The Operating Room management for emergency Surgical Activity (ORSA) study: a WSES international survey
ConclusionsThere is no dedicated emergency OR in the majority of hospitals internationally. Elective surgical procedures are usually postponed or even cancelled to perform emergency surgery. It is a priority to validate an effective universal triaging and scheduling system to allocate emergency surgical procedures. The new Timing in Acute Care Surgery (TACS) was recently proposed and validated by a Delphi consensus as a clear and reproducible triage tool to timely perform an emergency surgical procedure according to the clinical severity of the surgical disease. The new TACS needs to be prospectively validated in clinical ...
Source: Updates in Surgery - January 8, 2024 Category: Surgery Source Type: research
Locally advanced mid/low rectal cancer with synchronous resectable liver metastases: systematic review of the available strategies and outcome
In conclusion, different strategies can be adopted, but RT should be included to decrease the pelvic recurrence risk. LFA should be considered , especially in patients with high hepatic tumor burden, and RT before liver surgery (interval strategy) could maximize its completion rate. (Source: Updates in Surgery)
Source: Updates in Surgery - January 5, 2024 Category: Surgery Source Type: research
Combined application of gluteus maximus muscle flaps and random pattern skin flaps in repairing sacrococcygeal sinus tracts: a prospective study and technical note
ConclusionThe combined application of GMMFs and RPSFs for the treatment of sacrococcygeal sinus tracts gains the advantages of short operative time, quick postoperative recovery, and low postoperative recurrence rate. (Source: Updates in Surgery)
Source: Updates in Surgery - January 4, 2024 Category: Surgery Source Type: research
Free perforation during the first episode of acute diverticulitis: can it be avoided?
AbstractThe aims of the present study are to compare the severity of acute diverticulitis in the first episode and in later bouts, and to determine whether there are risk factors for the presence of free perforation at the onset of diverticulitis. A single-center retrospective study was conducted of patients who developed a first episode of acute diverticulitis between January 2011 and August 2021 diagnosed by computed tomography and followed up for at least 1 year. Free perforation was considered to be present in patients with diverticulitis stage III and IV according to the Hinchey classification (modified by Wasvary)....
Source: Updates in Surgery - January 3, 2024 Category: Surgery Source Type: research
Mining and validation of prognosis of various visceral metastasis in renal cell carcinoma: a study based on SEER database
AbstractOur study was aimed to analyze a substantial of renal cell carcinoma (RCC) patients, research the high-risk factors and prognostic factors of metastasis, and thoroughly examine the effects of primary site surgery, lymph node dissection (LND), and chemotherapy on the prognosis of different visceral metastases. The baseline characteristics were characterized, and logistic regression was used to predict the risk factors for metastasis. Prognostic factors of metastatic RCC were assessed using batch univariate and multivariate Cox regression, with adjustments made through PSM. Next, the Kaplan –Meier method was employ...
Source: Updates in Surgery - January 2, 2024 Category: Surgery Source Type: research
Acute cholecystitis management in high-risk, critically ill, and unfit-for-surgery patients: the Italian Society of Emergency Surgery and Trauma (SICUT) guidelines
AbstractDealing with acute cholecystitis in high-risk, critically ill, and unfit-for-surgery patients is frequent during daily practice and requires complex management. Several procedures exist to postpone and/or prevent surgical intervention in those patients who temporarily or definitively cannot undergo surgery. After a systematic review of the literature, an expert panel from the Italian Society of Emergency Surgery and Trauma (SICUT) discussed the different issues and statements in subsequent rounds. The final version of the statements was discussed during the annual meeting in Rome (September 2022). The present paper...
Source: Updates in Surgery - December 28, 2023 Category: Surgery Source Type: research
Adhesive small bowel obstruction: predictive factors of laparoscopic failure
AbstractThe adoption of laparoscopy for the management of adhesive small bowel obstruction (ASBO) patients is debated. The laparoscopic approach has been associated with a considerable conversion-to-open rate. Nonetheless, reliable predictors of conversion are still unclear. The present study aimed to identify factors associated with conversion to open in ASBO patients who underwent laparoscopic surgery. Patients who underwent laparoscopic surgery for ASBO and were admitted to our unit between December 2014 and October 2022 were retrospectively evaluated. The patients were categorized into two groups: patients who underwen...
Source: Updates in Surgery - December 27, 2023 Category: Surgery Source Type: research
Thrombosed external hemorrhoids during pregnancy: surgery versus conservative treatment
This study aims to compare efficacy and safety of conservative versus surgical treatment of acute TEH in pregnant women. Furthermore, the outcome of two different surgical approaches was evaluated. This is a prospective observational study including a sub-analysis on two randomized groups of pregnant women affected by TEH. The primary outcome measured was the impact of conservative and surgical treatment defined in terms of VAS, clinical patient grading assessment scale (CPGAS) and the SF-12 questionnaire. In a randomized sub-analysis of the surgical treatment, the outcome of local excision (LE) versus thrombectomy (TE) wa...
Source: Updates in Surgery - December 27, 2023 Category: Surgery Source Type: research
A new scoring system on the horizon to assess fecal incontinence: Garg Incontinence Scores (GIS)
(Source: Updates in Surgery)
Source: Updates in Surgery - December 27, 2023 Category: Surgery Source Type: research
Impact of robotic total mesorectal excision upon pathology metrics in overweight males with low rectal cancer: a pooled analysis of 836 cases
AbstractThe aim of this pooled analysis was to evaluate the impact of robotic total mesorectal excision (TME) on pathology metrics in Male Overweight patients with Low rectal cancer (MOL). This was a multicenter retrospective pooled analysis of data. Two groups were defined: MOL (Male, Overweight, Low rectal cancer) and non-MOL. Overweight was defined as BMI ≥ 25 kg/m2. Low rectal cancer was defined as cancer within 6 cm from the anal verge. The primary endpoints of this study were histopathological metrics, namely circumferential resection margin (CRM) (mm), CRM involvement rate (%), and the quality of TME. Circ...
Source: Updates in Surgery - December 26, 2023 Category: Surgery Source Type: research
Emergency laparotomy and perioperative COVID-19: a single-center retrospective cohort study
In this study, 50 patients in the COVID-19 group and 91 patients in the non-COVID-19 group were assessed. The 30-day mortality in the COVID-19 group was significantly higher than in the non-COVID-19 group (34% vs. 12.1%, respectively,P = 0.004). Postoperative complications were significantly higher in the COVID-19 group (64% vs. 26.4%,P < 0.001). The frequency of ICU admission and need for re-operation were significantly higher in the COVID-19 group (P = 0.003 andP = 0.039, respectively). Length of hospital stay was significantly lower in the non-COVID-19 group (P = 0.021). In patients with confirme...
Source: Updates in Surgery - December 26, 2023 Category: Surgery Source Type: research
Textbook outcome as indicator of surgical quality in a single Western center: results from 300 consecutive gastrectomies
This study was conducted to analyze the TO and TOO of patients with gastric adenocarcinoma who underwent surgery at our center. Data from a prospective database of patients operated on for gastric adenocarcinoma between September 2018 and September 2022 were analyzed. Postoperative management followed Enhanced Recovery After Surgery guidelines. The Dutch Upper Gastrointestinal Cancer Audit group defined TO as a multidimensional measure (10 items). TOO also considers guideline-accordant chemotherapeutic compliance. Three hundred patients underwent surgery during the study period (167 men, 133 women). One hundred seventy-six...
Source: Updates in Surgery - December 25, 2023 Category: Surgery Source Type: research
Initial experience of robotically assisted endometriosis surgery with a novel robotic system: first case series in a tertiary care center
AbstractEndometriosis is a benign disease requiring surgery if medical treatment can not achieve symptom control. Laparoscopy remains the gold standard and robotic assistance can be beneficial in complex cases. Robot-assisted radical endometriosis excision using the Hugo™ RAS system is a novel approach. The aim of this study is to describe its setting and outcomes in a series of patients in a robotic surgery center. Endometriosis patients who consecutively underwent robot-assisted surgery with the Hugo™ RAS system (Medtronic, USA) were retrospectively enrolled. Disease-specific symptoms before and after surgery, endo...
Source: Updates in Surgery - December 22, 2023 Category: Surgery Source Type: research
Total thyroidectomy versus unilateral lobectomy for unilateral multifocal papillary thyroid carcinoma: systematic review and meta ‑analysis
AbstractThe optimal surgical procedure(s) for unilateral multifocal papillary thyroid carcinomas is currently controversial. As such, the present study aimed to compare the efficacies of total thyroidectomy and lobectomy in patients with unilateral multifocal papillary thyroid carcinoma. A literature search of the PubMed/Medline, Embase, Web of Science, Cochrane Library, Wan Fang, and Zhi Wang databases for relevant studies, published from inception to October 31, 2022, was performed. Two researchers independently extracted data from the included studies. Lymph node metastasis, vocal fold paralysis, parathyroid injury, pos...
Source: Updates in Surgery - December 21, 2023 Category: Surgery Source Type: research
The management of low trans-sphincteric anal fistula during the COVID-19 pandemic: revisiting the role of the seton
This study aimed to evaluate the safety and effectiveness of the slow cutting seton technique for TAF performed in an outpatient setting during the COVID-19 pandemic.Patients treated for TAF between January 2020 and July 2022 and followed-up for at least 12 months were retrospectively evaluated. A vascular silicone tie used as seton was positioned in the fistula tract using a Lockhart–Mummery fistula probe. The seton was maintained in moderate tension until the sphincter muscle was passed. Percentage and time for healing, recurrence, SF-36, VAS and Vaizey’s Score were recorded.Fifty-eight patients [36 male/22 female,...
Source: Updates in Surgery - December 21, 2023 Category: Surgery Source Type: research
