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Petachia Reissman

Publications and source records attributed to Petachia Reissman.

9 recordsLinked to original sources
PubMed2026

Long-term outcomes of non-operative compared to operative management of acute uncomplicated appendicitis - a systematic review and meta-analysis.

BACKGROUND: We evaluated long-term outcomes of non-operative management (NOM) versus surgical management of acute uncomplicated appendicitis. METHODS: Systematic review of studies comparing NOM versus surgery with ≥2 years follow-up. Primary outcome was long-term failure rate. RESULTS: 9/1635 studies were included (3 RCTs; 6 non-RCT studies), involving 3883 patients; 5 were in pediatric populations. Median follow-up was 33.6 (range 24-312) months. NOM pooled long-term failure rate was 38.9% (95% CI: 31.1%-46.7%), increasing to 44.4% (95% CI: 41.4%-47.4%) in RCTs. Pooled appendectomy rate after NOM was 36.3% (95% CI: 28.9%-43.7%). Incidence of appendiceal neoplasms was approximately 0.3%. Non-operative management had cost savings of €1535 (95% CI: -€1892 to -€1178) versus surgery. CONCLUSIONS: NOM of acute uncomplicated appendicitis was associated with high long-term failure rates and significant risk of subsequent appendectomy.

Humans↗
PubMed2006

Surgeon and hospital leadership during terrorist-related multiple-casualty events: a coup d'état.

HYPOTHESIS: During terrorist-related multiple-casualty events (TMCEs), the role of the surgeon expands beyond providing traditional trauma care. DESIGN: Survey and expert opinion poll. SETTING: Interviews (structured, open/closed questions) conducted in 14 Israeli hospitals. PARTICIPANTS: Sixty hospital physicians selected for their experience in TMCEs. MAIN OUTCOME MEASURES: Identification of key staff members and their roles during TMCEs and development of recommendations for hospital management. RESULTS: During TMCEs, hospitals are comanaged by a physician hospital administrator and a clinical medical director (usually a surgeon) responsible for prioritization of patient care. Primary triage is often performed by a general surgeon experienced in trauma. Trauma specialists supervise other physicians providing patient care. Key staff members to recruit to the hospital at event onset include the chiefs of surgery and anesthesiology, attending surgeons and anesthesiologists, critical care physicians, and radiologists. Paramedics stationed in-hospital as emergency medical services liaisons improve communication between the field and the hospital. Operating room and intensive care unit (ICU) management remain unchanged. Controversies exist regarding continuation of planned and ongoing elective surgery and ICU triage despite use of the postanesthesia care unit as an extension of the ICU. CONCLUSIONS: During TMCEs, surgeons fill pivotal roles in hospital command and control and hands-on clinical care. Anesthesiology services and ICUs are relied on heavily for provision of patient care and should be included in information flow and decision making. Operating room and ICU management should remain unchanged since the care of patients who are already in these locations at the time disaster strikes is a subject of controversy with ethical implications.

General Surgery↗
PubMed2005

Blast lung injury: clinical manifestations, treatment, and outcome.

BACKGROUND: Blast lung injury (BLI) is a major cause of morbidity after terrorist bomb attacks (TBAs) and is seen with increasing frequency worldwide. Yet, many surgeons and intensivists have little experience treating BLI. Jerusalem sustained 31 TBAs since 1983, resulting in a local expertise in treating BLI. METHODS: A retrospective study of clinical and radiologic characteristics, management, and outcome of victims of TBAs sustaining BLI who were admitted to ICU during December 1983 to February 2004. Long-term outcome was determined by a telephone interview. RESULTS: Twenty-nine patients met inclusion criteria. Hypoxia and pulmonary infiltrates in chest x-ray were sine qua non for the diagnosis. Seventy-six percent required mechanical ventilation, all within 2 hours of admission. One patient died. Seventy-six percent had no long-term sequelae. CONCLUSIONS: Most patients with significant BLI injury require mechanical ventilation. Late deterioration is rare. Death because of BLI in patients who survived the explosion is unusual. Timely diagnosis and correct treatment result in excellent outcome.

Adolescent↗
PubMed2005

Perioperative management of patients undergoing elective colorectal surgery in Israel: a national survey.

BACKGROUND: The approach to perioperative antibiotic prophylaxis, bowel preparation, and postoperative routines in elective colorectal resections has changed over the last two decades. The aim of this national survey was to document the current methods of perioperative management of those patients scheduled for elective colorectal resections in surgical departments in Israel. METHODS: A mail and telephone survey of surgical departments was conducted in 2001 in order to evaluate the routines of perioperative management of elective colorectal resections. Re-evaluation was performed in 2004. RESULTS: In 2001, all but one of the responders used low-residue diet preoperatively and combined oral and parenteral antibiotic prophylaxis. Polyethylene glycol or sodium phosphate bowel preparation was used by 69% of the responders. The most common oral regimens were a combination of neomycin plus metronidazole (43.5%) or neomycin plus erythromycin (47.8%). The most common parenteral regimens used were gentamicin plus metronidazole or gentamicin plus metronidazole plus ampicillin (56.5% and 17% of the responders, respectively). Cephalosporins alone or in combination were used in three departments. In 17 departments (74%), parenteral prophylactic antibiotics were continued for 24 h or longer (up to 72 h). All but one of the departments left a nasogastric tube for 1-5 days after surgery. There were substantial changes over the last three years-that is, less use of preoperative restriction diets, shorter duration of perioperative antibiotic coverage, more common use of cephalosporins, switch to sodium dihydrogen and sodium hydrogen phosphate bowel preparation, shorter use of postoperative nasogastric drainage, and faster resumption of peroral fluids. CONCLUSIONS: In 2001, the majority of surgical departments in Israel used a conservative approach to perioperative management of patients undergoing elective colorectal resections. Significant changes occurred during the last three years. The perioperative routines used today in most general surgery departments in Israel comply with current recommendations.

Antibiotic Prophylaxis↗
PubMed2004

Neoadjuvant imatinib for unresectable gastrointestinal stromal tumor.

We have evaluated the feasibility of the use of neoadjuvant imatinib mesylate in the management of unresectable localized gastrointestinal stromal tumors. In a pilot experience, two patients with unresectable gastrointestinal tumors were treated with neoadjuvant imatinib. Their treatment course and surgical outcomes are described. In both cases, the patient attained sufficient tumor regression to enable complete resection of tumor. We conclude that in the management of unresectable gastrointestinal stromal tumors, neoadjuvant administration of imatinib may facilitate sufficient tumor regression to facilitate subsequent tumor resection with curative intent.

Benzamides↗
PubMed2004

Laparoscopic nephrectomy for infected, obstructed and non-functioning kidneys.

Since laparoscopic nephrectomy was introduced by Clayman et al, it has been doubted whether it should be employed in patients with extensive perirenal fibrosis. In this series, 20 consecutive patients underwent laparoscopic nephrectomy for obstructed, infected, non-functioning kidneys. Preoperative assessment included urine cultures, abdominal sonography, intravenous pyelography, computerized tomography and a renal scan. Laparoscopic nephrectomies were performed using either the transperitoneal or the retroperitoneal approach.Patients' mean age was 52 years (range 20-77, SD = 15.2). Three patients underwent previous open surgery on the same kidney and 15 had percutaneous nephrostomies. The etiology of obstruction was stone disease in 15 cases, uretero-pelvic junction obstruction (3), iatrogenic ureteral injury (1), and infected multicystic kidney (1). Mean operative time was 224 minutes (range 140-325, SD = 57). Conversion to open surgery was necessary in one patient due to splenic injury. Mean hospital stay was 3 days (range 2-6, SD = 1). Laparoscopic nephrectomy was feasible in cases of severe perirenal fibrosis, with an acceptable rate of complications, and may be considered in patients with obstructed, infected, and non-functioning kidneys.

Adult↗
PubMed2003

Pressure-related hemodynamic effects of CO2 pneumoperitoneum in a model of acute cardiac failure.

BACKGROUND: The adverse effects related to CO2 pneumoperitoneum (PP) have been well documented. Although these effects in the state of cardiac failure have not been investigated, it appears to be common current clinical practice to use low-pressure PP in this clinical setting, assuming it to be safer. OBJECTIVE: The aim of our study was to compare the hemodynamic changes with the application of conventional 15 mm Hg PP versus low-pressure 10 mm Hg PP in control and acute cardiac failure (ACF) animal models. METHODS: We studied changes in cardiac output (CO), stroke volume (SV), and systemic vascular resistance (SVR), applying 10 mm Hg and 15 mm Hg CO2 PP in control and, following the pharmacological induction of acute cardiac failure, in 10 domestic pigs. RESULTS: In control, the application of 10 mm Hg PP did not cause any significant hemodynamic changes compared to baseline parameters. The use of 15 mm Hg PP in the model with normal cardiac function, however, produced a significant change in the tested hemodynamic values: CO decreased from 3.8L/min to 2.8L/min (P =.0018); SV declined from 38 mL to 30 mL (P =.046); SVR increased from 1677 dyne.s.cm-5 to 2414 dyne.s.cm-5 (P =.049) compared to baseline. In the model of ACF induced by the intravenous infusion of sodium pentobarbital, the application of either 10 mm Hg or 15 mm Hg PP was found to have a similar hemodynamic trend: CO, 1.65 L/min vs. 1.41 L/min; SV, 23.2 L vs. 20.9 L; SVR, 2487 dyne.s.cm-5 vs. 2597 dyne.s.cm-5 (P = NS for all). CONCLUSIONS: The application of low-pressure 10 mm Hg PP, compared to conventional 15 mm Hg PP, in the animal model of ACF does not appear to have any hemodynamic advantages.

Acute Disease↗
PubMed2003

Laparoscopy for adhesions.

Intestinal and abdominal adhesions may be responsible for a variety of clinical conditions, including chronic recurrent small-bowel obstruction, acute small-bowel obstruction, closed-loop bowel obstruction and, debatably, abdominal or pelvic pain. Experience in laparoscopic surgery has increased at a rapid pace, thus adhesions are no longer considered a contraindication to treatment of these conditions. In recent years, numerous publications have reported the feasibility, safety, and favorable outcome of laparoscopic intervention in various adhesion-related conditions. As adhesions are the most common cause of recurrent or acute bowel obstruction, this review will focus on the laparoscopic management of these conditions and outline the technical considerations, indications, contraindications, and results.

Abdominal Pain↗