Search results for " Emergency surgery"
showing 10 items of 10 documents
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…
Acute cholecystitis during COVID-19 pandemic: a multisocietary position statement
2020
AbstractFollowing the spread of the infection from the new SARS-CoV2 coronavirus in March 2020, several surgical societies have released their recommendations to manage the implications of the COVID-19 pandemic for the daily clinical practice. The recommendations on emergency surgery have fueled a debate among surgeons on an international level.We maintain that laparoscopic cholecystectomy remains the treatment of choice for acute cholecystitis, even in the COVID-19 era. Moreover, since laparoscopic cholecystectomy is not more likely to spread the COVID-19 infection than open cholecystectomy, it must be organized in such a way as to be carried out safely even in the present situation, to gu…
Emergency hernia repair in the elderly: multivariate analysis of morbidity and mortality from an Italian registry
2020
Abstract Purpose The incidence of inguinal hernia is higher in elderly because of aging-related diseases like prostatism, bronchitis, collagen laxity. A conservative management is common in elderly to reduce surgery-related risks, however watchful waiting can expose to obstruction and strangulation. The aim of the present study was to assess the impact of emergency surgery in a large series of elderly with complicated groin hernia and to identify the independent risk factors for postoperative morbidity and mortality. The predictive performance of prognostic risk scores has been also assessed. Methods This is a prospective observational study carried out between January 2017 and June 2018 in…
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…
Physiological parameters for Prognosis in Abdominal Sepsis (PIPAS) Study: a WSES observational study
2019
Timing and adequacy of peritoneal source control are the most important pillars in the management of patients with acute peritonitis. Therefore, early prognostic evaluation of acute peritonitis is paramount to assess the severity and establish a prompt and appropriate treatment. The objectives of this study were to identify clinical and laboratory predictors for in-hospital mortality in patients with acute peritonitis and to develop a warning score system, based on easily recognizable and assessable variables, globally accepted. Background Timing and adequacy of peritoneal source control are the most important pillars in the management of patients with acute peritonitis. Therefore, early pr…
Changes in surgicaL behaviOrs dUring the CoviD-19 pandemic. The SICE CLOUD19 Study
2021
Abstract Background The spread of the SARS-CoV2 virus, which causes COVID-19 disease, profoundly impacted the surgical community. Recommendations have been published to manage patients needing surgery during the COVID-19 pandemic. This survey, under the aegis of the Italian Society of Endoscopic Surgery, aims to analyze how Italian surgeons have changed their practice during the pandemic. Methods The authors designed an online survey that was circulated for completion to the Italian departments of general surgery registered in the Italian Ministry of Health database in December 2020. Questions were divided into three sections: hospital organization, screening policies, and safety profile of…
Safety of primary anastomosis following emergency left sided colorectal resection: an international, multi-centre prospective audit
2018
Introduction: Some evidence suggests that primary anastomosis following left sided colorectal resection in the emergency setting may be safe in selected patients, and confer favourable outcomes to permanent enterostomy. The aim of this study was to compare the major postoperative complication rate in patients undergoing end stoma vs primary anastomosis following emergency left sided colorectal resection. Methods: A pre-planned analysis of the European Society of Coloproctology 2017 audit. Adult patients (> 16 years) who underwent emergency (unplanned, within 24 h of hospital admission) left sided colonic or rectal resection were included. The primary endpoint was the 30-day major complic…
The use of emergency laparoscopy for acute abdomen in the elderly: the FRAILESEL Italian Multicenter Prospective Cohort Study
2020
As the world population is aging rapidly, emergency abdominal surgery for acute abdomen in the elderly represents a global issue, both in developed and developing countries. Data regarding all the elderly patients who underwent emergency abdominal surgery from January 2017 to December 2017 at 36 Italian surgical departments were analyzed with the aim to appraise the contemporary reality regarding the use of emergency laparoscopy for acute abdomen in the elderly. 1993 patients were enrolled. 1369 (68.7%) patients were operated with an open technique; whereas, 624 (31.3%) underwent a laparoscopic operation. The postoperative morbidity rate was 32.6%, with a statically significant difference b…
A rare case of perforated ileal diverticulitis in a young man: A case report and literature review
2021
Jejunoileal diverticulosis is a rare, often asymptomatic condition, consisting of acquired false diverticula. Diagnosis of ileal perforation is usually made incidentally or after complications, including obstruction, haemorrhage and diverticulitis. A previously healthy 17-year-old man presented to the Emergency Department with diffuse abdominal pain and fever. CT scan showed air-fluid level in the RLQ and free intraperitoneal air and fluid. The patient underwent an urgent exploratory laparotomy with an intestinal resection and primary anastomosis. We report a rare case of ileal perforation, due to diverticular disease in a healthy young man, treated an urgent surgery. Such an event requires…
Amyand’s hernia, an unknown entity that may cause surgeons difficulty: Our experience and literature review
2021
Amyand's hernia is an inguinal hernia, containing the appendix within the hernial sac. Claudius Amyand described the first clinical case in 1735. Despite the high incidence of inguinal canal hernia disease in the population with approximately 20 milion patients that undergo hernia repair annually, Amyand's hernia is a rare clinical conditions. It is characterized by an incidence of 1 % (0,19-1.7) and in 0,13 % of all cases, the appendix is inflamed. In this article, we will present our experience related to the treatment of a complicated Amyand's hernia, occasionally found during an emergency surgery for the repair of an incarcerated inguinal hernia. In addition, we will conduct a medical r…