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3. Carbon dioxide embolism associated with transanal total mesorectal excision surgery: A report from the international registries

Author

Dickson, E. A., Penna, M., Cunningham, C., Ratcliffe, F. M., Chantler, J., Crabtree, N. A., Tuynman, J. B., Albert, M. R., Monson, J. R. T., Hompes, R., Abdelmoaty, W., Adamina, M., Aigner, F., Alavi, K., Albers, B., Al Furajii, H., Allison, A., Eduardo, S., Araujo, A., Apostolides, G. Y., Arezzo, A., Arnold, S. J., Aryal, K., Ashamalla, S., Ashraf, Sana, Attaluri, V., Austin, R., Barugo-La, G., Beggs, A., Belgers, H. J., Bell, S., Bemelman, W., Berti, S., Biebl, M., Blondeel, J., Binky, B., Baloyiannis, I. -N., Bandyopadhyay, D., Boni, L., Bordeianou, L., Box, B., Boyce, S., Brokelman, W., Brown, C. J., Bruegger, L., Buchli, C., Christian Buchs, N., Bulut, O., Burt, C., Bursics, A., Cahill, R. A., Pablo Campana, J., Caricato, M., Caro-Tar-Rago, A., Casans, F., Cassinotti, E., Caycedo-Marulan-Da, A., Chadi, S. A., Chandrasinghe, P., Chaudhri, S., Chaumont, N., Chitsabesan, P., Coget, J., Collera, P., Coleman, M., Courtney, E. D., Dagbert, F., Dalton, S. J., Daniel, G., Clark, D. A., De-Drye, L., De La Torre, J., Dapri, G., Dayal, S. P., De Chaisemartin, C., Borja De Lacy, F., Blasco Delgado, O., Di Candido, F., Diaz Del Gobbo, G., De Graaf, E. J. R., Delrio, P., De Pooter, K., D'Hooge, P., Doornebosch, P., Duff, S., Du Jardin, P., Dzhumabaev, K. E., Tom Edwards, M., Egenvall, I., Espin, E., Eugenio, M., Egenvall, M. -I., Ravn Eriksen, J., Faerden, A. E., Faes, S., Simo Fernandez, V., Fichera, A., Fierens, J., Fierens, K., Forgan, T., Francis, N., Francombe, J., Francone, E., Francone, T., Gamage, B., Perez Garcia, J. A., Ethem Gecim, I., Van Geluwe, B., Gin-Gert, C., George, V., Gloeckler, M., Gogenur, I., Goulart, A., Grolich, T., Haas, E., Hameed, U., Hahnloser, D., Harikrishnan, A., Harris, G., Haunold, I., Hendrickse, C., Hendrickx, T., Heyns, M., Horwood, J., Huerga, D., Ito, M., Jarimba, A., Joeng, H. K. M., Jones, O., Jutten, G., Kala, Z., Kita, Y., Knol, J., Thengugal Kochupapy, R., Kneist, W., Kok, A. S. Y., Kusters, M., Lacy, A. M., Laka-Tos, M., Lal, R., Lakkis, Z., Leao, P., Lambrechts, A., Lee, L., Lelong, B., Leung, E., Lezoche, E., Sender Liberman, A., Lidder, P., An-Drade Lima, M., Loganathan, A., Lombana, L. J., Lorenzon, Laura, Loriz, H., Lukas, M., Lutrin, D., Mackey, P., Mamedli, Z. Z., Mansfield, S., Marcello, P., Marcoen, S., Romero Marcos, J. M., Marcy, T., Marecik, S., Marks, J., Marsanic, P., Mattacheo, A., Maun, D., May, D., Maykel, J. A., Mcarthur, D., Mccallum, I., Mccarthy, K., Mclemore, E. C., Ramon Sil-Viera Mendes, C., Messaris, E., Michalopoulos, A., Mikalauskas, S., Miles, A., Millan, M., Mills, S., Miskovic, D., Montroni, I., Moore, E., Moore, T., Mori, Simona, Morino, M., Muratore, A., Mutafchiyski, V., Myers, A., Van Nieuwenhove, Y., Nishizawa, Y., Ng, P., John Nolan, G., Obias, V., Ochsner, A., Hwan Oh, J., Onghena, T., Oommen, S., Orkin, B. A., Osman, K., Ouro, S., Panis, Y., Papavramidis, T., Von Papen, M., Papp, G., Paquette, I., Paraoan, M. T., Paredes, J. P., Pastor, C., Pattyn, P. R. L., Karim Perdawood, S., Wan Pei, C. F., Piehslinger, J., Penchev, D., Oliva Perez, R., Persiani, Roberto, Pfeffer, F., Terry Phang, P., Pokela, V., Picchetto, A., Poskus, E., Prieto, D., Que-Reshy, F. A., Ramcharan, S., Rauch, S., Rega, D., Reyes, J. C., Ris, F., Delgado Rivilla, S., Alexander Rockall, T., Roquete, P., Rossi, G., Ruffo, G., Sakai, Y. -S., Sands, D., Sao Juliao, G. P., Scala, Alessandro, Scala, D., Estevez Schwarz, L., Edmond Seid, V., Seitinger, G., Shaikh, I. A., Sharma, A., Siet-Ses, C., Singh, B., Helmer Sjo, O., Kyung Sohn, D., Sora-Via, C., Sosef, M. N., Spinelli, A., Speakman, C., Steele, S., Stephan, V., Stevenson, A. R. L., Stotland, P., Studer, P., Strypstein, S., Sylla, P., Szyszkowitz, A., Talwar, A., Tanis, P., Tejedor, P., Pastor Teso, E., Tognelli, J., Torkington, J., Tschann, P., Tuech, J. -J., Tuerler, A., Tzovaras, G., Ugolini, G., Vallribera, F., Vansteenkiste, F., Vangenechten, E., Verdaasdonk, E. G. G., Vilela, N., Walter, B., Warren, O. J., Visser, T., Warrier, S., Warner, M., Waru-Savitarne, J., Whiteford, M. H., Andreas Wik, T., Witzig, J. -A., Wolff, T., Wolthuis, A. M., Wynn, G., Ashraf S., Lorenzon L. (ORCID:0000-0001-6736-0383), Mori S., Persiani R. (ORCID:0000-0002-1537-5097), Scala A., Dickson, E. A., Penna, M., Cunningham, C., Ratcliffe, F. M., Chantler, J., Crabtree, N. A., Tuynman, J. B., Albert, M. R., Monson, J. R. T., Hompes, R., Abdelmoaty, W., Adamina, M., Aigner, F., Alavi, K., Albers, B., Al Furajii, H., Allison, A., Eduardo, S., Araujo, A., Apostolides, G. Y., Arezzo, A., Arnold, S. J., Aryal, K., Ashamalla, S., Ashraf, Sana, Attaluri, V., Austin, R., Barugo-La, G., Beggs, A., Belgers, H. J., Bell, S., Bemelman, W., Berti, S., Biebl, M., Blondeel, J., Binky, B., Baloyiannis, I. -N., Bandyopadhyay, D., Boni, L., Bordeianou, L., Box, B., Boyce, S., Brokelman, W., Brown, C. J., Bruegger, L., Buchli, C., Christian Buchs, N., Bulut, O., Burt, C., Bursics, A., Cahill, R. A., Pablo Campana, J., Caricato, M., Caro-Tar-Rago, A., Casans, F., Cassinotti, E., Caycedo-Marulan-Da, A., Chadi, S. A., Chandrasinghe, P., Chaudhri, S., Chaumont, N., Chitsabesan, P., Coget, J., Collera, P., Coleman, M., Courtney, E. D., Dagbert, F., Dalton, S. J., Daniel, G., Clark, D. A., De-Drye, L., De La Torre, J., Dapri, G., Dayal, S. P., De Chaisemartin, C., Borja De Lacy, F., Blasco Delgado, O., Di Candido, F., Diaz Del Gobbo, G., De Graaf, E. J. R., Delrio, P., De Pooter, K., D'Hooge, P., Doornebosch, P., Duff, S., Du Jardin, P., Dzhumabaev, K. E., Tom Edwards, M., Egenvall, I., Espin, E., Eugenio, M., Egenvall, M. -I., Ravn Eriksen, J., Faerden, A. E., Faes, S., Simo Fernandez, V., Fichera, A., Fierens, J., Fierens, K., Forgan, T., Francis, N., Francombe, J., Francone, E., Francone, T., Gamage, B., Perez Garcia, J. A., Ethem Gecim, I., Van Geluwe, B., Gin-Gert, C., George, V., Gloeckler, M., Gogenur, I., Goulart, A., Grolich, T., Haas, E., Hameed, U., Hahnloser, D., Harikrishnan, A., Harris, G., Haunold, I., Hendrickse, C., Hendrickx, T., Heyns, M., Horwood, J., Huerga, D., Ito, M., Jarimba, A., Joeng, H. K. M., Jones, O., Jutten, G., Kala, Z., Kita, Y., Knol, J., Thengugal Kochupapy, R., Kneist, W., Kok, A. S. Y., Kusters, M., Lacy, A. M., Laka-Tos, M., Lal, R., Lakkis, Z., Leao, P., Lambrechts, A., Lee, L., Lelong, B., Leung, E., Lezoche, E., Sender Liberman, A., Lidder, P., An-Drade Lima, M., Loganathan, A., Lombana, L. J., Lorenzon, Laura, Loriz, H., Lukas, M., Lutrin, D., Mackey, P., Mamedli, Z. Z., Mansfield, S., Marcello, P., Marcoen, S., Romero Marcos, J. M., Marcy, T., Marecik, S., Marks, J., Marsanic, P., Mattacheo, A., Maun, D., May, D., Maykel, J. A., Mcarthur, D., Mccallum, I., Mccarthy, K., Mclemore, E. C., Ramon Sil-Viera Mendes, C., Messaris, E., Michalopoulos, A., Mikalauskas, S., Miles, A., Millan, M., Mills, S., Miskovic, D., Montroni, I., Moore, E., Moore, T., Mori, Simona, Morino, M., Muratore, A., Mutafchiyski, V., Myers, A., Van Nieuwenhove, Y., Nishizawa, Y., Ng, P., John Nolan, G., Obias, V., Ochsner, A., Hwan Oh, J., Onghena, T., Oommen, S., Orkin, B. A., Osman, K., Ouro, S., Panis, Y., Papavramidis, T., Von Papen, M., Papp, G., Paquette, I., Paraoan, M. T., Paredes, J. P., Pastor, C., Pattyn, P. R. L., Karim Perdawood, S., Wan Pei, C. F., Piehslinger, J., Penchev, D., Oliva Perez, R., Persiani, Roberto, Pfeffer, F., Terry Phang, P., Pokela, V., Picchetto, A., Poskus, E., Prieto, D., Que-Reshy, F. A., Ramcharan, S., Rauch, S., Rega, D., Reyes, J. C., Ris, F., Delgado Rivilla, S., Alexander Rockall, T., Roquete, P., Rossi, G., Ruffo, G., Sakai, Y. -S., Sands, D., Sao Juliao, G. P., Scala, Alessandro, Scala, D., Estevez Schwarz, L., Edmond Seid, V., Seitinger, G., Shaikh, I. A., Sharma, A., Siet-Ses, C., Singh, B., Helmer Sjo, O., Kyung Sohn, D., Sora-Via, C., Sosef, M. N., Spinelli, A., Speakman, C., Steele, S., Stephan, V., Stevenson, A. R. L., Stotland, P., Studer, P., Strypstein, S., Sylla, P., Szyszkowitz, A., Talwar, A., Tanis, P., Tejedor, P., Pastor Teso, E., Tognelli, J., Torkington, J., Tschann, P., Tuech, J. -J., Tuerler, A., Tzovaras, G., Ugolini, G., Vallribera, F., Vansteenkiste, F., Vangenechten, E., Verdaasdonk, E. G. G., Vilela, N., Walter, B., Warren, O. J., Visser, T., Warrier, S., Warner, M., Waru-Savitarne, J., Whiteford, M. H., Andreas Wik, T., Witzig, J. -A., Wolff, T., Wolthuis, A. M., Wynn, G., Ashraf S., Lorenzon L. (ORCID:0000-0001-6736-0383), Mori S., Persiani R. (ORCID:0000-0002-1537-5097), and Scala A.

Abstract

BACKGROUND: Carbon dioxide embolus has been reported as a rare but clinically important risk associated with transanal total mesorectal excision surgery. To date, there exists limited data describing the incidence, risk factors, and management of carbon dioxide embolus in transanal total mesorectal excision. OBJECTIVE: This study aimed to obtain data from the transanal total mesorectal excision registries to identify trends and potential risk factors for carbon dioxide embolus specific to this surgical technique. DESIGN: Contributors to both the LOREC and OSTRiCh transanal total mesorectal excision registries were invited to report their incidence of carbon dioxide embolus. Case report forms were collected detailing the patient-specific and technical factors of each event. SETTINGS: The study was conducted at the collaborating centers from the international transanal total mesorectal excision registries. MAIN OUTCOME MEASURES: Characteristics and outcomes of patients with carbon dioxide embolus associated with transanal mesorectal excision were measured. RESULTS: Twenty-five cases were reported. The incidence of carbon dioxide embolus during transanal total mesorectal excision is estimated to be ≈0.4% (25/6375 cases). A fall in end tidal carbon dioxide was noted as the initial feature in 22 cases, with 13 (52%) developing signs of hemodynamic compromise. All of the events occurred in the transanal component of dissection, with mean (range) insufflation pressures of 15 mm Hg (12-20 mm Hg). Patients were predominantly (68%) in a Trendelenburg position, between 30° and 45°. Venous bleeding was reported in 20 cases at the time of carbon dioxide embolus, with periprostatic veins documented as the most common site (40%). After carbon dioxide embolus, 84% of cases were completed after hemodynamic stabilization. Two patients required cardiopulmonary resuscitation because of cardiovascular collapse. There were no deaths. LIMITATIONS: This is a retrospective study surveying r

Published
2019

4. Occupational health and safety are prerequisites for efficient production.

Author

Sohn D., The power of mining: energy's influence, SME annual meeting and CMA 109th National western mining conference Denver, Colorado Society for Mining, Metallurgy and Exploration; Colorado Mining Association 25-28 Feb 2007 , no.07-094, Sohn D., and The power of mining: energy's influence, SME annual meeting and CMA 109th National western mining conference Denver, Colorado Society for Mining, Metallurgy and Exploration; Colorado Mining Association 25-28 Feb 2007 , no.07-094

Abstract

Reductions in injuries have been achieved in the German coal mining industry against the background of increasing production. The sustainable development of occupational health and safety is considered and the key elements of a safety management system described, including integrating health and safety into all operational processes, understanding the importance of preventive measures in relation to health and safety, development of target group-oriented programmes in health and safety, improving the motivation of all those involved in health and safety and implementation of a continuous improvement process., Reductions in injuries have been achieved in the German coal mining industry against the background of increasing production. The sustainable development of occupational health and safety is considered and the key elements of a safety management system described, including integrating health and safety into all operational processes, understanding the importance of preventive measures in relation to health and safety, development of target group-oriented programmes in health and safety, improving the motivation of all those involved in health and safety and implementation of a continuous improvement process.

Published
2007

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