World Journal of Emergency Surgery最新文献

{"title":"Clinical outcome analysis for surgical fixation versus conservative treatment on rib fractures: a systematic evaluation and meta-analysis","authors":"Penglong Zhao, Qiyue Ge, Haotian Zheng, Jing Luo, Xiaobin Song, Liwen Hu","doi":"10.1186/s13017-025-00581-y","DOIUrl":"https://doi.org/10.1186/s13017-025-00581-y","url":null,"abstract":"The efficacy of surgical intervention for traumatic rib fractures in improving clinical outcomes remains a subject of considerable debate. Over the past decade, the adoption of surgical stabilization for rib fractures (SSRF) has increased substantially. This study presents a systematic review and meta-analysis of the literature published over the past 20 years, with the objective of comparing the clinical outcomes of adult patients with multiple traumatic rib fractures who underwent SSRF, relative to those treated conservatively. We searched six online databases (PubMed, Web of Science, Embase, Cochrane Library, and the Sino-American Clinical Trials Database) for literature published between June 2004 and June 2024. The Cochrane Collaboration Risk of Bias 2 (RoB 2) and the Newcastle–Ottawa Scale (NOS) tool were employed to assess methodological quality, and relative risks (RR) with 95% confidence intervals (CI) were calculated to evaluate the outcome measures. The primary outcome was all-cause mortality, while the secondary outcomes included hospital length of stay (HLOS), ICU length of stay (ILOS), duration of mechanical ventilation (DMV), and the incidence of pneumonia. Subgroup analyses were performed to assess the effects of fracture type, age, timing of surgical fixation, and study design on treatment outcomes. A total of 47 studies involving 1,078,795 patients were included, consisting of three randomized controlled trials and 44 case–control studies. The results demonstrated that patients who underwent SSRF experienced better outcomes than those receiving conservative treatment in terms of all-cause mortality. However, SSRF was not superior to conservative treatment regarding HLOS, ILOS, or health care costs. Subgroup analyses revealed that the SSRF group had a lower incidence of pneumonia and shorter DMV in patients with flail chest, and patients older than 60 years may also benefit from SSRF, Furthermore, those who underwent SSRF within 72 h had shorter HLOS and DMV compared to those treated conservatively. SSRF reduces mortality in patients with multiple rib fractures compared to conservative management, particularly in those with flail chest and in patients over 60 years of age. It also offers benefits in terms of pneumonia incidence and DMV for patients with flail chest. Early SSRF may significantly reduce HLOS and DMV. However, careful screening of appropriate candidates is crucial to maximize the benefits of SSRF.","PeriodicalId":48867,"journal":{"name":"World Journal of Emergency Surgery","volume":"79 1 1","pages":""},"PeriodicalIF":8.0,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143125289","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk factors of 180-day rebleeding after management of blunt splenic injury without surgery and embolization: a national database study","authors":"Chung-Yen Chen, Hung-Yu Lin, Pie-Wen Hsieh, Yi-Kai Huang, Po-Chin Yu, Jian-Han Chen","doi":"10.1186/s13017-025-00586-7","DOIUrl":"https://doi.org/10.1186/s13017-025-00586-7","url":null,"abstract":"This study aimed to identify risk factors for rebleeding within 180 days post-discharge in blunt splenic injury patients managed without splenectomy or embolization. A retrospective analysis was conducted using Taiwan’s National Health Insurance Research Database. Adult patients aged ≥ 18 years with blunt splenic injury (ICD-9-CM codes 865.01–865.09) from 2000 to 2012 were included. Patients who died, underwent splenectomy (ICD-9-OP codes 41.5, 41.42,41.43, and 41.95) or transcatheter arterial embolization (TAE) (ICD-9-OP codes 39.79 and 99.29) on the first admission were excluded. The primary endpoint was rebleeding, which was identified if patients underwent splenectomy or TAE at 180 days after discharge. Multivariate logistic regression was used to identify risk factors, which were validated in a separate cohort. Of 6,140 patients, 80 (1.302%) experienced rebleeding within 180 days. Five significant risk factors were identified: age < 54 years (aOR 3.129, p = 0.014), male sex (aOR 2.691, p = 0.010), non-traffic accident-induced injury (aOR 2.459, p = 0.006), ISS ≥ 16 (aOR 2.130, p = 0.021), and congestive heart failure (aOR 6.014, p = 0.006). We generate Delayed Splenic Bleeding System (DSBS). Patients with > 2 points had significantly higher rebleeding rates (risk-identifying cohort: 2.2% vs. 0.6%, OR 3.790, p < 0.001; validation cohort: 2.6% vs. 0.8%, OR 3.129, p = 0.022). Age < 54 years, male, non-traffic accident-induced injury, ISS ≥ 16, and congestive heart failure are risk factors of rebleeding within 180 days after discharge from treating blunt splenic injury without splenectomy or embolization. Despite limitations, this study underscores large-scale data’s role in identifying risks which can aid clinicians in prioritizing additional interventions during NOM.","PeriodicalId":48867,"journal":{"name":"World Journal of Emergency Surgery","volume":"11 1","pages":""},"PeriodicalIF":8.0,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143125206","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Acute cholecystitis and subtotal cholecystectomy","authors":"Antonio Pesce, Rosario Lombardo, Antonio Di Cataldo, Gaetano La Greca","doi":"10.1186/s13017-024-00573-4","DOIUrl":"https://doi.org/10.1186/s13017-024-00573-4","url":null,"abstract":"&lt;p&gt;&lt;i&gt;Dear Editor&lt;/i&gt;,&lt;/p&gt;&lt;p&gt;We enjoyed reading the article by Toro A et al. [1], in which the authors reported a preliminary experience with a new technique to avoid subtotal cholecystectomy in acute cholecystitis. We would like to raise some interesting points and comments.&lt;/p&gt;&lt;p&gt;The authors reported that only three patients have undergone this technique in the last two years; this is a very small sample size for a trauma center service. Moreover, in the results section, the authors stated that “in the last 2 years from January 2019 to December 2021”, but this time interval spans three years, not two.&lt;/p&gt;&lt;p&gt;The original French technique is characterized by four-ports insertion. We would like to inquire why the authors used three ports in acute cholecystitis, where laparoscopic surgery is undoubtedly more challenging. However, it has been demonstrated that there isn’t any significant clinical benefit in using fewer than four-ports laparoscopic cholecystectomy compared to the standard four-ports approach during elective procedures. In emergency settings, the presence of dense fibrosis and inflammation of the hepatoduodenal ligament, as well as diffuse cholecysto-omental and cholecysto-duodeno-colic adhesions, may hinder proper exposure of the hepatocystic triangle when using only three ports. This increases the risk of iatrogenic biliary, vascular, and visceral injuries. In our opinion, under these specific conditions, the use of a fourth trocar is helpful to pull the gallbladder fundus upwards and facilitate wide exposure of the hepatocystic triangle, ensuring the safe dissection of Calot’s triangle [2]. Moreover, the three ports approach may lead to subsequent medico-legal litigations in case of biliary iatrogenic injuries. Neverthless, while a four-port approach may offer better exposure, particularly in this specific technique and generally in difficult cases, experienced surgeons may opt for a three-port approach if they are confident in their ability to handle challenging intraoperative situations. In such cases as patients with transhepatic percutaneous cholecystostomy, the three-port approach may be useful and sufficient without the need for a fourth trocar. Surgeons should feel empowered to adapt their approach based on intraoperative findings and should not hesitate to add an additional port at any time if they encounter difficulties during dissection.&lt;/p&gt;&lt;p&gt;Another technical comment is related to trocars’ size: the authors used two 5-mm operative trocars. Using a 5-mm clips applicator on an inflamed and edematous cystic duct in acute cholecystitis can indeed pose some challenges and risks, such as difficulties in performing a reconstituting subtotal cholecystectomy where the use of a linear endostapler might be necessary. There is also a risk that the clips may not securely close the cystic duct due to the tissue’s condition, potentially leading to postoperative cystic duct leakage. One important point to emphasize is that the endostap","PeriodicalId":48867,"journal":{"name":"World Journal of Emergency Surgery","volume":"44 1","pages":""},"PeriodicalIF":8.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143071393","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correction: Surgical stabilization of rib fractures (SSRF): the WSES and CWIS position paper","authors":"Giacomo Sermonesi, Riccardo Bertelli, Fredric M. Pieracci, Zsolt J. Balogh, Raul Coimbra, Joseph M. Galante, Andreas Hecker, Dieter Weber, Zachary M. Bauman, Susan Kartiko, Bhavik Patel, SarahAnn S. Whitbeck, Thomas W. White, Kevin N. Harrell, Daniele Perrina, Alessia Rampini, Brian Tian, Francesco Amico, Solomon G. Beka, Luigi Bonavina, Marco Ceresoli, Lorenzo Cobianchi, Federico Coccolini, Yunfeng Cui, Francesca Dal Mas, Belinda De Simone, Isidoro Di Carlo, Salomone Di Saverio, Agron Dogjani, Andreas Fette, Gustavo P. Fraga, Carlos Augusto Gomes, Jim S. Khan, Andrew W. Kirkpatrick, Vitor F. Kruger, Ari Leppäniemi, Andrey Litvin, Andrea Mingoli, David Costa Navarro, Eliseo Passera, Michele Pisano, Mauro Podda, Emanuele Russo, Boris Sakakushev, Domenico Santonastaso, Massimo Sartelli, Vishal G. Shelat, Edward Tan, Imtiaz Wani, Fikri M. Abu-Zidan, Walter L. Biffl, Ian Civil, Rifat Latifi, Ingo Marzi, Edoardo Picetti, Manos Pikoulis, Vanni Agnoletti, Francesca Bravi, Carlo Vall..","doi":"10.1186/s13017-024-00568-1","DOIUrl":"https://doi.org/10.1186/s13017-024-00568-1","url":null,"abstract":"&lt;p&gt;&lt;b&gt;Correction to: World Journal of Emergency Surgery (2024) 19:33&lt;/b&gt;&lt;/p&gt;&lt;p&gt;&lt;b&gt;https://doi.org/10.1186/s13017-024-00559-2&lt;/b&gt;.&lt;/p&gt;&lt;p&gt;The original publication of this article [1] contained an incorrect affiliation for author Imtiaz Wani. The incorrect and correct information is listed in this correction article; the original article has been updated.&lt;/p&gt;&lt;p&gt;Incorrect&lt;/p&gt;&lt;p&gt;Imtiaz Wani&lt;/p&gt;&lt;p&gt;43. Department of Surgery, Sheri-Kashmir Institute of Medical Sciences, Srinagar, India&lt;/p&gt;&lt;p&gt;Correct&lt;/p&gt;&lt;p&gt;Imtiaz Wani&lt;/p&gt;&lt;p&gt;43. Government Gousia Hospital, Srinagar, India&lt;/p&gt;&lt;ol data-track-component=\"outbound reference\" data-track-context=\"references section\"&gt;&lt;li data-counter=\"1.\"&gt;&lt;p&gt;Sermonesi G, Bertelli R, Pieracci FM. et al. Surgical stabilization of rib fractures (SSRF): the WSES and CWIS position paper. World J Emerg Surg. 2024;19(33). https://doi.org/10.1186/s13017-024-00559-2.&lt;/p&gt;&lt;/li&gt;&lt;/ol&gt;&lt;p&gt;Download references&lt;svg aria-hidden=\"true\" focusable=\"false\" height=\"16\" role=\"img\" width=\"16\"&gt;&lt;use xlink:href=\"#icon-eds-i-download-medium\" xmlns:xlink=\"http://www.w3.org/1999/xlink\"&gt;&lt;/use&gt;&lt;/svg&gt;&lt;/p&gt;&lt;h3&gt;Authors and Affiliations&lt;/h3&gt;&lt;ol&gt;&lt;li&gt;&lt;p&gt;Department of General and Emergency Surgery, Anesthesia and Intensive Care Unit, Maurizio Bufalini Hospital, Cesena, Italy&lt;/p&gt;&lt;p&gt;Giacomo Sermonesi, Riccardo Bertelli, Daniele Perrina, Alessia Rampini, Emanuele Russo, Domenico Santonastaso, Vanni Agnoletti, Carlo Vallicelli &amp; Fausto Catena&lt;/p&gt;&lt;/li&gt;&lt;li&gt;&lt;p&gt;Department of Surgery, University of Colorado School of Medicine, Denver, CO, USA&lt;/p&gt;&lt;p&gt;Fredric M. Pieracci &amp; Ernest E. Moore&lt;/p&gt;&lt;/li&gt;&lt;li&gt;&lt;p&gt;Department of Traumatology, John Hunter Hospital and University of Newcastle, Newcastle, NSW, Australia&lt;/p&gt;&lt;p&gt;Zsolt J. Balogh&lt;/p&gt;&lt;/li&gt;&lt;li&gt;&lt;p&gt;Comparative Effectiveness and Clinical Outcomes Research Center, Riverside University Health System Medical Center, Moreno Valley, CA, USA&lt;/p&gt;&lt;p&gt;Raul Coimbra&lt;/p&gt;&lt;/li&gt;&lt;li&gt;&lt;p&gt;Division of Trauma and Acute Care Surgery, Department of Surgery, University of California Davis, Sacramento, CA, USA&lt;/p&gt;&lt;p&gt;Joseph M. Galante&lt;/p&gt;&lt;/li&gt;&lt;li&gt;&lt;p&gt;Emergency Medicine Department of General and Thoracic Surgery, University Hospital of Giessen, Giessen, Germany&lt;/p&gt;&lt;p&gt;Andreas Hecker&lt;/p&gt;&lt;/li&gt;&lt;li&gt;&lt;p&gt;Department of Trauma Surgery, Royal Perth Hospital, Perth, Australia&lt;/p&gt;&lt;p&gt;Dieter Weber&lt;/p&gt;&lt;/li&gt;&lt;li&gt;&lt;p&gt;Department of Surgery, University of Nebraska Medical Center, Omaha, NE, USA&lt;/p&gt;&lt;p&gt;Zachary M. Bauman&lt;/p&gt;&lt;/li&gt;&lt;li&gt;&lt;p&gt;Department of Surgery, George Washington University School of Medicine and Health Sciences, Washington, DC, USA&lt;/p&gt;&lt;p&gt;Susan Kartiko&lt;/p&gt;&lt;/li&gt;&lt;li&gt;&lt;p&gt;Division of Trauma, Gold Coast University Hospital, Southport, QLD, Australia&lt;/p&gt;&lt;p&gt;Bhavik Patel&lt;/p&gt;&lt;/li&gt;&lt;li&gt;&lt;p&gt;Chest Wall Injury Society, Salt Lake City, UT, USA&lt;/p&gt;&lt;p&gt;SarahAnn S. Whitbeck&lt;/p&gt;&lt;/li&gt;&lt;li&gt;&lt;p&gt;Intermountain Medical Center, Salt Lake City, UT, USA&lt;/p&gt;&lt;p&gt;Thomas W. White&lt;/p&gt;&lt;/li&gt;&lt;li&gt;&lt;p&gt;Department of Surgery, University of Tennessee College of Medicine Chattanooga, Chattanooga, TN, USA&lt;/p&gt;&lt;p&gt;Kevin N. Ha","PeriodicalId":48867,"journal":{"name":"World Journal of Emergency Surgery","volume":"24 1","pages":""},"PeriodicalIF":8.0,"publicationDate":"2025-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143054997","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Feasibility and accuracy of continuous intraabdominal pressure monitoring with a capsular device in human pilot trial","authors":"Chien-Hung Liao, David A. Spain, Chih-Chi Chen, Chi-Tung Cheng, Wei-Cheng Lin, Dong-Ru Ho, Heng-Fu Lin, Fausto Catena","doi":"10.1186/s13017-024-00569-0","DOIUrl":"https://doi.org/10.1186/s13017-024-00569-0","url":null,"abstract":"Intrabdominal pressure (IAP) is an important parameter. Elevated IAP can reduce visceral perfusion, lead to intraabdominal hypertension, and result in life-threatening abdominal compartment syndrome. While ingestible capsular devices have been used for various abdominal diagnoses, their application in continuous IAP monitoring remains unproven. We conducted a prospective clinical trial to evaluate the feasibility of IAP measurement using a digital capsule PressureDOT, an ingestible capsule equipped with wireless transmission capability and a pressure sensor, then compared its reliability with conventional intravesical method. Patients undergoing laparoscopic or robotic surgeries were recruited. During surgery, we created pneumoperitoneum by inflating CO2 into the peritoneal cavity and IAP was simultaneously monitored using both the ingestible capsules and intravesical measurements from Foley catheter. We assessed the feasibility of signal transmission and the accuracy of pressure measurements. Six patients were enrolled in this pilot study. No adverse events were reported, and the average first-intake time was within 24 h. All capsules were successfully expelled, with an average excretion time of 81 h. In the summarized data, the mean IAPdot is 0.6 mmHg lower than the IAPivp, with a standard deviation of 1.68 mmHg. However, capsule measurements showed excellent correlation with intravesical IAP measurements, with an intraclass correlation coefficient of 0.916 (95% CI: 0.8821–0.9320). Our study demonstrates the feasibility and safety of using digital capsules for continuous IAP monitoring, providing the agreement between IAP measurements from digital capsules and conventional intravesical measurement within a near-normal pressure.","PeriodicalId":48867,"journal":{"name":"World Journal of Emergency Surgery","volume":"58 1","pages":""},"PeriodicalIF":8.0,"publicationDate":"2025-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143044100","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Uterine artery embolization in the management of postpartum hemorrhage","authors":"Hassan Elbiss, Shamsa Al Awar, Jamal Koteesh, Howaida Khair, Sara Maki, Dana H. Abdalla, Fikri M. Abu-Zidan","doi":"10.1186/s13017-025-00580-z","DOIUrl":"https://doi.org/10.1186/s13017-025-00580-z","url":null,"abstract":"Postpartum hemorrhage (PPH) is one of the leading preventable causes of maternal morbidity and mortality causing one-fourth of all maternal deaths. We aimed to study the role of uterine artery embolization (UAE) in controlling PPH and its impact on the need for hysterectomy. We studied patients who were diagnosed with primary PPH between February 2012 and March 2020 at Al Ain Hospital, United Arab Emirates. We studied the characteristics and outcomes of those undergoing interventional radiology via UAE. Logistic regression analysis was done to define the factors that predict the need for emergency UAE. Out of 79 patients who had elective (n = 53) or emergency (n = 26) embolization, the placenta previa accreta (69.8% vs. 23.1%) and placenta previa (24.4% vs. 3.8%) were the common indications for elective versus emergency UAE (p < 0.001). The indication for UAE was the most significant factor for predicting an emergency procedure (p = 0.002) with placenta previa being significantly different from other indications (p < 0.001). Bleeding stopped in 78/79 patients (success rate of 98.7%) following UAE. Those who failed stopping of the bleeding were similar between the elective and emergency IR, (1/53 (1.9%) compared with 0/26 (0%), p = 0.99 Fisher’s Exact test). Overall, eight patients (10%) had hysterectomy, one of them was needed as the final solution to stop bleeding. There were no maternal deaths. Interventional radiological UAE is very efficient in controlling postpartum hemorrhage. It should be recommended as the first line of treatment for significant bleeding when expertise and facilities are available. It increases survival, reduces hysterectomy rate, without a difference if done as an emergency or elective procedure.","PeriodicalId":48867,"journal":{"name":"World Journal of Emergency Surgery","volume":"49 1","pages":""},"PeriodicalIF":8.0,"publicationDate":"2025-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143020690","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Integrating acute care surgery in South Korea: enhancing trauma and non-trauma emergency care","authors":"Jin Young Lee, Seheon Kim, Jin Bong Ye, Jin Suk Lee, Younghoon Sul","doi":"10.1186/s13017-025-00578-7","DOIUrl":"https://doi.org/10.1186/s13017-025-00578-7","url":null,"abstract":"Trauma surgery is a fundamental aspect of medicine. According to the 2023 mortality report from Statistics Korea, external factors such as intentional self-harm and transportation incidents are leading causes of death among individuals aged 10 to 30, accounting for 7.9% of overall mortality. Despite advances in the field, specialization has hindered comprehensive trauma care. In South Korea, regional trauma centers have been established to meet critical trauma management needs; however, challenges remain, including a shortage of trauma surgeons and inefficient resource utilization. The reluctance of surgical residents to pursue trauma training exacerbates the scarcity of qualified specialists. Trauma surgeons often bear extensive responsibilities, which limits their ability to perform prompt interventions. Acute Care Surgery (ACS) offers a model to integrate trauma and non-trauma surgical care, enabling hospitals to implement effective protocols for urgent cases and improving patient outcomes. Research indicates that ACS enhances emergency surgical management, increases training opportunities for residents, and improves job satisfaction among participating surgeons. Integrating ACS into South Korea’s healthcare system is essential to optimize resource allocation and improve emergency care, ultimately leading to enhanced public health outcomes.","PeriodicalId":48867,"journal":{"name":"World Journal of Emergency Surgery","volume":"31 1","pages":""},"PeriodicalIF":8.0,"publicationDate":"2025-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142990061","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Global perspectives in acute and emergency general surgery in low and middle-income countries: a WSES project protocol for scoping review on global surgery","authors":"Mahmoud Diaa Hindawi, Arda Isik, Fausto Rosa, Diego Visconti, Taras Nechay, Sharfuddin Chowdhury, Abdourahmane Ndong, Tushar S. Mishra, Stefano Piero Bernardo Cioffi, Francesco Piscioneri, Edward C.T.H. Tan","doi":"10.1186/s13017-025-00576-9","DOIUrl":"https://doi.org/10.1186/s13017-025-00576-9","url":null,"abstract":"Around five billion people globally lack access to safe, timely, and affordable surgical facilities and care in low-income and middle-income countries (LMICs). Global initiatives have been launched, including efforts led by organizations. Also, regional efforts have shed light on the unique challenges faced by different areas within LMICs. Despite these efforts, many countries still face significant challenges, including inadequate infrastructure, limited availability of trained surgical personnel, lack of essential medical equipment, and insufficient financial resources allocated to healthcare and their related possible factors. Here is that we aim to identify the progress made in areas such as capacity building, training programs, infrastructure development, and policy reforms, as well as highlight the gaps that persist, providing a foundation for future research. Such a comprehensive scoping review will be crucial to enhance surgical care services and ultimately improve health outcomes in LMICs. A comprehensive literature search up to November 2024 will be conducted across six major databases. PubMed, Scopus, Ovoid, Web of Science, Cochrane Central, CNKI (China National Knowledge Infrastructure) database. The methodology will follow the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) Checklist. The first version of this project will not include a quality appraisal.","PeriodicalId":48867,"journal":{"name":"World Journal of Emergency Surgery","volume":"1 1","pages":""},"PeriodicalIF":8.0,"publicationDate":"2025-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142940300","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pre-operative antibiotics in patients with acute mild cholecystitis undergoing laparoscopic cholecystectomy: is it really useful? A systematic review","authors":"Camilo Ramírez-Giraldo, Isabella Van-Londoño, Antonio Pesce","doi":"10.1186/s13017-025-00574-x","DOIUrl":"https://doi.org/10.1186/s13017-025-00574-x","url":null,"abstract":"Empirical antibiotic therapy is often initiated during the hospital stay while awaiting laparoscopic cholecystectomy. This approach is generally justified in patients with moderate (Tokyo II) and severe (Tokyo III) acute cholecystitis, where organ dysfunction occurs as a result of the inflammatory or infectious process. However, there is no clear consensus regarding the use of antibiotics in patients with mild (Tokyo I) cholecystitis. This study aimed to evaluate the impact of preoperative antibiotic use on outcomes in patients with acute cholecystitis. A systematic review of PubMed, Embase and Cochrane was conducted following the PRISMA methodology. Studies were eligible for inclusion if they were randomized controlled trials or non-randomized comparative studies evaluating the use or non-use of preoperative antibiotics in patients with acute cholecystitis. Eligible studies were required to provide at least one of the following datasets: postoperative complication rate, postoperative infectious complication rate, or positive culture rate. The synthesis reports were prepared using the Synthesis Without Meta-analysis (SWiM) framework. A total of 622 articles were initially identified, of which 2 met the inclusion criteria. These two articles included 331 patients. They reported higher rates of postoperative complications and bacterobilia in the group that received preoperative antibiotics; however, the differences were not statistically significant (p > 0.05). Based on current evidence, no recommendation can be made regarding the therapeutic use of antibiotics in mild acute cholecystitis while awaiting laparoscopic cholecystectomy.","PeriodicalId":48867,"journal":{"name":"World Journal of Emergency Surgery","volume":"1 1","pages":""},"PeriodicalIF":8.0,"publicationDate":"2025-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142940358","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of the lethal triad and the lethal diamond in severe trauma patients: a multicenter cohort","authors":"Charles Dupuy, Thibault Martinez, Olivier Duranteau, Tobias Gauss, Natacha Kapandji, Jean Pasqueron, Mathilde Holleville, Georges Abi Abdallah, Anatole Harrois, Véronique Ramonda, Delphine Huet-Garrigue, Théophane Doublet, Marc Leone, Vincent Legros, Julien Pottecher, Gérard Audibert, Ingrid Millot, Benjamin Popoff, Benjamin Cohen, Fanny Vardon-Bounes, Mathieu Willig, Pierre Gosset, Emilie Angles, Nouchan Mellati, Nicolas Higel, Mathieu Boutonnet, Pierre Pasquier","doi":"10.1186/s13017-024-00572-5","DOIUrl":"https://doi.org/10.1186/s13017-024-00572-5","url":null,"abstract":"To reduce the number of deaths caused by exsanguination, the initial management of severe trauma aims to prevent, if not limit, the lethal triad, which consists of acidosis, coagulopathy, and hypothermia. Recently, several studies have suggested adding hypocalcemia to the lethal triad to form the lethal diamond, but the evidence supporting this change is limited. Therefore, the aim of this study was to compare the lethal triad and lethal diamond for their respective associations with 24-h mortality in severe trauma patients receiving transfusion. We performed a multicenter retrospective analysis of patients in TraumaBase®, a French database (2011–2023). The patients included in this study were all trauma patients who had received transfusions of at least 1 unit of red blood cells (RBCs) within the first 6 h of hospital admission and for whom ionized calcium measurements were available. Hypocalcemia was defined as an ionized calcium level < 1.1 mmol/L. A total of 2141 severe trauma patients were included (median age: 39, interquartile range [IQR]: 26–57; median injury severity score: 27, IQR: 17–41). Patients primarily presented with blunt trauma (81.7%), and a 24-h mortality rate of 16.1% was observed. Receiver operating characteristic curve analysis revealed no significant difference in the association with 24-h mortality between the lethal diamond (area under the curve [AUC]: 0.71) and the lethal triad (AUC: 0.72) (p = 0.26). The strength of the association with 24-h mortality was similar between the lethal triad and the lethal diamond, with Cramer’s V values of 0.29 and 0.28, respectively. This study revealed no significant difference between the lethal triad and the lethal diamond in terms of their respective associations with 24-h mortality in severe trauma patients requiring transfusion. These results raise questions about the independent role of hypocalcemia in early mortality.","PeriodicalId":48867,"journal":{"name":"World Journal of Emergency Surgery","volume":"7 1","pages":""},"PeriodicalIF":8.0,"publicationDate":"2025-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142934875","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}