Core Topics in General & Emergency Surgery: Companion to Specialist Surgical Practice (96 page)

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Authors: Simon Paterson-Brown MBBS MPhil MS FRCS

Q

Quality-adjusted life-years (QALYs),
28–30
See also
Economic evaluation
Question protocol,
8
Questionnaires, day case surgery,
47
QUORUM statement,
7

R

RAAA-POSSUM (ruptured abdominal aortic aneurysms),
289–290
Radiation enteritis,
162
Radiography, abdominal trauma,
231
Radiological imaging
acute abdomen,
87–95
acute pancreatitis,
145
biliary colic,
133–134
,
133f
contrast,
87–91
perianal abscess,
205–206
,
206f
plain,
87
,
87f
,
88f
Radionuclide imaging,
198
Random-effect model (meta-analysis),
9
Randomised controlled trials (RCTs),
5–8
,
6t
Ranson scoring system,
145
Rating scales vs visual analogue scales (VAS),
29
Recommendations, grading,
15t
,
16
Rectum injury scale,
261t
Recurrent inguinal hernias,
70–71
Recurrent peptic ulcer bleeding,
126–128
Re-feeding syndrome,
314–315
Regional anaesthesia,
49
,
49t
Regional trauma systems,
230
Reliability, defined,
24
Remifentanil,
48
Renal function,
238–239
Renin,
309b
Resources
evidence,
3–5
Respiratory function,
239
Respiratory muscle,
313
Resting metabolic rate (RMR),
292
Resuscitation, postoperative,
237
Retinol-binding protein,
313
Review Body for International Procedures (ReBIP),
5
Reviewers’ Handbook (Cochrane Library),
5
,
9
Revised cardiac risk index (RCRI),
291
,
292f
,
292t
Ribonucleic acid,
322
Richter hernia,
163
Risk
prediction models,
287–291
scoring systems,
287
See also
Surgical risk
Rivaroxaban,
274
,
278
,
280
Rockall score,
117–118
,
119t
Ropivacaine,
49t
Roux-en-Y,
104
,
346
,
346f
Royal College of Psychiatrists,
4
Royal College of Surgeons of England,
18
,
42
,
175
,
304
,
333
emergency/elective care,
82
,
83b
Ruptured abdominal aortic aneurysms (RAAAs),
289–290

S

Sandwich technique,
237
Scopinaro procedure,
347
Scoring systems,
287–291
SCOTIA study,
190
Scottish Intercollegiate Guidelines Network (SIGN),
12
,
274b
Scottish Medicines Consortium,
280
Scrotum injury scale,
266t
Sedation,
48
Sedo-analgesia,
48
Selective mesenteric embolisation,
127–128
,
127f
Selective non-operative management (SNOM),
248–249
,
250b
Selenium,
311b
,
322
Self-expandable covered stents (SEMS),
108
Sensitivity analysis,
36–37
Sepsis
defined,
329b
metabolic response,
310
See also
Abdominal sepsis
Septic shock, defined,
329b
Serum proteins,
312–313
Severe acute pancreatitis, defined,
142b
Severe sepsis, defined,
329b
SF-6D questionnaire,
27
,
29–30
SF-36 questionnaire,
27
,
29–30
Short stay cases,
53
Shouldice technique,
69b
Sickle cell disease,
47
Sigmoid volvulus,
182–183
,
182f
Skeletal muscle,
313
Skin erosion,
353
,
353f
Sleeve gastrectomy,
346–347
,
347f
complications,
351t
,
353–354
Sleeve stenosis,
354
Small-bowel enterotomy,
354
Small-bowel injury scale,
260t
Small-bowel obstruction,
88–90
,
89f
,
158–164
causes,
159b
early,
354
,
355f
investigations,
160
,
160f
management
initial,
159–160
non-operative,
160–161
mechanism,
158–159
presentation,
159
special conditions,
162–164
abdominal wall hernia,
163
,
163f
connective tissue disorders,
164
enterolith obstruction,
163–164
intestinal obstruction, postoperative,
164
intussusception,
164
laparoscopy,
164
,
164f
malignant obstruction,
162–163
radiation enteritis,
162
surgery,
161–162
,
161b
operative principles,
161–162
Smoking,
45
SNAP (Sepsis, Nutrition, Anatomy, Procedure) fistula care,
339–340
Soave procedure,
219
Social factors,
44
Somatostatin,
120
Special formulations,
316
Spinal anaesthesia,
49
Splanchnic circulation,
300
Spleen injury
blunt,
250
scale,
258t
selective non-operative management (SNOM),
249
,
249b
Splenic infarction,
353
Standard gamble method,
29
Staphylococcus aureus
, methicillin-resistant (MRSA),
76–77
Staple-line bleed,
353
,
354
Staple-line leak,
353
,
354
,
354b
Stasis,
269
Stercoral perforation,
194–195
diagnostic criteria,
195
Stomach injury scale,
260t
Stoppa technique,
70
Strategic Health Authorities (SHAs),
50
STROBE statement (Strengthening the Reporting of Observational Studies in Epidemiology),
7
Structure, in healthcare delivery,
18
Studies
applicability,
15
robustness of findings,
15
type/quality,
14
Subcutaneous fat thickness,
312
Subjective global assessment,
314–315
Sublay technique, open,
74–75
,
74f
,
75f
Submucosal tumours, endotherapy,
110
Subspecialisation, emergency general surgery,
83
Superficial thrombophlebitis (STP),
272
Superior mesenteric artery (SMA),
179–180
Surgical mortality probability model (SMPM),
291
,
291t
Surgical nutrition,
307–327
energy requirements,
311
,
311b
malnutrition,
307
,
312–315
anthropometric measures,
312
biochemical measures,
312–313
function tests,
313
status assessment,
313–315
metabolic responses,
307–310
minerals/micronutrients,
310
,
311–312
,
311b
nutritional support,
315–320
acute pancreatitis,
321
bariatric patients,
354b
enterocutaneous fistulas,
322
inflammatory bowel disease,
321–322
key nutrient supplementation,
322–325
,
323f
,
324f
major burns,
322
monitoring,
320
multidisciplinary teams,
320
perioperative period,
320–321
routes,
315
proteins/amino acids,
308–309
,
310
Surgical risk,
286–297
assessment methods,
286–287
,
287t
biomarkers,
294
clinical assessment,
287
communicating risk,
294–296
definition, GMC,
286b
functional assessment,
291–294
,
292t
prediction models/scoring systems,
287–291
reasons to assess,
286
,
286b
Surviving Sepsis Campaign,
330
,
330b
Swenson procedure,
219
Systematic literature reviews,
8–9
Systemic inflammatory response syndrome (SIRS),
328
,
329–330
defined,
328–329
,
329b

T

Tariffs/commissioning,
54
Tazobactam,
141
Tension-free prosthetic mesh repair, inguinal hernias,
66–68
,
66f
,
67f
,
70
Testis injury scale,
266t
Testosterone,
309b
Tetracaine (amethocaine),
49
,
49t
Thermal methods, peptic ulcers,
123
Thiamine,
311b
deficiency,
315b
Thoracic vascular injury scale,
257t
Threshold analysis,
36
Thrombocytopenia (HIT), heparin-induced,
271
Thrombolysis,
280
Thrombophlebitis (STP), superficial,
272
Thromboprophylaxis,
273–274
duration,
274
methods,
273
mechanical,
273
pharmacological,
273–274
Thrombosed haemorrhoids,
210–211
,
211t
Thrombus formation,
269
,
269b
Thyroid hormones,
309b
Time trade-off method,
29
Tonsillectomies,
51
Totally extraperitoneal prosthetic (TEP) repair,
68–69
,
70–71
Toxic colitis,
193–194
Transabdominal pre-peritoneal prosthetic (TAPP) repair,
68
,
70–71
Transarterial angiographic embolisation (TAE),
127
,
127f
Transferrin,
313
Transition zone, Hirschsprung’s disease (HD),
219
Transurethral resection of the prostate (TURP),
51
Transverse colonic volvulus,
184
Trauma
abdominal
See
Abdominal trauma
anorectal,
211
children,
226–227
metabolic response,
308–310
,
308f
,
309b
Travel, venous thromboembolism (VTE),
272
‘Trolley’ of procedures, day case surgery,
42
,
43b
,
46
Tumours, mucosal/submucosal,
110
Typhlitis,
193
,
193f

U

Ultrasound (US)
abdominal trauma,
232
acute abdomen,
91
,
91f
,
92f
endoscopic (EUS),
134b
,
151b
venous,
276
Umbilical hernias,
61–63
infantile,
61–62
clinical presentation,
61
complications,
62
management,
61–62
operative details,
62
adult,
63
congenital,
61
clinical presentation,
61
management,
61
para-,
61
,
62–63
clinical presentation,
62
complications,
63
management,
62–63
,
62f
operative details,
62–63
Uncontrolled systemic cytokine release,
329
Unfractionated heparin (UFH),
271
,
274
,
278–279
‘Unproven’, defined,
15
Upper gastrointestinal (UGI) tract, bleeding,
117–131
aetiology,
117–118
assessment/triage,
118–119
scoring systems,
118–119
,
119t
endoscopy,
120–121
technique,
120–121
Helicobacter pylori
eradication,
128
management,
119–120
,
121
blood/blood products,
119
massive haemorrhage,
119
pharmacological treatment,
120
management algorithm,
128f
non-steroidal anti-inflammatory drugs (NSAIDS),
128
peptic ulcers
See
Peptic ulcers, bleeding
Upper gastrointestinal (UGI) tract, perforations,
100–116
corrosive,
110
duodenal/jejunal, ERCP,
110–112
endotherapy, mucosal/submucosal tumours,
110
Ureter injury scale,
263t
Urethra injury scale,
264t
Uterus injury scale
pregnant,
264t
non-pregnant,
264t
Utilities,
29–30

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