Saudi Surgical Journal最新文献_第4页

Volume of resected stomach after laparoscopic sleeve gastrectomy and its correlation with initial body mass index and weight loss 腹腔镜袖胃切除术后切除胃体积与初始体重指数及体重减轻的关系

Saudi Surgical Journal Pub Date : 2020-01-01 DOI: 10.4103/ssj.ssj_26_20

Kshitij Kirane, Deepak S. Phalgune, S. Shah

{"title":"Volume of resected stomach after laparoscopic sleeve gastrectomy and its correlation with initial body mass index and weight loss","authors":"Kshitij Kirane, Deepak S. Phalgune, S. Shah","doi":"10.4103/ssj.ssj_26_20","DOIUrl":"https://doi.org/10.4103/ssj.ssj_26_20","url":null,"abstract":"Background: The relation between the resected stomach volume (RSV) and the weight loss after laparoscopic sleeve gastrectomy (LSG) appears conflicting in the literature. The aim of the present research was to find the correlation of RSV after LSG, the percentage of excess weight loss (%EWL) at 6-month and 1-year follow-up, and the initial body mass index (BMI). Materials and Methods: Sixty patients aged between 18 and 60 years who underwent LSG were included. Preoperatively, the baseline data of patients such as BMI and presence of Type 2 diabetes mellitus were noted. LSG was performed under general anesthesia. The resected stomach was punctured with Veress needle and insufflated with CO2. The maximum volume was recorded as RSV. The sleeve volume was measured by the amount of methylene blue used to distend the stomach during the leak test. %EWL was calculated at 6 months and 12 months. The primary outcome measures were to find the correlation of RSV with %EWL and BMI, whereas the secondary outcome measure was to find the correlation of vertical length of staple line with %EWL. Comparison of categorical and continuous variables was done using Chi-square test/Fisher's exact test and unpaired t-test, respectively. Correlation analysis was done using Pearson's correlation technique. Results: The RSV positively correlated with initial BMI (r = 0.456). There was no significant correlation of RSV, sleeve volume, and vertical length of staple line with %EWL at 6-month and 12-month postoperative intervals. Conclusion: RSV positively correlated with baseline BMI, but not correlated with %EWL.","PeriodicalId":420307,"journal":{"name":"Saudi Surgical Journal","volume":"8 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130747497","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

Management of postcholecystectomy biliary leakage: Five-year experience of a tertiary centre in Northeast India 胆囊切除术后胆漏的处理:印度东北部一家三级医疗中心的五年经验

Saudi Surgical Journal Pub Date : 2020-01-01 DOI: 10.4103/ssj.ssj_39_20

A. Roy, N. Das, U. Deka

引用次数: 0

Correlating intraoperative bile culture with postoperative morbidity in pancreaticoduodenectomy 胰十二指肠切除术术中胆汁培养与术后发病率的关系

Saudi Surgical Journal Pub Date : 2020-01-01 DOI: 10.4103/ssj.ssj_43_20

M. Lattoo, Sadaf Ali

{"title":"Correlating intraoperative bile culture with postoperative morbidity in pancreaticoduodenectomy","authors":"M. Lattoo, Sadaf Ali","doi":"10.4103/ssj.ssj_43_20","DOIUrl":"https://doi.org/10.4103/ssj.ssj_43_20","url":null,"abstract":"Background: The reported incidence of bacteria in bile is extremely variable from 8% to 42%. Several authors have been able to correlate the bacteria cultured from bile at pancreatico-duodenectomy (PD) with those subsequently causing wound infections and septicemia in the postoperative period. In addition, preoperative biliary intervention increases the risk of bactibilia that can translate into increased postoperative morbidity. Materials and Methods: This study was a prospective study conducted at the Department of Surgical Gastroenterology in Sher-I-Kashmir Institute of Medical Sciences from January 2015 to July 2020. A total of 71 patients who underwent PD were included in the study. Results: All patients had intraoperative bile culture (IBC). IBC was positive in forty (56.3%) patients. IBC was more likely to be positive in patients with preoperative intervention as compared to those with no intervention (86.11% vs. 13.89%). IBC was polymicrobial in 28/40 (70%) patients, with Escherichia coli and Klebsiella Pneumoniae both cultured together in 40% of patients. The monomicrobial infection was mainly due to E. coli in 22.5% of patients. Six/40 (15%) patients with bactibilia had wound infection and 4/40 (10%) patients had intra-abdominal collection. Patients with intervention had more of bactibilia (31/36 [86.11%]) compared to that of noninterventional group (9/35 [25.71%]), showing that the intervention was associated with an increased risk of biliary infection. The percentage of multidrug-resistant strains in our study was 97.7%. Conclusion: Positive IBC can determine the cohort of patients who are at risk of postoperative morbidity. Patients with preoperative intervention should be considered potentially infected who deserve careful operative technique to avoid spillage of bile to minimize wound infection and other morbidity. IBC also allows for early appropriate antibiotic use.","PeriodicalId":420307,"journal":{"name":"Saudi Surgical Journal","volume":"23 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127416723","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

Laparoscopic treatment of Morgagni hernia Morgagni疝的腹腔镜治疗

Saudi Surgical Journal Pub Date : 2020-01-01 DOI: 10.4103/ssj.ssj_13_20

B. Assakran, Shaima A. Alharbi, F. Alharbi

引用次数: 1

Thoracoscopic examination of the thoracic cavity during laparotomy in traumatic diaphragm injuries 外伤性横膈膜损伤开腹时胸腔镜下胸腔检查

Saudi Surgical Journal Pub Date : 2020-01-01 DOI: 10.4103/ssj.ssj_40_20

Y. Pi̇rhan, Tevrat Özalp

{"title":"Thoracoscopic examination of the thoracic cavity during laparotomy in traumatic diaphragm injuries","authors":"Y. Pi̇rhan, Tevrat Özalp","doi":"10.4103/ssj.ssj_40_20","DOIUrl":"https://doi.org/10.4103/ssj.ssj_40_20","url":null,"abstract":"Background: Traumatic diaphragmatic injury (TDI) is one of the injuries that can occur after blunt and penetrating trauma and can be neglected or missed due to the masking of accompanying organ injuries. In this study, we delved into the difficulties in the diagnostic and treatment approaches for TDI patients. Methods: We retrospectively examined 22 TDI cases who were urgently operated following blunt (n = 14) and penetrating (n = 8) traumas in thoracic and general surgery clinics between January 2004 and 2019. We recorded information such as trauma type, diagnostic techniques, concomitant organ injuries, the location of diaphragmatic injury and its stage, the herniated organs toward the chest cavity, and surgical method. Results: The average mean age of the cases in the study was 41.5 years (22–66 years), and all of them were male. Among these, the percentage of pericardial rupture was significant (23%). In abdominal approaches, thorax was examined with an optical camera through the diaphragmatic rupture. TDI was classified into five groups based on the severity of the injury. Additionally, diaphragmatic ruptures in the central tendon or subpericardial area were examined. The entire central diaphragmatic injury was found as blunt trauma. This group was diagnosed with a high rate of multiple organ injuries (100%) and pericardial rupture (30%). Morbidity was 36%, and mortality was 14%. Conclusion: TDI should be taken into consideration in thoracoabdominal traumas. The frequency of organ injury in high-level TDI is also high. Therefore, laparoscopic and thoracoscopic evaluations should be needed. A good preoperative and peroperative strategy diminishes mortality and morbidity. We suggest that laparoscopy and thoracoscopy will be a lifesaving method in high-grade TDIs.","PeriodicalId":420307,"journal":{"name":"Saudi Surgical Journal","volume":"11 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125448055","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

An audit of pain management at a tertiary care center 对三级保健中心疼痛管理的审计

Saudi Surgical Journal Pub Date : 2020-01-01 DOI: 10.4103/ssj.ssj_44_20

Dhananjay Kumar, B. Jat, S. Pachaury, H. Verma

{"title":"An audit of pain management at a tertiary care center","authors":"Dhananjay Kumar, B. Jat, S. Pachaury, H. Verma","doi":"10.4103/ssj.ssj_44_20","DOIUrl":"https://doi.org/10.4103/ssj.ssj_44_20","url":null,"abstract":"Introduction: Pain management is a vital part of postoperative treatment. Pain management in the postoperative period is based on a number of factors such as the extent of surgery, patient profile and surgeon experience, etc. The numbers of subjective scoring system were proposed to scale the severity of pain. Materials and Methods: This prospective audit was performed between November 2015 to January 2016. Pain scores were recorded in all patients underwent surgery for initial three days by numerical rating scale (NRS). Results: A total of 92 patients were included in this audit. The patients were broadly divided into the two groups: non-malignancy group and malignancy group. Pain scores were found higher in adult patients, in malignancy patients, and in patients who require wide excision. The scores were found on the lower side in the ear and throat surgery group in comparison to the nose surgery group. Discussion: Postoperative pain is an individual multi-factorial experience. Poor management is likely to increases the chances of local and systemic complications and delays in the recovery of the patients. Appropriate selection of analgesics would reduce hospital financial burden to a great extent but the side effect profile of each drug should be kept in mind.","PeriodicalId":420307,"journal":{"name":"Saudi Surgical Journal","volume":"45 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134515567","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

Surgery during the COVID-19 pandemic COVID-19大流行期间的手术

Saudi Surgical Journal Pub Date : 2020-01-01 DOI: 10.4103/ssj.ssj_29_20

D. Bhandarkar, L. Pinto

引用次数: 0

Controlled fistula: A valid option for the management of post bariatric surgery leak 控制瘘管:一个有效的选择，管理后减肥手术泄漏

Saudi Surgical Journal Pub Date : 2020-01-01 DOI: 10.4103/ssj.ssj_45_20

M. Rabie, Ahmad Al Hazmi, Ismaeel El Hakeem, Rifaat Shakik, Asim Elias, A. Al Qahtani, T. Malatani, Saeed Al Khiar

{"title":"Controlled fistula: A valid option for the management of post bariatric surgery leak","authors":"M. Rabie, Ahmad Al Hazmi, Ismaeel El Hakeem, Rifaat Shakik, Asim Elias, A. Al Qahtani, T. Malatani, Saeed Al Khiar","doi":"10.4103/ssj.ssj_45_20","DOIUrl":"https://doi.org/10.4103/ssj.ssj_45_20","url":null,"abstract":"Currently, bariatric surgery procedures has witnessed an upsurge in its utilization to control obesity and its allied morbidities. However, gastric or anastomotic leak, though rare, is its most dreadful complication. In this report we describe the clinical course of a 41 year-old-male, with a body mass index of 41.6, who underwent open mini gastric bypass which was followed by leak. A second laparotomy was performed in which intraperitoneal drains were inserted and a feeding jejunostomy was constructed. This was followed by the insertion of a mega stent, along with the application of over the scope clip at the site of the leak. Few days later, he appeared in our hospital with manifestations of sepsis. Computerized tomography scan showed persistence of leak with a perisplenic collection. A third laparotomy was performed and after tedious dissection, the stent was found eroding through the site of gastrojejunostomy. The defect was closed over a T tube and the perisplenic collection was drained. The patient tolerated surgery well, but he developed wound infection with disruption. Conservative treatment was followed to create a controlled incisional hernia, to be dealt with later. After a lengthy hospital stay, radioloic studies showed cessation of the leak with no collection. T tube, drains and jejunostomy tube were removed in time and the patient was discharged in good condition for OPD follow-up.","PeriodicalId":420307,"journal":{"name":"Saudi Surgical Journal","volume":"19 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132978834","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

Quality of life in post lumbar microdiscectomy patients using the EuroQol 5-dimension 5-level scale 使用EuroQol 5维5级量表评价腰椎微椎间盘切除术后患者的生活质量

Saudi Surgical Journal Pub Date : 2020-01-01 DOI: 10.4103/ssj.ssj_31_19

I. Alnaami, S. Shakir, K. Almalwi, A. Alquzi, M. Asiri, M. Asiri, Nasser G Alqahtani, Shehata F Shehata

{"title":"Quality of life in post lumbar microdiscectomy patients using the EuroQol 5-dimension 5-level scale","authors":"I. Alnaami, S. Shakir, K. Almalwi, A. Alquzi, M. Asiri, M. Asiri, Nasser G Alqahtani, Shehata F Shehata","doi":"10.4103/ssj.ssj_31_19","DOIUrl":"https://doi.org/10.4103/ssj.ssj_31_19","url":null,"abstract":"Objectives: The current study aimed to assess the impact of microdiscectomy surgery on quality of life (QOL) in postoperative patients across many facets of life to identify the most commonly affected ones. Our research question was, “does majority of postlumbar microdiscectomy patients have good QOL postsurgery?” Patients and Methods: In a single tertiary care center in southern region, Saudi Arabia, ninety-seven patients who underwent discectomy at Aseer Central Hospital (ACH) in southwestern Saudi Arabia from 2015 to 2017 were included in this study. ACH is the only tertiary care center in Asir province. Patients with spinal fractures or incomplete files were excluded. Patients' files were reviewed for data extraction. A phone call was made to all patients and they were asked to answer the five questions of the five domains of the EuroQoL 5-dimension 5-level (EQ-5D-5 L) QOL questionnaire. After considering other variables and adjusting for potential confounders, we assessed the amount of patients' satisfaction in the 5 domains of EQ-5D-5 L. Results: The study included 97 patients whose ages ranged from 28 to 56 years with a mean age of 42.6 ± 10.8 years. Nearly 61% of the patients were male. In all, 56.7% of patients reported a high QOL, while 4.1% of them had a poor QOL. About 82% of the included patients had no or minimal self-care problems, while 65.9% of the patients had no or minimal pain. Conclusions: The researchers concluded that about half of the patients who underwent lumbar microdiscectomy had a high QOL. The greatest improvements following microdiscectomy were recorded for self-care, mobility, and psychological status, while the lowest improvements were noted for pain and discomfort.","PeriodicalId":420307,"journal":{"name":"Saudi Surgical Journal","volume":"347 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121613081","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

Right congenital diaphragmatic hernia: Four cases and literature review 右侧先天性膈疝4例并文献复习

Saudi Surgical Journal Pub Date : 2019-10-01 DOI: 10.4103/ssj.ssj_42_17

Charu Tiwari, H. Shah, Vikrant Kumbhar, D. Makhija, Jyoti Bothra, Gursev Sandlas

{"title":"Right congenital diaphragmatic hernia: Four cases and literature review","authors":"Charu Tiwari, H. Shah, Vikrant Kumbhar, D. Makhija, Jyoti Bothra, Gursev Sandlas","doi":"10.4103/ssj.ssj_42_17","DOIUrl":"https://doi.org/10.4103/ssj.ssj_42_17","url":null,"abstract":"Background: Left-sided Bochdalek congenital diaphragmatic hernia (CDH) is the most common type of CDH. The right-sided Bochdalek CDH is rare and usually contains only the liver as its content. We describe four children with right CDH managed at our institution over 3 years. Materials and Methods: We present a retrospective analysis of four patients with right CDH managed at our institution from 2012 to 2015 with respect to age at presentation, sex, presenting symptoms, investigations, associated anomalies, management, and outcome. Results: The average age at presentation was 1.5 years, with range being 5 days to 4 years. The three older children presented with a history of frequent respiratory tract infections. The neonate was a preterm low-birth weight baby and had respiratory distress since birth. A chest radiograph suggested right pneumothorax for which intercostal chest drain insertion was done. A repeat chest X-ray showed suspicion of right-sided CDH which was confirmed on computerized tomography. All four patients underwent right thoracotomy with repair of the CDH. The neonate expired on the 4th postoperative day. The other three children had an uneventful postoperative recovery. Conclusion: Right-sided CDH is rare and has varied presentations and poorer outcome.","PeriodicalId":420307,"journal":{"name":"Saudi Surgical Journal","volume":"84 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126219211","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