0000000001153033

AUTHOR

Luca Ansaloni

showing 12 related works from this author

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

2023

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…

general surgeryacute care surgerySettore MED/18 - CHIRURGIA GENERALEclimate change; trauma; general surgery; acute care surgerySettore MED/40 - Ginecologia E Ostetriciaenvironmental impactsurgerySettore MED/31 - Otorinolaringoiatriaclimate changetraumaNoneMedicine and Health SciencesSurgeryoperating theatreenvironment
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Global economic burden of unmet surgical need for appendicitis

2022

Abstract Background There is a substantial gap in provision of adequate surgical care in many low- and middle-income countries. This study aimed to identify the economic burden of unmet surgical need for the common condition of appendicitis. Methods Data on the incidence of appendicitis from 170 countries and two different approaches were used to estimate numbers of patients who do not receive surgery: as a fixed proportion of the total unmet surgical need per country (approach 1); and based on country income status (approach 2). Indirect costs with current levels of access and local quality, and those if quality were at the standards of high-income countries, were estimated. A human capita…

surgical unmetneedno keywords listedsurgical unmetneed; appendicitis; global surgeryFinancial StressHealth Care Costsglobal surgeryAppendicitisFinancial StreHealth Care CostCost of IllnessHumansappendicitiseconomic burden surgerySurgeryAppendicitiHuman
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Laparoscopic approach to acute abdomen from the Consensus Development Conference of the Società Italiana di Chirurgia Endoscopica e nuove tecnologie …

2012

Abstract BACKGROUND: In January 2010, the SICE (Italian Society of Endoscopic Surgery), under the auspices of the EAES, decided to revisit the clinical recommendations for the role of laparoscopy in abdominal emergencies in adults, with the primary intent being to update the 2006 EAES indications and supplement the existing guidelines on specific diseases. METHODS: Other Italian surgical societies were invited into the Consensus to form a panel of 12 expert surgeons. In order to get a multidisciplinary panel, other stakeholders involved in abdominal emergencies were invited along with a patient's association. In November 2010, the panel met in Rome to discuss each chapter according to the D…

medicine.medical_specialtyDigestive System DiseasesPosturelaparoscopyEndoscopic surgeryGuidelineEmergency treatmentDigestive System DiseasePositive-Pressure RespirationRespiratory Physiological Processeacute abdomenIschemiaPregnancyimmune system diseasesVascular DiseasemedicineHumansAnesthesiaVascular DiseasesHemodynamicObesityPositive-Pressure RespirationEmergency TreatmentMonitoring PhysiologicRandomized Controlled Trials as Topiclaparoscopy; acute abdomen; surgeryAbdomen Acutebusiness.industryPatient SelectionGeneral surgeryHemodynamicsAcute surgeryPregnancy ComplicationSurgeryPregnancy ComplicationsSettore MED/18 - Chirurgia GeneraleMesenteric IschemiaRespiratory Physiological PhenomenaFemaleSurgeryLaparoscopy – Acute abdomen – GuidelinesbusinessGenital Diseases FemaleHumanSurgical Endoscopy
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2017 WSES guidelines for the management of iatrogenic colonoscopy perforation

2017

Abstract Iatrogenic colonoscopy perforation (ICP) is a severe complication that can occur during both diagnostic and therapeutic procedures. Although 45–60% of ICPs are diagnosed by the endoscopist while performing the colonoscopy, many ICPs are not immediately recognized but are instead suspected on the basis of clinical signs and symptoms that occur after the endoscopic procedure. There are three main therapeutic options for ICPs: endoscopic repair, conservative therapy, and surgery. The therapeutic approach must vary based on the setting of the diagnosis (intra- or post-colonoscopy), the type of ICP, the characteristics and general status of the patient, the operator’s level of experienc…

MaleIatrogenic DiseaseColonoscopyReviewIatrogenic colonoscopy perforation0302 clinical medicine80 and overOpen abdomenAged 80 and overintegumentary systemmedicine.diagnostic_testmusculoskeletal neural and ocular physiologylcsh:Medical emergencies. Critical care. Intensive care. First aidDisease ManagementIatrogenic colonoscopy perforation Colonoscopy Gastrointestinal endoscopy Emergency surgery Laparoscopy Antibiotic therapy Intra-abdominal infection Open abdomenColonoscopyMiddle Agedhumanities030220 oncology & carcinogenesisEmergency surgeryEmergency MedicineFemale030211 gastroenterology & hepatologymedicine.medical_specialtyColonPerforation (oil well)lcsh:SurgeryGuidelines as TopicSigns and symptomsGeneral status03 medical and health sciencesTherapeutic approachIntra-abdominal infectionEmergency surgerymedicineHumansGastrointestinal endoscopyIntensive care medicineAgedbusiness.industrylcsh:RD1-811lcsh:RC86-88.9Antibiotic therapyEndoscopic Procedurenervous system diseasesSettore MED/18 - Chirurgia GeneraleIntestinal PerforationAntibiotic therapy; Colonoscopy; Emergency surgery; Gastrointestinal endoscopy; Iatrogenic colonoscopy perforation; Intra-abdominal infection; Laparoscopy; Open abdomen; Aged; Aged 80 and over; Colon; Colonoscopy; Disease Management; Female; Humans; Intestinal Perforation; Male; Middle Aged; Guidelines as Topic; Iatrogenic DiseaseAntibiotic therapy; Colonoscopy; Emergency surgery; Gastrointestinal endoscopy; Iatrogenic colonoscopy perforation; Intra-abdominal infection; Laparoscopy; Open abdomen;LaparoscopySurgerySurgical devicebusiness
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Frailty and emergency surgery in the elderly: protocol of a prospective, multicenter study in Italy for evaluating perioperative outcome (The FRAILES…

2018

Improvements in living conditions and progress in medical management have resulted in better quality of life and longer life expectancy. Therefore, the number of older people undergoing surgery is increasing. Frailty is often described as a syndrome in aged patients where there is augmented vulnerability due to progressive loss of functional reserves. Studies suggest that frailty predisposes elderly to worsening outcome after surgery. Since emergency surgery is associated with higher mortality rates, it is paramount to have an accurate stratification of surgical risk in such patients. The aim of our study is to characterize the clinicopathological findings, management, and short-term outcom…

Elderly patient; Emergency surgery; Frailty; Geriatric; Risk assessment; Scores; Aged; Aged 80 and over; Clinical Protocols; Emergencies; Female; Frailty; Humans; Italy; Logistic Models; Male; Multivariate Analysis; Outcome Assessment Health Care; Postoperative Complications; Prognosis; Prospective Studies; ROC Curve; Risk Assessment; Frail ElderlyMaleOutcome Assessment030230 surgerylaw.invention0302 clinical medicinePostoperative ComplicationsQuality of lifeClinical ProtocolslawOutcome Assessment Health Care80 and overProspective StudiesProspective cohort studyMultivariate AnalysiAged 80 and overEmergencieFrailtyMortality rateScoreScoresPrognosisIntensive care unitElderly patient; Emergency surgery; Frailty; Geriatric; Risk assessment; Scores; Aged; Aged 80 and over; Clinical Protocols; Emergencies; Female; Frailty; Humans; Italy; Logistic Models; Male; Multivariate Analysis; Outcome Assessment (Health Care); Postoperative Complications; Prognosis; Prospective Studies; ROC Curve; Risk Assessment; Frail ElderlyItaly030220 oncology & carcinogenesiselderly patient emergency surgery frailty geriatric risk assessment scoresEmergency surgeryFemaleRisk assessmentElderly patientHumanmedicine.medical_specialtyElderly patient; Emergency surgery; Frailty; Geriatric; Risk assessment; Scores;Logistic ModelPrognosiFrail ElderlyRisk AssessmentNO03 medical and health sciencesOutcome Assessment (Health Care)medicineHumansClinical ProtocolAgedbusiness.industryPerioperativeElderly patient; Emergency surgery; Frailty; Geriatric; Risk assessment; ScoresSurgeryHealth CareProspective StudieSettore MED/18 - Chirurgia GeneraleLogistic ModelsROC CurveEmergency medicineMultivariate AnalysisLife expectancyObservational studySurgeryPostoperative ComplicationEmergenciesbusinessGeriatric
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Global variation in anastomosis and end colostomy formation following left-sided colorectal resection

2019

Background: End colostomy rates following colorectal resection vary across institutions in high-income settings, being influenced by patient, disease, surgeon and system factors. This study aimed to assess global variation in end colostomy rates after left-sided colorectal resection. Methods: This study comprised an analysis of GlobalSurg-1 and -2 international, prospective, observational cohort studies (2014, 2016), including consecutive adult patients undergoing elective or emergency left-sided colorectal resection within discrete 2-week windows. Countries were grouped into high-, middle- and low-income tertiles according to the United Nations Human Development Index (HDI). Factors associ…

Malemodelos logísticosmedicine.medical_treatmenthumanossurgial careColorectal Neoplasmpaíses desarrolladosLogistic regressionoutcomesGlobal Healthurgencias médicas0302 clinical medicinepaíses en desarrolloSurgicalestudios prospectivosColostomy80 and overglobalsurg030212 general & internal medicineProspective StudiesProspective cohort studyMultivariate Analysimediana edadCancerAged 80 and overEmergencieancianoAnastomosis colorectal resection colostomyAnastomosis SurgicalColostomyGeneral MedicineMiddle Agedadultocolostomy; colorectal cancer; human developlment index3. Good healthColo-Rectal Cancertraditional healersElective Surgical Procedures030220 oncology & carcinogenesisFemaleColorectal Neoplasms6.4 Surgerylow incomeCohort studyHumanDeveloped CountrieAdultAdult; Aged; Aged 80 and over; Anastomosis Surgical; Colorectal Neoplasms; Colostomy; Elective Surgical Procedures; Emergencies; Female; Global Health; Humans; Logistic Models; Male; Middle Aged; Multivariate Analysis; Prospective Studies; Developed Countries; Developing Countriesmedicine.medical_specialtyneoplasias colorrectalesLogistic Modelcancer anastomosis surgical income stomas colostomy procedure colorectal resection end colostomy emergency surgical procedure human development indexdelayAnastomosishuman developlment indexPerforation (oil well)lcsh:Surgerycolorectal cancerAnastomosisGlobalSurg CollaborativeNO03 medical and health sciencesCase mix indexClinical ResearchmedicinecancerHumansanálisis multifactorialDeveloping CountriesAgedemergency abdominal surgery low income surgial care traditional healers cancer mortality outcomes delayElective Surgical Procedurebusiness.industryKirurgiDeveloped Countriesleft colon resection anastomosis end colostomyEvaluation of treatments and therapeutic interventionslcsh:RD1-811Odds ratiomortalitySurgeryProspective StudieLogistic ModelsMultivariate AnalysisSurgeryEmergenciesbusinessDigestive Diseasescolostomíaemergency abdominal surgery
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Global validation of the WSES Sepsis Severity Score for patients with complicated intra-abdominal infections : a prospective multicentre study (WISS …

2015

BACKGROUND: To validate a new practical Sepsis Severity Score for patients with complicated intra-abdominal infections (cIAIs) including the clinical conditions at the admission (severe sepsis/septic shock), the origin of the cIAIs, the delay in source control, the setting of acquisition and any risk factors such as age and immunosuppression. ----- METHODS: The WISS study (WSES cIAIs Score Study) is a multicenter observational study underwent in 132 medical institutions worldwide during a four-month study period (October 2014-February 2015). Four thousand five hundred thirty-three patients with a mean age of 51.2 years (range 18-99) were enrolled in the WISS study. ----- RESULTS: Univariate…

medicine.medical_specialtyInfections; Intra-abdominal; Sepsis; Septic shock:Ciências da Saúde [Ciências Médicas]Infections; Intra-abdominal; Sepsis; Septic shock; Surgery; Emergency MedicineCiências Médicas::Ciências da SaúdeSepsimedicine.medical_treatment/macromolecular substances030230 surgeryGUIDELINESInfectionsLikelihood ratios in diagnostic testingSepsisPERITONITIS03 medical and health sciencesPROGNOSTIC-FACTORS0302 clinical medicineInternal medicineSepsisSeptic shockMedicine and Health SciencesMANAGEMENTmedicineIntra-abdominalIntra-abdominal SepsisUnivariate analysisScience & TechnologyCOLONIC PERFORATIONReceiver operating characteristicbusiness.industrySeptic shockAbdominal InfectionImmunosuppression3126 Surgery anesthesiology intensive care radiologymedicine.disease3. Good healthSurgery030220 oncology & carcinogenesisInfections Intra-abdominal Sepsis; Septic shockEmergency MedicineSurgeryObservational studyInfectionbusinessSYSTEMResearch Article
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Team dynamics in emergency surgery teams: results from a first international survey

2021

Abstract Background Emergency surgery represents a unique context. Trauma teams are often multidisciplinary and need to operate under extreme stress and time constraints, sometimes with no awareness of the trauma’s causes or the patient’s personal and clinical information. In this perspective, the dynamics of how trauma teams function is fundamental to ensuring the best performance and outcomes. Methods An online survey was conducted among the World Society of Emergency Surgery members in early 2021. 402 fully filled questionnaires on the topics of knowledge translation dynamics and tools, non-technical skills, and difficulties in teamwork were collected. Data were analyzed using the softwa…

RD1-811media_common.quotation_subjecteducationTrauma leadersContext (language use)Knowledge translationTrauma leaderTrauma teams Knowledge translation Team dynamics Non-technical skills Trauma leadersSettore SECS-P/07 - Economia AziendaleMultidisciplinary approachKnowledge translationSurveys and QuestionnairesHealth careMedicineHumansNon-technical skillknowledge translation; non-technical skills; team dynamics; trauma leaders; trauma teams; humans; surveys and questionnaires; patient care teamFunction (engineering)Trauma teamsNon-technical skillsmedia_commonPatient Care TeamMedical educationTeamworkRC86-88.9business.industryKnowledge translation; Non-technical skills; Team dynamics; Trauma leaders; Trauma teamsCorrectionMedical emergencies. Critical care. Intensive care. First aidChecklistEmergency MedicineSurgeryThe InternetTeam dynamicsTeam dynamicbusinessTrauma teamResearch Article
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Prospective Observational Study on acute Appendicitis Worldwide (POSAW)

2018

Acute appendicitis (AA) is the most common surgical disease, and appendectomy is the treatment of choice in the majority of cases. A correct diagnosis is key for decreasing the negative appendectomy rate. The management can become difficult in case of complicated appendicitis. The aim of this study is to describe the worldwide clinical and diagnostic work-up and management of AA in surgical departments.

Male:Medicina Básica [Ciências Médicas]Computed tomography030230 surgery0302 clinical medicineAntibioticsDiagnosisAppendicitiProspective StudiesLaparoscopyProspective cohort studyTomographymedicine.diagnostic_testAcute appendicitis; Antibiotics; Diagnosis; Management; Surgery; Surgery; Emergency MedicineAcute appendicitis; Antibiotics; Diagnosis; Management; Surgery; Acute Disease; Adult; Appendectomy; Appendicitis; Chi-Square Distribution; Female; Hospitalization; Humans; Laparoscopy; Length of Stay; Logistic Models; Male; Prospective Studies; Tomography X-Ray Computed; Treatment OutcomeMortality ratelcsh:Medical emergencies. Critical care. Intensive care. First aidApendicite3. Good healthX-Ray ComputedManagementHospitalizationTreatment Outcome030220 oncology & carcinogenesisCiências Médicas::Medicina BásicaAcute appendicitisAcute DiseaseEmergency MedicineFemaleAcute appendicitis; Antibiotics; Diagnosis; Management; Surgery; Acute Disease; Adult; Appendectomy; Appendicitis; Chi-Square Distribution; Female; Hospitalization; Humans; Laparoscopy; Length of Stay; Logistic Models; Male; Prospective Studies; Tomography X-Ray Computed; Treatment Outcome; Surgery; Emergency MedicineDiagnosiHumanResearch ArticleAdultmedicine.medical_specialtyLogistic Modellcsh:SurgeryNO03 medical and health sciencesmedicineAppendectomyHumansAcute appendicitisChi-Square Distributionbusiness.industryGeneral surgeryAntibioticAcute appendicitis; Antibiotics; Diagnosis; Management; Surgerylcsh:RD1-811lcsh:RC86-88.9Length of Staymedicine.diseaseAppendicitisAppendicitisProspective StudieLogistic ModelsObservational studyLaparoscopySurgeryAcute appendicitibusinessTomography X-Ray ComputedChi-squared distributionWorld Journal of Emergency Surgery
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Pooled analysis of who surgical safety checklist use and mortality after emergency laparotomy

2019

Background The World Health Organization (WHO) Surgical Safety Checklist has fostered safe practice for 10 years, yet its place in emergency surgery has not been assessed on a global scale. The aim of this study was to evaluate reported checklist use in emergency settings and examine the relationship with perioperative mortality in patients who had emergency laparotomy. Methods In two multinational cohort studies, adults undergoing emergency laparotomy were compared with those having elective gastrointestinal surgery. Relationships between reported checklist use and mortality were determined using multivariable logistic regression and bootstrapped simulation. Results Of 12 296 patients incl…

AdultMalebarriershumanoschecklist; surgery; human development indexGlobalSurg CollaborativeWHO Surgical Safety Checklist mortality emergency laparotomyWorld Health Organizationseguridad del pacienteNOCohort Studieslista de controlestudios prospectivosHumanstasa de supervivenciaProspective Studiesimplementationestudios de cohortesSurgery; implementation; health; barriersEmergency Treatment11 Medical and Health Sciencesmediana edadDigestive System Surgical ProceduresAgedancianoLaparotomyScience & TechnologyhealthOriginal ArticlesadultoMiddle Agedchecklist WHOprocedimientos quirúrgicos del sistema digestivoChecklistSurvival RateElective Surgical Procedureslaparotomíatratamiento de urgenciaSurgeryOriginal ArticleFemalePatient SafetyLife Sciences & Biomedicine
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Surgical site infection after gastrointestinal surgery in high-income, middle-income, and low-income countries: a prospective, international, multice…

2018

Background Surgical site infection (SSI) is one of the most common infections associated with health care, but its importance as a global health priority is not fully understood. We quantified the burden of SSI after gastrointestinal surgery in countries in all parts of the world. Methods This international, prospective, multicentre cohort study included consecutive patients undergoing elective or emergency gastrointestinal resection within 2-week time periods at any health-care facility in any country. Countries with participating centres were stratified into high-income, middle-income, and low-income groups according to the UN's Human Development Index (HDI). Data variables from the Globa…

Malehumanosfactores socioeconómicospaíses desarrolladosGlobal Healthglobal suregryincidenciaArticleNOCohort StudiesRisk Factorspaíses en desarrolloestudios prospectivossurgical site infection; global suregry; human development indexfactores de riesgoHumansSurgical Wound Infectiongastrointestinal surgeryProspective Studiesestudios de cohortesDeveloping CountriesPovertyDigestive System Surgical ProceduresCross InfectionDeveloped CountriesIncidencesurgical site infectionssurgical site infectioninfectionprocedimientos quirúrgicos del sistema digestivoInfectious Diseases surgical site infection gastrointestinal surgeryInfectious DiseasesSocioeconomic Factorshuman development indexinfección de la herida operatoriasurgical siteFemaleinfección hospitalaria
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Current status of laparoscopy for acute abdomen in Italy: a critical appraisal of 2012 clinical guidelines from two consecutive nationwide surveys wi…

2017

Background: Several authors have demonstrated the safety and feasibility of laparoscopy in selected cases of abdominal emergencies. The aim of the study was to analyse the current Italian practice on the use of laparoscopy in abdominal emergencies and to evaluate the impact of the 2012 national guidelines on the daily surgical activity. Methods: Two surveys (42 closed-ended questions) on the use of laparoscopy in acute abdomen were conducted nationwide with an online questionnaire, respectively, before (2010) and after (2014) the national guidelines publication. Data from two surveys were compared using Chi-square or Fisher’s exact test, and data were considered significant when p < 0.05…

MaleLaparoscopic surgeryClinical auditmedicine.medical_specialtymedicine.medical_treatmentAbdominal emergencies; Acute abdomen; Clinical audit; Emergency laparoscopy guidelines; Laparoscopic acute care surgery; Laparoscopic surgery; Laparoscopy; Laparoscopy acute abdomen; National survey; Nationwide survey on laparoscopyComputer-assisted web interviewing030230 surgeryLaparoscopic surgeryNOClinical auditAcute abdomen03 medical and health sciences0302 clinical medicinemedicineHumansPractice Patterns Physicians'LaparoscopyAbdomen AcuteLaparoscopy acute abdomenNational surveymedicine.diagnostic_testbusiness.industryAbdominal emergencies; Acute abdomen; Clinical audit; Emergency laparoscopy guidelines; Laparoscopic acute care surgery; Laparoscopic surgery; Laparoscopy; Laparoscopy acute abdomen; National survey; Nationwide survey on laparoscopy; SurgeryGeneral surgeryAbdominal emergenciesmedicine.diseaseLaparoscopic surgery Abdominal emergencies Acute abdomen Laparoscopy National survey Nationwide survey on laparoscopy Emergency laparoscopy guidelines Clinical audit Laparoscopy acute abdomen Laparoscopic acute care surgeryCritical appraisalItalyAcute abdomenEmergency laparoscopy guidelineEmergency laparoscopy guidelinesHealth Care SurveysPractice Guidelines as TopicCholecystitisAbdominal emergencieLaparoscopic acute care surgeryFemale030211 gastroenterology & hepatologyLaparoscopySurgeryGuideline AdherenceEmergenciesmedicine.symptomNationwide survey on laparoscopybusinessAbdominal surgery
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