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Papers by Michael El Boghdady
Acta chirurgica Belgica, Jun 28, 2024
Bulletin of the Royal College of Surgeons of England, Jun 1, 2024
Deleted Journal, Apr 12, 2024
Introduction: Even though acute appendicitis is the world's most common emergency general surgica... more Introduction: Even though acute appendicitis is the world's most common emergency general surgical operation, it remains under-researcher with wide variations in care. The aim of this review was to present current evidence on the management of acute appendicitis, focusing on risk assessment, diagnostic modalities, treatment strategies, and special considerations for specific patient populations. Methods: We conducted a modified, scoping Delphi to prioritise topic areas for inclusion in this review. Consensus was achieved when each topic had >70% for either important or strongly important. Scoping reviews of current and grey literature were conducted to identify relevant evidence, focussing on new publications in the last 5 years (2019-2024). Results: Validated risk scoring systems, such as the Adult Appendicitis Score and the AIRS score, aid in identifying low-risk patients suitable for ambulatory management, while imaging modalities, including CT scans and ultrasound, play a pivotal role in confirming diagnosis and guiding treatment decisions. The review highlights the efficacy of surgical intervention versus antibiotic therapy, emphasising the importance of shared decisionmaking and individualised treatment plans. Tailored care strategies are needed for elderly patients, pregnant women, and those with appendiceal neoplasms whilst strategies for optimising antibiotic stewardship, minimising negative appendectomy rates, and enhancing postoperative care will provide the best evidence-based care. Discussion: This review provides evidence-based practices can be integrated into routine clinical care and ongoing education for frontline clinicians. The practice recommendations are designed to be evidence based and can be tailored depending on local resources. These should form the basis of future educational packages and surgical training programmes.
Indian journal of surgery, Apr 11, 2024
International Journal of Health Sciences and Research, Dec 4, 2023
Objectives: The outbreak of the virus infection Monkeypox (Mpox) in England was on transmission l... more Objectives: The outbreak of the virus infection Monkeypox (Mpox) in England was on transmission level 2. Mpox and HIV infections may occur simultaneously among the MSM population, exacerbating the symptoms along with treating problems. We aimed to study if Mpox painful genital symptoms correlated with immunocompromised status, sexuality, admissions and length of hospital stay. Methods: A retrospective data analysis was conducted. The admissions were divided into four groups named: perianal, penile, rectal and other symptoms. Correlations between patients' pain groups, sexuality or immunocompromised status as well as length of hospital stay were studied. Significances were computed by Spearman's rho correlation and Kruskal-Wallis H analyses of variance. Results: Sixty-nine patients were included, 65 males with mean age=38,5 (SD 8.29; Md=39) and females' mean age=35.5 (SD 9.04; Md= 39.5) years (n.s.). The two gender's Mpox pain areas differed from each other (p= .014). A total of 38% of the male patients presented painful perianal or rectal lesions and 22 males displayed general symptoms and 17 acknowledged MSM. A total of 40% of the males were sexually active with multiple partners; an inverse correlation between males with MSM and males with HIV (rho [25] =-.385*, p= .029, 1-tailed) was revealed. Altogether 23% of males presented HIV and 8% suffered from additional STI. Those with rectal pain had the longest hospital stay with a mean of 6.0 (SD 7.63) days (p= .017) compared to other groups. Conclusion: Correlations between patients diagnosed with Mpox and genital symptoms were revealed as opposed to inverse correlations between immunocompromised status/HIV and MSM.
British Journal of Surgery
Introduction Racial discrimination indicates the unkind conduct towards other persons based on th... more Introduction Racial discrimination indicates the unkind conduct towards other persons based on their race or skin color. We aimed to systematically review racial discrimination in surgery and answer the following questions:1) Does racial/ethnic discrimination in surgery exist in the last 5 years. 2) If yes, are ways suggested to reduce racial/ethnic discrimination in surgery? Method The systematic review was performed in compliance with the PRISMA guidelines along AMSTAR 2. A 5-year literature search was carried out on PubMed for articles published from 1/1/2017 to 01/11/2022. The retrieved citations were quality assessed by MERSQI and evidence graded by GRADE. Results A total of 9116 participants responded with a mean of 1013 (SD = 2408) responses per citations reported in 9 studies from a final list of 10 included citations. Nine studies were from USA and 1 from South Africa. The evidence of racial discrimination was justified on strong scientific evidence constituting the basis f...
British Journal of Surgery
Introduction The impact of the COVID-19 pandemic has been particularly significant for surgical t... more Introduction The impact of the COVID-19 pandemic has been particularly significant for surgical trainees. We aimed to systematically review the prevalence of burnout in surgical trainees during the pandemic, to compare rates of burnout between different specialities, and to identify factors that may modify the risk of burnout. Method A systematic review was performed in compliance with the PRISMA guidelines to identify articles related to the keywords “surgeons’ burnout and Covid-19’’ and “surgical trainees burnout and Covid-19”. A search was performed on PubMed/Medline and ScienceDirect for articles published from January 2020 to August 2022. Results A total of 19 articles met the inclusion criteria, 3866 surgical trainees included across all the studies. The overall prevalence of burnout in surgical trainees during the pandemic was between 9.0%-95.2% across the globe. Burnout rates were higher in general surgery (33.1%-95.2%) than in urology (17.6%-55%), neurosurgery (16.2 %-44.1%...
Bulletin of The Royal College of Surgeons of England, Dec 31, 2023
British Journal of Surgery
Background A biliary quality improvement project (QuIP) was established in 2019 following 3 audit... more Background A biliary quality improvement project (QuIP) was established in 2019 following 3 audit cycles highlighting delays to laparoscopic cholecystectomy (Lap-C) in patients with gallstone pancreatitis. Limited theatre space and other urgent care priorities hindered efforts to meet other biliary key performance indicator targets between 2015 and 2019. The last phase of the QuIP has introduced a dedicated consultant lead biliary service, a live biliary patient tracking system, increased in-patient Lap-C, implementation of ambulatory pathways and a patient centred integrated care approach. Methods Prospectively collected data from a live biliary tracking system was compared with retrospective audit data from 2015-2019. Key performance indicators were; average time to Lap-C, rate of Lap-C with-in 2 weeks following pancreatitis, inpatient Lap-C rate and out-patient appointments saved. Results 523 patients were managed through inpatient and ambulatory biliary pathways from November 20...
The Bulletin of the Royal College of Surgeons of England
Sultan Qaboos University Medical Journal, Jul 19, 2023
Acute appendicitis is one of the most common abdominal emergencies. There has been an increasing ... more Acute appendicitis is one of the most common abdominal emergencies. There has been an increasing trend in the use of robotic surgery in abdominal surgery. However, it remains underutilised in emergency surgeries. We aimed to systematically review robotic appendicectomies (RA) feasibility. A 20-year systematic review was performed in compliance with PRISMA guidelines. MERSQI score was applied for quality assessment. The research protocol was registered with PROSPERO. The search resulted in 1242 citations, of which 9 articles were included. Quality scores mean:10.72(SD=2.56). The endpoints across the studies were: rate of conversion to open surgery, length of hospital stay, blood loss and operative time. RA is safe and feasible technique in elective and emergency settings with minimal blood loss. The operating time and the hospital stay were within acceptable limits. The major drawback of robotic surgery is its high cost and limited availability. Future studies are recommended to evaluate RA with a focus on its application during emergency and on its cost-effectiveness.
Sultan Qaboos University Medical Journal, Jul 19, 2023
Acute appendicitis is one of the most common abdominal emergencies. There has been an increasing ... more Acute appendicitis is one of the most common abdominal emergencies. There has been an increasing trend in the use of robotic surgery in abdominal surgery. However, it remains underutilised in emergency surgeries. We aimed to systematically review robotic appendicectomies (RA) feasibility. A 20-year systematic review was performed in compliance with PRISMA guidelines. MERSQI score was applied for quality assessment. The research protocol was registered with PROSPERO. The search resulted in 1242 citations, of which 9 articles were included. Quality scores mean:10.72(SD=2.56). The endpoints across the studies were: rate of conversion to open surgery, length of hospital stay, blood loss and operative time. RA is safe and feasible technique in elective and emergency settings with minimal blood loss. The operating time and the hospital stay were within acceptable limits. The major drawback of robotic surgery is its high cost and limited availability. Future studies are recommended to evaluate RA with a focus on its application during emergency and on its cost-effectiveness.
British Journal of Surgery, Sep 1, 2021
Annals of The Royal College of Surgeons of England, Aug 1, 2023
Introduction The impact of the COVID-19 pandemic has been particularly significant for surgical t... more Introduction The impact of the COVID-19 pandemic has been particularly significant for surgical trainees. The aim of this study was to systematically review the prevalence of burnout in surgical trainees during the pandemic, to compare rates of burnout between different specialties and to identify factors that may modify the risk of burnout. Methods A systematic review was undertaken following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) checklist to identify articles related to the keywords “surgeons burnout COVID-19” and “surgical trainees burnout COVID-19”. A search was carried out on the PubMed/MEDLINE® and ScienceDirect® databases for articles published from January 2020 to August 2022. Results A total of 19 articles met the inclusion criteria, with 3,866 surgical trainees included across all the studies. The overall prevalence of burnout in surgical trainees across the globe during the pandemic was between 9.1% and 95.2%. Burnout rates were higher in general surgery (33.1–95.2%) than in urology (17.6–54.6%), neurosurgery (16.2–44.1%) and orthopaedic surgery (9.1–44.1%). Otolaryngology trainees had the lowest burnout rate (10.9%). Factors associated with an increased risk of burnout included being a female trainee, being a more junior trainee and increased working hours. Conclusions There has been a high level of burnout among surgical trainees across the globe during the pandemic. In light of the devastating effect of COVID-19 on surgical training and the serious consequences of surgeon burnout (both for the individual and for the patients), targetted interventions for the prevention and treatment of burnout in surgical trainees are urgently needed, and must be prioritised by healthcare institutions and training programmes.
British Journal of Surgery, Sep 1, 2021
British Journal of Surgery, May 1, 2023
Acta chirurgica Belgica, Jun 28, 2024
Bulletin of the Royal College of Surgeons of England, Jun 1, 2024
Deleted Journal, Apr 12, 2024
Introduction: Even though acute appendicitis is the world's most common emergency general surgica... more Introduction: Even though acute appendicitis is the world's most common emergency general surgical operation, it remains under-researcher with wide variations in care. The aim of this review was to present current evidence on the management of acute appendicitis, focusing on risk assessment, diagnostic modalities, treatment strategies, and special considerations for specific patient populations. Methods: We conducted a modified, scoping Delphi to prioritise topic areas for inclusion in this review. Consensus was achieved when each topic had >70% for either important or strongly important. Scoping reviews of current and grey literature were conducted to identify relevant evidence, focussing on new publications in the last 5 years (2019-2024). Results: Validated risk scoring systems, such as the Adult Appendicitis Score and the AIRS score, aid in identifying low-risk patients suitable for ambulatory management, while imaging modalities, including CT scans and ultrasound, play a pivotal role in confirming diagnosis and guiding treatment decisions. The review highlights the efficacy of surgical intervention versus antibiotic therapy, emphasising the importance of shared decisionmaking and individualised treatment plans. Tailored care strategies are needed for elderly patients, pregnant women, and those with appendiceal neoplasms whilst strategies for optimising antibiotic stewardship, minimising negative appendectomy rates, and enhancing postoperative care will provide the best evidence-based care. Discussion: This review provides evidence-based practices can be integrated into routine clinical care and ongoing education for frontline clinicians. The practice recommendations are designed to be evidence based and can be tailored depending on local resources. These should form the basis of future educational packages and surgical training programmes.
Indian journal of surgery, Apr 11, 2024
International Journal of Health Sciences and Research, Dec 4, 2023
Objectives: The outbreak of the virus infection Monkeypox (Mpox) in England was on transmission l... more Objectives: The outbreak of the virus infection Monkeypox (Mpox) in England was on transmission level 2. Mpox and HIV infections may occur simultaneously among the MSM population, exacerbating the symptoms along with treating problems. We aimed to study if Mpox painful genital symptoms correlated with immunocompromised status, sexuality, admissions and length of hospital stay. Methods: A retrospective data analysis was conducted. The admissions were divided into four groups named: perianal, penile, rectal and other symptoms. Correlations between patients' pain groups, sexuality or immunocompromised status as well as length of hospital stay were studied. Significances were computed by Spearman's rho correlation and Kruskal-Wallis H analyses of variance. Results: Sixty-nine patients were included, 65 males with mean age=38,5 (SD 8.29; Md=39) and females' mean age=35.5 (SD 9.04; Md= 39.5) years (n.s.). The two gender's Mpox pain areas differed from each other (p= .014). A total of 38% of the male patients presented painful perianal or rectal lesions and 22 males displayed general symptoms and 17 acknowledged MSM. A total of 40% of the males were sexually active with multiple partners; an inverse correlation between males with MSM and males with HIV (rho [25] =-.385*, p= .029, 1-tailed) was revealed. Altogether 23% of males presented HIV and 8% suffered from additional STI. Those with rectal pain had the longest hospital stay with a mean of 6.0 (SD 7.63) days (p= .017) compared to other groups. Conclusion: Correlations between patients diagnosed with Mpox and genital symptoms were revealed as opposed to inverse correlations between immunocompromised status/HIV and MSM.
British Journal of Surgery
Introduction Racial discrimination indicates the unkind conduct towards other persons based on th... more Introduction Racial discrimination indicates the unkind conduct towards other persons based on their race or skin color. We aimed to systematically review racial discrimination in surgery and answer the following questions:1) Does racial/ethnic discrimination in surgery exist in the last 5 years. 2) If yes, are ways suggested to reduce racial/ethnic discrimination in surgery? Method The systematic review was performed in compliance with the PRISMA guidelines along AMSTAR 2. A 5-year literature search was carried out on PubMed for articles published from 1/1/2017 to 01/11/2022. The retrieved citations were quality assessed by MERSQI and evidence graded by GRADE. Results A total of 9116 participants responded with a mean of 1013 (SD = 2408) responses per citations reported in 9 studies from a final list of 10 included citations. Nine studies were from USA and 1 from South Africa. The evidence of racial discrimination was justified on strong scientific evidence constituting the basis f...
British Journal of Surgery
Introduction The impact of the COVID-19 pandemic has been particularly significant for surgical t... more Introduction The impact of the COVID-19 pandemic has been particularly significant for surgical trainees. We aimed to systematically review the prevalence of burnout in surgical trainees during the pandemic, to compare rates of burnout between different specialities, and to identify factors that may modify the risk of burnout. Method A systematic review was performed in compliance with the PRISMA guidelines to identify articles related to the keywords “surgeons’ burnout and Covid-19’’ and “surgical trainees burnout and Covid-19”. A search was performed on PubMed/Medline and ScienceDirect for articles published from January 2020 to August 2022. Results A total of 19 articles met the inclusion criteria, 3866 surgical trainees included across all the studies. The overall prevalence of burnout in surgical trainees during the pandemic was between 9.0%-95.2% across the globe. Burnout rates were higher in general surgery (33.1%-95.2%) than in urology (17.6%-55%), neurosurgery (16.2 %-44.1%...
Bulletin of The Royal College of Surgeons of England, Dec 31, 2023
British Journal of Surgery
Background A biliary quality improvement project (QuIP) was established in 2019 following 3 audit... more Background A biliary quality improvement project (QuIP) was established in 2019 following 3 audit cycles highlighting delays to laparoscopic cholecystectomy (Lap-C) in patients with gallstone pancreatitis. Limited theatre space and other urgent care priorities hindered efforts to meet other biliary key performance indicator targets between 2015 and 2019. The last phase of the QuIP has introduced a dedicated consultant lead biliary service, a live biliary patient tracking system, increased in-patient Lap-C, implementation of ambulatory pathways and a patient centred integrated care approach. Methods Prospectively collected data from a live biliary tracking system was compared with retrospective audit data from 2015-2019. Key performance indicators were; average time to Lap-C, rate of Lap-C with-in 2 weeks following pancreatitis, inpatient Lap-C rate and out-patient appointments saved. Results 523 patients were managed through inpatient and ambulatory biliary pathways from November 20...
The Bulletin of the Royal College of Surgeons of England
Sultan Qaboos University Medical Journal, Jul 19, 2023
Acute appendicitis is one of the most common abdominal emergencies. There has been an increasing ... more Acute appendicitis is one of the most common abdominal emergencies. There has been an increasing trend in the use of robotic surgery in abdominal surgery. However, it remains underutilised in emergency surgeries. We aimed to systematically review robotic appendicectomies (RA) feasibility. A 20-year systematic review was performed in compliance with PRISMA guidelines. MERSQI score was applied for quality assessment. The research protocol was registered with PROSPERO. The search resulted in 1242 citations, of which 9 articles were included. Quality scores mean:10.72(SD=2.56). The endpoints across the studies were: rate of conversion to open surgery, length of hospital stay, blood loss and operative time. RA is safe and feasible technique in elective and emergency settings with minimal blood loss. The operating time and the hospital stay were within acceptable limits. The major drawback of robotic surgery is its high cost and limited availability. Future studies are recommended to evaluate RA with a focus on its application during emergency and on its cost-effectiveness.
Sultan Qaboos University Medical Journal, Jul 19, 2023
Acute appendicitis is one of the most common abdominal emergencies. There has been an increasing ... more Acute appendicitis is one of the most common abdominal emergencies. There has been an increasing trend in the use of robotic surgery in abdominal surgery. However, it remains underutilised in emergency surgeries. We aimed to systematically review robotic appendicectomies (RA) feasibility. A 20-year systematic review was performed in compliance with PRISMA guidelines. MERSQI score was applied for quality assessment. The research protocol was registered with PROSPERO. The search resulted in 1242 citations, of which 9 articles were included. Quality scores mean:10.72(SD=2.56). The endpoints across the studies were: rate of conversion to open surgery, length of hospital stay, blood loss and operative time. RA is safe and feasible technique in elective and emergency settings with minimal blood loss. The operating time and the hospital stay were within acceptable limits. The major drawback of robotic surgery is its high cost and limited availability. Future studies are recommended to evaluate RA with a focus on its application during emergency and on its cost-effectiveness.
British Journal of Surgery, Sep 1, 2021
Annals of The Royal College of Surgeons of England, Aug 1, 2023
Introduction The impact of the COVID-19 pandemic has been particularly significant for surgical t... more Introduction The impact of the COVID-19 pandemic has been particularly significant for surgical trainees. The aim of this study was to systematically review the prevalence of burnout in surgical trainees during the pandemic, to compare rates of burnout between different specialties and to identify factors that may modify the risk of burnout. Methods A systematic review was undertaken following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) checklist to identify articles related to the keywords “surgeons burnout COVID-19” and “surgical trainees burnout COVID-19”. A search was carried out on the PubMed/MEDLINE® and ScienceDirect® databases for articles published from January 2020 to August 2022. Results A total of 19 articles met the inclusion criteria, with 3,866 surgical trainees included across all the studies. The overall prevalence of burnout in surgical trainees across the globe during the pandemic was between 9.1% and 95.2%. Burnout rates were higher in general surgery (33.1–95.2%) than in urology (17.6–54.6%), neurosurgery (16.2–44.1%) and orthopaedic surgery (9.1–44.1%). Otolaryngology trainees had the lowest burnout rate (10.9%). Factors associated with an increased risk of burnout included being a female trainee, being a more junior trainee and increased working hours. Conclusions There has been a high level of burnout among surgical trainees across the globe during the pandemic. In light of the devastating effect of COVID-19 on surgical training and the serious consequences of surgeon burnout (both for the individual and for the patients), targetted interventions for the prevention and treatment of burnout in surgical trainees are urgently needed, and must be prioritised by healthcare institutions and training programmes.
British Journal of Surgery, Sep 1, 2021
British Journal of Surgery, May 1, 2023