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Huang M, Yuan Z, Que M. Predictive Value of Preoperative Peripheral Blood Inflammatory Markers for Surgical Site Infection in Laparoscopic Radical Gastrectomy for Gastric Cancer. Surg Infect (Larchmt) 2024. [PMID: 39052533 DOI: 10.1089/sur.2024.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/27/2024] Open
Abstract
Background: To investigate the predictive value of preoperative peripheral blood inflammatory markers for surgical site infection (SSI) in laparoscopic radical gastrectomy for gastric cancer. Methods: A retrospective analysis was conducted on patients undergoing laparoscopic radical gastrectomy for gastric cancer, categorized into SSI and non-SSI groups based on postoperative SSI occurrences. Patient demographics, surgical details, laboratory results, and SSI incidence data were extracted. Differences in indicators, including neutrophil-lymphocyte ratio (NLR), systemic immune-inflammation index (SII), and platelet-lymphocyte ratio (PLR), were assessed between the two groups. Multivariate logistic regression was utilized to determine the independent association of each indicator with SSI. Receiver operating characteristics (ROC) curve analysis was utilized to evaluate the predictive value of parameters. Results: Of 169 patients, 36 (21.30%) experienced SSI postoperatively. The SSI group exhibited higher preoperative NLR and SII (p < 0.05). After adjusting for variables, preoperative NLR (OR = 1.691, 95% CI: 1.211-2.417, p = 0.003) and SII (OR = 1.001, 95% CI: 1.000-1.002, p = 0.006) were identified as independent risk factors for SSI. Both NLR (AUC = 0.758, 95% CI: 0.666-0.850) and SII (AUC = 0.753, 95% CI: 0.660-0.850) demonstrated favorable diagnostic performance for predicting postoperative SSI. Conclusion: Preoperative NLR and SII significantly associate with postoperative SSI in laparoscopic radical gastrectomy for gastric cancer, making them valuable indicators for early prediction of SSI.
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Affiliation(s)
- Mingqi Huang
- Department of Hospital Infection Control, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Zhe Yuan
- Department of Hospital Infection Control, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Mi Que
- Department of Hospital Infection Control, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
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Al-hajri A, Ghabisha S, Ahmed F, Al-wageeh S, Badheeb M, Alyhari Q, Altam A, Alsharif A. Identification of predictive factors for surgical site infections in gastrointestinal surgeries: A retrospective cross-sectional study in a resource-limited setting. F1000Res 2024; 12:733. [PMID: 39211056 PMCID: PMC11358685 DOI: 10.12688/f1000research.135681.3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/28/2024] [Indexed: 09/04/2024] Open
Abstract
Background Surgical site infection (SSI), albeit infrequent, drastically impacts the quality of care. This article endeavors to investigate the predictive factors of SSIs following surgical interventions that involve the gastrointestinal (GI) tract within a single institution in a resource-limited setting. Methods Over seven years from June 2015 to June 2022, patients who underwent GI surgery and developed SSI were retrospectively matched with an unaffected case-control cohort of patients. Standardized techniques for wound culture, laboratory evaluation of bacterial isolates, and antibiotic susceptibility tests were employed. Logistic regression analysis was utilized to investigate the predictive factors associated with 30-day postoperative SSI occurrence. Results A total of 525 patients who underwent GI surgical procedures were included, among whom, 86 (16.4%) developed SSI and the majority of SSIs were superficial (74.4%). Escherichia coli was the most commonly isolated bacterium (54.4%), and a high percentage of multidrug-resistant organisms were observed (63.8%). In multivariate Cox regression analysis, illiteracy (Odds ratio [OR]:40.31; 95% confidence interval [CI]: 9.54-170.26), smoking (OR: 21.15; 95% CI: 4.63-96.67), diabetes (OR: 5.07; 95% CI: 2.27-11.35), leukocytosis (OR: 2.62; 95% CI: 1.24-5.53), hypoalbuminemia (OR: 3.70; 95% CI: 1.35-10.16), contaminated and dirty wounds (OR: 6.51; 95% CI:1.62-26.09), longer operation duration (OR: 1.02; 95% CI: 1.01-1.03), emergency operations (OR: 12.58; 95% CI: 2.91-54.30), and extending antibiotic prophylaxis duration (OR: 3.01; 95% CI: 1.28-7.10) were the independent risk factors for SSI (all p < 0.05). Conclusions This study highlights significant predictors of SSI, including illiteracy, smoking, diabetes, leukocytosis, hypoalbuminemia, contaminated and dirty wounds, longer operative time, emergency operations, and extending antibiotic prophylaxis duration. Identifying these risk factors can help surgeons adopt appropriate measures to reduce postoperative SSI and improve the quality of surgical care, especially in a resource-limited setting with no obvious and strict policy for reducing SSI.
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Affiliation(s)
- Abdu Al-hajri
- Department of General Surgery, School of Medicine, Ibb University of Medical Sciences, Ibb, Yemen
| | - Saif Ghabisha
- Department of General Surgery, School of Medicine, Ibb University of Medical Sciences, Ibb, Yemen
| | - Faisal Ahmed
- Department of Urology, School of Medicine, Ibb University of Medical Sciences, Ibb, Yemen
| | - Saleh Al-wageeh
- Department of General Surgery, School of Medicine, Ibb University of Medical Sciences, Ibb, Yemen
| | - Mohamed Badheeb
- Department of Internal Medicine, Faculty of Medicine, Hadhramaut University, Hadhramau, Yemen
| | - Qasem Alyhari
- Department of General Surgery, School of Medicine, Ibb University of Medical Sciences, Ibb, Yemen
| | - Abdulfattah Altam
- Department of General Surgery, School of Medicine, 21 September University, Sana'a, Yemen
| | - Afaf Alsharif
- Department of Gynaecology, School of Medicine, Jeblah University for Medical and Health Sciences, Ibb, Yemen
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Coman IS, Vital RC, Coman VE, Burleanu C, Liţescu M, Florea CG, Cristian DA, Gorecki GP, Radu PA, Pleşea IE, Erchid A, Grigorean VT. Emergency and Elective Colorectal Cancer-Relationship between Clinical Factors, Tumor Topography and Surgical Strategies: A Cohort Study. MEDICINA (KAUNAS, LITHUANIA) 2024; 60:898. [PMID: 38929515 PMCID: PMC11205460 DOI: 10.3390/medicina60060898] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/02/2024] [Revised: 05/23/2024] [Accepted: 05/27/2024] [Indexed: 06/28/2024]
Abstract
Background and Objectives: The purpose of the study was to analyze the relationships among several clinical factors and also the tumor topography and surgical strategies used in patients with colorectal cancer. Materials and Methods: We designed an analytical, observational, retrospective study that included patients admitted to our emergency surgical department and diagnosed with colorectal cancer. The study group inclusion criteria were: patients admitted during 2020-2022; patients diagnosed with colorectal cancer (including the ileocecal valve); patients who benefited from a surgical procedure, either emergency or elective. Results: In our study group, consisting of 153 patients, we accounted for 56.9% male patients and 43.1% female patients. The most common clinical manifestations were pain (73.2% of the study group), followed by abdominal distension (69.3% of the study group) and absence of intestinal transit (38.6% of the study group). A total of 69 patients had emergency surgery (45.1%), while 84 patients (54.9%) benefited from elective surgery. The most frequent topography of the tumor was the sigmoid colon, with 19.60% of the patients, followed by the colorectal junction, with 15.68% of the patients, and superior rectum and inferior rectum, with 11.11% of the patients in each subcategory. The most frequent type of procedure was right hemicolectomy (21.6% of the study group), followed by rectosigmoid resection (20.9% of the study group). The surgical procedure was finished by performing an anastomosis in 49% of the patients, and an ostomy in 43.1% of the patients, while for 7.8% of the patients, a tumoral biopsy was performed. Conclusions: Colorectal cancer remains one of the most frequent cancers in the world, with a heavy burden that involves high mortality, alterations in the quality of life of patients and their families, and also the financial costs of the medical systems.
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Affiliation(s)
- Ionuţ Simion Coman
- 10th Clinical Department—General Surgery, Discipline of General Surgery—“Bagdasar-Arseni” Clinical Emergency Hospital, Faculty of Medicine, “Carol Davila” University of Medicine and Pharmacy, 37 Dionisie Lupu Street, 020021 Bucharest, Romania; (I.S.C.); (V.E.C.); (V.T.G.)
- General Surgery Department, “Bagdasar-Arseni” Clinical Emergency Hospital, 12 Berceni Road, 041915 Bucharest, Romania; (R.C.V.); (C.B.); (C.G.F.); (A.E.)
| | - Raluca Cristina Vital
- General Surgery Department, “Bagdasar-Arseni” Clinical Emergency Hospital, 12 Berceni Road, 041915 Bucharest, Romania; (R.C.V.); (C.B.); (C.G.F.); (A.E.)
| | - Violeta Elena Coman
- 10th Clinical Department—General Surgery, Discipline of General Surgery—“Bagdasar-Arseni” Clinical Emergency Hospital, Faculty of Medicine, “Carol Davila” University of Medicine and Pharmacy, 37 Dionisie Lupu Street, 020021 Bucharest, Romania; (I.S.C.); (V.E.C.); (V.T.G.)
- General Surgery Department, “Bagdasar-Arseni” Clinical Emergency Hospital, 12 Berceni Road, 041915 Bucharest, Romania; (R.C.V.); (C.B.); (C.G.F.); (A.E.)
| | - Cosmin Burleanu
- General Surgery Department, “Bagdasar-Arseni” Clinical Emergency Hospital, 12 Berceni Road, 041915 Bucharest, Romania; (R.C.V.); (C.B.); (C.G.F.); (A.E.)
| | - Mircea Liţescu
- 2nd Department of Surgery and General Anesthesia, Discipline of Surgery and General Anesthesia—“Sf. Ioan” Clinical Emergency Hospital, Faculty of Dental Medicine, “Carol Davila” University of Medicine and Pharmacy, 37 Dionisie Lupu Street, 020021 Bucharest, Romania
- General Surgery Department, “Sf. Ioan” Clinical Emergency Hospital, 13 Vitan-Bârzeşti Road, 042122 Bucharest, Romania
| | - Costin George Florea
- General Surgery Department, “Bagdasar-Arseni” Clinical Emergency Hospital, 12 Berceni Road, 041915 Bucharest, Romania; (R.C.V.); (C.B.); (C.G.F.); (A.E.)
| | - Daniel Alin Cristian
- 10th Clinical Department—General Surgery, Discipline of General Surgery—“Colţea” Clinical Hospital, Faculty of Medicine, “Carol Davila” University of Medicine and Pharmacy, 37 Dionisie Lupu Street, 020021 Bucharest, Romania;
- General Surgery Department, “Colţea” Clinical Hospital, 1 Ion C. Brătianu Boulevard, 030167 Bucharest, Romania
| | - Gabriel-Petre Gorecki
- Faculty of Medicine, “Titu Maiorescu” University, 67A Gheorghe Petraşcu Street, 031593 Bucharest, Romania;
- Department of Anesthesia and Intensive Care, CF2 Clinical Hospital, 63 Mărăşti Boulevard, 011464 Bucharest, Romania
| | - Petru Adrian Radu
- 10th Clinical Department—General Surgery, Discipline of General Surgery—“Dr. Carol Davila” Clinical Nephrology Hospital, Faculty of Medicine, “Carol Davila” University of Medicine and Pharmacy, 37 Dionisie Lupu Street, 020021 Bucharest, Romania;
- General Surgery Department, “Dr. Carol Davila” Clinical Nephrology Hospital, 4 Griviţei Road, 010731 Bucharest, Romania
| | - Iancu Emil Pleşea
- Pathology Department, “Bagdasar-Arseni” Clinical Emergency Hospital, 12 Berceni Road, 041915 Bucharest, Romania;
| | - Anwar Erchid
- General Surgery Department, “Bagdasar-Arseni” Clinical Emergency Hospital, 12 Berceni Road, 041915 Bucharest, Romania; (R.C.V.); (C.B.); (C.G.F.); (A.E.)
| | - Valentin Titus Grigorean
- 10th Clinical Department—General Surgery, Discipline of General Surgery—“Bagdasar-Arseni” Clinical Emergency Hospital, Faculty of Medicine, “Carol Davila” University of Medicine and Pharmacy, 37 Dionisie Lupu Street, 020021 Bucharest, Romania; (I.S.C.); (V.E.C.); (V.T.G.)
- General Surgery Department, “Bagdasar-Arseni” Clinical Emergency Hospital, 12 Berceni Road, 041915 Bucharest, Romania; (R.C.V.); (C.B.); (C.G.F.); (A.E.)
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Hirano Y, Konishi T, Kaneko H, Itoh H, Matsuda S, Kawakubo H, Uda K, Matsui H, Fushimi K, Daiko H, Itano O, Yasunaga H, Kitagawa Y. Antimicrobial Prophylaxis With Ampicillin-sulbactam Compared With Cefazolin for Esophagectomy: Nationwide Inpatient Database Study in Japan. Ann Surg 2024; 279:640-647. [PMID: 38099477 DOI: 10.1097/sla.0000000000006182] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/09/2024]
Abstract
OBJECTIVE To assess the effect of antimicrobial prophylaxis with ampicillin-sulbactam (ABPC/SBT) compared with cefazolin (CEZ) on the short-term outcomes after esophagectomy. BACKGROUND CEZ is widely used for antimicrobial prophylaxis in esophagectomy without procedure-specific evidence, whereas ABPC/SBT is preferred in some hospitals to target both aerobic and anaerobic oral bacteria. METHODS Data of patients who underwent esophagectomy for cancer between July 2010 and March 2019 were extracted from a nationwide Japanese inpatient database. Overlap propensity score weighting was conducted to compare the short-term outcomes [including surgical site infection (SSI), anastomotic leakage, and respiratory failure] between antimicrobial prophylaxis with CEZ and ABPC/SBT after adjusting for potential confounders. Sensitivity analyses were also performed using propensity score matching and instrumental variable analyses. RESULTS Among 17,772 eligible patients, 16,077 (90.5%) and 1695 (9.5%) patients were administered CEZ and ABPC/SBT, respectively. SSI, anastomotic leakage, and respiratory failure occurred in 2971 (16.7%), 2604 (14.7%), and 2754 patients (15.5%), respectively. After overlap weighting, ABPC/SBT was significantly associated with a reduction in SSI [odds ratio 0.51 (95% CI: 0.43-0.60)], anastomotic leakage [0.51 (0.43-0.61)], and respiratory failure [0.66 (0.57-0.77)]. ABPC/SBT was also associated with reduced respiratory complications, postoperative length of stay, and total hospitalization costs. The proportion of Clostridioides difficile colitis and noninfectious complications did not differ between the groups. Propensity score matching and instrumental variable analyses demonstrated equivalent results. CONCLUSIONS The administration of ABPC/SBT as antimicrobial prophylaxis for esophagectomy was associated with better short-term postoperative outcomes compared with CEZ.
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Affiliation(s)
- Yuki Hirano
- Department of Hepatobiliary-Pancreatic and Gastrointestinal Surgery, International University of Health and Welfare School of Medicine, Chiba, Japan
| | - Takaaki Konishi
- Department of Clinical Epidemiology and Health Economics, School of Public Health, The University of Tokyo, Tokyo, Japan
| | - Hidehiro Kaneko
- Department of Cardiovascular Medicine, The University of Tokyo, Tokyo, Japan
| | - Hidetaka Itoh
- Department of Cardiovascular Medicine, The University of Tokyo, Tokyo, Japan
| | - Satoru Matsuda
- Department of Surgery, Keio University School of Medicine, Tokyo, Japan
| | - Hirofumi Kawakubo
- Department of Surgery, Keio University School of Medicine, Tokyo, Japan
| | - Kazuaki Uda
- Department of Clinical Epidemiology and Health Economics, School of Public Health, The University of Tokyo, Tokyo, Japan
| | - Hiroki Matsui
- Department of Clinical Epidemiology and Health Economics, School of Public Health, The University of Tokyo, Tokyo, Japan
| | - Kiyohide Fushimi
- Department of Health Policy and Informatics, Tokyo Medical and Dental University Graduate School, Tokyo, Japan
| | - Hiroyuki Daiko
- Division of Esophageal Surgery, National Cancer Center Hospital, Tokyo, Japan
| | - Osamu Itano
- Department of Hepatobiliary-Pancreatic and Gastrointestinal Surgery, International University of Health and Welfare School of Medicine, Chiba, Japan
| | - Hideo Yasunaga
- Department of Clinical Epidemiology and Health Economics, School of Public Health, The University of Tokyo, Tokyo, Japan
| | - Yuko Kitagawa
- Department of Surgery, Keio University School of Medicine, Tokyo, Japan
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Chen XP, Zhang WJ, Cheng B, Yu YL, Peng JL, Bao SH, Tong CG, Zhao J. Clinical and economic comparison of laparoscopic versus open hepatectomy for primary hepatolithiasis: a propensity score-matched cohort study. Int J Surg 2024; 110:1896-1903. [PMID: 38668654 PMCID: PMC11020016 DOI: 10.1097/js9.0000000000001027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Accepted: 12/10/2023] [Indexed: 04/29/2024]
Abstract
BACKGROUND It is unclear whether laparoscopic hepatectomy (LH) for hepatolithiasis confers better clinical benefit and lower hospital costs than open hepatectomy (OH). This study aim to evaluate the clinical and economic value of LH versus OH. METHODS Patients undergoing OH or LH for primary hepatolithiasis at Yijishan Hospital of Wannan Medical College between 2015 and 2022 were divided into OH group and LH group. Propensity score matching (PSM) was used to balance the baseline data. Deviation-based cost modelling and weighted average median cost (WAMC) were used to assess and compare the economic value. RESULTS A total of 853 patients were identified. After exclusions, 403 patients with primary hepatolithiasis underwent anatomical hepatectomy (OH n=143; LH n=260). PSM resulted in 2 groups of 100 patients each. Although LH required a longer median operation duration compared with OH (285.0 versus 240.0 min, respectively, P<0.001), LH patients had fewer wound infections, fewer pre-discharge overall complications (26 versus 43%, respectively, P=0.009), and shorter median postoperative hospital stays (8.0 versus 12.0 days, respectively, P<0.001). No differences were found in blood loss, major complications, stone clearance, and mortality between the two matched groups. However, the median overall hospital cost of LH was significantly higher than that of OH (CNY¥52,196.1 versus 45,349.5, respectively, P=0.007). Although LH patients had shorter median postoperative hospital stays and fewer complications than OH patients, the WAMC was still higher for the LH group than for the OH group with an increase of CNY¥9,755.2 per patient undergoing LH. CONCLUSION The overall clinical benefit of LH for hepatolithiasis is comparable or even superior to that of OH, but with an economic disadvantage. There is a need to effectively reduce the hospital costs of LH and the gap between costs and diagnosis-related group reimbursement to promote its adoption.
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Affiliation(s)
- Xiao-Peng Chen
- Department of Hepatobiliary Surgery, Yijishan Hospital of Wannan Medical College, Wuhu, Anhui Province
| | - Wen-Jun Zhang
- Department of Hepatobiliary Surgery, Yijishan Hospital of Wannan Medical College, Wuhu, Anhui Province
| | - Bin Cheng
- Department of Hepatobiliary Surgery, Huangshan City People’s Hospital, Huangshan City
| | - Yuan-Lin Yu
- Department of Hepatobiliary Surgery, Yijishan Hospital of Wannan Medical College, Wuhu, Anhui Province
| | - Jun-Lu Peng
- Department of Hepatobiliary Surgery, Yijishan Hospital of Wannan Medical College, Wuhu, Anhui Province
| | - Sheng-Hua Bao
- Department of Hepatobiliary Surgery, Yijishan Hospital of Wannan Medical College, Wuhu, Anhui Province
| | - Chao-Gang Tong
- Department of Hepatobiliary Surgery, Chaohu Hospital, Anhui Medical University, Hefei, China
| | - Jun Zhao
- Department of Hepatobiliary Surgery, Yijishan Hospital of Wannan Medical College, Wuhu, Anhui Province
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Suárez-Lledó Grande A, Llop Talaveron JM, Leiva Badosa E, Farran Teixido L, Miró Martín M, Bas Minguet J, Navarro Velázquez S, Creus Costas G, Virgili Casas N, Fernández Álvarez M, Badía Tahull MB. Effect of Fish Oil Parenteral Emulsion Supplementation on Inflammatory Parameters after Esophagectomy. Nutrients 2023; 16:40. [PMID: 38201870 PMCID: PMC10780468 DOI: 10.3390/nu16010040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2023] [Revised: 12/15/2023] [Accepted: 12/19/2023] [Indexed: 01/12/2024] Open
Abstract
(Background) Esophagectomy (EPG) presents high morbidity and mortality. Omega-3 fatty acids (ω-3FA) are a pharmaconutrient with benefits for postoperative morbidity. Studies of ω-3FA administered parenterally after esophagectomy are scarce. This study proposes to investigate the effect of combining fish oil lipid emulsions (LE) administered parenterally with enteral nutrition support. (Methods) Randomization was 1:1:1 in three groups: Group A received a LE mixture of 0.4 g/kg/day of fish oil and 0.4 g/kg/day of LCT/MCT 50:50, Group B received 0.8 g/kg/day of fish oil LE, and Group C received 0.8 g/kg/day of LCT/MCT 50:50. Variables were measured at recruitment time and day +1, +3, and +5. Inflammatory variables studied were Interlukin-6, C-reactive protein (CRP), tumoral necrosis factor-α (TNF-α), IL-10, IL-8 and CD25s. Safety, nutritional parameters and complications were analyzed. (Results) Administration of ω-3LE in the immediate postoperative period did not modulate the earlier inflammatory response. Statistically significant differences were found in IL-6 and CRP overall temporal evolution but were not found when studying the type of LE administered or in patients needing critical care. Administration of ω-3 resulted in safe and improved hypertriglyceridemia, depending on the dose. (Conclusions) ω-3FA has no impact on the early inflammatory postoperative response assessed for a short period but was safe. More studies for longer periods are needed.
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Affiliation(s)
- Ana Suárez-Lledó Grande
- Pharmacy Department, Bellvitge University Hospital, University of Barcelona—IDIBELL, 08907 L’Hospitalet de Llobregat, Spain
| | - Josep M. Llop Talaveron
- Pharmacy Department, Bellvitge University Hospital, University of Barcelona—IDIBELL, 08907 L’Hospitalet de Llobregat, Spain
| | - Elisabet Leiva Badosa
- Pharmacy Department, Bellvitge University Hospital, University of Barcelona—IDIBELL, 08907 L’Hospitalet de Llobregat, Spain
| | - Leandre Farran Teixido
- General Digestive Surgery Department, Bellvitge University Hospital, University of Barcelona—IDIBELL, 08907 L’Hospitalet de Llobregat, Spain
| | - Mónica Miró Martín
- General Digestive Surgery Department, Bellvitge University Hospital, University of Barcelona—IDIBELL, 08907 L’Hospitalet de Llobregat, Spain
| | - Jordi Bas Minguet
- Immunology Department, Bellvitge University Hospital, University of Barcelona—IDIBELL, 08907 L’Hospitalet de Llobregat, Spain
| | - Sergio Navarro Velázquez
- Immunology Department, Bellvitge University Hospital, University of Barcelona—IDIBELL, 08907 L’Hospitalet de Llobregat, Spain
| | - Gloria Creus Costas
- Endocrinology and Nutrition Department, Bellvitge University Hospital, University of Barcelona—IDIBELL, 08907 L’Hospitalet de Llobregat, Spain
| | - Nuria Virgili Casas
- Endocrinology and Nutrition Department, Bellvitge University Hospital, University of Barcelona—IDIBELL, 08907 L’Hospitalet de Llobregat, Spain
| | - Mónica Fernández Álvarez
- Pharmacy Department, Bellvitge University Hospital, University of Barcelona—IDIBELL, 08907 L’Hospitalet de Llobregat, Spain
| | - María B. Badía Tahull
- Pharmacy Department, Bellvitge University Hospital, University of Barcelona—IDIBELL, 08907 L’Hospitalet de Llobregat, Spain
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Zhu Y, Jiang J. The efficacy of wound edge protectors in reducing the post-operative surgical site infections after abdominal surgery: a meta-analysis of randomized clinical studies. Wideochir Inne Tech Maloinwazyjne 2023; 18:541-550. [PMID: 38239586 PMCID: PMC10793155 DOI: 10.5114/wiitm.2023.132070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Accepted: 03/10/2023] [Indexed: 01/22/2024] Open
Abstract
Introduction Following abdominal surgery, surgical site infections (SSIs) are a common complication. The effectiveness of wound edge protectors in preventing SSI remains uncertain. Aim To determine the clinical effectiveness of a wound edge protector (WEP) in preventing surgical site infections (SSIs) after abdominal surgery. Material and methods A systematic search of the Cochrane Library, PubMed, Embase, and Web of Science yielded all relevant articles published through October 2022. The major evidence regarding the efficacy of WEPs in minimizing SSIs in abdominal surgery patients relative to the standard of care was determined by searching the literature. The primary outcome was SSI as clinically defined by CDC. To combine qualitative factors, risk ratios (RRs) were used. Results WEPs were related to a decreased incidence of SSI overall (RR = 0.75; 95% CI: 0.61-0.91; p = 0.004). WEPs are efficient in lowering the incidence of SSI at various abdominal surgical sites, with RR = 0.67; 95% CI: 0.47-0.96; p = 0.03 for pancreatoduodenectomy, RR = 0.52; 95% CI: 0.31-0.86; p = 0.01 for colorectal surgery, and RR = 0.39; 95% CI: 0.21-0.73; p = 0.003 for abdominal surgery. Moreover, both kinds of WEPs (single-ring and double-ring devices) were successful in lowering the risk of SSIs, with RR = 0.66; 95% CI: 0.47-0.93; p = 0.02 for double-ring devices and RR = 0.76; 95% CI: 0.58-0.98; p = 0.04 for single-ring devices. Conclusions These findings demonstrate that double- and single-ring wound edge protection devices are effective in preventing surgical site infections following pancreatoduodenectomy, colorectal, and abdominal procedures.
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Affiliation(s)
- Yu Zhu
- Ward 10 of General Surgery, The Second Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Jiefeng Jiang
- Respiratory Department, Chongming District Infectious Disease Hospital, Shanghai-Chongming District, Shanghai, China
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Jawalkar S, Karajagi R, Arakeri SU. Gastrointestinal stromal tumour: presenting as an ovarian cystadenoma. BMJ Case Rep 2023; 16:e256244. [PMID: 38035687 PMCID: PMC10689411 DOI: 10.1136/bcr-2023-256244] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2023] Open
Abstract
A gastrointestinal stromal tumortumour (GIST) is an uncommon gastrointestinal neoplasm that can arise from any part of the gastrointestinal tract. They can rarely present as a pelvic mass, which might result in a gynaecological condition being misdiagnosed in a female patient. A woman in her early 70s presented with a huge pelvic mass. Abdomen-pelvis CT scan showed a significant cystic mass in the left-sided pelvis with a mass effect on adjacent structures, which suggested a possibility of an ovarian cystadenoma. Her CA-125 was normal. She underwent an exploratory laparotomy with pelvic mass excision. A diagnosis of a gastrointestinal stromal tumour (GIST) arising from the ileum was made on a histopathology study.
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Affiliation(s)
- Sneha Jawalkar
- Pathology, BLDE(Deemed to be University) Shri B M Patil Medical college, Hospital and Research centre, Vijayapura, Karnataka, India
| | - Rachana Karajagi
- Pathology, BLDE(Deemed to be University) Shri B M Patil Medical college, Hospital and Research centre, Vijayapura, Karnataka, India
| | - Surekha Ulhas Arakeri
- Pathology, BLDE(Deemed to be University) Shri B M Patil Medical college, Hospital and Research centre, Vijayapura, Karnataka, India
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Xiong C, Ji H, Li F, Jiang Z, Pang Z, Li X. Assessment of safety during hospitalization for patients undergoing Surgery after neoadjuvant therapy for moderately advanced Esophageal cancer. BMC Surg 2023; 23:337. [PMID: 37940888 PMCID: PMC10633949 DOI: 10.1186/s12893-023-02252-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2023] [Accepted: 10/27/2023] [Indexed: 11/10/2023] Open
Abstract
PURPOSE To study the safety of patients with moderately advanced esophageal cancer during their hospital stay after undergoing surgery. METHODS The clinical and pathological data of 66 patients with locally advanced esophageal cancer discharged from the Department of Thoracic Surgery of Jiangsu University Hospital from January 2017 to October 2022 were selected, of whom 32 underwent direct surgery (control group) and 34 underwent neoadjuvant therapy followed by surgery (experimental group), to retrospectively analyze whether there were differences in surgical outcomes, complication rates, biochemical and infection indicators between the two groups. RESULTS The number of lymph node dissections, lymph node dissection rate, and hemoglobin value on the first day after the operation in the experimental group were smaller than those in the control group, and the difference was statistically significant (P < 0.05). The thoracic drainage volume of the experimental group was more than that of the control group, and the difference was statistically significant (P < 0.05). The incidence of pulmonary complications in the experimental group was higher than that in the control group, especially pulmonary infection, and the difference was statistically significant (P < 0.05). Compared with the control group, the experimental group was more prone to anastomotic leakage, and the difference was statistically significant (P < 0.05). CONCLUSION Neoadjuvant therapy combined with surgery for patients with advanced esophageal cancer is generally safe during hospitalization.
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Affiliation(s)
- Chenyi Xiong
- Department of Thoracic Surgery, Affiliated Hospital of Jiangsu University, Zhenjiang, Jiangsu, 212000, China
| | - Hongyun Ji
- Department of Thoracic Surgery, Affiliated Hospital of Jiangsu University, Zhenjiang, Jiangsu, 212000, China
| | - Feng Li
- Department of Thoracic Surgery, Affiliated Hospital of Jiangsu University, Zhenjiang, Jiangsu, 212000, China.
- Institute of Digestive Diseases, Affiliated Hospital of Jiangsu University, Zhenjiang, Jiangsu, 212000, China.
| | - Zhihua Jiang
- Department of Thoracic Surgery, Affiliated Hospital of Jiangsu University, Zhenjiang, Jiangsu, 212000, China.
| | - Zhonghao Pang
- Department of Thoracic Surgery, Affiliated Hospital of Jiangsu University, Zhenjiang, Jiangsu, 212000, China
| | - Xiaoran Li
- Department of Thoracic Surgery, Affiliated Hospital of Jiangsu University, Zhenjiang, Jiangsu, 212000, China
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10
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Sodhi K, Chanchalani G, Arya M, Shrestha GS, Chandwani JN, Kumar M, Kansal MG, Ashrafuzzaman M, Mudalige AD, Al Tayar A, Mansour B, Saeed HM, Hashmi M, Das M, Al Shirawi NN, Mathias R, Ahmed WO, Sharma A, Agarwal D, Nasa P. Knowledge and awareness of infection control practices among nursing professionals: A cross-sectional survey from South Asia and the Middle East. World J Crit Care Med 2023; 12:176-187. [PMID: 37397590 PMCID: PMC10308336 DOI: 10.5492/wjccm.v12.i3.176] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Revised: 05/15/2023] [Accepted: 05/31/2023] [Indexed: 06/08/2023] Open
Abstract
BACKGROUND The proficiency of nursing professionals in the infection prevention and control (IPC) practices is a core component of the strategy to mitigate the challenge of healthcare associated infections.
AIM To test knowledge of nurses working in intensive care units (ICU) in South Asia and Middle East countries on IPC practices.
METHODS An online self-assessment questionnaire based on various aspects of IPC practices was conducted among nurses over three weeks.
RESULTS A total of 1333 nurses from 13 countries completed the survey. The average score was 72.8% and 36% of nurses were proficient (mean score > 80%). 43% and 68.3% of respondents were from government and teaching hospitals, respectively. 79.2% of respondents worked in < 25 bedded ICUs and 46.5% in closed ICUs. Statistically, a significant association was found between the knowledge and expertise of nurses, the country’s per-capita income, type of hospitals, accreditation and teaching status of hospitals and type of ICUs. Working in high- and upper-middle-income countries (β = 4.89, 95%CI: 3.55 to 6.22) was positively associated, and the teaching status of the hospital (β = -4.58, 95%CI: -6.81 to -2.36) was negatively associated with the knowledge score among respondents.
CONCLUSION There is considerable variation in knowledge among nurses working in ICU. Factors like income status of countries, public vs private and teaching status of hospitals and experience are independently associated with nurses’ knowledge of IPC practices.
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Affiliation(s)
- Kanwalpreet Sodhi
- Department of Critical Care, Deep Hospital, Ludhiana 141001, Punjab, India
| | - Gunjan Chanchalani
- Critical Care Medicine, Somaiya Hospital and Research Centre, Mumbai 400001, Maharashtra, India
| | - Muktanjali Arya
- Department of Microbiology and Infection Control, Deep Hospital, Ludhiana 141001, India
| | - Gentle S Shrestha
- Department of Critical Care Medicine, Tribhuvan University Teaching Hospital, Kathmandu 44600, Nepal
| | - Juhi N Chandwani
- Anaesthesia and Intensive Care Unit, Royal Hospital, Muscat 112, Oman
| | - Manender Kumar
- Department of Cardiac Anaesthesia, Fortis Hospital, Ludhiana 141002, Punjab, India
| | - Monika G Kansal
- Intensive Care Medicine, Ng Teng Fong General Hospital, Singapore 609606, Singapore
| | - Mohammad Ashrafuzzaman
- Intensive Care Unit, Bangabandhu Sheikh Mujib Medical University, Dhaka 1000, Bangladesh
| | - Anushka D Mudalige
- Intensive Care Unit, Colombo North Teaching Hospital, Ragama 11010, Sri Lanka
| | - Ashraf Al Tayar
- Intensive Care Unit and Respiratory Therapy Department, Security Forces Hospital, Damman 34223, Saudi Arabia
| | - Bassam Mansour
- Pulmonary and Critical Care Division, Zahraa Hospital-University Medical Center, Beirut 1007, Lebanon
- Pulmonary Division, Faculty of Medical Sciences, Lebanese University, Beirut 1007, Lebanon
| | - Hasan M Saeed
- Department of Critical Care, Salmaniyah Medical Complex, Manama 323, Bahrain
| | - Madiha Hashmi
- Department of Critical Care Medicine, Ziauddin University, Karachi 75530, Pakistan
| | - Mitul Das
- Anaesthesia and Critical Care, Swasti Hospital, Rangia 781354, India
| | - Nehad N Al Shirawi
- Department of Critical Care Medicine, Al Fujairah Hospital, Fujairah 0000, United Arab Emirates
| | - Ranjan Mathias
- Department of Anesthesia and Intensive Care, Hamad Medical Corporation, Doha 974, Qatar
| | - Wagih O Ahmed
- Intensive Care Unit, Sulaiman Al Habib Medical Group, Buraidah 52211, Saudi Arabia
| | - Amandeep Sharma
- Department of Nursing, Deep Hospital, Ludhiana 141001, India
| | - Diptimala Agarwal
- Anesthesia and Intensive Care, Shantived Institute of Medical Sciences, Agra 282007, India
| | - Prashant Nasa
- Department of Critical Care Medicine, NMC Specialty Hospital, Dubai 7832, United Arab Emirates
- Internal Medicine, College of Medicine and Health Sciences, Al Ain 15551, Abu Dhabi, United Arab Emirates
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11
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Sodhi K, Chanchalani G, Arya M, Shrestha GS, Chandwani JN, Kumar M, Kansal MG, Ashrafuzzaman M, Mudalige AD, Al Tayar A, Mansour B, Saeed HM, Hashmi M, Das M, Al Shirawi NN, Mathias R, Ahmed WO, Sharma A, Agarwal D, Nasa P. Knowledge and awareness of infection control practices among nursing professionals: A cross-sectional survey from South Asia and the Middle East. World J Crit Care Med 2023; 12:176-187. [DOI: 10.5492/wjccm.v12.i3.176 sodhi k] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/03/2023] Open
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12
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Zhou D, Fu D, Yan L, Xie L. The Role of Hyperbaric Oxygen Therapy in the Treatment of Surgical Site Infections: A Narrative Review. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:medicina59040762. [PMID: 37109720 PMCID: PMC10145168 DOI: 10.3390/medicina59040762] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Revised: 03/12/2023] [Accepted: 04/03/2023] [Indexed: 04/29/2023]
Abstract
Surgical site infections (SSIs) are among the most prevalent postoperative complications, with significant morbidity and mortality worldwide. In the past half century, hyperbaric oxygen therapy (HBOT), the administration of 100% oxygen intermittently under a certain pressure, has been used as either a primary or alternative therapy for the management or treatment of chronic wounds and infections. This narrative review aims to gather information and evidence supporting the role of HBOT in the treatment of SSIs. We followed the Scale for the Quality Assessment of Narrative Review Articles (SANRA) guidelines and scrutinized the most relevant studies identified in Medline (via PubMed), Scopus, and Web of Science. Our review indicated that HBOT can result in rapid healing and epithelialization of various wounds and has potential beneficial effects in the treatment of SSIs or other similar infections following cardiac, neuromuscular scoliosis, coronary artery bypass, and urogenital surgeries. Moreover, it was a safe therapeutic procedure in most cases. The mechanisms related to the antimicrobial activity of HBOT include direct bactericidal effects through the formation of reactive oxygen species (ROS), the immunomodulatory effect of HBOT that increase the antimicrobial effects of the immune system, and the synergistic effects of HBOT with antibiotics. We emphasized the essential need for further studies, especially randomized clinical trials and longitudinal studies, to better standardize HBOT procedures as well as to determine its full benefits and possible side effects.
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Affiliation(s)
- Dingzi Zhou
- West China School of Public Health, West China Fourth Hospital, Sichuan University, Chengdu 610041, China
| | - Daigang Fu
- West China School of Public Health, West China Fourth Hospital, Sichuan University, Chengdu 610041, China
| | - Ling Yan
- West China School of Public Health, West China Fourth Hospital, Sichuan University, Chengdu 610041, China
| | - Linshen Xie
- West China School of Public Health, West China Fourth Hospital, Sichuan University, Chengdu 610041, China
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13
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Marano L, Verre L, Carbone L, Poto GE, Fusario D, Venezia DF, Calomino N, Kaźmierczak-Siedlecka K, Polom K, Marrelli D, Roviello F, Kok JHH, Vashist Y. Current Trends in Volume and Surgical Outcomes in Gastric Cancer. J Clin Med 2023; 12:jcm12072708. [PMID: 37048791 PMCID: PMC10094776 DOI: 10.3390/jcm12072708] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Revised: 03/27/2023] [Accepted: 04/03/2023] [Indexed: 04/08/2023] Open
Abstract
Gastric cancer is ranked as the fifth most frequently diagnosed type of cancer. Complete resection with adequate lymphadenectomy represents the goal of treatment with curative intent. Quality assurance is a crucial factor in the evaluation of oncological surgical care, and centralization of healthcare in referral hospitals has been proposed in several countries. However, an international agreement about the setting of “high-volume hospitals” as well as “minimum volume standards” has not yet been clearly established. Despite the clear postoperative mortality benefits that have been described for gastric cancer surgery conducted by high-volume surgeons in high-volume hospitals, many authors have highlighted the limitations of a non-composite variable to define the ideal postoperative period. The textbook outcome represents a multidimensional measure assessing the quality of care for cancer patients. Transparent and easily available hospital data will increase patients’ awareness, providing suitable elements for a more informed hospital choice.
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Affiliation(s)
- Luigi Marano
- Department of Medicine, Surgery and Neuroscience, University of Siena, 53100 Siena, Italy
| | - Luigi Verre
- Department of Medicine, Surgery and Neuroscience, University of Siena, 53100 Siena, Italy
| | - Ludovico Carbone
- Department of Medicine, Surgery and Neuroscience, University of Siena, 53100 Siena, Italy
| | - Gianmario Edoardo Poto
- Department of Medicine, Surgery and Neuroscience, University of Siena, 53100 Siena, Italy
| | - Daniele Fusario
- Department of Medicine, Surgery and Neuroscience, University of Siena, 53100 Siena, Italy
| | | | - Natale Calomino
- Department of Medicine, Surgery and Neuroscience, University of Siena, 53100 Siena, Italy
| | - Karolina Kaźmierczak-Siedlecka
- Department of Medical Laboratory Diagnostics-Fahrenheit Biobank BBMRI.pl, Medical University of Gdansk, 80-308 Gdańsk, Poland
| | - Karol Polom
- Department of Surgical Oncology, Medical University of Gdansk, 80-308 Gdańsk, Poland
| | - Daniele Marrelli
- Department of Medicine, Surgery and Neuroscience, University of Siena, 53100 Siena, Italy
| | - Franco Roviello
- Department of Medicine, Surgery and Neuroscience, University of Siena, 53100 Siena, Italy
| | - Johnn Henry Herrera Kok
- Department of General and Digestive Surgery, Complejo Asistencial Universitario de León, 24071 León, Spain
| | - Yogesh Vashist
- Organ Transplant Center of Excellence, King Faisal Specialist Hospital and Research Center, Riyadh 11211, Saudi Arabia
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14
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Marano L, Carbone L, Poto GE, Restaino V, Piccioni SA, Verre L, Roviello F, Marrelli D. Extended Lymphadenectomy for Gastric Cancer in the Neoadjuvant Era: Current Status, Clinical Implications and Contentious Issues. Curr Oncol 2023; 30:875-896. [PMID: 36661716 PMCID: PMC9858164 DOI: 10.3390/curroncol30010067] [Citation(s) in RCA: 13] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Revised: 01/05/2023] [Accepted: 01/06/2023] [Indexed: 01/11/2023] Open
Abstract
Despite its decreasing incidence, gastric cancer remains an important global healthcare problem due to its overall high prevalence and high mortality rate. Since the MAGIC and FNLCC/FFCD trials, the neoadjuvant chemotherapy has been recommended throughout Europe in gastric cancer. Potential benefits of preoperative treatments include a higher rate of R0 resection achieved by downstaging the primary tumor, a likely effect on micrometastases and isolated tumor cells in the lymph nodes, and, as a result, improved cancer-related survival. Nevertheless, distortion of anatomical planes of dissection, interstitial fibrosis, and sclerotic tissue changes may increase surgical difficulty. The collection of at least twenty-five lymph nodes after neoadjuvant therapy would seem to ensure removal of undetectable node metastasis and reduce the likelihood of locoregional recurrence. It is not what you take but what you leave behind that defines survival. Therefore, para-aortic lymph node dissection is safe and effective after neoadjuvant chemotherapy, in both therapeutic and prophylactic settings. In this review, the efficacy of adequate lymph node dissection, also in a neoadjuvant setting, has been investigated in the key studies conducted to date on the topic.
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Affiliation(s)
| | - Ludovico Carbone
- Unit of Surgical Oncology, Department of Medicine Surgery and Neurosciences, University of Siena, 53100 Siena, Italy
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15
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Verre L, Gallo G, Grassi G, Bussolin E, Carbone L, Poto GE, Carpineto Samorani O, Marano L, Marrelli D, Roviello F. Transanal hemorrhoidal dearterialization (THD) for hemorrhoidal disease: An Italian single-institution 5-year experience analysis and updated literature review. Front Surg 2022; 9:1088546. [PMID: 36620384 PMCID: PMC9811001 DOI: 10.3389/fsurg.2022.1088546] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2022] [Accepted: 12/05/2022] [Indexed: 12/24/2022] Open
Abstract
Background Hemorrhoidal disease is a highly prevalent, chronic disorder that usually compromise patients' quality of life. Despite recent advances in pharmacologic and surgical therapeutic options, a clear treatment "gold standard" is lacking. Our aim is to analyze the outcomes following Transanal Hemorrhoidal Dearterialization (THD) procedure. Methods Patients who failed conservative treatment and underwent THD Doppler between 2017 and 2021 were enrolled. Follow-up interviews (consisting of clinical examination, Visual Analog Scale for pain-VAS, Vaizey incontinence score, Hemorrhoid Severity Score) were administered 1 week, 2 weeks, 1 month and 6 months after surgery. Results Forty-seven out of 75 patients were male, and the mean age was 50 (± 17.9) years. Hemorrhoids were classified as Goligher's degree II in 25 cases, III in 40 and IV, simple irreducible without ischemic changes, in 10. The mean operative time was 35 (28-60) minutes, and most procedures were performed with epidural anesthesia (80%). No intraoperative complications occurred, and 73 patients (97.3%) were discharged within post-operative day 1. Early post-operative pain and bleeding occurred in 37.3% and 8% of patients, respectively. No patients experienced anal incontinence and severe symptoms at 6 months after surgery. The overall success rate was 97.3%. Conclusions THD is safe and effective in hemorrhoidal disease at degree II if bleeding, III, and IV without ischemic changes, both as a first intervention and on recurrence. Physician and patient need to understand each other's expectations, weight the risks and benefits, and customize the treatment.
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Affiliation(s)
- Luigi Verre
- Department of Medicine, Surgery and Neurosciences, Unit of General Surgery and Surgical Oncology, University of Siena, Siena, Italy,Correspondence: Luigi Verre
| | - Gaetano Gallo
- Department of Surgical Sciences, La Sapienza University of Roma, Roma, Italy
| | - Giulia Grassi
- Department of Medicine, Surgery and Neurosciences, Unit of General Surgery and Surgical Oncology, University of Siena, Siena, Italy
| | - Edoardo Bussolin
- Department of Medicine, Surgery and Neurosciences, Unit of General Surgery and Surgical Oncology, University of Siena, Siena, Italy
| | - Ludovico Carbone
- Department of Medicine, Surgery and Neurosciences, Unit of General Surgery and Surgical Oncology, University of Siena, Siena, Italy
| | - Gianmario Edoardo Poto
- Department of Medicine, Surgery and Neurosciences, Unit of General Surgery and Surgical Oncology, University of Siena, Siena, Italy
| | - Osvaldo Carpineto Samorani
- Department of Medicine, Surgery and Neurosciences, Unit of General Surgery and Surgical Oncology, University of Siena, Siena, Italy
| | - Luigi Marano
- Department of Medicine, Surgery and Neurosciences, Unit of General Surgery and Surgical Oncology, University of Siena, Siena, Italy
| | - Daniele Marrelli
- Department of Medicine, Surgery and Neurosciences, Unit of General Surgery and Surgical Oncology, University of Siena, Siena, Italy
| | - Franco Roviello
- Department of Medicine, Surgery and Neurosciences, Unit of General Surgery and Surgical Oncology, University of Siena, Siena, Italy
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16
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Ahmed NJ, Haseeb A, Alamer A, Almalki ZS, Alahmari AK, Khan AH. Meta-Analysis of Clinical Trials Comparing Cefazolin to Cefuroxime, Ceftriaxone, and Cefamandole for Surgical Site Infection Prevention. Antibiotics (Basel) 2022; 11:1543. [PMID: 36358198 PMCID: PMC9686604 DOI: 10.3390/antibiotics11111543] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2022] [Revised: 10/18/2022] [Accepted: 10/24/2022] [Indexed: 11/27/2023] Open
Abstract
Surgical site infections are among the most prevalent and costly healthcare-associated infections, resulting in poor patient outcomes and even death. Cefazolin is a first-generation cephalosporin antibiotic that is widely used for surgical prophylaxis in a variety of surgical disciplines. Although previous studies showed that cefazolin is effective in preventing surgical site infections, other agents, such as cefuroxime and ceftriaxone, were used excessively for surgical patients. The present analysis included only clinical trials comparing the efficacy of cefazolin to cefuroxime, ceftriaxone, and cefamandole in lowering SSIs using PubMed, Google Scholar, and ClinicalTrials.gov. Review Manager software (RevMan version 5.4) was used to conduct the meta-analyses. A total of 12,446 patients were included in the study. Among these patients, 6327 patients received cefazolin and 6119 patients received cefamandole, cefuroxime, or ceftriaxone. Our analysis showed that cefazolin is as effective as cefuroxime, cefamandole, and ceftriaxone in preventing surgical site infections. Hence, our findings have provided evidence for the use of cefazolin before surgeries because of its efficacy, as previous studies showed that it is inexpensive and safer than other agents.
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Affiliation(s)
- Nehad J. Ahmed
- Department of Clinical Pharmacy, College of Pharmacy, Prince Sattam Bin Abdulaziz University, Alkharj 11942, Saudi Arabia
- Discipline of Clinical Pharmacy, School of Pharmaceutical Sciences, Universiti Sains Malaysia, Pulau Pinang 11800, Malaysia
| | - Abdul Haseeb
- Clinical Pharmacy Department, College of Pharmacy, Umm Al-Qura University, Mekkah 13174, Saudi Arabia
| | - Ahmad Alamer
- Department of Clinical Pharmacy, College of Pharmacy, Prince Sattam Bin Abdulaziz University, Alkharj 11942, Saudi Arabia
| | - Ziyad S. Almalki
- Department of Clinical Pharmacy, College of Pharmacy, Prince Sattam Bin Abdulaziz University, Alkharj 11942, Saudi Arabia
| | - Abdullah K. Alahmari
- Department of Clinical Pharmacy, College of Pharmacy, Prince Sattam Bin Abdulaziz University, Alkharj 11942, Saudi Arabia
| | - Amer H. Khan
- Discipline of Clinical Pharmacy, School of Pharmaceutical Sciences, Universiti Sains Malaysia, Pulau Pinang 11800, Malaysia
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