[Implementation of the safe surgery checklist of the World Health Organization at the University hospital of Monastir [Tunisia]]

To evaluate the impact of introduction of the WHO safe surgery checklist in the university hospital of Monastir over a period of five months. We conducted a longitudinal study [before - after] with evaluation of five result indicators which were: percentage of surgical site infections, not prescribed antibioprophylaxis, unplanned return to the operating room, postoperative length of stay and postoperatively death. We identified 185 patients during the period and 323 patients after the introduction of the WHO checklist. The proportion of surgical site infection decreased significantly from 13.5% in the reference period to 1.3% after the introduction of the checklist [p < 0.001]. The proportion of unplanned return to the operative room was 10.3% before the introduction of the checklist and deceased significantly to 1.3% at the intervention period [p = 0.003]. The proportion of not prescribed antibioprophylaxis and median post-operative length of stay deceased also significantly during the study period [p < 0.001]. The surgical checklist control contributes to the development of a safety culture in the operating room. Maintaining its use should be supported by incentives such as certification and accreditation

Liver cystic echinococcosis: which cysts are correlated with false negative indirect passive hemagglutination [IHA]?

It's generally agreed that calcified liver cystic Echinococcosis [CE] is associated with negative serology; the influence of other cystic features on serologie result remains unclear. The aim of this study is to determine predictive factors of negative indirect passive hemagglutination [IHA] in liver CE. 119 patients operated on for liver CE, had preoperative IHA. Correlation was studied between serological result and sex, age of patient and number [single vs multiple], size, ultrasonic type [uni-locular, multivesicular, degenerative] and intrabiliary rupture of cyst. IHA sensitivity was 74.8%. Univaried analysis showed that false negative serology was correlated with age < 10 or > 20 years [p< 0.01], single cyst [p< 0.006], cystic size < 9 cm [p< 0.03] and unilocular or degenerative cyst in comparison with multivesicular type [p< 0.01 and p< 0.03 respectively]. in liver CE, cystic predictive factors of false negative IHA are single cyst, unilocular or degenerative type and size inferior to 9 cm