Introduction: Major abdominal surgery leads to a postoperative systemic inflammatory response, making it difficult to discriminate patients with systemic inflammatory response syndrome from those with a beginning postoperative infectious complication. At present, physicians have to rely on their clinical experience to differentiate between the two. Pancreatic stone protein (PSP) and pancreatitis-associated protein (PAP), both secretory proteins produced by the pancreas, are dramatically increased during pancreatic disease and have been shown to act as acute-phase proteins. Increased levels of PSP have been detected in polytrauma patients developing sepsis and PSP has shown a high diagnostic accuracy in discriminating the severity of peritonitis and in predicting death in intensive care unit patients. However, the prognostic value of PSP/PAP for infectious complications among patients undergoing major abdominal surgery is unknown.
Methods And Analysis: 160 patients undergoing major abdominal surgery will be recruited preoperatively. On the day before surgery, baseline blood values are attained. Following surgery, daily blood samples for measuring regular inflammatory markers (c-reactive protein, procalcitonin, interleukin-6, tumour necrosis factor-α and leucocyte counts) and PSP/PAP will be acquired. PSP/PAP will be measured using a validated ELISA developed in our research laboratory. Patient's discharge marks the end of his/her trial participation. Complication grade including mortality and occurrence of infectious postoperative complications according to validated diagnostic criteria will be correlated with PSP/PAP values. Total intensive care unit days and total length of stay will be recorded as further outcome parameters.
Ethics And Dissemination: The PSP trial is a prospective monocentric cohort study evaluating the prognostic value of PSP and PAP for postoperative infectious complications. In addition, a comparison with established inflammatory markers in patients undergoing major abdominal surgery will be performed to help evaluate the role of these proteins in predicting and diagnosing infectious and other postoperative complications.
Institution Ethics Board Approval Id: KEKZH-Nr. STV 11-2009.
Trial Registration: ClinicalTrials.gov: NCT01258179.
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http://dx.doi.org/10.1136/bmjopen-2014-004914 | DOI Listing |
JSLS
January 2025
Western New York Urology Associates, Cheektowaga, New York, USA. (Dr. Eddib).
Background: Sacrocolpopexy has become a favored treatment of pelvic organ prolapse due to its durability and efficacy. Sacrocolpopexy has not been standardized and there is no categorization scheme to facilitate communication or research efforts for the procedure. A systematic review was conducted to facilitate construction of a classification system for sacrocolpopexy based on extent of vaginal dissection described in the medical literature.
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December 2024
Department of Pathology, General Hospital of Thessaloniki Agios Pavlos, Thessaloniki, GRC.
The term "gossypiboma" or "textiloma" is used to describe a mass of retained cotton matrix and the surrounding inflammatory response inside a body cavity following surgical intervention. The precise incidence of this phenomenon is uncertain, as cases are frequently underreported due to concerns related to medical malpractice. This rare complication poses a diagnostic dilemma due to the non-specific clinical and radiological features, which can result in significant morbidity and mortality.
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December 2024
Trauma and Acute Care Surgery, Northeast Georgia Medical Center Gainesville, Gainesville, USA.
Roux-en-Y gastric bypass (RYGB) is a common surgical treatment for morbid obesity, but rare complications involving the excluded gastric remnant can pose significant challenges. A 65-year-old female with a history of RYGB presented with sudden onset of left upper quadrant abdominal pain, bloating, nausea, and loss of appetite. Laboratory tests revealed leukocytosis.
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December 2024
Department of Surgery, Royal Oldham Hospital, Northern Care Alliance NHS Trust, Manchester, GBR.
Gallstone ileus (GSI) is a rare complication of gallstone disease. It occurs as a result of the passage of a stone from the biliary tract into the gastrointestinal tract via an abnormal pathway (bilio-enteric fistula). Chronic inflammatory processes result in gall bladder adhering and subsequently eroding into the intestines, leading to a fistula.
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December 2024
Department of Anatomy, Ganesh Shankar Vidyarthi Memorial Medical College, Kanpur, IND.
Purpose Hepatic abscesses remain a significant clinical challenge due to high morbidity and mortality. This research aims to examine the etiological spectrum, management approaches, clinical features, and results in hepatic abscesses in a tertiary care facility in northern India, emphasizing the distinctions among pyogenic liver abscesses (PLAs) and amoebic liver abscesses (ALAs). Methods This retrospective study was done at GSVM Medical College, Kanpur, analyzing 725 patients with hepatic abscesses over a 10-year period.
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