Annals of African Surgery最新文献_第10页

Management and Complications of Nasal Septal Collections 鼻中隔集合的处理及并发症

Annals of African Surgery Pub Date : 2021-04-23 DOI: 10.4314/AAS.V18I2.4

O. Sogebi, E. A. Oyewole

{"title":"Management and Complications of Nasal Septal Collections","authors":"O. Sogebi, E. A. Oyewole","doi":"10.4314/AAS.V18I2.4","DOIUrl":"https://doi.org/10.4314/AAS.V18I2.4","url":null,"abstract":"Background: Nasal septum collections (hematoma and abscess) can lead to structural and functional abnormalities. Our objective was to assess the clinical characteristics, management and complications of nasal septal collections, and document factors associated with their complications. Methods: This was a retrospective study of patients managed for nasal septal collections. Socio-demographic and clinical information was recorded, and the main investigations and results noted. Follow-up and complications of septal collections were documented and the clinical factors associated with the complications explored. Results: Twenty-four patients records were studied: male: female ratio=2:1, mean age 40.1±13.1years,62.5% presented with complaints of nasal obstruction, 66.7% had antecedent nasal trauma, presentation was from 2 to 13 days,25%had co-morbid disease(s). All patients had incision and drainage of the septal collection within 1–7 h; 41.2% of the aspirated collections cultured microorganisms, 20.8% developed complications. Increased age above 45 years, co-morbidity, delayed presentation, culture-positive aspirate was all significantly associated with development of complications. Conclusion: Nasal septal collections were more common in adult males with antecedent nasal trauma; 20% developed complications associated with the presence of culturepositive abscesses, increased age, and duration of septal collection.","PeriodicalId":37442,"journal":{"name":"Annals of African Surgery","volume":"18 1","pages":"79-84"},"PeriodicalIF":0.0,"publicationDate":"2021-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43275842","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}

引用次数: 1

Partial Inferior Pubectomy in the Delayed Repair of Pelvic Fracture Urethral Injury: Adopting a Bone-nibbling Technique 骨盆骨折尿道损伤延迟修复中耻骨下部分切除术:采用咬骨技术

Annals of African Surgery Pub Date : 2021-04-23 DOI: 10.4314/AAS.V18I2.2

I. Nnabugwu, F. Ugwumba, Anthony Alex Ilukwe

{"title":"Partial Inferior Pubectomy in the Delayed Repair of Pelvic Fracture Urethral Injury: Adopting a Bone-nibbling Technique","authors":"I. Nnabugwu, F. Ugwumba, Anthony Alex Ilukwe","doi":"10.4314/AAS.V18I2.2","DOIUrl":"https://doi.org/10.4314/AAS.V18I2.2","url":null,"abstract":"Background: The use of wedge inferior pubectomy can be challenging to many urethral surgeons. Our objective was to introduce a bone-nibbling technique to accomplish a partial inferior pubectomy (PIP) in a resource-poor setting, and to report the mediumto longterm outcome of using the technique. Methods: Five patients were recruited (mean age: 38.8 years) who presented, over a 30-month period, with posterior urethral fibrosis from a pelvic fracture urethral injury (PFUI). One had failed a previous attempt at posterior urethral reconstruction elsewhere. The length of urethral defect was from 2 to 4 cm. We describe a bone-nibbling technique used to carry out PIP for the delayed repair of PFUI in these patients. The outcomes in the medium to long term of surgical procedures done with this technique are presented. Results: Immediate postoperative complications in all were essentially a Clavien–Dindo grade I. Peak flow rate assessed 12 weeks’ post operation was between 20 mL/s and 23 mL/s (mean: 21 mL/s). The longest duration of follow-up was 34 months, and all patients were voiding satisfactorily. Conclusions: A satisfactory and durable outcome can be obtained from nibbling at the bone from the inferior margin of the pubic bone to achieve PIP. This is of interest to lower urinary tract reconstructive surgeons who have concerns with chiseling-out wedge of the inferior pubis.","PeriodicalId":37442,"journal":{"name":"Annals of African Surgery","volume":"18 1","pages":"69-74"},"PeriodicalIF":0.0,"publicationDate":"2021-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41338514","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}

引用次数: 0

Clinical and Epidemiological Profile of Oral and Maxillofacial Trauma at Two Quaternary Hospitals in Mozambique in 2016 2016年莫桑比克两家第四医院口腔颌面外伤临床及流行病学分析

Annals of African Surgery Pub Date : 2021-04-23 DOI: 10.4314/AAS.V18I2.5

Nádia Armindo Henriques Fortes, Prem Yohannan

{"title":"Clinical and Epidemiological Profile of Oral and Maxillofacial Trauma at Two Quaternary Hospitals in Mozambique in 2016","authors":"Nádia Armindo Henriques Fortes, Prem Yohannan","doi":"10.4314/AAS.V18I2.5","DOIUrl":"https://doi.org/10.4314/AAS.V18I2.5","url":null,"abstract":"Background: Our objective was to evaluate the clinical and epidemiological profile of maxillofacial trauma in patients attended to at the Maputo Central and Nampula Central hospitals in 2016. Methods: A descriptive cross-sectional retrospective study based on clinical records of all patients with maxillofacial trauma who attended consultations or were admitted to wards of the maxillofacial surgery services from January to December 2016. Statistical tests looking for significance levels of 5% were performed in SPSS. Results: Trauma accounted for 482 (35.65%) patients treated at the central hospitals of Maputo and Nampula: of these patients 373 (77.4%) fell in the 15–44-year age group, 363 (75.31%) were male, and 430 (89.21%) were ethnically African. Most patients (259 or 53.77%) treated at these hospitals were outpatients. The most frequent cause of trauma (albeit without statistical significance) was physical violence. The lower floor of the face was more frequently involved (279 or 57.88%), and the most common treatment was closed reduction (238 or 49.38%). Conclusion: The characteristic clinical and epidemiological profile of patients with maxillofacial trauma is mainly fractures of the lower floor of the face. These types of injuries are usually severe, and developing preventative and multidisciplinary conducts and treatment protocols for these patients is imperative.","PeriodicalId":37442,"journal":{"name":"Annals of African Surgery","volume":"18 1","pages":"85-89"},"PeriodicalIF":0.0,"publicationDate":"2021-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42246067","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}

引用次数: 0

Obstructed Right Upper Moiety in a Bilateral Partial Duplex Renal System in an Adult 成人双侧部分双肾系统右上半区梗阻

Annals of African Surgery Pub Date : 2021-04-23 DOI: 10.4314/AAS.V18I2.11

S. Anyimba, I. Nnabugwu, Chinwe A. Nnabugwu

{"title":"Obstructed Right Upper Moiety in a Bilateral Partial Duplex Renal System in an Adult","authors":"S. Anyimba, I. Nnabugwu, Chinwe A. Nnabugwu","doi":"10.4314/AAS.V18I2.11","DOIUrl":"https://doi.org/10.4314/AAS.V18I2.11","url":null,"abstract":"Duplex renal system, a common congenital anomaly of the kidney and urinary tract, is preferably identified through screening. For obstructed symptomatic duplications, prompt relief of obstruction to forestall renal parenchymal loss is recommended. We present a case of neglected obstruction of the right upper moiety in an adult female with discordant bilateral renal duplex system. A 49-year-old female with a 10-year history of recurrent right flank pain and fever presented for clinical evaluation and treatment. She had no such symptoms in early childhood. A diagnosis was made of obstructed right upper renal moiety in bilateral discordant renal duplication with complete moiety parenchymal destruction. She had right renal exploration with complete excision of the hydronephrotic sac and the grossly dilated moiety ureter down to the obstruction at the fusion of both upper and lower moiety ureters. Her postoperative period was uneventful. She is symptomfree and her urinary tract is structurally intact. Hitherto asymptomatic renal duplication can become symptomatic in early adulthood from intrinsic moiety ureter obstruction, suggesting a need for lifetime monitoring of persons with duplex renal systems. Late presentation with neglected symptoms, and consequent renal moiety destruction as seen here, is a result of the absence of such monitoring.","PeriodicalId":37442,"journal":{"name":"Annals of African Surgery","volume":"18 1","pages":"119-122"},"PeriodicalIF":0.0,"publicationDate":"2021-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44514724","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}

引用次数: 1

Negative Appendectomy Rate in Urban Referral Hospitals in Tanzania: A Cross-sectional Analysis of Associated Factors 坦桑尼亚城市转诊医院阑尾切除术阴性率:相关因素的横断面分析

Annals of African Surgery Pub Date : 2021-04-23 DOI: 10.4314/AAS.V18I2.9

Masawa K. Nyamuryekung’e, A. Athar, Miten R. Patel, Aidan Njau, Omar Sherman, A. Jusabani, Allie Zehr

{"title":"Negative Appendectomy Rate in Urban Referral Hospitals in Tanzania: A Cross-sectional Analysis of Associated Factors","authors":"Masawa K. Nyamuryekung’e, A. Athar, Miten R. Patel, Aidan Njau, Omar Sherman, A. Jusabani, Allie Zehr","doi":"10.4314/AAS.V18I2.9","DOIUrl":"https://doi.org/10.4314/AAS.V18I2.9","url":null,"abstract":"Background: Acute appendicitis (AA) has a lifetime risk of 8.3% with a consequent 23% lifetime risk of emergency appendectomy. In atypical presentation, making a clinical diagnosis is difficult, leading to a high perforation rate (PR) or misdiagnoses and high negative appendectomy rates (NAR). This study aimed to establish NAR and explore the associated factors and possible attainable solutions to reduce it in urban referral hospitals in Tanzania. Methods: This was a crosssectional study with 91 consecutive patients, aged 10 years and older undergoing appendectomy for suspected AA with histological evaluation of specimens. The study was powered to detect the NAR at 95% confidence level and 80% power. Results: The histological NAR was 38.5% and the perforation rate was 25.3%. The Alvarado score (AS) was rarely applied (6%), despite a demonstrated ability in this study to decrease the NAR by half. Females were four times more likely to undergo negative appendectomy than males. Conclusion: The NAR is clinically significant as about two out of every five patients undergoing emergency appendectomy for suspected AA do not require the procedure. The AS is underutilized despite a demonstrated ability to decrease the NAR. We recommend that the AS be incorporated in the management of patients with suspected appendicitis.","PeriodicalId":37442,"journal":{"name":"Annals of African Surgery","volume":"18 1","pages":"109-114"},"PeriodicalIF":0.0,"publicationDate":"2021-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45595522","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}

引用次数: 3

Influence of Intestinal Strangulation Release on Ischemiareperfusion Injury in Sprague Dawley Rats 肠绞窄释放对大鼠缺血再灌注损伤的影响

Annals of African Surgery Pub Date : 2021-04-23 DOI: 10.4314/AAS.V18I2.6

A. Yani, D. Dorothy, Rizky Amaliah

{"title":"Influence of Intestinal Strangulation Release on Ischemiareperfusion Injury in Sprague Dawley Rats","authors":"A. Yani, D. Dorothy, Rizky Amaliah","doi":"10.4314/AAS.V18I2.6","DOIUrl":"https://doi.org/10.4314/AAS.V18I2.6","url":null,"abstract":"Background: In intestinal ischemia, reperfusion towards the injured intestine can cause further injury to the intestine itself and to remote organs. This research aimed to evaluate the influence of intestinal strangulation release (SR) before resection on the intestine outside margin of the strangulated intestine compared with subjects without intestinal strangulation release (WSR). Methods: Fourteen male Sprague Dawley rats were subjected to strangulation of one loop of the distal ileum for 4 h. In the SR group, the strangulated intestine was released for 5 min and then resected for necrotic parts. In the WSR group, the strangulated intestine was immediately resected WSR. The control group received a sham laparotomy. Four hours after the second laparotomy, the animals were sacrificed, and intestinal samples were taken for histomorphological analysis and measurement of intestinal malondialdehyde (MDA) level. Results: The injury on the histomorphological intestinal mucosa and intestinal MDA level were insignificantly higher in the SR group than in the WSR group (p>0.05). Conclusion: Intestinal SR before resection causes more tissue injury and oxidative stress on the intestine outside the strangulation section, but the difference is not statistically significant.","PeriodicalId":37442,"journal":{"name":"Annals of African Surgery","volume":"18 1","pages":"90-95"},"PeriodicalIF":0.0,"publicationDate":"2021-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45083517","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}

引用次数: 0

Chylous Leakage Post-mastectomy and Axillary Dissection 乳房切除术及腋窝夹层后乳糜漏

Annals of African Surgery Pub Date : 2021-04-23 DOI: 10.4314/AAS.V18I2.12

Matheka Mwongeli, R. Wasike

引用次数: 0

Perforated Appendix in a Neonate: A Review of Literature and a Case Report from Northern Tanzania 新生儿阑尾穿孔:坦桑尼亚北部文献回顾和病例报告

Annals of African Surgery Pub Date : 2021-04-23 DOI: 10.4314/AAS.V18I2.10

Lodhia Jay, P. Rune, Wapalila Daudi, Sadiq Adnan, Amsi Patrick, M. David, Herman Ayesiga

引用次数: 2

Comparison of Outcomes of Open Tension-free Mesh Repair and Totally Extraperitoneal Laparoscopic Repair of Inguinoscrotal Hernias 开放式无张力疝环网修补术与全腹膜外腹腔镜疝环修补术的疗效比较

Annals of African Surgery Pub Date : 2021-02-09 DOI: 10.4314/AAS.V18I1.6

B. Shazi, M. Koto, C. Osuagwu, H. Schoeman

{"title":"Comparison of Outcomes of Open Tension-free Mesh Repair and Totally Extraperitoneal Laparoscopic Repair of Inguinoscrotal Hernias","authors":"B. Shazi, M. Koto, C. Osuagwu, H. Schoeman","doi":"10.4314/AAS.V18I1.6","DOIUrl":"https://doi.org/10.4314/AAS.V18I1.6","url":null,"abstract":"Background: This study aimed to determine the differences in postoperative complications experienced by patients with inguinoscrotal hernia after laparoscopic versus open repair, and the association of risk factors to development of postoperative complications. \u0000Methods: We retrospectively reviewed the charts of all patients with inguinoscrotal hernias who had either Lichtenstein repair or totally extraperitoneal laparoscopic (TEP) repair from January 2014 to December 2017. \u0000Results: The study was performed on evaluable data that could be extracted for 49 patients: 14 were offered TEP repair and 35 Lichtenstein repairs. There was no statistical difference in the mean operative time and mean time taken to return to normal activities between the two groups. The length of hospital stay was one day for both groups. Two patients from the TEP repair group and one patient from the Lichtenstein repair group developed recurrence. Three patients from the TEP group and one patient from the Lichtenstein repair group developed chronic groin pain. One patient from the totally extraperitoneal laparoscopic repair group developed a seroma. \u0000Conclusion: Our study demonstrated a trend towards better postoperative outcomes in the Lichtenstein repair group than in the TEP group. \u0000Keywords: Open tension-free mesh repair, Totally extraperitoneal laparoscopic repair, Inguinoscrotal hernias","PeriodicalId":37442,"journal":{"name":"Annals of African Surgery","volume":"18 1","pages":"29-33"},"PeriodicalIF":0.0,"publicationDate":"2021-02-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45117854","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}

引用次数: 1

Predicting Response to Neoadjuvant Chemotherapy in Women with Locally Advanced Breast Cancer in Kenya: Utility of Ki67 预测肯尼亚局部晚期乳腺癌妇女对新辅助化疗的反应:Ki67的效用

Annals of African Surgery Pub Date : 2021-02-09 DOI: 10.4314/AAS.V18I1.5

E. Mogere, J. Githaiga, F. Owilla, M. Mungania, D. Ojuka

{"title":"Predicting Response to Neoadjuvant Chemotherapy in Women with Locally Advanced Breast Cancer in Kenya: Utility of Ki67","authors":"E. Mogere, J. Githaiga, F. Owilla, M. Mungania, D. Ojuka","doi":"10.4314/AAS.V18I1.5","DOIUrl":"https://doi.org/10.4314/AAS.V18I1.5","url":null,"abstract":"Background: Ki67 levels have been shown to have good predictive value in breast cancer treatment. There is paucity of data on Ki67 levels in predicting response to neoadjuvant chemotherapy (NACT) in Kenya. This study evaluated the utility of Ki67 in predicting response to NACT. Methods: This was a prospective observational study carried out at Kenyatta National Hospital between December 2017 and January 2019 onpatients with locally advanced breast cancer. We recruited 61 women through consecutive sampling technique. Data collected included patient demographics, pre-treatment tumor size, Ki67 levels and tumor biology. After 3 cycles of first-line chemotherapy, ultrasonography was used to determine response. Data were analyzed by SPSS for proportion of change in tumor size. The response was correlated with tumor biology and pretreatment levels of Ki67 using chisquare at a 95% confidence interval. A p-value <0.05 was considered statistically significant. Results: The response rate after 3 cycles of NACT was 39.4%, sensitivity and specificity of Ki67 levels were 70.8% and 43.2% respectively with a cut-off value of 32.5%. Conclusions: Ki67 was found to predict response in our context at a rate of 39.4% at 20% cutoff after 3 cycles. Keywords: Ki67, Breast cancer, Neoadjuvant chemotherapy","PeriodicalId":37442,"journal":{"name":"Annals of African Surgery","volume":"47 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-02-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86703789","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}

引用次数: 0