scholarly journals Evaluation of emergency general surgery operations in COVID-19 patients in a pandemic hospital: a single center experience

2021 ◽  
Vol 8 (8) ◽  
pp. 2267
Author(s):  
İsmail Hasirci ◽  
Mehmet E. Ulutas ◽  
Gurcan Simsek ◽  
Alpaslan Sahin ◽  
Kemal Arslan ◽  
...  
Keyword(s):  
Acute Appendicitis ◽  
General Surgery ◽  
Perforated Peptic Ulcer ◽  
Demographic Characteristics ◽  
Incarcerated Hernia ◽  
Emergency General Surgery ◽  
Wound Site ◽  
Mortality And Morbidity ◽  
Single Center Experience ◽  
Causes Of Mortality

Background: During the pandemic, the decision on delaying elective surgeries was implemented country-wide, and emergency surgeries were excluded from this scope. In this study, the patients diagnosed with COVID-19 and who underwent an emergency general surgery operation were evaluated regarding indications, demographic characteristics, and preoperative and postoperative clinical features.Methods: In the study, emergency surgeries performed by the department of general surgery between 1st June and 30th September, when our center cared only patients diagnosed with COVID-19, were reviewed retrospectively.Results: A total of 13 patients, 7 women and 6 men, were included in this study. The most common surgical diagnosis was acute appendicitis (9/13). For all of the patients with appendicitis, a conventional appendectomy procedure was performed. 2 patients were diagnosed with an incarcerated femoral hernia and then operated (2/13). One patient was operated on due to a sharp object injury, and one due to an acute abdomen caused by a perforation. Only 3 of the operated patients developed postoperative wound site complications (23%). No mortality was observed by the end of a 15-day follow-up.Conclusions: The most common cause of emergency surgeries during the pandemic, changelessly, remains to be acute appendicitis. Besides, cases of trauma, perforated peptic ulcer, and incarcerated hernia are also commonly encountered. While the pandemic continues full steam, these conditions that are associated with the pandemic but among causes of mortality and morbidity other than COVID-19 and that may require an emergency surgery should be considered. All emergency surgical procedures should continue to be performed punctually by using necessary protective types of equipment.

scholarly journals Clinical study of relaparotomy after emergency general surgery in a tertiary center of central India: a retrospective study

2020 ◽  
Vol 7 (8) ◽  
pp. 2490
Author(s):  
Archana Shukla ◽  
Ramashankar Gupta ◽  
Prateek Malpani
Keyword(s):  
General Surgery ◽  
Rare Complication ◽  
Morbidity And Mortality ◽  
Emergency Laparotomy ◽  
Anastomotic Site ◽  
Emergency General Surgery ◽  
Case Record ◽  
Mortality And Morbidity ◽  
Initial Surgery ◽  
Tertiary Center

Background: Relaparotomy after emergency surgery is a catastrophic situation associated with significant morbidity and mortality. Incidence is highly variable depending not only on hospital set up but also on the patient’s characteristics as well as on the initial surgery and postoperative care given. This study was thus, planned to identify the indications, procedure, risk factors and outcomes of relaparotomy so that timely intervention can lower incidence and morbidity.Methods: This was a retrospective cohort study conducted in department of general surgery, Gandhi Medical College and associated Hamidia Hospital from January 2018 to December 2019. All patients irrespective of age and sex, who have undergone emergency re-exploration of the abdomen during the period of hospitalization after the first operation and discharge of patients. Data were recorded in pre-validated case record form.Results: 32 cases of relaparotomy were identified. All patients had emergency laparotomy as primary surgery. Majority of patients required relaparotomy for anastomotic site leak in 16 cases (50%) followed by intestinal obstruction in 10 cases (31%), hemorrhage in 4 cases (16%) while the least cause being intra-abdominal sepsis in 2 cases (6.2%). Relaparotomy was associated with increased mortality and morbidity. Out of 32 patients, 4 (12.5%) patients died.Conclusions: Relaparotomy is a rare complication and a lifesaving procedure for patients. Calculative experience guided decision on relaparotomy can decrease the incidence of morbidity and mortality associated with the procedure.

scholarly journals American Association for the Surgery of Trauma emergency general surgery guideline summaries 2018: acute appendicitis, acute cholecystitis, acute diverticulitis, acute pancreatitis, and small bowel obstructionAcute cholecystitis management guidelines summaryAcute colonic diverticulitis management guidelines summaryIntestinal obstruction due to adhesions guideline summaryAcute pancreatitis management guidelines summary

2019 ◽  
Vol 4 (1) ◽  
pp. e000281 ◽  
Author(s):  
Kevin M Schuster ◽  
Daniel N Holena ◽  
Ali Salim ◽  
Stephanie Savage ◽  
Marie Crandall
Keyword(s):  
Acute Pancreatitis ◽  
Small Bowel ◽  
Acute Appendicitis ◽  
Acute Cholecystitis ◽  
General Surgery ◽  
Clinical Decision Making ◽  
American Association ◽  
Acute Diverticulitis ◽  
Emergency General Surgery ◽  
Management Guidelines

In April 2017, the American Association for the Surgery of Trauma (AAST) asked the AAST Patient Assessment Committee to undertake a gap analysis for published clinical practice guidelines in emergency general surgery (EGS). Committee members performed literature searches to catalogue published guidelines for common EGS diseases and also to identify gaps in the literature where guidelines could be created. For five of the most common EGS conditions, acute appendicitis, acute cholecystitis, acute diverticulitis, acute pancreatitis, and small bowel obstruction, we found multiple well-referenced guidelines published by leading professional organizations. We have summarized guideline recommendations for each of these disease states stratified by the AAST EGS anatomic severity score based on these published consensus guidelines. These summaries could be used to help inform evidence-based clinical decision-making, but are intended to be flexible and updatable in real time as further research emerges. Comprehensive guidelines were available for all of the diseases queried and identified gaps most commonly represented areas lacking a solid evidence base. These are therefore areas where further research is needed.

Validation of the American Association for the Surgery of Trauma emergency general surgery score for acute appendicitis—an EAST multicenter study

2019 ◽  
Vol 87 (1) ◽  
pp. 134-139 ◽  
Author(s):  
Georgia Vasileiou ◽  
Mohamed Ray-Zack ◽  
Martin Zielinski ◽  
Sinong Qian ◽  
Daniel Dante Yeh ◽  
...  
Keyword(s):  
Acute Appendicitis ◽  
Multicenter Study ◽  
General Surgery ◽  
American Association ◽  
Emergency General Surgery

The laparoscopy in emergency general surgery (LEGS) study: a questionnaire survey of UK practice

2021 ◽  
Vol 103 (2) ◽  
pp. 120-129
Author(s):  
N Heywood ◽  
KL Parmar ◽  
M Stott ◽  
P Sodde ◽  
DT Doherty ◽  
...  
Keyword(s):  
General Surgery ◽  
Questionnaire Survey ◽  
Laparoscopic Approach ◽  
Perforated Peptic Ulcer ◽  
Emergency Laparotomy ◽  
Emergency General Surgery ◽  
Factors Affecting ◽  
North West ◽  
The North ◽  
General Surgeons

Introduction Recent consensus guidelines suggest that the laparoscopic approach may be a useful, safe and feasible approach in emergency general surgery. Despite this, the UK National Emergency Laparotomy Audit (NELA) suggests the rate of laparoscopy is low (9% fully laparoscopic) and slow to increase over time. A European survey found uptake to be variable. This UK survey was therefore undertaken to establish current UK practice and to determine factors affecting implementation. Materials and methods A questionnaire survey of currently practising UK consultant general surgeons was carried out by the North West Surgical Research Collaborative, using a secure web-based database maintained by the North West Surgical Trials Centre. Results A total of 151 completed questionnaires were returned from 22 UK centres; 18% of respondents were unaware that laparoscopic cases should be reported to NELA. Appendicectomy (97%) and cholecystectomy (87%) were routinely performed laparoscopically. Laparoscopy was infrequently used in perforation, ischaemia or obstructed hernias. There appears to be equipoise regarding laparoscopic compared with open surgery in small-bowel obstruction among all subspecialty emergency general surgeons, in perforated peptic ulcer among upper gastrointestinal surgeons and in Hinchey III diverticulitis among colorectal surgeons. Conclusion Uptake of laparoscopy in UK emergency general surgery is influenced by surgeon preference, subspecialty, patient and operative factors. Further research into outcomes may help to identify areas of greatest potential benefit. The rate of laparoscopy reported by NELA may be an underestimate due to the 18% of surgeons unaware that laparoscopic cases should be reported, which may affect the validity of analyses performed from this dataset.

Chitosan-Based Hydrogel Nanoparticles for Cancer Therapy

2017 ◽  
Vol 7 (04) ◽  
Author(s):  
Azadi A. ◽  
Khazaei M. ◽  
Ashrafi H.
Keyword(s):  
Drug Delivery ◽  
Cancer Therapy ◽  
Recent Decade ◽  
Reticuloendothelial System ◽  
Malignant Neoplasms ◽  
Mortality And Morbidity ◽  
Hydrogel Nanoparticles ◽  
Tissue Invasion ◽  
Causes Of Mortality ◽  
Nanoparticulate Systems

Cancer, an uncontrollable growth of cells, is among the leading causes of mortality and morbidity throughout the world. Malignant neoplasms are difficult to treat diseases because of their single in kind characteristics such as tissue invasion, metastasis, evading reticuloendothelial system (RES) and so forth. In recent decade polymeric nanoparticulate systems has gained special attention in drug delivery and targeting among all biocompatible nanoforms. Among these systems, chitosan-based hydrogel nanoparticles have been wildly utilized for drug delivery purposes. The usage of chitosan nanogels in cancer therapy significantly improved in recent years. The various cancers were the target of chitosan nanogels. Also, modification of other delivery systems with chitosan were much reported. The aim of this study is the review and update of the recent studies on chitosan nanogels applications in cancer therapy by focus on cancer based classification.

scholarly journals Are Lipids Possible Markers of Suicide Behaviors?

2021 ◽  
Vol 10 (2) ◽  
pp. 333
Author(s):  
Agnieszka Kułak-Bejda ◽  
Grzegorz Bejda ◽  
Magdalena Lech ◽  
Napoleon Waszkiewicz
Keyword(s):  
Suicide Risk ◽  
Biological Marker ◽  
Low Density Lipoproteins ◽  
Low Density ◽  
Lipid Levels ◽  
Mortality And Morbidity ◽  
Additional Tool ◽  
Cholesterol Levels ◽  
Causes Of Mortality ◽  
Suicide Behaviors

Suicides and suicidal behaviors are very important causes of mortality and morbidity and have become a serious global problem. More than 800,000 people die from suicide every year. Previous researches have established that lipids play an important role in the pathogenesis of suicide. Moreover, lipid levels might be a biological marker of suicide. A lot of researchers have tried to identify biological markers that might be related to depressive disorder, bipolar disorder or schizophrenia and suicidal behavior. It was also important to consider the usefulness of an additional tool for prevention actions. Metabolic deregulation, particularly low total cholesterol and low-density lipoproteins-cholesterol levels may cause higher suicide risk in patients with these psychiatric disorders.

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