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Article ; Online: Modified enhanced recovery after surgery protocol in patients with acute cholecystitis: efficacy, safety and feasibility. Multicenter randomized control study.

Nechay, Taras / Titkova, Svetlana / Tyagunov, Alexander / Anurov, Mikhail / Sazhin, Alexander

2021 Volume 73, Issue 4, Page(s) 1407–1417

Abstract: Laparoscopic cholecystectomy (LC) is a common surgical procedure in acute cholecystitis (AC). Patients often suffer from considerable postoperative pain and indigestion, which prolongs in-hospital stay. The enhanced recovery after surgery (ERAS) program ... ...

Abstract	Laparoscopic cholecystectomy (LC) is a common surgical procedure in acute cholecystitis (AC). Patients often suffer from considerable postoperative pain and indigestion, which prolongs in-hospital stay. The enhanced recovery after surgery (ERAS) program has proven its efficacy in elective surgery and could hypothetically improve outcomes of emergency LC. Currently, there is no ERAS program for LC in patients with AC. A modified ERAS (mERAS) protocol was studied in a prospective, randomized non-blinded clinical trial (NCT03754751). The mERAS group consisted of 88 patients the control group of 101 patients. The modified protocol included a patient information brochure; minimizing drain use; local anesthesia; low-pressure pneumoperitoneum; PONV prophylaxis, early mobilization and oral diet. The primary outcome was postoperative length of stay (pLOS). The postoperative length of stay in the mERAS group was shorter (24 (21-45.5) h) than in the control (45 (41-68) h) (p < 0.0001). One re-admission in the mERAS group was reported (p = 0.466). There difference in complications was insignificant (mERAS 6.8% vs 5% p = 0.757). Post-operative pain intensity was significantly lower in the mERAS group immediately after awaking (3.7 ± 1.8 vs 5.4 ± 1.3 p < 0.0001), 2 h (3.3 ± 1.7 vs 4.9 ± 1.6 p = 0.0006), 6 h (2.9 ± 1.5 vs 4.2 ± 1.2 p < 0.0001), 12 h (2.7 ± 0.9 vs 4.1 ± 1.2 p = 0.0001) and 24 h after surgery (2.1 ± 1.2 vs 3 ± 1.2 p < 0.0001). The incidence of shoulder and neck pain was lower in mERAS group (13.6% vs 34.7% p = 0.0009). Peristalsis recovery was similar in both groups. The proposed protocol improved postoperative recovery and reduced hospital stay in patients with AC without increasing the rate of complications or re-admissions.
MeSH term(s)	Cholecystitis, Acute/surgery ; Enhanced Recovery After Surgery ; Feasibility Studies ; Humans ; Laparoscopy ; Length of Stay ; Multicenter Studies as Topic ; Postoperative Complications/epidemiology ; Postoperative Complications/prevention & control ; Prospective Studies ; Randomized Controlled Trials as Topic ; Treatment Outcome
Language	English
Publishing date	2021-03-22
Publishing country	Italy
Document type	Clinical Trial Protocol ; Journal Article
ZDB-ID	2572692-4
ISSN	2038-3312 ; 2038-131X
ISSN (online)	2038-3312
ISSN	2038-131X
DOI	10.1007/s13304-021-01031-5
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Article ; Online: Surgical and endovascular treatment of pelvic venous disorder: Results of a multicentre retrospective cohort study.

Gavrilov, Sergey G / Sazhin, Alexander V / Akhmetzianov, RustemV / Bredikhin, Roman A / Krasavin, Gennady V / Mishakina, Nadezhda Yu / Vasilyiev, Alexey V

Journal of vascular surgery. Venous and lymphatic disorders

2023 Volume 11, Issue 5, Page(s) 1045–1054

Abstract: Objective: In the present study, we investigated the clinical outcomes after gonadal vein resection (GVR) and gonadal vein embolization (GVE) with coils in patients with pelvic venous disorder (PeVD). We also assessed the rates of procedural ... ...

Abstract	Objective: In the present study, we investigated the clinical outcomes after gonadal vein resection (GVR) and gonadal vein embolization (GVE) with coils in patients with pelvic venous disorder (PeVD). We also assessed the rates of procedural complications and disease recurrence. Methods: Our multicenter retrospective cohort study included 361 female patients with PeVD-related chronic pelvic pain (CPP) and gonadal vein reflux who underwent GVR (n = 184) or GVE with coils (n = 177) from 1999 to 2020. The clinical outcomes (ie, presence and severity of CPP, procedural complications, disease recurrence) were assessed at 1 month and 1, 3, and 5 years after intervention. The pain intensity before and after treatment was assessed using a visual analog scale. All the patients underwent duplex ultrasound after GVR and GVE, and those with persistent CPP and suspected perforation of the gonadal vein by the coils were also evaluated by multiplanar pelvic venography. Results: GVR and GVE was associated with the reduction or elimination of CPP at 1 month after treatment in 100% and 74% of patients and postprocedural complications in 14% and 37% of patients, respectively (Р < 0.01 for both). The most common complication after either GVR or GVE was pelvic vein thrombosis (11% and 22% patients, respectively; P < .01 between groups). GVE was associated with postembolization syndrome in 20%, coil protrusion in 6%, and coil migration in 1% of patients. The long-term recurrence rate after GVR and GVE was 6% and 16%, respectively (P < .01). Conclusions: Both GVR and GVE were found to be effective in treating patients with PeVD. However, GVR was associated with better efficacy in the relief of CPP and lower rates of procedural complications and disease recurrence.
MeSH term(s)	Humans ; Female ; Retrospective Studies ; Pelvic Pain/diagnostic imaging ; Pelvic Pain/etiology ; Pelvic Pain/therapy ; Vascular Diseases/therapy ; Pelvis/blood supply ; Veins/diagnostic imaging ; Veins/surgery ; Embolization, Therapeutic/adverse effects ; Embolization, Therapeutic/methods ; Treatment Outcome
Language	English
Publishing date	2023-05-06
Publishing country	United States
Document type	Multicenter Study ; Journal Article
ISSN	2213-3348
ISSN (online)	2213-3348
DOI	10.1016/j.jvsv.2023.04.009
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Article ; Online: Comparative analysis of the efficacy and safety of endovascular and endoscopic interventions on the gonadal veins in the treatment of pelvic congestion syndrome.

Gavrilov, Sergey Gennadievich / Sazhin, Alexander / Krasavin, Gennady / Moskalenko, Ekaterina / Mishakina, Nadeshda

Journal of vascular surgery. Venous and lymphatic disorders

2020 Volume 9, Issue 1, Page(s) 178–186

Abstract: Objective: Comparison of the efficacy and safety of endovascular and endoscopic interventions on the gonadal vein in the treatment of patients with pelvic congestion syndrome (PCS).: Methods: We evaluated the treatment outcomes in 95 patients with ... ...

Abstract	Objective: Comparison of the efficacy and safety of endovascular and endoscopic interventions on the gonadal vein in the treatment of patients with pelvic congestion syndrome (PCS). Methods: We evaluated the treatment outcomes in 95 patients with PCS who underwent endovascular embolization of gonadal veins (EEGV) (group 1, n = 67) or endoscopic resection of the gonadal veins (ERGV) (group 2; n = 28). A comparative analysis of the efficacy and safety of EEGV and ERGV in the treatment of PCS included assessments of their effects on pelvic venous pain, pelvic venous reflux, diameter of the pelvic veins, and restoration of daily activity, as well as treatment safety assessment. Clinical examinations and ultrasound studies of the pelvic veins were repeated at 1, 10, and 30 days, and 36 months after EEGV and ERGV. Pain was assessed using a visual analogue scale and the Von Korff questionnaire. Results: A decrease in pelvic venous pain intensity was observed at 3.6 ± 1.4 days after EEGV and 2.5 ± 0.8 days after ERGV (P = .49 between the groups). At 1 month after the intervention, a complete relief of pelvic pain was reported by 52 and 25 patients in the EEGV and ERGV groups, respectively. The rates of valvular incompetence of the uterine veins were decreased from 85% in both groups at baseline to 3% in group 1 and 0% in group 2 at 36 months after the intervention, respectively. In the early postprocedural period, pain in the femoral or jugular vein puncture site was reported by eight patients (12%) who underwent EEGV (2.2 ± 0.7 scores). Postembolization syndrome was diagnosed in 13 patients (19.4%). After ERGV, all patients experienced pain in the area of the surgical wound, with a severity of 3.9 ± 0.5 scores. Hematoma at the puncture site of the main vein was observed in 6% of patients after EEGV. Protrusion of coils was identified in three patients (4.5%). The VTE incidence was four times greater in group 1 vs group 2 (14 vs 3 patients; P < .05). The relative risk of this complication after EEGV was 1.4 (95% confidence interval, 1.146-1.732). In two patients (7.1%) after the bilateral laparoscopic resection of the gonadal veins, an ileus developed. No complications of anesthesia were observed in either group. Conclusions: Endovascular and endoscopic techniques for decreasing blood flow through the gonadal veins are effective and safe in treating the PCS. The obvious advantages of EEGV are minimal injury and possibility to perform procedure under local anesthesia. The ERGV is associated with at least similar and, in some cases, even superior outcomes, in the terms of significantly (P < .05) shorter time to the postprocedural pain relief and avoiding postembolization syndrome.
MeSH term(s)	Adult ; Chronic Pain/diagnosis ; Chronic Pain/physiopathology ; Chronic Pain/therapy ; Embolization, Therapeutic/adverse effects ; Endoscopy/adverse effects ; Endovascular Procedures/adverse effects ; Female ; Gonads/blood supply ; Humans ; Male ; Pelvic Pain/diagnosis ; Pelvic Pain/physiopathology ; Pelvic Pain/therapy ; Pelvis/blood supply ; Regional Blood Flow ; Retrospective Studies ; Syndrome ; Time Factors ; Treatment Outcome ; Venous Insufficiency/diagnostic imaging ; Venous Insufficiency/physiopathology ; Venous Insufficiency/therapy ; Young Adult
Language	English
Publishing date	2020-05-25
Publishing country	United States
Document type	Comparative Study ; Journal Article
ISSN	2213-3348
ISSN (online)	2213-3348
DOI	10.1016/j.jvsv.2020.05.013
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Article ; Online: Author Correction: Evaluation of enhanced recovery after surgery program components implemented in laparoscopic appendectomy: prospective randomized clinical study.

Nechay, Taras / Sazhin, Alexander / Titkova, Svetlana / Tyagunov, Alexander / Anurov, Mikhail / Melnikov-Makarchuk, Kirill / Tyagunov, Anton

Scientific reports

2021 Volume 11, Issue 1, Page(s) 18646

Language	English
Publishing date	2021-09-14
Publishing country	England
Document type	Published Erratum
ZDB-ID	2615211-3
ISSN	2045-2322 ; 2045-2322
ISSN (online)	2045-2322
ISSN	2045-2322
DOI	10.1038/s41598-021-97902-3
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Article ; Online: Evaluation of enhanced recovery after surgery program components implemented in laparoscopic appendectomy: prospective randomized clinical study.

Nechay, Taras / Sazhin, Alexander / Titkova, Svetlana / Tyagunov, Alexander / Anurov, Mikhail / Melnikov-Makarchuk, Kirill / Tyagunov, Anton

Scientific reports

2020 Volume 10, Issue 1, Page(s) 10749

Abstract: Background: Laparoscopic appendectomy (LA) is a widely used surgical procedure. Patients often suffer from considerable postoperative pain and indigestion, which prolongs their in-hospital stay. Almost 10% of patients develop postoperative complications. ...

Abstract	Background: Laparoscopic appendectomy (LA) is a widely used surgical procedure. Patients often suffer from considerable postoperative pain and indigestion, which prolongs their in-hospital stay. Almost 10% of patients develop postoperative complications. The enhanced recovery after surgery (ERAS) program has proven its efficacy in elective surgery and could hypothetically improve LA outcomes. Currently, there is no ERAS program for LA. Methods: A modified ERAS (mERAS) protocol was studied in a prospective, randomized nonblinded clinical trial. The mERAS group consisted of 50 patients; the control group, of 54 patients. The mERAS protocol included a patient information brochure; minimizing drain use; local anesthesia; low-pressure pneumoperitoneum; early mobilization and oral diet. The primary outcome was postoperative length of stay (pLOS). Results: Modified protocol reduced median pLOS to 1.25 days vs 2 days in the controls (p < 0.0001). Twenty-one (42%) mERAS patients and 4 (7.4%) controls were discharged within 24 h (p < 0.001) after surgery; 0 readmissions were reported. Postoperative pain intensity assessed on the visual analogue scale was significantly lower in the mERAS group [mERAS vs control 0 h, 2 h, 6 h, 12 h and 24 h after surgery: 2.33 ± 2.12 vs 4.19 ± 2.08 (p < 0.0001), 2.27 ± 1.91 vs 4.02 ± 1.89 (p < 0.0001), 2.28 ± 1.98 vs 3.70 ± 1.57 (p = 0.0001), 1.98 ± 1.72 vs 3.43 ± 1.54 (p < 0.0001) and 1.80 ± 1.74 vs 3.00 ± 1.27 (p = 0.032), respectively)]. The severity of shoulder and neck pain was lower but its incidence was similar. Peristalsis recovery was achieved earlier in the study group (median (min-max))-mERAS 7 (2-34) h vs control 11 (3-43) h; p = 0.009) but did not affect the time of the first flatus 23 (2-72) h vs 29 (6-70) h, respectively; p = 0.499). Conclusions: The modified ERAS program for LA has advantages over the traditional approach. Registration: This trial was registered at ClinicalTrials.gov as NCT03754777 (27/11/2018).
MeSH term(s)	Adult ; Appendectomy ; Elective Surgical Procedures ; Enhanced Recovery After Surgery ; Female ; Humans ; Laparoscopy ; Length of Stay ; Male ; Middle Aged ; Pain, Postoperative/etiology ; Perioperative Care/methods ; Peristalsis ; Postoperative Complications/epidemiology ; Postoperative Period ; Prospective Studies ; Young Adult
Language	English
Publishing date	2020-07-01
Publishing country	England
Document type	Journal Article ; Multicenter Study ; Randomized Controlled Trial
ZDB-ID	2615211-3
ISSN	2045-2322 ; 2045-2322
ISSN (online)	2045-2322
ISSN	2045-2322
DOI	10.1038/s41598-020-67591-5
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Article ; Online: Thermal Processes in Bile Ducts During Laparoscopic Cholecystectomy with Monopolar Instruments. Experimental Study Using Real-Time Intraluminal and Surface Thermography.

Nechay, Taras / Sazhin, Alexander / Titkova, Svetlana / Anurov, Mikhail / Tyagunov, Alexander / Sheptunov, Sergey / Yakhutlov, Umar / Nakhushev, Rahim / Sannikov, Alexander

Surgical innovation

2020 Volume 28, Issue 5, Page(s) 525–535

Abstract: Introduction. ...

Abstract	Introduction.
MeSH term(s)	Animals ; Bile Ducts/surgery ; Cholecystectomy ; Cholecystectomy, Laparoscopic/adverse effects ; Common Bile Duct ; Swine ; Thermography
Language	English
Publishing date	2020-12-29
Publishing country	United States
Document type	Journal Article
ZDB-ID	2182571-3
ISSN	1553-3514 ; 1553-3506
ISSN (online)	1553-3514
ISSN	1553-3506
DOI	10.1177/1553350620979829
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Article ; Online: Thermal effects of monopolar electrosurgery detected by real-time infrared thermography: an experimental appendectomy study.

Nechay, Taras V / Titkova, Svetlana M / Anurov, Mikhail V / Mikhalchik, Elena V / Melnikov-Makarchyk, Kirill Y / Ivanova, Ekaterina A / Tyagunov, Alexander E / Fingerhut, Abe / Sazhin, Alexander V

BMC surgery

2020 Volume 20, Issue 1, Page(s) 116

Abstract: Background: Monopolar energy (ME) is routinely used in appendectomy. This study aimed to investigate the degree of lateral thermal spread generated by ME and to evaluate the thermal injury sustained by the close-lying tissues.: Methods: Appendectomy ... ...

Abstract	Background: Monopolar energy (ME) is routinely used in appendectomy. This study aimed to investigate the degree of lateral thermal spread generated by ME and to evaluate the thermal injury sustained by the close-lying tissues. Methods: Appendectomy with a monopolar Maryland dissector was performed in 8 rabbits (at 30 and 60 W power settings). A high-resolution infrared camera was used to record tissue heating during the intervention. After autopsy macroscopic changes were evaluated and tissue samples were subjected to myeloperoxidase (MPO) assay and histological examination. Results: No significant differences in the extent of thermal spread, MPO activity and histological signs of inflammation were observed between groups. Regardless of the power settings, the heat spread exceeded 2 cm laterally along the mesoappendix when application time exceeded 3 s. The spread of heat through tubular structures in both groups caused a significant temperature rise in the nearby intestinal loop, resulting in perforation (n = 3) and necrosis (n = 1). Conclusions: Application time is critical in thermal spread during appendectomy aided by ME. Tubular anatomic structures can enhance thermal injury on distant tissues. The observed effects of ME bear clinical relevance that need further investigation.
MeSH term(s)	Animals ; Appendectomy/methods ; Appendix/surgery ; Dissection ; Electrosurgery/methods ; Hot Temperature ; Male ; Rabbits ; Thermography
Language	English
Publishing date	2020-05-27
Publishing country	England
Document type	Journal Article
ZDB-ID	2050442-1
ISSN	1471-2482 ; 1471-2482
ISSN (online)	1471-2482
ISSN	1471-2482
DOI	10.1186/s12893-020-00735-6
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Article ; Online: Pancreas-preserving duodenal resections with bile and pancreatic duct replantation for duodenal dystrophy. Two case reports.

Egorov, Viacheslav Ivanovich / Butkevich, Alexander Cezarevich / Sazhin, Alexander Viacheslavovich / Yashina, Nina Ivanovna / Bogdanov, Sergei Nikolaievich

JOP : Journal of the pancreas

2010 Volume 11, Issue 5, Page(s) 446–452

Abstract: Context: Duodenal dystrophy is a rare disease, characterized by the chronic inflammation of the aberrant pancreatic tissue in the duodenal wall.: Case reports: Two middle-aged men were admitted with upper abdominal pain of several months duration, ... ...

Abstract	Context: Duodenal dystrophy is a rare disease, characterized by the chronic inflammation of the aberrant pancreatic tissue in the duodenal wall. Case reports: Two middle-aged men were admitted with upper abdominal pain of several months duration, periodic nausea and vomiting after meals, intermittent jaundice and weight loss. A diagnosis of cystic dystrophy of the vertical part of the duodenum without chronic inflammation of the orthotopic pancreas was established in both cases by multi-detector computed tomography, magnetic resonance imaging and endosonography. Both patients were successfully treated by two modifications of pancreas-preserving duodenal resections with reimplantation of the bile and pancreatic ducts into the neoduodenum. Conclusion: These cases are a good example of a pancreas-preserving approach to duodenal dystrophy treatment and can be an alternative to the Whipple procedure in cases of mild changes of the orthotopic gland.
MeSH term(s)	Adult ; Bile Ducts/surgery ; Bile Ducts/transplantation ; Duodenal Diseases/diagnostic imaging ; Duodenal Diseases/surgery ; Duodenoscopy ; Duodenum/diagnostic imaging ; Duodenum/surgery ; Humans ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Models, Biological ; Pancreas/diagnostic imaging ; Pancreas/pathology ; Pancreatic Diseases/prevention & control ; Pancreatic Ducts/surgery ; Pancreatic Ducts/transplantation ; Tomography, X-Ray Computed ; Transplantation, Autologous ; Ultrasonography
Language	English
Publishing date	2010-09-06
Publishing country	Italy
Document type	Case Reports ; Journal Article
ZDB-ID	2039637-5
ISSN	1590-8577 ; 1590-8577
ISSN (online)	1590-8577
ISSN	1590-8577
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Article ; Online: Prospective Observational Study on acute Appendicitis Worldwide (POSAW).

Sartelli, Massimo / Baiocchi, Gian L / Di Saverio, Salomone / Ferrara, Francesco / Labricciosa, Francesco M / Ansaloni, Luca / Coccolini, Federico / Vijayan, Deepak / Abbas, Ashraf / Abongwa, Hariscine K / Agboola, John / Ahmed, Adamu / Akhmeteli, Lali / Akkapulu, Nezih / Akkucuk, Seckin / Altintoprak, Fatih / Andreiev, Aurelia L / Anyfantakis, Dimitrios / Atanasov, Boiko /

Bala, Miklosh / Balalis, Dimitrios / Baraket, Oussama / Bellanova, Giovanni / Beltran, Marcelo / Melo, Renato Bessa / Bini, Roberto / Bouliaris, Konstantinos / Brunelli, Daniele / Castillo, Adrian / Catani, Marco / Che Jusoh, Asri / Chichom-Mefire, Alain / Cocorullo, Gianfranco / Coimbra, Raul / Colak, Elif / Costa, Silvia / Das, Koray / Delibegovic, Samir / Demetrashvili, Zaza / Di Carlo, Isidoro / Kiseleva, Nadezda / El Zalabany, Tamer / Faro, Mario / Ferreira, Margarida / Fraga, Gustavo P / Gachabayov, Mahir / Ghnnam, Wagih M / Giménez Maurel, Teresa / Gkiokas, Georgios / Gomes, Carlos A / Griffiths, Ewen / Guner, Ali / Gupta, Sanjay / Hecker, Andreas / Hirano, Elcio S / Hodonou, Adrien / Hutan, Martin / Ioannidis, Orestis / Isik, Arda / Ivakhov, Georgy / Jain, Sumita / Jokubauskas, Mantas / Karamarkovic, Aleksandar / Kauhanen, Saila / Kaushik, Robin / Kavalakat, Alfie / Kenig, Jakub / Khokha, Vladimir / Khor, Desmond / Kim, Dennis / Kim, Jae I / Kong, Victor / Lasithiotakis, Konstantinos / Leão, Pedro / Leon, Miguel / Litvin, Andrey / Lohsiriwat, Varut / López-Tomassetti Fernandez, Eudaldo / Lostoridis, Eftychios / Maciel, James / Major, Piotr / Dimova, Ana / Manatakis, Dimitrios / Marinis, Athanasio / Martinez-Perez, Aleix / Marwah, Sanjay / McFarlane, Michael / Mesina, Cristian / Pędziwiatr, Michał / Michalopoulos, Nickos / Misiakos, Evangelos / Mohamedahmed, Ali / Moldovanu, Radu / Montori, Giulia / Mysore Narayana, Raghuveer / Negoi, Ionut / Nikolopoulos, Ioannis / Novelli, Giuseppe / Novikovs, Viktors / Olaoye, Iyiade / Omari, Abdelkarim / Ordoñez, Carlos A / Ouadii, Mouaqit / Ozkan, Zeynep / Pal, Ajay / Palini, Gian M / Partecke, Lars I / Pata, Francesco / Pereira Júnior, Gerson A / Pintar, Tadeja / Pisarska, Magdalena / Ploneda-Valencia, Cesar F / Pouggouras, Konstantinos / Prabhu, Vinod / Ramakrishnapillai, Padmakumar / Regimbeau, Jean-Marc / Reitz, Marianne / Rios-Cruz, Daniel / Saar, Sten / Sakakushev, Boris / Seretis, Charalampos / Sazhin, Alexander / Shelat, Vishal / Skrovina, Matej / Smirnov, Dmitry / Spyropoulos, Charalampos / Strzałka, Marcin / Talving, Peep / Teixeira Gonsaga, Ricardo A / Theobald, George / Tomadze, Gia / Torba, Myftar / Tranà, Cristian / Ulrych, Jan / Uzunoğlu, Mustafa Y / Vasilescu, Alin / Occhionorelli, Savino / Venara, Aurélien / Vereczkei, Andras / Vettoretto, Nereo / Vlad, Nutu / Walędziak, Maciej / Yilmaz, Tonguç U / Yuan, Kuo-Ching / Yunfeng, Cui / Zilinskas, Justas / Grelpois, Gérard / Catena, Fausto

World journal of emergency surgery : WJES

2018 Volume 13, Page(s) 19

Abstract: Background: Acute appendicitis (AA) is the most common surgical disease, and appendectomy is the treatment of choice in the majority of cases. A correct diagnosis is key for decreasing the negative appendectomy rate. The management can become difficult ... ...

Abstract	Background: Acute appendicitis (AA) is the most common surgical disease, and appendectomy is the treatment of choice in the majority of cases. A correct diagnosis is key for decreasing the negative appendectomy rate. The management can become difficult in case of complicated appendicitis. The aim of this study is to describe the worldwide clinical and diagnostic work-up and management of AA in surgical departments. Methods: This prospective multicenter observational study was performed in 116 worldwide surgical departments from 44 countries over a 6-month period (April 1, 2016-September 30, 2016). All consecutive patients admitted to surgical departments with a clinical diagnosis of AA were included in the study. Results: A total of 4282 patients were enrolled in the POSAW study, 1928 (45%) women and 2354 (55%) men, with a median age of 29 years. Nine hundred and seven (21.2%) patients underwent an abdominal CT scan, 1856 (43.3%) patients an US, and 285 (6.7%) patients both CT scan and US. A total of 4097 (95.7%) patients underwent surgery; 1809 (42.2%) underwent open appendectomy and 2215 (51.7%) had laparoscopic appendectomy. One hundred eighty-five (4.3%) patients were managed conservatively. Major complications occurred in 199 patients (4.6%). The overall mortality rate was 0.28%. Conclusions: The results of the present study confirm the clinical value of imaging techniques and prognostic scores. Appendectomy remains the most effective treatment of acute appendicitis. Mortality rate is low.
MeSH term(s)	Acute Disease/therapy ; Adult ; Appendectomy/adverse effects ; Appendectomy/methods ; Appendectomy/standards ; Appendicitis/surgery ; Chi-Square Distribution ; Female ; Hospitalization/statistics & numerical data ; Humans ; Laparoscopy/methods ; Laparoscopy/statistics & numerical data ; Length of Stay/statistics & numerical data ; Logistic Models ; Male ; Prospective Studies ; Tomography, X-Ray Computed/methods ; Treatment Outcome
Language	English
Publishing date	2018-04-16
Publishing country	England
Document type	Journal Article ; Multicenter Study ; Observational Study
ISSN	1749-7922
ISSN (online)	1749-7922
DOI	10.1186/s13017-018-0179-0
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Article ; Online: Physiological parameters for Prognosis in Abdominal Sepsis (PIPAS) Study: a WSES observational study.

Sartelli, Massimo / Abu-Zidan, Fikri M / Labricciosa, Francesco M / Kluger, Yoram / Coccolini, Federico / Ansaloni, Luca / Leppäniemi, Ari / Kirkpatrick, Andrew W / Tolonen, Matti / Tranà, Cristian / Regimbeau, Jean-Marc / Hardcastle, Timothy / Koshy, Renol M / Abbas, Ashraf / Aday, Ulaş / Adesunkanmi, A R K / Ajibade, Adesina / Akhmeteli, Lali / Akın, Emrah /

Akkapulu, Nezih / Alotaibi, Alhenouf / Altintoprak, Fatih / Anyfantakis, Dimitrios / Atanasov, Boyko / Augustin, Goran / Azevedo, Constança / Bala, Miklosh / Balalis, Dimitrios / Baraket, Oussama / Baral, Suman / Barkai, Or / Beltran, Marcelo / Bini, Roberto / Bouliaris, Konstantinos / Caballero, Ana B / Calu, Valentin / Catani, Marco / Ceresoli, Marco / Charalampakis, Vasileios / Jusoh, Asri Che / Chiarugi, Massimo / Cillara, Nicola / Cuesta, Raquel Cobos / Cobuccio, Luigi / Cocorullo, Gianfranco / Colak, Elif / Conti, Luigi / Cui, Yunfeng / De Simone, Belinda / Delibegovic, Samir / Demetrashvili, Zaza / Demetriades, Demetrios / Dimova, Ana / Dogjani, Agron / Enani, Mushira / Farina, Federica / Ferrara, Francesco / Foghetti, Domitilla / Fontana, Tommaso / Fraga, Gustavo P / Gachabayov, Mahir / Gérard, Grelpois / Ghnnam, Wagih / Maurel, Teresa Giménez / Gkiokas, Georgios / Gomes, Carlos A / Guner, Ali / Gupta, Sanjay / Hecker, Andreas / Hirano, Elcio S / Hodonou, Adrien / Hutan, Martin / Ilaschuk, Igor / Ioannidis, Orestis / Isik, Arda / Ivakhov, Georgy / Jain, Sumita / Jokubauskas, Mantas / Karamarkovic, Aleksandar / Kaushik, Robin / Kenig, Jakub / Khokha, Vladimir / Khokha, Denis / Kim, Jae Il / Kong, Victor / Korkolis, Dimitris / Kruger, Vitor F / Kshirsagar, Ashok / Simões, Romeo Lages / Lanaia, Andrea / Lasithiotakis, Konstantinos / Leão, Pedro / Arellano, Miguel León / Listle, Holger / Litvin, Andrey / Lizarazu Pérez, Aintzane / Lopez-Tomassetti Fernandez, Eudaldo / Lostoridis, Eftychios / Luppi, Davide / Machain V, Gustavo M / Major, Piotr / Manatakis, Dimitrios / Reitz, Marianne Marchini / Marinis, Athanasios / Marrelli, Daniele / Martínez-Pérez, Aleix / Marwah, Sanjay / McFarlane, Michael / Mesic, Mirza / Mesina, Cristian / Michalopoulos, Nickos / Misiakos, Evangelos / Moreira, Felipe Gonçalves / Mouaqit, Ouadii / Muhtaroglu, Ali / Naidoo, Noel / Negoi, Ionut / Nikitina, Zane / Nikolopoulos, Ioannis / Nita, Gabriela-Elisa / Occhionorelli, Savino / Olaoye, Iyiade / Ordoñez, Carlos A / Ozkan, Zeynep / Pal, Ajay / Palini, Gian M / Papageorgiou, Kyriaki / Papagoras, Dimitris / Pata, Francesco / Pędziwiatr, Michał / Pereira, Jorge / Pereira Junior, Gerson A / Perrone, Gennaro / Pintar, Tadeja / Pisarska, Magdalena / Plehutsa, Oleksandr / Podda, Mauro / Poillucci, Gaetano / Quiodettis, Martha / Rahim, Tuba / Rios-Cruz, Daniel / Rodrigues, Gabriel / Rozov, Dmytry / Sakakushev, Boris / Sall, Ibrahima / Sazhin, Alexander / Semião, Miguel / Sharda, Taanya / Shelat, Vishal / Sinibaldi, Giovanni / Skicko, Dmitrijs / Skrovina, Matej / Stamatiou, Dimitrios / Stella, Marco / Strzałka, Marcin / Sydorchuk, Ruslan / Teixeira Gonsaga, Ricardo A / Tochie, Joel Noutakdie / Tomadze, Gia / Ugoletti, Lara / Ulrych, Jan / Ümarik, Toomas / Uzunoglu, Mustafa Y / Vasilescu, Alin / Vaz, Osborne / Vereczkei, Andras / Vlad, Nutu / Walędziak, Maciej / Yahya, Ali I / Yalkin, Omer / Yilmaz, Tonguç U / Ünal, Ali Ekrem / Yuan, Kuo-Ching / Zachariah, Sanoop K / Žilinskas, Justas / Zizzo, Maurizio / Pattonieri, Vittoria / Baiocchi, Gian Luca / Catena, Fausto

World journal of emergency surgery : WJES

2019 Volume 14, Page(s) 34

Abstract: Background: 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 ... ...

Abstract	Background: 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. Methods: This worldwide multicentre observational study included 153 surgical departments across 56 countries over a 4-month study period between February 1, 2018, and May 31, 2018. Results: A total of 3137 patients were included, with 1815 (57.9%) men and 1322 (42.1%) women, with a median age of 47 years (interquartile range [IQR] 28-66). The overall in-hospital mortality rate was 8.9%, with a median length of stay of 6 days (IQR 4-10). Using multivariable logistic regression, independent variables associated with in-hospital mortality were identified: age > 80 years, malignancy, severe cardiovascular disease, severe chronic kidney disease, respiratory rate ≥ 22 breaths/min, systolic blood pressure < 100 mmHg, AVPU responsiveness scale (voice and unresponsive), blood oxygen saturation level (SpO Conclusions: The simple PIPAS Severity Score can be used on a global level and can help clinicians to identify patients at high risk for treatment failure and mortality.
MeSH term(s)	Abdomen/abnormalities ; Abdomen/physiopathology ; Adult ; Aged ; Chi-Square Distribution ; Female ; Hospital Mortality ; Humans ; Injury Severity Score ; Logistic Models ; Male ; Middle Aged ; Prognosis ; Risk Factors ; Sepsis/diagnosis ; Sepsis/physiopathology
Language	English
Publishing date	2019-07-15
Publishing country	England
Document type	Journal Article ; Multicenter Study ; Observational Study
ISSN	1749-7922
ISSN (online)	1749-7922
DOI	10.1186/s13017-019-0253-2
Database	MEDical Literature Analysis and Retrieval System OnLINE

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