Adherence to enhanced recovery protocol in emergency general surgery: a prospective observational study.

Enhanced recovery pathways (ERPs) are evidence-based, multimodal strategies designed to promote early recovery and to optimize surgical outcomes. While extensively implemented in elective surgery, their adaptation to emergency general surgery (EGS) raises challenges due to patient instability and limited preoperative time. The study aimed to evaluate the adherence to each ERPs item and the impact on short-term outcomes in patients undergoing emergency general surgery.

Impact of the COVID-19 Pandemic on the Management of Acute Colonic Diverticulitis: A Retrospective Observational Study.

Introduction Acute colonic diverticulitis (ACD) is a frequent gastrointestinal disease, with its rising incidence and hospitalizations contributing to increased healthcare costs. The COVID-19 pandemic significantly impacted healthcare delivery, leading to shifts in hospital admissions and management strategies for various conditions, including ACD. This study aims to assess the changes in hospital admission rates for ACD before and during the COVID-19 pandemic.

Comparison between endovascular and surgical treatment of acute arterial occlusive mesenteric ischemia.

Background: The optimal strategy for initial treatment of acute occlusion of superior mesenteric artery (SMA) is debated. The aim of the study was to compare the effectiveness, timelines and outcomes of endovascular versus open surgical treatment in patients with acute SMA occlusion. This was a preplanned substudy of the prospective observational multicenter AMESI (Acute MESenteric Ischaemia) study.

A systematic review of the predictive factors for the recurrence of acute pancreatitis.

Purpose: Acute Pancreatitis (AP) is a prevalent clinical pancreatic disorder characterized by acute inflammation of the pancreas, frequently associated with biliary or alcoholic events. If not treated with cholecystectomy after the first episode, patients may experience a recurrence of AP, with consequent need for emergency surgery and increased risk of death. Analyzing the risk factors that may contribute to the recurrence of Biliary and Alcoholic Pancreatitis (BAP and AAP), future research can be driven toward new solutions for preventing and treating this pancreatic disease.

Machine learning for the rElapse risk eValuation in acute biliary pancreatitis: The deep learning MINERVA study protocol.

Background: Mild acute biliary pancreatitis (MABP) presents significant clinical and economic challenges due to its potential for relapse. Current guidelines advocate for early cholecystectomy (EC) during the same hospital admission to prevent recurrent acute pancreatitis (RAP). Despite these recommendations, implementation in clinical practice varies, highlighting the need for reliable and accessible predictive tools.

Minimally invasive approach to peritonitis from left colonic perforation: a retrospective multicenter observational study.

Background: Laparoscopic procedures have nowadays become the gold standard in multiple abdominal diseases, but in the emergency setting, especially in major surgery, laparoscopy still represents an obstacle for most surgeons. This multicentric study aims to define the surgical approach for emergency resective surgery in left colonic perforation peritonitis, determine the factors influencing the choice between MIS and open surgery, and identify factors associated with laparotomic conversion.

Methods: Retrospective data from 516 patients treated for left colonic perforation between January 2019 and December 2023 across six Italian centers was collected.

Costal fracture assessment for relief and enhancement of quality of life-CARE study.

Purpose: Rib fractures account for 10-15% of trauma-related hospital admissions. Few data are available regarding long-term follow-up of patients undergoing non-operative management. Our aim is to evaluate quality of life at 1, 2, 4, 12 and 24 weeks from the trauma.

Implementing recycling in the operating room: a single-center experience.

Background: Climate change poses significant challenges to global health, exacerbated by healthcare systems' carbon footprint and waste generation. Surgical activities contribute to these impacts, necessitating sustainable practices to mitigate environmental harm. This study aims to assess the feasibility and effectiveness of a recycling program in reducing waste, carbon emissions, and disposal costs in the operating rooms (ORs).

Preoperative Waiting Time Affects the Length of Stay of Patients Treated via Laparoscopic Cholecystectomy in an Acute Care Surgical Setting.

Acute cholecystitis (AC) presents a significant burden in emergency surgical settings. Early laparoscopic cholecystectomy (ELC) is the standard of care for AC, yet its implementation varies. This study aims to assess the impact of preoperative waiting time (WT) on postoperative length of stay (LOS) in patients undergoing urgent cholecystectomy.

D-Dimer in Acute Mesenteric Venous Thrombosis: A Prospective Case-Control International Multicenter Study.

Background: Acute mesenteric venous thrombosis (MVT) is rarely suspected as primary diagnosis in emergency departments and still carries an in-hospital mortality rate of above 20%.

Objectives: The aim of this study was to find differences in clinical and laboratory markers between patients with acute MVT and a control group of suspected but confirmed as not having any type of acute mesenteric ischaemia (AMI).

Design: Data was retrieved from the AMESI (Acute MESenteric Ischaemia) study.

Practice patterns and clinical outcomes in acute appendicitis differ in the elderly patient.

Background: Appendicitis is the most frequent global abdominal surgical emergency. An ageing population, who often exhibit atypical symptoms and delayed presentations, challenge conventional diagnostic and treatment paradigms.

Objectives: This study aims to delineate disparities in presentation, management, and outcomes between elderly patients and younger adults suffering from acute appendicitis.

Biomarkers In Prediction of Acute Mesenteric Ischaemia: a prospective multicentre study (BIPAMI study): a study protocol.

Background: Acute mesenteric ischaemia (AMI) is a life-threatening disease where early diagnosis is critical to avoid morbidity and mortality from extensive irreversible bowel necrosis. Appropriate prediction of presence of bowel necrosis is currently not available but would help to choose the optimal method of treatment. The study aims to identify combinations of biomarkers that can reliably identify AMI and distinguish between potentially reversible and irreversible bowel ischaemia.

Acute cholecystitis management in high-risk, critically ill, and unfit-for-surgery patients: the Italian Society of Emergency Surgery and Trauma (SICUT) guidelines.

Dealing with acute cholecystitis in high-risk, critically ill, and unfit-for-surgery patients is frequent during daily practice and requires complex management. Several procedures exist to postpone and/or prevent surgical intervention in those patients who temporarily or definitively cannot undergo surgery. After a systematic review of the literature, an expert panel from the Italian Society of Emergency Surgery and Trauma (SICUT) discussed the different issues and statements in subsequent rounds.

The Accuracy of Point-of-Care Ultrasound (POCUS) in Acute Gallbladder Disease.

There is increasing recognition that point-of-care ultrasound (POCUS), performed by the clinician at the bedside, can be a natural extension of the clinical examination-the modern abdominal "stethoscope" and provides an opportunity to expedite the care pathway for patients with acute gallbladder disease. The primary aims of this study were to benchmark the accuracy of surgeon-performed POCUS in suspected acute gallbladder disease against standard radiology or pathology reports and to compare time to POCUS diagnosis with time to definitive imaging. This prospective single-arm observational cohort study was conducted in four hospitals in Ireland, Italy, and Portugal to assess the accuracy of POCUS against standard radiology in patients with suspected acute biliary disease (ClinicalTrials.

Implementing Enhanced Perioperative Care in Emergency General Surgery: A Prospective Multicenter Observational Study.

Introduction: ERAS pathway has been proposed as the standard of care in elective abdominal surgery. Guidelines on ERAS in emergency surgery have been recently published; however, few evidences are still available in the literature. The aim of this study was to evaluate the feasibility of an enhanced recovery protocol in a large cohort of patients undergoing emergency surgery and to identify possible factors impacting postoperative protocol compliance.

Surgeon-Performed Point-of-Care Ultrasound in the Diagnosis of Acute Sigmoid Diverticulitis: A Pragmatic Prospective Multicenter Cohort Study.

Background and purpose Early diagnosis and risk stratification of sigmoid diverticulitis rely heavily on timely imaging. Computerized tomography (CT), the gold standard diagnostic test, may be delayed due to resource constraints or patient comorbidity. Point-of-care ultrasound (POCUS) has an established role in trauma evaluation, and could potentially diagnose and stage acute diverticulitis, thus shortening the time to definitive treatment.

Can the American College of Surgeons NSQIP Surgical Risk Calculator Accurately Predict Adverse Postoperative Outcomes in Emergency Abdominal Surgery? An Italian Multicenter Analysis.

Background: The American College of Surgeons NSQIP surgical risk calculator provides an estimation of 30-day postoperative adverse outcomes. It is useful in the identification of high-risk patients needing clinical optimization and supports the informed consent process. The purpose of this study is to validate its predictive value in the Italian emergency setting.

What trauma patients need: the European dilemma.

There is a need for implementation and maturation of an inclusive trauma system in every country in Europe, with patient centered care by dedicated surgeons. This process should be initiated by physicians and medical societies, based on the best available evidence, and supported and subsequently funded by the government and healthcare authorities. A systematic approach to organizing all aspects of trauma will result in health gain in terms of quality of care provided, higher survival rates, better functional outcomes and quality of life.

A rare case of reverse midgut rotation and jejunal transmesenteric internal hernia in an adult with Beckwith-Wiedemann syndrome.

Intestinal malrotation is a rare congenital condition with an incidence in adulthood between 0,0001% and 0,19%, affecting nearly 1:500 live births. It results from an abnormal rotation of the bowel within the peritoneal cavity during embryogenesis. Generally it involves both small and large bowel, leading to an increased risk of intestinal obstruction.

Surgeon-performed ultrasound for the staging of acute diverticulitis: Preliminary results of a prospective study.

Introduction: Although contrast-enhanced abdominal computed tomography (CEACT) is still considered the criterion standard for the assessment of suspected acute diverticulitis, in recent years, the use of point-of-care ultrasound (POCUS) has been spreading more and more in this setting. The aim of this study was to compare CEACT to POCUS for the diagnosis and staging of suspected acute diverticulitis.

Methods: This is a prospective study conducted on 55 patients admitted to the emergency department of two Italian Hospitals with a clinical suspicion of acute diverticulitis between January 2014 and December 2017.