Search results for " Abdominal surgery"
showing 10 items of 10 documents
Videolaparoscopic cholecystectomy in patients with previous abdominal surgery. Personal experience and literature review
2017
Objectives. Laparoscopic cholecystectomy (LC) is today the "gold standard" treatment of gallbladder stones. Role of LC is still debated in the presence of abdominal scars due to the frequent post-operative adhesions which make access to the peritoneal cavity difficult. This study aim to assess role and outcomes of LC on a previous abdominal surgery on the scarred abdomen. Materials and Methods. we have carried out a retrospective study on 499 consecutive patients who had undergone LC from 2009 to 2015; 21 of these (4.2%) undergone previous abdominal surgery. In all 21 cases the pneumoperitoneum was established with Veress needle at the Palmer's point and the procedure was carried out after …
3D laparoscopic surgery: a prospective clinical trial
2018
Since it's introduction, laparoscopic surgery represented a real revolution in clinical practice. The use of a new generation three-dimensional (3D) HD laparoscopic system can be considered a favorable "hybrid" made by combining two different elements: feasibility and diffusion of laparoscopy and improved quality of vision. In this study we report our clinical experience with use of three-dimensional (3D) HD vision system for laparoscopic surgery. Between 2013 and 2017 a prospective cohort study was conducted at the University Hospital of Palermo. We considered 163 patients underwent to laparoscopic three-dimensional (3D) HD surgery for various indications. This 3D-group was compared to a r…
High versus low positive end-expiratory pressure during general anaesthesia for open abdominal surgery (PROVHILO trial): a multicentre randomised con…
2014
BACKGROUND: The role of positive end-expiratory pressure in mechanical ventilation during general anaesthesia for surgery remains uncertain. Levels of pressure higher than 0 cm H(2)O might protect against postoperative pulmonary complications but could also cause intraoperative circulatory depression and lung injury from overdistension. We tested the hypothesis that a high level of positive end-expiratory pressure with recruitment manoeuvres protects against postoperative pulmonary complications in patients at risk of complications who are receiving mechanical ventilation with low tidal volumes during general anaesthesia for open abdominal surgery. METHODS: In this randomised controlled tri…
Vacuum-Assisted Wound Closure with Mesh-Mediated Fascial Traction Achieves Better Outcomes than Vacuum-Assisted Wound Closure Alone: A Comparative St…
2017
Background Open abdomen (OA) permits the application of damage control surgery principles when abdominal trauma, sepsis, severe acute peritonitis and abdominal compartmental syndrome (ACS) occur. Methods Non-traumatic patients treated with OA between January 2010 and December 2015 were identified in a prospective database, and the data collected were retrospectively reviewed. Patients’ records were collected from charts and the surgical and intensive care unit (ICU) registries. The Acosta ‘‘modified’’ technique was used to achieve fascial closure in vacuum-assisted wound closure and mesh-mediated fascial traction (VAWCM) patients. Sex, age, simplified acute physiology score II (SAPS II), ab…
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…
Postoperative continuous positive airway pressure to prevent pneumonia, re-intubation, and death after major abdominal surgery (PRISM): a multicentre…
2021
BackgroundRespiratory complications are an important cause of postoperative morbidity. We aimed to investigate whether continuous positive airway pressure (CPAP) administered immediately after major abdominal surgery could prevent postoperative morbidity.MethodsPRISM was an open-label, randomised, phase 3 trial done at 70 hospitals across six countries. Patients aged 50 years or older who were undergoing elective major open abdominal surgery were randomly assigned (1:1) to receive CPAP within 4 h of the end of surgery or usual postoperative care. Patients were randomly assigned using a computer-generated minimisation algorithm with inbuilt concealment. The primary outcome was a composite of…
EVALUATION OF THE EFFECTS OF CONTI- NUOUS PREPERITONEAL WOUND INFILTRATION ON POSTOPERATIVE RESPIRATORY PERFORMANCE IN PATIENTS WHO UNDERWENT MAJOR A…
2013
Aim. According to the recent literature, continuous pre-perito- neal wound infiltration with local anaesthetics (CPWI) is an effective analgesic therapy in patients who undergo major abdominal surgery 1. Although it is not inferior to other com- monly used techniques in postoperative analgesia, many studies report conflictive results about its efficacy compared to them 2. The aim of our study was to evaluate the effects of CPWI on the postoperative respiratory performance in patients after major abdominal surgery. Materials and methods. From June 2011 to July 2012, a total of 14 patients have been evaluated. All patients were treated using the protocol generally used in our Department for t…
KPC - 3 Klebsiella pneumoniae ST258 clone infection in postoperative abdominal surgery patients in an intensive care setting: analysis of a case seri…
2013
Background: Abdominal surgery carries significant morbidity and mortality, which is in turn associated with an enormous use of healthcare resources. We describe the clinical course of 30 Intensive Care Unit (ICU) patients who underwent abdominal surgery and showed severe infections caused by Klebsiella pneumoniae sequence type (ST) 258 producing K. pneumoniae carbapenemase (KPC-Kp). The aim was to evaluate risk factors for mortality and the impact of a combination therapy of colistin plus recommended regimen or higher dosage of tigecycline. Methods: A prospective assessment of severe monomicrobial KPC-Kp infections occurring after open abdominal surgery carried out from August 2011 to Augus…
Emergency abdominal surgery after solid organ transplantation: a systematic review
2016
Aims: Due to the increasing number of solid organs transplantations, emergency abdominal surgery in transplanted patients is becoming a relevant challenge for the general surgeon. The aim of this systematic review of the literature is to analyze morbidity and mortality of emergency abdominal surgery performed in transplanted patients for graft-unrelated surgical problems. Methods: The literature search was performed on online databases with the time limit 1990–2015. Studies describing all types of emergency abdominal surgery in solid organ transplanted patients were retrieved for evaluation. Results: Thirty-nine case series published between 1996 and 2015 met the inclusion criteria and were…
Peritoneal carcinomatosis index as a predictor of diaphragmatic involvement in stage III and IV ovarian cancer
2018
Antoni Llueca,1–3 Anna Serra,1–3 José Luis Herraiz,2 Isabel Rivadulla,1,4 Luis Gomez-Quiles,1,4 Juan Gilabert-Estelles,5,6 Javier Escrig1,3,4On behalf of the MUAPOS (Multidisciplinary Unit of Abdominal Pelvic Oncology Surgery) working group 1Multidisciplinary Unit of Abdominal Pelvic Oncology Surgery (MUAPOS), University General Hospital of Castellón, Castellón, Spain; 2Department of Obstetrics and Gynecology, University General Hospital of Castellón, Castellón, Spain; 3Department of Medicine, Universitat Jaume I, Castellón, Spain; 4Department of General Surgery, University General Hospital of Castell&…