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Results 1 through 20 out of 95

in category surgery


1: Surgical site infection and its associated factors in Ethiopia: A systematic review and meta-analysis

Wondimeneh Shibabaw Shiferaw, Yared Asmare Aynalem et al.

2,146 downloads (posted 30 Dec 2019)

BackgroundDespite being a preventable complication of surgical procedures, surgical site infections (SSIs) continue to threaten public health with significant impacts on the patients and the health-care human and financial resources. With millions affected globally, there issignificant variation in the primary studies on the prevalence of SSIs in Ethiopia. Therefore, this study aimed to estimate the pooled prevalence of SSI and its associated factors among postoperative patients in Ethiopia. MethodsPubMed, Scopus, Psyinfo, African Journals Online, and Google Scholar were searched for studies that looked at SSI in postoperative patients. A funnel plot and Eggers regression test were used to determine publication bias. The I2 statistic was used to check heterogeneity between the studies. DerSimonian and Laird random-effects model was applied to estimate the pooled effect size, odds ratios (ORs), and 95% confidence interval (CIs) across studies. The subgroup analysis was conducted by region, sample size, and year of publication. Sensitivity analysis was deployed to determine the effect of a single study on the overall estimation. Analysis was done using STATA Version 14 software. ResultA total of 24 studies with 13,136 study participants were included in this study. The estimated pooled prevalence of SSI in Ethiopia was 12.3% (95% CI: 10.19, 14.42). Duration of surgery > 1 hour (AOR = 1.78; 95% CI: 1.08 -2.94), diabetes mellitus (AOR = 3.25; 95% CI: 1.51-6.99), American Society of Anaesthesiologists score >1 (AOR = 2.51; 95% CI: 1.07-5.91), previous surgery (AOR = 2.5; 95% CI: 1.77-3.53), clean-contaminated wound (AOR = 2.15; 95% CI: 1.52-3.04), and preoperative hospital stay > 7 day (AOR = 5.76; 95% CI: 1.15-28.86), were significantly associated with SSI. ConclusionThe prevalence of SSI among postoperative patients in Ethiopia remains high with a pooled prevalence of 12.3% in 24 extracted studies. Therefore, situation based interventions and region context-specific preventive strategies should be developed to reduce the prevalence of SSI among postoperative patients.


2: The validation of the original and modified Caprini score in COVID-19 patients

Sergey Tsaplin, Ilya Schastlivtsev et al.

1,370 downloads (posted 23 Jun 2020)

Objective. The study aimed to validate the original Caprini score and its modifications considering coronavirus disease (COVID-19) as a severe prothrombotic condition in patients admitted to the hospital with confirmed infection. Methods. The relevant data were extracted from the electronic medical records with the implemented Caprini score and were evaluated retrospectively. The score was calculated twice: by the physician at the admission and by the investigator at discharge or after death. The second calculation at d...


3: Evaluation of 30-day mortality for 500 patients undergoing non-emergency surgery in a COVID-19 cold site within a multicentre regional surgical network during the COVID-19 pandemic

Veeru Kasivisvanathan, Jamie Lindsay et al.

1,055 downloads (posted 12 Jun 2020)

Background Two million non-emergency surgeries are being cancelled globally every week due to the COVID-19 pandemic, which will have a major impact on patients and healthcare systems. Objective To determine whether it is feasible and safe to continue non-emergency surgery in the COVID-19 pandemic Design, setting and participants This is a cohort study of 500 consecutive patients undergoing non-emergency surgery in a dedicated COVID-19 cold site following the first case of COVID-19 that was reported in the institution. T...


4: A propensity score matched study: Predictive signs of anastomotic leakage after gastric cancer surgery and the role of CT

Birendra Kumar Sah, Yang Zhang et al.

1,051 downloads (posted 29 Apr 2020)

Background: Anastomotic leakage is a critical postoperative complication after gastric cancer surgery. Previous studies have not specified radiological findings of anastomotic leakage. We investigated the potential burden caused by postoperative anastomotic leakage and explored the objective appearances of anastomotic leakage on computed tomography (CT) examination. Methods: Gastric cancer patients who underwent curative gastrectomy and had a CT examination after surgery were included in this study. Propensity score (PS...


5: Machine learning to predict early recurrence after oesophageal cancer surgery

Saqib A Rahman, Robert C Walker et al.

912 downloads (posted 03 Jul 2019)

ObjectiveTo develop a predictive model for early recurrence after surgery for oesophageal adenocarcinoma using a large multi-national cohort. Summary Background DataEarly cancer recurrence after oesophagectomy is a common problem with an incidence of 20-30% despite the widespread use of neoadjuvant treatment. Quantification of this risk is difficult and existing models perform poorly. Machine learning techniques potentially allow more accurate prognostication and have been applied in this study. MethodsConsecutive pat...


6: Mortality after surgery with SARS-CoV-2 infection in England: A population-wide epidemiological study

T E Abbott, A J Fowler et al.

847 downloads (posted 20 Feb 2021)

ObjectivesTo confirm the incidence of perioperative SARS-CoV-2 infection and associated mortality after surgery. Design and settingAnalysis of routine electronic health record data from National Health Service (NHS) hospitals in England. MethodsWe extracted data from Hospital Episode Statistics in England describing adult patients undergoing surgery between 1st January 2020 and 31st October 2020. The exposure was SARS-CoV-2 infection defined by ICD-10 codes. The primary outcome measure was 90-day in-hospital mortality...


7: Perforated appendicitis: can it be a bedside diagnosis?

Maham Taraiq, Sara Malik et al.

843 downloads (posted 01 May 2020)

ABSTRACT INTRODUCTION: Appendicitis remains one of the most common causes of acute abdomen worldwide. It presents as a spectrum of disease ranging from an acutely inflamed appendix to a perforated one. where acutely inflamed can be managed conservatively, a perforated appendix always needs surgery to prevent complications like pelvic abscesses. Bedside diagnosis remains relevant in our setup. AIMS AND OBJECTIVES: To determine whether history, clinical examination, and basic laboratory investigations can help in confiden...


8: Distinguish Coronavirus Disease 2019 Patients in General Surgery Emergency by CIAAD Scale: Development and Validation of a Prediction Model Based on 822 Cases in China

Bangbo Zhao, Yingxin Wei et al.

803 downloads (posted 23 Apr 2020)

IMPORTANCE In the epidemic, surgeons cannot distinguish infectious acute abdomen patients suspected COVID-19 quickly and effectively. OBJECTIVE To develop and validate a predication model, presented as nomogram and scale, to distinguish infectious acute abdomen patients suspected coronavirus disease 2019 (COVID-19). DESIGN Diagnostic model based on retrospective case series. SETTING Two hospitals in Wuhan and Beijing, China. PTRTICIPANTS 584 patients admitted to hospital with laboratory confirmed SARS-CoV-2 from 2 Jan 2...


9: Resource requirements for reintroducing elective surgery in England during the COVID-19 pandemic: a modelling study

A J Fowler, T. D. Dobbs et al.

722 downloads (posted 12 Jun 2020)

BackgroundThe COVID-19 response required the cancellation of all but the most urgent surgical procedures. The number of cancelled surgical procedures in the National Health Service (NHS) England due to COVID-19, and the reintroduction of surgical activity, was modelled. MethodsModelling study using Hospital Episode Statistics data (2014-2019). Using NHS England definitions, surgical procedures were grouped into four urgency classes. Expected numbers of surgical procedures performed between 1st March 2020 and 28th Febru...


10: Enhanced recovery after surgery (ERAS) protocols is extermely beneficial in liver surgeries. A metaanalysis.


663 downloads (posted 16 Apr 2020)

BACKGROUND: Enhanced recovery after surgery (ERAS) programs aim to improve postoperative outcomes.. This metaanalysis aims to evaluate the impact of ERAS programmes on outcomes following liver surgeries. METHODS: EMBASE, MEDLINE, PubMed and the Cochrane Database were searched for studies comparing outcomes in patients undergoing liver surgery utilizing ERAS principles with those patients receiving conventional care. The primary outcome was occurrence of 30 day morbidity and mortality. Secondary outcomes included length ...


11: The global impact of the first Coronavirus Disease 2019 (COVID-19) pandemic wave on vascular services

Vascular and Endovascular Research Network, Ruth A Benson et al.

662 downloads (posted 17 Jul 2020)

Background: The Coronavirus Disease 2019 (COVID-19) pandemic is having an unprecedented impact on healthcare delivery. This international qualitative study captured the global impact on vascular patient care during the first pandemic wave. Methods: An online structured survey was used to collect regular unit-level data regarding the modification to a wide range of vascular services and treatment pathways on a global scale. Results: The survey commenced on 23rd March 2020 worldwide. Over six weeks, 249 vascular units too...


12: Laser speckle contrast imaging for visualizing blood flow during cerebral aneurysm surgery: A comparison with indocyanine green angiography

David R Miller, Ramsey Ashour et al.

644 downloads (posted 29 Apr 2021)

Laser speckle contrast imaging (LSCI) has emerged as a promising tool for intraoperative cerebral blood flow (CBF) monitoring because it produces real-time full-field blood flow maps non-invasively and label-free. In this study, we compare LSCI with indocyanine green angiography (ICGA) to assess CBF during aneurysm clipping surgery in humans. LSCI hardware was attached to the surgical microscope prior to the start of each surgery and did not interfere with the sterile draping of the microscope or normal operation of the...


13: A new model to prioritize and optimize access to elective surgery throughout the COVID-19 pandemic: A feasibility & pilot study.

Roberto Valente, Stefano Di Domenico et al.

618 downloads (posted 26 Jul 2020)

The COVID-19 pandemic burdens non-covid elective surgical patients by reducing service capacity, forcing extreme selection of patients most in need. Our study assesses the SWALIS- 2020 model ability to prioritize access to surgery during the highest viral outbreak peaks. A 2020 March - May feasibility-pilot study tested a software-aided, inter-hospital, multidisciplinary pathway. All specialties patients in the Genoa Surgical Departments referred for urgent elective patients were prioritized by a modified Surgical Wait...


14: Conservative Management of Acute Appendicitis In The Era Of COVID 19: A Multicenter prospective observational study at The United Arab Emirates

Fatima Y. AL Hashmi, Abeer Al Zuabi et al.

598 downloads (posted 30 Sep 2020)

Background Since its emergence in December 2019, the Novel Coronavirus (COVID-19) pandemic resulted in a profound impact on the health care system worldwide. We propose herein to evaluate the impact of implementing conservative management as an alternative approach to surgical appendectomy in the treatment of proven acute appendicitis during COVID19 pandemic. Methods Our study is a prospective multicenter study that includes a cohort of 160 patients admitted to the surgical departments in both Tawam Hospital and Sheikh ...


15: Rationalising neurosurgical head injury referrals: The development and implementation of the Liverpool Head Injury Tomography Score (Liverpool HITS) for mild traumatic brain injury

Conor SN Gillespie, Christopher M Mcleavy et al.

596 downloads (posted 17 Aug 2019)

ObjectivesTo develop and implement a radiological scoring system to define a surgically significant mild Traumatic Brain Injury (TBI), stratify neurosurgical referrals and improve communication between referral centres and neurosurgical units. DesignRetrospective single centre case-control analysis of ten continuous months of mild TBI referrals. SettingA major tertiary neurosurgery centre in England, UK. ParticipantsAll neurosurgical referrals with a mild TBI (GCS 13-15) during the period of 1st January to 30th Octo...


16: Multifocal breast cancers are more prevalent in BRCA2 versus BRCA1 mutation carriers

Alan D McCrorie, Susannah Ashfield et al.

591 downloads (posted 13 Sep 2019)

Multifocal breast cancer is generally considered to be where two or more breast tumours are present within the same breast, but are clearly separated with no intervening in situ or invasive disease. It is seen in [~]10% of breast cancer cases. This study investigates multifocality prevalence in BRCA1/2 mutant patients via cross-sectional analysis. Data from 211 women with BRCA1/2 mutations (BRCA1 - 91), (BRCA2 - 120), with breast cancer were collected including age, tumour focality, size, type, grade, and receptor profi...


17: Early Impact of COVID-19 Pandemic on Paediatric Surgical Practice in Nigeria: a National Survey of Paediatric Surgeons.

Ibukunolu O Ogundele, Felix M Alakaloko et al.

560 downloads (posted 25 May 2020)

Introduction The novel Coronavirus disease has had significant impact on healthcare globally. Knowledge of this virus is evolving, definitive care is not yet known, and mortality is increasing. We assessed its initial impact on paediatric surgical practice in Nigeria, creating a benchmark for recommendations and future reference. Methods Survey of 120 paediatric surgeons from 50 centres to assess socio-demographics and specific domains of impact of COVID-19 on their services and training in Nigeria. Seventy four surgeon...


18: Minimizing Population Health Loss in Times of Scarce Surgical Capacity

Benjamin Gravesteijn, Eline Krijkamp et al.

558 downloads (posted 30 Jul 2020)

Background COVID-19 has put unprecedented pressure on healthcare systems worldwide, leading to a reduction of the available healthcare capacity. Our objective was to develop a decision model that supports prioritization of care from a utilitarian perspective, which is to minimize population health loss. Methods A cohort state-transition model was developed and applied to 43 semi-elective non-paediatric surgeries commonly performed in academic hospitals. Scenarios of delaying surgery from two weeks were compared with del...


19: Efficacy and safety of erythropoietin for traumatic brain injury: a meta-analysis of randomized controlled trials

Motao Liu, Amy J. Wang et al.

540 downloads (posted 23 Sep 2019)

ObjectiveRecent studies regarding the effects of erythropoietin (EPO) for treating traumatic brain injury (TBI) have been inconsistent. This study conducts a meta-analysis of randomized controlled trials (RCTs) to assess the safety and efficacy of EPO for TBI patients at various follow-up time points. MethodsA literature search was performed using PubMed, Web of Science, MEDLINE, Embase, Google Scholar and the Cochrane Library for RCTs studying EPO in TBI patients published through March 2019. Non-English manuscripts a...


20: Adopting a new model of care for treating patients with chronic limb threatening ischaemia: early results of a vascular limb salvage clinic

Andrew T.O. Nickinson, Jivka Dimitrova et al.

523 downloads (posted 27 Nov 2019)

Background Vascular limb salvage services can potentially improve outcomes for patients with chronic limb-threatening ischaemia (CLTI), although their description within the literature is limited. This study aims to evaluate the 12-month outcomes for an outpatient-based vascular limb salvage (VaLS) clinic and investigate times-to-treatment. Methods An analysis of a prospectively maintained database, involving all patients diagnosed with CLTI within the VaLS clinic from February 2018-February 2019, was undertaken. Data w...