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2. Management of complicated diaphragmatic hernia in the acute setting: a WSES position paper

Author

Giuffrida, M, Perrone, G, Abu-Zidan, F, Agnoletti, V, Ansaloni, L, Baiocchi, G, Bendinelli, C, Biffl, W, Bonavina, L, Bravi, F, Carcoforo, P, Ceresoli, M, Chichom-Mefire, A, Coccolini, F, Coimbra, R, De'Angelis, N, de Moya, M, De Simone, B, Di Saverio, S, Fraga, G, Galante, J, Ivatury, R, Kashuk, J, Kelly, M, Kirkpatrick, A, Kluger, Y, Koike, K, Leppaniemi, A, Maier, R, Moore, E, Peitzmann, A, Sakakushev, B, Sartelli, M, Sugrue, M, Tian, B, Broek, R, Vallicelli, C, Wani, I, Weber, D, Docimo, G, Catena, F, Giuffrida M., Perrone G., Abu-Zidan F., Agnoletti V., Ansaloni L., Baiocchi G. L., Bendinelli C., Biffl W. L., Bonavina L., Bravi F., Carcoforo P., Ceresoli M., Chichom-Mefire A., Coccolini F., Coimbra R., de'Angelis N., de Moya M., De Simone B., Di Saverio S., Fraga G. P., Galante J., Ivatury R., Kashuk J., Kelly M. D., Kirkpatrick A. W., Kluger Y., Koike K., Leppaniemi A., Maier R. V., Moore E. E., Peitzmann A., Sakakushev B., Sartelli M., Sugrue M., Tian B. W. C. A., Broek R. T., Vallicelli C., Wani I., Weber D. G., Docimo G., Catena F., Giuffrida, M, Perrone, G, Abu-Zidan, F, Agnoletti, V, Ansaloni, L, Baiocchi, G, Bendinelli, C, Biffl, W, Bonavina, L, Bravi, F, Carcoforo, P, Ceresoli, M, Chichom-Mefire, A, Coccolini, F, Coimbra, R, De'Angelis, N, de Moya, M, De Simone, B, Di Saverio, S, Fraga, G, Galante, J, Ivatury, R, Kashuk, J, Kelly, M, Kirkpatrick, A, Kluger, Y, Koike, K, Leppaniemi, A, Maier, R, Moore, E, Peitzmann, A, Sakakushev, B, Sartelli, M, Sugrue, M, Tian, B, Broek, R, Vallicelli, C, Wani, I, Weber, D, Docimo, G, Catena, F, Giuffrida M., Perrone G., Abu-Zidan F., Agnoletti V., Ansaloni L., Baiocchi G. L., Bendinelli C., Biffl W. L., Bonavina L., Bravi F., Carcoforo P., Ceresoli M., Chichom-Mefire A., Coccolini F., Coimbra R., de'Angelis N., de Moya M., De Simone B., Di Saverio S., Fraga G. P., Galante J., Ivatury R., Kashuk J., Kelly M. D., Kirkpatrick A. W., Kluger Y., Koike K., Leppaniemi A., Maier R. V., Moore E. E., Peitzmann A., Sakakushev B., Sartelli M., Sugrue M., Tian B. W. C. A., Broek R. T., Vallicelli C., Wani I., Weber D. G., Docimo G., and Catena F.

Abstract

BACKGROUND: Diaphragmatic hernia (DH) presenting acutely can be a potentially life-threatening condition. Its management continues to be debatable. METHODS: A bibliographic search using major databases was performed using the terms "emergency surgery" "diaphragmatic hernia," "traumatic diaphragmatic rupture" and "congenital diaphragmatic hernia." GRADE methodology was used to evaluate the evidence and give recommendations. RESULTS: CT scan of the chest and abdomen is the diagnostic gold standard to evaluate complicated DH. Appropriate preoperative assessment and prompt surgical intervention are important for a clinical success. Complicated DH repair is best performed via the use of biological and bioabsorbable meshes which have proven to reduce recurrence. The laparoscopic approach is the preferred technique in hemodynamically stable patients without significant comorbidities because it facilitates early diagnosis of small diaphragmatic injuries from traumatic wounds in the thoraco-abdominal area and reduces postoperative complications. Open surgery should be reserved for situations when skills and equipment for laparoscopy are not available, where exploratory laparotomy is needed, or if the patient is hemodynamically unstable. Damage Control Surgery is an option in the management of critical and unstable patients. CONCLUSIONS: Complicated diaphragmatic hernia is a rare life-threatening condition. CT scan of the chest and abdomen is the gold standard for diagnosing the diaphragmatic hernia. Laparoscopic repair is the best treatment option for stable patients with complicated diaphragmatic hernias. Open repair is considered necessary in majority of unstable patients in whom Damage Control Surgery can be life-saving.

Published
2023

3. ECLAPTE: Effective Closure of LAParoTomy in Emergency-2023 World Society of Emergency Surgery guidelines for the closure of laparotomy in emergency settings

Author

Frassini, S, Cobianchi, L, Fugazzola, P, Biffl, W, Coccolini, F, Damaskos, D, Moore, E, Kluger, Y, Ceresoli, M, Coimbra, R, Davies, J, Kirkpatrick, A, Di Carlo, I, Hardcastle, T, Isik, A, Chiarugi, M, Gurusamy, K, Maier, R, Segovia Lohse, H, Jeekel, H, Boermeester, M, Abu-Zidan, F, Inaba, K, Weber, D, Augustin, G, Bonavina, L, Velmahos, G, Sartelli, M, Di Saverio, S, Ten Broek, R, Granieri, S, Dal Mas, F, Fare, C, Peverada, J, Zanghi, S, Vigano, J, Tomasoni, M, Dominioni, T, Cicuttin, E, Hecker, A, Tebala, G, Galante, J, Wani, I, Khokha, V, Sugrue, M, Scalea, T, Tan, E, Malangoni, M, Pararas, N, Podda, M, De Simone, B, Ivatury, R, Cui, Y, Kashuk, J, Peitzman, A, Kim, F, Pikoulis, E, Sganga, G, Chiara, O, Kelly, M, Marzi, I, Picetti, E, Agnoletti, V, De'Angelis, N, Campanelli, G, de Moya, M, Litvin, A, Martinez-Perez, A, Sall, I, Rizoli, S, Tomadze, G, Sakakushev, B, Stahel, P, Civil, I, Shelat, V, Costa, D, Chichom-Mefire, A, Latifi, R, Chirica, M, Amico, F, Pardhan, A, Seenarain, V, Boyapati, N, Hatz, B, Ackermann, T, Abeyasundara, S, Fenton, L, Plani, F, Sarvepalli, R, Rouhbakhshfar, O, Caleo, P, Ho-Ching Yau, V, Clement, K, Christou, E, Castillo, A, Gosal, P, Balasubramaniam, S, Hsu, J, Banphawatanarak, K, Pisano, M, Adriana, T, Michele, A, Cioffi, S, Spota, A, Catena, F, Ansaloni, L, Frassini S., Cobianchi L., Fugazzola P., Biffl W. L., Coccolini F., Damaskos D., Moore E. E., Kluger Y., Ceresoli M., Coimbra R., Davies J., Kirkpatrick A., Di Carlo I., Hardcastle T. C., Isik A., Chiarugi M., Gurusamy K., Maier R. V., Segovia Lohse H. A., Jeekel H., Boermeester M. A., Abu-Zidan F., Inaba K., Weber D. G., Augustin G., Bonavina L., Velmahos G., Sartelli M., Di Saverio S., Ten Broek R. P. G., Granieri S., Dal Mas F., Fare C. N., Peverada J., Zanghi S., Vigano J., Tomasoni M., Dominioni T., Cicuttin E., Hecker A., Tebala G. D., Galante J. M., Wani I., Khokha V., Sugrue M., Scalea T. M., Tan E., Malangoni M. A., Pararas N., Podda M., De Simone B., Ivatury R., Cui Y., Kashuk J., Peitzman A., Kim F., Pikoulis E., Sganga G., Chiara O., Kelly M. D., Marzi I., Picetti E., Agnoletti V., De'Angelis N., Campanelli G., de Moya M., Litvin A., Martinez-Perez A., Sall I., Rizoli S., Tomadze G., Sakakushev B., Stahel P. F., Civil I., Shelat V., Costa D., Chichom-Mefire A., Latifi R., Chirica M., Amico F., Pardhan A., Seenarain V., Boyapati N., Hatz B., Ackermann T., Abeyasundara S., Fenton L., Plani F., Sarvepalli R., Rouhbakhshfar O., Caleo P., Ho-Ching Yau V., Clement K., Christou E., Castillo A. M. G., Gosal P. K. S., Balasubramaniam S., Hsu J., Banphawatanarak K., Pisano M., Adriana T., Michele A., Cioffi S. P. B., Spota A., Catena F., Ansaloni L., Frassini, S, Cobianchi, L, Fugazzola, P, Biffl, W, Coccolini, F, Damaskos, D, Moore, E, Kluger, Y, Ceresoli, M, Coimbra, R, Davies, J, Kirkpatrick, A, Di Carlo, I, Hardcastle, T, Isik, A, Chiarugi, M, Gurusamy, K, Maier, R, Segovia Lohse, H, Jeekel, H, Boermeester, M, Abu-Zidan, F, Inaba, K, Weber, D, Augustin, G, Bonavina, L, Velmahos, G, Sartelli, M, Di Saverio, S, Ten Broek, R, Granieri, S, Dal Mas, F, Fare, C, Peverada, J, Zanghi, S, Vigano, J, Tomasoni, M, Dominioni, T, Cicuttin, E, Hecker, A, Tebala, G, Galante, J, Wani, I, Khokha, V, Sugrue, M, Scalea, T, Tan, E, Malangoni, M, Pararas, N, Podda, M, De Simone, B, Ivatury, R, Cui, Y, Kashuk, J, Peitzman, A, Kim, F, Pikoulis, E, Sganga, G, Chiara, O, Kelly, M, Marzi, I, Picetti, E, Agnoletti, V, De'Angelis, N, Campanelli, G, de Moya, M, Litvin, A, Martinez-Perez, A, Sall, I, Rizoli, S, Tomadze, G, Sakakushev, B, Stahel, P, Civil, I, Shelat, V, Costa, D, Chichom-Mefire, A, Latifi, R, Chirica, M, Amico, F, Pardhan, A, Seenarain, V, Boyapati, N, Hatz, B, Ackermann, T, Abeyasundara, S, Fenton, L, Plani, F, Sarvepalli, R, Rouhbakhshfar, O, Caleo, P, Ho-Ching Yau, V, Clement, K, Christou, E, Castillo, A, Gosal, P, Balasubramaniam, S, Hsu, J, Banphawatanarak, K, Pisano, M, Adriana, T, Michele, A, Cioffi, S, Spota, A, Catena, F, Ansaloni, L, Frassini S., Cobianchi L., Fugazzola P., Biffl W. L., Coccolini F., Damaskos D., Moore E. E., Kluger Y., Ceresoli M., Coimbra R., Davies J., Kirkpatrick A., Di Carlo I., Hardcastle T. C., Isik A., Chiarugi M., Gurusamy K., Maier R. V., Segovia Lohse H. A., Jeekel H., Boermeester M. A., Abu-Zidan F., Inaba K., Weber D. G., Augustin G., Bonavina L., Velmahos G., Sartelli M., Di Saverio S., Ten Broek R. P. G., Granieri S., Dal Mas F., Fare C. N., Peverada J., Zanghi S., Vigano J., Tomasoni M., Dominioni T., Cicuttin E., Hecker A., Tebala G. D., Galante J. M., Wani I., Khokha V., Sugrue M., Scalea T. M., Tan E., Malangoni M. A., Pararas N., Podda M., De Simone B., Ivatury R., Cui Y., Kashuk J., Peitzman A., Kim F., Pikoulis E., Sganga G., Chiara O., Kelly M. D., Marzi I., Picetti E., Agnoletti V., De'Angelis N., Campanelli G., de Moya M., Litvin A., Martinez-Perez A., Sall I., Rizoli S., Tomadze G., Sakakushev B., Stahel P. F., Civil I., Shelat V., Costa D., Chichom-Mefire A., Latifi R., Chirica M., Amico F., Pardhan A., Seenarain V., Boyapati N., Hatz B., Ackermann T., Abeyasundara S., Fenton L., Plani F., Sarvepalli R., Rouhbakhshfar O., Caleo P., Ho-Ching Yau V., Clement K., Christou E., Castillo A. M. G., Gosal P. K. S., Balasubramaniam S., Hsu J., Banphawatanarak K., Pisano M., Adriana T., Michele A., Cioffi S. P. B., Spota A., Catena F., and Ansaloni L.

Abstract

Laparotomy incisions provide easy and rapid access to the peritoneal cavity in case of emergency surgery. Incisional hernia (IH) is a late manifestation of the failure of abdominal wall closure and represents frequent complication of any abdominal incision: IHs can cause pain and discomfort to the patients but also clinical serious sequelae like bowel obstruction, incarceration, strangulation, and necessity of reoperation. Previous guidelines and indications in the literature consider elective settings and evidence about laparotomy closure in emergency settings is lacking. This paper aims to present the World Society of Emergency Surgery (WSES) project called ECLAPTE (Effective Closure of LAParoTomy in Emergency): the final manuscript includes guidelines on the closure of emergency laparotomy.

Published
2023

4. The LIFE TRIAD of emergency general surgery

Author

Coccolini, F, Sartelli, M, Kluger, Y, Osipov, A, Cui, Y, Beka, S, Kirkpatrick, A, Sall, I, Moore, E, Biffl, W, Litvin, A, Pisano, M, Magnone, S, Picetti, E, de Angelis, N, Stahel, P, Ansaloni, L, Tan, E, Abu-Zidan, F, Ceresoli, M, Hecker, A, Chiara, O, Sganga, G, Khokha, V, di Saverio, S, Sakakushev, B, Campanelli, G, Fraga, G, Wani, I, Broek, R, Cicuttin, E, Cremonini, C, Tartaglia, D, Soreide, K, Galante, J, de Moya, M, Koike, K, De Simone, B, Balogh, Z, Amico, F, Shelat, V, Pikoulis, E, Di Carlo, I, Bonavina, L, Leppaniemi, A, Marzi, I, Ivatury, R, Khan, J, Maier, R, Hardcastle, T, Isik, A, Podda, M, Tolonen, M, Rasa, K, Navsaria, P, Demetrashvili, Z, Tarasconi, A, Carcoforo, P, Sibilla, M, Baiocchi, G, Pararas, N, Weber, D, Chiarugi, M, Catena, F, Coccolini F., Sartelli M., Kluger Y., Osipov A., Cui Y., Beka S. G., Kirkpatrick A., Sall I., Moore E. E., Biffl W. L., Litvin A., Pisano M., Magnone S., Picetti E., de Angelis N., Stahel P., Ansaloni L., Tan E., Abu-Zidan F., Ceresoli M., Hecker A., Chiara O., Sganga G., Khokha V., di Saverio S., Sakakushev B., Campanelli G., Fraga G., Wani I., Broek R., Cicuttin E., Cremonini C., Tartaglia D., Soreide K., Galante J., de Moya M., Koike K., De Simone B., Balogh Z., Amico F., Shelat V., Pikoulis E., Di Carlo I., Bonavina L., Leppaniemi A., Marzi I., Ivatury R., Khan J., Maier R. V., Hardcastle T. C., Isik A., Podda M., Tolonen M., Rasa K., Navsaria P. H., Demetrashvili Z., Tarasconi A., Carcoforo P., Sibilla M. G., Baiocchi G. L., Pararas N., Weber D., Chiarugi M., Catena F., Coccolini, F, Sartelli, M, Kluger, Y, Osipov, A, Cui, Y, Beka, S, Kirkpatrick, A, Sall, I, Moore, E, Biffl, W, Litvin, A, Pisano, M, Magnone, S, Picetti, E, de Angelis, N, Stahel, P, Ansaloni, L, Tan, E, Abu-Zidan, F, Ceresoli, M, Hecker, A, Chiara, O, Sganga, G, Khokha, V, di Saverio, S, Sakakushev, B, Campanelli, G, Fraga, G, Wani, I, Broek, R, Cicuttin, E, Cremonini, C, Tartaglia, D, Soreide, K, Galante, J, de Moya, M, Koike, K, De Simone, B, Balogh, Z, Amico, F, Shelat, V, Pikoulis, E, Di Carlo, I, Bonavina, L, Leppaniemi, A, Marzi, I, Ivatury, R, Khan, J, Maier, R, Hardcastle, T, Isik, A, Podda, M, Tolonen, M, Rasa, K, Navsaria, P, Demetrashvili, Z, Tarasconi, A, Carcoforo, P, Sibilla, M, Baiocchi, G, Pararas, N, Weber, D, Chiarugi, M, Catena, F, Coccolini F., Sartelli M., Kluger Y., Osipov A., Cui Y., Beka S. G., Kirkpatrick A., Sall I., Moore E. E., Biffl W. L., Litvin A., Pisano M., Magnone S., Picetti E., de Angelis N., Stahel P., Ansaloni L., Tan E., Abu-Zidan F., Ceresoli M., Hecker A., Chiara O., Sganga G., Khokha V., di Saverio S., Sakakushev B., Campanelli G., Fraga G., Wani I., Broek R., Cicuttin E., Cremonini C., Tartaglia D., Soreide K., Galante J., de Moya M., Koike K., De Simone B., Balogh Z., Amico F., Shelat V., Pikoulis E., Di Carlo I., Bonavina L., Leppaniemi A., Marzi I., Ivatury R., Khan J., Maier R. V., Hardcastle T. C., Isik A., Podda M., Tolonen M., Rasa K., Navsaria P. H., Demetrashvili Z., Tarasconi A., Carcoforo P., Sibilla M. G., Baiocchi G. L., Pararas N., Weber D., Chiarugi M., and Catena F.

Abstract

Emergency General Surgery (EGS) was identified as multidisciplinary surgery performed for traumatic and non-traumatic acute conditions during the same admission in the hospital by general emergency surgeons and other specialists. It is the most diffused surgical discipline in the world. To live and grow strong EGS necessitates three fundamental parts: emergency and elective continuous surgical practice, evidence generation through clinical registries and data accrual, and indications and guidelines production: the LIFE TRIAD.

Published
2022

5. Minimally invasive surgery in emergency surgery: a WSES survey

Author

Ceresoli, M, Pisano, M, Abu-Zidan, F, Allievi, N, Gurusamy, K, Biffl, W, Tebala, G, Catena, F, Ansaloni, L, Sartelli, M, Kluger, Y, Baiocchi, G, Fette, A, Hecker, A, Litvin, A, Forgione, A, Leppaniemi, A, De Simone, B, Sakakushev, B, Palmatier, C, Bendinelli, C, Damascos, D, Picetti, E, Tan, E, Poiasina, E, Pikoulis, E, Cicuttin, E, Moore, E, Velmahos, G, Fraga, G, Van Goor, H, Civil, I, Wani, I, Di Carlo, I, Galante, J, Soreide, K, Degrate, L, Zorcolo, L, De Moya, M, Braga, M, Cereda, M, Sugrue, M, Chirica, M, De Angelis, N, Stahel, P, Ivatury, R, Ten Broek, R, Di Saverio, S, Beka, S, Magnone, S, Cui, Y, Balogh, Z, Kelly, M, Inaba, K, Coccolini, F, Ceresoli M., Pisano M., Abu-Zidan F., Allievi N., Gurusamy K., Biffl W. L., Tebala G. D., Catena F., Ansaloni L., Sartelli M., Kluger Y., Baiocchi G., Fette A., Hecker A., Litvin A., Forgione A., Leppaniemi A., De Simone B., Sakakushev B., Palmatier C. R., Bendinelli C., Damascos D., Picetti E., Tan E., Poiasina E., Pikoulis E., Cicuttin E., Moore E. E., Velmahos G., Fraga G., Van Goor H., Civil I., Wani I., Di Carlo I., Galante J., Soreide K., Degrate L., Zorcolo L., De Moya M., Braga M., Cereda M., Sugrue M., Chirica M., De Angelis N., Stahel P. F., Ivatury R., Ten Broek R., Di Saverio S., Beka S. G., Magnone S., Cui Y., Balogh Z. J., Kelly M. D., Inaba K., Coccolini F., Ceresoli, M, Pisano, M, Abu-Zidan, F, Allievi, N, Gurusamy, K, Biffl, W, Tebala, G, Catena, F, Ansaloni, L, Sartelli, M, Kluger, Y, Baiocchi, G, Fette, A, Hecker, A, Litvin, A, Forgione, A, Leppaniemi, A, De Simone, B, Sakakushev, B, Palmatier, C, Bendinelli, C, Damascos, D, Picetti, E, Tan, E, Poiasina, E, Pikoulis, E, Cicuttin, E, Moore, E, Velmahos, G, Fraga, G, Van Goor, H, Civil, I, Wani, I, Di Carlo, I, Galante, J, Soreide, K, Degrate, L, Zorcolo, L, De Moya, M, Braga, M, Cereda, M, Sugrue, M, Chirica, M, De Angelis, N, Stahel, P, Ivatury, R, Ten Broek, R, Di Saverio, S, Beka, S, Magnone, S, Cui, Y, Balogh, Z, Kelly, M, Inaba, K, Coccolini, F, Ceresoli M., Pisano M., Abu-Zidan F., Allievi N., Gurusamy K., Biffl W. L., Tebala G. D., Catena F., Ansaloni L., Sartelli M., Kluger Y., Baiocchi G., Fette A., Hecker A., Litvin A., Forgione A., Leppaniemi A., De Simone B., Sakakushev B., Palmatier C. R., Bendinelli C., Damascos D., Picetti E., Tan E., Poiasina E., Pikoulis E., Cicuttin E., Moore E. E., Velmahos G., Fraga G., Van Goor H., Civil I., Wani I., Di Carlo I., Galante J., Soreide K., Degrate L., Zorcolo L., De Moya M., Braga M., Cereda M., Sugrue M., Chirica M., De Angelis N., Stahel P. F., Ivatury R., Ten Broek R., Di Saverio S., Beka S. G., Magnone S., Cui Y., Balogh Z. J., Kelly M. D., Inaba K., and Coccolini F.

Abstract

Background: The diffusion of minimally invasive surgery in emergency surgery still represents a developing challenge. Evidence about the use of minimally invasive surgery shows its feasibility and safety; however, the diffusion of these techniques is still poor. The aims of the present survey were to explore the diffusion and variations in the use of minimally invasive surgery among surgeons in the emergency setting. Methods: This is a web-based survey administered to all the WSES members investigating the diffusion of minimally invasive surgery in emergency. The survey investigated personal characteristics of participants, hospital characteristics, personal confidence in the use of minimally invasive surgery in emergency, limitations in the use of it and limitations to prosecute minimally invasive surgery in emergency surgery. Characteristics related to the use of minimally invasive surgery were studied with a multivariate ordinal regression. Results: The survey collected a total of 415 answers; 42.2% of participants declared a working experience > 15 years and 69.4% of responders worked in tertiary level center or academic hospital. In primary emergencies, only 28,7% of participants declared the use of laparoscopy in more than 50% of times. Personal confidence with minimally invasive techniques was the highest for appendectomy and cholecystectomy. At multivariate ordinal regression, a longer professional experience, the use of laparoscopy in major elective surgery and bariatric surgery expertise were related to a higher use of laparoscopy in emergency surgery. Conclusions: The survey shows that minimally invasive techniques in emergency surgery are still underutilized. Greater focus should be placed on the development of dedicated training in laparoscopy among emergency surgeons.

Published
2022

6. Minimally invasive surgery in emergency surgery: a WSES survey

Author

Ceresoli M., Pisano M., Abu-Zidan F., Allievi N., Gurusamy K., Biffl W. L., Tebala G. D., Catena F., Ansaloni L., Sartelli M., Kluger Y., Baiocchi G., Fette A., Hecker A., Litvin A., Forgione A., Leppaniemi A., De Simone B., Sakakushev B., Palmatier C. R., Bendinelli C., Damascos D., Picetti E., Tan E., Poiasina E., Pikoulis E., Cicuttin E., Moore E. E., Velmahos G., Fraga G., Van Goor H., Civil I., Wani I., Di Carlo I., Galante J., Soreide K., Degrate L., Zorcolo L., De Moya M., Braga M., Cereda M., Sugrue M., Chirica M., De Angelis N., Stahel P. F., Ivatury R., Ten Broek R., Di Saverio S., Beka S. G., Magnone S., Cui Y., Balogh Z. J., Kelly M. D., Inaba K., Coccolini F., Ceresoli, M, Pisano, M, Abu-Zidan, F, Allievi, N, Gurusamy, K, Biffl, W, Tebala, G, Catena, F, Ansaloni, L, Sartelli, M, Kluger, Y, Baiocchi, G, Fette, A, Hecker, A, Litvin, A, Forgione, A, Leppaniemi, A, De Simone, B, Sakakushev, B, Palmatier, C, Bendinelli, C, Damascos, D, Picetti, E, Tan, E, Poiasina, E, Pikoulis, E, Cicuttin, E, Moore, E, Velmahos, G, Fraga, G, Van Goor, H, Civil, I, Wani, I, Di Carlo, I, Galante, J, Soreide, K, Degrate, L, Zorcolo, L, De Moya, M, Braga, M, Cereda, M, Sugrue, M, Chirica, M, De Angelis, N, Stahel, P, Ivatury, R, Ten Broek, R, Di Saverio, S, Beka, S, Magnone, S, Cui, Y, Balogh, Z, Kelly, M, Inaba, K, and Coccolini, F

Subjects
Reconstructive and regenerative medicine Radboud Institute for Health Sciences [Radboudumc 10], All institutes and research themes of the Radboud University Medical Center, Minimally invasive surgery, Emergency Medicine, Emergency surgery, Surgery, Laparoscopy, Survey
Abstract

Background The diffusion of minimally invasive surgery in emergency surgery still represents a developing challenge. Evidence about the use of minimally invasive surgery shows its feasibility and safety; however, the diffusion of these techniques is still poor. The aims of the present survey were to explore the diffusion and variations in the use of minimally invasive surgery among surgeons in the emergency setting. Methods This is a web-based survey administered to all the WSES members investigating the diffusion of minimally invasive surgery in emergency. The survey investigated personal characteristics of participants, hospital characteristics, personal confidence in the use of minimally invasive surgery in emergency, limitations in the use of it and limitations to prosecute minimally invasive surgery in emergency surgery. Characteristics related to the use of minimally invasive surgery were studied with a multivariate ordinal regression. Results The survey collected a total of 415 answers; 42.2% of participants declared a working experience > 15 years and 69.4% of responders worked in tertiary level center or academic hospital. In primary emergencies, only 28,7% of participants declared the use of laparoscopy in more than 50% of times. Personal confidence with minimally invasive techniques was the highest for appendectomy and cholecystectomy. At multivariate ordinal regression, a longer professional experience, the use of laparoscopy in major elective surgery and bariatric surgery expertise were related to a higher use of laparoscopy in emergency surgery. Conclusions The survey shows that minimally invasive techniques in emergency surgery are still underutilized. Greater focus should be placed on the development of dedicated training in laparoscopy among emergency surgeons.

Published
2022

8. Minimally invasive surgery in emergency surgery: a WSES survey

Author

Ceresoli, M. Pisano, M. Abu-Zidan, F. Allievi, N. Gurusamy, K. Biffl, W.L. Tebala, G.D. Catena, F. Ansaloni, L. Sartelli, M. Kluger, Y. Baiocchi, G. Fette, A. Hecker, A. Litvin, A. Forgione, A. Leppaniemi, A. De Simone, B. Sakakushev, B. Palmatier, C.R. Bendinelli, C. Damascos, D. Picetti, E. Tan, E. Poiasina, E. Pikoulis, E. Cicuttin, E. Moore, E.E. Velmahos, G. Fraga, G. Van Goor, H. Civil, I. Wani, I. Di Carlo, I. Galante, J. Søreide, K. Degrate, L. Zorcolo, L. De Moya, M. Braga, M. Cereda, M. Sugrue, M. Chirica, M. De Angelis, N. Stahel, P.F. Ivatury, R. Ten Broek, R. Di Saverio, S. Beka, S.G. Magnone, S. Cui, Y. Balogh, Z.J. Kelly, M.D. Inaba, K. Coccolini, F. WSES MIS working group WSES MIS consortia

Abstract

Background: The diffusion of minimally invasive surgery in emergency surgery still represents a developing challenge. Evidence about the use of minimally invasive surgery shows its feasibility and safety; however, the diffusion of these techniques is still poor. The aims of the present survey were to explore the diffusion and variations in the use of minimally invasive surgery among surgeons in the emergency setting. Methods: This is a web-based survey administered to all the WSES members investigating the diffusion of minimally invasive surgery in emergency. The survey investigated personal characteristics of participants, hospital characteristics, personal confidence in the use of minimally invasive surgery in emergency, limitations in the use of it and limitations to prosecute minimally invasive surgery in emergency surgery. Characteristics related to the use of minimally invasive surgery were studied with a multivariate ordinal regression. Results: The survey collected a total of 415 answers; 42.2% of participants declared a working experience > 15 years and 69.4% of responders worked in tertiary level center or academic hospital. In primary emergencies, only 28,7% of participants declared the use of laparoscopy in more than 50% of times. Personal confidence with minimally invasive techniques was the highest for appendectomy and cholecystectomy. At multivariate ordinal regression, a longer professional experience, the use of laparoscopy in major elective surgery and bariatric surgery expertise were related to a higher use of laparoscopy in emergency surgery. Conclusions: The survey shows that minimally invasive techniques in emergency surgery are still underutilized. Greater focus should be placed on the development of dedicated training in laparoscopy among emergency surgeons. © 2022, The Author(s).

Published
2022

10. The open abdomen in trauma and non-trauma patients: WSES guidelines

Author

Coccolini, F, Roberts, D, Ansaloni, L, Ivatury, R, Gamberini, E, Kluger, Y, Moore, E, Coimbra, R, Kirkpatrick, A, Pereira, B, Montori, G, Ceresoli, M, Abu-Zidan, F, Sartelli, M, Velmahos, G, Fraga, G, Leppaniemi, A, Tolonen, M, Galante, J, Razek, T, Maier, R, Bala, M, Sakakushev, B, Khokha, V, Malbrain, M, Agnoletti, V, Peitzman, A, Demetrashvili, Z, Sugrue, M, Di Saverio, S, Martzi, I, Soreide, K, Biffl, W, Ferrada, P, Parry, N, Montravers, P, Melotti, R, Salvetti, F, Valetti, T, Scalea, T, Chiara, O, Cimbanassi, S, Kashuk, J, Larrea, M, Hernandez, J, Lin, H, Chirica, M, Arvieux, C, Bing, C, Horer, T, De Simone, B, Masiakos, P, Reva, V, Deangelis, N, Kike, K, Balogh, Z, Fugazzola, P, Tomasoni, M, Latifi, R, Naidoo, N, Weber, D, Handolin, L, Inaba, K, Hecker, A, Kuo-Ching, Y, Ordonez, C, Rizoli, S, Gomes, C, De Moya, M, Wani, I, Mefire, A, Boffard, K, Napolitano, L, Catena, F, Coccolini F., Roberts D., Ansaloni L., Ivatury R., Gamberini E., Kluger Y., Moore E. E., Coimbra R., Kirkpatrick A. W., Pereira B. M., Montori G., Ceresoli M., Abu-Zidan F. M., Sartelli M., Velmahos G., Fraga G. P., Leppaniemi A., Tolonen M., Galante J., Razek T., Maier R., Bala M., Sakakushev B., Khokha V., Malbrain M., Agnoletti V., Peitzman A., Demetrashvili Z., Sugrue M., Di Saverio S., Martzi I., Soreide K., Biffl W., Ferrada P., Parry N., Montravers P., Melotti R. M., Salvetti F., Valetti T. M., Scalea T., Chiara O., Cimbanassi S., Kashuk J. L., Larrea M., Hernandez J. A. M., Lin H. -F., Chirica M., Arvieux C., Bing C., Horer T., De Simone B., Masiakos P., Reva V., DeAngelis N., Kike K., Balogh Z. J., Fugazzola P., Tomasoni M., Latifi R., Naidoo N., Weber D., Handolin L., Inaba K., Hecker A., Kuo-Ching Y., Ordonez C. A., Rizoli S., Gomes C. A., De Moya M., Wani I., Mefire A. C., Boffard K., Napolitano L., Catena F., Coccolini, F, Roberts, D, Ansaloni, L, Ivatury, R, Gamberini, E, Kluger, Y, Moore, E, Coimbra, R, Kirkpatrick, A, Pereira, B, Montori, G, Ceresoli, M, Abu-Zidan, F, Sartelli, M, Velmahos, G, Fraga, G, Leppaniemi, A, Tolonen, M, Galante, J, Razek, T, Maier, R, Bala, M, Sakakushev, B, Khokha, V, Malbrain, M, Agnoletti, V, Peitzman, A, Demetrashvili, Z, Sugrue, M, Di Saverio, S, Martzi, I, Soreide, K, Biffl, W, Ferrada, P, Parry, N, Montravers, P, Melotti, R, Salvetti, F, Valetti, T, Scalea, T, Chiara, O, Cimbanassi, S, Kashuk, J, Larrea, M, Hernandez, J, Lin, H, Chirica, M, Arvieux, C, Bing, C, Horer, T, De Simone, B, Masiakos, P, Reva, V, Deangelis, N, Kike, K, Balogh, Z, Fugazzola, P, Tomasoni, M, Latifi, R, Naidoo, N, Weber, D, Handolin, L, Inaba, K, Hecker, A, Kuo-Ching, Y, Ordonez, C, Rizoli, S, Gomes, C, De Moya, M, Wani, I, Mefire, A, Boffard, K, Napolitano, L, Catena, F, Coccolini F., Roberts D., Ansaloni L., Ivatury R., Gamberini E., Kluger Y., Moore E. E., Coimbra R., Kirkpatrick A. W., Pereira B. M., Montori G., Ceresoli M., Abu-Zidan F. M., Sartelli M., Velmahos G., Fraga G. P., Leppaniemi A., Tolonen M., Galante J., Razek T., Maier R., Bala M., Sakakushev B., Khokha V., Malbrain M., Agnoletti V., Peitzman A., Demetrashvili Z., Sugrue M., Di Saverio S., Martzi I., Soreide K., Biffl W., Ferrada P., Parry N., Montravers P., Melotti R. M., Salvetti F., Valetti T. M., Scalea T., Chiara O., Cimbanassi S., Kashuk J. L., Larrea M., Hernandez J. A. M., Lin H. -F., Chirica M., Arvieux C., Bing C., Horer T., De Simone B., Masiakos P., Reva V., DeAngelis N., Kike K., Balogh Z. J., Fugazzola P., Tomasoni M., Latifi R., Naidoo N., Weber D., Handolin L., Inaba K., Hecker A., Kuo-Ching Y., Ordonez C. A., Rizoli S., Gomes C. A., De Moya M., Wani I., Mefire A. C., Boffard K., Napolitano L., and Catena F.

Abstract

Damage control resuscitation may lead to postoperative intra-abdominal hypertension or abdominal compartment syndrome. These conditions may result in a vicious, self-perpetuating cycle leading to severe physiologic derangements and multiorgan failure unless interrupted by abdominal (surgical or other) decompression. Further, in some clinical situations, the abdomen cannot be closed due to the visceral edema, the inability to control the compelling source of infection or the necessity to re-explore (as a "planned second-look" laparotomy) or complete previously initiated damage control procedures or in cases of abdominal wall disruption. The open abdomen in trauma and non-trauma patients has been proposed to be effective in preventing or treating deranged physiology in patients with severe injuries or critical illness when no other perceived options exist. Its use, however, remains controversial as it is resource consuming and represents a non-anatomic situation with the potential for severe adverse effects. Its use, therefore, should only be considered in patients who would most benefit from it. Abdominal fascia-to-fascia closure should be done as soon as the patient can physiologically tolerate it. All precautions to minimize complications should be implemented.

Published
2018

11. Phenobarbital for Acute Alcohol Withdrawal Management in Surgical Trauma Patients—A Retrospective Comparison Study

Author

Nejad, S. Nisavic, M. Larentzakis, A. Dijkink, S. Chang, Y. Levine, A.R. de Moya, M. Velmahos, G.

Abstract

Background: Alcohol withdrawal syndrome (AWS) in surgical trauma patients is associated with significant morbidity and mortality. Benzodiazepines, commonly used for withdrawal management, pose unique challenges in this population given the high prevalence of head trauma and delirium. Phenobarbital is an antiepileptic drug that offers a viable alternative to benzodiazepines for AWS treatment. Methods: This is a retrospective chart review of patients with active alcohol use disorder who presented to a level 1 trauma center over a 4-year period and required medication-assisted management for AWS. The primary outcome variable examined was the development of AWS and associated complications. Additional outcomes measured included hospital length of stay, mortality, and medication-related adverse events. Results: Of the 85 patients in the study sample, 52 received a fixed-dose benzodiazepine-based protocol and 33 received phenobarbital-based protocol. In the benzodiazepine-based protocol group, 25 patients (48.2%) developed AWD and 38 (73.1%) developed uncomplicated AWS, as compared to 0 patients in the phenobarbital-based protocol (P = 0.0001). There were 10 (19.2%) patients with medication adverse side effects in the benzodiazepine-based protocol group versus 0 patients in the phenobarbital-based protocol group. There were no statically significant differences between the 2 groups as pertains to rates of other AWS-related complications, patient mortality, or length of stay. Conclusion: The use of a phenobarbital-based protocol in trauma patients with underlying active alcohol use disorder resulted in a statistically significant decrease in the incidence of AWD and uncomplicated AWS secondary to AWS when compared to patients treated with a fixed-dose benzodiazepine-based protocol. © 2020 Academy of Consultation-Liaison Psychiatry

Published
2020

15. Splenic trauma: WSES classification and guidelines for adult and pediatric patients

Author

Coccolini, F, Montori, G, Catena, F, Kluger, Y, Biffl, W, Moore, E, Reva, V, Bing, C, Bala, M, Fugazzola, P, Bahouth, H, Marzi, I, Velmahos, G, Ivatury, R, Soreide, K, Horer, T, ten Broek, R, Pereira, B, Fraga, G, Inaba, K, Kashuk, J, Parry, N, Masiakos, P, Mylonas, K, Kirkpatrick, A, Abu-Zidan, F, Gomes, C, Benatti, S, Naidoo, N, Salvetti, F, Maccatrozzo, S, Agnoletti, V, Gamberini, E, Solaini, L, Costanzo, A, Celotti, A, Tomasoni, M, Khokha, V, Arvieux, C, Napolitano, L, Handolin, L, Pisano, M, Magnone, S, Spain, D, de Moya, M, Davis, K, De Angelis, N, Leppaniemi, A, Ferrada, P, Latifi, R, Navarro, D, Otomo, Y, Coimbra, R, Maier, R, Moore, F, Rizoli, S, Sakakushev, B, Galante, J, Chiara, O, Cimbanassi, S, Mefire, A, Weber, D, Ceresoli, M, Peitzman, A, Wehlie, L, Sartelli, M, Di Saverio, S, Ansaloni, L, Coccolini F., Montori G., Catena F., Kluger Y., Biffl W., Moore E. E., Reva V., Bing C., Bala M., Fugazzola P., Bahouth H., Marzi I., Velmahos G., Ivatury R., Soreide K., Horer T., ten Broek R., Pereira B. M., Fraga G. P., Inaba K., Kashuk J., Parry N., Masiakos P. T., Mylonas K. S., Kirkpatrick A., Abu-Zidan F., Gomes C. A., Benatti S. V., Naidoo N., Salvetti F., Maccatrozzo S., Agnoletti V., Gamberini E., Solaini L., Costanzo A., Celotti A., Tomasoni M., Khokha V., Arvieux C., Napolitano L., Handolin L., Pisano M., Magnone S., Spain D. A., de Moya M., Davis K. A., De Angelis N., Leppaniemi A., Ferrada P., Latifi R., Navarro D. C., Otomo Y., Coimbra R., Maier R. V., Moore F., Rizoli S., Sakakushev B., Galante J. M., Chiara O., Cimbanassi S., Mefire A. C., Weber D., Ceresoli M., Peitzman A. B., Wehlie L., Sartelli M., Di Saverio S., Ansaloni L., Coccolini, F, Montori, G, Catena, F, Kluger, Y, Biffl, W, Moore, E, Reva, V, Bing, C, Bala, M, Fugazzola, P, Bahouth, H, Marzi, I, Velmahos, G, Ivatury, R, Soreide, K, Horer, T, ten Broek, R, Pereira, B, Fraga, G, Inaba, K, Kashuk, J, Parry, N, Masiakos, P, Mylonas, K, Kirkpatrick, A, Abu-Zidan, F, Gomes, C, Benatti, S, Naidoo, N, Salvetti, F, Maccatrozzo, S, Agnoletti, V, Gamberini, E, Solaini, L, Costanzo, A, Celotti, A, Tomasoni, M, Khokha, V, Arvieux, C, Napolitano, L, Handolin, L, Pisano, M, Magnone, S, Spain, D, de Moya, M, Davis, K, De Angelis, N, Leppaniemi, A, Ferrada, P, Latifi, R, Navarro, D, Otomo, Y, Coimbra, R, Maier, R, Moore, F, Rizoli, S, Sakakushev, B, Galante, J, Chiara, O, Cimbanassi, S, Mefire, A, Weber, D, Ceresoli, M, Peitzman, A, Wehlie, L, Sartelli, M, Di Saverio, S, Ansaloni, L, Coccolini F., Montori G., Catena F., Kluger Y., Biffl W., Moore E. E., Reva V., Bing C., Bala M., Fugazzola P., Bahouth H., Marzi I., Velmahos G., Ivatury R., Soreide K., Horer T., ten Broek R., Pereira B. M., Fraga G. P., Inaba K., Kashuk J., Parry N., Masiakos P. T., Mylonas K. S., Kirkpatrick A., Abu-Zidan F., Gomes C. A., Benatti S. V., Naidoo N., Salvetti F., Maccatrozzo S., Agnoletti V., Gamberini E., Solaini L., Costanzo A., Celotti A., Tomasoni M., Khokha V., Arvieux C., Napolitano L., Handolin L., Pisano M., Magnone S., Spain D. A., de Moya M., Davis K. A., De Angelis N., Leppaniemi A., Ferrada P., Latifi R., Navarro D. C., Otomo Y., Coimbra R., Maier R. V., Moore F., Rizoli S., Sakakushev B., Galante J. M., Chiara O., Cimbanassi S., Mefire A. C., Weber D., Ceresoli M., Peitzman A. B., Wehlie L., Sartelli M., Di Saverio S., and Ansaloni L.

Abstract

Spleen injuries are among the most frequent trauma-related injuries. At present, they are classified according to the anatomy of the injury. The optimal treatment strategy, however, should keep into consideration the hemodynamic status, the anatomic derangement, and the associated injuries. The management of splenic trauma patients aims to restore the homeostasis and the normal physiopathology especially considering the modern tools for bleeding management. Thus, the management of splenic trauma should be ultimately multidisciplinary and based on the physiology of the patient, the anatomy of the injury, and the associated lesions. Lastly, as the management of adults and children must be different, children should always be treated in dedicated pediatric trauma centers. In fact, the vast majority of pediatric patients with blunt splenic trauma can be managed non-operatively. This paper presents the World Society of Emergency Surgery (WSES) classification of splenic trauma and the management guidelines.

Published
2017

16. 2016 WSES guidelines on acute calculous cholecystitis

Author

Ansaloni, L, Pisano, M, Coccolini, F, Peitzmann, A, Fingerhut, A, Catena, F, Agresta, F, Allegri, A, Bailey, I, Balogh, Z, Bendinelli, C, Biffl, W, Bonavina, L, Borzellino, G, Brunetti, F, Burlew, C, Camapanelli, G, Campanile, F, Ceresoli, M, Chiara, O, Civil, I, Coimbra, R, De Moya, M, Di Saverio, S, Fraga, G, Gupta, S, Kashuk, J, Kelly, M, Koka, V, Jeekel, H, Latifi, R, Leppaniemi, A, Maier, R, Marzi, I, Moore, F, Piazzalunga, D, Sakakushev, B, Sartelli, M, Scalea, T, Stahel, P, Taviloglu, K, Tugnoli, G, Uraneus, S, Velmahos, G, Wani, I, Weber, D, Viale, P, Sugrue, M, Ivatury, R, Kluger, Y, Gurusamy, K, Moore, E, Ansaloni L., Pisano M., Coccolini F., Peitzmann A. B., Fingerhut A., Catena F., Agresta F., Allegri A., Bailey I., Balogh Z. J., Bendinelli C., Biffl W., Bonavina L., Borzellino G., Brunetti F., Burlew C. C., Camapanelli G., Campanile F. C., Ceresoli M., Chiara O., Civil I., Coimbra R., De Moya M., Di Saverio S., Fraga G. P., Gupta S., Kashuk J., Kelly M. D., Koka V., Jeekel H., Latifi R., Leppaniemi A., Maier R. V., Marzi I., Moore F., Piazzalunga D., Sakakushev B., Sartelli M., Scalea T., Stahel P. F., Taviloglu K., Tugnoli G., Uraneus S., Velmahos G. C., Wani I., Weber D. G., Viale P., Sugrue M., Ivatury R., Kluger Y., Gurusamy K. S., Moore E. E., Ansaloni, L, Pisano, M, Coccolini, F, Peitzmann, A, Fingerhut, A, Catena, F, Agresta, F, Allegri, A, Bailey, I, Balogh, Z, Bendinelli, C, Biffl, W, Bonavina, L, Borzellino, G, Brunetti, F, Burlew, C, Camapanelli, G, Campanile, F, Ceresoli, M, Chiara, O, Civil, I, Coimbra, R, De Moya, M, Di Saverio, S, Fraga, G, Gupta, S, Kashuk, J, Kelly, M, Koka, V, Jeekel, H, Latifi, R, Leppaniemi, A, Maier, R, Marzi, I, Moore, F, Piazzalunga, D, Sakakushev, B, Sartelli, M, Scalea, T, Stahel, P, Taviloglu, K, Tugnoli, G, Uraneus, S, Velmahos, G, Wani, I, Weber, D, Viale, P, Sugrue, M, Ivatury, R, Kluger, Y, Gurusamy, K, Moore, E, Ansaloni L., Pisano M., Coccolini F., Peitzmann A. B., Fingerhut A., Catena F., Agresta F., Allegri A., Bailey I., Balogh Z. J., Bendinelli C., Biffl W., Bonavina L., Borzellino G., Brunetti F., Burlew C. C., Camapanelli G., Campanile F. C., Ceresoli M., Chiara O., Civil I., Coimbra R., De Moya M., Di Saverio S., Fraga G. P., Gupta S., Kashuk J., Kelly M. D., Koka V., Jeekel H., Latifi R., Leppaniemi A., Maier R. V., Marzi I., Moore F., Piazzalunga D., Sakakushev B., Sartelli M., Scalea T., Stahel P. F., Taviloglu K., Tugnoli G., Uraneus S., Velmahos G. C., Wani I., Weber D. G., Viale P., Sugrue M., Ivatury R., Kluger Y., 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

17. 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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18. Bologna guidelines for diagnosis and management of adhesive small bowel obstruction (ASBO): 2017 update of the evidence-based guidelines from the world society of emergency surgery ASBO working group

Author

ten Broek, RPG, Krielen, P, Di Saverio, S, Coccolini, F, Biffl, WL, Ansaloni, L, Velmahos, GC, Sartelli, M, Fraga, GP, Kelly, MD, Moore, FA, Peitzman, AB, Leppaniemi, A, Moore, EE, Jeekel, J (Hans), Kluger, Y, Sugrue, M, Balogh, Z J, Bendinelli, C, Civil, I, Coimbra, R, De Moya, M, Ferrada, P, Inaba, K, Ivatury, R, Latifi, R, Kashuk, JL, Kirkpatrick, AW, Maier, R, Rizoli, S, Sakakushev, B, Scalea, T, Soreide, K, Weber, D, Wani, I, Abu-Zidan, FM, De'Angelis, N, Piscioneri, F, Galante, JM, Catena, F, van Goor, H, ten Broek, RPG, Krielen, P, Di Saverio, S, Coccolini, F, Biffl, WL, Ansaloni, L, Velmahos, GC, Sartelli, M, Fraga, GP, Kelly, MD, Moore, FA, Peitzman, AB, Leppaniemi, A, Moore, EE, Jeekel, J (Hans), Kluger, Y, Sugrue, M, Balogh, Z J, Bendinelli, C, Civil, I, Coimbra, R, De Moya, M, Ferrada, P, Inaba, K, Ivatury, R, Latifi, R, Kashuk, JL, Kirkpatrick, AW, Maier, R, Rizoli, S, Sakakushev, B, Scalea, T, Soreide, K, Weber, D, Wani, I, Abu-Zidan, FM, De'Angelis, N, Piscioneri, F, Galante, JM, Catena, F, and van Goor, H

Published
2018

19. 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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20. 2016 WSES guidelines on acute calculous cholecystitis (vol 11, 25, 2016)

Author

University of Helsinki, II kirurgian klinikka, Ansaloni, L., Pisano, M., Coccolini, F., Peitzmann, A. B., Fingerhut, A., Catena, F., Agresta, F., Allegri, A., Bailey, I., Balogh, Z. J., Bendinelli, C., Biffl, W., Bonavina, L., Borzellino, G., Brunetti, F., Burlew, C. C., Camapanelli, G., Campanile, F. C., Ceresoli, M., Chiara, O., Civil, I., Coimbra, R., De Moya, M., Di Saverio, S., Fraga, G. P., Gupta, S., Kashuk, J., Kelly, M. D., Khokha, V., Jeekel, H., Latifi, R., Leppaniemi, A., Maier, R. V., Marzi, I., Moore, F., Piazzalunga, D., Sakakushev, B., Sartelli, M., Scalea, T., Stahel, P. F., Taviloglu, K., Tugnoli, G., Uraneus, S., Velmahos, G. C., Wani, I., Weber, D. G., Viale, P., Sugrue, M., Ivatury, R., Kluger, Y., Gurusamy, K. S., Moore, E. E., University of Helsinki, II kirurgian klinikka, Ansaloni, L., Pisano, M., Coccolini, F., Peitzmann, A. B., Fingerhut, A., Catena, F., Agresta, F., Allegri, A., Bailey, I., Balogh, Z. J., Bendinelli, C., Biffl, W., Bonavina, L., Borzellino, G., Brunetti, F., Burlew, C. C., Camapanelli, G., Campanile, F. C., Ceresoli, M., Chiara, O., Civil, I., Coimbra, R., De Moya, M., Di Saverio, S., Fraga, G. P., Gupta, S., Kashuk, J., Kelly, M. D., Khokha, V., Jeekel, H., Latifi, R., Leppaniemi, A., Maier, R. V., Marzi, I., Moore, F., Piazzalunga, D., Sakakushev, B., Sartelli, M., Scalea, T., Stahel, P. F., Taviloglu, K., Tugnoli, G., Uraneus, S., Velmahos, G. C., Wani, I., Weber, D. G., Viale, P., Sugrue, M., Ivatury, R., Kluger, Y., Gurusamy, K. S., and Moore, E. E.

Published
2016

21. Erratum to: 2016 WSES guidelines on acute calculous cholecystitis

Author

Ansaloni, L., primary, Pisano, M., additional, Coccolini, F., additional, Peitzmann, A. B., additional, Fingerhut, A., additional, Catena, F., additional, Agresta, F., additional, Allegri, A., additional, Bailey, I., additional, Balogh, Z. J., additional, Bendinelli, C., additional, Biffl, W., additional, Bonavina, L., additional, Borzellino, G., additional, Brunetti, F., additional, Burlew, C. C., additional, Camapanelli, G., additional, Campanile, F. C., additional, Ceresoli, M., additional, Chiara, O., additional, Civil, I., additional, Coimbra, R., additional, De Moya, M., additional, Di Saverio, S., additional, Fraga, G. P., additional, Gupta, S., additional, Kashuk, J., additional, Kelly, M. D., additional, Khokha, V., additional, Jeekel, H., additional, Latifi, R., additional, Leppaniemi, A., additional, Maier, R. V., additional, Marzi, I., additional, Moore, F., additional, Piazzalunga, D., additional, Sakakushev, B., additional, Sartelli, M., additional, Scalea, T., additional, Stahel, P. F., additional, Taviloglu, K., additional, Tugnoli, G., additional, Uraneus, S., additional, Velmahos, G. C., additional, Wani, I., additional, Weber, D. G., additional, Viale, P., additional, Sugrue, M., additional, Ivatury, R., additional, Kluger, Y., additional, Gurusamy, K. S., additional, and Moore, E. E., additional

Published
2016
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22. 2016 WSES guidelines on acute calculous cholecystitis

Author

Ansaloni, L., primary, Pisano, M., additional, Coccolini, F., additional, Peitzmann, A. B., additional, Fingerhut, A., additional, Catena, F., additional, Agresta, F., additional, Allegri, A., additional, Bailey, I., additional, Balogh, Z. J., additional, Bendinelli, C., additional, Biffl, W., additional, Bonavina, L., additional, Borzellino, G., additional, Brunetti, F., additional, Burlew, C. C., additional, Camapanelli, G., additional, Campanile, F. C., additional, Ceresoli, M., additional, Chiara, O., additional, Civil, I., additional, Coimbra, R., additional, De Moya, M., additional, Di Saverio, S., additional, Fraga, G. P., additional, Gupta, S., additional, Kashuk, J., additional, Kelly, M. D., additional, Khokha, V., additional, Jeekel, H., additional, Latifi, R., additional, Leppaniemi, A., additional, Maier, R. V., additional, Marzi, I., additional, Moore, F., additional, Piazzalunga, D., additional, Sakakushev, B., additional, Sartelli, M., additional, Scalea, T., additional, Stahel, P. F., additional, Taviloglu, K., additional, Tugnoli, G., additional, Uraneus, S., additional, Velmahos, G. C., additional, Wani, I., additional, Weber, D. G., additional, Viale, P., additional, Sugrue, M., additional, Ivatury, R., additional, Kluger, Y., additional, Gurusamy, K. S., additional, and Moore, E. E., additional

Published
2016
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34. The LIFE TRIAD of emergency general surgery

Author

Federico Coccolini, Massimo Sartelli, Yoram Kluger, Aleksei Osipov, Yunfeng Cui, Solomon Gurmu Beka, Andrew Kirkpatrick, Ibrahima Sall, Ernest E. Moore, Walter L. Biffl, Andrey Litvin, Michele Pisano, Stefano Magnone, Edoardo Picetti, Nicola de Angelis, Philip Stahel, Luca Ansaloni, Edward Tan, Fikri Abu-Zidan, Marco Ceresoli, Andreas Hecker, Osvaldo Chiara, Gabriele Sganga, Vladimir Khokha, Salomone di Saverio, Boris Sakakushev, Giampiero Campanelli, Gustavo Fraga, Imtiaz Wani, Richard ten Broek, Enrico Cicuttin, Camilla Cremonini, Dario Tartaglia, Kjetil Soreide, Joseph Galante, Marc de Moya, Kaoru Koike, Belinda De Simone, Zsolt Balogh, Francesco Amico, Vishal Shelat, Emmanouil Pikoulis, Isidoro Di Carlo, Luigi Bonavina, Ari Leppaniemi, Ingo Marzi, Rao Ivatury, Jim Khan, Ronald V. Maier, Timothy C. Hardcastle, Arda Isik, Mauro Podda, Matti Tolonen, Kemal Rasa, Pradeep H. Navsaria, Zaza Demetrashvili, Antonio Tarasconi, Paolo Carcoforo, Maria Grazia Sibilla, Gian Luca Baiocchi, Nikolaos Pararas, Dieter Weber, Massimo Chiarugi, Fausto Catena, Coccolini, F, Sartelli, M, Kluger, Y, Osipov, A, Cui, Y, Beka, S, Kirkpatrick, A, Sall, I, Moore, E, Biffl, W, Litvin, A, Pisano, M, Magnone, S, Picetti, E, de Angelis, N, Stahel, P, Ansaloni, L, Tan, E, Abu-Zidan, F, Ceresoli, M, Hecker, A, Chiara, O, Sganga, G, Khokha, V, di Saverio, S, Sakakushev, B, Campanelli, G, Fraga, G, Wani, I, Broek, R, Cicuttin, E, Cremonini, C, Tartaglia, D, Soreide, K, Galante, J, de Moya, M, Koike, K, De Simone, B, Balogh, Z, Amico, F, Shelat, V, Pikoulis, E, Di Carlo, I, Bonavina, L, Leppaniemi, A, Marzi, I, Ivatury, R, Khan, J, Maier, R, Hardcastle, T, Isik, A, Podda, M, Tolonen, M, Rasa, K, Navsaria, P, Demetrashvili, Z, Tarasconi, A, Carcoforo, P, Sibilla, M, Baiocchi, G, Pararas, N, Weber, D, Chiarugi, M, Catena, F, HUS Abdominal Center, II kirurgian klinikka, Department of Medicine, and Faculty of Health Sciences

Subjects
Surgeons, Data, Effectivene, Formation, Effectiveness, Outcomes, 3126 Surgery, anesthesiology, intensive care, radiology, Hospitals, Emergency General Surgery, Planning, Emergency Medicine, Humans, Learning, Surgery, Registries, Outcome
Abstract

Emergency General Surgery (EGS) was identified as multidisciplinary surgery performed for traumatic and non-traumatic acute conditions during the same admission in the hospital by general emergency surgeons and other specialists. It is the most diffused surgical discipline in the world. To live and grow strong EGS necessitates three fundamental parts: emergency and elective continuous surgical practice, evidence generation through clinical registries and data accrual, and indications and guidelines production: the LIFE TRIAD.

Published
2022

35. The open abdomen in trauma and non-trauma patients: WSES guidelines

Author

Osvaldo Chiara, Matteo Tomasoni, Peter T. Masiakos, Marco Ceresoli, Tino Martino Valetti, Viktor Reva, Kaoru Kike, Mircea Chirica, Fausto Catena, Stefania Cimbanassi, Lena M. Napolitano, Gustavo Pereira Fraga, Carlos A. Ordoñez, Yuan Kuo-Ching, Ingo Martzi, Federico Coccolini, Marc de Moya, Emiliano Gamberini, Walter L. Biffl, Zaza Demetrashvili, Kenneth D. Boffard, Paola Fugazzola, Martha Larrea, Andrew B. Peitzman, Nicola de’Angelis, Ernest E. Moore, Giulia Montori, Miklosh Bala, Paula Ferrada, Neil Parry, Zsolt J. Balogh, Manu L N G Malbrain, Matti Tolonen, Catherine Arvieux, Yoram Kluger, Fikri M. Abu-Zidan, Salomone Di Saverio, Luca Ansaloni, Alain Chichom Mefire, Carlos Augusto Gomes, Vanni Agnoletti, Francesco Salvetti, Dieter G. Weber, Rifat Latifi, Massimo Sartelli, Camilla Bing, Philippe Montravers, R. V. Maier, Jeffry L. Kashuk, Rita Maria Melotti, Raul Coimbra, Joseph M. Galante, Kenji Inaba, Tal M. Hörer, Belinda De Simone, Andreas Hecker, Sandro Rizoli, Rao R. Ivatury, Juan Alberto Martinez Hernandez, Michael Sugrue, Thomas M. Scalea, Noel Naidoo, Heng Fu Lin, Ari Leppäniemi, Kjetil Søreide, Andrew W. Kirkpatrick, George C. Velmahos, Vladimir Khokha, Bruno M. Pereira, Imtiaz Wani, Derek J. Roberts, Boris Sakakushev, Tarek Razek, Lauri Handolin, Coccolini, F, Roberts, D, Ansaloni, L, Ivatury, R, Gamberini, E, Kluger, Y, Moore, E, Coimbra, R, Kirkpatrick, A, Pereira, B, Montori, G, Ceresoli, M, Abu-Zidan, F, Sartelli, M, Velmahos, G, Fraga, G, Leppaniemi, A, Tolonen, M, Galante, J, Razek, T, Maier, R, Bala, M, Sakakushev, B, Khokha, V, Malbrain, M, Agnoletti, V, Peitzman, A, Demetrashvili, Z, Sugrue, M, Di Saverio, S, Martzi, I, Soreide, K, Biffl, W, Ferrada, P, Parry, N, Montravers, P, Melotti, R, Salvetti, F, Valetti, T, Scalea, T, Chiara, O, Cimbanassi, S, Kashuk, J, Larrea, M, Hernandez, J, Lin, H, Chirica, M, Arvieux, C, Bing, C, Horer, T, De Simone, B, Masiakos, P, Reva, V, Deangelis, N, Kike, K, Balogh, Z, Fugazzola, P, Tomasoni, M, Latifi, R, Naidoo, N, Weber, D, Handolin, L, Inaba, K, Hecker, A, Kuo-Ching, Y, Ordonez, C, Rizoli, S, Gomes, C, De Moya, M, Wani, I, Mefire, A, Boffard, K, Napolitano, L, Catena, F, Coccolini, Federico, Roberts, Derek, Ansaloni, Luca, Ivatury, Rao, Gamberini, Emiliano, Kluger, Yoram, Moore, Ernest E., Coimbra, Raul, Kirkpatrick, Andrew W., Pereira, Bruno M., Montori, Giulia, Ceresoli, Marco, Abu-Zidan, Fikri M., Sartelli, Massimo, Velmahos, George, Fraga, Gustavo Pereira, Leppaniemi, Ari, Tolonen, Matti, Galante, Joseph, Razek, Tarek, Maier, Ron, Bala, Miklosh, Sakakushev, Bori, Khokha, Vladimir, Malbrain, Manu, Agnoletti, Vanni, Peitzman, Andrew, Demetrashvili, Zaza, Sugrue, Michael, Di Saverio, Salomone, Martzi, Ingo, Soreide, Kjetil, Biffl, Walter, Ferrada, Paula, Parry, Neil, Montravers, Philippe, Melotti, Rita Maria, Salvetti, Francesco, Valetti, Tino M., Scalea, Thoma, Chiara, Osvaldo, Cimbanassi, Stefania, Kashuk, Jeffry L., Larrea, Martha, Hernandez, Juan Alberto Martinez, Lin, Heng-Fu, Chirica, Mircea, Arvieux, Catherine, Bing, Camilla, Horer, Tal, De Simone, Belinda, Masiakos, Peter, Reva, Viktor, DeAngelis, Nicola, Kike, Kaoru, Balogh, Zsolt J., Fugazzola, Paola, Tomasoni, Matteo, Latifi, Rifat, Naidoo, Noel, Weber, Dieter, Handolin, Lauri, Inaba, Kenji, Hecker, Andrea, Kuo-Ching, Yuan, Ordoñez, Carlos A., Rizoli, Sandro, Gomes, Carlos Augusto, De Moya, Marc, Wani, Imtiaz, Mefire, Alain Chichom, Boffard, Ken, Napolitano, Lena, Catena, Fausto, Supporting clinical sciences, Intensive Care, II kirurgian klinikka, Clinicum, Department of Surgery, I kirurgian klinikka (Töölö), HUS Abdominal Center, and HUS Musculoskeletal and Plastic Surgery

Subjects
Fistula, Abdominal Wound Closure Techniques, Abdominal compartment syndrome, medicine.medical_treatment, SEVERE ACUTE-PANCREATITIS, Review, Guideline, 030230 surgery, Cardiovascular, Abdominal wall, Postoperative Complications, 0302 clinical medicine, ACELLULAR DERMAL MATRIX, Laparotomy, Abdomen, Open abdomen, NEGATIVE-PRESSURE THERAPY, Medicine(all), DAMAGE CONTROL SURGERY, Peritoniti, lcsh:Medical emergencies. Critical care. Intensive care. First aid, Abdominal Wound Closure Technique, Abdominal Cavity, VENTRAL HERNIA REPAIR, Prophylactic Surgical Procedures, 3. Good health, Vascular emergencie, medicine.anatomical_structure, Emergency Medicine, Technique, Re-exploration, ABDOMINAL COMPARTMENT SYNDROME, Intra-Abdominal Hypertension, ACUTE MESENTERIC ISCHEMIA, Human, medicine.medical_specialty, Physical Injury - Accidents and Adverse Effects, Closure, Resuscitation, PRIMARY FASCIAL CLOSURE, lcsh:Surgery, Non-trauma, Peritonitis, Guidelines as Topic, Reintervention, Guidelines, Trauma, Prophylactic Surgical Procedure, 03 medical and health sciences, LONG-TERM COMPLICATIONS, Intra-abdominal infection, Rare Diseases, Clinical Research, medicine, Humans, ddc:610, Timing, Intensive care medicine, Nutrition, Mesh, Pancreatiti, Laparostomy, business.industry, Synthetic, Vascular emergencies, 030208 emergency & critical care medicine, lcsh:RD1-811, lcsh:RC86-88.9, 3126 Surgery, anesthesiology, intensive care, radiology, Biological, medicine.disease, Pancreatitis, Negative-Pressure Wound Therapy, RANDOMIZED-CONTROLLED-TRIAL, Surgery, Postoperative Complication, business
Abstract

Damage control resuscitation may lead to postoperative intra-abdominal hypertension or abdominal compartment syndrome. These conditions may result in a vicious, self-perpetuating cycle leading to severe physiologic derangements and multiorgan failure unless interrupted by abdominal (surgical or other) decompression. Further, in some clinical situations, the abdomen cannot be closed due to the visceral edema, the inability to control the compelling source of infection or the necessity to re-explore (as a "planned second-look" laparotomy) or complete previously initiated damage control procedures or in cases of abdominal wall disruption. The open abdomen in trauma and non-trauma patients has been proposed to be effective in preventing or treating deranged physiology in patients with severe injuries or critical illness when no other perceived options exist. Its use, however, remains controversial as it is resource consuming and represents a non-anatomic situation with the potential for severe adverse effects. Its use, therefore, should only be considered in patients who would most benefit from it. Abdominal fascia-to-fascia closure should be done as soon as the patient can physiologically tolerate it. All precautions to minimize complications should be implemented.

Published
2018
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36. Splenic trauma: WSES classification and guidelines for adult and pediatric patients

Author

Sandro Rizoli, Vladimir Khokha, Andrew B. Peitzman, Luca Ansaloni, Giulia Montori, Emiliano Gamberini, Paola Fugazzola, Catherine Arvieux, Rao R. Ivatury, Frederick A. Moore, Bruno M. Pereira, Francesco Salvetti, Carlos Augusto Gomes, Joseph M. Galante, Fausto Catena, Matteo Tomasoni, Neil Parry, Hany Bahouth, Kenji Inaba, Tal M. Hörer, Michele Pisano, Yoram Kluger, Camilla Bing, Noel Naidoo, David Costa Navarro, Viktor Reva, Marco Ceresoli, Federico Coccolini, Ronald V. Maier, Paula Ferrada, Boris Sakakushev, Richard P. G. ten Broek, Joseph Kashuk, Simone Vasilij Benatti, Osvaldo Chiara, Ingo Marzi, Andrea Celotti, Kjetil Søreide, Yashuiro Otomo, Lauri Handolin, Ernest E. Moore, Andrew W. Kirkpatrick, Peter T. Masiakos, Antonio Costanzo, Leonardo Solaini, Ari Leppäniemi, Raul Coimbra, Massimo Sartelli, Dieter G. Weber, Rifat Latifi, Gustavo Pereira Fraga, Fikri M. Abu-Zidan, Stefania Cimbanassi, Alain Chichom Mefire, David A. Spain, Marc de Moya, Liban Wehlie, Vanni Agnoletti, Walter L. Biffl, George C. Velmahos, Miklosh Bala, Stefano Maccatrozzo, Salomone Di Saverio, Lena M. Napolitano, Kimberly A. Davis, Nicola De Angelis, Stefano Magnone, Konstantinos S. Mylonas, Coccolini, F, Montori, G, Catena, F, Kluger, Y, Biffl, W, Moore, E, Reva, V, Bing, C, Bala, M, Fugazzola, P, Bahouth, H, Marzi, I, Velmahos, G, Ivatury, R, Soreide, K, Horer, T, ten Broek, R, Pereira, B, Fraga, G, Inaba, K, Kashuk, J, Parry, N, Masiakos, P, Mylonas, K, Kirkpatrick, A, Abu-Zidan, F, Gomes, C, Benatti, S, Naidoo, N, Salvetti, F, Maccatrozzo, S, Agnoletti, V, Gamberini, E, Solaini, L, Costanzo, A, Celotti, A, Tomasoni, M, Khokha, V, Arvieux, C, Napolitano, L, Handolin, L, Pisano, M, Magnone, S, Spain, D, de Moya, M, Davis, K, De Angelis, N, Leppaniemi, A, Ferrada, P, Latifi, R, Navarro, D, Otomo, Y, Coimbra, R, Maier, R, Moore, F, Rizoli, S, Sakakushev, B, Galante, J, Chiara, O, Cimbanassi, S, Mefire, A, Weber, D, Ceresoli, M, Peitzman, A, Wehlie, L, Sartelli, M, Di Saverio, S, Ansaloni, L, and DIPARTIMENTO DI SCIENZE MEDICHE E CHIRURGICHE

Subjects
Adult, medicine.medical_specialty, Splenic trauma, medicine.medical_treatment, lcsh:Surgery, Classification, Conservative, Embolization, Guidelines, Non-operative, Pediatric, Spleen, Surgery, Trauma, Abdominal Injuries, Conservative Treatment, Hemodynamics, Humans, Wounds and Injuries, Guidelines as Topic, Computed tomography, Review, Guideline, Blunt splenic trauma, 03 medical and health sciences, 0302 clinical medicine, Emergency surgery, medicine, ddc:610, Intensive care medicine, Liver injury, medicine.diagnostic_test, business.industry, Optimal treatment, lcsh:Medical emergencies. Critical care. Intensive care. First aid, 030208 emergency & critical care medicine, lcsh:RD1-811, lcsh:RC86-88.9, medicine.disease, 3. Good health, 030220 oncology & carcinogenesis, Emergency Medicine, business, Pediatric trauma
Abstract

none 68 si Spleen injuries are among the most frequent trauma-related injuries. At present, they are classified according to the anatomy of the injury. The optimal treatment strategy, however, should keep into consideration the hemodynamic status, the anatomic derangement, and the associated injuries. The management of splenic trauma patients aims to restore the homeostasis and the normal physiopathology especially considering the modern tools for bleeding management. Thus, the management of splenic trauma should be ultimately multidisciplinary and based on the physiology of the patient, the anatomy of the injury, and the associated lesions. Lastly, as the management of adults and children must be different, children should always be treated in dedicated pediatric trauma centers. In fact, the vast majority of pediatric patients with blunt splenic trauma can be managed non-operatively. This paper presents the World Society of Emergency Surgery (WSES) classification of splenic trauma and the management guidelines. open Coccolini, Federico; Montori, G; Catena, F; Kluger, Y; Biffl, W; Moore, Ee; Reva, V; Bing, C; Bala, M; Fugazzola, P; Bahouth, H; Marzi, I; Velmahos, G; Ivatury, R; Soreide, K; Horer, T; Nullr, nullTen Broek; Pereira, Bm; Fraga, Gp; Inaba, K; Kashuk, J; Parry, N; Masiakos, Pt; Mylonas, Ks; Kirkpatrick, A; Abu zidan, F; Gomes, Ca; Benatti, Sv; Naidoo, N; Salvetti, F; Maccatrozzo, S; Agnoletti, V; Gamberini, E; Solaini, Leonardo; Costanzo, A; Celotti, A; Tomasoni, M; Khokha, V; Arvieux, C; Napolitano, L; Handolin, L; Pisano, M; Magnone, S; Spain, Da; Nullm, nullDe Moya; Davis, Ka; Nulln, nullDe Angelis; Leppaniemi, A; Ferrada, P; Latifi, R; Navarro, Dc; Otomo, Y; Coimbra, R; Maier, Rv; Moore, F; Rizoli, S; Sakakushev, B; Galante, Jm; Chiara, O; Cimbanassi, S; Mefire, Ac; Weber, D; Ceresoli, M; Peitzman, Ab; Wehlie, L; Sartelli, M; Nulls, nullDi Saverio; Ansaloni, L. Coccolini, Federico; Montori, G; Catena, F; Kluger, Y; Biffl, W; Moore, Ee; Reva, V; Bing, C; Bala, M; Fugazzola, P; Bahouth, H; Marzi, I; Velmahos, G; Ivatury, R; Soreide, K; Horer, T; Nullr, nullTen Broek; Pereira, Bm; Fraga, Gp; Inaba, K; Kashuk, J; Parry, N; Masiakos, Pt; Mylonas, Ks; Kirkpatrick, A; Abu zidan, F; Gomes, Ca; Benatti, Sv; Naidoo, N; Salvetti, F; Maccatrozzo, S; Agnoletti, V; Gamberini, E; Solaini, Leonardo; Costanzo, A; Celotti, A; Tomasoni, M; Khokha, V; Arvieux, C; Napolitano, L; Handolin, L; Pisano, M; Magnone, S; Spain, Da; Nullm, nullDe Moya; Davis, Ka; Nulln, nullDe Angelis; Leppaniemi, A; Ferrada, P; Latifi, R; Navarro, Dc; Otomo, Y; Coimbra, R; Maier, Rv; Moore, F; Rizoli, S; Sakakushev, B; Galante, Jm; Chiara, O; Cimbanassi, S; Mefire, Ac; Weber, D; Ceresoli, M; Peitzman, Ab; Wehlie, L; Sartelli, M; Nulls, nullDi Saverio; Ansaloni, L.

Published
2017

37. 2016 WSES guidelines on acute calculous cholecystitis

Author

Sanjay Gupta, Fausto Catena, Giuseppe Borzellino, Gustavo Pereira Fraga, Dario Piazzalunga, Pierluigi Viale, Cino Bendinelli, Rifat Latifi, Philip F. Stahel, Imtiaz Wani, Kurinchi Selvan Gurusamy, M. De Moya, Yoram Kluger, G. Camapanelli, Clay Cothren Burlew, Zsolt J. Balogh, V. Koka, Ari Leppäniemi, Luigi Bonavina, Ferdinando Agresta, Federico Coccolini, Walter L. Biffl, Monica Ceresoli, Francesco Brunetti, M. D. Kelly, Boris Sakakushev, I. Bailey, Jeffry L. Kashuk, Rao R. Ivatury, Ian Civil, H. Jeekel, R. V. Maier, Gregorio Tugnoli, Luca Ansaloni, Fabio Cesare Campanile, Osvaldo Chiara, S. Uraneus, Massimo Sartelli, George C. Velmahos, A. B. Peitzmann, Michael Sugrue, Raul Coimbra, S. Di Saverio, Abe Fingerhut, Ernest E. Moore, Thomas M. Scalea, Korhan Taviloğlu, Ingo Marzi, Andrea Allegri, M. Pisano, F. A. Moore, Dieter G. Weber, Ansaloni, L, Pisano, M, Coccolini, F, Peitzmann, A, Fingerhut, A, Catena, F, Agresta, F, Allegri, A, Bailey, I, Balogh, Z, Bendinelli, C, Biffl, W, Bonavina, L, Borzellino, G, Brunetti, F, Burlew, C, Camapanelli, G, Campanile, F, Ceresoli, M, Chiara, O, Civil, I, Coimbra, R, De Moya, M, Di Saverio, S, Fraga, G, Gupta, S, Kashuk, J, Kelly, M, Koka, V, Jeekel, H, Latifi, R, Leppaniemi, A, Maier, R, Marzi, I, Moore, F, Piazzalunga, D, Sakakushev, B, Sartelli, M, Scalea, T, Stahel, P, Taviloglu, K, Tugnoli, G, Uraneus, S, Velmahos, G, Wani, I, Weber, D, Viale, P, Sugrue, M, Ivatury, R, Kluger, Y, Gurusamy, K, Moore, E, and Neurosciences

Subjects
medicine.medical_specialty, Biliary tree stone, 030230 surgery, 03 medical and health sciences, 0302 clinical medicine, Diagnosis, medicine, Cholecystectomy, ddc:610, Biliary tree stones, Abdominal infections, Acute calcolous cholecystitis, Antibiotic, Endoscopic ultrasound, Gallbladder percutaneous drainage, Magnetic resonance, Surgical risk, business.industry, General surgery, Gastroenterology, Abdominal infection, Acute calcolous cholecystiti, medicine.disease, Dermatology, 3. Good health, Cholecystitis, Emergency Medicine, 030211 gastroenterology & hepatology, Surgery, business, Diagnosi
Abstract

Acute calculus cholecystitis 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.

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38. Defining the acute care surgeon: American Association for the Surgery of Trauma (AAST) panel discussion on full-time employment, compensation and career trajectory.

Author

Murphy PB, Nahmias J, Bonne S, Coleman J, and de Moya M

Abstract

Since its inception, the specialty of acute care surgery has evolved and now represents a field with a broad clinical scope and large variations in implementation and practice. These variations produce unique challenges and there is no consistent definition of the scope, intensity or value of the work performed by acute care surgeons. This lack of clarity regarding expectations extends to surgeons and non-surgeons outside of our specialty, compounding difficulties in advocacy at the local, regional and national levels. Coupled with a lack of clarity surrounding the definition of full-time employment, these challenges have prompted surgeons to develop initiatives within acute care surgery in collaboration with the American Association for the Surgery of Trauma (AAST). A panel session at the AAST 2023 annual meeting was held to discuss the need to define a full-time equivalent for an acute care surgeon and how to consider and incorporate non-clinical responsibilities. Experiences, perspectives and propositions for change were discussed and are presented here., Competing Interests: None declared., (Copyright © Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Published
2024
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39. Suppressing upregulation of fibrinogen after polytrauma mitigates thrombosis in mice.

Author

Seadler MS, Ferraresso F, Bansal M, Haugen A, Hayssen WG, Flick MJ, de Moya M, Dyer MR, and Kastrup CJ

Abstract

Background: Polytrauma results in systemic inflammation and increased circulating fibrinogen, which increases the risk of microvascular and macrovascular thrombosis that contributes to secondary organ damage and venous thromboembolism (VTE). There are no clinically approved agents to prevent hyperfibrinogenemia after polytrauma. We hypothesized that preventing the increase in fibrinogen levels after polytrauma would suppress thrombosis., Methods: Small-interfering ribonucleic acid (siRNA) against fibrinogen was encapsulated in lipid nanoparticles (siFibrinogen). Mice underwent a model of polytrauma and were then given varying doses of siFibrinogen, control siRNA, or no treatment. Fibrinogen was measured for 1 week via enxyme-linked immunosorbent assay (ELISA). To model postinjury VTE, the inferior vena cava was ligated 2 days after polytrauma in a portion of the mice. Thrombus weight was measured 48 hours after the inferior vena cava was ligated., Results: Treatment with siFibrinogen prevented hyperfibrinogenemia after trauma without exacerbating the hypofibrinogenemic state that occurs in the acute injury period (1 hour). In treated groups, fibrinogen was significantly lower from 6 hours postinjury through the 7-day monitoring period. Maximal fibrinogen reduction was observed at 72 hours. Here, mice that received 2.0 mg/kg of siFibrinogen had 1% of normal values relative to untreated mice, and mice that received 1.0 or 0.5 mg/kg had 4%. Mice treated with siFibrinogen that underwent the postinjury VTE model had significantly reduced thrombus weight compared with control siRNA-treated animals. More notably, among all siFibrinogen treated mice, 12 of 18 were completely protected from thrombosis, compared with 0 of 9 displaying protection in the control group., Conclusion: The rise of fibrinogen and the size of thrombi after polytrauma can be mitigated via the administration of siRNA against fibrinogen. siFibrinogen represents a promising novel target for VTE prophylaxis posttrauma., (Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.)

Published
2024
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40. Mapping Milwaukee's Blueprint for Peace: Evaluating the Geospatial Reach of a Cure Violence Implementation, 414LIFE.

Author

Brandolino A, deRoon-Cassini TA, Nguyen P, Mann R, Timmer-Murillo S, de Moya M, Karam B, Schramm A, Moore R, Williams K, Pilarski A, McIntosh B, and Milia DJ

Subjects
Humans, Wisconsin, Male, Cross-Sectional Studies, Female, Adult, Gun Violence, Adolescent, Wounds, Gunshot, Residence Characteristics, Program Evaluation
Abstract

Background: Cure Violence interruption programs are evidence-based interventions aimed at reducing the transmission of gun violence and its related injuries. Assessing the implementation of these programs can include the metric of "reach." This study evaluated one such program - 414LIFE - in Milwaukee, Wisconsin. The evaluation reconceptualized "reach" as a metric for reaching the individuals and neighborhoods at greatest risk for gun violence., Methods: 414LIFE's reach was analyzed descriptively and geospatially through its program evaluation dataset from May 2019 through September 2020 using a cross-sectional design. Program referral criteria includes patients who sustained a gunshot wound, are less than 36 years old, and a resident of, or injured in, the city of Milwaukee. A choropleth map visualized location of participants' residence, which justified a global Moran's I, and then a local Moran's I calculation to identify statistically significant clustering of referrals., Results: In the first 1.5 years of the program's partnership with the local level I trauma center and affiliated academic medical institution, 398 patients were referred. Three hundred referrals (75.4%) met program criteria; 53.8% were Black men. Statistically significant clusters were identified and mapped. Half of the top 10 neighborhoods with referrals were the city's identified priority neighborhoods., Conclusions: 414LIFE successfully reaches its intended population and geographic locations. Geospatial reach should be considered routinely in program evaluations of Cure Violence programs to track growth and reach over time., (Copyright© Board of Regents of the University of Wisconsin System and The Medical College of Wisconsin, Inc.)

Published
2024

42. siRNA-mediated reduction of a circulating protein in swine using lipid nanoparticles.

Author

Cau MF, Ferraresso F, Seadler M, Badior K, Zhang Y, Ketelboeter LM, Rodriguez GG, Chen T, Ferraresso M, Wietrzny A, Robertson M, Haugen A, Cullis PR, de Moya M, Dyer M, and Kastrup CJ

Abstract

Genetic manipulation of animal models is a fundamental research tool in biology and medicine but is challenging in large animals. In rodents, models can be readily developed by knocking out genes in embryonic stem cells or by knocking down genes through in vivo delivery of nucleic acids. Swine are a preferred animal model for studying the cardiovascular and immune systems, but there are limited strategies for genetic manipulation. Lipid nanoparticles (LNPs) efficiently deliver small interfering RNA (siRNA) to knock down circulating proteins, but swine are sensitive to LNP-induced complement activation-related pseudoallergy (CARPA). We hypothesized that appropriately administering optimized siRNA-LNPs could knock down circulating levels of plasminogen, a blood protein synthesized in the liver. siRNA-LNPs against plasminogen (siPLG) reduced plasma plasminogen protein and hepatic plasminogen mRNA levels to below 5% of baseline values. Functional assays showed that reducing plasminogen levels modulated systemic blood coagulation. Clinical signs of CARPA were not observed, and occasional mild and transient hepatotoxicity was present in siPLG-treated animals at 5 h post-infusion, which returned to baseline by 7 days. These findings advance siRNA-LNPs in swine models, enabling genetic engineering of blood and hepatic proteins, which can likely expand to proteins in other tissues in the future., Competing Interests: C.J.K., P.R.C., and K.B. are directors, shareholders, and/or co-founders of companies developing RNA therapies. C.J.K., P.R.C., F.F., and K.B. have filed intellectual property on RNA-based therapies with the intention of commercializing these inventions., (© 2024 The Author(s).)

Published
2024
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45. Adult blunt hepatic injury: A Western Trauma Association critical decisions algorithm.

Author

Keric N, Shatz DV, Schellenberg M, de Moya M, Moore LJ, Brown CVR, Hartwell JL, Inaba K, Ley EJ, Peck KA, Fox CJ, Rosen NG, Weinberg JA, Coimbra R, Kozar R, and Martin MJ

Subjects
Adult, Humans, Algorithms, Retrospective Studies, Injury Severity Score, Liver injuries, Wounds, Nonpenetrating complications, Wounds, Nonpenetrating diagnosis, Wounds, Nonpenetrating therapy
Published
2024
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46. Mechanical Ventilation Does Not Predict Pneumothorax Observation Failure in the Severely Injured.

Author

Pokrzywa CJ, Figueroa J, Gomez J, Karam B, Murphy P, Iverson K, Morris R, Carver T, Milia D, and de Moya M

Subjects
Adult, Humans, Respiration, Artificial, Retrospective Studies, Chest Tubes adverse effects, Lung, Thoracostomy methods, Pneumothorax diagnostic imaging, Pneumothorax etiology, Pneumothorax therapy, Thoracic Injuries complications
Abstract

Background: Observative management of small traumatic pneumothoraces (PTX) has been shown to decrease chest tube utilization in non-mechanically ventilated patients without compromising outcomes. This approach could be used in mechanically ventilated (MV) patients, though many feel these patients are at increased risk of observation failure., Methods: A single center retrospective study of all adults undergoing observation of a computed tomography (CT) diagnosed PTX from 2015-2019. Patients with chest tube placement within 4-hours of arrival, concurrent hemothorax, or death within 24-hours were excluded. Observation failure was defined as chest tube placement., Results: Of 340 patients, 64 were on MV. The groups were of similar age, BMI, underlying pulmonary comorbidities, and PTX size (10.1 mm vs 8.8 mm, P = .20). The MV group was more severely injured (ISS [25+] [60.9% vs 11.2%, P < .001]). There was no difference in observation failure rates by MV status overall (6.3% vs 5.1%, P = .75) or by PTX size (<15 mm [5% vs 2.2%, P = .37], <20 mm [4.8% vs 3.1%, P = .45], <25 mm [4.8% vs 4.1%, P = .73], <30 mm [4.8% vs 4.1%, P = .73], <35 mm [4.8% vs 4.7%, P = 1.00]). MV was not an independent predictor of observation failure on multivariable analysis (OR .64, 95% CI .18-2.20), though PTX size was (OR 1.11, 95% CI 1.05-1.17). When comparing those who failed vs those who did not, the only difference was PTX size (9.34 mm vs 19.41 mm, P < .001)., Conclusion: MV is not an independent predictor of PTX observation failure. While PTX size appears to play a role, further studies are needed to outline safe parameters for observation in those undergoing MV., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Published
2023
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47. Early career acute care surgeons' priorities and perspectives: A mixed-methods analysis to better understand full-time employment.

Author

Murphy PB, Coleman J, Maring M, Pokrzywa C, Deshpande D, Al Tannir AH, Biesboer EA, Morris RS, Figueroa J, and de Moya M

Subjects
Humans, Employment, Surveys and Questionnaires, Workload, Personnel Staffing and Scheduling, Career Choice, Surgeons
Abstract

Background: Understanding the expectations of early career acute care surgeons will help clarify the practice and employment models that will attract and retain high-quality surgeons, thereby sustaining our workforce. This study aimed to outline the clinical and academic preferences and priorities of early career acute care surgeons and to better define full-time employment., Methods: A survey on clinical responsibilities, employment preferences, work priorities, and compensation was distributed to early career acute care surgeons in the first 5 years of practice. A subset of agreeable respondents underwent virtual semistructured interviews. Both quantitative and thematic analysis were used to describe current responsibilities, expectations, and perspectives., Results: Of 471 surgeons, 167 responded (35%), the majority of whom were assistant professors within the first 3 years of practice (80%). The median desired clinical volume was 24 clinical weeks and 48 call shifts per year, 4 weeks less than their median current clinical volume. Most respondents (61%) preferred a service-based model. The top priorities cited in choosing a job were geography, work schedule, and compensation. Qualitative interviews identified themes related to defining full-time employment, first job expectations and realities, and the often-misaligned system and surgeon., Conclusion: Understanding the perspectives of early career surgeons entering the workforce is important particularly in the field of acute care surgery where no standard workload or practice model exists. The wide variety of expectations, practice models, and schedule preferences may lead to a mismatch between surgeon desires and employment expectation. Consistent employment standards across our specialty would provide a framework for sustainability., Level of Evidence: Prognostic and Epidemiological; Level III., (Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.)

Published
2023
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48. Correction: ECLAPTE: Effective Closure of LAParoTomy in Emergency-2023 World Society of Emergency Surgery guidelines for the closure of laparotomy in emergency settings.

Author

Frassini S, Cobianchi L, Fugazzola P, Biffl WL, Coccolini F, Damaskos D, Moore EE, Kluger Y, Ceresoli M, Coimbra R, Davies J, Kirkpatrick A, Di Carlo I, Hardcastle TC, Isik A, Chiarugi M, Gurusamy K, Maier RV, Segovia Lohse HA, Jeekel H, Boermeester MA, Abu-Zidan F, Inaba K, Weber DG, Augustin G, Bonavina L, Velmahos G, Sartelli M, Di Saverio S, Ten Broek RPG, Granieri S, Dal Mas F, Farè CN, Peverada J, Zanghì S, Viganò J, Tomasoni M, Dominioni T, Cicuttin E, Hecker A, Tebala GD, Galante JM, Wani I, Khokha V, Sugrue M, Scalea TM, Tan E, Malangoni MA, Pararas N, Podda M, De Simone B, Ivatury R, Cui Y, Kashuk J, Peitzman A, Kim F, Pikoulis E, Sganga G, Chiara O, Kelly MD, Marzi I, Picetti E, Agnoletti V, De'Angelis N, Campanelli G, de Moya M, Litvin A, Martínez-Pérez A, Sall I, Rizoli S, Tomadze G, Sakakushev B, Stahel PF, Civil I, Shelat V, Costa D, Chichom-Mefire A, Latifi R, Chirica M, Amico F, Pardhan A, Seenarain V, Boyapati N, Hatz B, Ackermann T, Abeyasundara S, Fenton L, Plani F, Sarvepalli R, Rouhbakhshfar O, Caleo P, Ho-Ching Yau V, Clement K, Christou E, Castillo AMG, Gosal PKS, Balasubramaniam S, Hsu J, Banphawatanarak K, Pisano M, Toro A, Michele A, Cioffi SPB, Spota A, Catena F, and Ansaloni L

Published
2023
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50. Pediatric emergency resuscitative thoracotomy: A Western Trauma Association, Pediatric Trauma Society, and Eastern Association for the Surgery of Trauma collaborative critical decisions algorithm.

Author

Martin MJ, Brasel KJ, Brown CVR, Hartwell JL, de Moya M, Inaba K, Ley EJ, Moore EE, Peck KA, Rizzo AG, Rosen NG, Weinberg JA, Coimbra R, Crandall M, Mukherjee K, Ignacio R, Longshore S, Flynn-O'Brien KT, Ng G, Selesner L, and Jafri M

Subjects
Humans, Child, Thoracotomy, Emergency Service, Hospital, Retrospective Studies, Resuscitation, Algorithms, Wounds, Penetrating surgery, Wounds, Nonpenetrating surgery
Abstract

Level of Evidence: Literature synthesis and expert opinion, Level V., (Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.)

Published
2023
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