Impact of preoperative frailty on outcomes in patients subjected to emergency laparotomy: a prospective study.

Purpose: Emergency laparotomy (EL) is a high-risk procedure, especially in frail patients. This study investigates the prevalence of frailty in referral facilities, evaluates the impact of frailty on postoperative morbidity and mortality, and assesses the long-term effect of EL on patients' functional status.

Methods: This prospective multicentre cohort study included patients aged 50 years and older who underwent EL.

Impact of frailty on outcomes following emergency laparotomy: a retrospective analysis across diverse clinical conditions.

Purpose: Emergency laparotomy (EL) encompasses procedures of varying complexity and urgency, undertaken in different clinical scenarios, leading to different risks of morbidity and mortality. We hypothesized that the increased mortality and longer postoperative length of stay (LoS) observed in frail patients are related to differences in indication for operation, a higher rate of sepsis, worse intraperitoneal soiling, and more advanced malignancy in this group.

Methods: This retrospective cohort study analysed patients entered into the National Emergency Laparotomy Audit database between January 1, 2018, and June 15, 2021, in Oxford.

Short Postoperative Intravenous Versus Oral Antibacterial Therapy in Complicated Acute Appendicitis: A Pilot Noninferiority Randomized Trial.

Objective: The purpose of this study is to investigate noninferiority of postoperative oral administration of antibiotics in complicated appendicitis.

Background: Recent investigations have used exclusively intravenous administration of antibiotics when comparing outcomes of postoperative antibacterial therapy in complicated appendicitis. We hypothesized that oral antibacterial treatment results in noninferior outcomes in terms of postoperative infectious complications as intravenous treatment.

Frailty Assessment Can Enhance Current Risk Prediction Tools in Emergency Laparotomy: A Retrospective Cohort Study.

Objective: We set out to assess the performance of the P-POSSUM and NELA risk prediction tool (NELA RPT), and hypothesized that combining them with the Clinical Frailty Scale (CFS) would significantly improve their performance. Emergency laparotomy (EL) is a high-risk surgical intervention, particularly for elderly patients with marked comorbidities and frailty. Accurate risk prediction is crucial for appropriate resource allocation, clinical decision making, and informed consent.

Open versus laparoscopic appendectomy for acute appendicitis in pregnancy: a population-based study.

Background: Laparoscopic appendectomy (LA) is the standard treatment for acute appendicitis (AA) in general population. However, the safety of LA during pregnancy has remained a matter of debate. The purpose of this study was to compare surgical and obstetrical outcomes in pregnant women who underwent LA vs.

Management of small bowel obstruction and therapeutic role of contrast media: A multicenter study.

Background: Adhesive small bowel obstruction (SBO) accounts for 55-75% of mechanical small bowel obstructions [1,2]. According to guidelines, water-soluble contrast media (CM) is suggested in the diagnostic work-up of adhesive SBO [3], [4], [5]. However, there is currently no consensus on the therapeutic role of water-soluble CM in adhesive SBO [6] or a generally approved protocol as to when CM should be administered, how often should radiographs be taken and how long conservative management can safely be pursued.

Bile duct injuries during laparoscopic cholecystectomies: an 11-year population-based study.

Purpose: Iatrogenic bile duct injuries (BDI) following laparoscopic cholecystectomy (LC) result in major morbidity and incidental mortality. There is a lack of unselected population-based cross-sectional studies on the incidence, management, and outcomes of BDI. We hypothesised that due to improved imaging capabilities and collective laparoscopic experience, BDI incidence will decrease over the study period and compare favourably with contemporary literature.

Complications of chronic pancreatitis prior to and following surgical treatment: A proposal for classification.

Background: Chronic pancreatitis (CP) is a long-lasting disease frequently associated with complications for which there is no comprehensive pathophysiological classification.

Aim: The aims of this study were to: Propose a pathophysiological classification of the complications of CP; evaluate their prevalence in a surgical cohort prior to, and following surgical management; and assess the impact of the surgical treatment on the occurrence of new complications of CP during follow-up. We hypothesized that optimal surgical treatment can resolve existing complications and reduce the risk of new complications, with the exclusion of pancreatic insufficiency.

Voice and Swallowing Disorders After Thyroid Surgery.

Objective: The aim of the study was to evaluate voice and swallowing function following thyroid surgery, to identify dynamic changes during the follow-up period of 12-18 month and to find possible indicative signs of permanent or temporary vocal fold palsy.

Methods: All participants (N = 110) were prospectively enrolled from the preoperative thyroid surgery patients between September 2013 and December 2016. All subjects underwent preoperatively, first week and 12-18 month postoperatively videolaryngostroboscopy, filled in subjective evaluation of voice (voice handicap index, [VHI]) and swallowing (swallowing impairment score) complaints.

Flood syndrome following right-sided heart failure: a case report.

Flood syndrome is a rare condition, where a patient with ascites suffers sudden umbilical hernia rupture and a subsequent drainage of ascitic fluid from the abdominal cavity. The cause of ascites is usually liver cirrhosis. Complications associated with cirrhosis of the liver make Flood syndrome difficult to manage.

'Short' pancreaticojejunostomy might be a valid option for treatment of chronic pancreatitis in many cases.

Background: The Partington-Rochelle pancreaticojejunostomy (PJ) is an essential management option for patients with chronic pancreatitis (CP) associated with intractable pain and a dilated pancreatic duct (PD). Wide ductotomy and long PJ (L-PJ) have been advocated as the standard of care to ensure full PD decompression. However, the role of short PJ (S-PJ) in a uniformly dilated PD has not yet been evaluated.

Prethyroidectomy voice and swallowing disorders and the possible role of laryngopharyngeal reflux disease.

Objectives: The aim of the study was to evaluate voice and swallowing function before thyroid surgery and to explore the possible role of thyroid enlargement and laryngopharyngeal reflux (LPR).

Methods: We conducted a prospective study of patients who underwent hemi- or total thyroidectomy ( = 118) and compared the results with patients of laparoscopic cholecystectomy ( = 110). All subjects underwent videolaryngostroboscopy, filled in subjective evaluations of voice, swallowing and reflux complaints.

Remote ischaemic preconditioning influences the levels of acylcarnitines in vascular surgery: a randomised clinical trial.

Background: Vascular surgery patients have reduced tissues` blood supply, which may lead to mitochondrial dysfunction and accumulation of acylcarnitines (ACs). It has been suggested that remote ischaemic preconditioning (RIPC) has its organ protective effect via promoting mitochondrial function. The aim of this study was to evaluate the effect of RIPC on the profile of ACs in the vascular surgery patients.

Remote Ischaemic Preconditioning Reduces Kidney Injury Biomarkers in Patients Undergoing Open Surgical Lower Limb Revascularisation: A Randomised Trial.

Background And Aims: Perioperative kidney injury affects 12.7% of patients undergoing lower limb revascularisation surgery. Remote ischaemic preconditioning (RIPC) is a potentially protective procedure against organ damage and consists of short nonlethal episodes of ischaemia.

Remote Ischaemic Preconditioning Attenuates Cardiac Biomarkers During Vascular Surgery: A Randomised Clinical Trial.

Objective: The main aim of this study was to evaluate the effect of remote ischaemic preconditioning (RIPC) on preventing the leakage of cardiac damage biomarkers in patients undergoing vascular surgery.

Methods: This is a randomised, sham-controlled, double-blinded, single-centre study. Patients undergoing open abdominal aortic aneurysm repair, surgical lower limb revascularisation surgery or carotid endarterectomy were recruited non-consecutively.

The Effect of Remote Ischaemic Preconditioning on Arterial Stiffness in Patients Undergoing Vascular Surgery: A Randomised Clinical Trial.

Objectives: The main aim of this study was to evaluate the effect of remote ischaemic preconditioning (RIPC) on arterial stiffness in patients undergoing vascular surgery.

Methods: This was a randomised, sham controlled, double blind, single centre study. Patients undergoing open abdominal aortic aneurysm repair, surgical lower limb revascularisation surgery or carotid endarterectomy were recruited.

Cold-Stored Venous Allografts In Different Preserving Solutions: A Study On Changes In Vein Wall Morphology.

Background:: The saphenous vein is the most frequently used bypass conduit for vascular reconstructions, which may need to be stored for a prolonged time. The aim of this study was to compare the effect of different preservation solutions on the morphology of saphenous veins during the long-term cold storage.

Design:: An in vitro study.

Twenty-four hour versus extended antibiotic administration after surgery in complicated appendicitis: A randomized controlled trial.

Background: Recent investigations noted noninferiority in short-course antimicrobial treatments following source control in abdominal infections. We set out to investigate noninferiority of a short and fixed (24 hours) antibiotic administration compared to extended treatment after source control in complicated appendicitis in a prospective single-center open-label randomized controlled trial.

Methods: After Institutional Review Board (IRB) approval, all consecutive adult patients (age, ≥ 18 years) with complicated appendicitis including gangrenous appendicitis, perforated appendicitis, and appendicitis with periappendicular abscess between May 2016 and February 2018 were randomly allocated to antibacterial therapy limited to 24 hours (short) vs.

Cardiac Injuries at Estonian Major Trauma Facilities: A 23-year Perspective.

Background And Aims: Cardiac injuries are highly lethal lesions following trauma and most of the patients decease in pre-hospital settings. However, studies on cardiac trauma in Estonia are scarce. Thus, we set out to study cardiac injuries admitted to Estonian major trauma facilities during 23 years of Estonian independence.

Population-Based Autopsy Study of Traumatic Fatalities.

Background: Injuries result in 5.8 million global fatalities annually and are the leading cause of death in younger individuals. Nevertheless, population-based autopsy investigations on traumatic deaths are scarce.

Three-year results of a randomized study comparing self-gripping mesh with sutured mesh in open inguinal hernia repair.

Background: The primary aim of the present study was to evaluate whether usage of self-gripping mesh in open inguinal hernia repair, compared with standard Lichtenstein repair with sutured mesh, could result in a decreased rate of chronic pain. The secondary aim was to evaluate the rate of foreign body feeling, hernia recurrence, and risk factors for chronic pain development.

Methods: The patients were randomized into two study groups: the OLP group received Optilene LP mesh and the PPG group received self-gripping Parietex ProGrip mesh.

Prospective study evaluating the impact of severity of chronic pain on quality of life after inguinal hernioplasty.

Purpose: The definition of chronic pain after inguinal hernioplasty and the methods of its assessment vary a great deal, which make it complicated to conduct meta-analyses. The primary aim of the present prospective study was to evaluate at which pain severity degree the quality-of-life scores will be reduced.

Method: A prospective study of patients operated for inguinal hernia was conducted.

Evolution of severe trauma in Estonia comparing early versus established independence of the state.

Purpose: Trauma mechanisms and patterns of severe injuries during the Estonian independence have not been evaluated. The aim of the study was to compare the incidence and outcomes of severe injuries between time periods of early independence from the Soviet Union and the present time.

Methods: After the ethics review board approval, all adult trauma admissions to major trauma facilities in 1993-1994 and 2013-2014 with Injury Severity Score >15 were identified.

Three-Year Results of a Single-Centre Single-Blinded Randomised Study Evaluating the Impact of Mesh Pore Size on Chronic Pain after Lichtenstein Hernioplasty.

Background And Aims: The aim of the present study was to determine whether usage of mesh with larger pores, compared with mesh with smaller pores, would result in a decreased rate of chronic pain at 3-year follow-up. According to earlier published short-term results, differences in mesh pore size do not influence the rate of chronic pain.

Material And Methods: The patients were randomized into two study groups for which meshes with similar weight but different pore size were used: the UM group received Ultrapro mesh (pore size 3-4 mm) and the OM group received Optilene LP mesh (pore size 1 mm).

Delay Between Onset of Symptoms and Surgery in Acute Appendicitis Increases Perioperative Morbidity: A Prospective Study.

Background: Despite significant progress in surgery, controversy persists about timing of appendectomy. Objective of this prospective observational study was to determine associations between time interval from onset of symptoms in appendicitis to appendectomy and postoperative complications.

Methods: After institutional review board approval, all adult consecutive patients subjected to emergency appendectomy between 1/9/2013 and 1/12/2014 were prospectively enrolled.