Environmentally sustainable surgical systems.

Surgeons, anaesthetists, wider surgical teams and hospital managers are a large global group that has the capacity and power to play a leadership role to contribute to change. Hospitals are a good target for improvement since they are centres of communities, linking together surrounding healthcare facilities and influencing wider determinants of the environment. District and rural hospitals are good sites to start since they serve large populations, have the least sustained energy and clean water supplies and will benefit most from quality improvement.

Perioperative optimisation in low- and middle-income countries (LMICs): A systematic review and meta-analysis of enhanced recovery after surgery (ERAS).

Background: Enhanced recovery after surgery (ERAS) protocols have largely been incorporated into practice in high-income settings due to proven improvement in perioperative outcomes. We aimed to review the implementation of ERAS protocols and other perioperative optimisation strategies in low- and middle-income countries (LMICs) and their impact on length of hospital stay (LOS).

Methods: We searched MEDLINE, PubMed, Global Health (CABI), WHO Global Index Medicus, Index Medicus, and Latin American and Caribbean Health Sciences Literature (LILACS) for studies incorporating ERAS or other prehabilitation approaches in LMICs.

A multicentric, randomized, controlled phase III study of centhaquine (Lyfaquin ) as a resuscitative agent in hypovolemic shock patients.

Introduction: Centhaquine (Lyfaquin ) showed significant safety and efficacy in preclinical and clinical phase I and II studies.

Methods: A prospective, multicentric, randomized phase III study was conducted in patients with hypovolemic shock having systolic blood pressure (SBP) of ≤90 mm Hg and blood lactate levels of ≥2 mmol/L. Patients were randomized in a 2:1 ratio, 71 patients to the centhaquine group and 34 patients to the control (saline) group.

Laparoscopic Versus Open Sigmoid Loop Colostomy: A Comparative Study from a Cohort of 62 Patients Requiring Temporary Faecal Diversion at a Tertiary Care Center in North India.

Background: Over decades, colostomies have been done through open method, but laparoscopic creation of an intestinal stoma is safe, feasible and has distinct advantages over conventional techniques in specific procedures. The aim of this study compares operative and short-term outcomes of laparoscopic and open sigmoid loop colostomy formation for temporary fecal diversion.

Subjects And Methods: A single institution, comparative study conducted in the department of surgery for patients who underwent either laparoscopic or open sigmoid loop colostomy.

Kasabach-Merritt Syndrome Associated With a Large Cavernous Splenic Hemangioma Treated With Splenectomy: A Surgeon's Introspection of an Uncommon, Little Read, and Yet Complex Problem-Review Article.

Cavernous hemangiomas of the spleen are small benign lesions found incidentally, majority of times while patients are being investigated for some other disease and patients remain asymptomatic otherwise for this condition. The natural history of cavernous hemangiomas of spleen is slow, symptoms or complications, when present, occur late, they are rarely large and can manifest as a palpable non-tender mass in the left upper quadrant. A very rare syndrome is associated with this condition called Kasabach-Merritt syndrome (KMS), which is defined as diffuse cavernous hemangioma of the spleen alongwith anemia, thrombocytopenia, and coagulopathy.

Does an alcolmeter in the hands of an anesthesiologist make TURP safer? - Results from a case-control study.

Background: This hospital-based, prospective, case-controlled study was carried out to monitor fluid absorption during transurethral resection of the prostrate (TURP) by marking the irrigating fluid with ethanol for signs of TURP syndrome. Addition of ethanol allows early detection and prevention of full blown TURP syndrome as also the volume of fluid absorbed can be measured.

Subjects And Methods: Patients were divided into two groups of 50 each, taking males undergoing TURP belonging to ASA (American Society of Anesthesiologists) I and II.

Thoracic duct injury following esophagectomy in carcinoma of the esophagus: ligation by the abdominal approach.

Background: Thoracic duct injury (TDI) is a potentially lethal complication of esophagectomy. There is no consensus regarding when and how to intervene in these injuries. Both thoracic and abdominal approaches have been used.