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

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":null,"pages":null},"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":null,"pages":null},"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。

IF 0.5 4区医学

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

D M Winterton, U Jooma, S G Cox

引用次数: 0

Geographic distribution of pancreaticobiliary malignancy in central South Africa presenting to the Universitas Academic Hospital Complex 南非中部胰胆管恶性肿瘤的地理分布呈现给大学学术医院综合体

4区医学

South African Journal of Surgery Pub Date : 2023-09-01 DOI: 10.36303/sajs.3903

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":"10.36303/sajs.3903","DOIUrl":"https://doi.org/10.36303/sajs.3903","url":null,"abstract":"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.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.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.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":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135895168","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

An audit of traumatic haemothoraces in a regional hospital in KwaZulu-Natal, South Africa 南非夸祖鲁-纳塔尔省一家地区医院外伤性血胸的审计

4区医学

South African Journal of Surgery Pub Date : 2023-09-01 DOI: 10.36303/sajs.3986

C M Kithuka, V C Ntola, W Sibanda

{"title":"An audit of traumatic haemothoraces in a regional hospital in KwaZulu-Natal, South Africa","authors":"C M Kithuka, V C Ntola, W Sibanda","doi":"10.36303/sajs.3986","DOIUrl":"https://doi.org/10.36303/sajs.3986","url":null,"abstract":"Haemothorax occurs in approximately 60% of all thoracic and polytrauma cases and is responsible for 15-30% of all trauma mortalities. Penetrating injuries to the thorax are a common presentation in South African hospitals. This study aims to audit the traumatic haemothoraces and their outcomes in regional hospitals in Durban, KwaZulu-Natal, South Africa.In this study, patient characteristics were grouped as either continuous or categorical variables. Continuous variables, such as age were summarised as means (with standard deviations) or medians (interquartile range [IQR]), as appropriate. Categorical variables such as sex were summarised as proportions. Fisher's exact test was used to compare proportions. All analyses were performed using the Statistical Package for Social Sciences.A total of 118 patients were included comprising 110 (93%) males and eight (7%) females, with an average age of 29.7 years. Stab-chest was the most frequent mechanism of injury (76; 64.4%), followed by gunshot wound (GSW)- chest (27; 22.9%) and isolated blunt chest trauma (9; 7.6%). Other mechanisms of injury were stab-neck (3; 2.5%), stab-shoulder (2; 1.7%) and blunt chest trauma in the context of polytrauma (1; 0.8%). The most frequent type of injury was penetrating (108; 91.5%), with only 10 (8.5%) cases of blunt injury. This study found that there was a statistically significant association between patient age groups and type of injury.Haemothorax is a common sequela of chest trauma. Retained haemothorax (RH) results in worsened patient outcomes including increased hospital length of stay (LOS). This study points to the need for auditing of proper intercostal chest drain (ICD) positioning, which is crucial for the successful drainage of haemothorax.","PeriodicalId":51161,"journal":{"name":"South African Journal of Surgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135640019","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. 穿透性颈部创伤的外科探查——145例患者的结果审计。

IF 0.5 4区医学

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

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":"","DOIUrl":"","url":null,"abstract":"Background: 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.Methods: 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.Results: 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.Conclusions: 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":null,"pages":null},"PeriodicalIF":0.5,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41173960","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. 胸腔积液和右胸的空气液位-诊断难题。

IF 0.5 4区医学

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

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

引用次数: 0

An audit of traumatic haemothoraces in a regional hospital in KwaZulu-Natal, South Africa. 南非夸祖鲁-纳塔尔省一家地区医院的创伤性血胸审计。

IF 0.5 4区医学

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

C M Kithuka, V C Ntola, W Sibanda

{"title":"An audit of traumatic haemothoraces in a regional hospital in KwaZulu-Natal, South Africa.","authors":"C M Kithuka, V C Ntola, W Sibanda","doi":"","DOIUrl":"","url":null,"abstract":"Background: Haemothorax occurs in approximately 60% of all thoracic and polytrauma cases and is responsible for 15-30% of all trauma mortalities. Penetrating injuries to the thorax are a common presentation in South African hospitals. This study aims to audit the traumatic haemothoraces and their outcomes in regional hospitals in Durban, KwaZulu-Natal, South Africa.Methods: In this study, patient characteristics were grouped as either continuous or categorical variables. Continuous variables, such as age were summarised as means (with standard deviations) or medians (interquartile range [IQR]), as appropriate. Categorical variables such as sex were summarised as proportions. Fisher's exact test was used to compare proportions. All analyses were performed using the Statistical Package for Social Sciences.Results: A total of 118 patients were included comprising 110 (93%) males and eight (7%) females, with an average age of 29.7 years. Stab-chest was the most frequent mechanism of injury (76; 64.4%), followed by gunshot wound (GSW)- chest (27; 22.9%) and isolated blunt chest trauma (9; 7.6%). Other mechanisms of injury were stab-neck (3; 2.5%), stab-shoulder (2; 1.7%) and blunt chest trauma in the context of polytrauma (1; 0.8%). The most frequent type of injury was penetrating (108; 91.5%), with only 10 (8.5%) cases of blunt injury. This study found that there was a statistically significant association between patient age groups and type of injury.Conclusion: Haemothorax is a common sequela of chest trauma. Retained haemothorax (RH) results in worsened patient outcomes including increased hospital length of stay (LOS). This study points to the need for auditing of proper intercostal chest drain (ICD) positioning, which is crucial for the successful drainage of haemothorax.","PeriodicalId":51161,"journal":{"name":"South African Journal of Surgery","volume":null,"pages":null},"PeriodicalIF":0.5,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41162827","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