East University Hospital “Gailezers”, Riga, Latvia
| | | | - Mario Faro
- 0000 0004 0643 8839grid.412368.aDepartment of General Surgery, Trauma and Emergency Surgery Division, ABC Medical School, Santo Andreì, SP Brazil
| | - Margarida Ferreira
- 0000 0000 8563 4416grid.414708.eGeneral Surgery, Hospital Garcia de Orta, Lisbon, Portugal
| | - Gustavo P. Fraga
- 0000 0001 0723 2494grid.411087.bDivision of Trauma Surgery, Hospital de Clinicas, University of Campinas (Unicamp), Campinas, Brazil
| | - Mahir Gachabayov
- Department of Abdominal Surgery, Vladimir City Clinical Hospital of Emergency Medicine, Vladimir, Russia
| | - Wagih M. Ghnnam
- 0000000103426662grid.10251.37General Surgery Department, Mansoura Faculty of Medicine, Mansoura University, Mansoura, Egypt
| | - Teresa Giménez Maurel
- 0000 0000 9854 2756grid.411106.3Cirugía General y del Aparato Digestivo, Hospital Universitario Miguel Servet, Zaragoza, Spain
| | - Georgios Gkiokas
- 0000 0001 2155 0800grid.5216.0Second Department of Surgery, Aretaieion University Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Carlos A. Gomes
- Surgery, Therezinha de Jesus University Hospital, Juiz de Fora, Brazil
| | - Ewen Griffiths
- 0000 0004 0376 6589grid.412563.7Upper GI/General Surgery, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
| | - Ali Guner
- 0000 0001 2186 0630grid.31564.35Department of General Surgery, Karadeniz Technical University, Farabi Hospital, Trabzon, Turkey
| | - Sanjay Gupta
- 0000 0004 1767 2831grid.413220.6Surgery, Government Medical College and Hospital, Chandigarh, India
| | - Andreas Hecker
- 0000 0000 8584 9230grid.411067.5Department of General and Thoracic Surgery, University Hospital, Giessen, Germany
| | - Elcio S. Hirano
- 0000 0001 0723 2494grid.411087.bDivision of Trauma Surgery, Hospital de Clinicas, University of Campinas (Unicamp), Campinas, Brazil
| | | | - Martin Hutan
- Surgical Department, Landesklinikum Hainburg, Hainburg An Der Donau, Austria
| | - Orestis Ioannidis
- 0000000109457005grid.4793.94th Surgical Department, Aristotle University of Thessaloniki, Thessaloniki, Greece
- grid.414012.2General Hospital “George Papanikoalou”, Thessaloniki, Greece
| | - Arda Isik
- 0000 0001 1498 7262grid.412176.7General Surgery, Erzincan University Mengucek Gazi Training and Research Hospital, Erzincan, Turkey
| | | | - Sumita Jain
- 0000 0004 1767 3615grid.416077.3Surgery, S M S Medical college, Jaipur, India
| | - Mantas Jokubauskas
- 0000 0004 0575 8750grid.48349.32Department of Surgery, Hospital of Lithuanian University of Health Sciences Kaunas Clinics, Kaunas, Lithuania
| | - Aleksandar Karamarkovic
- 0000 0001 2166 9385grid.7149.bClinic for Emergency Surgery, Faculty of Medicine University of Belgrade, Belgrade, Serbia
| | - Saila Kauhanen
- 0000 0004 0628 215Xgrid.410552.7Division of Digestive Surgery and Urology, Turku University Hospital, Turku, Finland
| | - Robin Kaushik
- 0000 0004 1767 2831grid.413220.6Surgery, Government Medical College and Hospital, Chandigarh, India
| | - Alfie Kavalakat
- 0000 0004 1802 2603grid.464600.0General Surgery, Jubilee Mission Medical College & Research Institute, Thrissur, India
| | - Jakub Kenig
- 0000 0001 2162 9631grid.5522.03rd Department of General Surgery, Jagiellonian University Medical College, Krakow, Poland
| | | | - Desmond Khor
- 0000 0001 0084 1895grid.411409.9Acute Care Surgery, LAC+USC Medical Center, California, USA
| | - Dennis Kim
- 0000 0001 0157 6501grid.239844.0Department of Surgery, Harbor-UCLA Medical Center, Torrance, USA
| | - Jae I. Kim
- 0000 0004 0371 8173grid.411633.2Department of Surgery, Inje University Ilsan Paik Hospital, Goyang, Republic of Korea
| | - Victor Kong
- 0000 0004 0576 7753grid.414386.cDepartment of Surgery, Edendale Hospital, Pietermaritzburg, South Africa
| | | | - Pedro Leão
- General Surgery, Colorectal Unit, Hospital de Braga, Braga, Portugal
| | - Miguel Leon
- grid.419651.eGeneral and Digestive Surgery, Hospital Fundación Jimenez Diaz, Madrid, Spain
| | - Andrey Litvin
- Surgical Disciplines, Regional Clinical Hospital, Kaliningrad, Russia
| | - Varut Lohsiriwat
- grid.416009.aFaculty of Medicine, Department of Surgery, Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | | | | | - James Maciel
- 0000 0001 0157 6501grid.239844.0Department of Surgery, Harbor-UCLA Medical Center, Torrance, USA
| | - Piotr Major
- 0000 0001 2162 9631grid.5522.02nd Department of Surgery, Jagiellonian University Medical College, Krakow, Poland
| | - Ana Dimova
- 0000 0004 0397 9648grid.412688.1Clinic of surgery, Department of Gastrointestinal Surgery, University Hospital Centre Zagreb, Zagreb, Croatia
| | - Dimitrios Manatakis
- grid.414012.2Surgical Department, Konstantopouleio General Hospital, Athens, Greece
| | | | - Aleix Martinez-Perez
- 0000 0004 1770 9825grid.411289.7Department of General and Digestive Surgery, Hospital Universitario Doctor Peset, Valencia, Spain
| | - Sanjay Marwah
- 0000 0004 1771 1642grid.412572.7Department of General Surgery, Post-Graduate Institute of Medical Sciences, Rohtak, India
| | - Michael McFarlane
- 0000 0001 2322 4996grid.12916.3dDepartment of Surgery, Radiology, Anaesthetics and Intensive Care, University of the West Indies, Kingston, Jamaica
- 0000 0004 0500 5353grid.412963.bUniversity Hospital of the West Indies, Kingston, Jamaica
| | - Cristian Mesina
- Department of Surgery Second Surgical Clinic, Emergency Hospital of Craiova, Craiova, Romania
| | - Michał Pędziwiatr
- 0000 0001 1216 0093grid.412700.0Department of General Surgery and Emergency Medicine, University Hospital, Kraków, Poland
| | - Nickos Michalopoulos
- 0000 0004 0576 4544grid.411222.63rd Department of Surgery, Ahepa University Hospital, Thessaloniki, Greece
| | - Evangelos Misiakos
- 0000 0001 2155 0800grid.5216.03rd Department of Surgery, Attikon University Hospital, National and Kapodistrian University of Athens, Medical School, Athens, Greece
| | | | - Radu Moldovanu
- Department of Visceral, Digestive and Oncologic Surgery, Clinique Sainte Marie, Cambrai, France
| | - Giulia Montori
- 0000 0004 1758 8744grid.414682.dDepartment of Surgery, Bufalini Hospital, Cesena, Italy
| | | | - Ionut Negoi
- General Surgery, Emergency Hospital of Bucharest, Bucharest, Romania
| | | | - Giuseppe Novelli
- grid.414614.2General, Emergency Surgery, Infermi Hospital, Rimini, Italy
| | - Viktors Novikovs
- 0000 0004 0375 2558grid.488518.8General and Emergency Surgery, Riga East University Hospital “Gailezers”, Riga, Latvia
| | - Iyiade Olaoye
- 0000 0000 8878 5287grid.412975.cSurgery, University of Ilorin Teaching Hospital, Ilorin, Nigeria
| | - Abdelkarim Omari
- 0000 0004 0411 3985grid.460946.9General Surgery, King Abdullah University Hospital, Irbid, Jordan
| | - Carlos A. Ordoñez
- grid.477264.4Division of Trauma and Acute Care Surgery, Department of Surgery, Fundación Valle del Lili and Universidad del Valle, Cali, Colombia
| | - Mouaqit Ouadii
- Surgery Departement, Medical School of Fezm, Sidi Mohamed Benabdellah University, Fez, Morocco
| | - Zeynep Ozkan
- General Surgery, Elazig Training and Research Hospital, Elazig, Turkey
| | - Ajay Pal
- 0000 0004 0645 6578grid.411275.4General Surgery, King George’s Medical University, Lucknow, India
| | - Gian M. Palini
- grid.414614.2General, Emergency Surgery, Infermi Hospital, Rimini, Italy
| | | | - Francesco Pata
- Department of General Surgery, Sant’Antonio Abate Hospital, Gallarate, Italy
| | - Michał Pędziwiatr
- 0000 0001 1216 0093grid.412700.0Department of Emergency Surgery and Trauma Centre, University Hospital, Kraków, Poland
| | | | - Tadeja Pintar
- 0000 0004 0571 7705grid.29524.38Abdominal surgery, UMC Ljubljana, Ljubljana, Slovenia
| | - Magdalena Pisarska
- 0000 0001 1216 0093grid.412700.0Department of Endoscopic, Metabolic and Soft Tissue Tumors Surgery, The University Hospital in Krakow, Kraków, Poland
| | - Cesar F. Ploneda-Valencia
- 0000 0001 0432 668Xgrid.459608.6General Surgery, Hospital Civil de Guadalajara “Dr. Juan I. Menchaca”, Guadalajara, Mexico
| | | | - Vinod Prabhu
- 0000 0004 0503 0903grid.411681.bSurgery, Bharati Vidyapeeth Deemed University Medical College & Hospital, Sangli, Maharashtra India
| | | | - Jean-Marc Regimbeau
- 0000 0004 0593 702Xgrid.134996.0Digestive Surgery, CHU Amiens-Picardie, Amiens, France
| | - Marianne Reitz
- General Surgery, Hospital Municipal Dr. Jose de Carvalho Florence, Sao Jose Dos Campos, Brazil
| | - Daniel Rios-Cruz
- General Surgery, Hospital General Regional # 1 I.M.S.S, Cuernavaca, Mexico
| | - Sten Saar
- Acute Care Surgery, North Estonia Medical Center, Tallinn, Estonia
| | - Boris Sakakushev
- General Surgery, University Hospital St George, Plovdiv, Bulgaria
| | - Charalampos Seretis
- 0000 0004 0399 9948grid.416281.8General Surgery, Russells Hall Hospital, Birmingham, UK
| | | | - Vishal Shelat
- grid.240988.fGeneral Surgery, Tan Tock Seng Hospital, Singapore, Singapore
| | - Matej Skrovina
- Surgery, Hospital & Oncological Centre Novy Jicin, Novy Jicin, Czech Republic
| | - Dmitry Smirnov
- General Surgery, Clinical Hospital at Chelyabinsk Station OJSC “Russian Railways”, Chelyabinsk, Russian Federation
| | | | - Marcin Strzałka
- 0000 0001 2162 9631grid.5522.0General Surgery and Polytrauma, University Hospital, Medical College, Jagiellonian University, Kraków, Poland
| | - Peep Talving
- Acute Care Surgery, North Estonia Medical Center, Tallinn, Estonia
| | | | - George Theobald
- 0000 0004 0376 6589grid.412563.7General Surgery, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
| | - Gia Tomadze
- 0000 0004 0428 8304grid.412274.6Surgery Department #2, Tbilisi State Medical University, Tbilisi, Georgia
| | - Myftar Torba
- General Surgery, Trauma University Hospital, Tirana, Albania
| | - Cristian Tranà
- Department of Surgery, Macerata Hospital, Macerata, Italy
| | - Jan Ulrych
- 0000 0000 9100 9940grid.411798.21st Department of Surgery—Department of Abdominal Thoracic Surgery and Traumatology, General University Hospital, Prague, Czech Republic
| | - Mustafa Y. Uzunoğlu
- 0000 0001 0680 7823grid.14352.31General Surgery, Training and Research Hospital of Mustafa Kemal University, Hatay, Turkey
| | - Alin Vasilescu
- First Surgical Clinic, St. Spiridon University Hospital, Iasi, Romania
| | | | - Aurélien Venara
- 0000 0004 0472 0283grid.411147.6Digestive and Endocrinal Surgery, University Hospital, Angers, France
| | - Andras Vereczkei
- 0000 0001 0663 9479grid.9679.1Department of Surgery, Medical School University of Pécs, Pécs, Hungary
| | | | - Nutu Vlad
- First Surgical Clinic, St. Spiridon University Hospital, Iasi, Romania
| | - Maciej Walędziak
- 0000 0004 0620 0839grid.415641.3Department of General, Oncological, Metabolic and Thoracic Surgery, Military Institute of Medicine in Warsaw, Warsaw, Poland
| | - Tonguç U. Yilmaz
- 0000 0001 0691 9040grid.411105.0Department of General Surgery, Kocaeli University, Kocaeli, Turkey
| | - Kuo-Ching Yuan
- Trauma and Emergency Surgery, Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Cui Yunfeng
- grid.417036.7Department of Surgery, Tianjin Nankai Hospital, Tianjin, China
| | - Justas Zilinskas
- 0000 0004 0575 8750grid.48349.32Department of Surgery, Hospital of Lithuanian University of Health Sciences Kaunas Clinics, Kaunas, Lithuania
| | - Gérard Grelpois
- 0000 0004 0593 702Xgrid.134996.0Digestive Surgery, CHU Amiens-Picardie, Amiens, France
| | - Fausto Catena
- grid.469958.fEmergency Surgery, Mansoura University Hospital, Mansoura, Egypt
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Sartelli M, Kluger Y, Ansaloni L, Carlet J, Brink A, Hardcastle TC, Khanna A, Chicom-Mefire A, Rodríguez-Baño J, Nathwani D, Mendelson M, Watkins RR, Pulcini C, Beović B, May AK, Itani KMF, Mazuski JE, Fry DE, Coccolini F, Raşa K, Montravers P, Eckmann C, Abbo LM, Abubakar S, Abu-Zidan FM, Adesunkanmi AK, Al-Hasan MN, Althani AA, Ticas JEA, Ansari S, Ansumana R, da Silva ARA, Augustin G, Bala M, Balogh ZJ, Baraket O, Bassett,i M, Bellanova G, Beltran MA, Ben-Ishay O, Biffl WL, Boermeester MA, Brecher SM, Bueno J, Cainzos MA, Cairns K, Camacho-Ortiz A, Ceresoli M, Chandy SJ, Cherry-Bukowiec JR, Cirocchi R, Colak E, Corcione A, Cornely OA, Cortese F, Cui Y, Curcio D, Damaskos D, Daş K, Delibegovic S, Demetrashvili Z, De Simone B, de Souza HP, De Waele J, Dhingra S, Diaz JJ, Di Carlo I, Di Marzo F, Di Saverio S, Dogjani A, Dorj G, Dortet L, Duane TM, Dupont H, Egiev VN, Eid HO, Elmangory M, Marei HES, Enani MA, Escandón-Vargas K, Faro Junior MP, Ferrada P, Foghetti D, Foianini E, Fraga GP, Frattima S, Gandhi C, Gattuso G, Giamarellou E, Ghnnam W, Gkiokas G, Girardis M, Goff DA, Gomes CA, Gomi H, Gronerth RIG, Guirao X, Guzman-Blanco M, Haque M, Hecker A, Hell M, Herzog T, Hicks L, Kafka-Ritsch R, Kao LS, Kanj SS, Kaplan LJ, Kapoor G, Karamarkovic A, Kashuk J, Kenig J, Khamis F, Khokha V, Kiguba R, Kirkpatrick AW, Kørner H, Koike K, Kok KYY, Kon K, Kong V, Inaba K, Ioannidis O, Isik A, Iskandar K, Labbate M, Labricciosa FM, Lagrou K, Lagunes L, Latifi R, Lasithiotakis K, Laxminarayan R, Lee JG, Leone M, Leppäniemi A, Li Y, Liang SY, Liau KH, Litvin A, Loho T, Lowman W, Machain GM, Maier RV, Manzano-Nunez R, Marinis A, Marmorale C, Martin-Loeches I, Marwah S, Maseda E, McFarlane M, de Melo RB, Melotti MR, Memish Z, Mertz D, Mesina C, Menichetti F, Mishra SK, Montori G, Moore EE, Moore FA, Naidoo N, Napolitano L, Negoi I, Nicolau DP, Nikolopoulos I, Nord CE, Ofori-Asenso R, Olaoye I, Omari AH, Ordoñez CA, Ouadii M, Ouedraogo AS, Pagani L, Paiva JA, Parreira JG, Pata F, Pereira J, Pereira NR, Petrosillo N, Picetti E, Pintar T, Ponce-de-Leon A, Popovski Z, Poulakou G, Preller J, Guerrero AP, Pupelis G, Quiodettis M, Rawson TM, Reichert M, Reinhart K, Rems M, Rello J, Rizoli S, Roberts J, Rubio-Perez I, Ruppé E, Sakakushev B, Sall I, Kafil HS, Sanders J, Sato N, Sawyer RG, Scalea T, Scibé R, Scudeller L, Lohse HS, Sganga G, Shafiq N, Shah JN, Spigaglia P, Suroowan S, Tsioutis C, Sifri CD, Siribumrungwong B, Sugrue M, Talving P, Tan BK, Tarasconi A, Tascini C, Tilsed J, Timsit JF, Tumbarello M, Trung NT, Ulrych J, Uranues S, Velmahos G, Vereczkei AG, Viale P, Estape JV, Viscoli C, Wagenlehner F, Wright BJ, Xiao Y, Yuan KC, Zachariah SK, Zahar JR, Mergulhão P, Catena F. A Global Declaration on Appropriate Use of Antimicrobial Agents across the Surgical Pathway. Surg Infect (Larchmt) 2017; 18:846-853. [PMID: 29173054 DOI: 10.1089/sur.2017.219] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
This declaration, signed by an interdisciplinary task force of 234 experts from 83 different countries with different backgrounds, highlights the threat posed by antimicrobial resistance and the need for appropriate use of antibiotic agents and antifungal agents in hospitals worldwide especially focusing on surgical infections. As such, it is our intent to raise awareness among healthcare workers and improve antimicrobial prescribing. To facilitate its dissemination, the declaration was translated in different languages.
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