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Article ; Online: Emergency Surgery in a "No-Covid-19 Spoke Center" during the pandemic. One year of experience and a new organizational model.

Palazzo, Paola / Angrisano, Anna / Sacco, Michele / Pizzoleo, Stefano / Pungente, Salvatore / Cornacchiulo, Vito / Bellanova, Giovanni

Annali italiani di chirurgia

2021 Volume 93, Page(s) 147–151

Abstract: Aim: We analysed our one-year surgical activity in a spoke 'COVID-19 free' centre during the pandemic in South Italy.: Material of study: From Feb 2020 to Feb 2021 we performed 800 operations (40% in emergency and 60% of major surgery). We applied ... ...

Abstract	Aim: We analysed our one-year surgical activity in a spoke 'COVID-19 free' centre during the pandemic in South Italy. Material of study: From Feb 2020 to Feb 2021 we performed 800 operations (40% in emergency and 60% of major surgery). We applied restrictive measures for the access of patients in our department from 15/2/2020 after several cases of unclear fever. Visitors were not allowed to stay in the ward. Results: In the first period of lockdown, from March to June 2020, in our Region, biomolecular test was indicated only for symptomatic people. We organized the hospitalization with a sealed compartment system (that we defined "boing system") in which the patient stationed in an 'isolation room' for at least 48 hours upon the entry. From July 2020 molecular test were made to all patients before hospitalization. The boing system remains for emergency recovery. Discussion: In the first phase of pandemia we chose to subject patients to serological examination based on the IgM assay to consider them negative. We organized the hospitalization with a sealed compartment system (that we defined "boing system") CONCLUSION: In the first phase of the pandemic the serological examination has shown high specificity in identifying positive patients for COVID 19. In that period we supposed that patients with negative serology could be considered non-contagious Neither patients or staff has been resulted positive to SarS CoV2 test. Key words: Covid 19, Emercency Surgery, Spoke Center, Pandemia, Serological Tests.
MeSH term(s)	COVID-19/epidemiology ; Communicable Disease Control ; Humans ; Models, Organizational ; Pandemics ; SARS-CoV-2
Language	English
Publishing date	2021-12-24
Publishing country	Italy
Document type	Journal Article
ZDB-ID	418927-9
ISSN	2239-253X ; 0003-469X
ISSN (online)	2239-253X
ISSN	0003-469X
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Article ; Online: From damage control surgery to complex abdominal wall reconstruction It is possible even in the elderly in a Spoke Center?

De Matteis, Antonio / Sacco, Michele / Napoletano, Pasqua / Pizzoleo, Stefano / Palazzo, Paola / Angrisano, Anna / Pungente, Salvatore / Lamacchia, Domenico / Erario, Silvia / Bellanova, Giovanni

Annali italiani di chirurgia

2023 Volume 94, Page(s) 95–98

Abstract: Aim: To describe our Spoke Center experience in Damage Control Surgery (DCS) in a non traumatic patient and the possibility of delayed abdominal wall reconstruction (AWR). Material of Study The case of a 73 years old Caucasian male treated with DCS for ... ...

Abstract	Aim: To describe our Spoke Center experience in Damage Control Surgery (DCS) in a non traumatic patient and the possibility of delayed abdominal wall reconstruction (AWR). Material of Study The case of a 73 years old Caucasian male treated with DCS for a septic shock due to a duodenal perforation and his clinical course till the abdominal wall reconstruction. Results: We made DCS with abbreviated laparotomy, suture of the ulcer and duodenostomy with a foley placed in right hypochondrium. Patiens was discharged with a low-flow fistula and with TPN. After 18 months we made an open cholecystectomy and a complete abdominal wall reconstruction with Fasciotens Hernia System® adding a biological mesh. Discussion and comments: Periodic training in emergency settings and in complex abdominal wall procedures is the right way to manage critic clinical case. Like Niebuhr's abbreviated laparotomy experience also in our case this procedure allows primary closure of complex hernias and is potentially less prone to complications than component separation methods. Unlike Fung's experience we didn' t use negative pressure wound therapy system (NPWT) equally achieving good results. Conclusions: Elective repair of abdominal wall disaster is possible even in elderly patients who have been treated by abbreviated laparotomy and DCS surgery. In order to obtain good results is fundamental to have a trained staff. Key words: Damage Control Surgery (DCS), Giant incisional Hernia, Abdominal Wall Repair.
MeSH term(s)	Aged ; Humans ; Male ; Abdominal Muscles/surgery ; Abdominal Wall/surgery ; Hernia, Ventral/surgery ; Incisional Hernia/surgery ; Laparotomy ; Surgical Mesh/adverse effects
Language	English
Publishing date	2023-02-22
Publishing country	Italy
Document type	Case Reports ; Journal Article
ZDB-ID	418927-9
ISSN	2239-253X ; 0003-469X
ISSN (online)	2239-253X
ISSN	0003-469X
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Article ; Online: Laparoscopic Repair of Perforated Peptic Ulcer in the Elderly: An Interim Analysis of the FRAILESEL Italian Multicenter Prospective Cohort Study.

Fransvea, Pietro / Costa, Gianluca / Lepre, Luca / Podda, Mauro / Giordano, Alessio / Bellanova, Giovanni / Agresta, Ferdinando / Marini, Pierluigi / Sganga, Gabriele

Surgical laparoscopy, endoscopy & percutaneous techniques

2020 Volume 31, Issue 1, Page(s) 2–7

Abstract: Introduction: The number of elderly patients requiring emergency surgical intervention has increased dramatically. Perforated peptic ulcer (PPU) complications, such as perforation, have remained relatively stable and associated morbidity remains between ...

Abstract	Introduction: The number of elderly patients requiring emergency surgical intervention has increased dramatically. Perforated peptic ulcer (PPU) complications, such as perforation, have remained relatively stable and associated morbidity remains between 10% and 20%. Advances in perioperative care have greatly improved the outcomes of laparoscopic emergency surgery, allowing increasing numbers of patients, even the elderly, to undergo safe repair. The aim of this study was to evaluate the feasibility, safety, and outcome of laparoscopic gastric repair in the elderly using the database of the FRAILESEL (Frailty and Emergency Surgery in the Elderly) study. Materials and methods: This is a retrospective analysis carried out on data of the FRAILESEL study. Data on all the elderly patients who underwent emergency abdominal surgery for PPU from January 2017 to December 2017 at 36 Italian surgical departments were analyzed. Patients who underwent PPU repair were further divided into a laparoscopic gastroduodenal repair (LGR) cohort and an open gastroduodenal repair (OGR) cohort, and the clinicopathologic features of the patients in both the groups were compared. Results: Sixty-seven patients fulfilled the inclusion criteria. Thirty-three patients (47.8%) underwent LGR. The LGR patients had less blood loss and shorter postoperative stay, even if the difference was not statistically significant. The mean operative time was significantively higher in the OGR (OGR 96.5±27.7 vs. LGR 78.6±16.3 P=0.000). The rate of death after laparoscopic surgery was similar to the rate of the open surgery. Multivariate analysis indicated that only age (P=0.018), admission haemoblogbin (Hb) level (P=0.006), platelet count (P=0.16), lactate level (P=0.47), and Mannheim Peritonitis Index (P=0.18) were independent variables associated with the risk of overall mortality. Conclusions: LGR is safe and feasible in elderly patients with PPU and it is associated with better perioperative outcomes. However, patient selection and preoperative frailty evaluation in the elderly population are the key to achieving better outcomes.
MeSH term(s)	Aged ; Cohort Studies ; Humans ; Italy/epidemiology ; Laparoscopy ; Length of Stay ; Peptic Ulcer Perforation/surgery ; Postoperative Complications/epidemiology ; Postoperative Complications/etiology ; Prospective Studies ; Retrospective Studies ; Treatment Outcome
Language	English
Publishing date	2020-07-14
Publishing country	United States
Document type	Journal Article ; Multicenter Study
ZDB-ID	1475108-2
ISSN	1534-4908 ; 1530-4515 ; 1051-7200
ISSN (online)	1534-4908
ISSN	1530-4515 ; 1051-7200
DOI	10.1097/SLE.0000000000000826
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Article: Addome acuto da neoformazioni primitive del tenue. Approccio diagnostico e modalità terapeutiche.

Bellanova, Giovanni / Mastropasqua, Guido / Iorio, Beniamino / Antonellis, Donato / Serao, Angelo

Chirurgia italiana

2007 Volume 59, Issue 3, Page(s) 305–312

Abstract: We report our experience over the period 2000-2004 with the diagnosis and treatment of primary small bowel neoplasms in the emergency setting, stressing the importance of a correct preoperative diagnosis for the implementation of specific treatment. From ...

Title translation	Acute abdomen due to primary small bowel neoplasm. Diagnostic approach and therapeutic modalities.
Abstract	We report our experience over the period 2000-2004 with the diagnosis and treatment of primary small bowel neoplasms in the emergency setting, stressing the importance of a correct preoperative diagnosis for the implementation of specific treatment. From January 2000 to September 2004 we treated 5674 patients, 8 of whom (0.8%) presented a primary small bowel neoplasm emergency. The diagnosis was made using small bowel ultrasound. We detected 8 cases of primary small bowel neoplasms using ultrasound. This examination was specific for the small bowel and enabled us to obtain an accurate preoperative diagnosis. A correct diagnosis of primitive small bowel neoplasm is necessary in order to institute the right treatment. The main treatment is surgery in our experience, the gold standard being laparoscopy but only when performed by expert surgeons.
MeSH term(s)	Abdomen, Acute/diagnosis ; Abdomen, Acute/surgery ; Adolescent ; Aged ; Aged, 80 and over ; Female ; Follow-Up Studies ; Humans ; Intestinal Neoplasms/diagnosis ; Intestinal Neoplasms/surgery ; Intestine, Small ; Male ; Middle Aged
Language	Italian
Publishing date	2007-05
Publishing country	Italy
Document type	English Abstract ; Journal Article
ZDB-ID	603591-7
ISSN	0009-4773
ISSN	0009-4773
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Article ; Online: Damage Control Strategy and aggressive resuscitation in polytraumatized patient with severe hypothermia. Importance of multidisciplinary management from the territory to the operating room. Case report.

Bellanova, Giovanni / Motta, Alessandro / Mazzetti, Chiara / Motter, Michele / Fabris, Luca / DeVigili, Giorgio / Liguori, Gerardo

Annali italiani di chirurgia

2013 Volume 84, Issue 4, Page(s) 445–449

Abstract: Aim: Our objective is to describe a case of hypothermic politrauma management in our country.: Material of study: We report the case of a 29-year-old male who was a beating victim and fell off from 4 meters, and was afterwards found after an unknown ... ...

Abstract	Aim: Our objective is to describe a case of hypothermic politrauma management in our country. Material of study: We report the case of a 29-year-old male who was a beating victim and fell off from 4 meters, and was afterwards found after an unknown time interval. The patient came to our DEA in cardiac arrest and underwent to a aggressive and prolonged resuscitation which included sternotomy and extracorporeal circulation. Results: The patient was discharged in 40th postoperative day without neurologic complications and complete recovery. Discussion: Even without a dedicated protocol for the hypothermic politrauma the correct multidisciplinary approach lead to the complete recovery of the patient. In literature many papers describe the aggressive resuscitation of hypothermic patients underlining that the politrauma management must be multidisciplinar. Conclusion: We want to underline the importance of the "Damage control strategy" in a politrauma team in the major hospitals in our country. Key words: Cardiopulmonary resuscitation, Extracorporeal circulation, Hypothermia, Polytrauma, Trauma team.
MeSH term(s)	Adult ; Cardiopulmonary Resuscitation ; Extracorporeal Circulation ; Humans ; Hypothermia/etiology ; Hypothermia/therapy ; Male ; Multiple Trauma/complications ; Operating Rooms ; Patient Care Team ; Severity of Illness Index
Language	English
Publishing date	2013-07
Publishing country	Italy
Document type	Case Reports ; Journal Article
ZDB-ID	418927-9
ISSN	2239-253X ; 0003-469X
ISSN (online)	2239-253X
ISSN	0003-469X
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Article ; Online: How formative courses about damage control surgery and non-operative management improved outcome and survival in unstable politrauma patients in a Mountain Trauma Center.

Bellanova, Giovanni / Buccelletti, Francesco / Berletti, Riccardo / Cavana, Marco / Folgheraiter, Giorgio / Groppo, Francesca / Marchetti, Chiara / Marzano, Amelia / Massè, Alessandro / Musetti, Antonio / Pelanda, Tina / Ricci, Nicola / Tugnoli, Gregorio / Papadia, Damiano / Ramponi, Claudio

Annali italiani di chirurgia

2016 Volume 87, Page(s) 68–74

Abstract: Aim: Aim of this study is to analyze how the starting of Course of Trauma in our hospital improved survival and organization in management of polytraumatized patients.: Material of study: We analysed all major trauma patients (Injury Severity Score ( ... ...

Abstract	Aim: Aim of this study is to analyze how the starting of Course of Trauma in our hospital improved survival and organization in management of polytraumatized patients. Material of study: We analysed all major trauma patients (Injury Severity Score (Injury Severity Score (ISS)> 15) treated at Emergency Department of the Santa Chiara Hospital between January 2011 and December 2014. The training courses (TC) were named "management of polytrauma" (MP) and "clinical cases discussion" (CCD), and started in November 2013. We divided the patients between two groups: before November 2013 (pre-TC group) and after November 2013 (post-TC group). Results: MTG's courses (EMC accredited), CCD and MP courses started in November 2013. The target of these courses was the multidisciplinary management of polytrauma patient; the courses were addressed to general surgeons, anaesthesiologists, radiologists, orthopaedics and emergency physicians. Respectively 110 and 78 doctors were formed in CCD's and MP's courses. Patients directly transported to our trauma centre rose from 67.5% to 83% (p<0,005), and E-FAST grew from 15.6% in the pre-TC group to 51.3% in the post-TC group. Time of access in operatory theatre decreased from 62 to 44 minutes. Early Mortality (within 48 hours from the hospital arrival) was 9% in the pre-TC group and 4.5% in the post-tc group (p<0.005). Discussion: Be needed to complete our goal. Further analysis and possible comparison with other trauma centers be needed to complete our goal Conclusions: Our results show that in our experience the multidisciplinary approach to polytrauma patients increased early survival and improved outcome with an evidence of worker's satisfaction. However, the best practice would ask to start with the approval of procedures and guidelines by the hospital governance, followed by clinical practice changes, in order to create a dedicated emergency and trauma surgery group. Key word: Damage Control Surgery, Non Operative Management, Trauma Course, Trauma Team, Trauma Center.
MeSH term(s)	Blood Transfusion/statistics & numerical data ; Conservative Treatment/statistics & numerical data ; Diagnostic Imaging/statistics & numerical data ; Disease Management ; Education, Medical, Continuing ; Emergencies ; Emergency Medicine/education ; Emergency Service, Hospital/organization & administration ; Emergency Service, Hospital/statistics & numerical data ; Hospital Mortality ; Humans ; Injury Severity Score ; Multiple Trauma/mortality ; Multiple Trauma/surgery ; Multiple Trauma/therapy ; Organizational Policy ; Practice Guidelines as Topic ; Surgical Procedures, Operative/statistics & numerical data ; Time-to-Treatment ; Trauma Centers/organization & administration ; Trauma Centers/statistics & numerical data ; Treatment Outcome ; Unnecessary Procedures
Language	English
Publishing date	2016-01-22
Publishing country	Italy
Document type	Journal Article
ZDB-ID	418927-9
ISSN	2239-253X ; 0003-469X
ISSN (online)	2239-253X
ISSN	0003-469X
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Article ; Online: A systematic review on the use of topical hemostats in trauma and emergency surgery.

Chiara, Osvaldo / Cimbanassi, Stefania / Bellanova, Giovanni / Chiarugi, Massimo / Mingoli, Andrea / Olivero, Giorgio / Ribaldi, Sergio / Tugnoli, Gregorio / Basilicò, Silvia / Bindi, Francesca / Briani, Laura / Renzi, Federica / Chirletti, Piero / Di Grezia, Giuseppe / Martino, Antonio / Marzaioli, Rinaldo / Noschese, Giuseppe / Portolani, Nazario / Ruscelli, Paolo /

Zago, Mauro / Sgardello, Sebastian / Stagnitti, Franco / Miniello, Stefano

BMC surgery

2018 Volume 18, Issue 1, Page(s) 68

Abstract: Background: A wide variety of hemostats are available as adjunctive measures to improve hemostasis during surgical procedures if residual bleeding persists despite correct application of conventional methods for hemorrhage control. Some are considered ... ...

Abstract	Background: A wide variety of hemostats are available as adjunctive measures to improve hemostasis during surgical procedures if residual bleeding persists despite correct application of conventional methods for hemorrhage control. Some are considered active agents, since they contain fibrinogen and thrombin and actively participate at the end of the coagulation cascade to form a fibrin clot, whereas others to be effective require an intact coagulation system. The aim of this study is to provide an evidence-based approach to correctly select the available agents to help physicians to use the most appropriate hemostat according to the clinical setting, surgical problem and patient's coagulation status. Methods: The literature from 2000 to 2016 was systematically screened according to PRISMA [Preferred Reporting Items for Systematic Reviews and Meta-Analyses] protocol. Sixty-six articles were reviewed by a panel of experts to assign grade of recommendation (GoR) and level of evidence (LoE) using the GRADE [Grading of Recommendations Assessment, Development and Evaluation] system, and a national meeting was held. Results: Fibrin adhesives, in liquid form (fibrin glues) or with stiff collagen fleece (fibrin patch) are effective in the presence of spontaneous or drug-induced coagulation disorders. Mechanical hemostats should be preferred in patients who have an intact coagulation system. Sealants are effective, irrespective of patient's coagulation status, to improve control of residual oozing. Hemostatic dressings represent a valuable option in case of external hemorrhage at junctional sites or when tourniquets are impractical or ineffective. Conclusions: Local hemostatic agents are dissimilar products with different indications. A knowledge of the properties of each single agent should be in the armamentarium of acute care surgeons in order to select the appropriate product in different clinical conditions.
MeSH term(s)	Administration, Topical ; Emergencies ; Hemorrhage/etiology ; Hemorrhage/therapy ; Hemostatics/administration & dosage ; Humans ; Wounds and Injuries/complications ; Wounds and Injuries/surgery
Chemical Substances	Hemostatics
Keywords	covid19
Language	English
Publishing date	2018-08-29
Publishing country	England
Document type	Journal Article ; Review ; Systematic Review
ZDB-ID	2050442-1
ISSN	1471-2482 ; 1471-2482
ISSN (online)	1471-2482
ISSN	1471-2482
DOI	10.1186/s12893-018-0398-z
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Article: Localizzazione endotoracica della malattia di Von Recklinghausen. Caso clinico.

Serao, Angelo / Bellanova, Giovanni / Papi, Maria Grazia / Matteucci, Giuseppe / Antonellis, Donato

Annali italiani di chirurgia

2006 Volume 77, Issue 2, Page(s) 165–168

Abstract: Objective: A case of a 45 years old man affected by the Von Recklinghausen disease with a rare neurofibroma of the thoracic wall is reported.: Materials: Starting from 2000 the Authors are using the V.A.T.S. (video assisted thoracic surgery) in their ...

Title translation	Endothoracic localization of the Von Recklinghausen disease. A case report.
Abstract	Objective: A case of a 45 years old man affected by the Von Recklinghausen disease with a rare neurofibroma of the thoracic wall is reported. Materials: Starting from 2000 the Authors are using the V.A.T.S. (video assisted thoracic surgery) in their Department of surgery, as minimally invasive approach to diagnosis and treatment of some thoracic diseases: initially the patient was studied by a standard chest x-ray followed by tomography and magnetic resonance to determine the localization of the neoplasm of the chest wall. Results: The neurofibroma was removed by V.A.T.S., through a minimal thoracic access. After treatment we observed the complete remission of symptoms. Discussion: Single localization of the neurofibroma in the Von Recklinghausen disease can transform into a malignant neoplasm. The indication to surgery, in the case presented, was determined by the intense thoracic pain and by the risk of malignant degeneration. The minimally invasive approach showed to be the best option according to the dimensions of the neurofibroma. In the actual literature this approach represents the gold standard in the treatment of small intrathoracic neoplasm. Conclusion: In the chest wall localization of the Von Recklinghausen disease the Authors recommend the minimal surgical treatment by using V.A.T.S.
MeSH term(s)	Follow-Up Studies ; Humans ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Minimally Invasive Surgical Procedures ; Neurofibromatosis 1/diagnosis ; Neurofibromatosis 1/diagnostic imaging ; Neurofibromatosis 1/surgery ; Radiography, Thoracic ; Thoracic Surgery, Video-Assisted ; Thoracic Wall ; Time Factors ; Tomography, X-Ray Computed ; Treatment Outcome
Language	Italian
Publishing date	2006-03
Publishing country	Italy
Document type	Case Reports ; Journal Article
ZDB-ID	418927-9
ISSN	2239-253X ; 0003-469X
ISSN (online)	2239-253X
ISSN	0003-469X
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Article ; Online: 2017 WSES guidelines on colon and rectal cancer emergencies: obstruction and perforation.

Pisano, Michele / Zorcolo, Luigi / Merli, Cecilia / Cimbanassi, Stefania / Poiasina, Elia / Ceresoli, Marco / Agresta, Ferdinando / Allievi, Niccolò / Bellanova, Giovanni / Coccolini, Federico / Coy, Claudio / Fugazzola, Paola / Martinez, Carlos Augusto / Montori, Giulia / Paolillo, Ciro / Penachim, Thiago Josè / Pereira, Bruno / Reis, Tarcisio / Restivo, Angelo /

Rezende-Neto, Joao / Sartelli, Massimo / Valentino, Massimo / Abu-Zidan, Fikri M / Ashkenazi, Itamar / Bala, Miklosh / Chiara, Osvaldo / De' Angelis, Nicola / Deidda, Simona / De Simone, Belinda / Di Saverio, Salomone / Finotti, Elena / Kenji, Inaba / Moore, Ernest / Wexner, Steven / Biffl, Walter / Coimbra, Raul / Guttadauro, Angelo / Leppäniemi, Ari / Maier, Ron / Magnone, Stefano / Mefire, Alain Chicom / Peitzmann, Andrew / Sakakushev, Boris / Sugrue, Michael / Viale, Pierluigi / Weber, Dieter / Kashuk, Jeffry / Fraga, Gustavo P / Kluger, Ioran / Catena, Fausto / Ansaloni, Luca

World journal of emergency surgery : WJES

2018 Volume 13, Page(s) 36

Abstract: ᅟ: Obstruction and perforation due to colorectal cancer represent challenging matters in terms of diagnosis, life-saving strategies, obstruction resolution and oncologic challenge. The aims of the current paper are to update the previous WSES guidelines ...

Abstract	ᅟ: Obstruction and perforation due to colorectal cancer represent challenging matters in terms of diagnosis, life-saving strategies, obstruction resolution and oncologic challenge. The aims of the current paper are to update the previous WSES guidelines for the management of large bowel perforation and obstructive left colon carcinoma (OLCC) and to develop new guidelines on obstructive right colon carcinoma (ORCC). Methods: The literature was extensively queried for focused publication until December 2017. Precise analysis and grading of the literature has been performed by a working group formed by a pool of experts: the statements and literature review were presented, discussed and voted at the Consensus Conference of the 4th Congress of the World Society of Emergency Surgery (WSES) held in Campinas in May 2017. Results: CT scan is the best imaging technique to evaluate large bowel obstruction and perforation. For OLCC, self-expandable metallic stent (SEMS), when available, offers interesting advantages as compared to emergency surgery; however, the positioning of SEMS for surgically treatable causes carries some long-term oncologic disadvantages, which are still under analysis. In the context of emergency surgery, resection and primary anastomosis (RPA) is preferable to Hartmann's procedure, whenever the characteristics of the patient and the surgeon are permissive. Right-sided loop colostomy is preferable in rectal cancer, when preoperative therapies are predicted.With regards to the treatment of ORCC, right colectomy represents the procedure of choice; alternatives, such as internal bypass and loop ileostomy, are of limited value.Clinical scenarios in the case of perforation might be dramatic, especially in case of free faecal peritonitis. The importance of an appropriate balance between life-saving surgical procedures and respect of oncologic caveats must be stressed. In selected cases, a damage control approach may be required.Medical treatments including appropriate fluid resuscitation, early antibiotic treatment and management of co-existing medical conditions according to international guidelines must be delivered to all patients at presentation. Conclusions: The current guidelines offer an extensive overview of available evidence and a qualitative consensus regarding management of large bowel obstruction and perforation due to colorectal cancer.
MeSH term(s)	Colectomy/methods ; Colorectal Neoplasms/therapy ; Colostomy/methods ; Guidelines as Topic/standards ; Humans ; Intestinal Obstruction/diagnosis ; Intestinal Obstruction/therapy ; Intestinal Perforation/diagnosis ; Intestinal Perforation/therapy ; Self Expandable Metallic Stents ; Tomography, X-Ray Computed/methods
Language	English
Publishing date	2018-08-13
Publishing country	England
Document type	Journal Article ; Review
ISSN	1749-7922
ISSN (online)	1749-7922
DOI	10.1186/s13017-018-0192-3
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article: IROA: International Register of Open Abdomen, preliminary results.

Coccolini, Federico / Montori, Giulia / Ceresoli, Marco / Catena, Fausto / Ivatury, Rao / Sugrue, Michael / Sartelli, Massimo / Fugazzola, Paola / Corbella, Davide / Salvetti, Francesco / Negoi, Ionut / Zese, Monica / Occhionorelli, Savino / Maccatrozzo, Stefano / Shlyapnikov, Sergei / Galatioto, Christian / Chiarugi, Massimo / Demetrashvili, Zaza / Dondossola, Daniele /

Yovtchev, Yovcho / Ioannidis, Orestis / Novelli, Giuseppe / Nacoti, Mirco / Khor, Desmond / Inaba, Kenji / Demetriades, Demetrios / Kaussen, Torsten / Jusoh, Asri Che / Ghannam, Wagih / Sakakushev, Boris / Guetta, Ohad / Dogjani, Agron / Costa, Stefano / Singh, Sandeep / Damaskos, Dimitrios / Isik, Arda / Yuan, Kuo-Ching / Trotta, Francesco / Rausei, Stefano / Martinez-Perez, Aleix / Bellanova, Giovanni / Fonseca, Vinicius Cordeiro / Hernández, Fernando / Marinis, Athanasios / Fernandes, Wellington / Quiodettis, Martha / Bala, Miklosh / Vereczkei, Andras / Curado, Rafael L / Fraga, Gustavo Pereira / Pereira, Bruno M / Gachabayov, Mahir / Chagerben, Guillermo Perez / Arellano, Miguel Leon / Ozyazici, Sefa / Costa, Gianluca / Tezcaner, Tugan / Ansaloni, Luca

World journal of emergency surgery : WJES

2017 Volume 12, Page(s) 10

Abstract: Background: No definitive data about open abdomen (OA) epidemiology and outcomes exist. The World Society of Emergency Surgery (WSES) and the Panamerican Trauma Society (PTS) promoted the International Register of Open Abdomen (IROA).: Methods: A ... ...

Abstract	Background: No definitive data about open abdomen (OA) epidemiology and outcomes exist. The World Society of Emergency Surgery (WSES) and the Panamerican Trauma Society (PTS) promoted the International Register of Open Abdomen (IROA). Methods: A prospective observational cohort study including patients with an OA treatment. Data were recorded on a web platform (Clinical Registers®) through a dedicated website: www.clinicalregisters.org. Results: Four hundred two patients enrolled. Adult patients: 369 patients; Mean age: 57.39±18.37; 56% male; Mean BMI: 36±5.6. OA indication: Peritonitis (48.7%), Trauma (20.5%), Vascular Emergencies/Hemorrhage (9.4%), Ischemia (9.1%), Pancreatitis (4.2%),Post-operative abdominal-compartment-syndrome (3.9%), Others (4.2%). The most adopted Temporary-abdominal-closure systems were the commercial negative pressure ones (44.2%). During OA 38% of patients had complications; among them 10.5% had fistula. Definitive closure: 82.8%; Mortality during treatment: 17.2%. Mean duration of OA: 5.39(±4.83) days; Mean number of dressing changes: 0.88(±0.88). After-closure complications: (49.5%) and Mortality: (9%). No significant associations among TACT, indications, mortality, complications and fistula. A linear correlationexists between days of OA and complications (Pearson linear correlation = 0.326 Conclusion: Temporary abdominal closure is reliable and safe. The different techniques account for different results according to the different indications. In peritonitis commercial negative pressure temporary closure seems to improve results. In trauma skin-closure and Bogotà-bag seem to improve results. Trial registration: ClinicalTrials.gov NCT02382770.
MeSH term(s)	Abdomen/surgery ; Abdominal Wound Closure Techniques/trends ; Adult ; Aged ; Child ; Child, Preschool ; Cohort Studies ; Digestive System Surgical Procedures/methods ; Digestive System Surgical Procedures/statistics & numerical data ; Female ; Humans ; Internationality ; Kaplan-Meier Estimate ; Male ; Middle Aged ; Prospective Studies ; Registries/statistics & numerical data ; Wounds and Injuries/surgery
Language	English
Publishing date	2017-02-21
Publishing country	England
Document type	Journal Article ; Observational Study
ISSN	1749-7922
ISSN	1749-7922
DOI	10.1186/s13017-017-0123-8
Database	MEDical Literature Analysis and Retrieval System OnLINE

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