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3. 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

4. Enhanced perioperative care in emergency general surgery: the WSES position paper

Author

Ceresoli, M, Braga, M, Zanini, N, Abu-Zidan, F, Parini, D, Langer, T, Sartelli, M, Damaskos, D, Biffl, W, Amico, F, Ansaloni, L, Balogh, Z, Bonavina, L, Civil, I, Cicuttin, E, Chirica, M, Cui, Y, De Simone, B, Di Carlo, I, Fette, A, Foti, G, Fogliata, M, Fraga, G, Fugazzola, P, Galante, J, Beka, S, Hecker, A, Jeekel, J, Kirkpatrick, A, Koike, K, Leppaniemi, A, Marzi, I, Moore, E, Picetti, E, Pikoulis, E, Pisano, M, Podda, M, Sakakushev, B, Shelat, V, Tan, E, Tebala, G, Velmahos, G, Weber, D, Agnoletti, V, Kluger, Y, Baiocchi, G, Catena, F, Coccolini, F, Ceresoli M., Braga M., Zanini N., Abu-Zidan F. M., Parini D., Langer T., Sartelli M., Damaskos D., Biffl W. L., Amico F., Ansaloni L., Balogh Z. J., Bonavina L., Civil I., Cicuttin E., Chirica M., Cui Y., De Simone B., Di Carlo I., Fette A., Foti G., Fogliata M., Fraga G. P., Fugazzola P., Galante J. M., Beka S. G., Hecker A., Jeekel J., Kirkpatrick A. W., Koike K., Leppaniemi A., Marzi I., Moore E. E., Picetti E., Pikoulis E., Pisano M., Podda M., Sakakushev B. E., Shelat V. G., Tan E., Tebala G. D., Velmahos G., Weber D. G., Agnoletti V., Kluger Y., Baiocchi G., Catena F., Coccolini F., Ceresoli, M, Braga, M, Zanini, N, Abu-Zidan, F, Parini, D, Langer, T, Sartelli, M, Damaskos, D, Biffl, W, Amico, F, Ansaloni, L, Balogh, Z, Bonavina, L, Civil, I, Cicuttin, E, Chirica, M, Cui, Y, De Simone, B, Di Carlo, I, Fette, A, Foti, G, Fogliata, M, Fraga, G, Fugazzola, P, Galante, J, Beka, S, Hecker, A, Jeekel, J, Kirkpatrick, A, Koike, K, Leppaniemi, A, Marzi, I, Moore, E, Picetti, E, Pikoulis, E, Pisano, M, Podda, M, Sakakushev, B, Shelat, V, Tan, E, Tebala, G, Velmahos, G, Weber, D, Agnoletti, V, Kluger, Y, Baiocchi, G, Catena, F, Coccolini, F, Ceresoli M., Braga M., Zanini N., Abu-Zidan F. M., Parini D., Langer T., Sartelli M., Damaskos D., Biffl W. L., Amico F., Ansaloni L., Balogh Z. J., Bonavina L., Civil I., Cicuttin E., Chirica M., Cui Y., De Simone B., Di Carlo I., Fette A., Foti G., Fogliata M., Fraga G. P., Fugazzola P., Galante J. M., Beka S. G., Hecker A., Jeekel J., Kirkpatrick A. W., Koike K., Leppaniemi A., Marzi I., Moore E. E., Picetti E., Pikoulis E., Pisano M., Podda M., Sakakushev B. E., Shelat V. G., Tan E., Tebala G. D., Velmahos G., Weber D. G., Agnoletti V., Kluger Y., Baiocchi G., Catena F., and Coccolini F.

Abstract

Enhanced perioperative care protocols become the standard of care in elective surgery with a significant improvement in patients’ outcome. The key element of the enhanced perioperative care protocol is the multimodal and interdisciplinary approach targeted to the patient, focused on a holistic approach to reduce surgical stress and improve perioperative recovery. Enhanced perioperative care in emergency general surgery is still a debated topic with little evidence available. The present position paper illustrates the existing evidence about perioperative care in emergency surgery patients with a focus on each perioperative intervention in the preoperative, intraoperative and postoperative phase. For each item was proposed and approved a statement by the WSES collaborative group.

Published
2023

5. Source control in emergency general surgery: WSES, GAIS, SIS-E, SIS-A guidelines

Author

Coccolini, F, Sartelli, M, Sawyer, R, Rasa, K, Viaggi, B, Abu-Zidan, F, Soreide, K, Hardcastle, T, Gupta, D, Bendinelli, C, Ceresoli, M, Shelat, V, Broek, R, Baiocchi, G, Moore, E, Sall, I, Podda, M, Bonavina, L, Kryvoruchko, I, Stahel, P, Inaba, K, Montravers, P, Sakakushev, B, Sganga, G, Ballestracci, P, Malbrain, M, Vincent, J, Pikoulis, M, Beka, S, Doklestic, K, Chiarugi, M, Falcone, M, Bignami, E, Reva, V, Demetrashvili, Z, Di Saverio, S, Tolonen, M, Navsaria, P, Bala, M, Balogh, Z, Litvin, A, Hecker, A, Wani, I, Fette, A, De Simone, B, Ivatury, R, Picetti, E, Khokha, V, Tan, E, Ball, C, Tascini, C, Cui, Y, Coimbra, R, Kelly, M, Martino, C, Agnoletti, V, Boermeester, M, De'Angelis, N, Chirica, M, Biffl, W, Ansaloni, L, Kluger, Y, Catena, F, Kirkpatrick, A, Coccolini F., Sartelli M., Sawyer R., Rasa K., Viaggi B., Abu-Zidan F., Soreide K., Hardcastle T., Gupta D., Bendinelli C., Ceresoli M., Shelat V. G., Broek R., Baiocchi G. L., Moore E. E., Sall I., Podda M., Bonavina L., Kryvoruchko I. A., Stahel P., Inaba K., Montravers P., Sakakushev B., Sganga G., Ballestracci P., Malbrain M. L. N. G., Vincent J. -L., Pikoulis M., Beka S. G., Doklestic K., Chiarugi M., Falcone M., Bignami E., Reva V., Demetrashvili Z., Di Saverio S., Tolonen M., Navsaria P., Bala M., Balogh Z., Litvin A., Hecker A., Wani I., Fette A., De Simone B., Ivatury R., Picetti E., Khokha V., Tan E., Ball C., Tascini C., Cui Y., Coimbra R., Kelly M., Martino C., Agnoletti V., Boermeester M. A., De'Angelis N., Chirica M., Biffl W. L., Ansaloni L., Kluger Y., Catena F., Kirkpatrick A. W., Coccolini, F, Sartelli, M, Sawyer, R, Rasa, K, Viaggi, B, Abu-Zidan, F, Soreide, K, Hardcastle, T, Gupta, D, Bendinelli, C, Ceresoli, M, Shelat, V, Broek, R, Baiocchi, G, Moore, E, Sall, I, Podda, M, Bonavina, L, Kryvoruchko, I, Stahel, P, Inaba, K, Montravers, P, Sakakushev, B, Sganga, G, Ballestracci, P, Malbrain, M, Vincent, J, Pikoulis, M, Beka, S, Doklestic, K, Chiarugi, M, Falcone, M, Bignami, E, Reva, V, Demetrashvili, Z, Di Saverio, S, Tolonen, M, Navsaria, P, Bala, M, Balogh, Z, Litvin, A, Hecker, A, Wani, I, Fette, A, De Simone, B, Ivatury, R, Picetti, E, Khokha, V, Tan, E, Ball, C, Tascini, C, Cui, Y, Coimbra, R, Kelly, M, Martino, C, Agnoletti, V, Boermeester, M, De'Angelis, N, Chirica, M, Biffl, W, Ansaloni, L, Kluger, Y, Catena, F, Kirkpatrick, A, Coccolini F., Sartelli M., Sawyer R., Rasa K., Viaggi B., Abu-Zidan F., Soreide K., Hardcastle T., Gupta D., Bendinelli C., Ceresoli M., Shelat V. G., Broek R., Baiocchi G. L., Moore E. E., Sall I., Podda M., Bonavina L., Kryvoruchko I. A., Stahel P., Inaba K., Montravers P., Sakakushev B., Sganga G., Ballestracci P., Malbrain M. L. N. G., Vincent J. -L., Pikoulis M., Beka S. G., Doklestic K., Chiarugi M., Falcone M., Bignami E., Reva V., Demetrashvili Z., Di Saverio S., Tolonen M., Navsaria P., Bala M., Balogh Z., Litvin A., Hecker A., Wani I., Fette A., De Simone B., Ivatury R., Picetti E., Khokha V., Tan E., Ball C., Tascini C., Cui Y., Coimbra R., Kelly M., Martino C., Agnoletti V., Boermeester M. A., De'Angelis N., Chirica M., Biffl W. L., Ansaloni L., Kluger Y., Catena F., and Kirkpatrick A. W.

Abstract

Intra-abdominal infections (IAI) are among the most common global healthcare challenges and they are usually precipitated by disruption to the gastrointestinal (GI) tract. Their successful management typically requires intensive resource utilization, and despite the best therapies, morbidity and mortality remain high. One of the main issues required to appropriately treat IAI that differs from the other etiologies of sepsis is the frequent requirement to provide physical source control. Fortunately, dramatic advances have been made in this aspect of treatment. Historically, source control was left to surgeons only. With new technologies non-surgical less invasive interventional procedures have been introduced. Alternatively, in addition to formal surgery open abdomen techniques have long been proposed as aiding source control in severe intra-abdominal sepsis. It is ironic that while a lack or even delay regarding source control clearly associates with death, it is a concept that remains poorly described. For example, no conclusive definition of source control technique or even adequacy has been universally accepted. Practically, source control involves a complex definition encompassing several factors including the causative event, source of infection bacteria, local bacterial flora, patient condition, and his/her eventual comorbidities. With greater understanding of the systemic pathobiology of sepsis and the profound implications of the human microbiome, adequate source control is no longer only a surgical issue but one that requires a multidisciplinary, multimodality approach. Thus, while any breach in the GI tract must be controlled, source control should also attempt to control the generation and propagation of the systemic biomediators and dysbiotic influences on the microbiome that perpetuate multi-system organ failure and death. Given these increased complexities, the present paper represents the current opinions and recommendations for future research of th

Published
2023

6. 2023 WSES guidelines for the prevention, detection, and management of iatrogenic urinary tract injuries (IUTIs) during emergency digestive surgery

Author

De'Angelis, N, Schena, C, Marchegiani, F, Reitano, E, De Simone, B, Wong, G, Martinez-Perez, A, Abu-Zidan, F, Agnoletti, V, Aisoni, F, Ammendola, M, Ansaloni, L, Bala, M, Biffl, W, Ceccarelli, G, Ceresoli, M, Chiara, O, Chiarugi, M, Cimbanassi, S, Coccolini, F, Coimbra, R, Di Saverio, S, Diana, M, Dioguardi Burgio, M, Fraga, G, Gavriilidis, P, Gurrado, A, Inchingolo, R, Ingels, A, Ivatury, R, Kashuk, J, Khan, J, Kirkpatrick, A, Kim, F, Kluger, Y, Lakkis, Z, Leppaniemi, A, Maier, R, Memeo, R, Moore, E, Ordonez, C, Peitzman, A, Pellino, G, Picetti, E, Pikoulis, M, Pisano, M, Podda, M, Romeo, O, Rosa, F, Tan, E, Ten Broek, R, Testini, M, Tian Wei Cheng, B, Weber, D, Sacco, E, Sartelli, M, Tonsi, A, Dal Moro, F, Catena, F, de'Angelis N., Schena C. A., Marchegiani F., Reitano E., De Simone B., Wong G. Y. M., Martinez-Perez A., Abu-Zidan F. M., Agnoletti V., Aisoni F., Ammendola M., Ansaloni L., Bala M., Biffl W., Ceccarelli G., Ceresoli M., Chiara O., Chiarugi M., Cimbanassi S., Coccolini F., Coimbra R., Di Saverio S., Diana M., Dioguardi Burgio M., Fraga G., Gavriilidis P., Gurrado A., Inchingolo R., Ingels A., Ivatury R., Kashuk J. L., Khan J., Kirkpatrick A. W., Kim F. J., Kluger Y., Lakkis Z., Leppaniemi A., Maier R. V., Memeo R., Moore E. E., Ordonez C. A., Peitzman A. B., Pellino G., Picetti E., Pikoulis M., Pisano M., Podda M., Romeo O., Rosa F., Tan E., Ten Broek R. P., Testini M., Tian Wei Cheng B. A., Weber D., Sacco E., Sartelli M., Tonsi A., Dal Moro F., Catena F., De'Angelis, N, Schena, C, Marchegiani, F, Reitano, E, De Simone, B, Wong, G, Martinez-Perez, A, Abu-Zidan, F, Agnoletti, V, Aisoni, F, Ammendola, M, Ansaloni, L, Bala, M, Biffl, W, Ceccarelli, G, Ceresoli, M, Chiara, O, Chiarugi, M, Cimbanassi, S, Coccolini, F, Coimbra, R, Di Saverio, S, Diana, M, Dioguardi Burgio, M, Fraga, G, Gavriilidis, P, Gurrado, A, Inchingolo, R, Ingels, A, Ivatury, R, Kashuk, J, Khan, J, Kirkpatrick, A, Kim, F, Kluger, Y, Lakkis, Z, Leppaniemi, A, Maier, R, Memeo, R, Moore, E, Ordonez, C, Peitzman, A, Pellino, G, Picetti, E, Pikoulis, M, Pisano, M, Podda, M, Romeo, O, Rosa, F, Tan, E, Ten Broek, R, Testini, M, Tian Wei Cheng, B, Weber, D, Sacco, E, Sartelli, M, Tonsi, A, Dal Moro, F, Catena, F, de'Angelis N., Schena C. A., Marchegiani F., Reitano E., De Simone B., Wong G. Y. M., Martinez-Perez A., Abu-Zidan F. M., Agnoletti V., Aisoni F., Ammendola M., Ansaloni L., Bala M., Biffl W., Ceccarelli G., Ceresoli M., Chiara O., Chiarugi M., Cimbanassi S., Coccolini F., Coimbra R., Di Saverio S., Diana M., Dioguardi Burgio M., Fraga G., Gavriilidis P., Gurrado A., Inchingolo R., Ingels A., Ivatury R., Kashuk J. L., Khan J., Kirkpatrick A. W., Kim F. J., Kluger Y., Lakkis Z., Leppaniemi A., Maier R. V., Memeo R., Moore E. E., Ordonez C. A., Peitzman A. B., Pellino G., Picetti E., Pikoulis M., Pisano M., Podda M., Romeo O., Rosa F., Tan E., Ten Broek R. P., Testini M., Tian Wei Cheng B. A., Weber D., Sacco E., Sartelli M., Tonsi A., Dal Moro F., and Catena F.

Abstract

Iatrogenic urinary tract injury (IUTI) is a severe complication of emergency digestive surgery. It can lead to increased postoperative morbidity and mortality and have a long-term impact on the quality of life. The reported incidence of IUTIs varies greatly among the studies, ranging from 0.3 to 1.5%. Given the high volume of emergency digestive surgery performed worldwide, there is a need for well-defined and effective strategies to prevent and manage IUTIs. Currently, there is a lack of consensus regarding the prevention, detection, and management of IUTIs in the emergency setting. The present guidelines, promoted by the World Society of Emergency Surgery (WSES), were developed following a systematic review of the literature and an international expert panel discussion. The primary aim of these WSES guidelines is to provide evidence-based recommendations to support clinicians and surgeons in the prevention, detection, and management of IUTIs during emergency digestive surgery. The following key aspects were considered: (1) effectiveness of preventive interventions for IUTIs during emergency digestive surgery; (2) intra-operative detection of IUTIs and appropriate management strategies; (3) postoperative detection of IUTIs and appropriate management strategies and timing; and (4) effectiveness of antibiotic therapy (including type and duration) in case of IUTIs.

Published
2023

7. 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

8. Assessing and managing frailty in emergency laparotomy: a WSES position paper

Author

Tian, B, Stahel, P, Picetti, E, Campanelli, G, Di Saverio, S, Moore, E, Bensard, D, Sakakushev, B, Galante, J, Fraga, G, Koike, K, Di Carlo, I, Tebala, G, Leppaniemi, A, Tan, E, Damaskos, D, De'Angelis, N, Hecker, A, Pisano, M, Yunfengcui, Maier, R, De Simone, B, Amico, F, Ceresoli, M, Pikoulis, M, Weber, D, Biffl, W, Beka, S, Abu-Zidan, F, Valentino, M, Coccolini, F, Kluger, Y, Sartelli, M, Agnoletti, V, Chirica, M, Bravi, F, Sall, I, Catena, F, Tian B. W. C. A., Stahel P. F., Picetti E., Campanelli G., Di Saverio S., Moore E., Bensard D., Sakakushev B., Galante J., Fraga G. P., Koike K., Di Carlo I., Tebala G. D., Leppaniemi A., Tan E., Damaskos D., De'Angelis N., Hecker A., Pisano M., YunfengCui, Maier R. V., De Simone B., Amico F., Ceresoli M., Pikoulis M., Weber D. G., Biffl W., Beka S. G., Abu-Zidan F. M., Valentino M., Coccolini F., Kluger Y., Sartelli M., Agnoletti V., Chirica M., Bravi F., Sall I., Catena F., Tian, B, Stahel, P, Picetti, E, Campanelli, G, Di Saverio, S, Moore, E, Bensard, D, Sakakushev, B, Galante, J, Fraga, G, Koike, K, Di Carlo, I, Tebala, G, Leppaniemi, A, Tan, E, Damaskos, D, De'Angelis, N, Hecker, A, Pisano, M, Yunfengcui, Maier, R, De Simone, B, Amico, F, Ceresoli, M, Pikoulis, M, Weber, D, Biffl, W, Beka, S, Abu-Zidan, F, Valentino, M, Coccolini, F, Kluger, Y, Sartelli, M, Agnoletti, V, Chirica, M, Bravi, F, Sall, I, Catena, F, Tian B. W. C. A., Stahel P. F., Picetti E., Campanelli G., Di Saverio S., Moore E., Bensard D., Sakakushev B., Galante J., Fraga G. P., Koike K., Di Carlo I., Tebala G. D., Leppaniemi A., Tan E., Damaskos D., De'Angelis N., Hecker A., Pisano M., YunfengCui, Maier R. V., De Simone B., Amico F., Ceresoli M., Pikoulis M., Weber D. G., Biffl W., Beka S. G., Abu-Zidan F. M., Valentino M., Coccolini F., Kluger Y., Sartelli M., Agnoletti V., Chirica M., Bravi F., Sall I., and Catena F.

Abstract

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

Published
2023

9. WSES consensus guidelines on sigmoid volvulus management

Author

Tian, B, Vigutto, G, Tan, E, van Goor, H, Bendinelli, C, Abu-Zidan, F, Ivatury, R, Sakakushev, B, Di Carlo, I, Sganga, G, Maier, R, Coimbra, R, Leppaniemi, A, Litvin, A, Damaskos, D, Broek, R, Biffl, W, Di Saverio, S, De Simone, B, Ceresoli, M, Picetti, E, Galante, J, Tebala, G, Beka, S, Bonavina, L, Cui, Y, Khan, J, Cicuttin, E, Amico, F, Kenji, I, Hecker, A, Ansaloni, L, Sartelli, M, Moore, E, Kluger, Y, Testini, M, Weber, D, Agnoletti, V, Angelis, N, Coccolini, F, Sall, I, Catena, F, Tian B. W. C. A., Vigutto G., Tan E., van Goor H., Bendinelli C., Abu-Zidan F., Ivatury R., Sakakushev B., Di Carlo I., Sganga G., Maier R. V., Coimbra R., Leppaniemi A., Litvin A., Damaskos D., Broek R. T., Biffl W., Di Saverio S., De Simone B., Ceresoli M., Picetti E., Galante J., Tebala G. D., Beka S. G., Bonavina L., Cui Y., Khan J., Cicuttin E., Amico F., Kenji I., Hecker A., Ansaloni L., Sartelli M., Moore E. E., Kluger Y., Testini M., Weber D., Agnoletti V., Angelis N. D., Coccolini F., Sall I., Catena F., Tian, B, Vigutto, G, Tan, E, van Goor, H, Bendinelli, C, Abu-Zidan, F, Ivatury, R, Sakakushev, B, Di Carlo, I, Sganga, G, Maier, R, Coimbra, R, Leppaniemi, A, Litvin, A, Damaskos, D, Broek, R, Biffl, W, Di Saverio, S, De Simone, B, Ceresoli, M, Picetti, E, Galante, J, Tebala, G, Beka, S, Bonavina, L, Cui, Y, Khan, J, Cicuttin, E, Amico, F, Kenji, I, Hecker, A, Ansaloni, L, Sartelli, M, Moore, E, Kluger, Y, Testini, M, Weber, D, Agnoletti, V, Angelis, N, Coccolini, F, Sall, I, Catena, F, Tian B. W. C. A., Vigutto G., Tan E., van Goor H., Bendinelli C., Abu-Zidan F., Ivatury R., Sakakushev B., Di Carlo I., Sganga G., Maier R. V., Coimbra R., Leppaniemi A., Litvin A., Damaskos D., Broek R. T., Biffl W., Di Saverio S., De Simone B., Ceresoli M., Picetti E., Galante J., Tebala G. D., Beka S. G., Bonavina L., Cui Y., Khan J., Cicuttin E., Amico F., Kenji I., Hecker A., Ansaloni L., Sartelli M., Moore E. E., Kluger Y., Testini M., Weber D., Agnoletti V., Angelis N. D., Coccolini F., Sall I., and Catena F.

Abstract

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

Published
2023

10. The new timing in acute care surgery (new TACS) classification: a WSES Delphi consensus study

Author

De Simone, B, Kluger, Y, Moore, E, Sartelli, M, Abu-Zidan, F, Coccolini, F, Ansaloni, L, Tebala, G, Di Saverio, S, Di Carlo, I, Sakakushev, B, Bonavina, L, Sugrue, M, Galante, J, Ivatury, R, Picetti, E, Chirica, M, Wani, I, Bala, M, Sall, I, Kirkpatrick, A, Shelat, V, Pikoulis, E, Leppäniemi, A, Tan, E, Broek, R, Gurmu Beka, S, Litvin, A, Chouillard, E, Coimbra, R, Cui, Y, De’ Angelis, N, Sganga, G, Stahel, P, Agnoletti, V, Rampini, A, Damaskos, D, Carcoforo, P, Biffl, W, Hecker, A, Di Salomone, S, Balogh, Z, Beka, S, Velmahos, G, Ceresoli, M, Chiara, O, Leppaniemi, A, Marzi, I, Inaba, K, Khokha, V, Reva, V, Khan, M, Toro, A, de’ Angelis, N, Malangoni, M, Scozzafava, E, Civil, I, Maier, R, Weber, D, Chiarugi, M, Soreide, K, Testini, M, Bravi, F, Catena, F, De Simone B., Kluger Y., Moore E. E., Sartelli M., Abu-Zidan F. M., Coccolini F., Ansaloni L., Tebala G. D., Di Saverio S., Di Carlo I., Sakakushev B. E., Bonavina L., Sugrue M., Galante J. M., Ivatury R., Picetti E., Chirica M., Wani I., Bala M., Sall I., Kirkpatrick A. W., Shelat V. G., Pikoulis E., Leppäniemi A., Tan E., Broek R. P. G. t., Gurmu Beka S., Litvin A., Chouillard E., Coimbra R., Cui Y., De’ Angelis N., Sganga G., Stahel P. F., Agnoletti V., Rampini A., Shelat V., Damaskos D., Carcoforo P., Biffl W. L., Hecker A., Kirkpatrick A., Di Salomone S., Balogh Z., Beka S. G., Broek R. T., Velmahos G., Sakakushev B., Ceresoli M., Chiara O., Stahel P., Leppaniemi A., Marzi I., Inaba K., Khokha V., Reva V., Khan M., Toro A., de’ Angelis N., Malangoni M., Scozzafava E., Civil I., Maier R., Weber D., Chiarugi M., Soreide K., Testini M., Bravi F., Maier R. V., Catena F., De Simone, B, Kluger, Y, Moore, E, Sartelli, M, Abu-Zidan, F, Coccolini, F, Ansaloni, L, Tebala, G, Di Saverio, S, Di Carlo, I, Sakakushev, B, Bonavina, L, Sugrue, M, Galante, J, Ivatury, R, Picetti, E, Chirica, M, Wani, I, Bala, M, Sall, I, Kirkpatrick, A, Shelat, V, Pikoulis, E, Leppäniemi, A, Tan, E, Broek, R, Gurmu Beka, S, Litvin, A, Chouillard, E, Coimbra, R, Cui, Y, De’ Angelis, N, Sganga, G, Stahel, P, Agnoletti, V, Rampini, A, Damaskos, D, Carcoforo, P, Biffl, W, Hecker, A, Di Salomone, S, Balogh, Z, Beka, S, Velmahos, G, Ceresoli, M, Chiara, O, Leppaniemi, A, Marzi, I, Inaba, K, Khokha, V, Reva, V, Khan, M, Toro, A, de’ Angelis, N, Malangoni, M, Scozzafava, E, Civil, I, Maier, R, Weber, D, Chiarugi, M, Soreide, K, Testini, M, Bravi, F, Catena, F, De Simone B., Kluger Y., Moore E. E., Sartelli M., Abu-Zidan F. M., Coccolini F., Ansaloni L., Tebala G. D., Di Saverio S., Di Carlo I., Sakakushev B. E., Bonavina L., Sugrue M., Galante J. M., Ivatury R., Picetti E., Chirica M., Wani I., Bala M., Sall I., Kirkpatrick A. W., Shelat V. G., Pikoulis E., Leppäniemi A., Tan E., Broek R. P. G. t., Gurmu Beka S., Litvin A., Chouillard E., Coimbra R., Cui Y., De’ Angelis N., Sganga G., Stahel P. F., Agnoletti V., Rampini A., Shelat V., Damaskos D., Carcoforo P., Biffl W. L., Hecker A., Kirkpatrick A., Di Salomone S., Balogh Z., Beka S. G., Broek R. T., Velmahos G., Sakakushev B., Ceresoli M., Chiara O., Stahel P., Leppaniemi A., Marzi I., Inaba K., Khokha V., Reva V., Khan M., Toro A., de’ Angelis N., Malangoni M., Scozzafava E., Civil I., Maier R., Weber D., Chiarugi M., Soreide K., Testini M., Bravi F., Maier R. V., and Catena F.

Abstract

Background: Timely access to the operating room for emergency general surgery (EGS) indications remains a challenge across the globe, largely driven by operating room availability and staffing constraints. The “timing in acute care surgery” (TACS) classification was previously published to introduce a new tool to triage the timely and appropriate access of EGS patients to the operating room. However, the clinical and operational effectiveness of the TACS classification has not been investigated in subsequent validation studies. This study aimed to improve the TACS classification and provide further consensus around the appropriate use of the new TACS classification through a standardized Delphi approach with international experts. Methods: This is a validation study of the new TACS by a selected international panel of experts using the Delphi method. The TACS questionnaire was designed as a web-based survey. The consensus agreement level was established to be ≥ 75%. The collective consensus agreement was defined as the sum of the percentage of the highest Likert scale levels (4–5) out of all participants. Surgical emergency diseases and correlated clinical scenarios were defined for each of the proposed classes. Subsequent rounds were carried out until a definitive level of consensus was reached. Frequencies and percentages were calculated to determine the degree of agreement for each surgical disease. Results: Four polling rounds were carried out. The new TACS classification provides 6 colour-code classes correlated to a precise timing to surgery, defined scenarios and surgical condition. The WHITE colour-code class was introduced to rapidly (within a week) reschedule cancelled or postponed surgical procedures. Haemodynamic stability is the main tool to stratify patients for immediate surgery or not in the presence of sepsis/septic shock. Fifty-one surgical diseases were included in the different colour-code classes of priority. Conclusion: The new TACS classificat

Published
2023

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

Author

Cobianchi, L, Piccolo, D, Dal Mas, F, Agnoletti, V, Ansaloni, L, Balch, J, Biffl, W, Butturini, G, Catena, F, Coccolini, F, Denicolai, S, De Simone, B, Frigerio, I, Fugazzola, P, Marseglia, G, Martellucci, J, Modenese, M, Previtali, P, Ruta, F, Venturi, A, Kaafarani, H, Loftus, T, Abbott, K, Abdelmalik, A, Abebe, N, Abu-Zidan, F, Adam, Y, Adamou, H, Adamovich, D, Agresta, F, Agrusa, A, Akin, E, Alessiani, M, Alexandrino, H, Ali, S, Mihai, V, Almeida, P, Al-Shehari, M, Altomare, M, Amico, F, Ammendola, M, Andreuccetti, J, Anestiadou, E, Angelos, P, Annicchiarico, A, Antonelli, A, Aparicio-Sanchez, D, Ardito, A, Argenio, G, Arvieux, C, Askevold, I, Atanasov, B, Augustin, G, Awad, S, Bacchiocchi, G, Bagnoli, C, Bahouth, H, Baili, E, Bains, L, Baiocchi, G, Bala, M, Balague, C, Balalis, D, Baldini, E, Baraket, O, Baral, S, Barone, M, Barranquero, A, Barreras, J, Bass, G, Bayhan, Z, Bellanova, G, Ben-Ishay, O, Bert, F, Bianchi, V, Biancuzzi, H, Bidoli, C, Radulescu, R, Bignell, M, Biloslavo, A, Bini, R, Bissacco, D, Boati, P, Boddaert, G, Bogdanic, B, Bombardini, C, Bonavina, L, Bonomo, L, Bottari, A, Bouliaris, K, Brachini, G, Brillantino, A, Brisinda, G, Bulanauca, M, Buonomo, L, Burcharth, J, Buscemi, S, Calabretto, F, Calini, G, Calu, V, Campanile, F, Dall'Orto, R, Campos-Serra, A, Campostrini, S, Capoglu, R, Carvas, J, Cascella, M, Pattacini, G, Celentano, V, Centonze, D, Ceresoli, M, Chatzipetris, D, Chessa, A, Chiarello, M, Chirica, M, Chooklin, S, Chouliaras, C, Chowdhury, S, Cianci, P, Cillara, N, Cimbanassi, S, Cioffi, S, Colak, E, Ruiz, E, Conti, L, Coppola, A, De Sa, T, Costa, S, Cozza, V, Curro', G, Dabekaussen, K, D'Acapito, F, Damaskos, D, D'Ambrosio, G, Das, K, Davies, R, De Beaux, A, Fernandez, S, De Luca, A, De Stefano, F, Degrate, L, Demetrashvili, Z, Demetriades, A, Detanac, D, Dezi, A, Di Buono, G, Di Carlo, I, Di Lascio, P, Di Martino, M, Di Saverio, S, Diaconescu, B, Diaz, J, Dibra, R, Dimitrov, E, Dinuzzi, V, Dios-Barbeito, S, Diyani, J, Dogjani, A, Domanin, M, D'Oria, M, Munoz-Cruzado, V, East, B, Ekelund, M, Ekwen, G, Elbaih, A, Elhadi, M, Enninghorst, N, Ernisova, M, Escalera-Antezana, J, Esposito, S, Esposito, G, Estaire, M, Fare, C, Farre, R, Favi, F, Ferrario, L, Vajana, A, Filisetti, C, Fleres, F, Fonseca, V, Forero-Torres, A, Forfori, F, Fortuna, L, Fradelos, E, Fraga, G, Fransvea, P, Frassini, S, Frazzetta, G, Pizzocaro, E, Frountzas, M, Gachabayov, M, Galeiras, R, Vazquez, A, Gargarella, S, Garzali, I, Ghannam, W, Ghazi, F, Gillman, L, Gioco, R, Giordano, A, Giordano, L, Giove, C, Giraudo, G, Giuffrida, M, Capponi, M, Gois, E, Gomes, C, Gomes, F, Gonsaga, R, Gonullu, E, Goosen, J, Goranovic, T, Gracia-Roman, R, Graziano, G, Griffiths, E, Guagni, T, Hadzhiev, D, Haidar, M, Hamid, H, Hardcastle, T, Hayati, F, Healey, A, Hecker, A, Hecker, M, Garcia, E, Hodonou, A, Huaman, E, Huerta, M, Ibrahim, A, Ibrahim, B, Ietto, G, Inama, M, Ioannidis, O, Isik, A, Ismail, N, Ismail, A, Jailani, R, Jang, J, Kalfountzos, C, Kalipershad, S, Kaouras, E, Kaplan, L, Kara, Y, Karamagioli, E, Karamarkovia, A, Katsaros, I, Kavalakat, A, Kechagias, A, Kenig, J, Kessel, B, Khan, J, Khokha, V, Kim, J, Kirkpatrick, A, Klappenbach, R, Kluger, Y, Kobe, Y, Lymperis, E, Kok, K, Kong, V, Korkolis, D, Koukoulis, G, Kovacevic, B, Kruger, V, Kryvoruchko, I, Kurihara, H, Kuriyama, A, Landaluce-Olavarria, A, Lapolla, P, Leppaniemi, A, Licari, L, Lisi, G, Litvin, A, Lizarazu, A, Bayo, H, Lohsiriwat, V, Moreira, C, Lostoridis, E, Luna, A, Luppi, D, Machain, V, Maegele, M, Maggiore, D, Magnone, S, Maier, R, Major, P, Manangi, M, Manetti, A, Mantoglu, B, Marafante, C, Mariani, F, Marinis, A, Mariot, E, Martines, G, Perez, A, Martino, C, Mascagni, P, Massalou, D, Massaro, M, Matias-Garcia, B, Mazzarella, G, Mazzarolo, G, Melo, R, Mendoza-Moreno, F, Meric, S, Meyer, J, Miceli, L, Michalopoulos, N, Milana, F, Mingoli, A, Mishra, T, Mohamed, M, Mohamedahmed, A, Mohammed, M, Mohan, R, Moore, E, Morales-Garcia, D, Muhrbeck, M, Mulita, F, Mustafa, S, Muttillo, E, Naimzada, M, Navsaria, P, Negoi, I, Nespoli, L, Nguyen, C, Nidaw, M, Nigri, G, Nikolopoulos, I, O'Connor, D, Ogundipe, H, Oliveri, C, Olmi, S, Ong, E, Orecchia, L, Osipov, A, Othman, M, Pace, M, Pacilli, M, Pagani, L, Palomba, G, Pantalone, D, Panyko, A, Paolillo, C, Papa, M, Papaconstantinou, D, Papadoliopoulou, M, Papadopoulos, A, Papis, D, Pararas, N, Parreira, J, Parry, N, Pata, F, Patel, T, Paterson-Brown, S, Pavone, G, Pecchini, F, Pegoraro, V, Pellino, G, Pelloni, M, Peloso, A, Del Pozo, E, Pereira, R, Pereira, B, Perez, S, Perra, T, Perrone, G, Pesce, A, Petagna, L, Petracca, G, Phupong, V, Picardi, B, Picciariello, A, Piccoli, M, Picetti, E, Pikoulis, E, Pintar, T, Pirozzolo, G, Piscioneri, F, Podda, M, Porcu, A, Privitera, F, Punzo, C, Quaresima, S, Quiodettis, M, Qvist, N, Rahim, R, de Almeida, F, Ramely, R, Rasa, H, Reichert, M, Reinisch-Liese, A, Renne, A, Riccetti, C, Rodriguez-Luna, M, Roizblatt, D, Romanzi, A, Romeo, L, Roscio, F, Rosnelifaizur, R, Rossi, S, Rubiano, A, Ruiz-Ucar, E, Sakakushev, B, Salamea, J, Sall, I, Samarakoon, L, Sammartano, F, Arteaga, A, Sanchez-Cordero, S, Santoanastaso, D, Sartelli, M, Sasia, D, Sato, N, Savchuk, A, Sawyer, R, Scaioli, G, Schizas, D, Sebastiani, S, Seeliger, B, Lohse, H, Seretis, C, Sermonesi, G, Serradilla-Martin, M, Shelat, V, Shlyapnikov, S, Sidiropoulos, T, Simoes, R, Siragusa, L, Siribumrungwong, B, Slavchev, M, Solaini, L, Soldini, G, Sopuev, A, Soreide, K, Sovatzidis, A, Stahel, P, Strickland, M, Sultan, M, Sydorchuk, R, Sydorchuk, L, Syed, S, Tallon-Aguilar, L, Tamburini, A, Tamini, N, Tan, E, Tan, J, Tarasconi, A, Tartaglia, N, Tartaglia, G, Tartaglia, D, Taylor, J, Tebala, G, Teuben, M, Theodorou, A, Tolonen, M, Tomasicchio, G, Toro, A, Torre, B, Triantafyllou, T, Trigiante, G, Tripepi, M, Trostchansky, J, Tsekouras, K, Turrado-Rodriguez, V, Tutino, R, Uccelli, M, Uchikov, P, Ugarte-Sierra, B, Ukkonen, M, Vailas, M, Vassiliu, P, Vazquez, R, Velmahos, G, Verde, J, Veroux, M, Vigano, J, Vilallonga, R, Visconti, D, Vittori, A, Waledziak, M, Wannatoop, T, Widmer, L, Wilson, M, Woltz, S, Wong, T, Xenaki, S, Yu, B, Yule, S, Zachariah, S, Zacharis, G, Zaghi, C, Zakaria, A, Zambrano, D, Zampitis, N, Zampogna, B, Zanghi, S, Zantedeschi, M, Zapsalis, K, Zattoni, F, Zese, M, Cobianchi L., Piccolo D., Dal Mas F., Agnoletti V., Ansaloni L., Balch J., Biffl W., Butturini G., Catena F., Coccolini F., Denicolai S., De Simone B., Frigerio I., Fugazzola P., Marseglia G., Marseglia G. 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B., Biloslavo A., Bini R., Bissacco D., Boati P., Boddaert G., Bogdanic B., Bombardini C., Bonavina L., Bonomo L., Bottari A., Bouliaris K., Brachini G., Brillantino A., Brisinda G., Bulanauca M. M., Buonomo L. A., Burcharth J., Buscemi S., Calabretto F., Calini G., Calu V., Campanile F. C., Dall'Orto R. C., Campos-Serra A., Campostrini S., Capoglu R., Carvas J. M., Cascella M., Pattacini G. C., Celentano V., Centonze D. C., Ceresoli M., Chatzipetris D., Chessa A., Chiarello M. M., Chirica M., Chooklin S., Chouliaras C., Chowdhury S., Cianci P., Cillara N., Cimbanassi S., Cioffi S. P. B., Colak E., Ruiz E. C., Conti L., Coppola A., De Sa T. C., Costa S. D., Cozza V., Curro' G., Dabekaussen K. F. A. -S. A., D'acapito F., Damaskos D., D'ambrosio G., Das K., Davies R. J., De Beaux A. C., Fernandez S. P. L., De Luca A., De Stefano F., Degrate L., Demetrashvili Z., Demetriades A. K., Detanac D. S., Dezi A., Di Buono G., Di Carlo I., Di Lascio P., Di Martino M., Di Saverio S., Diaconescu B., Diaz J. J., Dibra R., Dimitrov E. N., Dinuzzi V. P., Dios-Barbeito S., Diyani J. F. A., Dogjani A., Domanin M., D'Oria M., Munoz-Cruzado V. D., East B., Ekelund M., Ekwen G. T., Elbaih A. H., Elhadi M., Enninghorst N., Ernisova M., Escalera-Antezana J. P., Esposito S., Esposito G., Estaire M., Fare C. N., Farre R., Favi F., Ferrario L., Vajana A. F. T., Filisetti C., Fleres F., Fonseca V. C., Forero-Torres A., Forfori F., Fortuna L., Fradelos E., Fraga G. P., Fransvea P., Frassini S., Frazzetta G., Pizzocaro E., Frountzas M., Gachabayov M., Galeiras R., Vazquez A. A. G., Gargarella S., Garzali I. U., Ghannam W. M., Ghazi F. N., Gillman L. M., Gioco R., Giordano A., Giordano L., Giove C., Giraudo G., Giuffrida M., Capponi M. G., Gois E., Gomes C. A., Gomes F. C., Gonsaga R. A. T., Gonullu E., Goosen J., Goranovic T., Gracia-Roman R., Graziano G. M. P., Griffiths E. A., Guagni T., Hadzhiev D. B., Haidar M. G., Hamid H. K. S., Hardcastle T. C., Hayati F., Healey A. J., Hecker A., Hecker M., Garcia E. F. H., Hodonou A. M., Huaman E. C., Huerta M., Ibrahim A. F., Ibrahim B. M. S., Ietto G., Inama M., Ioannidis O., Isik A., Ismail N., Ismail A. M. H., Jailani R. F., Jang J. Y., Kalfountzos C., Kalipershad S. N. R., Kaouras E., Kaplan L. J., Kara Y., Karamagioli E., Karamarkovia A., Katsaros I., Kavalakat A. J., Kechagias A., Kenig J., Kessel B. J., Khan J. S., Khokha V., Kim J. I., Kirkpatrick A. W., Klappenbach R., Kluger Y., Kobe Y., Lymperis E. K., Kok K. Y. Y., Kong V., Korkolis D. P., Koukoulis G., Kovacevic B., Kruger V. F., Kryvoruchko I. A., Kurihara H., Kuriyama A., Landaluce-Olavarria A., Lapolla P., Leppaniemi A., Licari L., Lisi G., Litvin A., Lizarazu A., Bayo H. L., Lohsiriwat V., Moreira C. C. L., Lostoridis E., Luna A. T., Luppi D., Machain V. G. M., Maegele M., Maggiore D., Magnone S., Maier R. V., Major P., Manangi M., Manetti A., Mantoglu B., Marafante C., Mariani F., Marinis A., Mariot E. A. S., Martines G., Perez A. M., Martino C., Mascagni P., Massalou D., Massaro M., Matias-Garcia B., Mazzarella G., Mazzarolo G., Melo R. B., Mendoza-Moreno F., Meric S., Meyer J., Miceli L., Michalopoulos N. V., Milana F., Mingoli A., Mishra T. S., Mohamed M., Mohamed M. I. E. A., Mohamedahmed A. Y., Mohammed M. J. S., Mohan R., Moore E. E., Morales-Garcia D., Muhrbeck M., Mulita F., Mustafa S. M. S., Muttillo E. M., Naimzada M. D., Navsaria P. H., Negoi I., Nespoli L., Nguyen C., Nidaw M. K., Nigri G., Nikolopoulos I., O'connor D. B., Ogundipe H. D., Oliveri C., Olmi S., Ong E. C. W., Orecchia L., Osipov A. V., Othman M. F., Pace M., Pacilli M., Pagani L., Palomba G., Pantalone D., Panyko A., Paolillo C., Papa M. V., Papaconstantinou D., Papadoliopoulou M., Papadopoulos A., Papis D., Pararas N., Parreira J. G., Parry N. G., Pata F., Patel T., Paterson-Brown S., Pavone G., Pecchini F., Pegoraro V., Pellino G., Pelloni M., Peloso A., Del Pozo E. P., Pereira R. G., Pereira B. M., Perez A. L., Perez S., Perra T., Perrone G., Pesce A., Petagna L., Petracca G., Phupong V., Picardi B., Picciariello A., Piccoli M., Picetti E., Pikoulis E. P., Pintar T., Pirozzolo G., Piscioneri F., Podda M., Porcu A., Privitera F., Punzo C., Quaresima S., Quiodettis M. A., Qvist N., Rahim R., de Almeida F. R., Ramely R. B., Rasa H. K., Reichert M., Reinisch-Liese A., Renne A., Riccetti C., Rodriguez-Luna M. R., Roizblatt D., Romanzi A., Romeo L., Roscio F. P. M., Rosnelifaizur R. B., Rossi S., Rubiano A. M., Ruiz-Ucar E., Sakakushev B. E., Salamea J. C., Sall I., Samarakoon L. B., Sammartano F., Arteaga A. S., Sanchez-Cordero S., Santoanastaso D. P. M., Sartelli M., Sasia D., Sato N., Savchuk A., Sawyer R. G., Scaioli G., Schizas D., Sebastiani S., Seeliger B., Lohse H. A. S., Seretis C., Sermonesi G., Serradilla-Martin M., Shelat V. G., Shlyapnikov S., Sidiropoulos T., Simoes R. L., Siragusa L., Siribumrungwong B., Slavchev M., Solaini L., Soldini G., Sopuev A., Soreide K., Sovatzidis A., Stahel P. F., Strickland M., Sultan M. A. H., Sydorchuk R., Sydorchuk L., Syed S. M. A. M., Tallon-Aguilar L., Tamburini A. M., Tamini N., Tan E. C. T. H., Tan J. H., Tarasconi A., Tartaglia N., Tartaglia G., Tartaglia D., Taylor J. V., Tebala G. D., Teuben M., Theodorou A., Tolonen M., Tomasicchio G., Toro A., Torre B., Triantafyllou T., Trigiante G. T., Tripepi M., Trostchansky J., Tsekouras K., Turrado-Rodriguez V., Tutino R., Uccelli M., Uchikov P. A., Ugarte-Sierra B., Ukkonen M. T., Vailas M., Vassiliu P. G., Vazquez A. G., Vazquez R. G., Velmahos G., Verde J. E., Verde J. M., Veroux M., Vigano J., Vilallonga R., Visconti D., Vittori A., Waledziak M., Wannatoop T., Widmer L. W., Wilson M. S. J., Woltz S., Wong T. H., Xenaki S., Yu B., Yule S., Zachariah S. K., Zacharis G., Zaghi C., Zakaria A. D., Zambrano D. A., Zampitis N., Zampogna B., Zanghi S., Zantedeschi M., Zapsalis K., Zattoni F., Zese M., Cobianchi, L, Piccolo, D, Dal Mas, F, Agnoletti, V, Ansaloni, L, Balch, J, Biffl, W, Butturini, G, Catena, F, Coccolini, F, Denicolai, S, De Simone, B, Frigerio, I, Fugazzola, P, Marseglia, G, Martellucci, J, Modenese, M, Previtali, P, Ruta, F, Venturi, A, Kaafarani, H, Loftus, T, Abbott, K, Abdelmalik, A, Abebe, N, Abu-Zidan, F, Adam, Y, Adamou, H, Adamovich, D, Agresta, F, Agrusa, A, Akin, E, Alessiani, M, Alexandrino, H, Ali, S, Mihai, V, Almeida, P, Al-Shehari, M, Altomare, M, Amico, F, Ammendola, M, Andreuccetti, J, Anestiadou, E, Angelos, P, Annicchiarico, A, Antonelli, A, Aparicio-Sanchez, D, Ardito, A, Argenio, G, Arvieux, C, Askevold, I, Atanasov, B, Augustin, G, Awad, S, Bacchiocchi, G, Bagnoli, C, Bahouth, H, Baili, E, Bains, L, Baiocchi, G, Bala, M, Balague, C, Balalis, D, Baldini, E, Baraket, O, Baral, S, Barone, M, Barranquero, A, Barreras, J, Bass, G, Bayhan, Z, Bellanova, G, Ben-Ishay, O, Bert, F, Bianchi, V, Biancuzzi, H, Bidoli, C, Radulescu, R, Bignell, M, Biloslavo, A, Bini, R, Bissacco, D, Boati, P, Boddaert, G, Bogdanic, B, Bombardini, C, Bonavina, L, Bonomo, L, Bottari, A, Bouliaris, K, Brachini, G, Brillantino, A, Brisinda, G, Bulanauca, M, Buonomo, L, Burcharth, J, Buscemi, S, Calabretto, F, Calini, G, Calu, V, Campanile, F, Dall'Orto, R, Campos-Serra, A, Campostrini, S, Capoglu, R, Carvas, J, Cascella, M, Pattacini, G, Celentano, V, Centonze, D, Ceresoli, M, Chatzipetris, D, Chessa, A, Chiarello, M, Chirica, M, Chooklin, S, Chouliaras, C, Chowdhury, S, Cianci, P, Cillara, N, Cimbanassi, S, Cioffi, S, Colak, E, Ruiz, E, Conti, L, Coppola, A, De Sa, T, Costa, S, Cozza, V, Curro', G, Dabekaussen, K, D'Acapito, F, Damaskos, D, D'Ambrosio, G, Das, K, Davies, R, De Beaux, A, Fernandez, S, De Luca, A, De Stefano, F, Degrate, L, Demetrashvili, Z, Demetriades, A, Detanac, D, Dezi, A, Di Buono, G, Di Carlo, I, Di Lascio, P, Di Martino, M, Di Saverio, S, Diaconescu, B, Diaz, J, Dibra, R, Dimitrov, E, Dinuzzi, V, Dios-Barbeito, S, Diyani, J, Dogjani, A, Domanin, M, D'Oria, M, Munoz-Cruzado, V, East, B, Ekelund, M, Ekwen, G, Elbaih, A, Elhadi, M, Enninghorst, N, Ernisova, M, Escalera-Antezana, J, Esposito, S, Esposito, G, Estaire, M, Fare, C, Farre, R, Favi, F, Ferrario, L, Vajana, A, Filisetti, C, Fleres, F, Fonseca, V, Forero-Torres, A, Forfori, F, Fortuna, L, Fradelos, E, Fraga, G, Fransvea, P, Frassini, S, Frazzetta, G, Pizzocaro, E, Frountzas, M, Gachabayov, M, Galeiras, R, Vazquez, A, Gargarella, S, Garzali, I, Ghannam, W, Ghazi, F, Gillman, L, Gioco, R, Giordano, A, Giordano, L, Giove, C, Giraudo, G, Giuffrida, M, Capponi, M, Gois, E, Gomes, C, Gomes, F, Gonsaga, R, Gonullu, E, Goosen, J, Goranovic, T, Gracia-Roman, R, Graziano, G, Griffiths, E, Guagni, T, Hadzhiev, D, Haidar, M, Hamid, H, Hardcastle, T, Hayati, F, Healey, A, Hecker, A, Hecker, M, Garcia, E, Hodonou, A, Huaman, E, Huerta, M, Ibrahim, A, Ibrahim, B, Ietto, G, Inama, M, Ioannidis, O, Isik, A, Ismail, N, Ismail, A, Jailani, R, Jang, J, Kalfountzos, C, Kalipershad, S, Kaouras, E, Kaplan, L, Kara, Y, Karamagioli, E, Karamarkovia, A, Katsaros, I, Kavalakat, A, Kechagias, A, Kenig, J, Kessel, B, Khan, J, Khokha, V, Kim, J, Kirkpatrick, A, Klappenbach, R, Kluger, Y, Kobe, Y, Lymperis, E, Kok, K, Kong, V, Korkolis, D, Koukoulis, G, Kovacevic, B, Kruger, V, Kryvoruchko, I, Kurihara, H, Kuriyama, A, Landaluce-Olavarria, A, Lapolla, P, Leppaniemi, A, Licari, L, Lisi, G, Litvin, A, Lizarazu, A, Bayo, H, Lohsiriwat, V, Moreira, C, Lostoridis, E, Luna, A, Luppi, D, Machain, V, Maegele, M, Maggiore, D, Magnone, S, Maier, R, Major, P, Manangi, M, Manetti, A, Mantoglu, B, Marafante, C, Mariani, F, Marinis, A, Mariot, E, Martines, G, Perez, A, Martino, C, Mascagni, P, Massalou, D, Massaro, M, Matias-Garcia, B, Mazzarella, G, Mazzarolo, G, Melo, R, Mendoza-Moreno, F, Meric, S, Meyer, J, Miceli, L, Michalopoulos, N, Milana, F, Mingoli, A, Mishra, T, Mohamed, M, Mohamedahmed, A, Mohammed, M, Mohan, R, Moore, E, Morales-Garcia, D, Muhrbeck, M, Mulita, F, Mustafa, S, Muttillo, E, Naimzada, M, Navsaria, P, Negoi, I, Nespoli, L, Nguyen, C, Nidaw, M, Nigri, G, Nikolopoulos, I, O'Connor, D, Ogundipe, H, Oliveri, C, Olmi, S, Ong, E, Orecchia, L, Osipov, A, Othman, M, Pace, M, Pacilli, M, Pagani, L, Palomba, G, Pantalone, D, Panyko, A, Paolillo, C, Papa, M, Papaconstantinou, D, Papadoliopoulou, M, Papadopoulos, A, Papis, D, Pararas, N, Parreira, J, Parry, N, Pata, F, Patel, T, Paterson-Brown, S, Pavone, G, Pecchini, F, Pegoraro, V, Pellino, G, Pelloni, M, Peloso, A, Del Pozo, E, Pereira, R, Pereira, B, Perez, S, Perra, T, Perrone, G, Pesce, A, Petagna, L, Petracca, G, Phupong, V, Picardi, B, Picciariello, A, Piccoli, M, Picetti, E, Pikoulis, E, Pintar, T, Pirozzolo, G, Piscioneri, F, Podda, M, Porcu, A, Privitera, F, Punzo, C, Quaresima, S, Quiodettis, M, Qvist, N, Rahim, R, de Almeida, F, Ramely, R, Rasa, H, Reichert, M, Reinisch-Liese, A, Renne, A, Riccetti, C, Rodriguez-Luna, M, Roizblatt, D, Romanzi, A, Romeo, L, Roscio, F, Rosnelifaizur, R, Rossi, S, Rubiano, A, Ruiz-Ucar, E, Sakakushev, B, Salamea, J, Sall, I, Samarakoon, L, Sammartano, F, Arteaga, A, Sanchez-Cordero, S, Santoanastaso, D, Sartelli, M, Sasia, D, Sato, N, Savchuk, A, Sawyer, R, Scaioli, G, Schizas, D, Sebastiani, S, Seeliger, B, Lohse, H, Seretis, C, Sermonesi, G, Serradilla-Martin, M, Shelat, V, Shlyapnikov, S, Sidiropoulos, T, Simoes, R, Siragusa, L, Siribumrungwong, B, Slavchev, M, Solaini, L, Soldini, G, Sopuev, A, Soreide, K, Sovatzidis, A, Stahel, P, Strickland, M, Sultan, M, Sydorchuk, R, Sydorchuk, L, Syed, S, Tallon-Aguilar, L, Tamburini, A, Tamini, N, Tan, E, Tan, J, Tarasconi, A, Tartaglia, N, Tartaglia, G, Tartaglia, D, Taylor, J, Tebala, G, Teuben, M, Theodorou, A, Tolonen, M, Tomasicchio, G, Toro, A, Torre, B, Triantafyllou, T, Trigiante, G, Tripepi, M, Trostchansky, J, Tsekouras, K, Turrado-Rodriguez, V, Tutino, R, Uccelli, M, Uchikov, P, Ugarte-Sierra, B, Ukkonen, M, Vailas, M, Vassiliu, P, Vazquez, R, Velmahos, G, Verde, J, Veroux, M, Vigano, J, Vilallonga, R, Visconti, D, Vittori, A, Waledziak, M, Wannatoop, T, Widmer, L, Wilson, M, Woltz, S, Wong, T, Xenaki, S, Yu, B, Yule, S, Zachariah, S, Zacharis, G, Zaghi, C, Zakaria, A, Zambrano, D, Zampitis, N, Zampogna, B, Zanghi, S, Zantedeschi, M, Zapsalis, K, Zattoni, F, Zese, M, Cobianchi L., Piccolo D., Dal Mas F., Agnoletti V., Ansaloni L., Balch J., Biffl W., Butturini G., Catena F., Coccolini F., Denicolai S., De Simone B., Frigerio I., Fugazzola P., Marseglia G., Marseglia G. R., Martellucci J., Modenese M., Previtali P., Ruta F., Venturi A., Kaafarani H. M., Loftus T. J., Abbott K. L., Abdelmalik A., Abebe N. S., Abu-Zidan F., Adam Y. A. Y., Adamou H., Adamovich D. M., Agresta F., Agrusa A., Akin E., Alessiani M., Alexandrino H., Ali S. M., Mihai V. A., Almeida P. M., Al-Shehari M. M., Altomare M., Amico F., Ammendola M., Andreuccetti J., Anestiadou E., Angelos P., Annicchiarico A., Antonelli A., Aparicio-Sanchez D., Ardito A., Argenio G., Arvieux C. C., Askevold I. H., Atanasov B. T., Augustin G., Awad S. S., Bacchiocchi G., Bagnoli C., Bahouth H., Baili E., Bains L., Baiocchi G. L., Bala M., Balague C., Balalis D., Baldini E., Baraket O., Baral S., Barone M., Barranquero A. G., Barreras J. A., Bass G. A., Bayhan Z., Bellanova G., Ben-Ishay O., Bert F., Bianchi V., Biancuzzi H., Bidoli C., Radulescu R. B., Bignell M. B., Biloslavo A., Bini R., Bissacco D., Boati P., Boddaert G., Bogdanic B., Bombardini C., Bonavina L., Bonomo L., Bottari A., Bouliaris K., Brachini G., Brillantino A., Brisinda G., Bulanauca M. M., Buonomo L. A., Burcharth J., Buscemi S., Calabretto F., Calini G., Calu V., Campanile F. C., Dall'Orto R. C., Campos-Serra A., Campostrini S., Capoglu R., Carvas J. M., Cascella M., Pattacini G. C., Celentano V., Centonze D. C., Ceresoli M., Chatzipetris D., Chessa A., Chiarello M. M., Chirica M., Chooklin S., Chouliaras C., Chowdhury S., Cianci P., Cillara N., Cimbanassi S., Cioffi S. P. B., Colak E., Ruiz E. C., Conti L., Coppola A., De Sa T. C., Costa S. D., Cozza V., Curro' G., Dabekaussen K. F. A. -S. A., D'acapito F., Damaskos D., D'ambrosio G., Das K., Davies R. J., De Beaux A. C., Fernandez S. P. L., De Luca A., De Stefano F., Degrate L., Demetrashvili Z., Demetriades A. K., Detanac D. S., Dezi A., Di Buono G., Di Carlo I., Di Lascio P., Di Martino M., Di Saverio S., Diaconescu B., Diaz J. J., Dibra R., Dimitrov E. N., Dinuzzi V. P., Dios-Barbeito S., Diyani J. F. A., Dogjani A., Domanin M., D'Oria M., Munoz-Cruzado V. D., East B., Ekelund M., Ekwen G. T., Elbaih A. H., Elhadi M., Enninghorst N., Ernisova M., Escalera-Antezana J. P., Esposito S., Esposito G., Estaire M., Fare C. N., Farre R., Favi F., Ferrario L., Vajana A. F. T., Filisetti C., Fleres F., Fonseca V. C., Forero-Torres A., Forfori F., Fortuna L., Fradelos E., Fraga G. P., Fransvea P., Frassini S., Frazzetta G., Pizzocaro E., Frountzas M., Gachabayov M., Galeiras R., Vazquez A. A. G., Gargarella S., Garzali I. U., Ghannam W. M., Ghazi F. N., Gillman L. M., Gioco R., Giordano A., Giordano L., Giove C., Giraudo G., Giuffrida M., Capponi M. G., Gois E., Gomes C. A., Gomes F. C., Gonsaga R. A. T., Gonullu E., Goosen J., Goranovic T., Gracia-Roman R., Graziano G. M. P., Griffiths E. A., Guagni T., Hadzhiev D. B., Haidar M. G., Hamid H. K. S., Hardcastle T. C., Hayati F., Healey A. J., Hecker A., Hecker M., Garcia E. F. H., Hodonou A. M., Huaman E. C., Huerta M., Ibrahim A. F., Ibrahim B. M. S., Ietto G., Inama M., Ioannidis O., Isik A., Ismail N., Ismail A. M. H., Jailani R. F., Jang J. Y., Kalfountzos C., Kalipershad S. N. R., Kaouras E., Kaplan L. J., Kara Y., Karamagioli E., Karamarkovia A., Katsaros I., Kavalakat A. J., Kechagias A., Kenig J., Kessel B. J., Khan J. S., Khokha V., Kim J. I., Kirkpatrick A. W., Klappenbach R., Kluger Y., Kobe Y., Lymperis E. K., Kok K. Y. Y., Kong V., Korkolis D. P., Koukoulis G., Kovacevic B., Kruger V. F., Kryvoruchko I. A., Kurihara H., Kuriyama A., Landaluce-Olavarria A., Lapolla P., Leppaniemi A., Licari L., Lisi G., Litvin A., Lizarazu A., Bayo H. L., Lohsiriwat V., Moreira C. C. L., Lostoridis E., Luna A. T., Luppi D., Machain V. G. M., Maegele M., Maggiore D., Magnone S., Maier R. V., Major P., Manangi M., Manetti A., Mantoglu B., Marafante C., Mariani F., Marinis A., Mariot E. A. S., Martines G., Perez A. M., Martino C., Mascagni P., Massalou D., Massaro M., Matias-Garcia B., Mazzarella G., Mazzarolo G., Melo R. B., Mendoza-Moreno F., Meric S., Meyer J., Miceli L., Michalopoulos N. V., Milana F., Mingoli A., Mishra T. S., Mohamed M., Mohamed M. I. E. A., Mohamedahmed A. Y., Mohammed M. J. S., Mohan R., Moore E. E., Morales-Garcia D., Muhrbeck M., Mulita F., Mustafa S. M. S., Muttillo E. M., Naimzada M. D., Navsaria P. H., Negoi I., Nespoli L., Nguyen C., Nidaw M. K., Nigri G., Nikolopoulos I., O'connor D. B., Ogundipe H. D., Oliveri C., Olmi S., Ong E. C. W., Orecchia L., Osipov A. V., Othman M. F., Pace M., Pacilli M., Pagani L., Palomba G., Pantalone D., Panyko A., Paolillo C., Papa M. V., Papaconstantinou D., Papadoliopoulou M., Papadopoulos A., Papis D., Pararas N., Parreira J. G., Parry N. G., Pata F., Patel T., Paterson-Brown S., Pavone G., Pecchini F., Pegoraro V., Pellino G., Pelloni M., Peloso A., Del Pozo E. P., Pereira R. G., Pereira B. M., Perez A. L., Perez S., Perra T., Perrone G., Pesce A., Petagna L., Petracca G., Phupong V., Picardi B., Picciariello A., Piccoli M., Picetti E., Pikoulis E. P., Pintar T., Pirozzolo G., Piscioneri F., Podda M., Porcu A., Privitera F., Punzo C., Quaresima S., Quiodettis M. A., Qvist N., Rahim R., de Almeida F. R., Ramely R. B., Rasa H. K., Reichert M., Reinisch-Liese A., Renne A., Riccetti C., Rodriguez-Luna M. R., Roizblatt D., Romanzi A., Romeo L., Roscio F. P. M., Rosnelifaizur R. B., Rossi S., Rubiano A. M., Ruiz-Ucar E., Sakakushev B. E., Salamea J. C., Sall I., Samarakoon L. B., Sammartano F., Arteaga A. S., Sanchez-Cordero S., Santoanastaso D. P. M., Sartelli M., Sasia D., Sato N., Savchuk A., Sawyer R. G., Scaioli G., Schizas D., Sebastiani S., Seeliger B., Lohse H. A. S., Seretis C., Sermonesi G., Serradilla-Martin M., Shelat V. G., Shlyapnikov S., Sidiropoulos T., Simoes R. L., Siragusa L., Siribumrungwong B., Slavchev M., Solaini L., Soldini G., Sopuev A., Soreide K., Sovatzidis A., Stahel P. F., Strickland M., Sultan M. A. H., Sydorchuk R., Sydorchuk L., Syed S. M. A. M., Tallon-Aguilar L., Tamburini A. M., Tamini N., Tan E. C. T. H., Tan J. H., Tarasconi A., Tartaglia N., Tartaglia G., Tartaglia D., Taylor J. V., Tebala G. D., Teuben M., Theodorou A., Tolonen M., Tomasicchio G., Toro A., Torre B., Triantafyllou T., Trigiante G. T., Tripepi M., Trostchansky J., Tsekouras K., Turrado-Rodriguez V., Tutino R., Uccelli M., Uchikov P. A., Ugarte-Sierra B., Ukkonen M. T., Vailas M., Vassiliu P. G., Vazquez A. G., Vazquez R. G., Velmahos G., Verde J. E., Verde J. M., Veroux M., Vigano J., Vilallonga R., Visconti D., Vittori A., Waledziak M., Wannatoop T., Widmer L. W., Wilson M. S. J., Woltz S., Wong T. H., Xenaki S., Yu B., Yule S., Zachariah S. K., Zacharis G., Zaghi C., Zakaria A. D., Zambrano D. A., Zampitis N., Zampogna B., Zanghi S., Zantedeschi M., Zapsalis K., Zattoni F., and Zese M.

Abstract

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

Published
2023

12. Training curriculum in minimally invasive emergency digestive surgery: 2022 WSES position paper

Author

De'Angelis, N, Marchegiani, F, Schena, C, Khan, J, Agnoletti, V, Ansaloni, L, Barria Rodriguez, A, Bianchi, P, Biffl, W, Bravi, F, Ceccarelli, G, Ceresoli, M, Chiara, O, Chirica, M, Cobianchi, L, Coccolini, F, Coimbra, R, Cotsoglou, C, D'Hondt, M, Damaskos, D, De Simone, B, Di Saverio, S, Diana, M, Espin-Basany, E, Fichtner-Feigl, S, Fugazzola, P, Gavriilidis, P, Gronnier, C, Kashuk, J, Kirkpatrick, A, Ammendola, M, Kouwenhoven, E, Laurent, A, Leppaniemi, A, Lesurtel, M, Memeo, R, Milone, M, Moore, E, Pararas, N, Peitzmann, A, Pessaux, P, Picetti, E, Pikoulis, M, Pisano, M, Ris, F, Robison, T, Sartelli, M, Shelat, V, Spinoglio, G, Sugrue, M, Tan, E, Van Eetvelde, E, Kluger, Y, Weber, D, Catena, F, de'Angelis N., Marchegiani F., Schena C. A., Khan J., Agnoletti V., Ansaloni L., Barria Rodriguez A. G., Bianchi P. P., Biffl W., Bravi F., Ceccarelli G., Ceresoli M., Chiara O., Chirica M., Cobianchi L., Coccolini F., Coimbra R., Cotsoglou C., D'Hondt M., Damaskos D., De Simone B., Di Saverio S., Diana M., Espin-Basany E., Fichtner-Feigl S., Fugazzola P., Gavriilidis P., Gronnier C., Kashuk J., Kirkpatrick A. W., Ammendola M., Kouwenhoven E. A., Laurent A., Leppaniemi A., Lesurtel M., Memeo R., Milone M., Moore E., Pararas N., Peitzmann A., Pessaux P., Picetti E., Pikoulis M., Pisano M., Ris F., Robison T., Sartelli M., Shelat V. G., Spinoglio G., Sugrue M., Tan E., Van Eetvelde E., Kluger Y., Weber D., Catena F., De'Angelis, N, Marchegiani, F, Schena, C, Khan, J, Agnoletti, V, Ansaloni, L, Barria Rodriguez, A, Bianchi, P, Biffl, W, Bravi, F, Ceccarelli, G, Ceresoli, M, Chiara, O, Chirica, M, Cobianchi, L, Coccolini, F, Coimbra, R, Cotsoglou, C, D'Hondt, M, Damaskos, D, De Simone, B, Di Saverio, S, Diana, M, Espin-Basany, E, Fichtner-Feigl, S, Fugazzola, P, Gavriilidis, P, Gronnier, C, Kashuk, J, Kirkpatrick, A, Ammendola, M, Kouwenhoven, E, Laurent, A, Leppaniemi, A, Lesurtel, M, Memeo, R, Milone, M, Moore, E, Pararas, N, Peitzmann, A, Pessaux, P, Picetti, E, Pikoulis, M, Pisano, M, Ris, F, Robison, T, Sartelli, M, Shelat, V, Spinoglio, G, Sugrue, M, Tan, E, Van Eetvelde, E, Kluger, Y, Weber, D, Catena, F, de'Angelis N., Marchegiani F., Schena C. A., Khan J., Agnoletti V., Ansaloni L., Barria Rodriguez A. G., Bianchi P. P., Biffl W., Bravi F., Ceccarelli G., Ceresoli M., Chiara O., Chirica M., Cobianchi L., Coccolini F., Coimbra R., Cotsoglou C., D'Hondt M., Damaskos D., De Simone B., Di Saverio S., Diana M., Espin-Basany E., Fichtner-Feigl S., Fugazzola P., Gavriilidis P., Gronnier C., Kashuk J., Kirkpatrick A. W., Ammendola M., Kouwenhoven E. A., Laurent A., Leppaniemi A., Lesurtel M., Memeo R., Milone M., Moore E., Pararas N., Peitzmann A., Pessaux P., Picetti E., Pikoulis M., Pisano M., Ris F., Robison T., Sartelli M., Shelat V. G., Spinoglio G., Sugrue M., Tan E., Van Eetvelde E., Kluger Y., Weber D., and Catena F.

Abstract

Background: Minimally invasive surgery (MIS), including laparoscopic and robotic approaches, is widely adopted in elective digestive surgery, but selectively used for surgical emergencies. The present position paper summarizes the available evidence concerning the learning curve to achieve proficiency in emergency MIS and provides five expert opinion statements, which may form the basis for developing standardized curricula and training programs in emergency MIS. Methods: This position paper was conducted according to the World Society of Emergency Surgery methodology. A steering committee and an international expert panel were involved in the critical appraisal of the literature and the development of the consensus statements. Results: Thirteen studies regarding the learning curve in emergency MIS were selected. All but one study considered laparoscopic appendectomy. Only one study reported on emergency robotic surgery. In most of the studies, proficiency was achieved after an average of 30 procedures (range: 20–107) depending on the initial surgeon’s experience. High heterogeneity was noted in the way the learning curve was assessed. The experts claim that further studies investigating learning curve processes in emergency MIS are needed. The emergency surgeon curriculum should include a progressive and adequate training based on simulation, supervised clinical practice (proctoring), and surgical fellowships. The results should be evaluated by adopting a credentialing system to ensure quality standards. Surgical proficiency should be maintained with a minimum caseload and constantly evaluated. Moreover, the training process should involve the entire surgical team to facilitate the surgeon’s proficiency. Conclusions: Limited evidence exists concerning the learning process in laparoscopic and robotic emergency surgery. The proposed statements should be seen as a preliminary guide for the surgical community while stressing the need for further research.

Published
2023

13. Pair production in a strong electric field: an initial value problem in quantum field theory

Author

Kluger, Y., Eisenberg, J. M., and Svetitsky, B.

Subjects
High Energy Physics - Phenomenology
Abstract

We review recent achievements in the solution of the initial-value problem for quantum back-reaction in scalar and spinor QED. The problem is formulated and solved in the semiclassical mean-field approximation for a homogeneous, time-dependent electric field. Our primary motivation in examining back-reaction has to do with applications to theoretical models of production of the quark-gluon plasma, though we here address practicable solutions for back-reaction in general. We review the application of the method of adiabatic regularization to the Klein-Gordon and Dirac fields in order to renormalize the expectation value of the current and derive a finite coupled set of ordinary differential equations for the time evolution of the system. Three time scales are involved in the problem and therefore caution is needed to achieve numerical stability for this system. Several physical features, like plasma oscillations and plateaus in the current, appear in the solution. From the plateau of the electric current one can estimate the number of pairs before the onset of plasma oscillations, while the plasma oscillations themselves yield the number of particles from the plasma frequency. We compare the field-theory solution to a simple model based on a relativistic Boltzmann-Vlasov equation, with a particle production source term inferred from the Schwinger particle creation rate and a Pauli-blocking (or Bose-enhancement) factor. This model reproduces very well the time behavior of the electric field and the creation rate of charged pairs of the semiclassical calculation. It therefore provides a simple intuitive understanding of the nature of the solution since nearly all the physical features can be expressed in terms of the classical distribution function., Comment: Old paper, already published, but in an obscure journal

Published
2003
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15. Dilepton from Disoriented Chiral Condensates

Author

Koch, V., Randrup, J., Wang, X. N., and Kluger, Y.

Subjects
Nuclear Theory
Abstract

Disoriented chiral condensates are manifested as long wavelength pionic oscillations and their interaction with the thermal environment can be a significant source of dileptons. We calculate the yield of such dilepton production within the linear sigma model and illustrate the basic features of the dilepton spectrum in a schematic model. We find that the dilepton yield with invariant mass near and below $2m_{\pi}$ due to the soft pion modes can be up to two orders of magnitude larger than the corresponding equilibrium yield. We conclude with a discussion on how this enhancement can be detected by present dilepton experiments., Comment: 15 pages, 9 figs, uses epsf and sprocl style files Contribution to Proceedings, International Workshop on Astro Hadron Physics `Hadrons in Dense Matter', APCTP, Seoul, Korea, October 1997

Published
1997
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16. Dileptons from Disoriented Chiral Condensates

Author

Kluger, Y., Koch, V., Randrup, J., and Wang, X. N.

Subjects
Nuclear Theory, High Energy Physics - Phenomenology
Abstract

Disoriented chiral condensates or long wavelength pionic oscillations and their interaction with the thermal environment can be a significant source of dileptons. We calculate the yield of such dilepton production within the linear sigma model, both in a quantal mean-field treatment and in a semi-classical approximation. We then illustrate the basic features of the dilepton spectrum in a schematic model. We find that dilepton yield with invariant mass near and below $2m_{\pi}$ due to the soft pion modes can be up to two orders of magnitude larger than the corresponding equilibrium yield., Comment: 22 pages, 8 figures, uses epsf-style

Published
1997
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17. Anomalous Transverse Distribution of Pions as a signal for the production of DCC's

Author

Cooper, F., Kluger, Y., and Mottola, E.

Subjects
High Energy Physics - Phenomenology
Abstract

We give evidence that the production of DCC's during a non-equilibrium phase transition can lead to an anomalous transverse distribution of secondary pions when compared to a more conventional boost invariant hydrodynamic flow in local thermal equilibrium. Our results pertain to the linear $\sigma$ model,treated in leading order in large-$N$, in a boost invariant approximation. We also show that the interpolating number density of the field theory calculation plays the role of a classical relativistic phase space number distribution in determining the momentum distribution of pions in the center of mass frame., Comment: 10 pages, LaTex and 3 eps figures

Published
1996
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18. Quantum evolution of the disoriented chiral condensates

Author

Kluger, Y., Cooper, F., Mottola, E., Paz, J. P., and Kovner, A.

Subjects
High Energy Physics - Phenomenology
Abstract

We study the dynamics of the chiral phase transition expected during the expansion of the quark-gluon plasma produced in a high energy hadron or heavy ion collision, using the $O(4)$ linear sigma model in the mean field approximation. Imposing boost invariant initial conditions at an initial proper time $\tau_0$ and starting from an approximate equilibrium configuration, we investigate the possibility of formation of disoriented chiral condensate during the expansion. In order to create large domains of disoriented chiral condensates low-momentum instabilities have to last for long enough periods of time. Our simulations show no instabilities for an initial thermal configuration. For some of the out-of-equilibrium initial states studied, the fluctuation in the number of particles with low transverse momenta become large at late proper times., Comment: 4 pages, uuencoded and gziped ps-file, talk presented at Quark Matter '95, Monterey, CA, USA, January 1995

Published
1995
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19. Assessing and managing frailty in emergency laparotomy: a WSES position paper

Author

Tian B. W. C. A., Stahel P. F., Picetti E., Campanelli G., Di Saverio S., Moore E., Bensard D., Sakakushev B., Galante J., Fraga G. P., Koike K., Di Carlo I., Tebala G. D., Leppaniemi A., Tan E., Damaskos D., De'Angelis N., Hecker A., Pisano M., YunfengCui, Maier R. V., De Simone B., Amico F., Ceresoli M., Pikoulis M., Weber D. G., Biffl W., Beka S. G., Abu-Zidan F. M., Valentino M., Coccolini F., Kluger Y., Sartelli M., Agnoletti V., Chirica M., Bravi F., Sall I., Catena F., Tian, B, Stahel, P, Picetti, E, Campanelli, G, Di Saverio, S, Moore, E, Bensard, D, Sakakushev, B, Galante, J, Fraga, G, Koike, K, Di Carlo, I, Tebala, G, Leppaniemi, A, Tan, E, Damaskos, D, De'Angelis, N, Hecker, A, Pisano, M, Yunfengcui, Maier, R, De Simone, B, Amico, F, Ceresoli, M, Pikoulis, M, Weber, D, Biffl, W, Beka, S, Abu-Zidan, F, Valentino, M, Coccolini, F, Kluger, Y, Sartelli, M, Agnoletti, V, Chirica, M, Bravi, F, Sall, I, and Catena, F

Subjects
Laparotomy, Elderly, Frail, Frailty, Emergency surgery
Abstract

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

Published
2023

20. WSES consensus guidelines on sigmoid volvulus management

Author

Tian, B.W.C.A., Vigutto, G., Tan, E.C.T.H., Goor, H. van, Bendinelli, C., Abu-Zidan, F., Ivatury, R., Sakakushev, B., Carlo, I. Di, Sganga, G., Maier, R.V., Coimbra, R., Leppäniemi, A., Litvin, A., Damaskos, D., Broek, R.P.G ten, Biffl, W., Saverio, S. Di, Simone, B. De, Ceresoli, M., Picetti, E., Galante, J., Tebala, G.D., Beka, S.G., Bonavina, L., Cui, Y., Khan, J., Cicuttin, E., Amico, F., Kenji, I., Hecker, A., Ansaloni, L., Sartelli, M., Moore, E.E., Kluger, Y., Testini, M., Weber, D., Agnoletti, V., Angelis, N.D., Coccolini, F., Sall, I., Catena, F., Tian, B, Vigutto, G, Tan, E, van Goor, H, Bendinelli, C, Abu-Zidan, F, Ivatury, R, Sakakushev, B, Di Carlo, I, Sganga, G, Maier, R, Coimbra, R, Leppaniemi, A, Litvin, A, Damaskos, D, Broek, R, Biffl, W, Di Saverio, S, De Simone, B, Ceresoli, M, Picetti, E, Galante, J, Tebala, G, Beka, S, Bonavina, L, Cui, Y, Khan, J, Cicuttin, E, Amico, F, Kenji, I, Hecker, A, Ansaloni, L, Sartelli, M, Moore, E, Kluger, Y, Testini, M, Weber, D, Agnoletti, V, Angelis, N, Coccolini, F, Sall, I, and Catena, F

Subjects
Reconstructive and regenerative medicine Radboud Institute for Health Sciences [Radboudumc 10], Tumours of the digestive tract Radboud Institute for Health Sciences [Radboudumc 14], All institutes and research themes of the Radboud University Medical Center, Emergency Medicine, sigmoid volvolus, Surgery
Abstract

Contains fulltext : 293045.pdf (Publisher’s version ) (Open Access) Sigmoid volvulus is a common surgical emergency, especially in elderly patients. Patients can present with a wide range of clinical states: from asymptomatic, to frank peritonitis secondary to colonic perforation. These patients generally need urgent treatment, be it endoscopic decompression of the colon or an upfront colectomy. The World Society of Emergency Surgery united a worldwide group of international experts to review the current evidence and propose a consensus guidelines on the management of sigmoid volvulus.

Published
2023

21. The new timing in acute care surgery (new TACS) classification: a WSES Delphi consensus study

Author

De Simone B., Kluger Y., Moore E. E., Sartelli M., Abu-Zidan F. M., Coccolini F., Ansaloni L., Tebala G. D., Di Saverio S., Di Carlo I., Sakakushev B. E., Bonavina L., Sugrue M., Galante J. M., Ivatury R., Picetti E., Chirica M., Wani I., Bala M., Sall I., Kirkpatrick A. W., Shelat V. G., Pikoulis E., Leppäniemi A., Tan E., Broek R. P. G. t., Gurmu Beka S., Litvin A., Chouillard E., Coimbra R., Cui Y., De’ Angelis N., Sganga G., Stahel P. F., Agnoletti V., Rampini A., Shelat V., Damaskos D., Carcoforo P., Biffl W. L., Hecker A., Kirkpatrick A., Di Salomone S., Balogh Z., Beka S. G., Broek R. T., Velmahos G., Sakakushev B., Ceresoli M., Chiara O., Stahel P., Leppaniemi A., Marzi I., Inaba K., Khokha V., Reva V., Khan M., Toro A., de’ Angelis N., Malangoni M., Scozzafava E., Civil I., Maier R., Weber D., Chiarugi M., Soreide K., Testini M., Bravi F., Maier R. V., Catena F., De Simone, B, Kluger, Y, Moore, E, Sartelli, M, Abu-Zidan, F, Coccolini, F, Ansaloni, L, Tebala, G, Di Saverio, S, Di Carlo, I, Sakakushev, B, Bonavina, L, Sugrue, M, Galante, J, Ivatury, R, Picetti, E, Chirica, M, Wani, I, Bala, M, Sall, I, Kirkpatrick, A, Shelat, V, Pikoulis, E, Leppäniemi, A, Tan, E, Broek, R, Gurmu Beka, S, Litvin, A, Chouillard, E, Coimbra, R, Cui, Y, De’ Angelis, N, Sganga, G, Stahel, P, Agnoletti, V, Rampini, A, Damaskos, D, Carcoforo, P, Biffl, W, Hecker, A, Di Salomone, S, Balogh, Z, Beka, S, Velmahos, G, Ceresoli, M, Chiara, O, Leppaniemi, A, Marzi, I, Inaba, K, Khokha, V, Reva, V, Khan, M, Toro, A, de’ Angelis, N, Malangoni, M, Scozzafava, E, Civil, I, Maier, R, Weber, D, Chiarugi, M, Soreide, K, Testini, M, Bravi, F, and Catena, F

Subjects
Healthcare system, Delay in surgery, Operating room management, Delphi method, Emergency surgery, Priority, Time to surgery, Timing in acute care surgery (TACS), Triage, Classification
Abstract

Background: Timely access to the operating room for emergency general surgery (EGS) indications remains a challenge across the globe, largely driven by operating room availability and staffing constraints. The “timing in acute care surgery” (TACS) classification was previously published to introduce a new tool to triage the timely and appropriate access of EGS patients to the operating room. However, the clinical and operational effectiveness of the TACS classification has not been investigated in subsequent validation studies. This study aimed to improve the TACS classification and provide further consensus around the appropriate use of the new TACS classification through a standardized Delphi approach with international experts. Methods: This is a validation study of the new TACS by a selected international panel of experts using the Delphi method. The TACS questionnaire was designed as a web-based survey. The consensus agreement level was established to be ≥ 75%. The collective consensus agreement was defined as the sum of the percentage of the highest Likert scale levels (4–5) out of all participants. Surgical emergency diseases and correlated clinical scenarios were defined for each of the proposed classes. Subsequent rounds were carried out until a definitive level of consensus was reached. Frequencies and percentages were calculated to determine the degree of agreement for each surgical disease. Results: Four polling rounds were carried out. The new TACS classification provides 6 colour-code classes correlated to a precise timing to surgery, defined scenarios and surgical condition. The WHITE colour-code class was introduced to rapidly (within a week) reschedule cancelled or postponed surgical procedures. Haemodynamic stability is the main tool to stratify patients for immediate surgery or not in the presence of sepsis/septic shock. Fifty-one surgical diseases were included in the different colour-code classes of priority. Conclusion: The new TACS classification is a comprehensive, simple, clear and reproducible triage system which can be used to assess the severity of the patient and the surgical disease, to reduce the time to access to the operating room, and to manage the emergency surgical patients within a “safe” timeframe. By including well-defined surgical diseases in the different colour-code classes of priority, validated through a Delphi consensus, the new TACS improves communication among surgeons, between surgeons and anaesthesiologists and decreases conflicts and waste and waiting time in accessing the operating room for emergency surgical patients.

Published
2023

22. Acute mesenteric ischemia: updated guidelines of the World Society of Emergency Surgery

Author

Bala, M, Catena, F, Kashuk, J, De Simone, B, Gomes, C, Weber, D, Sartelli, M, Coccolini, F, Kluger, Y, Abu-Zidan, F, Picetti, E, Ansaloni, L, Augustin, G, Biffl, W, Ceresoli, M, Chiara, O, Chiarugi, M, Coimbra, R, Cui, Y, Damaskos, D, Di Saverio, S, Galante, J, Khokha, V, Kirkpatrick, A, Inaba, K, Leppaniemi, A, Litvin, A, Peitzman, A, Shelat, V, Sugrue, M, Tolonen, M, Rizoli, S, Sall, I, Beka, S, Di Carlo, I, Ten Broek, R, Mircea, C, Tebala, G, Pisano, M, van Goor, H, Maier, R, Jeekel, H, Civil, I, Hecker, A, Tan, E, Soreide, K, Lee, M, Wani, I, Bonavina, L, Malangoni, M, Koike, K, Velmahos, G, Fraga, G, Fette, A, De'Angelis, N, Balogh, Z, Scalea, T, Sganga, G, Kelly, M, Khan, J, Stahel, P, Moore, E, Bala M., Catena F., Kashuk J., De Simone B., Gomes C. A., Weber D., Sartelli M., Coccolini F., Kluger Y., Abu-Zidan F. M., Picetti E., Ansaloni L., Augustin G., Biffl W. L., Ceresoli M., Chiara O., Chiarugi M., Coimbra R., Cui Y., Damaskos D., Di Saverio S., Galante J. M., Khokha V., Kirkpatrick A. W., Inaba K., Leppaniemi A., Litvin A., Peitzman A. B., Shelat V. G., Sugrue M., Tolonen M., Rizoli S., Sall I., Beka S. G., Di Carlo I., Ten Broek R., Mircea C., Tebala G., Pisano M., van Goor H., Maier R. V., Jeekel H., Civil I., Hecker A., Tan E., Soreide K., Lee M. J., Wani I., Bonavina L., Malangoni M. A., Koike K., Velmahos G. C., Fraga G. P., Fette A., de'Angelis N., Balogh Z. J., Scalea T. M., Sganga G., Kelly M. D., Khan J., Stahel P. F., Moore E. E., Bala, M, Catena, F, Kashuk, J, De Simone, B, Gomes, C, Weber, D, Sartelli, M, Coccolini, F, Kluger, Y, Abu-Zidan, F, Picetti, E, Ansaloni, L, Augustin, G, Biffl, W, Ceresoli, M, Chiara, O, Chiarugi, M, Coimbra, R, Cui, Y, Damaskos, D, Di Saverio, S, Galante, J, Khokha, V, Kirkpatrick, A, Inaba, K, Leppaniemi, A, Litvin, A, Peitzman, A, Shelat, V, Sugrue, M, Tolonen, M, Rizoli, S, Sall, I, Beka, S, Di Carlo, I, Ten Broek, R, Mircea, C, Tebala, G, Pisano, M, van Goor, H, Maier, R, Jeekel, H, Civil, I, Hecker, A, Tan, E, Soreide, K, Lee, M, Wani, I, Bonavina, L, Malangoni, M, Koike, K, Velmahos, G, Fraga, G, Fette, A, De'Angelis, N, Balogh, Z, Scalea, T, Sganga, G, Kelly, M, Khan, J, Stahel, P, Moore, E, Bala M., Catena F., Kashuk J., De Simone B., Gomes C. A., Weber D., Sartelli M., Coccolini F., Kluger Y., Abu-Zidan F. M., Picetti E., Ansaloni L., Augustin G., Biffl W. L., Ceresoli M., Chiara O., Chiarugi M., Coimbra R., Cui Y., Damaskos D., Di Saverio S., Galante J. M., Khokha V., Kirkpatrick A. W., Inaba K., Leppaniemi A., Litvin A., Peitzman A. B., Shelat V. G., Sugrue M., Tolonen M., Rizoli S., Sall I., Beka S. G., Di Carlo I., Ten Broek R., Mircea C., Tebala G., Pisano M., van Goor H., Maier R. V., Jeekel H., Civil I., Hecker A., Tan E., Soreide K., Lee M. J., Wani I., Bonavina L., Malangoni M. A., Koike K., Velmahos G. C., Fraga G. P., Fette A., de'Angelis N., Balogh Z. J., Scalea T. M., Sganga G., Kelly M. D., Khan J., Stahel P. F., and Moore E. E.

Abstract

Acute mesenteric ischemia (AMI) is a group of diseases characterized by an interruption of the blood supply to varying portions of the intestine, leading to ischemia and secondary inflammatory changes. If untreated, this process may progress to life-threatening intestinal necrosis. The incidence is low, estimated at 0.09–0.2% of all acute surgical admissions, but increases with age. Although the entity is an uncommon cause of abdominal pain, diligence is required because if untreated, mortality remains in the range of 50%. Early diagnosis and timely surgical intervention are the cornerstones of modern treatment to reduce the high mortality associated with this entity. The advent of endovascular approaches in parallel with modern imaging techniques is evolving and provides new treatment options. Lastly, a focused multidisciplinary approach based on early diagnosis and individualized treatment is essential. Thus, we believe that updated guidelines from World Society of Emergency Surgery are warranted, in order to provide the most recent and practical recommendations for diagnosis and treatment of AMI.

Published
2022

23. 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

24. Follow-up strategies for patients with splenic trauma managed non-operatively: the 2022 World Society of Emergency Surgery consensus document

Author

Podda, M, De Simone, B, Ceresoli, M, Virdis, F, Favi, F, Wiik Larsen, J, Coccolini, F, Sartelli, M, Pararas, N, Beka, S, Bonavina, L, Bova, R, Pisanu, A, Abu-Zidan, F, Balogh, Z, Chiara, O, Wani, I, Stahel, P, Di Saverio, S, Scalea, T, Soreide, K, Sakakushev, B, Amico, F, Martino, C, Hecker, A, De'Angelis, N, Chirica, M, Galante, J, Kirkpatrick, A, Pikoulis, E, Kluger, Y, Bensard, D, Ansaloni, L, Fraga, G, Civil, I, Tebala, G, Di Carlo, I, Cui, Y, Coimbra, R, Agnoletti, V, Sall, I, Tan, E, Picetti, E, Litvin, A, Damaskos, D, Inaba, K, Leung, J, Maier, R, Biffl, W, Leppaniemi, A, Moore, E, Gurusamy, K, Catena, F, Podda M., De Simone B., Ceresoli M., Virdis F., Favi F., Wiik Larsen J., Coccolini F., Sartelli M., Pararas N., Beka S. G., Bonavina L., Bova R., Pisanu A., Abu-Zidan F., Balogh Z., Chiara O., Wani I., Stahel P., Di Saverio S., Scalea T., Soreide K., Sakakushev B., Amico F., Martino C., Hecker A., de'Angelis N., Chirica M., Galante J., Kirkpatrick A., Pikoulis E., Kluger Y., Bensard D., Ansaloni L., Fraga G., Civil I., Tebala G. D., Di Carlo I., Cui Y., Coimbra R., Agnoletti V., Sall I., Tan E., Picetti E., Litvin A., Damaskos D., Inaba K., Leung J., Maier R., Biffl W., Leppaniemi A., Moore E., Gurusamy K., Catena F., Podda, M, De Simone, B, Ceresoli, M, Virdis, F, Favi, F, Wiik Larsen, J, Coccolini, F, Sartelli, M, Pararas, N, Beka, S, Bonavina, L, Bova, R, Pisanu, A, Abu-Zidan, F, Balogh, Z, Chiara, O, Wani, I, Stahel, P, Di Saverio, S, Scalea, T, Soreide, K, Sakakushev, B, Amico, F, Martino, C, Hecker, A, De'Angelis, N, Chirica, M, Galante, J, Kirkpatrick, A, Pikoulis, E, Kluger, Y, Bensard, D, Ansaloni, L, Fraga, G, Civil, I, Tebala, G, Di Carlo, I, Cui, Y, Coimbra, R, Agnoletti, V, Sall, I, Tan, E, Picetti, E, Litvin, A, Damaskos, D, Inaba, K, Leung, J, Maier, R, Biffl, W, Leppaniemi, A, Moore, E, Gurusamy, K, Catena, F, Podda M., De Simone B., Ceresoli M., Virdis F., Favi F., Wiik Larsen J., Coccolini F., Sartelli M., Pararas N., Beka S. G., Bonavina L., Bova R., Pisanu A., Abu-Zidan F., Balogh Z., Chiara O., Wani I., Stahel P., Di Saverio S., Scalea T., Soreide K., Sakakushev B., Amico F., Martino C., Hecker A., de'Angelis N., Chirica M., Galante J., Kirkpatrick A., Pikoulis E., Kluger Y., Bensard D., Ansaloni L., Fraga G., Civil I., Tebala G. D., Di Carlo I., Cui Y., Coimbra R., Agnoletti V., Sall I., Tan E., Picetti E., Litvin A., Damaskos D., Inaba K., Leung J., Maier R., Biffl W., Leppaniemi A., Moore E., Gurusamy K., and Catena F.

Abstract

Background: In 2017, the World Society of Emergency Surgery published its guidelines for the management of adult and pediatric patients with splenic trauma. Several issues regarding the follow-up of patients with splenic injuries treated with NOM remained unsolved. Methods: Using a modified Delphi method, we sought to explore ongoing areas of controversy in the NOM of splenic trauma and reach a consensus among a group of 48 international experts from five continents (Africa, Europe, Asia, Oceania, America) concerning optimal follow-up strategies in patients with splenic injuries treated with NOM. Results: Consensus was reached on eleven clinical research questions and 28 recommendations with an agreement rate ≥ 80%. Mobilization after 24 h in low-grade splenic trauma patients (WSES Class I, AAST Grades I–II) was suggested, while in patients with high-grade splenic injuries (WSES Classes II–III, AAST Grades III–V), if no other contraindications to early mobilization exist, safe mobilization of the patient when three successive hemoglobins 8 h apart after the first are within 10% of each other was considered safe according to the panel. The panel suggests adult patients to be admitted to hospital for 1 day (for low-grade splenic injuries—WSES Class I, AAST Grades I–II) to 3 days (for high-grade splenic injuries—WSES Classes II–III, AAST Grades III–V), with those with high-grade injuries requiring admission to a monitored setting. In the absence of specific complications, the panel suggests DVT and VTE prophylaxis with LMWH to be started within 48–72 h from hospital admission. The panel suggests splenic artery embolization (SAE) as the first-line intervention in patients with hemodynamic stability and arterial blush on CT scan, irrespective of injury grade. Regarding patients with WSES Class II blunt splenic injuries (AAST Grade III) without contrast extravasation, a low threshold for SAE has been suggested in the presence of risk factors for NOM failure. The panel als

Published
2022

25. Diversity and ethics in trauma and acute care surgery teams: results from an international survey

Author

Cobianchi, L, Dal Mas, F, Massaro, M, Biffl, W, Catena, F, Coccolini, F, Dionigi, B, Dionigi, P, Di Saverio, S, Fugazzola, P, Kluger, Y, Leppaniemi, A, Moore, E, Sartelli, M, Velmahos, G, Woltz, S, Angelos, P, Ansaloni, L, Abdelmalik, A, Abebe, N, Abu-Zidan, F, Adam, Y, Adamou, H, Agrusa, A, Akin, E, Alexandrino, H, Ali, S, Almeida, P, Amico, F, Ammendola, M, Andreuccetti, J, Aparicio-Sanchez, D, Ardito, A, Argenio, G, Askevold, I, Atanasov, B, Augustin, G, Awad, S, Bagnoli, C, Bains, L, Balalis, D, Baldini, E, Baraket, O, Barone, M, Barreras, J, Bellanova, G, Biancuzzi, H, Bignell, M, Bini, R, Bissacco, D, Boati, P, Bottari, A, Bouliaris, K, Brillantino, A, Buonomo, L, Buscemi, S, Calu, V, Campo Dall'Orto, R, Campostrini, S, Carvas, J, Casoni Pattacini, G, Celentano, V, Ceresoli, M, Chirica, M, Cianci, P, Cillara, N, Cimbanassi, S, Cioffi, S, Colak, E, Conti, L, Dantas Costa, S, D'Acapito, F, Damaskos, D, Das, K, Davies, R, De Beaux, A, De Simone, B, Demetrashvili, Z, Demetriades, A, Denicolai, S, Di Buono, G, Di Carlo, I, Diaconescu, B, Dibra, R, Dios-Barbeito, S, Dogjani, A, Domanin, M, D'Oria, M, Duran Munoz-Cruzado, V, East, B, Ekwen, G, Elbaih, A, Escalera-Antezana, J, Esposito, G, Farre, R, Ferrario di Tor Vajana, A, Cordeiro Fonseca, V, Forfori, F, Fortuna, L, Fradelos, E, Fraga, G, Fransvea, P, Gachabayov, M, Garcia Vazquez, A, Ghannam, W, Gioco, R, Giraudo, G, Giuffrida, M, Giulii Capponi, M, Gomes, C, Teixeira Gonsaga, R, Gonullu, E, Goosen, J, Goranovic, T, Griffiths, E, Haidar, M, Hamid, H, Harddastle, T, Healey, A, Hecker, M, Hernandez Garcia, E, Huaman, E, Hutan, M, Ioannidis, O, Isik, A, Ismail, A, Ismail, N, Jang, J, Kaafarani, H, Kalipershad, S, Kaplan, L, Kara, Y, Karamagioli, E, Karamarkovia, A, Kavalakat, A, Kechagias, A, Kenig, J, Khan, J, Khokha, V, Klappenbach, R, Kobe, Y, Kong, V, Korkolis, D, Kurihara, H, Kuriyama, A, Landaluce-Olavarria, A, Licari, L, Litvin, A, Loftus, T, Lohsiriwat, V, Lopes Moreira, C, Lostoridis, E, Luna, A, Luppi, D, Machain, G, Maegele, M, Maggiore, D, Maier, R, Manangi, M, Manetti, A, Mantoglu, B, Mariani, F, Marinis, A, Sbalcheiro Mariot, E, Marseglia, G, Martellucci, J, Martines, G, Martinez Perez, A, Mascagni, P, Massalou, D, Melo, R, Miceli, L, Mingoli, A, Mishra, T, Mohamedahmed, A, Mohan, R, Morales-Garcia, D, Mustafa, S, Naimzada, M, Negoi, I, Nguyen, C, Nidaw, M, Nigri, G, Ogundipe, H, Oliveri, C, Olmi, S, Pagani, L, Palomba, G, Pantalone, D, Panyko, A, Paolillo, C, Papis, D, Pararas, N, Pata, F, Paterson-Brown, S, Pavone, G, Pecchini, F, Pellino, G, Pelloni, M, Peloso, A, Perea del Pozo, E, Goncalves Pereira, R, Monteiro Pereira, B, Lizarazu Perez, A, Perrone, G, Pesce, A, Petracca, G, Piccoli, M, Piccolo, D, Picetti, E, Pikoulis, E, Pintar, T, Pirozzolo, G, Podda, M, Previtali, P, Privitera, F, Punzo, C, Quiodettis, M, Qvist, N, Rahim, R, Reinisch-Liese, A, Rodriguez-Luna, M, Roizblatt, D, Roscio, F, Rossi, S, Ruta, F, Sakakushev, B, Salamea, J, Sall, I, Sammartano, F, Sanchez Arteaga, A, Sanchez-Cordero, S, Sasia, D, Sawyer, R, Seretis, C, Serradilla-Martin, M, Shelat, V, Shlyapnikov, S, Simoes, R, Siribumrungwong, B, Slavchev, M, Solaini, L, Soldini, G, Soreide, K, Spada, F, Stahel, P, Sydorchuk, L, Sydorchuk, R, Syed, A, Tallon-Aguilar, L, Tan, J, Tan, E, Tarasconi, A, Tartaglia, D, Tartaglia, N, Taylor, J, Tebala, G, Teuben, M, Tolonen, M, Tomasicchio, G, Triantafyllou, T, Trigiante, G, Turrado-Rodriguez, V, Tutino, R, Uccelli, M, Ugarte-Sierra, B, Ukkonen, M, Vassiliu, P, Verde, J, Veroux, M, Vilallonga, R, Visconti, D, Waledziak, M, Wannatoop, T, Widmer, L, Wilson, M, Wong, T, Xenaki, S, Yu, B, Yule, S, Zakaria, A, Zambrano, D, Zese, M, Cobianchi L., Dal Mas F., Massaro M., Biffl W., Catena F., Coccolini F., Dionigi B., Dionigi P., Di Saverio S., Fugazzola P., Kluger Y., Leppaniemi A., Moore E. E., Sartelli M., Velmahos G., Woltz S., Angelos P., Ansaloni L., Abdelmalik A., Abebe N. S., Abu-Zidan F. M., Adam Y. A. Y., Adamou H., Agrusa A., Akin E., Alexandrino H., Ali S. M., Almeida P. M., Amico F., Ammendola M., Andreuccetti J., Aparicio-Sanchez D., Ardito A., Argenio G., Askevold I. H., Atanasov B. T., Augustin G., Awad S. S., Bagnoli C., Bains L., Balalis D., Baldini E., Baraket O., Barone M., Barreras J. A., Bellanova G., Biancuzzi H., Bignell M. B., Bini R., Bissacco D., Boati P., Bottari A., Bouliaris K., Brillantino A., Buonomo L. A., Buscemi S., Calu V., Campo Dall'Orto R., Campostrini S., Carvas J. M., Casoni Pattacini G., Celentano V., Ceresoli M., Chirica M., Cianci P., Cillara N., Cimbanassi S., Cioffi S. P. B., Colak E., Conti L., Dantas Costa S., D'Acapito F., Damaskos D., Das K., Davies R. J., De Beaux A. C., De Simone B., Demetrashvili Z., Demetriades A. K., Denicolai S., Di Buono G., Di Carlo I., Diaconescu B., Dibra R., Dios-Barbeito S., Dogjani A., Domanin M., D'Oria M., Duran Munoz-Cruzado V., East B., Ekwen G. T., Elbaih A. H., Escalera-Antezana J. P., Esposito G., Farre R., Ferrario di Tor Vajana A., Cordeiro Fonseca V., Forfori F., Fortuna L., Fradelos E., Fraga G. P., Fransvea P., Gachabayov M., Garcia Vazquez A. A., Ghannam W. M., Gioco R., Giraudo G., Giuffrida M., Giulii Capponi M., Gomes C. A., Teixeira Gonsaga R. A., Gonullu E., Goosen J., Goranovic T., Griffiths E. A., Haidar M. G., Hamid H. K. S., Harddastle T. C., Healey A. J., Hecker M., Hernandez Garcia E. F., Huaman E. C., Hutan M., Ioannidis O., Isik A., Ismail A. M. H., Ismail N., Jang J. Y., Kaafarani H. M. A., Kalipershad S. N. R., Kaplan L. J., Kara Y., Karamagioli E., Karamarkovia A., Kavalakat A. J., Kechagias A., Kenig J., Khan J. S., Khokha V., Klappenbach R., Kobe Y., Kong V., Korkolis D., Kurihara H., Kuriyama A., Landaluce-Olavarria A., Licari L., Litvin A., Loftus T. J., Lohsiriwat V., Lopes Moreira C. C., Lostoridis E., Luna A. T., Luppi D., Machain G. M., Maegele M., Maggiore D., Maier R. V., Manangi M., Manetti A., Mantoglu B., Mariani F., Marinis A., Sbalcheiro Mariot E. A., Marseglia G. R., Martellucci J., Martines G., Martinez Perez A., Mascagni P., Massalou D., Melo R. B., Miceli L., Mingoli A., Mishra T. S., Mohamedahmed A. Y. Y., Mohan R., Morales-Garcia D., Mustafa S. M. S., Naimzada M. D., Negoi I., Nguyen C., Nidaw M. K., Nigri G., Ogundipe H. D., Oliveri C., Olmi S., Pagani L., Palomba G., Pantalone D., Panyko A., Paolillo C., Papis D., Pararas N., Pata F., Paterson-Brown S., Pavone G., Pecchini F., Pellino G., Pelloni M., Peloso A., Perea del Pozo E., Goncalves Pereira R., Monteiro Pereira B., Lizarazu Perez A., Perrone G., Pesce A., Petracca G., Piccoli M., Piccolo D., Picetti E., Pikoulis E., Pintar T., Pirozzolo G., Podda M., Previtali P., Privitera F., Punzo C., Quiodettis M. A., Qvist N., Rahim R., Reinisch-Liese A., Rodriguez-Luna M. R., Roizblatt D., Roscio F. P. M., Rossi S., Ruta F., Sakakushev B. E., Salamea J. C., Sall I., Sammartano F., Sanchez Arteaga A., Sanchez-Cordero S., Sasia D., Sawyer R. G., Seretis C., Serradilla-Martin M., Shelat V. G., Shlyapnikov S., Simoes R. L., Siribumrungwong B., Slavchev M., Solaini L., Soldini G., Soreide K., Spada F., Stahel P., Sydorchuk L., Sydorchuk R., Syed A. M., Tallon-Aguilar L., Tan J. H., Tan E., Tarasconi A., Tartaglia D., Tartaglia N., Taylor J., Tebala G. D., Teuben M., Tolonen M., Tomasicchio G., Triantafyllou T., Trigiante G., Turrado-Rodriguez V., Tutino R., Uccelli M., Ugarte-Sierra B., Ukkonen M., Vassiliu P. G., Verde J. M., Veroux M., Vilallonga R., Visconti D., Waledziak M., Wannatoop T., Widmer L. W., Wilson M. S. J., Wong T. H., Xenaki S., Yu B., Yule S., Zakaria A. D., Zambrano D. A., Zese M., Cobianchi, L, Dal Mas, F, Massaro, M, Biffl, W, Catena, F, Coccolini, F, Dionigi, B, Dionigi, P, Di Saverio, S, Fugazzola, P, Kluger, Y, Leppaniemi, A, Moore, E, Sartelli, M, Velmahos, G, Woltz, S, Angelos, P, Ansaloni, L, Abdelmalik, A, Abebe, N, Abu-Zidan, F, Adam, Y, Adamou, H, Agrusa, A, Akin, E, Alexandrino, H, Ali, S, Almeida, P, Amico, F, Ammendola, M, Andreuccetti, J, Aparicio-Sanchez, D, Ardito, A, Argenio, G, Askevold, I, Atanasov, B, Augustin, G, Awad, S, Bagnoli, C, Bains, L, Balalis, D, Baldini, E, Baraket, O, Barone, M, Barreras, J, Bellanova, G, Biancuzzi, H, Bignell, M, Bini, R, Bissacco, D, Boati, P, Bottari, A, Bouliaris, K, Brillantino, A, Buonomo, L, Buscemi, S, Calu, V, Campo Dall'Orto, R, Campostrini, S, Carvas, J, Casoni Pattacini, G, Celentano, V, Ceresoli, M, Chirica, M, Cianci, P, Cillara, N, Cimbanassi, S, Cioffi, S, Colak, E, Conti, L, Dantas Costa, S, D'Acapito, F, Damaskos, D, Das, K, Davies, R, De Beaux, A, De Simone, B, Demetrashvili, Z, Demetriades, A, Denicolai, S, Di Buono, G, Di Carlo, I, Diaconescu, B, Dibra, R, Dios-Barbeito, S, Dogjani, A, Domanin, M, D'Oria, M, Duran Munoz-Cruzado, V, East, B, Ekwen, G, Elbaih, A, Escalera-Antezana, J, Esposito, G, Farre, R, Ferrario di Tor Vajana, A, Cordeiro Fonseca, V, Forfori, F, Fortuna, L, Fradelos, E, Fraga, G, Fransvea, P, Gachabayov, M, Garcia Vazquez, A, Ghannam, W, Gioco, R, Giraudo, G, Giuffrida, M, Giulii Capponi, M, Gomes, C, Teixeira Gonsaga, R, Gonullu, E, Goosen, J, Goranovic, T, Griffiths, E, Haidar, M, Hamid, H, Harddastle, T, Healey, A, Hecker, M, Hernandez Garcia, E, Huaman, E, Hutan, M, Ioannidis, O, Isik, A, Ismail, A, Ismail, N, Jang, J, Kaafarani, H, Kalipershad, S, Kaplan, L, Kara, Y, Karamagioli, E, Karamarkovia, A, Kavalakat, A, Kechagias, A, Kenig, J, Khan, J, Khokha, V, Klappenbach, R, Kobe, Y, Kong, V, Korkolis, D, Kurihara, H, Kuriyama, A, Landaluce-Olavarria, A, Licari, L, Litvin, A, Loftus, T, Lohsiriwat, V, Lopes Moreira, C, Lostoridis, E, Luna, A, Luppi, D, Machain, G, Maegele, M, Maggiore, D, Maier, R, Manangi, M, Manetti, A, Mantoglu, B, Mariani, F, Marinis, A, Sbalcheiro Mariot, E, Marseglia, G, Martellucci, J, Martines, G, Martinez Perez, A, Mascagni, P, Massalou, D, Melo, R, Miceli, L, Mingoli, A, Mishra, T, Mohamedahmed, A, Mohan, R, Morales-Garcia, D, Mustafa, S, Naimzada, M, Negoi, I, Nguyen, C, Nidaw, M, Nigri, G, Ogundipe, H, Oliveri, C, Olmi, S, Pagani, L, Palomba, G, Pantalone, D, Panyko, A, Paolillo, C, Papis, D, Pararas, N, Pata, F, Paterson-Brown, S, Pavone, G, Pecchini, F, Pellino, G, Pelloni, M, Peloso, A, Perea del Pozo, E, Goncalves Pereira, R, Monteiro Pereira, B, Lizarazu Perez, A, Perrone, G, Pesce, A, Petracca, G, Piccoli, M, Piccolo, D, Picetti, E, Pikoulis, E, Pintar, T, Pirozzolo, G, Podda, M, Previtali, P, Privitera, F, Punzo, C, Quiodettis, M, Qvist, N, Rahim, R, Reinisch-Liese, A, Rodriguez-Luna, M, Roizblatt, D, Roscio, F, Rossi, S, Ruta, F, Sakakushev, B, Salamea, J, Sall, I, Sammartano, F, Sanchez Arteaga, A, Sanchez-Cordero, S, Sasia, D, Sawyer, R, Seretis, C, Serradilla-Martin, M, Shelat, V, Shlyapnikov, S, Simoes, R, Siribumrungwong, B, Slavchev, M, Solaini, L, Soldini, G, Soreide, K, Spada, F, Stahel, P, Sydorchuk, L, Sydorchuk, R, Syed, A, Tallon-Aguilar, L, Tan, J, Tan, E, Tarasconi, A, Tartaglia, D, Tartaglia, N, Taylor, J, Tebala, G, Teuben, M, Tolonen, M, Tomasicchio, G, Triantafyllou, T, Trigiante, G, Turrado-Rodriguez, V, Tutino, R, Uccelli, M, Ugarte-Sierra, B, Ukkonen, M, Vassiliu, P, Verde, J, Veroux, M, Vilallonga, R, Visconti, D, Waledziak, M, Wannatoop, T, Widmer, L, Wilson, M, Wong, T, Xenaki, S, Yu, B, Yule, S, Zakaria, A, Zambrano, D, Zese, M, Cobianchi L., Dal Mas F., Massaro M., Biffl W., Catena F., Coccolini F., Dionigi B., Dionigi P., Di Saverio S., Fugazzola P., Kluger Y., Leppaniemi A., Moore E. E., Sartelli M., Velmahos G., Woltz S., Angelos P., Ansaloni L., Abdelmalik A., Abebe N. S., Abu-Zidan F. M., Adam Y. A. Y., Adamou H., Agrusa A., Akin E., Alexandrino H., Ali S. M., Almeida P. M., Amico F., Ammendola M., Andreuccetti J., Aparicio-Sanchez D., Ardito A., Argenio G., Askevold I. H., Atanasov B. T., Augustin G., Awad S. S., Bagnoli C., Bains L., Balalis D., Baldini E., Baraket O., Barone M., Barreras J. A., Bellanova G., Biancuzzi H., Bignell M. B., Bini R., Bissacco D., Boati P., Bottari A., Bouliaris K., Brillantino A., Buonomo L. A., Buscemi S., Calu V., Campo Dall'Orto R., Campostrini S., Carvas J. M., Casoni Pattacini G., Celentano V., Ceresoli M., Chirica M., Cianci P., Cillara N., Cimbanassi S., Cioffi S. P. B., Colak E., Conti L., Dantas Costa S., D'Acapito F., Damaskos D., Das K., Davies R. J., De Beaux A. C., De Simone B., Demetrashvili Z., Demetriades A. K., Denicolai S., Di Buono G., Di Carlo I., Diaconescu B., Dibra R., Dios-Barbeito S., Dogjani A., Domanin M., D'Oria M., Duran Munoz-Cruzado V., East B., Ekwen G. T., Elbaih A. H., Escalera-Antezana J. P., Esposito G., Farre R., Ferrario di Tor Vajana A., Cordeiro Fonseca V., Forfori F., Fortuna L., Fradelos E., Fraga G. P., Fransvea P., Gachabayov M., Garcia Vazquez A. A., Ghannam W. M., Gioco R., Giraudo G., Giuffrida M., Giulii Capponi M., Gomes C. A., Teixeira Gonsaga R. A., Gonullu E., Goosen J., Goranovic T., Griffiths E. A., Haidar M. G., Hamid H. K. S., Harddastle T. C., Healey A. J., Hecker M., Hernandez Garcia E. F., Huaman E. C., Hutan M., Ioannidis O., Isik A., Ismail A. M. H., Ismail N., Jang J. Y., Kaafarani H. M. A., Kalipershad S. N. R., Kaplan L. J., Kara Y., Karamagioli E., Karamarkovia A., Kavalakat A. J., Kechagias A., Kenig J., Khan J. S., Khokha V., Klappenbach R., Kobe Y., Kong V., Korkolis D., Kurihara H., Kuriyama A., Landaluce-Olavarria A., Licari L., Litvin A., Loftus T. J., Lohsiriwat V., Lopes Moreira C. C., Lostoridis E., Luna A. T., Luppi D., Machain G. M., Maegele M., Maggiore D., Maier R. V., Manangi M., Manetti A., Mantoglu B., Mariani F., Marinis A., Sbalcheiro Mariot E. A., Marseglia G. R., Martellucci J., Martines G., Martinez Perez A., Mascagni P., Massalou D., Melo R. B., Miceli L., Mingoli A., Mishra T. S., Mohamedahmed A. Y. Y., Mohan R., Morales-Garcia D., Mustafa S. M. S., Naimzada M. D., Negoi I., Nguyen C., Nidaw M. K., Nigri G., Ogundipe H. D., Oliveri C., Olmi S., Pagani L., Palomba G., Pantalone D., Panyko A., Paolillo C., Papis D., Pararas N., Pata F., Paterson-Brown S., Pavone G., Pecchini F., Pellino G., Pelloni M., Peloso A., Perea del Pozo E., Goncalves Pereira R., Monteiro Pereira B., Lizarazu Perez A., Perrone G., Pesce A., Petracca G., Piccoli M., Piccolo D., Picetti E., Pikoulis E., Pintar T., Pirozzolo G., Podda M., Previtali P., Privitera F., Punzo C., Quiodettis M. A., Qvist N., Rahim R., Reinisch-Liese A., Rodriguez-Luna M. R., Roizblatt D., Roscio F. P. M., Rossi S., Ruta F., Sakakushev B. E., Salamea J. C., Sall I., Sammartano F., Sanchez Arteaga A., Sanchez-Cordero S., Sasia D., Sawyer R. G., Seretis C., Serradilla-Martin M., Shelat V. G., Shlyapnikov S., Simoes R. L., Siribumrungwong B., Slavchev M., Solaini L., Soldini G., Soreide K., Spada F., Stahel P., Sydorchuk L., Sydorchuk R., Syed A. M., Tallon-Aguilar L., Tan J. H., Tan E., Tarasconi A., Tartaglia D., Tartaglia N., Taylor J., Tebala G. D., Teuben M., Tolonen M., Tomasicchio G., Triantafyllou T., Trigiante G., Turrado-Rodriguez V., Tutino R., Uccelli M., Ugarte-Sierra B., Ukkonen M., Vassiliu P. G., Verde J. M., Veroux M., Vilallonga R., Visconti D., Waledziak M., Wannatoop T., Widmer L. W., Wilson M. S. J., Wong T. H., Xenaki S., Yu B., Yule S., Zakaria A. D., Zambrano D. A., and Zese M.

Abstract

Background: Investigating the context of trauma and acute care surgery, the article aims at understanding the factors that can enhance some ethical aspects, namely the importance of patient consent, the perceptiveness of the ethical role of the trauma leader, and the perceived importance of ethics as an educational subject. Methods: The article employs an international questionnaire promoted by the World Society of Emergency Surgery. Results: Through the analysis of 402 fully filled questionnaires by surgeons from 72 different countries, the three main ethical topics are investigated through the lens of gender, membership of an academic or non-academic institution, an official trauma team, and a diverse group. In general terms, results highlight greater attention paid by surgeons belonging to academic institutions, official trauma teams, and diverse groups. Conclusions: Our results underline that some organizational factors (e.g., the fact that the team belongs to a university context or is more diverse) might lead to the development of a higher sensibility on ethical matters. Embracing cultural diversity forces trauma teams to deal with different mindsets. Organizations should, therefore, consider those elements in defining their organizational procedures. Level of evidence: Trauma and acute care teams work under tremendous pressure and complex circumstances, with their members needing to make ethical decisions quickly. The international survey allowed to shed light on how team assembly decisions might represent an opportunity to coordinate team member actions and increase performance.

Published
2022

26. Operative management of acute abdomen after bariatric surgery in the emergency setting: the OBA guidelines

Author

De Simone, B, Chouillard, E, Ramos, A, Donatelli, G, Pintar, T, Gupta, R, Renzi, F, Mahawar, K, Madhok, B, Maccatrozzo, S, Abu-Zidan, F, E. Moore, E, Weber, D, Coccolini, F, Di Saverio, S, Kirkpatrick, A, Shelat, V, Amico, F, Pikoulis, E, Ceresoli, M, Galante, J, Wani, I, De' Angelis, N, Hecker, A, Sganga, G, Tan, E, Balogh, Z, Bala, M, Coimbra, R, Damaskos, D, Ansaloni, L, Sartelli, M, Parasas, N, Kluger, Y, Chahine, E, Agnoletti, V, Fraga, G, Biffl, W, Catena, F, De Simone B., Chouillard E., Ramos A. C., Donatelli G., Pintar T., Gupta R., Renzi F., Mahawar K., Madhok B., Maccatrozzo S., Abu-Zidan F. M., E. Moore E., Weber D. G., Coccolini F., Di Saverio S., Kirkpatrick A., Shelat V. G., Amico F., Pikoulis E., Ceresoli M., Galante J. M., Wani I., De' Angelis N., Hecker A., Sganga G., Tan E., Balogh Z. J., Bala M., Coimbra R., Damaskos D., Ansaloni L., Sartelli M., Parasas N., Kluger Y., Chahine E., Agnoletti V., Fraga G., Biffl W. L., Catena F., De Simone, B, Chouillard, E, Ramos, A, Donatelli, G, Pintar, T, Gupta, R, Renzi, F, Mahawar, K, Madhok, B, Maccatrozzo, S, Abu-Zidan, F, E. Moore, E, Weber, D, Coccolini, F, Di Saverio, S, Kirkpatrick, A, Shelat, V, Amico, F, Pikoulis, E, Ceresoli, M, Galante, J, Wani, I, De' Angelis, N, Hecker, A, Sganga, G, Tan, E, Balogh, Z, Bala, M, Coimbra, R, Damaskos, D, Ansaloni, L, Sartelli, M, Parasas, N, Kluger, Y, Chahine, E, Agnoletti, V, Fraga, G, Biffl, W, Catena, F, De Simone B., Chouillard E., Ramos A. C., Donatelli G., Pintar T., Gupta R., Renzi F., Mahawar K., Madhok B., Maccatrozzo S., Abu-Zidan F. M., E. Moore E., Weber D. G., Coccolini F., Di Saverio S., Kirkpatrick A., Shelat V. G., Amico F., Pikoulis E., Ceresoli M., Galante J. M., Wani I., De' Angelis N., Hecker A., Sganga G., Tan E., Balogh Z. J., Bala M., Coimbra R., Damaskos D., Ansaloni L., Sartelli M., Parasas N., Kluger Y., Chahine E., Agnoletti V., Fraga G., Biffl W. L., and Catena F.

Abstract

Background: Patients presenting with acute abdominal pain that occurs after months or years following bariatric surgery may present for assessment and management in the local emergency units. Due to the large variety of surgical bariatric techniques, emergency surgeons have to be aware of the main functional outcomes and long-term surgical complications following the most performed bariatric surgical procedures. The purpose of these evidence-based guidelines is to present a consensus position from members of the WSES in collaboration with IFSO bariatric experienced surgeons, on the management of acute abdomen after bariatric surgery focusing on long-term complications in patients who have undergone laparoscopic sleeve gastrectomy and laparoscopic Roux-en-Y gastric bypass. Method: A working group of experienced general, acute care, and bariatric surgeons was created to carry out a systematic review of the literature following the Preferred Reporting Items for Systematic Review and Meta-analysis Protocols (PRISMA-P) and to answer the PICO questions formulated after the Operative management in bariatric acute abdomen survey. The literature search was limited to late/long-term complications following laparoscopic sleeve gastrectomy and laparoscopic Roux-en-Y gastric bypass. Conclusions: The acute abdomen after bariatric surgery is a common cause of admission in emergency departments. Knowledge of the most common late/long-term complications (> 4 weeks after surgical procedure) following sleeve gastrectomy and Roux-en-Y gastric bypass and their anatomy leads to a focused management in the emergency setting with good outcomes and decreased morbidity and mortality rates. A close collaboration between emergency surgeons, radiologists, endoscopists, and anesthesiologists is mandatory in the management of this group of patients in the emergency setting.

Published
2022

27. 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

28. The WSES/SICG/ACOI/SICUT/AcEMC/SIFIPAC guidelines for diagnosis and treatment of acute left colonic diverticulitis in the elderly

Author

Fugazzola, P, Ceresoli, M, Coccolini, F, Gabrielli, F, Puzziello, A, Monzani, F, Amato, B, Sganga, G, Sartelli, M, Menichetti, F, Puglisi, G, Tartaglia, D, Carcoforo, P, Avenia, N, Kluger, Y, Paolillo, C, Zago, M, Leppaniemi, A, Tomasoni, M, Cobianchi, L, Dal Mas, F, Improta, M, Moore, E, Peitzman, A, Sugrue, M, Agnoletti, V, Fraga, G, Weber, D, Damaskos, D, Abu-Zidan, F, Wani, I, Kirkpatrick, A, Pikoulis, M, Pararas, N, Tan, E, Broek, R, Maier, R, Davies, R, Kashuk, J, Shelat, V, Mefire, A, Augustin, G, Magnone, S, Poiasina, E, De Simone, B, Chiarugi, M, Biffl, W, Baiocchi, G, Catena, F, Ansaloni, L, Fugazzola P., Ceresoli M., Coccolini F., Gabrielli F., Puzziello A., Monzani F., Amato B., Sganga G., Sartelli M., Menichetti F., Puglisi G. A., Tartaglia D., Carcoforo P., Avenia N., Kluger Y., Paolillo C., Zago M., Leppaniemi A., Tomasoni M., Cobianchi L., Dal Mas F., Improta M., Moore E. E., Peitzman A. B., Sugrue M., Agnoletti V., Fraga G. P., Weber D. G., Damaskos D., Abu-Zidan F. M., Wani I., Kirkpatrick A. W., Pikoulis M., Pararas N., Tan E., Broek R. T., Maier R. V., Davies R. J., Kashuk J., Shelat V. G., Mefire A. C., Augustin G., Magnone S., Poiasina E., De Simone B., Chiarugi M., Biffl W., Baiocchi G. L., Catena F., Ansaloni L., Fugazzola, P, Ceresoli, M, Coccolini, F, Gabrielli, F, Puzziello, A, Monzani, F, Amato, B, Sganga, G, Sartelli, M, Menichetti, F, Puglisi, G, Tartaglia, D, Carcoforo, P, Avenia, N, Kluger, Y, Paolillo, C, Zago, M, Leppaniemi, A, Tomasoni, M, Cobianchi, L, Dal Mas, F, Improta, M, Moore, E, Peitzman, A, Sugrue, M, Agnoletti, V, Fraga, G, Weber, D, Damaskos, D, Abu-Zidan, F, Wani, I, Kirkpatrick, A, Pikoulis, M, Pararas, N, Tan, E, Broek, R, Maier, R, Davies, R, Kashuk, J, Shelat, V, Mefire, A, Augustin, G, Magnone, S, Poiasina, E, De Simone, B, Chiarugi, M, Biffl, W, Baiocchi, G, Catena, F, Ansaloni, L, Fugazzola P., Ceresoli M., Coccolini F., Gabrielli F., Puzziello A., Monzani F., Amato B., Sganga G., Sartelli M., Menichetti F., Puglisi G. A., Tartaglia D., Carcoforo P., Avenia N., Kluger Y., Paolillo C., Zago M., Leppaniemi A., Tomasoni M., Cobianchi L., Dal Mas F., Improta M., Moore E. E., Peitzman A. B., Sugrue M., Agnoletti V., Fraga G. P., Weber D. G., Damaskos D., Abu-Zidan F. M., Wani I., Kirkpatrick A. W., Pikoulis M., Pararas N., Tan E., Broek R. T., Maier R. V., Davies R. J., Kashuk J., Shelat V. G., Mefire A. C., Augustin G., Magnone S., Poiasina E., De Simone B., Chiarugi M., Biffl W., Baiocchi G. L., Catena F., and Ansaloni L.

Abstract

Acute left colonic diverticulitis (ALCD) in the elderly presents with unique epidemiological features when compared with younger patients. The clinical presentation is more nuanced in the elderly population, having higher in-hospital and postoperative mortality. Furthermore, geriatric comorbidities are a risk factor for complicated diverticulitis. Finally, elderly patients have a lower risk of recurrent episodes and, in case of recurrence, a lower probability of requiring urgent surgery than younger patients. The aim of the present work is to study age-related factors that may support a unique approach to the diagnosis and treatment of this problem in the elderly when compared with the WSES guidelines for the management of acute left-sided colonic diverticulitis. During the 1° Pisa Workshop of Acute Care & Trauma Surgery held in Pisa (Italy) in September 2019, with the collaboration of the World Society of Emergency Surgery (WSES), the Italian Society of Geriatric Surgery (SICG), the Italian Hospital Surgeons Association (ACOI), the Italian Emergency Surgery and Trauma Association (SICUT), the Academy of Emergency Medicine and Care (AcEMC) and the Italian Society of Surgical Pathophysiology (SIFIPAC), three panel members presented a number of statements developed for each of the four themes regarding the diagnosis and management of ALCD in older patients, formulated according to the GRADE approach, at a Consensus Conference where a panel of experts participated. The statements were subsequently debated, revised, and finally approved by the Consensus Conference attendees. The current paper is a summary report of the definitive guidelines statements on each of the following topics: diagnosis, management, surgical technique and antibiotic therapy.

Published
2022

29. WSES/GAIS/WSIS/SIS-E/AAST global clinical pathways for patients with skin and soft tissue infections

Author

Sartelli, M, Coccolini, F, Kluger, Y, Agastra, E, Abu-Zidan, F, Abbas, A, Ansaloni, L, Adesunkanmi, A, Augustin, G, Bala, M, Baraket, O, Biffl, W, Ceresoli, M, Cerutti, E, Chiara, O, Cicuttin, E, Chiarugi, M, Coimbra, R, Corsi, D, Cortese, F, Cui, Y, Damaskos, D, De'Angelis, N, Delibegovic, S, Demetrashvili, Z, De Simone, B, de Jonge, S, Di Bella, S, Di Saverio, S, Duane, T, Fugazzola, P, Galante, J, Ghnnam, W, Gkiokas, G, Gomes, C, Griffiths, E, Hardcastle, T, Hecker, A, Herzog, T, Karamarkovic, A, Khokha, V, Kim, P, Kim, J, Kirkpatrick, A, Kong, V, Koshy, R, Inaba, K, Isik, A, Ivatury, R, Labricciosa, F, Lee, Y, Leppaniemi, A, Litvin, A, Luppi, D, Maier, R, Marinis, A, Marwah, S, Mesina, C, Moore, E, Moore, F, Negoi, I, Olaoye, I, Ordonez, C, Ouadii, M, Peitzman, A, Perrone, G, Pintar, T, Pipitone, G, Podda, M, Rasa, K, Ribeiro, J, Rodrigues, G, Rubio-Perez, I, Sall, I, Sato, N, Sawyer, R, Shelat, V, Sugrue, M, Tarasconi, A, Tolonen, M, Viaggi, B, Celotti, A, Casella, C, Pagani, L, Dhingra, S, Baiocchi, G, Catena, F, Sartelli M., Coccolini F., Kluger Y., Agastra E., Abu-Zidan F. M., Abbas A. E. S., Ansaloni L., Adesunkanmi A. K., Augustin G., Bala M., Baraket O., Biffl W. L., Ceresoli M., Cerutti E., Chiara O., Cicuttin E., Chiarugi M., Coimbra R., Corsi D., Cortese F., Cui Y., Damaskos D., de'Angelis N., Delibegovic S., Demetrashvili Z., De Simone B., de Jonge S. W., Di Bella S., Di Saverio S., Duane T. M., Fugazzola P., Galante J. M., Ghnnam W., Gkiokas G., Gomes C. A., Griffiths E. A., Hardcastle T. C., Hecker A., Herzog T., Karamarkovic A., Khokha V., Kim P. K., Kim J. I., Kirkpatrick A. W., Kong V., Koshy R. M., Inaba K., Isik A., Ivatury R., Labricciosa F. M., Lee Y. Y., Leppaniemi A., Litvin A., Luppi D., Maier R. V., Marinis A., Marwah S., Mesina C., Moore E. E., Moore F. A., Negoi I., Olaoye I., Ordonez C. A., Ouadii M., Peitzman A. B., Perrone G., Pintar T., Pipitone G., Podda M., Rasa K., Ribeiro J., Rodrigues G., Rubio-Perez I., Sall I., Sato N., Sawyer R. G., Shelat V. G., Sugrue M., Tarasconi A., Tolonen M., Viaggi B., Celotti A., Casella C., Pagani L., Dhingra S., Baiocchi G. L., Catena F., Sartelli, M, Coccolini, F, Kluger, Y, Agastra, E, Abu-Zidan, F, Abbas, A, Ansaloni, L, Adesunkanmi, A, Augustin, G, Bala, M, Baraket, O, Biffl, W, Ceresoli, M, Cerutti, E, Chiara, O, Cicuttin, E, Chiarugi, M, Coimbra, R, Corsi, D, Cortese, F, Cui, Y, Damaskos, D, De'Angelis, N, Delibegovic, S, Demetrashvili, Z, De Simone, B, de Jonge, S, Di Bella, S, Di Saverio, S, Duane, T, Fugazzola, P, Galante, J, Ghnnam, W, Gkiokas, G, Gomes, C, Griffiths, E, Hardcastle, T, Hecker, A, Herzog, T, Karamarkovic, A, Khokha, V, Kim, P, Kim, J, Kirkpatrick, A, Kong, V, Koshy, R, Inaba, K, Isik, A, Ivatury, R, Labricciosa, F, Lee, Y, Leppaniemi, A, Litvin, A, Luppi, D, Maier, R, Marinis, A, Marwah, S, Mesina, C, Moore, E, Moore, F, Negoi, I, Olaoye, I, Ordonez, C, Ouadii, M, Peitzman, A, Perrone, G, Pintar, T, Pipitone, G, Podda, M, Rasa, K, Ribeiro, J, Rodrigues, G, Rubio-Perez, I, Sall, I, Sato, N, Sawyer, R, Shelat, V, Sugrue, M, Tarasconi, A, Tolonen, M, Viaggi, B, Celotti, A, Casella, C, Pagani, L, Dhingra, S, Baiocchi, G, Catena, F, Sartelli M., Coccolini F., Kluger Y., Agastra E., Abu-Zidan F. M., Abbas A. E. S., Ansaloni L., Adesunkanmi A. K., Augustin G., Bala M., Baraket O., Biffl W. L., Ceresoli M., Cerutti E., Chiara O., Cicuttin E., Chiarugi M., Coimbra R., Corsi D., Cortese F., Cui Y., Damaskos D., de'Angelis N., Delibegovic S., Demetrashvili Z., De Simone B., de Jonge S. W., Di Bella S., Di Saverio S., Duane T. M., Fugazzola P., Galante J. M., Ghnnam W., Gkiokas G., Gomes C. A., Griffiths E. A., Hardcastle T. C., Hecker A., Herzog T., Karamarkovic A., Khokha V., Kim P. K., Kim J. I., Kirkpatrick A. W., Kong V., Koshy R. M., Inaba K., Isik A., Ivatury R., Labricciosa F. M., Lee Y. Y., Leppaniemi A., Litvin A., Luppi D., Maier R. V., Marinis A., Marwah S., Mesina C., Moore E. E., Moore F. A., Negoi I., Olaoye I., Ordonez C. A., Ouadii M., Peitzman A. B., Perrone G., Pintar T., Pipitone G., Podda M., Rasa K., Ribeiro J., Rodrigues G., Rubio-Perez I., Sall I., Sato N., Sawyer R. G., Shelat V. G., Sugrue M., Tarasconi A., Tolonen M., Viaggi B., Celotti A., Casella C., Pagani L., Dhingra S., Baiocchi G. L., and Catena F.

Abstract

Skin and soft-tissue infections (SSTIs) encompass a variety of pathological conditions that involve the skin and underlying subcutaneous tissue, fascia, or muscle, ranging from simple superficial infections to severe necrotizing infections. Together, the World Society of Emergency Surgery, the Global Alliance for Infections in Surgery, the Surgical Infection Society-Europe, The World Surgical Infection Society, and the American Association for the Surgery of Trauma have jointly completed an international multi-society document to promote global standards of care in SSTIs guiding clinicians by describing reasonable approaches to the management of SSTIs. An extensive non-systematic review was conducted using the PubMed and MEDLINE databases, limited to the English language. The resulting evidence was shared by an international task force with different clinical backgrounds.

Published
2022

30. Particle production in the central rapidity region

Author

Cooper, F., Eisenberg, J. M., Kluger, Y., Mottola, E., and Svetitsky, B.

Subjects
High Energy Physics - Phenomenology
Abstract

We study pair production from a strong electric field in boost-invariant coordinates as a simple model for the central rapidity region of a heavy-ion collision. We derive and solve the renormalized equations for the time evolution of the mean electric field and current of the produced particles, when the field is taken to be a function only of the fluid proper time $\tau = \sqrt{t^2-z^2}$. We find that a relativistic transport theory with a Schwinger source term modified to take Pauli blocking (or Bose enhancement) into account gives a good description of the numerical solution to the field equations. We also compute the renormalized energy-momentum tensor of the produced particles and compare the effective pressure, energy and entropy density to that expected from hydrodynamic models of energy and momentum flow of the plasma., Comment: 38 pages (LaTex, 9 Figures available upon request)

Published
1992
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31. Training curriculum in minimally invasive emergency digestive surgery: 2022 WSES position paper.

Author

De'Angelis, N., Marchegiani, F., Schena, C.A., Khan, J., Agnoletti, V., Ansaloni, L., arría Rodríguez, A.G. B, Bianchi, P.P., Biffl, W., Bravi, F., Ceccarelli, G., Ceresoli, M., Chiara, O., Chirica, M., Cobianchi, L., Coccolini, F., Coimbra, R., Cotsoglou, C., D'Hondt, M., Damaskos, D., Simone, B. De, Saverio, S. Di, Diana, M., Espin-Basany, E., Fichtner-Feigl, S., Fugazzola, P., Gavriilidis, P., Gronnier, C., Kashuk, J., Kirkpatrick, A.W., Ammendola, M., Kouwenhoven, E.A., Laurent, A., Leppaniemi, A., Lesurtel, M., Memeo, R., Milone, M., Moore, E., Pararas, N., Peitzmann, A., Pessaux, P., Picetti, E., Pikoulis, M., Pisano, M., Ris, F., Robison, T., Sartelli, M., Shelat, V.G., Spinoglio, G., Sugrue, M., Tan, E.C.T.H., Eetvelde, E. Van, Kluger, Y., Weber, D., Catena, F., De'Angelis, N., Marchegiani, F., Schena, C.A., Khan, J., Agnoletti, V., Ansaloni, L., arría Rodríguez, A.G. B, Bianchi, P.P., Biffl, W., Bravi, F., Ceccarelli, G., Ceresoli, M., Chiara, O., Chirica, M., Cobianchi, L., Coccolini, F., Coimbra, R., Cotsoglou, C., D'Hondt, M., Damaskos, D., Simone, B. De, Saverio, S. Di, Diana, M., Espin-Basany, E., Fichtner-Feigl, S., Fugazzola, P., Gavriilidis, P., Gronnier, C., Kashuk, J., Kirkpatrick, A.W., Ammendola, M., Kouwenhoven, E.A., Laurent, A., Leppaniemi, A., Lesurtel, M., Memeo, R., Milone, M., Moore, E., Pararas, N., Peitzmann, A., Pessaux, P., Picetti, E., Pikoulis, M., Pisano, M., Ris, F., Robison, T., Sartelli, M., Shelat, V.G., Spinoglio, G., Sugrue, M., Tan, E.C.T.H., Eetvelde, E. Van, Kluger, Y., Weber, D., and Catena, F.

Abstract

Item does not contain fulltext, BACKGROUND: Minimally invasive surgery (MIS), including laparoscopic and robotic approaches, is widely adopted in elective digestive surgery, but selectively used for surgical emergencies. The present position paper summarizes the available evidence concerning the learning curve to achieve proficiency in emergency MIS and provides five expert opinion statements, which may form the basis for developing standardized curricula and training programs in emergency MIS. METHODS: This position paper was conducted according to the World Society of Emergency Surgery methodology. A steering committee and an international expert panel were involved in the critical appraisal of the literature and the development of the consensus statements. RESULTS: Thirteen studies regarding the learning curve in emergency MIS were selected. All but one study considered laparoscopic appendectomy. Only one study reported on emergency robotic surgery. In most of the studies, proficiency was achieved after an average of 30 procedures (range: 20-107) depending on the initial surgeon's experience. High heterogeneity was noted in the way the learning curve was assessed. The experts claim that further studies investigating learning curve processes in emergency MIS are needed. The emergency surgeon curriculum should include a progressive and adequate training based on simulation, supervised clinical practice (proctoring), and surgical fellowships. The results should be evaluated by adopting a credentialing system to ensure quality standards. Surgical proficiency should be maintained with a minimum caseload and constantly evaluated. Moreover, the training process should involve the entire surgical team to facilitate the surgeon's proficiency. CONCLUSIONS: Limited evidence exists concerning the learning process in laparoscopic and robotic emergency surgery. The proposed statements should be seen as a preliminary guide for the surgical community while stressing the need for further research.

Published
2023

32. The new timing in acute care surgery (new TACS) classification: a WSES Delphi consensus study.

Author

Simone, B. De, Kluger, Y., Moore, E.E., Sartelli, M., Abu-Zidan, F.M., Coccolini, F., Ansaloni, L., Tebala, G.D., Saverio, S. Di, Carlo, I. Di, Sakakushev, B.E., Bonavina, L., Sugrue, M., Galante, J.M., Ivatury, R., Picetti, E., Chirica, M., Wani, I., Bala, M., Sall, I., Kirkpatrick, A.W., Shelat, V.G., Pikoulis, E., Leppäniemi, A., Tan, E., Broek, R.P.G ten, Gurmu Beka, S., Litvin, A., Chouillard, E., Coimbra, R., Cui, Y., De' Angelis, N., Sganga, G., Stahel, P.F., Agnoletti, V., Rampini, A., Testini, M., Bravi, F., Maier, R.V., Biffl, W.L., Catena, F., Simone, B. De, Kluger, Y., Moore, E.E., Sartelli, M., Abu-Zidan, F.M., Coccolini, F., Ansaloni, L., Tebala, G.D., Saverio, S. Di, Carlo, I. Di, Sakakushev, B.E., Bonavina, L., Sugrue, M., Galante, J.M., Ivatury, R., Picetti, E., Chirica, M., Wani, I., Bala, M., Sall, I., Kirkpatrick, A.W., Shelat, V.G., Pikoulis, E., Leppäniemi, A., Tan, E., Broek, R.P.G ten, Gurmu Beka, S., Litvin, A., Chouillard, E., Coimbra, R., Cui, Y., De' Angelis, N., Sganga, G., Stahel, P.F., Agnoletti, V., Rampini, A., Testini, M., Bravi, F., Maier, R.V., Biffl, W.L., and Catena, F.

Abstract

Item does not contain fulltext, BACKGROUND: Timely access to the operating room for emergency general surgery (EGS) indications remains a challenge across the globe, largely driven by operating room availability and staffing constraints. The "timing in acute care surgery" (TACS) classification was previously published to introduce a new tool to triage the timely and appropriate access of EGS patients to the operating room. However, the clinical and operational effectiveness of the TACS classification has not been investigated in subsequent validation studies. This study aimed to improve the TACS classification and provide further consensus around the appropriate use of the new TACS classification through a standardized Delphi approach with international experts. METHODS: This is a validation study of the new TACS by a selected international panel of experts using the Delphi method. The TACS questionnaire was designed as a web-based survey. The consensus agreement level was established to be ≥ 75%. The collective consensus agreement was defined as the sum of the percentage of the highest Likert scale levels (4-5) out of all participants. Surgical emergency diseases and correlated clinical scenarios were defined for each of the proposed classes. Subsequent rounds were carried out until a definitive level of consensus was reached. Frequencies and percentages were calculated to determine the degree of agreement for each surgical disease. RESULTS: Four polling rounds were carried out. The new TACS classification provides 6 colour-code classes correlated to a precise timing to surgery, defined scenarios and surgical condition. The WHITE colour-code class was introduced to rapidly (within a week) reschedule cancelled or postponed surgical procedures. Haemodynamic stability is the main tool to stratify patients for immediate surgery or not in the presence of sepsis/septic shock. Fifty-one surgical diseases were included in the different colour-code classes of priority. CONCLUSION: The new TACS classificat

Published
2023

33. 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.L., Bendinelli, C., Biffl, W.L., Bonavina, L., Bravi, F., Carcoforo, P., Ceresoli, M., Chichom-Mefire, A., Coccolini, F., Coimbra, R., De'Angelis, N., Moya, M. de, Simone, B. De, Saverio, S. Di, Fraga, G.P., Galante, J., Ivatury, R., Kashuk, J., Kelly, M.D., Kirkpatrick, A.W., Kluger, Y., Koike, Kaoru, Leppaniemi, A., Maier, R.V., Moore, E.E., Peitzmann, A., Sakakushev, B., Sartelli, M., Sugrue, M., Tian, B.W.C.A., Broek, R.P.G ten, Vallicelli, C., Wani, I., Weber, D.G., 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., Moya, M. de, Simone, B. De, Saverio, S. Di, Fraga, G.P., Galante, J., Ivatury, R., Kashuk, J., Kelly, M.D., Kirkpatrick, A.W., Kluger, Y., Koike, Kaoru, Leppaniemi, A., Maier, R.V., Moore, E.E., Peitzmann, A., Sakakushev, B., Sartelli, M., Sugrue, M., Tian, B.W.C.A., Broek, R.P.G ten, Vallicelli, C., Wani, I., Weber, D.G., Docimo, G., and Catena, F.

Abstract

Contains fulltext : 296002.pdf (Publisher’s version ) (Open Access), 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

34. 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.L., Coccolini, F., Damaskos, D., Moore, E.E., Kluger, Y., Ceresoli, M., Coimbra, R., Davies, J., Kirkpatrick, A., Carlo, I. Di, 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., Saverio, S. Di, Broek, R.P.G ten, Granieri, S., Mas, F. Dal, Farè, C.N., Peverada, J., Zanghì, S., Viganò, 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.C.T.H., Malangoni, M.A., Pararas, N., Podda, M., Simone, B. De, 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., Moya, M. de, Litvin, A., Martínez-Pérez, 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.L., Coccolini, F., Damaskos, D., Moore, E.E., Kluger, Y., Ceresoli, M., Coimbra, R., Davies, J., Kirkpatrick, A., Carlo, I. Di, 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., Saverio, S. Di, Broek, R.P.G ten, Granieri, S., Mas, F. Dal, Farè, C.N., Peverada, J., Zanghì, S., Viganò, 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.C.T.H., Malangoni, M.A., Pararas, N., Podda, M., Simone, B. De, 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., Moya, M. de, Litvin, A., Martínez-Pérez, 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

Contains fulltext : 296003.pdf (Publisher’s version ) (Open Access), 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

35. 2023 WSES guidelines for the prevention, detection, and management of iatrogenic urinary tract injuries (IUTIs) during emergency digestive surgery.

Author

De'Angelis, N., Schena, C.A., Marchegiani, F., Reitano, E., Simone, B. De, Wong, G.Y.M., Martínez-Pérez, A., Abu-Zidan, F.M., Agnoletti, V., Aisoni, F., Ammendola, M., Ansaloni, L., Bala, M., Biffl, W., Ceccarelli, G., Ceresoli, M., Chiara, O., Chiarugi, M., Cimbanassi, S., Coccolini, F., Coimbra, R., Saverio, S. Di, Diana, M., oguardi Burgio, M. Di, Fraga, G., Gavriilidis, P., Gurrado, A., Inchingolo, R., Ingels, A., Ivatury, R., Kashuk, J.L., Khan, J., Kirkpatrick, A.W., Kim, F.J., Kluger, Y., Lakkis, Z., Leppäniemi, A., Maier, R.V., Memeo, R., Moore, E.E., Ordoñez, C.A., Peitzman, A.B., Pellino, G., Picetti, E., Pikoulis, M., Pisano, M., Podda, M., Romeo, O., Rosa, F., Tan, E.C.T.H., Broek, R.P. ten, Testini, M., Tian Wei Cheng, B.A., Weber, D., Sacco, E., Sartelli, M., Tonsi, A., Moro, F. Dal, Catena, F., De'Angelis, N., Schena, C.A., Marchegiani, F., Reitano, E., Simone, B. De, Wong, G.Y.M., Martínez-Pérez, A., Abu-Zidan, F.M., Agnoletti, V., Aisoni, F., Ammendola, M., Ansaloni, L., Bala, M., Biffl, W., Ceccarelli, G., Ceresoli, M., Chiara, O., Chiarugi, M., Cimbanassi, S., Coccolini, F., Coimbra, R., Saverio, S. Di, Diana, M., oguardi Burgio, M. Di, Fraga, G., Gavriilidis, P., Gurrado, A., Inchingolo, R., Ingels, A., Ivatury, R., Kashuk, J.L., Khan, J., Kirkpatrick, A.W., Kim, F.J., Kluger, Y., Lakkis, Z., Leppäniemi, A., Maier, R.V., Memeo, R., Moore, E.E., Ordoñez, C.A., Peitzman, A.B., Pellino, G., Picetti, E., Pikoulis, M., Pisano, M., Podda, M., Romeo, O., Rosa, F., Tan, E.C.T.H., Broek, R.P. ten, Testini, M., Tian Wei Cheng, B.A., Weber, D., Sacco, E., Sartelli, M., Tonsi, A., Moro, F. Dal, and Catena, F.

Abstract

Contains fulltext : 296327.pdf (Publisher’s version ) (Open Access), Iatrogenic urinary tract injury (IUTI) is a severe complication of emergency digestive surgery. It can lead to increased postoperative morbidity and mortality and have a long-term impact on the quality of life. The reported incidence of IUTIs varies greatly among the studies, ranging from 0.3 to 1.5%. Given the high volume of emergency digestive surgery performed worldwide, there is a need for well-defined and effective strategies to prevent and manage IUTIs. Currently, there is a lack of consensus regarding the prevention, detection, and management of IUTIs in the emergency setting. The present guidelines, promoted by the World Society of Emergency Surgery (WSES), were developed following a systematic review of the literature and an international expert panel discussion. The primary aim of these WSES guidelines is to provide evidence-based recommendations to support clinicians and surgeons in the prevention, detection, and management of IUTIs during emergency digestive surgery. The following key aspects were considered: (1) effectiveness of preventive interventions for IUTIs during emergency digestive surgery; (2) intra-operative detection of IUTIs and appropriate management strategies; (3) postoperative detection of IUTIs and appropriate management strategies and timing; and (4) effectiveness of antibiotic therapy (including type and duration) in case of IUTIs.

Published
2023

36. Source control in emergency general surgery: WSES, GAIS, SIS-E, SIS-A guidelines.

Author

Coccolini, F., Sartelli, M., Sawyer, R., Rasa, K., Viaggi, B., Abu-Zidan, F., Soreide, K., Hardcastle, T., Gupta, D., Bendinelli, C., Ceresoli, M., Shelat, V.G., Broek, R.P. ten, Baiocchi, G.L., Moore, E.E., Sall, I., Podda, M., Bonavina, L., Kryvoruchko, I.A., Stahel, P., Inaba, K., Montravers, P., Sakakushev, B., Sganga, G., Ballestracci, P., Malbrain, M.L.N.G., Vincent, J.L., Pikoulis, M., Beka, S.G., Doklestic, K., Chiarugi, M., Falcone, M., Bignami, E., Reva, V., Demetrashvili, Z., Saverio, S. Di, Tolonen, M., Navsaria, P., Bala, M., Balogh, Z., Litvin, A., Hecker, A., Wani, I., Fette, A., Simone, B. De, Ivatury, R., Picetti, E., Khokha, V., Tan, E.C.T.H., Ball, C., Tascini, C., Cui, Y., Coimbra, R., Kelly, M., Martino, C., Agnoletti, V., Boermeester, M.A., De'Angelis, N., Chirica, M., Biffl, W.L., Ansaloni, L., Kluger, Y., Catena, F., Kirkpatrick, A.W., Coccolini, F., Sartelli, M., Sawyer, R., Rasa, K., Viaggi, B., Abu-Zidan, F., Soreide, K., Hardcastle, T., Gupta, D., Bendinelli, C., Ceresoli, M., Shelat, V.G., Broek, R.P. ten, Baiocchi, G.L., Moore, E.E., Sall, I., Podda, M., Bonavina, L., Kryvoruchko, I.A., Stahel, P., Inaba, K., Montravers, P., Sakakushev, B., Sganga, G., Ballestracci, P., Malbrain, M.L.N.G., Vincent, J.L., Pikoulis, M., Beka, S.G., Doklestic, K., Chiarugi, M., Falcone, M., Bignami, E., Reva, V., Demetrashvili, Z., Saverio, S. Di, Tolonen, M., Navsaria, P., Bala, M., Balogh, Z., Litvin, A., Hecker, A., Wani, I., Fette, A., Simone, B. De, Ivatury, R., Picetti, E., Khokha, V., Tan, E.C.T.H., Ball, C., Tascini, C., Cui, Y., Coimbra, R., Kelly, M., Martino, C., Agnoletti, V., Boermeester, M.A., De'Angelis, N., Chirica, M., Biffl, W.L., Ansaloni, L., Kluger, Y., Catena, F., and Kirkpatrick, A.W.

Abstract

Item does not contain fulltext, Intra-abdominal infections (IAI) are among the most common global healthcare challenges and they are usually precipitated by disruption to the gastrointestinal (GI) tract. Their successful management typically requires intensive resource utilization, and despite the best therapies, morbidity and mortality remain high. One of the main issues required to appropriately treat IAI that differs from the other etiologies of sepsis is the frequent requirement to provide physical source control. Fortunately, dramatic advances have been made in this aspect of treatment. Historically, source control was left to surgeons only. With new technologies non-surgical less invasive interventional procedures have been introduced. Alternatively, in addition to formal surgery open abdomen techniques have long been proposed as aiding source control in severe intra-abdominal sepsis. It is ironic that while a lack or even delay regarding source control clearly associates with death, it is a concept that remains poorly described. For example, no conclusive definition of source control technique or even adequacy has been universally accepted. Practically, source control involves a complex definition encompassing several factors including the causative event, source of infection bacteria, local bacterial flora, patient condition, and his/her eventual comorbidities. With greater understanding of the systemic pathobiology of sepsis and the profound implications of the human microbiome, adequate source control is no longer only a surgical issue but one that requires a multidisciplinary, multimodality approach. Thus, while any breach in the GI tract must be controlled, source control should also attempt to control the generation and propagation of the systemic biomediators and dysbiotic influences on the microbiome that perpetuate multi-system organ failure and death. Given these increased complexities, the present paper represents the current opinions and recommendations for future research of th

Published
2023

37. Enhanced perioperative care in emergency general surgery: the WSES position paper.

Author

Ceresoli, M., Braga, M., Zanini, N., Abu-Zidan, F.M., Parini, D., Langer, T., Sartelli, M., Damaskos, D., Biffl, W.L., Amico, F., Ansaloni, L., Balogh, Z.J., Bonavina, L., Civil, I., Cicuttin, E., Chirica, M., Cui, Y., Simone, B. De, Carlo, I. Di, Fette, A., Foti, G., Fogliata, M., Fraga, G.P., Fugazzola, P., Galante, J.M., Beka, S.G., Hecker, A., Jeekel, J., Kirkpatrick, A.W., Koike, Kaoru, Leppäniemi, A., Marzi, I., Moore, E.E., Picetti, E., Pikoulis, E., Pisano, M., Podda, M., Sakakushev, B.E., Shelat, V.G., Tan, E.C.T.H., Tebala, G.D., Velmahos, G., Weber, D.G., Agnoletti, V., Kluger, Y., Baiocchi, G., Catena, F., Coccolini, F., Ceresoli, M., Braga, M., Zanini, N., Abu-Zidan, F.M., Parini, D., Langer, T., Sartelli, M., Damaskos, D., Biffl, W.L., Amico, F., Ansaloni, L., Balogh, Z.J., Bonavina, L., Civil, I., Cicuttin, E., Chirica, M., Cui, Y., Simone, B. De, Carlo, I. Di, Fette, A., Foti, G., Fogliata, M., Fraga, G.P., Fugazzola, P., Galante, J.M., Beka, S.G., Hecker, A., Jeekel, J., Kirkpatrick, A.W., Koike, Kaoru, Leppäniemi, A., Marzi, I., Moore, E.E., Picetti, E., Pikoulis, E., Pisano, M., Podda, M., Sakakushev, B.E., Shelat, V.G., Tan, E.C.T.H., Tebala, G.D., Velmahos, G., Weber, D.G., Agnoletti, V., Kluger, Y., Baiocchi, G., Catena, F., and Coccolini, F.

Abstract

Contains fulltext : 297347.pdf (Publisher’s version ) (Open Access), Enhanced perioperative care protocols become the standard of care in elective surgery with a significant improvement in patients' outcome. The key element of the enhanced perioperative care protocol is the multimodal and interdisciplinary approach targeted to the patient, focused on a holistic approach to reduce surgical stress and improve perioperative recovery. Enhanced perioperative care in emergency general surgery is still a debated topic with little evidence available. The present position paper illustrates the existing evidence about perioperative care in emergency surgery patients with a focus on each perioperative intervention in the preoperative, intraoperative and postoperative phase. For each item was proposed and approved a statement by the WSES collaborative group.

Published
2023

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

Author

Sermonesi, G., Tian, B.W.C.A., Vallicelli, C., Abu-Zidan, F.M., Damaskos, D., Kelly, M.D., Leppäniemi, A., Galante, J.M., Tan, E.C.T.H., Kirkpatrick, A.W., Khokha, V., Romeo, O.M., Chirica, M., Pikoulis, M., Litvin, A., Shelat, V.G., Sakakushev, B., Wani, I., Sall, I., Fugazzola, P., Cicuttin, E., Toro, A., Amico, F., Mas, F.D., Simone, B. De, Sugrue, M., Bonavina, L., Campanelli, G., Carcoforo, P., Cobianchi, L., Coccolini, F., Chiarugi, M., Carlo, I. Di, Saverio, S. Di, Podda, M., Pisano, M., Sartelli, M., Testini, M., Fette, A., Rizoli, S., Picetti, E., Weber, D., Latifi, R., Kluger, Y., Balogh, Z.J., Biffl, W., Jeekel, H., Civil, I., Hecker, A., Ansaloni, L., Bravi, F., Agnoletti, V., Beka, S.G., Moore, E.E., Catena, F., Sermonesi, G., Tian, B.W.C.A., Vallicelli, C., Abu-Zidan, F.M., Damaskos, D., Kelly, M.D., Leppäniemi, A., Galante, J.M., Tan, E.C.T.H., Kirkpatrick, A.W., Khokha, V., Romeo, O.M., Chirica, M., Pikoulis, M., Litvin, A., Shelat, V.G., Sakakushev, B., Wani, I., Sall, I., Fugazzola, P., Cicuttin, E., Toro, A., Amico, F., Mas, F.D., Simone, B. De, Sugrue, M., Bonavina, L., Campanelli, G., Carcoforo, P., Cobianchi, L., Coccolini, F., Chiarugi, M., Carlo, I. Di, Saverio, S. Di, Podda, M., Pisano, M., Sartelli, M., Testini, M., Fette, A., Rizoli, S., Picetti, E., Weber, D., Latifi, R., Kluger, Y., Balogh, Z.J., Biffl, W., Jeekel, H., Civil, I., Hecker, A., Ansaloni, L., Bravi, F., Agnoletti, V., Beka, S.G., Moore, E.E., and Catena, F.

Abstract

Contains fulltext : 300061.pdf (Publisher’s version ) (Open Access), BACKGROUND: Laparoscopy is widely adopted across nearly all surgical subspecialties in the elective setting. Initially finding indication in minor abdominal emergencies, it has gradually become the standard approach in the majority of elective general surgery procedures. Despite many technological advances and increasing acceptance, the laparoscopic approach remains underutilized in emergency general surgery and in abdominal trauma. Emergency laparotomy continues to carry a high morbidity and mortality. In recent years, there has been a growing interest from emergency and trauma surgeons in adopting minimally invasive surgery approaches in the acute surgical setting. The present position paper, supported by the World Society of Emergency Surgery (WSES), aims to provide a review of the literature to reach a consensus on the indications and benefits of a laparoscopic-first approach in patients requiring emergency abdominal surgery for general surgery emergencies or abdominal trauma. METHODS: This position paper was developed according to the WSES methodology. A steering committee performed the literature review and drafted the position paper. An international panel of 54 experts then critically revised the manuscript and discussed it in detail, to develop a consensus on a position statement. RESULTS: A total of 323 studies (systematic review and meta-analysis, randomized clinical trial, retrospective comparative cohort studies, case series) have been selected from an initial pool of 7409 studies. Evidence demonstrates several benefits of the laparoscopic approach in stable patients undergoing emergency abdominal surgery for general surgical emergencies or abdominal trauma. The selection of a stable patient seems to be of paramount importance for a safe adoption of a laparoscopic approach. In hemodynamically stable patients, the laparoscopic approach was found to be safe, feasible and effective as a therapeutic tool or helpful to identify further management steps and n

Published
2023

39. Early management of isolated severe traumatic brain injury patients in a hospital without neurosurgical capabilities: a consensus and clinical recommendations of the World Society of Emergency Surgery (WSES)

Author

Picetti, E, Catena, F, Abu-Zidan, F, Ansaloni, L, Armonda, R, Bala, M, Balogh, Z, Bertuccio, A, Biffl, W, Bouzat, P, Buki, A, Cerasti, D, Chesnut, R, Citerio, G, Coccolini, F, Coimbra, R, Coniglio, C, Fainardi, E, Gupta, D, Gurney, J, Hawrylux, G, Helbok, R, Hutchinson, P, Iaccarino, C, Kolias, A, Maier, R, Martin, M, Meyfroidt, G, Okonkwo, D, Rasulo, F, Rizoli, S, Rubiano, A, Sahuquillo, J, Sams, V, Servadei, F, Sharma, D, Shutter, L, Stahel, P, Taccone, F, Udy, A, Zoerle, T, Agnoletti, V, Bravi, F, De Simone, B, Kluger, Y, Martino, C, Moore, E, Sartelli, M, Weber, D, Robba, C, Picetti, Edoardo, Catena, Fausto, Abu-Zidan, Fikri, Ansaloni, Luca, Armonda, Rocco A., Bala, Miklosh, Balogh, Zsolt J., Bertuccio, Alessandro, Biffl, Walt L., Bouzat, Pierre, Buki, Andras, Cerasti, Davide, Chesnut, Randall M., Citerio, Giuseppe, Coccolini, Federico, Coimbra, Raul, Coniglio, Carlo, Fainardi, Enrico, Gupta, Deepak, Gurney, Jennifer M., Hawrylux, Gregory W. J., Helbok, Raimund, Hutchinson, Peter J. A., Iaccarino, Corrado, Kolias, Angelos, Maier, Ronald W., Martin, Matthew J., Meyfroidt, Geert, Okonkwo, David O., Rasulo, Frank, Rizoli, Sandro, Rubiano, Andres, Sahuquillo, Juan, Sams, Valerie G., Servadei, Franco, Sharma, Deepak, Shutter, Lori, Stahel, Philip F., Taccone, Fabio S., Udy, Andrew, Zoerle, Tommaso, Agnoletti, Vanni, Bravi, Francesca, De Simone, Belinda, Kluger, Yoram, Martino, Costanza, Moore, Ernest E., Sartelli, Massimo, Weber, Dieter, Robba, Chiara, Picetti, E, Catena, F, Abu-Zidan, F, Ansaloni, L, Armonda, R, Bala, M, Balogh, Z, Bertuccio, A, Biffl, W, Bouzat, P, Buki, A, Cerasti, D, Chesnut, R, Citerio, G, Coccolini, F, Coimbra, R, Coniglio, C, Fainardi, E, Gupta, D, Gurney, J, Hawrylux, G, Helbok, R, Hutchinson, P, Iaccarino, C, Kolias, A, Maier, R, Martin, M, Meyfroidt, G, Okonkwo, D, Rasulo, F, Rizoli, S, Rubiano, A, Sahuquillo, J, Sams, V, Servadei, F, Sharma, D, Shutter, L, Stahel, P, Taccone, F, Udy, A, Zoerle, T, Agnoletti, V, Bravi, F, De Simone, B, Kluger, Y, Martino, C, Moore, E, Sartelli, M, Weber, D, Robba, C, Picetti, Edoardo, Catena, Fausto, Abu-Zidan, Fikri, Ansaloni, Luca, Armonda, Rocco A., Bala, Miklosh, Balogh, Zsolt J., Bertuccio, Alessandro, Biffl, Walt L., Bouzat, Pierre, Buki, Andras, Cerasti, Davide, Chesnut, Randall M., Citerio, Giuseppe, Coccolini, Federico, Coimbra, Raul, Coniglio, Carlo, Fainardi, Enrico, Gupta, Deepak, Gurney, Jennifer M., Hawrylux, Gregory W. J., Helbok, Raimund, Hutchinson, Peter J. A., Iaccarino, Corrado, Kolias, Angelos, Maier, Ronald W., Martin, Matthew J., Meyfroidt, Geert, Okonkwo, David O., Rasulo, Frank, Rizoli, Sandro, Rubiano, Andres, Sahuquillo, Juan, Sams, Valerie G., Servadei, Franco, Sharma, Deepak, Shutter, Lori, Stahel, Philip F., Taccone, Fabio S., Udy, Andrew, Zoerle, Tommaso, Agnoletti, Vanni, Bravi, Francesca, De Simone, Belinda, Kluger, Yoram, Martino, Costanza, Moore, Ernest E., Sartelli, Massimo, Weber, Dieter, and Robba, Chiara

Abstract

Background: Severe traumatic brain-injured (TBI) patients should be primarily admitted to a hub trauma center (hospital with neurosurgical capabilities) to allow immediate delivery of appropriate care in a specialized environment. Sometimes, severe TBI patients are admitted to a spoke hospital (hospital without neurosurgical capabilities), and scarce data are available regarding the optimal management of severe isolated TBI patients who do not have immediate access to neurosurgical care. Methods: A multidisciplinary consensus panel composed of 41 physicians selected for their established clinical and scientific expertise in the acute management of TBI patients with different specializations (anesthesia/intensive care, neurocritical care, acute care surgery, neurosurgery and neuroradiology) was established. The consensus was endorsed by the World Society of Emergency Surgery, and a modified Delphi approach was adopted. Results: A total of 28 statements were proposed and discussed. Consensus was reached on 22 strong recommendations and 3 weak recommendations. In three cases, where consensus was not reached, no recommendation was provided. Conclusions: This consensus provides practical recommendations to support clinician’s decision making in the management of isolated severe TBI patients in centers without neurosurgical capabilities and during transfer to a hub center.

Published
2023

40. Correction: Early management of isolated severe traumatic brain injury patients in a hospital without neurosurgical capabilities: a consensus and clinical recommendations of the World Society of Emergency Surgery (WSES)

Author

Picetti, Edoardo, Picetti, E, Catena, F, Abu-Zidan, F, Ansaloni, L, Armonda, R, Bala, M, Balogh, Z, Bertuccio, A, Biffl, W, Bouzat, P, Buki, A, Cerasti, D, Chesnut, R, Citerio, G, Coccolini, F, Coimbra, R, Coniglio, C, Fainardi, E, Gupta, D, Gurney, J, Hawryluk, G, Helbok, R, Hutchinson, P, Iaccarino, C, Kolias, A, Maier, R, Martin, M, Meyfroidt, G, Okonkwo, D, Rasulo, F, Rizoli, S, Rubiano, A, Sahuquillo, J, Sams, V, Servadei, F, Sharma, D, Shutter, L, Stahel, P, Taccone, F, Udy, A, Zoerle, T, Agnoletti, V, Bravi, F, De Simone, B, Kluger, Y, Martino, C, Moore, E, Sartelli, M, Weber, D, Robba, C, Picetti, Edoardo, Catena, Fausto, Abu-Zidan, Fikri, Ansaloni, Luca, Armonda, Rocco A, Bala, Miklosh, Balogh, Zsolt J, Bertuccio, Alessandro, Biffl, Walt L, Bouzat, Pierre, Buki, Andras, Cerasti, Davide, Chesnut, Randall M, Citerio, Giuseppe, Coccolini, Federico, Coimbra, Raul, Coniglio, Carlo, Fainardi, Enrico, Gupta, Deepak, Gurney, Jennifer M, Hawryluk, Gregory W J, Helbok, Raimund, Hutchinson, Peter J A, Iaccarino, Corrado, Kolias, Angelos, Maier, Ronald W, Martin, Matthew J, Meyfroidt, Geert, Okonkwo, David O, Rasulo, Frank, Rizoli, Sandro, Rubiano, Andres, Sahuquillo, Juan, Sams, Valerie G, Servadei, Franco, Sharma, Deepak, Shutter, Lori, Stahel, Philip F, Taccone, Fabio S, Udy, Andrew, Zoerle, Tommaso, Agnoletti, Vanni, Bravi, Francesca, De Simone, Belinda, Kluger, Yoram, Martino, Costanza, Moore, Ernest E, Sartelli, Massimo, Weber, Dieter, Robba, Chiara, Picetti, Edoardo, Picetti, E, Catena, F, Abu-Zidan, F, Ansaloni, L, Armonda, R, Bala, M, Balogh, Z, Bertuccio, A, Biffl, W, Bouzat, P, Buki, A, Cerasti, D, Chesnut, R, Citerio, G, Coccolini, F, Coimbra, R, Coniglio, C, Fainardi, E, Gupta, D, Gurney, J, Hawryluk, G, Helbok, R, Hutchinson, P, Iaccarino, C, Kolias, A, Maier, R, Martin, M, Meyfroidt, G, Okonkwo, D, Rasulo, F, Rizoli, S, Rubiano, A, Sahuquillo, J, Sams, V, Servadei, F, Sharma, D, Shutter, L, Stahel, P, Taccone, F, Udy, A, Zoerle, T, Agnoletti, V, Bravi, F, De Simone, B, Kluger, Y, Martino, C, Moore, E, Sartelli, M, Weber, D, Robba, C, Picetti, Edoardo, Catena, Fausto, Abu-Zidan, Fikri, Ansaloni, Luca, Armonda, Rocco A, Bala, Miklosh, Balogh, Zsolt J, Bertuccio, Alessandro, Biffl, Walt L, Bouzat, Pierre, Buki, Andras, Cerasti, Davide, Chesnut, Randall M, Citerio, Giuseppe, Coccolini, Federico, Coimbra, Raul, Coniglio, Carlo, Fainardi, Enrico, Gupta, Deepak, Gurney, Jennifer M, Hawryluk, Gregory W J, Helbok, Raimund, Hutchinson, Peter J A, Iaccarino, Corrado, Kolias, Angelos, Maier, Ronald W, Martin, Matthew J, Meyfroidt, Geert, Okonkwo, David O, Rasulo, Frank, Rizoli, Sandro, Rubiano, Andres, Sahuquillo, Juan, Sams, Valerie G, Servadei, Franco, Sharma, Deepak, Shutter, Lori, Stahel, Philip F, Taccone, Fabio S, Udy, Andrew, Zoerle, Tommaso, Agnoletti, Vanni, Bravi, Francesca, De Simone, Belinda, Kluger, Yoram, Martino, Costanza, Moore, Ernest E, Sartelli, Massimo, Weber, Dieter, and Robba, Chiara

Published
2023

41. Diversity and ethics in trauma and acute care surgery teams: results from an international survey

Author

Cobianchi L., Dal Mas F., Massaro M., Biffl W., Catena F., Coccolini F., Dionigi B., Dionigi P., Di Saverio S., Fugazzola P., Kluger Y., Leppaniemi A., Moore E. E., Sartelli M., Velmahos G., Woltz S., Angelos P., Ansaloni L., Abdelmalik A., Abebe N. S., Abu-Zidan F. M., Adam Y. A. Y., Adamou H., Agrusa A., Akin E., Alexandrino H., Ali S. M., Almeida P. M., Amico F., Ammendola M., Andreuccetti J., Aparicio-Sanchez D., Ardito A., Argenio G., Askevold I. H., Atanasov B. T., Augustin G., Awad S. S., Bagnoli C., Bains L., Balalis D., Baldini E., Baraket O., Barone M., Barreras J. A., Bellanova G., Biancuzzi H., Bignell M. B., Bini R., Bissacco D., Boati P., Bottari A., Bouliaris K., Brillantino A., Buonomo L. A., Buscemi S., Calu V., Campo Dall'Orto R., Campostrini S., Carvas J. M., Casoni Pattacini G., Celentano V., Ceresoli M., Chirica M., Cianci P., Cillara N., Cimbanassi S., Cioffi S. P. B., Colak E., Conti L., Dantas Costa S., D'Acapito F., Damaskos D., Das K., Davies R. J., De Beaux A. C., De Simone B., Demetrashvili Z., Demetriades A. K., Denicolai S., Di Buono G., Di Carlo I., Diaconescu B., Dibra R., Dios-Barbeito S., Dogjani A., Domanin M., D'Oria M., Duran Munoz-Cruzado V., East B., Ekwen G. T., Elbaih A. H., Escalera-Antezana J. P., Esposito G., Farre R., Ferrario di Tor Vajana A., Cordeiro Fonseca V., Forfori F., Fortuna L., Fradelos E., Fraga G. P., Fransvea P., Gachabayov M., Garcia Vazquez A. A., Ghannam W. M., Gioco R., Giraudo G., Giuffrida M., Giulii Capponi M., Gomes C. A., Teixeira Gonsaga R. A., Gonullu E., Goosen J., Goranovic T., Griffiths E. A., Haidar M. G., Hamid H. K. S., Harddastle T. C., Healey A. J., Hecker M., Hernandez Garcia E. F., Huaman E. C., Hutan M., Ioannidis O., Isik A., Ismail A. M. H., Ismail N., Jang J. Y., Kaafarani H. M. A., Kalipershad S. N. R., Kaplan L. J., Kara Y., Karamagioli E., Karamarkovia A., Kavalakat A. J., Kechagias A., Kenig J., Khan J. S., Khokha V., Klappenbach R., Kobe Y., Kong V., Korkolis D., Kurihara H., Kuriyama A., Landaluce-Olavarria A., Licari L., Litvin A., Loftus T. J., Lohsiriwat V., Lopes Moreira C. C., Lostoridis E., Luna A. T., Luppi D., Machain G. M., Maegele M., Maggiore D., Maier R. V., Manangi M., Manetti A., Mantoglu B., Mariani F., Marinis A., Sbalcheiro Mariot E. A., Marseglia G. R., Martellucci J., Martines G., Martinez Perez A., Mascagni P., Massalou D., Melo R. B., Miceli L., Mingoli A., Mishra T. S., Mohamedahmed A. Y. Y., Mohan R., Morales-Garcia D., Mustafa S. M. S., Naimzada M. D., Negoi I., Nguyen C., Nidaw M. K., Nigri G., Ogundipe H. D., Oliveri C., Olmi S., Pagani L., Palomba G., Pantalone D., Panyko A., Paolillo C., Papis D., Pararas N., Pata F., Paterson-Brown S., Pavone G., Pecchini F., Pellino G., Pelloni M., Peloso A., Perea del Pozo E., Goncalves Pereira R., Monteiro Pereira B., Lizarazu Perez A., Perrone G., Pesce A., Petracca G., Piccoli M., Piccolo D., Picetti E., Pikoulis E., Pintar T., Pirozzolo G., Podda M., Previtali P., Privitera F., Punzo C., Quiodettis M. A., Qvist N., Rahim R., Reinisch-Liese A., Rodriguez-Luna M. R., Roizblatt D., Roscio F. P. M., Rossi S., Ruta F., Sakakushev B. E., Salamea J. C., Sall I., Sammartano F., Sanchez Arteaga A., Sanchez-Cordero S., Sasia D., Sawyer R. G., Seretis C., Serradilla-Martin M., Shelat V. G., Shlyapnikov S., Simoes R. L., Siribumrungwong B., Slavchev M., Solaini L., Soldini G., Soreide K., Spada F., Stahel P., Sydorchuk L., Sydorchuk R., Syed A. M., Tallon-Aguilar L., Tan J. H., Tan E., Tarasconi A., Tartaglia D., Tartaglia N., Taylor J., Tebala G. D., Teuben M., Tolonen M., Tomasicchio G., Triantafyllou T., Trigiante G., Turrado-Rodriguez V., Tutino R., Uccelli M., Ugarte-Sierra B., Ukkonen M., Vassiliu P. G., Verde J. M., Veroux M., Vilallonga R., Visconti D., Waledziak M., Wannatoop T., Widmer L. W., Wilson M. S. J., Wong T. H., Xenaki S., Yu B., Yule S., Zakaria A. D., Zambrano D. A., Zese M., Cobianchi, L, Dal Mas, F, Massaro, M, Biffl, W, Catena, F, Coccolini, F, Dionigi, B, Dionigi, P, Di Saverio, S, Fugazzola, P, Kluger, Y, Leppaniemi, A, Moore, E, Sartelli, M, Velmahos, G, Woltz, S, Angelos, P, Ansaloni, L, Abdelmalik, A, Abebe, N, Abu-Zidan, F, Adam, Y, Adamou, H, Agrusa, A, Akin, E, Alexandrino, H, Ali, S, Almeida, P, Amico, F, Ammendola, M, Andreuccetti, J, Aparicio-Sanchez, D, Ardito, A, Argenio, G, Askevold, I, Atanasov, B, Augustin, G, Awad, S, Bagnoli, C, Bains, L, Balalis, D, Baldini, E, Baraket, O, Barone, M, Barreras, J, Bellanova, G, Biancuzzi, H, Bignell, M, Bini, R, Bissacco, D, Boati, P, Bottari, A, Bouliaris, K, Brillantino, A, Buonomo, L, Buscemi, S, Calu, V, Campo Dall'Orto, R, Campostrini, S, Carvas, J, Casoni Pattacini, G, Celentano, V, Ceresoli, M, Chirica, M, Cianci, P, Cillara, N, Cimbanassi, S, Cioffi, S, Colak, E, Conti, L, Dantas Costa, S, D'Acapito, F, Damaskos, D, Das, K, Davies, R, De Beaux, A, De Simone, B, Demetrashvili, Z, Demetriades, A, Denicolai, S, Di Buono, G, Di Carlo, I, Diaconescu, B, Dibra, R, Dios-Barbeito, S, Dogjani, A, Domanin, M, D'Oria, M, Duran Munoz-Cruzado, V, East, B, Ekwen, G, Elbaih, A, Escalera-Antezana, J, Esposito, G, Farre, R, Ferrario di Tor Vajana, A, Cordeiro Fonseca, V, Forfori, F, Fortuna, L, Fradelos, E, Fraga, G, Fransvea, P, Gachabayov, M, Garcia Vazquez, A, Ghannam, W, Gioco, R, Giraudo, G, Giuffrida, M, Giulii Capponi, M, Gomes, C, Teixeira Gonsaga, R, Gonullu, E, Goosen, J, Goranovic, T, Griffiths, E, Haidar, M, Hamid, H, Harddastle, T, Healey, A, Hecker, M, Hernandez Garcia, E, Huaman, E, Hutan, M, Ioannidis, O, Isik, A, Ismail, A, Ismail, N, Jang, J, Kaafarani, H, Kalipershad, S, Kaplan, L, Kara, Y, Karamagioli, E, Karamarkovia, A, Kavalakat, A, Kechagias, A, Kenig, J, Khan, J, Khokha, V, Klappenbach, R, Kobe, Y, Kong, V, Korkolis, D, Kurihara, H, Kuriyama, A, Landaluce-Olavarria, A, Licari, L, Litvin, A, Loftus, T, Lohsiriwat, V, Lopes Moreira, C, Lostoridis, E, Luna, A, Luppi, D, Machain, G, Maegele, M, Maggiore, D, Maier, R, Manangi, M, Manetti, A, Mantoglu, B, Mariani, F, Marinis, A, Sbalcheiro Mariot, E, Marseglia, G, Martellucci, J, Martines, G, Martinez Perez, A, Mascagni, P, Massalou, D, Melo, R, Miceli, L, Mingoli, A, Mishra, T, Mohamedahmed, A, Mohan, R, Morales-Garcia, D, Mustafa, S, Naimzada, M, Negoi, I, Nguyen, C, Nidaw, M, Nigri, G, Ogundipe, H, Oliveri, C, Olmi, S, Pagani, L, Palomba, G, Pantalone, D, Panyko, A, Paolillo, C, Papis, D, Pararas, N, Pata, F, Paterson-Brown, S, Pavone, G, Pecchini, F, Pellino, G, Pelloni, M, Peloso, A, Perea del Pozo, E, Goncalves Pereira, R, Monteiro Pereira, B, Lizarazu Perez, A, Perrone, G, Pesce, A, Petracca, G, Piccoli, M, Piccolo, D, Picetti, E, Pikoulis, E, Pintar, T, Pirozzolo, G, Podda, M, Previtali, P, Privitera, F, Punzo, C, Quiodettis, M, Qvist, N, Rahim, R, Reinisch-Liese, A, Rodriguez-Luna, M, Roizblatt, D, Roscio, F, Rossi, S, Ruta, F, Sakakushev, B, Salamea, J, Sall, I, Sammartano, F, Sanchez Arteaga, A, Sanchez-Cordero, S, Sasia, D, Sawyer, R, Seretis, C, Serradilla-Martin, M, Shelat, V, Shlyapnikov, S, Simoes, R, Siribumrungwong, B, Slavchev, M, Solaini, L, Soldini, G, Soreide, K, Spada, F, Stahel, P, Sydorchuk, L, Sydorchuk, R, Syed, A, Tallon-Aguilar, L, Tan, J, Tan, E, Tarasconi, A, Tartaglia, D, Tartaglia, N, Taylor, J, Tebala, G, Teuben, M, Tolonen, M, Tomasicchio, G, Triantafyllou, T, Trigiante, G, Turrado-Rodriguez, V, Tutino, R, Uccelli, M, Ugarte-Sierra, B, Ukkonen, M, Vassiliu, P, Verde, J, Veroux, M, Vilallonga, R, Visconti, D, Waledziak, M, Wannatoop, T, Widmer, L, Wilson, M, Wong, T, Xenaki, S, Yu, B, Yule, S, Zakaria, A, Zambrano, D, Zese, M, Cobianchi L., Dal Mas F., Massaro M., Biffl W., Catena F., Coccolini F., Dionigi B., Dionigi P., Di Saverio S., Fugazzola P., Kluger Y., Leppaniemi A., Moore E.E., Sartelli M., Velmahos G., Woltz S., Angelos P., Ansaloni L., Abdelmalik A., Abebe N.S., Abu-Zidan F.M., Adam Y.A.Y., Adamou H., Agrusa A., Akin E., Alexandrino H., Ali S.M., Almeida P.M., Amico F., Ammendola M., Andreuccetti J., Aparicio-Sanchez D., Ardito A., Argenio G., Askevold I.H., Atanasov B.T., Augustin G., Awad S.S., Bagnoli C., Bains L., Balalis D., Baldini E., Baraket O., Barone M., Barreras J.A., Bellanova G., Biancuzzi H., Bignell M.B., Bini R., Bissacco D., Boati P., Bottari A., Bouliaris K., Brillantino A., Buonomo L.A., Buscemi S., Calu V., Campo Dall'Orto R., Campostrini S., Carvas J.M., Casoni Pattacini G., Celentano V., Ceresoli M., Chirica M., Cianci P., Cillara N., Cimbanassi S., Cioffi S.P.B., Colak E., Conti L., Dantas Costa S., D'Acapito F., Damaskos D., Das K., Davies R.J., De Beaux A.C., De Simone B., Demetrashvili Z., Demetriades A.K., Denicolai S., Di Buono G., Di Carlo I., Diaconescu B., Dibra R., Dios-Barbeito S., Dogjani A., Domanin M., D'Oria M., Duran Munoz-Cruzado V., East B., Ekwen G.T., Elbaih A.H., Escalera-Antezana J.P., Esposito G., Farre R., Ferrario di Tor Vajana A., Cordeiro Fonseca V., Forfori F., Fortuna L., Fradelos E., Fraga G.P., Fransvea P., Gachabayov M., Garcia Vazquez A.A., Ghannam W.M., Gioco R., Giraudo G., Giuffrida M., Giulii Capponi M., Gomes C.A., Teixeira Gonsaga R.A., Gonullu E., Goosen J., Goranovic T., Griffiths E.A., Haidar M.G., Hamid H.K.S., Harddastle T.C., Healey A.J., Hecker M., Hernandez Garcia E.F., Huaman E.C., Hutan M., Ioannidis O., Isik A., Ismail A.M.H., Ismail N., Jang J.Y., Kaafarani H.M.A., Kalipershad S.N.R., Kaplan L.J., Kara Y., Karamagioli E., Karamarkovia A., Kavalakat A.J., Kechagias A., Kenig J., Khan J.S., Khokha V., Klappenbach R., Kobe Y., Kong V., Korkolis D., Kurihara H., Kuriyama A., Landaluce-Olavarria A., Licari L., Litvin A., Loftus T.J., Lohsiriwat V., Lopes Moreira C.C., Lostoridis E., Luna A.T., Luppi D., Machain G.M., Maegele M., Maggiore D., Maier R.V., Manangi M., Manetti A., Mantoglu B., Mariani F., Marinis A., Sbalcheiro Mariot E.A., Marseglia G.R., Martellucci J., Martines G., Martinez Perez A., Mascagni P., Massalou D., Melo R.B., Miceli L., Mingoli A., Mishra T.S., Mohamedahmed A.Y.Y., Mohan R., Morales-Garcia D., Mustafa S.M.S., Naimzada M.D., Negoi I., Nguyen C., Nidaw M.K., Nigri G., Ogundipe H.D., Oliveri C., Olmi S., Pagani L., Palomba G., Pantalone D., Panyko A., Paolillo C., Papis D., Pararas N., Pata F., Paterson-Brown S., Pavone G., Pecchini F., Pellino G., Pelloni M., Peloso A., Perea del Pozo E., Goncalves Pereira R., Monteiro Pereira B., Lizarazu Perez A., Perrone G., Pesce A., Petracca G., Piccoli M., Piccolo D., Picetti E., Pikoulis E., Pintar T., Pirozzolo G., Podda M., Previtali P., Privitera F., Punzo C., Quiodettis M.A., Qvist N., Rahim R., Reinisch-Liese A., Rodriguez-Luna M.R., Roizblatt D., Roscio F.P.M., Rossi S., Ruta F., Sakakushev B.E., Salamea J.C., Sall I., Sammartano F., Sanchez Arteaga A., Sanchez-Cordero S., Sasia D., Sawyer R.G., Seretis C., Serradilla-Martin M., Shelat V.G., Shlyapnikov S., Simoes R.L., Siribumrungwong B., Slavchev M., Solaini L., Soldini G., Soreide K., Spada F., Stahel P., Sydorchuk L., Sydorchuk R., Syed A.M., Tallon-Aguilar L., Tan J.H., Tan E., Tarasconi A., Tartaglia D., Tartaglia N., Taylor J., Tebala G.D., Teuben M., Tolonen M., Tomasicchio G., Triantafyllou T., Trigiante G., Turrado-Rodriguez V., Tutino R., Uccelli M., Ugarte-Sierra B., Ukkonen M., Vassiliu P.G., Verde J.M., Veroux M., Vilallonga R., Visconti D., Waledziak M., Wannatoop T., Widmer L.W., Wilson M.S.J., Wong T.H., Xenaki S., Yu B., Yule S., Zakaria A.D., Zambrano D.A., Zese M., HUS Abdominal Center, II kirurgian klinikka, and Helsinki University Hospital Area

Subjects
Ethics, Patient Care Team, Diversity, Acute care surgery, 3126 Surgery, anesthesiology, intensive care, radiology, Trauma surgery, Settore SECS-P/10 - Organizzazione Aziendale, Settore MED/18 - Chirurgia Generale, Settore SECS-P/07 - Economia Aziendale, Surveys and Questionnaires, Emergency Medicine, Humans, Surveys and Questionnaire, Surgery, Team dynamics, Ethic, Team dynamic, Human
Abstract

Background Investigating the context of trauma and acute care surgery, the article aims at understanding the factors that can enhance some ethical aspects, namely the importance of patient consent, the perceptiveness of the ethical role of the trauma leader, and the perceived importance of ethics as an educational subject. Methods The article employs an international questionnaire promoted by the World Society of Emergency Surgery. Results Through the analysis of 402 fully filled questionnaires by surgeons from 72 different countries, the three main ethical topics are investigated through the lens of gender, membership of an academic or non-academic institution, an official trauma team, and a diverse group. In general terms, results highlight greater attention paid by surgeons belonging to academic institutions, official trauma teams, and diverse groups. Conclusions Our results underline that some organizational factors (e.g., the fact that the team belongs to a university context or is more diverse) might lead to the development of a higher sensibility on ethical matters. Embracing cultural diversity forces trauma teams to deal with different mindsets. Organizations should, therefore, consider those elements in defining their organizational procedures. Level of evidence Trauma and acute care teams work under tremendous pressure and complex circumstances, with their members needing to make ethical decisions quickly. The international survey allowed to shed light on how team assembly decisions might represent an opportunity to coordinate team member actions and increase performance.

Published
2022

43. Open Abdomen and Fluid Instillation in the Septic Abdomen: Results from the IROA Study

Author

Coccolini F., Gubbiotti F., Ceresoli M., Tartaglia D., Fugazzola P., Ansaloni L., Sartelli M., Kluger Y., Kirkpatrick A., Amico F., Catena F., Chiarugi M., Montori G., Salvetti F., Negoi I., Zese M., Occhionorelli S., Shlyapnikov S., Sugrue M., Demetrashvili Z., Dondossola D., Ioannidis O., Novelli G., Nacoti M., Khor D., Inaba K., Demetriades D., Kaussen T., Jusoh A. C., Ghannam W., Sakakushev B., Guetta O., Dogjani A., Costa S., Singh S., Damaskos D., Isik A., Yuan K. -C., Trotta F., Rausei S., Martinez-Perez A., Bellanova G., Fonseca V. C., Hernandez F., Marinis A., Fernandes W., Quiodettis M., Bala M., Vereczkei A., Curado R., Fraga G. P., Pereira B. M., Gachabayov M., Chagerben G. P., Arellano M. L., Ozyazici S., Costa G., Tezcaner T., Porta M., Li Y., Karateke F., Manatakis D., Mariani F., Lora F., Sahderov I., Atanasov B., Zegarra S., Fattori L., Ivatury R., Xiao J., Ben-Ishay O., Lippi A., Improta M., Zharikov A., Dubuisson V., Coccolini, F, Gubbiotti, F, Ceresoli, M, Tartaglia, D, Fugazzola, P, Ansaloni, L, Sartelli, M, Kluger, Y, Kirkpatrick, A, Amico, F, Catena, F, Chiarugi, M, Montori, G, Salvetti, F, Negoi, I, Zese, M, Occhionorelli, S, Shlyapnikov, S, Sugrue, M, Demetrashvili, Z, Dondossola, D, Ioannidis, O, Novelli, G, Nacoti, M, Khor, D, Inaba, K, Demetriades, D, Kaussen, T, Jusoh, A, Ghannam, W, Sakakushev, B, Guetta, O, Dogjani, A, Costa, S, Singh, S, Damaskos, D, Isik, A, Yuan, K, Trotta, F, Rausei, S, Martinez-Perez, A, Bellanova, G, Fonseca, V, Hernandez, F, Marinis, A, Fernandes, W, Quiodettis, M, Bala, M, Vereczkei, A, Curado, R, Fraga, G, Pereira, B, Gachabayov, M, Chagerben, G, Arellano, M, Ozyazici, S, Costa, G, Tezcaner, T, Porta, M, Li, Y, Karateke, F, Manatakis, D, Mariani, F, Lora, F, Sahderov, I, Atanasov, B, Zegarra, S, Fattori, L, Ivatury, R, Xiao, J, Ben-Ishay, O, Lippi, A, Improta, M, Zharikov, A, and Dubuisson, V

Subjects
Adult, Male, medicine.medical_specialty, Original Scientific Report, Fistula, medicine.medical_treatment, open abdomen, Peritonitis, 030230 surgery, NO, 03 medical and health sciences, 0302 clinical medicine, Sepsis, peritoneal resuscitation, Negative-pressure wound therapy, Abdomen, medicine, Humans, Surgical Wound Infection, Prospective Studies, fascial closure, peritoneal resuscitation, management, therapy, fascial closure, Digestive System Surgical Procedures, Aged, therapy, business.industry, Peritoneal fluid, Abdominal Cavity, Abdominal Wound Closure Techniques, Middle Aged, medicine.disease, Surgery, Cardiac surgery, Treatment Outcome, medicine.anatomical_structure, Cardiothoracic surgery, 030220 oncology & carcinogenesis, fluid instillation, Fluid Therapy, Female, business, Negative-Pressure Wound Therapy, management, Abdominal surgery
Abstract

Background Open abdomen (OA) is a surgical option that can be used in patients with severe peritonitis. Few evidences exist to recommend the use of intraperitoneal fluid instillation associated with OA in managing septic abdomen. Materials and methods A prospective analysis of adult patients enrolled in the International Register of Open Abdomen (trial registration: NCT02382770) was performed. Results A total of 387 patients were enrolled in two groups: 84 with peritoneal fluid instillation (FI) and 303 without (NFI). The groups were homogeneous for baseline characteristics. Overall complications were 92.9% in FI and 86.3% in NFI (p = 0.106). Complications during OA were 72.6% in FI and 59.9% in NFI (p = 0.034). Complications after definitive closure were 70.8% in FI and 61.1% in NFI (p = 0.133). Entero-atmospheric fistula was 13.1% in FI and 12% in NFI (p = 0.828). Fascial closure was 78.6% in FI and 63.7% in NFI (p = 0.02). Analysis of FI in negative pressure wound therapy (NPWT) showed: Overall morbidity in NPWT was 94% and in non-NPWT 91.2% (p = 0.622) and morbidity during OA was 68% and 79.4% (p = 0.25), respectively. Definitive fascial closure in NPWT was 87.8% and 96.8% in non-NPWT (p = 0.173). Overall mortality was 40% in NPWT and 29.4% in non-NPWT (p = 0.32) and morality during OA period was 18% and 8.8% (p = 0.238), respectively. Conclusion We found intraperitoneal fluid instillation during open abdomen in peritonitic patients to increase the complication rate during the open abdomen period, with no impact on mortality, entero-atmospheric fistula rate and opening time. Fascial closure rate is increased by instillation. Fluid instillation is feasible even when associated with nonnegative pressure temporary abdominal closure techniques.

Published
2020

44. Correction: Operative management of acute abdomen after bariatric surgery in the emergency setting: the OBA guidelines (World Journal of Emergency Surgery, (2022), 17, 1, (51), 10.1186/s13017-022-00452-w)

Author

De Simone B., Chouillard E., Ramos A. C., Donatelli G., Pintar T., Gupta R., Renzi F., Mahawar K., Madhok B., Maccatrozzo S., Abu-Zidan F. M., Moore E. E., Weber D. G., Coccolini F., Di Saverio S., Kirkpatrick A., Shelat V. G., Amico F., Pikoulis E., Ceresoli M., Galante J. M., Wani I., De'Angelis N., Hecker A., Sganga G., Tan E., Balogh Z. J., Bala M., Coimbra R., Damaskos D., Ansaloni L., Sartelli M., Pararas N., Kluger Y., Chahine E., Agnoletti V., Fraga G., Biffl W. L., Catena F., De Simone B., Chouillard E., Ramos A.C., Donatelli G., Pintar T., Gupta R., Renzi F., Mahawar K., Madhok B., Maccatrozzo S., Abu-Zidan F.M., Moore E.E., Weber D.G., Coccolini F., Di Saverio S., Kirkpatrick A., Shelat V.G., Amico F., Pikoulis E., Ceresoli M., Galante J.M., Wani I., De'Angelis N., Hecker A., Sganga G., Tan E., Balogh Z.J., Bala M., Coimbra R., Damaskos D., Ansaloni L., Sartelli M., Pararas N., Kluger Y., Chahine E., Agnoletti V., Fraga G., Biffl W.L., and Catena F.

Subjects
acute abdomen, bariatric surgery, emergency, guidelines
Abstract

Following publication of the original article [1], the co-author “Nikolaos Pararas” has misspelled wrongly as “Nikolaos Parasas”. The original article has been corrected.

Published
2022

45. 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

46. Multidisciplinary management of elderly patients with rectal cancer: recommendations from the SICG (Italian Society of Geriatric Surgery), SIFIPAC (Italian Society of Surgical Pathophysiology), SICE (Italian Society of Endoscopic Surgery and new technologies), and the WSES (World Society of Emergency Surgery) International Consensus Project

Author

Podda, M, Sylla, P, Baiocchi, G, Adamina, M, Agnoletti, V, Agresta, F, Ansaloni, L, Arezzo, A, Avenia, N, Biffl, W, Biondi, A, Bui, S, Campanile, F, Carcoforo, P, Commisso, C, Crucitti, A, De'Angelis, N, De'Angelis, G, De Filippo, M, De Simone, B, Di Saverio, S, Ercolani, G, Fraga, G, Gabrielli, F, Gaiani, F, Guerrieri, M, Guttadauro, A, Kluger, Y, Leppaniemi, A, Loffredo, A, Meschi, T, Moore, E, Ortenzi, M, Pata, F, Parini, D, Pisanu, A, Poggioli, G, Polistena, A, Puzziello, A, Rondelli, F, Sartelli, M, Smart, N, Sugrue, M, Tejedor, P, Vacante, M, Coccolini, F, Davies, J, Catena, F, Podda M., Sylla P., Baiocchi G., Adamina M., Agnoletti V., Agresta F., Ansaloni L., Arezzo A., Avenia N., Biffl W., Biondi A., Bui S., Campanile F. C., Carcoforo P., Commisso C., Crucitti A., De'Angelis N., De'Angelis G. L., De Filippo M., De Simone B., Di Saverio S., Ercolani G., Fraga G. P., Gabrielli F., Gaiani F., Guerrieri M., Guttadauro A., Kluger Y., Leppaniemi A. K., Loffredo A., Meschi T., Moore E. E., Ortenzi M., Pata F., Parini D., Pisanu A., Poggioli G., Polistena A., Puzziello A., Rondelli F., Sartelli M., Smart N., Sugrue M. E., Tejedor P., Vacante M., Coccolini F., Davies J., Catena F., Podda, M, Sylla, P, Baiocchi, G, Adamina, M, Agnoletti, V, Agresta, F, Ansaloni, L, Arezzo, A, Avenia, N, Biffl, W, Biondi, A, Bui, S, Campanile, F, Carcoforo, P, Commisso, C, Crucitti, A, De'Angelis, N, De'Angelis, G, De Filippo, M, De Simone, B, Di Saverio, S, Ercolani, G, Fraga, G, Gabrielli, F, Gaiani, F, Guerrieri, M, Guttadauro, A, Kluger, Y, Leppaniemi, A, Loffredo, A, Meschi, T, Moore, E, Ortenzi, M, Pata, F, Parini, D, Pisanu, A, Poggioli, G, Polistena, A, Puzziello, A, Rondelli, F, Sartelli, M, Smart, N, Sugrue, M, Tejedor, P, Vacante, M, Coccolini, F, Davies, J, Catena, F, Podda M., Sylla P., Baiocchi G., Adamina M., Agnoletti V., Agresta F., Ansaloni L., Arezzo A., Avenia N., Biffl W., Biondi A., Bui S., Campanile F. C., Carcoforo P., Commisso C., Crucitti A., De'Angelis N., De'Angelis G. L., De Filippo M., De Simone B., Di Saverio S., Ercolani G., Fraga G. P., Gabrielli F., Gaiani F., Guerrieri M., Guttadauro A., Kluger Y., Leppaniemi A. K., Loffredo A., Meschi T., Moore E. E., Ortenzi M., Pata F., Parini D., Pisanu A., Poggioli G., Polistena A., Puzziello A., Rondelli F., Sartelli M., Smart N., Sugrue M. E., Tejedor P., Vacante M., Coccolini F., Davies J., and Catena F.

Abstract

Background and aims: Although rectal cancer is predominantly a disease of older patients, current guidelines do not incorporate optimal treatment recommendations for the elderly and address only partially the associated specific challenges encountered in this population. This results in a wide variation and disparity in delivering a standard of care to this subset of patients. As the burden of rectal cancer in the elderly population continues to increase, it is crucial to assess whether current recommendations on treatment strategies for the general population can be adopted for the older adults, with the same beneficial oncological and functional outcomes. This multidisciplinary experts’ consensus aims to refine current rectal cancer-specific guidelines for the elderly population in order to help to maximize rectal cancer therapeutic strategies while minimizing adverse impacts on functional outcomes and quality of life for these patients. Methods: The discussion among the steering group of clinical experts and methodologists from the societies’ expert panel involved clinicians practicing in general surgery, colorectal surgery, surgical oncology, geriatric oncology, geriatrics, gastroenterologists, radiologists, oncologists, radiation oncologists, and endoscopists. Research topics and questions were formulated, revised, and unanimously approved by all experts in two subsequent modified Delphi rounds in December 2020–January 2021. The steering committee was divided into nine teams following the main research field of members. Each conducted their literature search and drafted statements and recommendations on their research question. Literature search has been updated up to 2020 and statements and recommendations have been developed according to the GRADE methodology. A modified Delphi methodology was implemented to reach agreement among the experts on all statements and recommendations. Conclusions: The 2021 SICG-SIFIPAC-SICE-WSES consensus for the multidisciplinary

Published
2021

47. Anorectal emergencies: WSES-AAST guidelines

Author

Tarasconi, A, Perrone, G, Davies, J, Coimbra, R, Moore, E, Azzaroli, F, Abongwa, H, De Simone, B, Gallo, G, Rossi, G, Abu-Zidan, F, Agnoletti, V, De'Angelis, G, De'Angelis, N, Ansaloni, L, Baiocchi, G, Carcoforo, P, Ceresoli, M, Chichom-Mefire, A, Di Saverio, S, Gaiani, F, Giuffrida, M, Hecker, A, Inaba, K, Kelly, M, Kirkpatrick, A, Kluger, Y, Leppaniemi, A, Litvin, A, Ordonez, C, Pattonieri, V, Peitzman, A, Pikoulis, M, Sakakushev, B, Sartelli, M, Shelat, V, Tan, E, Testini, M, Velmahos, G, Wani, I, Weber, D, Biffl, W, Coccolini, F, Catena, F, Tarasconi A., Perrone G., Davies J., Coimbra R., Moore E., Azzaroli F., Abongwa H., De Simone B., Gallo G., Rossi G., Abu-Zidan F., Agnoletti V., de'Angelis G., de'Angelis N., Ansaloni L., Baiocchi G. L., Carcoforo P., Ceresoli M., Chichom-Mefire A., Di Saverio S., Gaiani F., Giuffrida M., Hecker A., Inaba K., Kelly M., Kirkpatrick A., Kluger Y., Leppaniemi A., Litvin A., Ordonez C., Pattonieri V., Peitzman A., Pikoulis M., Sakakushev B., Sartelli M., Shelat V., Tan E., Testini M., Velmahos G., Wani I., Weber D., Biffl W., Coccolini F., Catena F., Tarasconi, A, Perrone, G, Davies, J, Coimbra, R, Moore, E, Azzaroli, F, Abongwa, H, De Simone, B, Gallo, G, Rossi, G, Abu-Zidan, F, Agnoletti, V, De'Angelis, G, De'Angelis, N, Ansaloni, L, Baiocchi, G, Carcoforo, P, Ceresoli, M, Chichom-Mefire, A, Di Saverio, S, Gaiani, F, Giuffrida, M, Hecker, A, Inaba, K, Kelly, M, Kirkpatrick, A, Kluger, Y, Leppaniemi, A, Litvin, A, Ordonez, C, Pattonieri, V, Peitzman, A, Pikoulis, M, Sakakushev, B, Sartelli, M, Shelat, V, Tan, E, Testini, M, Velmahos, G, Wani, I, Weber, D, Biffl, W, Coccolini, F, Catena, F, Tarasconi A., Perrone G., Davies J., Coimbra R., Moore E., Azzaroli F., Abongwa H., De Simone B., Gallo G., Rossi G., Abu-Zidan F., Agnoletti V., de'Angelis G., de'Angelis N., Ansaloni L., Baiocchi G. L., Carcoforo P., Ceresoli M., Chichom-Mefire A., Di Saverio S., Gaiani F., Giuffrida M., Hecker A., Inaba K., Kelly M., Kirkpatrick A., Kluger Y., Leppaniemi A., Litvin A., Ordonez C., Pattonieri V., Peitzman A., Pikoulis M., Sakakushev B., Sartelli M., Shelat V., Tan E., Testini M., Velmahos G., Wani I., Weber D., Biffl W., Coccolini F., and Catena F.

Abstract

Anorectal emergencies comprise a wide variety of diseases that share common symptoms, i.e., anorectal pain or bleeding and might require immediate management. While most of the underlying conditions do not need inpatient management, some of them could be life-threatening and need prompt recognition and treatment. It is well known that an incorrect diagnosis is frequent for anorectal diseases and that a delayed diagnosis is related to an impaired outcome. This paper aims to improve the knowledge and the awareness on this specific topic and to provide a useful tool for every physician dealing with anorectal emergencies. The present guidelines have been developed according to the GRADE methodology. To create these guidelines, a panel of experts was designed and charged by the boards of the World Society of Emergency Surgery (WSES) and American Association for the Surgery of Trauma (AAST) to perform a systematic review of the available literature and to provide evidence-based statements with immediate practical application. All the statements were presented and discussed during the WSES-AAST-WJES Consensus Conference on Anorectal Emergencies, and for each statement, a consensus among the WSES-AAST panel of experts was reached. We structured our work into seven main topics to cover the entire management of patients with anorectal emergencies and to provide an up-to-date, easy-to-use tool that can help physicians and surgeons during the decision-making process.

Published
2021

48. Team dynamics in emergency surgery teams: results from a first international survey

Author

Cobianchi, L, Dal Mas, F, Massaro, M, Fugazzola, P, Coccolini, F, Kluger, Y, Leppaniemi, A, Moore, E, Sartelli, M, Angelos, P, Ansaloni, L, Abdelmalik, A, Abebe, N, Abu-Zidan, F, Adam, Y, Adamou, H, Agrusa, A, Akin, E, Alexandrino, H, Ali, S, Almeida, P, Amico, F, Ammendola, M, Andreuccetti, J, Aparicio-Sanchez, D, Ardito, A, Argenio, G, Askevold, I, Atanasov, B, Augustin, G, Awad, S, Bagnoli, C, Bains, L, Balalis, D, Baldini, E, Baraket, O, Barone, M, Barreras, J, Bellanova, G, Biancuzzi, H, Bignell, M, Bini, R, Bissacco, D, Boati, P, Bottari, A, Bouliaris, K, Brillantino, A, Buonomo, L, Buscemi, S, Calu, V, Campo Dall'Orto, R, Carvas, J, Casoni Pattacini, G, Catena, F, Celentano, V, Ceresoli, M, Chirica, M, Cianci, P, Cillara, N, Cimbanassi, S, Cioffi, S, Colak, E, Conti, L, Dantas Costa, S, D'Acapito, F, Damaskos, D, Das, K, Davies, R, De Beaux, A, De Simone, B, Demetrashvili, Z, Demetriades, A, Denicolai, S, Di Buono, G, Di Carlo, I, Di Saverio, S, Diaconescu, B, Dibra, R, Dios-Barbeito, S, Dogjani, A, Domanin, M, D'Oria, M, Duran Munoz-Cruzado, V, East, B, Ekwen, G, Elbaih, A, Escalera-Antezana, J, Esposito, G, Farre, R, Ferrario di Tor Vajana, A, Cordeiro Fonseca, V, Forfori, F, Fortuna, L, Fradelos, E, Fraga, G, Fransvea, P, Gachabayov, M, Garcia Vazquez, A, Ghannam, W, Gioco, R, Giraudo, G, Giuffrida, M, Giulii Capponi, M, Gomes, C, Teixeira Gonsaga, R, Gonullu, E, Goosen, J, Goranovic, T, Griffiths, E, Haidar, M, Hamid, H, Harddastle, T, Hecker, M, Hernandez Garcia, E, Cancio Huaman, E, Hutan, M, Ioannidis, O, Isik, A, Ismail, A, Ismail, N, Jang, J, Kalipershad, S, Kaplan, L, Kara, Y, Karamagioli, E, Karamarkovia, A, Kavalakat, A, Kechagias, A, Kenig, J, Khan, J, Khokha, V, Klappenbach, R, Kobe, Y, Kong, V, Korkolis, D, Kurihara, H, Kuriyama, A, Landaluce-Olavarria, A, Licari, L, Litvin, A, Lohsiriwat, V, Lopes Moreira, C, Lostoridis, E, Tovar Luna, A, Luppi, D, Machain, G, Maegele, M, Maggiore, D, Maier, R, Manangi, M, Manetti, A, Mantoglu, B, Mariani, F, Marinis, A, Sbalcheiro Mariot, E, Martines, G, Martinez Perez, A, Mascagni, P, Massalou, D, Bessa Melo, R, Miceli, L, Mingoli, A, Mishra, T, Mohamedahmed, A, Mohan, R, Morales-Garcia, D, Mustafa, S, Naimzada, M, Negoi, I, Nidaw, M, Nigri, G, Ogundipe, H, Oliveri, C, Olmi, S, Pagani, L, Palomba, G, Pantalone, D, Panyko, A, Paolillo, C, Papis, D, Pararas, N, Pata, F, Pavone, G, Pecchini, F, Pellino, G, Pelloni, M, Peloso, A, Perea Del Pozo, E, Goncalves Pereira, R, Monteiro Pereira, B, Lizarazu Perez, A, Perrone, G, Pesce, A, Petracca, G, Piccoli, M, Picetti, E, Pikoulis, E, Pintar, T, Pirozzolo, G, Podda, M, Previtali, P, Privitera, F, Punzo, C, Quiodettis, M, Qvist, N, Rahim, R, Reinisch-Liese, A, Rodriguez-Luna, M, Roizblatt, D, Roscio, F, Rossi, S, Sakakushev, B, Salamea, J, Sall, I, Sammartano, F, Sanchez Arteaga, A, Sanchez-Cordero, S, Sasia, D, Sawyer, R, Seretis, C, Serradilla-Martin, M, Shelat, V, Shlyapnikov, S, Lages Simoes, R, Siribumrungwong, B, Slavchev, M, Solaini, L, Soldini, G, Soreide, K, Sydorchuk, L, Sydorchuk, R, Syed, A, Tallon-Aguilar, L, Tan, J, Tarasconi, A, Tartaglia, D, Tartaglia, N, Taylor, J, Tebala, G, Teuben, M, Tolonen, M, Tomasicchio, G, Triantafyllou, T, Trigiante, G, Turrado-Rodriguez, V, Tutino, R, Uccelli, M, Ugarte-Sierra, B, Ukkonen, M, Vassiliu, P, Verde, J, Veroux, M, Vilallonga, R, Visconti, D, Waledziak, M, Wannatoop, T, Widmer, L, Wilson, M, Wong, T, Xenaki, S, Yu, B, Zakaria, A, Zambrano, D, Zese, M, Cobianchi L., Dal Mas F., Massaro M., Fugazzola P., Coccolini F., Kluger Y., Leppaniemi A., Moore E. E., Sartelli M., Angelos P., Ansaloni L., Abdelmalik A., Abebe N. S., Abu-Zidan F. M., Adam Y. A. Y., Adamou H., Agrusa A., Akin E., Alexandrino H., Ali S. M., Almeida P. M., Amico F., Ammendola M., Andreuccetti J., Aparicio-Sanchez D., Ardito A., Argenio G., Askevold I. H., Atanasov B. T., Augustin G., Awad S. S., Bagnoli C., Bains L., Balalis D., Baldini E., Baraket O., Barone M., Barreras J. A., Bellanova G., Biancuzzi H., Bignell M. B., Bini R., Bissacco D., Boati P., Bottari A., Bouliaris K., Brillantino A., Buonomo L. A., Buscemi S., Calu V., Campo Dall'Orto R., Carvas J. M., Casoni Pattacini G., Catena F., Celentano V., Ceresoli M., Chirica M., Cianci P., Cillara N., Cimbanassi S., Cioffi S. P. B., Colak E., Conti L., Dantas Costa S., D'acapito F., Damaskos D., Das K., Davies R. J., De Beaux A. C., De Simone B., Demetrashvili Z., Demetriades A. K., Denicolai S., Di Buono G., Di Carlo I., Di Saverio S., Diaconescu B., Dibra R., Dios-Barbeito S., Dogjani A., Domanin M., D'Oria M., Duran Munoz-Cruzado V., East B., Ekwen G. T., Elbaih A. H., Escalera-Antezana J. P., Esposito G., Farre R., Ferrario di Tor Vajana A., Cordeiro Fonseca V., Forfori F., Fortuna L., Fradelos E., Fraga G. P., Fransvea P., Gachabayov M., Garcia Vazquez A., Ghannam W. M., Gioco R., Giraudo G., Giuffrida M., Giulii Capponi M., Gomes C. A., Teixeira Gonsaga R. A., Gonullu E., Goosen J., Goranovic T., Griffiths E. A., Haidar M. G., Hamid H. K. S., Harddastle T. C., Hecker M., Hernandez Garcia E. F., Cancio Huaman E., Hutan M., Ioannidis O., Isik A., Ismail A. M. H., Ismail N., Jang J. Y., Kalipershad S. N. R., Kaplan L. J., Kara Y., Karamagioli E., Karamarkovia A., Kavalakat A. J., Kechagias A., Kenig J., Khan J. S., Khokha V., Klappenbach R. F., Klappenbach R., Kobe Y., Kong V., Korkolis D., Kurihara H., Kuriyama A., Landaluce-Olavarria A., Licari L., Litvin A., Lohsiriwat V., Lopes Moreira C. C., Lostoridis E., Tovar Luna A., Luppi D., Machain G. M., Maegele M., Maggiore D., Maier R. V., Manangi M., Manetti A., Mantoglu B., Mariani F., Marinis A., Sbalcheiro Mariot E. A., Martines G., Martinez Perez A., Mascagni P., Massalou D., Bessa Melo R., Miceli L., Mingoli A., Mishra T. S., Mohamedahmed A. Y. Y., Mohan R., Morales-Garcia D., Mustafa S. M. S., Naimzada M. D., Negoi I., Nidaw M. K., Nigri G., Ogundipe H. D., Oliveri C., Olmi S., Pagani L., Palomba G., Pantalone D., Panyko A., Paolillo C., Papis D., Pararas N., Pata F., Pavone G., Pecchini F., Pellino G., Pelloni M., Peloso A., Perea Del Pozo E., Goncalves Pereira R., Monteiro Pereira B., Lizarazu Perez A., Perrone G., Pesce A., Petracca G., Piccoli M., Picetti E., Pikoulis E., Pintar T., Pirozzolo G., Podda M., Previtali P., Privitera F., Punzo C., Quiodettis M. A., Qvist N., Rahim R., Reinisch-Liese A., Rodriguez-Luna M. R., Roizblatt D., Roscio F. P. M., Rossi S., Sakakushev B. E., Salamea J. C., Sall I., Sammartano F., Sanchez Arteaga A., Sanchez-Cordero S., Sasia D., Sawyer R. G., Seretis C., Serradilla-Martin M., Shelat V. G., Shlyapnikov S., Lages Simoes R., Siribumrungwong B., Slavchev M., Solaini L., Soldini G., Soreide K., Sydorchuk L., Sydorchuk R., Syed A. M., Tallon-Aguilar L., Tan J. H., Tarasconi A., Tartaglia D., Tartaglia N., Taylor J., Tebala G. D., Teuben M., Tolonen M., Tomasicchio G., Triantafyllou T., Trigiante G., Turrado-Rodriguez V., Tutino R., Uccelli M., Ugarte-Sierra B., Ukkonen M., Vassiliu P. G., Verde J. M., Veroux M., Vilallonga R., Visconti D., Waledziak M., Wannatoop T., Widmer L. W., Wilson M. S. J., Wong T. H., Xenaki S., Yu B., Zakaria A. D., Zambrano D. A., Zese M., Cobianchi, L, Dal Mas, F, Massaro, M, Fugazzola, P, Coccolini, F, Kluger, Y, Leppaniemi, A, Moore, E, Sartelli, M, Angelos, P, Ansaloni, L, Abdelmalik, A, Abebe, N, Abu-Zidan, F, Adam, Y, Adamou, H, Agrusa, A, Akin, E, Alexandrino, H, Ali, S, Almeida, P, Amico, F, Ammendola, M, Andreuccetti, J, Aparicio-Sanchez, D, Ardito, A, Argenio, G, Askevold, I, Atanasov, B, Augustin, G, Awad, S, Bagnoli, C, Bains, L, Balalis, D, Baldini, E, Baraket, O, Barone, M, Barreras, J, Bellanova, G, Biancuzzi, H, Bignell, M, Bini, R, Bissacco, D, Boati, P, Bottari, A, Bouliaris, K, Brillantino, A, Buonomo, L, Buscemi, S, Calu, V, Campo Dall'Orto, R, Carvas, J, Casoni Pattacini, G, Catena, F, Celentano, V, Ceresoli, M, Chirica, M, Cianci, P, Cillara, N, Cimbanassi, S, Cioffi, S, Colak, E, Conti, L, Dantas Costa, S, D'Acapito, F, Damaskos, D, Das, K, Davies, R, De Beaux, A, De Simone, B, Demetrashvili, Z, Demetriades, A, Denicolai, S, Di Buono, G, Di Carlo, I, Di Saverio, S, Diaconescu, B, Dibra, R, Dios-Barbeito, S, Dogjani, A, Domanin, M, D'Oria, M, Duran Munoz-Cruzado, V, East, B, Ekwen, G, Elbaih, A, Escalera-Antezana, J, Esposito, G, Farre, R, Ferrario di Tor Vajana, A, Cordeiro Fonseca, V, Forfori, F, Fortuna, L, Fradelos, E, Fraga, G, Fransvea, P, Gachabayov, M, Garcia Vazquez, A, Ghannam, W, Gioco, R, Giraudo, G, Giuffrida, M, Giulii Capponi, M, Gomes, C, Teixeira Gonsaga, R, Gonullu, E, Goosen, J, Goranovic, T, Griffiths, E, Haidar, M, Hamid, H, Harddastle, T, Hecker, M, Hernandez Garcia, E, Cancio Huaman, E, Hutan, M, Ioannidis, O, Isik, A, Ismail, A, Ismail, N, Jang, J, Kalipershad, S, Kaplan, L, Kara, Y, Karamagioli, E, Karamarkovia, A, Kavalakat, A, Kechagias, A, Kenig, J, Khan, J, Khokha, V, Klappenbach, R, Kobe, Y, Kong, V, Korkolis, D, Kurihara, H, Kuriyama, A, Landaluce-Olavarria, A, Licari, L, Litvin, A, Lohsiriwat, V, Lopes Moreira, C, Lostoridis, E, Tovar Luna, A, Luppi, D, Machain, G, Maegele, M, Maggiore, D, Maier, R, Manangi, M, Manetti, A, Mantoglu, B, Mariani, F, Marinis, A, Sbalcheiro Mariot, E, Martines, G, Martinez Perez, A, Mascagni, P, Massalou, D, Bessa Melo, R, Miceli, L, Mingoli, A, Mishra, T, Mohamedahmed, A, Mohan, R, Morales-Garcia, D, Mustafa, S, Naimzada, M, Negoi, I, Nidaw, M, Nigri, G, Ogundipe, H, Oliveri, C, Olmi, S, Pagani, L, Palomba, G, Pantalone, D, Panyko, A, Paolillo, C, Papis, D, Pararas, N, Pata, F, Pavone, G, Pecchini, F, Pellino, G, Pelloni, M, Peloso, A, Perea Del Pozo, E, Goncalves Pereira, R, Monteiro Pereira, B, Lizarazu Perez, A, Perrone, G, Pesce, A, Petracca, G, Piccoli, M, Picetti, E, Pikoulis, E, Pintar, T, Pirozzolo, G, Podda, M, Previtali, P, Privitera, F, Punzo, C, Quiodettis, M, Qvist, N, Rahim, R, Reinisch-Liese, A, Rodriguez-Luna, M, Roizblatt, D, Roscio, F, Rossi, S, Sakakushev, B, Salamea, J, Sall, I, Sammartano, F, Sanchez Arteaga, A, Sanchez-Cordero, S, Sasia, D, Sawyer, R, Seretis, C, Serradilla-Martin, M, Shelat, V, Shlyapnikov, S, Lages Simoes, R, Siribumrungwong, B, Slavchev, M, Solaini, L, Soldini, G, Soreide, K, Sydorchuk, L, Sydorchuk, R, Syed, A, Tallon-Aguilar, L, Tan, J, Tarasconi, A, Tartaglia, D, Tartaglia, N, Taylor, J, Tebala, G, Teuben, M, Tolonen, M, Tomasicchio, G, Triantafyllou, T, Trigiante, G, Turrado-Rodriguez, V, Tutino, R, Uccelli, M, Ugarte-Sierra, B, Ukkonen, M, Vassiliu, P, Verde, J, Veroux, M, Vilallonga, R, Visconti, D, Waledziak, M, Wannatoop, T, Widmer, L, Wilson, M, Wong, T, Xenaki, S, Yu, B, Zakaria, A, Zambrano, D, Zese, M, Cobianchi L., Dal Mas F., Massaro M., Fugazzola P., Coccolini F., Kluger Y., Leppaniemi A., Moore E. E., Sartelli M., Angelos P., Ansaloni L., Abdelmalik A., Abebe N. S., Abu-Zidan F. M., Adam Y. A. Y., Adamou H., Agrusa A., Akin E., Alexandrino H., Ali S. M., Almeida P. M., Amico F., Ammendola M., Andreuccetti J., Aparicio-Sanchez D., Ardito A., Argenio G., Askevold I. H., Atanasov B. T., Augustin G., Awad S. S., Bagnoli C., Bains L., Balalis D., Baldini E., Baraket O., Barone M., Barreras J. A., Bellanova G., Biancuzzi H., Bignell M. B., Bini R., Bissacco D., Boati P., Bottari A., Bouliaris K., Brillantino A., Buonomo L. A., Buscemi S., Calu V., Campo Dall'Orto R., Carvas J. M., Casoni Pattacini G., Catena F., Celentano V., Ceresoli M., Chirica M., Cianci P., Cillara N., Cimbanassi S., Cioffi S. P. B., Colak E., Conti L., Dantas Costa S., D'acapito F., Damaskos D., Das K., Davies R. J., De Beaux A. C., De Simone B., Demetrashvili Z., Demetriades A. K., Denicolai S., Di Buono G., Di Carlo I., Di Saverio S., Diaconescu B., Dibra R., Dios-Barbeito S., Dogjani A., Domanin M., D'Oria M., Duran Munoz-Cruzado V., East B., Ekwen G. T., Elbaih A. H., Escalera-Antezana J. P., Esposito G., Farre R., Ferrario di Tor Vajana A., Cordeiro Fonseca V., Forfori F., Fortuna L., Fradelos E., Fraga G. P., Fransvea P., Gachabayov M., Garcia Vazquez A., Ghannam W. M., Gioco R., Giraudo G., Giuffrida M., Giulii Capponi M., Gomes C. A., Teixeira Gonsaga R. A., Gonullu E., Goosen J., Goranovic T., Griffiths E. A., Haidar M. G., Hamid H. K. S., Harddastle T. C., Hecker M., Hernandez Garcia E. F., Cancio Huaman E., Hutan M., Ioannidis O., Isik A., Ismail A. M. H., Ismail N., Jang J. Y., Kalipershad S. N. R., Kaplan L. J., Kara Y., Karamagioli E., Karamarkovia A., Kavalakat A. J., Kechagias A., Kenig J., Khan J. S., Khokha V., Klappenbach R. F., Klappenbach R., Kobe Y., Kong V., Korkolis D., Kurihara H., Kuriyama A., Landaluce-Olavarria A., Licari L., Litvin A., Lohsiriwat V., Lopes Moreira C. C., Lostoridis E., Tovar Luna A., Luppi D., Machain G. M., Maegele M., Maggiore D., Maier R. V., Manangi M., Manetti A., Mantoglu B., Mariani F., Marinis A., Sbalcheiro Mariot E. A., Martines G., Martinez Perez A., Mascagni P., Massalou D., Bessa Melo R., Miceli L., Mingoli A., Mishra T. S., Mohamedahmed A. Y. Y., Mohan R., Morales-Garcia D., Mustafa S. M. S., Naimzada M. D., Negoi I., Nidaw M. K., Nigri G., Ogundipe H. D., Oliveri C., Olmi S., Pagani L., Palomba G., Pantalone D., Panyko A., Paolillo C., Papis D., Pararas N., Pata F., Pavone G., Pecchini F., Pellino G., Pelloni M., Peloso A., Perea Del Pozo E., Goncalves Pereira R., Monteiro Pereira B., Lizarazu Perez A., Perrone G., Pesce A., Petracca G., Piccoli M., Picetti E., Pikoulis E., Pintar T., Pirozzolo G., Podda M., Previtali P., Privitera F., Punzo C., Quiodettis M. A., Qvist N., Rahim R., Reinisch-Liese A., Rodriguez-Luna M. R., Roizblatt D., Roscio F. P. M., Rossi S., Sakakushev B. E., Salamea J. C., Sall I., Sammartano F., Sanchez Arteaga A., Sanchez-Cordero S., Sasia D., Sawyer R. G., Seretis C., Serradilla-Martin M., Shelat V. G., Shlyapnikov S., Lages Simoes R., Siribumrungwong B., Slavchev M., Solaini L., Soldini G., Soreide K., Sydorchuk L., Sydorchuk R., Syed A. M., Tallon-Aguilar L., Tan J. H., Tarasconi A., Tartaglia D., Tartaglia N., Taylor J., Tebala G. D., Teuben M., Tolonen M., Tomasicchio G., Triantafyllou T., Trigiante G., Turrado-Rodriguez V., Tutino R., Uccelli M., Ugarte-Sierra B., Ukkonen M., Vassiliu P. G., Verde J. M., Veroux M., Vilallonga R., Visconti D., Waledziak M., Wannatoop T., Widmer L. W., Wilson M. S. J., Wong T. H., Xenaki S., Yu B., Zakaria A. D., Zambrano D. A., and Zese M.

Abstract

Background: Emergency surgery represents a unique context. Trauma teams are often multidisciplinary and need to operate under extreme stress and time constraints, sometimes with no awareness of the trauma’s causes or the patient’s personal and clinical information. In this perspective, the dynamics of how trauma teams function is fundamental to ensuring the best performance and outcomes. Methods: An online survey was conducted among the World Society of Emergency Surgery members in early 2021. 402 fully filled questionnaires on the topics of knowledge translation dynamics and tools, non-technical skills, and difficulties in teamwork were collected. Data were analyzed using the software R, and reported following the Checklist for Reporting Results of Internet E-Surveys (CHERRIES). Results: Findings highlight how several surgeons are still unsure about the meaning and potential of knowledge translation and its mechanisms. Tools like training, clinical guidelines, and non-technical skills are recognized and used in clinical practice. Others, like patients’ and stakeholders’ engagement, are hardly implemented, despite their increasing importance in the modern healthcare scenario. Several difficulties in working as a team are described, including the lack of time, communication, training, trust, and ego. Discussion: Scientific societies should take the lead in offering training and support about the abovementioned topics. Dedicated educational initiatives, practical cases and experiences, workshops and symposia may allow mitigating the difficulties highlighted by the survey’s participants, boosting the performance of emergency teams. Additional investigation of the survey results and its characteristics may lead to more further specific suggestions and potential solutions.

Published
2021

49. 2020 WSES guidelines for the detection and management of bile duct injury during cholecystectomy

Author

De'Angelis, N, Catena, F, Memeo, R, Coccolini, F, Martinez-Perez, A, Romeo, O, De Simone, B, Di Saverio, S, Brustia, R, Rhaiem, R, Piardi, T, Conticchio, M, Marchegiani, F, Beghdadi, N, Abu-Zidan, F, Alikhanov, R, Allard, M, Allievi, N, Amaddeo, G, Ansaloni, L, Andersson, R, Andolfi, E, Azfar, M, Bala, M, Benkabbou, A, Ben-Ishay, O, Bianchi, G, Biffl, W, Brunetti, F, Carra, M, Casanova, D, Celentano, V, Ceresoli, M, Chiara, O, Cimbanassi, S, Bini, R, Coimbra, R, Luigi de'Angelis, G, Decembrino, F, De Palma, A, de Reuver, P, Domingo, C, Cotsoglou, C, Ferrero, A, Fraga, G, Gaiani, F, Gheza, F, Gurrado, A, Harrison, E, Henriquez, A, Hofmeyr, S, Iadarola, R, Kashuk, J, Kianmanesh, R, Kirkpatrick, A, Kluger, Y, Landi, F, Langella, S, Lapointe, R, Le Roy, B, Luciani, A, Machado, F, Maggi, U, Maier, R, Mefire, A, Hiramatsu, K, Ordonez, C, Patrizi, F, Planells, M, Peitzman, A, Pekolj, J, Perdigao, F, Pereira, B, Pessaux, P, Pisano, M, Puyana, J, Rizoli, S, Portigliotti, L, Romito, R, Sakakushev, B, Sanei, B, Scatton, O, Serradilla-Martin, M, Schneck, A, Sissoko, M, Sobhani, I, ten Broek, R, Testini, M, Valinas, R, Veloudis, G, Vitali, G, Weber, D, Zorcolo, L, Giuliante, F, Gavriilidis, P, Fuks, D, Sommacale, D, de'Angelis N., Catena F., Memeo R., Coccolini F., Martinez-Perez A., Romeo O. M., De Simone B., Di Saverio S., Brustia R., Rhaiem R., Piardi T., Conticchio M., Marchegiani F., Beghdadi N., Abu-Zidan F. M., Alikhanov R., Allard M. -A., Allievi N., Amaddeo G., Ansaloni L., Andersson R., Andolfi E., Azfar M., Bala M., Benkabbou A., Ben-Ishay O., Bianchi G., Biffl W. L., Brunetti F., Carra M. C., Casanova D., Celentano V., Ceresoli M., Chiara O., Cimbanassi S., Bini R., Coimbra R., Luigi de'Angelis G., Decembrino F., De Palma A., de Reuver P. R., Domingo C., Cotsoglou C., Ferrero A., Fraga G. P., Gaiani F., Gheza F., Gurrado A., Harrison E., Henriquez A., Hofmeyr S., Iadarola R., Kashuk J. L., Kianmanesh R., Kirkpatrick A. W., Kluger Y., Landi F., Langella S., Lapointe R., Le Roy B., Luciani A., Machado F., Maggi U., Maier R. V., Mefire A. C., Hiramatsu K., Ordonez C., Patrizi F., Planells M., Peitzman A. B., Pekolj J., Perdigao F., Pereira B. M., Pessaux P., Pisano M., Puyana J. C., Rizoli S., Portigliotti L., Romito R., Sakakushev B., Sanei B., Scatton O., Serradilla-Martin M., Schneck A. -S., Sissoko M. L., Sobhani I., ten Broek R. P., Testini M., Valinas R., Veloudis G., Vitali G. C., Weber D., Zorcolo L., Giuliante F., Gavriilidis P., Fuks D., Sommacale D., De'Angelis, N, Catena, F, Memeo, R, Coccolini, F, Martinez-Perez, A, Romeo, O, De Simone, B, Di Saverio, S, Brustia, R, Rhaiem, R, Piardi, T, Conticchio, M, Marchegiani, F, Beghdadi, N, Abu-Zidan, F, Alikhanov, R, Allard, M, Allievi, N, Amaddeo, G, Ansaloni, L, Andersson, R, Andolfi, E, Azfar, M, Bala, M, Benkabbou, A, Ben-Ishay, O, Bianchi, G, Biffl, W, Brunetti, F, Carra, M, Casanova, D, Celentano, V, Ceresoli, M, Chiara, O, Cimbanassi, S, Bini, R, Coimbra, R, Luigi de'Angelis, G, Decembrino, F, De Palma, A, de Reuver, P, Domingo, C, Cotsoglou, C, Ferrero, A, Fraga, G, Gaiani, F, Gheza, F, Gurrado, A, Harrison, E, Henriquez, A, Hofmeyr, S, Iadarola, R, Kashuk, J, Kianmanesh, R, Kirkpatrick, A, Kluger, Y, Landi, F, Langella, S, Lapointe, R, Le Roy, B, Luciani, A, Machado, F, Maggi, U, Maier, R, Mefire, A, Hiramatsu, K, Ordonez, C, Patrizi, F, Planells, M, Peitzman, A, Pekolj, J, Perdigao, F, Pereira, B, Pessaux, P, Pisano, M, Puyana, J, Rizoli, S, Portigliotti, L, Romito, R, Sakakushev, B, Sanei, B, Scatton, O, Serradilla-Martin, M, Schneck, A, Sissoko, M, Sobhani, I, ten Broek, R, Testini, M, Valinas, R, Veloudis, G, Vitali, G, Weber, D, Zorcolo, L, Giuliante, F, Gavriilidis, P, Fuks, D, Sommacale, D, de'Angelis N., Catena F., Memeo R., Coccolini F., Martinez-Perez A., Romeo O. M., De Simone B., Di Saverio S., Brustia R., Rhaiem R., Piardi T., Conticchio M., Marchegiani F., Beghdadi N., Abu-Zidan F. M., Alikhanov R., Allard M. -A., Allievi N., Amaddeo G., Ansaloni L., Andersson R., Andolfi E., Azfar M., Bala M., Benkabbou A., Ben-Ishay O., Bianchi G., Biffl W. L., Brunetti F., Carra M. C., Casanova D., Celentano V., Ceresoli M., Chiara O., Cimbanassi S., Bini R., Coimbra R., Luigi de'Angelis G., Decembrino F., De Palma A., de Reuver P. R., Domingo C., Cotsoglou C., Ferrero A., Fraga G. P., Gaiani F., Gheza F., Gurrado A., Harrison E., Henriquez A., Hofmeyr S., Iadarola R., Kashuk J. L., Kianmanesh R., Kirkpatrick A. W., Kluger Y., Landi F., Langella S., Lapointe R., Le Roy B., Luciani A., Machado F., Maggi U., Maier R. V., Mefire A. C., Hiramatsu K., Ordonez C., Patrizi F., Planells M., Peitzman A. B., Pekolj J., Perdigao F., Pereira B. M., Pessaux P., Pisano M., Puyana J. C., Rizoli S., Portigliotti L., Romito R., Sakakushev B., Sanei B., Scatton O., Serradilla-Martin M., Schneck A. -S., Sissoko M. L., Sobhani I., ten Broek R. P., Testini M., Valinas R., Veloudis G., Vitali G. C., Weber D., Zorcolo L., Giuliante F., Gavriilidis P., Fuks D., and Sommacale D.

Abstract

Bile duct injury (BDI) is a dangerous complication of cholecystectomy, with significant postoperative sequelae for the patient in terms of morbidity, mortality, and long-term quality of life. BDIs have an estimated incidence of 0.4–1.5%, but considering the number of cholecystectomies performed worldwide, mostly by laparoscopy, surgeons must be prepared to manage this surgical challenge. Most BDIs are recognized either during the procedure or in the immediate postoperative period. However, some BDIs may be discovered later during the postoperative period, and this may translate to delayed or inappropriate treatments. Providing a specific diagnosis and a precise description of the BDI will expedite the decision-making process and increase the chance of treatment success. Subsequently, the choice and timing of the appropriate reconstructive strategy have a critical role in long-term prognosis. Currently, a wide spectrum of multidisciplinary interventions with different degrees of invasiveness is indicated for BDI management. These World Society of Emergency Surgery (WSES) guidelines have been produced following an exhaustive review of the current literature and an international expert panel discussion with the aim of providing evidence-based recommendations to facilitate and standardize the detection and management of BDIs during cholecystectomy. In particular, the 2020 WSES guidelines cover the following key aspects: (1) strategies to minimize the risk of BDI during cholecystectomy; (2) BDI rates in general surgery units and review of surgical practice; (3) how to classify, stage, and report BDI once detected; (4) how to manage an intraoperatively detected BDI; (5) indications for antibiotic treatment; (6) indications for clinical, biochemical, and imaging investigations for suspected BDI; and (7) how to manage a postoperatively detected BDI.

Published
2021

50. A pandemic recap: lessons we have learned

Author

Coccolini, F, Cicuttin, E, Cremonini, C, Tartaglia, D, Viaggi, B, Kuriyama, A, Picetti, E, Ball, C, Abu-Zidan, F, Ceresoli, M, Turri, B, Jain, S, Palombo, C, Guirao, X, Rodrigues, G, Gachabayov, M, Machado, F, Eftychios, L, Kanj, S, Di Carlo, I, Di Saverio, S, Khokha, V, Kirkpatrick, A, Massalou, D, Forfori, F, Corradi, F, Delibegovic, S, Machain Vega, G, Fantoni, M, Demetriades, D, Kapoor, G, Kluger, Y, Ansari, S, Maier, R, Leppaniemi, A, Hardcastle, T, Vereczkei, A, Karamagioli, E, Pikoulis, E, Pistello, M, Sakakushev, B, Navsaria, P, Galeiras, R, Yahya, A, Osipov, A, Dimitrov, E, Doklestic, K, Pisano, M, Malacarne, P, Carcoforo, P, Sibilla, M, Kryvoruchko, I, Bonavina, L, Kim, J, Shelat, V, Czepiel, J, Maseda, E, Marwah, S, Chirica, M, Biancofiore, G, Podda, M, Cobianchi, L, Ansaloni, L, Fugazzola, P, Seretis, C, Gomez, C, Tumietto, F, Malbrain, M, Reichert, M, Augustin, G, Amato, B, Puzziello, A, Hecker, A, Gemignani, A, Isik, A, Cucchetti, A, Nacoti, M, Kopelman, D, Mesina, C, Ghannam, W, Ben-Ishay, O, Dhingra, S, Coimbra, R, Moore, E, Cui, Y, Quiodettis, M, Bala, M, Testini, M, Diaz, J, Girardis, M, Biffl, W, Hecker, M, Sall, I, Boggi, U, Materazzi, G, Ghiadoni, L, Matsumoto, J, Zuidema, W, Ivatury, R, Enani, M, Litvin, A, Al-Hasan, M, Demetrashvili, Z, Baraket, O, Ordonez, C, Negoi, I, Kiguba, R, Memish, Z, Elmangory, M, Tolonen, M, Das, K, Ribeiro, J, O'Connor, D, Tan, B, Van Goor, H, Baral, S, De Simone, B, Corbella, D, Brambillasca, P, Scaglione, M, Basolo, F, De'Angelis, N, Bendinelli, C, Weber, D, Pagani, L, Monti, C, Baiocchi, G, Chiarugi, M, Catena, F, Sartelli, M, Coccolini F., Cicuttin E., Cremonini C., Tartaglia D., Viaggi B., Kuriyama A., Picetti E., Ball C., Abu-Zidan F., Ceresoli M., Turri B., Jain S., Palombo C., Guirao X., Rodrigues G., Gachabayov M., Machado F., Eftychios L., Kanj S. S., Di Carlo I., Di Saverio S., Khokha V., Kirkpatrick A., Massalou D., Forfori F., Corradi F., Delibegovic S., Machain Vega G. M., Fantoni M., Demetriades D., Kapoor G., Kluger Y., Ansari S., Maier R., Leppaniemi A., Hardcastle T., Vereczkei A., Karamagioli E., Pikoulis E., Pistello M., Sakakushev B. E., Navsaria P. H., Galeiras R., Yahya A. I., Osipov A. V., Dimitrov E., Doklestic K., Pisano M., Malacarne P., Carcoforo P., Sibilla M. G., Kryvoruchko I. A., Bonavina L., Kim J. I., Shelat V. G., Czepiel J., Maseda E., Marwah S., Chirica M., Biancofiore G., Podda M., Cobianchi L., Ansaloni L., Fugazzola P., Seretis C., Gomez C. A., Tumietto F., Malbrain M., Reichert M., Augustin G., Amato B., Puzziello A., Hecker A., Gemignani A., Isik A., Cucchetti A., Nacoti M., Kopelman D., Mesina C., Ghannam W., Ben-Ishay O., Dhingra S., Coimbra R., Moore E. E., Cui Y., Quiodettis M. A., Bala M., Testini M., Diaz J., Girardis M., Biffl W. L., Hecker M., Sall I., Boggi U., Materazzi G., Ghiadoni L., Matsumoto J., Zuidema W. P., Ivatury R., Enani M. A., Litvin A., Al-Hasan M. N., Demetrashvili Z., Baraket O., Ordonez C. A., Negoi I., Kiguba R., Memish Z. A., Elmangory M. M., Tolonen M., Das K., Ribeiro J., O'Connor D. B., Tan B. K., Van Goor H., Baral S., De Simone B., Corbella D., Brambillasca P., Scaglione M., Basolo F., De'Angelis N., Bendinelli C., Weber D., Pagani L., Monti C., Baiocchi G., Chiarugi M., Catena F., Sartelli M., Coccolini, F, Cicuttin, E, Cremonini, C, Tartaglia, D, Viaggi, B, Kuriyama, A, Picetti, E, Ball, C, Abu-Zidan, F, Ceresoli, M, Turri, B, Jain, S, Palombo, C, Guirao, X, Rodrigues, G, Gachabayov, M, Machado, F, Eftychios, L, Kanj, S, Di Carlo, I, Di Saverio, S, Khokha, V, Kirkpatrick, A, Massalou, D, Forfori, F, Corradi, F, Delibegovic, S, Machain Vega, G, Fantoni, M, Demetriades, D, Kapoor, G, Kluger, Y, Ansari, S, Maier, R, Leppaniemi, A, Hardcastle, T, Vereczkei, A, Karamagioli, E, Pikoulis, E, Pistello, M, Sakakushev, B, Navsaria, P, Galeiras, R, Yahya, A, Osipov, A, Dimitrov, E, Doklestic, K, Pisano, M, Malacarne, P, Carcoforo, P, Sibilla, M, Kryvoruchko, I, Bonavina, L, Kim, J, Shelat, V, Czepiel, J, Maseda, E, Marwah, S, Chirica, M, Biancofiore, G, Podda, M, Cobianchi, L, Ansaloni, L, Fugazzola, P, Seretis, C, Gomez, C, Tumietto, F, Malbrain, M, Reichert, M, Augustin, G, Amato, B, Puzziello, A, Hecker, A, Gemignani, A, Isik, A, Cucchetti, A, Nacoti, M, Kopelman, D, Mesina, C, Ghannam, W, Ben-Ishay, O, Dhingra, S, Coimbra, R, Moore, E, Cui, Y, Quiodettis, M, Bala, M, Testini, M, Diaz, J, Girardis, M, Biffl, W, Hecker, M, Sall, I, Boggi, U, Materazzi, G, Ghiadoni, L, Matsumoto, J, Zuidema, W, Ivatury, R, Enani, M, Litvin, A, Al-Hasan, M, Demetrashvili, Z, Baraket, O, Ordonez, C, Negoi, I, Kiguba, R, Memish, Z, Elmangory, M, Tolonen, M, Das, K, Ribeiro, J, O'Connor, D, Tan, B, Van Goor, H, Baral, S, De Simone, B, Corbella, D, Brambillasca, P, Scaglione, M, Basolo, F, De'Angelis, N, Bendinelli, C, Weber, D, Pagani, L, Monti, C, Baiocchi, G, Chiarugi, M, Catena, F, Sartelli, M, Coccolini F., Cicuttin E., Cremonini C., Tartaglia D., Viaggi B., Kuriyama A., Picetti E., Ball C., Abu-Zidan F., Ceresoli M., Turri B., Jain S., Palombo C., Guirao X., Rodrigues G., Gachabayov M., Machado F., Eftychios L., Kanj S. S., Di Carlo I., Di Saverio S., Khokha V., Kirkpatrick A., Massalou D., Forfori F., Corradi F., Delibegovic S., Machain Vega G. M., Fantoni M., Demetriades D., Kapoor G., Kluger Y., Ansari S., Maier R., Leppaniemi A., Hardcastle T., Vereczkei A., Karamagioli E., Pikoulis E., Pistello M., Sakakushev B. E., Navsaria P. H., Galeiras R., Yahya A. I., Osipov A. V., Dimitrov E., Doklestic K., Pisano M., Malacarne P., Carcoforo P., Sibilla M. G., Kryvoruchko I. A., Bonavina L., Kim J. I., Shelat V. G., Czepiel J., Maseda E., Marwah S., Chirica M., Biancofiore G., Podda M., Cobianchi L., Ansaloni L., Fugazzola P., Seretis C., Gomez C. A., Tumietto F., Malbrain M., Reichert M., Augustin G., Amato B., Puzziello A., Hecker A., Gemignani A., Isik A., Cucchetti A., Nacoti M., Kopelman D., Mesina C., Ghannam W., Ben-Ishay O., Dhingra S., Coimbra R., Moore E. E., Cui Y., Quiodettis M. A., Bala M., Testini M., Diaz J., Girardis M., Biffl W. L., Hecker M., Sall I., Boggi U., Materazzi G., Ghiadoni L., Matsumoto J., Zuidema W. P., Ivatury R., Enani M. A., Litvin A., Al-Hasan M. N., Demetrashvili Z., Baraket O., Ordonez C. A., Negoi I., Kiguba R., Memish Z. A., Elmangory M. M., Tolonen M., Das K., Ribeiro J., O'Connor D. B., Tan B. K., Van Goor H., Baral S., De Simone B., Corbella D., Brambillasca P., Scaglione M., Basolo F., De'Angelis N., Bendinelli C., Weber D., Pagani L., Monti C., Baiocchi G., Chiarugi M., Catena F., and Sartelli M.

Abstract

On January 2020, the WHO Director General declared that the outbreak constitutes a Public Health Emergency of International Concern. The world has faced a worldwide spread crisis and is still dealing with it. The present paper represents a white paper concerning the tough lessons we have learned from the COVID-19 pandemic. Thus, an international and heterogenous multidisciplinary panel of very differentiated people would like to share global experiences and lessons with all interested and especially those responsible for future healthcare decision making. With the present paper, international and heterogenous multidisciplinary panel of very differentiated people would like to share global experiences and lessons with all interested and especially those responsible for future healthcare decision making.

Published
2021

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