Surgery Research and Practice最新文献

{"title":"Linear versus Circular Stapler for Gastrojejunal Anastomosis in Laparoscopic Roux-En-Y Gastric Bypass: An Analysis of 211 Cases.","authors":"Laurin Burla,&nbsp;Pascal Weibel,&nbsp;Cornelia Baum,&nbsp;Markus Huber,&nbsp;Thomas Gürtler,&nbsp;Markus Weber","doi":"10.1155/2020/4090797","DOIUrl":"https://doi.org/10.1155/2020/4090797","url":null,"abstract":"<p><strong>Purpose: </strong>Although laparoscopic Roux-en-Y gastric bypass (LRYGB) is a frequently performed bariatric procedure, there is still no consensus on its technical implementation.</p><p><strong>Methods: </strong>211 patients treated with LRYGB in a single institution between March 2011 and October 2016 were analyzed retrospectively. A subgroup analysis for the linear (LSA) versus circular stapler technique (CSA) for gastrojejunal anastomosis (GJA) was performed to evaluate complications and outcomes.</p><p><strong>Results: </strong>128 (60.6%) patients received GJA with CSA and 83 (39.4%) with LSA. Average weight loss one year after surgery, respectively, BMI after one year of follow-up (kg/m²), showed no significant difference. Median surgery time was significantly shorter in the LSA group. If the procedure was performed with CSA, significantly more wound infections occurred.</p><p><strong>Conclusions: </strong>Both the circular and the linear stapler techniques for gastrojejunal anastomosis in laparoscopic Roux-en-Y gastric bypass are safe methods with comparable outcomes. A disadvantage of CSA is the significantly higher rate of wound infections, a circumstance which requires increased attention.</p>","PeriodicalId":30584,"journal":{"name":"Surgery Research and Practice","volume":"2020 ","pages":"4090797"},"PeriodicalIF":0.0,"publicationDate":"2020-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2020/4090797","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38269937","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ileosigmoid Knotting: Analysis of Patients Clinical Profiles and Determinants of Outcomes.","authors":"Kirubel Abebe,&nbsp;Kalid Sherefa,&nbsp;Henok Teshome,&nbsp;Engida Abebe","doi":"10.1155/2020/3826138","DOIUrl":"https://doi.org/10.1155/2020/3826138","url":null,"abstract":"<p><strong>Introduction: </strong>Ileosigmoid knotting (ISK) is an uncommon form of bowel obstruction due to wrapping of the ileum or sigmoid colon around the base of the other. It is associated with poor prognosis. Data on ISK are scarce in our country. The aim of this study was to assess clinical profiles, management, and outcome of patients operated for ISK. <i>Methodology</i>. A retrospective analysis of all patients operated for ISK at St. Paul's hospital millennium medical college (SPHMMC) from February 2014 to January 2020 was performed.</p><p><strong>Results: </strong>A total of 28 patients (M: <i>F</i> = 3 : 1) were studied. The mean age was 41.7 years (SD ± 19.5) and ranged from 18 to 80 years. The mean duration of illness was 1.6 days (SD ± 1.1). Abdominal pain and vomiting were seen in all patients followed by abdominal distention (24, 85.7%) and failure to pass feces or flatus (23, 82.1%). Preoperative diagnosis was correct in 6 (21.4%) patients. Almost all patients (26, 92.8%) had gangrenous bowel. The commonest procedure performed was resection of the gangrenous segments with primary ileoileal anastomosis and sigmoid end colostomy (16, 57.1%). Complications were seen in 11 (39.3%) patients and the commonest being surgical site infection (SSI) (7, 25%). Death occurred in 6 (21.4%) patients, and it was significantly (<i>p</i>=0.020) associated with intraoperative shock (systolic blood pressure (SBP) < 90 mmHg).</p><p><strong>Conclusion: </strong>ISK lacks specific clinical features and imposes a significant rate of bowel strangulation, which deserves high index of suspicion and urgent laparotomy. The choice of surgical procedure should be determined by intraoperative bowel status and patients' general condition.</p>","PeriodicalId":30584,"journal":{"name":"Surgery Research and Practice","volume":"2020 ","pages":"3826138"},"PeriodicalIF":0.0,"publicationDate":"2020-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2020/3826138","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38256586","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Do Racial/Ethnic and Economic Factors Affect the Rate of Complicated Appendicitis in Children?","authors":"Abhinav Totapally,&nbsp;Paul Martinez,&nbsp;Andre Raszynski,&nbsp;Fuad Alkhoury,&nbsp;Balagangadhar R Totapally","doi":"10.1155/2020/3268567","DOIUrl":"https://doi.org/10.1155/2020/3268567","url":null,"abstract":"<p><strong>Introduction: </strong>Appendicitis continues to be one of the most common surgical conditions in the pediatric population. We set out to determine demographic and practice variations among children admitted with appendicitis and highlight the racial/ethnic and healthcare access role in relation to the rate of complicated appendicitis using the 2012 Kids' Inpatient Database (KID). <i>Methodology</i>. A retrospective cross-sectional database study was performed using the 2012 KID. All children (age 1 months to 20 years) with appendicitis were identified using the ICD-9 diagnosis codes. Children with a diagnosis of appendicitis were compared with all other discharges. Among children with appendicitis, demographic and practice variations and the rate of complicated appendicitis were evaluated. Univariate and multivariate analyses were done to analyze the data. Sample weighing was done to present national estimates.</p><p><strong>Results: </strong>In 2012, a total of 89, 935 out of 2.7 million pediatric hospital discharges (3.3%) had a diagnosis of appendicitis. The incidence of appendicitis was higher in males (4.7%), 6-15-year age group (7.43%), Hispanics (5.2%), and in the Western region (5.2%) and was lower in infants (0.02%) and African American children (1.2%) (<i>p</i> < 0.0001). The proportion of children with peritonitis or abscess was higher in children's hospitals (48.2% vs. 29.0%; OR 2.3, 95% CI: 2.2-2.4). The risk of complicated appendicitis was inversely related to age, while racial and ethnic minority status, bottom quartile of the income group, and government insurance increased the risk. Laparoscopic appendectomy was performed more frequently at children's hospitals (84.8% vs. 74.3%; <i>p</i> < 0.0001).</p><p><strong>Conclusions: </strong>Appendicitis is more common in Hispanics, males, older children, and in the Western region. Complicated appendicitis is more common in younger children, minority groups, low-income group, and children with government insurance. Children's hospitals manage more children with complicated appendicitis and are more likely to perform laparoscopic appendectomy.</p>","PeriodicalId":30584,"journal":{"name":"Surgery Research and Practice","volume":"2020 ","pages":"3268567"},"PeriodicalIF":0.0,"publicationDate":"2020-06-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2020/3268567","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38169855","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rolling in the Deep: Imaging Findings and Diagnostic Pearls in Gallstone Ileus.","authors":"Carnevale Aldo,&nbsp;Motta Lorenzo,&nbsp;Labaj Olgerta,&nbsp;Cossu Alberto,&nbsp;Uccelli Licia,&nbsp;Giganti Melchiore","doi":"10.1155/2020/1421753","DOIUrl":"https://doi.org/10.1155/2020/1421753","url":null,"abstract":"<p><p>Gallstone ileus is a dramatic complication of gallstone disease, uncommon but not exceptional in a busy emergency department. It represents a cause of mechanical intestinal obstruction, which predominantly occurs in elderly and frail patients; this contributes to the high morbidity and mortality rates associated with this condition. The modern radiologist is frequently asked to determine the cause of bowel obstruction and should be aware of the most pictorial features of this unusual disease. Broadly speaking, abdominal radiography and ultrasonography alone are limited in detecting the cause of bowel obstruction, but the sensitivity for the preoperative diagnosis of gallstone ileus may be improved by combining the findings obtained by both techniques. Computed tomography is the modality of choice for the diagnosis of this disease: it may accurately describe the number, size, and location of migrated gallstones and the exact site of bowel obstruction, providing a detailed preoperative planning. Magnetic resonance imaging may be used in selected cases for an exquisite anatomic definition of the fistulous communication.</p>","PeriodicalId":30584,"journal":{"name":"Surgery Research and Practice","volume":"2020 ","pages":"1421753"},"PeriodicalIF":0.0,"publicationDate":"2020-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2020/1421753","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37905753","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Management of Choledochal Cysts at a Tertiary Care Centre: A Nine-Year Experience from India.","authors":"Pranav Honnavara Srinivasan,&nbsp;Amudhan Anbalagan,&nbsp;Rajendran Shanmugasundaram,&nbsp;Naganathbabu Obla Lakshmanamoorthy","doi":"10.1155/2020/8017460","DOIUrl":"https://doi.org/10.1155/2020/8017460","url":null,"abstract":"<p><strong>Background: </strong>Although choledochal cyst disease is seen predominantly in childhood, it is becomingly increasingly diagnosed in adult patients.</p><p><strong>Methods: </strong>Data of 36 patients with choledochal cysts managed in our institute between January 2010 and December 2018 were retrospectively analyzed.</p><p><strong>Results: </strong>Median age at presentation was 37 years (range: 13-72 years). Female-to-male ratio was 3.5 : 1. All patients were symptomatic, and abdominal pain was the most common symptom. 72.2% had other associated conditions. There was a considerable delay from the onset of symptoms to referral, median duration being 348 days. There were 28 cases of type I (77.8%), 5 cases of type IVA (13.9%), and 3 cases of type IVB (8.3%). Cyst excision with Roux-en-Y hepaticojejunostomy was performed in 29 (80.55%) cases. This procedure was combined with a left lateral sectionectomy, left hepatectomy, and radical cholecystectomy in 1, 2, and 1 cases, respectively. Lilly's technique was used in 2 cases, and cyst excision with hepaticoduodenostomy was performed in 1 case. Early complications were seen in 21 patients (58.3%), and late complications were seen in 5 patients (13.8%). 2 patients were found to have associated malignancies. One patient was detected to have cholangiocarcinoma in the resected liver incidentally, and another patient was diagnosed to have gall bladder cancer intraoperatively.</p><p><strong>Conclusion: </strong>Choledochal cysts should be considered in the differential diagnosis of adults presenting with epigastric or right hypochondrium pain or jaundice. A thorough preoperative evaluation is required. Cyst excision with Roux-en-Y hepaticojejunostomy forms the standard treatment in most cases. Long-term follow-up is essential for management of complications and early detection of malignant change.</p>","PeriodicalId":30584,"journal":{"name":"Surgery Research and Practice","volume":"2020 ","pages":"8017460"},"PeriodicalIF":0.0,"publicationDate":"2020-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2020/8017460","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37905754","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Comparison of Treatments and Outcomes for Medullary versus Nonmedullary Colon Cancer: A Single Institutional Experience Showing a Worse Prognosis for Stage 3 Disease.","authors":"A Gupta,&nbsp;B Protyniak,&nbsp;J Dove,&nbsp;K Chu,&nbsp;T Erchinger,&nbsp;J Bannon,&nbsp;J Oxenberg","doi":"10.1155/2020/5783729","DOIUrl":"https://doi.org/10.1155/2020/5783729","url":null,"abstract":"<p><strong>Background: </strong>Prior studies have shown a better prognosis with medullary colon cancer (MCC) compared to nonmedullary colon carcinomas (NMC); however, data are inconsistent and lacking the evaluation of treatments received. As we did not see similar survival outcomes, we aimed to retrospectively examine survival and receipt of treatment differences between MCC and NMC within the Geisinger Health System.</p><p><strong>Methods: </strong>The Cancer Registry was retrospectively reviewed for MCC and NMC from 2006 to 2017. Demographics and treatments were compared using <i>T</i>-test and chi-squared analyses, also comparing MCC to poorly differentiated (PD) or undifferentiated (UD) NMC. Overall survival was analyzed using Kaplan-Meier curves and log-rank tests.</p><p><strong>Results: </strong>33 MCC and 1775 NMC patients were identified and 31 (93.9%) MCC and 1433 (87.0%) NMC underwent resection. MCC were older (<i>p</i>=0.0002), had a higher Charlson Comorbidity Index (<i>p</i>=0.013) and were more likely right sided (<i>p</i>=0.013). Seven patients (22.6%) with MCC vs. 149 (10.4%) NMC underwent resection of contiguous organs. Overall median survival was significantly worse for MCC as compared to NMC (19.6 vs. 60.5 months, <i>p</i>=0.0002). Only stage 3 patients had a significantly worse median survival when compared to PD/UD NMC (9.6 vs. 47.2 months, <i>p</i> < 0.001). Contiguous organ resection and failure to receive chemotherapy were not found as contributing factors to decreased survival.</p><p><strong>Conclusion: </strong>Multiple previous studies showed a better prognosis for MCC compared to PD/UD NMC. We, however, found stage 3 patients had a worse prognosis which may be secondary to higher comorbidities, increased stage, and higher rate of UD.</p>","PeriodicalId":30584,"journal":{"name":"Surgery Research and Practice","volume":"2020 ","pages":"5783729"},"PeriodicalIF":0.0,"publicationDate":"2020-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2020/5783729","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37825725","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence and Predictors of Cancellation of Elective Surgical Procedures at a Tertiary Hospital in Uganda: A Cross-Sectional Study.","authors":"Alfred Ogwal,&nbsp;Felix Oyania,&nbsp;Emmanuel Nkonge,&nbsp;Timothy Makumbi,&nbsp;Moses Galukande","doi":"10.1155/2020/1464098","DOIUrl":"https://doi.org/10.1155/2020/1464098","url":null,"abstract":"<p><p><i>Introduction</i>. The cancellation of elective procedures has been shown to waste resources and to have the potential to increase morbidity and mortality among patients. This study aimed to determine the prevalence of the cancellation of elective surgical procedures and to identify the factors associated with these cancellations at Mulago Hospital, a large public hospital in Kampala, Uganda.</p><p><strong>Methods: </strong>A cross-sectional study was conducted from January 10, 2018, to February 20, 2018. We recruited patients of all ages who were admitted to surgical wards and scheduled for elective surgery. Data on patients' demographic characteristics and diagnosis, as well as the specialty of the surgery, the planned procedure, the specific operating theatre, cancellation, and the reasons for cancellation were extracted and analyzed using logistic regression.</p><p><strong>Results: </strong>Of a total of 400 cases, 115 procedures were canceled-a cancellation prevalence of 28.8%. Orthopedic surgery had the highest cancellation rate, at 40.9% (<i>n</i> = 47). Facility-related factors were responsible for 67.8% of all cancellations. The most common reason for cancellation was insufficient time in the theatre to complete the procedure on the scheduled day. No procedures were canceled because of a lack of intensive care unit beds. There was a significant association between surgical specialty and cancellation (<i>P</i> < 0.05) at multivariate analysis.</p><p><strong>Conclusion: </strong>The prevalence of cancellation of elective surgical procedures at Mulago Hospital was 28.8%, with orthopedic surgery having the highest cancellation rate. Two-thirds of the factors causing cancellations were facility-related, and more than 50% of all cancellations were potentially preventable. Quality-improvement strategies are necessary in the specialties that are susceptible to procedure cancellation because of facility factors.</p>","PeriodicalId":30584,"journal":{"name":"Surgery Research and Practice","volume":"2020 ","pages":"1464098"},"PeriodicalIF":0.0,"publicationDate":"2020-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2020/1464098","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37809654","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Does Helium Pneumoperitoneum Reduce the Hyperinflammatory Response in Septic Animals during Laparoscopy?","authors":"Paulo Roberto Rodrigues Bicalho,&nbsp;Fernanda Magna Ribeiro,&nbsp;Pedro Henrique Ferreira Marçal,&nbsp;Daniel Gomes de Alvarenga,&nbsp;Fernando de Sá Silva","doi":"10.1155/2020/5738236","DOIUrl":"https://doi.org/10.1155/2020/5738236","url":null,"abstract":"<p><p><i>Background/Aim</i>. An exacerbated reaction to peritoneal infection and attendant surgical procedures is characterized by an intense hyperinflammatory state, the magnitude of which is proportional to the severity of tissue injury. Laparoscopy generates lower levels of tissue damage compared with open surgery and should induce less pronounced immune responses. The aim of this study was to determine whether laparoscopy assisted by helium rather than carbon dioxide pneumoperitoneum would induce an attenuated inflammatory state in septic animals. <i>Materials and Methods</i>. Thirty-two Wistar rats were divided randomly into four equal groups, two of which were submitted to carbon dioxide or helium pneumoperitoneum-assisted laparoscopic cecal ligation and puncture (CLP) induced sepsis and subsequent abdominal lavage. Two control groups were submitted to identical laparoscopic procedures with carbon dioxide or helium as insufflator gas but without CLP. After 24 hours, serum levels of tumor necrosis factor alpha (TNF-<i>α</i>), interleukins 1 and 6 (IL-1 and IL-6, respectively), and cortisol were determined.</p><p><strong>Results: </strong>Mean concentrations of I L-1 and IL-6 in the groups of septic animals submitted to laparoscopy with carbon dioxide or helium pneumoperitoneum were not significantly different but were significantly higher than those of their respective non-CLP controls. In contrast, the levels of TNF-<i>α</i>), interleukins 1 and 6 (IL-1 and IL-6, respectively), and cortisol were determined.</p><p><strong>Conclusions: </strong>Laparoscopy with helium insufflation was similar to carbon dioxide in relation to the inflammatory response since levels of the proinflammatory TNF-<i>α</i>, IL-1, and IL-6 and of the anti-inflammatory cortisol were comparable for both gases.<i>α</i>), interleukins 1 and 6 (IL-1 and IL-6, respectively), and cortisol were determined.</p>","PeriodicalId":30584,"journal":{"name":"Surgery Research and Practice","volume":"2020 ","pages":"5738236"},"PeriodicalIF":0.0,"publicationDate":"2020-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2020/5738236","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37789083","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Multicentre Covariate Adjustment Analysis of Short-Term and 5-Year Outcomes after Endovascular Repair according to Sex.","authors":"Bibombe P Mwipatayi,&nbsp;Rebekah L W Tan,&nbsp;Joseph Faraj,&nbsp;Ali Daneshmand,&nbsp;Olufemi Oshin,&nbsp;Nishath Altaf,&nbsp;Shannon D Thomas,&nbsp;Patrik J Tosenovsky,&nbsp;Jackie Wong,&nbsp;Vikram Vijayan,&nbsp;Anthony J Freeman,&nbsp;Sally A Burrows","doi":"10.1155/2020/8970759","DOIUrl":"https://doi.org/10.1155/2020/8970759","url":null,"abstract":"<p><strong>Background: </strong>Several studies have reported worse outcomes in women compared to men after endovascular aneurysm repair (EVAR). This study aimed to evaluate sex-specific short-term and 5-year outcomes after EVAR.</p><p><strong>Methods: </strong>A total of 409 consecutive patients underwent elective EVAR from 2004 to 2017 at two tertiary hospitals in Western Australia. Baseline, intraoperative, and postoperative variables were examined retrospectively according to sex. The primary outcome was 30-day mortality (death within 30 days after EVAR). Secondary outcomes were 30-day composite endpoint, length of stay after EVAR, 5-year survival, freedom from reintervention, residual aneurysm size after EVAR, and major adverse event rate at 5-year follow-up.</p><p><strong>Results: </strong>A cohort of 409 patients, comprising 57 women (14%) and 352 men (86%), was analysed. Female patients were older (median age, 76.8 versus 73.5 years, <i>p</i>=0.017). Male patients were more likely to be past smokers (40.9% versus 22.8%, <i>p</i>=0.017). Male patients were more likely to be past smokers (40.9% versus 22.8%, <i>p</i>=0.017). Male patients were more likely to be past smokers (40.9% versus 22.8%, <i>p</i>=0.017). Male patients were more likely to be past smokers (40.9% versus 22.8%, <i>p</i>=0.017). Male patients were more likely to be past smokers (40.9% versus 22.8%, <i>p</i>=0.017). Male patients were more likely to be past smokers (40.9% versus 22.8%, <i>p</i>=0.017). Male patients were more likely to be past smokers (40.9% versus 22.8%.</p><p><strong>Conclusion: </strong>This study found no significant differences in 30-day and 5-year outcomes between female and male patients treated with EVAR, implying that EVAR remains a safe treatment choice for female patients.</p>","PeriodicalId":30584,"journal":{"name":"Surgery Research and Practice","volume":"2020 ","pages":"8970759"},"PeriodicalIF":0.0,"publicationDate":"2020-03-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2020/8970759","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37788051","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Magnitude of Abdominal Wound Dehiscence and Associated Factors of Patients Who Underwent Abdominal Operation at St. Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia.","authors":"Berhanetsehay Teklewold,&nbsp;Dut Pioth,&nbsp;Tadele Dana","doi":"10.1155/2020/1379738","DOIUrl":"https://doi.org/10.1155/2020/1379738","url":null,"abstract":"<p><strong>Background: </strong>Abdominal wound dehiscence (AWD) is the separation of different layers of an abdominal wound before complete healing has taken place. It is a major cause of postoperative morbidity and mortality in sub-Saharan Africa including Ethiopia, and little is known about its prevalence and related factors in the study area.</p><p><strong>Objectives: </strong>The aim of this study is to assess the magnitude of abdominal wound dehiscence and related factors on patients operated at St. Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia.</p><p><strong>Methods: </strong>A hospital-based retrospective review of the chart was carried out by using the data covering three years (September 2014-September 2017) period. Data were collected from hospital medical records of sampled patients such as operation room logbooks and individual patient medical records. The collected data were checked for consistency, coded, and entered into SPSS version 20 for data processing and analysis. Descriptive analysis was conducted, and tables and graphs and summary statistics were used to depict data.</p><p><strong>Results: </strong>A total of 41 patients developed abdominal wound dehiscence from among 4137 patients who underwent abdominal laparotomy in the hospital. Among the patients, 51.2% were in the age range of 41 and above with mean age 29.8 (SD = 1.21) and 70.7% of them were male. Abdominal wound dehiscence was more common in emergency patients (90%) and vertical incision was the most common type of incision. Over half (58.5%) of the wound dehiscence occurred within 6-10 postoperative days. The majority (95.2%) of dehisced patients underwent relaparotomy for the management of the wound dehiscence, and 48.8% of them were treated with tension suture during the second operation of abdominal closure. Four of the patients (9.7%) died after the management of the second operation.</p><p><strong>Conclusion: </strong>The current study revealed that the overall magnitude of abdominal wound dehiscence in the study area was 0.99%. Most of the dehiscence has occurred in male patients, and older age groups were highly affected than the younger ones. Emergency admission is the most common form of admission identified in the study, and this signifies appropriate preoperative preparation of patients for an optimal outcome. However, regarding the management outcome, 9.8% of patients died in our study within the institution after the second operation which is the high mortality rate.</p>","PeriodicalId":30584,"journal":{"name":"Surgery Research and Practice","volume":"2020 ","pages":"1379738"},"PeriodicalIF":0.0,"publicationDate":"2020-02-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2020/1379738","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37789082","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}