Ethical and Surgical Dilemmas in Patients with Neglected Surgical Diseases Visiting a Field Hospital in a Zone of Recent Disaster.

Abstract:

OBJECT:The massive typhoon Haiyan (Yolanda) ripped across the central Philippines on November 8, 2013, and damaged infrastructure including hospitals. The Israeli Defense Forces field hospital was directed by the Philippine authorities to Bogo City in the northern part of the island of Cebu, to assist the damaged local hospital. Hundreds of patients with neglected diseases sought for medical treatment which was merely out of reach for them. Our ethical dilemmas were whether to intervene, when the treatment we could offer was not the best possible. METHODS:Each patient had an electronic medical record that included diagnosis, management and aftercare instructions. We retrospectively reviewed all charts of patients. RESULTS:Over 200 patients presented with neglected chronic diseases (tuberculosis, goiter, hypertension and diabetes). We limited our intervention to extreme values of glucose and blood pressure. We had started anti-tuberculosis medications, hoping that the patients will have an option to continue treatment. We examined 85 patients with a presumed diagnosis of malignancy. Without histopathology and advanced imaging modality, we performed palliative operations on three patients. Eighteen patients presented with inguinal hernia. We performed pure tissue repair on seven patients with large symptomatic hernias. We examined 12 children with cleft lip/palate and transferred two of them to Israel. We operated on one child with bilateral club feet. Out of 37 patients with pterygium, our ophthalmologist repaired the nine patients with the most severe vision disturbance. CONCLUSION:Medical delegations to disaster areas should prepare a plan and appropriate measures to deal with non-urgent diseases.

journal_name

World J Surg

journal_title

World journal of surgery

authors

Lin G,Marom T,Dagan D,Merin O

doi

10.1007/s00268-016-3692-x

subject

Has Abstract

pub_date

2017-02-01 00:00:00

pages

381-385

issue

2

eissn

0364-2313

issn

1432-2323

pii

10.1007/s00268-016-3692-x

journal_volume

41

pub_type

杂志文章
  • Educational and clinical impact of Advanced Trauma Life Support (ATLS) courses: a systematic review.

    abstract:BACKGROUND:We aimed to systematically review the literature on the educational impact of Advanced Trauma Life Support (ATLS) courses and their effects on death rates of multiple trauma patients. METHODS:All Medline, Pubmed, and the Cochrane Library English articles on the educational impact of ATLS courses and their e...

    journal_title:World journal of surgery

    pub_type: 杂志文章,评审

    doi:10.1007/s00268-013-2294-0

    authors: Mohammad A,Branicki F,Abu-Zidan FM

    更新日期:2014-02-01 00:00:00

  • The Clinical Indications for Limited Surgery of Intraductal Papillary Mucinous Neoplasms of the Pancreas.

    abstract:BACKGROUND:There are many reports about limited surgery for intraductal papillary mucinous neoplasms (IPMNs) of the pancreas. However, there is no consensus on limited surgery for IPMNs. The primary objective of this study was to define the clinical indications for limited surgery for IPMNs. METHODS:The data of 98 pat...

    journal_title:World journal of surgery

    pub_type: 杂志文章

    doi:10.1007/s00268-016-3824-3

    authors: Kimura K,Amano R,Ymazoe S,Ohira G,Nishio K,Hirakawa K,Ohira M

    更新日期:2017-05-01 00:00:00

  • Applicability of intraoperative parathyroid hormone assay during total thyroidectomy as a guide for the surgeon to selective parathyroid tissue autotransplantation.

    abstract:BACKGROUND:Intraoperative parathyroid hormone assay (IOPTH) has been suggested to have value in predicting the development of postoperative hypoparathyroidism after thyroid surgery. IOPTH has been validated in identification of patients at risk of postoperative hypocalcemia requiring early onset of calcium supplementat...

    journal_title:World journal of surgery

    pub_type: 杂志文章,随机对照试验

    doi:10.1007/s00268-007-9405-8

    authors: Barczyński M,Cichoń S,Konturek A,Cichoń W

    更新日期:2008-05-01 00:00:00

  • State of the art in robotic hepatobiliary surgery.

    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

    authors: Milone L,Daskalaki D,Fernandes E,Damoli I,Giulianotti PC

    更新日期:2013-12-01 00:00:00

  • Length of stay: an inappropriate readout of the success of enhanced recovery programs.

    abstract:BACKGROUND:Enhanced recovery after surgery (ERAS) programs are designed to reduce hospital length of stay by shortening the postoperative recovery period. The intended effect of an accelerated recovery on the length of stay may be frustrated by a delayed discharge. This study was designed to assess the influence of an ...

    journal_title:World journal of surgery

    pub_type: 杂志文章

    doi:10.1007/s00268-007-9404-9

    authors: Maessen JM,Dejong CH,Kessels AG,von Meyenfeldt MF,Enhanced Recovery After Surgery (ERAS) Group.

    更新日期:2008-06-01 00:00:00

  • Correction to: Twelve Hundred Consecutive Pancreato-Duodenectomies from Single Centre: Impact of Centre of Excellence on Pancreatic Cancer Surgery Across India.

    abstract::The authors' affiliations are updated as reflected here. ...

    journal_title:World journal of surgery

    pub_type: 杂志文章,已发布勘误

    doi:10.1007/s00268-020-05519-w

    authors: Shrikhande SV,Shinde RS,Chaudhari VA,Kurunkar SR,Desouza AL,Agarwal V,Bhandare MS

    更新日期:2020-08-01 00:00:00

  • Sequential abdominal reexploration with the zipper technique.

    abstract::Frequently, several multiple abdominal reexplorations are needed in patients with acute necrotizing hemorrhagic pancreatitis (ANP) or with persistent intraabdominal sepsis (PIAS). Residual undrained necrotic and septic foci lead to multiple organ failure. To provide wide-open drainage of the abdominal cavity, since 19...

    journal_title:World journal of surgery

    pub_type: 杂志文章

    doi:10.1007/BF01658968

    authors: Cuesta MA,Doblas M,Castañeda L,Bengoechea E

    更新日期:1991-01-01 00:00:00

  • Determining the Learning Curve of Transcutaneous Laryngeal Ultrasound in Vocal Cord Assessment by CUSUM Analysis of Eight Surgical Residents: When to Abandon Laryngoscopy.

    abstract::Transcutaneous laryngeal ultrasonography (TLUSG) is a promising alternative to laryngoscopy in vocal cords (VCs) assessment which might be challenging in the beginning. However, it remains unclear when an assessor can provide proficient TLUSG enough to abandon direct laryngoscopy . Eight surgical residents (SRs) witho...

    journal_title:World journal of surgery

    pub_type: 历史文章,杂志文章

    doi:10.1007/s00268-015-3348-2

    authors: Wong KP,Lang BH,Lam S,Au KP,Chan DT,Kotewall NC

    更新日期:2016-03-01 00:00:00

  • Significance of serum connective tissue growth factor in patients with hepatocellular carcinoma and relationship with angiogenesis.

    abstract:BACKGROUND:Connective tissue growth factor (CTGF) expression changes variously in different human malignancies. The role of CTGF in hepatocellular carcinoma (HCC) is still not clear. The purpose of this study was to investigate the role of serum CTGF in patients with HCC and its correlation with HCC angiogenesis. METH...

    journal_title:World journal of surgery

    pub_type: 杂志文章

    doi:10.1007/s00268-010-0648-4

    authors: Wang GB,Zhou XY,Yuan T,Xie J,Guo LP,Gao N,Wang XQ

    更新日期:2010-10-01 00:00:00

  • Multimodal perioperative rehabilitation for colonic surgery in the elderly.

    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

    authors: Rumstadt B,Guenther N,Wendling P,Engemann R,Germer CT,Schmid M,Kipfmueller K,Walz MK,Schwenk W

    更新日期:2009-08-01 00:00:00

  • The neglect of the global surgical workforce: experience and evidence from Uganda.

    abstract:BACKGROUND:Africa's health workforce crisis has recently been emphasized by major international organizations. As a part of this discussion, it has become apparent that the workforce required to deliver surgical services has been significantly neglected. METHODS:This paper reviews some of the reasons for this relative...

    journal_title:World journal of surgery

    pub_type: 杂志文章

    doi:10.1007/s00268-008-9473-4

    authors: Ozgediz D,Galukande M,Mabweijano J,Kijjambu S,Mijumbi C,Dubowitz G,Kaggwa S,Luboga S

    更新日期:2008-06-01 00:00:00

  • Prognostic Significance of Muscle Attenuation in Pancreatic Cancer Patients Treated with Neoadjuvant Chemoradiotherapy.

    abstract:BACKGROUND:Emerging evidences have gradually revealed the skeletal muscle attenuation (MA) was not only reflected the accumulation of lipids in skeletal muscle but also associated with physiological and pathological states. The aim of this study was to evaluate the impact of MA on the prognosis of pancreatic cancer pat...

    journal_title:World journal of surgery

    pub_type: 杂志文章

    doi:10.1007/s00268-015-3205-3

    authors: Akahori T,Sho M,Kinoshita S,Nagai M,Nishiwada S,Tanaka T,Tamamoto T,Ohbayashi C,Hasegawa M,Kichikawa K,Nakajima Y

    更新日期:2015-12-01 00:00:00

  • Modified technique of laparoscopic intraperitoneal hernioplasty for irreducible scrotal hernias (omentoceles): how to remove the hernial contents.

    abstract:INTRODUCTION:The surgical repair of large irreducible scrotal hernias is, in general, technically difficult. Laparoscopic repair for these cases is controversial, although extraperitoneal and transperitoneal approaches have been described. We present a small series of patients with large irreducible groin hernias (omen...

    journal_title:World journal of surgery

    pub_type: 杂志文章

    doi:10.1007/s00268-007-9157-5

    authors: Palanivelu C,Rangarajan M,John SJ

    更新日期:2007-09-01 00:00:00

  • Prognostic factors of primary small bowel adenocarcinoma: univariate and multivariate analysis.

    abstract:BACKGROUND:Adenocarcinoma of the small bowel is relatively less common than malignancies of the esophagus, stomach, and colorectum. In small bowel adenocarcinoma, various prognostic factors influence the disease-free status and overall survival rates. MATERIALS AND METHODS:Eighty patients who were diagnosed with small...

    journal_title:World journal of surgery

    pub_type: 杂志文章

    doi:10.1007/s00268-005-7898-6

    authors: Wu TJ,Yeh CN,Chao TC,Jan YY,Chen MF

    更新日期:2006-03-01 00:00:00

  • Outcomes After Urgent Thyroidectomy Following Rapid Control of Thyrotoxicosis in Graves' Disease are Similar to Those After Elective Surgery in Well-Controlled Disease.

    abstract:BACKGROUND:Surgery for Graves' disease (GD) is usually performed after adequate control with medical treatment. Occasionally, rapid pre-operative optimization is required. The primary objective was to compare the outcomes of patients undergoing elective surgery for well-controlled GD with those undergoing rapid pre-ope...

    journal_title:World journal of surgery

    pub_type: 杂志文章

    doi:10.1007/s00268-019-05125-5

    authors: Ali A,Debono M,Balasubramanian SP

    更新日期:2019-12-01 00:00:00

  • Lack of benefit of combined pancreaticosplenectomy in D2 resection for proximal-third gastric carcinoma.

    abstract::Of the 2790 patients with gastric carcinoma who underwent surgery between January 1978 and December 1993, there were 224 who underwent a D2 resection for cancer of the proximal third of the stomach. Survival in these patients was retrospectively analyzed with special reference to the survival benefit of pancreaticospl...

    journal_title:World journal of surgery

    pub_type: 杂志文章

    doi:10.1007/s002689900283

    authors: Kodera Y,Yamamura Y,Shimizu Y,Torii A,Hirai T,Yasui K,Morimoto T,Kato T,Kito T

    更新日期:1997-07-01 00:00:00

  • Excising the reexcision: stereotactic core-needle biopsy decreases need for reexcision of breast cancer.

    abstract::There is debate regarding use of the stereotactic core-needle biopsy (SCNB) for highly suspicious mammographic lesions. This study compares a serial group of mammography-detected breast cancer patients treated before and after the use of SCNB. We studied 113 consecutive nonpalpable breast cancers between 1994 and 1996...

    journal_title:World journal of surgery

    pub_type: 杂志文章

    doi:10.1007/s002689900510

    authors: Kaufman CS,Delbecq R,Jacobson L

    更新日期:1998-10-01 00:00:00

  • Impact of intraoperative distractions on patient safety: a prospective descriptive study using validated instruments.

    abstract:BACKGROUND:There is emerging evidence indicating that distractions in the operating room (OR) are prevalent. Studies have shown a negative impact of distractions, but they have been conducted mostly with residents in simulated environments. We tested the hypothesis that intraoperative distractions are associated with d...

    journal_title:World journal of surgery

    pub_type: 杂志文章

    doi:10.1007/s00268-013-2315-z

    authors: Sevdalis N,Undre S,McDermott J,Giddie J,Diner L,Smith G

    更新日期:2014-04-01 00:00:00

  • Recurrent inguinal hernia: disease of the collagen matrix?

    abstract::The aim of this study was to investigate the collagen matrix in recurrent inguinal hernias. Total ribonucleic acid (RNA) was extracted from skin fibroblasts of three groups (control group I = healthy skin; control group II = plain skin scar; recurrent inguinal hernia group = skin of recurrent inguinal hernias; each n ...

    journal_title:World journal of surgery

    pub_type: 杂志文章

    doi:10.1007/s00268-001-0239-5

    authors: Zheng H,Si Z,Kasperk R,Bhardwaj RS,Schumpelick V,Klinge U,Klosterhalfen B

    更新日期:2002-04-01 00:00:00

  • Provision of Surgical Care for Children Across Somaliland: Challenges and Policy Guidance.

    abstract:BACKGROUND:Existing data suggest a large burden of surgical conditions in low- and middle-income countries (LMICs). However, surgical care for children in LMICs remains poorly understood. Our goal was to define the hospital infrastructure, workforce, and delivery of surgical care for children across Somaliland and prov...

    journal_title:World journal of surgery

    pub_type: 杂志文章

    doi:10.1007/s00268-019-05079-8

    authors: Concepcion TL,Smith ER,Mohamed M,Dahir S,Ismail EA,Leather AJM,Poenaru D,Rice HE,Global Initiative for Children’s Surgery.

    更新日期:2019-11-01 00:00:00

  • Catheter tract recurrence after percutaneous biliary drainage for hilar cholangiocarcinoma.

    abstract:BACKGROUND:Despite its wide use, catheter tract recurrence after percutaneous biliary drainage (PBD) is rarely reported. However, one recent large-scale study reported a catheter tract recurrence rate as high as 5.2 % in patients with perihilar or distal bile duct cancer. We report on our 20 years of experience with ca...

    journal_title:World journal of surgery

    pub_type: 杂志文章

    doi:10.1007/s00268-012-1844-1

    authors: Kang MJ,Choi YS,Jang JY,Han IW,Kim SW

    更新日期:2013-02-01 00:00:00

  • Long-term results of the Modified Thal procedure in patients with chagasic megaesophagus.

    abstract:BACKGROUND:Chagas disease is a serious public health issue in South and Central America due to its high prevalence, morbidity, and mortality. The esophageal form of the disease leads to achalasia and consequent megaesophagus. In advanced or recurrent cases of megaesophagus, there is no consensus for which of three esta...

    journal_title:World journal of surgery

    pub_type: 杂志文章

    doi:10.1007/s00268-013-2445-3

    authors: Alves AP,de Oliveira PG,de Oliveira JM,de Mesquita DM,Dos Santos JH

    更新日期:2014-06-01 00:00:00

  • A randomized controlled trial comparing post-operative pain in single-incision laparoscopic cholecystectomy versus conventional laparoscopic cholecystectomy.

    abstract:INTRODUCTION:An increasing body of evidence is being published about single-incision laparoscopic cholecystectomy (SILC), but there are no well-powered trials with an adequate evaluation of post-operative pain. This randomized trial compares SILC against four-port laparoscopic cholecystectomy (LC) with post-operative p...

    journal_title:World journal of surgery

    pub_type: 杂志文章,随机对照试验

    doi:10.1007/s00268-014-2903-6

    authors: Chang SK,Wang YL,Shen L,Iyer SG,Madhavan K

    更新日期:2015-04-01 00:00:00

  • Intraoperative local insufflation of warmed humidified CO₂ increases open wound and core temperatures: a randomized clinical trial.

    abstract:BACKGROUND:The open surgical wound is exposed to cold dry ambient air, resulting in substantial heat loss through radiation, evaporation, and convection. At the same time, anesthesia decreases the patient's core temperature. Despite preventive measures, mild intraoperative hypothermia has been associated with postopera...

    journal_title:World journal of surgery

    pub_type: 杂志文章,随机对照试验

    doi:10.1007/s00268-012-1735-5

    authors: Frey JM,Janson M,Svanfeldt M,Svenarud PK,van der Linden JA

    更新日期:2012-11-01 00:00:00

  • Tragic knowledge: truth telling and the maintenance of hope in surgery.

    abstract::Surgeons often are faced with the challenge of balancing truth telling and the maintenance of hope in the setting of a poor prognosis. This ethical dilemma is informed by conflicting appeals to principles of autonomy and nonmaleficence, where a patient's right to be told important medical information must be weighed a...

    journal_title:World journal of surgery

    pub_type: 杂志文章

    doi:10.1007/s00268-014-2566-3

    authors: Suri M,McKneally M,Devon K

    更新日期:2014-07-01 00:00:00

  • Surgical Management of Iatrogenic Perforation of the Gastrointestinal Tract: 15 Years of Experience in a Single Center.

    abstract:BACKGROUND:Gastrointestinal (GI) tract perforation during endoscopy is a rare but severe complication. The aim of this study was to determine predictors of morbidity and mortality after iatrogenic endoscopic perforation. MATERIALS AND METHODS:All cases with iatrogenic endoscopic perforation receiving surgery at a tert...

    journal_title:World journal of surgery

    pub_type: 杂志文章

    doi:10.1007/s00268-017-3986-7

    authors: Holmer C,Mallmann CA,Musch MA,Kreis ME,Gröne J

    更新日期:2017-08-01 00:00:00

  • Effect of anesthetic methods on cerebral oxygen saturation in elderly surgical patients: prospective, randomized, observational study.

    abstract:BACKGROUND:Intraoperative cerebral oxygen desaturation was reported to be associated with postoperative cognitive dysfunction in elderly patients. The effect of the anesthesia method on regional cerebral oxygen saturation (rSO(2)) is still a question under debate. The purpose of this study was to compare the effects of...

    journal_title:World journal of surgery

    pub_type: 杂志文章,随机对照试验

    doi:10.1007/s00268-012-1676-z

    authors: Lee A,Kim SH,Hong JY,Hwang JH

    更新日期:2012-10-01 00:00:00

  • Low-molecular-weight heparin versus warfarin for prevention of recurrent venous thromboembolism: a randomized trial.

    abstract::A group of 105 consecutive patients with venographically proved major acute deep vein thrombosis (DVT) were randomized in an open prospective study to evaluate the comparative efficacy and safety of a fixed dose of subcutaneous low-molecular-weight heparin (LMWH) and warfarin for the prevention of recurrent venous thr...

    journal_title:World journal of surgery

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1007/s002689900081

    authors: Das SK,Cohen AT,Edmondson RA,Melissari E,Kakkar VV

    更新日期:1996-06-01 00:00:00

  • Clinical, radiological, and manometric profile in 145 patients with untreated achalasia.

    abstract:BACKGROUND:Esophageal achalasia is characterized by the absence of esophageal peristalsis and by a dysfunctional lower esophageal sphincter (LES). Descriptions of clinical, radiological, and manometric findings in patients with achalasia usually have been based on small numbers of patients. This study was designed to d...

    journal_title:World journal of surgery

    pub_type: 杂志文章

    doi:10.1007/s00268-008-9656-z

    authors: Fisichella PM,Raz D,Palazzo F,Niponmick I,Patti MG

    更新日期:2008-09-01 00:00:00

  • Preoperative Toll-like receptor expression in monocytes is associated with host immunological responses following gastrointestinal surgery.

    abstract:BACKGROUND:The present study was designed to evaluate the relationship between preoperative Toll-like receptor (TLR) expression in peripheral blood monocytes (PBMC) and the postoperative inflammatory cytokine secretion from PBMC, as well as the postoperative infectious complications in patients with gastrointestinal ca...

    journal_title:World journal of surgery

    pub_type: 杂志文章

    doi:10.1007/s00268-010-0839-z

    authors: Ono S,Tsujimoto H,Hiraki S,Kinoshita M,Hase K

    更新日期:2011-02-01 00:00:00