0000000000168910
AUTHOR
Matteo Rottoli
Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries
Background: Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods: This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, r…
Elective surgery system strengthening: development, measurement, and validation of the surgical preparedness index across 1632 hospitals in 119 countries
© 2022 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 licenseBackground: The 2015 Lancet Commission on global surgery identified surgery and anaesthesia as indispensable parts of holistic health-care systems. However, COVID-19 exposed the fragility of planned surgical services around the world, which have also been neglected in pandemic recovery planning. This study aimed to develop and validate a novel index to support local elective surgical system strengthening and address growing backlogs. Methods: First, we performed an international consultation through a four-stage consensus process to develop a multidomain index for hospital-level assess…
SARS-CoV-2 infection and venous thromboembolism after surgery: an international prospective cohort study
SARS-CoV-2 has been associated with an increased rate of venous thromboembolism in critically ill patients. Since surgical patients are already at higher risk of venous thromboembolism than general populations, this study aimed to determine if patients with peri-operative or prior SARS-CoV-2 were at further increased risk of venous thromboembolism. We conducted a planned sub-study and analysis from an international, multicentre, prospective cohort study of elective and emergency patients undergoing surgery during October 2020. Patients from all surgical specialties were included. The primary outcome measure was venous thromboembolism (pulmonary embolism or deep vein thrombosis) within 30 da…
Risk factors for locally advanced cancer associated with ulcerative colitis: Results of a retrospective multicentric study in the era of biologics
Abstract Background Patients affected by ulcerative colitis (UC) are more likely to develop colorectal cancer, and are often diagnosed with lymph node involvement (N+) at surgery. Aim To identify the risk factors for N+ cancer in UC patients. Methods Patients undergoing surgery from 2001 to 2018 in six European tertiary centres were included. N+ patients were compared to the control group (N−) for clinical variables. The evaluation of risk factors for N+ was assessed using univariate and multivariable logistic regression analyses. Results A total of 130 patients were included. Median duration of disease was 21 years (1–52). Forty patients (30.8%) were N+ at surgery. Eighteen (13.8%) develop…
P145 Inflammatory Bowel Disease patients requiring surgery can be treated in referral centres regardless of the COVID-19 status of the hospital: results of a multicentric European study during the first COVID-19 outbreak (COVIBD-Surg)
Abstract Background Little is known regarding the outcomes of inflammatory bowel disease (IBD) patients who required surgery during the outbreak of Coronavirus disease 19 (COVID-19). This study aimed to compare outcomes of IBD patients undergoing surgery in COVID-19-treatment and COVID-19-free hospitals. Methods Retrospective study involving patients undergoing IBD surgery in seven centres (six COVID-19-treatment hubs and one COVID-free hospital) across 5 European countries during the period of highest reduction of elective activity due to the first peak of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections. Predictive variables of the risk of moderate-to-severe postope…
Chirurgie des maladies inflammatoires chroniques de l’intestin et COVID-19 : étude européenne multicentrique (COVIBD-SURG)
But Comparer les resultats postoperatoires des patients operes d’une maladie inflammatoire chronique de l’intestin (MICI) pendant l’epidemie de coronavirus-19 (COVID-19) dans des hopitaux avec (HC19) ou sans patients COVID-19 (HSC19). Methodes Etude retrospective dans 7 centres europeens (six HC19 et un HSC19) pendant le premier pic de COVID-19. Les variables predictives du risque de complications postoperatoires ont ete analysees a l’aide d’une analyse de regression logistique. Resultats Quatre-vingt-onze patients (59 hommes, 65 %) ont ete operes d’une maladie de Crohn (54, 59 %) ou d’une rectocolite hemorragique (37, 41 %) : 66 (73 %) dans des HC19 et 25 (27 %) dans l’HSC19. Une proportio…