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1. Surgeons' perspectives on artificial intelligence to support clinical decision-making in trauma and emergency contexts: results from an international survey: results from an international survey

Author

Cobianchi, L. (Lorenzo), Piccolo, D. (Daniele), Dal Mas, F. (Francesca), Agnoletti, V. (Vanni), Ansaloni, L. (Luca), Balch, J. (Jeremy), Biffl, W. (Walter), Butturini, G. (Giovanni), Catena, F. (Fausto), Coccolini, F. (Federico), Denicolai, S. (Stefano), De Simone, B. (Belinda), Frigerio, I. (Isabella), Fugazzola, P. (Paola), Marseglia, G. (Gianluigi), Marseglia, G. (Giuseppe Roberto), Martellucci, J. (Jacopo), Modenese, M. (Mirko), Previtali, P. (Pietro), Ruta, F. (Federico), Venturi, A. (Alessandro), Kaafarani, Haytham M., Loftus, Tyler. J, Mascagni, P. (Pietro), Rodriguez Luna, M. (Maria Rita), and Seeliger, B. (Barbara)

Subjects
Sciences du Vivant [q-bio]/Ingénierie biomédicale
Abstract

BACKGROUND: Artificial intelligence (AI) is gaining traction in medicine and surgery. AI-based applications can offer tools to examine high-volume data to inform predictive analytics that supports complex decision-making processes. Time-sensitive trauma and emergency contexts are often challenging. The study aims to investigate trauma and emergency surgeons' knowledge and perception of using AI-based tools in clinical decision-making processes. METHODS: An online survey grounded on literature regarding AI-enabled surgical decision-making aids was created by a multidisciplinary committee and endorsed by the World Society of Emergency Surgery (WSES). The survey was advertised to 917 WSES members through the society's website and Twitter profile. RESULTS: 650 surgeons from 71 countries in five continents participated in the survey. Results depict the presence of technology enthusiasts and skeptics and surgeons' preference toward more classical decision-making aids like clinical guidelines, traditional training, and the support of their multidisciplinary colleagues. A lack of knowledge about several AI-related aspects emerges and is associated with mistrust. DISCUSSION: The trauma and emergency surgical community is divided into those who firmly believe in the potential of AI and those who do not understand or trust AI-enabled surgical decision-making aids. Academic societies and surgical training programs should promote a foundational, working knowledge of clinical AI.

Published
2023

2. Time for a paradigm shift in shared decision-making in trauma and emergency surgery? Results from an international survey: Results from an international survey

Author

Cobianchi, L. (Lorenzo), Dal Mas, F. (Francesca), Agnoletti, V. (Vanni), Ansaloni, L. (Luca), Biffl, W. (Walter), Butturini, G. (Giovanni), Campostrini, S. (Stefano), Catena, F. (Fausto), Denicolai, S. (Stefano), Fugazzola, P. (Paola), Martellucci, J. (Jacopo), Massaro, M. (Maurizio), Previtali, P. (Pietro), Ruta, F. (Federico), Venturi, A. (Alessandro), Woltz, S. (Sarah), Kaafarani, Haytham M., Loftus, Tyler J., Mascagni, P. (Pietro), Rodriguez Luna, M. (Maria Rita) R. (Rita), and Seeliger, B. (Barbara)

Subjects
Sciences du Vivant [q-bio]/Médecine humaine et pathologie
Abstract

BACKGROUND: Shared decision-making (SDM) between clinicians and patients is one of the pillars of the modern patient-centric philosophy of care. This study aims to explore SDM in the discipline of trauma and emergency surgery, investigating its interpretation as well as the barriers and facilitators for its implementation among surgeons. METHODS: Grounding on the literature on the topics of the understanding, barriers, and facilitators of SDM in trauma and emergency surgery, a survey was created by a multidisciplinary committee and endorsed by the World Society of Emergency Surgery (WSES). The survey was sent to all 917 WSES members, advertised through the society's website, and shared on the society's Twitter profile. RESULTS: A total of 650 trauma and emergency surgeons from 71 countries in five continents participated in the initiative. Less than half of the surgeons understood SDM, and 30% still saw the value in exclusively engaging multidisciplinary provider teams without involving the patient. Several barriers to effectively partnering with the patient in the decision-making process were identified, such as the lack of time and the need to concentrate on making medical teams work smoothly. DISCUSSION: Our investigation underlines how only a minority of trauma and emergency surgeons understand SDM, and perhaps, the value of SDM is not fully accepted in trauma and emergency situations. The inclusion of SDM practices in clinical guidelines may represent the most feasible and advocated solutions.

Published
2023

3. Laparoscopic versus open adhesiolysis for adhesive small bowel obstruction (LASSO):an international, multicentre, randomised, open-label trial

Author

Sallinen, V. (Ville), Di Saverio, S. (Salomone), Haukijärvi, E. (Eija), Juusela, R. (Risto), Wikström, H. (Heidi), Koivukangas, V. (Vesa), Catena, F. (Fausto), Enholm, B. (Berndt), Birindelli, A. (Arianna), Leppäniemi, A. (Ari), and Mentula, P. (Panu)

Abstract

Background: Although laparoscopic adhesiolysis for adhesive small bowel obstruction is being done more frequently, it is not widely accepted due to the lack of supporting evidence of its superiority over an open approach and concerns regarding its benefits. We aimed to investigate whether laparoscopic adhesiolysis was a superior treatment for adhesive small bowel obstruction compared with an open approach in terms of length of postoperative hospital stay and morbidity. Methods: In this international, multicentre, parallel, open-label trial, we randomly assigned patients (1:1) aged 18–95 years who had adhesive small bowel obstruction that had not resolved with conservative management to have either open or laparoscopic adhesiolysis. The study was done in five academic university hospitals and three community (central) hospitals in two countries (Finland [n=3 academic university hospitals; n=3 community hospitals] and Italy [n=2 academic university hospitals]). We included only patients with high likelihood of a single adhesive band in the trial; additionally, patients who had an anaesthesiological contraindication, were pregnant, living in institutionalised care, or who had a hospital stay of more than 1 week before the surgical consultation were excluded from the trial. The randomisation sequence was generated using block randomisation, with randomly varied block sizes and stratified according to centre. The primary outcome was postoperative length of hospital stay assessed at time of discharge in the modified intention-to-treat population. Findings: Between July 18, 2013, and April 9, 2018, 566 patients were assessed for eligibility, of whom 104 patients were randomly assigned to the open surgery group (n=51) or to the laparoscopy group (n=53). Of these patients, 100 were included in the modified intention-to-treat analyses (49 in the open surgery group; 51 in the laparoscopy group). The postoperative length of hospital stay for open surgery group was on average 1·3 days longer than that in the laparoscopy group (geometric mean 5·5 days [range 2–19] vs 4·2 days [range 1 −20]; ratio of geometric means 1·31 [95% CI 1·06–1·61]; p=0·013). 21 (43%) patients in the open surgery group and 16 (31%) patients in the laparoscopy group had postoperative complications (Clavien-Dindo any grade) within 30 days (odds ratio 0·61 [95% CI 0·27–1·38]; p=0·23). One patient died in each group within 30 days. Interpretation: Laparoscopic adhesiolysis provides quicker recovery in selected patients with adhesive small bowel obstruction than open adhesiolysis.

Published
2019

4. Bologna guidelines for diagnosis and management of adhesive small bowel obstruction (ASBO)

Author

Broek, R.P. (R.) ten, Krielen, P. (Pepijn), Di Saverio, S. (Salomone), Coccolini, F. (Federico), Biffl, W.L. (Walter), Ansaloni, L. (Luca), Velmahos, G.C. (George ), Sartelli, M. (Massimo), Fraga, G.P. (Gustavo), Kelly, M.D. (Michael D.), Moore, F.A. (Frederick), Peitzman, A.B. (Andrew), Leppaniemi, A. (Ari), Moore, E.E. (Ernest), Jeekel, J. (Hans), Kluger, Y. (Yoram), Sugrue, M. (Michael), Balogh, Z.J. (Zsolt J.), Bendinelli, C. (Cino), Civil, I. (Ian), Coimbra, R. (Raul), De Moya, M. (Mark), Ferrada, P. (Paula), Inaba, K. (Kenji), Ivatury, R. (Rao), Latifi, R. (Rifat), Kashuk, J.L. (Jeffry L.), Kirkpatrick, A.W. (Andrew W.), Maier, R. (Ron), Rizoli, S. (Sandro), Sakakushev, B. (Boris), Scalea, T. (Thomas), Søreide, K. (Kjetil), Weber, D. (Dieter), Wani, I. (Imtiaz), Abu-Zidan, F.M. (Fikri M.), De'Angelis, N. (Nicola), Piscioneri, F. (Frank), Galante, J.M. (Joseph M.), Catena, F. (Fausto), Goor, H. (Harry) van, Broek, R.P. (R.) ten, Krielen, P. (Pepijn), Di Saverio, S. (Salomone), Coccolini, F. (Federico), Biffl, W.L. (Walter), Ansaloni, L. (Luca), Velmahos, G.C. (George ), Sartelli, M. (Massimo), Fraga, G.P. (Gustavo), Kelly, M.D. (Michael D.), Moore, F.A. (Frederick), Peitzman, A.B. (Andrew), Leppaniemi, A. (Ari), Moore, E.E. (Ernest), Jeekel, J. (Hans), Kluger, Y. (Yoram), Sugrue, M. (Michael), Balogh, Z.J. (Zsolt J.), Bendinelli, C. (Cino), Civil, I. (Ian), Coimbra, R. (Raul), De Moya, M. (Mark), Ferrada, P. (Paula), Inaba, K. (Kenji), Ivatury, R. (Rao), Latifi, R. (Rifat), Kashuk, J.L. (Jeffry L.), Kirkpatrick, A.W. (Andrew W.), Maier, R. (Ron), Rizoli, S. (Sandro), Sakakushev, B. (Boris), Scalea, T. (Thomas), Søreide, K. (Kjetil), Weber, D. (Dieter), Wani, I. (Imtiaz), Abu-Zidan, F.M. (Fikri M.), De'Angelis, N. (Nicola), Piscioneri, F. (Frank), Galante, J.M. (Joseph M.), Catena, F. (Fausto), and Goor, H. (Harry) van

Abstract

Background: Adhesive small bowel obstruction (ASBO) is a common surgical emergency, causing high morbidity and even some mortality. The adhesions causing such bowel obstructions are typically the footprints of previous abdominal surgical procedures. The present paper presents a revised version of the Bologna guidelines to evidence-based diagnosis and treatment of ASBO. The working group has added paragraphs on prevention of ASBO and special patient groups. Methods: The guideline was written under the auspices of the World Society of Emergency Surgery by the ASBO working group. A systematic literature search was performed prior to the update of the guidelines to identify relevant new papers on epidemiology, diagnosis, and treatment of ASBO. Literature was critically appraised according to an evidence-based guideline development method. Final recommendations were approved by the workgroup, taking into account the level of evidence of the conclusion. Recommendations: Adhesion formation might be reduced by minimally invasive surgical techniques and the use of adhesion barriers. Non-operative treatment is effective in most patients with ASBO. Contraindications for non-operative treatment include peritonitis, strangulation, and ischemia. When the adhesive etiology of obstruction is unsure, or when contraindications for non-operative management might be present, CT is the diagnostic technique of choice. The principles of non-operative treatment are nil per os, naso-gastric, or long-tube decompression, and intravenous supplementation with fluids and electrolytes. When operative treatment is required, a laparoscopic approach may be beneficial for selected cases of simple ASBO. Younger patients have a higher lifetime risk for recurrent ASBO and might therefore benefit from application of adhesion barriers as both primary and secondary prevention. Discussion: This guideline presents recommendations that can be used by surgeons who treat patients with ASBO. Scientific evidence

Published
2018
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5. 2017 update of the WSES guidelines for emergency repair of complicated abdominal wall hernias

Author

Birindelli, A. (Arianna), Sartelli, M. (Massimo), Di Saverio, S. (Salomone), Coccolini, F. (Federico), Ansaloni, L. (Luca), Ramshorst, G.H. (Gabrielle) van, Campanelli, G. (Giampiero), Khokha, V. (Vladimir), Moore, E.E. (Ernest), Peitzman, A.B. (Andrew), Velmahos, G.C. (George ), Moore, F.A. (Frederick), Leppaniemi, A. (Ari), Burlew, C.C. (Clay), Biffl, W.L. (Walter), Koike, K. (Kaoru), Kluger, Y. (Yoram), Fraga, G.P. (Gustavo), Ordonez, C.A. (Carlos A.), Novello, M. (Matteo), Agresta, F., Sakakushev, B. (Boris), Gerych, I. (Igor), Wani, I. (Imtiaz), Kelly, M.D. (Michael D.), Gomes, C.A. (Carlos Augusto), Faro Jr., M.P. (Mario), Tarasconi, A. (Antonio), Demetrashvili, Z. (Zaza), Lee, J.G. (Jae Gil), Vettoretto, N. (Nereo), Guercioni, G. (Gianluca), Persiani, R. (Roberto), Tranà, C. (Cristian), Cui, Y. (Yunfeng), Kok, K.Y.Y. (Kenneth), Ghnnam, W.M. (Wagih), Abbas, A.E.-S. (Ashraf El-Sayed), Sato, N. (Norio), Marwah, S. (Sanjay), Rangarajan, M. (Muthukumaran), Ben-Ishay, O. (Offir), Adesunkanmi, A.R.K. (Abdul Rashid), Lohse, H.A.S. (Helmut Alfredo Segovia), Kenig, J. (Jakub), Mandalà, V. (Vincenzo), Coimbra, R. (Raul), Bhangu, A. (Aneel), Suggett, N. (Nigel), Biondi, A. (Antonio), Portolani, N. (Nazario), Baiocchi, G. (Gianluca), Kirkpatrick, A.W. (Andrew W.), Scibé, R. (Rodolfo), Sugrue, M. (Michael), Chiara, O. (Osvaldo), Catena, F. (Fausto), Birindelli, A. (Arianna), Sartelli, M. (Massimo), Di Saverio, S. (Salomone), Coccolini, F. (Federico), Ansaloni, L. (Luca), Ramshorst, G.H. (Gabrielle) van, Campanelli, G. (Giampiero), Khokha, V. (Vladimir), Moore, E.E. (Ernest), Peitzman, A.B. (Andrew), Velmahos, G.C. (George ), Moore, F.A. (Frederick), Leppaniemi, A. (Ari), Burlew, C.C. (Clay), Biffl, W.L. (Walter), Koike, K. (Kaoru), Kluger, Y. (Yoram), Fraga, G.P. (Gustavo), Ordonez, C.A. (Carlos A.), Novello, M. (Matteo), Agresta, F., Sakakushev, B. (Boris), Gerych, I. (Igor), Wani, I. (Imtiaz), Kelly, M.D. (Michael D.), Gomes, C.A. (Carlos Augusto), Faro Jr., M.P. (Mario), Tarasconi, A. (Antonio), Demetrashvili, Z. (Zaza), Lee, J.G. (Jae Gil), Vettoretto, N. (Nereo), Guercioni, G. (Gianluca), Persiani, R. (Roberto), Tranà, C. (Cristian), Cui, Y. (Yunfeng), Kok, K.Y.Y. (Kenneth), Ghnnam, W.M. (Wagih), Abbas, A.E.-S. (Ashraf El-Sayed), Sato, N. (Norio), Marwah, S. (Sanjay), Rangarajan, M. (Muthukumaran), Ben-Ishay, O. (Offir), Adesunkanmi, A.R.K. (Abdul Rashid), Lohse, H.A.S. (Helmut Alfredo Segovia), Kenig, J. (Jakub), Mandalà, V. (Vincenzo), Coimbra, R. (Raul), Bhangu, A. (Aneel), Suggett, N. (Nigel), Biondi, A. (Antonio), Portolani, N. (Nazario), Baiocchi, G. (Gianluca), Kirkpatrick, A.W. (Andrew W.), Scibé, R. (Rodolfo), Sugrue, M. (Michael), Chiara, O. (Osvaldo), and Catena, F. (Fausto)

Abstract

Emergency repair of complicated abdominal wall hernias may be associated with worsen outcome and a significant rate of postoperative complications. There is no consensus on management of complicated abdominal hernias. The main matter of debate is about the use of mesh in case of intestinal resection and the type of mesh to be used. Wound infe

Published
2017
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6. 2016 WSES guidelines on acute calculous cholecystitis

Author

Ansaloni, L. (Luca), Pisano, M., Coccolini, F. (Federico), Peitzmann, A.B., Fingerhut, A. (A.), Catena, F. (Fausto), Agresta, F., Allegri, A., Bailey, I., Balogh, Z.J., Bendinelli, C. (Cino), Biffl, W.L. (Walter), Bonavina, L., Borzellino, G., Brunetti, F., Burlew, C.C. (Clay), Camapanelli, G., Campanile, F.C., Ceresoli, M., Chiara, O., Civil, I., Coimbra, R., De Moya, M., Di Saverio, S. (Salomone), Fraga, G.P. (Gustavo), Gupta, S., Kashuk, J., Kelly, M.D., Koka, V., Jeekel, J. (Hans), Latifi, R., Leppaniemi, A. (Ari), Maier, R.V., Marzi, I., Moore, F.A. (Frederick), Piazzalunga, D., Sakakushev, B., Sartelli, M. (Massimo), Scalea, T., Stahel, P.F., Taviloglu, K. (Korhan), Tugnoli, G. (Gregorio), Uraneus, S., Velmahos, G.C. (George ), Wani, I., Weber, D.G., Viale, P., Sugrue, M. (Michael), Ivatury, R. (Rao), Kluger, Y. (Yoram), Gurusamy, K.S., Moore, E.E., Ansaloni, L. (Luca), Pisano, M., Coccolini, F. (Federico), Peitzmann, A.B., Fingerhut, A. (A.), Catena, F. (Fausto), Agresta, F., Allegri, A., Bailey, I., Balogh, Z.J., Bendinelli, C. (Cino), Biffl, W.L. (Walter), Bonavina, L., Borzellino, G., Brunetti, F., Burlew, C.C. (Clay), Camapanelli, G., Campanile, F.C., Ceresoli, M., Chiara, O., Civil, I., Coimbra, R., De Moya, M., Di Saverio, S. (Salomone), Fraga, G.P. (Gustavo), Gupta, S., Kashuk, J., Kelly, M.D., Koka, V., Jeekel, J. (Hans), Latifi, R., Leppaniemi, A. (Ari), Maier, R.V., Marzi, I., Moore, F.A. (Frederick), Piazzalunga, D., Sakakushev, B., Sartelli, M. (Massimo), Scalea, T., Stahel, P.F., Taviloglu, K. (Korhan), Tugnoli, G. (Gregorio), Uraneus, S., Velmahos, G.C. (George ), Wani, I., Weber, D.G., Viale, P., Sugrue, M. (Michael), Ivatury, R. (Rao), Kluger, Y. (Yoram), Gurusamy, K.S., and Moore, E.E.

Abstract

Acute calculus , is a very common disease with several area of uncertainty. The World Society of Emergency Surgery developed extensive guidelines in order to cover grey areas. The diagnostic criteria, the antimicrobial therapy, the evaluation of associated common bile duct stones, the identification of "high risk" patients, the surgical timing, the type of surgery, and the alternatives to surgery are discussed. Moreover the algorithm is proposed: as soon as diagnosis is made and after the evaluation of choledocholitiasis risk, laparoscopic cholecystectomy should be offered to all patients exception of those with high risk of morbidity or mortality. These Guidelines must be considered as an adjunctive tool for decision but they are not substitute of the clinical judgement for the individual patient.

Published
2016
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7. Erratum to: 2016 WSES guidelines on acute calculous cholecystitis [J Emerg Surg, 11, (2016), (25)], DOI: 10.1186/s13017-016-0082-5

Author

Ansaloni, L. (Luca), Pisano, M., Coccolini, F. (Federico), Peitzmann, A.B., Fingerhut, A. (A.), Catena, F. (Fausto), Agresta, F., Allegri, A., Bailey, I., Balogh, Z.J., Bendinelli, C. (Cino), Biffl, W.L. (Walter), Bonavina, L., Borzellino, G., Brunetti, F., Burlew, C.C. (Clay), Camapanelli, G., Campanile, F.C., Ceresoli, M., Chiara, O., Civil, I., Coimbra, R., Moya, M., Saverio, S., Fraga, G.P. (Gustavo), Gupta, S., Kashuk, J., Kelly, M.D., Khokha, V., Jeekel, J. (Hans), Latifi, R., Leppaniemi, A. (Ari), Maier, R.V., Marzi, I., Moore, F.A. (Frederick), Piazzalunga, D., Sakakushev, B., Sartelli, M. (Massimo), Scalea, T., Stahel, P.F., Taviloglu, K. (Korhan), Tugnoli, G. (Gregorio), Uraneus, S., Velmahos, G.C. (George ), Wani, I., Weber, D.G., Viale, P., Sugrue, M. (Michael), Ivatury, R. (Rao), Kluger, Y. (Yoram), Gurusamy, K.S., Moore, E.E., Ansaloni, L. (Luca), Pisano, M., Coccolini, F. (Federico), Peitzmann, A.B., Fingerhut, A. (A.), Catena, F. (Fausto), Agresta, F., Allegri, A., Bailey, I., Balogh, Z.J., Bendinelli, C. (Cino), Biffl, W.L. (Walter), Bonavina, L., Borzellino, G., Brunetti, F., Burlew, C.C. (Clay), Camapanelli, G., Campanile, F.C., Ceresoli, M., Chiara, O., Civil, I., Coimbra, R., Moya, M., Saverio, S., Fraga, G.P. (Gustavo), Gupta, S., Kashuk, J., Kelly, M.D., Khokha, V., Jeekel, J. (Hans), Latifi, R., Leppaniemi, A. (Ari), Maier, R.V., Marzi, I., Moore, F.A. (Frederick), Piazzalunga, D., Sakakushev, B., Sartelli, M. (Massimo), Scalea, T., Stahel, P.F., Taviloglu, K. (Korhan), Tugnoli, G. (Gregorio), Uraneus, S., Velmahos, G.C. (George ), Wani, I., Weber, D.G., Viale, P., Sugrue, M. (Michael), Ivatury, R. (Rao), Kluger, Y. (Yoram), Gurusamy, K.S., and Moore, E.E.

Abstract

Unfortunately, the original version of this article [1] contained an error in the spelling of an author's name. The surname is written as Koka, but should be spelt as Khokha.

Published
2016
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8. WSES guidelines for emergency repair of complicated abdominal wall hernias

Author

Sartelli, M. (Massimo), Coccolini, F. (Federico), Ramshorst, G.H. (Gabrielle) van, Campanelli, G. (Giampiero), Mandala, V., Ansaloni, L. (Luca), Moore, E.E. (Ernest), Peitzman, A. (Andrew), Velmahos, G.C. (George ), Moore, F.A. (Fredrick), Leppaniemi, A. (Ari), Burlew, C.C. (Clay), Biffl, W.L. (Walter), Koike, K. (Kaoru), Kluger, Y. (Yoram), Fraga, G.P. (Gustavo), Ordonez, C.A. (Carlos), Di Saverio, S. (Salomone), Agresta, F., Sakakushev, B. (Boris), Gerych, I. (Igor), Wani, I. (Imtiaz), Kelly, M.D. (Michael ), Gomes, C.A. (Carlos), Faro Jr., M.P. (Mario), Taviloglu, K. (Korhan), Demetrashvili, Z. (Zaza), Lee, J.G. (Jeong ), Vettoretto, N. (Nereo), Guercioni, G. (Gianluca), Tranà, C. (Cristian), Cui, Y. (Yijun), Kok, K.Y.Y. (Kenneth), Ghnnam, W.M. (Wagih), Abbas, A.E.S. (Ashraf El-Sayed), Sato, N. (Norio), Marwah, S. (Sanjay), Rangarajan, M. (Muthukumaran), Ben-Ishay, O. (Offir), Adesunkanmi, A.R.K. (Abdul Rashid), Segovia Lohse, H.A. (Helmut), Kenig, J. (Jakub), Mandalà, V. (Vincenzo), Patrizi, A. (Andrea), Scibé, R. (Rodolfo), Catena, F. (Fausto), Sartelli, M. (Massimo), Coccolini, F. (Federico), Ramshorst, G.H. (Gabrielle) van, Campanelli, G. (Giampiero), Mandala, V., Ansaloni, L. (Luca), Moore, E.E. (Ernest), Peitzman, A. (Andrew), Velmahos, G.C. (George ), Moore, F.A. (Fredrick), Leppaniemi, A. (Ari), Burlew, C.C. (Clay), Biffl, W.L. (Walter), Koike, K. (Kaoru), Kluger, Y. (Yoram), Fraga, G.P. (Gustavo), Ordonez, C.A. (Carlos), Di Saverio, S. (Salomone), Agresta, F., Sakakushev, B. (Boris), Gerych, I. (Igor), Wani, I. (Imtiaz), Kelly, M.D. (Michael ), Gomes, C.A. (Carlos), Faro Jr., M.P. (Mario), Taviloglu, K. (Korhan), Demetrashvili, Z. (Zaza), Lee, J.G. (Jeong ), Vettoretto, N. (Nereo), Guercioni, G. (Gianluca), Tranà, C. (Cristian), Cui, Y. (Yijun), Kok, K.Y.Y. (Kenneth), Ghnnam, W.M. (Wagih), Abbas, A.E.S. (Ashraf El-Sayed), Sato, N. (Norio), Marwah, S. (Sanjay), Rangarajan, M. (Muthukumaran), Ben-Ishay, O. (Offir), Adesunkanmi, A.R.K. (Abdul Rashid), Segovia Lohse, H.A. (Helmut), Kenig, J. (Jakub), Mandalà, V. (Vincenzo), Patrizi, A. (Andrea), Scibé, R. (Rodolfo), and Catena, F. (Fausto)

Abstract

Emergency repair of complicated abdominal hernias is associated with poor prognosis and a high rate of post-operative complications. A World Society of Emergency Surgery (WSES) Consensus Conference was held in Bergamo in July 2013, during the 2nd Congress of the World Society of Emergency Surgery with the goal of defining recommendations for emergency repair of abdominal wall hernias in adults. This document represents the executive summary of the consensus conference approved by a WSES expert panel.

Published
2013
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9. Bologna guidelines for diagnosis and management of adhesive small bowel obstruction (ASBO): 2013 update of the evidence-based guidelines from the world society of emergency surgery ASBO working group

Author

Di Saverio, S. (Salomone), Coccolini, F. (Federico), Galati, M. (Marica), Smerieri, N. (Nazareno), Biffl, W.L. (Walter), Ansaloni, L. (Luca), Tugnoli, G. (Gregorio), Velmahos, G.C. (George ), Sartelli, M. (Massimo), Bendinelli, C. (Cino), Fraga, G.P. (Gustavo), Kelly, M.D. (Michael ), Moore, F.A. (Frederick), Mandala, V., Mandalà, V. (Vincenzo), Masetti, M. (Michele), Jovine, E. (Elio), Pinna, A.D. (Antonio ), Peitzman, A.B. (Andrew), Leppaniemi, A. (Ari), Sugarbaker, P.H. (Paul ), Goor, H. (Harry) van, Moore, E.E. (Ernest), Jeekel, J. (Hans), Catena, F. (Fausto), Di Saverio, S. (Salomone), Coccolini, F. (Federico), Galati, M. (Marica), Smerieri, N. (Nazareno), Biffl, W.L. (Walter), Ansaloni, L. (Luca), Tugnoli, G. (Gregorio), Velmahos, G.C. (George ), Sartelli, M. (Massimo), Bendinelli, C. (Cino), Fraga, G.P. (Gustavo), Kelly, M.D. (Michael ), Moore, F.A. (Frederick), Mandala, V., Mandalà, V. (Vincenzo), Masetti, M. (Michele), Jovine, E. (Elio), Pinna, A.D. (Antonio ), Peitzman, A.B. (Andrew), Leppaniemi, A. (Ari), Sugarbaker, P.H. (Paul ), Goor, H. (Harry) van, Moore, E.E. (Ernest), Jeekel, J. (Hans), and Catena, F. (Fausto)

Abstract

Background: In 2013 Guidelines on diagnosis and management of ASBO have been revised and updated by the WSES Working Group on ASBO to develop current evidence-based algorithms and focus indications and safety of conservative treatment, timing of surgery and indications for laparoscopy.Recommendations: In absence of signs of strangulation and history of persistent vomiting or combined CT-scan signs (free fluid, mesenteric edema, small-bowel feces sign, devascularization) patients with partial ASBO can be managed safely with NOM and tube decompression should be attempted. These patients are good candidates for Water-Soluble-Contrast-Medium (WSCM) with both diagnostic and therapeutic purposes. The radiologic appearance of WSCM in the colon within 24 hours from administration predicts resolution. WSCM maybe administered either orally or via NGT both immediately at admission or after failed conservative treatment for 48 hours. The use of WSCM

Published
2013
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10. Bologna Guidelines for Diagnosis and Management of Adhesive Small Bowel Obstruction (ASBO): 2010 Evidence-Based Guidelines of the World Society of Emergency Surgery

Author

Catena, F. (Fausto), Di Saverio, S. (Salomone), Kelly, M.D. (Michael ), Biffl, W.L. (Walter), Ansaloni, L. (Luca), Mandalà, V. (Vincenzo), Velmahos, G.C. (George ), Sartelli, M. (Massimo), Tugnoli, G. (Gregorio), Lupo, M. (Massimo), Pinna, A.D. (Antonio ), Sugarbaker, P.H. (Paul ), Goor, H. (Harry) van, Moore, E.E. (Ernest), Jeekel, J. (Hans), Catena, F. (Fausto), Di Saverio, S. (Salomone), Kelly, M.D. (Michael ), Biffl, W.L. (Walter), Ansaloni, L. (Luca), Mandalà, V. (Vincenzo), Velmahos, G.C. (George ), Sartelli, M. (Massimo), Tugnoli, G. (Gregorio), Lupo, M. (Massimo), Pinna, A.D. (Antonio ), Sugarbaker, P.H. (Paul ), Goor, H. (Harry) van, Moore, E.E. (Ernest), and Jeekel, J. (Hans)

Abstract

Background: There is no consensus on diagnosis and management of ASBO. Initial conservative management is usually safe, however proper timing for discontinuing non operative treatment is still controversial. Open surgery or laparoscopy are used without standardized indications.Methods: A panel of 13 international experts with interest and background in ASBO and peritoneal diseases, participated in a consensus conference during the 1stInternational Congress of the World Society of Emergency Surgery and 9thPeritoneum and Surgery Society meeting, in Bologna, July 1-3, 2

Published
2011
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