Browsing by Subject "Emergency surgery"

Sort by: Order: Results:

Now showing items 1-8 of 8
  • Birindelli, Arianna; Sartelli, Massimo; Di Saverio, Salomone; Coccolini, Federico; Ansaloni, Luca; van Ramshorst, Gabrielle H.; Campanelli, Giampiero; Khokha, Vladimir; Moore, Ernest E.; Peitzman, Andrew; Velmahos, George; Moore, Frederick Alan; Leppaniemi, Ari; Burlew, Clay Cothren; Biffl, Walter L.; Koike, Kaoru; Kluger, Yoram; Fraga, Gustavo P.; Ordonez, Carlos A.; Novello, Matteo; Agresta, Ferdinando; Sakakushev, Boris; Gerych, Igor; Wani, Imtiaz; Kelly, Michael D.; Gomes, Carlos Augusto; Faro, Mario Paulo; Tarasconi, Antonio; Demetrashvili, Zaza; Lee, Jae Gil; Vettoretto, Nereo; Guercioni, Gianluca; Persiani, Roberto; Trana, Cristian; Cui, Yunfeng; Kok, Kenneth Y. Y.; Ghnnam, Wagih M.; Abbas, Ashraf El-Sayed; Sato, Norio; Marwah, Sanjay; Rangarajan, Muthukumaran; Ben-Ishay, Offir; Adesunkanmi, Abdul Rashid K.; Lohse, Helmut Alfredo Segovia; Kenig, Jakub; Mandala, Stefano; Coimbra, Raul; Bhangu, Aneel; Suggett, Nigel; Biondi, Antonio; Portolani, Nazario; Baiocchi, Gianluca; Kirkpatrick, Andrew W.; Scibe, Rodolfo; Sugrue, Michael; Chiara, Osvaldo; Catena, Fausto (2017)
    Emergency repair of complicated abdominal wall hernias may be associated with worsen outcome and a significant rate of postoperative complications. There is no consensus on management of complicated abdominal hernias. The main matter of debate is about the use of mesh in case of intestinal resection and the type of mesh to be used. Wound infection is the most common complication encountered and represents an immense burden especially in the presence of a mesh. The recurrence rate is an important topic that influences the final outcome. A World Society of Emergency Surgery (WSES) Consensus Conference was held in Bergamo in July 2013 with the aim to define recommendations for emergency repair of abdominal wall hernias in adults. This document represents the executive summary of the consensus conference approved by a WSES expert panel. In 2016, the guidelines have been revised and updated according to the most recent available literature.
  • Bala, Miklosh; Kashuk, Jeffry; Moore, Ernest E.; Catena, Fausto; Leppäniemi, Ari; Ansaloni, Luca; Biffl, Walter; Coccolini, Federico; Peitzman, Andrew; Sartelli, Massimo; Sugrue, Michael; Fraga, Gustavo P.; Di Saverio, Salomone; Kluger, Yoram (2018)
    A position paper (PP) should establish a unified voice in areas where controversy occurs based upon multiple practices and/or therapeutic choices. Typically, a position paper should elucidate the knowledge gap, followed by an evidence-based review of options, leading to an "endorsed position." A position paper should represent more than the opinion or consensus of the authors but should present current opinions and practices supported by the World Society of Emergency Surgery (WSES). Accordingly, position papers should require the approval of an expert group of WSES and in parallel be presented at an annual meeting prior to submission for publication. It is important that a unified approach for drafting of position papers be established and endorsed by WSES in order to establish credibility and prevent misunderstandings during a smooth transition to publication. The purpose of this article is to suggest a uniform process for the development of WSES guidelines.
  • Sartelli, Massimo; Abu-Zidan, Fikri M.; Labricciosa, Francesco M.; Kluger, Yoram; Coccolini, Federico; Ansaloni, Luca; Leppäniemi, Ari; Kirkpatrick, Andrew W.; Tolonen, Matti; Trana, Cristian; Regimbeau, Jean-Marc; Hardcastle, Timothy; Koshy, Renol M.; Abbas, Ashraf; Aday, Ulas; Adesunkanmi, A. R. K.; Ajibade, Adesina; Akhmeteli, Lali; Akin, Emrah; Akkapulu, Nezih; Alotaibi, Alhenouf; Altintoprak, Fatih; Anyfantakis, Dimitrios; Atanasov, Boyko; Augustin, Goran; Azevedo, Constanca; Bala, Miklosh; Balalis, Dimitrios; Baraket, Oussama; Baral, Suman; Barkai, Or; Beltran, Marcelo; Bini, Roberto; Bouliaris, Konstantinos; Caballero, Ana B.; Calu, Valentin; Catani, Marco; Ceresoli, Marco; Charalampakis, Vasileios; Jusoh, Asri Che; Chiarugi, Massimo; Cillara, Nicola; Cobos Cuesta, Raquel; Cobuccio, Luigi; Cocorullo, Gianfranco; Colak, Elif; Conti, Luigi; Cui, Yunfeng; De Simone, Belinda; Delibegovic, Samir; Demetrashvili, Zaza; Demetriades, Demetrios; Dimova, Ana; Dogjani, Agron; Enani, Mushira; Farina, Federica; Ferrara, Francesco; Foghetti, Domitilla; Fontana, Tommaso; Fraga, Gustavo P.; Gachabayov, Mahir; Gerard, Grelpois; Ghnnam, Wagih; Gimenez Maurel, Teresa; Gkiokas, Georgios; Gomes, Carlos A.; Guner, Ali; Gupta, Sanjay; Hecker, Andreas; Hirano, Elcio S.; Hodonou, Adrien; Hutan, Martin; Ilaschuk, Igor; Ioannidis, Orestis; Isik, Arda; Ivakhov, Georgy; Jain, Sumita; Jokubauskas, Mantas; Karamarkovic, Aleksandar; Kaushik, Robin; Kenig, Jakub; Khokha, Vladimir; Khokha, Denis; Kim, Jae Il; Kong, Victor; Korkolis, Dimitris; Kruger, Vitor F.; Kshirsagar, Ashok; Simoes, Romeo Lages; Lanaia, Andrea; Lasithiotakis, Konstantinos; Leao, Pedro; Leon Arellano, Miguel; Listle, Holger; Litvin, Andrey; Lizarazu Perez, Aintzane; Lopez-Tomassetti Fernandez, Eudaldo; Lostoridis, Eftychios; Luppi, Davide; Machain, Gustavo M.; Major, Piotr; Manatakis, Dimitrios; Reitz, Marianne Marchini; Marinis, Athanasios; Marrelli, Daniele; Martinez-Perez, Aleix; Marwah, Sanjay; McFarlane, Michael; Mesic, Mirza; Mesina, Cristian; Michalopoulos, Nickos; Misiakos, Evangelos; Moreira, Felipe Goncalves; Mouaqit, Ouadii; Muhtaroglu, Ali; Naidoo, Noel; Negoi, Ionut; Nikitina, Zane; Nikolopoulos, Ioannis; Nita, Gabriela-Elisa; Occhionorelli, Savino; Olaoye, Iyiade; Ordonez, Carlos A.; Ozkan, Zeynep; Pal, Ajay; Palini, Gian M.; Papageorgiou, Kyriaki; Papagoras, Dimitris; Pata, Francesco; Pedziwiatr, Michal; Pereira, Jorge; Pereira Junior, Gerson A.; Perrone, Gennaro; Pintar, Tadeja; Pisarska, Magdalena; Plehutsa, Oleksandr; Podda, Mauro; Poillucci, Gaetano; Quiodettis, Martha; Rahim, Tuba; Rios-Cruz, Daniel; Rodrigues, Gabriel; Rozov, Dmytry; Sakakushev, Boris; Sall, Ibrahima; Sazhin, Alexander; Semiao, Miguel; Sharda, Taanya; Shelat, Vishal; Sinibaldi, Giovanni; Skicko, Dmitrijs; Skrovina, Matej; Stamatiou, Dimitrios; Stella, Marco; Strzalka, Marcin; Sydorchuk, Ruslan; Gonsaga, Ricardo A. Teixeira; Tochie, Joel Noutakdie; Tomadze, Gia; Ugoletti, Lara; Ulrych, Jan; Umarik, Toomas; Uzunoglu, Mustafa Y.; Vasilescu, Alin; Vaz, Osborne; Vereczkei, Andras; Vlad, Nutu; Waledziak, Maciej; Yahya, Ali I.; Yalkin, Omer; Yilmaz, Tonguc U.; Unal, Ali Ekrem; Yuan, Kuo-Ching; Zachariah, Sanoop K.; Zilinskas, Justas; Zizzo, Maurizio; Pattonieri, Vittoria; Baiocchi, Gian Luca; Catena, Fausto (2019)
    BackgroundTiming 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.MethodsThis 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.ResultsA total of 3137 patients were included, with 1815 (57.9%) men and 1322 (42.1%) women, with a median age of 47years (interquartile range [IQR] 28-66). The overall in-hospital mortality rate was 8.9%, with a median length of stay of 6days (IQR 4-10). Using multivariable logistic regression, independent variables associated with in-hospital mortality were identified: age > 80years, malignancy, severe cardiovascular disease, severe chronic kidney disease, respiratory rate >= 22 breaths/min, systolic blood pressure <100mmHg, AVPU responsiveness scale (voice and unresponsive), blood oxygen saturation level (SpO(2)) <90% in air, platelet count <50,000 cells/mm3, and lactate > 4mmol/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.ConclusionsThe 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.
  • Sartelli, Massimo; Abu-Zidan, Fikri M; Labricciosa, Francesco M; Kluger, Yoram; Coccolini, Federico; Ansaloni, Luca; Leppäniemi, Ari; Kirkpatrick, Andrew W; Tolonen, Matti; Tranà, Cristian; Regimbeau, Jean-Marc; Hardcastle, Timothy; Koshy, Renol M; Abbas, Ashraf; Aday, Ulaş; Adesunkanmi, A. R K; Ajibade, Adesina; Akhmeteli, Lali; Akın, Emrah; Akkapulu, Nezih; Alotaibi, Alhenouf; Altintoprak, Fatih; Anyfantakis, Dimitrios; Atanasov, Boyko; Augustin, Goran; Azevedo, Constança; Bala, Miklosh; Balalis, Dimitrios; Baraket, Oussama; Baral, Suman; Barkai, Or; Beltran, Marcelo; Bini, Roberto; Bouliaris, Konstantinos; Caballero, Ana B; Calu, Valentin; Catani, Marco; Ceresoli, Marco; Charalampakis, Vasileios; Jusoh, Asri C; Chiarugi, Massimo; Cillara, Nicola; Cuesta, Raquel C; Cobuccio, Luigi; Cocorullo, Gianfranco; Colak, Elif; Conti, Luigi; Cui, Yunfeng; De Simone, Belinda; Delibegovic, Samir; Demetrashvili, Zaza; Demetriades, Demetrios; Dimova, Ana; Dogjani, Agron; Enani, Mushira; Farina, Federica; Ferrara, Francesco; Foghetti, Domitilla; Fontana, Tommaso; Fraga, Gustavo P; Gachabayov, Mahir; Gérard, Grelpois; Ghnnam, Wagih; Maurel, Teresa G; Gkiokas, Georgios; Gomes, Carlos A; Guner, Ali; Gupta, Sanjay; Hecker, Andreas; Hirano, Elcio S; Hodonou, Adrien; Hutan, Martin; Ilaschuk, Igor; Ioannidis, Orestis; Isik, Arda; Ivakhov, Georgy; Jain, Sumita; Jokubauskas, Mantas; Karamarkovic, Aleksandar; Kaushik, Robin; Kenig, Jakub; Khokha, Vladimir; Khokha, Denis; Kim, Jae I; Kong, Victor; Korkolis, Dimitris; Kruger, Vitor F; Kshirsagar, Ashok; Simões, Romeo L; Lanaia, Andrea; Lasithiotakis, Konstantinos; Leão, Pedro; Arellano, Miguel L; Listle, Holger; Litvin, Andrey; Lizarazu Pérez, Aintzane; Lopez-Tomassetti Fernandez, Eudaldo; Lostoridis, Eftychios; Luppi, Davide; Machain V, Gustavo M; Major, Piotr; Manatakis, Dimitrios; Reitz, Marianne M; Marinis, Athanasios; Marrelli, Daniele; Martínez-Pérez, Aleix; Marwah, Sanjay; McFarlane, Michael; Mesic, Mirza; Mesina, Cristian; Michalopoulos, Nickos; Misiakos, Evangelos; Moreira, Felipe G; Mouaqit, Ouadii; Muhtaroglu, Ali; Naidoo, Noel; Negoi, Ionut; Nikitina, Zane; Nikolopoulos, Ioannis; Nita, Gabriela-Elisa; Occhionorelli, Savino; Olaoye, Iyiade; Ordoñez, Carlos A; Ozkan, Zeynep; Pal, Ajay; Palini, Gian M; Papageorgiou, Kyriaki; Papagoras, Dimitris; Pata, Francesco; Pędziwiatr, Michał; Pereira, Jorge; Pereira Junior, Gerson A; Perrone, Gennaro; Pintar, Tadeja; Pisarska, Magdalena; Plehutsa, Oleksandr; Podda, Mauro; Poillucci, Gaetano; Quiodettis, Martha; Rahim, Tuba; Rios-Cruz, Daniel; Rodrigues, Gabriel; Rozov, Dmytry; Sakakushev, Boris; Sall, Ibrahima; Sazhin, Alexander; Semião, Miguel; Sharda, Taanya; Shelat, Vishal; Sinibaldi, Giovanni; Skicko, Dmitrijs; Skrovina, Matej; Stamatiou, Dimitrios; Stella, Marco; Strzałka, Marcin; Sydorchuk, Ruslan; Teixeira Gonsaga, Ricardo A; Tochie, Joel N; Tomadze, Gia; Ugoletti, Lara; Ulrych, Jan; Ümarik, Toomas; Uzunoglu, Mustafa Y; Vasilescu, Alin; Vaz, Osborne; Vereczkei, Andras; Vlad, Nutu; Walędziak, Maciej; Yahya, Ali I; Yalkin, Omer; Yilmaz, Tonguç U; Ünal, Ali E; Yuan, Kuo-Ching; Zachariah, Sanoop K; Žilinskas, Justas; Zizzo, Maurizio; Pattonieri, Vittoria; Baiocchi, Gian L; Catena, Fausto (BioMed Central, 2019)
    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.
  • Sugrue, M.; Maier, R.; Moore, E. E.; Boermeester, M.; Catena, F.; Coccolini, F.; Leppaniemi, A.; Peitzman, A.; Velmahos, G.; Ansaloni, L.; Abu-Zidan, F.; Balfe, P.; Bendinelli, C.; Biffl, W.; Bowyer, M.; DeMoya, M.; De Waele, J.; Di Saverio, S.; Drake, A.; Fraga, G. P.; Hallal, A.; Henry, C.; Hodgetts, T.; Hsee, L.; Huddart, S.; Kirkpatrick, A. W.; Kluger, Y.; Lawler, L.; Malangoni, M. A.; Malbrain, M.; MacMahon, P.; Mealy, K.; O'Kane, M.; Loughlin, P.; Paduraru, M.; Pearce, L.; Pereira, B. M.; Priyantha, A.; Sartelli, M.; Soreide, K.; Steele, C.; Thomas, S.; Vincent, J. L.; Woods, L. (2017)
    Background: Opportunities to improve emergency surgery outcomes exist through guided better practice and reduced variability. Few attempts have been made to define optimal care in emergency surgery, and few clinically derived key performance indicators (KPIs) have been published. A summit was therefore convened to look at resources for optimal care of emergency surgery. The aim of the Donegal Summit was to set a platform in place to develop guidelines and KPIs in emergency surgery. Methods: The project had multidisciplinary global involvement in producing consensus statements regarding emergency surgery care in key areas, and to assess feasibility of producing KPIs that could be used to monitor process and outcome of care in the future. Results: Forty-four key opinion leaders in emergency surgery, across 7 disciplines from 17 countries, composed evidence-based position papers on 14 key areas of emergency surgery and 112 KPIs in 20 acute conditions or emergency systems. Conclusions: The summit was successful in achieving position papers and KPIs in emergency surgery. While position papers were limited by non-graded evidence and non-validated KPIs, the process set a foundation for the future advancement of emergency surgery.
  • Tolonen, Matti; Sallinen, Ville; Leppäniemi, Ari; Bäcklund, Minna; Mentula, Panu (BioMed Central, 2019)
    Abstract Background The prognostic role of what a surgeon observes in the abdomen of patients with complicated intra-abdominal infection (cIAI) is largely unknown. The aim of this prospective study was to systemically analyze components of the intra-abdominal view (IAV) and their association to severe complicated intra-abdominal sepsis (SCIAS) or mortality. Methods The study cohort consisted of adult patients with cIAI. The operating surgeon filled a paper form describing the intra-abdominal view. Demographics, operative details, and preoperative physiological status were collected. Descriptive, univariate, and multivariate statistical analyses were performed, and a new score was developed based on regression coefficients. The primary outcome was a composite outcome of SCIAS or 30-day mortality, in which SCIAS was defined as organ dysfunctions requiring intensive care unit admission. Results A total of 283 patients were analyzed. The primary outcome was encountered in 71 (25%) patients. In the IAV, independent risk factors for the primary outcome were fecal or bile as exudate (odds ratio (OR) 1.98, 95% confidence interval 1.05–3.73), diffuse peritonitis (OR 2.15, 1.02–4.55), diffuse substantial redness of the peritoneum (OR 5.73, 2.12–15.44), and a non-appendiceal source of cIAI (OR 11.20, 4.11–30.54). Based on these factors, an IAV score was developed and its performance analyzed. The area under the receiver operating characteristic for the IAV score was 0.81. The IAV score also correlated significantly with several outcomes and organ dysfunctions. Conclusions The extent of peritonitis, diffuse substantial redness of the peritoneum, type of exudate, and source of infection associate independently with SCIAS or mortality. A high IAV score associates with mortality and organ dysfunctions, yet it needs further external validation. Combining components of IAV into comprehensive scoring systems for cIAI patients may provide additional value compared to the current scoring systems. Trial registration The study protocol was retrospectively registered on April 4, 2016, right after the first enrolled patient at Clinicaltrials.gov database ( NCT02726932 ).
  • Tolonen, Matti; Sallinen, Ville; Leppäniemi, Ari; Bäcklund, Minna; Mentula, Panu (2019)
    BackgroundThe prognostic role of what a surgeon observes in the abdomen of patients with complicated intra-abdominal infection (cIAI) is largely unknown. The aim of this prospective study was to systemically analyze components of the intra-abdominal view (IAV) and their association to severe complicated intra-abdominal sepsis (SCIAS) or mortality.MethodsThe study cohort consisted of adult patients with cIAI. The operating surgeon filled a paper form describing the intra-abdominal view. Demographics, operative details, and preoperative physiological status were collected. Descriptive, univariate, and multivariate statistical analyses were performed, and a new score was developed based on regression coefficients. The primary outcome was a composite outcome of SCIAS or 30-day mortality, in which SCIAS was defined as organ dysfunctions requiring intensive care unit admission.ResultsA total of 283 patients were analyzed. The primary outcome was encountered in 71 (25%) patients. In the IAV, independent risk factors for the primary outcome were fecal or bile as exudate (odds ratio (OR) 1.98, 95% confidence interval 1.05-3.73), diffuse peritonitis (OR 2.15, 1.02-4.55), diffuse substantial redness of the peritoneum (OR 5.73, 2.12-15.44), and a non-appendiceal source of cIAI (OR 11.20, 4.11-30.54). Based on these factors, an IAV score was developed and its performance analyzed. The area under the receiver operating characteristic for the IAV score was 0.81. The IAV score also correlated significantly with several outcomes and organ dysfunctions.ConclusionsThe extent of peritonitis, diffuse substantial redness of the peritoneum, type of exudate, and source of infection associate independently with SCIAS or mortality. A high IAV score associates with mortality and organ dysfunctions, yet it needs further external validation. Combining components of IAV into comprehensive scoring systems for cIAI patients may provide additional value compared to the current scoring systems.Trial registrationThe study protocol was retrospectively registered on April 4, 2016, right after the first enrolled patient at Clinicaltrials.gov database (NCT02726932).
  • De Simone, Belinda; Davies, Justin; Chouillard, Elie; Di Saverio, Salomone; Hoentjen, Frank; Tarasconi, Antonio; Sartelli, Massimo; Biffl, Walter L; Ansaloni, Luca; Coccolini, Federico; Chiarugi, Massimo; De’Angelis, Nicola; Moore, Ernest E; Kluger, Yoram; Abu-Zidan, Fikri; Sakakushev, Boris; Coimbra, Raul; Celentano, Valerio; Wani, Imtiaz; Pintar, Tadeja; Sganga, Gabriele; Di Carlo, Isidoro; Tartaglia, Dario; Pikoulis, Manos; Cardi, Maurizio; De Moya, Marc A; Leppaniemi, Ari; Kirkpatrick, Andrew; Agnoletti, Vanni; Poggioli, Gilberto; Carcoforo, Paolo; Baiocchi, Gian L; Catena, Fausto (BioMed Central, 2021)
    Abstract Background Despite the current therapeutic options for the treatment of inflammatory bowel disease, surgery is still frequently required in the emergency setting, although the number of cases performed seems to have decreased in recent years. The World Society of Emergency Surgery decided to debate in a consensus conference of experts, the main pertinent issues around the management of inflammatory bowel disease in the emergent situation, with the need to provide focused guidelines for acute care and emergency surgeons. Method A group of experienced surgeons and gastroenterologists were nominated to develop the topics assigned and answer the questions addressed by the Steering Committee of the project. Each expert followed a precise analysis and grading of the studies selected for review. Statements and recommendations were discussed and voted at the Consensus Conference of the 6th World Society of Emergency Surgery held in Nijmegen (The Netherlands) in June 2019. Conclusions Complicated inflammatory bowel disease requires a multidisciplinary approach because of the complexity of this patient group and disease spectrum in the emergency setting, with the aim of obtaining safe surgery with good functional outcomes and a decreasing stoma rate where appropriate.