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Surgery

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https://read.qxmd.com/read/31210778/2019-wses-guidelines-for-the-management-of-severe-acute-pancreatitis
#1
REVIEW
Ari Leppäniemi, Matti Tolonen, Antonio Tarasconi, Helmut Segovia-Lohse, Emiliano Gamberini, Andrew W Kirkpatrick, Chad G Ball, Neil Parry, Massimo Sartelli, Daan Wolbrink, Harry van Goor, Gianluca Baiocchi, Luca Ansaloni, Walter Biffl, Federico Coccolini, Salomone Di Saverio, Yoram Kluger, Ernest Moore, Fausto Catena
Although most patients with acute pancreatitis have the mild form of the disease, about 20-30% develops a severe form, often associated with single or multiple organ dysfunction requiring intensive care. Identifying the severe form early is one of the major challenges in managing severe acute pancreatitis. Infection of the pancreatic and peripancreatic necrosis occurs in about 20-40% of patients with severe acute pancreatitis, and is associated with worsening organ dysfunctions. While most patients with sterile necrosis can be managed nonoperatively, patients with infected necrosis usually require an intervention that can be percutaneous, endoscopic, or open surgical...
2019: World Journal of Emergency Surgery: WJES
https://read.qxmd.com/read/31071753/the-bubble-sign-a-novel-way-to-detect-a-perforation-after-cold-snare-polypectomy
#2
Joaquín Rodríguez Sánchez, Mónica Sánchez Alonso, María Pellisé Urquiza
No abstract text is available yet for this article.
May 9, 2019: Endoscopy
https://read.qxmd.com/read/30607165/use-of-sentinel-lymph-node-biopsy-after-neoadjuvant-chemotherapy-in-patients-with-axillary-node-positive-breast-cancer-in-diagnosis
#3
Hee Jun Choi, Isaac Kim, Emad Alsharif, Sungmin Park, Jae-Myung Kim, Jai Min Ryu, Seok Jin Nam, Seok Won Kim, Jonghan Yu, Se Kyung Lee, Jeong Eon Lee
Purpose: This study aimed to evaluate the effects of sentinel lymph node biopsy (SLNB) on recurrence and survival after neoadjuvant chemotherapy (NAC) in breast cancer patients with cytology-proven axillary node metastasis. Methods: We selected patients who were diagnosed with invasive breast cancer and axillary lymph node metastasis and were treated with NAC followed by curative surgery between January 2007 and December 2014. We classified patients into three groups: group A, negative sentinel lymph node (SLN) status and no further dissection; group B, negative SLN status with backup axillary lymph node dissection (ALND); and group C, no residual axillary metastasis on pathology with standard ALND...
December 2018: Journal of Breast Cancer
https://read.qxmd.com/read/30720507/open-versus-laparoscopic-versus-robotic-versus-transanal-mesorectal-excision-for-rectal-cancer-a-systematic-review-and-network-meta-analysis
#4
Constantinos Simillis, Nikhil Lal, Sarah N Thoukididou, Christos Kontovounisios, Jason J Smith, Roel Hompes, Michel Adamina, Paris P Tekkis
OBJECTIVE: To compare techniques for rectal cancer resection. SUMMARY BACKGROUND DATA: Different surgical approaches exist for mesorectal excision. METHODS: Systematic literature review and Bayesian network meta-analysis performed. RESULTS: Twenty-nine randomized controlled trials included, reporting on 6237 participants, comparing: open versus laparoscopic versus robotic versus transanal mesorectal excision. No significant differences identified between treatments in intraoperative morbidity, conversion rate, grade III/IV morbidity, reoperation, anastomotic leak, nodes retrieved, involved distal margin, 5-year overall survival, and locoregional recurrence...
July 2019: Annals of Surgery
https://read.qxmd.com/read/30535100/seven-versus-fourteen-days-of-antibiotic-therapy-for-uncomplicated-gram-negative-bacteremia-a-non-inferiority-randomized-controlled-trial
#5
Dafna Yahav, Erica Franceschini, Fidi Koppel, Adi Turjeman, Tanya Babich, Roni Bitterman, Ami Neuberger, Nesrin Ghanem-Zoubi, Antonella Santoro, Noa Eliakim-Raz, Barak Pertzov, Tali Steinmetz, Anat Stern, Yaakov Dickstein, Elias Maroun, Hiba Zayyad, Jihad Bishara, Danny Alon, Yonatan Edel, Elad Goldberg, Claudia Venturelli, Cristina Mussini, Leonard Leibovici, Mical Paul
Background: Gram-negative bacteremia is a major cause of morbidity and mortality in hospitalized patients. Data to guide the duration of antibiotic therapy are limited. Methods: Randomized, multicenter, open-label, non-inferiority trial. Inpatients with Gram-negative bacteremia, afebrile and hemodynamically stable for at least 48 hours, were randomized to receive 7 (intervention) or 14 days (control) of covering antibiotic therapy. Patients with uncontrolled focus of infection were excluded...
December 11, 2018: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://read.qxmd.com/read/26783860/comparison-between-revised-atlanta-classification-and-determinant-based-classification-for-acute-pancreatitis-in-intensive-care-medicine-why-do-not-use-a-modified-determinant-based-classification
#6
MULTICENTER STUDY
Felix Zubia-Olaskoaga, Enrique Maraví-Poma, Iratxe Urreta-Barallobre, María-Rosario Ramírez-Puerta, Mónica Mourelo-Fariña, María-Pilar Marcos-Neira
OBJECTIVE: To compare the classification performance of the Revised Atlanta Classification, the Determinant-Based Classification, and a new modified Determinant-Based Classification according to observed mortality and morbidity. DESIGN: A prospective multicenter observational study conducted in 1-year period. SETTING: Forty-six international ICUs (Epidemiology of Acute Pancreatitis in Intensive Care Medicine study). PATIENTS: Admitted to an ICU with acute pancreatitis and at least one organ failure...
May 2016: Critical Care Medicine
https://read.qxmd.com/read/29736167/mechanisms-and-management-of-acute-pancreatitis
#7
REVIEW
Ari Garber, Catherine Frakes, Zubin Arora, Prabhleen Chahal
Acute pancreatitis represents a disorder characterized by acute necroinflammatory changes of the pancreas and is histologically characterized by acinar cell destruction. Diagnosed clinically with the Revised Atlanta Criteria, and with alcohol and cholelithiasis/choledocholithiasis as the two most prominent antecedents, acute pancreatitis ranks first amongst gastrointestinal diagnoses requiring admission and 21st amongst all diagnoses requiring hospitalization with estimated costs approximating 2.6 billion dollars annually...
2018: Gastroenterology Research and Practice
https://read.qxmd.com/read/29887421/use-of-a-piece-of-free-omentum-to-prevent-bile-leakage-after-subtotal-cholecystectomy
#8
Yoichi Matsui, Satoshi Hirooka, Masaya Kotsuka, So Yamaki, Tomohisa Yamamoto, Hisashi Kosaka, Sohei Satoi
BACKGROUND: Bile leakage after subtotal cholecystectomy (SC) is clinically serious. To prevent such leakage, we developed a new surgical technique in which a free piece of omentum is plugged into the gallbladder stump (omentum plugging technique). We evaluated whether the omentum plugging technique prevents bile leakage after subtotal cholecystectomy. METHODS: Prospectively collected data of patients who had undergone subtotal cholecystectomy without cystic duct closure in the Department of Surgery of Kansai Medical University during the 12 years from January 2006 to March 2018 were reviewed retrospectively...
September 2018: Surgery
https://read.qxmd.com/read/29946347/bologna-guidelines-for-diagnosis-and-management-of-adhesive-small-bowel-obstruction-asbo-2017-update-of-the-evidence-based-guidelines-from-the-world-society-of-emergency-surgery-asbo-working-group
#9
REVIEW
Richard P G Ten Broek, Pepijn Krielen, Salomone Di Saverio, Federico Coccolini, Walter L Biffl, Luca Ansaloni, George C Velmahos, Massimo Sartelli, Gustavo P Fraga, Michael D Kelly, Frederick A Moore, Andrew B Peitzman, Ari Leppaniemi, Ernest E Moore, Johannes Jeekel, Yoram Kluger, Michael Sugrue, Zsolt J Balogh, Cino Bendinelli, Ian Civil, Raul Coimbra, Mark De Moya, Paula Ferrada, Kenji Inaba, Rao Ivatury, Rifat Latifi, Jeffry L Kashuk, Andrew W Kirkpatrick, Ron Maier, Sandro Rizoli, Boris Sakakushev, Thomas Scalea, Kjetil Søreide, Dieter Weber, Imtiaz Wani, Fikri M Abu-Zidan, Nicola De'Angelis, Frank Piscioneri, Joseph M Galante, Fausto Catena, Harry van Goor
Background: Adhesive small bowel obstruction (ASBO) is a common surgical emergency, causing high morbidity and even some mortality. The adhesions causing such bowel obstructions are typically the footprints of previous abdominal surgical procedures. The present paper presents a revised version of the Bologna guidelines to evidence-based diagnosis and treatment of ASBO. The working group has added paragraphs on prevention of ASBO and special patient groups. Methods: The guideline was written under the auspices of the World Society of Emergency Surgery by the ASBO working group...
2018: World Journal of Emergency Surgery: WJES
https://read.qxmd.com/read/30458567/reprocessing-of-flexible-endoscopes-and-endoscopic-accessories-used-in-gastrointestinal-endoscopy-position-statement-of-the-european-society-of-gastrointestinal-endoscopy-esge-and-european-society-of-gastroenterology-nurses-and-associates-esgena-update-2018
#10
Ulrike Beilenhoff, Holger Biering, Reinhard Blum, Jadranka Brljak, Monica Cimbro, Jean-Marc Dumonceau, Cesare Hassan, Michael Jung, Birgit Kampf, Christiane Neumann, Michael Pietsch, Lionel Pineau, Thierry Ponchon, Stanislav Rejchrt, Jean-François Rey, Verona Schmidt, Jayne Tillett, Jeanin E van Hooft
This Position Statement from the European Society of Gastrointestinal Endoscopy (ESGE) and the European Society of Gastroenterology Nurses and Associates (ESGENA) sets standards for the reprocessing of flexible endoscopes and endoscopic devices used in gastroenterology. An expert working group of gastroenterologists, endoscopy nurses, chemists, microbiologists, and industry representatives provides updated recommendations on all aspects of reprocessing in order to maintain hygiene and infection control.
December 2018: Endoscopy
https://read.qxmd.com/read/30423593/performance-measures-for-endoscopy-services-a-european-society-of-gastrointestinal-endoscopy-esge-quality-improvement-initiative
#11
Roland Valori, George Cortas, Thomas de Lange, Omer Salem Balfaqih, Marjon de Pater, Pierre Eisendrath, Premysl Falt, Irfan Koruk, Akiko Ono, Nadan Rustemović, Erik Schoon, Andrew Veitch, Carlo Senore, Cristina Bellisario, Silvia Minozzi, Cathy Bennett, Michael Bretthauer, Mario Dinis-Ribeiro, Dirk Domagk, Cesare Hassan, Michal F Kaminski, Colin J Rees, Cristiano Spada, Raf Bisschops, Mathew Rutter
The European Society of Gastrointestinal Endoscopy (ESGE) and United European Gastroenterology present a list of key performance measures for endoscopy services. We recommend that these performance measures be adopted by all endoscopy services across Europe. The measures include those related to the leadership, organization, and delivery of the service, as well as those associated with the patient journey. Each measure includes a recommendation for a minimum and target standard for endoscopy services to achieve...
December 2018: Endoscopy
https://read.qxmd.com/read/30465238/current-status-of-immunotherapy-in-metastatic-colorectal-cancer
#12
REVIEW
Pawel Wrobel, Shahid Ahmed
BACKGROUND: Immunotherapy focuses on selectively enhancing the host's immune response against malignant disease. It has been investigated as an important treatment modality against malignant disease for many years, but until recently its use was mostly limited to a few cancers. The advent of new immunemodulating agents in the recent past has changed the landscape for management of many solid tumors. Currently, immunotherapy offers a valuable, and in many cases, a more effective alternate to the conventional cytotoxic therapy...
January 2019: International Journal of Colorectal Disease
https://read.qxmd.com/read/21324384/local-anaesthetic-wound-infiltration-following-paediatric-appendicectomy-a-randomised-controlled-trial-time-to-stop-using-local-anaesthetic-wound-infiltration-following-paediatric-appendicectomy
#13
RANDOMIZED CONTROLLED TRIAL
T J Edwards, S J Carty, A S Carr, A W Lambert
OBJECTIVE: This study sought to determine the efficacy of post-operative wound infiltration with local anaesthetic following paediatric appendicectomy. METHOD: In a randomised, controlled, prospective, clinical trial children aged between five and sixteen years were assigned to one of three treatment arms; infiltration of the surgical wound with bupivicaine, saline, or no infiltration. Anaesthetic and analgesic protocols were employed. Patients and observers were blinded to the treatment group...
2011: International Journal of Surgery
https://read.qxmd.com/read/30338444/controversies-and-techniques-in-the-repair-of-abdominal-wall-hernias
#14
Jeffrey A Blatnik, L Michael Brunt
Abdominal wall hernia repair is one of the most common operations done by general surgeons today. Patients with incisional hernias can be extremely challenging to manage due to a number of factors that include obesity, prior hernia repairs, previous mesh placement, loss of domain, and other variables. The approach to patients with incisional hernias has evolved considerably over the last 20 years due to both advances in mesh technology and surgical approaches. Key factors in a successful outcome include modification of risk factors prior to surgery such as smoking cessation and weight reduction, selection of mesh appropriate to the hernia type and planned location of the mesh, and broad overlap of mesh beyond the margins of the hernia defect...
April 2019: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
https://read.qxmd.com/read/30424839/sarcopenia-predicts-poor-outcomes-in-urgent-exploratory-laparotomy
#15
Lisa M Francomacaro, Charles Walker, Kathryn Jaap, James Dove, Marie Hunsinger, Kenneth Widom, Denise Torres, Mohsen Shabahang, Joseph Blansfield, Jeffrey Wild
BACKGROUND: Emergent laparotomies are associated with higher rates of morbidity and mortality. Recent studies suggest sarcopenia predicts worse outcomes in elective operations. The purpose of this study is to examine outcomes following urgent exploratory laparotomy in sarcopenic patients. METHODS: This was a retrospective review of patients in a rural tertiary care facility between 2010 and 2014. Patients underwent a laparotomy within 72 h of admission and had an abdomen/pelvis CT scan were included...
December 2018: American Journal of Surgery
https://read.qxmd.com/read/30446160/pneumomediastinum-in-blunt-trauma-if-aerodigestive-injury-is-not-seen-on-ct-invasive-workup-is-not-indicated
#16
Nicholas G Matthees, James A Mankin, Amy M Trahan, Sharjeel Israr, Michael D Jones, Jonathan L Dameworth, Scott R Petersen, Jordan A Weinberg
BACKGROUND: Pneumomediastinum following blunt trauma is often observed on CT imaging, and concern for associated aerodigestive injury often prompts endoscopy and/or fluoroscopy. In recent years, adoption of multi-detector CT technology has resulted in high resolution images that may clearly identify aerodigestive injuries. The purpose of this study was to evaluate the utility of multi-detector CT in the identification of blunt aerodigestive injuries. METHODS: Over five years, patients with pneumomediastinum following blunt trauma were identified from the registry of a level 1 trauma center...
June 2019: American Journal of Surgery
https://read.qxmd.com/read/30446161/a-randomized-double-blinded-study-to-determine-the-effectiveness-of-utilizing-intraperitoneal-bupivacaine-does-it-reduce-postoperative-opioid-use-following-laparoscopic-appendectomy
#17
Karlin Sevensma, Thomas Schleichert, Caroline Schwickerath, Alan Shoemaker, Clayton Miller
BACKGROUND: Improving postoperative pain control may lead to improved outcomes including decreased opioid use, shorter hospital stays, and improved patient satisfaction. This study examined the effects of instilling intraperitoneal bupivacaine following laparoscopic appendectomy. METHODS: In this prospective, randomized, double-blinded, placebo-controlled study, patients with appendicitis were randomized to receive either the bupivacaine or normal saline instilled at the appendectomy site prior to close...
March 2019: American Journal of Surgery
https://read.qxmd.com/read/30374729/hemodynamic-support-in-the-early-phase-of-septic-shock-a-review-of-challenges-and-unanswered-questions
#18
REVIEW
Olivier Lesur, Eugénie Delile, Pierre Asfar, Peter Radermacher
BACKGROUND: Improving sepsis support is one of the three pillars of a 2017 resolution according to the World Health Organization (WHO). Septic shock is indeed a burden issue in the intensive care units. Hemodynamic stabilization is a cornerstone element in the bundle of supportive treatments recommended in the Surviving Sepsis Campaign (SSC) consecutive biannual reports. MAIN BODY: The "Pandera's box" of septic shock hemodynamics is an eternal debate, however, with permanent contentious issues...
October 29, 2018: Annals of Intensive Care
https://read.qxmd.com/read/30426190/guidelines-for-perioperative-care-in-elective-colorectal-surgery-enhanced-recovery-after-surgery-eras-%C3%A2-society-recommendations-2018
#19
REVIEW
U O Gustafsson, M J Scott, M Hubner, J Nygren, N Demartines, N Francis, T A Rockall, T M Young-Fadok, A G Hill, M Soop, H D de Boer, R D Urman, G J Chang, A Fichera, H Kessler, F Grass, E E Whang, W J Fawcett, F Carli, D N Lobo, K E Rollins, A Balfour, G Baldini, B Riedel, O Ljungqvist
BACKGROUND: This is the fourth updated Enhanced Recovery After Surgery (ERAS® ) Society guideline presenting a consensus for optimal perioperative care in colorectal surgery and providing graded recommendations for each ERAS item within the ERAS® protocol. METHODS: A wide database search on English literature publications was performed. Studies on each item within the protocol were selected with particular attention paid to meta-analyses, randomised controlled trials and large prospective cohorts and examined, reviewed and graded according to Grading of Recommendations, Assessment, Development and Evaluation (GRADE) system...
November 13, 2018: World Journal of Surgery
https://read.qxmd.com/read/30415929/cancel-that-picc-line-order-cholecystostomy-tube-and-short-course-of-antibiotics
#20
Charles Walker, Katelyn Young, Ali Moosavi, Nicholas Molacek, James Dove, Marie Hunsinger, Joseph Blansfield, Kenneth Widom, Denise Torres, James Gregory, Jeffrey Wild
BACKGROUND: Current guidelines do not specifically address optimal antibiotic duration following cholecystostomy. This study compares outcomes for short-course (<7 days) and long-course (≥7 days) antibiotics post-cholecystostomy. METHODS: This was a retrospective review of cholecystostomy patients (≥18 years) admitted (1/1/2007-12/31/2017) to one healthcare system. RESULTS: Overall, 214 patients were studied. Demographics were similar, except short-course patients had higher Charlson Comorbidity Index (p < 0...
March 2019: American Journal of Surgery
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