Abstract:
BACKGROUND:The Acute Surgical Unit (ASU) is a recent change in management of acute general surgical patients in hospitals worldwide. In contrast to traditional management of acute surgical presentations by a rotating on-call system, ASUs are shown to deliver improved efficiency and patient outcomes. This study investigated the impact of an ASU on operative management of appendicitis, the most common acute surgical presentation, by comparing performance indicators and patient outcomes prior to and after introduction of an ASU at the Gold Coast Hospital, Queensland, Australia. METHODS:A retrospective study of patients admitted from the Emergency Department (ED) and who underwent emergency appendectomy from February 2010 to January 2011 (pre-ASU) and after introduction of the ASU from February 2011 to January 2012 (post-ASU). A total of 548 patients underwent appendectomy between February 2010 and January 2012, comprising 247 pre-ASU and 301 post-ASU patients. RESULTS:Significant improvements were demonstrated: reduced time to surgical review, fewer complications arising from operations commencing during ASU in-hours, and more appendectomies performed during the daytime attended by the consultant. There was no significant difference in total cost of admission or total admission length of stay. CONCLUSIONS:This study demonstrated that ASUs have potential to significantly improve the outcomes for operative management of acute appendicitis compared to the traditional on-call model. The impact of the ASU was limited by access to theaters and restricted ASU operation hours. Further investigation of site-specific determinants could be beneficial to optimize this new model of acute surgical care.
journal_name
World J Surgjournal_title
World journal of surgeryauthors
Lancashire JF,Steele M,Parker D,Puhalla Hdoi
10.1007/s00268-014-2497-zsubject
Has Abstractpub_date
2014-08-01 00:00:00pages
1947-53issue
8eissn
0364-2313issn
1432-2323journal_volume
38pub_type
杂志文章abstract:BACKGROUND:Burns are a major public health concern, affecting mostly low- and middle-income countries. However, there is a lack of epidemiological studies on burns in these countries, particularly in Latin American countries. Our aim was to analyze nationwide demographic, epidemiological and economic characteristics of...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-017-3988-5
更新日期:2017-08-01 00:00:00
abstract:BACKGROUND:Traditional perioperative care for colonic surgery in elderly patients is associated with increased morbidity and mortality compared to that of younger patients. Although multimodal perioperative rehabilitation has evolved as a valid concept to improve postoperative outcome, its use has not yet been establis...
journal_title:World journal of surgery
pub_type: 杂志文章,多中心研究
doi:10.1007/s00268-009-0018-2
更新日期:2009-08-01 00:00:00
abstract:BACKGROUND:Never events (NEs) are serious clinical incidents that cause potentially avoidable harm and impose a significant financial burden on healthcare systems. The purpose of this study was to identify common never events. METHODS:We analysed the NHS England NE data from 2012 to 2020 to identify common never event...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-020-05867-7
更新日期:2021-03-01 00:00:00
abstract:BACKGROUND:In uremic patients, metabolism of 1-84 parathyroid hormone (PTH) and fragments are delayed, and in these patients, the usefulness of intraoperative PTH assay may be problematic. We evaluated the usefulness of the QuiCk-IntraOperative Bio-Intact PTH (QPTH) assay for uremic patients with secondary hyperparathy...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-006-0601-8
更新日期:2007-04-01 00:00:00
abstract:BACKGROUND:Adrenocortical carcinoma (ACC) is a rare and aggressive malignancy with poor prognosis, as a majority of patients present with advanced disease. Current adjuvant strategies for metastatic patients include mitotane or other cytotoxic agents and carry a significant morbidity as well as a low (<10 %) 5-year sur...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-014-2532-0
更新日期:2014-06-01 00:00:00
abstract::A new technique for ligating vessels and similar structures that offers more security is described. The aim of the study was to test whether this hypothesis was correct. Six different types of knots, including the one described in this article were compared by a strength-testing study. The knots were tied on a silicon...
journal_title:World journal of surgery
pub_type: 杂志文章,评审
doi:10.1007/s00268-005-7675-6
更新日期:2005-10-01 00:00:00
abstract::Although palpable axillary lymphadenopathy is most often related to benign disorders, it may be a harbinger of an underlying advanced malignancy. Fewer than 1% of patients diagnosed with breast cancer initially present with axillary metastases as their only clinical manifestation. This study represents the Mayo Clinic...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-004-7290-y
更新日期:2004-06-01 00:00:00
abstract::Four cases of H-type tracheoesophageal fistula are reported. The patients all had chronic aspiration from the esophagus. Although serious symptoms were present in all, definitive diagnoses were not made until the patients had reached 1, 6, 12, and 50 years of age, because ordinary radiologic methods failed to establis...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/BF01654780
更新日期:1979-09-20 00:00:00
abstract::Radiologically demonstrable pancreatic endocrine tumors are a frequent requirement for exploration in patients with multiple endocrine neoplasia type I (MEN-I). Such delayed intervention is accompanied by a 30% to 50% incidence of pancreatic endocrine metastases. This study explores biochemical tumor markers and opera...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s002689900451
更新日期:1998-07-01 00:00:00
abstract:BACKGROUND:There is a consensus on the indication of laparoscopy-assisted distal gastrectomy (LADG) for early gastric cancer that needs D1 + alpha or D1 + beta lymph node dissection. However, many gastrointestinal surgeons consider D2 lymph node dissection in LADG to be difficult, therefore, only a few medical institut...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-008-9697-3
更新日期:2008-11-01 00:00:00
abstract:BACKGROUND:Understanding the lymphatic drainage route in gastric cancer is crucial for complete lymph node retrieval from sites susceptible to metastasis. However, the lymphatic stream of the stomach is complex and remains incompletely characterized. METHODS:Patients with small (<4 cm) serosa-negative gastric cancer w...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-009-9985-6
更新日期:2009-06-01 00:00:00
abstract:BACKGROUND:Diabetes mellitus (DM) is a known risk factor for worse outcomes after emergency abdominal surgery (EAS). However, it is unclear if the type of diabetes treatment (insulin or oral agents) has any effect on outcomes after EAS. METHODS:Matched cohort study utilizing the ACS NSQIP database. Patients with DM un...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-016-3469-2
更新日期:2016-07-01 00:00:00
abstract:BACKGROUND:This study was undertaken to determine the efficacy of the clinical indications for performing staging laparoscopy for locally advanced gastric cancer to detect peritoneal metastasis or positive cytology findings. METHODS:The study included 231 patients with T4 gastric cancer without hematogenous or clinica...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-011-1290-5
更新日期:2011-12-01 00:00:00
abstract:BACKGROUND:Delayed access to surgical care for congenital conditions in low- and middle-income countries is associated with increased risk of death and life-long disabilities, although the actual burden of delayed access to care is unknown. Our goal was to quantify the burden of disease related to delays to surgical ca...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-019-05239-w
更新日期:2020-03-01 00:00:00
abstract::Subfascial elimination of incompetent perforating veins is the most effective therapeutic principle in the treatment of trophic skin disorders associated with varicosis. A recently developed endoscopic technique allows accurate sectioning of perforating veins with direct observation of the veins and minor trauma. From...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/BF02067007
更新日期:1992-09-01 00:00:00
abstract::This paper reviews aspects of head injury management and research in the United Kingdom (UK). We discuss evidence about the scale and etiology of head injury in Britain and how this information has supported a triage-based approach, incorporating risk analysis. A Cohesive organization based upon nationally accepted, y...
journal_title:World journal of surgery
pub_type: 杂志文章,评审
doi:10.1007/s00268-001-0084-6
更新日期:2001-09-01 00:00:00
abstract::Leiomyomas and leiomyosarcomas are derived from smooth muscle tissues. Smooth muscle cells also surround the blood vessels that supply the alimentary tract. These cells have at times been said to contribute to the formation of smooth muscle tumors in the alimentary canal. With such an abundance of smooth muscle, there...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s002689910063
更新日期:2000-04-01 00:00:00
abstract:BACKGROUND:Ghrelin is a brain-gut peptide with GH-releasing and appetite-inducing properties. Because ghrelin is secreted mainly by the stomach, fasting levels fall after distal gastrectomy. The vagal nerve is responsible for periprandial changes. The presents study investigated the impact of preserving the celiac bran...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-013-2078-6
更新日期:2013-09-01 00:00:00
abstract::Among 26 patients with gallbladder carcinoma, 11 resected cases were studied retrospectively with respect to the preoperative imaging techniques and the operative procedures employed. Ultrasonography, endoscopic ultrasonography, and computed tomography were valuable in detecting gallbladder carcinoma preoperatively wh...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/BF01658723
更新日期:1991-05-01 00:00:00
abstract::Fingertip injuries constitute a large portion of the traumatic injuries sustained to the hand and are frequently associated with significant disability for the patient. While many methods are available for the treatment of such injuries, quite often only certain procedures are appropriate for a particular digit in any...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/BF01675641
更新日期:1991-07-01 00:00:00
abstract:INTRODUCTION:The impact of diabetes mellitus (DM) on outcomes in patients undergoing emergency laparotomy for adhesive small bowel obstruction (ASBO) remains unknown. METHODS:Low-risk (ASA class of I and II) patients requiring emergency operation for ASBO were identified using the ACS NSQIP database. Propensity score ...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-015-3338-4
更新日期:2016-04-01 00:00:00
abstract::We sought to determine whether early eschar excision en masse (EEE) at one operation would be effective in the prevention and treatment of postburn organ dysfunction (OD) and multiple organ dysfunction syndrome (MODS). A total of 60 patients, with total body surface burned area over 35% and a third degree burn area ov...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s002689900661
更新日期:1999-12-01 00:00:00
abstract::This paper summarizes the place of thoracic surgery in the management of hydatid disease. Although based on the author's 31-year personal experience, it draws on the experience of others where that of the author is deficient. The treatment of pulmonary, pleural, liver, and cardiac cysts is discussed. The importance of...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s002689900631
更新日期:1999-11-01 00:00:00
abstract::Percutaneous dilatational tracheostomy (PDT) is being increasingly used. Concerns have been raised as to its safety, especially when it is done at the bedside. A prospective evaluation was conducted of 100 consecutive, unselected critically ill patients with PDT. The mean intensive care unit (ICU) stay before PDT was ...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s002680010180
更新日期:2000-09-01 00:00:00
abstract::The aim of this study was to identify the risk factors for bacterial translocation and to determine the clinical significance of bacterial translocation in patients with colorectal cancer. Mesenteric lymph node sampling was performed to identify the presence of bacterial translocation in 75 patients with colorectal ca...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-004-7576-0
更新日期:2005-02-01 00:00:00
abstract:INTRODUCTION:The utilization of laparoscopy in colorectal surgery is increasing. However, conversion to open surgery remains relatively high. OBJECTIVE:We evaluated (1) conversion rates in laparoscopic colorectal surgery; (2) the outcomes of converted cases compared with successful laparoscopic and open colorectal ope...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-015-2958-z
更新日期:2015-05-01 00:00:00
abstract::Hepatobiliary (HB) surgery is a challenging surgical subspecialty that requires highly specialized training and an adequate level of experience in order to be performed safely. As a result, minimally invasive HB surgery has been met with slower acceptance as compared to other subspecialties, with many surgeons in the ...
journal_title:World journal of surgery
pub_type: 杂志文章,评审
doi:10.1007/s00268-013-2276-2
更新日期:2013-12-01 00:00:00
abstract:BACKGROUND:The goal of the present study was to determine the frequency, mode of presentation, and need for reoperation in the treatment of recurrent inguinal hernia at Liaquat University Hospital, Jamshoro, Sindh, Pakistan. METHODS:This descriptive, cross-sectional study was conducted over a period of four years, fro...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-012-1897-1
更新日期:2013-03-01 00:00:00
abstract::It has been widely acknowledged that exomphalos and gastroschisis are two different clinical entities. Their etiology and pathogenesis, however, remain controversial. Several techniques are available for making a prenatal diagnosis of these as well as many other malformations. Some prenatal treatment is possible, but ...
journal_title:World journal of surgery
pub_type: 杂志文章,评审
doi:10.1007/BF01658701
更新日期:1993-05-01 00:00:00
abstract::Studies of large series of melanoma patients indicated that the average incidence of developing a recurrence during follow-up was 40%. The most frequent first sites of these recurrences were the regional lymph nodes. We hypothesized that the sentinel node (SN) procedure may change the pattern of recurrence by reducing...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-002-6197-8
更新日期:2002-12-01 00:00:00