Sri Lanka Journal of Surgery最新文献

{"title":"A case of Castlemans disease presenting as left axillary tumor","authors":"S. Sivakumar, V. Rangarajan, M. Manikesi, A. Akeel, S. G. Krishnan, Apollo Hospitals Chennai","doi":"10.4038/sljs.v41i03.8981","DOIUrl":"https://doi.org/10.4038/sljs.v41i03.8981","url":null,"abstract":"No abstract available","PeriodicalId":227431,"journal":{"name":"Sri Lanka Journal of Surgery","volume":" 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138617445","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Recurrent Ureteric Obstruction due to an intraluminal hematoma following live donor renal transplant","authors":"V. R. Gunasena, A. Weerasuriya, S. Godahewa","doi":"10.4038/sljs.v41i03.8946","DOIUrl":"https://doi.org/10.4038/sljs.v41i03.8946","url":null,"abstract":"No abstract available","PeriodicalId":227431,"journal":{"name":"Sri Lanka Journal of Surgery","volume":" 11","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138617662","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The effect of routine ureteral stent placement on post-ureteroscopy complications: A prospective study from a resource limited setting","authors":"B. Balasingam, R. Sripandurangana, M. Sivashankar, S. Varothayan, K. Dinoshiga, K. Heerthikan, K. Priyatharsan, T. Vaishnavi, G. M. Sureshka","doi":"10.4038/sljs.v41i03.9077","DOIUrl":"https://doi.org/10.4038/sljs.v41i03.9077","url":null,"abstract":"Background: Rigid ureterorenoscopy (URS) stands as a highly successful treatment for ureteral stones. The current guidelines from the European Association of Urology (EAU) recommends selective double J (DJ) stent placement post-URS to mitigate major complications. However, in resource-limited hospital setups, executing selective stent placement poses substantial risks in preventing complications and reducing readmission rates. This study aims to unveil the ramifications of our routine stent replacement approach after ureteric stone surgery on surgical outcomes in a resource-constrained setting.Materials and Methods: This prospective study was conducted at a urological unit within a tertiary care center in Sri Lanka, over a one-year period, involving 112 diagnosed patients. Patients underwent routine DJ stenting following rigid URS for ureteral stone management, without additional intervention. Data collected from clinical records encompassed demographics, stone characteristics, and complications. Postoperative complications linked to routine DJ stenting were assessed using the Clavien-Dindo classification system. Descriptive statistics were employed for data summary using SPSS version 23.0.Results: The mean age of patients was 47.3±14.9 years (range: 13-76 years), with 67.9% being males. The mean stone size was 15.35±6.58 mm (range: 4.5-35 mm), distributed across right (48.2%), left (44.6%), and bilateral (7.1%) ureters, of which 52.7% were proximal, 30.4% distal, and 17% mid ureteric stones. Postoperative evaluation revealed 26.8% of patients experiencing Clavien-Dindo grade I complications (e.g.,dysuria, haematuria, loin pain, and lower urinary tract symptoms), managed conservatively. Moreover, 4.5% encountered Clavien-Dindo grade II complications, predominantly postoperative fever, necessitating hospital readmission specifically for intravenous antibiotic administration.Conclusion: Despite guidelines advocating selective stent placement, this study underscores the safety and efficacy of routine DJ stent implementation after the URS laser procedure. The findings showcase a notable reduction in postoperative complications alongside decreased hospital readmission rates in resourcelimited environments. Embracing routine DJ stenting post- URS in such settings could serve as a pragmatic approach, potentially enhancing patient outcomes and minimizing healthcare burdens.","PeriodicalId":227431,"journal":{"name":"Sri Lanka Journal of Surgery","volume":" 11","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138611540","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Usefulness of simultaneous use of anatomical landmarks in identification of facial nerve in parotid gland dissection","authors":"V. Abeysuriya, H. Modaragama","doi":"10.4038/sljs.v41i03.9070","DOIUrl":"https://doi.org/10.4038/sljs.v41i03.9070","url":null,"abstract":"Introduction: Identification of Facial nerve trunk is important in parotid surgery to avoid an iatrogenic injury. The objective of our study was to assess consistent and reliable landmarks for identification of the main trunk of facial nerve during parotid surgery.Methods: This prospective study was carried out in the department of Anatomy, faculty of Medicine, Ragama from 2022 to 2023. Our study included 35 fresh cadavers (70 parotid regions). The anatomical landmarks of tragal pointer (TP), tympanomastoid suture (TMS), and superior border of posterior belly of digastric (PBD) muscle to the facial nerve trunk was measured. The shortest distances were taken from the facial trunk by using a slide calliper.Results: The age of subjects of the cadavers ranged from 42 to 64 years with a mean of 54.4 years. The mean distance between the TP and the facial nerve trunk was 9.15 mm (8.1–11.7 mm). The mean distance between PBD and the facial nerve trunk was 8.6 mm (7.2–9.8 mm). The mean distance between the TMS and the facial nerve trunk was 6.5 mm (5.2–7.5 mm).Conclusion: Our study showed that the tympanomastoid suture line is the closest to the facial nerve trunk, followed by the posterior belly of digastric muscle and the tragal pointer respectively. Further clinical studies are needed to assess these landmarks through various parameters to determine their usefulness in surgical practice.","PeriodicalId":227431,"journal":{"name":"Sri Lanka Journal of Surgery","volume":" 6","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138615857","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"We report you decide","authors":"R. C. Siriwardana","doi":"10.4038/sljs.v41i03.9098","DOIUrl":"https://doi.org/10.4038/sljs.v41i03.9098","url":null,"abstract":"No abstract available","PeriodicalId":227431,"journal":{"name":"Sri Lanka Journal of Surgery","volume":"50 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138626320","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Trials, tribulations and the emergence of total thyroidectomy - A Sri Lankan perspective","authors":"R. Fernando","doi":"10.4038/sljs.v41i2.9042","DOIUrl":"https://doi.org/10.4038/sljs.v41i2.9042","url":null,"abstract":"Abstract \u0000The technique of thyroidectomy has emerged during the last 100 years, from a turbulent past’, due to the outstanding contributions made by many including the “Magnificent Seven” of thyroid surgery. The dissection of the gland, preservation Parathyroid function and protecting the Nerves are dealt with meticulously. \u0000Total thyroidectomy is associated with complications of bleeding, permanent injury to Nerves and permanent hypoparathyroidism. Many centres have reported incidence of complications around 1-3%. This is the bench mark for surgeons world over. \u0000Voice change is a major concern after thyroidectomy. A study has shown that RLN recovery much faster than the recovery of the EBSLN. The recovery will take up to 3 months in most patients. \u0000Assessment of the surgical practices related to thyroid disease in Sri Lanka has shown that the practices have changed over the last decade. More total thyroidectomies are undertaken. Younger surgeons are undertaking more total thyroidectomies. \u0000The quoted incidence of Incidental carcinoma is around 10-20% in the literature. In two studies done in the unit, an incidence between 8.8% and 11.38% was seen. This factor must be considered in surgical decision making for benign disease. \u0000Most common cause of recurrences is the enlargement of embryological remnants of the thyroid and a modern thyroid surgeon must excise the embryological remnants meticulously. \u0000Surgery for recurrent goitre is a difficult task. Data confirms that Lateral approach to the thyroid makes the task much easier. This must be considered a bench for Sri Lanka. \u0000Cosmetic issues and cost must also be considered in thyroidectomy. Data confirms that Mini incision open thyroidectomy is a safe cost effective alternative to endoscopic thyroidectomy The obituary of open total thyroidectomy shall not be written for a long time. \u0000","PeriodicalId":227431,"journal":{"name":"Sri Lanka Journal of Surgery","volume":"4 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"117255476","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Body packing with pyloric stenosis successfully treated with open pack retrieval and gastric bypass","authors":"H. Praemanathan, T. J. Huei, M. Silvarajah","doi":"10.4038/sljs.v41i2.8942","DOIUrl":"https://doi.org/10.4038/sljs.v41i2.8942","url":null,"abstract":"Foreign body ingestion unintentionally or intentionally in adults are not uncommon on the contrary to children. Intentional ingestion of illicit drugs or tobacco/drug pack is one common reason other than psychosis. Infrequently, body packing may end up with bowel obstruction with ‘drug pack’ impacted at various constriction point of gastrointestinal tract [1]. Here, we report a case of intentional foreign body ingestion by a jail inmate whom unfortunately also has pyloric stenosis. The clinic presentations and treatment strategy are discussed.","PeriodicalId":227431,"journal":{"name":"Sri Lanka Journal of Surgery","volume":"22 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126479529","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Open thrombectomy for mesenteric vein injury and acute thrombosis. Is it the right way? A case report and review of literature","authors":"J. Arudchelvam, A. Parthiepan","doi":"10.4038/sljs.v41i2.8980","DOIUrl":"https://doi.org/10.4038/sljs.v41i2.8980","url":null,"abstract":"Mesenteric vein thrombosis following injury to the superior mesenteric vein (SMV) during abdominal surgery is rare but it is associated with poor outcome. Late detection of mesenteric vein thrombosis results in extensive bowel gangrene resulting in poor patient outcome. Thrombectomy is rarely attempted at the time of re exploration even if the SMV is found to have a thrombus. But evidence suggests that performing thrombectomy at the time of re exploration will reduce the length of bowel resection. In addition venous thrombectomy will also result in better patient outcome. This case describes a patient who developed superior mesenteric vein thrombosis in the immediate post laparotomy period following SMV injury. She was managed successfully with open thrombectomy and bowel resection. \u0000 \u0000","PeriodicalId":227431,"journal":{"name":"Sri Lanka Journal of Surgery","volume":"33 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123660000","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Retrospective analysis of a single unit experience in laparoscopic cholecystectomy in Northern Sri Lanka during the Covid-19 pandemic","authors":"S. Gobishangar, S. Gobinath, R. Thevya, P. Shathana","doi":"10.4038/sljs.v41i2.9037","DOIUrl":"https://doi.org/10.4038/sljs.v41i2.9037","url":null,"abstract":"Introduction: Laparoscopic cholecystectomy is a surgical procedure that removes a diseased gallbladder for various indications. It is preferred over open cholecystectomy due to fewer complications and early recovery. However, it carries different operative and postoperative complications. In addition, the availability of resources and skillful surgeons limits its use worldwide. Analysing the experience of laparoscopic cholecystectomy will enhance the training and skills and improve the surgical outcome. \u0000Methods: All the laparoscopic cholecystectomies done from July 2020 to July 2022 were analysed retrospectively. \u0000Results: This study included eighty-seven surgeries with patients ages 8 to 84 years (mean 51.76 ±17.15). Male patients were 32.2% and females 67.8%. The indication for laparoscopic cholecystectomy was symptomatic gallstone disease in 72.4% acute/chronic cholecystitis in 14.9%, distal CBD stones in 5.7%, Gall bladder polyp in 3.4%, biliary colic in 18.4%, cholangitis in 1.2%, obstructive jaundice in 1.2% and pyocele in 1.2%. ERCP was performed by the surgeons of the same unit to manage 6.8% of the cases preoperatively and 2.2% post-operatively. Intra-operative difficulty or problems was seen in 24.13% of the cases, which included adhesions with adjacent organs in 14.9%, difficult identification of Calot's triangle in 3.4%, bile spillage 6.8% and abnormally distended gall bladder, adhered deep into the liver, and double gallbladder in 1.2% each. 1.2% of the cases needed conversion to open. Postoperative complications were noted in 20.68% of cases. 3.4% had Clavian Dindo grade I complications. \u0000Conclusion: Professorial unit Teaching hospital Jaffna is performing laparoscopic cholecystectomies even in the presence of limited resources. The outcomes were comparable with the international standards published up to date. \u0000","PeriodicalId":227431,"journal":{"name":"Sri Lanka Journal of Surgery","volume":"9 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130186645","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"With the rising trend of prostate cancer, where does northern Sri Lanka stand? A cohort study from a tertiary care centre.","authors":"B. Balagobi, S. Gobinath, C. Rajasooriyar, A. Jenil, J. Theepan, T. Gowribahan, P. Shathana, S. Abirame","doi":"10.4038/sljs.v41i2.9056","DOIUrl":"https://doi.org/10.4038/sljs.v41i2.9056","url":null,"abstract":"Introduction: Prostate cancer is the second most common cancer among males all over the world in 2020. As per the global cancer observatory 1, 414, 259 (7.3%) cases were diagnosed in 2020 worldwide. The study aims to analyse the variations in demographic and clinico-pathological characteristics of prostate cancer in the Northern Province. Methods: This is a cross-sectional descriptive institution-based study that recruited all the prostate cancer patients who were treated at the Teaching hospital, Jaffna from August 2019 to August 2022. Data were extracted retrospectively from the clinic records of the patients as well as histopathology documents. Results: A total of 141 diagnosed patients at Teaching Hospital Jaffna were analysed. The mean age of the sample was 70.11± 8.43 years. Out of 141 patients, 30.49% were diagnosed to have localized disease and 26.24% and 43.26% with locally advanced and metastatic disease respectively. Out of those who had localized disease 68.5% were managed with radiotherapy, 23.25% with active surveillance and 11.6% with radical prostatectomy. The mean value of PSA was 70.11±8.4. The majority 97.2% had small acinar adeno carcinoma as histology. As per the D’Amico classification system for prostate cancer, 2.83% belonged to low-risk category and 80.1% belonged to high-risk category. Conclusion: There is a rising trend in the incidence of prostate cancer in Sri Lanka over the recent past. Most of the cases are advanced at the initial presentation. It implies the need for screening programmes with PSA in near future to detect cancer at early stages, implementation of cancer awareness programmes as practised in Western countries and strict adherence to national guidelines on management and referral pathways.","PeriodicalId":227431,"journal":{"name":"Sri Lanka Journal of Surgery","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130532850","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}