South African Journal of Surgery最新文献_第3页

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

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

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

Spinal hydatid cyst with myelopathy: a rare case report. 棘球蚴囊肿伴脊髓病：罕见病例报告。

IF 0.6 4区医学

South African Journal of Surgery Pub Date : 2025-11-01 DOI: 10.36303/SAJS.03095

N Deveduthras, T Govender, R Harricharan

引用次数: 0

The economic burden of traumatic brain injury at Pietersburg Hospital, Limpopo Province: a retrospective micro-costing study. 林波波省Pietersburg医院创伤性脑损伤的经济负担：一项回顾性微观成本研究。

IF 0.6 4区医学

South African Journal of Surgery Pub Date : 2025-11-01 DOI: 10.36303/SAJS.02492

S N Phaleng, T C Hardcastle

{"title":"The economic burden of traumatic brain injury at Pietersburg Hospital, Limpopo Province: a retrospective micro-costing study.","authors":"S N Phaleng, T C Hardcastle","doi":"10.36303/SAJS.02492","DOIUrl":"10.36303/SAJS.02492","url":null,"abstract":"Background: Trauma cost studies have been limited in low-to middle-income countries (LMICs). The aim of the study was to calculate economic costs resulting from major trauma in those with brain injuries.Methods: This is a retrospective study of patients who sustained a traumatic brain injury (TBI) and injury severity score (ISS) > 16 treated at Pietersburg Hospital in a 2-year period (January 2019 to December 2020). Theatre registers were used as starting point for data collection. Additional data was obtained from ICU and the neurosurgical ward. Data analysis utilised dual methods with both micro-costing and grossing models.Results: The review identified 83 patients. The most common mechanism of injury was assault with a blunt object (54.2%), followed by motor vehicle collisions (MVC) (16.9%). The mean length of stay for ICU admissions was 14 days, while ward admissions were 9.2 days. The most common diagnosis on CT scan was epidural haematoma with or without skull fracture (51.8%), followed by isolated skull fracture (21.8%). The average cost per admission was R572 925.00 for ICU patients and R244 503.00 for the ward stay.Conclusion: The most common cause of TBI was assault. The cost of treating a patient with TBI was higher than in most studies and exceeded R50 000 per patient per day.","PeriodicalId":51161,"journal":{"name":"South African Journal of Surgery","volume":"63 4","pages":"234-239"},"PeriodicalIF":0.6,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147349726","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

Gallbladder tuberculosis: an unlikely diagnosis after laparoscopic cholecystectomy. 胆囊结核：腹腔镜胆囊切除术后不太可能的诊断。

IF 0.6 4区医学

South African Journal of Surgery Pub Date : 2025-11-01 DOI: 10.36303/SAJS.03022

M Malik, I N Palkowski

引用次数: 0

Missed appendicitis presenting as necrotising fasciitis of the thigh. 遗漏的阑尾炎表现为大腿坏死性筋膜炎。

IF 0.6 4区医学

South African Journal of Surgery Pub Date : 2025-11-01 DOI: 10.36303/SAJS.03253

K Hendry, O O Jolayemi

引用次数: 0

Preoperative risk factors for 90-day postoperative mortality in patients with pancreatic ductal adenocarcinoma: a cohort-based study. 胰腺导管腺癌患者术后90天死亡率的术前危险因素：一项基于队列的研究

IF 0.6 4区医学

South African Journal of Surgery Pub Date : 2025-11-01 DOI: 10.36303/SAJS.02398

C M Clasen, U Kotze, M Bernon, S Burmeister, C Kloppers, E Jonas, H Bayadsi

{"title":"Preoperative risk factors for 90-day postoperative mortality in patients with pancreatic ductal adenocarcinoma: a cohort-based study.","authors":"C M Clasen, U Kotze, M Bernon, S Burmeister, C Kloppers, E Jonas, H Bayadsi","doi":"10.36303/SAJS.02398","DOIUrl":"10.36303/SAJS.02398","url":null,"abstract":"Background: Pancreatic ductal adenocarcinoma (PDAC) has a 5-year survival rate of less than 10%. Treatment with curative intent surgery still poses high rates of overall postoperative morbidity (68.7%) and mortality (5.4%). It is therefore essential to identify preoperative factors influencing early postoperative outcomes to provide better insight for improved patient selection and care.Methods: Sixty patients diagnosed with PDAC who had undergone surgical resection at Groote Schuur Hospital, Cape Town, between 2016 and 2023 were included. The patient cohort was divided into two groups, postoperative survival ≤ 90 days vs > 90 days. The groups were compared regarding demographic and preoperative assessment tools using ASA, ECOG and Codman scores, baseline clinical and imaging data, preoperative treatment and surgical related parameters.Results: Significant differences were found in patients, with patients presenting with pancreatic duct dilation (p < 0.05), tumour location in the pancreatic head (p < 0.05), elevated gamma-glutamyl transferase (GGT) (p < 0.01) and carbohydrate antigen 19-9 (CA19-9) (p < 0.05). Using regression analysis, GGT serum levels > 500 U/L were correlated with mortality ≤ 90 days, while pancreatic duct dilatation and CA19-9 levels > 200 U/L were associated with survival > 90 days.Conclusion: The results of this study present important insights regarding risk factors influencing postoperative mortality and offer a potential roadmap for optimising preoperative care and judicious patient selection before pancreatic surgery.","PeriodicalId":51161,"journal":{"name":"South African Journal of Surgery","volume":"63 4","pages":"222-228"},"PeriodicalIF":0.6,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147349706","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