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Mario Testini, Lucia Ilaria Sgaramella, Giuseppe Massimiliano De Luca, Alessandro Pasculli, Angela Gurrado, Antonio Biondi, Giuseppe Piccinni
INTRODUCTION: Mirizzi syndrome (MS) is a rare complication of cholelithiasis. Despite the success of laparoscopic cholecystectomy as a minimally invasive approach to gallstone disease, MS remains a challenge, also for open and robotic approaches, due to the subverted anatomy of the hepatocystic triangle. Moreover, when emergency surgery is needed, the optimal preoperative diagnostic assessment could not be always achievable. We aim to analyze our experience of MS treated in emergency and to assess the feasibility of a diagnostic and therapeutic decisional algorithm...
September 9, 2016: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
Xishan Wang
Colorectal surgery is rapidly developing in the direction of minimally invasive surgery and functional surgery. New technology and ideas are constantly emerging recently. Laparoscopic colon surgery has already been recommended by NCCN guideline. However, laparoscopic rectal cancer surgery still needs to wait for survival and recurrence rates of long-term follow-up data for verification. In recent years, with the rapid progression of imaging equipment of laparoscope, the new 3D laparoscopic system will process image more quickly, and surgeons can get space depth feeling like open surgery only with a pair of glasses...
June 2016: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
Milan Kumar Taye, Syed Abul Fazal, David Pegu, Dayanada Saikia
INTRODUCTION: Safe placement of the Verres needle or the primary trocar for establishment of pneumoperitoneum is the most critical step in laparoscopic procedure as it is associated with bowel, bladder and life threatening vascular injuries and embolism. In the last few decades many techniques and guidelines have been introduced to eliminate complications in creation of pneumoperitoneum. Classical closed technique (Verres needle) and the open classic technique (Hasson) are the most commonly used techniques for creation of pneumoperitoneum...
February 2016: Journal of Clinical and Diagnostic Research: JCDR
M Björck, A W Kirkpatrick, M Cheatham, M Kaplan, A Leppäniemi, J J De Waele
BACKGROUND: In 2009, a classification system for the open abdomen was introduced. The aim of such a classification is to aid the (1) description of the patient's clinical course; (2) standardization of clinical guidelines for guiding open abdomen management; and (3) facilitation of comparisons between studies and heterogeneous patient populations, thus serving as an aid in clinical research. METHODS: As part of the revision of the definitions and clinical guidelines performed by the World Society of the Abdominal Compartment Syndrome, this 2009 classification system was amended following a review of experiences in teaching and research and published as part of updated consensus statements and clinical practice guidelines in 2013...
March 2016: Scandinavian Journal of Surgery: SJS
Derek J Roberts, Chad G Ball, Andrew W Kirkpatrick
PURPOSE OF REVIEW: This article reviews recent developments related to intra-abdominal hypertension (IAH)/abdominal compartment syndrome (ACS) and clinical practice guidelines published in 2013. RECENT FINDINGS: IAH/ACS often develops because of the acute intestinal distress syndrome. Although the incidence of postinjury ACS is decreasing, IAH remains common and associated with significant morbidity and mortality among critically ill/injured patients. Many risk factors for IAH include those findings suggested to be indications for use of damage control surgery in trauma patients...
April 2016: Current Opinion in Critical Care
M Tuna, R Latifi, A El-Menyar, H Al Thani
BACKGROUND: Enteral nutrition (EN) is a widely used, standard-of-care technique for nutrition support in critically ill and trauma patients. OBJECTIVE: To review the current techniques of gastrointestinal tract access for EN. METHODS: For this traditional narrative review, we accessed English-language articles and abstracts published from January 1988 through October 2012, using three research engines (MEDLINE, Scopus, and EMBASE) and the following key terms: "enteral nutrition," "critically ill," and "gut access...
June 2013: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
Andrew W Kirkpatrick, Derek J Roberts, Roman Jaeschke, Jan J De Waele, Bart L De Keulenaer, Juan Duchesne, Martin Bjorck, Ari Leppäniemi, Janeth C Ejike, Michael Sugrue, Michael L Cheatham, Rao Ivatury, Chad G Ball, Annika Reintam Blaser, Adrian Regli, Zsolt Balogh, Scott D'Amours, Inneke De Laet, Manu L N G Malbrain
The Abdominal Compartment Society ( previously created highly cited Consensus Definitions/Management Guidelines related to intra-abdominal hypertension (IAH) and abdominal compartment syndrome (ACS). Implicit in this previous work, was a commitment to regularly reassess and update in relation to evolving research. Two years preceding the Fifth World Congress on Abdominal Compartment Syndrome, an International Guidelines committee began preparation. An oversight/steering committee formulated key clinical questions regarding IAH/ /ACS based on polling of the Executive to redundancy, structured according to the Patient, Intervention, Comparator, and Outcome (PICO) format...
2015: Anaesthesiology Intensive Therapy
Jacob Glaser, Matthew Vasquez, Cassandra Cardarelli, James Dunne, Eric Elster, Emily Hathaway, Benjamin Bograd, Shawn Safford, Carlos Rodriguez
BACKGROUND: Operation Iraqi Freedom and Operation Enduring Freedom have seen the highest rates of combat casualties since Vietnam. These casualties often require massive transfusion (MT) and immediate surgical attention to control hemorrhage. Clinical practice guidelines dictate ratio-driven resuscitation (RDR) for patients requiring MT. With the transition from crystalloid to blood product resuscitation, we have seen fewer open abdomens in combat casualties. We sought to determine the effect RDR has on achieving early definitive abdominal fascial closure in combat casualties undergoing exploratory laparotomy...
October 2015: Journal of Trauma and Acute Care Surgery
Federico Coccolini, Walter Biffl, Fausto Catena, Marco Ceresoli, Osvaldo Chiara, Stefania Cimbanassi, Luca Fattori, Ari Leppaniemi, Roberto Manfredi, Giulia Montori, Giovanni Pesenti, Michael Sugrue, Luca Ansaloni
The indications for Open Abdomen (OA) are generally all those situations in which is ongoing the development an intra-abdominal hypertension condition (IAH), in order to prevent the development of abdominal compartmental syndrome (ACS). In fact all those involved in care of a critically ill patient should in the first instance think how to prevent IAH and ACS. In case of ACS goal directed therapy to achieve early opening and early closure is the key: paradigm of closure shifts to combination of therapies including negative pressure wound therapy and dynamic closure, in order to reduce complications and avoid incisional hernia...
2015: World Journal of Emergency Surgery: WJES
Keith Harding
In recent years, the provision of wound care for patients has dramatically improved through the development of new therapeutic options, allowing for a wide range of wound care therapy choices. In June 2014, an educational International Surgical Wound Forum (ISWF) was held to present current options in wound care to a multidisciplinary group of healthcare providers. Topics included negative pressure wound therapy with instillation and dwell time (NPWTi-d), surgical incision management (SIM), use of NPWT in the management of the open abdomen, epidermal skin harvesting, and advanced wound dressings...
April 2015: Journal of Wound Care
Pankaj Kumar, Maneesh Singhal, Sushma Sagar, Amit Gupta
A 30-year-old man was referred to us after 48 days of gunshot injury to left groin, with torrential bleeding from a pseudoaneurysm of the left external iliac artery. He was successfully managed with a team of specialists involving trauma surgeon, vascular and plastic surgeon, general surgeons and intervention radiologist with the help of critical care specialists. He required judicious debridement, a transverse rectus abdominis musculocutaneous flap, stenting of the external iliac artery, repair of the external iliac vein and ligation of the bilateral internal iliac artery...
2014: BMJ Case Reports
Andreas A Prachalias, Elissaios Kontis
PURPOSE OF REVIEW: The scope of the present study is to review the topics of initial assessment, diagnosis and clinical management of an isolated abdominal trauma. RECENT FINDINGS: Progress in the management of trauma patients increasing survival includes a multidisciplinary approach involving multiple specialties at presentation. If immediate surgical intervention is needed, 'damage control' is the best option; if not, it has been proven that conservative management is superior to operative, in terms of survival for the majority of intraabdominal injury...
April 2014: Current Opinion in Critical Care
M Björck, A Wanhainen
OBJECTIVES: The management of the abdominal compartment syndrome (ACS) and the open abdomen (OA) are important to improve survival after major vascular surgery, in particular ruptured abdominal aortic aneurysm (RAAA). The aim is to summarize contemporary knowledge in this field. METHODS: The consensus definitions of the World Society of the Abdominal Compartment Syndrome (WSACS) that were published in 2006 and the clinical practice guidelines published in 2007 were updated in 2013...
March 2014: European Journal of Vascular and Endovascular Surgery
Miguel Ángel García-Ureña, Javier López-Monclús, Álvaro Robín
The new published guidelines of compartment syndrome are supposed to be a helpful tool in order to make decisions in patients with abdominal hypertension. From a surgical perspective of view, an important effort has been made in order to reach consensus in different phases in which there is no clear answer in evidence-based medicine. It is mandatory the use of a universal classification of open abdomen and there are three main concepts that must be observed: make a decompressive laparotomy when conservative measures have failed, attempt to closure the abdomen as soon as possible and the use of negative-pressure treatments that facilitates the management of an open abdomen...
April 2014: Medicina Intensiva
Davide Ciclamini, Bernardino Panero, Paolo Titolo, Pierluigi Tos, Bruno Battiston
Hand and wrist lesions are relatively common in polytraumatised patients. These subjects sustain a wide range of potential life-threatening conditions and hand and wrist injuries incurred are often not diagnosed or are insufficiently treated. Closed lesions are the most frequently missed diagnosis, but even severe open lesions may be incorrectly treated. Most of these hand and wrist injuries can have a strong negative impact on long-term quality of life, particularly when treatment of these injuries is poor or delayed...
February 2014: Injury
Sunil V Patel, Shaun C Coughlin, Richard A Malthaner
BACKGROUND: There has been recent interest in using high-concentration oxygen to prevent surgical site infections (SSIs). Previous meta-analyses in this area have produced conflicting results. With the publication of 2 new randomized controlled trials (RCTs) that were not included in previous meta-analyses, an updated review is warranted. Our objective was to perform a meta-analysis on RCTs comparing high- and low- concentration oxygen in adults undergoing open abdominal surgery. METHODS: We completed independent literature reviews using electronic databases, bibliographies and other sources of grey literature to identify relevant studies...
August 2013: Canadian Journal of Surgery. Journal Canadien de Chirurgie
Srinivas Nalamachu, Matthew Wieman, Leah Bednarek, Surya Chitra
PURPOSE: Lidocaine patch 5% is recommended as a first-line therapy for postherpetic neuralgia pain in neuropathic pain guidelines. Postherpetic neuralgia can occur anywhere on the body but often follows acute herpes zoster occurring in trigeminal and brachial plexus dermatomes. An analysis was conducted to determine whether the anatomic location of lidocaine patch 5% is associated with variations in effectiveness or tolerability in patients with postherpetic neuralgia. METHODS: This was a post hoc analysis by anatomic site of patch placement (head [including neck], trunk [chest, abdomen, back, hips], and extremities [arm, leg]) of a 4-week, multicenter, open-label study that enrolled patients with persistent pain following herpes zoster infection...
2013: Patient Preference and Adherence
Andrew W Kirkpatrick, Derek J Roberts, Jan De Waele, Roman Jaeschke, Manu L N G Malbrain, Bart De Keulenaer, Juan Duchesne, Martin Bjorck, Ari Leppaniemi, Janeth C Ejike, Michael Sugrue, Michael Cheatham, Rao Ivatury, Chad G Ball, Annika Reintam Blaser, Adrian Regli, Zsolt J Balogh, Scott D'Amours, Dieter Debergh, Mark Kaplan, Edward Kimball, Claudia Olvera
PURPOSE: To update the World Society of the Abdominal Compartment Syndrome (WSACS) consensus definitions and management statements relating to intra-abdominal hypertension (IAH) and the abdominal compartment syndrome (ACS). METHODS: We conducted systematic or structured reviews to identify relevant studies relating to IAH or ACS. Updated consensus definitions and management statements were then derived using a modified Delphi method and the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) guidelines, respectively...
July 2013: Intensive Care Medicine
Michael Gawenda, Jan Brunkwall
BACKGROUND: Ruptured abdominal aortic aneurysm (rAAA) remains a challenging problem: 2,410 cases were treated in Germany in 2010. Ruptured abdominal aortic aneurysm should be suspected in patients over age 50 who complain of pain in the abdomen or back and in whom examination reveals a pulsatile abdominal mass. The incidence of hospitalization for rAAA is 12 per 100,000 persons over age 65 per year (statistics for Germany, 2010), and rAAA carries an overall mortality of 80%. METHODS: The current state of knowledge of rAAA was surveyed in a selective review of pertinent literature retrieved by an electronic search in the PubMed, Web of Science, and Cochrane Library databases with the keywords "abdominal aortic aneurysm," "ruptured," "open repair," and "endovascular...
October 2012: Deutsches Ärzteblatt International
Torsten Kaussen, Gerd Steinau, Pramod Kadaba Srinivasan, Jens Otto, Michael Sasse, Franz Staudt, Alexander Schachtrupp
INTRODUCTION: Several decades ago, the beneficial effects of goal-directed therapy, which include decompressive laparotomy (DL) and open abdomen procedures in cases of intra-abdominal hypertension (IAH) in children, were proven in the context of closures of abdominal wall defects and large-for-size organ transplantations. Different neonatologic and pediatric disease patterns are also known to be capable of increasing intra-abdominal pressure (IAP). Nevertheless, a considerable knowledge transfer regarding such risk factors has hardly taken place...
July 5, 2012: Annals of Intensive Care
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