South African Journal of Surgery最新文献

Stakeholder engagement towards establishing a national thyroid cancer registry in South Africa. 利益攸关方参与建立南非国家甲状腺癌登记处。

IF 0.6 4区医学

South African Journal of Surgery Pub Date : 2025-11-01 DOI: 10.36303/SAJS.03031

W Conradie, K J Baatjes, L Martin, T Luvhengo, J Lübbe, E Archer

{"title":"Stakeholder engagement towards establishing a national thyroid cancer registry in South Africa.","authors":"W Conradie, K J Baatjes, L Martin, T Luvhengo, J Lübbe, E Archer","doi":"10.36303/SAJS.03031","DOIUrl":"10.36303/SAJS.03031","url":null,"abstract":"Background: Patient registries in South Africa (SA) are not common. This study explored the perceptions and experiences of thyroid clinicians and members of existing patient registries in SA, aiming to establish a national thyroid cancer registry.Methods: This was an exploratory qualitative study based on surveys and semi-structured interviews of participants' experiences treating thyroid cancer and using registries in general. Convenience sampling was performed for the surveys (n = 27) and purposive sampling for the interviews (n = 20). Data collection and analysis were conducted concurrently, facilitating an iterative process. The thematic analysis followed the steps outlined by Braun and Clarke.Results: Four themes were identified. The South African healthcare system, the perceived value of a patient registry, the role of various stakeholders, and barriers to registry implementation. Participants expressed the value of registries in SA for both clinical and research purposes. However, concerns were raised regarding perceived challenges, such as resource and time constraints.Conclusion: Developing a national thyroid cancer registry in SA requires responsiveness to national and local challenges and opportunities, necessitating an adaptable registry format. The principle of a registry is strongly supported by clinician stakeholders. The registry, as a clinical note-keeping system, will optimise clinicians' time efficiency in patient care, and standardisation of radiology and pathology reporting across a uniform platform will enhance patient care and data entry. The benefits of a registry strongly outweigh the challenges as it facilitates the development of local guidelines, improves patient outcomes, and promotes collaborative research among endocrine clinicians.","PeriodicalId":51161,"journal":{"name":"South African Journal of Surgery","volume":"63 4","pages":"212-221"},"PeriodicalIF":0.6,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147349686","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Damage control surgery: Trauma. 损伤控制外科：创伤。

IF 0.6 4区医学

South African Journal of Surgery Pub Date : 2025-11-01 DOI: 10.36303/SAJS.03268

H Wain

引用次数: 0

Audit to evaluate the clinical presentation and surgical management of acute appendicitis at a secondary-level hospital in the Western Cape. 审计以评估西开普省一家二级医院急性阑尾炎的临床表现和外科治疗。

IF 0.6 4区医学

South African Journal of Surgery Pub Date : 2025-11-01 DOI: 10.36303/SAJS.02727

I N Palkowski, K Polden, C Claasen, Y Lee, A H Stark

{"title":"Audit to evaluate the clinical presentation and surgical management of acute appendicitis at a secondary-level hospital in the Western Cape.","authors":"I N Palkowski, K Polden, C Claasen, Y Lee, A H Stark","doi":"10.36303/SAJS.02727","DOIUrl":"10.36303/SAJS.02727","url":null,"abstract":"Background: Acute appendicitis is a frequent cause of abdominal emergencies, with delayed presentation and diagnosis increasing the risk of perforation and postoperative morbidity. In South Africa, the accessibility to healthcare and referral to surgical services can impact patient outcomes.Methods: All patients treated for acute appendicitis at George Regional Hospital during the period January 2024 - December 2024 (1 year) were included in the study. Patients who were admitted with acute appendicitis but discharged with an alternative diagnosis were excluded.Results: The sample consisted of 218 patients. The majority (88.5%) underwent surgical management, with the remainder managed conservatively. Patients referred from district hospitals had a significantly higher rate of perforated appendicitis compared to local patients (57.9% vs 40.2%, p = 0.014). Delayed presentation with symptoms beyond 72 hours was strongly associated with perforation (IQR 2.0-4.5; p = 0.034). Laparoscopic appendicectomy was performed in 66.3% of cases, with a 20.3% conversion rate to open surgery, predominantly in cases of perforation. The median length of stay was longer in patients with perforated appendicitis (IQR 3-6 days; p < 0.001). No in-hospital mortality was observed.Conclusion: Delayed presentation was significantly associated with a higher risk of perforated appendicitis and greater operative complexity. Patients referred from district hospitals experienced higher rates of perforation likely due to delays in recognition, referral, and access to surgical care. Improving early diagnosis and streamlining referral pathways may reduce the incidence of complicated appendicitis and improve patient outcomes in our region.","PeriodicalId":51161,"journal":{"name":"South African Journal of Surgery","volume":"63 4","pages":"252-256"},"PeriodicalIF":0.6,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147349637","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Editorial commentary: Abbreviated laparotomy: advantages and disadvantages in South African practice. 编辑评论：缩短剖腹手术：优缺点在南非的做法。

IF 0.6 4区医学

South African Journal of Surgery Pub Date : 2025-11-01 DOI: 10.36303/SAJS.03689

M S Moeng, T C Hardcastle

引用次数: 0

Preliminary experience of reverse lymphatic mapping technique using indocyanine green dye lymphangiography and patent blue dye in melanoma patients undergoing sentinel lymph node biopsies: a case series. 用吲哚菁绿染色淋巴管造影和专利蓝染色在接受前哨淋巴结活检的黑色素瘤患者中的反向淋巴作图技术的初步经验：一个病例系列。

IF 0.6 4区医学

South African Journal of Surgery Pub Date : 2025-11-01 DOI: 10.36303/SAJS.02845

C K Hsu, F Y Hsu

引用次数: 0

Eight-year survival with metastatic oesophageal carcinoma: a case report and review of the literature. 转移性食管癌8年生存率：1例报告及文献回顾。

IF 0.6 4区医学

South African Journal of Surgery Pub Date : 2025-11-01 DOI: 10.36303/SAJS.02497

H Kasai, W Begg, M Mihalik

引用次数: 0

Microductectomy under local anaesthetic for pathological nipple discharge. Is it time to change practice? 局部麻醉下微导管切除术治疗病理性乳头溢液。是时候改变做法了吗？

IF 0.6 4区医学

South African Journal of Surgery Pub Date : 2025-11-01 DOI: 10.36303/SAJS.02501

A Khamajeet, F Malherbe

{"title":"Microductectomy under local anaesthetic for pathological nipple discharge. Is it time to change practice?","authors":"A Khamajeet, F Malherbe","doi":"10.36303/SAJS.02501","DOIUrl":"10.36303/SAJS.02501","url":null,"abstract":"Background: Pathological nipple discharge (PND) is a common clinical concern that requires careful evaluation to rule out malignancy. Microductectomy is the gold-standard surgical intervention for both diagnosis and symptom relief. In most centres, it is usually performed under general anaesthesia. This study aims to assess the feasibility, efficacy, and safety of performing microductectomy under local anaesthesia without sedation, a technique adapted during the COVID-19 pandemic to address resource constraints.Methods: A retrospective review was conducted on all patients who underwent microductectomy under local anaesthesia at Groote Schuur Hospital between January 2021 and December 2022. Data were collected on demographics, imaging used, imaging findings, biopsy results, and histological diagnoses.Results: A total of 23 patients were included, with a median age of 55 years (interquartile range, IQR, 45-60 years). All patients presented with spontaneous nipple discharge (ND), with 75% reporting bloody ND. Dual imaging (mammography and ultrasound) was performed in 78.2% of cases, while 39.1% of patients underwent preoperative biopsy. Histology revealed intraductal papilloma in 65.2%, ductal hyperplasia in 39.1%, and ductal ectasia in 21.7% of cases. One patient (4.3%) was diagnosed with papillary ductal carcinoma in situ (DCIS). No invasive malignancy was detected, and no complications were reported postoperatively.Conclusion: Microductectomy conducted under local anaesthesia without sedation appears to be a safe, effective, and feasible method for managing PND. It benefits resource-limited settings by decreasing reliance on general anaesthesia while preserving diagnostic and therapeutic efficacy. Further prospective studies with larger sample sizes incorporating patient satisfaction, procedure duration, diagnostic yield, recurrence rates, and completeness of excision are advised to evaluate long-term outcomes and patient experiences.","PeriodicalId":51161,"journal":{"name":"South African Journal of Surgery","volume":"63 4","pages":"207-211"},"PeriodicalIF":0.6,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147349574","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Abbreviated laparotomy (damage control) in emergency general surgery: indications, risks and resource-based applications in the South African context. 急诊普通外科中的简易剖腹手术（损伤控制）：南非背景下的适应症、风险和基于资源的应用

IF 0.6 4区医学

South African Journal of Surgery Pub Date : 2025-11-01 DOI: 10.36303/SAJS.03298

C Pothas

引用次数: 0

Retrospective observational review comparing pre- and post-COVID-19 surgical services at Mankweng Hospital. 回顾性观察性评价比较满城医院covid -19术前和术后手术服务。

IF 0.6 4区医学

South African Journal of Surgery Pub Date : 2025-11-01 DOI: 10.36303/SAJS.02810

M M Z Bhuiyan

{"title":"Retrospective observational review comparing pre- and post-COVID-19 surgical services at Mankweng Hospital.","authors":"M M Z Bhuiyan","doi":"10.36303/SAJS.02810","DOIUrl":"10.36303/SAJS.02810","url":null,"abstract":"Background: The COVID-19 pandemic disrupted normal activity in the whole world. During the hard lockdown, surgical services were drastically reduced in all South African hospitals. The main objective of the study was to assess the recovery phase of surgical activity in the post-pandemic period at Mankweng Hospital, a tertiary hospital in Limpopo.Methods: A retrospective descriptive study of surgical services was done for three periods, namely pre-COVID-19, during COVID-19 and post-pandemic COVID-19. Data for the study were collected for one year from each group, from April to March, from the general surgery, orthopaedic and gynaecology departments. The pre-COVID-19 period included April 2019 to March 2020, the COVID-19 pandemic period from April 2020 to March 2021, and the post-pandemic COVID-19 period from April 2023 to March 2024.Results: The total combined operations performed from general surgery, orthopaedic and gynaecology departments during the pre-pandemic period were 2 446, during the COVID-19 pandemic period: 1 969, and during the post-pandemic period: 2 200. Department-wise, the number of operations performed in general surgery during the pre-COVID-19 period was 712, during the COVID-19 period: 657, and during post-pandemic COVID-19 period: 780. In the orthopaedics department, operations performed during the pre-COVID-19 period were 1 031, during the COVID-19 period: 912, and during the post-pandemic COVID-19 period: 752. In the gynaecology department, the number of operations performed during the pre-COVID-19 period was 703, during the COVID-19 period: 400, and during the post-pandemic COVID-19 period: 668.Conclusion: The recovery phase of the post-pandemic COVID-19 surgical service was not adequate in comparison to the pre-COVID-19 period, particularly for orthopaedic operations. It is of paramount importance that a drastic plan be made to increase theatre utilisation.","PeriodicalId":51161,"journal":{"name":"South African Journal of Surgery","volume":"63 4","pages":"257-261"},"PeriodicalIF":0.6,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147349698","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Risk factors for foetal loss in injured pregnant patients: an analysis of 105 patients managed at a major trauma centre in South Africa. 受伤孕妇胎儿丢失的危险因素：对南非一家主要创伤中心管理的105名患者的分析。

IF 0.6 4区医学

South African Journal of Surgery Pub Date : 2025-11-01 DOI: 10.36303/SAJS.02713

L N Yong, C Y Chung, V Y Kong, J Ko, H Lee, H Wain, W Bekker, J L Bruce, G L Laing, D L Clarke

{"title":"Risk factors for foetal loss in injured pregnant patients: an analysis of 105 patients managed at a major trauma centre in South Africa.","authors":"L N Yong, C Y Chung, V Y Kong, J Ko, H Lee, H Wain, W Bekker, J L Bruce, G L Laing, D L Clarke","doi":"10.36303/SAJS.02713","DOIUrl":"10.36303/SAJS.02713","url":null,"abstract":"Background: Pregnant patients in trauma present a unique challenge for clinicians to manage both foetal and maternal well-being, requiring specialised resuscitation algorithms. This study reviews the outcome of pregnant trauma patients in a major trauma centre in South Africa and the risk factors associated with foetal loss.Methods: This is a retrospective analysis of all pregnant patients admitted to the Pietermaritzburg Metropolitan Trauma Service (PMTS) from January 2012 to December 2023. Patient data abstracted included mechanism of injury, physiological parameters, injury severity score (ISS), gestational age, diagnostic and surgical procedures performed, complications, and maternal and foetal mortality. Univariate logistic regression analysis was used.Results: During the study period, a total of 124 female pregnant patients were admitted, and 105 were analysed after excluding 19 patients with missing data. The mean age of the patients in the study was 26 years, with an average gestation age of 18 weeks. Blunt trauma accounted for majority of the injuries (62%). Foetal death occurred in 16% of cases. Risk factors associated with foetal death were high shock index (OR 38.0, 95% CI: 0.8-1793.0), high ISS (OR 1.2, 95% CI: 1.1-1.3), and the need for laparotomy (OR 6.9, CI: 1.4-34.1).Conclusion: Risk factors for foetal loss include injury severity, shock on admission and the need for laparotomy. Identifying these risk factors might improve management of foetal and maternal health.","PeriodicalId":51161,"journal":{"name":"South African Journal of Surgery","volume":"63 4","pages":"229-233"},"PeriodicalIF":0.6,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147349737","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0