Surgery Research and Practice最新文献

{"title":"Laparoscopic Versus Open Hartmann Reversal: A Case-Control Study.","authors":"Paolo Panaccio,&nbsp;Tommaso Grottola,&nbsp;Rossana Percario,&nbsp;Federico Selvaggi,&nbsp;Severino Cericola,&nbsp;Alfonso Lapergola,&nbsp;Maira Farrukh,&nbsp;Giuseppe Di Martino,&nbsp;Marco Ricciardiello,&nbsp;Pierluigi Di Sebastiano,&nbsp;Fabio Francesco Di Mola","doi":"10.1155/2021/4547537","DOIUrl":"https://doi.org/10.1155/2021/4547537","url":null,"abstract":"<p><strong>Background: </strong>Laparoscopic reversal of Hartmann's procedure (LHR) offers reduced morbidity compared with open Hartmann's reversal (OHR). The aim of this study is to compare the outcome of laparoscopic versus open Hartmann reversal.</p><p><strong>Materials and methods: </strong>Thirty-four patients who underwent Hartmann reversal between January 2017 and July 2019 were evaluated. Patients underwent either LHR (<i>n</i> = 17) or OHR (<i>n</i> = 17). Variables such as numbers of patients, patient's age, sex, body mass index (BMI), comorbidities, ASA (American Society of Anesthesiology) score, indication for previous open sigmoid resection, mean operation time, rate of conversion to open surgery, length of hospital stay, mortality, and morbidity were retrospectively evaluated.</p><p><strong>Results: </strong>The two groups of patients were homogeneous for gender, age, body mass index, cause of primary surgery, time to reversal, and comorbidities. In 97% of the cases, HP was done by open surgery. Our data revealed no difference in mean operation time (LHR: 180.5 ± 35.1 vs. OHR: 225.2 ± 48.4) and morbidity rate, although, in OHR group, there were more severe complications. Less intraoperative blood loss (LHR: 100 ± 40 mL vs. OHR: 450 ± 125 mL; <i>p</i> value <0.001), shorter time to flatus (LHR: 2.4 days vs. OHR: 3.6 days; <i>p</i> value <0.021), and shorter hospitalization (LHR: 4.4 vs. OHR: 11.2 days; <i>p</i> value <0.001) were observed in the LHR group. Mortality rate was null in both groups. <i>Discussion</i>. LHR is feasible and safe even for patients who received a primary open Hartmann's procedure. We suggest careful patient's selection allowing LHR procedures to highly skilled laparoscopy surgeons.</p>","PeriodicalId":30584,"journal":{"name":"Surgery Research and Practice","volume":"2021 ","pages":"4547537"},"PeriodicalIF":0.0,"publicationDate":"2021-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7847322/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25342492","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Does Premedication with Mucolytic Agents Improve Mucosal Visualization during Oesophagogastroduodenoscopy: A Systematic Review and Meta-Analysis.","authors":"Eoghan Burke,&nbsp;Patricia Harkins,&nbsp;Frank Moriarty,&nbsp;Ibrahim Ahmed","doi":"10.1155/2021/1570121","DOIUrl":"https://doi.org/10.1155/2021/1570121","url":null,"abstract":"<p><strong>Introduction: </strong>Gastric Cancer (GC) is the fourth most common malignancy worldwide and the second leading cause of cancer-related mortality for both sexes. The gold standard for diagnosing GC is oesophagogastroduodenoscopy (OGD). Excess mucus on the gastric mucosa impairs the detection of early GC.</p><p><strong>Aim: </strong>To synthesize available evidence of the effect of premedication with a mucolytic agent among adults undergoing elective nontherapeutic OGD, compared to placebo or other mucolytic agents, on mucosal visibility during OGD.</p><p><strong>Methods: </strong>A systematic review was conducted. PubMed, EMBASE, CINAHL, Cochrane central register of controlled trials (CENTRAL), and Web of Science were searched for relevant studies. A random-effects meta-analysis was performed to determine the mean difference in total mucosal visibility score (TMVS) between the pooled mucolytic agents and control. Subgroup analyses were performed to determine the mean TMVS difference for simethicone versus control and the impact of different timings and doses of mucolytic premedication.</p><p><strong>Results: </strong>13 studies, involving 11,086 patients, including 6178 females (55.7%), with a mean age of 53.4 were identified and 6 of these were brought forward to meta-analysis. This revealed a mean difference of -2.69 (95% CI -3.5, -1.88) in total mucosal visibility scores (TMVS) between the pooled mucolytic agents and control. For simethicone, the mean difference was -2.68 (95% CI -4.94, -0.43). A simethicone dose of 133 mg was most effective with a mean difference of -4.22 (95% CI -5.11, -3.33). Assessing timing of administration across all mucolytic agents revealed a mean difference for the >20 minutes group of -3.68 (95% CI -4.77, -2.59). No adverse events were reported in any included trials.</p><p><strong>Conclusions: </strong>Regular use of premedication with mucolytic agents prior to routine OGD is associated with improved TMVS with no reported adverse events.</p>","PeriodicalId":30584,"journal":{"name":"Surgery Research and Practice","volume":"2021 ","pages":"1570121"},"PeriodicalIF":0.0,"publicationDate":"2021-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7846405/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25342491","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of Preoperative CT Colonography and Colonoscopy for Esophageal Reconstruction with Colonic Interposition.","authors":"Prasit Mahawongkajit, Nuttorn Boochangkool","doi":"10.1155/2020/6585762","DOIUrl":"10.1155/2020/6585762","url":null,"abstract":"<p><p>Colonic evaluation is an essential step before proceeding with esophagectomy to reconstruct by colonic interposition. Colonoscopy is the standard practice for colorectal cancer screening, but it has a chance of failing cecal intubation and carries a risk of horrific adverse events by colonic perforation. CT colonography is a less invasive alternative method reported as useful for colonoscopic screening in cases of average risk of colorectal cancer. This study set out to report our clinical experience and to evaluate CT colonography in the preoperative process for colonic interposition of esophagectomy patients. Data for esophagectomy with colonic interposition patients were retrospectively analyzed and compared the colonoscopy group with the CT colonography group. During eight years, 31 patients, 12 patients in the colonoscopy group and 19 patients in the CT colonography group, included in this study. In both groups, the patient demographic data, procedures, and outcomes were not different. After colonic interposition, endoscopy was performed, and no lesions of conduits were detected. CT colonography is a minimally invasive and reliable option for colonic evaluation method for the patient of average colorectal cancer risk who has undergone esophagectomy with colonic interposition.</p>","PeriodicalId":30584,"journal":{"name":"Surgery Research and Practice","volume":"2020 ","pages":"6585762"},"PeriodicalIF":0.0,"publicationDate":"2020-11-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7685867/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38341494","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Duodenal Perforation: Outcomes after Surgical Management at a Tertiary Care Centre-A Retrospective Cross-Sectional Study.","authors":"Srinivas Bojanapu, Ronak Atulbhai Malani, Samrat Ray, Vivek Mangla, Naimish Mehta, Samiran Nundy","doi":"10.1155/2020/8392716","DOIUrl":"10.1155/2020/8392716","url":null,"abstract":"<p><strong>Introduction: </strong>Duodenal perforation is a common surgical emergency and carries mortality ranging from 4% to 30% reported in Western countries, but there is a paucity of reports from India. We aimed to determine the factors which influence the surgical outcomes in patients with duodenal perforation.</p><p><strong>Methods: </strong>We retrospectively analyzed prospectively collected data from January 2010 to December 2018.</p><p><strong>Results: </strong>A total of 55 patients were included in the study of which 69% (38) were males and 31% (17) were females (M : F = 4.5 : 2). The mean age was 52.3 years. The cause for duodenal perforation was duodenal ulcer (<i>n</i> = 25, 45.5%), followed by post-ERCP complications (<i>n</i> = 15, 27.3%), surgery (<i>n</i> = 11, 20%), and blunt trauma (<i>n</i> = 4, 7.2%) with perforations localized at D2 (<i>n</i> = 28, 51%) and at D1 (<i>n</i> = 27, 49%). Patients underwent primary repair with an additional diversion procedure (<i>n</i> = 28, 51%) and repair only in 18 (32.8%). There were 21 (38%) deaths. Patients with ERCP-associated duodenal perforation had longer hospital stay (<i>P</i> ≤ 0.001), ICU stay (<i>P</i>=0.049), duration of drainage (<i>P</i> ≤ 0.001), and higher leak rate (<i>P</i>=0.001) and re-exploration rate (<i>P</i>=0.037). A high mortality rate was seen in patients with preoperative organ failure (<i>n</i>  = 18, 78% versus 9.4%, <i>P</i>=0.001), postoperative leak (<i>n</i> = 7, 64% versus 32%, <i>P</i>=0.05), and longer duration from onset of symptoms to surgery (≥4 days) (<i>P</i>=0.045).</p><p><strong>Conclusion: </strong>Perforation of the duodenum is associated with high morbidity and mortality regardless of its cause and is higher in those who have a longer interval to surgery, preoperative organ failure, and a postoperative leak.</p>","PeriodicalId":30584,"journal":{"name":"Surgery Research and Practice","volume":"2020 ","pages":"8392716"},"PeriodicalIF":0.0,"publicationDate":"2020-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7641718/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38702389","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ureteral Avulsion during Semirigid Ureteroscopy: A Single-Centre Experience.","authors":"A R Bhaskarapprakash,&nbsp;Leelakrishna Karri,&nbsp;P Velmurugan,&nbsp;S Venkatramanan,&nbsp;K Natarajan","doi":"10.1155/2020/3198689","DOIUrl":"https://doi.org/10.1155/2020/3198689","url":null,"abstract":"<p><strong>Aims: </strong>The aim of the study is to present our experience with the management of ureteral avulsions following semirigid ureteroscopy for ureteral stones. This is one of the largest series reported so far.</p><p><strong>Methods and materials: </strong>It is a retrospective and observational study done at Sri Ramachandra Institute of Higher Education and Research over the last 18 years.</p><p><strong>Results: </strong>There were seven cases of ureteral avulsion following semirigid ureteroscopy. All patients were males with a mean age of 35.7 years. All had impacted stones, with proximal ureteric location in 6 patients and distal ureteric location in 1 patient. Five cases had two-point avulsions with loss of entire ureter. Two cases had one-point avulsion: one distal ureteric and the other mid-ureteric. Of the five cases with whole length ureteral avulsion, four were managed by classical ileal replacement of ureter and the the fifth case was managed by ileal replacement of ureter by the Yang-Monti technique. Of the two cases with one-point avulsion, one was managed by uretero-neocystostomy and the other by uretero-ureterostomy. All the patients had successful outcome.</p><p><strong>Conclusions: </strong>Even though rare, ureteral avulsion can potentially happen especially when dealing with impacted ureteric stones. Being conscious of the possible occurrence of this serious complication during any difficult ureteroscopy and exercising utmost care during the procedure are important preventive measures. However, this catastrophe can be successfully managed by either immediate definitive repair or in a staged manner.</p>","PeriodicalId":30584,"journal":{"name":"Surgery Research and Practice","volume":"2020 ","pages":"3198689"},"PeriodicalIF":0.0,"publicationDate":"2020-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2020/3198689","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38658934","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Comparison of the Predictive Value of the Glasgow Coma Scale and the Kampala Trauma Score for Mortality and Length of Hospital Stay in Head Injury Patients at a Tertiary Hospital in Uganda: A Diagnostic Prospective Study.","authors":"Herbert Ariaka,&nbsp;Joel Kiryabwire,&nbsp;Ssenyonjo Hussein,&nbsp;Alfred Ogwal,&nbsp;Emmanuel Nkonge,&nbsp;Felix Oyania","doi":"10.1155/2020/1362741","DOIUrl":"https://doi.org/10.1155/2020/1362741","url":null,"abstract":"<p><strong>Introduction: </strong>The prevalence rates of head injury have been shown to be as high as 25% among trauma patients with severe head injury contributing to about 31% of all trauma deaths. Triage utilizes numerical cutoff points along the scores continuum to predict the greatest number of people who would have a poor outcome, \"severe\" patients, when scoring below the threshold and a good outcome \"non severe\" patients, when scoring above the cutoff or numerical threshold. This study aimed to compare the predictive value of the Glasgow Coma Scale and the Kampala Trauma Score for mortality and length of hospital stay at a tertiary hospital in Uganda.</p><p><strong>Methods: </strong>A diagnostic prospective study was conducted from January 12, 2018 to March 16, 2018. We recruited patients with head injury admitted to the accidents and emergency department who met the inclusion criteria for the study. Data on patient's demographic characteristics, mechanisms of injury, category of road use, and classification of injury according to the GCS and KTS at initial contact and at 24 hours were collected. The receiver operating characteristics (ROC) analysis and logistic regression analysis were used for comparison.</p><p><strong>Results: </strong>The GCS predicted mortality and length of hospital stay with the GCS at admission with AUC of 0.9048 and 0.7972, respectively (KTS at admission time, AUC 0.8178 and 0.7243). The GCS predicted mortality and length of hospital stay with the GCS at 24 hours with AUC of 0.9567 and 0.8203, respectively (KTS at 24 hours, AUC 0.8531 and 0.7276). At admission, the GCS at a cutoff of 11 had a sensitivity of 83.23% and specificity of 82.61% while the KTS had 88.02% and 73.91%, respectively, at a cutoff of 13 for predicting mortality. At admission, the GCS at a cutoff of 13 had sensitivity of 70.48% and specificity of 66.67% while the KTS had 68.07% and 62.50%, respectively, at a cutoff of 14 for predicting length of hospital stay.</p><p><strong>Conclusion: </strong>Comparatively, the GCS performed better than the KTS in predicting mortality and length of hospital stay. The GCS was also more accurate at labelling the head injury patients who died as severely injured as opposed to the KTS that categorized most of them as moderately injured. In general, the two scores were sensitive at detection of mortality and length of hospital stay among the study population.</p>","PeriodicalId":30584,"journal":{"name":"Surgery Research and Practice","volume":"2020 ","pages":"1362741"},"PeriodicalIF":0.0,"publicationDate":"2020-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2020/1362741","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38535105","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Is Intragastric Botulinum Toxin A Injection Effective in Obesity Treatment?","authors":"Bulent Kaya,&nbsp;Nuriye Esen Bulut,&nbsp;Mahir Fersahoglu","doi":"10.1155/2020/2419491","DOIUrl":"https://doi.org/10.1155/2020/2419491","url":null,"abstract":"<p><strong>Aims: </strong>The objective of this prospective study was to evaluate the efficacy of intragastric botulinum toxin A (BTX-A) injection for the treatment of obesity.</p><p><strong>Materials and methods: </strong>The study was performed between January and August 2019. This is a prospective study. After 6-12 hours of fasting, the patients were submitted to upper GI endoscopy under sedation for the injection of BTX-A. A total of 250 U of BTA-X was diluted with 10 ml of 0.9% saline. Injections were administered into the gastric antrum, each containing 1 ml of prepared solution (25 U BX-A + 1 ml saline). Continuous data were compared using a two-sample <i>t</i>-test. Statistical significance was determined as <i>P</i> ≤ 0.05. All statistical analysis was performed using SPSS for Windows 22.1 software (SPSS, Chicago, IL, USA).</p><p><strong>Results: </strong>A total of 56 patients were studied. Mean weight before gastric Botox was 85.25 ± 14.02, and mean weight after gastric Botox was 76.98 ± 12.68. Mean weight loss was approximately 9 kg in studied patients. BMI decreased about 3 units. The mean time for maximum weight loss was 60.39 ± 37.43 days. A total of 49 patients (87.5%) had reported decrease in appetite and early satiety. About 53.6% of patients were satisfied. No complications resulting from the endoscopic procedure were observed in this series.</p><p><strong>Conclusions: </strong>Intragastric BTX-A injection can be beneficial in weight loss. It is a minimally invasive, cost-effective procedure, without serious side effects.</p>","PeriodicalId":30584,"journal":{"name":"Surgery Research and Practice","volume":"2020 ","pages":"2419491"},"PeriodicalIF":0.0,"publicationDate":"2020-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2020/2419491","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38494332","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Uncommon Locations of Cystic Echinococcosis: A Report of 46 Cases from Southern Iran.","authors":"Reza Shahriarirad,&nbsp;Amirhossein Erfani,&nbsp;Mehrdad Eskandarisani,&nbsp;Mohammad Rastegarian,&nbsp;Bahador Sarkari","doi":"10.1155/2020/2061045","DOIUrl":"https://doi.org/10.1155/2020/2061045","url":null,"abstract":"<p><strong>Background: </strong>Most cases of hydatid cysts form in the liver and lung and other tissues are considered as unusual locations in hydatid cysts. The current study aimed to find out the rate and features of hydatid cysts in uncommon locations in Fars Province, Southern Iran, over a 15-year period.</p><p><strong>Methods: </strong>The hospital records of patients who underwent surgery for hydatid cysts in university-affiliated hospitals in Fars Province, Southern Iran, from 2004 to 2018, were retrospectively reviewed. For each patient, clinical and demographical data were recorded.</p><p><strong>Results: </strong>During a 15-year period, a total of 501 patients were surgically treated for hydatid cysts, and out of these, 46 (9.2%) were presented with the unusual locations of hydatid disease. Males constituted 28 (60.9%) of these patients while 18 (39.1%) of the patients were females. The patients' age ranged from 5 to 80 years (mean = 40.49; SD = 20.37). The size of the cysts ranged from 2 to 20 cm (mean = 8.69, SD = 4.59). The most common unusual location for the hydatid cyst was the spleen with 30.4% of cases, followed by the pelvic cavity (15.2%). Out of 46 cases with unusual location of the hydatid cyst, 10 (21.7%) cases had lung, 22 (47.8%) cases had liver, and 5 (10.9%) cases had both liver and lung hydatid cysts, simultaneously with cysts in unusual locations.</p><p><strong>Conclusion: </strong>In cystic echinococcosis- (CE) endemic areas, hydatid disease can affect any organ, from head to toe, in humans. The disease should be considered in the differential diagnosis of any cystic entities anywhere in the body.</p>","PeriodicalId":30584,"journal":{"name":"Surgery Research and Practice","volume":"2020 ","pages":"2061045"},"PeriodicalIF":0.0,"publicationDate":"2020-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2020/2061045","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38452931","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Systematic Review of Early versus Late Closure of Loop Ileostomy.","authors":"Ahmed A Aljorfi,&nbsp;Abdulhameed H Alkhamis","doi":"10.1155/2020/9876527","DOIUrl":"https://doi.org/10.1155/2020/9876527","url":null,"abstract":"<p><strong>Introduction: </strong>A Loop ileostomy is one of the most common techniques used in colorectal surgery to establish a reversible faecal diversion and bypass the large bowels, in order to protect either a downstream colorectal anastomosis or a coloanal anastomosis. However, it is a procedure that can cause a plethora of complications including long term ones such as the psychological effects. Currently, there is no consensus regarding the optimal time to perform closure of a loop ileostomy. Some studies suggested the early reversal of ileostomy procedure as a solution to reduce these complications. This study aims to review the available literature in order to ascertain the benefits behind early closure of loop ileostomy.</p><p><strong>Methods: </strong>The literature was searched for all studies that included a comparison between the outcomes of early and late closure of loop ileostomy in terms of morbidity, mortality, or quality of life, where available. Early closure of loop ileostomy is defined as closure less than three months and late as more than three months, in accordance with conventional literature. The resultant articles were filtered using our inclusion and exclusion criteria. Finally, the remaining articles were assessed for quality and their results were compared to one another in order to draw our conclusions. <i>Results and Discussion</i>. The results were slightly inclined toward early closure of loop ileostomy. However, there were limitations of the studies reviewed, including the heterogenicity of studies, selection bias, lack of clear definition of measured outcomes, and small sample size. Taking that into consideration, the results of early closure of loop ileostomies in the selected patients were promising and require further investigation.</p>","PeriodicalId":30584,"journal":{"name":"Surgery Research and Practice","volume":"2020 ","pages":"9876527"},"PeriodicalIF":0.0,"publicationDate":"2020-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2020/9876527","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38399731","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of the COVID-19 Pandemic on Acute General Surgical Admissions in a District General Hospital in the United Kingdom: A Retrospective Cohort Study.","authors":"Rory Callan,&nbsp;Nazrin Assaf,&nbsp;Katharine Bevan","doi":"10.1155/2020/2975089","DOIUrl":"https://doi.org/10.1155/2020/2975089","url":null,"abstract":"<p><p>The COVID-19 pandemic of 2020 has greatly impacted healthcare systems and society more generally around the world. The management of patients infected with SARS-CoV-2 has primarily impacted emergency departments, medical teams, and intensive care units. However, the impact on health systems as a whole, including surgical specialties, has been wide ranging. We aimed to establish the impact of the COVID-19 pandemic and associated lockdown on the number and characteristics of general surgical patients reviewed and/or admitted by the surgical team within a district general hospital. We performed a retrospective cohort analysis of patients admitted in the 2-week period from start of the lockdown (Monday 23rd March 2020 to 5th April 2020), and the same period 1 year earlier (Monday 25th March 2019 to 7th April 2019). Number of patients reviewed and admitted were compared between the two cohorts. Data including diagnosis, operation/procedural interventions, and length of stay were analysed. The overall number of patients reviewed and admitted by the surgical team was substantially lower during the period of lockdown (61 vs 126). Of the patients seen during lockdown, a smaller proportion were admitted to hospital after initial surgical review (59% vs 77%, <i>p</i> < 0.05). Interventional/operative procedures were performed in a similar proportion of patients in both cohorts (31%). Our data show that there has been a substantial reduction in the number of patients being referred to and admitted by the general surgical team at our centre during the COVID-19 pandemic. Explanations for this include reduced attendance due to risk perception of the patients, the impact of lockdown messages and advice regarding self-isolation, as well as an increased threshold for patient admission during the COVID-19 pandemic. Key learning points include the possible benefits of a reduction in admission to hospital of patients with nonurgent conditions.</p>","PeriodicalId":30584,"journal":{"name":"Surgery Research and Practice","volume":"2020 ","pages":"2975089"},"PeriodicalIF":0.0,"publicationDate":"2020-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2020/2975089","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38294101","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}