18 results on '"Gomez-Rosado JC"'
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2. Evaluation of appendicitis risk prediction models in adults with suspected appendicitis
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Nepogodiev, D., Matthews, J. H., Morley, G. L., Naumann, D. N., Ball, A., Chauhan, P., Bhanderi, S., Mohamed, I., Glasbey, J. C., Wilkin, R. J. W., Drake, T. M., Clements, J., Blencowe, N. S., Herrod, P. J. J., Pata, F., Frasson, M., Blanco-Colino, R., Soares, A. S., Nepogodiev D, Bhangu A., Matthews, Jh, Morley, Gl, Naumann, Dn, Ball, A, Chauhan, P, Bhanderi, S, Mohamed, I, Glasbey, Jc, Wilkin, R, Drake, Tm, Clements, J, Blencowe, Ns, Herrod, P, Pata, F, Frasson, M, Blanco-Colino, R, Soares, As, Bhangu, A, Nepogodiev, D, Jain, S, Amuthalingam, T, Tyler, R, Griffiths, Ea, Pinkney, Td, Gee, O, Morton, Dg, Beggs, A, Beral, D, Bowley, D, Cruickshank, N, Daniels, I, Griffiths, E, Hornby, St, Lund, Jn, Marriott, P, Singh, P, Smart, Nj, Speake, D, Thompson, C, Torkington, J, Torrance, A, Vohra, R, Warren, O, Winter, Dc, Pellino, G, Sgrò, A, Simioni, A, Farina, V, Podda, M, Di Saverio, S, Birindelli, A, Pasquali, S, Itsurg, Surg, Pt, Bolton, W, Bradshaw, Cj, Chean, Cs, Harris, G, Haddow, Jb, Jamieson, Nb, Mccain, S, Mason, J, Milgrom, D, Nana, Gr, Mohamed, Mn, Brien, Jo, Pearce, J, Rabie, M, Sahnan, K, Sarmah, P, Skerritt, C, Ghazanfar, Ma, Sreedharan, L, Kabwama, S, Gray, Rt, Kamande, Iw, Nazarian, S, Dar, Fa, Misky, At, Arunachalam, S, Twum-Barima, Cs, Mohamed, Im, Connor, Kl, Coe, Po, Kosti, A, Elshaer, M, Colvin, Da, Charalambous, Mp, Yeung, K, Merker, L, Morrison, T, Thaventhiran, Aj, Gilbert, Tm, Clements, Jm, Hicks, G, Afshar, S, Mckinley, Nc, Assaf, N, Hanna, T, Macinnes, E, Thavanesan, N, Dubois, As, Palani-Velu, Lk, Tezas, S, Yow, L, Radwan, Rw, Abdelrahman, M, Lee, Ka, Zarka, Za, Mcdowall, Na, Tan, Cy, Venn, Ml, Ashmore, Dl, Whitehorn, Se, Golder, Am, Reddy, A, Delimpalta, C, Kay, Oh, Shah, Sm, Eiben, I, Doyle, C, Tudyka, V, Issa, E, West, H, Brewer, Hk, Farrow, Ez, Taylor, Ns, Smart, Cj, Griffiths, Np, Halkias, C, Vitish-Sharma, P, Knight, Sr, Mowbray, Ng, Olivier, Jb, Lee, Kj, Clement, Kd, Chrastek, D, Panda, N, Connor, Mj, Fahmy, Se, Bryan, Es, Ngu, Ws, Adegbola, So, Vaughan, Em, Stupalkowska, W, Simmonds, L, Malik, A, Hussein, A, Karim, Mj, Singhal, T, Ormiston, R, Kung, V, Rabie, Ma, Park, Jh, Lal, N, Worku, D, D'Auria, M, Ang, A, Orizu, M, Gammeri, E, Clough, E, Choy, Ch, Lawday, S, Hann, Aj, Robinson, D, Wardle, Bg, Mcdonnell, D, Rutherford, Dg, Hickey, Lm, Garg, Ag, Rezvani, S, Bell, Cr, Mahmood, F, Rehman, S, Donaldson, G, Peleki, A, Pearce, L, Sharp, Ol, Singh, S, Thompson, Db, El-Tayar, O, Hollyman, M, Rupasinghe, Sn, Toomey, Db, Murray, Mp, Amtul, N, Mersh, Rj, Newton, Rc, Al-Khyatt, W, Stephens, Gf, Abbas, Sh, Iqbal, Mr, Brown, Ce, Renshaw, S, Hureibi, Ka, Pullabatla-Venkata, Up, Donohoe, No, Myatt, A, Egan, Rj, Rangarajan, K, Trail, M, Mckay, Sc, Engall, N, Jerome, E, Townsend, Dc, Patel, By, Pronin, S, Chandratreya, N, Choong, Jh, Mohamed, Tm, Hudson-Peacock, Nj, Manson, R, Hebbar, K, Mothe, Bs, Weegenaar, Cr, Saad, M, Bowman, Cr, Serventi, F, Fleres, F, Foppa, C, Pata, G, Baronio, G, Pertile, D, Lucchi, A, Sagnotta, A, Maretto, I, Campagnaro, T, Gatti, M, Gjoni, E, Roscio, F, Inama, M, Coccolini, F, Colombo, F, Avanzolini, A, Aresu, S, De-Manzoni-Garberini, A, Merlini, Da, Chessa, A, Tamini, N, Mulas, S, Cillara, N, Coletta, D, Atzeni, J, Erdas, E, Gallo, G, Francone, E, Di Gioia, P, Bianchi, Cl, Ferrara, F, Biancafarina, A, Scabini, S, Marano, L, Miegge, A, Sasia, D, Savino, G, Scatizzi, M, D'Amico, Fe, Arcuri, Ga, Gavagna, L, Salamone, G, Tatulli, F, Goldin, E, Matos, Ml, Caldeira, Ab, Romano, J, Pereira, J, Azevedo, J, Azevedo, Jm, Simoes, J, Silva, A, O'Leary, Dp, Kennedy, Nd, Quinn, Em, Zhang, Ay, Neary, Pm, De-Marchi, Ja, O'Connor, Br, Wijesundera, K, Foley, Nm, Wong, J, Tiedt, La, Bolger, Jc, Connelly, Tm, Ahmed, Os, Vigorita, V, García, V, Arredondo, J, Redondo, E, Sainz, B, Aldrey, I, Landaluce-Olavarria, A, Gómez, Aa, Cordoba, E, Sánchez-Fuentes, Mn, Cerdán-Santacruz, C, Beltran-De-Heredia, J, García, M, Veres, T, García-Novoa, A, Abellán, Am, García-Catalá, L, Ruiz-Marín, M, Menendez, P, Roldán-Ortiz, S, Navas-Cuéllar, Ja, Sabia, D, Gomez-Rosado, Jc, Navidad, Ms, Caula, C, Sanchez, Er, Espin-Basany, E, Fernández-Martínez, D, Bravo-Gutiérrez, Af, Payá-Llorente, C, Dujovne, P, Lima, F, Soria-Aledo, V, Gomez, Cj, Pascual-Miguelañez, I, Muinelo, M, Alvarez, Cm, Vargas-Pierola, Hj, Vallve-Bernal, M, Hidalgo-Rosas, Jm, Arenal-Vera, Jj, Sena-Ruiz, F, Sanchez-Guillen, L, Villarejo-Campos, P, Tallon-Aguilar, L, Garcea, A, Bennett, Jm, Whittaker, L, Gidwani, Al, Byrnes, Ck, Saunders, S, Shiwani, Mh, Ashraf, N, Venkatasubramaniam, Ak, Bevan, Ke, Mcarthur, D, Mustafa, Ak, Griffith, Jp, Blazeby, Jm, Charalabopoulos, A, Campbell, W, Reese, G, Warren, Oj, Peacock, M, Menzies, D, Jenner, D, Eardley, Nj, Yoong, S, Abulafi, M, Avalapati, H, Thompson, R, Nastro, P, Kochupapy, R, Stubbs, Bm, Mcintyre, R, Crozier, J, Patel, Pk, Pento, V, Beasley, Wd, Roxburgh, C, Youssef, H, Alexander, R, Denley, S, Di Franco, F, Quddus, A, Saha, A, Hunter, I, Hannay, J, Velchuru, Vr, Bond-Smith, G, Salama, Y, Bhargava, A, Panagiotopoulos, Sp, Watson, N, Garcea, G, Boddy, Ap, Dunning, Pg, Lloyd, G, Gurjar, Sv, Hill, J, Andrews, B, Singh, A, Ruzvidzo, F, Shingler, G, Mahon, D, Elgaddal, S, Payne, Cj, Shaikh, Ia, Dalmia, S, Nair, Ms, Finch, Jg, Chapple, Ks, Bawa, S, Watfah, J, Carden, Ca, Makhija, R, Rao, M, Sarveswaran, J, Vijay, V, Rekhraj, S, Knight, B, Siddiqui, Mn, Sebastian, Jf, Glen, P, Vakis, S, Ebied, H, Rajaram, R, Gray, J, Mcgrath, D, Faulkner, G, Gopalswamy, S, Varcada, M, Woodward, A, Williams, Gl, Szentpali, K, Ravindran, R, Bronder, C, Thaha, Ma, Rate, A, Shetty, Vd, Rao, V, Sajid, Ms, Clements, B, Patel, Rt, Mason, C, Branagan, G, Maude, K, Kaur, G, Lyons, A, Ainsworth, P, Hagger, R, Zadi, Az, Maslekar, Su, Kinross, J, Irukulla, S, Hawkins, W, Wheatstone, S, Magro, T, Bailey, S, Marshall, G, Mccullough, J, Marangoni, G, Leung, El, Borg, Cm, Gopinath, S, Kirkby-Bott, J, Yalamarthi, S, Mirza, S, Brett, M, Ramcharan, S, Pandey, V, Thava, B, Andreani, Sm, Sahay, Sj, Aravind, B, Downey, M, Nicol, D, Whitehouse, P, Sharma, A, Francis, N, Chitsabesan, P, Stewart, Dj, Norcia, Gg, Cucinotta, E, Cianchi, F, Romario, Uf, Taglietti, L, Capelli, P, Garulli, G, Parisi, A, Nitti, D, Guglielmi, A, Alonzo, A, Scandroglio, Is, Moretto, G, Ansaloni, L, Pietrabissa, A, Foschi, D, Vettoretto, N, Ercolani, G, Coppola, M, Colangelo, E, Morandi, E, Niolu, P, Pala, M, Coletti, M, Pisanu, A, Nicolosi, A, Sammarco, G, Berti, S, Soliani, P, Tonini, V, Stella, M, Ceccarelli, G, De Nisco, C, Castagnoli, G, De Nardi, P, Borghi, F, Agresta, F, Benevento, A, Cantafio, S, Cesari, Mc, Rubbini, M, Chetta, G, De Marchi, F, Nora, Mf, Sousa, Hs, Nascimento, Ca, Casimiro, C, Costa, Sd, Rosa, Mj, Carvalho, N, Correia, J, Gomes, Ap, Hill, Ad, Walsh, Tn, Aremu, Ma, Mulsow, J, El-Masry, S, Gillick, J, Garvin, J, Caldwell, M, Mehigan, B, Peirce, Cb, Cooke, F, Mealy, K, Ruano, A, Ais, G, Fueyo, J, Parajó, Ae, Bernal-Sprekelsen, Jc, Monzón-Abad, Ja, Blanco, F, Arroyo, A, Bazán-Hinojo, Mc, Ramos-Bernado, Mi, Lopez-Ruiz, Ja, Golda, T, Julià, D, Cuadrado, Mm, Gómez-Abril, Sa, Martinez, J, Aguayo, Jl, Millan, M, Alvarez-Gallego, M, Muinelo-Lorenzo, M, Parra, Jm, Muñoz-Muñoz, E, De Chaves-Rodríguez PG, Cánovas-Moreno, G, Rodriguez-Lopez, M, Segura-Sampedro, Jj, García-Granero, A, Redondo-Calvo, Fj, Dyson, S, Thakur, D, Swords, C, Siaw, O, Zelazek, M, Woo, R, Badran, A, Aruparayil, N, Christopoulos, P, Chambers, B, O'Neill, N, Long, Rh, Mccaughey, P, Wong, Ml, Mccain, Rs, Lennox-Warburton, Hc, Moore, C, Manektella, Km, Mcilwaine, S, Rupani, S, Simpson, Dj, Wauchope, J, Ng, M, Christian, L, Crone, A, Sacks, R, Symons, N, Lazzaro, A, Patil, Sd, Roomi, S, Silva, I, Hodgson, Jm, Ly, C, Froud, H, Patel, H, Cay, P, Karwal, Rs, Danquah-Boateng, D, Berry, B, Esmail, Hd, Maripi, H, Bilku, D, Mckelvie, Ma, Miller, K, Maina, A, Velho, R, Hasan, R, Clingan, R, Jah, S, Waite, K, Jones, A, Buckley-Jones, S, Lecky-Thompson, L, Saghir, N, Mansoor, S, Mistry, D, Brown, R, Wong, A, Gurung, S, Wensley, F, Fleming, Ta, Griggs, R, Haines, S, Bedoya, S, Beverstock, A, Johnson, J, Govind, G, Niaz, O, Dyal, A, Tokidis, E, Punj, S, Leusink, A, Rudland, I, Kelly, M, Morgan, R, Al-Musawi, S, Lek, C, Gilbert, A, Gosal, A, Mahoney, R, Parwaiz, I, Mitchard, Mj, Ribeiro, B, Merai, H, Dean, Ea, Khan, S, Baginski, A, Mann, C, Foers, W, Jones, L, Woodward, B, Mcwhirter, Dm, Thomas, At, Gilbert, Tg, Weatherburn, Lw, Pilkington, Jp, Cameron, Fc, Clements, Jd, Mccann, C, Davidson, S, Hackney, L, Clements, Js, Martin, A, Du, Dt, Shakoor, Z, Yen, Sk, Adnan, M, Ranathunga, S, Sana, S, Tay, Yh, Chin, My, Gillespie, M, Brown, Ag, Campbell, U, Chatzikonstantinou, M, Mahendran, B, Flack, T, Chowdhary, M, Lim, Jm, Whiteman, E, Shepherd, Ja, Pedder, A, Siggens, Kl, Lai, Cw, Morrison-Jones, V, Hayat, Z, Nehikhare, I, Macleod, C, Quinn, Hc, Brown, A, Neagle, G, Chok, Sm, Carrano, Fm, Abbassi, Oa, Divekar, Ga, Halmer, S, Adams, Re, Davies, Pl, Wong, Sy, Amarasinghe, R, Tague, Le, Jones, E, Singh, J, Boza, K, Kelly, Sd, Morrison, F, Chan, Wh, Wilson, Ej, Awokoya, Oo, Griffiths, Sn, Kirkham, En, Cotton, Ae, Adimonye, A, Leighton, Pa, Abdelrahman, A, Cartwright, H, Gates, Z, Miguras, M, Khan, K, Louw, C, Grove, T, Badenoch, T, Mckeon, J, Wood, Cs, Leitch, Rp, Sgardelis, P, Perera, Mi, Nagarajan, D, Malam, Y, Theodoropoulou, K, Rajagopal, S, Kaptanis, S, Popova, D, Olagbaiye, O, Tayeh, S, Rigby, S, Harris, Mp, Ren, Kz, Liaw, G, Zhou, S, White, F, Marshall, Cm, Mitchell, Jh, Anderson, Dj, Kanakala, V, Hollingsworth, A, Paramasevon, Kr, Milward, J, Ahmed, S, Fanibi, Bf, Ferguson, N, Dickson, Ea, Shaw, Av, Dixon, F, Morrish, S, Dandy, R, Fooks, P, Sharma, P, Islam, N, Tabain, V, Keegan, R, Ahel, J, Alhammali, T, Graveston, J, Balai, Ej, Rothnie, K, Pankin, Gp, Eiben, Ie, Jackson, Nj, Dhar, M, Nash, D, Dharamavaram, S, Seth, M, Chowdhury, F, Rezacova, M, Seneviratne, N, Turner, Ej, Currow, C, Isherwood, Jd, Hobson, Bm, Lui, Dh, Rodger, V, Ting, N, Photiou, D, Taze, D, Lodhia, S, Earnshaw, L, Kumar, K, Neale, A, Bastianpillai, J, Cipparrone, M, Barrie, A, Nash, Z, Anandan, L, Tailor, K, Vinnicombe, Z, Krivan, S, Kuo, R, Giorga, A, Habib, H, Malik, K, Bogdan, M, Mahon-Daly, Fp, Athersmith, Mj, Strange, Ja, Wheeler, C, Summerfield, L, Khaw, Ra, Ashour, O, Iosif, E, Fadel, M, Gopalakrishnan, K, Orme, N, Williams, S, Rashid, M, Sultana, A, Patel, N, Pearson, R, Yasin, T, Bevan, V, Al-Sarireh, B, Brown, M, Mohd, N, Howie, Ee, Poudevigne, M, Paget, C, Rallage, H, Chui, K, Fawzi, F, Layman, S, Okorocha, E, Jama, Gm, Orawiec, P, Kouli, O, Hassane, A, Kilkenny, J, Devine, Aa, Laurenson, M, Slezak, I, Barker, T, Lau, E, Limbada, M, O'Brien, J, Weaver, J, Hajibandeh, S, Shah, J, Mansour, Mm, Malik, Sn, Davis, S, Trew, F, Bandyopadhyay, Sk, Dart, K, Guru-Naidu, S, Callan, R, Nair, Mk, Alani, M, Sezen, E, Salim, S, Shurlock, J, Siddique, K, Forouzanfar, A, Brews, R, Acharya, A, Jain, A, Tozer, Pj, Warusavitarne, J, Emslie, Km, Collier-Wakefield, O, Sivaloganathan, P, Dobson, C, Elseedawy, M, Mcnally, L, Williams, M, Motiwala, Fh, Choi, S, Asmadi, Aa, Burnside, D, Everden, A, Suriyakumar, S, Sandu, L, Kent, Da, Bowen, J, Long, P, Khair, A, Shah, K, Phelan, L, Pierre, R, Dhari, Aa, Hoff, M, Nickson, S, Setshwaelo, T, Chalk, A, Parkola, Mj, Harlinska, A, Chan, T, Dudek, Jg, Rolph, R, Allen, M, Pollard, H, Gormely, R, Finlayson, H, Ljungqvist, G, Peponis, C, Rahman, M, Dhesi, S, Arshad, F, Faris, Ar, Sooriyamoorthy, T, Springate, El, Barnieh, W, Patel, As, Siddiqui, Za, Chishti, Ia, Ayube-Brown, J, Rabie, Mr, Blake, L, Yardimci, E, Nagendram, S, Neophytou, Gi, Henderson, L, Farhan-Alanie, M, Kong, Cy, Ghazala, R, Evans, J, Hussain, N, Kabir, M, Hraishawi, I, Cox, M, Bailey, Ja, Muhibullah, N, Yanni, F, Stevenson, R, Nair, A, Murphy, C, Mcgucken, O, Pandya, R, Bowerman, H, Lafaurie, G, Van Boxel GI, Shanmugarajah, K, Maragouthakis, D, Hanif, Z, Evans, Jd, Yoganathan, S, Richardson, Td, Cook, V, Clark, Gl, Rigney, B, O'Neill, E, Guliani, J, Chan, D, Harper, F, Sian, T, Boereboom, C, Blackwell, J, Hardy, E, Boyd-Carson, H, Couch, Dg, Barter, Ca, Thoukididou, Sn, Hatt, Jr, Jones, Cs, Dean, S, Rajaretnam, N, Masood, M, Thakral, N, Griffith, D, Doherty, C, Longshaw, A, Peprah, D, Mathew, G, Hook, A, Vance-Daniel, J, Ibrahim, Y, Walters, Kj, Whewell, He, Sherif, Ma, Mckenna, M, O'Sullivan, D, Woodrow, C, Gill, S, Johnstone, A, Gentry, R, Irwin, R, Forgie, A, Welsh, S, Ivey, P, Bullivant, Jk, English, Wj, Osterberg, A, Morowala, A, Al-Faham, Z, Islam, S, Tan, E, Sadek, S, Sihra, N, Shrestha, D, Chong, B, Nadeem, A, Fasuyi, Ja, Patel, Mm, Daureeawoo, R, Okekunle, B, Cheruvu, M, Mazumdar, E, Hussain, A, Patel, C, Mcquaid, M, Banks, A, Robinson, A, Khan, Ms, Riaz, W, Verroiotou, M, Cohen, Ja, Kouroumpas, E, Ghaffari, I, Moradzadeh, J, Kamal, M, Gulamhussein, M, Gaines, E, Ghatorae, S, Clark, S, Savill, A, Hutchinson, B, Chapman, J, Wu, F, Creasy, W, Raymond, M, Grosvenor, S, Odeh, A, Malik, Y, Bansal, H, Grant, C, Raofi, A, Ahmed, B, Mai, D, Souter, J, Hamelmann, Rn, Ikram, S, Durbacz, M, Gilliland, N, Salem, A, Chudek, D, Ladwa, N, Storey, R, Fontaine, C, Toomey, D, Miller, B, Oakey, M, Smoker, H, Chapman, Sj, O'Hagan, Sc, Tahir, W, Wilcox, G, Ahmad, A, Akram, F, Baddams, Ts, Boshier, Pr, Fehervari, M, Easdon, S, Ilozue, T, Adam, Me, Jokhan, S, Foster, A, Nambiar, K, Bohra, P, Janardanan, S, Shanmuganathan, V, Maqboul, F, Ettles, C, Wardle, Sd, Martinou, E, Khasria, A, Bagga, R, Motter, D, Mundkur, N, Pan, Y, Akbari, K, Farrell, Sm, Rahim, A, Gummaraju, A, Mahmoud, A, Akinsola, O, Smallcombe, N, Tarazi, M, Hanley, C, Campbell, Um, Franklin, D, Davidson, Jr, Raza, Ss, Krishnamoorthy, A, Rajjoub, Y, Ali, M, Seddon, Tc, Payne, Re, Das, A, Martin, Lm, Naismith, Kn, Venkata, Up, Manda, Vm, Burns, Km, Huang, J, Samuel, M, Docherty, Ja, Cheah, Wl, Ooi, R, Nyeko-Lacek, M, Marsh, L, Prideaux, A, Li, Ch, Poacher, A, Lee, M, Muzaffar, M, Kara, A, Walsh, E, Sunter, H, Roth, N, Roy, C, Mcmorran, D, Turnbull, A, Layton, Gr, Archer, Je, Yang, P, Douka, E, Amin, V, Borghol, K, Blackford, Od, Bond, S, Baker, B, Mohamed, Wo, Williams, R, Garnham, J, Robb, Hd, Allington, J, Cloney, L, Tamborska, A, Kalia, K, Fung, E, Johnston, Z, Lynch, L, Christides, A, Tan, Hl, Cynthia, G, Tsang, B, Rossi, C, Kaubrys, M, Al-Khafaji, N, Jenkins, M, Peiris, Gb, Gunning, S, Nimako, E, Pandya, D, Hever, P, Amayo, A, Bull, C, Clements, C, Al-Sheikh, M, Savioli, F, Long, M, Horsfield, E, Robertson, C, Ogboru, S, Mcilwrath, Ac, Bell, J, Limb, C, Obeid, N, Rich, Je, Balasubramaniam, A, Mashar, R, Taylor, M, Bruce, Js, Dennison, G, Curtis, Nj, Ezerska, E, Ellis, B, Wiggill, S, Tee, A, Ng, S, Carder, C, Abdelwahed, A, Chandler, Sb, Tinsley, Bj, Finotti, E, Occhioni, G, Cossu, F, Vulcano, I, Viscosi, F, Michelini, M, Compagnoni, B, Sepe, C, Isolani, Sm, Regina, G, Alagna, V, Martorelli, G, Gabbianelli, C, Moroni, P, Zuin, M, Conci, S, Lazzari, G, Costamagna, D, Zurleni, Tz, Altomare, Ma, Desiderio, J, Di Cintio, A, Gemini, A, Trastulli, S, Viviani, E, Tomasoni, M, Montori, G, Harder, G, Argenti, F, Malabarba, S, Checcacci, P, Montanelli, P, Guerra, F, Skalamera, I, Staderini, F, Grandi, S, Nelli, T, Coratti, F, Sorrentino, L, Maffioli, A, Cavallo, D, Bondurri, A, Groppo, G, Curti, R, Solaini, L, Xidas, A, Manias, T, Delogu, D, Vacca, A, Solinas, L, Corbellini, C, Fiore, L, Nigro, A, Santurro, L, Angrisani, M, Sparta, C, Lorettu, A, Mura, Fa, Ruggiu, Gv, Pirari, Pf, Pau, R, Melis, M, Piu, F, Patti, S, Deserra, A, Angelieri, D, Del Basso, C, Rossi, D, Iannone, I, De Padua, C, Giubilo, C, Falaschi, F, Cirillo, B, Gordini, L, Podda, F, Sanna, S, Saba, A, Poillucci, G, Pinna, E, Messina, A, Sena, G, Cardona, R, De Luca, E, Sacco, R, Vescio, G, Ammendola, M, Romano, R, Bianco, A, Bonfante, P, D'Ambra, L, Feleppa, C, Gennai, A, Lizzi, V, Moggia, E, Imperatore, M, Bolzon, S, Belvedere, A, Amaducci, E, Ripoli, Mc, Segalini, E, Cervellera, M, Vaccari, S, Eretta, Co, O'Neill, R, Llewelyn, O, Jones, N, Clerici, F, Ballabio, M, Andolfi, E, Angelini, M, Fontani, A, Miranda, E, Scricciolo, M, Provenza, G, Pellicanò, Ga, Pulighe, F, Argenio, G, Melis, A, Balestra, F, Anania, M, Cruccu, A, Massaiu, C, Murru, Ml, Martino, A, Luzzi, Ap, La Valle, G, Chillitupa, Cz, Bartoli, A, Conti, D, Spaziani, A, Bellochi, R, Listorti, C, 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Gulamhussein M., Gaines E., Ghatorae S., Clark S., Savill A., Hutchinson B., Chapman J., Wu F., Creasy W., Raymond M., Grosvenor S., Odeh A., Malik Y., Bansal H., Grant C., Raofi A., Ahmed B., Mai D., Souter J., Hamelmann R.N., Ikram S., Durbacz M., Gilliland N., Salem A., Chudek D., Ladwa N., Storey R., Fontaine C., Toomey D., Miller B., Oakey M., Smoker H., Chapman S.J., O'Hagan S.C., Tahir W., Wilcox G., Ahmad A., Akram F., Baddams T.S., Boshier P.R., Fehervari M., Easdon S., Ilozue T., Adam M.E., Jokhan S., Foster A., Nambiar K., Bohra P., Janardanan S., Shanmuganathan V., Maqboul F., Ettles C., Wardle S.D., Martinou E., Khasria A., Bagga R., Motter D., Mundkur N., Pan Y., Akbari K., Farrell S.M., Rahim A., Gummaraju A., Mahmoud A., Akinsola O., Smallcombe N., Tarazi M., Hanley C., Campbell U.M., Franklin D., Davidson J.R., Raza S.S., Krishnamoorthy A., Rajjoub Y., Ali M., Seddon T.C., Payne R.E., Das A., Martin L.M., Naismith K.N., Venkata U.P., Manda V.M., Burns K.M., Huang J., 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D'Ambra L., Feleppa C., Gennai A., Lizzi V., Moggia E., Imperatore M., Bolzon S., Belvedere A., Amaducci E., Ripoli M.C., Segalini E., Cervellera M., Vaccari S., Eretta C.O., O'Neill R., Llewelyn O., Jones N., Clerici F., Ballabio M., Andolfi E., Angelini M., Fontani A., Miranda E., Scricciolo M., Provenza G., Pellicano G.A., Pulighe F., Argenio G., Melis A., Balestra F., Anania M., Cruccu A., Massaiu C., Murru M.L., Martino A., Luzzi A.P., La Valle G., Chillitupa C.Z., Bartoli A., Conti D., Spaziani A., Bellochi R., Listorti C., Salandini M.C., Carlucci M., Tenconi S.M., Cannavo M., Marano A., Giuffrida M.C., Cannata G., Pellegrino L., Giraudo G., Baraghini M., Garzi A., Giudicissi R., Zalla T., Romoli L., Vannucchi A., Giani I., Feroci F., Calussi M., Ribaudo M., Fiorot A., Stecca T., Nistri C., Fornasier C., Valiani S.V., Brunelli D.B., Evoli L.E., Giuliani N.G., Contine A.C., Renzi C.R., Feo C.V., Anania G., Carcoforo P., Aisoni F., Licari L., Tutino R., Cocorullo G., Silvestri V., De Marco P., Fontana T., Orlando G., Falco N., Baseggio M., Napetti S., Mella A., Rossi G.M., Chimetto A., Cosci M., Bonomo M., Scialandrone G., Chetta N., Carvalho L.C., Magalhaes J.S., Pereira A.M., Fernandes C., Fareleira A., Goncalves D., Pais M., Pereira A., Resende F.M., Correia D., Cardoso D., Tojal A., Santos S.C., Barbosa L., Louro H.C., Bairos F., Martins F.M., Messias F.M., Ferreira M.S., Borges F.C., Botelho P., Lima M., Valente P.M., Joao A.A., Guimaraes J.M., Rocha R., Nogueira S.T., Kabir U., Wong C., Rahmani L.S., Tan S., Chng S., Jasinski B., Cheng S.A., Mardhiah S., McGlynn K., Hannan E., Burke J., Haveliwala Z., O'Neill M., Boland M., Hayes C., Fox A., Zaborowski A., Mitru R.M., Mc-Dermott A., Coyle D., Stoica I., McMahon S.V., Laughlin D.M., Kannegieser-Bailey M., Murphy R., Muntean A., Shet S., Thomas L., De Freitas S., Quill S., Aljorfi A., Soh B., Law J.J., Hartnett J., Jansen T., Gilgan J., Jung J., Scanlon K., Szucs A., Ahern D.P., Redmond A.E., Edwards S.E., Manoharan P., Brennan S., Abdelgadir A.M., Mckevitt K.L., Zarog M.A., Ahmed G., Bukhari W., Ahad A., Paniagua M., Samartin C., Primo J.C., Garrido L., Lopez M., Rufo E., Trostchansky I., Rodriguez L., Infante H., Acosta A., Cremades P., Cidoncha A., Olmos V., Oliva I., Santamaria C., Cavero A., Calvo H., Suero C.A., Maderuelo V.M., Galvez P., Hernando A., Eguaras I., Recreo A.C., Garcia-Carrero M., Moreda R., De Andres U., Del Pozo E., Calvo M., Moratalla C.N., Ronda R.N., Contreras R.G., De Burgos C.B., Cortes G.V., Martinez C.C., Agudo A.R., Soriano J.T., Ramos X.H., Echazarreta E., Elia M., Hernaez A., Sanchez L., Vallejo-Bernad C., Oliver J.R., Sanchez-Rubio M., Kalviainen H.K., Genzor S., Gonzalez-Nicolas T., Puerta E., Laviano E., Gimenez T., Ferminan A., Muriel-Alvarez P., Sierra-Granon J.E., Escoll-Rufino J., Cuello-Guzman E., Mestres-Petit N., Merichal-Resina M., Pinillos-Somalo A., Gomez-Carmona Z., Vazquez-Fernandez A.P., Trujillo-Diaz J.J., Couso J.R., Fernandez M.D., Riera E., Espinosa J., Carral-Freire M., Martinez-Almeida R., Santarrufina-Martinez S., Sebastian-Tomas J.C., Gonzalvez-Guardiola P., Fernandez E.C., Mozo A.S., Stoyanov T.I., Santamaria P.C., Grimaldo E.G., Fernandez-Candela A., Curtis-Martinez C., Del-Valle-Ruiz S.R., Sanchez-Cifuentes A., Ramirez-Faraco M., Lopez A.F., Leon C., Kumar S., Fornell-Ariza M., Ayllon-Gamez S., Pena-Barturen C., Ojea-Ruiz-Yherla L., Saavedra-Chacon M., Perez-Calvo J., Gomez-Facundo H., Riba-Combatti L., Manas O.C., De-Soto-Cardenal B., De-La-Herranz-Guerrero P., Dominguez-Sanchez C., Gamero-Huaman J.C., Suarez-Cabrera A., Ramirez-Redondo A.A., Lara-Fernandez Y., Bascuas-Rodrigo B., Lopez-Duran B.L., Pigem A., Gil J., Salvador H., Planellas P., Farres R., Caballero A., Arnau M., Tapiolas I., Ridaura N., Roncero L.S., Collado-Roura F., Fijo L.M., Cormenzana O.B., Vinas N.L., Grifell M.S., Prats M.A., Torrado A.A., Sanz-Navarro S., Contreras-Saiz E., Solar-Garcia L., Moreno-Gijon M., Suarez-Sanchez A., Diaz-Vico T., Rodicio-Miravalles J.L., Garcia-Gutierrez C., Pila U., Melone S., Martin-Prieto L., Rojo J.A., Gonzalez M., Zorrilla L., Garcia-Marin J.A., Baeza-Murcia M., Pellicer-Franco E., Jimenez-Ballester M.A., Asensio-Gomez L., Gortazar-De-Las-Casas S., Guevara-Martinez J., Ramirez L., Verea S., Anguita F., Navarro G., Criado ADC., Lara M.C., Martinez E.T., Sanchez-Martinez A., Hernandez-Gimenez L., Galofre-Recasens M., Ferrer-Vilela I., Perez-Sanchez L.E., Esteves M.B., Menendez-Moreno A., Baz-Figueroa C., Rosat A., Hontoria M.S., Garcia N.A., Gracia-Roman R., Pascua-Sole M., Pino-Perez O., Garcia-Perez J.M., Pineno-Flores C., Ambrona-Zafra D., Sancho-Muriel J., Alvarez E., Jimenez-Rosellon R., Daga O., Alberca-Paramo A., Sanchez-Garcia S., Garcia-Santos E., Pareja-Ciuro F., Olivares-Oliver C., Navarro-Morales L., Tamayo-Lopez M.J., Tinoco-Gonzalez J., Garcia-Rivera C.O., Agua I.A., Moreno-Suero F., Pereira-Mosquera E., Zerpa C., Llacer E., Diaz A., Caro A., Feliu F., Franco M., Escuder J., Abellan M., Padilla E., Mambrilla-Herrero S., Plua-Muniz K.T., Bailon-Cuadrado M., Tejero-Pintor F.J., Choolani-Bhojwani E., Vila-Zarate C., Delgado-Plasencia L.J., Ponchietti L., Cousins L., Busuttil A., Baird C., Drye N., Brown O.D., Mansour S., Anderson O., Mahapatra R., Clements J.A., D'Souza N., Littlehales D.J., Tang A.M., Byrne B.E., Cunha P., Ogbuokiri C., Eiben P., Gravante G., Kho H., Dobbs S., Doulias T., Ng J., Wilson M., Venugopal R., Wolff J., Akhtar K., Walji H.D., Tognarelli J.M., Knight K.A., Ansari A., Hussaini S.A., Wright E., Brewer H., Rinkoff S., Harries R.L., Fairfield C.J., Abbott T., Jackson A., Wright H.L., Walters U., Carney K., Logan P.C., Mughal Z., Strachan E., Chasty B., Ma J., Mazzeo C., Badii B., Armellini A., Grassia M., Perin A., Ruzzenente A., Magnoli M., Depalma N., Longheu A., Papandrea M., Dova L., De Prizio M., Gusai G.P., Di Zitti L., Geretto P., Azabdaftari A., Chianese G., Elbetti C., Ruffolo C., Giaccari S., Devezas V., Ferreira J.S., Peixoto R., Alshafei A., Simo V., Jose H.S., Ugarte-Sierra B., Salva A.B., Gomez N., Marinello F., Medina-Arana V., Vega L., Ballester M.M., Espina B., Prieto-Nieto M.I., Rodriguez E.C., Padilla-Valverde D., and Duran-Munoz-Cruzado V.M.
- Subjects
Adult ,humanos ,Decision Making ,Risk Assessment ,NO ,apendicectomía ,apendicitis ,evaluación de riesgos ,Appendectomy ,Humans ,hospital ,General ,collaborative ,LS7_4 ,right iliac fossa ,appendicitis ,emergency service ,Original Articles ,adulto ,Appendicitis ,adult ,appendectomy ,humans ,risk assessment ,decision making ,Lower GI ,Original Article ,appendicitis, prediction models, right iliac fossa pain ,Emergency Service, Hospital ,toma de decisión - Abstract
Background Appendicitis is the most common general surgical emergency worldwide, but its diagnosis remains challenging. The aim of this study was to determine whether existing risk prediction models can reliably identify patients presenting to hospital in the UK with acute right iliac fossa (RIF) pain who are at low risk of appendicitis. Methods A systematic search was completed to identify all existing appendicitis risk prediction models. Models were validated using UK data from an international prospective cohort study that captured consecutive patients aged 16–45 years presenting to hospital with acute RIF in March to June 2017. The main outcome was best achievable model specificity (proportion of patients who did not have appendicitis correctly classified as low risk) whilst maintaining a failure rate below 5 per cent (proportion of patients identified as low risk who actually had appendicitis). Results Some 5345 patients across 154 UK hospitals were identified, of which two‐thirds (3613 of 5345, 67·6 per cent) were women. Women were more than twice as likely to undergo surgery with removal of a histologically normal appendix (272 of 964, 28·2 per cent) than men (120 of 993, 12·1 per cent) (relative risk 2·33, 95 per cent c.i. 1·92 to 2·84; P, Women in the UK had a disproportionate risk of admission without surgical intervention and had high rates of normal appendicectomy. Risk prediction models to support shared decision‐making were identified by identifying UK adults at low risk of appendicitis. An online calculator is available (http://appy-risk.org). WCC, white cell count; CRP, C‐reactive protein; AIRS, Appendicitis Inflammatory Response Score; AAS, Adult Appendicitis Score. Important differences between men and women
- Published
- 2019
3. Nutritional approach in digestive surgery. One way to improve postoperative results.
- Author
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Oliva Mompean, F, primary, Gomez Rosado, JC, additional, Valdes Hernandez, J, additional, and Cornejo Jurado, I, additional
- Published
- 2021
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4. An individualised versus a conventional pneumoperitoneum pressure strategy during colorectal laparoscopic surgery: rationale and study protocol for a multicentre randomised clinical study
- Author
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Diaz-Cambronero, O, Mazzinari, G, Errando, CL, Schultz, MJ, Lorente, BF, Garcia-Gregorio, N, Montanes, MV, Arnal, LEO, Martin-De-Pablos, A, Mari, AM, Navarro, MPA, Alberola-Estelles, MJ, Ayas-Montero, B, Matoses-Jaen, S, Verdeguer, S, Inigo, JMA, Domenech, JB, Velez, ME, Cuesta-Frau, D, Pous, S, Ballester, C, Frasson, M, Garcia-Granero, A, Cerdan-Santacruz, C, Garcia-Granero, E, Sanchez-Guillen, L, Robles-Hernandez, D, Boquera-Albert, D, Casado-Rodrigo, D, Cosa-Rodriguez, R, Oimedilla-Amai, LE, Rodriguez-Martin, M, Zorrilla-Ortuzar, J, Perez-Pena, JM, Martin-de-Pablos, A, Valdes-Hernandez, J, Gomez-Rosado, JC, Heredia-Perez, P, Cintas-Catena, J, Flor-Parra, F, Oyonarte, CLE, and IPPCollapse-II Study Grp
- Subjects
Postoperative complications ,Pneumoperitoneum pressure ,Colorectal surgery ,Abdominal laparoscopy ,Post-operative Quality of Recovery Scale (PQRS) ,Safety ,Outcome - Abstract
Background: A recent study shows that a multifaceted strategy using an individualised intra-abdominal pressure titration strategy during colorectal laparoscopic surgery results in an acceptable workspace at low intra-abdominal pressure in most patients. The multifaceted strategy, focused on lower to individualised intra-abdominal pressures, includes prestretching the abdominal wall during initial insufflation, deep neuromuscular blockade, low tidal volume ventilation settings and a modified lithotomy position. The study presented here tests the hypothesis that this strategy improves outcomes of patients scheduled for colorectal laparoscopic surgery. Methods: The Individualized Pneumoperitoneum Pressure in Colorectal Laparoscopic Surgery versus Standard Therapy (IPPCollapse-II) study is a multicentre, two-arm, parallel-group, single-blinded randomised 1:1 clinical study that runs in four academic hospitals in Spain. Patients scheduled for colorectal laparoscopic surgery with American Society of Anesthesiologists classification I to III who are aged > 18 years and are without cognitive deficits are randomised to an individualised pneumoperitoneum pressure strategy (the intervention group) or to a conventional pneumoperitoneum pressure strategy (the control group). The primary outcome is recovery assessed with the Post-operative Quality of Recovery Scale (PQRS) at postoperative day 1. Secondary outcomes include PQRS score in the post anaesthesia care unit and at postoperative day 3, postoperative complications until postoperative day 28, hospital length of stay and process-related outcomes. Discussion: The IPPCollapse-II study will be the first randomised clinical study that assesses the impact of an individualised pneumoperitoneum pressure strategy focused on working with the lowest intra-abdominal pressure during colorectal laparoscopic surgery on relevant patient-centred outcomes. The results of this large study, to be disseminated through conference presentations and publications in international peer-reviewed journals, are of ultimate importance for optimising the care and safety of laparoscopic abdominal surgery. Selection of patient-reported outcomes as the primary outcome of this study facilitates the translation into clinical practice. Access to source data will be made available through anonymised datasets upon request and after agreement of the Steering Committee of the IPPCollapse-II study.
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- 2019
5. Minimally invasive endoscopic retromuscular technique with transversus abdominis release associated (eTEP-TAR) for right subcostal incisional hernias improves postoperative results when compared to conventional laparoscopic incisional hernia repair: a case-control study.
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Bellido-Luque J, Alpizar O, Gomez Rosado JC, Gomez Menchero J, and Morales-Conde S
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- Humans, Male, Female, Case-Control Studies, Middle Aged, Aged, Postoperative Complications etiology, Length of Stay statistics & numerical data, Pain, Postoperative etiology, Abdominal Muscles, Endoscopy methods, Recurrence, Surgical Mesh, Retrospective Studies, Adult, Herniorrhaphy methods, Herniorrhaphy adverse effects, Laparoscopy methods, Incisional Hernia surgery
- Abstract
Propose: The aim was to evaluate results in terms of intra and postoperative complications, hospital stay, postoperative pain, functional recovery, aesthetic results and recurrence rate of totally endoscopic retromuscular hernia repair(eTEP-TAR)compared to conventional laparoscopic incisional hernia repair with defect closure(IPOM+)for right subcostal incisional hernias., Methods: Data from consecutive patients requiring conventional minimally invasive subcostal incisional hernia repair collected from January 2014 to December 2018 were compared with patients underwent eTEP from January 2019 to July 2024 in a case-control study., Results: 51 patients in the IPOM + group and 46 in eTEP group were included.Both groups were comparable considering demographic variables.No significant differences were identified in mean defect length (6,6
+ /- 1,4 vs. 7,5+ /- 1,2 cm, p = 0,08) or width(6,3+ /- 1,5 vs. 5,9+ /- 1,4 cm, p = 0,3).The mean mesh area was significantly bigger in eTEP group(907,9+ /- 136,4 vs. 631,5+ /- 129,3 cm2 ,p < 0,05)with significant longer surgical time (106,3+ /- 22,7 vs. 67,2+ /- 15,5 min, p = 0,03).No differences in intraoperative complications were identified.Hospital stay was significantly improved in eTEP group when compared to IPOM + group (33,6+ /- 13,8 vs. 61,09+ /- 12,2 hours, p = 0,03).Postoperative complications were significantly higher in the IPOM + group due to postoperative ileus (9% vs. 2%,p < 0,05).One recurrence was identified in eTEP group(2%), and 2 recurrences in IPOM + group(3%) with an average follow-up of 20.6+/-10.6 months and 60.6+/-10.6 months respectively. eTEP group showed significantly lower pain on the 1st -7th -30th -90th postoperative days than IPOM + group.Functional recovery was significantly improved in the eTEP group one and six months after surgery.No differences in terms of cosmetic results were identified., Conclusion: eTEP-TAR for subcostal hernias shows lower postoperative pain and hospital stay with better functional recovery than IPOM+,without differences in recurrence rate and cosmesis result.Postoperative ileus is increased when intraperitoneal mesh is laparoscopically placed. eTEP-TAR in subcostal hernia repair requires significant higher operative time due to its complexity., Competing Interests: Declarations. Conflict of interest: Juan Bellido-Luque, Oscar Alpizar, Juan Carlos Gomez Rosado, Julio Gomez Menchero and Salvador Morales Conde have no conflicts of interest to disclose., (© 2024. The Author(s), under exclusive licence to Springer-Verlag France SAS, part of Springer Nature.)- Published
- 2024
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6. Full endoscopic minimally invasive extraperitoneal modified Sugarbaker approach for para-colostomy hernia repair: Technical aspects and 2-year follow-up results of a prospective cohort.
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Bellido-Luque J, Bellido-Luque A, Gomez-Rosado JC, Gomez-Menchero J, Suarez-Grau JM, Licardie E, Tejada-Gomez A, Navarro-Morales L, Moreno-Suero F, Sanchez-Matamoros I, Capitán-Morales L, Nogales Muñoz A, and Morales-Conde S
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- Humans, Adolescent, Young Adult, Adult, Middle Aged, Aged, Aged, 80 and over, Colostomy adverse effects, Colostomy methods, Follow-Up Studies, Prospective Studies, Herniorrhaphy methods, Postoperative Complications epidemiology, Postoperative Complications etiology, Postoperative Complications surgery, Pain, Postoperative, Surgical Mesh adverse effects, Hernia, Ventral surgery, Laparoscopy methods, Incisional Hernia etiology, Incisional Hernia surgery
- Abstract
Aim: This study aimed to assess technical aspects and clinical results of a new minimally invasive technique in parastomal hernia (PSH) repair, full endoscopic retromuscular access, after 2 years of follow-up., Methods: Data from consecutive patients requiring minimally invasive ventral PSH repair were collected from 2019 to 2022. The inclusion criteria were patients aged between 18 and 80 years old with symptomatic PSH. Demographics and perioperative and postoperative data were collected. Postoperative pain and functional recovery were compared with preoperative data., Results: Twelve patients with symptomatic PSH were included. The mean PSH defect area was 16.2 cm
2 and the mean midline defect was 8.7 cm2 . No intra-operative complications or conversion to open surgery were detected. One patient (8%) required postoperative readmission due to partial bowel obstruction symptoms that required catheterization of the stoma. Pain significantly worsened after the first postoperative day compared to preoperative data but improved after the first postoperative month compared to the first postoperative week and after the 90th postoperative day compared to the first postoperative month, with significant differences. Significant restriction improvement was identified when 30 days after surgery data were compared to preoperative data and when the 180th postoperative day results were compared to 30 days after surgery. The average follow-up was 29 months. During the follow-up no clinical or radiological recurrence was observed., Conclusion: This paper shows low rate of intra- and postoperative complications with significant improvement in terms of pain activities restriction compared to preoperatory. After 29 months follow-up, no recurrence was identified, confirming that this approach offers good mid-term results., (© 2023 Association of Coloproctology of Great Britain and Ireland.)- Published
- 2023
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7. Severe rectus diastasis with midline hernia associated in males: high recurrence in mid-term follow-up of minimally invasive surgical technique.
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Bellido-Luque J, Gomez-Rosado JC, Bellido-Luque A, Matamoros IS, Muñoz AN, Mompeán FO, and Conde SM
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- Humans, Male, Follow-Up Studies, Retrospective Studies, Herniorrhaphy methods, Rectus Abdominis surgery, Postoperative Complications surgery, Pain, Postoperative surgery, Surgical Mesh, Recurrence, Hernia, Ventral surgery, Incisional Hernia surgery
- Abstract
Propose: The present study aimed to assess clinical results, in terms of postoperative pain, functional recovery and recurrence rates of FESSA (Full Endoscopic Suprapubic Subcutaneous Access) technique compared to endoscopic anterior rectus sheaths plication and mesh, in male patients with midline ventral or incisional hernias and severe rectus diastasis (SRD) associated. Secondary aims were to identify intra- and postoperative complications associated with each technique., Methods: Male patients with midline ventral or incisional hernia and severe rectus diastasis were included in a prospectively maintained databased and retrospectively analyzed from January 2017 to December 2020. From January 2017 to January 2019, male patients underwent to anterior rectus sheaths plication (ARSP) (Control group). From January 2019 to December 2020, male patients underwent to FESSA technique (FT) (Case group)., Results: 53 patients were finally included. 28 patients (52%) underwent to FT and 25 patients (48%) to ARSP. Regarding intraoperative complications, no significant differences were identified between the groups. Hospital stay was significantly improved in FT group when compared to ARSP group. No significant differences in terms of postoperative seroma or hematomas, were shown. FT group showed significantly less pain on 1st, 7th and 30th postoperative days than ARSP group. Functional recovery was significantly improved in FT group compared to ARSP group on the 30th day and no differences were observed on the 180th day after surgery. The mean follow-up was 17.3 ± 2.6 months in FT group and 24 ± 3 months in ARSP group. During the follow-up, 1(3%) and 9 (36%) diastasis recurrences were identified respectively, with significant differences in favor of FT group., Conclusion: In males with SRD and symptomatic midlines hernias, ARSP with onlay mesh placement shows high diastasis recurrence rate in mid-term follow-up. We propose FESSA technique in those patients, which decreases the excessive midline tension, improving the postoperative pain, functional recovery and recurrence rate, without increasing postoperative complications., (© 2022. The Author(s), under exclusive licence to Springer-Verlag France SAS, part of Springer Nature.)
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- 2023
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8. Initial experience with intraoperative testing and repair of colorectal anastomosis using a TAMIS approach after a positive leak test.
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Valdes-Hernandez J, Cintas-Catena J, Del Rio-Lafuente FJ, Cano-Matias A, Torres-Arcos C, Perez-Sanchez A, Capitan-Morales L, Oliva-Mompean F, and Gomez-Rosado JC
- Subjects
- Anastomosis, Surgical adverse effects, Anastomotic Leak etiology, Anastomotic Leak surgery, Humans, Methylene Blue, Quality of Life, Rectum surgery, Retrospective Studies, Rectal Neoplasms surgery, Transanal Endoscopic Surgery adverse effects
- Abstract
Anastomotic leak is one of the most feared complications of colorectal anastomosis. Different techniques have been described for intraoperative testing of anastomotic integrity. These include air insufflation, methylene blue and endoscopic visualisation. If an anastomotic leak is identified intraoperatively, there are various management options. Redo anastomosis is a possibility, but may be difficult in some cases. Defunctioning is another option, but there is an associated morbidity and signficant detrimental effect on quality of life. Direct transanal repair is only possible when a low anastomosis has been performed. When the anastomotic leak occurs high in the rectum or a partial mesorectal excision is performed a transanal approach is technically very challenging. We present our experience with transanal minimally invasive surgery (TAMIS) approach for anastomotic assessment and repair in four patients. In all cases, a colorectal anastomosis was performed and the air insufflation test was positive. We assessed the anastomosis with TAMIS. In three cases, a defect was found and subsequently sutured. In one case, a scar in the rectal mucosa was found and reinforced with a suture. A protective ileostomy was performed in two cases, while in the other two cases, no stoma was added. All four patients were discharged with no further complications. Both protective ileostomies were taken down after radiological and endoscopic confirmation of anastomotic integrity and all 4 anastomoses remain intact after follow-up. TAMIS intraoperative assessment and repair of anastomotic leak is a safe and feasible technique whcih may avoid the need for a defunctioning stoma., (© 2022. Springer Nature Switzerland AG.)
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- 2022
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9. Correction: Feasibility of quantitative analysis of colonic perfusion using indocyanine green to prevent anastomotic leak in colorectal surgery.
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Gomez-Rosado JC, Valdes-Hernandez J, Cintas-Catena J, Cano-Matias A, Perez-Sanchez A, Del Rio-Lafuente FJ, Torres-Arcos C, Lara-Fernandez Y, Capitan-Morales LC, and Oliva-Mompean F
- Published
- 2022
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10. Feasibility of quantitative analysis of colonic perfusion using indocyanine green to prevent anastomotic leak in colorectal surgery.
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Gomez-Rosado JC, Valdes-Hernandez J, Cintas-Catena J, Cano-Matias A, Perez-Sanchez A, Del Rio-Lafuente FJ, Torres-Arcos C, Lara-Fernandez Y, Capitan-Morales LC, and Oliva-Mompean F
- Subjects
- Anastomosis, Surgical adverse effects, Anastomotic Leak etiology, Anastomotic Leak prevention & control, Feasibility Studies, Fluorescein Angiography, Humans, Indocyanine Green, Perfusion, Retrospective Studies, Colorectal Neoplasms surgery, Colorectal Surgery
- Abstract
Background: The aim of this study was to quantify Fluorescence angiography with indocyanine green (ICG) in colorectal cancer anastomosis, determine influential factors in its temporary intensity and pattern, assessing the ability to predict the AL, and setting the cut-off levels to establish high- or low-risk groups., Methods: Retrospective analysis of prospectively managed database, including 70 patients who underwent elective surgery for colorectal cancer in which performing a primary anastomosis was in primary plan. In all of them, ICG fluorescence angiography was performed as usual clinical practice with VisionSense™ VS Iridium (Medtronic, Mansfield, MA, USA), in Elevision™ IR Platform (Medtronic, Mansfield, MA, USA). Parameters measured at real time or calculated were T
0 , Tmax , ∆T, Fmax , %pos , Fpos , and Slope., Results: 70 patients were included, 69 anastomosis were performed and one end colostomy. Arterial hypertension demonstrated higher Fmax , as well as the location of the anastomosis (the nearest to rectum, the most intensity detected). A statistical relationship was found between AL and the lower Fpos and Slope. The decision of changing the subjectively decided point of division did not demonstrate statistical difference on the further development of AL. All parameters were analyzed to detect the cut-off related with AL. Only in case of Fpos lower than 158.3 U and Slope lower than 13.1 U/s p-value were significant. The most valuable diagnostic parameter after risk stratification was the Negative Predictive Value., Conclusion: Quantitative analysis of ICG fluorescence in colorectal surgery is safe and feasible to stratify risk of AL. Hypertension and location of anastomosis influence the intensity of fluorescence at the point of section. A change of division place should be considered to avoid AL related to vascular reasons when intensities of fluorescence at the point of section is lower than 169 U or slopes lower than 14.4 U/s., (© 2021. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)- Published
- 2022
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11. Impact of the patient-nurse ratio on health outcomes in public hospitals of the Andalusian Health Service. Ecological study.
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Ayuso-Fernandez MA, Gomez-Rosado JC, Barrientos-Trigo S, Rodríguez-Gómez S, and Porcel-Gálvez AM
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- Adult, Cross-Sectional Studies, Health Services, Hospitals, Public, Humans, Outcome Assessment, Health Care, Nursing Staff, Hospital
- Abstract
Objective: To analyse the patient-nurse ratio and its association with health outcomes in public hospitals of the Andalusian Health Service (SAS)., Method: Cross-sectional ecological study carried out in adult units of 26 Andalusian public hospitals. Data on structure (beds, type of unit, nursing control), management (average stay, index of use of stays, complexity index) and nursing staff were collected. They were extracted from official sources: CMBDA, SAS/Health Council (CS) publications and specific respondents to Nursing Directorates. The patient-nurse ratio was calculated and related to 19 indicators of hospital quality, safety, and mortality. Measures of central tendency and Spearman's correlation coefficient were used for statistical analysis., Results: A response was obtained from 100% of the Andalusian hospitals. The average patient-nurse ratio in the three shifts was lower in hospitals with a broader portfolio of services-regional scope (11.6), followed by those with a medium portfolio-specialties (12.7) and hospitals with a basic portfolio-county (13.5). By type of unit, the medical units were 11.8 (SD = 1.8) lower than the surgical ones 13.5 (SD = 2.7). Significant differences were only found in medical units of regional hospitals 10.5 (SD = 1.4) and district hospitals 13.03 (SD = 1.46) (p = .001). In critical care, the ratio was greater than 2 patients per nurse in the three groups. When relating the ratio to health outcomes, 5 significant associations were found: pressure ulcers (p = .005), prevalence of nosocomial infections (p = .036), postoperative sepsis (p = .022), zero bacteraemia verification (p = .045) and mortality from heart failure (p = .004)., Conclusions: The results indicate a high patient-nurse ratio in adult hospitalization units and that there is a positive association between the patient-nurse ratio and worse results related to nursing care., Competing Interests: Conflict of interests The authors have no conflict of interests to declare., (Copyright © 2020 Elsevier España, S.L.U. All rights reserved.)
- Published
- 2021
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12. Endoscopic retromuscular technique (eTEP) vs conventional laparoscopic ventral or incisional hernia repair with defect closure (IPOM +) for midline hernias. A case-control study.
- Author
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Bellido Luque J, Gomez Rosado JC, Bellido Luque A, Gomez Menchero J, Suarez Grau JM, Sanchez Matamoros I, Nogales Muñoz A, Oliva Mompeán F, and Morales Conde S
- Subjects
- Case-Control Studies, Herniorrhaphy adverse effects, Humans, Surgical Mesh, Hernia, Ventral surgery, Incisional Hernia surgery, Laparoscopy
- Abstract
Purpose: This study aimed at clinical results in terms of postoperative pain and functional recovery of new technique (eTEP) compared to IPOM + for ventral/incisional midline hernias. Recurrence rate, intra/postoperative complications and aesthetic results are secondary aims., Methods: Data from consecutive patients requiring minimally invasive hernia repair were collected. From January 2015 to September 2018, patients with midline ventral/incisional hernias underwent IPOM + were compared to patients underwent eTEP procedure from October 2018 to December 2019 in a case/control study., Results: Thirty-nine patients in IPOM + group and 40 in eTEP group were included. No significant differences were identified when hernias types, mean defect area, mean mesh area and intraoperative/postoperative complications (except seroma rate in favor of eTEP group) were compared. Operative time and hospital stay were significantly higher in eTEP group and IPOM + group, respectively. eTEP group showed significantly less pain on 1st, 7th and 30th postoperative days than IPOM + group. Restriction of activities was significantly decreased in eTEP group on the 30th and 180th day after surgery. Significant differences were observed in terms of cosmetic results 30th and 180th days after surgery in favor of eTEP group. Average follow-up was 15 months in eTEP group and 28 months in IPOM + group. No recurrences were identified in eTEP group and one recurrence in IPOM + group with no significant differences., Conclusion: Endoscopic retromuscular technique shows significant lower postoperative pain, better functional recovery and cosmesis than IPOM + without differences in intra/postoperative complications (except seroma rate) or recurrences during the follow-up. eTEP requires longer operative time., (© 2021. The Author(s), under exclusive licence to Springer-Verlag France SAS part of Springer Nature.)
- Published
- 2021
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13. Reply to the letter «Discrepancies in analysis of frequency, type of complications and economic costs of outlying patients in general and digestive surgery».
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Gomez-Rosado JC, Li YH, Valdés-Hernández J, and Capitán-Morales LC
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- Costs and Cost Analysis, Humans, Digestive System Surgical Procedures
- Published
- 2019
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14. Analysis of frequency, type of complications and economic costs of outlying patients in general and digestive surgery.
- Author
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Gomez-Rosado JC, Li YH, Valdés-Hernández J, Oliva-Mompeán F, and Capitán-Morales LC
- Subjects
- Bed Occupancy statistics & numerical data, Digestive System Surgical Procedures adverse effects, Digestive System Surgical Procedures economics, Digestive System Surgical Procedures statistics & numerical data, Female, Health Services Research methods, Humans, Length of Stay economics, Male, Patient Admission statistics & numerical data, Postoperative Complications economics, Retrospective Studies, Spain epidemiology, Surgical Procedures, Operative adverse effects, Surgical Procedures, Operative economics, Hospital Costs statistics & numerical data, Length of Stay statistics & numerical data, Postoperative Complications epidemiology, Specialties, Surgical organization & administration, Surgical Procedures, Operative statistics & numerical data
- Abstract
Introduction: The shortage of available beds and the increase in Emergency Department pressure can cause some patients to be admitted in wards with available beds assigned to other services (outlying patients). The aim of this study is to assess the frequency, types of complications and costs of outlying patients., Methods: Using a retrospective cohort model, we analysed the 2015 general and digestive surgery records (source: Minimum Basic Data Set and economic database). After selecting all outlying patients, we compared the complications, length of stay, costs and consequences of complications against a randomized sample of non-outlying patients with the same DRG and date of episode for every outlying patient, obtaining one non-outlying patient for each selected outlying patient. Thirteen outlying patients with no non-outlying patient pair were excluded from the study., Results: From a total of 2,915 patients, 363 (12.45%) were outlying patients. A total of 350 outlying patients were analysed versus 350 non-outlying patients. There were no significant differences in complications (9.4 vs. 8.3%), length of stay (4.33 vs. 4.65 days) or costs (€3,034.12 vs. €3,223.27). Outlying patients men presented a significantly higher risk of complications compared to women (RR=2.10). Outlying patients presented complications after 2.5 or more days., Conclusions: When outlying admissions become necessary, the selection of patients with less complex pathologies does not increase complications or their consequences (ICU admissions, readmissions, reoperations or mortality), hospital stays or costs. Only in cases of prolonged outlying stays of more than 2.5 days, or in males, may more complications appear. Therefore, male outliers should be avoided in general, and patients should be transferred to the proper ward if a length of stay beyond 2.5 days is foreseen., (Copyright © 2019 AEC. Publicado por Elsevier España, S.L.U. All rights reserved.)
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- 2019
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15. TAMIS resection of a large colonic polyp 20 cm from the anal verge: could endo-stapling be the solution to peritoneal entry?
- Author
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Valdes-Hernandez J, Gomez-Rosado JC, Cintas-Catena J, Perez-Sanchez A, Torres C, Del Rio F, Oliva F, and Capitan-Morales LC
- Subjects
- Aged, Humans, Male, Anal Canal surgery, Colonic Polyps surgery, Peritoneum surgery, Surgical Stapling methods, Transanal Endoscopic Surgery methods
- Published
- 2019
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16. Economic Cost Analysis Related to Complications in General and Digestive Surgery.
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Gomez-Rosado JC, Salas-Turrens J, and Olry-de-Labry-Lima A
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- Case-Control Studies, Digestive System Surgical Procedures economics, Female, Humans, Male, Middle Aged, Retrospective Studies, Costs and Cost Analysis, Postoperative Complications economics, Surgical Procedures, Operative economics
- Abstract
Introduction: The aim was to assess the impact on economic costs and length of stay (LOS) of postoperative complications., Methods: 5,822 records from BMDS (2014-2015) are included. A descriptive, univariate and multivariate study evaluated the correlation between complications, Clavien-Dindo grade and vacation periods with LOS and economic costs, based on a full-cost model, aggregated by DRG., Results and Conclusions: Mean cost per stay was €676.71, and €4,309.02 per episode. Complications appeared in 639 patients (11%). Admission to ICU was required in 203 patients, re-operation in 134 and re-admission in 243, while 66 patients died (1.1%). Complications caused significantly longer LOS (20.08 vs 5.48 days) and higher economic cost (€11,670.31 vs €3,354.12); infectious complications were the most frequent and respiratory the most expensive (€20,428.53), together with ICU admission (€20,242.66). Clavien-Dindo grade correlated with greater LOS and costs (except gradev). During vacation periods, complications and LOS are increased, but costs of these complications and LOS did not differ significantly from complications detected in non-vacation periods., (Copyright © 2018 AEC. Publicado por Elsevier España, S.L.U. All rights reserved.)
- Published
- 2018
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17. [Importance of the quality of the discharge report in the management of a surgical clinical unit].
- Author
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Gomez-Rosado JC, Sanchez-Ramirez M, Valdes-Hernandez J, Capitan-Morales LC, Del-Nozal-Nalda MI, and Oliva-Mompean F
- Subjects
- Diagnosis-Related Groups, Humans, Quality Control, Hospital Units organization & administration, Medical Records standards, Patient Discharge, Surgery Department, Hospital organization & administration, Surgical Procedures, Operative
- Abstract
Background: The discharge report is a basic document at the end of a care process, and is a key element in the coding process, since its correct wording, reliability and completeness are factors used to determine the hospital production., Material and Methods: From a hypothesis based on the analysis of the consistency between the discharge report and data collected from the routine clinical notes during admission, we should be able to re-code all those mis-coded, thus placing them in a more appropriate diagnosis-related group (DRG). A total of 24 patient outliers were analysed for the correct filling in of the type and reason for admission, personal history, medication, anamnesis, primary and secondary diagnosis, sugical procedure, outcome, number of diagnostic and procedures cited, concordance between discharge report and history and recoding of the DRG., Results: From a total of 24 episodes, 6 had precise and valid reports, 4 were valid but not precise enough, 9 were insufficient, and 5 were clearly invalid. The recoded DRG after the documentation review was not significantly different, according to the Wilcoxon test, being changed in only 5 cases (P = .680)., Conclusion: Quality in discharge reports depends on an adequate minimum data set (MDS) in concordance with the source documentation during admission. Discordance can change the DRG, despite it not being significantly different in our series. Self-audit of discharge reports allows quality improvements to be developed along with a reduction in information mistakes., (Copyright © 2012 AEC. Published by Elsevier Espana. All rights reserved.)
- Published
- 2013
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18. [One year follow-up after doppler-guided haemorrhoidal artery ligation].
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Gomez-Rosado JC, Sanchez-Ramirez M, Capitan-Morales LC, Valdes-Hernandez J, Reyes-Diaz ML, Cintas-Catena J, Guerrero-Garcia JM, Galan-Alvarez J, and Oliva-Mompean F
- Subjects
- Adult, Aged, Female, Follow-Up Studies, Humans, Ligation methods, Male, Middle Aged, Prospective Studies, Time Factors, Hemorrhoidectomy methods, Hemorrhoids diagnostic imaging, Hemorrhoids surgery, Ultrasonography, Doppler, Ultrasonography, Interventional
- Abstract
Introduction: The Doppler-guided haemorrhoidal artery ligation (DG-HAL) is a non-exeresis technique for the treatment of haemorrhoids, consisting in the ligature of the distal branches of the upper rectal artery. The aim of this work is to evaluate the safety and efficacy of this technique after one year of follow-up., Material and Method: A total of 30 patients were operated on using DG-HAL for grade II or III haemorrhoids. The mean age was 49.9 years (30-70 years). The THD® (Transanal Haemorrhoidal Dearterialisation) device was employed in all cases. The procedures were performed under intradural anaesthesia in a short-stay surgery unit. The operating time, pain, bleeding, postoperative stay, and complications and symptoms after 3-6 months and 12 months were recorded., Results: The mean operating time was 23minutes (15-50). The pain according to a visual analogue scale (VAS) was 5.5 during the first day (90% required analgesia). Only 2 patients required analgesia after the second day. One patient described persistent pain up to 3 months, and 2 slight bleeding. A further operation was performed due to a haemorrhoidal thrombosis on the 10(th) day. There were no other complications and no re-admissions. The mean hospital stay was 1.4 days (0-2), and normal daily activity re-established at 7-8 days. A large majority (87%) of patients described having tenesmus, which disappeared in 3 months. After one year, two patients had had further operations, 3 had recurrences (2 slight prolapses and 1 occasional bleeding). The success rate was 80%., Conclusions: Haemorrhoidal dearterialisation using Doppler-guided arterial ligation seems to be effective after one year, with a low percentage of complications., (Copyright © 2012 AEC. Published by Elsevier Espana. All rights reserved.)
- Published
- 2012
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