International Journal of Surgery Research and Practice最新文献

{"title":"Retrospective Study on the Incidence of Thyroid Disorders in Bisha and Evolving Surgical Management Considerations","authors":"D. Bawa, Saleem Khan, Y. Khalifa, Shashi Sharma, Amal A Alghamdi, H. Albishi, Nasser Al Tufail","doi":"10.23937/2378-3397/1410130","DOIUrl":"https://doi.org/10.23937/2378-3397/1410130","url":null,"abstract":"Background: There is a high prevalence of goiter in Bisha despite more than 15 years of the national campaign for increased dietary iodine supplementation. The cause is multifactorial. It is associated with non-neoplastic and neoplastic conditions. Surgical management has evolved over many years. Purpose: To describe the pathological types of goiter in Bisha along with their management and to discuss current surgical considerations. Methodology: A retrospective review of 339 patients with goiter diagnosed by FNAC and or histopathological examination and managed surgically or non-surgically. Results: There were 339 patients, of which 280 (82.6%) were females and 59 (17.4%) males. Age range was seven to 94 years with a mean of 39.18 ± 13.87 years. There were 138 (40.7%) multinodular goiters, 82 (24.2%) colloid goiters, 8 diffuse goiters (2.4%), 40 (11%) solitary thyroid nodules, 10 thyroid nodules (2.9%), 14 thyroid cysts (4.1%), 20 Hashimoto’s thyroiditis (5.9%) and two de Quervain’s thyroiditis (0.6%). Benign thyroid neoplasms comprised of 25 (7.4%) follicular adenomas and 11 (3.2%) Hürthle cell adenomas. Malignant thyroid disorders consisted of 18 (5.3%) papillary thyroid cancers, 7 (2.1%) mixed papillary/ follicular thyroid cancers, one (0.3%) mixed follicular/ papillary thyroid cancer, and three (0.9%) follicular thyroid cancers respectively. There were 128 (37.1%) total thyroidectomies, 70 (20.6%) hemithyroidectomies, 10 (2.9%) subtotal thyroidectomies and, 5 (1.5%) near-total thyroidectomies. There were 125 (36.9%) patients who had no surgery. The overall complication rate was 14.5%. Conclusion: Thyroid disorders are still prevalent despite years of dietary iodine supplementation campaigns. The rate of complications following total thyroidectomy is significant and guidelines are changing.","PeriodicalId":326011,"journal":{"name":"International Journal of Surgery Research and Practice","volume":"70 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127136599","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":"Cancer of the Bladder in South East Nigeria: Epidemiological Patterns in a Low Resource Region","authors":"Ogolo Donald E","doi":"10.23937/2378-3397/1410131","DOIUrl":"https://doi.org/10.23937/2378-3397/1410131","url":null,"abstract":"Background: Bladder cancer (CAB) is a urological malignancy that significantly contributes to morbidity and mortality, especially when detected late. Aim: This study highlights the challenges of late presentation and changing histological trend of the condition in a low resource region. The objectives were to establish the relationship between demographic factors, and to elucidate some characteristics of histological patterns in our region. Methods: A retrospective cohort study of all cases of bladder cancer seen at our facility between 2011 and 2015 was carried out utilizing data from patient case notes. Extracted data was analyzed using descriptive statistics. Results: A total of 18 cases of histologically confirmed bladder cancer were reviewed-12 males (66.7%) and 6 females (33.3%), with a male to female ratio of 2:1. The patients were aged between 19 and 78 years. Majority were petty traders (44%). Transitional cell carcinoma (TCCAB) was confirmed in 12 cases (66.7%) and squamous cell cancer (SCCAB) in 6 cases (33.3%). Majority of the cases of SCCAB were seen in patients below 30 years of age (66.7%) while majority for TCCAB were above 50 years (91.7%). The commonest presenting complaint was total, painless haematuria with associated clots (77.8%) with average duration from time of onset to presentation at this facility of 2 months and 3 weeks for SCCAB and 17 months for TCCAB. Hemoglobin level at presentation was between 6-8 g/dl in 44.4% of cases. Majority seen on abdominal ultrasound scan and cystoscopy were flat masses (61.1%). Most cases were stage I for TCCAB (58.3%) and stage II for SCCAB (83.3%), while 11.1% were metastatic requiring chemotherapy. There was one case of recurrence (stage II) within the first year of follow up. Conclusion: TCCAB is taking an increasing prominence relative to SCCAB in the region. Effective treatment of bladder cancer is highly dependent on early presentation and diagnosis, and prevention entails prompt risk factor identification and intervention.","PeriodicalId":326011,"journal":{"name":"International Journal of Surgery Research and Practice","volume":"100 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132204768","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":"Telemedicine Clinic Reviews as an Alternative to Traditional Postoperative Clinic Visits: Sub-Saharan Africa Dilemma","authors":"alfred ogwal, K. K. Toitole, Vincent Medeyi, Emmanuel Nkonge, Herbert Ariaka, Felix Oyania","doi":"10.23937/2378-3397/1410132","DOIUrl":"https://doi.org/10.23937/2378-3397/1410132","url":null,"abstract":"","PeriodicalId":326011,"journal":{"name":"International Journal of Surgery Research and Practice","volume":"9 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133694650","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":"International Journal of Surgery Research and Practice","authors":"Karmakar Shilpi, Singh Arun Kumar, Karmakar Saurabh","doi":"10.23937/2378-3397","DOIUrl":"https://doi.org/10.23937/2378-3397","url":null,"abstract":"","PeriodicalId":326011,"journal":{"name":"International Journal of Surgery Research and Practice","volume":"11 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128423990","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":"Laparoscopic Peritoneal Lavage versus Sigmoidectomy for Management of Perforated Diverticulitis: Meta-Analysis of Randomized Controlled Trials","authors":"Pannu Arslan, Dar Ghulam Murtaza, A. Shahzad, Hajibandeh Shahab, Hajibaneh Shahin, Lawrence Eloise, J. Salman, K. Khurram, S. Rishabha, M. Ahmad","doi":"10.23937/2378-3397/1410106","DOIUrl":"https://doi.org/10.23937/2378-3397/1410106","url":null,"abstract":"Introduction: Controversy exists regarding the role of laparoscopic peritoneal lavage in patients with perforated diverticulitis. Our objective was to conduct the first meta-anal ysis of Randomized Controlled Trials (RCT’s) to compare the outcomes of patient undergoing laparoscopic peritoneal lavage with sigmoidectomy in patients with perforated di verticulitis. Methods: In accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) state ment standards, we conducted a systematic search of elec tronic information sources, including MEDLINE; EMBASE; CINAHL; CENTRAL; The World Health Organization Inter national Clinical Trials Registry; ClinicalTrials.gov; ISRCTN Register and bibliographic reference lists. We applied a combination of free text and controlled vocabulary search adapted to thesaurus headings, search operators and limits in each of the above databases. Overall morbidity, mortality, and postoperative complications were defined as the prima ry outcome parameters. Procedure time and length of hos pital stay were secondary outcomes. The combined overall effect sizes were calculated using fixed-effect or random-ef fects models. Results: We identified 4 RCT’s comparing outcomes of lap aroscopic peritoneal lavage and open sigmoidectomy for perforated diverticulitis. All studies included only Hinchey grade III diverticulitis. The subsequent analysis, including 390 patients, demonstrated that laparoscopic peritoneal lavage of perforated diverticulitis was associated with significantly increased rates of overall morbidity (OR: 1.30, 95% CI 1.07-1.57, p = 0.007) and intra-abdominal abscess (OR: 3.10, 95% CI 1.71-5.63, p = 0.0002) compared to sig -moidectomy. However, there was no significant difference in mortality (OR: 0.86, 95% CI 0.42-1.77, p = 0.69) and re-operation (OR: 1.20, 95% CI 0.36-4.02, p = 0.77) rates between the two groups. Between-study heterogeneity was non-significant in all analyses, except reoperation rate (I 2 = 79%, p = 0.002). The available data did not allow an appro priate analysis of procedure time, length of hospital stay and other postoperative complications. Conclusions: Our analysis of randomised trials demon strated that laparoscopic peritoneal lavage of perforated diverticulitis may lead to more adverse events than open sigmoid resection. Future high quality RCT’s are indeed re quired to provide stronger evidence as no definitive conclu sion can be drawn considering the limited number of avail able RCT’s.","PeriodicalId":326011,"journal":{"name":"International Journal of Surgery Research and Practice","volume":"9 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-01-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125466616","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":"A Case Report of an Epiphrenic Esophageal Diverticulum was Treated via Laparoscopic Transhiatal Diverticulectomy","authors":"A. Kusay, B. Bashar, Banjah Bassel","doi":"10.23937/2378-3397/1410105","DOIUrl":"https://doi.org/10.23937/2378-3397/1410105","url":null,"abstract":"Introduction: Epiphrenic diverticulum is a relatively rare clinical case. It is defined as an outpouching of the mucosal and submucosal layers through the muscular layer of esophagus in association with motility disorders. Most patients are asymptomatic and the other manifest with variable symptoms including dysphagia, regurgitation, halitosis, vomiting, heartburn and weight loss. Presentation of case: Herein we report a case of a 50-year-old female who presented to our hospital with complaint of dysphagia and weight loss. The clinical and radiological findings suggested left epiphrenic diverticulum about 3 cm in diameter. As the best and most appropriate treatment, we performed laparoscopic transhiatal diverticulectomy, Heller esophageo cardiomyotomy and Dor anterior fundoplication. The patient was discharged home in the second day with some recommendations and she was well. Discussion: The main treatment of epiphrenic diverticula is diverticulectomy transhiatal via laparoscopy followed by Heller myotomy and antireflux procedure. Conclusion: We advise surgeons to consider the operative approach because it is safe, effective and has less complications compared the other approaches.","PeriodicalId":326011,"journal":{"name":"International Journal of Surgery Research and Practice","volume":"14 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127600653","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":"Intestinal Obstruction Secondary to Intra-Luminal Retained Laparotomy Towel: A Case Report","authors":"Yorke Joseph, A. Williams, A. George, H. Bernard, Boateng Edward Amoah, G. Frank, Aitpillah Francis Somiah-Kwaw, Ababio Kwabena Acheamfour, Ahulu Dorcas, Yorke Dennis Afful, A. Emmanuel","doi":"10.23937/2378-3397/1410104","DOIUrl":"https://doi.org/10.23937/2378-3397/1410104","url":null,"abstract":"Retained surgical sponges (gossypiboma) are very rare but occur even under the presumed correct sponge counts postoperatively. Gossypiboma has the ability to cause significant harm to the patient and carry heartfelt medicolegal and professional repercussions to clinicians and hospitals. Its mani-festations may be non-specific and may take weeks, months or even years from the time of surgery. Therefore, diagnosis is based on a high index of suspicion with careful assessment of the patient’s history, physical examination, and investigation. Retained sponges may extrude externally through a fistulous tract or internally into the rectum, vagina, bladder, intestinal lumen or through direct migration; however, intra-luminal migration is relatively rare. It is in consonance with this rarity that we report a case of an intestinal obstruction secondary to an intra-luminal foreign body. Intra-operative findings revealed a laparotomy towel accidentally left behind during a laparotomy for a ruptured acute appendicitis.","PeriodicalId":326011,"journal":{"name":"International Journal of Surgery Research and Practice","volume":"9 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"120974368","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":"Vertebral Endplate, Posterior Ligamentous Complex and Neural Dysfunction: Key Factors for Posterior Fusion Strategy in Thoracolumbar Fractures","authors":"Ming-yong Liu, Liang Zhang, Liang Zhang, Jian-hua Zhao, Peng Liu, W. Fan, X. Ying, Y. Liu","doi":"10.23937/2378-3397/1410101","DOIUrl":"https://doi.org/10.23937/2378-3397/1410101","url":null,"abstract":"The thoracolumbar region (T11 to L2) is more susceptible to injury than other parts of the spine, and posterior pedicle screw-based instrumentation and fusion is a widely accepted procedure to restore alignment and achieve instant and long term segmental stability of the injured spine through fusion, while the key factors determining the level of fusion remain unclear. To study the influence of vertebral endplate, Posterior Ligamentous Complex (PLC) and neural function on fusion strategy for thoracolumbar fractures via a posterior approach, a prospective study was committed. Here we report that neurological status and the integrity of the involved endplates and PLC are crucial for fusion strategy in thoracolumbar fractures. It is recommended that fusion segments are limited to the levels of the severely injured endplates and/or PLC and implantation is removed early at non fusion segments to preserve the mobility function. Mingyong Liu, Liang Zhang, Liangmin Zhang, Jianhua Zhao* and Peng Liu* Department of Spine Surgery, Daping Hospital, Third Military Medical University, China","PeriodicalId":326011,"journal":{"name":"International Journal of Surgery Research and Practice","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-05-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128456393","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":"Role of Laparoscopy in Abdominal Trauma","authors":"Wafa Ala, E. Mustafa, Friwan Rawad, Baio Abdulaziz","doi":"10.23937/2378-3397/1410100","DOIUrl":"https://doi.org/10.23937/2378-3397/1410100","url":null,"abstract":"Background: The role of laparoscopy in abdominal trauma has increased in the last years in diagnosis as well as therapeutic interventions. It is a viable alternative for the diagnosis of intra-abdominal injury in both penetrating and blunt trauma. The number of negative laparotomies decreased since the use of laparoscopy in trauma patients. Methods: A retrospective study of twenty eight patients with abdominal trauma (22 penetrating trauma, 6 blunt trauma) were laparoscopic intervention done by general surgery department at Aljazeera Hospital for Orthopedic and Specialized Surgery from January 2017 to March 2019. All patients underwent clinical assessment and FAST-Scan, CT-scan done for twenty patients and unavailable for eight patients. All of the patients included for the research were stable with normal blood pressure. Results: In our series twenty-eight patients with abdominal trauma, 22 penetrating trauma (78.57%) all were shotgun injuries, and 6 blunt trauma (21.43%). In penetrating trauma therapeutic laparoscopy for seven patients (31.8%), diagnostic laparoscopy for 10 patients (45.5%), and negative laparoscopy for 5 cases (22.7%). In blunt trauma therapeutic laparoscopy for 2 cases (33.3%), diagnostic laparoscopy for 3 cases (50%), and negative laparoscopy for 1 case (16.7%). The rate of conversion to laparotomies was 8 cases (28.5%) for both penetrating and blunt trauma. Conclusion: Laparoscopy can be safely performed in hemodynamically stable patients with abdominal trauma for both diagnostic and therapeutic purposes; also it helps to cut down the number of non-therapeutic laparotomies.","PeriodicalId":326011,"journal":{"name":"International Journal of Surgery Research and Practice","volume":"25 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130907779","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":"Management Outcome and Associated Factors of Surgically Treated Non Traumatic Acute Abdomen at Attat Hospital, Gurage Zone, Ethiopia","authors":"Gebrie Tekalign Admasu, Handiso Tilahun Beyene, Hagisso Shemsu Nuriye","doi":"10.23937/2378-3397/1410099","DOIUrl":"https://doi.org/10.23937/2378-3397/1410099","url":null,"abstract":"Background: Non traumatic acute abdomen is an acute onset of abdominal disease entities that require immediate surgical intervention in most of the cases. The causes of non-traumatic surgical acute abdomen and their relative incidence vary in different populations. Objective: The aim of this study was to assess the management outcome and associated factors of surgically treated non-traumatic acute abdomen. Methods: Hospital-based prospective cross sectional study was conducted on surgically treated non-traumatic acute abdomen cases admitted at Attat catholic hospital surgical ward starting from January 2017 to September 2018. Data was collected using history, physical examination, patients’ card and operation registration book as necessary. The collected data were checked for incorrectness and inconsistencies and SPSS version 21 used for the descriptive, binary and multivariate logistic regression analysis of the data. On binary logistic regression analysis a p-value < 0.25 was used as a candidate for multivariate logistic regression analysis. Statistical significant association was tested at a p-value of < 0.05. Results: There were 192 non-traumatic emergency surgical acute abdomens admitted in surgical ward and 171 (89%) of cases were managed surgically while 11% were managed conservatively. The three top causes of acute surgical abdomen were acute appendicitis accounting 48% followed by bowel obstruction 28% and Peritonitis 24%. Late presentation of patients before intervention, sex, age and postoperative complications were independent predictors with management outcome in our study. The total postoperative complication rate was 17% of which the commonest early postoperative complications were wound infection (5.4%), sepsis (4.3%) and pneumonia (2.3%). About 90.1% were discharged well while 9.35% were passed away in the hospital which is unacceptably high mortality. Conclusion and recommendation: The overall mortality was more in cases from rural area due to delay at presentation, on higher extreme age patients, those who developed peritonitis and postoperative complications. To decrease this problem, creation of health awareness on acute abdomen to the general population and to the low and mid-level health care providers for early referral, pre and postoperative management to decrease postoperative complications and death has great importance.","PeriodicalId":326011,"journal":{"name":"International Journal of Surgery Research and Practice","volume":"28 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114496967","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}