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2. Goodbye Hartmann trial: a prospective, international, multicenter, observational study on the current use of a surgical procedure developed a century ago

Author

Perrone, Gennaro, Giuffrida, Mario, Abu-Zidan, Fikri, Kruger, Vitor F., Livrini, Marco, Petracca, Gabriele Luciano, Rossi, Giorgio, Tarasconi, Antonio, Tian, Brian W. C. A., Bonati, Elena, Mentz, Ricardo, Mazzini, Federico N., Campana, Juan P., Gasser, Elisabeth, Kafka-Ritsch, Reinhold, Felsenreich, Daniel M., Dawoud, Christopher, Riss, Stefan, Gomes, Carlos Augusto, Gomes, Felipe Couto, Gonzaga, Ricardo Alessandro Teixeira, Canton, Cassio Alfred Brattig, Pereira, Bruno Monteiro, Fraga, Gustavo P., Zem, Leticia Gonçalves, Cordeiro-Fonseca, Vinicius, de Mesquita Tauil, Renato, Atanasov, Boyko, Belev, Nikolay, Kovachev, Nikola, Meléndez, L. Juan José, Dimova, Ana, Dimov, Stefan, Zelić, Zdravko, Augustin, Goran, Bogdanić, Branko, Morić, Trpimir, Chouillard, Elie, Bajul, Melinda, De Simone, Belinda, Panis, Yves, Esposito, Francesco, Notarnicola, Margherita, Lauka, Lelde, Fabbri, Anna, Hentati, Hassen, Fnaiech, Iskander, Aurélien, Venara, Bougard, Marie, Roulet, Maxime, Demetrashvili, Zaza, Pipia, Irakli, Merabishvili, Giorgi, Bouliaris, Konstantinos, Koukoulis, Georgios, Doudakmanis, Christos, Xenaki, Sofia, Chrysos, Emmanuel, Kokkinakis, Stamatios, Vassiliu, Panteleimon, Michalopoulos, Nikolaos, Margaris, Ioannis, Kechagias, Aristotelis, Avgerinos, Konstantinos, Katunin, Jevgeni, Lostoridis, Eftychios, Nagorni, Eleni-Aikaterini, Pujante, Antonio, Mulita, Francesk, Maroulis, Ioannis, Vailas, Michail, Marinis, Athanasios, Siannis, Ioannis, Bourbouteli, Eirini, Manatakis, Dimitrios K., Tasis, Nikolaos, Acheimastos, Vasileios, Maria, Sotiropoulou, Stylianos, Kapiris, Kuzeridis, Harilaos, Korkolis, Dimitrios, Fradelos, Evangelos, Kavalieratos, George, Petropoulou, Thalia, Polydorou, Andreas, Papacostantinou, Ioannis, Triantafyllou, Tania, Kimpizi, Despina, Theodorou, Dimitrios, Toutouzas, Konstantinos, Chamzin, Alexandros, Frountzas, Maximos, Schizas, Dimitrios, Karavokyros, Ioannis, Syllaios, Athanasios, Charalabopoulos, Alexandros, Boura, Maria, Baili, Efstratia, Ioannidis, Orestis, Loutzidou, Lydia, Anestiadou, Elissavet, Tsouknidas, Ioannis, Petrakis, Georgios, Polenta, Eleni, Bains, Lovenish, Gupta, Rahul, Singh, Sudhir K., Khanduri, Archana, Bala, Miklosh, Kedar, Asaf, Pisano, Marcello, Podda, Mauro, Pisanu, Adolfo, Martines, Gennaro, Trigiante, Giuseppe, Lantone, Giuliano, Agrusa, Antonino, Di Buono, Giuseppe, Buscemi, Salvatore, Veroux, Massimiliano, Gioco, Rossella, Veroux, Gastone, Oragano, Luigi, Zonta, Sandro, Lovisetto, Federico, Feo, Carlo V., Pesce, Antonio, Fabbri, Nicolò, Lantone, Giulio, Marino, Fabio, Perrone, Fabrizio, Vincenti, Leonardo, Papagni, Vincenzo, Picciariello, Arcangelo, Rossi, Stefano, Picardi, Biagio, Del Monte, Simone Rossi, Visconti, Diego, Osella, Giulia, Petruzzelli, Luca, Pignata, Giusto, Andreuccetti, Jacopo, D’Alessio, Rossella, Buonfantino, Massimo, Guaitoli, Eleonora, Spinelli, Stefano, Sampietro, Gianluca Matteo, Corbellini, Carlo, Lorusso, Leonardo, Frontali, Alice, Pezzoli, Isabella, Bonomi, Alessandro, Chierici, Andrea, Cotsoglou, Christian, Manca, Giuseppe, Delvecchio, Antonella, Musa, Nicola, Casati, Massimiliano, Letizia, Laface, Abate, Emmanuele, Ercolani, Giorgio, D’Acapito, Fabrizio, Solaini, Leonardo, Guercioni, Gianluca, Cicconi, Simone, Sasia, Diego, Borghi, Felice, Giraudo, Giorgio, Sena, Giuseppe, Castaldo, Pasquale, Cardamone, Eugenia, Portale, Giuseppe, Zuin, Matteo, Spolverato, Ylenia, Esposito, Marialusia, Isernia, Roberta Maria, Di Salvo, Maria, Manunza, Romina, Esposito, Giuseppe, Agus, Marcello, Asti, Emanuele Luigi Giuseppe, Bernardi, Daniele Tiziano, Tonucci, Tommaso Panici, Luppi, Davide, Casadei, Massimiliano, Bonilauri, Stefano, Pezzolla, Angela, Panebianco, Annunziata, Laforgia, Rita, De Luca, Maurizio, Zese, Monica, Parini, Dario, Jovine, Elio, De Sario, Giuseppina, Lombardi, Raffaele, Aprea, Giovanni, Palomba, Giuseppe, Capuano, Marianna, Argenio, Giulio, Orio, Gianluca, Armellino, Mariano Fortunato, Troian, Marina, Guerra, Martina, Nagliati, Carlo, Biloslavo, Alan, Germani, Paola, Aizza, Giada, Monsellato, Igor, Chahrour, Ali Chaouki, Anania, Gabriele, Bombardini, Cristina, Bagolini, Francesco, Sganga, Gabriele, Fransvea, Pietro, Bianchi, Valentina, Boati, Paolo, Ferrara, Francesco, Palmieri, Francesco, Cianci, Pasquale, Gattulli, Domenico, Restini, Enrico, Cillara, Nicola, Cannavera, Alessandro, Nita, Gabriela Elisa, Sarnari, Jlenia, Roscio, Francesco, Clerici, Federico, Scandroglio, Ildo, Berti, Stefano, Cadeo, Alessandro, Filippelli, Alice, Conti, Luigi, Grassi, Carmine, Cattaneo, Gaetano Maria, Pighin, Marina, Papis, Davide, Gambino, Giovanni, Bertino, Vanessa, Schifano, Domenico, Prando, Daniela, Fogato, Luisella, Cavallo, Fabio, Ansaloni, Luca, Picheo, Roberto, Pontarolo, Nicholas, Depalma, Norma, Spampinato, Marcello, D’Ugo, Stefano, Lepre, Luca, Capponi, Michela Giulii, Campa, Rossella Domenica, Sarro, Giuliano, Dinuzzi, Vincenza Paola, Olmi, Stefano, Uccelli, Matteo, Ferrari, Davide, Inama, Marco, Moretto, Gianluigi, Fontana, Michele, Favi, Francesco, Picariello, Erika, Rampini, Alessia, Barberis, Andrea, Azzinnaro, Antonio, Oliva, Alba, Totaro, Luigi, Benzoni, Ilaria, Ranieri, Valerio, Capolupo, Gabriella Teresa, Carannante, Filippo, Caricato, Marco, Ronconi, Maurizio, Casiraghi, Silvia, Casole, Giovanni, Pantalone, Desire, Alemanno, Giovanni, Scheiterle, Maximilian, Ceresoli, Marco, Cereda, Marco, Fumagalli, Chiara, Zanzi, Federico, Bolzon, Stefano, Guerra, Enrico, Lecchi, Francesca, Cellerino, Paola, Ardito, Antonella, Scaramuzzo, Rosa, Balla, Andrea, Lepiane, Pasquale, Tartaglia, Nicola, Ambrosi, Antonio, Pavone, Giovanna, Palini, Gian Marco, Veneroni, Simone, Garulli, Gianluca, Ricci, Claudio, Torre, Beatrice, Russo, Iris Shari, Rottoli, Matteo, Tanzanu, Marta, Belvedere, Angela, Milone, Marco, Manigrasso, Michele, De Palma, Giovanni Domenico, Piccoli, Micaela, Pattacini, Gianmaria Casoni, Magnone, Stefano, Bertoli, Paolo, Pisano, Michele, Massucco, Paolo, Palisi, Marco, Luzzi, Andrea-Pierre, Fleres, Francesco, Clarizia, Guglielmo, Spolini, Alessandro, Kobe, Yoshiro, Toma, Takayuki, Shimamura, Fumihiko, Parker, Robert, Ranketi, Sinkeet, Mitei, Mercy, Svagzdys, Saulius, Pauzas, Henrikas, Zilinskas, Justas, Poskus, Tomas, Kryzauskas, Marius, Jakubauskas, Matas, Zakaria, Andee Dzulkarnaen, Zakaria, Zaidi, Wong, Michael Pak-Kai, Jusoh, Asri Che, Zakaria, Muhammad Nazreen, Cruz, Daniel Rios, Elizalde, Aurea Barbara Rodriguez, Reynaud, Alejandro Bañon, Hernandez, Edgard Efren Lozada, Monroy, Jose maria Victor Palomo, Hinojosa-Ugarte, Diego, Quiodettis, Martha, Du Bois, María Esther, Latorraca, José, Major, Piotr, Pędziwiatr, Michał, Pisarska-Adamczyk, Magdalena, Walędziak, Maciej, Kwiatkowski, Andrzej, Czyżykowski, Łukasz, da Costa, Silvia Dantas, Pereira, Bela, Ferreira, Ana Rita Oliveira, Almeida, Filipe, Rocha, Ricardo, Carneiro, Carla, Perez, Diego Pita, Carvas, João, Rocha, Catarina, Ferreira, Cátia, Marques, Rita, Fernandes, Urânia, Leao, Pedro, Goulart, André, Pereira, Rita Gonçalves, Patrocínio, Sara Daniela Direito, de Mendonça, Nuno Gonçalo Gonçalves, Manso, Maria Isabel Cerqueira, Morais, Henrique Manuel Cardoso, Cardoso, Paulo Sebastião, Calu, Valentin, Miron, Adrian, Toma, Elena Adelina, Gachabayov, Mahir, Abdullaev, Abakar, Litvin, Andrey, Nechay, Taras, Tyagunov, Alexander, Yuldashev, Anvar, Bradley, Alison, Wilson, Michael, Panyko, Arpád, Látečková, Zuzana, Lacko, Vladimír, Lesko, Dusan, Soltes, Marek, Radonak, Jozef, Turrado-Rodriguez, Victor, Termes-Serra, Roser, Morales-Sevillano, Xavier, Lapolla, Pierfrancesco, Mingoli, Andrea, Brachini, Gioia, Degiuli, Maurizio, Sofia, Silvia, Reddavid, Rossella, de Manzoni Garberini, Andrea, Buffone, Angelica, del Pozo, Eduardo Perea, Aparicio-Sánchez, Daniel, Dos Barbeito, Sandra, Estaire-Gómez, Mercedes, Vitón-Herrero, Rebeca, de los Ángeles Gil Olarte-Marquez, Mª, Gil-Martínez, José, Alconchel, Felipe, Nicolás-López, Tatiana, Rahy-Martin, Aida Cristina, Pelloni, María, Bañolas-Suarez, Raquel, Mendoza-Moreno, Fernando, Nisa, Francisca García-Moreno, Díez-Alonso, Manuel, Rodas, María Elisa Valle, Agundez, María Carmona, Andrés, María Inmaculada Pérez, Moreira, Claudia Cristina Lopes, Perez, Aintzane Lizarazu, Ponce, Iñigo Augusto, González-Castillo, Ana María, Membrilla-Fernández, Estela, Salvans, Silvia, Serradilla-Martín, Mario, Pardo, Pablo Sancho, Rivera-Alonso, Daniel, Dziakova, Jana, Huguet, Jose Mugüerza, Valle, Naila Pagès, Ruiz, Enrique Colás, Valcárcel, Cristina Rey, Moreno, Cristina Ruiz, Salazar, Yeniffer Tatiana Moreno, García, Juan Jesús Rubio, Micó, Silvia Sevila, López, Joaquín Ruiz, Farré, Silvia Pérez, Gomez, Maite Santamaria, Petit, Nuria Mestres, Titos-García, Alberto, Aranda-Narváez, Jose Manuel, Romacho-López, Laura, Sánchez-Guillén, Luis, Aranaz-Ostariz, Veronica, Bosch-Ramírez, Marina, Martínez-Pérez, Aleix, Martínez-López, Elías, Sebastián-Tomás, Juan Carlos, Jimenez-Riera, Granada, Jimenez-Vega, Javier, Cuellar, Jose Aurelio Navas, Campos-Serra, Andrea, Muñoz-Campaña, Anna, Gràcia-Roman, Raquel, Alegre, Javier Martínez, Pinto, Francisca Lima, O’Sullivan, Sara Nuñez, Antona, Francisco Blanco, Jiménez, Beatriz Muñoz, López-Sánchez, Jaime, Carmona, Zahira Gómez, Fernández, Rocio Torres, Sierra, Isabel Blesa, de León, Laura Román García, Moreno, Verónica Polaino, Iglesias, Eva, Cumplido, Paola Lora, Bravo, Altea Arango, Simó, Ignacio Rey, Domínguez, Carlota López, Caamaño, Aloia Guerreiro, Lozano, Rafael Calleja, Martínez, Manuel Durán, Torres, Álvaro Naranjo, de Quiros, Javier Tomas Morales Bernaldo, Pellino, Gianluca, Cloquell, Miriam Moratal, Moller, Elsa García, Jalal-Eldin, Sami, Abdoun, Ahmed K., Hamid, Hytham K. S., Lohsiriwat, Varut, Mongkhonsupphawan, Aitsariya, Baraket, Oussama, Ayed, Karim, Abbassi, Imed, Ali, Ali Ben, Ammar, Houssem, Kchaou, Ali, Tlili, Ahmed, Zribi, Imen, Colak, Elif, Polat, Suleyman, Koylu, Zehra Alan, Guner, Ali, Usta, Mehmet Arif, Reis, Murat Emre, Mantoglu, Baris, Gonullu, Emre, Akin, Emrah, Altintoprak, Fatih, Bayhan, Zulfu, Firat, Necattin, Isik, Arda, Memis, Ufuk, Bayrak, Mehmet, Altıntaş, Yasemin, Kara, Yasin, Bozkurt, Mehmet Abdussamet, Kocataş, Ali, Das, Koray, Seker, Ahmet, Ozer, Nazmi, Atici, Semra Demirli, Tuncer, Korhan, Kaya, Tayfun, Ozkan, Zeynep, Ilhan, Onur, Agackiran, Ibrahim, Uzunoglu, Mustafa Yener, Demirbas, Eren, Altinel, Yuksel, Meric, Serhat, Hacım, Nadir Adnan, Uymaz, Derya Salim, Omarov, Nail, Balık, Emre, Tebala, Giovanni D., Khalil, Hany, Rana, Mridul, Khan, Mansoor, Florence, Charlotte, Swaminathan, Christie, Leo, Cosimo Alex, Liasis, Lampros, Watfah, Josef, Trostchansky, Ivan, Delgado, Edward, Pontillo, Marcelo, Latifi, Rifat, Coimbra, Raul, Edwards, Sara, Lopez, Ana, Velmahos, George, Dorken, Ander, Gebran, Anthony, Palmer, Amanda, Oury, Jeffrey, Bardes, James M., Seng, Sirivan Suon, Coffua, Lauren S., Ratnasekera, Asanthi, Egodage, Tanya, Echeverria-Rosario, Karla, Armento, Isabella, Napolitano, Lena M., Sangji, Naveen F., Hemmila, Mark, Quick, Jacob A., Austin, Tyler R., Hyman, Theodore S., Curtiss, William, McClure, Amanda, Cairl, Nicholas, Biffl, Walter L., Truong, Hung P., Schaffer, Kathryn, Reames, Summer, Banchini, Filippo, Capelli, Patrizio, Coccolini, Federico, Sartelli, Massimo, Bravi, Francesca, Vallicelli, Carlo, Agnoletti, Vanni, Baiocchi, Gian Luca, and Catena, Fausto

Published
2024
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3. Strategies to prevent blood loss and reduce transfusion in emergency general surgery, WSES-AAST consensus paper.

Author

Coccolini, Federico, Shander, Aryeh, Ceresoli, Marco, Moore, Ernest, Tian, Brian, Parini, Dario, Sartelli, Massimo, Sakakushev, Boris, Doklestich, Krstina, Abu-Zidan, Fikri, Horer, Tal, Shelat, Vishal, Hardcastle, Timothy, Bignami, Elena, Kirkpatrick, Andrew, Weber, Dieter, Kryvoruchko, Igor, Leppaniemi, Ari, Tan, Edward, and Kessel, Boris

Subjects
PREVENTION of surgical complications, HEMORRHAGE prevention, CONSENSUS (Social sciences), SURGICAL blood loss, TRAUMA surgery, OPERATIVE surgery, DISEASES, RELIGION, BLOOD transfusion, PATIENT refusal of treatment, QUALITY assurance, PERIOPERATIVE care
Abstract

Emergency general surgeons often provide care to severely ill patients requiring surgical interventions and intensive support. One of the primary drivers of morbidity and mortality is perioperative bleeding. In general, when addressing life threatening haemorrhage, blood transfusion can become an essential part of overall resuscitation. However, under all circumstances, indications for blood transfusion must be accurately evaluated. When patients decline blood transfusions, regardless of the reason, surgeons should aim to provide optimal care and respect and accommodate each patient's values and target the best outcome possible given the patient's desires and his/her clinical condition. The aim of this position paper was to perform a review of the existing literature and to provide comprehensive recommendations on organizational, surgical, anaesthetic, and haemostatic strategies that can be used to provide optimal peri-operative blood management, reduce, or avoid blood transfusions and ultimately improve patient outcomes. [ABSTRACT FROM AUTHOR]

Published
2024
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4. Cesena guidelines: WSES consensus statement on laparoscopic-first approach to general surgery emergencies and abdominal trauma.

Author

Sermonesi, Giacomo, Tian, Brian W. C. A., Vallicelli, Carlo, Abu‑Zidan, Fikri M., Damaskos, Dimitris, Kelly, Michael Denis, Leppäniemi, Ari, Galante, Joseph M., Tan, Edward, Kirkpatrick, Andrew W., Khokha, Vladimir, Romeo, Oreste Marco, Chirica, Mircea, Pikoulis, Manos, Litvin, Andrey, Shelat, Vishal Girishchandra, Sakakushev, Boris, Wani, Imtiaz, Sall, Ibrahima, and Fugazzola, Paola

Subjects
*CONSENSUS (Social sciences), *ONLINE information services, *MEDICAL databases, *HOSPITAL emergency services, *MEDICAL information storage & retrieval systems, *SYSTEMATIC reviews, *MINIMALLY invasive procedures, *LAPAROSCOPIC surgery, *MEDICAL protocols, *DESCRIPTIVE statistics, *ABDOMEN, *WOUNDS & injuries, *MEDLINE
Abstract

Background: Laparoscopy is widely adopted across nearly all surgical subspecialties in the elective setting. Initially finding indication in minor abdominal emergencies, it has gradually become the standard approach in the majority of elective general surgery procedures. Despite many technological advances and increasing acceptance, the laparoscopic approach remains underutilized in emergency general surgery and in abdominal trauma. Emergency laparotomy continues to carry a high morbidity and mortality. In recent years, there has been a growing interest from emergency and trauma surgeons in adopting minimally invasive surgery approaches in the acute surgical setting. The present position paper, supported by the World Society of Emergency Surgery (WSES), aims to provide a review of the literature to reach a consensus on the indications and benefits of a laparoscopic-first approach in patients requiring emergency abdominal surgery for general surgery emergencies or abdominal trauma. Methods: This position paper was developed according to the WSES methodology. A steering committee performed the literature review and drafted the position paper. An international panel of 54 experts then critically revised the manuscript and discussed it in detail, to develop a consensus on a position statement. Results: A total of 323 studies (systematic review and meta-analysis, randomized clinical trial, retrospective comparative cohort studies, case series) have been selected from an initial pool of 7409 studies. Evidence demonstrates several benefits of the laparoscopic approach in stable patients undergoing emergency abdominal surgery for general surgical emergencies or abdominal trauma. The selection of a stable patient seems to be of paramount importance for a safe adoption of a laparoscopic approach. In hemodynamically stable patients, the laparoscopic approach was found to be safe, feasible and effective as a therapeutic tool or helpful to identify further management steps and needs, resulting in improved outcomes, regardless of conversion. Appropriate patient selection, surgeon experience and rigorous minimally invasive surgical training, remain crucial factors to increase the adoption of laparoscopy in emergency general surgery and abdominal trauma. Conclusions: The WSES expert panel suggests laparoscopy as the first approach for stable patients undergoing emergency abdominal surgery for general surgery emergencies and abdominal trauma. [ABSTRACT FROM AUTHOR]

Published
2023
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5. Management of Intra-Abdominal Infections: The Role of Procalcitonin.

Author

Tian, Brian W. C. A., Agnoletti, Vanni, Ansaloni, Luca, Coccolini, Federico, Bravi, Francesca, Sartelli, Massimo, Vallicelli, Carlo, and Catena, Fausto

Subjects
INTRA-abdominal infections, CALCITONIN, NOSOCOMIAL infections, LITERATURE reviews, C-reactive protein
Abstract

Patients with intra-abdominal sepsis suffer from significant mortality and morbidity. The main pillars of treatment for intra-abdominal infections are (1) source control and (2) early delivery of antibiotics. Antibiotic therapy should be started as soon as possible. However, the duration of antibiotics remains a matter of debate. Prolonged antibiotic delivery can lead to increased microbial resistance and the development of nosocomial infections. There has been much research on biomarkers and their ability to aid the decision on when to stop antibiotics. Some of these biomarkers include interleukins, C-reactive protein (CRP) and procalcitonin (PCT). PCT's value as a biomarker has been a focus area of research in recent years. Most studies use either a cut-off value of 0.50 ng/mL or an >80% reduction in PCT levels to determine when to stop antibiotics. This paper performs a literature review and provides a synthesized up-to-date global overview on the value of PCT in managing intra-abdominal infections. [ABSTRACT FROM AUTHOR]

Published
2023
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6. Assessing and managing frailty in emergency laparotomy: a WSES position paper.

Author

Tian, Brian W. C. A., Stahel, Philip F., Picetti, Edoardo, Campanelli, Giampiero, Di Saverio, Salomone, Moore, Ernest, Bensard, Denis, Sakakushev, Boris, Galante, Joseph, Fraga, Gustavo P., Koike, Kaoru, Di Carlo, Isidoro, Tebala, Giovanni D., Leppaniemi, Ari, Tan, Edward, Damaskos, Dimitris, De'Angelis, Nicola, Hecker, Andreas, Pisano, Michele, and YunfengCui

Subjects
*CINAHL database, *MEDICAL databases, *PSYCHOLOGY information storage & retrieval systems, *FRAIL elderly, *MEDICAL information storage & retrieval systems, *SYSTEMATIC reviews, *MEDICAL emergencies, *ABDOMINAL surgery, *AMED (Information retrieval system)
Abstract

Many countries are facing an aging population. As people live longer, surgeons face the prospect of operating on increasingly older patients. Traditional teaching is that with older age, these patients face an increased risk of mortality and morbidity, even to a level deemed too prohibitive for surgery. However, this is not always true. An active 90-year-old patient can be much fitter than an overweight, sedentary 65-year-old patient with comorbidities. Recent literature shows that frailty—an age-related cumulative decline in multiple physiological systems, is therefore a better predictor of mortality and morbidity than chronological age alone. Despite recognition of frailty as an important tool in identifying vulnerable surgical patients, many surgeons still shun objective tools. The aim of this position paper was to perform a review of the existing literature and to provide recommendations on emergency laparotomy and in frail patients. This position paper was reviewed by an international expert panel composed of 37 experts who were asked to critically revise the manuscript and position statements. The position paper was conducted according to the WSES methodology. We shall present the derived statements upon which a consensus was reached, specifying the quality of the supporting evidence and suggesting future research directions. [ABSTRACT FROM AUTHOR]

Published
2023
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7. WSES consensus guidelines on sigmoid volvulus management.

Author

Tian, Brian W. C. A., Vigutto, Gabriele, Tan, Edward, van Goor, Harry, Bendinelli, Cino, Abu-Zidan, Fikri, Ivatury, Rao, Sakakushev, Boris, Di Carlo, Isidoro, Sganga, Gabriele, Maier, Ronald V., Coimbra, Raul, Leppäniemi, Ari, Litvin, Andrey, Damaskos, Dimitrios, Broek, Richard Ten, Biffl, Walter, Di Saverio, Salomone, De Simone, Belinda, and Ceresoli, Marco

Subjects
*PHYSICAL diagnosis, *ISCHEMIA, *SIGMOID volvulus, *CHEST X rays, *COLECTOMY, *SURGICAL decompression, *MEDICAL protocols, *DISEASE relapse, *EMERGENCY medical services, *LACTATES, *BLOOD testing, *COMPUTED tomography, *ENDOSCOPIC gastrointestinal surgery, *INTESTINAL perforation, *ABDOMINAL radiography
Abstract

Sigmoid volvulus is a common surgical emergency, especially in elderly patients. Patients can present with a wide range of clinical states: from asymptomatic, to frank peritonitis secondary to colonic perforation. These patients generally need urgent treatment, be it endoscopic decompression of the colon or an upfront colectomy. The World Society of Emergency Surgery united a worldwide group of international experts to review the current evidence and propose a consensus guidelines on the management of sigmoid volvulus. [ABSTRACT FROM AUTHOR]

Published
2023
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10. The rise of ACS and its importance.

Author

Tian, Brian WCA

Subjects
*TRAUMA surgery, *TRAUMA centers, *OPERATIVE surgery, *ABILITY, *INTENSIVE care units, *LENGTH of stay in hospitals, *TRAINING, *TIME, *MEDICAL care costs, PREVENTION of surgical complications
Abstract

The article focuses on the rise of acute care surgery (ACS) as a specialized model of care and the challenges it faces in establishing a universal gold standard for its implementation worldwide. Topics discussed include the proposed ideal characteristics of ACS surgeons, variations in ACS systems globally, and the potential benefits of ACS in reducing time to surgery and complication rates for common conditions.

Published
2024
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11. Novel technique of creating a seal for the vacuum-assisted closure system application in complex head and neck wounds.

Author

Tian, Brian, Iyer, N. Gopalakrishna, Tan, Hiang Khoon, Tay, Ai Choo, Soo, Khee Chee, and Tan, Ngian Chye

Subjects
NEGATIVE-pressure wound therapy, FISTULA, GRANULATION tissue, NECK injuries, HEAD injuries
Abstract

Background Achieving a good seal for the application of the vacuum-assisted closure (VAC) system in complex head and neck wounds is difficult. Methods A case series of 4 patients who developed postoperative orocutaneous or pharyngocutaneous fistulas were studied. A sterile green glove was used as a sealant together with the VAC system. Results With utilization of a green glove, a good seal for the VAC system was obtained. This gave ample time to cleanse the wound and allow granulation tissue to form before proceeding on to the next stage of treatment. Conclusion A green glove technique allows for a good seal for the VAC system to work, especially when applied to complex head and neck wounds. © 2016 Wiley Periodicals, Inc. Head Neck 38: E2523-E2526, 2016 [ABSTRACT FROM AUTHOR]

Published
2016
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12. Treatment of Freckles Using a Fractional Nonablative 2940nm Erb:YAG Laser in a Series of Asian Patients.

Author

TIAN, BRIAN

Subjects
*FRECKLES, *LASER surgery, *HYPERPIGMENTATION, *DISEASE relapse, *FOLLOW-up studies (Medicine), *THERAPEUTICS
Abstract

OBJECTIVE: The purpose of this study was to demonstrate a novel, effective, and safe way to utilize the Erb:YAG laser to clear freckles in Type III/IV Asian skin. DESIGN: This was a prospective study. SETTING: The setting was a Singapore-based clinic. PARTICIPANTS: Participants included five women, aged 25 to 38 years, three with Skin Type III and two with Skin Type IV. All of them had freckles. MEASUREMENTS: Photographs were taken pretreatment and one month after laser treatment. Three independent physicians evaluated the photographs using a grading system. Patients were followed clinically for a total of six months post-laser treatment to monitor for post-inflammatory hyperpigmentation and recurrence. RESULTS: At one month post-laser treatment, all five patients were evaluated. The three independent physicians agreed that all five patients had greater than 90-percent clearance of their freckles. During the subsequent follow-up visits (up to 6 months post-laser treatment), no post-inflammatory hyperpigmentation, hypopigmentation, or recurrence was seen. CONCLUSION: The Erb:Yag laser might be considered an effective and safe treatment for freckles in Asian patients. [ABSTRACT FROM AUTHOR]

Published
2017

13. The Asian Problem of Frequent Laser Toning for Melasma.

Author

TIAN, BRIAN

Subjects
*LASER therapy, *MELANOSIS, *PIGMENTATION disorders, *HYPOPIGMENTATION, *HUMAN skin color, *THERAPEUTICS
Abstract

In recent years, laser toning or laser facial to treat melasma has become increasingly popular in Asia. It is common to see patients undergoing lasers three times a week, or even daily. This is part of a growing trend and is sometimes recommended in the user manuals from laser manufacturers. In our study, we report on 23 Chinese patients who had lasers performed three times a week for two consecutive months, followed by rest. All 23 of them developed bilateral confetti-like hypopigmentation at the end of two months. During the four-month follow-up and rest, 10 patients were lost to follow-up. Of the remaining 13 patients, none of them had repigmentation. We conclude that frequent laser facials or laser toning at regular intervals may result in undesirable outcomes and thus should not be performed in regular intervals. [ABSTRACT FROM AUTHOR]

Published
2017

14. Laser toning for melasma: A single-centre experience with 38 970 cases.

Author

Tian, Brian

Subjects
*PIGMENTATION disorders, *LASER therapy, *WOMEN, *MELANOSIS, *PATIENTS, *THERAPEUTICS
Abstract

Melasma is a common pigmentation in Asian women. Lasers have been used to lighten melasma, although with variable outcomes and complications. In Asia, laser toning is a common technique used to safely lighten melasma. However, no large studies have been performed to validate efficacy. In our study, we demonstrate that in 38 970 Asian women, at least 35 890 patients (92.1%) had noticeable to excellent improvement in their melasma. [ABSTRACT FROM PUBLISHER]

Published
2017
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