The Carbon Footprint of Surgical Operations: A Systematic Review.

Abstract:

OF BACKGROUND DATA AND OBJECTIVES:Operating theatres are typically the most resource-intensive area of a hospital, 3-6 times more energy-intensive than the rest of the hospital and a major contributor of waste. The primary objective of this systematic review was to evaluate existing literature calculating the carbon footprint of surgical operations, determining opportunities for improving the environmental impact of surgery. METHODS:A systematic review was conducted in accordance with PRISMA guidelines. The Cochrane Database, Embase, Ovid MEDLINE, and PubMed were searched and inclusion criteria applied. The study endpoints were extracted and compared, with the risk of bias determined. RESULTS:A total of 4604 records were identified, and 8 were eligible for inclusion. This review found that the carbon footprint of a single operation ranged 6-814 kg carbon dioxide equivalents. The studies found that major carbon hotspots within the examined operating theatres were electricity use, and procurement of consumables. It was possible to reduce the carbon footprint of surgery through improving energy-efficiency of theatres, using reusable or reprocessed surgical devices and streamlining processes. There were significant methodological limitations within included studies. CONCLUSIONS:Future research should focus on optimizing the carbon footprint of operating theatres through streamlining operations, expanding assessments to other surgical contexts, and determining ways to reduce the footprint through targeting carbon hotspots.

journal_name

Ann Surg

journal_title

Annals of surgery

authors

Rizan C,Steinbach I,Nicholson R,Lillywhite R,Reed M,Bhutta MF

doi

10.1097/SLA.0000000000003951

subject

Has Abstract

pub_date

2020-12-01 00:00:00

pages

986-995

issue

6

eissn

0003-4932

issn

1528-1140

pii

00000658-202012000-00021

journal_volume

272

pub_type

杂志文章
  • Appendectomy: a contemporary appraisal.

    abstract:OBJECTIVE:The authors present an accurate and comprehensive snapshot of appendicitis and the practice of appendectomy in the 1990s. METHODS:Appendectomies were performed on 4950 patients in 147 Department of Defense hospitals worldwide over a 12-month period ending January 31, 1993. RESULTS:The median age was 23 year...

    journal_title:Annals of surgery

    pub_type: 杂志文章,评审

    doi:10.1097/00000658-199703000-00003

    authors: Hale DA,Molloy M,Pearl RH,Schutt DC,Jaques DP

    更新日期:1997-03-01 00:00:00

  • Acute bleeding varices: a five-year prospective evaluation of tamponade and sclerotherapy.

    abstract::In a five-year study of massive upper gastrointestinal hemorrhage, 143 patients had esophageal varices diagnosed on emergency endoscopic examination. Seventy-one patients had active bleeding from varices and required Sengstaken tube tamponade during at least one hospital admission. The remaining patients included 33 w...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/00000658-198110000-00015

    authors: Terblanche J,Yakoob HI,Bornman PC,Stiegmann GV,Bane R,Jonker M,Wright J,Kirsch R

    更新日期:1981-10-01 00:00:00

  • Surgical aspects of sclerosing cholangitis. Results in 178 patients.

    abstract::Of 178 patients with sclerosing cholangitis treated since 1950, 88 patients had associated inflammatory bowel disease, 72 had no such history, and 18 had iatrogenic injury or stone disease. A total of 233 biliary operations were performed, with a 75% rate of temporary improvement after initial operation. Subsequent op...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/00000658-199010000-00017

    authors: Martin FM,Rossi RL,Nugent FW,Scholz FJ,Jenkins RL,Lewis WD,Gagner M,Foley E,Braasch JW

    更新日期:1990-10-01 00:00:00

  • Villous tumors of the duodenum.

    abstract::Records of 32 patients with 34 villous and tubulovillous adenomas of the duodenum, treated at the Cleveland Clinic over the past 21 years, were reviewed. Twenty-two patients (69%) had complete resection of the adenoma; the incidence of malignancy was 47%. Five patients underwent a Whipple procedure; 4 patients had seg...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/00000658-198803000-00002

    authors: Galandiuk S,Hermann RE,Jagelman DG,Fazio VW,Sivak MV

    更新日期:1988-03-01 00:00:00

  • Cultured epidermis for the coverage of massive burn wounds. A single center experience.

    abstract::Seven patients with a mean burn size of 69.6% total body-surface area underwent skin grafting with autologous cultured epidermis. They were compared with a historical group of 18 controls, with a mean burn size of 60%, who underwent grafting with conventional meshed split-thickness autograft. There were no statistical...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/00000658-199006000-00005

    authors: Munster AM,Weiner SH,Spence RJ

    更新日期:1990-06-01 00:00:00

  • Preoperative and long-term cardiac risk assessment. Predictive value of 23 clinical descriptors, 7 multivariate scoring systems, and quantitative dipyridamole imaging in 360 patients.

    abstract::A total of 360 patients underwent preoperative cardiac risk assessment using 23 clinical parameters, seven multivariate clinical scoring systems, and quantitative dipyridamole-thallium imaging to predict postoperative and long-term myocardial infarction and cardiac death after noncardiac surgery. There were 30 postope...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/00000658-199208000-00010

    authors: Lette J,Waters D,Bernier H,Champagne P,Lassonde J,Picard M,Cerino M,Nattel S,Boucher Y,Heyen F

    更新日期:1992-08-01 00:00:00

  • Cytology adds value to imaging studies for risk assessment of malignancy in pancreatic mucinous cysts.

    abstract:OBJECTIVE:Evaluate the value of cytology relative to imaging features in risk assessment for malignancy as defined in the Sendai Guidelines. BACKGROUND:The Sendai Guidelines list symptoms, cyst size >30 mm, dilated main pancreatic duct (MPD) >6 mm, mural nodule (MN) and "positive" cytology as high risk stigmata for ma...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/SLA.0b013e3182383118

    authors: Genevay M,Mino-Kenudson M,Yaeger K,Konstantinidis IT,Ferrone CR,Thayer S,Castillo CF,Sahani D,Bounds B,Forcione D,Brugge WR,Pitman MB

    更新日期:2011-12-01 00:00:00

  • Multivisceral transplantation for diffuse portomesenteric thrombosis.

    abstract:OBJECTIVE:To evaluate the clinical outcomes of multivisceral transplantation (MVT) in the setting of diffuse thrombosis of the portomesenteric venous system. BACKGROUND:Liver transplantation (LT) in the face of cirrhosis and diffuse portomesenteric thrombosis (PMT) is controversial and contraindicated in many transpla...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/SLA.0b013e31825429c0

    authors: Vianna RM,Mangus RS,Kubal C,Fridell JA,Beduschi T,Tector AJ

    更新日期:2012-06-01 00:00:00

  • Neurovascular compression in the thoracic outlet: changing management over 50 years.

    abstract:SUMMARY BACKGROUND DATA:During the past five decades, significant improvements have been made in the diagnosis and treatment of thoracic outlet syndrome (TOS) secondary to sports activities, breast implants, or median sternotomy. METHODS, RESULTS, AND CONCLUSIONS:Of more than 15,000 patients evaluated for TOS, 3914 un...

    journal_title:Annals of surgery

    pub_type: 杂志文章,评审

    doi:10.1097/00000658-199810000-00017

    authors: Urschel HC Jr,Razzuk MA

    更新日期:1998-10-01 00:00:00

  • Troponin Elevation After Colorectal Surgery: Significance and Management.

    abstract:OBJECTIVE:The aim of this study is to identify the association between early postoperative troponin elevations and outcomes after major colorectal surgery. BACKGROUND:Myocardial infarction is the leading cause of death after noncardiac surgery. Most postoperative myocardial infarctions are clinically silent, and asymp...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/SLA.0000000000001854

    authors: Gorgun E,Lan BY,Aydinli HH,Reed GW,Menon V,Sessler DI,Stocchi L,Remzi FH

    更新日期:2016-10-01 00:00:00

  • Splenic injury during resection for esophageal cancer: risk factors and consequences.

    abstract:OBJECTIVE:Esophageal cancer surgery carries a risk of splenic injury, which may require splenectomy, but predictors of such events remain uncertain. Moreover, the hypothesis that incidental splenectomy carries a worse prognosis deserves attention. DESIGN:A population-based, nationwide cohort study was conducted on 167...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/SLA.0000000000000650

    authors: Derogar M,Sadr-Azodi O,Lagergren P,Lagergren J

    更新日期:2015-01-01 00:00:00

  • A Clinical Nomogram for Predicting Node-positive Disease in Esophageal Cancer.

    abstract:OBJECTIVE:We developed and validated a nomogram predicting the likelihood of occult lymph node metastases in surgically resectable esophageal cancers. BACKGROUND:Patients with esophageal cancer with positive lymph nodes benefit from neoadjuvant therapy, but limitations in current clinical staging techniques mean nodal...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/SLA.0000000000003450

    authors: Semenkovich TR,Yan Y,Subramanian M,Meyers BF,Kozower BD,Nava R,Patterson GA,Kreisel D,Puri V

    更新日期:2019-07-03 00:00:00

  • A comparative study of the elective treatment of variceal hemorrhage with beta-blockers, transendoscopic sclerotherapy, and surgery: a prospective, controlled, and randomized trial during 10 years.

    abstract:OBJECTIVE:To compare three options for the elective treatment of portal hypertension during a 10-year period. METHODS:Patients included in the trial were 18 to 76 years old, had a history of bleeding portal hypertension, and had undergone no prior treatment. Treatment options were beta-blockers (propranolol), scleroth...

    journal_title:Annals of surgery

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1097/00000658-200008000-00011

    authors: Orozco H,Mercado MA,Chan C,Guillén-Navarro E,López-Martínez LM

    更新日期:2000-08-01 00:00:00

  • Somatostatin receptor gene therapy combined with targeted therapy with radiolabeled octreotide: a new treatment for liver metastases.

    abstract:OBJECTIVE:To evaluate the effect of peptide receptor radionuclide therapy (PRRT) on somatostatin receptor (SSR)-transfected colon carcinoma cells in a rat liver metastases model. SUMMARY BACKGROUND DATA:Previously the authors have shown highly effective therapy with PRRT of SSR-positive tumors. This treatment is SSR-m...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/00000658-200212000-00004

    authors: Mearadji A,Breeman W,Hofland L,van Koetsveld P,Marquet R,Jeekel J,Krenning E,van Eijck C

    更新日期:2002-12-01 00:00:00

  • Risk factors for surgery and postoperative recurrence in Crohn's disease.

    abstract:OBJECTIVE:To assess the impact of possible risk factors on intestinal resection and postoperative recurrence in Crohn's disease (CD) and to evaluate the disease course. SUMMARY BACKGROUND DATA:The results of previous studies on possible risk factors for surgery and recurrence in Crohn's disease have been inconsistent....

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/00000658-200001000-00006

    authors: Bernell O,Lapidus A,Hellers G

    更新日期:2000-01-01 00:00:00

  • Intramuscular pressure in the lower leg in deep vein thrombosis and phlegmasia cerulae dolens.

    abstract::The influence of deep vein thrombosis on intramuscular pressure was evaluated in 22 patients by means of the wick technique. Intramuscular pressure was measured in the anterior tibial and the deep posterior compartments in both legs before and during treatment. The intramuscular pressure was significantly (p less than...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/00000658-198304000-00013

    authors: Qvarfordt P,Eklöf B,Ohlin P

    更新日期:1983-04-01 00:00:00

  • Fifty years' experience with esophageal atresia and tracheoesophageal fistula. Beginning with Cameron Haight's first operation in 1935.

    abstract::Four hundred twenty-six patients with esophageal atresia with or without tracheoesophageal fistula have been primarily cared for at the University of Michigan Medical Center since Cameron Haight's initial experience with this entity. Over the period of observation, the incidence of new cases as well as the number of a...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/00000658-198610000-00013

    authors: Manning PB,Morgan RA,Coran AG,Wesley JR,Polley TZ Jr,Behrendt DM,Kirsh MM,Sloan HE

    更新日期:1986-10-01 00:00:00

  • The Effect of Arterial Disease Level on Outcomes of Supervised Exercise Therapy for Intermittent Claudication: A Prospective Cohort Study.

    abstract:OBJECTIVE:To assess whether level of arterial obstruction determines the effectiveness of SET in patients with IC. BACKGROUND DATA:Guidelines advocate SET before invasive treatment for IC, but early revascularization remains widespread, especially in patients with aortoiliac disease. METHODS:Patients were recruited f...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/SLA.0000000000004073

    authors: van den Houten MML,Jansen S,van der Laan L,Vriens PWHE,Willigendael EM,Koelemay MJW,Scheltinga MRM,Teijink JAW,ELECT Study Group.

    更新日期:2020-07-24 00:00:00

  • Pancreatic necrosis: results of necrosectomy, packing, and ultimate closure over drains.

    abstract:OBJECTIVE:The treatment of pancreatic necrosis at a tertiary referral center was reviewed to effect better patient outcome. SUMMARY BACKGROUND DATA:Pancreatic necrosis is a devastating disease that leads to death in 10% to 50% of cases. Infected necrosis is particularly deadly because 80% of deaths from necrosis are d...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/00000658-199806000-00010

    authors: Branum G,Galloway J,Hirchowitz W,Fendley M,Hunter J

    更新日期:1998-06-01 00:00:00

  • Pancreatic Cancer Surgery: The New R-status Counts.

    abstract:OBJECTIVE:To assess the relevance of resection margin status for survival outcome after resection and adjuvant therapy for pancreatic cancer. BACKGROUND:The definitions for R0 and R1 margin status after resection for pancreatic cancer are controversial. The strict definition of R0 requiring a 1 mm tumor-free margin is...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/SLA.0000000000001731

    authors: Strobel O,Hank T,Hinz U,Bergmann F,Schneider L,Springfeld C,Jäger D,Schirmacher P,Hackert T,Büchler MW

    更新日期:2017-03-01 00:00:00

  • Hereditary spherocytosis. Recent experience and current concepts of pathophysiology.

    abstract::Hereditary spherocytosis is a clinically heterogeneous, genetically determined red blood cell membrane disorder resulting in hemolytic anemia. A deficiency of spectrin, the largest and most abundant structural protein of the erythrocyte membrane skeleton, results in the formation of spherocytes which lack the strength...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/00000658-198601000-00007

    authors: Croom RD 3rd,McMillan CW,Orringer EP,Sheldon GF

    更新日期:1986-01-01 00:00:00

  • Incorporation of Procedure-specific Risk Into the ACS-NSQIP Surgical Risk Calculator Improves the Prediction of Morbidity and Mortality After Pancreatoduodenectomy.

    abstract:OBJECTIVE:This multicenter study sought to evaluate the accuracy of the American College of Surgeons National Surgical Quality Improvement Program's (ACS-NSQIP) surgical risk calculator for predicting outcomes after pancreatoduodenectomy (PD) and to determine whether incorporating other factors improves its predictive ...

    journal_title:Annals of surgery

    pub_type: 杂志文章,多中心研究

    doi:10.1097/SLA.0000000000001796

    authors: McMillan MT,Allegrini V,Asbun HJ,Ball CG,Bassi C,Beane JD,Behrman SW,Berger AC,Bloomston M,Callery MP,Christein JD,Dickson E,Dixon E,Drebin JA,Fernandez-Del Castillo C,Fisher WE,Fong ZV,Haverick E,Hollis RH,House MG

    更新日期:2017-05-01 00:00:00

  • The 30-day versus in-hospital and 90-day mortality after esophagectomy as indicators for quality of care.

    abstract:OBJECTIVE:To describe causes of death in the first year after esophagectomy and determine the time frame that should be used for measurement of quality of surgery. A case-mix adjustment model was developed for the comparison between hospitals. BACKGROUND:The time period in which postoperative mortality should be measu...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/SLA.0000000000000482

    authors: Talsma AK,Lingsma HF,Steyerberg EW,Wijnhoven BP,Van Lanschot JJ

    更新日期:2014-08-01 00:00:00

  • Use of extended criteria livers decreases wait time for liver transplantation without adversely impacting posttransplant survival.

    abstract:INTRODUCTION:The use of extended criteria donors (ECDs) could minimize shortage of suitable donor livers for transplantation. In 3 years, the aggressive use of ECD livers has reduced the wait list at our center from 257 to 30 patients with a median wait time of 18 days without using living donors. This study compares t...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/01.sla.0000234896.18207.fa

    authors: Tector AJ,Mangus RS,Chestovich P,Vianna R,Fridell JA,Milgrom ML,Sanders C,Kwo PY

    更新日期:2006-09-01 00:00:00

  • Laparoscopic sphincter-preserving total mesorectal excision with colonic J-pouch reconstruction: five-year results.

    abstract:OBJECTIVE:To prospectively evaluate the oncologic and functional outcomes of laparoscopic total mesorectal excision (TME) with colonic J-pouch reconstruction. BACKGROUND:TME is considered the established gold standard in rectal cancer surgery. However, data on laparoscopic sphincter-preserving TME are limited. METHOD...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/01.sla.0000202180.16723.03

    authors: Tsang WW,Chung CC,Kwok SY,Li MK

    更新日期:2006-03-01 00:00:00

  • Laparoscopic versus open appendectomy: a prospective randomized double-blind study.

    abstract:SUMMARY BACKGROUND DATA:The value of laparoscopy in appendicitis is not established. Studies suffer from multiple limitations. Our aim is to compare the safety and benefits of laparoscopic versus open appendectomy in a prospective randomized double blind study. METHODS:Two hundred forty-seven patients were analyzed fo...

    journal_title:Annals of surgery

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1097/01.sla.0000179648.75373.2f

    authors: Katkhouda N,Mason RJ,Towfigh S,Gevorgyan A,Essani R

    更新日期:2005-09-01 00:00:00

  • Management of secondary peritonitis.

    abstract:OBJECTIVE:The authors review current definition, classification, scoring, microbiology, inflammatory response, and goals of management of secondary peritonitis. SUMMARY BACKGROUND DATA:Despite improved diagnostic modalities, potent antibiotics, modern intensive care, and aggressive surgical treatment, up to one third ...

    journal_title:Annals of surgery

    pub_type: 杂志文章,评审

    doi:10.1097/00000658-199607000-00003

    authors: Wittmann DH,Schein M,Condon RE

    更新日期:1996-07-01 00:00:00

  • Unsuccessful experience with closure of Jaboulay gastroduodenostomies in the treatment of post-vagotomy dumping and diarrhea.

    abstract::Eight patients after vagotomy and Jaboulay gastroduodenostomy had their gastroduodenostomy closed to treat dumping and diarrhea. Eight gastroduodenostomies were closed once and four were closed twice, a total of 12 procedures. Of these, ten were "simple" closures (direct suture of the opening into the duodenum via a g...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/00000658-198308000-00005

    authors: Hoffmann J,Fischer A,Jensen HE

    更新日期:1983-08-01 00:00:00

  • Analysis of reduced death and complication rates after esophageal resection.

    abstract:OBJECTIVE:To identify factors that have contributed to reduced rates of death and complications after esophageal resection in a 17-year period at a tertiary referral center. SUMMARY BACKGROUND DATA:There has been an evolving refinement in surgical technique and perioperative management of patients undergoing esophagea...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/00000658-200103000-00006

    authors: Whooley BP,Law S,Murthy SC,Alexandrou A,Wong J

    更新日期:2001-03-01 00:00:00

  • Abdominal aortic surgery in the presence of a horseshoe kidney.

    abstract::Prior experience with the rare combination of horseshoe kidney and significant atherosclerotic vascular disease suggests difficulty in intraoperative management, often requiring division of the renal isthmus or sacrifice of some renal tissue. Seven patients have been managed successfully over the past ten years at The...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/00000658-197807000-00012

    authors: Lobe TE,Martin EW Jr,Cooperman M,Vasko J,Evans WE

    更新日期:1978-07-01 00:00:00