Practice parameters for the management of rectal prolapse.

Dis Colon Rectum. 2011 Nov;54(11):1339-46

Authors: Varma M, Rafferty J, Buie WD,

PMID: 21979176 [PubMed - indexed for MEDLINE]

Evaluation and management of peripheral vascular injury. Part 1. Western Trauma Association/critical decisions in trauma.

J Trauma. 2011 Jun;70(6):1551-6

Authors: Feliciano DV, Moore FA, Moore EE, West MA, Davis JW, Cocanour CS, Kozar RA, McIntyre RC

PMID: 21817992 [PubMed - indexed for MEDLINE]

East Practice Management Guidelines Work Group: update to practice management guidelines for prophylactic antibiotic use in open fractures.

J Trauma. 2011 Mar;70(3):751-4

Authors: Hoff WS, Bonadies JA, Cachecho R, Dorlac WC

PMID: 21610369 [PubMed - indexed for MEDLINE]

Trauma association of Canada Pediatric Subcommittee National Pediatric Cervical Spine Evaluation Pathway: consensus guidelines.

J Trauma. 2011 Apr;70(4):873-84

Authors: Chung S, Mikrogianakis A, Wales PW, Dirks P, Shroff M, Singhal A, Grant V, Hancock BJ, Creery D, Atkinson J, St-Vil D, Crevier L, Yanchar N, Hayashi A, Mehta V, Carey T, Dhanani S, Siemens R, Singh S, Price D

The Institute of Medicine calls for the use of clinical guidelines and practice parameters to promote “best practices” and improve patient outcomes. In 2006, The Trauma Association of Canada Pediatric Committee set out to create an evidence-based, national pediatric cervical spine (c-spine) clearance guideline based on the literature, existing algorithms from each pediatric trauma center and from expert opinion from across Canada.

PMID: 21610393 [PubMed - indexed for MEDLINE]

Guidelines for clinical care: anti-infective agents for intra-abdominal infection. A Surgical Infection Society policy statement.

Arch Surg. 1992 Jan;127(1):83-9; discussion 89

Authors: Bohnen JM, Solomkin JS, Dellinger EP, Bjornson HS, Page CP

Several antibiotics have been marketed for therapeutic use in intra-abdominal infection. Often, these agents do not provide a sufficient spectrum activity against both facultative and obligate anaerobic gram-negative organisms, or have certain toxic effects that would not otherwise support their use. Guidelines have been developed for selection of antibiotic therapy for intra-abdominal infections and are presented as a statement of the Surgical Infection Society endorsed by the Executive Council. These guidelines are restricted to infections derived from the gastrointestinal tract and deal with those microorganisms commonly seen in such infections. The recommendations are based on in vitro activity against enteric bacteria, experience in animal models, and documented efficacy in clinical trials. Other concerns regarding pharmacokinetics, mechanisms of action, microbial resistance, and safety were also used in the formation of these guidelines. For community-acquired infections of mild to moderate severity, single-agent therapy with cefoxitin, cefotetan, or cefmetazole or ticarcillin-clavulanic acid is recommended. For more severe infections, single-agent therapy with carbapenems (imipenem/cilastatin) or combination therapy with either a third-generation cephalosporin, a monobactam (aztreonam), or an aminoglycoside plus clindamycin or metronidazole is recommended. Regimens with little or no activity against facultative gram-negative rods or anaerobic gram-negative rods are not considered acceptable.

PMID: 1734854 [PubMed - indexed for MEDLINE]

The Surgical Infection Society’s policy on human immunodeficiency virus and hepatitis B and C infection. The Ad Hoc Committee on Acquired Immunodeficiency Syndrome and Hepatitis.

Arch Surg. 1992 Feb;127(2):218-21

Authors: Davis JM, Demling RH, Lewis FR, Hoover E, Waymack JP

The Ad Hoc Committee on Acquired Immunodeficiency Syndrome and Hepatitis of The Surgical Infection Society has outlined its policy regarding three deadly blood-borne viral infections. The risk of transmission of these microbes, the role of preoperative testing, the problem of the human immunodeficiency virus-infected surgeon, and conduct in the operating room are discussed.

PMID: 1540101 [PubMed - indexed for MEDLINE]

Practice parameters for the management of anal fissure. The Standards Task Force American Society of Colon and Rectal Surgeons.

Dis Colon Rectum. 1992 Feb;35(2):206-8

Authors: Rosen L, Abel ME, Gordon PH, Denstman FJ, Fleshman JW, Hicks TC, Huber PJ, Kennedy HL, Levin SE, Nicholson JD

It should be recognized that these guidelines should not be deemed inclusive of all proper methods of care or exclusive of methods of care reasonably directed to obtaining the same results. The ultimate judgment regarding the propriety of any specific procedure must be made by the physician in light of all of the circumstances presented by the individual patient.

PMID: 1735328 [PubMed - indexed for MEDLINE]

Practice parameters for antibiotic prophylaxis to prevent infective endocarditis or infected prosthesis during colon and rectal endoscopy. The American Society of Colon and Rectal Surgeons.

Dis Colon Rectum. 1992 Mar;35(3):277

Authors:

PMID: 1740077 [PubMed - indexed for MEDLINE]

Practice parameters for antibiotic prophylaxis–supporting documentation. The Standards Task Force. American Society of Colon and Rectal Surgeons.

Dis Colon Rectum. 1992 Mar;35(3):278-85

Authors:

PMID: 1740078 [PubMed - indexed for MEDLINE]

Practice parameters for the detection of colorectal neoplasms. The American Society of Colon and Rectal Surgeons.

Dis Colon Rectum. 1992 Apr;35(4):389-90

Authors:

PMID: 1582363 [PubMed - indexed for MEDLINE]

Practice parameters for the detection of colorectal neoplasms–supporting documentation. The Standards Task Force. AmericanSociety of Colon and Rectal Surgeons.

Dis Colon Rectum. 1992 Apr;35(4):391-4

Authors: Rosen L, Abel ME, Gordon PH, Denstman FJ, Fleshman JW, Hicks TC, Huber PJ, Kennedy HL, Levin SE, Nicholson JD

PMID: 1582364 [PubMed - indexed for MEDLINE]

Organ injury scaling. III: Chest wall, abdominal vascular, ureter, bladder, and urethra.

J Trauma. 1992 Sep;33(3):337-9

Authors: Moore EE, Cogbill TH, Jurkovich GJ, McAninch JW, Champion HR, Gennarelli TA, Malangoni MA, Shackford SR, Trafton PG

PMID: 1404499 [PubMed - indexed for MEDLINE]

Antimicrobial prophylaxis for surgical wounds. Guidelines for clinical care.

Arch Surg. 1993 Jan;128(1):79-88

Authors: Page CP, Bohnen JM, Fletcher JR, McManus AT, Solomkin JS, Wittmann DH

Prophylactic administration of antibiotics can decrease postoperative morbidity, shorten hospitalization, and reduce the overall costs attributable to infections. Principles of prophylaxis include providing effective levels of antibiotics in the decisive interval, and, in most instances, limiting the course to intraoperative coverage only. Use in The National Research Council clean contaminated operations is appropriate and, in many instances, has been proven beneficial. Antibiotic prophylaxis is also indicated for clean operations, such as those involved with insertion of prosthetic devices, that are associated with low infection risk and high morbidity. Extension of antibiotic prophylaxis to other categories of clean wounds should be limited to patients with two or more risk factors established by criteria in the study of the efficacy of nosocomial infection control (SENIC) because the baseline infection rate in these patients is high enough to justify their use. Cefazolin (or cefoxitin when anaerobic coverage is necessary) remains the mainstay of prophylactic therapy. Selection of an alternate agent should be based on specific contraindications, local infection control surveillance data, and the results of clinical trials. Newer criteria for determining the risk of “site infection” (wound and intracavitary) are in evolution and may lead to modification of these recommendations over the next several years.

PMID: 8418785 [PubMed - indexed for MEDLINE]

Gallstones and laparoscopic cholecystectomy. NIH Consensus Development Panel on Gallstones and Laparoscopic Cholecystectomy.

Surg Endosc. 1993 May-Jun;7(3):271-9

Authors:

PMID: 8503085 [PubMed - indexed for MEDLINE]

Guidelines for diagnostic laparoscopy. Society of American Gastrointestinal Endoscopic Surgeons (SAGES).

Surg Endosc. 1993 Jul-Aug;7(4):367-8

Authors:

PMID: 8351616 [PubMed - indexed for MEDLINE]

The role of laparoscopic cholecystectomy (L.C.). Guidelines for clinical application. Society of American Gastrointestinal Endoscopic Surgeons (SAGES).

Surg Endosc. 1993 Jul-Aug;7(4):369-70

Authors:

PMID: 8351617 [PubMed - indexed for MEDLINE]

Guidelines for office endoscopic services. Society of American Gastrointestinal Endoscopic Surgeons (SAGES).

Surg Endosc. 1993 Jul-Aug;7(4):371

Authors:

PMID: 8351618 [PubMed - indexed for MEDLINE]

Practice parameters for the treatment of rectal carcinoma. The American Society of Colon and Rectal Surgeons.

Dis Colon Rectum. 1993 Nov;36(11):989-1006

Authors:

PMID: 8223065 [PubMed - indexed for MEDLINE]

Practice parameters for the treatment of hemorrhoids. The Standards Task Force American Society of Colon and Rectal Surgeons.

Dis Colon Rectum. 1993 Dec;36(12):1118-20

Authors:

It should be recognized that these guidelines should not be deemed inclusive of all proper methods of care or exclusive of methods of care reasonably directed to obtaining the same results. The ultimate judgment regarding the propriety of any specific procedure must be made by the physician in light of all of the circumstances presented by the individual patient.

PMID: 8253007 [PubMed - indexed for MEDLINE]

National guidelines for enterostomal patient education. Prepared by the Standards Development Committee of the United Ostomy Association with the Assistance of Prospect Associates.

Dis Colon Rectum. 1994 Jun;37(6):559-63

Authors:

PMID: 8200234 [PubMed - indexed for MEDLINE]

Practice management guidelines for trauma care: presidential address, Seventh Scientific Assembly of the Eastern Association for the Surgery of Trauma.

J Trauma. 1994 Oct;37(4):635-44

Authors: Rhodes M

PMID: 7932896 [PubMed - indexed for MEDLINE]

Guidelines for the clinical application of laparoscopic biliary tract surgery. SAGES. Society of American Gastrointestinal Endoscopic Surgeons.

Surg Endosc. 1994 Dec;8(12):1457-8

Authors:

PMID: 7878519 [PubMed - indexed for MEDLINE]

Practice parameters for sigmoid diverticulitis. The Standards Task Force American Society of Colon and Rectal Surgeons.

Dis Colon Rectum. 1995 Feb;38(2):125-32

Authors: Roberts P, Abel M, Rosen L, Cirocco W, Fleshman J, Leff E, Levien D, Pritchard T, Wexner S, Hicks T

It should be recognized that these guidelines should not be deemed inclusive of all proper methods of care or exclusive of methods of care reasonably directed to obtaining the same results. The ultimate judgment regarding the propriety of any specific procedure must be made by the physician in light of all of the circumstances presented by the individual patient.

PMID: 7851165 [PubMed - indexed for MEDLINE]

Surgical red blood cell transfusion practice policies. Blood Management Practice Guidelines Conference.

Am J Surg. 1995 Dec;170(6A Suppl):3S-15S

Authors: Spence RK

PMID: 8546244 [PubMed - indexed for MEDLINE]

Code of Ethics. Royal Australasian College of Surgeons, September 1993.

Arch Surg. 1996 Aug;131(8):900-1

Authors:

PMID: 8712917 [PubMed - indexed for MEDLINE]

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Granting of ultrasonography privileges for surgeons. Society of American Gastrointestinal Endoscopic Surgeons.

Surg Endosc. 1996 Sep;10(9):952-3

Authors:

PMID: 8703165 [PubMed - indexed for MEDLINE]

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Guidelines for the surgical practice of telemedicine. Board of Governors of the Society of American Gastrointestinal Endoscopic Surgeons.

Surg Endosc. 1997 Jul;11(7):789-92

Authors:

PMID: 9235636 [PubMed - indexed for MEDLINE]

Practice parameters for treatment of fistula-in-ano–supporting documentation. The Standards Practice Task Force. The American Society of Colon and Rectal Surgeons.

Dis Colon Rectum. 1996 Dec;39(12):1363-72

Authors:

PMID: 8969662 [PubMed - indexed for MEDLINE]

Practice parameters for treatment of fistula-in-ano. The Standards Practice Task Force. The American Society of Colon and Rectal Surgeons.

Dis Colon Rectum. 1996 Dec;39(12):1361-2

Authors:

PMID: 8969661 [PubMed - indexed for MEDLINE]

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Guidelines for surgical treatment of gastroesophageal reflux disease (GERD). Society of American Gastrointestinal Endoscopic Surgeons (SAGES).

Surg Endosc. 1998 Feb;12(2):186-8

Authors:

Gastroesophageal reflux disease (GERD) is a significant health concern. Medical management is expensive and may be necessary lifelong. Effective surgical therapy is available and, if performed by experienced surgeons, is successful in greater than 90% of patients. Laparoscopic techniques which reproduce their “open” counterpart are also available. When performed by appropriately trained surgeons, these laparoscopic approaches appear to hasten the patient’s recovery and return to normal function.

PMID: 9479742 [PubMed - indexed for MEDLINE]

Practice parameters for the treatment of mucosal ulcerative colitis–supporting documentation. The Standards Practice Task Force. The American Society of Colon and Rectal Surgeons.

Dis Colon Rectum. 1997 Nov;40(11):1277-85

Authors: Wexner SD, Rosen L, Lowry A, Roberts PL, Burnstein M, Hicks T, Kerner B, Oliver GC, Robertson HD, Robertson WG, Ross TM, Senatore PJ, Simmang C, Smith C, Vernava AM, Wong WD

PMID: 9369100 [PubMed - indexed for MEDLINE]

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Guidelines for laparoscopic surgery during pregnancy. Society of American Gastrointestinal Endoscopic Surgeons (SAGES).

Surg Endosc. 1998 Feb;12(2):189-90

Authors:

PMID: 9479743 [PubMed - indexed for MEDLINE]

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Guidelines for office endoscopic services. Society of American Gastrointestinal Endoscopic Surgeons (SAGES).

Surg Endosc. 1998 Feb;12(2):191-2

Authors:

PMID: 9479744 [PubMed - indexed for MEDLINE]

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Guidelines for sentinel node biopsy and lymphatic mapping of patients with breast cancer.

Ann Surg. 1998 May;227(5):645-51; discussion 651-3

Authors: Cox CE, Pendas S, Cox JM, Joseph E, Shons AR, Yeatman T, Ku NN, Lyman GH, Berman C, Haddad F, Reintgen DS

OBJECTIVE: To define preliminary guidelines for the use of lymphatic mapping techniques in patients with breast cancer. SUMMARY BACKGROUND DATA: Lymphatic mapping techniques have the potential of changing the standard of surgical care of patients with breast cancer. METHODS: Four hundred sixty-six consecutive patients with newly diagnosed breast cancer underwent a prospective trial of intraoperative lymphatic mapping using a combination of vital blue dye and filtered technetium-labeled sulfur colloid. A sentinel lymph node (SLN) was defined as a blue node and/or a hot node with a 10:1 ex vivo gamma probe ratio of SLN to non-SLN. All SLNs were bivalved, step-sectioned, and examined with routine hematoxylin and eosin (H&E) stains and immunohistochemical stains for cytokeratin. A cytokeratin-positive SLN was defined as any SLN with a defined cluster of positive-staining cells that could be confirmed histologically on H&E sections. RESULTS: Fine-needle aspiration (FNA) or stereotactic core biopsy was used to diagnose 195 of the 422 patients (46.2%) with breast cancer; 227 of 422 patients (53.8%) were diagnosed by excisional biopsy. The SLN was successfully identified in 440 of 466 patients (94.4%). Failure to identify an SLN to the axilla intraoperatively occurred in 26 of 466 patients (5.6%). In all patients who failed lymphatic mappings, a complete axillary dissection was performed, and metastatic disease was documented in 4 of 26 (15.4%) of these patients. Of the 26 patients who failed lymphatic mapping, 11 of 227 (4.8%) were diagnosed by excisional biopsy and 15 of 195 (7.7%) were diagnosed by FNA or stereotactic core biopsy. Of interest, there was only one skip metastasis (defined as a negative SLN with higher nodes in the chain being positive) in a patient with prior excisional biopsy. A mean of 1.92 SLNs were harvested per patient. Twenty percent of the SLNs removed were positive for metastatic disease in 105 of 440 (23.8%) of the patients. Descriptive information on 844 SLNs was evaluated: 339 of 844 (40.2%) were hot, 272 of 844 (32.2%) were blue, and 233 of 844 (27.6%) were both hot and blue. At least one positive SLN was found in 4 of 87 patients (4.6%) with noninvasive (ductal carcinoma in situ) tumors. A greater incidence of positive SLNs was found in patients who had invasive tumors of increasing size: 18 of 112 patients (16%) with tumor size between 0.1 mm and 1 cm had positive SLNs. However, a significantly greater percentage of patients (43 of 131 [32.8%] with tumor size between 1 and 2 cm and 31 of 76 [40.8%] with tumor size between 2 and 5 cm) had positive SLNs. The highest incidence of positive SLNs was seen with patients of tumor size greater than 5 cm; in this group, 9 of 12 (75%) had a positive SLN (p < 0.001). CONCLUSIONS: This study demonstrates that accurate SLN identification was obtained when all blue and hot lymph nodes were harvested as SLNs. Therefore, lymphatic mapping and SLN biopsy is most effective when a combination of vital blue dye and radiolabeled sulfur colloid is used. Furthermore, these data demonstrate that patients with ductal carcinoma in situ or small tumors exhibit a low but significant incidence of metastatic disease to the axillary lymph nodes and may benefit most from selective lymphadenectomy, avoiding the unnecessary complications of a complete axillary lymph node dissection.

PMID: 9605656 [PubMed - indexed for MEDLINE]

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Diagnosis and treatment of common bile duct stones (CBDS). Results of a consensus development conference. Scientific Committee of the European Association for Endoscopic Surgery (E.A.E.S.).

Surg Endosc. 1998 Jun;12(6):856-64

Authors:

BACKGROUND: Common bile duct stones (CBDS) are a frequent problem (10-15%) in patients with symptomatic cholecystolithiasis. Over the last decade, new diagnostic and surgical techniques have expanded the options for their management. This report of the Consensus Development Conference is intended to summarize the current state of the art, including principal guidelines and an extensive review of the literature. METHODS: An international panel of 12 experts met under the auspices of the European Association of Endoscopic Surgery (EAES) to investigate the diagnostic and therapeutic alternatives for gallstone disease. Prior to the conference, all the experts were asked to submit their arguments in the form of published results. All papers received were weighted according to their scientific quality and relevance. The preconsensus document compiled out of this correspondence was altered following a discussion of the external evidence made available by the panel members and presented at the public conference session. The personal experiences of the participants and other aspects of individualized therapy were also considered. RESULTS: Our panel of experts agreed that the presence of common bile duct stones should be investigated in all patients with symptomatic cholecystolithiasis. Based on preoperative noninvasive diagnostics, either endoscopic retrograde cholangiopancreaticography (ERCP) or intraoperative cholangiography should be employed for detecting CBDS. Eight of the 12 panelists recommended treating any diagnosed CBDS. For patients with no other extenuating circumstances, several treatment options exist. Stones can be extracted during ERCP, or either before or (in exceptional cases) after laparoscopic or open surgery. Bile duct clearance should always be combined with cholecystectomy. Evidence for further special aspects of CBDS treatment is equivocal and drawn from nonrandomized trials only. CONCLUSIONS: The management of common bile duct stones is currently undergoing some major changes. Many diagnostic and therapeutic strategies need further study.

PMID: 9602006 [PubMed - indexed for MEDLINE]

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Guidelines for diagnostic laparoscopy.SAGES guidelines. Society of American Gastrointestinal Endoscopic Surgeons.

Surg Endosc. 1999 Feb;13(2):202-3

Authors:

PMID: 9918636 [PubMed - indexed for MEDLINE]

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Treatment of gallstone and gallbladder disease using cholecystectomy. The Society for Surgery of the Alimentary Tract Patient Care Committee.

J Gastrointest Surg. 1998 Sep-Oct;2(5):485-6

Authors:

PMID: 9935327 [PubMed - indexed for MEDLINE]

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Practice management guidelines for trauma from the Eastern Association for the Surgery of Trauma.

J Trauma. 1998 Jun;44(6):941-56; discussion 956-7

Authors: Pasquale M, Fabian TC

PMID: 9637148 [PubMed - indexed for MEDLINE]

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Treatment of acute pancreatitis. The Society for Surgery of the Alimentary Tract Patient Care Committee.

J Gastrointest Surg. 1998 Sep-Oct;2(5):487-8

Authors:

PMID: 9935328 [PubMed - indexed for MEDLINE]

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Surgical treatment of chronic pancreatitis.The Society for Surgery of the Alimentary Tract Patient Care Committee.

J Gastrointest Surg. 1998 Sep-Oct;2(5):489-90

Authors:

PMID: 9935329 [PubMed - indexed for MEDLINE]

Practice parameters for detection of colorectal neoplasms. The Standards Committee, The American Society of Colon and Rectal Surgeons.

Dis Colon Rectum. 1999 Sep;42(9):1123-9

Authors: Simmang CL, Senatore P, Lowry A, Hicks T, Burnstein M, Dentsman F, Fazio V, Glennon E, Hyman N, Kerner B, Kilkenny J, Moore R, Peters W, Ross T, Savoca P, Vernava A, Wong WD

PMID: 10496550 [PubMed - indexed for MEDLINE]

Practice parameters for the treatment of sigmoid diverticulitis. The Standards Task Force. The American Society of Colon and Rectal Surgeons.

Dis Colon Rectum. 2000 Mar;43(3):289

Authors:

PMID: 10733107 [PubMed - indexed for MEDLINE]

Practice parameters for the treatment of sigmoid diverticulitis–supporting documentation. The Standards Task Force. The American Society of Colon and Rectal Surgeons.

Dis Colon Rectum. 2000 Mar;43(3):290-7

Authors: Wong WD, Wexner SD, Lowry A, Vernava A, Burnstein M, Denstman F, Fazio V, Kerner B, Moore R, Oliver G, Peters W, Ross T, Senatore P, Simmang C

It should be recognized that these guidelines should not be deemed inclusive of all proper methods of care or exclusive of methods of care reasonably directed to obtaining the same results. The ultimate judgment regarding the propriety of any specific procedure must be made by the physician in light of all of the circumstances presented by the individual patient.

PMID: 10733108 [PubMed - indexed for MEDLINE]

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Practice Management Guidelines for Prophylactic Antibiotic Use in Tube Thoracostomy for Traumatic Hemopneumothorax: the EAST Practice Management Guidelines Work Group. Eastern Association for Trauma.

J Trauma. 2000 Apr;48(4):753-7

Authors: Luchette FA, Barrie PS, Oswanski MF, Spain DA, Mullins CD, Palumbo F, Pasquale MD

Multiple factors contribute to the development of posttraumatic empyema. These factors include the conditions under which the tube is inserted (emergent or urgent), the mechanism of injury, retained hemothorax, and ventilator care. The incidence of empyema in placebo groups ranges between 0 and 18%. The administration of antibiotics for longer than 24 hours did not seem to significantly reduce this risk compared with a shorter duration, although the numbers in each series were small. Most reports found a significant reduction in pneumonitis when patients received prolonged prophylactic antibiotics. This use of antibiotics might possibly be better described as presumptive therapy rather than prophylactic.

PMID: 10780613 [PubMed - indexed for MEDLINE]

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Practice management guidelines for prophylactic antibiotic use in penetrating abdominal trauma: the EAST Practice Management Guidelines Work Group.

J Trauma. 2000 Mar;48(3):508-18

Authors: Luchette FA, Borzotta AP, Croce MA, O’Neill PA, Whittmann DH, Mullins CD, Palumbo F, Pasquale MD

PMID: 10744294 [PubMed - indexed for MEDLINE]

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Scandinavian guidelines for initial management of minimal, mild, and moderate head injuries.The Scandinavian Neurotrauma Committee.

J Trauma. 2000 Apr;48(4):760-6

Authors: Ingebrigtsen T, Romner B, Kock-Jensen C

BACKGROUND: The Scandinavian Neurotrauma Committee was initiated by the Scandinavian Neurosurgical Society to develop evidence-based guidelines for improved care of neurotrauma patients. METHODS: A MEDLINE search identified 475 papers dealing with the management of minimal, mild, and moderate head injuries. Forty-two studies presenting class II evidence on the initial management of such injuries were reviewed and management guidelines were developed. RESULTS: Implementation of the Head Injury Severity Scale is advocated. Patients with minimal injuries (no loss of consciousness, Glasgow Coma Scale score of 15) can be safely discharged. Routine early computed tomographic scan is recommended in cases with mild injuries (history of loss of consciousness, Glasgow Coma Scale score = 14-15) and patients with normal scans may be discharged. Computed tomographic scan and admission is mandatory in moderate injuries (Glasgow Coma Scale score = 13). All patients harboring additional risk factors should be scanned and admitted. A flow-chart for clinical decision making and a Head Injury Instruction card is introduced. CONCLUSIONS: The Scandinavian Neurotrauma Committee suggests guidelines that should be safe and cost-effective for the initial management of minimal, mild, and moderate head injuries.

PMID: 10780615 [PubMed - indexed for MEDLINE]

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Guidelines for the diagnosis and management of blunt aortic injury: an EAST Practice Management Guidelines Work Group.

J Trauma. 2000 Jun;48(6):1128-43

Authors: Nagy K, Fabian T, Rodman G, Fulda G, Rodriguez A, Mirvis S

In summary, BAI is a lethal result of severe blunt trauma. It should be considered in all patients who sustained injury by a deceleration or acceleration mechanism, especially in the face of physical or radiographic findings suggestive of mediastinal injury. Angiography remains the “gold standard” for diagnosis, although CT scanning is taking more of a role, especially for screening. Diagnosis should be followed by prompt surgical repair using some method of distal perfusion to minimize renal and spinal cord ischemia. If prompt repair is not feasible because of other injuries or comorbidities, medical control of blood pressure is warranted in the interim.

PMID: 10866262 [PubMed - indexed for MEDLINE]

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Surgical treatment of cancer of the colon or rectum. Patient Care Committee of the Society for Surgery of the Alimentary Tract (SSAT).

J Gastrointest Surg. 1999 Mar-Apr;3(2):210-1

Authors:

PMID: 10885947 [PubMed - indexed for MEDLINE]

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Surgical treatment of diverticulitis. Patient Care Committee of the Society for Surgery of the Alimentary Tract (SSAT).

J Gastrointest Surg. 1999 Mar-Apr;3(2):212-3

Authors:

PMID: 10885948 [PubMed - indexed for MEDLINE]

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Surgical treatment of pancreatic cancer. Patient Care Committee of the Society for Surgery of the Alimentary Tract (SSAT).

J Gastrointest Surg. 1999 Mar-Apr;3(2):208-9

Authors:

PMID: 10885946 [PubMed - indexed for MEDLINE]

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Surgical management of hemorrhoids. Patient Care Committee of the Society for Surgery of the Alimentary Tract (SSAT).

J Gastrointest Surg. 1999 Mar-Apr;3(2):214-5

Authors:

PMID: 10885949 [PubMed - indexed for MEDLINE]

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Surgical repair of groin hernias. Patient Care Committee of the Society for Surgery of the Alimentary Tract (SSAT).

J Gastrointest Surg. 1999 Mar-Apr;3(2):216-7

Authors:

PMID: 10885950 [PubMed - indexed for MEDLINE]

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Splenectomy. Patient Care Committee of the Society for Surgery of the Alimentary Tract (SSAT).

J Gastrointest Surg. 1999 Mar-Apr;3(2):218-9

Authors:

PMID: 10885951 [PubMed - indexed for MEDLINE]

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Management of colonic polyps and adenomas. Patient Care Committee of the Society for Surgery of the Alimentary Tract (SSAT).

J Gastrointest Surg. 1999 Mar-Apr;3(2):220-2

Authors:

PMID: 10885952 [PubMed - indexed for MEDLINE]

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Practical guidelines for optimal gamma probe detection of sentinel lymph nodes in breast cancer: results of a multi-institutional study. For the University of Louisville Breast Cancer Study Group.

Surgery. 2000 Aug;128(2):139-44

Authors: Martin RC, Edwards MJ, Wong SL, Tuttle TM, Carlson DJ, Brown CM, Noyes RD, Glaser RL, Vennekotter DJ, Turk PS, Tate PS, Sardi A, Cerrito PB, McMasters KM

INTRODUCTION: Multiple radioactive lymph nodes are often removed during the course of sentinel lymph node (SLN) biopsy for breast cancer when both blue dye and radioactive colloid injection are used. Some of the less radioactive lymph nodes are second echelon nodes, not true SLNs. The purpose of this analysis was to determine whether harvesting these less radioactive nodes, in addition to the “hottest” SLNs, reduces the false-negative rate. METHODS: Patients were enrolled in this multicenter (121 surgeons) prospective, institutional review board-approved study after informed consent was obtained. Patients with clinical stage T1-2, N0, M0 invasive breast cancer were eligible. This analysis includes all patients who underwent axillary SLN biopsy with the use of an injection of both isosulfan blue dye and radioactive colloid. The protocol specified that all blue nodes and all nodes with 10% or more of the ex vivo count of the hottest node should be removed and designated SLNs. All patients underwent completion level I/II axillary dissection. RESULTS: SLNs were identified in 672 of 758 patients (89%). Of the patients with SLNs identified, 403 patients (60%) had more than 1 SLN removed (mean, 1.96 SLN/patient) and 207 patients (31%) had nodal metastases. The use of filtered or unfiltered technetium sulfur colloid had no impact on the number of SLNs identified. Overall, 33% of histologically positive SLNs had no evidence of blue dye staining. Of those patients with multiple SLNs removed, histologically positive SLNs were found in 130 patients. In 15 of these 130 patients (11.5%), the hottest SLN was negative when a less radioactive node was positive for tumor. If only the hottest node had been removed, the false-negative rate would have been 13.0% versus 5.8% when all nodes with 10% or more of the ex vivo count of the hottest node were removed (P =.01). CONCLUSIONS: These data support the policy that all blue nodes and all nodes with 10% or more of the ex vivo count of the hottest SLN should be harvested for optimal nodal staging.

PMID: 10922983 [PubMed - indexed for MEDLINE]

Practice parameters for the prevention of venous thromboembolism. The Standards Task Force of the American Society of Colon and Rectal Surgeons.

Dis Colon Rectum. 2000 Aug;43(8):1037-47

Authors:

PMID: 10950001 [PubMed - indexed for MEDLINE]

Guidelines for the clinical application of laparoscopic biliary tract surgery. Society of American Gastrointestinal Endoscopic Surgeons.

Surg Endosc. 2000 Aug;14(8):771-2

Authors:

PMID: 10954829 [PubMed - indexed for MEDLINE]

Guidelines for collaborative practice in endoscopic thoracoscopic spinal surgery for the general surgeon: privileges, clinical applications, training.

Surg Endosc. 2000 Sep;14(9):872-5

Authors:

PMID: 11000375 [PubMed - indexed for MEDLINE]

Practice parameters for antibiotic prophylaxis to prevent infective endocarditis or infected prosthesis during colon and rectal endoscopy. The Standards Task Force. The American Society of Colon and Rectal Surgeons.

Dis Colon Rectum. 2000 Sep;43(9):1193

Authors:

PMID: 11005481 [PubMed - indexed for MEDLINE]

Practice parameters for antibiotic prophylaxis–supporting documentation. The Standards Task Force. The American Society of Colon and Rectal Surgeons.

Dis Colon Rectum. 2000 Sep;43(9):1194-200

Authors: Oliver G, Lowry A, Vernava A, Hicks T, Burnstein M, Denstman F, Fazio V, Kerner B, Moore R, Peters W, Ross T, Senatore P, Simmang C, Wexner S, Wong WD

PMID: 11005482 [PubMed - indexed for MEDLINE]

Guidelines for the surgical practice of telemedicine. Society of American Gastrointestinal Endoscopic Surgeons.

Surg Endosc. 2000 Oct;14(10):975-9

Authors:

PMID: 11080420 [PubMed - indexed for MEDLINE]

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Practice management guidelines for the optimal timing of long-bone fracture stabilization in polytrauma patients: the EAST Practice Management Guidelines Work Group.

J Trauma. 2001 May;50(5):958-67

Authors: Dunham CM, Bosse MJ, Clancy TV, Cole FJ, Coles MJ, Knuth T, Luchette FA, Ostrum R, Plaisier B, Poka A, Simon RJ,

PMID: 11379595 [PubMed - indexed for MEDLINE]

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Practice management guidelines for emergency department thoracotomy. Working Group, Ad Hoc Subcommittee on Outcomes, American College of Surgeons-Committee on Trauma.

J Am Coll Surg. 2001 Sep;193(3):303-9

Authors:

PMID: 11548801 [PubMed - indexed for MEDLINE]

Practice parameters for the identification and testing of patients at risk for dominantly inherited colorectal cancer.

Dis Colon Rectum. 2001 Oct;44(10):1403

Authors: , ,

PMID: 11598465 [PubMed - indexed for MEDLINE]

Practice parameters for the identification and testing of patients at risk for dominantly inherited colorectal cancer–supporting documentation.

Dis Colon Rectum. 2001 Oct;44(10):1404-12

Authors: Church J, Lowry A, Simmang C, ,

PMID: 11598466 [PubMed - indexed for MEDLINE]

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Practice management guidelines for the management of mild traumatic brain injury: the EAST practice management guidelines work group.

J Trauma. 2001 Nov;51(5):1016-26

Authors: Cushman JG, Agarwal N, Fabian TC, Garcia V, Nagy KK, Pasquale MD, Salotto AG,

PMID: 11706358 [PubMed - indexed for MEDLINE]

Principles of privileging and credentialing for endoscopy and colonoscopy.

Dis Colon Rectum. 2002 Feb;45(2):161-4

Authors: Wexner SD, Eisen GM, Simmang C, , ,

PMID: 11852325 [PubMed - indexed for MEDLINE]

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The European Association for Endoscopic Surgery clinical practice guideline on the pneumoperitoneum for laparoscopic surgery.

Surg Endosc. 2002 Jul;16(7):1121-43

Authors: Neudecker J, Sauerland S, Neugebauer E, Bergamaschi R, Bonjer HJ, Cuschieri A, Fuchs KH, Jacobi Ch, Jansen FW, Koivusalo AM, Lacy A, McMahon MJ, Millat B, Schwenk W

BACKGROUND: The pneumoperitoneum is the crucial element in laparoscopic surgery. Different clinical problems are associated with this procedure, which has led to various modifications of the technique. The aim of this guideline is to define the scientifically proven standards of the pneumoperitoneum. METHODS: Based on systematic literature searches (Medline, Embase, and Cochrane), an expert panel consensually formulated clinical recommendations, which were graded according to the strength of available literature evidence. RECOMMENDATIONS: Preoperatively, all patients should be assessed for the presence of cardiac, pulmonary, hepatic, renal, or vascular comorbidity. Presupposing appropriate perioperative measures and surgical technique, there is no reason to contraindicate pneumoperitoneum in patients with peritonitis or intraabdominal malignancy. During laparoscopy, monitoring of end tidal CO2 concentration is mandatory. The available data on closed- (Veress needle) and open-access techniques do not allow us to principally favor the use of either technique. Using 2 to 5-mm instead of 5 to 10-mm trocars improves cosmetic result and postoperative pain marginally. It is recommended to use the lowest intraabdominal pressure allowing adequate exposure of the operative field, rather than using a routine pressure. In patients with limited cardiac, pulmonary, or renal function, abdominal wall lifting combined with low-pressure pneumoperitoneum might be an alternative. Abdominal wall lifting devices have no clinically relevant advantages compared to low-pressure (5-7 mmHg) pneumoperitoneum. In patients with cardiopulmonary diseases, intra- and postoperative arterial blood gas monitoring is recommended. The clinical benefits of warmed, humidified insufflation gas are minor and contradictory. Intraoperative sequential intermittent pneumatic compression of the lower extremities is recommended for all prolonged laparoscopic procedures. For the prevention of postoperative pain a wide range of treatment options exists. Although all these options seem to reduce pain, the data currently do not justify a general recommendation.

PMID: 12015619 [PubMed - indexed for MEDLINE]

The American College of Surgeons: statement on principles guiding care at the end of life.

J Am Coll Surg. 2002 May;194(5):664

Authors:

PMID: 12022608 [PubMed - indexed for MEDLINE]

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Practice management guidelines for the prevention of venous thromboembolism in trauma patients: the EAST practice management guidelines work group.

J Trauma. 2002 Jul;53(1):142-64

Authors: Rogers FB, Cipolle MD, Velmahos G, Rozycki G, Luchette FA

PMID: 12131409 [PubMed - indexed for MEDLINE]

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Practice management guidelines for the evaluation of blunt abdominal trauma: the East practice management guidelines work group.

J Trauma. 2002 Sep;53(3):602-15

Authors: Hoff WS, Holevar M, Nagy KK, Patterson L, Young JS, Arrillaga A, Najarian MP, Valenziano CP,

PMID: 12352507 [PubMed - indexed for MEDLINE]

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Guidelines for withholding or termination of resuscitation in prehospital traumatic cardiopulmonary arrest: joint position statement of the National Association of EMS Physicians and the American College of Surgeons Committee on Trauma.

J Am Coll Surg. 2003 Jan;196(1):106-12

Authors: Hopson LR, Hirsh E, Delgado J, Domeier RM, McSwain NE, Krohmer J, ,

PMID: 12517561 [PubMed - indexed for MEDLINE]

Inhalation injury: diagnosis.

J Am Coll Surg. 2003 Feb;196(2):307-12

Authors:

PMID: 12632576 [PubMed - indexed for MEDLINE]

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Guidelines for withholding or termination of resuscitation in prehospital traumatic cardiopulmonary arrest.

J Am Coll Surg. 2003 Mar;196(3):475-81

Authors: Hopson LR, Hirsh E, Delgado J, Domeier RM, Krohmer J, McSwain NE, Weldon C, Friel M, Hoyt DB, ,

PMID: 12648687 [PubMed - indexed for MEDLINE]

Practice parameters for ambulatory anorectal surgery.

Dis Colon Rectum. 2003 May;46(5):573-6

Authors: Place R, Hyman N, Simmang C, Cataldo P, Church J, Cohen J, Denstman F, Kilkenny J, Nogueras J, Orsay C, Otchy D, Rakinic J, Tjandra J, ,

PMID: 12792430 [PubMed - indexed for MEDLINE]

Practice parameters for the treatment of patients with dominantly inherited colorectal cancer (familial adenomatous polyposis and hereditary nonpolyposis colorectal cancer).

Dis Colon Rectum. 2003 Aug;46(8):1001-12

Authors: Church J, Simmang C, , ,

PMID: 12907889 [PubMed - indexed for MEDLINE]

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Statement on disaster and mass casualty management.

J Am Coll Surg. 2003 Nov;197(5):855-6

Authors:

PMID: 14585425 [PubMed - indexed for MEDLINE]

Guideline for hand hygiene in healthcare settings.

J Am Coll Surg. 2004 Jan;198(1):121-7

Authors: , , ,

PMID: 14710718 [PubMed - indexed for MEDLINE]

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Guidelines for institutions granting bariatric privileges utilizing laparoscopic techniques.

Surg Endosc. 2003 Dec;17(12):2037-40

Authors:

PMID: 14973660 [PubMed - indexed for MEDLINE]

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Practice parameters for the surveillance and follow-up of patients with colon and rectal cancer.

Dis Colon Rectum. 2004 Jun;47(6):807-17

Authors: Anthony T, Simmang C, Hyman N, Buie D, Kim D, Cataldo P, Orsay C, Church J, Otchy D, Cohen J, Perry WB, Dunn G, Rafferty J, Ellis CN, Rakinic J, Fleshner P, Stahl T, Gregorcyk S, Ternent C, Kilkenny JW, Whiteford M,

PMID: 15108028 [PubMed - indexed for MEDLINE]

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Evaluation of quality of life after laparoscopic surgery: evidence-based guidelines of the European Association for Endoscopic Surgery.

Surg Endosc. 2004 Jun;18(6):879-97

Authors: Korolija D, Sauerland S, Wood-Dauphinée S, Abbou CC, Eypasch E, Caballero MG, Lumsden MA, Millat B, Monson JR, Nilsson G, Pointner R, Schwenk W, Shamiyeh A, Szold A, Targarona E, Ure B, Neugebauer E,

BACKGROUND: Measuring health-related quality of life (QoL) after surgery is essential for decision making by patients, surgeons, and payers. The aim of this consensus conference was twofold. First, it was to determine for which diseases endoscopic surgery results in better postoperative QoL than open surgery. Second, it was to recommend QoL instruments for clinical research. METHODS: An expert panel selected 12 conditions in which QoL and endoscopic surgery are important. For each condition, studies comparing endoscopic and open surgery in terms of QoL were identified. The expert panel reached consensus on the relative benefits of endoscopic surgery and recommended generic and disease-specific QoL instruments for use in clinical research. RESULTS: Randomized trials indicate that QoL improves earlier after endoscopic than open surgery for gastroesophageal reflux disease (GERD), cholecystolithiasis, colorectal cancer, inguinal hernia, obesity (gastric bypass), and uterine disorders that require hysterectomy. For spleen, prostate, malignant kidney, benign colorectal, and benign non-GERD esophageal diseases, evidence from nonrandomized trials supports the use of laparoscopic surgery. However, many studies failed to collect long-term results, used nonvalidated questionnaires, or measured QoL components only incompletely. The following QoL instruments can be recommended: for benign esophageal and gallbladder disease, the GIQLI or the QOLRAD together with SF-36 or the PGWB; for obesity surgery, the IWQOL-Lite with the SF-36; for colorectal cancer, the FACT-C or the EORTC QLQ-C30/CR38; for inguinal and renal surgery, the VAS for pain with the SF-36 (or the EORTC QLQ-C30 in case of malignancy); and after hysterectomy, the SF-36 together with an evaluation of urinary and sexual function. CONCLUSIONS: Laparoscopic surgery provides better postoperative QoL in many clinical situations. Researchers would improve the quality of future studies by using validated QoL instruments such as those recommended here.

PMID: 15108103 [PubMed - indexed for MEDLINE]

Treatment of gallstone and gallbladder disease. SSAT patient care guidelines.

J Gastrointest Surg. 2004 Mar-Apr;8(3):363-4

Authors:

PMID: 15115004 [PubMed - indexed for MEDLINE]

Surgical repair of groin hernias. SSAT patient care guidelines.

J Gastrointest Surg. 2004 Mar-Apr;8(3):365-6

Authors:

PMID: 15115005 [PubMed - indexed for MEDLINE]

Esophageal achalasia. SSAT patient care guidelines.

J Gastrointest Surg. 2004 Mar-Apr;8(3):367-8

Authors:

PMID: 15115006 [PubMed - indexed for MEDLINE]

Surgical repair of incisional hernias. SSAT patient care guidelines.

J Gastrointest Surg. 2004 Mar-Apr;8(3):369-70

Authors:

PMID: 15115007 [PubMed - indexed for MEDLINE]

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Optimal management of the morbidly obese patient. SAGES appropriateness conference statement.

Surg Endosc. 2004 Jul;18(7):1029-37

Authors: Jones DB, Provost DA, DeMaria EJ, Smith CD, Morgenstern L, Schirmer B

BACKGROUND: Obesity is a growing health problem that contributes to numerous life-threatening or disabling disorders, including coronary artery disease, hypertension, type 2 diabetes mellitus, hyperlipidemia, degenerative joint disease, and obstructive sleep apnea. Significant weight reduction in the morbidly obese improves or reverses associated illness and benefits well-being. The purpose of the SAGES Appropriateness Conference was to summarize the state of the art for open and laparoscopic operations for the morbidly obese. METHODS: The English literature comparing bariatric procedures was reviewed and grouped by level of evidence by three surgeons (BS, LV, and CC). From more than 1,500 articles, all conference participants were provided with reprints and table summaries of no less than 50 selected manuscripts. Ten experts were requested to present reviews and make evidence-based arguments for and against the open and laparoscopic approaches in written format. An expert panel of six surgeons, including an ethicist and patient, commented on implications of data presented. The finalized statement was e-mailed to all participants for approval and comment. RESULTS: Consensus statements were achieved on various aspects of morbid obesity, including indications for surgery, resolution of comorbid illnesses with significant weight loss, and the importance of committed bariatric program. Our panel of experts agreed, in general, to the advantages of laparoscopic approaches compared to open operations in skilled hands. CONCLUSIONS: Laparoscopic Roux-en-Y gastric bypass (RYGB) affords improved short-term recovery compared to open gastric bypass. Laparoscopic adjustable banding can be performed with lower average mortality than either RYGB or any of the malabsorptive operations, and it produces variable degrees of short-term weight loss. Prospective randomized trials are needed to compare gastric bypass, malabsorptive, and restrictive procedures.

PMID: 15162240 [PubMed - indexed for MEDLINE]

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Practice management guidelines for nutritional support of the trauma patient.

J Trauma. 2004 Sep;57(3):660-78; discussion 679

Authors: Jacobs DG, Jacobs DO, Kudsk KA, Moore FA, Oswanski MF, Poole GV, Sacks G, Scherer LR, Sinclair KE,

PMID: 15454822 [PubMed - indexed for MEDLINE]

Practice parameters for colon cancer.

Dis Colon Rectum. 2004 Aug;47(8):1269-84

Authors: Otchy D, Hyman NH, Simmang C, Anthony T, Buie WD, Cataldo P, Church J, Cohen J, Dentsman F, Ellis CN, Kilkenny JW, Ko C, Moore R, Orsay C, Place R, Rafferty J, Rakinic J, Savoca P, Tjandra J, Whiteford M, ,

PMID: 15484340 [PubMed - indexed for MEDLINE]

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Obesity surgery: evidence-based guidelines of the European Association for Endoscopic Surgery (EAES).

Surg Endosc. 2005 Feb;19(2):200-21

Authors: Sauerland S, Angrisani L, Belachew M, Chevallier JM, Favretti F, Finer N, Fingerhut A, Garcia Caballero M, Guisado Macias JA, Mittermair R, Morino M, Msika S, Rubino F, Tacchino R, Weiner R, Neugebauer EA,

BACKGROUND: The increasing prevalence of morbid obesity together with the development of laparoscopic approaches has led to a steep rise in the number of bariatric operations. These guidelines intend to define the comparative effectiveness and surrounding circumstances of the various types of obesity surgery. METHODS: A consensus panel representing the fields of general/endoscopic surgery, nutrition and epidemiology convened to agree on specific questions in obesity surgery. Databases were systematically searched for clinical trial results in order to produce evidence-based recommendations. Following two days of discussion by the experts and a plenary discussion, the final statements were issued. RECOMMENDATIONS: After the patient’s multidisciplinary evaluation, obesity surgery should be considered in adults with a documented BMI greater than or equal to 35 and related comorbidity, or a BMI of at least 40. In addition to standard laboratory testing, chest radiography, electrocardiography, spirometry, and abdominal ultrasonography, the preoperative evaluation of obesity surgery patients also includes upper gastrointestinal endoscopy or radiologic evaluation with a barium meal. Psychiatric consultation and polysomnography can safely be restricted to patients with clinical symptoms on preoperative screening. Adjustable gastric banding (GB), vertical banded gastroplasty (VBG), Roux-en-Y gastric bypass (RYGB) and biliopancreatic diversion (BPD) are all effective in the treatment of morbid obesity, but differ in degree of weight loss and range of complications. The choice of procedure therefore should be tailored to the individual situation. There is evidence that a laparoscopic approach is advantageous for LAGB, VBG, and GB (and probably also for BPD). Antibiotic and antithromboembolic prophylaxis should be used routinely. Patients should be seen 3 to 8 times during the first postoperative year, 1 to 4 times during the second year and once or twice a year thereafter. Outcome assessment after surgery should include weight loss and maintainance, nutritional status, comorbidities and quality-of-life.

PMID: 15580436 [PubMed - indexed for MEDLINE]

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Practice parameters for the management of anal fissures (revised).

Dis Colon Rectum. 2004 Dec;47(12):2003-7

Authors: Orsay C, Rakinic J, Perry WB, Hyman N, Buie D, Cataldo P, Newstead G, Dunn G, Rafferty J, Ellis CN, Shellito P, Gregorcyk S, Ternent C, Kilkenny J, Tjandra J, Ko C, Whiteford M, Nelson R, ,

PMID: 15657647 [PubMed - indexed for MEDLINE]

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Practice management guidelines for timing of tracheostomy: the EAST Practice Management Guidelines Work Group.

J Trauma. 2009 Oct;67(4):870-4

Authors: Holevar M, Dunham JC, Brautigan R, Clancy TV, Como JJ, Ebert JB, Griffen MM, Hoff WS, Kurek SJ, Talbert SM, Tisherman SA

PMID: 19820599 [PubMed - indexed for MEDLINE]

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The international position on laparoscopic liver surgery: The Louisville Statement, 2008.

Ann Surg. 2009 Nov;250(5):825-30

Authors: Buell JF, Cherqui D, Geller DA, O’Rourke N, Iannitti D, Dagher I, Koffron AJ, Thomas M, Gayet B, Han HS, Wakabayashi G, Belli G, Kaneko H, Ker CG, Scatton O, Laurent A, Abdalla EK, Chaudhury P, Dutson E, Gamblin C, D’Angelica M, Nagorney D, Testa G, Labow D, Manas D, Poon RT, Nelson H, Martin R, Clary B, Pinson WC, Martinie J, Vauthey JN, Goldstein R, Roayaie S, Barlet D, Espat J, Abecassis M, Rees M, Fong Y, McMasters KM, Broelsch C, Busuttil R, Belghiti J, Strasberg S, Chari RS,

OBJECTIVE: To summarize the current world position on laparoscopic liver surgery. SUMMARY BACKGROUND DATA: Multiple series have reported on the safety and efficacy of laparoscopic liver surgery. Small and medium sized procedures have become commonplace in many centers, while major laparoscopic liver resections have been performed with efficacy and safety equaling open surgery in highly specialized centers. Although the field has begun to expand rapidly, no consensus meeting has been convened to discuss the evolving field of laparoscopic liver surgery. METHODS: On November 7 to 8, 2008, 45 experts in hepatobiliary surgery were invited to participate in a consensus conference convened in Louisville, KY, US. In addition, over 300 attendees were present from 5 continents. The conference was divided into sessions, with 2 moderators assigned to each, so as to stimulate discussion and highlight controversies. The format of the meeting varied from formal presentation of experiential data to expert opinion debates. Written and video records of the presentations were produced. Specific areas of discussion included indications for surgery, patient selection, surgical techniques, complications, patient safety, and surgeon training. RESULTS: The consensus conference used the terms pure laparoscopy, hand-assisted laparoscopy, and the hybrid technique to define laparoscopic liver procedures. Currently acceptable indications for laparoscopic liver resection are patients with solitary lesions, 5 cm or less, located in liver segments 2 to 6. The laparoscopic approach to left lateral sectionectomy should be considered standard practice. Although all types of liver resection can be performed laparoscopically, major liver resections (eg, right or left hepatectomies) should be reserved for experienced surgeons facile with more advanced laparoscopic hepatic resections. Conversion should be performed for difficult resections requiring extended operating times, and for patient safety, and should be considered prudent surgical practice rather than failure. In emergent situations, efforts should be made to control bleeding before converting to a formal open approach. Utilization of a hand assist or hybrid technique may be faster, safer, and more efficacious. Indications for surgery for benign hepatic lesions should not be widened simply because the surgery can be done laparoscopically. Although data presented on colorectal metastases did not reveal an adverse effect of the laparoscopic approach on oncological outcomes in terms of margins or survival, adequacy of margins and ability to detect occult lesions are concerns. The pure laparoscopic technique of left lateral sectionectomy was used for adult to child donation while the hybrid approach has been the only one reported to date in the case of adult to adult right lobe donation. Laparoscopic liver surgery has not been tested by controlled trials for efficacy or safety. A prospective randomized trial appears to be logistically prohibitive; however, an international registry should be initiated to document the role and safety of laparoscopic liver resection. CONCLUSIONS: Laparoscopic liver surgery is a safe and effective approach to the management of surgical liver disease in the hands of trained surgeons with experience in hepatobiliary and laparoscopic surgery. National and international societies, as well as governing boards, should become involved in the goal of establishing training standards and credentialing, to ensure consistent standards and clinical outcomes.

PMID: 19916210 [PubMed - indexed for MEDLINE]

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Guidelines for prehospital fluid resuscitation in the injured patient.

J Trauma. 2009 Aug;67(2):389-402

Authors: Cotton BA, Jerome R, Collier BR, Khetarpal S, Holevar M, Tucker B, Kurek S, Mowery NT, Shah K, Bromberg W, Gunter OL, Riordan WP,

Although the need and benefit of prehospital interventions has been controversial for quite some time, an increasing amount of evidence has stirred both sides into more frequent debate. Proponents of the traditional “scoop-and-run” technique argue that this approach allows a more timely transfer to definitive care facilities and limits unnecessary (and potentially harmful) procedures. However, advocates of the “stay-and-play” method point to improvement in survival to reach the hospital and better neurologic outcomes after brain injury. Given the lack of consensus, the Eastern Association for the Surgery of Trauma convened a Practice Management Guideline committee to answer the following questions regarding prehospital resuscitation: (1) should injured patients have vascular access attempted in the prehospital setting? (2) if so, what location is preferred for access? (3) if access is achieved, should intravenous fluids be administered? (4) if fluids are to be administered, which solution is preferred? and (5) if fluids are to be administered, what volume and rate should be infused?

PMID: 19667896 [PubMed - indexed for MEDLINE]

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Practice parameters for the management of hemorrhoids (revised).

Dis Colon Rectum. 2005 Feb;48(2):189-94

Authors: Cataldo P, Ellis CN, Gregorcyk S, Hyman N, Buie WD, Church J, Cohen J, Fleshner P, Kilkenny J, Ko C, Levien D, Nelson R, Newstead G, Orsay C, Perry WB, Rakinic J, Shellito P, Strong S, Ternent C, Tjandra J, Whiteford M,

PMID: 15711856 [PubMed - indexed for MEDLINE]

Practice parameters for the management of rectal cancer (revised).

Dis Colon Rectum. 2005 Mar;48(3):411-23

Authors: Tjandra JJ, Kilkenny JW, Buie WD, Hyman N, Simmang C, Anthony T, Orsay C, Church J, Otchy D, Cohen J, Place R, Denstman F, Rakinic J, Moore R, Whiteford M, ,

The American Society of Colon and Rectal Surgeons is dedicated to assuring high-quality patient care by advancing the science, prevention, and management of disorders and diseases of the colon, rectum, and anus. The Standards Committee is composed of Society members who are chosen because they have demonstrated expertise in the specialty of colon and rectal surgery. This Committee was created to lead international efforts in defining quality care for conditions related to the colon, rectum, and anus. This is accompanied by developing Clinical Practice Guidelines based on the best available evidence. These guidelines are inclusive, and not prescriptive. Their purpose is to provide information on which decisions can be made, rather than dictate a specific form of treatment. These guidelines are intended for the use of all practitioners, health care workers, and patients who desire information about the management of the conditions addressed by the topics covered in these guidelines. It should be recognized that these guidelines should not be deemed inclusive of all proper methods of care or exclusive of methods of care reasonably directed to obtaining the same results. The ultimate judgment regarding the propriety of any specific procedure must be made by the physician in light of all of the circumstances presented by the individual patient.

PMID: 15875292 [PubMed - indexed for MEDLINE]

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Practice parameters for the treatment of perianal abscess and fistula-in-ano (revised).

Dis Colon Rectum. 2005 Jul;48(7):1337-42

Authors: Whiteford MH, Kilkenny J, Hyman N, Buie WD, Cohen J, Orsay C, Dunn G, Perry WB, Ellis CN, Rakinic J, Gregorcyk S, Shellito P, Nelson R, Tjandra JJ, Newstead G, ,

The American Society of Colon and Rectal Surgeons is dedicated to assuring high-quality patient care by advancing the science, prevention, and management of disorders and diseases of the colon, rectum, and anus. The Standards Committee is composed of Society members who are chosen because they have demonstrated expertise in the specialty of colon and rectal surgery. This Committee was created to lead international efforts in defining quality care for conditions related to the colon, rectum, and anus. This is accompanied by developing Clinical Practice Guidelines based on the best available evidence. These guidelines are inclusive, and not prescriptive. Their purpose is to provide information on which decisions can be made, rather than dictate a specific form of treatment. These guidelines are intended for the use of all practitioners, health care workers, and patients who desire information about the management of the conditions addressed by the topics covered in these guidelines. It should be recognized that these guidelines should not be deemed inclusive of all proper methods of care or exclusive of methods of care reasonably directed to obtaining the same results. The ultimate judgment regarding the propriety of any specific procedure must be made by the physician in light of all of the circumstances presented by the individual patient.

PMID: 15933794 [PubMed - indexed for MEDLINE]

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Consensus guidelines for validation of virtual reality surgical simulators.

Surg Endosc. 2005 Dec;19(12):1523-32

Authors: Carter FJ, Schijven MP, Aggarwal R, Grantcharov T, Francis NK, Hanna GB, Jakimowicz JJ,

The Work Group for Evaluation and Implementation of Simulators and Skills Training Programmes is a newly formed sub-group of the European Association of Endoscopic Surgeons (EAES). This work group undertook a review of validation evidence for surgical simulators and the resulting consensus is presented in this article. Using clinical guidelines criteria, the evidence for validation for six different simulators was rated and subsequently translated to a level of recommendation for each system. The simulators could be divided into two basic types; systems for laparoscopic general surgery and flexible gastrointestinal endoscopy. Selection of simulators for inclusion in this consensus was based on their availability and relatively widespread usage as of July 2004. Whilst level 2 recommendations were achieved for a few systems, it was clear that there was an overall lack of published validation studies with rigorous experimental methodology. Since the consensus meeting, there have been a number of new articles, system upgrades and new devices available. The work group intends to update these consensus guidelines on a regular basis, with the resulting article available on the EAES website (http://www.eaes-eur.org ).

PMID: 16252077 [PubMed - indexed for MEDLINE]

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Practice parameters for the surgical treatment of ulcerative colitis.

Dis Colon Rectum. 2005 Nov;48(11):1997-2009

Authors: Cohen JL, Strong SA, Hyman NH, Buie WD, Dunn GD, Ko CY, Fleshner PR, Stahl TJ, Kim DG, Bastawrous AL, Perry WB, Cataldo PA, Rafferty JF, Ellis CN, Rakinic J, Gregorcyk S, Shellito PC, Kilkenny JW, Ternent CA, Koltun W, Tjandra JJ, Orsay CP, Whiteford MH, Penzer JR,

The American Society of Colon and Rectal Surgeons is dedicated to assuring high-quality patient care by advancing the science, prevention, and management of disorders and diseases of the colon, rectum, and anus. The Standards Committee is composed of Society members who are chosen because they have demonstrated expertise in the specialty of colon and rectal surgery. This committee was created to lead international efforts in defining quality care for conditions related to the colon, rectum, and anus. This is accompanied by developing Clinical Practice Guidelines based on the best available evidence. These guidelines are inclusive, and not prescriptive. Their purpose is to provide information on which decisions can be made, rather than dictate a specific form of treatment. These guidelines are intended for the use of all practitioners, health care workers, and patients who desire information about the management of the conditions addressed by the topics covered in these guidelines. It should be recognized that these guidelines should not be deemed inclusive of all proper methods of care or exclusive of methods of care reasonably directed to obtaining the same results. The ultimate judgment regarding the propriety of any specific procedure must be made by the physician in light of all of the circumstances presented by the individual patient.

PMID: 16258712 [PubMed - indexed for MEDLINE]

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Pain management guidelines for blunt thoracic trauma.

J Trauma. 2005 Nov;59(5):1256-67

Authors: Simon BJ, Cushman J, Barraco R, Lane V, Luchette FA, Miglietta M, Roccaforte DJ, Spector R,

PMID: 16385313 [PubMed - indexed for MEDLINE]

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Inflammation and the Host Response to Injury, a Large-Scale Collaborative Project: patient-oriented research core–standard operating procedures for clinical care. II. Guidelines for prevention, diagnosis and treatment of ventilator-associated pneumonia (VAP) in the trauma patient.

J Trauma. 2006 May;60(5):1106-13; discussion 1113

Authors: Minei JP, Nathens AB, West M, Harbrecht BG, Moore EE, Shapiro MB, Bankey PE, Johnson JL, Freeman B, McKinley BA, Moore FA, Maier RV,

PMID: 16688078 [PubMed - indexed for MEDLINE]