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  1. Article: Patient Outcomes Related to In-Hospital Delays in Appendicectomy for Appendicitis: A Retrospective Study.

    Claydon, Oliver / Down, Billy / Kumar, Sidharth

    Cureus

    2022  Volume 14, Issue 3, Page(s) e23034

    Abstract: Background and objective In many hospitals, the availability of operating theatres and access to senior surgical and anaesthetic support diminish during night hours. Therefore, urgent surgery is sometimes postponed until the following morning rather than ...

    Abstract Background and objective In many hospitals, the availability of operating theatres and access to senior surgical and anaesthetic support diminish during night hours. Therefore, urgent surgery is sometimes postponed until the following morning rather than performed overnight, if it is judged to be safe. In this study, we aimed to determine if a delay in laparoscopic appendicectomy in cases of acute appendicitis of over 12 hours, analogous to an overnight delay, correlated with worse patient outcomes. Our primary outcome was delayed discharge from the hospital. Our secondary outcomes were appendicitis severity, conversions, and postoperative complications. Methods We undertook a retrospective review of the medical records of patients who underwent laparoscopic appendicectomy for appendicitis at a UK district general hospital between 01/01/2018 and 30/08/2019. For each patient, clinical and demographic information, and time of hospital admission, surgery, and discharge were collected. Delayed discharge was defined as "time to discharge" >24 hours after surgery. Results A total of 446 patients were included in the study. In 137 patients (30.7%), "time to surgery" was under 12 hours; in 309 patients (69.3%) "time to surgery" was over 12 hours. Of note, 319 patients (71.5%) had a delayed discharge; 303 patients (67.9%) had complicated appendicitis, and 143 patients had severe appendicitis (32.1%). No statistically significant association between "time to surgery" and delayed discharge, appendicitis severity, conversion, or 30-day re-presentations was observed. Conclusion Time from admission to the start of appendicectomy did not affect patient outcomes. Short in-hospital delays in appendicectomy, such as an overnight delay, may be safe in certain patients and should be determined based on clinical judgement.
    Language English
    Publishing date 2022-03-10
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2747273-5
    ISSN 2168-8184
    ISSN 2168-8184
    DOI 10.7759/cureus.23034
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Understanding complaints made about surgical departments in a UK district general hospital.

    Claydon, Oliver / Keeler, Barrie / Khanna, Achal

    International journal for quality in health care : journal of the International Society for Quality in Health Care

    2021  Volume 33, Issue 3

    Abstract: Background: Patient complaints are increasingly recognized to provide a valuable insight into patients' experience of healthcare. Being local and subjective, they can bring to light previously under-appreciated causes of patient dissatisfaction. The ... ...

    Abstract Background: Patient complaints are increasingly recognized to provide a valuable insight into patients' experience of healthcare. Being local and subjective, they can bring to light previously under-appreciated causes of patient dissatisfaction. The focus of surgical care is usually an intervention, and the nature of complaints made about surgical care may vary substantially from that in non-surgical specialties. This may have specific implications for quality improvement in surgical departments.
    Objective: To investigate the causes of patient dissatisfaction in surgical care.
    Methods: We retrospectively examined the content and frequency of patient complaints received by surgical departments at a UK district general hospital in the calendar year 2017. Second-hand reports of complaints, documented by the members of the hospital's complaints department, were collated from a prospectively maintained database and categorized by content.
    Results: Three hundred and ninety-nine complaints were received over the study period. These related to the care of 327 different patients. One complaint was generated for every 111 patient encounters. Ninety-one per cent of the complaints were made by the patient, and 8.8% were made by a family member. Complaints cited communication with hospital staff in 25% of cases, out-of-hospital delays in 24%, clinical issues in 22%, hospital administration in 16% and in-hospital delays in 10%. Post-operative symptoms and complications accounted for only 2% of the complaints. Twenty-six per cent of the complaints resulted in the rescheduling of an operation or a clinic appointment. Seventeen per cent of the complaints prompted internal actions within the surgical department to investigate and learn from the incident.
    Conclusion: The profile of complaints made about surgical departments is similar to that of non-surgical departments in other studies. Clinical issues represented only the third largest cause of complaints. More complaints implicated patient-staff communication, and around half implicated management-related issues. Improving staff communication training, clinical standards and hospital administration continues to represent opportunities to enhance the patients' overall experience of surgical care.
    MeSH term(s) Hospital Departments ; Hospitals, General ; Humans ; Patient Satisfaction ; Retrospective Studies ; United Kingdom
    Language English
    Publishing date 2021-06-24
    Publishing country England
    Document type Journal Article
    ZDB-ID 1194150-9
    ISSN 1464-3677 ; 1353-4505
    ISSN (online) 1464-3677
    ISSN 1353-4505
    DOI 10.1093/intqhc/mzab095
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    In stock of ZB MED Cologne/Königswinter

    Zs.A 3052: Show issues Location:
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    bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular
    Jg. 1995 - 2021: Lesesall (2.OG)
    ab Jg. 2022: Lesesaal (EG)

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  3. Article ; Online: Outcomes of chest wall fixation in cardiopulmonary resuscitation-induced flail chest.

    Claydon, Oliver / Benamore, Rachel / Belcher, Elizabeth

    Interactive cardiovascular and thoracic surgery

    2020  Volume 31, Issue 3, Page(s) 417–418

    Abstract: Chest wall injury is a common complication of cardiopulmonary resuscitation. Chest wall fixation of flail chest has been shown to improve outcomes in patients in whom trauma is the primary pathology. Its efficacy in the post-cardiopulmonary resuscitation ...

    Abstract Chest wall injury is a common complication of cardiopulmonary resuscitation. Chest wall fixation of flail chest has been shown to improve outcomes in patients in whom trauma is the primary pathology. Its efficacy in the post-cardiopulmonary resuscitation setting where the primary event is cardiac arrest is yet to be determined. We report outcomes in a series of 4 patients who underwent rib fixation in the setting of cardiopulmonary resuscitation-induced flail chest.
    MeSH term(s) Adult ; Aged ; Cardiopulmonary Resuscitation/adverse effects ; Female ; Flail Chest/diagnosis ; Flail Chest/etiology ; Flail Chest/surgery ; Fracture Fixation, Internal/methods ; Heart Arrest/therapy ; Humans ; Male ; Middle Aged ; Rib Fractures/diagnosis ; Rib Fractures/etiology ; Rib Fractures/surgery ; Thoracic Wall/surgery ; Tomography, X-Ray Computed
    Language English
    Publishing date 2020-07-15
    Publishing country England
    Document type Journal Article
    ZDB-ID 2095298-3
    ISSN 1569-9285 ; 1569-9293
    ISSN (online) 1569-9285
    ISSN 1569-9293
    DOI 10.1093/icvts/ivaa118
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    In stock of ZB MED Cologne/Königswinter

    Zs.A 5730: Show issues Location:
    Je nach Verfügbarkeit (siehe Angabe bei Bestand)
    bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular
    Jg. 1995 - 2021: Lesesall (2.OG)
    ab Jg. 2022: Lesesaal (EG)

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  4. Article: Open Appendicectomy under Spinal Anesthesia-A Valuable Alternative during COVID-19.

    Mai, Dinh Van Chi / Sagar, Alex / Claydon, Oliver / Park, Ji Young / Tapuria, Niteen / Keeler, Barrie D

    Surgery journal (New York, N.Y.)

    2021  Volume 7, Issue 2, Page(s) e69–e72

    Abstract: ... ...

    Abstract Introduction
    Language English
    Publishing date 2021-06-03
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2864275-2
    ISSN 2378-5136 ; 2378-5128
    ISSN (online) 2378-5136
    ISSN 2378-5128
    DOI 10.1055/s-0041-1725933
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  5. Article: A local experience of non-operative management for an appendicitis cohort during COVID-19.

    Mai, Dinh Van Chi / Sagar, Alex / Menon, Nainika Suresh / Claydon, Oliver / Park, Ji Young / Down, Billy / Keeler, Barrie David

    Annals of medicine and surgery (2012)

    2021  Volume 63, Page(s) 102160

    Abstract: Background: During the first United Kingdom COVID-19 wave, the Royal Colleges of Surgeons initially recommended conservative management with antibiotics instead of surgery for appendicitis. This study compared local outcomes of appendicitis during this ... ...

    Abstract Background: During the first United Kingdom COVID-19 wave, the Royal Colleges of Surgeons initially recommended conservative management with antibiotics instead of surgery for appendicitis. This study compared local outcomes of appendicitis during this period with a pre-COVID-19 cohort.
    Methods: An observational study was conducted in a district general hospital. All episodes of appendicitis were prospectively studied from 25
    Results: Over nine weeks, there were 39 cases of appendicitis during COVID-19 and 50 cases pre-COVID-19. Twenty-six and 50 cases underwent appendicectomy during and pre-COVID-19 respectively. There was no difference in 30-day postoperative complication rates and nor were there any peri-operative COVID-19 infections.Twelve cases of simple appendicitis underwent conservative management during COVID-19 and were compared with 23 operatively managed simple cases pre-pandemic. There was a higher failure rate in the conservative versus operative group (33.3 vs 0% OR = 24.88, 95% CI 1.21 to 512.9,
    Discussion: Locally, conservative management was more likely to fail than initial appendicectomy. We suggest that surgery should remain first line for appendicitis, with conservative management reserved for those with suspected or proven COVID-19 infection.
    Language English
    Publishing date 2021-02-12
    Publishing country England
    Document type Journal Article
    ZDB-ID 2745440-X
    ISSN 2049-0801
    ISSN 2049-0801
    DOI 10.1016/j.amsu.2021.02.006
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  6. Article: Open Appendicectomy under Spinal Anesthesia—A Valuable Alternative during COVID-19

    Mai, Dinh Van Chi / Sagar, Alex / Claydon, Oliver / Park, Ji Young / Tapuria, Niteen / Keeler, Barrie D.

    The Surgery Journal

    2021  Volume 07, Issue 02, Page(s) e69–e72

    Abstract: Introduction: Concerns relating to coronavirus disease 2019 (COVID-19) and general anesthesia (GA) prompted our department to consider that open appendicectomy under spinal anesthesia (SA) avoids aerosolization from intubation and laparoscopy. While ... ...

    Abstract Introduction: Concerns relating to coronavirus disease 2019 (COVID-19) and general anesthesia (GA) prompted our department to consider that open appendicectomy under spinal anesthesia (SA) avoids aerosolization from intubation and laparoscopy. While common in developing nations, it is unusual in the United Kingdom. We present the first United Kingdom case series and discuss its potential role during and after this pandemic.
    Methods: We prospectively studied patients with appendicitis at a British district general hospital who were unsuitable for conservative management and consequently underwent open appendicectomy under SA. We also reviewed patient satisfaction after 30 days. This ran for 5 weeks from March 25th, 2020 until the surgical department reverted to the laparoscopic appendicectomy as the standard of care. Main outcomes were 30-day complication rates and patient satisfaction.
    Results: None of the included seven patients were COVID positive. The majority (four-sevenths) had complicated appendicitis. There were no major adverse (Clavien-Dindo grade III to V) postoperative events. Two patients suffered minor postoperative complications. Two experienced intraoperative pain. Mean operative time was 44 minutes. Median length of stay and return to activity was 1 and 14 days, respectively. Although four stated preference in hindsight for GA, the majority (five-sevenths) were satisfied with the operative experience under SA.
    Discussion: Although contraindications, risk of pain, and specific complications may be limiting, our series demonstrates open appendicectomy under SA to be safe and feasible in the United Kingdom. The technique could be a valuable contingency for COVID-suspected cases and patients with high-risk respiratory disease.
    Keywords COVID-19 ; SARS-CoV-2 ; appendicitis ; appendicectomy ; anesthesia ; spinal
    Language English
    Publishing date 2021-04-01
    Publisher Thieme Medical Publishers, Inc.
    Publishing place Stuttgart ; New York
    Document type Article
    ZDB-ID 2864275-2
    ISSN 2378-5136 ; 2378-5128
    ISSN (online) 2378-5136
    ISSN 2378-5128
    DOI 10.1055/s-0041-1725933
    Database Thieme publisher's database

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  7. Article ; Online: Completely minimally invasive versus hybrid Ivor-Lewis oesophagectomy for oesophageal and gastro-oesophageal junctional cancer: a UK multi-centre comparative study.

    Patel, Krashna / Askari, Alan / Abbassi, Omar / Jayanthi, Naga Venkatesh / Claydon, Oliver / Laycock, James / Ramalingam, Aravindh / Kumar, Bhaskar / Wong, Joshua / Aly, Mohamed / Jambulingam, Periyathambi

    Surgical endoscopy

    2022  Volume 36, Issue 8, Page(s) 5822–5832

    Abstract: Background: Limited robust evidence exists comparing outcomes following completely minimally invasive oesophagectomy (CMIO) to hybrid oesophagectomy (HO) in the treatment of resectable oesophageal and gastro-oesophageal junctional (GOJ) cancer. This ... ...

    Abstract Background: Limited robust evidence exists comparing outcomes following completely minimally invasive oesophagectomy (CMIO) to hybrid oesophagectomy (HO) in the treatment of resectable oesophageal and gastro-oesophageal junctional (GOJ) cancer. This multi-centre study aims to assess postoperative morbidity between HO and CMIO according to the full Esophagectomy Complications Consensus Group (ECCG) complication platform.
    Methods: All consecutive patients undergoing an Ivor-Lewis HO or Ivor-Lewis CMIO for cancer between 2016 and 2018 in three UK tertiary centres were included. The primary study outcome was 30-day overall complications, evaluated by the ECCG complication subgroups. Secondary outcomes included survival outcomes and perioperative parameters between the two approaches.
    Results: Of the 382 patients included, 228 (59.7%) patients had HOs and 154 (40.3%) patients had CMIOs with no inter-group baseline differences. Patients undergoing CMIO experienced less 30-day postoperative complications compared to those under undergoing HO (43.5% vs 57.0%, p = 0.010). ECCG defined pulmonary and infective complications were less frequent in the CMIO group. Anastomotic leak rates and oncological outcomes were similar between the two groups. Independent predictors of 30-day postoperative complications include surgical approach with HO and high ASA grade on multivariable analysis.
    Conclusions: Ivor-Lewis CMIO demonstrates superior short-term surgical outcomes when compared to Ivor-Lewis HO with no compromise in oncological feasibility. Anastomotic leak rates were equivalent between both groups. A robust randomised controlled trial is required to validate the findings of this study.
    MeSH term(s) Anastomotic Leak/surgery ; Esophageal Neoplasms ; Esophagectomy/adverse effects ; Humans ; Length of Stay ; Minimally Invasive Surgical Procedures/adverse effects ; Postoperative Complications/epidemiology ; Postoperative Complications/etiology ; Postoperative Complications/surgery ; Retrospective Studies ; Stomach Neoplasms/surgery ; Treatment Outcome ; United Kingdom/epidemiology
    Language English
    Publishing date 2022-01-19
    Publishing country Germany
    Document type Journal Article ; Multicenter Study
    ZDB-ID 639039-0
    ISSN 1432-2218 ; 0930-2794
    ISSN (online) 1432-2218
    ISSN 0930-2794
    DOI 10.1007/s00464-022-09043-x
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    In stock of ZB MED Cologne/Königswinter

    Zs.A 2214: Show issues Location:
    Je nach Verfügbarkeit (siehe Angabe bei Bestand)
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    Jg. 1995 - 2021: Lesesall (1.OG)
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