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1. Outcomes after perioperative SARS-CoV-2 infection in patients with proximal femoral fractures: an international cohort study

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T Richards, S Shaikh, S Rehman, A Khan, J Shah, C Smith, A Brown, S Singh, A P Arnaud, A Young, D Bowen, P Patel, S Williams, J Dunn, J John, M Loubani, A Hainsworth, A Kolias, PJ Hutchinson, R Singh, S Sinha, S Shaw, J Edwards, S Mukherjee, AAB Jamjoom, A Singh, S Saeed, J Martin, S Smith, S Ross, M Mohan, P Hutchinson, G James, RDC Moon, P Brennan, A Williams, S Brown, A Ward, M Lee, K Thompson, S Ali, J Williams, S Reid, U Khan, J Lambert, A Smith, B Singh, M Hassan, N Sharma, J Reynolds, N Wright, T Williams, H Smith, M Ng, M Rahman, A Taylor, P Shah, D Saxena, J Evans, I Omar, M Ali, A Hanson, Z Li, R Andrade, P Cardoso, H Jeong, P Sharma, M Arrieta, J Clark, L Pearce, J McVeigh, V Sharma, B Kim, J Singh, S Newman, J Byrne, A Hassan, A Persad, A Gardner, H Liu, K Shah, I Hughes, S Davison, A Balakrishnan, K Patel, J Hall, S Mistry, J Parry, R Baumber, N McGrath, E Ross, R Mannion, S Murphy, FL Wright, A Rogers, B Rai, M Thomas, R Ribeiro, E Hamilton, J Teixeira, B Davidson, L Carvalho, R Garrido, A Puppo, A Guimarães, E Santos, M Kamal, M Denning, M Elhadi, J E Fitzgerald, D Miller, M Gowda, C Morris, A Phillips, H Yang, Y Zhang, N Machairas, A Fisher, A Kaufmann, A Aggarwal, L Hansen, M Otify, H Soleymani Majd, A Jones, M Rodrigues, S Sundar, C Jones, R Edmondson, A Sharkey, L Smith, G Williams, J Dunning, E Belcher, D Stavroulias, V Zamvar, M Patel, M Baker, R Evans, M Sherif, J Hopkins, R Mohammed, A Hill, H Jackson, G Jones, K George, J Dixon, A Tong, S Jallad, Deborah S Keller, A Pereira, L Elliott, D Ford, A Sermon, M Almond, Andrew Metcalfe, C Peluso, T White, S Shah, A Witek, Chetan Khatri, A Tiwari, T Lo, K Agarwal, C Sweeney, C Hart, T Holme, S Green, I Ahmed, A Sobti, C Anderson, N Modi, R Campbell, C Magee, M Mirza, D Jones, N Stylianides, X Luo, C Kang, J Ribeiro, L Kumar, J Diaz, A Bhalla, R Young, C Perkins, A James, A Walters, J Reid, R Pereira, C McDonald, A Aujayeb, K Jackson, M Allen, D Ghosh, M Chan, C Price, K Khan, R Moore, M Ibrahim, A Marchbank, M Silva, M Baig, J De Coster, J Castellanos, S Saxena, M Duque, E Li, E Martin, A Isik, J González, RJ Davies, B Smith, R Owen, K Lakhoo, M Rogers, MA Akhtar, K Mellor, S Agrawal, L Foster, G Harris, J McIntyre, M Garner, R West, R Cuthbert, D Johnson, H Gomes, C Roy, N Spencer, D Mehta, J Freedman, J Blair, K Rajput, K Williams, J Wall, A Soliman, F Chen, A Mokhtari, I Mohamed, J Pascoe, M Khalifa, R Das, A Lara, M Costa, A Mahmoud, K Roberts, J Lane, S Robertson, J P Evans, E Krishnan, I Haq, S Rogers, J Knowles, M Chowdhury, A Ghanbari, L Macdonald, S Powell, J Hunt, J Cornish, J Engel, S Page, I Blake, A Rolls, H Ross, D Simpson, J Hammond, A Goyal, K Parkins, A Desai, A Gaunt, A Salim, Y Yousef, A Schache, H Mohan, SR Brown, R Nair, M Flatman, J Lord, RJ Egan, R Harries, N Judkins, K Sugand, T Hine, J Luck, C Johnson, G Salerno, AW Phillips, R Houston, A Volpe, C Walker, C Steele, M Rela, C Barry, R Alves, L Ramsay, A Turnbull, A Daniele, C S Jones, P Gallagher, G Gradinariu, A Oliveira, C Hardie, H Ferguson, S Bhattacharya, E Davies, P Joshi, C Mellor, E Griffiths, A Bhangu, R Mahoney, F Kashora, G Ruiz, K Wong, G Hill, V Testa, S Ford, C Park, P Gomez, C Lopes, A Lázaro, A Shabana, A Agarwal, C Chung, C Politis, G Martin, E Chung, M Ismail, C Cunha, S Correia, I Santos, A Tang, A Robson, T Collier, G Baltazar, M Quintana, C English, M Ip, K Newton, J Kahn, C Tan, D Cheng, R Woods, M Ho, A ABBAS, A Henry, F Rivas, M Mohammed, N Parsons, T Board, S Madan, A Osorio, M Jarvis, M Hashem, A Egglestone, E Halliday, A Ridgway, G Gallo, J Gilliland, W Marx, R Shaw, A Mahmood, K Gohil, B Gallagher, D Alderson, A Karim, G D Stewart, G Peck, L Majkowski, J Carter, H Ishii, L HUMPHREYS, J Khan, S Abbott, C Newton, F Borghi, A Sud, K Bhatia, H Cao, V Vijay, L Sanderson, E Holler, N Hanna, D Ferguson, P Miranda, L Pickering, T Singhal, T Newman, K Ghosh, C Camacho, D Manning, C Lipede, R Clifford, S Higgs, C Menakaya, S Shankar, K Booth, M Abdalla, T Nelson, T Farrell, H Naseem, J Johnstone, A Wilkins, A Brunt, A Nogués, A Patience, D Jeevan, M Vatish, G Stables, S Adegbola, I Hunt, K Dickson, W Matthews, N Dunne, M Maher, G Faulkner, E Hernandez, R Sofat, K Sahnan, A Brunelli, M Raza, K Chui, C Brennan, P Vaughan, H Chu, R Hagger, ASD Liyanage, R Perkins, S Duff, C Gill, H Dean, S Bandyopadhyay, K Ragupathy, Y Cunningham, A Bateman, V Brown, B Ho, E Britton, H Ikram, R Hasan, A Colquhoun, S Handa, A Maqsood, M Caputo, J Torkington, G Fusai, N Hossain, DJ Lin, S Stefan, IR Daniels, D Pournaras, A Askari, P Nisar, S Moug, J Sagar, N Yassin, G Minto, Z Hamady, JR O'Neill, S Chowdhury, R Cresner, D Vimalachandran, FD Mcdermott, RP Jones, P Zerbib, L Sreedharan, S Wahed, SS Gisbertz, MI van Berge Henegouwen, R Preece, I Liew, S McCluney, D Watts, D Nehra, B Dean, D Chaudhry, L Ross, F Solari, S Chatterji, B Barmayehvar, S Lourenco, L Onos, F Mansour, A Radhakrishnan, M Varcada, M Richmond, I Hernández, A Spinelli, H Pham, J Shalhoub, F Wells, K Bevan, A Peckham-Cooper, N Campain, J Steinke, R Wilkin, K McEvoy, S Mastoridis, N Fine, J Bayer, Y Joshi, A Yener, S C McKay, NS Kalson, S Horvath, H Fu, A Parente, SE Lewis, Y Ahmad, G Seidel, M Dunstan, U von Oppell, J Vatish, H Hirsch, K Breen, C Dott, D Mathieu, J Hardie, K Aldridge, A Doorgakant, P Petrone, R Tansey, M El Amrani, C Branco, Y Viswanath, A Meagher, B Keeler, N Tewari, A Gabr, J Kinross, M Longhi, E M Harrison, P Daliya, P Asaad, F Langlands, N Misra, S Kristinsson, S Di Saverio, C Conso, H Roy, E Massie, L Masterson, D Baskaran, A Hannah, O Ismail, S URBAN, J Domenech, S Ranjit, L Massey, S Mannan, D Rutherford, F Colombo, R Kulkarni, D Kearney, Neil J Smart, G Bourke, D Shrestha, P Nankivell, O Breik, R Exley, D Zakai, AK Abou-Foul, P Naredla, R Vidya, G Mundy, H Marin, A E Ward, A Sudarsanam, W Singleton, M Ganau, F Moura, J Blanco, R Myatt, S Sousa, H Zahid, S Garrido, A Fell, E Caruana, D Nepogodiev, F Dhaif, B Bankhad-Kendall, H Kaafarani, C Bretherton, L Marais, K Siaw-Acheampong, B E Dawson, J C Glasbey, R R Gujjuri, E Heritage, S K Kamarajah, J M Keatley, S Lawday, G Pellino, J F F Simoes, I M Trout, M L Venn, R J W Wilkin, A O Ademuyiwa, E Al Ameer, O Alser, K M Augestad, B Bankhead-Kendall, R A Benson, S Chakrabortee, R Blanco-Colino, A Brar, A Minaya Bravo, K A Breen, I Lima Buarque, M F Cunha, G H Davidson, S Farik, M Fiore, G M A Gomes, C Halkias, I Lawani, H Lederhuber, S Leventoglu, M W Loffler, H Mashbari, D Mazingi, D Moszkowicz, J S Ng-Kamstra, S Metallidis, M Niquen, F Ntirenganya, O Outani, F Pata, T D Pinkney, P Pockney, D Radenkovic, A Ramos-De la Medina, A Schnitzbauer, S Shu, K Soreide, S Tabiri, P Townend, G Tsoulfas, G van Ramshorst, Mak JKC, F Tirotta, A Kisiel, LD Cato, AM Pathanki, A Chebaro, K Lecolle, S Truant, FR Pruvot, E Surmei, L Mattei, J Dudek, S El-Hasani, J Cuschieri, GH Davidson, RG Wade, H Elkadi, C Pompili, JR Burke, E Bagouri, Z Abual-Rub, S Munot, M Kowal, SC Winter, F Di Chiara, K Wallwork, A Qureishi, M Lami, S Sravanam, S Chidambaram, R Smillie, AV Shaw, C Cernei, D Jeyaretna, RJ Piper, E Duck, C Jelley, SC Tucker, G Bond-Smith, XL Griffin, GD Tebala, N Neal, TM Noton, H Ghattaura, OBF Risk, H Kharkar, C Verberne, A Senent-Boza, A Sánchez-Arteaga, I Benítez-Linero, F Manresa-Manresa, L Tallón-Aguilar, L Melero-Cortés, MR Fernández-Marín, VM Durán-Muñoz-Cruzado, I Ramallo-Solís, P Beltrán-Miranda, F Pareja-Ciuró, BT Antón-Eguía, AC Dawson, A Drane, F Oliva Mompean, J Gomez-Rosado, J Reguera-Rosal, J Valdes-Hernandez, L Capitan-Morales, del Toro Lopez, A Alanbuki, O Usman, AJ Beamish, D Bosanquet, D Magowan, H Nassa, G Mccabe, D Holroyd, NB Jamieson, NM Mariani, V Nicastro, D Motter, C Jenvey, T Minto, DR Sarma, C Godbole, W Carlos, A Khajuria, H Connolly, G Di Taranto, S Shanbhag, J Skillman, M Sait, H Al-omishy, B Heer, R Lunevicius, ARG Sheel, M Sundhu, AJA Santini, Fathelbab MSAT, KMA Hussein, QM Nunes, K Shahzad, Baig MMAS, JL Hughes, A Kattakayam, SB Shah, AL Clynch, N Georgopoulou, HM Sharples, AA Apampa, IC Nzenwa, D Podolsky, NL Coleman, MP Callahan, P Beak, I Gerogiannis, A Ebrahim, A Alwadiya, C Demetriou, E Grimley, E Theophilidou, E Ogden, FL Malcolm, G Davies-Jones, Ng JCK, N Elmaleh, Z Chia, J A'Court, A Konarski, R Talwar, P S Jambulingam, A Maity, C Hatzantonis, S Kudchadkar, N Cirocchi, CH Chan, H Eberbach, B Erdle, R Sandkamp, G Velmahos, LR Maurer, M El Moheb, A Gaitanidis, L Naar, MA Christensen, C Kapoen, K Langeveld, M El Hechi, B Main, T Maccabe, NS Blencowe, DP Fudulu, D Bhojwani, M Baquedano, F Rapetto, O Flannery, D Tadross, C Blundell, S Forlani, S Guha, CJ Kelty, G Chetty, G Lye, SP Balasubramanian, N Sureshkumar Shah, A Al-mukhtar, E Whitehall, A Giblin, A Adamec, J Konsten, M Van Heinsbergen, A Sou, J Jimeno Fraile, D Morales-Garcia, M Carrillo-Rivas, E Toledo Martínez, Pascual À, A Landaluce-olavarria, M Gonzalez De miguel, Fernández Gómez Cruzado L, E Begoña, D Lecumberri, A Calvo Rey, GM Prada hervella, L Dos Santos Carregal, MI Rodriguez Fernandez, M Freijeiro, S El Drubi Vega, J Van den Eynde, W Oosterlinck, R Van den Eynde, A Boeckxstaens, A Cordonnier, J Jaekers, M Miserez, M Galipienso Eri, JD Garcia Montesino, J Dellonder Frigolé, D Noriego Muñoz, V Lizzi, F Vovola, A Arminio, A Cotoia, AL Sarni, M Bekheit, BS Kamera, M Elhusseini, A Ahmeidat, W Cymes, G Mignot, J Agilinko, A Sgrò, MM Rashid, K Milne, KE Stewart, MSJ Wilson, K McGivern, BC Brown, B Wadham, IA Aneke, J Collis, H Warburton, DM Fountain, R Laurente, KV Sigamoney, M Dasa, Z Naqui, M Galhoum, MT Hasan, R Kalenderov, O Pathmanaban, R Chelva, K Subba, M Khalefa, F Hossain, T Moores, J Anthoney, O Emmerson, R Makin-Taylor, CS Ong, R Callan, O Bloom, G Chauhan, J Kaur, A Burahee, S Bleibleh, N Pigadas, D Snee, S Bhasin, A Crichton, A Habeebullah, AS Bodla, M Mondragon, V Dewan, MC Giuffrida, A Marano, S Palagi, S Di Maria Grimaldi, A Simonato, M D'Agruma, R Chiarpenello, L Pellegrino, F Maione, D Cianflocca, Pruiti Ciarello, G Giraudo, E Gelarda, E Dalmasso, A Abrate, V Ciriello, F Rosato, A Garnero, L Leotta, M Chiozza, G Anania, A Urbani, M Koleva Radica, P Carcoforo, M Portinari, M Sibilla, JE Archer, A Odeh, N Siddaiah, H Carmichael, CG Velopulos, RC McIntyre, TJ Schroeppel, EA Hennessy, L Zier, C Parmar, JM Muñoz Vives, CJ Gómez Díaz, CA Guariglia, C Soto Montesinos, L Sanchon, M Xicola Martínez, N Guàrdia, P Collera, R Diaz Del Gobbo, R Sanchez Jimenez, R Farre Font, R Flores Clotet, CEM Brathwaite, H Hakmi, AH Sohail, R Heckburn, D Townshend, N McLarty, A Shenfine, K Madhvani, M Hampton, AP Hormis, V Miu, K Sheridan, C Luney, MA Williams, A Alqallaf, A Ben-Sassi, R Crichton, J Sonksen, GR Layton, B Karki, S Pankhania, S Asher, A Folorunso, J Winyard, J Mangwani, BHB Babu, C Weerasinghe, M Ballabio, P Bisagni, T Armao, M Madonini, A Gagliano, P Pizzini, A Älgå, M Nordberg, G Sandblom, J El Kafsi, K Logishetty, A Saadya, R Midha, H Subbiah Ponniah, T Stockdale, T Bacarese-Hamilton, N Anjarwalla, D Marujo Henriques, R Hettige, C Baban, A Tenovici, F Anazor, SD King, S Kazzaz, S HKruijff, De Vries JPPM, PJ Steinkamp, PKC Jonker, WY Van der Plas, W Bierman, Y Janssen, ABJ Borgstein, D Enjuto, M Perez Gonzalez, P Díaz Peña, M Marqueta De Salas, P Martinez Pascual, L Rodríguez Gómez, R Garcés García, A Ramos Bonilla, N Herrera-Merino, P Fernández Bernabé, EP Cagigal Ortega, García de Castro Rubio E, I Cervera, MH Siddique, C Barmpagianni, A Basgaran, A Basha, V Okechukwu, A Bartsch, CA Leo, HK Ubhi, N Zafar, H Abdul-Jabar, F Mongelli, M Bernasconi, M Di Giuseppe, D Christoforidis, D La Regina, M Arigoni, A Al-Sukaini, S Mediratta, O Brown, M Boal, S Stanger, H Abdalaziz, J Constable, G Dovell, R Gopi reddy, A Dehal, HB Shah, GWV Cross, P Seyed-Safi, YW Smart, A Kuc, M Al-Yaseen, B Jayasankar, D Balasubramaniam, K Abdelsaid, N Mundkur, RE Soulsby, O Ryska, T Raymond, P Hawkin, G Kinnaman, I Sharma, K Freystaetter, JN Hadfield, A Hilley, S Arkani, M Youssef, I Shaikh, K Seebah, V Kouritas, D Chrastek, G Maryan, DF Gill, F Khatun, J Parakh, V Sarodaya, A Daadipour, KD Bosch, V Bashkirova, LS Dvorkin, VK Kalidindi, A Choudhry, M Espino Segura-Illa, G Sánchez Aniceto, AM Castaño-Leon, L Jimenez-Roldan, J Delgado Fernandez, A Pérez Núñez, A Lagares, D Garcia Perez, M Santas, I Paredes, O Esteban Sinovas, L Moreno-Gomez, E Rubio, V Vega, A Vivas Lopez, M Labalde Martinez, O García Villar, PM Pelaéz Torres, J Garcia Borda, E Ferrero Herrero, C Eiriz Fernandez, C Ojeda-Thies, JM Pardo Garcia, H Wynn Jones, H Divecha, C Whelton, E Powell-Smith, M Alotaibi, A Maashi, A Zowgar, M Alsakkaf, O Izquierdo, D Ventura, D Escobar, U Garcia de cortazar, Villamor Garcia, A Cioci, K Rakoczy, W Pavlis, R Saberi, A Khaleel, A Unnithan, K Memon, RR Pala Bhaskar, F Maqboul, F Kamel, A Al-Samaraee, R Madani, H Llaquet Bayo, N Duchateau, C De Gheldere, A Fayad, ML Wood, G Groot, I Hakami, C Boeker, J Mall, AF Haugstvedt, ML Jönsson, P Caja Vivancos, Villalabeitia Ateca, M Prieto Calvo, P Martin Playa, A Gainza, EJ Aragon Achig, A Rodriguez Fraga, Melchor Corcóstegui, G Mallabiabarrena Ormaechea, JJ Garcia Gutierrez, L Barbier, MA Pesántez Peralta, M Jiménez Jiménez, JA Municio Martín, J Gómez Suárez, G García Operé, LA Pascua Gómez, M Oñate Aguirre, A Fernandez-Colorado, M De la Rosa-Estadella, A Gasulla-Rodriguez, M Serrano-Martin, A Peig-Font, S Junca-Marti, M Juarez-Pomes, S Garrido-Ondono, L Blasco-Torres, M Molina-Corbacho, Y Maldonado-Sotoca, A Gasset-Teixidor, J Blasco-Moreu, V Turrado-Rodriguez, AM Lacy, FB de Lacy, X Morales, A Carreras-Castañer, P Torner, M Jornet-Gibert, M Balaguer-Castro, M Renau-Cerrillo, P Camacho-Carrasco, M Vives-Barquiel, B Campuzano-Bitterling, I Gracia, R Pujol-Muncunill, M Estaire Gómez, D Padilla-Valverde, S Sánchez-García, D Sanchez-Pelaez, E Jimenez Higuera, R Picón Rodríguez, Fernández Camuñas À, C Martínez-Pinedo, EP Garcia Santos, V Muñoz-Atienza, A Moreno Pérez, CA Cano, D Crego-Vita, M Huecas-Martinez, A Roselló Añón, MJ Sangüesa, JC Bernal-Sprekelsen, JC Catalá Bauset, P Renovell Ferrer, C Martínez Pérez, O Gil-Albarova, J Gilabert Estellés, K Aghababyan, R Rivas, J Escartin, JL Blas Laina, B Cros, Talal El-Abur, J Garcia Egea, C Yanez, JH Kauppila, E Sarjanoja, S Tzedakis, PA Bouche, S Gaujoux, D Gossot, A Seguin-Givelet, D Fuks, M Grigoroiu, R Sanchez Salas, X Cathelineau, P Macek, Y Barbé, F Rozet, E Barret, A Mombet, N Cathala, E Brian, F Zadegan, AJ Baldwin, E Gammeri, A Catton, S Marinos Kouris, J Pereca, M Kaushal, A Kler, V Reghuram, S Tezas, V Oktseloglou, F Mosley, MFI De La Cruz Monroy, P Bobak, S Ahad, E Lostis, GK Ambler, J Manara, M Doe, T Jichi, GD Stewart, J Ramzi, AA Singh, J Ashcroft, OJ Baker, P Coughlin, Durst AZED, A Abood, A Habeeb, VE Hudson, B Lamb, L Luke, S Mitrasinovic, Ngu AWT, S Waseem, F Georgiades, XS Tan, J Pushpa-rajah, I Abu-Nayla, S Rooney, E Irune, MHV Byrne, A Durrani, A Sethuraman Venkatesan, T Combellack, G Tahhan, M Kornaszewska, V Valtzoglou, I Deglurkar, M Koutentakis, Syed Nong Chek SAH, M Shinkwin, F Ayeni, H Tustin, M Bordenave, N Manu, N Eardley, OL Serevina, S Roy Mahapatra, K Mohankumar, I Khawaja, A Palepa, T Doulias, Y Premakumar, Y Jauhari, Z Koshnow, A Uberai, F Hirri, BM Stubbs, J Manickavasagam, S Dalgleish, R Kanitkar, CJ Payne, Ng CE, DE Henshall, T Drake, EM Harrison, A Tambyraja, RJE Skipworth, G Linder, R McGregor, J Mayes, R Pasricha, A Razik, S Thrumurthy, D Howden, Z Baxter, L Osagie, M Bence, GE Fowler, N Rajaretnam, A Goubran, JS McGrath, JRA Phillips, DA Raptis, JM Pollok, F Soggiu, S Xyda, C Hidalgo Salinas, H Tzerbinis, T Pissanou, R Mirnezami, N Angamuthu, T Shakir, H Capitelli-McMahon, L Hitchman, A Andronic, A Aboelkassem Ibrahim, J Totty, S Tayeh, T Chase, J Ayorinde, T Cuming, A Trompeter, C Hing, P Tsinaslanidis, MW Benjamin, A Leyte, J Smelt, G Santhirakumaran, A Labib, O Lyons, S Onida, KM Sarraf, S Erridge, S Yalamanchili, A Abuown, D Davenport, S Wheatstone, SM Andreani, MF Bath, A Sahni, L Rigueros Springford, C Sohrabi, J Bacarese-Hamilton, FG Taylor, P Patki, C Tanabalan, ME Alexander, CJ Smart, L Abdeh, M Zeiton, R Advani, S Nikolaou, T Oni, N Ilahi, K Ballantyne, Z Woodward, R Merh, B Robertson-Smith, P Ameerally, JG Finch, C Gnanachandran, I Pop, D Dass, G Thiruchandran, Toh SKC, A Allana, C Bellis, O Babawale, YC Phan, U Lokman, T Koc, L Duggleby, S Shamoon, H Clancy, A Mansuri, A Thakrar, L Wickramarachchi, S Sivayoganathan, E Karam, HV Colvin, A Badran, A Cadersa, A Cumpstey, R Aftab, F Wensley, V Morrison-Jones, GK Sekhon, H Shields, Z Shakoor, T Talbot, A Alzetani, J Rooney, M Rudic, A Aladeojebi, M Kitchen, R Lefroy, P Nanjaiah, AD Rajgor, RJ Scurrah, LJ Watson, T Royle, B Steel, Luk ACO, VG Thiruvasagam, W Marlow, C Konstantinou, D Yershov, A Denning, E Mangos, T Nambirajan, I Flindall, V Mahendran, J De Marchi, NF Davis, A Picciariello, V Papagni, DF Altomare, S Granieri, C Cotsoglou, A Cabeleira, P Serralheiro, T Teles, C Canhoto, J Simões, AC Almeida, O Nogueira, R Athayde Nemésio, MJ Amaral, A Valente da Costa, R Martins, P Guerreiro, A Ruivo, D Breda, JM Oliveira, AL De Oliveira Lopez, M Colino, J De Barros, AP Soares, H Morais, T Revez, MI Manso, JC Domingues, P Henriques, Cardoso N Ribeiro VI, G Martins dos Santos, M Peralta Ferreira, J Ascensão, B Costeira, L Rio Rodrigues, M Sousa Fernandes, P Azevedo, I Lourenço, G Mendinhos, A Nobre Pinto, H Taflin, H Abdou, L O'Meara, Z Cooper, SA Hirji, BU Okafor, V Roxo, CP Raut, JS Jolissaint, DA Mahvi, C Reinke, S Merola, A Ssentongo, P Ssentongo, Oh JS, J Hazelton, J Maines, N Gusani, RCG Martin, N Bhutiani, R Choron, F Soliman, MD E Dauer, E Renza-Stingone, E Gokcen, E Kropf, H Sufrin, J Sewards, J Poggio, K Sanserino, L Rae, M Philp, M Metro, P McNelis, R Petrov, T Pazionis, DB Lumenta, SP Nischwitz, E Richtig, M Pau, P Srekl-Filzmaier, N Eibinger, B Michelitsch, M Fediuk, A Papinutti, TU Cohnert, E Kantor, J Kahiu, S Hosny, A Sultana, M Taggarsi, L Vitone, OP Vaz, I Sarantitis, S Timbrell, A Shugaba, GP Jones, SS Tripathi, MS Greenhalgh, H Emerson, K Vejsbjerg, W McCormick, K Singisetti, Y Aawsaj, R Vanker, M Ghobrial, S Kanthasamy, H Fawi, M Awadallah, J Cheung, S Tingle, F Abbadessa, A Sachdeva, CD Chan, I McPherson, F Mahmoud Ali, S Pandanaboyana, T Grainger, S Nandhra, N Dawe, C McCaffer, J Riches, J Moir, H Elamin Ahmed, C Saleh, RM Koshy, LJ Rogers, PL Labib, N Hope, K Emslie, P Panahi, E Clough, I Enemosah, J Natale, N Raza, JI Webb, M Antar, J Noel, R Nunn, F Eriberto, R Tanna, S Lodhia, C Osório, J Antunes, P Balau, and M Godinho

Subjects
Medicine
Abstract

Objectives Studies have demonstrated high rates of mortality in people with proximal femoral fracture and SARS-CoV-2, but there is limited published data on the factors that influence mortality for clinicians to make informed treatment decisions. This study aims to report the 30-day mortality associated with perioperative infection of patients undergoing surgery for proximal femoral fractures and to examine the factors that influence mortality in a multivariate analysis.Setting Prospective, international, multicentre, observational cohort study.Participants Patients undergoing any operation for a proximal femoral fracture from 1 February to 30 April 2020 and with perioperative SARS-CoV-2 infection (either 7 days prior or 30-day postoperative).Primary outcome 30-day mortality. Multivariate modelling was performed to identify factors associated with 30-day mortality.Results This study reports included 1063 patients from 174 hospitals in 19 countries. Overall 30-day mortality was 29.4% (313/1063). In an adjusted model, 30-day mortality was associated with male gender (OR 2.29, 95% CI 1.68 to 3.13, p80 years (OR 1.60, 95% CI 1.1 to 2.31, p=0.013), preoperative diagnosis of dementia (OR 1.57, 95% CI 1.15 to 2.16, p=0.005), kidney disease (OR 1.73, 95% CI 1.18 to 2.55, p=0.005) and congestive heart failure (OR 1.62, 95% CI 1.06 to 2.48, p=0.025). Mortality at 30 days was lower in patients with a preoperative diagnosis of SARS-CoV-2 (OR 0.6, 95% CI 0.6 (0.42 to 0.85), p=0.004). There was no difference in mortality in patients with an increase to delay in surgery (p=0.220) or type of anaesthetic given (p=0.787).Conclusions Patients undergoing surgery for a proximal femoral fracture with a perioperative infection of SARS-CoV-2 have a high rate of mortality. This study would support the need for providing these patients with individualised medical and anaesthetic care, including medical optimisation before theatre. Careful preoperative counselling is needed for those with a proximal femoral fracture and SARS-CoV-2, especially those in the highest risk groups.Trial registration number NCT04323644

Published
2021
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2. Appendicitis risk prediction models in children presenting with right iliac fossa pain (RIFT study): a prospective, multicentre validation study

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Dmitri Nepogodiev, Richard JW Wilkin, Catherine J Bradshaw, Clare Skerritt, Alasdair Ball, Waaka Moni-Nwinia, Ruth Blanco-Colino, Priyesh Chauhan, Thomas M Drake, Matteo Frasson, Oliver Gee, James C Glasbey, Jacob H Matthews, Gabriella L Morley, David N Naumann, Francesco Pata, Antonio S Soares, Aneel Bhangu, SH Abbas, AM Abdelgadir, A Abdelrahman, M Abdelrahman, A Abdelwahed, Y Abou El Ella, M Abulafi, A Acharya, ME Adam, RE Adams, SO Adegbola, A Adimonye, M Adnan, S Afshar, A Ahad, J Ahel, DP Ahern, A Ahmad Asmadi, B Ahmed, G Ahmed, OS Ahmed, S Ahmed, K Akbari, O Akinsola, W Al-Khyatt, B Al-Sarireh, M Al-Sheikh, M Alani, R Alexander, T Alhammali, M Ali, A Aljorfi, M Allen, J Allington, A Alshafei, R Amarasinghe, A Amayo, V Amin, Thuva Amuthalingam, L Anandan, O Anderson, SM Andreani, B Andrews, A Ang, B Aravind, JE Archer, MA Aremu, S Arunachalam, N Aruparayil, DL Ashmore, O Ashour, N Ashraf, N Assaf, H Avalapati, OO Awokoya, J Ayube-Brown, T Badenoch, R Bagga, A Baginski, S Bailey, STR Bailey, C Baird, B Baker, EJ Balai, A Balasubramaniam, SK Bandyopadhyay, A Banks, H Bansal, W Barnieh, A Barrie, CA Barter, J Bastianpillai, WD Beasley, CR Bell, J Bell, D Beral, BJM Berry, KE Bevan, V Bevan, Shiv Bhanderi, A Bhargava, D Bilku, A Birindelli, OD Blackford, JEM Blackwell, L Blake, Natalie S Blencowe, TD Boam, C Boereboom, M Bogdan, P Bohra, JC Bolger, W Bolton, S Bond, CM Borg, K Borghol, PR Boshier, N Bouhadiba, J Bowen, H Bowerman, CR Bowman, H Boyd-Carson, CJ Bradshaw, G Branagan, P Brennan, M Brett, HK Brewer, H Brewer, C Bronder, A Brown, AG Brown, CE Brown, M Brown, R Brown, S Buckley-Jones, A Budzanowski, W Bukhari, C Bull, JK Bullivant, KM Burns, D Burnside, A Busuttil, BE Byrne, CK Byrnes, M Caldwell, R Callan, FC Cameron, U Campbell, UM Campbell, W Campbell, CA Carden, CFW Carder, K Carney, H Cartwright, P Cay, A Chalk, B Chambers, A Champsi, D Chan, TCW Chan, SB Chandler, J Chapman, A Charalabopoulos, B Chasty, M Chatzikonstantinou, WL Cheah, CS Chean, S Cheng, SA Cheng, M Cheruvu, MY Chin, IA Chishti, S Choi, SM Chok, B Chong, JH Choong, M Chowdhary, F Chowdhury, CH Choy, L Christian, P Christopoulos, K Chui, M Cipparrone, GL Clark, SA Clarke, SJ Cleeve, KD Clement, B Clements, C Clements, JD Clements, JM Clements, JS Clements, JA Clements, R Clingan, L Cloney, ECS Clough, PO Coe, O Collier-Wakefield, DW Colliver, DA Colvin, TM Connelly, MJ Connor, V Cook, F Cooke, F Cooper, AE Cotton, DG Couch, L Cousins, D Coyle, W Creasy, RL Cresner, A Crone, K Cross, J Crozier, P Cunha, NJ Curtis, N D'Souza, H Dagash, S Dalmia, I Daniels, D Danquah-Boateng, FA Dar, K Dart, A Das, R Daureeawoo, S Davidson, JR Davidson, PL Davies, S Davis, V Daya Shetty, A De-Manzoni-Garberini, JA De-Marchi, EA Dean, S Dean, C Delimpalta, S Denley, G Dennison, AA Devine, S Dharamavaram, AA Dhari, F Di Franco, S Di Saverio, C Dobson, JA Docherty, C Doherty, G Donaldson, NO Donohoe, O Donohoe, E Douka, T Doulias, M Downey, C Doyle, N Drye, DT Du, JG Dudek, PG Dunning, ARS Dyal, NJ Eardley, L Earnshaw, S Easdon, SE Edwards, RJ Egan, S El-Masry, O El-Tayar, CR Elbourne, S Elgaddal, M Elseedawy, M Elshaer, OH Elsharnoby, WMA Elzeneini, KM Emslie, NFT Engall, B Ertansel, HD Esmail, C Ettles, J Evans, JD Evans, A Everden, M Fadel, SE Fahmy, CJ Fairfield, BF Fanibi, Valeria Farina, SM Farrell, EZ Farrow, JA Fasuyi, G Faulkner, D Fawkner-Corbett, F Fawzi, M Fehervari, N Ferguson, JG Finch, H Finlayson, T Flack, W Foers, NM Foley, K Ford, A Forgie, A Foster, JD Foster, AMW Fox, N Francis, D Franklin, H Froud, HL Fuller, E Gaines, J Galea, E Gammeri, J Garnham, J Garvin, Z Gates, R Gentry, I Ghaffari, S Ghatorae, AL Gidwani, TG Gilbert, TM Gilbert, S Gill, M Gillespie, J Gillick, A Giorga, K Gopalakrishnan, S Gopalswamy, S Gopinath, R Gormely, G Govind, C Grant, J Graveston, J Gray, RT Gray, D Griffith, JP Griffith, Ewen A Griffiths, SN Griffiths, EJ Griggs, S Grosvenor, T Grove, M Gulamhussein, J Guliani, A Gummaraju, S Gunning, SV Gurjar, S Guru-Naidu, S Gurung, H Habib, L Hackney, James B Haddow, S Hajibandeh, C Halkias, NJ Hall, RN Hamelmann, M Haneef, MS Haneef, Z Hanif, C Hanley, AJ Hann, T Hanna, E Hardy, A Harlinska, F Harper, RL Harries, A Harris, Grant Harris, MP Harris, R Hasan, A Hassane, JR Hatt, Z Haveliwala, W Hawkins, Z Hayat, C Hayes, KRM Hebbar, L Henderson, LT Henderson, PJJ Herrod, P Hever, LM Hickey, G Hicks, JM Hodgson, M Hoff, A Hollingsworth, A Hook, ST Hornby, E Horsfield, EE Howie, L Huang, NJ Hudson-Peacock, DL Hughes, KA Hureibi, A Hussain, N Hussain, SA Hussaini, A Hussein, B Hutchinson, YMS Ibrahim, S Ikram, T Ilozue, E Iosif, MR Iqbal, S Irukulla, R Irwin, N Islam, P Ivey, CR Jackson, A Jackson, SMH Jah, A Jain, S Jain, Sarus Jain, GM Jama, NB Jamieson, S Janardanan, B Jasinski, D Jenner, E Jerome, B Johnson, A Johnstone, S Jokhan, A Jones, CE Jones, CS Jones, E Jones, L Jones, U Kabir, S Kabwama, M Kamal, IW Kamande, V Kanakala, M Kannegieser-Bailey, S Kaptanis, MJ Karim, RS Karwal, G Kaur, R Keegan, A Kelay, ND Kennedy, DA Kent, A Khair, K Khan, S Khan, A Khasria, H Kho, J Kilkenny, R King, J Kinross, EN Kirkham, B Knight, R Kochupapy, C Koh, O Kouli, A Krishnamoorthy, S Krivan, K Kumar, S Kumar, VWS Kung, R Kuo, G Lafaurie, CW Lai, N Lal, S Lawday, S Layman, GR Layton, A Lazzaro, L Lecky-Thompson, KA Lee, KJ Lee, M Lee, SL Lee, PA Leighton, RP Leitch, HC Lennox-Warburton, EL Leung, CH Li, JM Lim, C Limb, G Ljungqvist, G Lloyd, S Lodhia, PC Logan, M Long, P Long, RH Long, A Longshaw, C Louw, JN Lund, C Ly, MJ Lynch Wong, JKY Ma, A Macdonald, EGE Macinnes, T Magro, R Mahapatra, B Mahendran, F Mahmood, A Mahmoud, D Mahon, D Mai, A Maina, CP Major, R Makhija, Y Malam, A Malik, K Malik, SN Malik, VM Manda, KM Manektella, C Mann, P Manoharan, R Manson, S Mansoor, MM Mansour, S Mansour, F Maqboul, D Maragouthakis, G Marangoni, S Mardhiah, H Maripi, P Marriott, L Marsh, G Marshall, A Martin, LM Martin, E Martinou, R Mashar, John Mason, M Masood, G Mathew, K Maude, E Mazumdar, A Mc-Dermott, D Mcarthur, RS Mccain, S McCain, C Mccann, P Mccaughey, SJ Mccluney, J Mccullough, D Mcdonnell, NA Mcdowall, JE McEntee, K McGlynn, D Mcgrath, O Mcgucken, S Mcilwaine, AC Mcilwrath, SC Mckay, MA McKelvie, M Mckenna, J Mckeon, KL Mckevitt, NC Mckinley, D McLaughlin, SV McMahon, D Mcmorran, L McNally, M Mcquaid, DM Mcwhirter, K Mealy, A Mears, D Menzies, H Merai, RJ Mersh, M Miguras, D Milgrom, K Miller, J Milward, S Mirza, AT Misky, D Mistry, MJ Mitchard, RM Mitru, IM Mohamed, Imran Mohamed, TM Mohamed, WO Mohamed, N Mohd, C Moore, J Moradzadeh, TEM Morrison, V Morrison-Jones, Dion G Morton, BS Mothe, Fh Motiwala, D Motter, NG Mowbray, Z Mughal, J Mulsow, N Mundkur, A Muntean, C Murphy, R Murphy, MP Murray, M Muzaffar, A Myatt, A Nadeem, D Nagarajan, S Nagendram, A Nair, MK Nair, MS Nair, KN Naismith, K Nambiar, GR Nana, Z Nash, P Nastro, S Nazarian, G Neagle, A Neale, PM Neary, RC Newton, M Ng, S Ng, O Niaz, S Nickson, D Nicol, E Nimako, MS Noor Mohamed, M Nyeko-Lacek, BR O'Connor, E O'Neill, N O'Neill, D O'Sullivan, J O'Brien, M Oakey, N Obeid, A Odeh, S Ogboru, C Ogbuokiri, B Okekunle, E Okorocha, O Olagbaiye, JB Olivier, R Ooi, P Orawiec, M Orizu, N Orme, R Ormiston, C Paget, A Pal, LK Palani-Velu, Y Pan, N Panda, V Pandey, R Pandya, D Pandya, KR Paramasevon, C Pardy, MJ Parkola, Sandro Pasquali, AS Patel, BY Patel, C Patel, H Patel, N Patel, RT Patel, S Patel, Y Patel, MM Patel, SD Patil, CJ Payne, RE Payne, JCH Pearce, L Pearce, A Pedder, CB Peirce, GB Peiris, A Peleki, Gianluca Pellino, V Pento, D Peprah, HS Perera, MI Perera, L Phelan, D Photiou, R Pierre, JP Pilkington, Thomas D Pinkney, B Pisavadia, A Poacher, M Podda, H Pollard, D Popova, M Poudevigne, A Prideaux, UP Pullabatla Venkata, A Quddus, S Quill, M Rabie, MR Rabie, RW Radwan, JF Rae, A Rahim, LS Rahmani, S Rajagopal, R Rajaram, N Rajaretnam, Y Rajjoub, H Rallage, S Ramcharan, S Ranathunga, M Rao, VSR Rao, A Raofi, M Rashid, A Rate, R Ravindran, M Raymond, SS Raza, A Reddy, EP Redman, AE Redmond, 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Strachan, BM Stubbs, W Stupalkowska, A Suliman, A Sultana, H Sunter, S Suriyakumar, NRA Symons, K Szentpali, A Szucs, V Tabain, LE Tague, K Tailor, CY Tan, S Tan, AM Tang, M Tarazi, YH Tay, S Tayeh, M Taylor, NS Taylor, D Taze, E Teasdale, N Thakral, B Thava, N Thavanesan, AJ Thaventhiran, K Theodoropoulou, AT Thomas, L Thomas, DB Thompson, R Thompson, SN Thoukididou, SG Tiboni, LA Tiedt, N Ting, BJ Tinsley, JM Tognarelli, J Torkington, A Torrance, DC Townsend, PJ Tozer, M Trail, F Trew, V Tudyka, L Tullie, A Turnbull, EJ Turner, CS Twum-Barima, Robert Tyler, S Vakis, A La Valle, GI Van Boxel, J Vance-Daniel, M Varcada, N Varma, EM Vaughan, VR Velchuru, R Velho, AK Venkatasubramaniam, ML Venn, V Vijay, Z Vinnicombe, P Vitish-Sharma, S Wagener, K Waite, KJ Walters, U Walters, BG Wardle, SD Wardle, J Warusavitarne, J Watfah, N Watson, J Wauchope, LW Weatherburn, CR Weegenaar, S Welsh, S Wheatstone, HE Whewell, P Whitehouse, E Whiteman, L Whittaker, K Wijesundera, D Wilkinson, GL Williams, M Williams, R Williams, S Williams, EJ Wilson, MSJ Wilson, DC Winter, G Winter, J Wolff, A Wong, CLL Wong, SY Wong, CS Wood, C Woodrow, A Woodward, B Woodward, E Wright, HL Wright, F Wu, S Yalamarthi, P Yang, E Yardimci, T Yasin, SK Yen, S Yoganathan, S Yoong, H Youssef, LPS Yow, A Zaborowski, AZ Zadi, ZA Zarka, MA Zarog, AY Zhang, Nepogodiev, D., Wilkin, R. 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C., Campbell, U., Campbell, U. M., Campbell, W., Carden, C. A., Carder, C. F. W., Carney, K., Cartwright, H., Cay, P., Chalk, A., Chambers, B., Champsi, A., Chan, D., Chan, T. C. W., Chandler, S. B., Chapman, J., Charalabopoulos, A., Chasty, B., Chatzikonstantinou, M., Cheah, W. L., Chean, C. S., Cheng, S., Cheng, S. A., Cheruvu, M., Chin, M. Y., Chishti, I. A., Choi, S., Chok, S. M., Chong, B., Choong, J. H., Chowdhary, M., Chowdhury, F., Choy, C. H., Christian, L., Christopoulos, P., Chui, K., Cipparrone, M., Clark, G. L., Clarke, S. A., Cleeve, S. J., Clement, K. D., Clements, B., Clements, C., Clements, J. D., Clements, J. M., Clements, J. S., Clements, J. A., Clingan, R., Cloney, L., Clough, E. C. S., Coe, P. O., Collier-Wakefield, O., Colliver, D. W., Colvin, D. A., Connelly, T. M., Connor, M. J., Cook, V., Cooke, F., Cooper, F., Cotton, A. E., Couch, D. G., Cousins, L., Coyle, D., Creasy, W., Cresner, R. L., Crone, A., Cross, K., Crozier, J., Cunha, P., Curtis, N. J., D'Souza, N., Dagash, H., Dalmia, S., Daniels, I., Danquah-Boateng, D., Dar, F. A., Dart, K., Das, A., Daureeawoo, R., Davidson, S., Davidson, J. R., Davies, P. L., Davis, S., Daya Shetty, V., De-Manzoni-Garberini, A., De-Marchi, J. A., Dean, E. A., Dean, S., Delimpalta, C., Denley, S., Dennison, G., Devine, A. A., Dharamavaram, S., Dhari, A. A., Di Franco, F., Di Saverio, S., Dobson, C., Docherty, J. A., Doherty, C., Donaldson, G., Donohoe, N. O., Donohoe, O., Douka, E., Doulias, T., Downey, M., Doyle, C., Drye, N., Du, D. T., Dudek, J. G., Dunning, P. G., Dyal, A. R. S., Eardley, N. J., Earnshaw, L., Easdon, S., Edwards, S. E., Egan, R. J., El-Masry, S., El-Tayar, O., Elbourne, C. R., Elgaddal, S., Elseedawy, M., Elshaer, M., Elsharnoby, O. H., Elzeneini, W. M. A., Emslie, K. M., Engall, N. F. T., Ertansel, B., Esmail, H. D., Ettles, C., Evans, J., Evans, J. D., Everden, A., Fadel, M., Fahmy, S. E., Fairfield, C. J., Fanibi, B. F., Farina, V., Farrell, S. M., Farrow, E. Z., Fasuyi, J. A., Faulkner, G., Fawkner-Corbett, D., Fawzi, F., Fehervari, M., Ferguson, N., Finch, J. G., Finlayson, H., Flack, T., Foers, W., Foley, N. M., Ford, K., Forgie, A., Foster, A., Foster, J. D., Fox, A. M. W., Francis, N., Franklin, D., Froud, H., Fuller, H. L., Gaines, E., Galea, J., Gammeri, E., Garnham, J., Garvin, J., Gates, Z., Gentry, R., Ghaffari, I., Ghatorae, S., Gidwani, A. L., Gilbert, T. G., Gilbert, T. M., Gill, S., Gillespie, M., Gillick, J., Giorga, A., Gopalakrishnan, K., Gopalswamy, S., Gopinath, S., Gormely, R., Govind, G., Grant, C., Graveston, J., Gray, J., Gray, R. T., Griffith, D., Griffith, J. P., Griffiths, E. A., Griffiths, S. N., Griggs, E. J., Grosvenor, S., Grove, T., Gulamhussein, M., Guliani, J., Gummaraju, A., Gunning, S., Gurjar, S. V., Guru-Naidu, S., Gurung, S., Habib, H., Hackney, L., Haddow, J. B., Hajibandeh, S., Halkias, C., Hall, N. J., Hamelmann, R. N., Haneef, M., Haneef, M. S., Hanif, Z., Hanley, C., Hann, A. J., Hanna, T., Hardy, E., Harlinska, A., Harper, F., Harries, R. L., Harris, A., Harris, G., Harris, M. P., Hasan, R., Hassane, A., Hatt, J. R., Haveliwala, Z., Hawkins, W., Hayat, Z., Hayes, C., Hebbar, K. R. M., Henderson, L., Henderson, L. T., Herrod, P. J. J., Hever, P., Hickey, L. M., Hicks, G., Hodgson, J. M., Hoff, M., Hollingsworth, A., Hook, A., Hornby, S. T., Horsfield, E., Howie, E. E., Huang, L., Hudson-Peacock, N. J., Hughes, D. L., Hureibi, K. A., Hussain, A., Hussain, N., Hussaini, S. A., Hussein, A., Hutchinson, B., Ibrahim, Y. M. S., Ikram, S., Ilozue, T., Iosif, E., Iqbal, M. R., Irukulla, S., Irwin, R., Islam, N., Ivey, P., Jackson, C. R., Jackson, A., Jah, S. M. H., Jain, A., Jain, S., Jama, G. M., Jamieson, N. B., Janardanan, S., Jasinski, B., Jenner, D., Jerome, E., Johnson, B., Johnstone, A., Jokhan, S., Jones, A., Jones, C. E., Jones, C. S., Jones, E., Jones, L., Kabir, U., Kabwama, S., Kamal, M., Kamande, I. 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P., Makhija, R., Malam, Y., Malik, A., Malik, K., Malik, S. N., Manda, V. M., Manektella, K. M., Mann, C., Manoharan, P., Manson, R., Mansoor, S., Mansour, M. M., Mansour, S., Maqboul, F., Maragouthakis, D., Marangoni, G., Mardhiah, S., Maripi, H., Marriott, P., Marsh, L., Marshall, G., Martin, A., Martin, L. M., Martinou, E., Mashar, R., Mason, J., Masood, M., Mathew, G., Maude, K., Mazumdar, E., Mc-Dermott, A., Mcarthur, D., Mccain, R. S., Mccain, S., Mccann, C., Mccaughey, P., Mccluney, S. J., Mccullough, J., Mcdonnell, D., Mcdowall, N. A., Mcentee, J. E., Mcglynn, K., Mcgrath, D., Mcgucken, O., Mcilwaine, S., Mcilwrath, A. C., Mckay, S. C., Mckelvie, M. A., Mckenna, M., Mckeon, J., Mckevitt, K. L., Mckinley, N. C., Mclaughlin, D., Mcmahon, S. V., Mcmorran, D., Mcnally, L., Mcquaid, M., Mcwhirter, D. M., Mealy, K., Mears, A., Menzies, D., Merai, H., Mersh, R. J., Miguras, M., Milgrom, D., Miller, K., Milward, J., Mirza, S., Misky, A. T., Mistry, D., Mitchard, M. J., Mitru, R. M., Mohamed, I. M., Mohamed, I., Mohamed, T. M., Mohamed, W. O., Mohd, N., Moore, C., Moradzadeh, J., Morrison, T. E. M., Morrison-Jones, V., Morton, D. G., Mothe, B. S., Motiwala, F., Motter, D., Mowbray, N. G., Mughal, Z., Mulsow, J., Mundkur, N., Muntean, A., Murphy, C., Murphy, R., Murray, M. P., Muzaffar, M., Myatt, A., Nadeem, A., Nagarajan, D., Nagendram, S., Nair, A., Nair, M. K., Nair, M. S., Naismith, K. N., Nambiar, K., Nana, G. R., Nash, Z., Nastro, P., Nazarian, S., Neagle, G., Neale, A., Neary, P. M., Newton, R. C., Ng, M., Ng, S., Niaz, O., Nickson, S., Nicol, D., Nimako, E., Noor Mohamed, M. S., Nyeko-Lacek, M., O'Connor, B. R., O'Neill, E., O'Neill, N., O'Sullivan, D., O'Brien, J., Oakey, M., Obeid, N., Odeh, A., Ogboru, S., Ogbuokiri, C., Okekunle, B., Okorocha, E., Olagbaiye, O., Olivier, J. B., Ooi, R., Orawiec, P., Orizu, M., Orme, N., Ormiston, R., Paget, C., Pal, A., Palani-Velu, L. K., Pan, Y., Panda, N., Pandey, V., Pandya, R., Pandya, D., Paramasevon, K. R., Pardy, C., Parkola, M. J., Pasquali, S., Patel, A. S., Patel, B. Y., Patel, C., Patel, H., Patel, N., Patel, R. T., Patel, S., Patel, Y., Patel, M. M., Patil, S. D., Payne, C. J., Payne, R. E., Pearce, J. C. H., Pearce, L., Pedder, A., Peirce, C. B., Peiris, G. B., Peleki, A., Pellino, G., Pento, V., Peprah, D., Perera, H. S., Perera, M. I., Phelan, L., Photiou, D., Pierre, R., Pilkington, J. P., Pinkney, T. D., Pisavadia, B., Poacher, A., Podda, M., Pollard, H., Popova, D., Poudevigne, M., Prideaux, A., Pullabatla Venkata, U. P., Quddus, A., Quill, S., Rabie, M., Rabie, M. R., Radwan, R. W., Rae, J. F., Rahim, A., Rahmani, L. S., Rajagopal, S., Rajaram, R., Rajaretnam, N., Rajjoub, Y., Rallage, H., Ramcharan, S., Ranathunga, S., Rao, M., Rao, V. S. R., Raofi, A., Rashid, M., Rate, A., Ravindran, R., Raymond, M., Raza, S. S., Reddy, A., Redman, E. P., Redmond, A. E., Rekhraj, S., Renshaw, S., Rex, D., Rezacova, M., Rezvani, S., Ribeiro, B., Rich, J. E., Richardson, T. D., Rigby, S., Rigney, B., Rinkoff, S., Robb, H. D., Robertson, C., Robinson, D., Robinson, A., Rodger, V., Rolph, R., Roomi, S., Roth, N. P. G., Rothnie, K., Roy, C., Rupani, S., Rutherford, D. G., Sacks, R., Saghir, N., Saha, A., Sahay, S. J., Sahnan, K., Salama, Y., Salim, S., Samuel, M., Sana, S., Sandu, L., Sarmah, P., Sarveswaran, J., Saunders, S. M. F., Savill, A., Savioli, F., Schuster Bruce, J. R., Sebastian, J. F., Seddon, T. C., Seneviratne, N., Seth, M., Setshwaelo, T., Sezen, E., Sgardelis, P., Sgro, A., Shah, C., Shah, J., Shah, K., Shah, S. M., Shakoor, Z., Shalaby, M. S., Shanmuganathan, V., Shanmugarajah, K., Sharma, A., Sharma, P., Sharp, O. L., Shepherd, J. A., Sherif, M. A., Shet, S., Shingler, G., Shiwani, M. H., Shreshta, D., Sian, T., Siddiqui, M. N., Siddiqui, Z. A., Siggens, K. L., Sihra, N., Silva, I., Simioni, A., Simmonds, L. F. C., Simpson, D. J., Singh, A., Singh, S., Singhal, T., Sivaloganathan, P., Sloan, K., Smallcombe, N., Smart, C. J., Smart, N. J., Smith, R., Smoker, H., Solinas, L., Souter, J. E. H., Springate, E. L., Stephens, G. F., Stevenson, R., Stewart, D. J., Stoica, I., Strachan, E., Stubbs, B. M., Stupalkowska, W., Suliman, A., Sultana, A., Sunter, H., Suriyakumar, S., Symons, N. R. A., Szentpali, K., Szucs, A., Tabain, V., Tague, L. E., Tailor, K., Tan, C. Y., Tan, S., Tang, A. M., Tarazi, M., Tay, Y. H., Tayeh, S., Taylor, M., Taylor, N. S., Taze, D., Teasdale, E., Thakral, N., Thava, B., Thavanesan, N., Thaventhiran, A. J., Theodoropoulou, K., Thomas, A. T., Thomas, L., Thompson, D. B., Thompson, R., Thoukididou, S. N., Tiboni, S. G., Tiedt, L. A., Ting, N., Tinsley, B. J., Tognarelli, J. M., Torkington, J., Torrance, A., Townsend, D. C., Tozer, P. J., Trail, M., Trew, F., Tudyka, V., Tullie, L., Turnbull, A., Turner, E. J., Twum-Barima, C. S., Tyler, R., Vakis, S., Valle, A. L., Van Boxel, G. I., Vance-Daniel, J., Varcada, M., Varma, N., Vaughan, E. M., Velchuru, V. R., Velho, R., Venkatasubramaniam, A. K., Venn, M. L., Vijay, V., Vinnicombe, Z., Vitish-Sharma, P., Wagener, S., Waite, K., Walters, K. J., Walters, U., Wardle, B. G., Wardle, S. D., Warusavitarne, J., Watfah, J., Watson, N., Wauchope, J., Weatherburn, L. W., Weegenaar, C. R., Welsh, S., Wheatstone, S., Whewell, H. E., Whitehouse, P., Whiteman, E., Whittaker, L., Wijesundera, K., Wilkinson, D., Williams, G. L., Williams, M., Williams, R., Williams, S., Wilson, E. J., Wilson, M. S. J., Winter, D. C., Winter, G., Wolff, J., Wong, A., Wong, C. L. L., Wong, S. Y., Wood, C. S., Woodrow, C., Woodward, A., Woodward, B., Wright, E., Wright, H. L., Wu, F., Yalamarthi, S., Yang, P., Yardimci, E., Yasin, T., Yen, S. K., Yoganathan, S., Yoong, S., Youssef, H., Yow, L. P. S., Zaborowski, A., Zadi, A. Z., Zarka, Z. A., Zarog, M. A., and Zhang, A. Y.

Subjects
Male, Pediatrics, medicine.medical_specialty, Validation study, Adolescent, Ultrasound scan, Pain, Risk prediction models, Risk Assessment, Sensitivity and Specificity, Cohort Studies, Ilium, 03 medical and health sciences, 0302 clinical medicine, Predictive Value of Tests, 030225 pediatrics, Developmental and Educational Psychology, medicine, Appendectomy, Humans, Prospective Studies, 030212 general & internal medicine, Surgical emergency, Child, Ultrasonography, business.industry, Area under the curve, Appendicitis, medicine.disease, United Kingdom, Child, Preschool, Acute Disease, Pediatrics, Perinatology and Child Health, Female, Right iliac fossa pain, business, Ireland, Cohort study
Abstract

BACKGROUND: Acute appendicitis is the most common surgical emergency in children. Differentiation of acute appendicitis from conditions that do not require operative management can be challenging in children. This study aimed to identify the optimum risk prediction model to stratify acute appendicitis risk in children. METHODS: We did a rapid review to identify acute appendicitis risk prediction models. A prospective, multicentre cohort study was then done to evaluate performance of these models. Children (aged 5-15 years) presenting with acute right iliac fossa pain in the UK and Ireland were included. For each model, score cutoff thresholds were systematically varied to identify the best achievable specificity while maintaining a failure rate (ie, proportion of patients identified as low risk who had acute appendicitis) less than 5%. The normal appendicectomy rate was the proportion of resected appendixes found to be normal on histopathological examination. FINDINGS:15 risk prediction models were identified that could be assessed. The cohort study enrolled 1827 children from 139 centres, of whom 630 (34·5%) underwent appendicectomy. The normal appendicectomy rate was 15·9% (100 of 630 patients). The Shera score was the best performing model, with an area under the curve of 0·84 (95% CI 0·82-0·86). Applying score cutoffs of 3 points or lower for children aged 5-10 years and girls aged 11-15 years, and 2 points or lower for boys aged 11-15 years, the failure rate was 3·3% (95% CI 2·0-5·2; 18 of 539 patients), specificity was 44·3% (95% CI 41·4-47·2; 521 of 1176), and positive predictive value was 41·4% (38·5-44·4; 463 of 1118). Positive predictive value for the Shera score with a cutoff of 6 points or lower (72·6%, 67·4-77·4) was similar to that of ultrasound scan (75·0%, 65·3-83·1). INTERPRETATION: The Shera score has the potential to identify a large group of children at low risk of acute appendicitis who could be considered for early discharge. Risk scoring does not identify children who should proceed directly to surgery. Medium-risk and high-risk children should undergo routine preoperative ultrasound imaging by operators trained to assess for acute appendicitis, and MRI or low-dose CT if uncertainty remains. FUNDING: None.

Published
2021
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3. Surgical Assessment Units: The Key to More Efficient Emergency Surgical Provision and Admissions?

Author

Reeds MG, Andreani SM, Rohatgi A, and Taylor FGM

Subjects
Cost-Benefit Analysis, Emergency Treatment methods, General Surgery economics, Humans, Organizational Innovation, Patient Discharge economics, Emergency Service, Hospital, General Surgery statistics & numerical data, Patient Discharge statistics & numerical data, Referral and Consultation statistics & numerical data, Surgery Department, Hospital
Abstract

Background: Hospitals establish surgical assessment units to promote efficiency and improve patient experience. Surgical assessment units are believed to reduce unnecessary admissions. We evaluated a hospital's on-call surgery service without this facility to determine benefits of implementation., Methods: All emergency surgery referrals made over a 3-month period were recorded, including whether the patient was immediately discharged directly from emergency surgery. Data collection was undertaken by each surgical firm on-call. Immediate discharges were classed as patients not admitted to the hospital overnight (regardless of whether the patient had outpatient follow-up planned)., Results: Nine hundred eighty-four referrals were identified. Seven hundred ninety-three referrals had complete data and therefore were included for analysis. Of these, 349 patients (44.0% of referrals) were immediately discharged from emergency surgery, thereby preventing unnecessary admissions (a high proportion of surgical referrals not requiring hospital admission). This improves hospital efficiency, cost savings, and patient experience. Immediate discharge was less frequent and more difficult to accomplish if patients were initially assessed on wards (instead of in the emergency department). This is likely due to patients' perceptions that admission was required when transferred from emergency department to a ward., Conclusions: Establishment of surgical assessment units has multiple potential benefits to patients, hospitals and clinicians. Appropriateness of surgical assessment unit implementation by every hospital ought to be evaluated.

Published
2020
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4. Laparoscopic vs. open appendicectomies: results obtained by junior surgeons at a British University Hospital.

Author

Colombo F, Andreani SM, Gravante G, and Davies A

Subjects
Adult, Appendectomy adverse effects, Appendectomy education, Clinical Competence, Education, Medical, Graduate, Female, Humans, Length of Stay, London, Male, Middle Aged, Postoperative Complications etiology, Retrospective Studies, Time Factors, Treatment Outcome, Workforce, Young Adult, Appendectomy methods, Hospitals, University, Laparoscopy adverse effects, Laparoscopy education, Medical Staff, Hospital education, Medical Staff, Hospital statistics & numerical data, Outcome and Process Assessment, Health Care statistics & numerical data
Abstract

Background: The laparoscopic approach for appendicectomies remains a frequent topic of debate. In this study we report the experience with laparoscopic (LA) and open appendicectomies (OA) achieved in a British University Hospital over one year where most of these operations have been conducted by junior trainees., Methods: Retrospective review of LA and OA performed at the Whipps Cross University Hospital of London (U.K.). Outcomes measured were the operating time, length of hospital stay and post-operative complications., Results: Between January and December 2008 205 appendicectomies have been performed on adult patients. Eighty-eight per cent of the procedures were conducted by junior surgeons. The operating time was significantly shorter for the OA vs. LA patients (55 +/- 26.8 vs. 83 +/- 26.9 min, p < 0.01). The hospital stay confirmed a significant advantage for LA (2.2 vs. 3.7 days, p = 0.02). No significant differences were present among techniques for the overall morbidity, post-operative intra-abdominal abscesses and rate of readmissions., Conclusions: Under adequate supervision LA can be safely performed by junior surgeons and reduces the hospital stay.

Published
2012

5. Crohn's disease of the vulva.

Author

Andreani SM, Ratnasingham K, Dang HH, Gravante G, and Giordano P

Subjects
Anti-Infective Agents therapeutic use, Anti-Inflammatory Agents therapeutic use, Combined Modality Therapy, Crohn Disease diagnosis, Crohn Disease drug therapy, Female, Humans, Metronidazole therapeutic use, Prednisolone therapeutic use, Vulvar Diseases diagnosis, Vulvar Diseases drug therapy, Crohn Disease surgery, Vulvar Diseases surgery
Abstract

Crohn's involvement of the Vulva is unfamiliar and difficult to treat. The aim is to review the presentation, clinical course and different treatments of Vulva Crohn's disease (CD). We have reviewed the literature without language barrier from 1966 to 2009 through Pubmed with the following words: vulva and CD, vulvitis and CD, genital CD. We included articles that had Crohn's involvement of the vulva arising from a distant site (metastatic) or arising from a Crohn's fistula from the perineum and/or anorectum. We excluded CD of other gynaecological organs. One hundred thirty six abstracts were identified and related articles reviewed. Fifty-five cases of CD of the vulva were included in the final anlaysis of this review. Vulva involvement is rare and gives long-term discomfort. A combined medical therapy (metronidazole with prednisolone) appears to be the most effective treatment. The surgical approach should be reserved for non-responding cases. CD is often unrecognized cause of vulva pain and difficult to diagnose. However if diagnosed and adequately treated it usually responds to conservative therapies., (Copyright 2009 Surgical Associates Ltd. Published by Elsevier Ltd. All rights reserved.)

Published
2010
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6. Meta-analysis of the use of glyceryl trinitrate ointment after haemorrhoidectomy as an analgesic and in promoting wound healing.

Author

Ratnasingham K, Uzzaman M, Andreani SM, Light D, and Patel B

Subjects
Headache epidemiology, Humans, Ointments, Pain Measurement, Analgesics therapeutic use, Hemorrhoids surgery, Nitroglycerin therapeutic use, Pain, Postoperative prevention & control, Wound Healing
Abstract

Introduction: Glyceryl Trinitrate (GTN) ointment has been used to treat anal fissure and pain relief in haemorrhoids, but the value of its use post-haemorrhoidectomy as an analgesic and in wound healing is unclear. The side effect of headache has often been an associated problem. Therefore, a meta-analysis of randomised controlled trials was carried out investigating the role of GTN post-haemorrhoidectomy as an analgesic, its role in would healing and the unwanted incidence of headache., Method: A structured literature search from 1966 to 2009, both paper and online, with no language barrier was carried out. 760 papers were identified and 5 randomised control trials which met the entry criteria were included in this study., Results: A total of 333 patients were included in the meta-analysis. The results revealed that GTN ointment was statistically significant in reducing pain on Day 3 and 7 compared to the placebo group. Day 3 shows a pain score of - 1.51 (p value of 0.029) and Day 7 by - 1.66 (p value of 0.014) respectively. However, it was not significant in reducing pain on Day 1. The Odds ratio for wound healing after GTN treatment at 3 weeks was 3.57 (P < 0.0001) when compared to the placebo group. Side effect of headache was not statistically significant., Conclusion: This meta-analysis has shown that GTN ointment used post-haemorrhoidectomy has a significant analgesic effect in the intermediate time period (ie. Days 3-7). It also significantly improved wound healing at 3 weeks., (Copyright © 2010 Surgical Associates Ltd. Published by Elsevier Ltd. All rights reserved.)

Published
2010
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7. Laparoscopic repair of spontaneous vaginal evisceration of small bowel: report of a case.

Author

Sinclair MD, Davies AR, Sankaran S, Agnihotri S, and Andreani SM

Subjects
Aged, Female, Humans, Prolapse, Ileal Diseases surgery, Ileum, Laparoscopy methods, Vaginal Diseases surgery
Abstract

Spontaneous vaginal evisceration of the small bowel is a rare event. It is precipitated in the postmenopausal woman commonly by hysterectomy and in the premenopausal woman by vaginal trauma. We report a case of a 75-year-old woman presenting with a protruding mass in her vagina and associated abdominal pain. A combined laparoscopic and transvaginal method of repair is described and the advantage of using both techniques highlighted.

Published
2010
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8. Mechanical bowel preparation for colorectal surgery: a meta-analysis on abdominal and systemic complications on almost 5,000 patients.

Author

Gravante G, Caruso R, Andreani SM, and Giordano P

Subjects
Cardiovascular Diseases etiology, Elective Surgical Procedures, Humans, Postoperative Complications, Prospective Studies, Randomized Controlled Trials as Topic, Surgical Wound Infection etiology, Colorectal Surgery methods, Preoperative Care methods
Abstract

Background: Several studies concluded that mechanical bowel preparation (MBP) does not confer any advantage on reducing the anastomotic leak rate or wound infections. The aim of this meta-analysis was to review all prospective randomised controlled trials on the use of MBP before colorectal surgery in order to find differences in the rates of abdominal and systemic complications in view of recent published articles., Methods: Review of all randomised prospective trials compare MBP vs. non-MBP. Primary outcome measures were anastomotic leakages, abdomino-pelvic abscesses and postoperative ileus. Secondary outcomes were wound infections, extra-abdominal complications (urinary infections, pulmonary infections, deep venous thrombosis or pulmonary embolism, cardiac events), sepsis and mortality., Results: Twelve articles met the inclusion criteria with 4,919 patients. The non-MBP group showed no significant increase of the anastomotic leakages (3.4% vs. 4.1%; p = NS) and wound infections (8.7% vs. 9.6%; p = NS) but had a lower rate of postoperative cardiac events (2.5% vs. 4.0%; p = 0.04)., Conclusion: The evidence from recent studies, combined with previous ones, further suggests that the dogma of the necessity of mechanical bowel preparation before elective colorectal surgery should be reconsidered.

Published
2008
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9. Double gallstone ileus.

Author

Khan AZ, Nariculum J, Andreani SM, and Stacey-Clear A

Subjects
Aged, 80 and over, Female, Gallstones diagnostic imaging, Gallstones surgery, Humans, Ileus diagnostic imaging, Ileus surgery, Radiography, Treatment Outcome, Gallstones complications, Ileus etiology, Intestine, Small diagnostic imaging, Intestine, Small surgery
Abstract

Background: Gallstone ileus remains a rare but important cause of intestinal obstruction., Method: We present a unique case of two gallstones causing intestinal obstruction at the same time., Results: A 90-year-old lady presented with signs and symptoms of small bowel obstruction. At operation, two gallstones stuck at different points within the bowel were causing the obstruction and were removed., Conclusion: When operating on patients with small bowel obstruction from gallstone ileus, examination of the entire small bowel should be considered mandatory.

Published
2008

10. Rectovaginal fistula in Crohn's disease.

Author

Andreani SM, Dang HH, Grondona P, Khan AZ, and Edwards DP

Subjects
Crohn Disease epidemiology, Female, Humans, Prevalence, Prognosis, Rectum surgery, Retrospective Studies, Surgical Flaps, Vagina surgery, Crohn Disease complications, Digestive System Surgical Procedures methods, Rectovaginal Fistula epidemiology, Rectovaginal Fistula etiology, Rectovaginal Fistula surgery
Abstract

Purpose: Crohn's disease is characterized by transmural bowel inflammation and a tendency to form fistulas with adjacent structures. Several different fistulas have been described: enterocutaneous, enteroenteric, enterovesical, enterovaginal, and perineal. Rectovaginal fistulas are difficult to treat despite multimodal therapy. This study was designed to review the current strategic options to best manage this condition., Methods: We reviewed the English-language literature from 1966 to 2006, using PUBMED, targeting Crohn's disease involving vagina using key words "rectovaginal fistula and CD," "anovaginal fistula and CD," "anovaginal fistula," and "rectovaginal fistula." We excluded the involvement of the vagina from a pouch after a proctectomy. A total of 776 articles were found; 206 articles were identified and judged as being relevant on the basis of title-related articles and links were reviewed. Fifty-three articles were selected after reading the abstract or full manuscript., Results: The management of rectovaginal fistula, representing 9 percent of all fistulas, remains a challenge in the setting of Crohn's disease. Medical treatments are not favorable with low rates of long-term symptomatic control and unacceptable high rates of recurrence. Several novel and new surgical techniques have been described, and rectal advancement flap, in selected patients, seems to have the most successful results., Conclusions: The management of rectovaginal fistula of Crohn's origin should involve both gastroenterologists and coloproctologists, with the best surgical results being achieved in patients receiving optimum medical therapy. More focused studies targeting these patients with the use of combined medical and surgical therapy are necessary.

Published
2007
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11. Ovarian Crohn's disease: contiguous or metastatic?

Author

Andreani SM, Dang HH, Edwards DP, Baig MK, Khan M, and Payne JG

Subjects
Adult, Female, Granuloma pathology, Granuloma surgery, Humans, Ovarian Diseases pathology, Ovarian Diseases surgery, Ovary pathology, Crohn Disease complications, Granuloma etiology, Ovarian Diseases etiology
Published
2006
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12. Proposal of a novel system for the staging of thymic epithelial tumors.

Author

Bedini AV, Andreani SM, Tavecchio L, Fabbri A, Giardini R, Camerini T, Bufalino R, Morabito A, and Rosai J

Subjects
Carcinoma mortality, Disease-Free Survival, Female, Humans, Male, Middle Aged, Prognosis, Survival Rate, Thymus Neoplasms mortality, Carcinoma pathology, Neoplasm Staging methods, Thymus Neoplasms pathology
Abstract

Background: We designed and assessed a new TNM staging system (herein called the INT [Istituto Nazionale Tumori] system) for thymic epithelial tumors in order to overcome the perceived drawbacks of Masaoka's system, which represents the current standard., Methods: In all, 123 cases were evaluated. The histologic types according to the World Health Organization (WHO) classification were as follows: subtype A: 5 cases; AB: 40; B1: 16; B2: 29; B3: 16; and C: 17 cases. There were 45 Masaoka's stage I, 33 stage II, 26 stage III, and 19 stage IV cases. A total of 11 INT definitions were grouped into three stages: locally restricted disease (75 cases), which included Masaoka's stage I and selected stage II cases (no pleural invasion); locally advanced disease (37 cases), which included Masaoka's stage III cases plus those staged II owing to pleural invasion and those staged IV owing to intrathoracic nodal or limited pleuropericardial involvement; and systemic disease (11 cases), which included the remaining Masaoka's stage IV cases., Results: Completeness of resection, WHO types, and both staging systems were significant prognostic factors (p < 0.0001) on univariate analysis. The 95-month progression-free survival rates according to Masaoka's system were stage I: 100%; II: 93.6%; III: 46.3%; and IV: 23.2%. The INT system corresponding figures were as follows: locally restricted disease: 98.6%; locally advanced disease: 46.9%; and systemic disease: 11.7%. The INT system was the prognostic factor with the greatest impact (p = 0.0218) on multivariate analysis (Masaoka's system: p = 0.2012; completeness of resection: p = 0.6855; histology: p = 0.9386)., Conclusions: The INT system allows finer disease descriptions than Masaoka's system, resulting in a stage grouping with higher prognostic distinctiveness.

Published
2005
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13. Laparoscopic feeding jejunostomy technique as part of staging laparoscopy.

Author

Grondona P, Andreani SM, Barr N, and Singh KK

Subjects
Aged, Enteral Nutrition methods, Humans, Middle Aged, Neoplasm Staging methods, Stomach Neoplasms pathology, Esophageal Neoplasms surgery, Esophagogastric Junction, Jejunostomy methods, Laparoscopy methods, Stomach Neoplasms surgery
Abstract

Placement of a feeding jejunostomy tube is indicated for patients who need enteral access but where a gastrostomy is not feasible. This paper presents the technique and results of laparoscopic placement of feeding jejunostomy tubes in patients presenting with esophagogastric cancer. From December 2002 to February 2004, patients diagnosed with esophagogastric cancer with a potentially resectable lesion underwent staging laparoscopy. Laparoscopic feeding jejunostomy was performed on patients who were potential candidates for chemotherapy with palliative intent or neoadjuvant treatment prior to resection surgery. Surgical technique, recovery of bowel function, commencement of feeding jejunostomy, total time tube was in situ, and perioperative complications were analyzed. Of the 22 patients who underwent staging laparoscopy, a feeding jejunostomy tube was placed in 18. The remaining 4 patients were deemed to have advanced disease precluding any therapeutic options and underwent placement of esophageal stents. Feeding tubes remained in situ for a median time period of 76 days. Fourteen patients required enteral support and tubes were used for a median of 30 days. Complications from tube placement included 2 cases of wound infections, 1 of minor leak and 1 tube dislodgment. Patients were followed up for a median time of 112 days. Findings from current series suggest that placement of a feeding jejunostomy tube at the time of staging laparoscopy is a safe and reliable means of providing and maintaining nutrition for patients presenting with esophagogastric cancers.

Published
2005
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14. Surgically proven complete response of stage III non-small cell lung cancer after cisplatin-enhanced radiotherapy. Clinical implications and long-term results.

Author

Bedini AV, Tavecchio L, Delledonne V, and Andreani SM

Subjects
Carcinoma, Non-Small-Cell Lung pathology, Carcinoma, Non-Small-Cell Lung surgery, Chemotherapy, Adjuvant, Disease-Free Survival, Female, Humans, Lung Neoplasms pathology, Lung Neoplasms surgery, Male, Middle Aged, Neoplasm Staging, Radiotherapy, Adjuvant, Survival Analysis, Treatment Outcome, Antineoplastic Agents therapeutic use, Carcinoma, Non-Small-Cell Lung drug therapy, Carcinoma, Non-Small-Cell Lung radiotherapy, Cisplatin therapeutic use, Lung Neoplasms drug therapy, Lung Neoplasms radiotherapy, Radiation-Sensitizing Agents therapeutic use
Abstract

Aims and Background: Pathologic complete response in locally advanced non-small cell lung cancer is the main end point of combined therapies (chemotherapy and/or radiotherapy). Surgery after an induction treatment can improve local control, allowing the histologic assessment of treatment activity by means of resection or extensive biopsies., Methods: Thirty patients surgically assessed without viable tumor after concurrent radiotherapy and continuous infusion of low-dose cisplatin, owing to an initially unresectable stage III non-small-cell lung cancer, were the object of evaluation to assess clinical implications, short- and long-term surgical results., Results: The specificity rate of the preoperative restaging was 36.6%. The surgical procedures consisted of 22 resections and of extensive biopsies in 8 cases. The operative mortality was 4% (1/25) for procedures other than right pneumonectomy (3/5). No patient received postoperative chemotherapy. Eleven distant progressions, 4 local recurrences, and 4 new primary tumors were assessed as initial failures. The 8-year overall survival was 36%., Conclusions: Pathologic complete response after cisplatin-enhanced radiotherapy cannot be satisfactorily assessed by clinical means. Surgery is required to obtain a reliable evaluation; however, right pneumonectomy should be contraindicated because of prohibitive risk. Although an effective local treatment can cure patients with advanced stage III disease, the addition of chemotherapy seems advisable to improve tumor relapse control.

Published
2003
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15. Bronchoscopically-guided conformal radiation therapy for radiographically occult lung carcinoma.

Author

Tavecchio L, Gramaglia A, Mancini A, Scorsetti M, and Andreani SM

Subjects
Aged, Carcinoma, Squamous Cell diagnostic imaging, Humans, Lung Neoplasms diagnostic imaging, Middle Aged, Radiography, Bronchoscopy, Carcinoma, Squamous Cell radiotherapy, Lung Neoplasms radiotherapy, Radiotherapy, Conformal methods
Abstract

Radiographically occult lung carcinoma has a very good prognosis after complete surgical resection. In medically inoperable patients three-dimensional conformal radiation therapy cannot be performed, as computed tomography scan images fail to localize the disease. Presented here is an original technique of marking radiographically occult tumors by fiberoptic bronchoscopy, applied on four patients. No short-term complications were recorded. All the patients are alive, with no evidence of disease, after a mean follow-up of 15 months.

Published
2001
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16. Latissimus dorsi reverse flap to substitute the diaphragm after extrapleural pneumonectomy.

Author

Bedini AV, Andreani SM, and Muscolino G

Subjects
Adult, Aged, Chondrosarcoma surgery, Hemangiopericytoma surgery, Humans, Middle Aged, Diaphragm surgery, Mesothelioma surgery, Pleural Neoplasms surgery, Pneumonectomy, Plastic Surgery Procedures, Surgical Flaps
Abstract

Background: The standard procedure for diaphragm reconstruction after extrapleural pneumonectomy for a malignancy consists of the use of prosthetic patches. Our original technique utilizing the reverse flap of the latissimus dorsi is evaluated., Methods: Once the extrapleural pneumonectomy is performed, the distal portion of the latissimus dorsi, which has been divided with a standard posterolateral thoracotomy at the level of the fifth to sixth rib, is elevated into the chest through the passage obtained by resection of the tenth rib and sutured to the lower pericardium and to the chest wall. Nine patients were evaluated., Results: No operative death occurred. No flap-related complication nor infection was postoperatively assessed. Six patients received adjuvant radiotherapy. No late complication was observed., Conclusions: The distal latissimus dorsi can be used for total reconstruction of one hemidiaphragm, ensuring a watertight separation between the pleural and peritoneal cavities and avoiding paradoxical respiratory motion. In our opinion, the technique was easier, faster, and more reliable than the standard procedure employing prosthetic materials. We recommend that the procedure be integrated with the standard technique of extrapleural pneumonectomy.

Published
2000
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17. Intrathoracic benign metastasizing leiomyoma with extrapulmonary growth pattern. A case report.

Author

Tavecchio L, Bedini AV, Di Palma S, and Andreani SM

Subjects
Female, Humans, Middle Aged, Leiomyoma pathology, Leiomyoma surgery, Lung Neoplasms secondary, Lung Neoplasms surgery, Uterine Neoplasms pathology
Abstract

The authors report a case of a woman in whom complete resection of an extrapulmonary differentiated leiomyomatous tumor of uterine origin was performed 39 years after hysterectomy for uterine leiomyomas.

Published
1999
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18. Extrapericardial solitary fibrous tumour of the pericardium.

Author

Andreani SM, Tavecchio L, Giardini R, and Bedini AV

Subjects
Heart Neoplasms diagnostic imaging, Heart Neoplasms pathology, Humans, Male, Mesothelioma diagnostic imaging, Mesothelioma pathology, Middle Aged, Tomography, X-Ray Computed, Heart Neoplasms surgery, Mesothelioma surgery, Pericardium
Abstract

Solitary fibrous tumour (SFT) occurs most commonly in the pleura and is extremely rare in the pericardium. The authors report a case of a 60-year-old man in whom a large mediastinal mass was accidentally discovered. Computed tomography showed involvement of the left anterosuperior mediastinum with displacement of the trachea, large vessels and oesophagus; histopathological findings after complete resection of the neoplasia demonstrated an SFT of the pericardium, the first reported case with extrapericardial pattern of growth. A review of the literature on SFTs of the pericardium is provided.

Published
1998
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19. Re-exploration of the saphenofemoral junction in the treatment of recurrent varicose veins.

Author

Viani MP, Poggi RV, Pinto A, Andreani SM, Spagnoli C, and Maruotti RA

Subjects
Adult, Aged, Female, Humans, Male, Middle Aged, Recurrence, Retrospective Studies, Femoral Vein surgery, Saphenous Vein surgery, Varicose Veins surgery
Abstract

A retrospective study of 61 patients (61 legs) with recurrent varicose veins (RVV) and saphenofemoral junction (SFJ) incompetence was set up to assess the efficacy of re-exploration of the SFJ through a lateral approach. All the patients underwent re-exploration of the SFJ by a single surgeon (MPV) through a lateral approach. Thirty-one patients (50.8%) presented an intact SFJ. Twenty-seven patients (44.2%) presented intact major tributaries emerging from the stump of SFJ. In 2 patients (3.2%) the recurrence was related to neovascularization and in 1 case (1.6%) to cross groin venous connection. Follow-up averaged 2.81 years. Three (4.9%) patients were lost, 56 out of 58 patients (96.55%) were asymptomatic, 2 out of 58 (3.4%) presented a new recurrence in the groin. Complete isolation of the FV to identify every tributary and ligation of the SFJ flush with the FV are essential to avoid further recurrences.

Published
1996

20. Gasless laparoscopic gastrostomy.

Author

Viani MP, Poggi RV, Pinto A, Fusai G, Andreani SM, and Marvotti RA

Subjects
Carbon Dioxide, Carcinoma complications, Deglutition Disorders etiology, Deglutition Disorders surgery, Enteral Nutrition instrumentation, Enteral Nutrition methods, Esophageal Neoplasms complications, Esophageal Stenosis complications, Esophageal Stenosis etiology, Gastrostomy instrumentation, Humans, Laparoscopes, Male, Middle Aged, Pneumoperitoneum, Artificial, Gastrostomy methods, Laparoscopy methods
Abstract

Percutaneous endoscopic gastrostomy (PEG) is the procedure of choice in the nutritional management of patients requiring gastrostomies. Laparoscopic gastrostomy is usually performed when PEG is contraindicated, for example, in patients with esophageal strictures, large gastric tumors, or a history of multiple abdominal surgery. We report herein a case of gasless laparoscopic gastrostomy performed for carcinoma associated with a severe respiratory distress syndrome in a malnourished patient with a tight esophageal stricture. The gasless technique uses the Laparolift System (Laparolift, Origin Medsystem, Inc.), a device composed of a fan-shaped retractor and a mechanical lifting arm that produces an abdominal wall distention resembling a truncated pyramid. Gasless laparoscopy was a safe alternative approach to CO2 pneumoperitoneum in this patient.

Published
1995
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