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Intravenous antibiotic therapy after laparoscopic appendectomy in acute complicated appendicitis: the patient clinical response is the key
CONCLUSION: 48 patients with ACA intraoperative findings were included. Regarding postoperative antibiotic management, only preoperative IVA: 7 (14.58%), IVA 1-3 days: 1 (20.83%), IVA 1-3 days and change to OA: 21 (43.75%), IVA > 3 days: 6 (12.5%), and only OA: 3 (27.08%). The bivariate analysis did not show statistically significant differences in reconsultation (p = 0.81), rehospitalization (p = 0.44), and surgical site infection (p = 0.56) between the antibiotic scheme based on the postoperative clinical response and the traditional one regarding intra-abdominal collection rate, the hospital stays, and hospitalizatio...
Source: Cirugia y Cirujanos - September 7, 2023 Category: Surgery Authors: Andres Mendoza-Zuchini Laura C Arce-Polania Carlos J P érez-Rivera Source Type: research

Frailty is associated with increased waiting time for relevant process-of-care measures; findings from the Emergency Laparoscopic and Laparotomy Scottish audit (ELLSA)
Br J Surg. 2021 Nov 9:znab371. doi: 10.1093/bjs/znab371. Online ahead of print.NO ABSTRACTPMID:34750619 | DOI:10.1093/bjs/znab371
Source: The British Journal of Surgery - November 9, 2021 Category: Surgery Authors: Euan A Ramsay Ben Carter Roy L Soiza Siobhan Duffy Susan J Moug Phyo K Myint Source Type: research

Interventions to reduce waiting times for elective procedures.
CONCLUSIONS: As only a handful of low-quality studies are presently available, we cannot draw any firm conclusions about the effectiveness of the evaluated interventions in reducing waiting times. However, interventions involving the provision of more accessible services (open access or direct booking/referral) show some promise. PMID: 25706039 [PubMed - as supplied by publisher]
Source: Cochrane Database of Systematic Reviews - February 23, 2015 Category: Journals (General) Authors: Ballini L, Negro A, Maltoni S, Vignatelli L, Flodgren G, Simera I, Holmes J, Grilli R Tags: Cochrane Database Syst Rev Source Type: research

Early versus delayed laparoscopic cholecystectomy for uncomplicated biliary colic.
CONCLUSIONS: Based on evidence from only one high-bias risk trial, it appears that early laparoscopic cholecystectomy (less than 24 hours after diagnosis of biliary colic) decreases the morbidity during the waiting period for elective laparoscopic cholecystectomy (mean waiting time 4.2 months), the hospital stay, and operating time. Further randomised clinical trials are necessary to confirm or refute these findings, and to determine if early laparoscopic cholecystectomy is better than the delayed laparoscopic cholecystectomy if the waiting time is shortened further. PMID: 23813478 [PubMed - in process]
Source: Cochrane Database of Systematic Reviews - July 6, 2013 Category: Journals (General) Authors: Gurusamy KS, Koti R, Fusai G, Davidson BR Tags: Cochrane Database Syst Rev Source Type: research

Early versus delayed laparoscopic cholecystectomy for people with acute cholecystitis.
CONCLUSIONS: We found no significant difference between early and late laparoscopic cholecystectomy on our primary outcomes. However, trials with high risk of bias indicate that early laparoscopic cholecystectomy during acute cholecystitis seems safe and may shorten the total hospital stay. The majority of the important outcomes occurred rarely, and hence the confidence intervals are wide. It is unlikely that future randomised clinical trials will be powered to measure differences in bile duct injury and other serious complications since this might involve performing a trial of more than 50,000 people, but several smaller ...
Source: Cochrane Database of Systematic Reviews - July 6, 2013 Category: Journals (General) Authors: Gurusamy KS, Davidson C, Gluud C, Davidson BR Tags: Cochrane Database Syst Rev Source Type: research