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Peritonitis Guideline

Karol Polom, Christine Böger, Elizabeth Smyth, Daniele Marrelli, Hans-Michael Behrens, Luigi Marano, Thomas Becker, Florian Lordick, Christoph Röcken, Franco Roviello
BACKGROUND: Current guidelines recommend that metastatic gastric cancer should not be treated with surgery unless this is required for symptom control. We hypothesized that patients with mismatch repair deficiency (MMRd) gastric cancer and metastatic disease detected at the timepoint of surgical resection would have superior survival compared to patients with MMRd cancers in the same setting. METHODS: Clinicopathological details and survival data were collected from prospective databases at two large European centers on patients who had undergone surgery and were diagnosed with synchronous stage IV gastric cancer (distant lymph nodes, positive peritoneal cytology, peritoneal, and distant metastases) at the timepoint of surgery...
March 2, 2018: European Journal of Surgical Oncology
E Mathieu d'Argent, J Cohen, C Chauffour, J L Pouly, J Boujenah, C Poncelet, C Decanter, P Santulli
Deeply infiltrating endometriosis is a severe form of the disease, defined by endometriotic tissue peritoneal infiltration. The disease may involve the rectovaginal septum, uterosacral ligaments, digestive tract or bladder. Deeply infiltrating endometriosis is responsible for disabling pain and infertility. The purpose of these recommendations is to answer the following question: in case of deeply infiltrating endometriosis associated infertility, what is the best therapeutic strategy? First-line surgery and then in vitro fertilization (IVF) in case of persistent infertility or first-line IVF, without surgery? After exhaustive literature analysis, we suggest the following recommendations: studies focusing on spontaneous fertility of infertile patients with deeply infiltrating endometriosis found spontaneous pregnancy rates about 10%...
March 12, 2018: Gynecologie, Obstetrique, Fertilite & Senologie
Emily Wonder, Lorena Simón-Gracia, Pablo Scodeller, Ramsey N Majzoub, Venkata Ramana Kotamraju, Kai K Ewert, Tambet Teesalu, Cyrus R Safinya
Cationic liposome-nucleic acid (CL-NA) complexes, which form spontaneously, are a highly modular gene delivery system. These complexes can be sterically stabilized via PEGylation [PEG: poly (ethylene glycol)] into nanoparticles (NPs) and targeted to specific tissues and cell types via the conjugation of an affinity ligand. However, there are currently no guidelines on how to effectively navigate the large space of compositional parameters that modulate the specific and nonspecific binding interactions of peptide-targeted NPs with cells...
March 2, 2018: Biomaterials
P H Cashin, H Mahteme, I Syk, J E Frödin, B Glimelius, W Graf
BACKGROUND: The aim was to compare health-related quality-of-life (HRQOL) and cost-effectiveness between cytoreductive surgery with intraperitoneal chemotherapy (CRS + IPC) and systemic chemotherapy for patients with colorectal peritoneal metastases. METHODS: Patients included in the Swedish Peritoneal Trial comparing CRS + IPC and systemic chemotherapy completed the EORTC QLQ-C30 and SF-36 questionnaires at baseline, 2, 4, 6, 12, 18, and 24 months. HRQOL at 24 months was the primary endpoint...
February 21, 2018: European Journal of Surgical Oncology
Yasmine Yousef, Fouad Youssef, Michael Homsy, Trish Dinh, Hayden Stagg, Robin Petroze, Robert Baird, Jean-Martin Larberge, Dan Poenaru, Pramod Puligandla, Kenneth Shaw, Sherif Emil
BACKGROUND: Total parenteral nutrition (TPN) is often used in children with perforated appendicitis, despite the absence of clear indications. We assessed the validity of specific clinical indications for initiation of TPN in this patient cohort. METHODS: Data were gathered prospectively on duration of nil per os (NPO) status and TPN use in a cohort of children treated under a perforated appendicitis protocol during a 19-month period. TPN was started in the immediate postoperative period in patients who had generalized peritonitis and severe intestinal dilatation at operation, or later per the discretion of the attending surgeon...
February 9, 2018: Journal of Pediatric Surgery
Cuan M Harrington, Dara O Kavanagh, Sean Tierney, Richard Deane, Dermot Hehir
BACKGROUND: With rapidly evolving surgical technologies, minimally invasive surgery (MIS) has become the mainstay approach for many surgeons worldwide. As laparoscopic surgery was introduced in Ireland over two decades ago, we may be encountering a higher prevalence of related complications. AIMS: This study aimed to gather data pertaining to risk factors for port-site herniation in MIS. METHODS: A 14-point anonymous questionnaire was distributed electronically between January and May 2017 to consultant and trainee laparoscopists in the Republic of Ireland...
February 6, 2018: Irish Journal of Medical Science
Ioannis Baloyiannis, Konstantinos Perivoliotis, Chamaidi Sarakatsianou, George Tzovaras
BACKGROUND: General anesthesia has been used as a standard for laparoscopic inguinal hernia repair including both techniques (Trans-Abdominal Pre-Peritoneal repair and the Total Extra-Peritoneal repair), while regional anesthesia has been occasionally applied in high risk patients where general anesthesia is contraindicated. In case of the total extraperitoneal repair (TEP), several authors have attempted to perform TEP repair under regional anesthesia and reported on the safety and feasibility of this procedure...
February 5, 2018: Surgical Endoscopy
İnanc Samil Sarici, Mustafa Uygar Kalayci
INTRODUCTION: The current literature and guidelines recommend that determination of peritoneal violation is done first in cases of anterior abdominal stab wounds. The primary endpoint of this study was to determine the reliability of computed tomographic (CT) tractography to assess peritoneal violation in anterior abdominal stab wounds. The secondary endpoint is to compare local wound exploration between conventional CT and CT tractography in the evaluation of peritoneal violation. MATERIAL AND METHODS: A total of 252 patients who were referred with anterior abdominal stab wounds were included in this prospective observational study...
February 2, 2018: American Journal of Emergency Medicine
Qi-Wei Wang, Xiao-Tian Zhang, Ming Lu, Lin Shen
AIM: To provide evidence regarding the postoperative treatment of patients with T4bN1-3M0/TxN3bM0 gastric cancer, for which guidelines have not been established. METHODS: Patients who had undergone curative resection between 1996 and 2014 with a pathological stage of T4bN1-3M0/TxN3bM0 for gastric cancer were retrospectively analyzed; staging was based on the 7th edition of the American Joint Committee on Cancer staging system. The clinicopathological characteristics, administration of adjuvant chemotherapy, and patterns of recurrence were studied...
January 15, 2018: World Journal of Gastrointestinal Oncology
José V Roig, Luis Sánchez-Guillén, Juan J GARCíA-Armengol
Diverticulitis is a common condition in industrialized countries and an important cause of hospital admissions. Its growing trend is a challenge for the surgeons who perform emergency surgery, because approximately 15-25 percent of the patients will require surgery, being the surgical management of complicated acute diverticulitis controversial. The past decade has seen a paradigm shift in the treatment of sigmoid diverticulitis based on new epidemiological studies and refinement of surgical techniques that has produced a reassessment of our guidelines...
January 23, 2018: Minerva Chirurgica
T Galetin, A Galetin, K-H Vestweber, A D Rink
PURPOSE: Diverticular disease is common and of increasing medical and economical importance. Various practice guidelines on diagnostic and treatment on this disease exist. We compared current guidelines on the disease in order to identify concordant and discordant recommendations. METHOD: Eleven national and international guidelines on diverticular disease published over the last 10 years have been identified by a systematic literature review on PubMed and compared in detail for 20 main and 51 subtopics...
January 18, 2018: International Journal of Colorectal Disease
Anna Mathew, Jody-Ann McLeggon, Nirav Mehta, Samuel Leung, Valerie Barta, Thomas McGinn, Gihad Nesrallah
Background: Survival and hospitalization are critically important outcomes considered when choosing between intensive hemodialysis (HD), conventional HD, and peritoneal dialysis (PD). However, the comparative effectiveness of these modalities is unclear. Objective: We had the following aims: (1) to compare the association of mortality and hospitalization in patients undergoing intensive HD, compared with conventional HD or PD and (2) to appraise the methodological quality of the supporting evidence...
2018: Canadian Journal of Kidney Health and Disease
Wenqiong Wu, Shipeng Yan, Xianzhen Liao, Haifang Xiao, Zhongxi Fu, Lizhang Chen, Jinsong Mou, Haibo Yu, Lian Zhao, Xiangguo Liu
The objective of this study was to provide an up-to-date summary of the current evidence that may be useful for updating guidelines. We comprehensively searched the published literatures and conferences for studies that compared curative with palliative treatments in colorectal cancer patients with peritoneal metastasis. The primary outcomes considered in this study were three- and five-year overall survival rates. We pooled data across studies and estimated summary effect sizes. Overall, patients who received curative treatments had improved three-year survival (hazard ratio (HR), 2...
December 22, 2017: Oncotarget
Gianluca Pellino, Oliver Warren, Sarah Mills, Shahnawaz Rasheed, Paris P Tekkis, Christos Kontovounisios
BACKGROUND: Guidelines are important to standardize treatments and optimize outcomes. Several societies have published authoritative guidelines for patients with colon cancer, and a certain degree of variation can be predicted. OBJECTIVE: This study aims to compare Western and Asian guidelines for the management of colon cancer. DATA SOURCES: A literature review was performed following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines for studies published between 2010 and 2017 by the online resources from the official Web sites of the societies/panels...
February 2018: Diseases of the Colon and Rectum
Tomasz Jastrzębski, Marek Bębenek
The incidence of peritoneal carcinomatosis of colorectal cancer amounts to 5%-15% for synchronous metastases and as much as 40% in cases of local recurrence. Best results are obtained for cytoreductive surgery combined with hyperthermic intraperitoneal chemotherapy (HIPEC). This treatment offers much better outcomes, leading to 5-year survival rates of as much as 30%-50%. The procedures require significant experience in abdominal surgery, are time-consuming (mean duration of the procedure ranging from 6 to 8 hours) and are burdened by complications that are due not only to the procedure itself but also to the intraperitoneal administration of the cytostatic drug at elevated temperature (41...
December 30, 2017: Polski Przeglad Chirurgiczny
Ziyu Li, Zhemin Li, Lianhai Zhang, Qian Liu, Zhenjun Wang, Zhongtao Zhang, Gang Xiao, Wei Fu, Xin Wang, Yingjiang Ye, Jianchun Yu, Fei Li, Lin Chen, Shibin Wang, Jiafu Ji
BACKGROUND: Staging laparoscopy(SL) is a recommended technique for the staging of Gastric Cancer(GC) and provides the indication for a radical surgery. Considering the medical practice in China, the standardized and regular usage of SL is yet to be spread. However, existing guidelines vary and make an ambiguity of indication for SL. Besides, the specific indication for Chinese patients remains a niche. This study aims to the essential, missing information of Chinese patients and tries to normalize the indication of LS in medical practice in China...
January 10, 2018: BMC Cancer
Louis L Huang, Ellen Ramas, Priti Prasad, Jenny Catania, Pauline Meade, Eamonn Butler, Lawrence P McMahon
There is a paucity of data on the sterility of peritoneal dialysis fluid (PDF) after drug admixture. International Society for Peritoneal Dialysis (ISPD) guidelines suggest using sterile technique when admixing antibiotics; however, the degree of sterility remains unclear. This issue is most pertinent when preparing take-home PDF for outpatient treatment of peritonitis. This study compares the sterility of PDF admixed with antibiotics using a non-touch aseptic technique (NTAT) versus sterile technique.Groups of 8 PDF mixtures (1...
January 2018: Peritoneal Dialysis International: Journal of the International Society for Peritoneal Dialysis
Marco Fiore, Ivan Gentile, Alberto E Maraolo, Sebastiano Leone, Vittorio Simeon, Paolo Chiodini, Maria C Pace, Thierry Gustot, Fabio S Taccone
BACKGROUND: Spontaneous bacterial peritonitis (SBP) is a common complication among cirrhotic patients. Guidelines recommend third-generation cephalosporins (3GCs) as empiric antibiotic therapy (EAT) of SBP. Recently, a broad-spectrum EAT was shown to be more effective than cephalosporins in the treatment of nosocomial spontaneous bacterial peritonitis (N-SBP); however, the prevalence of 3GCs-resistant bacteria is high in the nosocomial setting and broad-spectrum EAT cannot be used in all cases of SBP...
March 2018: European Journal of Gastroenterology & Hepatology
Andrés García-Marín, Mercedes Pérez-López, Elena Martínez-Guerrero, Lorena Rodríguez-Cazalla, Antonio Compañ-Rosique
BACKGROUND: Microbiologic studies suggest that complicated (CAA) and uncomplicated (UAA) acute appendicitis are different entities. Routine peritoneal fluid cultures continue to be controversially related to a low positive rate, found mainly in UAA; to isolation of typical micro-organisms with expected susceptibilities; and to a community-acquired intra-abdominal infection. The aim of this study was to describe microbiologic isolates in CAA and UAA and the usefulness of peritoneal fluid cultures to determine the susceptibilities to our antibiotic therapy guidelines...
January 2018: Surgical Infections
Mark Christopher Sykes, Bilal Azhar, Laurence John, Salman Bokhari
INTRODUCTION: Here we present a case of atraumatic splenic rupture secondary to varicella infection requiring emergency splenectomy. The presentation was as would be expected for epstein barr virus (EBV) related splenic injury, which is well documented in the literature. Dermatological findings however suggested varicella zoster, and viral serology subsequently confirmed the diagnosis. PRESENTATION OF CASE: A young Romanian male presented to the emergency department with peritonism without preceding trauma...
December 24, 2017: International Journal of Surgery Case Reports
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