South African Journal of Surgery最新文献_第10页

Factors influencing outcome in patients with perforated peptic ulcer disease at a South African tertiary hospital. 南非一家三级医院消化性溃疡穿孔患者预后的影响因素。

IF 0.5 4区医学

South African Journal of Surgery Pub Date : 2023-10-17 DOI: 10.36303/SAJS.4005

J J Nanack, L Ferndale

{"title":"Factors influencing outcome in patients with perforated peptic ulcer disease at a South African tertiary hospital.","authors":"J J Nanack, L Ferndale","doi":"10.36303/SAJS.4005","DOIUrl":"https://doi.org/10.36303/SAJS.4005","url":null,"abstract":"Background: Perforated peptic ulcer (PPU) is associated with significant morbidity and mortality, particularly in low to middle income countries. This study aimed to scrutinise the clinical course of patients diagnosed with PPU and identify modifiable factors to improve outcomes.Methods: A retrospective review of the hybrid electronic medical record (HEMR) database at Grey's Hospital was performed. All patients diagnosed with PPU between January 2013 and December 2020 were entered into the study. The variables collected include age, ethnicity, comorbid profile, Boey score, type of surgery performed and complications. These factors were analysed to determine the factors responsible for morbidity and mortality.Results: One hundred and ninety four patients were diagnosed with PPU during the study period. Six patients were treated non-operatively, all of whom survived. In the surgically treated group, omental patch repair was performed in 159 (84.5%) patients, and primary closure in 26 (13.8%) patients. The leak rate was 32% in the cohort that underwent relaparotomy and the overall mortality was 14%. There was no significant relationship between the type of repair performed and outcome. All patients had a Boey score of 1 or more. The following factors were found to increase the probability of in-hospital mortality: age > 40 years (OR: 8.49, 95% CI 2.46-29.29 p < 0.01), female gender (OR: 2.509, CI 0.98-6.37, p = 0.048), need for relaparotomy (OR: 0.398, CI 0.17-0.91, p = 0.027) and Boey score > 1 (OR: 46.437, CI 6.13-350.28, p < 0.01). A Boey score > 1 was the only variable that increased the likelihood of finding a leaking repair at relaparotomy (p < 0.01).Conclusion: The Boey score was a significant predictor of mortality and leak rate in our patients with PPU. Adding age as a variable may improve the ability to predict mortality in our setting, while the impact of gender and ethnicity needs further investigation.","PeriodicalId":51161,"journal":{"name":"South African Journal of Surgery","volume":"61 4","pages":""},"PeriodicalIF":0.5,"publicationDate":"2023-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41240737","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

Small bowel metastasis from embryonal rhabdomyosarcoma of the extremity- a case report. 胚胎性四肢横纹肌肉瘤小肠转移1例报告。

IF 0.5 4区医学

South African Journal of Surgery Pub Date : 2023-10-17 DOI: 10.36303/SAJS.4120

P Joubert, M Mihalik

引用次数: 0

The impact of the COVID-19 pandemic on presentation of surgical disease in paediatric patients at a tertiary centre in Cape Town, South Africa. 新冠肺炎大流行对南非开普敦一家三级中心儿科患者外科疾病表现的影响。

IF 0.5 4区医学

South African Journal of Surgery Pub Date : 2023-10-17 DOI: 10.36303/SAJS.4060

C Kohler, B Banieghbal

{"title":"The impact of the COVID-19 pandemic on presentation of surgical disease in paediatric patients at a tertiary centre in Cape Town, South Africa.","authors":"C Kohler, B Banieghbal","doi":"10.36303/SAJS.4060","DOIUrl":"https://doi.org/10.36303/SAJS.4060","url":null,"abstract":"Background: Children are less susceptible to infection with SARS-CoV-2 and subsequent severe disease, yet especially vulnerable to the indirect effects of the pandemic. A constrained healthcare service, combined with the societal and behavioural changes observed during the pandemic, is likely to have altered the presentation of paediatric surgical disease. The objective was to investigate the impact of the COVID-19 pandemic on the volume of paediatric surgical admissions, the severity of disease and the type of surgical pathology treated at our centre.Methods: A retrospective cohort study compared paediatric surgical admissions in an eleven-month period before COVID-19 to the same period during the pandemic. Comparisons in volume and diagnoses were based on the number of admissions. Predetermined criteria for severity of disease using triage scores, intraoperative findings and intensive care admissions were compared.Results: A total of 1 810 admissions were recorded, 1061 in the pre-COVID group and 749 during COVID. Emergency admissions reduced by 9.2%, most notably due to a reduction in trauma, caustic ingestions and constipation. There was an increase in incarcerated inguinal hernias and helminth-related pathologies. Significantly more intussusceptions failed pneumatic reduction requiring surgical intervention with bowel resection. There was a two-fold increase in patients requiring emergency intensive care.Conclusion: Paediatric surgical volumes at our centre decreased during the COVID-19 pandemic. There was evidence of more advanced disease on presentation of inguinal hernias and intussusception and a generalised increased demand for emergency ICU admission.","PeriodicalId":51161,"journal":{"name":"South African Journal of Surgery","volume":"61 4","pages":""},"PeriodicalIF":0.5,"publicationDate":"2023-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41240747","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: 1

Geographic distribution of pancreaticobiliary malignancy in central South Africa presenting to the Universitas Academic Hospital Complex. 南非中部的胰胆管恶性肿瘤的地理分布向Universitas Academic Hospital Complex展示。

IF 0.5 4区医学

South African Journal of Surgery Pub Date : 2023-09-01

R J Mthunzi, C B Noel

{"title":"Geographic distribution of pancreaticobiliary malignancy in central South Africa presenting to the Universitas Academic Hospital Complex.","authors":"R J Mthunzi, C B Noel","doi":"","DOIUrl":"","url":null,"abstract":"Background: There is limited data on the epidemiology, determination of risk factors and geographical variation of pancreatic cancer in South Africa. The aim of this study is to describe these parameters within central South Africa and compare to national and international reports.Methods: A retrospective review of all patients with newly diagnosed pancreatic cancer on clinical and radiological grounds admitted to Universitas Academic Hospital from 1st January 2015 to 31st December 2019 was performed. Patients were grouped into geographical regions based on their district municipality to identify clusters of pancreatic cancer. Demographic information and details of family history, diabetes and smoking status, and chronic pancreatitis were recorded and analysed in conjuction with the geographical and census data to provided estimates of disease incidence.Results: The mean age of the the 382 patients with pancreatic cancer in the study period was 62.8 years ± 11.06. Two hundred and twelve (55.5%) were females. The Frances Baard district in the Northern Cape had the highest estimated rate of 3.5/100 000 and the Thabo Mofutsanyana district the lowest at 1.0/100 000. Of the cohort 132 (34.5%) were active smokers, 71 (18.6%) had diabetes mellitus, four (1%) had a history of chronic pancreatitis and two (0.5%) had a family history of pancreatic cancer.Conclusion: The incidence of pancreatic cancer in central South Africa is higher than that reported nationally with a female gender bias, marked regional variation and lack of a family history. These observations merit further evalualtion in the South African context.","PeriodicalId":51161,"journal":{"name":"South African Journal of Surgery","volume":"61 3","pages":"7-11"},"PeriodicalIF":0.5,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41173418","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

Concordance of fine needle aspiration cytology and final histology of salivary gland tumours 涎腺肿瘤细针穿刺细胞学与最终组织学的一致性

4区医学

South African Journal of Surgery Pub Date : 2023-09-01 DOI: 10.36303/sajs.4039

F R Ndotora, B S Jackson

{"title":"Concordance of fine needle aspiration cytology and final histology of salivary gland tumours","authors":"F R Ndotora, B S Jackson","doi":"10.36303/sajs.4039","DOIUrl":"https://doi.org/10.36303/sajs.4039","url":null,"abstract":"Fine needle aspiration cytology (FNAC) is a widely used diagnostic tool to evaluate salivary gland tumours. The Milan system for reporting salivary gland cytopathology allows for standardisation and facilitates cytologicalhistological correlation. However, FNAC findings can still pose a diagnostic challenge. The accuracy of FNAC should be assessed at each centre. The aim of this study was to assess the concordance of FNAC and final histology of salivary gland tumours in three academic hospitals affiliated with the University of Pretoria, South Africa.The study was a cross-sectional retrospective analytical study of 214 patients who underwent an operation for salivary gland tumours. All patients with FNAC and histology results between 2007-2017 were included. Patients were recruited from three University of Pretoria, South Africa, affiliated hospitals: Steve Biko Academic, Kalafong Provincial Tertiary and Tembisa Provincial Tertiary Hospital.Of the 214 patients with salivary gland tumours, the majority were located in the parotid gland (56.1%). Pleomorphic adenoma was the most common tumour (62.6%). The FNAC sensitivity, specificity and diagnostic accuracy (receiver operating characteristic) were 92.7%, 98.1% and 0.95 respectively. The concordance between salivary gland tumour FNAC and final histology was 96.95% with a Cohen's kappa coefficient of 0.91 (p= 0.0001).There is strong concordance between FNAC and histology of salivary gland tumours. FNAC is an accurate, minimally invasive diagnostic tool with high sensitivity and specificity. It provides the clinician with a reliable preoperative diagnosis determining whether the salivary gland tumour is benign or malignant.","PeriodicalId":51161,"journal":{"name":"South African Journal of Surgery","volume":"25 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135640023","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

Surgical exploration for penetrating neck trauma – an audit of results in 145 patients 颈部穿透性创伤的外科探查——145例临床分析

4区医学

South African Journal of Surgery Pub Date : 2023-09-01 DOI: 10.36303/sajs.4020

N Laher, B Monzon-Torres, M Mauser

{"title":"Surgical exploration for penetrating neck trauma – an audit of results in 145 patients","authors":"N Laher, B Monzon-Torres, M Mauser","doi":"10.36303/sajs.4020","DOIUrl":"https://doi.org/10.36303/sajs.4020","url":null,"abstract":"Selective non-operative management (SNOM) is the current gold standard for the treatment of patients with penetrating neck trauma. The policy revolves around the liberal use of computed tomography angiography (CTA) in those patients who are haemodynamically stable, irrespective of the anatomical zone of injury, aiming at reducing the incidence of negative and non-therapeutic interventions and their potential complications.A retrospective audit of results of patients who underwent immediate surgical exploration at the Chris Hani Baragwanath Academic Hospital in Soweto between January 2010 and December 2015 was performed.One-hundred and forty-five (145) patients, with a median age of 28 years (range 18-67 years), predominantly males (93.8%), underwent immediate exploration. Most injuries were caused by stab wounds (92.4%) and affected zone 2 (54.1%) on the left side of the neck (69.6%). The most common presentations were active haemorrhage (29.4%), shock (24.1%) and expanding haematoma (15.1%). A major vascular injury was found in 40%, and aero-digestive organ injury in 19.3%. The rate of negative-non-therapeutic exploration in this cohort was 4.1%. Complications were recorded in 7.6%, and the overall mortality was 9.6% secondary to early uncontrolled haemorrhage, sepsis and occlusive strokes.The utilisation of SNOM with strict criteria for selection of patients who require immediate surgical exploration versus investigations with CTA results in a low rate of non-therapeutic interventions.","PeriodicalId":51161,"journal":{"name":"South African Journal of Surgery","volume":"44 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135640020","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

Concordance of fine needle aspiration cytology and final histology of salivary gland tumours. 唾液腺肿瘤细针抽吸细胞学检查与最终组织学检查的一致性。

IF 0.5 4区医学

South African Journal of Surgery Pub Date : 2023-09-01

F R Ndotora, B S Jackson

{"title":"Concordance of fine needle aspiration cytology and final histology of salivary gland tumours.","authors":"F R Ndotora, B S Jackson","doi":"","DOIUrl":"","url":null,"abstract":"Background: Fine needle aspiration cytology (FNAC) is a widely used diagnostic tool to evaluate salivary gland tumours. The Milan system for reporting salivary gland cytopathology allows for standardisation and facilitates cytologicalhistological correlation. However, FNAC findings can still pose a diagnostic challenge. The accuracy of FNAC should be assessed at each centre. The aim of this study was to assess the concordance of FNAC and final histology of salivary gland tumours in three academic hospitals affiliated with the University of Pretoria, South Africa.Methods: The study was a cross-sectional retrospective analytical study of 214 patients who underwent an operation for salivary gland tumours. All patients with FNAC and histology results between 2007-2017 were included. Patients were recruited from three University of Pretoria, South Africa, affiliated hospitals: Steve Biko Academic, Kalafong Provincial Tertiary and Tembisa Provincial Tertiary Hospital.Results: Of the 214 patients with salivary gland tumours, the majority were located in the parotid gland (56.1%). Pleomorphic adenoma was the most common tumour (62.6%). The FNAC sensitivity, specificity and diagnostic accuracy (receiver operating characteristic) were 92.7%, 98.1% and 0.95 respectively. The concordance between salivary gland tumour FNAC and final histology was 96.95% with a Cohen's kappa coefficient of 0.91 (p= 0.0001).Conclusion: There is strong concordance between FNAC and histology of salivary gland tumours. FNAC is an accurate, minimally invasive diagnostic tool with high sensitivity and specificity. It provides the clinician with a reliable preoperative diagnosis determining whether the salivary gland tumour is benign or malignant.","PeriodicalId":51161,"journal":{"name":"South African Journal of Surgery","volume":"61 3","pages":"35-38"},"PeriodicalIF":0.5,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41174583","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

Hydrothorax and air fluid levels in the right chest – a diagnostic dilemma 右胸胸水和空气液水平——诊断难题

4区医学

South African Journal of Surgery Pub Date : 2023-09-01 DOI: 10.36303/sajs.4041

M Morar, T B Rangaka, A B Ogunrombi, A Abd Elrahman

引用次数: 0

Trans-anal small bowel evisceration in a patient with a perforated rectal prolapse. 直肠脱垂穿孔患者经肛门小肠切除术。

IF 0.5 4区医学

South African Journal of Surgery Pub Date : 2023-09-01

H J Lee, D Hendricks, T Rangaka, A Abd Elrahman

引用次数: 0

A rare occurrence of multiple intestinal atresias, with successful one-procedure resection and primary anastomosis. 一种罕见的多发性肠闭锁，一次手术切除并一次吻合成功。