Abstract：
BACKGROUND:Management of critically ill patients is challenging in a low-resource setting. In Rwanda, peritonitis is a common surgical condition where patients often present late, with advanced disease. We aim to describe critical care management of patients with peritonitis in Rwanda. METHODS:Data were collected at a tertiary referral hospital in Rwanda on patients undergoing operation for peritonitis over a 6-month period. Data included epidemiology, hospital course and outcomes. Patients requiring admission to the intensive care unit (ICU) were compared with those not requiring ICU admission using Chi-square and Wilcoxon rank-sum test. RESULTS:Over a 6-month period, 280 patients were operated for peritonitis. Of these, 46 (16.4%) were admitted to the ICU. The most common diagnoses were intestinal obstruction (N = 17, 37.0%) and typhoid intestinal perforation (N = 6, 13.0%). Thirty-nine (89%) patients had sepsis. The median American Society of Anesthesiologist score was 3 (range 2-4), and the median Surgical Apgar Score was 4 (range 0-6). Twenty-four (52.2%) patients required vasopressors, with dopamine and adrenaline being the only vasopressors available. Patients admitted to the ICU, compared with non-critically ill patients, were more likely to have major complications (80.4 vs. 14%, p < 0.001), unplanned reoperation (28 vs. 10%, p < 0.001) and death (72 vs. 8%, p < 0.001). CONCLUSION:Patients with peritonitis admitted to the ICU commonly presented with features of sepsis. Due to limited resources in this setting, interventions are primarily supportive with intravenous fluids, intravenous antibiotics, ventilator support and vasopressors. Morbidity and mortality remain high in this patient population.
journal_name
World J Surgjournal_title
World journal of surgeryauthors
Rickard J,Ngarambe C,Ndayizeye L,Smart B,Riviello R,Majyambere JPdoi
10.1007/s00268-018-4598-6subject
Has Abstractpub_date
2018-10-01 00:00:00pages
3075-3080issue
10eissn
0364-2313issn
1432-2323pii
10.1007/s00268-018-4598-6journal_volume
42pub_type
杂志文章abstract：BACKGROUND:Postoperative liver failure (PHLF) is one of the most common complications following major hepatectomy. The preoperative assessment of future liver remnant (FLR) function is critical to predict the incidence of PHLF. OBJECTIVE:To determine the efficacy of the plasma clearance rate of indocyanine green clear...
journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/s00268-016-3441-1
更新日期：2016-06-01 00:00:00
abstract：:Organ transplantation continues to be hindered by a limited supply of organs. A significant percentage of potential organ donors are lost to either medical failure or inability to obtain consent for donation. In a surgical intensive care unit (ICU) we have refocused our efforts toward aggressive resuscitation, directe...
journal_title：World journal of surgery
pub_type： 杂志文章,评审
doi：10.1007/pl00012362
更新日期：1999-07-01 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：BACKGROUND:The role of circular staplers in gastroduodenostomy during subtotal gastrectomy for gastric cancer has not been defined clearly. METHODS:A randomized clinical trial included patients with gastric cancer who underwent subtotal gastrectomy with either stapled (99 patients) or handsewn gastroduodenostomy (98 p...
journal_title：World journal of surgery
pub_type： 杂志文章,随机对照试验
doi：10.1007/s00268-011-1038-2
更新日期：2011-05-01 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：: ...
journal_title：World journal of surgery
pub_type： 评论,信件
doi：10.1007/s00268-019-04919-x
更新日期：2019-04-01 00:00:00
abstract：BACKGROUND:Due to advances in operative methods and perioperative care, mortality and morbidity following major hepatic resection have decreased substantially, making long-term quality of life (QoL) an increasingly prominent issue. We evaluated whether postoperative diagnosis was associated with long-term QoL and healt...
journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/s00268-009-0032-4
更新日期：2009-07-01 00:00:00
abstract：BACKGROUND:There have been no reports on the impact of preoperative biliary MRSA infection on the outcome of major hepatectomy. The aim of this study was to review the surgical outcome of patients who underwent hepatobiliary resection after biliary drainage and to evaluate the impact of preoperative biliary MRSA infect...
journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/s00268-011-0990-1
更新日期：2011-04-01 00:00:00
abstract：:Secretin is a stimulator of both endocrine and exocrine secretions of the pancreas, and we aimed to evaluate its effects on splanchnic blood flow in rats with a microsphere technique. Anesthetized rats were infused with secretin (0.5 or 2.0 micrograms/kg body weight/hr) for 10 minutes. Some animals were normoglycemic,...
journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/s00268-001-0037-0
更新日期：2001-07-01 00:00:00
abstract：:Despite careful selection of cirrhotic patients with hepatocellular carcinoma (HCC), liver resection remains associated with a greater risk than in patients without underlying liver disease. In this study we assessed by multivariate analysis parameters associated with in-hospital mortality and morbidity in a selected ...
journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/pl00012259
更新日期：1997-05-01 00:00:00
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
更新日期：2011-02-01 00:00:00
abstract：:Information including respiratory rate, blood pressure, Glasgow Coma Scale, and anatomic injuries were obtained for all injured patients consecutively admitted to the Lagos University Teaching Hospital (LUTH) during the 9-month period from September 1995 to May 1996. The data were analyzed using the UK Major Trauma Ou...
journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/s002680020369
更新日期：2001-01-01 00:00:00
abstract：:The aim of this study was to clarify the role of ganglion cells in the development and recurrence of sigmoid volvulus. We analyzed 9 samples obtained from 9 patients who had undergone sigmoidectomy for sigmoid volvulus, and, for comparison, 18 samples from 18 patients who had undergone sigmoidectomy or low anterior re...
journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/s00268-004-7462-9
更新日期：2005-01-01 00:00:00
abstract：BACKGROUND:Few studies in the literature have reported recovery data for different types of recurrent laryngeal nerve injuries (RLNIs). This study is the first attempt to classify RLNIs and rank them by severity. METHODS:This prospective clinical study analyzed 281 RLNIs in which a true loss of signal was identified b...
journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/s00268-016-3415-3
更新日期：2016-06-01 00:00:00
abstract：BACKGROUND:Pilonidal sinus is a common chronic disease affecting young adults. Many surgical procedures have been developed for its treatment, but an optimal one has still not been achieved. This study presents a modification to the Karydakis operation. METHODS:A total of 265 patients with chronic pilonidal sinus betw...
journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/s00268-017-4406-8
更新日期：2018-06-01 00:00:00
abstract：BACKGROUND:To evaluate whether the preoperative magnetic resonance angiography (MRA) can predict the risk of cerebral ischemia associated with the carotid endarterectomy (CEA). METHODS:Between January 2004 and December 2010, 382 consecutive patients (mean age: 56.6 years; range: 45-78 years) were identified to have un...
journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/s00268-012-1851-2
更新日期：2013-03-01 00:00:00
abstract：BACKGROUND:Strictures at the pharyngoesophageal junction represent a subgroup of corrosive esophageal strictures requiring a specialized management approach. Non-dilatable cricopharyngeal strictures need surgical intervention. We report the use of the sternocleidomastoid muscle myocutaneous inlay flap (SCMMIF) for reco...
journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/s00268-007-9120-5
更新日期：2007-08-01 00:00:00
abstract：BACKGROUND:Thymic epithelial tumors are characterized by slow growth and variable malignant behavior. We present our experience on the surgical management of these tumors. MATERIALS AND METHODS:We conducted a retrospective analysis of patients with thymomas undergoing modified maximal thymectomy over a period of 16 ye...
journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/s00268-009-0097-0
更新日期：2009-08-01 00:00:00
abstract：:Mansonic schistosomiasis is an endemic disease in Brazil, with an estimated 10-12 million people infested. Among its clinical manifestations, the hepatosplenic form causes portal hypertension which, in turn, brings about severe digestive hemorrhage, the most serious complication of the disease. Normally, the patients ...
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/BF01659051
更新日期：1991-03-01 00:00:00
abstract：:The introduction of laparoscopic techniques for the management of biliary stone disease has expanded the therapeutic choices for surgeons confronted with choledocholithiasis. As new strategies emerge, the treatment of cholelithiasis and choledocholithiasis remains controversial. This paper discusses the options availa...
journal_title：World journal of surgery
pub_type： 杂志文章,评审
doi：10.1007/s002689900531
更新日期：1998-11-01 00:00:00
abstract：BACKGROUND:Roux-en-Y anastomosis is the standard of care for biliary reconstruction. Yet, a direct bilio-biliary anastomosis preserves the normal sphincter mechanism and endoscopic access to the biliary tree for diagnostic and therapeutic purposes. Duct-to-duct biliary reconstruction is widely used in liver transplanta...
journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/s00268-011-1318-x
更新日期：2012-01-01 00:00:00
abstract：BACKGROUND:The extent to which obesity and genetics determine postoperative complications is incompletely understood. METHODS:We performed a retrospective study using two population cohorts with electronic health record (EHR) data. The first included 736,726 adults with body mass index (BMI) recorded between 1990 and ...
journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/s00268-019-05202-9
更新日期：2020-01-01 00:00:00
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
更新日期：2019-11-01 00:00:00
abstract：BACKGROUND:The majority of small bowel obstructions (SBO) are the result of adhesions caused by a previous abdominal operation. On rare occasions, adhesional SBO occurs in the absence of such an operation. Our objective was to describe the management, findings, and outcomes of unexplained adhesional SBO (UA-SBO) and ex...
journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/s00268-009-0200-6
更新日期：2009-11-01 00:00:00
abstract：:This paper describes a model humanitarian mission to Guyana; it illustrates the value of excellent ongoing care in collaboration with local physicians and surgeons, cooperation with local government and medical officials, and frequent periodic follow-up missions (always to the same hospital, working with the same staf...
journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/s00268-015-3049-x
更新日期：2015-08-01 00:00:00
abstract：BACKGROUND:Neuroendocrine neoplasias (NEN) of the gastroenteropancreatic (GEP) system frequently present with metastatic deposits. The proliferation marker Ki-67 is used for diagnosis and to assess the prognosis of disease. The aim of our study was to evaluate the usefulness of Ki-67 % in the assessment of NEN patients...
journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/s00268-014-2451-0
更新日期：2014-06-01 00:00:00
abstract：:Breast cancer is a common disease, and the surgical management is continually evolving. The objective of this study was to describe the current breast cancer practice patterns among Canadian surgeons. All active General Surgeons (n=1172), as accredited by the Royal College of Physicians and Surgeons of Canada, were se...
journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/s00268-003-7040-6
更新日期：2004-01-01 00:00:00
abstract：:The novel trend toward focused parathyroidectomy requires precise preoperative localization of the parathyroid adenoma in patients with primary hyperparathyroidism (PHPT). The present study evaluated the impact of hybrid single photon emission computed tomography/computed tomography (SPECT/CT), using 99mTc-sestamibi (...
journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/s00268-005-7849-2
更新日期：2006-01-01 00:00:00
abstract：BACKGROUND:In patients with well-differentiated thyroid cancer, the incidence of pathologic central compartment lymph node metastases is reported to be approximately 50%. Recently level VI lymph node dissection has been advocated as a means of reducing recurrence rates in these patients, even if there are no clinically...
journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/s00268-012-1507-2
更新日期：2012-06-01 00:00:00
abstract：BACKGROUND:Increasing numbers of patients are treated by robotic distal gastrectomy (RDG); however, it remains unclear whether RDG is clinically comparable with conventional laparoscopic distal gastrectomy (LDG). This study aimed to clarify the feasibility of RDG from safety aspects. METHODS:The study included 109 cT1...
journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/s00268-017-4345-4
更新日期：2018-06-01 00:00:00
