World Journal of Emergency Surgery最新文献

{"title":"Correction: ECLAPTE: Effective Closure of LAParoTomy in Emergency-2023 World Society of Emergency Surgery guidelines for the closure of laparotomy in emergency settings.","authors":"Simone Frassini, Lorenzo Cobianchi, Paola Fugazzola, Walter L Biffl, Federico Coccolini, Dimitrios Damaskos, Ernest E Moore, Yoram Kluger, Marco Ceresoli, Raul Coimbra, Justin Davies, Andrew Kirkpatrick, Isidoro Di Carlo, Timothy C Hardcastle, Arda Isik, Massimo Chiarugi, Kurinchi Gurusamy, Ronald V Maier, Helmut A Segovia Lohse, Hans Jeekel, Marja A Boermeester, Fikri Abu-Zidan, Kenji Inaba, Dieter G Weber, Goran Augustin, Luigi Bonavina, George Velmahos, Massimo Sartelli, Salomone Di Saverio, Richard P G Ten Broek, Stefano Granieri, Francesca Dal Mas, Camilla Nikita Farè, Jacopo Peverada, Simone Zanghì, Jacopo Viganò, Matteo Tomasoni, Tommaso Dominioni, Enrico Cicuttin, Andreas Hecker, Giovanni D Tebala, Joseph M Galante, Imtiaz Wani, Vladimir Khokha, Michael Sugrue, Thomas M Scalea, Edward Tan, Mark A Malangoni, Nikolaos Pararas, Mauro Podda, Belinda De Simone, Rao Ivatury, Yunfeng Cui, Jeffry Kashuk, Andrew Peitzman, Fernando Kim, Emmanouil Pikoulis, Gabriele Sganga, Osvaldo Chiara, Michael D Kelly, Ingo Marzi, Edoardo Picetti, Vanni Agnoletti, Nicola De'Angelis, Giampiero Campanelli, Marc de Moya, Andrey Litvin, Aleix Martínez-Pérez, Ibrahima Sall, Sandro Rizoli, Gia Tomadze, Boris Sakakushev, Philip F Stahel, Ian Civil, Vishal Shelat, David Costa, Alain Chichom-Mefire, Rifat Latifi, Mircea Chirica, Francesco Amico, Amyn Pardhan, Vidya Seenarain, Nikitha Boyapati, Basil Hatz, Travis Ackermann, Sandun Abeyasundara, Linda Fenton, Frank Plani, Rohit Sarvepalli, Omid Rouhbakhshfar, Pamela Caleo, Victor Ho-Ching Yau, Kristenne Clement, Erasmia Christou, Ana María González Castillo, Preet K S Gosal, Sunder Balasubramaniam, Jeremy Hsu, Kamon Banphawatanarak, Michele Pisano, Adriana Toro, Altomare Michele, Stefano P B Cioffi, Andrea Spota, Fausto Catena, Luca Ansaloni","doi":"10.1186/s13017-023-00522-7","DOIUrl":"10.1186/s13017-023-00522-7","url":null,"abstract":"","PeriodicalId":48867,"journal":{"name":"World Journal of Emergency Surgery","volume":"18 1","pages":"52"},"PeriodicalIF":8.0,"publicationDate":"2023-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10683098/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138446664","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Continuous versus interrupted abdominal wall closure after emergency midline laparotomy: CONTINT: a randomized controlled trial [NCT00544583].","authors":"Georgios Polychronidis, Nuh N Rahbari, Thomas Bruckner, Anja Sander, Florian Sommer, Selami Usta, Janssen Hermann, Max Benjamin Albers, Mine Sargut, Phillip Knebel, Rosa Klotz","doi":"10.1186/s13017-023-00517-4","DOIUrl":"10.1186/s13017-023-00517-4","url":null,"abstract":"<p><strong>Background: </strong>High-level evidence regarding the technique of abdominal wall closure for patients undergoing emergency midline laparotomy is sparse. Therefore, we conducted a randomized controlled trial (RCT) to evaluate the efficacy and safety of two commonly applied abdominal wall closure strategies after primary emergency midline laparotomy.</p><p><strong>Methods/design: </strong>CONTINT was a multi-center pragmatic open-label exploratory randomized controlled parallel trial. Two different abdominal wall closure strategies in patients undergoing primary midline laparotomy for an emergency surgical intervention with a suspected septic focus in the abdominal cavity were compared: the continuous, all-layer suture and the interrupted suture technique. The primary composite endpoint was burst abdomen within 30 days after surgery or incisional hernia within 12 months. As reliable data on this composite primary endpoint were not available for patients undergoing emergency surgery, it was planned to initially recruit 80 patients and conduct an interim analysis after these had completed the 12 months follow-up.</p><p><strong>Results: </strong>From August 31, 2009, to June 28, 2012, 124 patients were randomized of whom 119 underwent surgery and were analyzed according to the intention-to-treat (ITT) principal. The primary composite endpoint did not differ between the continuous suture (C: 27.1%) and the interrupted suture group (I: 30.0%). None of the individual components of the primary endpoint (reoperation due to burst abdomen after 30 days (C: 13.5%, I: 15.1%) and reoperation due to incisional hernia (C: 3.0%, I:11.1%)) differed between groups. Time needed for fascial closure was longer in the interrupted suture group (C: 12.8 ± 4.5 min, I: 17.4 ± 6.1 min). BMI was associated with burst abdomen during the first 30 days with an OR of 1.17 (95% CI 1.04-1.32).</p><p><strong>Conclusion: </strong>This RCT showed no difference between continuous suture with slowly absorbable suture versus interrupted rapidly absorbable sutures after primary emergency midline laparotomy in rates of postoperative burst abdomen and incisional hernia after one year. However, the trial was stopped after the interim analysis due to futility as there was no chance to show superiority of one suture technique.</p>","PeriodicalId":48867,"journal":{"name":"World Journal of Emergency Surgery","volume":"18 1","pages":"51"},"PeriodicalIF":8.0,"publicationDate":"2023-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10583371/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41240019","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ten golden rules for optimal antibiotic use in hospital settings: the WARNING call to action.","authors":"","doi":"10.1186/s13017-023-00518-3","DOIUrl":"10.1186/s13017-023-00518-3","url":null,"abstract":"<p><p>Antibiotics are recognized widely for their benefits when used appropriately. However, they are often used inappropriately despite the importance of responsible use within good clinical practice. Effective antibiotic treatment is an essential component of universal healthcare, and it is a global responsibility to ensure appropriate use. Currently, pharmaceutical companies have little incentive to develop new antibiotics due to scientific, regulatory, and financial barriers, further emphasizing the importance of appropriate antibiotic use. To address this issue, the Global Alliance for Infections in Surgery established an international multidisciplinary task force of 295 experts from 115 countries with different backgrounds. The task force developed a position statement called WARNING (Worldwide Antimicrobial Resistance National/International Network Group) aimed at raising awareness of antimicrobial resistance and improving antibiotic prescribing practices worldwide. The statement outlined is 10 axioms, or \"golden rules,\" for the appropriate use of antibiotics that all healthcare workers should consistently adhere in clinical practice.</p>","PeriodicalId":48867,"journal":{"name":"World Journal of Emergency Surgery","volume":"18 1","pages":"50"},"PeriodicalIF":8.0,"publicationDate":"2023-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10580644/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41240020","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Limb salvage and survival after urgent surgical treatment of popliteal artery aneurysm.","authors":"Sara Pomatto, Gianluca Faggioli, Rodolfo Pini, Ilaria Ficarelli, Alessia Pini, Cecilia Angherà, Cristina Rocchi, Stefania Caputo, Andrea Vacirca, Carlo Ruotolo, Mauro Gargiulo","doi":"10.1186/s13017-023-00514-7","DOIUrl":"10.1186/s13017-023-00514-7","url":null,"abstract":"<p><strong>Background: </strong>Popliteal artery aneurysms (PAAs) need urgent treatment in case of acute thrombosis, distal embolization, or rupture. Few data are available in the literature about the treatment results in these scenarios. The aim of the present study was to evaluate an 11-year multicenter experience in the urgent treatment of PAAs.</p><p><strong>Methods: </strong>All symptomatic PAAs surgically treated in two vascular centers between 2010 and 2021 were retrospectively analyzed. In the postoperative period periodical clinical and Duplex-Ultrasound evaluation were performed. The evaluated endpoint was the outcome of urgent PAAs treatment according to their clinical presentation. Statistical analysis was performed by Kaplan-Meier log-rank evaluation and multivariable Cox regression tests.</p><p><strong>Results: </strong>Sixty-six PAAs needed an urgent repair. Twelve (18%) patients had a PAA rupture and 54 (82%) had an acute limb ischemia (ALI) due to either distal embolization or acute thrombosis. Patients with ALI underwent bypass surgery in 51 (95%) cases, which was associated with preoperative thrombolysis in 18 (31%) cases. A primary major amputation was performed in 3 (5%) cases. The mean follow-up was 52 ± 21 months with an overall 5-year limb salvage of 83 ± 6%. Limb salvage was influenced only by the number of patent tibial arteries (pTA) [5-years limb salvage 0%, 86 ± 10%, 92 ± 8% and 100% in case of 0, 1, 2 or 3 pTA, respectively (P = .001)]. An independent association of number of pTA and limb loss was found [hazard ratio (HR): 0.14 (95% confidence interval (CI) 0.03-0.6), P = .001]. Overall 5-year survival was 71 ± 7%. Ruptured PAAs were associated with lower 5-year survival compared with the ALI group (48 ± 2% vs. 79 ± 7%, P = .001). The number of pTA (33 ± 20%, 65 ± 10%, 84 ± 10% and 80 ± 10% for 0, 1, 2 and 3 pTA, respectively, P = .001) and the thrombolysis (94 ± 6% vs. 62 ± 10%, P = .03) were associated with higher survival in patients with ALI. There was an independent association of number of pTA and long-term survival [HR 0.15 (95% CI 0.03-0.8), P = .03].</p><p><strong>Conclusions: </strong>PAA rupture is the cause of urgent PAA treatment in almost one fifth of cases, and it is associated with lower long-term survival. ALI can benefit from thrombolysis, and long-term limb salvage and survival are associated with the number of pTA.</p>","PeriodicalId":48867,"journal":{"name":"World Journal of Emergency Surgery","volume":"18 1","pages":"49"},"PeriodicalIF":8.0,"publicationDate":"2023-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10576300/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41216828","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Surgical management of ostomy complications: a MISSTO-WSES mapping review.","authors":"Dario Parini, Andrea Bondurri, Francesco Ferrara, Gianluca Rizzo, Francesco Pata, Marco Veltri, Cristiana Forni, Federico Coccolini, Walt L Biffl, Massimo Sartelli, Yoram Kluger, Luca Ansaloni, Ernest Moore, Fausto Catena, Piergiorgio Danelli","doi":"10.1186/s13017-023-00516-5","DOIUrl":"10.1186/s13017-023-00516-5","url":null,"abstract":"<p><strong>Background: </strong>The creation of an ileostomy or colostomy is a common surgical event, both in elective and in emergency context. The main aim of stoma creation is to prevent postoperative complications, such as the anastomotic leak. However, stoma-related complications can also occur and their morbidity is not negligible, with a rate from 20 to 70%. Most stomal complications are managed conservatively, but, when this approach is not resolutive, surgical treatment becomes necessary. The aim of this mapping review is to get a comprehensive overview on the incidence, the risk factors, and the management of the main early and late ostomy complications: stoma necrosis, mucocutaneous separation, stoma retraction, stoma prolapse, parastomal hernia, stoma stenosis, and stoma bleeding.</p><p><strong>Material and methods: </strong>A complete literature research in principal databases (PUBMED, EMBASE, SCOPUS and COCHRANE) was performed by Multidisciplinary Italian Study group for STOmas (MISSTO) for each topic, with no language restriction and limited to the years 2011-2021. An international expert panel, from MISSTO and World Society of Emergency Surgery (WSES), subsequently reviewed the different issues, endorsed the project, and approved the final manuscript.</p><p><strong>Conclusion: </strong>Stoma-related complications are common and require a step-up management, from conservative stoma care to surgical stoma revision. A study of literature evidence in clinical practice for stoma creation and an improved management of stoma-related complications could significantly increase the quality of life of patients with ostomy. Solid evidence from the literature about the correct management is lacking, and an international consensus is needed to draw up new guidelines on this subject.</p>","PeriodicalId":48867,"journal":{"name":"World Journal of Emergency Surgery","volume":"18 1","pages":"48"},"PeriodicalIF":8.0,"publicationDate":"2023-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10563348/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41216829","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Enhanced perioperative care in emergency general surgery: the WSES position paper.","authors":"Marco Ceresoli, Marco Braga, Nicola Zanini, Fikri M Abu-Zidan, Dario Parini, Thomas Langer, Massimo Sartelli, Dimitrios Damaskos, Walter L Biffl, Francesco Amico, Luca Ansaloni, Zsolt J Balogh, Luigi Bonavina, Ian Civil, Enrico Cicuttin, Mircea Chirica, Yunfeng Cui, Belinda De Simone, Isidoro Di Carlo, Andreas Fette, Giuseppe Foti, Michele Fogliata, Gustavo P Fraga, Paola Fugazzola, Joseph M Galante, Solomon Gurmu Beka, Andreas Hecker, Johannes Jeekel, Andrew W Kirkpatrick, Kaoru Koike, Ari Leppäniemi, Ingo Marzi, Ernest E Moore, Edoardo Picetti, Emmanouil Pikoulis, Michele Pisano, Mauro Podda, Boris E Sakakushev, Vishal G Shelat, Edward Tan, Giovanni D Tebala, George Velmahos, Dieter G Weber, Vanni Agnoletti, Yoram Kluger, Gianluca Baiocchi, Fausto Catena, Federico Coccolini","doi":"10.1186/s13017-023-00519-2","DOIUrl":"10.1186/s13017-023-00519-2","url":null,"abstract":"<p><p>Enhanced perioperative care protocols become the standard of care in elective surgery with a significant improvement in patients' outcome. The key element of the enhanced perioperative care protocol is the multimodal and interdisciplinary approach targeted to the patient, focused on a holistic approach to reduce surgical stress and improve perioperative recovery. Enhanced perioperative care in emergency general surgery is still a debated topic with little evidence available. The present position paper illustrates the existing evidence about perioperative care in emergency surgery patients with a focus on each perioperative intervention in the preoperative, intraoperative and postoperative phase. For each item was proposed and approved a statement by the WSES collaborative group.</p>","PeriodicalId":48867,"journal":{"name":"World Journal of Emergency Surgery","volume":"18 1","pages":"47"},"PeriodicalIF":8.0,"publicationDate":"2023-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10559594/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41148512","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Self-expanding metal stents versus decompression tubes as a bridge to surgery for patients with obstruction caused by colorectal cancer: a systematic review and meta-analysis.","authors":"Wei Ma, Jian-Cheng Zhang, Kun Luo, Lu Wang, Chi Zhang, Bin Cai, Hua Jiang","doi":"10.1186/s13017-023-00515-6","DOIUrl":"10.1186/s13017-023-00515-6","url":null,"abstract":"<p><strong>Background: </strong>Using self-expanding metal stents (SEMS) and decompression tubes (DT) as a bridge-to-surgery (BTS) treatment may avoid emergency operations for patients with colorectal cancer-caused obstructions. This study aimed to evaluate the efficacy and safety of the two approaches.</p><p><strong>Methods: </strong>We systematically retrieved literature from January 1, 2000, to May 30, 2023, from the PubMed, Embase, Web of Science, SinoMed, Wanfang Data, Chinese National Knowledge Infrastructure, and Cochrane Central Register of Clinical Trials databases. Randomized controlled trials (RCTs) or cohort studies of SEMS versus DT as BTS in colorectal cancer obstruction were selected. Risks of bias were assessed for RCTs and cohort studies using the Cochrane Risk of Bias tool version 2 and Risk of Bias in Nonrandomized Studies of Interventions. Certainty of evidence was determined using the Graded Recommendation Assessment. Odds ratio (OR), mean difference (MD), and 95% confidence interval (95% CI) were used to analyze measurement data.</p><p><strong>Results: </strong>We included eight RCTs and eighteen cohort studies involving 2,061 patients (SEMS, 1,044; DT, 1,017). Pooled RCT and cohort data indicated the SEMS group had a significantly higher clinical success rate than the DT group (OR = 1.99, 95% CI 1.04, 3.81, P = 0.04), but no significant difference regarding technical success (OR = 1.29, 95% CI 0.56, 2.96, P = 0.55). SEMS had a shorter postoperative length of hospital stays (MD = - 4.47, 95% CI - 6.26, - 2.69, P < 0.00001), a lower rates of operation-related abdominal pain (OR = 0.16, 95% CI 0.05, 0.50, P = 0.002), intraoperative bleeding (MD = - 37.67, 95% CI - 62.73, - 12.60, P = 0.003), stoma creation (OR = 0.41, 95% CI 0.23, 0.73, P = 0.002) and long-term tumor recurrence rate than DT (OR = 0.47, 95% CI 0.22, 0.99, P = 0.05).</p><p><strong>Conclusion: </strong>SEMS and DT are both safe as BTS to avoid emergency surgery for patients with colorectal cancer obstruction. SEMS is preferable because of higher clinical success rates, lower rates of operation-related abdominal pain, intraoperative bleeding, stoma creation, and long-term tumor recurrence, as well as a shorter postoperative length of hospital stays. Trial registration CRD42022365951 .</p>","PeriodicalId":48867,"journal":{"name":"World Journal of Emergency Surgery","volume":"18 1","pages":"46"},"PeriodicalIF":8.0,"publicationDate":"2023-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10536785/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41180340","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"2023 WSES guidelines for the prevention, detection, and management of iatrogenic urinary tract injuries (IUTIs) during emergency digestive surgery.","authors":"Nicola de'Angelis, Carlo Alberto Schena, Francesco Marchegiani, Elisa Reitano, Belinda De Simone, Geoffrey Yuet Mun Wong, Aleix Martínez-Pérez, Fikri M Abu-Zidan, Vanni Agnoletti, Filippo Aisoni, Michele Ammendola, Luca Ansaloni, Miklosh Bala, Walter Biffl, Graziano Ceccarelli, Marco Ceresoli, Osvaldo Chiara, Massimo Chiarugi, Stefania Cimbanassi, Federico Coccolini, Raul Coimbra, Salomone Di Saverio, Michele Diana, Marco Dioguardi Burgio, Gustavo Fraga, Paschalis Gavriilidis, Angela Gurrado, Riccardo Inchingolo, Alexandre Ingels, Rao Ivatury, Jeffry L Kashuk, Jim Khan, Andrew W Kirkpatrick, Fernando J Kim, Yoram Kluger, Zaher Lakkis, Ari Leppäniemi, Ronald V Maier, Riccardo Memeo, Ernest E Moore, Carlos A Ordoñez, Andrew B Peitzman, Gianluca Pellino, Edoardo Picetti, Manos Pikoulis, Michele Pisano, Mauro Podda, Oreste Romeo, Fausto Rosa, Edward Tan, Richard P Ten Broek, Mario Testini, Brian Anthony Tian Wei Cheng, Dieter Weber, Emilio Sacco, Massimo Sartelli, Alfredo Tonsi, Fabrizio Dal Moro, Fausto Catena","doi":"10.1186/s13017-023-00513-8","DOIUrl":"10.1186/s13017-023-00513-8","url":null,"abstract":"<p><p>Iatrogenic urinary tract injury (IUTI) is a severe complication of emergency digestive surgery. It can lead to increased postoperative morbidity and mortality and have a long-term impact on the quality of life. The reported incidence of IUTIs varies greatly among the studies, ranging from 0.3 to 1.5%. Given the high volume of emergency digestive surgery performed worldwide, there is a need for well-defined and effective strategies to prevent and manage IUTIs. Currently, there is a lack of consensus regarding the prevention, detection, and management of IUTIs in the emergency setting. The present guidelines, promoted by the World Society of Emergency Surgery (WSES), were developed following a systematic review of the literature and an international expert panel discussion. The primary aim of these WSES guidelines is to provide evidence-based recommendations to support clinicians and surgeons in the prevention, detection, and management of IUTIs during emergency digestive surgery. The following key aspects were considered: (1) effectiveness of preventive interventions for IUTIs during emergency digestive surgery; (2) intra-operative detection of IUTIs and appropriate management strategies; (3) postoperative detection of IUTIs and appropriate management strategies and timing; and (4) effectiveness of antibiotic therapy (including type and duration) in case of IUTIs.</p>","PeriodicalId":48867,"journal":{"name":"World Journal of Emergency Surgery","volume":"18 1","pages":"45"},"PeriodicalIF":8.0,"publicationDate":"2023-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10492308/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10212326","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diagnostic accuracy of biomarkers to detect acute mesenteric ischaemia in adult patients: a systematic review and meta-analysis.","authors":"Annika Reintam Blaser, Joel Starkopf, Martin Björck, Alastair Forbes, Karri Kase, Ele Kiisk, Kaja-Triin Laisaar, Vladislav Mihnovits, Marko Murruste, Merli Mändul, Anna-Liisa Voomets, Kadri Tamme","doi":"10.1186/s13017-023-00512-9","DOIUrl":"10.1186/s13017-023-00512-9","url":null,"abstract":"<p><strong>Background: </strong>Acute mesenteric ischaemia (AMI) is a disease with different pathophysiological mechanisms, leading to a life-threatening condition that is difficult to diagnose based solely on clinical signs. Despite widely acknowledged need for biomarkers in diagnosis of AMI, a broad systematic review on all studied biomarkers in different types of AMI is currently lacking. The aim of this study was to estimate the diagnostic accuracy of all potential biomarkers of AMI studied in humans.</p><p><strong>Methods: </strong>A systematic literature search in PubMed, The Cochrane Library, Web of Science and Scopus was conducted in December 2022. Studies assessing potential biomarkers of AMI in (at least 10) adult patients and reporting their diagnostic accuracy were included. Meta-analyses of biomarkers' sensitivity, specificity, and positive and negative likelihood ratios were conducted. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed, and the study quality was assessed with the QUADAS-2 tool.</p><p><strong>Results: </strong>Seventy-five studies including a total of 9914 patients assessed 18 different biomarkers in serum/plasma and one in urine (each reported in at least two studies), which were included in meta-analyses. None of the biomarkers reached a conclusive level for accurate prediction. The best predictive value overall (all studies with any type and stage of AMI pooled) was observed for Ischaemia-modified albumin (2 studies, sensitivity 94.7 and specificity 90.5), interleukin-6 (n = 4, 96.3 and 82.6), procalcitonin (n = 6, 80.1 and 86.7), and intestinal fatty acid-binding protein (I-FABP) measured in serum (n = 16, 73.9 and 90.5) or in urine (n = 4, 87.9 and 78.9). In assessment of transmural mesenteric ischaemia, urinary I-FABP (n = 2, 92.3 and 85.2) and D-dimer (n = 3, 87.6 and 83.6) showed moderate predictive value. Overall risk of bias was high, mainly because of selected study populations and unclear timings of the biomarker measurements after onset of symptoms. Combinations of biomarkers were rarely studied, not allowing meta-analyses.</p><p><strong>Conclusions: </strong>None of the studied biomarkers had sufficient sensitivity and specificity to diagnose AMI, although some biomarkers showed moderate predictive accuracy. Future studies should focus on timing of measurements of biomarkers, distinguishing between early stage and transmural necrosis, and between different types of AMI. Additionally, studies on combinations of biomarkers are warranted. PROSPERO registration: CRD42022379341.</p>","PeriodicalId":48867,"journal":{"name":"World Journal of Emergency Surgery","volume":"18 1","pages":"44"},"PeriodicalIF":8.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10474684/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10153685","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Management of complicated diaphragmatic hernia in the acute setting: a WSES position paper.","authors":"Mario Giuffrida,&nbsp;Gennaro Perrone,&nbsp;Fikri Abu-Zidan,&nbsp;Vanni Agnoletti,&nbsp;Luca Ansaloni,&nbsp;Gian Luca Baiocchi,&nbsp;Cino Bendinelli,&nbsp;Walter L Biffl,&nbsp;Luigi Bonavina,&nbsp;Francesca Bravi,&nbsp;Paolo Carcoforo,&nbsp;Marco Ceresoli,&nbsp;Alain Chichom-Mefire,&nbsp;Federico Coccolini,&nbsp;Raul Coimbra,&nbsp;Nicola de'Angelis,&nbsp;Marc de Moya,&nbsp;Belinda De Simone,&nbsp;Salomone Di Saverio,&nbsp;Gustavo Pereira Fraga,&nbsp;Joseph Galante,&nbsp;Rao Ivatury,&nbsp;Jeffry Kashuk,&nbsp;Michael Denis Kelly,&nbsp;Andrew W Kirkpatrick,&nbsp;Yoram Kluger,&nbsp;Kaoru Koike,&nbsp;Ari Leppaniemi,&nbsp;Ronald V Maier,&nbsp;Ernest Eugene Moore,&nbsp;Andrew Peitzmann,&nbsp;Boris Sakakushev,&nbsp;Massimo Sartelli,&nbsp;Michael Sugrue,&nbsp;Brian W C A Tian,&nbsp;Richard Ten Broek,&nbsp;Carlo Vallicelli,&nbsp;Imtaz Wani,&nbsp;Dieter G Weber,&nbsp;Giovanni Docimo,&nbsp;Fausto Catena","doi":"10.1186/s13017-023-00510-x","DOIUrl":"https://doi.org/10.1186/s13017-023-00510-x","url":null,"abstract":"<p><strong>Background: </strong>Diaphragmatic hernia (DH) presenting acutely can be a potentially life-threatening condition. Its management continues to be debatable.</p><p><strong>Methods: </strong>A bibliographic search using major databases was performed using the terms \"emergency surgery\" \"diaphragmatic hernia,\" \"traumatic diaphragmatic rupture\" and \"congenital diaphragmatic hernia.\" GRADE methodology was used to evaluate the evidence and give recommendations.</p><p><strong>Results: </strong>CT scan of the chest and abdomen is the diagnostic gold standard to evaluate complicated DH. Appropriate preoperative assessment and prompt surgical intervention are important for a clinical success. Complicated DH repair is best performed via the use of biological and bioabsorbable meshes which have proven to reduce recurrence. The laparoscopic approach is the preferred technique in hemodynamically stable patients without significant comorbidities because it facilitates early diagnosis of small diaphragmatic injuries from traumatic wounds in the thoraco-abdominal area and reduces postoperative complications. Open surgery should be reserved for situations when skills and equipment for laparoscopy are not available, where exploratory laparotomy is needed, or if the patient is hemodynamically unstable. Damage Control Surgery is an option in the management of critical and unstable patients.</p><p><strong>Conclusions: </strong>Complicated diaphragmatic hernia is a rare life-threatening condition. CT scan of the chest and abdomen is the gold standard for diagnosing the diaphragmatic hernia. Laparoscopic repair is the best treatment option for stable patients with complicated diaphragmatic hernias. Open repair is considered necessary in majority of unstable patients in whom Damage Control Surgery can be life-saving.</p>","PeriodicalId":48867,"journal":{"name":"World Journal of Emergency Surgery","volume":"18 1","pages":"43"},"PeriodicalIF":8.0,"publicationDate":"2023-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10373334/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9947636","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}