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105 results on '"Rengifo, C"'

2. Diagnostic accuracy of intraoperative pelvic autonomic nerve monitoring during rectal surgery: a systematic review.

Author

O'Connor, A., Rengifo, C., Griffiths, B., Cornish, J. A., Tiernan, J. P., Khan, Jim, Nunoo-Mensah, J. W., Telford, K., and Harji, D.

Subjects
*RECTAL surgery, *FECAL incontinence, *PROCTOLOGY, *CINAHL database, *SEXUAL dysfunction, *INTRAOPERATIVE monitoring, *ANORECTAL function tests
Abstract

Purpose: Anorectal and urogenital dysfunctions are common after rectal surgery and have a significant impact on quality of life. Intraoperative pelvic autonomic nerve monitoring (pIONM) has been proposed as a tool to identify patients at risk of these functional sequelae. This systematic review aims to evaluate the diagnostic accuracy of pIONM in detecting anorectal and urogenital dysfunction following rectal surgery. Methods: A systematic review of articles published since 1990 was conducted using MEDLINE, Embase, CINAHL, Google Scholar, Scopus, and Web of Science. Studies describing pIONM for rectal surgery and reporting anorectal or urogenital functional outcomes were included. The risk of bias was assessed using the QUADS-2 tool. The diagnostic accuracy of pIONM was established with pooled sensitivity and specificity alongside summary receiver-operating characteristic curves. Results: Twenty studies including 686 patients undergoing pIONM were identified, with seven of these studies including a control group. There was heterogeneity in the pIONM technique and reported outcome measures used. Results from five studies indicate pIONM may be able to predict postoperative anorectal (sensitivity 1.00 [95% CI 0.03–1.00], specificity 0.98 [0.91–0.99]) and urinary (sensitivity 1.00 [95% CI 0.03–1.00], specificity 0.99 [0.92–0.99]) dysfunction. Conclusions: This review identifies the diagnostic accuracy of pIONM in detecting postoperative anorectal and urogenital dysfunction following rectal surgery. Further research is necessary before pIONM can be routinely used in clinical practice. PROSPERO Registration Details: CRD42022313934. [ABSTRACT FROM AUTHOR]

Published
2024
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4. Explorando la dinámica de la marcha humana: Una revisión de sistemas de análisis basados en dispositivos de captura de imágenes.

Author

Fernández, D. A., Rengifo, C. F., and Caicedo, P. E.

Subjects
*PARKINSON'S disease, *GAIT disorders, *IMAGING systems, *CAMERAS, *WOUNDS & injuries
Abstract

Human gait has been studied using various technologies that measure spatiotemporal variables, such as the duration of support phases, speed and cadence, step length, and width, among others. In this review, static and mobile systems integrated with image capture devices such as RGB-D cameras have been explored. These systems have been tested on various groups of participants, including people with Parkinson's and cerebrovascular injuries, as well as healthy individuals. The results show that many of these technologies have significant correlation with "Gold Standard" systems such as Vicon, although limitations and challenges are evident, such as accuracy and applicability in different settings. Nevertheless, these advances have a potentially significant impact on the assessment and treatment of gait disorders. [ABSTRACT FROM AUTHOR]

Published
2024
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5. Cost‐effectiveness of emergency versus delayed laparoscopic cholecystectomy for acute gallbladder pathology

Author

Sutton, A. J., Vohra, R. S., Hollyman, M., Marriott, P. J., Buja, A., Alderson, D., Pasquali, S., Griffiths, E. A., Vohra, R. S., Spreadborough, P., Hollyman, M., Marriott, P. J., Kirkham, A., Pasquali, S., Alderson, D., Griffiths, E. A., Fenwick, S., Elmasry, M., Nunes, Q. M., Kennedy, D., Khan, R. B., Khan, M. A. S., Magee, C. J., Jones, S. M., Mason, D., Parappally, C. P., Mathur, P., Saunders, M., Jamel, S., Ul Haque, S., Zafar, S., Shiwani, M. H., Samuel, N., Dar, F., Jackson, A., Lovett, B., Dindyal, S., Winter, H., Fletcher, T., Rahman, S., Wheatley, K., Nieto, T., Ayaani, S., Youssef, H., Nijjar, R. S., Watkin, H., Naumann, D., Emesih, S., Sarmah, P. B., Lee, K., Joji, N., Heath, J., Teasdale, R. L., Weerasinghe, C., Needham, P. J., Welbourn, H., Forster, L., Finch, D., Blazeby, J. M., Robb, W., McNair, A. G. K., Hrycaiczuk, A., Charalabopoulos, A., Kadirkamanathan, S., Tang, C.‐B., Jayanthi, N. V. G., Noor, N., Dobbins, B., Cockbain, A. J., Nilsen‐Nunn, A., de Siqueira, J., Pellen, M., Cowley, J. B., Ho, W.‐M., Miu, V., White, T. J., Hodgkins, K. A., Kinghorn, A., Tutton, M. G., Al‐Abed, Y. A., Menzies, D., Ahmad, A., Reed, J., Khan, S., Monk, D., Vitone, L. J., Murtaza, G., Joel, A., Brennan, S., Shier, D., Zhang, C., Yoganathan, T., Robinson, S. J., McCallum, I. J. D., Jones, M. J., Elsayed, M., Tuck, E., Wayman, J., Carney, K., Aroori, S., Hosie, K. B., Kimble, A., Bunting, D.M., Fawole, A. S., Basheer, M., Dave, R. V., Sarveswaran, J., Jones, E., Kendal, C., Tilston, M. P., Gough, M., Wallace, T., Singh, S., Downing, J., Mockford, K. A., Issa, E., Shah, N., Chauhan, N., Wilson, T. R., Forouzanfar, A., Wild, J. R. L., Nofal, E., Bunnell, C., Madbak, K., Rao, S. T. V., Devoto, L., Siddiqi, N., Khawaja, Z., Hewes, J. C., Gould, L., Chambers, A., Rodriguez, D. U., Sen, G., Robinson, S., Carney, K., Bartlett, F., Rae, D. M., Stevenson, T. E. J., Sarvananthan, K., Dwerryhouse, S. J., Higgs, S. M., Old, O. J., Hardy, T. J., Shah, R., Hornby, S. T., Keogh, K., Frank, L., Al‐Akash, M., Upchurch, E. A., Frame, R. J., Hughes, M., Jelley, C., Weaver, S., Roy, S., Sillo, T. O., Galanopoulos, G., Cuming, T., Cunha, P., Tayeh, S., Kaptanis, S., Heshaishi, M., Eisawi, A., Abayomi, M., Ngu, W. S., Fleming, K., Bajwa, D. S., Chitre, V., Aryal, K., Ferris, P., Silva, M., Lammy, S., Mohamed, S., Khawaja, A., Hussain, A., Ghazanfar, M. A., Bellini, M. I., Ebdewi, H., Elshaer, M., Gravante, G., Drake, B., Ogedegbe, A., Mukherjee, D., Arhi, C., Iqbal, L. G. N., Watson, N. F., Aggarwal, S. K., Orchard, P., Villatoro, E., Willson, P. D., Mok, J., Woodman, T., Deguara, J., Garcea, G., Babu, B. I., Dennison, A. R., Malde, D., Lloyd, D., Satheesan, S., Al‐Taan, O., Boddy, A., Slavin, J. P., Jones, R. P., Ballance, L., Gerakopoulos, S., Jambulingam, P., Mansour, S., Sakai, N., Acharya, V., Sadat, M. M., Karim, L., Larkin, D., Amin, K., Khan, A., Law, J., Jamdar, S., Smith, S. R., Sampat, K., Oʼshea, K. M., Manu, M., Asprou, F. M., Malik, N. S., Chang, J., Johnstone, M., Lewis, M., Roberts, G. P., Karavadra, B., Photi, E., Hewes, J., Gould, L., Chambers, A., Rodriguez, D., OʼReilly, D. A., Rate, A. J., Sekhar, H., Henderson, L. T., Starmer, B. Z., Coe, P. O., Tolofari, S., Barrie, J., Bashir, G., Sloane, J., Madanipour, S., Halkias, C., Trevatt, A. E. J., Borowski, D. W., Hornsby, J., Courtney, M. J., Virupaksha, S., Seymour, K., Robinson, S., Hawkins, H., Bawa, S., Gallagher, P. V., Reid, A., Wood, P., Finch, J. G., Parmar, J., Stirland, E., Gardner‐Thorpe, J., Al‐Muhktar, A., Peterson, M., Majeed, A., Bajwa, F. M., Martin, J., Choy, A., Tsang, A., Pore, N., Andrew, D. R., Al‐Khyatt, W., Taylor, C., Bhandari, S., Chambers, A., Subramanium, D., Toh, S. K. C., Carter, N. C., Tate, S., Pearce, B., Wainwright, D., Mercer, S. J., Knight, B., Vijay, V., Alagaratnam, S., Sinha, S., Khan, S., El‐Hasani, S. S., Hussain, A. A., Bhattacharya, V., Kansal, N., Fasih, T., Jackson, C., Siddiqui, M. N., Chishti, I. A., Fordham, I. J., Siddiqui, Z., Bausbacher, H., Geogloma, I., Gurung, K., Tsavellas, G., Basynat, P., Shrestha, A. K., Basu, S., Mohan, A. C., Harilingam, M., Rabie, M., Akhtar, M., Kumar, P., Jafferbhoy, S. F., Hussain, N., Raza, S., Haque, M., Alam, I., Aseem, R., Patel, S., Asad, M., Booth, M. I., Ball, W. R., Wood, C. P. J., Pinho‐Gomes, A. C., Kausar, A., Obeidallah, M. R., Varghase, J., Lodhia, J., Bradley, D., Rengifo, C., Lindsay, D., Gopalswamy, S., Finlay, I., Wardle, S., Bullen, N., Iftikhar, S. Y., Awan, A., Ahmed, J., Leeder, P., Fusai, G., Bond‐Smith, G., Psica, A., Puri, Y., Hou, D., Noble, F., Szentpali, K., Broadhurst, J., Date, R., Hossack, M. R., Goh, Y. L., Turner, P., Shetty, V., Riera, M., Macano, C. A.W., Sukha, A., Preston, S. R., Hoban, J. R., Puntis, D. J., Williams, S. V., Krysztopik, R., Kynaston, J., Batt, J., Doe, M., Goscimski, A., Jones, G. H., Smith, S. R., Hall, C., Carty, N., Ahmed, J., Panteleimonitis, S., Gunasekera, R. T., Sheel, A. R. G., Lennon, H., Hindley, C., Reddy, M., Kenny, R., Elkheir, N., McGlone, E. R., Rajaganeshan, R., Hancorn, K., Hargreaves, A., Prasad, R., Longbotham, D. A., Vijayanand, D., Wijetunga, I., Ziprin, P., Nicolay, C. R., Yeldham, G., Read, E., Gossage, J. A., Rolph, R. C., Ebied, H., Phull, M., Khan, M. A., Popplewell, M., Kyriakidis, D., Hussain, A., Henley, N., Packer, J. R., Derbyshire, L., Porter, J., Appleton, S., Farouk, M., Basra, M., Jennings, N. A., Ali, S., Kanakala, V., Ali, H., Lane, R., Dickson‐Lowe, R., Zarsadias, P., Mirza, D., Puig, S., Al Amari, K., Vijayan, D., Sutcliffe, R., Marudanayagam, R., Hamady, Z., Prasad, A. R., Patel, A., Durkin, D., Kaur, P., Bowen, L., Byrne, J. P., Pearson, K. L., Delisle, T. G., Davies, J., Tomlinson, M. A., Johnpulle, M. A., Slawinski, C., Macdonald, A., Nicholson, J., Newton, K., Mbuvi, J., Farooq, A., Mothe, B. S., Zafrani, Z., Brett, D., Francombe, J., Spreadborough, P., Barnes, J., Cheung, M., Al‐Bahrani, A. Z., Preziosi, G., Urbonas, T., Alberts, J., Mallik, M., Patel, K., Segaran, A., Doulias, T., Sufi, P. A., Yao, C., Pollock, S., Manzelli, A., Wajed, S., Kourkulos, M., Pezzuto, R., Wadley, M., Hamilton, E., Jaunoo, S., Padwick, R., Sayegh, M., Newton, R. C., Hebbar, M., Farag, S. F., Spearman, J., Hamdan, M. F., DʼCosta, C., Blane, C., Giles, M., Peter, M. B., Hirst, N. A., Hossain, T., Pannu, A., El‐Dhuwaib, Y., Morrison, T. E. M., Taylor, G. W., Thompson, R. L. E., McCune, K., Loughlin, P., Lawther, R., Byrnes, C. K., Simpson, D. J., Mawhinney, A., Warren, C., McKay, D., McIlmunn, C., Martin, S., MacArtney, M., Diamond, T., Davey, P., Jones, C., Clements, J.M., Digney, R., Chan, W. M., McCain, S., Gull, S., Janeczko, A., Dorrian, E., Harris, A., Dawson, S., Johnston, D., McAree, B., Ghareeb, E., Thomas, G., Connelly, M., McKenzie, S., Cieplucha, K., Spence, G., Campbell, W., Hooks, G., Bradley, N., Hill, A. D. K., Cassidy, J. T., Boland, M., Burke, P., Nally, D. M., Hill, A. D. K., Khogali, E., Shabo, W., Iskandar, E., McEntee, G. P., OʼNeill, M. A., Peirce, C., Lyons, E. M., OʼSullivan, A. W., Thakkar, R., Carroll, P., Ivanovski, I., Balfe, P., Lee, M., Winter, D. C., Kelly, M. E., Hoti, E., Maguire, D., Karunakaran, P., Geoghegan, J. G., McDermott, F., Martin, S. T., Cross, K. S., Cooke, F., Zeeshan, S., Murphy, J. O., Mealy, K., Mohan, H. M., Nedujchelyn, Y., Ullah, M. F., Ahmed, I., Giovinazzo, F., Milburn, J., Prince, S., Brooke, E., Buchan, J., Khalil, A. M., Vaughan, E. M., Ramage, M. I., Aldridge, R. C., Gibson, S., Nicholson, G. A., Vass, D. G., Grant, A. J., Holroyd, D. J., Jones, M. A., Sutton, C. M. L. R., OʼDwyer, P., Nilsson, F., Weber, B., Williamson, T. K., Lalla, K., Bryant, A., Carter, C. R., Forrest, C. R., Hunter, D. I., Nassar, A. H., Orizu, M. N., Knight, K., Qandeel, H., Suttie, S., Belding, R., McClarey, A., Boyd, A. T., Guthrie, G. J. K., Lim, P. J., Luhmann, A., Watson, A. J. M., Richards, C. H., Nicol, L., Madurska, M., Harrison, E., Boyce, K. M., Roebuck, A., Ferguson, G., Pati, P., Wilson, M. S. J., Dalgaty, F., Fothergill, L., Driscoll, P. J., Mozolowski, K. L., Banwell, V., Bennett, S. P., Rogers, P. N., Skelly, B. L., Rutherford, C. L., Mirza, A. K., Lazim, T., Lim, H. C. C., Duke, D., Ahmed, T., Beasley, W. D., Wilkinson, M. D., Maharaj, G., Malcolm, C., Brown, T. H., Shingler, G. M., Mowbray, N., Radwan, R., Morcous, P., Wood, S., Kadhim, A., Stewart, D. J., Baker, A. L., Tanner, N., Shenoy, H., Hafiz, S., De Marchi, J. A., Singh‐Ranger, D., Hisham, E., Ainley, P., OʼNeill, S., Terrace, J., Napetti, S., Hopwood, B., Rhys, T., Downing, J., Kanavati, O., Coats, M., Aleksandrov, D., Kallaway, C., Yahya, S., Weber, B., Templeton, A., Trotter, M., Lo, C., Dhillon, A., Heywood, N., Aawsaj, Y., Hamdan, A., Reece‐Bolton, O., McGuigan, A., Shahin, Y., Ali, A., Luther, A., Nicholson, J. A., Rajendran, I., Boal, M., and Ritchie, J.

Published
2017
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6. Back Cover

Author

Rengifo, Carlos, Vega, Elena, Quilter, Jeffrey, Turner, Andrew D., Pachas, Ulla Holmquist, Lynch, Kathleen, O'Neil, Megan E., and Saunders, David

Published
2024

7. Plate List

Author

Rengifo, Carlos, Vega, Elena, Quilter, Jeffrey, Turner, Andrew D., Pachas, Ulla Holmquist, Lynch, Kathleen, O'Neil, Megan E., and Saunders, David

Published
2024

8. Index

Author

Rengifo, Carlos, Vega, Elena, Quilter, Jeffrey, Turner, Andrew D., Pachas, Ulla Holmquist, Lynch, Kathleen, O'Neil, Megan E., and Saunders, David

Published
2024

9. Illustration Credits

Author

Rengifo, Carlos, Vega, Elena, Quilter, Jeffrey, Turner, Andrew D., Pachas, Ulla Holmquist, Lynch, Kathleen, O'Neil, Megan E., and Saunders, David

Published
2024

10. Bibliography

Author

Rengifo, Carlos, Vega, Elena, Quilter, Jeffrey, Turner, Andrew D., Pachas, Ulla Holmquist, Lynch, Kathleen, O'Neil, Megan E., and Saunders, David

Published
2024

11. Postscript

Author

Rengifo, Carlos, Vega, Elena, Quilter, Jeffrey, Turner, Andrew D., Pachas, Ulla Holmquist, Lynch, Kathleen, O'Neil, Megan E., and Saunders, David

Published
2024

12. The Journey of the Maya Maize God

Author

Rengifo, Carlos, Vega, Elena, Quilter, Jeffrey, Turner, Andrew D., Pachas, Ulla Holmquist, Lynch, Kathleen, O'Neil, Megan E., and Saunders, David

Published
2024

13. The Adventures of Wrinkle Face

Author

Rengifo, Carlos, Vega, Elena, Quilter, Jeffrey, Turner, Andrew D., Pachas, Ulla Holmquist, Lynch, Kathleen, O'Neil, Megan E., and Saunders, David

Published
2024

14. Violent Legumes

Author

Rengifo, Carlos, Vega, Elena, Quilter, Jeffrey, Turner, Andrew D., Pachas, Ulla Holmquist, Lynch, Kathleen, O'Neil, Megan E., and Saunders, David

Published
2024

15. Satyrs

Author

Rengifo, Carlos, Vega, Elena, Quilter, Jeffrey, Turner, Andrew D., Pachas, Ulla Holmquist, Lynch, Kathleen, O'Neil, Megan E., and Saunders, David

Published
2024

17. Understanding the Imagery

Author

Rengifo, Carlos, Vega, Elena, Quilter, Jeffrey, Turner, Andrew D., Pachas, Ulla Holmquist, Lynch, Kathleen, O'Neil, Megan E., and Saunders, David

Published
2024

18. The Trojan War

Author

Rengifo, Carlos, Vega, Elena, Quilter, Jeffrey, Turner, Andrew D., Pachas, Ulla Holmquist, Lynch, Kathleen, O'Neil, Megan E., and Saunders, David

Published
2024

19. Maya Gift Giving

Author

Rengifo, Carlos, Vega, Elena, Quilter, Jeffrey, Turner, Andrew D., Pachas, Ulla Holmquist, Lynch, Kathleen, O'Neil, Megan E., and Saunders, David

Published
2024

20. Stories and Pictures

Author

Rengifo, Carlos, Vega, Elena, Quilter, Jeffrey, Turner, Andrew D., Pachas, Ulla Holmquist, Lynch, Kathleen, O'Neil, Megan E., and Saunders, David

Published
2024

21. Maya Vase Production and Use

Author

Rengifo, Carlos, Vega, Elena, Quilter, Jeffrey, Turner, Andrew D., Pachas, Ulla Holmquist, Lynch, Kathleen, O'Neil, Megan E., and Saunders, David

Published
2024

22. Uses and Users of Moche Painted Vessels

Author

Rengifo, Carlos, Vega, Elena, Quilter, Jeffrey, Turner, Andrew D., Pachas, Ulla Holmquist, Lynch, Kathleen, O'Neil, Megan E., and Saunders, David

Published
2024

24. Maya

Author

Rengifo, Carlos, Vega, Elena, Quilter, Jeffrey, Turner, Andrew D., Pachas, Ulla Holmquist, Lynch, Kathleen, O'Neil, Megan E., and Saunders, David

Published
2024

27. Athenian Figured Pottery at Home and Abroad

Author

Rengifo, Carlos, Vega, Elena, Quilter, Jeffrey, Turner, Andrew D., Pachas, Ulla Holmquist, Lynch, Kathleen, O'Neil, Megan E., and Saunders, David

Published
2024

28. The Moche, 200-850 Ce: An Overview

Author

Rengifo, Carlos, Vega, Elena, Quilter, Jeffrey, Turner, Andrew D., Pachas, Ulla Holmquist, Lynch, Kathleen, O'Neil, Megan E., and Saunders, David

Published
2024

29. Modern Histories of Ancient Vases

Author

Rengifo, Carlos, Vega, Elena, Quilter, Jeffrey, Turner, Andrew D., Pachas, Ulla Holmquist, Lynch, Kathleen, O'Neil, Megan E., and Saunders, David

Published
2024

30. Ancient Greece, 700-323 Bce: An Overview

Author

Rengifo, Carlos, Vega, Elena, Quilter, Jeffrey, Turner, Andrew D., Pachas, Ulla Holmquist, Lynch, Kathleen, O'Neil, Megan E., and Saunders, David

Published
2024

31. Greek

Author

Rengifo, Carlos, Vega, Elena, Quilter, Jeffrey, Turner, Andrew D., Pachas, Ulla Holmquist, Lynch, Kathleen, O'Neil, Megan E., and Saunders, David

Published
2024

32. Makers and Users

Author

Rengifo, Carlos, Vega, Elena, Quilter, Jeffrey, Turner, Andrew D., Pachas, Ulla Holmquist, Lynch, Kathleen, O'Neil, Megan E., and Saunders, David

Published
2024

33. Acknowledgments

Author

Rengifo, Carlos, Vega, Elena, Quilter, Jeffrey, Turner, Andrew D., Pachas, Ulla Holmquist, Lynch, Kathleen, O'Neil, Megan E., and Saunders, David

Published
2024

34. Director's Foreword

Author

Rengifo, Carlos, Vega, Elena, Quilter, Jeffrey, Turner, Andrew D., Pachas, Ulla Holmquist, Lynch, Kathleen, O'Neil, Megan E., and Saunders, David

Published
2024

35. Contributors

Author

Rengifo, Carlos, Vega, Elena, Quilter, Jeffrey, Turner, Andrew D., Pachas, Ulla Holmquist, Lynch, Kathleen, O'Neil, Megan E., and Saunders, David

Published
2024

36. Contents Page

Author

Rengifo, Carlos, Vega, Elena, Quilter, Jeffrey, Turner, Andrew D., Pachas, Ulla Holmquist, Lynch, Kathleen, O'Neil, Megan E., and Saunders, David

Published
2024

37. Title Page, Copyright Page

Author

Rengifo, Carlos, Vega, Elena, Quilter, Jeffrey, Turner, Andrew D., Pachas, Ulla Holmquist, Lynch, Kathleen, O'Neil, Megan E., and Saunders, David

Published
2024

38. Greek Painted Pottery: Production and Use

Author

Rengifo, Carlos, Vega, Elena, Quilter, Jeffrey, Turner, Andrew D., Pachas, Ulla Holmquist, Lynch, Kathleen, O'Neil, Megan E., and Saunders, David

Published
2024

39. Predicting the difficult laparoscopic cholecystectomy: development and validation of a pre-operative risk score using an objective operative difficulty grading system

Author

Nassar, A. H. M., Hodson, J., H. J., Ng, Vohra, R. S., Katbeh, T., Zino, S., Griffiths, E. A., Kirkham, A. J., Pasquali, S., Marriott, P., Johnstone, M., Spreadborough, P., Alderson, D., Fenwick, S., Elmasry, M., Nunes, Q. M., Kennedy, D., Khan, R. B., Khan, M. A. S., Magee, C. J., Jones, S. M., Mason, D., Parappally, C. P., Mathur, P., Saunders, M., Jamel, S., Haque, S. U., Zafar, S., Shiwani, M. H., Samuel, N., Dar, F., Jackson, A., Lovett, B., Dindyal, S., Winter, H., Fletcher, T., Rahman, S., Wheatley, K., Nieto, T., Ayaani, S., Youssef, H., Nijjar, R. S., Watkin, H., Naumann, D., Emesih, S., Sarmah, P. B., Lee, K., Joji, N., Lambert, J., Heath, J., Teasdale, R. L., Weerasinghe, C., Needham, P. J., Welbourn, H., Forster, L., Finch, D., Blazeby, J. M., Robb, W., Mcnair, A. G. K., Hrycaiczuk, A., Charalabopoulos, A., Kadirkamanathan, S., Tang, C. -B., Jayanthi, N. V. G., Noor, N., Dobbins, B., Cockbain, A. J., Nilsen-Nunn, A., de Siqueira, J., Pellen, M., Cowley, J. B., W. -M., Ho, Miu, V., White, T. J., Hodgkins, K. A., Kinghorn, A., Tutton, M. G., Al-Abed, Y. A., Menzies, D., Ahmad, A., Reed, J., Khan, S., Monk, D., Vitone, L. J., Murtaza, G., Joel, A., Brennan, S., Shier, D., Zhang, C., Yoganathan, T., Robinson, S. J., Mccallum, I. J. D., Jones, M. J., Elsayed, M., Tuck, L., Wayman, J., Carney, K., Aroori, S., Hosie, K. B., Kimble, A., Bunting, D. M., Fawole, A. S., Basheer, M., Dave, R. V., Sarveswaran, J., Jones, E., Kendal, C., Tilston, M. P., Gough, M., Wallace, T., Singh, S., Mockford, J. D. K. A., Issa, E., Shah, N., Chauhan, N., Wilson, T. R., Forouzanfar, A., Wild, J. R. L., Nofal, E., Bunnell, C., Madbak, K., Rao, S. T. V., Devoto, L., Siddiqi, N., Khawaja, Z., Hewes, J. C., Gould, L., Chambers, A., Rodriguez, D. U., Sen, G., Robinson, S., Bartlett, F., Rae, D. M., Stevenson, T. E. J., Sarvananthan, K., Dwerryhouse, S. J., Higgs, S. M., Old, O. J., Hardy, T. J., Shah, R., Hornby, S. T., Keogh, K., Frank, L., Al-Akash, M., Upchurch, E. A., Frame, R. J., Hughes, M., Jelley, C., Weaver, S., Roy, S., Sillo, T. O., Galanopoulos, G., Cuming, T., Cunha, P., Tayeh, S., Kaptanis, S., Heshaishi, M., Eisawi, A., Abayomi, M., Ngu, W. S., Fleming, K., Bajwa, D. S., Chitre, V., Aryal, K., Ferris, P., Silva, M., Lammy, S., Mohamed, S., Khawaja, A., Hussain, A., Ghazanfar, M. A., Bellini, M. I., Ebdewi, H., Elshaer, M., Gravante, G., Drake, B., Ogedegbe, A., Mukherjee, D., Arhi, C., Giwa, L., Iqbal, N., Watson, N. F., Aggarwal, S. K., Orchard, P., Villatoro, E., Willson, P. D., Mok, K. W. J., Woodman, T., Deguara, J., Garcea, G., Babu, B. I., Dennison, A. R., Malde, D., Lloyd, D., Satheesan, S., Al-Taan, O., Boddy, A., Slavin, J. P., Jones, R. P., Ballance, L., Gerakopoulos, S., Jambulingam, P., Mansour, S., Sakai, N., Acharya, V., Sadat, M. M., Karim, L., Larkin, D., Amin, K., Khan, A., Law, J., Jamdar, S., Smith, S. R., Sampat, K., O'Shea, K. M., Manu, M., Asprou, F. M., Malik, N. S., Chang, J., Lewis, M., Roberts, G. P., Karavadra, B., Photi, E., Hewes, J., Rodriguez, D., O'Reilly, D. A., Rate, A. J., Sekhar, H., Henderson, L. T., Starmer, B. Z., Coe, P. O., Tolofari, S., Barrie, J., Bashir, G., Sloane, J., Madanipour, S., Halkias, C., Trevatt, A. E. J., Borowski, D. W., Hornsby, J., Courtney, M. J., Virupaksha, S., Seymour, K., Hawkins, H., Bawa, S., Gallagher, P. V., Reid, A., Wood, P., Finch, J. G., Guy Finch, J., Parmar, J., Stirland, E., Gardner-Thorpe, J., Al-Muhktar, A., Peterson, M., Majeed, A., Bajwa, F. M., Martin, J., Choy, A., Tsang, A., Pore, N., Andrew, D. R., Al-Khyatt, W., Taylor, C., Bhandari, S., Subramanium, D., Toh, S. K. C., Carter, N. C., Tate, S., Pearce, B., Wainwright, D., Mercer, S. J., Knight, B., Vijay, V., Alagaratnam, S., Sinha, S., El-Hasani, S. S., Hussain, A. A., Bhattacharya, V., Kansal, N., Fasih, T., Jackson, C., Siddiqui, M. N., Chishti, I. A., Fordham, I. J., Siddiqui, Z., Bausbacher, H., Geogloma, I., Gurung, K., Tsavellas, G., Basynat, P., Shrestha, A. K., Basu, S., Chhabra, A., Harilingam, M., Rabie, M., Akhtar, M., Kumar, P., Jafferbhoy, S. F., Hussain, N., Raza, S., Haque, M., Alam, I., Aseem, R., Patel, S., Asad, M., Booth, M. I., Ball, W. R., Wood, C. P. J., Pinho-Gomes, A. C., Kausar, A., Obeidallah, M. R., Varghase, J., Lodhia, J., Bradley, D., Rengifo, C., Lindsay, D., Gopalswamy, S., Finlay, I., Wardle, S., Bullen, N., Iftikhar, S. Y., Awan, A., Ahmed, J., Leeder, P., Fusai, G., Bond-Smith, G., Psica, A., Puri, Y., Hou, D., Noble, F., Szentpali, K., Broadhurst, J., Date, R., Hossack, M. R., Goh, Y. L., Turner, P., Shetty, V., Riera, M., Macano, C. A. W., Sukha, A., Preston, S. R., Hoban, J. R., Puntis, D. J., Williams, S. V., Krysztopik, R., Kynaston, J., Batt, J., Doe, M., Goscimski, A., Jones, G. H., Hall, C., Carty, N., Panteleimonitis, S., Gunasekera, R. T., Sheel, A. R. G., Lennon, H., Hindley, C., Reddy, M., Kenny, R., Elkheir, N., Mcglone, E. R., Rajaganeshan, R., Hancorn, K., Hargreaves, A., Prasad, R., Longbotham, D. A., Vijayanand, D., Wijetunga, I., Ziprin, P., Nicolay, C. R., Yeldham, G., Read, E., Gossage, J. A., Rolph, R. C., Ebied, H., Phull, M., Khan, M. A., Popplewell, M., Kyriakidis, D., Henley, N., Packer, J. R., Derbyshire, L., Porter, J., Appleton, S., Farouk, M., Basra, M., Jennings, N. A., Ali, S., Kanakala, V., Ali, H., Lane, R., Dickson-Lowe, R., Zarsadias, P., Mirza, D., Puig, S., Al Amari, K., Vijayan, D., Sutcliffe, R., Marudanayagam, R., Hamady, Z., Prasad, A. R., Patel, A., Durkin, D., Kaur, P., Bowen, L., Byrne, J. P., Pearson, K. L., Delisle, T. G., Davies, J., Tomlinson, M. A., Johnpulle, M. A., Slawinski, C., Macdonald, A., Nicholson, J., Newton, K., Mbuvi, J., Farooq, A., Mothe, B. S., Zafrani, Z., Brett, D., Francombe, J., Barnes, J., Cheung, M., Al-Bahrani, A. Z., Preziosi, G., Urbonas, T., Alberts, J., Mallik, M., Patel, K., Segaran, A., Doulias, T., Sufi, P. A., Yao, C., Pollock, S., Manzelli, A., Wajed, S., Kourkulos, M., Pezzuto, R., Wadley, M., Hamilton, E., Jaunoo, S., Padwick, R., Sayegh, M., Newton, R. C., Hebbar, M., Farag, S. F., Spearman, J., Hamdan, M. F., D'Costa, C., Blane, C., Giles, M., Peter, M. B., Hirst, N. A., Hossain, T., Pannu, A., El-Dhuwaib, Y., Morrison, T. E. M., Taylor, G. W., Thompson, R. L. E., Mccune, K., Loughlin, P., Lawther, R., Byrnes, C. K., Simpson, D. J., Mawhinney, A., Warren, C., Mckay, D., Mcilmunn, C., Martin, S., Macartney, M., Diamond, T., Davey, P., Jones, C., Clements, J. M., Digney, R., Chan, W. M., Mccain, S., Gull, S., Janeczko, A., Dorrian, E., Harris, A., Dawson, S., Johnston, D., Mcaree, B., Ghareeb, E., Thomas, G., Connelly, M., Mckenzie, S., Cieplucha, K., Spence, G., Campbell, W., Hooks, G., Bradley, N., Hill, A. D. K., Cassidy, J. T., Boland, M., Burke, P., Nally, D. M., Khogali, E., Shabo, W., Iskandar, E., Mcentee, G. P., O'Neill, M. A., Peirce, C., Lyons, E. M., O'Sullivan, A. W., Thakkar, R., Carroll, P., Ivanovski, I., Balfe, P., Lee, M., Winter, D. C., Kelly, M. E., Hoti, E., Maguire, D., Karunakaran, P., Geoghegan, J. G., Mcdermott, F., Martin, S. T., Cross, K. S., Cooke, F., Zeeshan, S., Murphy, J. O., Mealy, K., Mohan, H. M., Nedujchelyn, Y., Ullah, M. F., Ahmed, I., Giovinazzo, F., Milburn, J., Prince, S., Brooke, E., Buchan, J., Khalil, A. M., Vaughan, E. M., Ramage, M. I., Aldridge, R. C., Gibson, S., Nicholson, G. A., Vass, D. G., Grant, A. J., Holroyd, D. J., Jones, M. A., Sutton, C. M. L. R., O'Dwyer, P., Nilsson, F., Weber, B., Williamson, T. K., Lalla, K., Bryant, A., Carter, C. R., Forrest, C. R., Hunter, D. I., Nassar, A. H., Orizu, M. N., Knight, K., Qandeel, H., Suttie, S., Belding, R., Mcclarey, A., Boyd, A. T., Guthrie, G. J. K., Lim, P. J., Luhmann, A., Watson, A. J. M., Richards, C. H., Nicol, L., Madurska, M., Harrison, E., Boyce, K. M., Roebuck, A., Ferguson, G., Pati, P., Wilson, M. S. J., Dalgaty, F., Fothergill, L., Driscoll, P. J., Mozolowski, K. L., Banwell, V., Bennett, S. P., Rogers, P. N., Skelly, B. L., Rutherford, C. L., Mirza, A. K., Lazim, T., Lim, H. C. C., Duke, D., Ahmed, T., Beasley, W. D., Wilkinson, M. D., Maharaj, G., Malcolm, C., Brown, T. H., Al-Sarireh, B., Shingler, G. M., Mowbray, N., Radwan, R., Morcous, P., Wood, S., Kadhim, A., Stewart, D. J., Baker, A. L., Tanner, N., Shenoy, H., Hafiz, S., De Marchi, J. A., Singh-Ranger, D., Hisham, E., Ainley, P., O'Neill, S., Terrace, J., Napetti, S., Hopwood, B., Rhys, T., Downing, J., Kanavati, O., Coats, M., Aleksandrov, D., Kallaway, C., Yahya, S., Templeton, A., Trotter, M., Lo, C., Dhillon, A., Heywood, N., Aawsaj, Y., Hamdan, A., Reece-Bolton, O., Mcguigan, A., Shahin, Y., Aymon, Luther, A. A., Nicholson, J. A., Rajendran, I., Boal, M., and Ritchie, J.

Subjects
Adult, Male, operative difficulty, medicine.medical_specialty, medicine.medical_treatment, Difficulty grading, difficult cholecystectomy, predictive score, surgery, laparoscopic, cholecystectomy, Surgical planning, Cohort Studies, 03 medical and health sciences, 0302 clinical medicine, Risk Factors, Preoperative Care, Humans, Medicine, Laparoscopic cholecystectomy, Framingham Risk Score, business.industry, General surgery, Reproducibility of Results, Middle Aged, medicine.disease, Pre operative, Single surgeon, Cholecystectomy, Laparoscopic, ROC Curve, 030220 oncology & carcinogenesis, Multivariate Analysis, Cholecystitis, Female, 030211 gastroenterology & hepatology, Surgery, Cholecystectomy, business, Abdominal surgery
Abstract

The prediction of a difficult cholecystectomy has traditionally been based on certain pre-operative clinical and imaging factors. Most of the previous literature reported small patient cohorts and have not used an objective measure of operative difficulty. The aim of this study was to develop a pre-operative score to predict difficult cholecystectomy, as defined by a validated intra-operative difficulty grading scale. Two cohorts from prospectively maintained databases of patients who underwent laparoscopic cholecystectomy were analysed: the CholeS Study (8755 patients) and a single surgeon series (4089 patients). Factors potentially predictive of difficulty were correlated to the Nassar intra-operative difficulty scale. A multivariable binary logistic regression analysis was then used to identify factors that were independently associated with difficult laparoscopic cholecystectomy, defined as operative difficulty grades 3 to 5. The resulting model was then converted to a risk score, and validated on both internal and external datasets. Increasing age and ASA classification, male gender, diagnosis of CBD stone or cholecystitis, thick-walled gallbladders, CBD dilation, use of pre-operative ERCP and non-elective operations were found to be significant independent predictors of difficult cases. A risk score based on these factors returned an area under the ROC curve of 0.789 (95% CI 0.773–0.806, p

Published
2019
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42. Outcomes of obstructed abdominal wall hernia: results from the UK national small bowel obstruction audit

Author

Lee, MJ, Drake, TM, Sayers, AE, Walsh, CJ, Davies, MM, Fearnhead, NS, Abercrombie, J, Acheson, A, Alderson, D, Anderson, I, Bach, S, Davies, M, Hamady, Z, Hind, D, Hollyman, M, Hare, S, Lee, E, Northover, J, Lewis, C, Marriott, P, Maynard, N, Murray, D, Tierney, G, Verjee, A, Wild, J, Abbott, S, Abdulaal, Y, Afshar, S, Ah‐Chuen, J, Ahmed, T, Akhtar, M, Akram, F, Aldred, E, Ali, A, Aly, M, Amajuoyi, A, Amin, V, Anderson, D, Anderson, O, Andreou, A, Ansari, A, Appleton, S, Ardley, R, Arshad, F, Ashour, O, Asour, A, Athem, A, Athersmith, M, Ayoub, F, Azeem, H, Azhar, B, Badenoch, T, Baillie, C, Bandyopadhyay, D, Barker, J, Barker, S, Barkham, B, Baron, R, Barrie, J, Barry‐Yarrow, E, Bashir, G, Battersby, N, Bazoua, G, Behar, N, Bellam, S, Berger, C, Bhandari, S, Bhasin, S, Biggs, S, Bisset, C, Blake, L, Blencowe, N, Boam, T, Boddy, A, Boereboom, C, Bogdan, M, Bogle, R, Bohra, P, Boland, M, Bolkan, H, Borg, C, Boulton, R, Bouras, G, Boyer, M, Boyle, J, Branagan, G, Brewer, H, Briggs, C, Broadhurst, J, Brown, E, Brown, J, Brown, L, Brown, O, Burns, K, Butcher, K, Butler, M, Byrne, B, Campbell, L, Capper, C, Cartmell, M, Cash, T, Chan, S, Chandratreya, N, Chapman, J, Chapman, S, Charalabopoulos, A, Cheek, C, Chok, S, Choong, W, Chow, M, Chowdhury, J, Coe, P, Conaghan, P, Conn, G, Cook, N, Cook, T, Cooper, S, Cornish, J, Cotton, D, Cox, C, Coyne, P, Crook, R, Crozier, J, Cuffolo, G, Cunha, P, Curtis, N, Cutting, J, Da Costa, K, Silva, L, Das, B, Davenport, M, Davies, J, Davies, T, Day, A, Dayal, S, Dean, S, Demetriou, G, Dengu, F, Dennis, R, Dent, H, Dent, P, Deputy, M, Devoto, L, Di Benedetto, G, Dindyal, S, Donnelly, E, Doody, P, Douka, E, Downham, C, Dowson, H, Edent, H, Edgerton, K, Ekpete, N, El Farran, M, Elamin, O, Eljaafari, M, Elsaid, N, El‐Sharif, M, Evans, J, Evans, M, Ewe, R, Ewing, A, Exarchou, K, Fallaize, R, Faoury, M, Farag, S, Farinella, E, Faulkner, G, Ferguson, H, Fisher, O, Fletcher, J, Forouzanfar, A, Foster, A, Fox, R, Francis, N, Fretwell, V, Fung, D, Gammeri, E, Garnham, J, Geraghty, A, Gilbert, A, Gill, C, Gill, M, Gillespie, M, Giordano, P, Glasbey, J, Goh, M, Golder, A, Green, N, Gregoir, T, Grey, T, Groundwater, E, Grove, T, Growcott, S, Gunasekaran, S, Habib, H, Haddow, J, Halahakoon, V, Halkias, C, Hall, C, Hampson, A, Hancock, L, Hanna, T, Hannay, J, Harikrishnan, A, Harries, R, Harris, G, Hartley, J, Harvey, K, Hawkin, P, Hawkins, J, Healy, R, Heard, R, Heartshorne, R, Heller, S, Hendra, L, Herrod, P, Heywood, N, Hicks, G, Hobson, B, Holtham, S, Hope, C, Hopley, P, Hossain, T, Hossaini, S, Howse, F, Hubbard, T, Humphreys, A, Ikram, H, Ioannis, M, Iqbal, M, Iqbal, N, Jain, R, Jatania, J, Jenkinson, P, Jokhan, S, Jones, A, Jones, C, Jones, L, Joshi, H, Joshi, K, Joy, M, Jull, P, Kakaniaris, G, Kallam, R, Kane, E, Kang, P, Kanitkar, R, Kauser, S, Kazmi, F, Kedrzycki, M, Kelly, S, Kendall, J, Khan, M, Khan, T, King, G, Kisiel, A, Kitsis, C, Kolawole, I, Korambayil, S, Kosasih, S, Kosti, A, Kotb, A, Kouris, S, Kshatriya, K, Kumar, S, Lafaurie, G, Lal, R, Lau, A, Lazim, T, Lazzaro, A, Lee, K, Lefroy, R, Leinhardt, D, Lennon, H, Leong, K, Levy, B, Lim, E, Lim, J, Lindley, S, Liu, D, Lloyd, P, Locker, D, Lockwood, S, Lowe, C, Lund, J, Lunevicius, R, Lunt, A, Lutfi, S, Luther, A, Luwemba, S, Mahankali‐Rao, P, Mahroof, S, Mai, D, Majid, S, Malik, A, Malik, K, Mann, K, Mansour, S, Manu, N, Mapara, R, Martin, C, Martin, J, Martin, R, Mason, C, Massey, L, Mathias, J, Mathur, P, Maude, K, McArthur, D, McCain, S, McCluney, S, McFall, M, McIlroy, B, McKay, S, McKinley, N, McNair, A, McWhirter, D, Mekhail, P, Mellor, K, Merchant, J, Merker, L, Messenger, D, Miles, A, Mir, S, Mishra, A, Mistry, P, Miu, V, Moat, M, Mockford, K, Mohamed, E, Mohamed, I, Mondragon‐Pritchard, M, Moore, N, Moretti, L, Morris, H, Morrison, T, Morrison‐Jones, V, Moss, J, Moug, S, Mountford, D, Moynihan, R, Muhammad, K, Muldoon‐Smith, D, Mulholland, J, Mullan, M, Murgitroyd, E, Murugaiyan, K, Myers, A, Mykoniatis, I, Nana, G, Nash, T, Nassar, A, Newton, R, Ng, C, Ng, P, Nguyen, K, Nicholas, F, Noor, M, Nowers, J, Nugent, C, Nunn, A, Nunn, R, Obeid, N, O'Callaghan, J, O'Hara, R, Oke, O, Olivier, J, O'Neill, A, O'Neill, S, Osei‐Bordom, D, Osgood, L, Panagiotopoulos, S, Panchasara, B, Parks, R, Patel, H, Patel, P, Patel, R, Patel, S, Pawelec, K, Payne, C, Pearson, K, Perin, G, Peristerakis, I, Petronio, B, Phelan, L, Phillips, J, Pisaneschi, C, Pitt, J, Plunkett‐Reed, K, Ponchietti, L, Pouzi, A, Pouzi, M, Powell, A, Powell‐Chandler, A, Pranesh, N, Proctor, V, Pywell, S, Qureshi, A, Qureshi, N, Rahman, M, Rai, Z, Ramcharan, S, Rangarajan, K, Rashid, M, Reader, H, Rehman, A, Rehman, S, Rengifo, C, Richards, E, Richardson, N, Robinson, A, Robinson, D, Rossi, B, Rutherford, F, Sadien, I, Saghir, T, Sahnan, K, Salahia, G, Sarveswaran, J, Saunders, M, Scott, B, Scott, K, Seager, A, Seal, S, Sezen, E, Shaban, F, Shah, P, Shahmohammadi, M, Shamsiddinova, A, Shankar, S, Sharpe, A, Shatkar, V, Sheel, A, Shields, T, Shinkwin, M, Shurmer, J, Siddika, A, Siddiqui, S, Simson, R, Sinclair, P, Singh, B, Singh, S, Sivaraj, J, Skaife, P, Skelly, B, Skinner, A, Slim, N, Smart, C, Smart, N, Smith, F, Smith, I, Smith, R, Spence, G, Sreedhar, A, Steinke, J, Stevenson, L, Stewart‐Parker, E, Stott, M, Stubbs, B, Stylianides, N, Subramonia, S, Swinkin, M, Swinscoe, M, Symons, N, Tahir, W, Taj, T, Takacs, K, Tam, J, Tan, K, Tani, S, Tanner, N, Tao, D, Taylor, M, Thava, B, Thippeswamy, K, Thomas, C, Thompson, E, Thompson, R, Thompson‐Reil, C, Thorn, C, Tongo, F, Toth, G, Turnbull, A, Turnbull, J, Valero, C, Boxel, G, Varcada, M, Venn, M, Ventham, N, Venza, M, Vimalachandran, D, Virlos, I, Wade, T, Wafi, A, Waite, K, Walker, M, Walker, N, Walker, T, Walsh, U, Wardle, S, Warner, R, Watfah, J, Watson, N, Watt, J, Watts, J, Wayman, J, Weegenaar, C, West, H, West, M, Whitehurst, L, Whyler, M, Wiggans, M, Wijeyekoon, S, Williams, G, Williams, R, Williamson, A, Williamson, J, Wilson, J, Winter, A, Wolpert, L, Wong, J, Yeap, E, Yeong, T, Zaman, S, Zappa, B, and Zosimas, D

Subjects
Adult, Male, medicine.medical_specialty, National Audit of Small Bowel Obstruction Steering Group and National Audit of Small Bowel Obstruction Collaborators, Incisional hernia, lcsh:Surgery, 030230 surgery, Abdominal wall, 03 medical and health sciences, 0302 clinical medicine, Postoperative Complications, NASBO Collaborators, medicine, Humans, Hernia, Hospital Mortality, General, Emergency Treatment, Aged, Proportional Hazards Models, Aged, 80 and over, Groin, business.industry, Mortality rate, Hazard ratio, West Midlands Research Collaborative, General Medicine, Odds ratio, Original Articles, lcsh:RD1-811, Middle Aged, medicine.disease, Quality Improvement, United Kingdom, Surgery, Hernia, Abdominal, Bowel obstruction, medicine.anatomical_structure, Logistic Models, 030220 oncology & carcinogenesis, Original Article, Female, business, NASBO Steering Group, Intestinal Obstruction
Abstract

Background Abdominal wall hernia is a common surgical condition. Patients may present in an emergency with bowel obstruction, incarceration or strangulation. Small bowel obstruction (SBO) is a serious surgical condition associated with significant morbidity. The aim of this study was to describe current management and outcomes of patients with obstructed hernia in the UK as identified in the National Audit of Small Bowel Obstruction (NASBO). Methods NASBO collated data on adults treated for SBO at 131 UK hospitals between January and March 2017. Those with obstruction due to abdominal wall hernia were included in this study. Demographics, co‐morbidity, imaging, operative treatment, and in‐hospital outcomes were recorded. Modelling for factors associated with mortality and complications was undertaken using Cox proportional hazards and multivariable regression modelling. Results NASBO included 2341 patients, of whom 415 (17·7 per cent) had SBO due to hernia. Surgery was performed in 312 (75·2 per cent) of the 415 patients; small bowel resection was required in 198 (63·5 per cent) of these operations. Non‐operative management was reported in 35 (54 per cent) of 65 patients with a parastomal hernia and in 34 (32·1 per cent) of 106 patients with an incisional hernia. The in‐hospital mortality rate was 9·4 per cent (39 of 415), and was highest in patients with a groin hernia (11·1 per cent, 17 of 153). Complications were common, including lower respiratory tract infection in 16·3 per cent of patients with a groin hernia. Increased age was associated with an increased risk of death (hazard ratio 1·05, 95 per cent c.i. 1·01 to 1·10; P = 0·009) and complications (odds ratio 1·05, 95 per cent c.i. 1·02 to 1·09; P = 0·001). Conclusion NASBO has highlighted poor outcomes for patients with SBO due to hernia, highlighting the need for quality improvement initiatives in this group., This study shows that small bowel obstruction due to abdominal wall hernia is common, typically involves a co‐morbid group of patients and has poor outcomes, including high mortality rates. High mortality from this problem

Published
2020

44. National prospective cohort study of the burden of acute small bowel obstruction

Author

Lee, M. J., Sayers, A. E., Drake, T. M., Marriott, P. J., Anderson, I. D., Bach, S. P., Bradburn, M., Hind, D., Verjee, A., Fearnhead, N. S., Abercrombie, John, Acheson, Austin, Alderson, Derek, Anderson, Iain, Davies, Michael, Hamady, Zaed, Hollyman, Marianne, Hare, Sarah, Lee, Ellen, Northover, John, Lewis, Christopher, McFall, Malcolm, Murugananthan, Aravinth, Murray, David, Singh, Pritam, Tierney, Gillian, Walsh, Ciaran, Wild, Jonathan, Wilson, Timothy, Abbott, S, Abdulaal, Y, Afshar, S, Ah‐Chuen, J, Ahmed, T, Akhtar, M, Akram, F, Aldred, E, Ali, A, Aly, M, Amajuoyi, A, Amin, V, Anderson, D, Anderson, O, Andreou, A, Ansari, A, Appleton, S, Ardley, R, Arshad, F, Ashour, O, Asour, A, Athem, A, Athersmith, M, Ayoub, F, Azeem, H, Azhar, B, Badenoch, T, Baillie, C, Bandyopadhyay, D, Barker, J, Barker, S, Barkham, B, Baron, R, Barrie, J, Barry‐Yarrow, E, Bashir, G, Battersby, N, Bazoua, G, Behar, N, Bellam, S, Berger, C, Bhandari, S, Bhasin, S, Biggs, S, Bisset, C, Blake, L, Blencowe, N, Boam, T, Boddy, A, Boereboom, C, Bogdan, M, Bogle, R, Bohra, P, Boland, M, Bolkan, H, Borg, C, Boulton, R, Bouras, G, Boyer, M, Boyle, J, Branagan, G, Brewer, H, Briggs, C, Broadhurst, J, Brown, E, Brown, J, Brown, L, Brown, O, Burns, K, Butcher, K, Butler, M, Byrne, B, Campbell, L, Capper, C, Cartmell, M, Cash, T, Chan, S, Chandratreya, N, Chapman, J, Chapman, S, Charalabopoulos, A, Cheek, C, Chok, S, Choong, W, Chow, M, Chowdhury, J, Coe, P, Conaghan, P, Conn, G, Cook, N, Cook, T, Cooper, S, Cornish, J, Cotton, D, Cox, C, Coyne, P, Crook, R, Crozier, J, Cuffolo, G, Cunha, P, Curtis, N, Cutting, J, Da Costa, K, Silva, L, Das, B, Davenport, M, Davies, J, Davies, T, Day, A, Dayal, S, Dean, S, Demetriou, G, Dengu, F, Dennis, R, Dent, H, Dent, P, Deputy, M, Devoto, L, Di Benedetto, G, Dindyal, S, Donnelly, E, Doody, P, Douka, E, Downham, C, Dowson, H, Edent, H, Edgerton, K, Ekpete, N, El Farran, M, Elamin, O, Eljaafari, M, Elsaid, N, El‐Sharif, M, Evans, J, Evans, M, Ewe, R, Ewing, A, Exarchou, K, Fallaize, R, Faoury, M, Farag, S, Farinella, E, Faulkner, G, Ferguson, H, Fisher, O, Fletcher, J, Forouzanfar, A, Foster, A, Fox, R, Francis, N, Fretwell, V, Fung, D, Gammeri, E, Garnham, J, Geraghty, A, Gilbert, A, Gill, C, Gill, M, Gillespie, M, Giordano, P, Glasbey, J, Goh, M, Golder, A, Green, N, Gregoir, T, Grey, T, Groundwater, E, Grove, T, Growcott, S, Gunasekaran, S, Habib, H, Haddow, J, Halahakoon, V, Halkias, C, Hall, C, Hampson, A, Hancock, L, Hanna, T, Hannay, J, Harikrishnan, A, Harries, R, Harris, G, Hartley, J, Harvey, K, Hawkin, P, Hawkins, J, Healy, R, Heard, R, Heartshorne, R, Heller, S, Hendra, L, Herrod, P, Heywood, N, Hicks, G, Hobson, B, Holtham, S, Hope, C, Hopley, P, Hossain, T, Hossaini, S, Howse, F, Hubbard, T, Humphreys, A, Ikram, H, Ioannis, M, Iqbal, M, Iqbal, N, Jain, R, Jatania, J, Jenkinson, P, Jokhan, S, Jones, A, Jones, C, Jones, L, Joshi, H, Joshi, K, Joy, M, Jull, P, Kakaniaris, G, Kallam, R, Kane, E, Kang, P, Kanitkar, R, Kauser, S, Kazmi, F, Kedrzycki, M, Kelly, S, Kendall, J, Khan, M, Khan, T, King, G, Kisiel, A, Kitsis, C, Kolawole, I, Korambayil, S, Kosasih, S, Kosti, A, Kotb, A, Kouris, S, Kshatriya, K, Kumar, S, Lafaurie, G, Lal, R, Lau, A, Lazim, T, Lazzaro, A, Lee, K, Lefroy, R, Leinhardt, D, Lennon, H, Leong, K, Levy, B, Lim, E, Lim, J, Lindley, S, Liu, D, Lloyd, P, Locker, D, Lockwood, S, Lowe, C, Lund, J, Lunevicius, R, Lunt, A, Lutfi, S, Luther, A, Luwemba, S, Mahankali‐Rao, P, Mahroof, S, Mai, D, Majid, S, Malik, A, Malik, K, Mann, K, Mansour, S, Manu, N, Mapara, R, Martin, C, Martin, J, Martin, R, Mason, C, Massey, L, Mathias, J, Mathur, P, Maude, K, McArthur, D, McCain, S, McCluney, S, McIlroy, B, McKay, S, McKinley, N, McNair, A, McWhirter, D, Mekhail, P, Mellor, K, Merchant, J, Merker, L, Messenger, D, Miles, A, Mir, S, Mishra, A, Mistry, P, Miu, V, Moat, M, Mockford, K, Mohamed, E, Mohamed, I, Mondragon‐Pritchard, M, Moore, N, Moretti, L, Morris, H, Morrison, T, Morrison‐Jones, V, Moss, J, Moug, S, Mountford, D, Moynihan, R, Muhammad, K, Muldoon‐Smith, D, Mulholland, J, Mullan, M, Murgitroyd, E, Murugaiyan, K, Myers, A, Mykoniatis, I, Nana, G, Nash, T, Nassar, A, Newton, R, Ng, C, Ng, P, Nguyen, K, Nicholas, F, Noor, M, Nowers, J, Nugent, C, Nunn, A, Nunn, R, Obeid, N, O'Callaghan, J, O'Hara, R, Oke, O, Olivier, J, O'Neill, A, O'Neill, S, Osei‐Bordom, D, Osgood, L, Panagiotopoulos, S, Panchasara, B, Parks, R, Patel, H, Patel, P, Patel, R, Patel, S, Pawelec, K, Payne, C, Pearson, K, Perin, G, Peristerakis, I, Petronio, B, Phelan, L, Phillips, J, Pisaneschi, C, Pitt, J, Plunkett‐Reed, K, Ponchietti, L, Pouzi, A, Pouzi, M, Powell, A, Powell‐Chandler, A, Pranesh, N, Proctor, V, Pywell, S, Qureshi, A, Qureshi, N, Rahman, M, Rai, Z, Ramcharan, S, Rangarajan, K, Rashid, M, Reader, H, Rehman, A, Rehman, S, Rengifo, C, Richards, E, Richardson, N, Robinson, A, Robinson, D, Rossi, B, Rutherford, F, Sadien, I, Saghir, T, Sahnan, K, Salahia, G, Sarveswaran, J, Saunders, M, Scott, B, Scott, K, Seager, A, Seal, S, Sezen, E, Shaban, F, Shah, P, Shahmohammadi, M, Shamsiddinova, A, Shankar, S, Sharpe, A, Shatkar, V, Sheel, A, Shields, T, Shinkwin, M, Shurmer, J, Siddika, A, Siddiqui, S, Simson, R, Sinclair, P, Singh, B, Singh, S, Sivaraj, J, Skaife, P, Skelly, B, Skinner, A, Slim, N, Smart, C, Smart, N, Smith, F, Smith, I, Smith, R, Spence, G, Sreedhar, A, Steinke, J, Stevenson, L, Stewart‐Parker, E, Stott, M, Stubbs, B, Stylianides, N, Subramonia, S, Swinkin, M, Swinscoe, M, Symons, N, Tahir, W, Taj, T, Takacs, K, Tam, J, Tan, K, Tani, S, Tanner, N, Tao, D, Taylor, M, Thava, B, Thippeswamy, K, Thomas, C, Thompson, E, Thompson, R, Thompson‐Reil, C, Thorn, C, Tongo, F, Toth, G, Turnbull, A, Turnbull, J, Valero, C, Boxel, G, Varcada, M, Venn, M, Ventham, N, Venza, M, Vimalachandran, D, Virlos, I, Wade, T, Wafi, A, Waite, K, Walker, M, Walker, N, Walker, T, Walsh, U, Wardle, S, Warner, R, Watfah, J, Watson, N, Watt, J, Watts, J, Wayman, J, Weegenaar, C, West, H, West, M, Whitehurst, L, Whyler, M, Wiggans, M, Wijeyekoon, S, Williams, G, Williams, R, Williamson, A, Williamson, J, Wilson, J, Winter, A, Wolpert, L, Wong, J, Yeap, E, Yeong, T, Zaman, S, Zappa, B, Zosimas, D, Moug S Mondragon‐Pritchard, M, Rehan, S, and van Boxel, G

Abstract

Background: \ud Small bowel obstruction is a common surgical emergency, and is associated with high levels of morbidity and mortality across the world. The literature provides little information on the conservatively managed group. The aim of this study was to describe the burden of small bowel obstruction in the UK.\ud \ud Methods: \ud This prospective cohort study was conducted in 131 acute hospitals in the UK between January and April 2017, delivered by trainee research collaboratives. Adult patients with a diagnosis of mechanical small bowel obstruction were included. The primary outcome was in‐hospital mortality. Secondary outcomes included complications, unplanned intensive care admission and readmission within 30 days of discharge. Practice measures, including use of radiological investigations, water soluble contrast, operative and nutritional interventions, were collected.\ud \ud Results: \ud Of 2341 patients identified, 693 (29·6 per cent) underwent immediate surgery (within 24 h of admission), 500 (21·4 per cent) had delayed surgery after initial conservative management, and 1148 (49·0 per cent) were managed non‐operatively. The mortality rate was 6·6 per cent (6·4 per cent for non‐operative management, 6·8 per cent for immediate surgery, 6·8 per cent for delayed surgery; P = 0·911). The major complication rate was 14·4 per cent overall, affecting 19·0 per cent in the immediate surgery, 23·6 per cent in the delayed surgery and 7·7 per cent in the non‐operative management groups (P < 0·001). Cox regression found hernia or malignant aetiology and malnutrition to be associated with higher rates of death. Malignant aetiology, operative intervention, acute kidney injury and malnutrition were associated with increased risk of major complication.\ud \ud Conclusion: \ud Small bowel obstruction represents a significant healthcare burden. Patient‐level factors such as timing of surgery, acute kidney injury and nutritional status are factors that might be modified to improve outcomes.

Published
2019

45. Correction to: Utilisation of an operative difficulty grading scale for laparoscopic cholecystectomy

Author

Griffiths, E. A., Hodson, J., Vohra, R. S., Marriott, P., Katbeh, T., Zino, S., Nassar, A. H. M., Kirkham, A. J., Pasquali, S., Johnstone, M., Spreadborough, P., Alderson, D., Fenwick, S., Elmasry, M., Nunes, Q. M., Kennedy, D., Khan, R. B., Khan, M. A. S., Magee, C. J., Jones, S. M., Mason, D., Parappally, C. P., Mathur, P., Saunders, M., Jamel, S., Haque, S. U., Zafar, S., Shiwani, M. H., Samuel, N., Dar, F., Jackson, A., Lovett, B., Dindyal, S., Winter, H., Fletcher, T., Rahman, S., Wheatley, K., Nieto, T., Ayaani, S., Youssef, H., Nijjar, R. S., Watkin, H., Naumann, D., Emesih, S., Sarmah, P. B., Lee, K., Joji, N., Lambert, J., Heath, J., Teasdale, R. L., Weerasinghe, C., Needham, P. J., Welbourn, H., Forster, L., Finch, D., Blazeby, J. M., Robb, W., Mcnair, A. G. K., Hrycaiczuk, A., Charalabopoulos, A., Kadirkamanathan, S., Tang, C. -B., Jayanthi, N. V. G., Noor, N., Dobbins, B., Cockbain, A. J., Nilsen-Nunn, A., de Siqueira, J., Pellen, M., Cowley, J. B., W. -M., Ho, Miu, V., White, T. J., Hodgkins, K. A., Kinghorn, A., Tutton, M. G., Al-Abed, Y. A., Menzies, D., Ahmad, A., Reed, J., Khan, S., Monk, D., Vitone, L. J., Murtaza, G., Joel, A., Brennan, S., Shier, D., Zhang, C., Yoganathan, T., Robinson, S. J., Mccallum, I. J. D., Jones, M. J., Elsayed, M., Tuck, L., Wayman, J., Carney, K., Aroori, S., Hosie, K. B., Kimble, A., Bunting, D. M., Fawole, A. S., Basheer, M., Dave, R. V., Sarveswaran, J., Jones, E., Kendal, C., Tilston, M. P., Gough, M., Wallace, T., Singh, S., Mockford, J. D. K. A., Issa, E., Shah, N., Chauhan, N., Wilson, T. R., Forouzanfar, A., Wild, J. R. L., Nofal, E., Bunnell, C., Madbak, K., Rao, S. T. V., Devoto, L., Siddiqi, N., Khawaja, Z., Hewes, J. C., Gould, L., Chambers, A., Rodriguez, D. U., Sen, G., Robinson, S., Bartlett, F., Rae, D. M., Stevenson, T. E. J., Sarvananthan, K., Dwerryhouse, S. J., Higgs, S. M., Old, O. J., Hardy, T. J., Hornby, R. S. S. T., Keogh, K., Frank, L., Al-Akash, M., Upchurch, E. A., Frame, R. J., Hughes, M., Jelley, C., Weaver, S., Roy, S., Sillo, T. O., Galanopoulos, G., Cuming, T., Cunha, P., Tayeh, S., Kaptanis, S., Heshaishi, M., Eisawi, A., Abayomi, M., Ngu, W. S., Fleming, K., Bajwa, D. S., Chitre, V., Aryal, K., Ferris, P., Silva, M., Mohamed, S. L. S., Khawaja, A., Hussain, A., Ghazanfar, M. A., Bellini, M. I., Ebdewi, H., Elshaer, M., Gravante, G., Drake, B., Ogedegbe, A., Mukherjee, D., Arhi, C., Iqbal, L. G. N., Watson, N. F., Aggarwal, S. K., Orchard, P., Villatoro, E., Willson, P. D., Mok, K. W. J., Woodman, T., Deguara, J., Garcea, G., Babu, B. I., Dennison, A. R., Malde, D., Lloyd, D., Satheesan, S., Al-Taan, O., Boddy, A., Slavin, J. P., Jones, R. P., Ballance, L., Gerakopoulos, S., Jambulingam, P., Mansour, S., Sakai, N., Acharya, V., Sadat, M. M., Karim, L., Larkin, D., Amin, K., Khan, A., Law, J., Jamdar, S., Smith, S. R., Sampat, K., O'Shea, K. M., Manu, M., Asprou, F. M., Malik, N. S., Chang, J., Lewis, M., Roberts, G. P., Karavadra, B., Photi, E., Hewes, J., Rodriguez, D., O'Reilly, D. A., Rate, A. J., Sekhar, H., Henderson, L. T., Starmer, B. Z., Coe, P. O., Tolofari, S., Barrie, J., Bashir, G., Sloane, J., Madanipour, S., Halkias, C., Trevatt, A. E. J., Borowski, D. W., Hornsby, J., Courtney, M. J., Virupaksha, S., Seymour, K., Hawkins, H., Bawa, S., Gallagher, P. V., Reid, A., Wood, P., Finch, J. G., Guy Finch, J., Parmar, J., Stirland, E., Gardner-Thorpe, J., Al-Muhktar, A., Peterson, M., Majeed, A., Bajwa, F. M., Martin, J., Choy, A., Tsang, A., Pore, N., Andrew, D. R., Al-Khyatt, W., Bhandari, C. T. S., Subramanium, D., Toh, S. K. C., Carter, N. C., Tate, S., Pearce, B., Wainwright, D., Mercer, S. J., Knight, B., Vijay, V., Alagaratnam, S., Sinha, S., El-Hasani, S. S., Hussain, A. A., Bhattacharya, V., Kansal, N., Fasih, T., Jackson, C., Siddiqui, M. N., Chishti, I. A., Fordham, I. J., Siddiqui, Z., Bausbacher, H., Geogloma, I., Gurung, K., Tsavellas, G., Basynat, P., Shrestha, A. K., Basu, S., Harilingam, A. C. M., Rabie, M., Akhtar, M., Kumar, P., Jafferbhoy, S. F., Hussain, N., Raza, S., Haque, M., Alam, I., Aseem, R., Patel, S., Asad, M., Booth, M. I., Ball, W. R., Wood, C. P. J., Pinho-Gomes, A. C., Kausar, A., Obeidallah, M. R., Varghase, J., Lodhia, J., Bradley, D., Rengifo, C., Lindsay, D., Gopalswamy, S., Finlay, I., Wardle, S., Bullen, N., Iftikhar, S. Y., Awan, A., Ahmed, J., Leeder, P., Fusai, G., Bond-Smith, G., Psica, A., Puri, Y., Hou, D., Noble, F., Szentpali, K., Broadhurst, J., Date, R., Hossack, M. R., Goh, Y. L., Turner, P., Shetty, V., Riera, M., Macano, C. A. W., Sukha, A., Preston, S. R., Hoban, J. R., Puntis, D. J., Williams, S. V., Krysztopik, R., Kynaston, J., Batt, J., Doe, M., Goscimski, A., Jones, G. H., Hall, C., Carty, N., Panteleimonitis, S., Gunasekera, R. T., Sheel, A. R. G., Lennon, H., Hindley, C., Reddy, M., Kenny, R., Elkheir, N., Mcglone, E. R., Rajaganeshan, R., Hancorn, K., Hargreaves, A., Prasad, R., Longbotham, D. A., Vijayanand, D., Wijetunga, I., Ziprin, P., Nicolay, C. R., Yeldham, G., Read, E., Gossage, J. A., Rolph, R. C., Ebied, H., Phull, M., Khan, M. A., Popplewell, M., Kyriakidis, D., Henley, N., Packer, J. R., Derbyshire, L., Porter, J., Appleton, S., Farouk, M., Basra, M., Jennings, N. A., Ali, S., Kanakala, V., Ali, H., Lane, R., Dickson-Lowe, R., Zarsadias, P., Mirza, D., Puig, S., Amari, K. A., Vijayan, D., Sutcliffe, R., Marudanayagam, R., Hamady, Z., Prasad, A. R., Patel, A., Durkin, D., Kaur, P., Bowen, L., Byrne, J. P., Pearson, K. L., Delisle, T. G., Davies, J., Tomlinson, M. A., Johnpulle, M. A., Slawinski, C., Macdonald, A., Nicholson, J., Newton, K., Mbuvi, J., Farooq, A., Mothe, B. S., Zafrani, Z., Brett, D., Francombe, J., Barnes, J., Cheung, M., Al-Bahrani, A. Z., Preziosi, G., Urbonas, T., Alberts, J., Mallik, M., Patel, K., Segaran, A., Doulias, T., Sufi, P. A., Yao, C., Pollock, S., Manzelli, A., Wajed, S., Kourkulos, M., Pezzuto, R., Wadley, M., Hamilton, E., Jaunoo, S., Padwick, R., Sayegh, M., Newton, R. C., Hebbar, M., Farag, S. F., Spearman, J., Hamdan, M. F., D'Costa, C., Blane, C., Giles, M., Peter, M. B., Hirst, N. A., Hossain, T., El-Dhuwaib, A. P. Y., Morrison, T. E. M., Taylor, G. W., Thompson, R. L. E., Mccune, K., Loughlin, P., Lawther, R., Byrnes, C. K., Simpson, D. J., Mawhinney, A., Warren, C., Mckay, D., Mcilmunn, C., Martin, S., Macartney, M., Diamond, T., Davey, P., Jones, C., Clements, J. M., Digney, R., Chan, W. M., Mccain, S., Gull, S., Janeczko, A., Dorrian, E., Harris, A., Dawson, S., Johnston, D., Mcaree, B., Ghareeb, E., Thomas, G., Connelly, M., Mckenzie, S., Cieplucha, K., Spence, G., Campbell, W., Hooks, G., Bradley, N., Hill, A. D. K., Cassidy, J. T., Boland, M., Burke, P., Nally, D. M., Khogali, E., Shabo, W., Iskandar, E., Mcentee, G. P., O'Neill, M. A., Peirce, C., Lyons, E. M., O'Sullivan, A. W., Thakkar, R., Carroll, P., Ivanovski, I., Balfe, P., Lee, M., Winter, D. C., Kelly, M. E., Hoti, E., Maguire, D., Karunakaran, P., Geoghegan, J. G., Mcdermott, F., Martin, S. T., Cross, K. S., Cooke, F., Zeeshan, S., Murphy, J. O., Mealy, K., Mohan, H. M., Nedujchelyn, Y., Ullah, M. F., Ahmed, I., Giovinazzo, F., Milburn, J., Prince, S., Brooke, E., Buchan, J., Khalil, A. M., Vaughan, E. M., Ramage, M. I., Aldridge, R. C., Gibson, S., Nicholson, G. A., Vass, D. G., Grant, A. J., Holroyd, D. J., Angharad Jones, M., Sutton, C. M. L. R., O'Dwyer, P., Nilsson, F., Weber, B., Williamson, T. K., Lalla, K., Bryant, A., Ross Carter, C., Forrest, C. R., Hunter, D. I., Nassar, A. H., Orizu, M. N., Knight, K., Qandeel, H., Suttie, S., Belding, R., Mcclarey, A., Boyd, A. T., Guthrie, G. J. K., Lim, P. J., Luhmann, A., Watson, A. J. M., Richards, C. H., Nicol, L., Madurska, M., Harrison, E., Boyce, K. M., Roebuck, A., Ferguson, G., Pati, P., Wilson, M. S. J., Dalgaty, F., Fothergill, L., Driscoll, P. J., Mozolowski, K. L., Banwell, V., Bennett, S. P., Rogers, P. N., Skelly, B. L., Rutherford, C. L., Mirza, A. K., Lazim, T., Lim, H. C. C., Duke, D., Ahmed, T., Beasley, W. D., Wilkinson, M. D., Maharaj, G., Malcolm, C., Brown, T. H., Al-Sarireh, B., Shingler, G. M., Mowbray, N., Radwan, R., Morcous, P., Wood, S., Kadhim, A., Stewart, D. J., Baker, A. L., Tanner, N., Shenoy, H., Hafiz, S., De Marchi, J. A., Singh-Ranger, D., Hisham, E., Ainley, P., John Terrace, S. O. N., Napetti, S., Hopwood, B., Rhys, T., Downing, J., Kanavati, O., Coats, M., Aleksandrov, D., Kallaway, C., Yahya, S., Templeton, A., Trotter, M., Lo, C., Dhillon, A., Heywood, N., Aawsaj, Y., Hamdan, A., Reece-Bolton, O., Mcguigan, A., Shahin, Y., Aymon, Luther, A. A., Nicholson, J. A., Rajendran, I., Boal, M., and Ritchie, J.

Subjects
Adult, Male, operative difficulty, medicine.medical_specialty, MEDLINE, cholecystectomy, difficulty grading, laparoscopic, Surgery, 03 medical and health sciences, 0302 clinical medicine, Postoperative Complications, Internal medicine, medicine, Humans, Prospective Studies, GeneralLiterature_REFERENCE(e.g.,dictionaries,encyclopedias,glossaries), Laparoscopic cholecystectomy, Aged, business.industry, General surgery, Correction, Hepatology, Length of Stay, Middle Aged, Conversion to Open Surgery, Cholecystectomy, Laparoscopic, ROC Curve, 030220 oncology & carcinogenesis, Multivariate Analysis, 030211 gastroenterology & hepatology, Female, business, Grading scale, Abdominal surgery
Abstract

A reliable system for grading operative difficulty of laparoscopic cholecystectomy would standardise description of findings and reporting of outcomes. The aim of this study was to validate a difficulty grading system (Nassar scale), testing its applicability and consistency in two large prospective datasets.Patient and disease-related variables and 30-day outcomes were identified in two prospective cholecystectomy databases: the multi-centre prospective cohort of 8820 patients from the recent CholeS Study and the single-surgeon series containing 4089 patients. Operative data and patient outcomes were correlated with Nassar operative difficultly scale, using Kendall's tau for dichotomous variables, or Jonckheere-Terpstra tests for continuous variables. A ROC curve analysis was performed, to quantify the predictive accuracy of the scale for each outcome, with continuous outcomes dichotomised, prior to analysis.A higher operative difficulty grade was consistently associated with worse outcomes for the patients in both the reference and CholeS cohorts. The median length of stay increased from 0 to 4 days, and the 30-day complication rate from 7.6 to 24.4% as the difficulty grade increased from 1 to 4/5 (both p 0.001). In the CholeS cohort, a higher difficulty grade was found to be most strongly associated with conversion to open and 30-day mortality (AUROC = 0.903, 0.822, respectively). On multivariable analysis, the Nassar operative difficultly scale was found to be a significant independent predictor of operative duration, conversion to open surgery, 30-day complications and 30-day reintervention (all p 0.001).We have shown that an operative difficulty scale can standardise the description of operative findings by multiple grades of surgeons to facilitate audit, training assessment and research. It provides a tool for reporting operative findings, disease severity and technical difficulty and can be utilised in future research to reliably compare outcomes according to case mix and intra-operative difficulty.

Published
2018

46. Outcomes following small bowel obstruction due to malignancy in the national audit of small bowel obstruction

Author

Drake, Thomas M., primary, Lee, Matthew J., additional, Sayers, Adele E., additional, Abercrombie, John, additional, Acheson, Austin, additional, Alderson, Derek, additional, Anderson, Iain, additional, Bradburn, Mike, additional, Davies, Michael, additional, Hamady, Zaed, additional, Hind, Daniel, additional, Hollyman, Marianne, additional, Hare, Sarah, additional, Lee, Ellen, additional, Northover, John, additional, Lewis, Christopher, additional, Marriott, Paul J., additional, Maynard, Nick, additional, McFall, Malcolm, additional, Muragananthan, Aravinth, additional, Murray, David, additional, Singh, Pritam, additional, Tierney, Gillian, additional, Verjee, Azmina, additional, Walsh, Ciaran, additional, Wild, Jonathan RL., additional, Wilson, Timothy, additional, Abbott, S., additional, Abdulaal, Y., additional, Afshar, S., additional, Akhtar, M., additional, Anderson, D., additional, Appleton, S., additional, Bandyopadhyay, D., additional, Bashir, G., additional, Behar, N., additional, Bhandari, S., additional, Branagan, G., additional, Boulton, R., additional, Borg, C., additional, Bouras, G., additional, Boyle, J., additional, Brewer, H., additional, Brown, L., additional, Briggs, C., additional, Cartmell, M., additional, Chan, S., additional, Chandratreya, N., additional, Conaghan, P., additional, Cornish, J., additional, Cotton, D., additional, Coyne, P., additional, Crozier, J., additional, Cook, T., additional, Cunha, P., additional, Curtis, N., additional, Day, A., additional, Dayal, S., additional, Dennis, R., additional, Dent, P., additional, Dowson, H., additional, Fallaize, R., additional, Farag, S., additional, El Farran, M., additional, Faulkner, G., additional, Giordano, P., additional, Grey, T., additional, Halahakoon, V., additional, Hannay, J., additional, Harikrishnan, A., additional, Holtham, S., additional, Hawkin, P., additional, Hall, C., additional, Hancock, L., additional, Hartley, J., additional, Howse, F., additional, Kallam, R., additional, Kakaniaris, G., additional, Kelly, S., additional, Lockwood, S., additional, Leinhardt, D., additional, Levy, B., additional, Lal, R., additional, Lazim, T., additional, Lund, J., additional, Lunevicius, R., additional, Mathur, P., additional, Maude, K., additional, McArthur, D., additional, McIlroy, B., additional, Miles, A., additional, Moug, S., additional, Mondragon-Pritchard, M., additional, Messenger, D., additional, Mullan, M., additional, Myers, A., additional, Muhammad, K., additional, Mason, C., additional, Sarveswaran, J., additional, Shatkar, V., additional, Singh, B., additional, Skelly, B., additional, Subramonia, S., additional, Swinscoe, M., additional, Thava, B., additional, Thorn, C., additional, Panagiotopoulos, S., additional, Patel, P., additional, Phillips, J., additional, Peristerakis, I., additional, Qureshi, A., additional, Saunders, M., additional, Shah, P., additional, Sheel, A., additional, Siddiqui, S., additional, Skaife, P., additional, Smart, N., additional, Smith, I., additional, Stevenson, L., additional, Stylianides, N., additional, Steinke, J., additional, Stubbs, B., additional, Thompson, R., additional, Varcada, M., additional, Vimalachandran, D., additional, Virlos, I., additional, Watfah, J., additional, Watson, N., additional, Walker, M., additional, Ventham, N., additional, West, H., additional, Wilson, J., additional, Wijeyekoon, S., additional, Ah-Chuen, J., additional, Ahmed, T., additional, Akram, F., additional, Aldred, E., additional, Ali, A., additional, Aly, M., additional, Amajuoyi, A., additional, Amin, V., additional, Andreou, A., additional, Ansari, A., additional, Ardley, R., additional, Arshad, F., additional, Ashour, O., additional, Asour, A., additional, Ayoub, F., additional, Azeem, H., additional, Azhar, B., additional, Baillie, C., additional, Barker, J., additional, Barkham, B., additional, Baron, R., additional, Barrie, J., additional, Barry-Yarrow, E., additional, Battersby, N., additional, Bazoua, G., additional, Berger, C., additional, Bhasin, S., additional, Biggs, S., additional, Bisset, C., additional, Blencowe, N., additional, Boddy, A., additional, Boereboom, C., additional, Bogdan, M., additional, Bogle, R., additional, Bohra, P., additional, Bolkan, H., additional, Boyer, M., additional, Broadhurst, J., additional, Brown, E., additional, Brown, J., additional, Burns, K., additional, Butcher, K., additional, Capper, C., additional, Cash, T., additional, Chapman, J., additional, Chapman, S., additional, Charalabopoulos, A., additional, Cheek, C., additional, Chok, S., additional, Choong, W., additional, Chowdhury, J., additional, Coe, P., additional, Conn, G., additional, Cook, N., additional, Cooper, S., additional, Cox, C., additional, Crook, R., additional, Cuffolo, G., additional, da Silva, L., additional, Das, B., additional, Davenport, M., additional, Davies, J., additional, Davies, T., additional, Dean, S., additional, Demetriou, G., additional, Dengu, F., additional, Dent, H., additional, Di Benedetto, G., additional, Dindyal, S., additional, Donnelly, E., additional, Douka, E., additional, Downham, C., additional, Edent, H., additional, Edgerton, K., additional, El-Sharif, M., additional, Elamin, O., additional, Elsaid, N., additional, Evans, J., additional, Evans, M., additional, Ewe, R., additional, Ewing, A., additional, Ferguson, H., additional, Fisher, O., additional, Fletcher, J., additional, Forouzanfar, A., additional, Foster, A., additional, Fox, R., additional, Francis, N., additional, Fretwell, V., additional, Fung, D., additional, Gammeri, E., additional, Garnham, J., additional, Geraghty, A., additional, Gilbert, A., additional, Gill, M., additional, Gillespie, M., additional, Glasbey, J., additional, Golder, A., additional, Green, N., additional, Groundwater, E., additional, Grove, T., additional, Habib, H., additional, Haddow, J., additional, Halkias, C., additional, Hampson, A., additional, Hanna, T., additional, Harries, R., additional, Harvey, K., additional, Hawkins, J., additional, Healy, R., additional, Heartshorne, R., additional, Heller, S., additional, Hendra, L., additional, Herrod, P., additional, Heywood, N., additional, Hicks, G., additional, Ng, P., additional, Hope, C., additional, Hopley, P., additional, Hossain, T., additional, Hossaini, S., additional, Hubbard, T., additional, Humphreys, A., additional, Ikram, H., additional, Ioannis, M., additional, Iqbal, M., additional, Jatania, J., additional, Jenkinson, P., additional, Jokhan, S., additional, Jones, A., additional, Jones, C., additional, Jones, L., additional, Joshi, H., additional, Joshi, K., additional, Joy, M., additional, Jull, P., additional, Kane, E., additional, Kanitkar, R., additional, Kauser, S., additional, Kazmi, F., additional, Kedrzycki, M., additional, Kendall, J., additional, Khan, T., additional, King, G., additional, Kisiel, A., additional, Kitsis, C., additional, Kolawole, I., additional, Kosasih, S., additional, Kosti, A., additional, Kotb, A., additional, Lau, A., additional, Lafaurie, G., additional, Lazzaro, A., additional, Lefroy, R., additional, Lennon, H., additional, Leong, K., additional, Lim, E., additional, Lim, J., additional, Lindley, S., additional, Liu, D., additional, Lloyd, P., additional, Locker, D., additional, Lowe, C., additional, Lunt, A., additional, Lutfi, S., additional, Luther, A., additional, Luwemba, S., additional, Mahankali-Rao, P., additional, Mai, D., additional, Majid, S., additional, Malik, A., additional, Manu, N., additional, Mapara, R., additional, Martin, C., additional, Martin, J., additional, Massey, L., additional, Mathias, J., additional, McCain, S., additional, McCluney, S., additional, McNair, A., additional, Mekhail, P., additional, Merchant, J., additional, Merker, L., additional, Mir, S., additional, Mistry, P., additional, Miu, V., additional, Moat, M., additional, Mohamed, E., additional, Mohamed, I., additional, Moore, N., additional, Moretti, L., additional, Morris, H., additional, Morrison, T., additional, Moss, J., additional, Mountford, D., additional, Moynihan, R., additional, Muldoon-Smith, D., additional, Mulholland, J., additional, Murgitroyd, E., additional, Murugaiyan, K., additional, Mykoniatis, I., additional, Nana, G., additional, Nash, T., additional, Nassar, A., additional, Newton, R., additional, Nguyen, K., additional, Nicholas, F., additional, Noor, M., additional, Nowers, J., additional, Nugent, C., additional, Nunn, A., additional, O'Callaghan, J., additional, O'Hara, R., additional, O'Neill, A., additional, Olivier, J., additional, Osei-Bordom, D., additional, Osgood, L., additional, Panchasara, B., additional, Parks, R., additional, Patel, H., additional, Pawelec, K., additional, Payne, C., additional, Pearson, K., additional, Perin, G., additional, Petronio, B., additional, Phelan, L., additional, Pisaneschi, C., additional, Pitt, J., additional, Ponchietti, L., additional, Powell, A., additional, Powell-Chandler, A., additional, Pranesh, N., additional, Proctor, V., additional, Qureshi, N., additional, Rahman, M., additional, Rai, Z., additional, Ramcharan, S., additional, Rangarajan, K., additional, Rashid, M., additional, Reader, H., additional, Rehman, A., additional, Rehan, S., additional, Rengifo, C., additional, Richardson, N., additional, Robinson, A., additional, Robinson, D., additional, Rossi, B., additional, Rutherford, F., additional, Sadien, I., additional, Saghir, T., additional, Sahnan, K., additional, Salahia, G., additional, Scott, B., additional, Scott, K., additional, Seager, A., additional, Seal, S., additional, Sezen, E., additional, Shaban, F., additional, Shahmohammadi, M., additional, Shamsiddinova, A., additional, Shankar, S., additional, Sharpe, A., additional, Shields, T., additional, Shinkwin, M., additional, Shurmer, J., additional, Siddika, A., additional, Simson, R., additional, Singh, S., additional, Sivaraj, J., additional, Skinner, A., additional, Smart, C., additional, Smith, F., additional, Smith, R., additional, Sreedhar, A., additional, Stewart-Parker, E., additional, Stott, M., additional, Symons, N., additional, Taj, T., additional, Tam, J., additional, Tan, K., additional, Tani, S., additional, Tao, D., additional, Thippeswamy, K., additional, Thomas, C., additional, Thompson, E., additional, Thompson-Reil, C., additional, Tongo, F., additional, Toth, G., additional, Turnbull, A., additional, Turnbull, J., additional, Wade, T., additional, Wafi, A., additional, Waite, K., additional, Walker, N., additional, Walker, T., additional, Walsh, U., additional, Wardle, S., additional, Warner, R., additional, Watt, J., additional, Watts, J., additional, Wayman, J., additional, Weegenaar, C., additional, West, M., additional, Whyler, M., additional, Whitehurst, L., additional, Wiggans, M., additional, Williams, G., additional, Williams, R., additional, Williamson, A., additional, Williamson, J., additional, Winter, A., additional, Wolpert, L., additional, Wong, J., additional, van Boxel, G., additional, Yeap, E., additional, Zaman, S., additional, Zappa, B., additional, Zosimas, D., additional, Anderson, O., additional, Athem, A., additional, Athersmith, M., additional, Badenoch, T., additional, Barker, S., additional, Bellam, S., additional, Boam, T., additional, Boland, M., additional, Blake, L., additional, Brown, O., additional, Butler, M., additional, Byrne, B., additional, Campbell, L., additional, Chow, M., additional, Da Costa, K., additional, Cutting, J., additional, Deputy, M., additional, Devoto, L., additional, Doody, P., additional, Ekpete, N., additional, Eljaafari, M., additional, Exarchou, K., additional, Faoury, M., additional, Farinella, E., additional, Gill, C., additional, Goh, M., additional, Gregoir, T., additional, Growcott, S., additional, Gunasekaran, S., additional, Harris, G., additional, Heard, R., additional, Hobson, B., additional, Iqbal, N., additional, Jain, R., additional, Kang, P., additional, Khan, M., additional, Korambayil, S., additional, Kouris, S., additional, Kshatriya, K., additional, Kumar, S., additional, Lee, K., additional, Mahroof, S., additional, Malik, K., additional, Mann, K., additional, Mansour, S., additional, Martin, R., additional, McKay, S., additional, McKinley, N., additional, McWhirter, D., additional, Mellor, K., additional, Mishra, A., additional, Mockford, K., additional, Morrison-Jones, V., additional, Ng, C., additional, Nunn, R., additional, O'Neill, S., additional, Oke, O., additional, Obeid, N., additional, Patel, R., additional, Patel, S., additional, Plunkett-Reed, K., additional, Pouzi, M., additional, Pywell, S., additional, Richards, E., additional, Sinclair, P., additional, Slim, N., additional, Spence, G., additional, Swinkin, M., additional, Tahir, W., additional, Takacs, K., additional, Tanner, N., additional, Taylor, M., additional, Valero, C., additional, Venn, M., additional, Venza, M., additional, Yeong, T., additional, and Fearnhead, Nicola S., additional

Published
2019
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49. The development and validation of a scoring tool to predict the operative duration of elective laparoscopic cholecystectomy

Author

Bharamgoudar, R., Sonsale, A., Hodson, J., Griffiths, E., Vohra, R.S., Kirkham, A.J., Pasquali, S., Marriott, P., Johnstone, M., Spreadborough, P., Alderson, D., Griffiths, E.A., Fenwick, S., Elmasry, M., Nunes, Q.M., Kennedy, D., Khan, R.B., Khan, M.A.S., Magee, C.J., Jones, S.M., Mason, D., Parappally, C.P., Mathur, P., Saunders, M., Jamel, S., Haque, S.U., Zafar, S., Shiwani, M.H., Samuel, N., Dar, F., Jackson, A., Lovett, B., Dindyal, S., Winter, H., Fletcher, T., Rahman, S., Wheatley, K., Nieto, T., Ayaani, S., Youssef, H., Nijjar, R.S., Watkin, H., Naumann, D., Emesih, S., Sarmah, P.B., Lee, K., Joji, N., Lambert, J., Heath, J., Teasdale, R.L., Weerasinghe, C., Needham, P.J., Welbourn, H., Forster, L., Finch, D., Blazeby, J.M., Robb, W., McNair, A.G.K., Hrycaiczuk, A., Charalabopoulos, A., Kadirkamanathan, S., Tang, C.-B., Jayanthi, N.V.G., Noor, N., Dobbins, B., Cockbain, A.J., Nilsen-Nunn, A., de Siqueira, J., Pellen, M., Cowley, J.B., Ho, W.-M., Miu, V., White, T.J., Hodgkins, K.A., Kinghorn, A., Tutton, M.G., Al-Abed, Y.A., Menzies, D., Ahmad, A., Reed, J., Khan, S., Monk, D., Vitone, L.J., Murtaza, G., Joel, A., Brennan, S., Shier, D., Zhang, C., Yoganathan, T., Robinson, S.J., McCallum, I.J.D., Jones, M.J., Elsayed, M., Tuck, L., Wayman, J., Carney, K., Aroori, S., Hosie, K.B., Kimble, A., Bunting, D.M., Fawole, A.S., Basheer, M., Dave, R.V., Sarveswaran, J., Jones, E., Kendal, C., Tilston, M.P., Gough, M., Wallace, T., Singh, S., Mockford, J.D.K.A., Issa, E., Shah, N., Chauhan, N., Wilson, T.R., Forouzanfar, A., Wild, J.R.L., Nofal, E., Bunnell, C., Madbak, K., Rao, S.T.V., Devoto, L., Siddiqi, N., Khawaja, Z., Hewes, J.C., Gould, L., Chambers, A., Rodriguez, D.U., Sen, G., Robinson, S., Bartlett, F., Rae, D.M., Stevenson, T.E.J., Sarvananthan, K., Dwerryhouse, S.J., Higgs, S.M., Old, O.J., Hardy, T.J., Shah, R., Hornby, S.T., Keogh, K., Frank, L., Al-Akash, M., Upchurch, E.A., Frame, R.J., Hughes, M., Jelley, C., Weaver, S., Roy, S., Sillo, T.O., Galanopoulos, G., Cuming, T., Cunha, P., Tayeh, S., Kaptanis, S., Heshaishi, M., Eisawi, A., Abayomi, M., Ngu, W.S., Fleming, K., Bajwa, D.S., Chitre, V., Aryal, K., Ferris, P., Silva, M., Lammy, S., Mohamed, S., Khawaja, A., Hussain, A., Ghazanfar, M.A., Bellini, M.I., Ebdewi, H., Elshaer, M., Gravante, G., Drake, B., Ogedegbe, A., Mukherjee, D., Arhi, C., Giwa, L., Iqbal, N., Watson, N.F., Aggarwal, S.K., Orchard, P., Villatoro, E., Willson, P.D., Mok, K.W.J., Woodman, T., Deguara, J., Garcea, G., Babu, B.I., Dennison, A.R., Malde, D., Lloyd, D., Satheesan, S., Al-Taan, O., Boddy, A., Slavin, J.P., Jones, R.P., Ballance, L., Gerakopoulos, S., Jambulingam, P., Mansour, S., Sakai, N., Acharya, V., Sadat, M.M., Karim, L., Larkin, D., Amin, K., Khan, A., Law, J., Jamdar, S., Smith, S.R., Sampat, K., O?shea, K.M., Manu, M., Asprou, F.M., Malik, N.S., Chang, J., Lewis, M., Roberts, G.P., Karavadra, B., Photi, E., Hewes, J., Rodriguez, D., O?Reilly, D.A., Rate, A.J., Sekhar, H., Henderson, L.T., Starmer, B.Z., Coe, P.O., Tolofari, S., Barrie, J., Bashir, G., Sloane, J., Madanipour, S., Halkias, C., Trevatt, A.E.J., Borowski, D.W., Hornsby, J., Courtney, M.J., Virupaksha, S., Seymour, K., Hawkins, H., Bawa, S., Gallagher, P.V., Reid, A., Wood, P., Finch, J.G., Guy Finch, J., Parmar, J., Stirland, E., Gardner-Thorpe, J., Al-Muhktar, A., Peterson, M., Majeed, A., Bajwa, F.M., Martin, J., Choy, A., Tsang, A., Pore, N., Andrew, D.R., Al-Khyatt, W., Taylor, C., Bhandari, S., Subramanium, D., Toh, S.K.C., Carter, N.C., Tate, S., Pearce, B., Wainwright, D., Mercer, S.J., Knight, B., Vijay, V., Alagaratnam, S., Sinha, S., El-Hasani, S.S., Hussain, A.A., Bhattacharya, V., Kansal, N., Fasih, T., Jackson, C., Siddiqui, M.N., Chishti, I.A., Fordham, I.J., Siddiqui, Z., Bausbacher, H., Geogloma, I., Gurung, K., Tsavellas, G., Basynat, P., Shrestha, A.K., Basu, S., Chhabra, A., Harilingam, M., Rabie, M., Akhtar, M., Kumar, P., Jafferbhoy, S.F., Hussain, N., Raza, S., Haque, M., Alam, I., Aseem, R., Patel, S., Asad, M., Booth, M.I., Ball, W.R., Wood, C.P.J., Pinho-Gomes, A.C., Kausar, A., Obeidallah, M.R., Varghase, J., Lodhia, J., Bradley, D., Rengifo, C., Lindsay, D., Gopalswamy, S., Finlay, I., Wardle, S., Bullen, N., Iftikhar, S.Y., Awan, A., Ahmed, J., Leeder, P., Fusai, G., Bond-Smith, G., Psica, A., Puri, Y., Hou, D., Noble, F., Szentpali, K., Broadhurst, J., Date, R., Hossack, M.R., Goh, Y.L., Turner, P., Shetty, V., Riera, M., Macano, C.A.W., Sukha, A., Preston, S.R., Hoban, J.R., Puntis, D.J., Williams, S.V., Krysztopik, R., Kynaston, J., Batt, J., Doe, M., Goscimski, A., Jones, G.H., Hall, C., Carty, N., Panteleimonitis, S., Gunasekera, R.T., Sheel, A.R.G., Lennon, H., Hindley, C., Reddy, M., Kenny, R., Elkheir, N., McGlone, E.R., Rajaganeshan, R., Hancorn, K., Hargreaves, A., Prasad, R., Longbotham, D.A., Vijayanand, D., Wijetunga, I., Ziprin, P., Nicolay, C.R., Yeldham, G., Read, E., Gossage, J.A., Rolph, R.C., Ebied, H., Phull, M., Khan, M.A., Popplewell, M., Kyriakidis, D., Henley, N., Packer, J.R., Derbyshire, L., Porter, J., Appleton, S., Farouk, M., Basra, M., Jennings, N.A., Ali, S., Kanakala, V., Ali, H., Lane, R., Dickson-Lowe, R., Zarsadias, P., Mirza, D., Puig, S., Al Amari, K., Vijayan, D., Sutcliffe, R., Marudanayagam, R., Hamady, Z., Prasad, A.R., Patel, A., Durkin, D., Kaur, P., Bowen, L., Byrne, J.P., Pearson, K.L., Delisle, T.G., Davies, J., Tomlinson, M.A., Johnpulle, M.A., Slawinski, C., Macdonald, A., Nicholson, J., Newton, K., Mbuvi, J., Farooq, A., Mothe, B.S., Zafrani, Z., Brett, D., Francombe, J., Barnes, J., Cheung, M., Al-Bahrani, A.Z., Preziosi, G., Urbonas, T., Alberts, J., Mallik, M., Patel, K., Segaran, A., Doulias, T., Sufi, P.A., Yao, C., Pollock, S., Manzelli, A., Wajed, S., Kourkulos, M., Pezzuto, R., Wadley, M., Hamilton, E., Jaunoo, S., Padwick, R., Sayegh, M., Newton, R.C., Hebbar, M., Farag, S.F., Spearman, J., Hamdan, M.F., D?Costa, C., Blane, C., Giles, M., Peter, M.B., Hirst, N.A., Hossain, T., Pannu, A., El-Dhuwaib, Y., Morrison, T.E.M., Taylor, G.W., Thompson, R.L.E., McCune, K., Loughlin, P., Lawther, R., Byrnes, C.K., Simpson, D.J., Mawhinney, A., Warren, C., McKay, D., McIlmunn, C., Martin, S., MacArtney, M., Diamond, T., Davey, P., Jones, C., Clements, J.M., Digney, R., Chan, W.M., McCain, S., Gull, S., Janeczko, A., Dorrian, E., Harris, A., Dawson, S., Johnston, D., McAree, B., Ghareeb, E., Thomas, G., Connelly, M., McKenzie, S., Cieplucha, K., Spence, G., Campbell, W., Hooks, G., Bradley, N., Hill, A.D.K., Cassidy, J.T., Boland, M., Burke, P., Nally, D.M., Khogali, E., Shabo, W., Iskandar, E., McEntee, G.P., O?Neill, M.A., Peirce, C., Lyons, E.M., O?Sullivan, A.W., Thakkar, R., Carroll, P., Ivanovski, I., Balfe, P., Lee, M., Winter, D.C., Kelly, M.E., Hoti, E., Maguire, D., Karunakaran, P., Geoghegan, J.G., McDermott, F., Martin, S.T., Cross, K.S., Cooke, F., Zeeshan, S., Murphy, J.O., Mealy, K., Mohan, H.M., Nedujchelyn, Y., Ullah, M.F., Ahmed, I., Giovinazzo, F., Milburn, J., Prince, S., Brooke, E., Buchan, J., Khalil, A.M., Vaughan, E.M., Ramage, M.I., Aldridge, R.C., Gibson, S., Nicholson, G.A., Vass, D.G., Grant, A.J., Holroyd, D.J., Jones, M.A., Sutton, C.M.L.R., O?Dwyer, P., Nilsson, F., Weber, B., Williamson, T.K., Lalla, K., Bryant, A., Carter, C.R., Forrest, C.R., Hunter, D.I., Nassar, A.H., Orizu, M.N., Knight, K., Qandeel, H., Suttie, S., Belding, R., McClarey, A., Boyd, A.T., Guthrie, G.J.K., Lim, P.J., Luhmann, A., Watson, A.J.M., Richards, C.H., Nicol, L., Madurska, M., Harrison, E., Boyce, K.M., Roebuck, A., Ferguson, G., Pati, P., Wilson, M.S.J., Dalgaty, F., Fothergill, L., Driscoll, P.J., Mozolowski, K.L., Banwell, V., Bennett, S.P., Rogers, P.N., Skelly, B.L., Rutherford, C.L., Mirza, A.K., Lazim, T., Lim, H.C.C., Duke, D., Ahmed, T., Beasley, W.D., Wilkinson, M.D., Maharaj, G., Malcolm, C., Brown, T.H., Al-Sarireh, B., Shingler, G.M., Mowbray, N., Radwan, R., Morcous, P., Wood, S., Kadhim, A., Stewart, D.J., Baker, A.L., Tanner, N., Shenoy, H., Hafiz, S., De Marchi, J.A., Singh-Ranger, D., Hisham, E., Ainley, P., O?Neill, S., Terrace, J., Napetti, S., Hopwood, B., Rhys, T., Downing, J., Kanavati, O., Coats, M., Aleksandrov, D., Kallaway, C., Yahya, S., Templeton, A., Trotter, M., Lo, C., Dhillon, A., Heywood, N., Aawsaj, Y., Hamdan, A., Reece-Bolton, O., McGuigan, A., Shahin, Y., Aymon, Luther, A.A., Nicholson, J.A., Rajendran, I., Boal, M., and Ritchie, J.

Subjects
Adult, Male, Scoring tool, medicine.medical_specialty, Patient factors, medicine.medical_treatment, Operative Time, Operative duration, 030230 surgery, Logistic regression, Article, patient factors, 03 medical and health sciences, Laparoscopic cholecystectomy, 0302 clinical medicine, Patient satisfaction, 030202 anesthesiology, Interquartile range, medicine, Humans, theatre utilisation, Propensity Score, Aged, Framingham Risk Score, Receiver operating characteristic, business.industry, prediction, Middle Aged, operative duration, Cholecystectomy, Laparoscopic, ROC Curve, scoring tool, Centre for Surgical Research, Elective Surgical Procedures, Theatre utilisation, Emergency medicine, Cohort, Propensity score matching, Female, Surgery, Cholecystectomy, Prediction, business
Abstract

Background The ability to accurately predict operative duration has the potential to optimise theatre efficiency and utilisation, thus reducing costs and increasing staff and patient satisfaction. With laparoscopic cholecystectomy being one of the most commonly performed procedures worldwide, a tool to predict operative duration could be extremely beneficial to healthcare organisations. Methods Data collected from the CholeS study on patients undergoing cholecystectomy in UK and Irish hospitals between 04/2014 and 05/2014 were used to study operative duration. A multivariable binary logistic regression model was produced in order to identify significant independent predictors of long (> 90 min) operations. The resulting model was converted to a risk score, which was subsequently validated on second cohort of patients using ROC curves. Results After exclusions, data were available for 7227 patients in the derivation (CholeS) cohort. The median operative duration was 60 min (interquartile range 45–85), with 17.7% of operations lasting longer than 90 min. Ten factors were found to be significant independent predictors of operative durations > 90 min, including ASA, age, previous surgical admissions, BMI, gallbladder wall thickness and CBD diameter. A risk score was then produced from these factors, and applied to a cohort of 2405 patients from a tertiary centre for external validation. This returned an area under the ROC curve of 0.708 (SE = 0.013, p 90 min increasing more than eightfold from 5.1 to 41.8% in the extremes of the score. Conclusion The scoring tool produced in this study was found to be significantly predictive of long operative durations on validation in an external cohort. As such, the tool may have the potential to enable organisations to better organise theatre lists and deliver greater efficiencies in care.

Published
2018
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