Agricultural and forestry tractors are very often involved in accidents with overturning because of their construction with a high centre of gravity. Such accidents are caused by various factors such ...as drivers, vehicles, driving conditions, or landscape/terrain. The data related to the number of deaths in accidents with agriculture and forestry tractors was collected from several European countries. The landscapes (or terrain) of the countries for tractor traffic was assessed by the coefficient of the topography and the economic development level of the countries was evaluated in terms of the GDP. The correlation analysis among the factors showed us that neither the relief of the country landscape nor the economic development level of the countries have a significant influence on the number of deaths in such accidents. The essential influence is in the legislation for the tractors and drivers. The comparison of three countries (Austria, Slovenia, and Serbia) showed the implementation of legislation in this area and time are needed for reducing the number of deaths by half.
Kmetijski in gozdarski traktorji so zelo pogosto vpleteni v nesreče s prevračanjem, saj imajo zaradi njihove konstrukcije zelo visoko težišče. Take nesreče se dogajajo zaradi različnih vplivov kot so vozniki, vozila, vozne razmere ali površina/teren. Zbrani so bili podatki o številu mrtvih v nesrečah s kmetijskimi in gozdarskimi traktorji za več evropskih držav. Oblika površine držav, po katerih poteka vožnja traktorja, je bila ocenjena s koeficientom topografije, stopnja gospodarskega razvoja držav pa je bila ocenjena z BDP. Korelacijska analiza med faktorji je pokazala, da niti oblika površine države niti stopnja gospodarskega razvoja držav nimata močnejšega vpliva na število mrtvih v tovrstnih nesrečah. Bistveni vpliv imajo predpisi za traktorje in voznike. Primerjava treh držav (Avstrije, Slovenije in Srbije) je pokazala, da sta potrebna implementacija predpisov na tem področju in čas, da se število mrtvih prepolovi.
Background
The aim of this study was to compare lateral thermal damage of the appendix and clinical outcomes after laparoscopic appendectomy using new versus reused Harmonic scalpels.
Methods
A total ...of 100 consecutive patients with acute appendicitis who underwent laparoscopic appendectomy were enrolled in the two-center, randomized clinical trial. Using a computer random number generator, patients were allocated to
new
or
reused
group. Histopathological measurement of lateral thermal damage of the appendiceal base and mesoappendix, speed of transection of the appendiceal base, duration of surgery, subjective rating of device functionality, length of hospital stay, and complications were compared within groups.
Results
The median lateral thermal damage on the appendiceal base in the
new
group (
N
= 49) was 0.2 mm (IQR 0.1–0.2) and 0.1 mm (IQR 0.1–0.3) in the
reused
group (
N
= 51) (
P
= 0.644), while on the mesoappendix for both groups, thermal damage was 0.1 mm (IQR 0.1–0.2) (
P
= 0.418). The median time required for base transection in both groups was 8 s (IQR 7–9) (
P
= 0.776). The median duration of surgery was also comparable between the groups (22 min, IQR 20–30 vs 25 min, IQR 21–35;
P
= 0.233). Two postoperative complications in the new group and one in the reused group were recorded (4% vs 2%;
P
= 0.536). Surgeons’ subjective assessment of the instrument did not reveal significant difference between the groups in all of the investigated categories.
Conclusions
The results of our study support the reuse of Harmonic scalpels especially in the settings where economic constraints might hamper access to minimally invasive surgery to a larger number of patients. The results obtained on laparoscopic appendectomy might not be reproducible to other more demanding surgical procedures.
Trial registration
ClinicalTrials.gov
registry under identifier NCT04226482
PDF
