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  1. Article ; Online: Open abdomen for the management of catastrophic abdomen: Evidence and controversies.

    Leppäniemi, Ari

    Cirugia espanola

    2020  Volume 99, Issue 8, Page(s) 559–561

    MeSH term(s) Abdomen/surgery ; Humans ; Laparotomy
    Language English
    Publishing date 2020-10-02
    Publishing country Spain
    Document type Editorial
    ISSN 2173-5077
    ISSN (online) 2173-5077
    DOI 10.1016/j.cireng.2020.09.012
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Open Abdomen for the Management of Catastrophic Abdomen: Evidence and Controversies.

    Leppäniemi, Ari

    Cirugia espanola

    2020  

    Title translation Abdomen abierto en el tratamiento del abdomen catastrófico: evidencia y controversias.
    Language Spanish
    Publishing date 2020-07-31
    Publishing country Spain
    Document type Editorial
    ISSN 2173-5077
    ISSN (online) 2173-5077
    DOI 10.1016/j.ciresp.2020.06.011
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article ; Online: Pre-hospital management and patient-related factors affecting access to the surgical care of appendicitis - a survey study.

    Lastunen, Kirsi Serenella / Leppäniemi, Ari Kalevi / Mentula, Panu Juhani

    Scandinavian journal of primary health care

    2024  , Page(s) 1–9

    Abstract: Background and aims: Long pre-hospital delay substantially increases the likelihood of perforated appendicitis. This study aimed to find patient-related factors affecting this delay.: Methods: A survey was conducted for patients with acute ... ...

    Abstract Background and aims: Long pre-hospital delay substantially increases the likelihood of perforated appendicitis. This study aimed to find patient-related factors affecting this delay.
    Methods: A survey was conducted for patients with acute appendicitis after appendectomy. The participants were asked about their path to the surgical center and socioeconomic status. Variables affecting delays and the rate of complicated appendicitis were analyzed.
    Results: The study included 510 patients; 157 (31%) had complicated appendicitis with a median prehospital delay of 42 h. In patients with uncomplicated appendicitis, the delay was 21 h,
    Conclusions: Advanced age, fever and failure to suspect acute appendicitis in primary care are associated with prolonged pre-hospital delay and complicated appendicitis.
    Language English
    Publishing date 2024-03-18
    Publishing country United States
    Document type Journal Article
    ZDB-ID 605763-9
    ISSN 1502-7724 ; 0281-3432 ; 0284-6020
    ISSN (online) 1502-7724
    ISSN 0281-3432 ; 0284-6020
    DOI 10.1080/02813432.2024.2329214
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  4. Article ; Online: Complex duodenal fistulae: a surgical nightmare.

    Leppäniemi, Ari / Tolonen, Matti / Mentula, Panu

    World journal of emergency surgery : WJES

    2023  Volume 18, Issue 1, Page(s) 35

    Abstract: Introduction: A common feature of external duodenal fistulae is the devastating effect of the duodenal content rich in bile and pancreatic juice on nearby tissues with therapy-resistant local and systemic complications. This study analyzes the results ... ...

    Abstract Introduction: A common feature of external duodenal fistulae is the devastating effect of the duodenal content rich in bile and pancreatic juice on nearby tissues with therapy-resistant local and systemic complications. This study analyzes the results of different management options with emphasis on successful fistula closure rates.
    Methods: A retrospective single academic center study of adult patients treated for complex duodenal fistulas over a 17-year period with descriptive and univariate analyses was performed.
    Results: Fifty patients were identified. First line treatment was surgical in 38 (76%) cases and consisted of resuture or resection with anastomosis combined with duodenal decompression and periduodenal drainage in 36 cases, rectus muscle patch, and surgical decompression with T-tube in one each. Fistula closure rate was 29/38 (76%). In 12 cases, the initial management was nonoperative with or without percutaneous drainage. The fistula was closed without surgery in 5/6 patients (1 patient died with persistent fistula). Among the remaining 6 patients eventually operated, fistula closure was achieved in 4 cases. There was no difference in successful fistula closure rates among initially operatively versus nonoperatively managed patients (29/38 vs. 9/12, p = 1.000). However, when considering eventually failed nonoperative management in 7/12 patients, there was a significant difference in the fistula closure rate (29/38 vs. 5/12, p = 0.036). The overall in-hospital mortality rate was 20/50 (40%).
    Conclusions: Surgical closure combined with duodenal decompression in complex duodenal leaks offers the best chance of successful outcome. In selected cases, nonoperative management can be tried, accepting that some patients may require surgery later.
    MeSH term(s) Adult ; Humans ; Retrospective Studies ; Duodenal Diseases/surgery ; Duodenal Diseases/complications ; Duodenum/surgery ; Intestinal Fistula/surgery ; Intestinal Fistula/etiology ; Anastomosis, Surgical
    Language English
    Publishing date 2023-05-19
    Publishing country England
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 2233734-9
    ISSN 1749-7922 ; 1749-7922
    ISSN (online) 1749-7922
    ISSN 1749-7922
    DOI 10.1186/s13017-023-00503-w
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  5. Book ; Online ; E-Book: Emergency surgery course (ESC®) manual

    Fingerhut, Abe / Leppäniemi, Ari / Coimbra, Raul / Peitzman, Andrew B. / Scalea, Thomas M. / Voiglio, Eric J.

    the official EST/AAST guide

    2016  

    Institution European Society for Trauma and Emergency Surgery
    American Association for the Surgery of Trauma
    Author's details Abe Fingerhut, Ari Leppänemi, Raul Coimbra, Andrew B. Peitzman, Thomas M. Scaela, ERic J. Voiglio ; European Society for Trauma and Emergency Surgery, American Association for the Surgery of Trauma
    Language English
    Size 1 Online-Ressource (xv, 252 Seiten), Illustrationen
    Publisher Springer
    Publishing place Cham
    Publishing country Switzerland
    Document type Book ; Online ; E-Book
    Remark Zugriff für angemeldete ZB MED-Nutzerinnen und -Nutzer
    HBZ-ID HT018923804
    ISBN 978-3-319-21338-5 ; 978-3-319-21337-8 ; 3-319-21338-5 ; 3-319-21337-7
    DOI 10.1007/978-3-319-21338-5
    Database ZB MED Catalogue: Medicine, Health, Nutrition, Environment, Agriculture

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  6. Article ; Online: Author response to: Comment on: DIAgnostic iMaging or Observation in early equivocal appeNDicitis (DIAMOND): open-label, randomized clinical trial.

    Lastunen, Kirsi S / Leppäniemi, Ari K / Mentula, Panu J

    The British journal of surgery

    2022  Volume 110, Issue 2, Page(s) 280

    MeSH term(s) Humans ; Appendicitis/diagnostic imaging ; Appendicitis/surgery ; Appendectomy/methods ; Tomography, X-Ray Computed ; Acute Disease ; Ultrasonography ; Sensitivity and Specificity
    Language English
    Publishing date 2022-10-24
    Publishing country England
    Document type Randomized Controlled Trial ; Letter ; Comment
    ZDB-ID 2985-3
    ISSN 1365-2168 ; 0263-1202 ; 0007-1323 ; 1355-7688
    ISSN (online) 1365-2168
    ISSN 0263-1202 ; 0007-1323 ; 1355-7688
    DOI 10.1093/bjs/znac367
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  7. Article ; Online: DIAgnostic iMaging or Observation in early equivocal appeNDicitis (DIAMOND): open-label, randomized clinical trial.

    Lastunen, Kirsi S / Leppäniemi, Ari K / Mentula, Panu J

    The British journal of surgery

    2022  Volume 109, Issue 7, Page(s) 588–594

    Abstract: Background: Mild appendicitis may resolve spontaneously. The use of CT may lead to an overdiagnosis of uncomplicated appendicitis. The aims of this study were to examine whether early imaging results in more patients being diagnosed with acute ... ...

    Abstract Background: Mild appendicitis may resolve spontaneously. The use of CT may lead to an overdiagnosis of uncomplicated appendicitis. The aims of this study were to examine whether early imaging results in more patients being diagnosed with acute appendicitis than initial observation, and to study the safety and feasibility of score-based observation compared with imaging in patients with equivocal signs of appendicitis.
    Methods: Patients with suspected appendicitis with symptoms for fewer than 24 h and an Adult Appendicitis Score of 11-15 were eligible for this trial. After exclusions, patients were randomized openly into two equal-sized groups: imaging and observation. Patients in the imaging group had ultrasound imaging followed by CT when necessary, whereas those in the observation group were reassessed after 6-8 h with repeated scoring and managed accordingly. The primary outcome was the number of patients requiring treatment for acute appendicitis within 30 days.
    Results: Ninety-three patients were randomized to imaging and 92 to observation; after exclusions, 93 and 88 patients respectively were analysed. In the imaging group, more patients underwent treatment for acute appendicitis than in the observation group: 72 versus 57 per cent (difference 15 (95 per cent c.i. 1 to 29) per cent). This suggests that patients with spontaneously resolving appendicitis were not diagnosed or treated in the observation group. Some 55 per cent of patients in the observation group did not need diagnostic imaging within 30 days after randomization. There was no difference in the number of patients diagnosed with complicated appendicitis (4 versus 2 per cent) or negative appendicectomies (1 versus 1 per cent) in the imaging and observation groups.
    Conclusion: Score-based observation of patients with early equivocal appendicitis results in fewer patients requiring treatment for appendicitis. Registration number: NCT02742402 (http://www.clinicaltrials.gov).
    MeSH term(s) Acute Disease ; Adult ; Appendectomy/methods ; Appendicitis/diagnostic imaging ; Appendicitis/surgery ; Humans ; Ultrasonography
    Language English
    Publishing date 2022-04-28
    Publishing country England
    Document type Journal Article ; Randomized Controlled Trial
    ZDB-ID 2985-3
    ISSN 1365-2168 ; 0263-1202 ; 0007-1323 ; 1355-7688
    ISSN (online) 1365-2168
    ISSN 0263-1202 ; 0007-1323 ; 1355-7688
    DOI 10.1093/bjs/znac120
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  8. Article ; Online: Who invented damage control surgery?

    Leppäniemi, Ari

    Scandinavian journal of surgery : SJS : official organ for the Finnish Surgical Society and the Scandinavian Surgical Society

    2014  Volume 103, Issue 3, Page(s) 165–166

    Language English
    Publishing date 2014-09
    Publishing country England
    Document type Editorial
    ZDB-ID 2077691-3
    ISSN 1799-7267 ; 1457-4969
    ISSN (online) 1799-7267
    ISSN 1457-4969
    DOI 10.1177/1457496914542192
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  9. Article ; Online: What can we learn from a critically ill mouse?

    Leppäniemi, Ari

    Scandinavian journal of surgery : SJS : official organ for the Finnish Surgical Society and the Scandinavian Surgical Society

    2014  Volume 103, Issue 4, Page(s) 225

    MeSH term(s) Animals ; Critical Illness/therapy ; Disease Management ; Disease Models, Animal ; Humans ; Mice
    Language English
    Publishing date 2014-12
    Publishing country England
    Document type Editorial
    ZDB-ID 2077691-3
    ISSN 1799-7267 ; 1457-4969
    ISSN (online) 1799-7267
    ISSN 1457-4969
    DOI 10.1177/1457496914557397
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  10. Article ; Online: Acute appendicitis--we thought we knew it all?

    Leppäniemi, Ari

    Scandinavian journal of surgery : SJS : official organ for the Finnish Surgical Society and the Scandinavian Surgical Society

    2014  Volume 103, Issue 1, Page(s) 3–4

    MeSH term(s) Acute Disease ; Anti-Bacterial Agents/therapeutic use ; Appendectomy/methods ; Appendicitis/diagnosis ; Appendicitis/therapy ; Humans ; Laparoscopy
    Chemical Substances Anti-Bacterial Agents
    Language English
    Publishing date 2014-03
    Publishing country England
    Document type Editorial
    ZDB-ID 2077691-3
    ISSN 1799-7267 ; 1457-4969
    ISSN (online) 1799-7267
    ISSN 1457-4969
    DOI 10.1177/1457496914525695
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