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1. Diagnosis and treatment of acute appendicitis: 2020 update of the WSES Jerusalem guidelines.

Author

Di Saverio S, Podda M, De Simone B, Ceresoli M, Augustin G, Gori A, Boermeester M, Sartelli M, Coccolini F, Tarasconi A, De' Angelis N, Weber DG, Tolonen M, Birindelli A, Biffl W, Moore EE, Kelly M, Soreide K, Kashuk J, Ten Broek R, Gomes CA, Sugrue M, Davies RJ, Damaskos D, Leppäniemi A, Kirkpatrick A, Peitzman AB, Fraga GP, Maier RV, Coimbra R, Chiarugi M, Sganga G, Pisanu A, De' Angelis GL, Tan E, Van Goor H, Pata F, Di Carlo I, Chiara O, Litvin A, Campanile FC, Sakakushev B, Tomadze G, Demetrashvili Z, Latifi R, Abu-Zidan F, Romeo O, Segovia-Lohse H, Baiocchi G, Costa D, Rizoli S, Balogh ZJ, Bendinelli C, Scalea T, Ivatury R, Velmahos G, Andersson R, Kluger Y, Ansaloni L, and Catena F

Subjects
Acute Disease, Anti-Bacterial Agents therapeutic use, Appendectomy, Evidence-Based Medicine, Humans, Laparoscopy methods, Abdominal Pain diagnosis, Abdominal Pain surgery, Appendicitis diagnosis, Appendicitis surgery, Practice Guidelines as Topic
Abstract

Background and Aims: Acute appendicitis (AA) is among the most common causes of acute abdominal pain. Diagnosis of AA is still challenging and some controversies on its management are still present among different settings and practice patterns worldwide. In July 2015, the World Society of Emergency Surgery (WSES) organized in Jerusalem the first consensus conference on the diagnosis and treatment of AA in adult patients with the intention of producing evidence-based guidelines. An updated consensus conference took place in Nijemegen in June 2019 and the guidelines have now been updated in order to provide evidence-based statements and recommendations in keeping with varying clinical practice: use of clinical scores and imaging in diagnosing AA, indications and timing for surgery, use of non-operative management and antibiotics, laparoscopy and surgical techniques, intra-operative scoring, and peri-operative antibiotic therapy., Methods: This executive manuscript summarizes the WSES guidelines for the diagnosis and treatment of AA. Literature search has been updated up to 2019 and statements and recommendations have been developed according to the GRADE methodology. The statements were voted, eventually modified, and finally approved by the participants to the consensus conference and by the board of co-authors, using a Delphi methodology for voting whenever there was controversy on a statement or a recommendation. Several tables highlighting the research topics and questions, search syntaxes, and the statements and the WSES evidence-based recommendations are provided. Finally, two different practical clinical algorithms are provided in the form of a flow chart for both adults and pediatric (< 16 years old) patients., Conclusions: The 2020 WSES guidelines on AA aim to provide updated evidence-based statements and recommendations on each of the following topics: (1) diagnosis, (2) non-operative management for uncomplicated AA, (3) timing of appendectomy and in-hospital delay, (4) surgical treatment, (5) intra-operative grading of AA, (6) ,management of perforated AA with phlegmon or abscess, and (7) peri-operative antibiotic therapy.

Published
2020
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2. Prospective Observational Study on acute Appendicitis Worldwide (POSAW).

Author

Sartelli M, Baiocchi GL, Di Saverio S, Ferrara F, Labricciosa FM, Ansaloni L, Coccolini F, Vijayan D, Abbas A, Abongwa HK, Agboola J, Ahmed A, Akhmeteli L, Akkapulu N, Akkucuk S, Altintoprak F, Andreiev AL, Anyfantakis D, Atanasov B, Bala M, Balalis D, Baraket O, Bellanova G, Beltran M, Melo RB, Bini R, Bouliaris K, Brunelli D, Castillo A, Catani M, Che Jusoh A, Chichom-Mefire A, Cocorullo G, Coimbra R, Colak E, Costa S, Das K, Delibegovic S, Demetrashvili Z, Di Carlo I, Kiseleva N, El Zalabany T, Faro M, Ferreira M, Fraga GP, Gachabayov M, Ghnnam WM, Giménez Maurel T, Gkiokas G, Gomes CA, Griffiths E, Guner A, Gupta S, Hecker A, Hirano ES, Hodonou A, Hutan M, Ioannidis O, Isik A, Ivakhov G, Jain S, Jokubauskas M, Karamarkovic A, Kauhanen S, Kaushik R, Kavalakat A, Kenig J, Khokha V, Khor D, Kim D, Kim JI, Kong V, Lasithiotakis K, Leão P, Leon M, Litvin A, Lohsiriwat V, López-Tomassetti Fernandez E, Lostoridis E, Maciel J, Major P, Dimova A, Manatakis D, Marinis A, Martinez-Perez A, Marwah S, McFarlane M, Mesina C, Pędziwiatr M, Michalopoulos N, Misiakos E, Mohamedahmed A, Moldovanu R, Montori G, Mysore Narayana R, Negoi I, Nikolopoulos I, Novelli G, Novikovs V, Olaoye I, Omari A, Ordoñez CA, Ouadii M, Ozkan Z, Pal A, Palini GM, Partecke LI, Pata F, Pędziwiatr M, Pereira Júnior GA, Pintar T, Pisarska M, Ploneda-Valencia CF, Pouggouras K, Prabhu V, Ramakrishnapillai P, Regimbeau JM, Reitz M, Rios-Cruz D, Saar S, Sakakushev B, Seretis C, Sazhin A, Shelat V, Skrovina M, Smirnov D, Spyropoulos C, Strzałka M, Talving P, Teixeira Gonsaga RA, Theobald G, Tomadze G, Torba M, Tranà C, Ulrych J, Uzunoğlu MY, Vasilescu A, Occhionorelli S, Venara A, Vereczkei A, Vettoretto N, Vlad N, Walędziak M, Yilmaz TU, Yuan KC, Yunfeng C, Zilinskas J, Grelpois G, and Catena F

Subjects
Acute Disease therapy, Adult, Appendectomy adverse effects, Appendectomy methods, Chi-Square Distribution, Female, Hospitalization statistics & numerical data, Humans, Laparoscopy methods, Laparoscopy statistics & numerical data, Length of Stay statistics & numerical data, Logistic Models, Male, Prospective Studies, Tomography, X-Ray Computed methods, Treatment Outcome, Appendectomy standards, Appendicitis surgery
Abstract

Background: Acute appendicitis (AA) is the most common surgical disease, and appendectomy is the treatment of choice in the majority of cases. A correct diagnosis is key for decreasing the negative appendectomy rate. The management can become difficult in case of complicated appendicitis. The aim of this study is to describe the worldwide clinical and diagnostic work-up and management of AA in surgical departments., Methods: This prospective multicenter observational study was performed in 116 worldwide surgical departments from 44 countries over a 6-month period (April 1, 2016-September 30, 2016). All consecutive patients admitted to surgical departments with a clinical diagnosis of AA were included in the study., Results: A total of 4282 patients were enrolled in the POSAW study, 1928 (45%) women and 2354 (55%) men, with a median age of 29 years. Nine hundred and seven (21.2%) patients underwent an abdominal CT scan, 1856 (43.3%) patients an US, and 285 (6.7%) patients both CT scan and US. A total of 4097 (95.7%) patients underwent surgery; 1809 (42.2%) underwent open appendectomy and 2215 (51.7%) had laparoscopic appendectomy. One hundred eighty-five (4.3%) patients were managed conservatively. Major complications occurred in 199 patients (4.6%). The overall mortality rate was 0.28%., Conclusions: The results of the present study confirm the clinical value of imaging techniques and prognostic scores. Appendectomy remains the most effective treatment of acute appendicitis. Mortality rate is low., Competing Interests: The data was completely anonymized, and no patient or hospital information was collected in the database. The study protocol was approved by the board of the WSES, and the study was conducted under its supervision. The board of the WSES grants the proper ethical conduct of the study.The authors declare that they have no competing interests.Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Published
2018
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3. Two years later: Is the SARS-CoV-2 pandemic still having an impact on emergency surgery? An international cross-sectional survey among WSES members

Author

Reichert, Martin, Sartelli, Massimo, Weigand, Markus A, Hecker, Matthias, Oppelt, Philip U, Noll, Julia, Askevold, Ingolf H, Liese, Juliane, Padberg, Winfried, Coccolini, Federico, Catena, Fausto, Hecker, Andreas, Adam Peckham-Cooper, Adrian Camacho-Ortiz, Aikaterini T. Mastoraki, Aitor Landaluce-Olavarria, Ajay Kumar Pal, Akira Kuriyama, Alain Chichom-Mefire, Alberto Porcu, Aleix Martínez-Pérez, Aleksandar R. Karamarkovic, Aleksei V. Osipov, Alessandro Coppola, Alessandro Cucchetti, Alessandro Spolini, Alessio Giordano, Alexander Reinisch-Liese, Alfie J. Kavalakat, Alin Vasilescu, Amin Alamin, Amit Gupta, Ana Maria Dascalu, Ana-Maria Musina, Anargyros Bakopoulos, Andee Dzulkarnaen Zakaria, Andras Vereczkei, Andrea Balla, Andrea Bottari, Andreas Baumann, Andreas Fette, Andrey Litvin, Aniella Katharina Reichert, Anna Guariniello, Anna Paspala, Anne-Sophie Schneck, Antonio Brillantino, Antonio Pesce, Arda Isik, Ari Kalevi Leppäniemi, Aristeidis Papadopoulos, Aristotelis Kechagias, Ashraf Yehya Abdalla Mohamed, Ashrarur Rahman Mitul, Athanasios Marinis, Athanasios Syllaios, Baris Mantoglu, Belinda De Simone, Benjamin Stefan Weiss, Bernd Pösentrup, Biagio Picardi, Biagio Zampogna, Boris Eugeniev Sakakushev, Boyko Chavdarov Atanasov, Bruno Nardo, Bulent Calik, Camilla Cremonini, Carlos A. Ordoñez, Charalampos Seretis, Chiara Cascone, Christos Chouliaras, Cino Bendinelli, Claudia Lopes, Claudio Guerci, Clemens Weber, Constantinos Nastos, Cristian Mesina, Damiano Caputo, Damien Massalou, Davide Cavaliere, Deborah A. McNamara, Demetrios Demetriades, Desirè Pantalone, Diego Coletta, Diego Sasia, Diego Visconti, Dieter G. Weber, Diletta Corallino, Dimitrios Chatzipetris, Dimitrios K. Manatakis, Dimitrios Ntourakis, Dimitrios Papaconstantinou, Dimitrios Schizas, Dimosthenis Chrysikos, Dmitry Mikhailovich Adamovich, Doaa Elkafrawy, Dragos Seban, Edgar Fernando Hernandez García, Edoardo Baldini, Edoardo Picetti, Edward C. T. H. Tan, Efstratia Baili, Eftychios Lostoridis, Elena Adelina Toma, Elif Colak, Elisabetta Cerutti, Elmin Steyn, Elmuiz A. Hsabo, Emmanouil Ioannis Kapetanakis, Emmanouil Kaouras, Emmanuel Schneck, Emrah Akin, Emre Gonullu, Enes çelik, Enrico Cicuttin, Enrico Pinotti, Erik Johnsson, Ernest E. Moore, Ervis Agastra, Evgeni Nikolaev Dimitrov, Ewen A. Griffiths, Fabrizio D’Acapito, Federica Saraceno, Felipe Alconchel, Felix Alexander Zeppernick, Fernando Machado Rodríguez, Fikri Abu-Zidan, Francesca Pecchini, Francesco Favi, Francesco Ferrara, Francesco Fleres, Francesco Pata, Francesco Pietro Maria Roscio, Francesk Mulita, Frank J. M. F. Dor, Fredrik Linder, Gabriel Dimofte, Gabriel Rodrigues, Gabriela Nita, Gabriele Sganga, Gennaro Martines, Gennaro Mazzarella, Gennaro Perrone, George Velmahos, Georgios D. Lianos, Gia Tomadze, Gian Luca Baiocchi, Giancarlo D’Ambrosio, Gianluca Pellino, Gianmaria Casoni Pattacini, Giorgio Giraudo, Giorgio Lisi, Giovanni Domenico Tebala, Giovanni Pirozzolo, Giulia Montori, Giulio Argenio, Giuseppe Brisinda, Giuseppe Currò, Giuseppe Giuliani, Giuseppe Palomba, Giuseppe Roscitano, Gökhan Avşar, Goran Augustin, Guglielmo Clarizia, Gustavo M. Machain Vega, Gustavo P. Fraga, Harsheet Sethi, Hazim Abdulnassir Eltyeb, Helmut A. Segovia Lohse, Herald René Segovia Lohse, Hüseyin Bayhan, Hytham K. S. Hamid, Igor A. Kryvoruchko, Immacolata Iannone, Imtiaz Wani, Ioannis I. Lazaridis, Ioannis Katsaros, Ioannis Nikolopoulos, Ionut Negoi, Isabella Reccia, Isidoro Di Carlo, Iyiade Olatunde Olaoye, Jacek Czepiel, Jae Il Kim, Jeremy Meyer, Jesus Manuel Saenz Terrazas, Joel Noutakdie Tochie, Joseph M. Galante, Justin Davies, Kapil Sugand, Kebebe Bekele Gonfa, Kemal Rasa, Kenneth Y. Y. Kok, Konstantinos G. Apostolou, Konstantinos Lasithiotakis, Konstantinos Tsekouras, Kumar Angamuthu, Lali Akhmeteli, Larysa Sydorchuk, Laura Fortuna, Leandro Siragusa, Leonardo Pagani, Leonardo Solaini, Lisa A. Miller, Lovenish Bains, Luca Ansaloni, Luca Ferrario, Luigi Bonavina, Luigi Conti, Luis Antonio Buonomo, Luis Tallon-Aguilar, Lukas Tomczyk, Lukas Werner Widmer, Maciej Walędziak, Mahir Gachabayov, Maloni M. Bulanauca, Manu L. N. G. Malbrain, Marc Maegele, Marco Catarci, Marco Ceresoli, Maria Chiara Ranucci, Maria Ioanna Antonopoulou, Maria Papadoliopoulou, Maria Rosaria Valenti, Maria Sotiropoulou, Mario D’Oria, Mario Serradilla Martín, Markus Hirschburger, Massimiliano Veroux, Massimo Fantoni, Matteo Nardi, Matti Tolonen, Mauro Montuori, Mauro Podda, Maximilian Scheiterle, Maximos Frountzas, Mehmet Sarıkaya, Mehmet Yildirim, Michael Bender, Michail Vailas, Michel Teuben, Michela Campanelli, Michele Ammendola, Michele Malerba, Michele Pisano, Mihaela Pertea, Mihail Slavchev, Mika Ukkonen, Miklosh Bala, Mircea Chirica, Mirko Barone, Mohamed Maher Shaat, Mohammed Jibreel Suliman Mohammed, Mona Awad Akasha Abuelgasim, Monika Gureh, Mouaqit Ouadii, Mujdat Balkan, Mumin Mohamed, Musluh Hakseven, Natalia Velenciuc, Nicola Cillara, Nicola de’Angelis, Nicolò Tamini, Nikolaos J. Zavras, Nikolaos Machairas, Nikolaos Michalopoulos, Nikolaos N. Koliakos, Nikolaos Pararas, Noel E. Donlon, Noushif Medappil, Offir Ben-Ishay, Olmi Stefano, Omar Islam, Ömer Tammo, Orestis Ioannidis, Oscar Aparicio, Oussama Baraket, Pankaj Kumar, Pasquale Cianci, Per Örtenwall, Petar Angelov Uchikov, Philip de Reuver, Philip F. Stahel, Philip S. Barie, Micaela Piccoli, Piotr Major, Pradeep H. Navsaria, Prakash Kumar Sasmal, Raul Coimbra, Razrim Rahim, Recayi Çapoğlu, Renol M. Koshy, Ricardo Alessandro Teixeira Gonsaga, Riccardo Pertile, Rifat Ramadan Mussa Mohamed, Rıza Deryol, Robert G. Sawyer, Roberta Angelico, Roberta Ragozzino, Roberto Bini, Roberto Cammarata, Rosa Scaramuzzo, Rossella Gioco, Ruslan Sydorchuk, Salma Ahmed, Salomone Di Saverio, Sameh Hany Emile, Samir Delibegovic, Sanjay Marwah, Savvas Symeonidis, Scott G. Thomas, Sebahattin Demir, Selmy S. Awad, Semra Demirli Atici, Serge Chooklin, Serhat Meric, Sevcan Sarıkaya, Sharfuddin Chowdhury, Shaza Faycal Mirghani, Sherry M. Wren, Simone Gargarella, Simone Rossi Del Monte, Sofia Esposito, Sofia Xenaki, Soliman Fayez Ghedan Mohamed, Solomon Gurmu Beka, Sorinel Lunca, Spiros G. Delis, Spyridon Dritsas, Stefan Morarasu, Stefano Magnone, Stefano Rossi, Stefanos Bitsianis, Stylianos Kykalos, Suman Baral, Sumita A. Jain, Syed Muhammad Ali, Tadeja Pintar, Tania Triantafyllou, Tarik Delko, Teresa Perra, Theodoros A. Sidiropoulos, Thomas M. Scalea, Tim Oliver Vilz, Timothy Craig Hardcastle, Tongporn Wannatoop, Torsten Herzog, Tushar Subhadarshan Mishra, Ugo Boggi, Valentin Calu, Valentina Tomajer, Vanni Agnoletti, Varut Lohsiriwat, Victor Kong, Virginia Durán Muñoz-Cruzado, Vishal G. Shelat, Vladimir Khokha, Wagih Mommtaz Ghannam, Walter L. Biffl, Wietse Zuidema, Yasin Kara, Yoshiro Kobe, Zaza Demetrashvili, Ziad A. Memish, Zoilo Madrazo, Zsolt J. Balogh, Zulfu Bayhan, Surgery, AMS - Musculoskeletal Health, Other Research, APH - Quality of Care, Reichert, Martin, Sartelli, Massimo, Weigand, Markus A, Hecker, Matthia, Oppelt, Philip U, Noll, Julia, Askevold, Ingolf H, Liese, Juliane, Padberg, Winfried, Coccolini, Federico, Catena, Fausto, Hecker, Andrea, Adam Peckham-Cooper, Adrian Camacho-Ortiz, Aikaterini T. Mastoraki, Aitor Landaluce-Olavarria, Ajay Kumar Pal, Akira Kuriyama, Alain Chichom-Mefire, Alberto Porcu, Aleix Martínez-Pérez, Aleksandar R. Karamarkovic, Aleksei V. Osipov, Alessandro Coppola, Alessandro Cucchetti, Alessandro Spolini, Alessio Giordano, Alexander Reinisch-Liese, Alfie J. Kavalakat, Alin Vasilescu, Amin Alamin, Amit Gupta, Ana Maria Dascalu, Ana-Maria Musina, Anargyros Bakopoulos, Andee Dzulkarnaen Zakaria, Andras Vereczkei, Andrea Balla, Andrea Bottari, Andreas Baumann, Andreas Fette, Andrey Litvin, Aniella Katharina Reichert, Anna Guariniello, Anna Paspala, Anne-Sophie Schneck, Antonio Brillantino, Antonio Pesce, Arda Isik, Ari Kalevi Leppäniemi, Aristeidis Papadopoulos, Aristotelis Kechagias, Ashraf Yehya Abdalla Mohamed, Ashrarur Rahman Mitul, Athanasios Marinis, Athanasios Syllaios, Baris Mantoglu, Belinda De Simone, Benjamin Stefan Weiss, Bernd Pösentrup, Biagio Picardi, Biagio Zampogna, Boris Eugeniev Sakakushev, Boyko Chavdarov Atanasov, Bruno Nardo, Bulent Calik, Camilla Cremonini, Carlos A. Ordoñez, Charalampos Seretis, Chiara Cascone, Christos Chouliaras, Cino Bendinelli, Claudia Lopes, Claudio Guerci, Clemens Weber, Constantinos Nastos, Cristian Mesina, Damiano Caputo, Damien Massalou, Davide Cavaliere, Deborah A. McNamara, Demetrios Demetriades, Desirè Pantalone, Diego Coletta, Diego Sasia, Diego Visconti, Dieter G. Weber, Diletta Corallino, Dimitrios Chatzipetris, Dimitrios K. Manatakis, Dimitrios Ntourakis, Dimitrios Papaconstantinou, Dimitrios Schizas, Dimosthenis Chrysikos, Dmitry Mikhailovich Adamovich, Doaa Elkafrawy, Dragos Seban, Edgar Fernando Hernandez García, Edoardo Baldini, Edoardo Picetti, Edward C. T. H. Tan, Efstratia Baili, Eftychios Lostoridis, Elena Adelina Toma, Elif Colak, Elisabetta Cerutti, Elmin Steyn, Elmuiz A. Hsabo, Emmanouil Ioannis Kapetanakis, Emmanouil Kaouras, Emmanuel Schneck, Emrah Akin, Emre Gonullu, Enes çelik, Enrico Cicuttin, Enrico Pinotti, Erik Johnsson, Ernest E. Moore, Ervis Agastra, Evgeni Nikolaev Dimitrov, Ewen A. Griffiths, Fabrizio D’Acapito, Federica Saraceno, Felipe Alconchel, Felix Alexander Zeppernick, Fernando Machado Rodríguez, Fikri Abu-Zidan, Francesca Pecchini, Francesco Favi, Francesco Ferrara, Francesco Fleres, Francesco Pata, Francesco Pietro Maria Roscio, Francesk Mulita, Frank J. M. F. Dor, Fredrik Linder, Gabriel Dimofte, Gabriel Rodrigues, Gabriela Nita, Gabriele Sganga, Gennaro Martines, Gennaro Mazzarella, Gennaro Perrone, George Velmahos, Georgios D. Lianos, Gia Tomadze, Gian Luca Baiocchi, Giancarlo D’Ambrosio, Gianluca Pellino, Gianmaria Casoni Pattacini, Giorgio Giraudo, Giorgio Lisi, Giovanni Domenico Tebala, Giovanni Pirozzolo, Giulia Montori, Giulio Argenio, Giuseppe Brisinda, Giuseppe Currò, Giuseppe Giuliani, Giuseppe Palomba, Giuseppe Roscitano, Gökhan Avşar, Goran Augustin, Guglielmo Clarizia, Gustavo M. Machain Vega, Gustavo P. Fraga, Harsheet Sethi, Hazim Abdulnassir Eltyeb, Helmut A. Segovia Lohse, Herald René Segovia Lohse, Hüseyin Bayhan, Hytham K. S. Hamid, Igor A. Kryvoruchko, Immacolata Iannone, Imtiaz Wani, Ioannis I. Lazaridis, Ioannis Katsaros, Ioannis Nikolopoulos, Ionut Negoi, Isabella Reccia, Isidoro Di Carlo, Iyiade Olatunde Olaoye, Jacek Czepiel, Jae Il Kim, Jeremy Meyer, Jesus Manuel Saenz Terrazas, Joel Noutakdie Tochie, Joseph M. Galante, Justin Davies, Kapil Sugand, Kebebe Bekele Gonfa, Kemal Rasa, Kenneth Y. Y. Kok, Konstantinos G. Apostolou, Konstantinos Lasithiotakis, Konstantinos Tsekouras, Kumar Angamuthu, Lali Akhmeteli, Larysa Sydorchuk, Laura Fortuna, Leandro Siragusa, Leonardo Pagani, Leonardo Solaini, Lisa A. Miller, Lovenish Bains, Luca Ansaloni, Luca Ferrario, Luigi Bonavina, Luigi Conti, Luis Antonio Buonomo, Luis Tallon-Aguilar, Lukas Tomczyk, Lukas Werner Widmer, Maciej Walędziak, Mahir Gachabayov, Maloni M. Bulanauca, Manu L. N. G. Malbrain, Marc Maegele, Marco Catarci, Marco Ceresoli, Maria Chiara Ranucci, Maria Ioanna Antonopoulou, Maria Papadoliopoulou, Maria Rosaria Valenti, Maria Sotiropoulou, Mario D’Oria, Mario Serradilla Martín, Markus Hirschburger, Massimiliano Veroux, Massimo Fantoni, Matteo Nardi, Matti Tolonen, Mauro Montuori, Mauro Podda, Maximilian Scheiterle, Maximos Frountzas, Mehmet Sarıkaya, Mehmet Yildirim, Michael Bender, Michail Vailas, Michel Teuben, Michela Campanelli, Michele Ammendola, Michele Malerba, Michele Pisano, Mihaela Pertea, Mihail Slavchev, Mika Ukkonen, Miklosh Bala, Mircea Chirica, Mirko Barone, Mohamed Maher Shaat, Mohammed Jibreel Suliman Mohammed, Mona Awad Akasha Abuelgasim, Monika Gureh, Mouaqit Ouadii, Mujdat Balkan, Mumin Mohamed, Musluh Hakseven, Natalia Velenciuc, Nicola Cillara, Nicola de’Angelis, Nicolò Tamini, Nikolaos J. Zavras, Nikolaos Machairas, Nikolaos Michalopoulos, Nikolaos N. Koliakos, Nikolaos Pararas, Noel E. Donlon, Noushif Medappil, Offir Ben-Ishay, Olmi Stefano, Omar Islam, Ömer Tammo, Orestis Ioannidis, Oscar Aparicio, Oussama Baraket, Pankaj Kumar, Pasquale Cianci, Per Örtenwall, Petar Angelov Uchikov, Philip de Reuver, Philip F. Stahel, Philip S. Barie, Micaela Piccoli, Piotr Major, Pradeep H. Navsaria, Prakash Kumar Sasmal, Raul Coimbra, Razrim Rahim, Recayi Çapoğlu, Renol M. Koshy, Ricardo Alessandro Teixeira Gonsaga, Riccardo Pertile, Rifat Ramadan Mussa Mohamed, Rıza Deryol, Robert G. Sawyer, Roberta Angelico, Roberta Ragozzino, Roberto Bini, Roberto Cammarata, Rosa Scaramuzzo, Rossella Gioco, Ruslan Sydorchuk, Salma Ahmed, Salomone Di Saverio, Sameh Hany Emile, Samir Delibegovic, Sanjay Marwah, Savvas Symeonidis, Scott G. Thomas, Sebahattin Demir, Selmy S. Awad, Semra Demirli Atici, Serge Chooklin, Serhat Meric, Sevcan Sarıkaya, Sharfuddin Chowdhury, Shaza Faycal Mirghani, Sherry M. Wren, Simone Gargarella, Simone Rossi Del Monte, Sofia Esposito, Sofia Xenaki, Soliman Fayez Ghedan Mohamed, Solomon Gurmu Beka, Sorinel Lunca, Spiros G. Delis, Spyridon Dritsas, Stefan Morarasu, Stefano Magnone, Stefano Rossi, Stefanos Bitsianis, Stylianos Kykalos, Suman Baral, Sumita A. Jain, Syed Muhammad Ali, Tadeja Pintar, Tania Triantafyllou, Tarik Delko, Teresa Perra, Theodoros A. Sidiropoulos, Thomas M. Scalea, Tim Oliver Vilz, Timothy Craig Hardcastle, Tongporn Wannatoop, Torsten Herzog, Tushar Subhadarshan Mishra, Ugo Boggi, Valentin Calu, Valentina Tomajer, Vanni Agnoletti, Varut Lohsiriwat, Victor Kong, Virginia Durán Muñoz-Cruzado, Vishal G. Shelat, Vladimir Khokha, Wagih Mommtaz Ghannam, Walter L. Biffl, Wietse Zuidema, Yasin Kara, Yoshiro Kobe, Zaza Demetrashvili, Ziad A. Memish, Zoilo Madrazo, Zsolt J. Balogh, Zulfu Bayhan, Reichert, M, Sartelli, M, Weigand, M, Hecker, M, Oppelt, P, Noll, J, Askevold, I, Liese, J, Padberg, W, Coccolini, F, Catena, F, Hecker, A, Peckham-Cooper, A, Camacho-Ortiz, A, Mastoraki, A, Landaluce-Olavarria, A, Pal, A, Kuriyama, A, Chichom-Mefire, A, Porcu, A, Martinez-Perez, A, Karamarkovic, A, Osipov, A, Coppola, A, Cucchetti, A, Spolini, A, Giordano, A, Reinisch-Liese, A, Kavalakat, A, Vasilescu, A, Alamin, A, Gupta, A, Dascalu, A, Musina, A, Bakopoulos, A, Zakaria, A, Vereczkei, A, Balla, A, Bottari, A, Baumann, A, Fette, A, Litvin, A, Reichert, A, Guariniello, A, Paspala, A, Schneck, A, Brillantino, A, Pesce, A, Isik, A, Leppaniemi, A, Papadopoulos, A, Kechagias, A, Mohamed, A, Mitul, A, Marinis, A, Syllaios, A, Mantoglu, B, De Simone, B, Weiss, B, Posentrup, B, Picardi, B, Zampogna, B, Sakakushev, B, Atanasov, B, Nardo, B, Calik, B, Cremonini, C, Ordonez, C, Seretis, C, Cascone, C, Chouliaras, C, Bendinelli, C, Lopes, C, Guerci, C, Weber, C, Nastos, C, Mesina, C, Caputo, D, Massalou, D, Cavaliere, D, Mcnamara, D, Demetriades, D, Pantalone, D, Coletta, D, Sasia, D, Visconti, D, Weber, D, Corallino, D, Chatzipetris, D, Manatakis, D, Ntourakis, D, Papaconstantinou, D, Schizas, D, Chrysikos, D, Adamovich, D, Elkafrawy, D, Seban, D, Garcia, E, Baldini, E, Picetti, E, Tan, E, Baili, E, Lostoridis, E, Toma, E, Colak, E, Cerutti, E, Steyn, E, Hsabo, E, Kapetanakis, E, Kaouras, E, Schneck, E, Akin, E, Gonullu, E, Celik, E, Cicuttin, E, Pinotti, E, Johnsson, E, Moore, E, Agastra, E, Dimitrov, E, Griffiths, E, D'Acapito, F, Saraceno, F, Alconchel, F, Zeppernick, F, Rodriguez, F, Abu-Zidan, F, Pecchini, F, Favi, F, Ferrara, F, Fleres, F, Pata, F, Roscio, F, Mulita, F, Dor, F, Linder, F, Dimofte, G, Rodrigues, G, Nita, G, Sganga, G, Martines, G, Mazzarella, G, Perrone, G, Velmahos, G, Lianos, G, Tomadze, G, Baiocchi, G, D'Ambrosio, G, Pellino, G, Pattacini, G, Giraudo, G, Lisi, G, Tebala, G, Pirozzolo, G, Montori, G, Argenio, G, Brisinda, G, Curro, G, Giuliani, G, Palomba, G, Roscitano, G, Avsar, G, Augustin, G, Clarizia, G, Vega, G, Fraga, G, Sethi, H, Eltyeb, H, Lohse, H, Bayhan, H, Hamid, H, Kryvoruchko, I, Iannone, I, Wani, I, Lazaridis, I, Katsaros, I, Nikolopoulos, I, Negoi, I, Reccia, I, Di Carlo, I, Olaoye, I, Czepiel, J, Kim, J, Meyer, J, Terrazas, J, Tochie, J, Galante, J, Davies, J, Sugand, K, Gonfa, K, Rasa, K, Kok, K, Apostolou, K, Lasithiotakis, K, Tsekouras, K, Angamuthu, K, Akhmeteli, L, Sydorchuk, L, Fortuna, L, Siragusa, L, Pagani, L, Solaini, L, Miller, L, Bains, L, Ansaloni, L, Ferrario, L, Bonavina, L, Conti, L, Buonomo, L, Tallon-Aguilar, L, Tomczyk, L, Widmer, L, Waledziak, M, Gachabayov, M, Bulanauca, M, Malbrain, M, Maegele, M, Catarci, M, Ceresoli, M, Ranucci, M, Antonopoulou, M, Papadoliopoulou, M, Valenti, M, Sotiropoulou, M, D'Oria, M, Martin, M, Hirschburger, M, Veroux, M, Fantoni, M, Nardi, M, Tolonen, M, Montuori, M, Podda, M, Scheiterle, M, Frountzas, M, Sarikaya, M, Yildirim, M, Bender, M, Vailas, M, Teuben, M, Campanelli, M, Ammendola, M, Malerba, M, Pisano, M, Pertea, M, Slavchev, M, Ukkonen, M, Bala, M, Chirica, M, Barone, M, Shaat, M, Mohammed, M, Abuelgasim, M, Gureh, M, Ouadii, M, Balkan, M, Mohamed, M, Hakseven, M, Velenciuc, N, Cillara, N, De'Angelis, N, Tamini, N, Zavras, N, Machairas, N, Michalopoulos, N, Koliakos, N, Pararas, N, Donlon, N, Medappil, N, Ben-Ishay, O, Stefano, O, Islam, O, Tammo, O, Ioannidis, O, Aparicio, O, Baraket, O, Kumar, P, Cianci, P, Ortenwall, P, Uchikov, P, de Reuver, P, Stahel, P, Barie, P, Piccoli, M, Major, P, Navsaria, P, Sasmal, P, Coimbra, R, Rahim, R, Capoglu, R, Koshy, R, Gonsaga, R, Pertile, R, Mohamed, R, Deryol, R, Sawyer, R, Angelico, R, Ragozzino, R, Bini, R, Cammarata, R, Scaramuzzo, R, Gioco, R, Sydorchuk, R, Ahmed, S, Di Saverio, S, Emile, S, Delibegovic, S, Marwah, S, Symeonidis, S, Thomas, S, Demir, S, Awad, S, Atici, S, Chooklin, S, Meric, S, Sarikaya, S, Chowdhury, S, Mirghani, S, Wren, S, Gargarella, S, Del Monte, S, Esposito, S, Xenaki, S, Mohamed, S, Beka, S, Lunca, S, Delis, S, Dritsas, S, Morarasu, S, Magnone, S, Rossi, S, Bitsianis, S, Kykalos, S, Baral, S, Jain, S, Ali, S, Pintar, T, Triantafyllou, T, Delko, T, Perra, T, Sidiropoulos, T, Scalea, T, Vilz, T, Hardcastle, T, Wannatoop, T, Herzog, T, Mishra, T, Boggi, U, Calu, V, Tomajer, V, Agnoletti, V, Lohsiriwat, V, Kong, V, Munoz-Cruzado, V, Shelat, V, Khokha, V, Ghannam, W, Biffl, W, Zuidema, W, Kara, Y, Kobe, Y, Demetrashvili, Z, Memish, Z, Madrazo, Z, Balogh, Z, and Bayhan, Z

Subjects
Cross-Sectional Studie, ddc:610, Capacity, Pandemic, SARS-CoV-2, COVID-19, WSES, Time to intervention, Appendicitis, Reconstructive and regenerative medicine Radboud Institute for Health Sciences [Radboudumc 10], Cross-Sectional Studies, Emergency, Quarantine, Emergency Medicine, Emergency surgery, Humans, Surgery, Appendiciti, COVID-19, SARS-CoV-2, Pandemic, Emergency surgery, Emergency, Appendicitis, WSES, Time to intervention, Capacity, Quarantine, Pandemics, Diverticulitis, Human
Abstract

Background The SARS-CoV-2 pandemic is still ongoing and a major challenge for health care services worldwide. In the first WSES COVID-19 emergency surgery survey, a strong negative impact on emergency surgery (ES) had been described already early in the pandemic situation. However, the knowledge is limited about current effects of the pandemic on patient flow through emergency rooms, daily routine and decision making in ES as well as their changes over time during the last two pandemic years. This second WSES COVID-19 emergency surgery survey investigates the impact of the SARS-CoV-2 pandemic on ES during the course of the pandemic. Methods A web survey had been distributed to medical specialists in ES during a four-week period from January 2022, investigating the impact of the pandemic on patients and septic diseases both requiring ES, structural problems due to the pandemic and time-to-intervention in ES routine. Results 367 collaborators from 59 countries responded to the survey. The majority indicated that the pandemic still significantly impacts on treatment and outcome of surgical emergency patients (83.1% and 78.5%, respectively). As reasons, the collaborators reported decreased case load in ES (44.7%), but patients presenting with more prolonged and severe diseases, especially concerning perforated appendicitis (62.1%) and diverticulitis (57.5%). Otherwise, approximately 50% of the participants still observe a delay in time-to-intervention in ES compared with the situation before the pandemic. Relevant causes leading to enlarged time-to-intervention in ES during the pandemic are persistent problems with in-hospital logistics, lacks in medical staff as well as operating room and intensive care capacities during the pandemic. This leads not only to the need for triage or transferring of ES patients to other hospitals, reported by 64.0% and 48.8% of the collaborators, respectively, but also to paradigm shifts in treatment modalities to non-operative approaches reported by 67.3% of the participants, especially in uncomplicated appendicitis, cholecystitis and multiple-recurrent diverticulitis. Conclusions The SARS-CoV-2 pandemic still significantly impacts on care and outcome of patients in ES. Well-known problems with in-hospital logistics are not sufficiently resolved by now; however, medical staff shortages and reduced capacities have been dramatically aggravated over last two pandemic years.

Published
2022
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4. Impact of the SARS-CoV-2 pandemic on emergency surgery services-a multi-national survey among WSES members

Author

Reichert, Martin, Sartelli, Massimo, Weigand, Markus A, Doppstadt, Christoph, Hecker, Matthias, Reinisch-Liese, Alexander, Bender, Fabienne, Askevold, Ingolf, Padberg, Winfried, Coccolini, Federico, Catena, Fausto, Hecker, Andreas, Abakar, Abdullaev, Adrian, Camacho-Ortiz, Adriana, Toro, Alain, Chichom-Mefire, Aleix, Martínez-Pérez, Alfie, J Kavalakat, Ali Yasen Y, Mohamedahmed, Andrey,Litvin, Antonio, Brillantino, Antonio, Pesce, Arda, Isik, Aristotelis, Kechagias, Azzain M H, Ismail, Baris, Mantoglu, Basil, Ibrahim, Birgit, Hecker, Boris, Sakakushev, Charalampos, Seretis, Dimitrios, Manatakis, Edgar Fernando, Hernández García, Eli, olak, Elmin, Steyn, Emrah, Akin, Emre, Gonullu, Fabio Cesare, Campanile, Francesco, Pata, Francesco, Roscio, Fredrik, Linder, Gia, Tomadze, Gianluca, Pellino, Gianmaria, Casoni Pattacini, Giovanni, Pirozzolo, Gustavo M, Machain, Gustavo P, Fraga, Hazim Abdulnassir, Eltyeb, Ioannis, Nikolopoulos, Isidoro, Di Carlo, Jae Il, Kim, Jesus-Manuel, Saenz-Terrazas, Juan Carlos, Rodriguez Sanjuan, Juliane, Liese, Justin, Davies, Kim, Platte, Lawrence, Lottenberg, Leonardo, Pagani, Leonardo, Solaini, Lisa, Miller, Lovenish Bains, Luis Buonomo, Maciej Walędziak, Mahir Gachabayov, Marc Maegele, Marco Catarci, Marco Vittorio Rossi Ardizzone Alberio, Maria Grazia Alberio, Massimiliano Veroux, Matteo Nardi, Mauro Podda, Michael Sugrue, Michele Pisano, Mihail Slavchev, Mika Ukkonen, Miklosh Bala, Mircea Chirica, Mouaqit Ouadii, Orestis Ioannidis, Osvaldo Chiara, Pankaj Kumar, Per Örtenwall, Pradeep Navsaria, Raul Coimbra, Riccardo Somigli, Robert G Sawyer, Saad Shebrain, Salomone Di Saverio, Sanjay Marwah, Sergio Zegarra, Shahd Nour, Shahed Abdelmahmoud, Stefano Magnone, Syed Muhammad Ali, Tadeja Pintar, Tushar S Mishra, Valentina Tomajer, Varut Lohsiriwat, Vijay Shivpuje, Vladimir Khokha, Yoshiro Kobe, Zaza Demetrashvili, Reichert, Martin, Sartelli, Massimo, Weigand, Markus A, Doppstadt, Christoph, Hecker, Matthia, Reinisch-Liese, Alexander, Bender, Fabienne, Askevold, Ingolf, Padberg, Winfried, Coccolini, Federico, Catena, Fausto, Hecker, Andrea, Abakar, Abdullaev, Adrian, Camacho-Ortiz, Adriana, Toro, Alain, Chichom-Mefire, Aleix, Martínez-Pérez, Alfie, J Kavalakat, Ali Yasen Y, Mohamedahmed, Andrey,Litvin, Antonio, Brillantino, Antonio, Pesce, Arda, Isik, Aristotelis, Kechagia, Azzain M H, Ismail, Baris, Mantoglu, Basil, Ibrahim, Birgit, Hecker, Boris, Sakakushev, Charalampos, Sereti, Dimitrios, Manataki, Edgar Fernando, Hernández García, Eli, olak, Elmin, Steyn, Emrah, Akin, Emre, Gonullu, Fabio Cesare, Campanile, Francesco, Pata, Francesco, Roscio, Fredrik, Linder, Gia, Tomadze, Gianluca, Pellino, Gianmaria, Casoni Pattacini, Giovanni, Pirozzolo, Gustavo M, Machain, Gustavo P, Fraga, Hazim Abdulnassir, Eltyeb, Ioannis, Nikolopoulo, Isidoro, Di Carlo, Jae Il, Kim, Jesus-Manuel, Saenz-Terraza, Juan Carlos, Rodriguez Sanjuan, Juliane, Liese, Justin, Davie, Kim, Platte, Lawrence, Lottenberg, Leonardo, Pagani, Leonardo, Solaini, Lisa, Miller, Lovenish Bains, Luis Buonomo, Maciej Walędziak, Mahir Gachabayov, Marc Maegele, Marco Catarci, Marco Vittorio Rossi Ardizzone Alberio, Maria Grazia Alberio, Massimiliano Veroux, Matteo Nardi, Mauro Podda, Michael Sugrue, Michele Pisano, Mihail Slavchev, Mika Ukkonen, Miklosh Bala, Mircea Chirica, Mouaqit Ouadii, Orestis Ioannidis, Osvaldo Chiara, Pankaj Kumar, Per Örtenwall, Pradeep Navsaria, Raul Coimbra, Riccardo Somigli, Robert G Sawyer, Saad Shebrain, Salomone Di Saverio, Sanjay Marwah, Sergio Zegarra, Shahd Nour, Shahed Abdelmahmoud, Stefano Magnone, Syed Muhammad Ali, Tadeja Pintar, Tushar S Mishra, Valentina Tomajer, Varut Lohsiriwat, Vijay Shivpuje, Vladimir Khokha, Yoshiro Kobe, Zaza Demetrashvili, Reichert, M., Sartelli, M., Weigand, M. A., Doppstadt, C., Hecker, M., Reinisch-Liese, A., Bender, F., Askevold, I., Padberg, W., Coccolini, F., Catena, F., Hecker, A., Abdullaev, A., Camacho-Ortiz, A., Toro, A., Chichom-Mefire, A., Martinez-Perez, A., Kavalakat, A. J., Mohamedahmed, A. Y. Y., Litvin, A., Brillantino, A., Pesce, A., Isik, A., Kechagias, A., Ismail, A. M. H., Mantoglu, B., Ibrahim, B., Hecker, B., Sakakushev, B., Seretis, C., Manatakis, D., Garcia, E. F. H., Colak, E., Steyn, E., Akin, E., Gonullu, E., Campanile, F. C., Pata, F., Roscio, F., Linder, F., Tomadze, G., Pellino, G., Casoni Pattacini, G., Pirozzolo, G., Machain, G. M., Fraga, G. P., Eltyeb, H. A., Nikolopoulos, I., Di Carlo, I., Kim, J. I., Saenz-Terrazas, J. -M., Sanjuan, J. C. R., Liese, J., Davies, J., Platte, K., Lottenberg, L., Pagani, L., Solaini, L., Miller, L., Bains, L., Buonomo, L., Waledziak, M., Gachabayov, M., Maegele, M., Catarci, M., Alberio, M. V. R. A., Alberio, M. G., Veroux, M., Nardi, M., Podda, M., Sugrue, M., Pisano, M., Slavchev, M., Ukkonen, M., Bala, M., Chirica, M., Ouadii, M., Ioannidis, O., Chiara, O., Kumar, P., Ortenwall, P., Navsaria, P., Coimbra, R., Somigli, R., Sawyer, R. G., Shebrain, S., Di Saverio, S., Marwah, S., Zegarra, S., Nour, S., Abdelmahmoud, S., Magnone, S., Muhammad Ali, S., Pintar, T., Mishra, T. S., Tomajer, V., Lohsiriwat, V., Shivpuje, V., Khokha, V., Kobe, Y., Demetrashvili, Z., and Tampere University

Subjects
lcsh:Surgery, Appendicitis, Cholecystitis, COVID-19, Emergency surgery, SARS-CoV-2, WSES, Emergency Service, Hospital, Facilities and Services Utilization, General Surgery, Global Health, Health Care Surveys, Humans, Surgical Procedures, Operative, Hospital, Cholecystiti, Appendiciti, ddc:610, Emergency Service, Surgical Procedures, lcsh:Medical emergencies. Critical care. Intensive care. First aid, lcsh:RD1-811, lcsh:RC86-88.9, 3126 Surgery, anesthesiology, intensive care, radiology, Operative, Health Care Survey, Research Article, Human
Abstract

Background: The SARS-CoV-2 pandemic is a major challenge for health care services worldwide. It’s impact on oncologic therapies and elective surgery has been described recently, and the literature provides guidelines regarding appropriate elective patient treatment during the pandemic. However, the impact of SARS-CoV-2 pandemic on emergency surgery services has been poorly investigated up to now. Methods: A 17-item web survey had been distributed to emergency surgeons in June 2020 around the world, investigating the impact of SARS-CoV-2 pandemic on patients and septic diseases both requiring emergency surgery and the time-to-intervention in emergency surgery routine, as well as experiences with surgery in COVID-19 patients. Results: Ninety-eight collaborators from 31 countries responded to the survey. The majority (65.3%) estimated the impact of the SARS-CoV-2 pandemic on emergency surgical patient care as being strong or very strong. Due to the pandemic, 87.8% reported a decrease in the total number of patients undergoing emergency surgery and approximately 25% estimated a delay of more than 2 h in the time-to-diagnosis and another 2 h in the time-to-intervention. Fifty percent make structural problems with in-hospital logistics (e.g. transport of patients, closed normal wards etc.) mainly responsible for delayed emergency surgery and the frequent need (56.1%) for a triage of emergency surgical patients. 56.1% of the collaborators observed more severe septic abdominal diseases during the pandemic, especially for perforated appendicitis and severe septic cholecystitis (41.8% and 40.2%, respectively). 62.2% had experiences with surgery in COVID-19-infected patients. Conclusions: The results of The WSES COVID-19 emergency surgery survey are alarming. The combination of an estimated decrease in numbers of emergency surgical patients and an observed increase in more severe septic diseases may be a result of the fear of patients from infection with COVID-19 and a consecutive delayed hospital admission and diagnosis. A critical delay in time-to-diagnosis and time-to-intervention may be a result of changes in in-hospital logistics and operating room as well as intensive care capacities. Both reflect the potentially harmful impact of SARS-CoV-2 pandemic on emergency surgery services. publishedVersion

Published
2020

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