Salomone Di Saverio, Mauro Podda, Belinda De Simone, Marco Ceresoli, Goran Augustin, Alice Gori, Marja Boermeester, Massimo Sartelli, Federico Coccolini, Antonio Tarasconi, Nicola De' Angelis, Dieter G Weber, Matti Tolonen, Arianna Birindelli, Walter Biffl, Ernest E Moore, Michael Kelly, Kjetil Soreide, Jeffry Kashuk, Richard Ten Broek, Carlos Augusto Gomes, Michael Sugrue, Richard Justin Davies, Dimitrios Damaskos, Ari Leppäniemi, Andrew Kirkpatrick, Andrew B Peitzman, Gustavo P Fraga, Ronald V Maier, Raul Coimbra, Massimo Chiarugi, Gabriele Sganga, Adolfo Pisanu, Gian Luigi De' Angelis, Edward Tan, Harry Van Goor, Francesco Pata, Isidoro Di Carlo, Osvaldo Chiara, Andrey Litvin, Fabio C Campanile, Boris Sakakushev, Gia Tomadze, Zaza Demetrashvili, Rifat Latifi, Fakri Abu-Zidan, Oreste Romeo, Helmut Segovia-Lohse, Gianluca Baiocchi, David Costa, Sandro Rizoli, Zsolt J Balogh, Cino Bendinelli, Thomas Scalea, Rao Ivatury, George Velmahos, Roland Andersson, Yoram Kluger, Luca Ansaloni, Fausto Catena
BACKGROUND AND AIMS: Acute appendicitis (AA) is among the most common causes of acute abdominal pain. Diagnosis of AA is still challenging and some controversies on its management are still present among different settings and practice patterns worldwide. In July 2015, the World Society of Emergency Surgery (WSES) organized in Jerusalem the first consensus conference on the diagnosis and treatment of AA in adult patients with the intention of producing evidence-based guidelines. An updated consensus conference took place in Nijemegen in June 2019 and the guidelines have now been updated in order to provide evidence-based statements and recommendations in keeping with varying clinical practice: use of clinical scores and imaging in diagnosing AA, indications and timing for surgery, use of non-operative management and antibiotics, laparoscopy and surgical techniques, intra-operative scoring, and peri-operative antibiotic therapy...
April 15, 2020: World Journal of Emergency Surgery: WJES
Daniël Pv Lambrichts, Pim P Edomskis, Ruben D van der Bogt, Gert-Jan Kleinrensink, Willem A Bemelman, Johan F Lange
PURPOSE: The optimal surgical approach for perforated diverticulitis with purulent or fecal peritonitis (Hinchey grade III or IV) remains debated. In recent years, accumulating evidence comparing sigmoid resection with primary anastomosis (PA) with the Hartmann's procedure (HP) was presented. Therefore, the aim was to provide an updated and extensive synthesis of the available evidence. METHODS: A systematic search in Embase, MEDLINE, Cochrane, and Web of Science databases was performed...
June 5, 2020: International Journal of Colorectal Disease
Howard Thom, Gill Norman, Nicky J Welton, Emma J Crosbie, Jane Blazeby, Jo C Dumville
Background: Surgical site infections (SSIs) are costly and associated with poorer patient outcomes. Intra-operative surgical site irrigation and intra-cavity lavage may reduce the risk of SSIs through removal of dead or damaged tissue, metabolic waste, and site exudate. Irrigation with antibiotic or antiseptic solutions may further reduce the risk of SSI because of bacteriocidal properties. Randomized controlled trials (RCTs) have been conducted comparing irrigation solutions, but important comparisons (e.g...
April 29, 2020: Surgical Infections
Yalini Vigneswaran, Vivek N Prachand, Mitchell C Posner, Jeffrey B Matthews, Mustafa Hussain
INTRODUCTION: Among surgeons worldwide, a concern with the use of minimally invasive techniques has been raised due to a proposed risk of viral transmission of the coronavirus disease of 2019 (COVID-19) with the creation of pneumoperitoneum. Due to this proposed concern, we sought to collect the available data and evaluate the use of laparoscopy and the risk of COVID-19 transmission. METHODS: A literature review of viral transmission in surgery and of the available literature regarding the transmission of the COVID-19 virus was performed...
April 13, 2020: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
Bita Hazhirkarzar, Pegah Khoshpouri, Mohammadreza Shaghaghi, Mounes Aliyari Ghasabeh, Timothy M Pawlik, Ihab R Kamel
One of the most common cancers worldwide, colorectal cancer (CRC) has been associated with significant morbidity and mortality and therefore represents an enormous burden to the health care system. Recent advances in CRC treatments have provided patients with primary and metastatic CRC a better long-term prognosis. The presence of synchronous or metachronous metastasis has been associated, however, with worse survival. The most common site of metastatic disease is the liver. A variety of treatment modalities aimed at targeting colorectal liver metastases (CRLM) has been demonstrated to improve the prognosis of these patients...
February 2020: Hepatobiliary Surgery and Nutrition
Arden M Morris, Scott E Regenbogen, Karin M Hardiman, Samantha Hendren
IMPORTANCE: Diverticulitis is a common disease. Recent changes in understanding its natural history have substantially modified treatment paradigms. OBJECTIVE: To review the etiology and natural history of diverticulitis and recent changes in treatment guidelines. EVIDENCE REVIEW: We searched the MEDLINE and Cochrane databases for English-language articles pertaining to diagnosis and management of diverticulitis published between January 1, 2000, and March 31, 2013...
January 15, 2014: JAMA: the Journal of the American Medical Association
Marissa K Srour, Joshua Tseng, Michael Luu, Rodrigo F Alban, Armando E Giuliano, Alice Chung
BACKGROUND: The American College of Surgeons Oncology Group (ACOSOG) Z1071 and Sentinel Neoadjuvant (SENTINA) trials of sentinel node biopsy for node-positive breast cancer treated with neoadjuvant chemotherapy (NAC) demonstrated false-negative rates that varied on the basis of surgical technique. This study evaluated trends in axillary operations before and after publication of these trials. METHODS: This study analyzed patients from National Cancer Database (NCDB) with clinical T0 through T4, N1 and N2, M0 breast cancer who received NAC from 1 January 2012 to 31 December 2015 and sentinel lymph node biopsy (SNB) or axillary lymph node dissection (ALND)...
October 2019: Annals of Surgical Oncology
Ingrid G M Poodt, Coco J E F Walstra, Guusje Vugts, Adriana J G Maaskant-Braat, Adri C Voogd, Robert-Jan Schipper, Grard A P Nieuwenhuijzen
BACKGROUND: Unlike sentinel lymph node biopsy (SLNB) in the primary setting, the repeat SLNB (rSLNB) in patients with ipsilateral breast tumor recurrence (IBTR) is challenging, because it is difficult to visualize and/or harvest a sentinel lymph node in every patient. Regional treatments options and safety in terms of regional disease control after such an unsuccessful rSLNB remain unclear. This study assesses factors associated with the performance of axillary lymph node dissection (ALND) after unsuccessful rSLNB and evaluates the occurrence of regional recurrences...
August 2019: Annals of Surgical Oncology
Dominique Farge, Corinne Frere, Jean M Connors, Cihan Ay, Alok A Khorana, Andres Munoz, Benjamin Brenner, Ajay Kakkar, Hanadi Rafii, Susan Solymoss, Dialina Brilhante, Manuel Monreal, Henri Bounameaux, Ingrid Pabinger, James Douketis
Venous thromboembolism (VTE) is the second leading cause of death in patients with cancer. These patients are at a high risk of VTE recurrence and bleeding during anticoagulant therapy. The International Initiative on Thrombosis and Cancer is an independent academic working group aimed at establishing a global consensus for the treatment and prophylaxis of VTE in patients with cancer. The International Initiative on Thrombosis and Cancer last updated its evidence-based clinical practice guidelines in 2016 with a free, web-based mobile phone application, which was subsequently endorsed by the International Society on Thrombosis and Haemostasis...
September 3, 2019: Lancet Oncology
Michael D Alvarado, Elizabeth A Mittendorf, Mediget Teshome, Alastair M Thompson, Richard J Bold, Mark A Gittleman, Peter D Beitsch, Sarah L Blair, Kaisa Kivilaid, Quentin J Harmer, Kelly K Hunt
BACKGROUND: Sentinel lymph node biopsy (SLNB) is a highly accurate method for staging the axilla in early breast cancer. Superparamagnetic iron oxide mapping agents have been explored to overcome the disadvantages of the standard SLNB technique, which uses a radioisotope tracer with or without blue dye. One such agent, Sienna+, was shown to be non-inferior to the standard technique for SLNB in a number of studies. The SentimagIC trial was designed to establish the non-inferiority of a new formulation of this magnetic tracer, Magtrace (formerly SiennaXP)...
October 2019: Annals of Surgical Oncology
Loris Pironi, Anna Simona Sasdelli
Chronic intestinal pseudo-obstruction (CIPO) is a severe form of intestinal dysmotility disorder, characterized by the impairment of gastrointestinal propulsion of the gut content in the absence of fixed occluding lesions. CIPO is a rare disease that can develop in both children and adults. CIPO is classified as primary/idiopathic, when no underlying disorder is demonstrated, or secondary, when related to systemic diseases. Diagnosis relies on the finding of chronic/recurrent obstructive type symptoms with radiological features of dilated intestine with air/fluid levels without any lumen occluding lesion...
December 2019: Gastroenterology Clinics of North America
Neena S Abraham
The management of antiplatelet and anticoagulant (ie, antithrombotic) agents is challenging in the periendoscopic setting. In this state-of-the-art update, we review current best practice recommendations focusing on the risk of immediate and delayed postpolypectomy bleeding in the context of drug discontinuation (ie, temporary interruption) and drug continuation. The data regarding polypectomy technique (cold snare vs conventional thermal-based) and prophylactic placement of hemostatic clips are evaluated to assess whether these endoscopic techniques are beneficial in reducing postpolypectomy bleeding...
February 2020: Gastrointestinal Endoscopy
Krislynn M Mueck, Shuyan Wei, Claudia Pedroza, Karla Bernardi, Margaret L Jackson, Mike K Liang, Tien C Ko, Jon E Tyson, Lillian S Kao
INTRODUCTION: Early cholecystectomy shortly after admission for mild gallstone pancreatitis has been proposed based on observational data. We hypothesized that cholecystectomy within 24 hours of admission versus after clinical resolution of gallstone pancreatitis that is predicted to be mild results in decreased length-of-stay (LOS) without an increase in complications. METHODS: Adults with predicted mild gallstone pancreatitis were randomized to cholecystectomy with cholangiogram within 24 hours of presentation (early group) versus after clinical resolution (control) based on abdominal exam and normalized laboratory values...
September 2019: Annals of Surgery
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
Joaquín Rodríguez Sánchez, Mónica Sánchez Alonso, María Pellisé Urquiza
No abstract text is available yet for this article.
August 2019: Endoscopy
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
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
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: This was a randomized, multicenter, open-label, noninferiority trial. Inpatients with gram-negative bacteremia, who were afebrile and hemodynamically stable for at least 48 hours, were randomized to receive 7 days (intervention) or 14 days (control) of covering antibiotic therapy. Patients with uncontrolled focus of infection were excluded...
September 13, 2019: Clinical Infectious Diseases
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
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
2019-01-03 15:36:32
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