114 research outputs found

    Intraperitoneal drain placement and outcomes after elective colorectal surgery: international matched, prospective, cohort study

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    Despite current guidelines, intraperitoneal drain placement after elective colorectal surgery remains widespread. Drains were not associated with earlier detection of intraperitoneal collections, but were associated with prolonged hospital stay and increased risk of surgical-site infections.Background Many surgeons routinely place intraperitoneal drains after elective colorectal surgery. However, enhanced recovery after surgery guidelines recommend against their routine use owing to a lack of clear clinical benefit. This study aimed to describe international variation in intraperitoneal drain placement and the safety of this practice. Methods COMPASS (COMPlicAted intra-abdominal collectionS after colorectal Surgery) was a prospective, international, cohort study which enrolled consecutive adults undergoing elective colorectal surgery (February to March 2020). The primary outcome was the rate of intraperitoneal drain placement. Secondary outcomes included: rate and time to diagnosis of postoperative intraperitoneal collections; rate of surgical site infections (SSIs); time to discharge; and 30-day major postoperative complications (Clavien-Dindo grade at least III). After propensity score matching, multivariable logistic regression and Cox proportional hazards regression were used to estimate the independent association of the secondary outcomes with drain placement. Results Overall, 1805 patients from 22 countries were included (798 women, 44.2 per cent; median age 67.0 years). The drain insertion rate was 51.9 per cent (937 patients). After matching, drains were not associated with reduced rates (odds ratio (OR) 1.33, 95 per cent c.i. 0.79 to 2.23; P = 0.287) or earlier detection (hazard ratio (HR) 0.87, 0.33 to 2.31; P = 0.780) of collections. Although not associated with worse major postoperative complications (OR 1.09, 0.68 to 1.75; P = 0.709), drains were associated with delayed hospital discharge (HR 0.58, 0.52 to 0.66; P < 0.001) and an increased risk of SSIs (OR 2.47, 1.50 to 4.05; P < 0.001). Conclusion Intraperitoneal drain placement after elective colorectal surgery is not associated with earlier detection of postoperative collections, but prolongs hospital stay and increases SSI risk

    Agostini Zefirino

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    Sacerdote veronese, fondatore di un istituto di suore dedite all'assistenza e all'educazione delle ragazze nella Verona dell'800

    L'Istituto "privato" e "vescovile" per i sordomuti di Trento

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    Nascita ed evoluzione dell'istituto per sordomuti di Trento, privato e vescovile

    Bardellini Filippo

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    Filippo Bardellini si occup\uf2 soprattutto di handicap e fond\uf2 alcune istituzioni allo scopo

    Garbini Adriano

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    Professore, esperto in educazione fisica su cui ha scritto alcuni trattati, \ue8 presidente della Lega di insegnamento a Verona nel XIX secolo

    Calabria Giovanni

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    Giovanni Calabria ha fondato un istituto per l'assistenza dei bambini poveri nel 1907 per insegnare loro una profession

    Rossi Alessandro

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    Alessandro Rossi, industriale e filantropo, sviluppa l'industria tessile a Schio e s'interessa della formazione dei suoi operai e delle loro famiglie

    L'evoluzione dell'educazione femminile nella Verona dell'Ottocento

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    L'evoluzione delle strutture di educazione presenti a Verona e provincia nell'Ottocento. Le istituzioni educative femminili, dalle riforme napoleoniche al periodo asburgico. Il posto della donna nella societ\ue0

    Scopoli Giovanni

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    Scopoli Giovanni ha avuto diversi incarichi nel Governo del periodo napoleonico, prefetto, direttore generale della pubblica istruzione dal 1809 al 1817
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