Background: Development of abdominal compartment syndrome (ACS) in patients with severe acute pancreatitis (SAP) has a strong impact on the course of disease. Number of patients with this complication increases during the years due more aggressive fluid resuscitation, much bigger proportion of patients who is treated conservatively or by minimal invasive approach, and efforts to delay open surgery. There have not been standard recommendations for a surgical or some other interventional treatment of patients who develop ACS during the SAP. The aim of DECOMPRESS study was to compare decompresive laparotomy with temporary abdominal closure and percutaneus puncture with placement of abdominal catheter in these patients.
Methods: One hundred patients with ACS will be randomly allocated to two groups: I) decompresive laparotomy with temporary abdominal closure or II) percutaneus puncture with placement of abdominal catheter. Patients will be recruited from five hospitals in Belgrade during two years period. The primary endpoint is the mortality rate within hospitalization. Secondary endpoints are time interval between intervention and resolving of organ failure and multi organ dysfunction syndrome, incidence of infectious complications and duration of hospital and ICU stay. A total sample size of 100 patients was calculated to demonstrate that decompresive laparotomy with temporary abdominal closure can reduce mortality rate from 60% to 40% with 80% power at 5% alfa.
Conclusion: DECOMPRESS study is designed to reveal a reduction in mortality and major morbidity by using decompresive laparotomy with temporary abdominal closure in comparison with percutaneus puncture with placement of abdominal catheter in patients with ACS during SAP.
Trial Registration: ClinicalTrials.gov Identifier: NTC00793715.
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http://dx.doi.org/10.1186/1471-2482-10-22 | DOI Listing |
J Cardiothorac Surg
January 2025
Section of Cardiothoracic Surgery, Department of Heart Disease, Haukeland University Hospital, Jonas Lies vei 65, 5021, Bergen, Norway.
Background: A broncho-esophageal fistula (BEF) is a medical and surgical disaster. Treatment of BEF is often limited to palliative stent treatment that may migrate or cause erosions and tissue necrosis. Surgical repair of BEF is the only established definite treatment.
View Article and Find Full Text PDFJ Clin Med
January 2025
Jackie and Gene Autry Children's Orthopedic Center, Children's Hospital Los Angeles, Los Angeles, CA 90027, USA.
Postoperative ileus, the temporary cessation of gastrointestinal motility leading to accumulation of fluid and gas in the bowel, is a common complication following posterior spine fusion (PSF) in patients with neuromuscular scoliosis (NMS). Abdominal radiographs (KUBs) are often ordered to differentiate between ileus and mechanical obstruction but expose patients to radiation, add cost, and may lead to unnecessary work up. The aim of this study was to determine how often KUBs led to a change in treatment after PSF in patients with NMS.
View Article and Find Full Text PDFAm J Case Rep
January 2025
Department of General Surgery, Fundación Cardioinfantil - LaCardio, Bogotá, Colombia.
BACKGROUND Terminal ileum (TI) anastomoses present challenges due to anatomical features and pressure from the ileocecal valve (ICV). The use of negative-pressure wound therapy (NPWT) is commonly used to treat chronic skin ulcers. Its use for temporary abdominal closure following anastomosis is controversial but has shown promise in patients with inflammatory or vascular disease.
View Article and Find Full Text PDFPatient Saf Surg
December 2024
Department of Trauma Surgery, University Hospital Zurich, University of Zurich, Raemistr. 100, Zurich, 8091, Switzerland.
Background: Hemodynamically unstable pelvic ring fractures from high-energy trauma are critical injuries in trauma care, requiring urgent intervention and precise diagnostics. With ongoing advancements in trauma management, treatment strategies have evolved, with some techniques becoming obsolete as new ones emerge. This study aimed to evaluate changes and trends in treatment algorithms for these injuries over approximately 40 years.
View Article and Find Full Text PDFEur J Cardiothorac Surg
December 2024
Department of Cardiac Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan.
Objectives: Mesenteric malperfusion in acute aortic dissection remains a life-threatening complication with no standardized treatment strategy. This study aimed to describe and evaluate the outcomes of our integrated approach combining exploratory laparotomy, immediate mesenteric reperfusion, and central aortic repair.
Methods: We retrospectively reviewed patients with acute aortic dissection with a preoperative diagnosis of mesenteric malperfusion who were treated between August 2011 and November 2022.
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