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  1. Article ; Online: Stroke volume variation does not correlate with central venous pressure during hepatectomy.

    Parra-Membrives, Pablo / Lorente-Herce, José M / Jiménez-Riera, Granada / Martínez-Baena, Darío

    HPB : the official journal of the International Hepato Pancreato Biliary Association

    2023  Volume 25, Issue 5, Page(s) 518–520

    Abstract: Background: Central venous pressure measurement has been the standard for patient monitoring during hepatectomy to assure low pressure and reduce blood loss. Recently SVV has been employed to monitor preload and guide fluid replacement during liver ... ...

    Abstract Background: Central venous pressure measurement has been the standard for patient monitoring during hepatectomy to assure low pressure and reduce blood loss. Recently SVV has been employed to monitor preload and guide fluid replacement during liver surgery. The aim of the study is to determine if SVV correlates with CVP values and may replace CVP measurement.
    Methods: From January 2021 to February 2022 thirty patients undergoing 32 liver resections were included in the study. Repeated paired data of CVP and SVV were determined every 10 minutes throughout liver resection. The Correlation between CVP and SVV values was calculated. Analysis was then stratified by surgical approach, hilar clamping tempus, operative timing and PEEP values.
    Results: A total number of 519 paired SSV/CVP values were recorded. Only a very weak correlation between SSV and CVP was detected (Pearson coefficient -0.122/ p=0.005). The results were unaltered after the stratified analysis by surgical approach, presence of hilar clamping, operative timing and PEEP use, revealing no correlation between SSV and CVP values.
    Conclusion: The CVP /SVV values do not show a relevant correlation during liver surgery. CVP measurement is still of value and should not be replaced by SVV monitoring to conduct a safe hepatectomy.
    MeSH term(s) Humans ; Hepatectomy/adverse effects ; Hepatectomy/methods ; Stroke Volume ; Central Venous Pressure ; Liver ; Monitoring, Physiologic/methods
    Language English
    Publishing date 2023-02-09
    Publishing country England
    Document type Journal Article
    ZDB-ID 2131251-5
    ISSN 1477-2574 ; 1365-182X
    ISSN (online) 1477-2574
    ISSN 1365-182X
    DOI 10.1016/j.hpb.2023.01.013
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Enterovesical fistula secondary to migrated transpapillary stent.

    Jiménez-Riera, Granada / Martínez-Baena, Darío / Lorente-Herce, José Manuel / Parra-Membrives, Pablo

    Cirugia espanola

    2021  Volume 100, Issue 2, Page(s) 104

    MeSH term(s) Humans ; Intestinal Fistula/complications ; Intestinal Fistula/etiology ; Stents/adverse effects ; Urinary Bladder Fistula/complications
    Language English
    Publishing date 2021-12-29
    Publishing country Spain
    Document type Journal Article
    ISSN 2173-5077
    ISSN (online) 2173-5077
    DOI 10.1016/j.cireng.2021.12.005
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  3. Article ; Online: Enterovesical fistula secondary to migrated transpapillary stent.

    Jiménez-Riera, Granada / Martínez-Baena, Darío / Lorente-Herce, José Manuel / Parra-Membrives, Pablo

    Cirugia espanola

    2021  

    Title translation Fístula enterovesical por migración de endoprótesis biliar transpapilar.
    Language Spanish
    Publishing date 2021-03-08
    Publishing country Spain
    Document type Journal Article
    ISSN 2173-5077
    ISSN (online) 2173-5077
    DOI 10.1016/j.ciresp.2020.12.018
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  4. Article: Long-term outcome of patients with biliary pancreatitis not undergoing cholecystectomy. A retrospective study.

    Parra-Membrives, Pablo / García-Vico, Ana / Martínez-Baena, Darío / Lorente-Herce, José Manuel / Jiménez-Riera, Granada

    Revista espanola de enfermedades digestivas : organo oficial de la Sociedad Espanola de Patologia Digestiva

    2021  Volume 114, Issue 2, Page(s) 96–102

    Abstract: Background and objective: most acute pancreatitis cases are of biliary origin and cholecystectomy is recommended to prevent recurrence. However, some patients will never be referred for surgery. In this study, the long-term follow-up of this group of ... ...

    Abstract Background and objective: most acute pancreatitis cases are of biliary origin and cholecystectomy is recommended to prevent recurrence. However, some patients will never be referred for surgery. In this study, the long-term follow-up of this group of patients was reviewed.
    Methods: all new cases of biliary pancreatitis from January 2015 to December 2017 that did not undergo cholecystectomy were analyzed. Epidemiologic data and Charlson's comorbidity index (CCI) were recorded. Recurrent episodes of pancreatitis or biliary events and mortality during the follow-up period were recorded.
    Results: a total of 104 patients were included in the study (30.4 % of all biliary pancreatitis cases) and the median age was 82 years (range, 27-96). Average CCI was 5 (range, 0-18) and the median follow-up period was 37 months (range, 1-70). A total of 41 patients (39.4 %) had gallstone-related complications. Twenty-three patients (22,1 %) had recurrent pancreatitis and 34 (32,7 %) developed biliary events. Twenty-five patients died during follow-up (24 %) but only in 6 (5,8 %) was death due to gallstone-related complications. Non-related mortality was 15.5 % in patients who refused surgery and 25 % in multiple-comorbidity patients.
    Conclusion: patients who did not undergo cholecystectomy were at high risk for biliary events and pancreatitis recurrence. Conservative treatment and surgical abstention should be individualized and reserved for patients with multiple comorbidities with a short life expectancy.
    MeSH term(s) Acute Disease ; Aged, 80 and over ; Cholecystectomy/adverse effects ; Gallstones/complications ; Gallstones/surgery ; Humans ; Pancreatitis/etiology ; Pancreatitis/surgery ; Recurrence ; Retrospective Studies ; Sphincterotomy, Endoscopic/adverse effects ; Treatment Outcome
    Language English
    Publishing date 2021-05-04
    Publishing country Spain
    Document type Journal Article
    ZDB-ID 1070381-0
    ISSN 1130-0108 ; 0212-7512
    ISSN 1130-0108 ; 0212-7512
    DOI 10.17235/reed.2021.7891/2021
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    In stock of ZB MED Cologne/Königswinter

    Zs.B 199: Show issues Location:
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  5. Article ; Online: Hepatic PEcoma: an unusual tumor in an infrequent location.

    Sánchez-Gálvez, MaÁngeles / Parra-Membrives, Pablo / Sánchez-Bernal, Ma Luisa / Martínez-Baena, Darío / Lorente-Herce, José M / Jiménez-Riera, Granada

    Cirugia y cirujanos

    2020  Volume 88, Issue 2, Page(s) 215–218

    Abstract: Perivascular epithelioid cell neoplasms (PEComas) are a tumor family defined as such just a couple of decades ago. They make an unusual group of neoplasms, which can appear in different locations of the organism. PEComas are usually considered to be ... ...

    Title translation PEComa hepático: un tumor inusual en una localización infrecuente.
    Abstract Perivascular epithelioid cell neoplasms (PEComas) are a tumor family defined as such just a couple of decades ago. They make an unusual group of neoplasms, which can appear in different locations of the organism. PEComas are usually considered to be benign tumors, but there are some histological features that make some subgroups suspicious of malignancy. The treatment of these tumors consist in their surgical resection, with no current effective complementary oncological treatment known. We present the clinical case of a woman that underwent surgery for a resection of a hepatic lesion labeled afterwards as a PEComa with malignant features.
    MeSH term(s) Female ; Humans ; Liver Neoplasms/pathology ; Liver Neoplasms/surgery ; Middle Aged ; Perivascular Epithelioid Cell Neoplasms/pathology ; Perivascular Epithelioid Cell Neoplasms/surgery
    Language English
    Publishing date 2020-03-02
    Publishing country Mexico
    Document type Case Reports ; Journal Article
    ZDB-ID 730699-4
    ISSN 2444-054X ; 0009-7411
    ISSN (online) 2444-054X
    ISSN 0009-7411
    DOI 10.24875/CIRU.19001093
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    In stock of ZB MED Cologne/Königswinter

    Zs.B 797: Show issues Location:
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  6. Article ; Online: Choledocholithiasis recurrence following laparoscopic common bile duct exploration.

    Parra-Membrives, Pablo / Martínez-Baena, Darío / Lorente-Herce, José Manuel / Jiménez-Riera, Granada / Sánchez-Gálvez, María Ángeles

    Cirugia espanola

    2019  Volume 97, Issue 6, Page(s) 336–342

    Abstract: Introduction: Choledocholithiasis may be treated following an endoscopic approach or by laparoscopic common bile duct exploration (LCBDE). Stone recurrence following endoscopic management has been extensively investigated. We analyze the risk factors ... ...

    Title translation Recurrencia de coledocolitiasis tras exploración laparoscópica de la vía biliar principal.
    Abstract Introduction: Choledocholithiasis may be treated following an endoscopic approach or by laparoscopic common bile duct exploration (LCBDE). Stone recurrence following endoscopic management has been extensively investigated. We analyze the risk factors associated with stone recurrence following LCBDE.
    Methods: Patients who underwent LCBDE from February 2004 to July 2016 were examined in an univariate and multivariate analysis to assess the association of stone recurrence with the following variables: gender; age; hepatopathy; dyslipidemia, obesity or diabetes mellitus; previous abdominal surgery; presence of cholecystitis, cholangitis or pancreatitis; preoperative liver function tests, number of retrieved stones; method of common bile duct clearance and closure; presence of impacted or intrahepatic stones; conversion to open surgery and postoperative morbidity.
    Results: A total of 156 patients were included. Recurrence rate for choledocholithiasis was 14.1% with a mean time to recurrence of 38.18 month. Age was the only independent risk factor for stone recurrence at univariate and multivariate analysis. No patient aged under 55 years developed new common bile duct stones, and 86.4% of the recurrences occurred in patients aged above 65.
    Conclusions: Age is the only independent risk factor associated to choledocholithiasis recurrence following LCBDE. Different mechanism in common bile duct stone development may be present for younger and older patients.
    MeSH term(s) Adult ; Age Factors ; Aged ; Cholecystectomy, Laparoscopic/adverse effects ; Cholecystectomy, Laparoscopic/methods ; Choledocholithiasis/diagnosis ; Choledocholithiasis/physiopathology ; Choledocholithiasis/surgery ; Common Bile Duct/surgery ; Female ; Humans ; Male ; Middle Aged ; Postoperative Complications/epidemiology ; Postoperative Complications/surgery ; Recurrence ; Reoperation/statistics & numerical data ; Risk Assessment/methods ; Risk Factors
    Language Spanish
    Publishing date 2019-04-23
    Publishing country Spain
    Document type Journal Article
    ISSN 2173-5077
    ISSN (online) 2173-5077
    DOI 10.1016/j.ciresp.2019.02.012
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  7. Article ; Online: Controlled attenuation parameter-insulin resistance (CIR) score to predict non-alcoholic steatohepatitis.

    Macias, Juan / Parra-Membrives, Pablo / Sosa-Moreno, Francisco / Rincon, Pilar / Martinez-Baena, Dario / Fernandez-Fuertes, Marta / Lorente-Herce, Jose M / Martinez, Rafael C / Jimenez-Riera, Granada / Corma-Gomez, Anaïs / Gonzalez-Serna, Alejandro / Pineda, Juan A / Real, Luis Miguel

    Scientific reports

    2022  Volume 12, Issue 1, Page(s) 21897

    Abstract: The diagnosis of non-alcoholic steatohepatitis (NASH) requires liver biopsy. Patients with NASH are at risk of progression to advanced fibrosis and hepatocellular carcinoma. A reliable non-invasive tool for the detection of NASH is needed. We aimed at ... ...

    Abstract The diagnosis of non-alcoholic steatohepatitis (NASH) requires liver biopsy. Patients with NASH are at risk of progression to advanced fibrosis and hepatocellular carcinoma. A reliable non-invasive tool for the detection of NASH is needed. We aimed at developing a tool to diagnose NASH based on a predictive model including routine clinical and transient hepatic elastography (TE) data. All subjects undergoing elective cholecystectomy in our center were invited to participate, if alcohol intake was < 30 g/d for men and < 15 g/d for women. TE with controlled attenuation parameter (CAP) was obtained before surgery. A liver biopsy was taken during surgery. Multivariate logistic regression models to predict NASH were constructed with the first 100 patients, the elaboration group, and the results were validated in the next pre-planned 50 patients. Overall, 155 patients underwent liver biopsy. In the elaboration group, independent predictors of NASH were CAP value [adjusted OR (AOR) 1.024, 95% confidence interval (95% CI) 1.002-1.046, p = 0.030] and HOMA value (AOR 1.847, 95% CI 1.203-2.835, p < 0.001). An index derived from the logistic regression equation to identify NASH was designated as the CAP-insulin resistance (CIR) score. The area under the receiver operating characteristic curve (95%CI) of the CIR score was 0.93 (0.87-0.99). Positive (PPV) and negative predictive values (NPV) of the CIR score were 82% and 91%, respectively. In the validation set, PPV was 83% and NPV was 88%. In conclusion, the CIR score, a simple index based on CAP and HOMA, can reliably identify patients with and without NASH.
    MeSH term(s) Male ; Humans ; Female ; Non-alcoholic Fatty Liver Disease/pathology ; Elasticity Imaging Techniques/methods ; Insulin Resistance ; Liver/pathology ; ROC Curve ; Biopsy ; Liver Neoplasms/pathology ; Liver Cirrhosis/pathology
    Language English
    Publishing date 2022-12-19
    Publishing country England
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 2615211-3
    ISSN 2045-2322 ; 2045-2322
    ISSN (online) 2045-2322
    ISSN 2045-2322
    DOI 10.1038/s41598-022-25931-7
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  8. Article ; Online: Comparative Study of Three Bile Duct Closure Methods Following Laparoscopic Common Bile Duct Exploration for Choledocholithiasis.

    Parra-Membrives, Pablo / Martínez-Baena, Darío / Lorente-Herce, José / Jiménez-Riera, Granada

    Journal of laparoendoscopic & advanced surgical techniques. Part A

    2017  Volume 28, Issue 2, Page(s) 145–151

    Abstract: Background: There are three choledochotomy closure methods available following laparoscopic common bile duct exploration: T-tube insertion, antegrade stenting, and primary choledochorrhaphy. We reviewed the experience of 12 years at our center searching ...

    Abstract Background: There are three choledochotomy closure methods available following laparoscopic common bile duct exploration: T-tube insertion, antegrade stenting, and primary choledochorrhaphy. We reviewed the experience of 12 years at our center searching for the optimal closure technique.
    Methods: We analyzed retrospectively 146 patients that underwent one of the three closure methods from February 2004 to March 2016. Hospital stay, need for readmission, incidence of early and long-term complications, and biliary leakage development and their clinical impact were determined for each technique.
    Results: Hospital stay was more prolonged, and need for readmission was higher in the T-tube group. Nine patients of the T-tube group (17.3%), 5 patients (8.6%) of the antegrade stenting group, and 1 patient of the primary suture group (2.8%) developed Dindo-Clavien ≥3 complications (P = .076). The incidence of biliary leakage was 3.8%, 8.6%, and 16.7% for the T-tube group, antegrade stenting group, and primary suture group, respectively. There was no grade C biliary fistula in the primary suture group, and all grade B leaks in these patients were only due to prolonged duration. The T-tube removal caused adverse events in 21.1% of the patients, and complications directly related with stents occurred in 9.6%.
    Conclusion: Antegrade stents or T-tube insertion do not provide any added value for choledochotomy closure but are charged with specific morbidity. On the contrary, despite biliary leaks being more frequent after primary suture, they are of little clinical consequence and may be managed on an outpatient basis.
    MeSH term(s) Adult ; Aged ; Aged, 80 and over ; Biliary Tract Surgical Procedures/adverse effects ; Biliary Tract Surgical Procedures/methods ; Choledocholithiasis/surgery ; Common Bile Duct/surgery ; Drainage/adverse effects ; Drainage/methods ; Female ; Follow-Up Studies ; Humans ; Laparoscopy/adverse effects ; Laparoscopy/methods ; Length of Stay/statistics & numerical data ; Male ; Middle Aged ; Patient Readmission/statistics & numerical data ; Postoperative Complications/epidemiology ; Retrospective Studies ; Stents/adverse effects ; Wound Closure Techniques/adverse effects
    Language English
    Publishing date 2017-10-04
    Publishing country United States
    Document type Comparative Study ; Journal Article
    ZDB-ID 2608063-1
    ISSN 1557-9034 ; 1092-6429
    ISSN (online) 1557-9034
    ISSN 1092-6429
    DOI 10.1089/lap.2017.0433
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  9. Article ; Online: Goodbye Hartmann trial: a prospective, international, multicenter, observational study on the current use of a surgical procedure developed a century ago.

    Perrone, Gennaro / Giuffrida, Mario / Abu-Zidan, Fikri / Kruger, Vitor F / Livrini, Marco / Petracca, Gabriele Luciano / Rossi, Giorgio / Tarasconi, Antonio / Tian, Brian W C A / Bonati, Elena / Mentz, Ricardo / Mazzini, Federico N / Campana, Juan P / Gasser, Elisabeth / Kafka-Ritsch, Reinhold / Felsenreich, Daniel M / Dawoud, Christopher / Riss, Stefan / Gomes, Carlos Augusto /
    Gomes, Felipe Couto / Gonzaga, Ricardo Alessandro Teixeira / Canton, Cassio Alfred Brattig / Pereira, Bruno Monteiro / Fraga, Gustavo P / Zem, Leticia Gonçalves / Cordeiro-Fonseca, Vinicius / de Mesquita Tauil, Renato / Atanasov, Boyko / Belev, Nikolay / Kovachev, Nikola / Meléndez, L Juan José / Dimova, Ana / Dimov, Stefan / Zelić, Zdravko / Augustin, Goran / Bogdanić, Branko / Morić, Trpimir / Chouillard, Elie / Bajul, Melinda / De Simone, Belinda / Panis, Yves / Esposito, Francesco / Notarnicola, Margherita / Lauka, Lelde / Fabbri, Anna / Hentati, Hassen / Fnaiech, Iskander / Aurélien, Venara / Bougard, Marie / Roulet, Maxime / Demetrashvili, Zaza / Pipia, Irakli / Merabishvili, Giorgi / Bouliaris, Konstantinos / Koukoulis, Georgios / Doudakmanis, Christos / Xenaki, Sofia / Chrysos, Emmanuel / Kokkinakis, Stamatios / Vassiliu, Panteleimon / Michalopoulos, Nikolaos / Margaris, Ioannis / Kechagias, Aristotelis / Avgerinos, Konstantinos / Katunin, Jevgeni / Lostoridis, Eftychios / Nagorni, Eleni-Aikaterini / Pujante, Antonio / Mulita, Francesk / Maroulis, Ioannis / Vailas, Michail / Marinis, Athanasios / Siannis, Ioannis / Bourbouteli, Eirini / Manatakis, Dimitrios K / Tasis, Nikolaos / Acheimastos, Vasileios / Maria, Sotiropoulou / Stylianos, Kapiris / Kuzeridis, Harilaos / Korkolis, Dimitrios / Fradelos, Evangelos / Kavalieratos, George / Petropoulou, Thalia / Polydorou, Andreas / Papacostantinou, Ioannis / Triantafyllou, Tania / Kimpizi, Despina / Theodorou, Dimitrios / Toutouzas, Konstantinos / Chamzin, Alexandros / Frountzas, Maximos / Schizas, Dimitrios / Karavokyros, Ioannis / Syllaios, Athanasios / Charalabopoulos, Alexandros / Boura, Maria / Baili, Efstratia / Ioannidis, Orestis / Loutzidou, Lydia / Anestiadou, Elissavet / Tsouknidas, Ioannis / Petrakis, Georgios / Polenta, Eleni / Bains, Lovenish / Gupta, Rahul / Singh, Sudhir K / Khanduri, Archana / Bala, Miklosh / Kedar, Asaf / Pisano, Marcello / Podda, Mauro / Pisanu, Adolfo / Martines, Gennaro / Trigiante, Giuseppe / Lantone, Giuliano / Agrusa, Antonino / Di Buono, Giuseppe / Buscemi, Salvatore / Veroux, Massimiliano / Gioco, Rossella / Veroux, Gastone / Oragano, Luigi / Zonta, Sandro / Lovisetto, Federico / Feo, Carlo V / Pesce, Antonio / Fabbri, Nicolò / Lantone, Giulio / Marino, Fabio / Perrone, Fabrizio / Vincenti, Leonardo / Papagni, Vincenzo / Picciariello, Arcangelo / Rossi, Stefano / Picardi, Biagio / Del Monte, Simone Rossi / Visconti, Diego / Osella, Giulia / Petruzzelli, Luca / Pignata, Giusto / Andreuccetti, Jacopo / D'Alessio, Rossella / Buonfantino, Massimo / Guaitoli, Eleonora / Spinelli, Stefano / Sampietro, Gianluca Matteo / Corbellini, Carlo / Lorusso, Leonardo / Frontali, Alice / Pezzoli, Isabella / Bonomi, Alessandro / Chierici, Andrea / Cotsoglou, Christian / Manca, Giuseppe / Delvecchio, Antonella / Musa, Nicola / Casati, Massimiliano / Letizia, Laface / Abate, Emmanuele / Ercolani, Giorgio / D'Acapito, Fabrizio / Solaini, Leonardo / Guercioni, Gianluca / Cicconi, Simone / Sasia, Diego / Borghi, Felice / Giraudo, Giorgio / Sena, Giuseppe / Castaldo, Pasquale / Cardamone, Eugenia / Portale, Giuseppe / Zuin, Matteo / Spolverato, Ylenia / Esposito, Marialusia / Isernia, Roberta Maria / Di Salvo, Maria / Manunza, Romina / Esposito, Giuseppe / Agus, Marcello / Asti, Emanuele Luigi Giuseppe / Bernardi, Daniele Tiziano / Tonucci, Tommaso Panici / Luppi, Davide / Casadei, Massimiliano / Bonilauri, Stefano / Pezzolla, Angela / Panebianco, Annunziata / Laforgia, Rita / De Luca, Maurizio / Zese, Monica / Parini, Dario / Jovine, Elio / De Sario, Giuseppina / Lombardi, Raffaele / Aprea, Giovanni / Palomba, Giuseppe / Capuano, Marianna / Argenio, Giulio / Orio, Gianluca / Armellino, Mariano Fortunato / Troian, Marina / Guerra, Martina / Nagliati, Carlo / Biloslavo, Alan / Germani, Paola / Aizza, Giada / Monsellato, Igor / Chahrour, Ali Chaouki / Anania, Gabriele / Bombardini, Cristina / Bagolini, Francesco / Sganga, Gabriele / Fransvea, Pietro / Bianchi, Valentina / Boati, Paolo / Ferrara, Francesco / Palmieri, Francesco / Cianci, Pasquale / Gattulli, Domenico / Restini, Enrico / Cillara, Nicola / Cannavera, Alessandro / Nita, Gabriela Elisa / Sarnari, Jlenia / Roscio, Francesco / Clerici, Federico / Scandroglio, Ildo / Berti, Stefano / Cadeo, Alessandro / Filippelli, Alice / Conti, Luigi / Grassi, Carmine / Cattaneo, Gaetano Maria / Pighin, Marina / Papis, Davide / Gambino, Giovanni / Bertino, Vanessa / Schifano, Domenico / Prando, Daniela / Fogato, Luisella / Cavallo, Fabio / Ansaloni, Luca / Picheo, Roberto / Pontarolo, Nicholas / Depalma, Norma / Spampinato, Marcello / D'Ugo, Stefano / Lepre, Luca / Capponi, Michela Giulii / Campa, Rossella Domenica / Sarro, Giuliano / Dinuzzi, Vincenza Paola / Olmi, Stefano / Uccelli, Matteo / Ferrari, Davide / Inama, Marco / Moretto, Gianluigi / Fontana, Michele / Favi, Francesco / Picariello, Erika / Rampini, Alessia / Barberis, Andrea / Azzinnaro, Antonio / Oliva, Alba / Totaro, Luigi / Benzoni, Ilaria / Ranieri, Valerio / Capolupo, Gabriella Teresa / Carannante, Filippo / Caricato, Marco / Ronconi, Maurizio / Casiraghi, Silvia / Casole, Giovanni / Pantalone, Desire / Alemanno, Giovanni / Scheiterle, Maximilian / Ceresoli, Marco / Cereda, Marco / Fumagalli, Chiara / Zanzi, Federico / Bolzon, Stefano / Guerra, Enrico / Lecchi, Francesca / Cellerino, Paola / Ardito, Antonella / Scaramuzzo, Rosa / Balla, Andrea / Lepiane, Pasquale / Tartaglia, Nicola / Ambrosi, Antonio / Pavone, Giovanna / Palini, Gian Marco / Veneroni, Simone / Garulli, Gianluca / Ricci, Claudio / Torre, Beatrice / Russo, Iris Shari / Rottoli, Matteo / Tanzanu, Marta / Belvedere, Angela / Milone, Marco / Manigrasso, Michele / De Palma, Giovanni Domenico / Piccoli, Micaela / Pattacini, Gianmaria Casoni / Magnone, Stefano / Bertoli, Paolo / Pisano, Michele / Massucco, Paolo / Palisi, Marco / Luzzi, Andrea-Pierre / Fleres, Francesco / Clarizia, Guglielmo / Spolini, Alessandro / Kobe, Yoshiro / Toma, 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Ratnasekera, Asanthi / Egodage, Tanya / Echeverria-Rosario, Karla / Armento, Isabella / Napolitano, Lena M / Sangji, Naveen F / Hemmila, Mark / Quick, Jacob A / Austin, Tyler R / Hyman, Theodore S / Curtiss, William / McClure, Amanda / Cairl, Nicholas / Biffl, Walter L / Truong, Hung P / Schaffer, Kathryn / Reames, Summer / Banchini, Filippo / Capelli, Patrizio / Coccolini, Federico / Sartelli, Massimo / Bravi, Francesca / Vallicelli, Carlo / Agnoletti, Vanni / Baiocchi, Gian Luca / Catena, Fausto

    World journal of emergency surgery : WJES

    2024  Volume 19, Issue 1, Page(s) 14

    Abstract: Background: Literature suggests colonic resection and primary anastomosis (RPA) instead of Hartmann's procedure (HP) for the treatment of left-sided colonic emergencies. We aim to evaluate the surgical options globally used to treat patients with acute ... ...

    Abstract Background: Literature suggests colonic resection and primary anastomosis (RPA) instead of Hartmann's procedure (HP) for the treatment of left-sided colonic emergencies. We aim to evaluate the surgical options globally used to treat patients with acute left-sided colonic emergencies and the factors that leading to the choice of treatment, comparing HP and RPA.
    Methods: This is a prospective, international, multicenter, observational study registered on ClinicalTrials.gov. A total 1215 patients with left-sided colonic emergencies who required surgery were included from 204 centers during the period of March 1, 2020, to May 31, 2020. with a 1-year follow-up.
    Results: 564 patients (43.1%) were females. The mean age was 65.9 ± 15.6 years. HP was performed in 697 (57.3%) patients and RPA in 384 (31.6%) cases. Complicated acute diverticulitis was the most common cause of left-sided colonic emergencies (40.2%), followed by colorectal malignancy (36.6%). Severe complications (Clavien-Dindo ≥ 3b) were higher in the HP group (P < 0.001). 30-day mortality was higher in HP patients (13.7%), especially in case of bowel perforation and diffused peritonitis. 1-year follow-up showed no differences on ostomy reversal rate between HP and RPA. (P = 0.127). A backward likelihood logistic regression model showed that RPA was preferred in younger patients, having low ASA score (≤ 3), in case of large bowel obstruction, absence of colonic ischemia, longer time from admission to surgery, operating early at the day working hours, by a surgeon who performed more than 50 colorectal resections.
    Conclusions: After 100 years since the first Hartmann's procedure, HP remains the most common treatment for left-sided colorectal emergencies. Treatment's choice depends on patient characteristics, the time of surgery and the experience of the surgeon. RPA should be considered as the gold standard for surgery, with HP being an exception.
    MeSH term(s) Female ; Humans ; Middle Aged ; Aged ; Aged, 80 and over ; Male ; Emergencies ; Prospective Studies ; Postoperative Complications/etiology ; Anastomosis, Surgical/methods ; Colorectal Neoplasms/surgery
    Language English
    Publishing date 2024-04-16
    Publishing country England
    Document type Observational Study ; Multicenter Study ; Journal Article
    ZDB-ID 2233734-9
    ISSN 1749-7922 ; 1749-7922
    ISSN (online) 1749-7922
    ISSN 1749-7922
    DOI 10.1186/s13017-024-00543-w
    Database MEDical Literature Analysis and Retrieval System OnLINE

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