Journal of the West African College of Surgeons最新文献

{"title":"Factors Associated with Patients' Rejection of Root Canal Treatment in a Tertiary Hospital, Southwest Nigeria: A Pilot Survey.","authors":"Shakeerah Olaide Gbadebo,&nbsp;Gbenga Emmanuel Adebayo","doi":"10.4103/jwas.jwas_282_22","DOIUrl":"10.4103/jwas.jwas_282_22","url":null,"abstract":"<p><strong>Objective: </strong>Root canal treatment (RCT) is a major procedure in dentistry. It aims to relieve the pain of pulpal origin and maintain the affected tooth as a functional unit on the arch. Despite these achievable goals, RCT is sometimes rejected by patients. This study, therefore, sought to assess the reasons for rejection in patients planned for endodontic/RCT.</p><p><strong>Materials and methods: </strong>This was a cross-sectional pilot survey of patients planned for RCT using a self-administered questionnaire. The questionnaire included sociodemographics, the Index for Dental Anxiety and Fear (IDAF-4C), and questions to assess the reasons for rejection of endodontic treatment. Data collected were analysed with IBM Statistical Package for the Social Sciences software program, version 23.0. Descriptive statistics were used; chi-square was used to test the association between categorical variables. Statistical significance was set at <i>P</i> ≤ 0.05.</p><p><strong>Result: </strong>Thirty-one patients between the age range of 16 and 81 years, with a mean age of 38.16 ± 17.87, participated in the survey. Only nine (29.03%) of the participants declined to have the treatment. The majority 6(66.7%), and 7(77.8%) of those that refused the treatment did so, due to fear of drilling (<i>P</i> = 0.014) and cost of treatment (<i>P</i> = 0.001), respectively. Mean IDAF-4C was 1.86 ± 0.9 (standard deviation).The rejection was, however, not affected by past experience, the risk of taking multiple radiographs, and the number of hours or visits for the procedure.</p><p><strong>Conclusion: </strong>The cost of treatment and fear of drilling were the major reasons for the rejection of RCT in this study. Therefore, there is a need to further look into making endodontic treatment a more comfortable, less costly, and less fear-provoking procedure for patients.</p>","PeriodicalId":73993,"journal":{"name":"Journal of the West African College of Surgeons","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/b7/0c/JWACS-13-22.PMC10395846.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9935782","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Adequacy of Orthopaedic Surgery Educational Teaching Methods amongst Medical Students in Enugu State.","authors":"Kelechi U Imediegwu, Ogechi M Ugwu, Stanislaus C Onyekaonwu, Chigozie S Ikeaba, Chinonso J Dimson, Stephen I Okogu, Hillary I Ugwu, Owhiri Orerome","doi":"10.4103/jwas.jwas_246_22","DOIUrl":"10.4103/jwas.jwas_246_22","url":null,"abstract":"<p><strong>Introduction: </strong>Orthopaedic surgery educational teaching methods for medical students vary across different tertiary institutions in Nigeria.</p><p><strong>Aims: </strong>To determine the perception of medical students on the adequacy of orthopaedic surgery teaching methods in Enugu state, Nigeria.</p><p><strong>Materials and methods: </strong>A cross-sectional online survey conducted using a well-structured questionnaire with the Google forms software and distributed to final year medical students at the two tertiary universities in Enugu state via online forums. SPSS was used for analysis. Significance set at <i>P</i> < 0.05.</p><p><strong>Results: </strong>106 final year medical students filled the form. Response rate was 65.1%. 85.8% of the respondents reported that every student gets posted for orthopaedic surgery while 53% agreed that graphical illustrations were used. 50% reported that the learning environment were serene whereas 94.3% reported that their lecturers are well-trained. However, 55.6% reported that they do not have surgery simulations. Furthermore, 15.09% reported that they are aware of pitfalls in the teaching methods where only 27.36% alluded to using the library. There was no statistically significant association between gender and perception on quality of trainers/teaching methods of orthopaedic surgery in Enugu state (<i>P</i> value < 0.112).</p><p><strong>Conclusion/recommendation: </strong>The orthopaedic surgery teaching methods currently being used are not adequate. Efforts should be made to increase the quality of exposure of medical students to orthopaedic surgery and increase the use of graphical illustrations/simulations.</p>","PeriodicalId":73993,"journal":{"name":"Journal of the West African College of Surgeons","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/00/8c/JWACS-13-10.PMC10395856.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9938906","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Determinants of Mortality among Patients Managed for Prostate Cancer: Experience from Korle Bu Teaching Hospital in Ghana.","authors":"James Mensah, Yaw Amoah, Emanuele Ofori, Mohamed Albezel Verna Vanderpuye","doi":"10.4103/jwas.jwas_26_23","DOIUrl":"10.4103/jwas.jwas_26_23","url":null,"abstract":"<p><strong>Background: </strong>Over the past two decades, diagnosis and treatment approaches for men with prostate cancer have changed dramatically, with improvements in established prostate cancer treatments and new treatment strategies. However, In sub-Saharan African countries, there is a paucity of data on the characteristics and treatment of men who eventually die from Prostate Cancer (PCa). We used the clinical records of patients who died from PCa to describe the natural history and treatment PCa patients in Ghana.</p><p><strong>Methods: </strong>From 2013 to 2022, the medical records of 234 men who died of PCa at a tertiary hospital in Ghana were prospectively collected and retrospectively analysed.</p><p><strong>Results: </strong>The mean age at death was 71.6 years, and the median was 72.5 years. 51.3% died within 24 months of diagnosis, 23.0% between 2 and 5 years after diagnosis, and a quarter survived for more than 5 years. Over 80% presented with advanced disease, characterised by high prostate-specific antigen (PSA) levels, a high T stage on DRE, and evidence of metastasis. 43.6% presented with haemoglobin levels below 10ng/dl at diagnosis. These patients had the worst outcome, with 73% dying less than 2 years after diagnosis. The 5-yr survival rate of patients who presented with metastatic disease was 21.2 %. Over 80% were treated with bilateral total orchidectomy, with less than 10% receiving treatment intensification with the newer generation antiandrogens or chemotherapy.</p><p><strong>Conclusion: </strong>Our analysis shows that patients who die from PCa have aggressive disease, are diagnosed at an advanced stage, and are relatively younger than in Western countries. There is also a slow uptake of newer treatment strategies for metastatic prostate cancer. These results confirm literature suggesting that blacks have poorer outcomes due to the disease's aggressive nature. Further research is needed to understand the mechanisms and also define appropriate management for metastatic PCa in sub-Saharan Africa.</p>","PeriodicalId":73993,"journal":{"name":"Journal of the West African College of Surgeons","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/54/06/JWACS-13-65.PMC10395851.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9935787","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Van Der Woude Syndrome: A Case Series at Chu D' Treichville, Abidjan, Cote D' Ivoire.","authors":"Ajibola Yussuf Salami,&nbsp;Kouame Soroboua Agbara,&nbsp;Olivier Martial Moulot,&nbsp;Adjoba Manuela Ehua,&nbsp;Taofiq Olamide Opaleye,&nbsp;Adewale Oluwafemi Adesina,&nbsp;Rouma Bankole","doi":"10.4103/jwas.jwas_20_23","DOIUrl":"10.4103/jwas.jwas_20_23","url":null,"abstract":"<p><strong>Background: </strong>Van der Woude syndrome (VWS), characterised mainly by lower lip pits and orofacial cleft (OFC), is the most common syndrome associated with an OFC. It is inherited as an autosomal dominant, high penetrance disorder with variable phenotypic expression and caused by the genetic mutation of the interferon regulatory factor 6 gene (IRF6). This study showcases the syndrome's variable phenotypic expressivity in six cases seen at Chu d' Treichvile, Abidjan, and Cote d'Ivoire.</p><p><strong>Materials and methods: </strong>A review of six cases at the above-named hospital. Data collected include age at presentation, gender, type of cleft, presence or absence of lip pits, and family history of VWS.</p><p><strong>Results: </strong>Six cases of VWS were reviewed with an age range from 2 to 39 years and a male-to-female ratio of 1:2. Three of the patients had a bilateral cleft lip, one case of unilateral cleft lip and palate, another single case of cleft palate only while the sixth patient has no cleft deformity. All the patients have bilateral lower lip pits except one with a single median pit on the lower lip. There is a family history of VWS in three of the patients.</p><p><strong>Conclusion: </strong>Our study demonstrates the variable expressivity of VWS as different forms of lower lip pits and OFC. The presence of lower lip pits should be a signal for examination of family members to identify other cases and those likely to have cleft babies. Genetic mapping to detect mutation of IRF6 genes will be of tremendous aid in the effective diagnosis of VWS.</p>","PeriodicalId":73993,"journal":{"name":"Journal of the West African College of Surgeons","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/3b/98/JWACS-13-56.PMC10395858.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9935788","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cultural Beliefs and Practices in Postpartum Women in Iran: A Qualitative Study.","authors":"Maryam Derakhshani,&nbsp;Azadeh Asgarian,&nbsp;Howra Tousi,&nbsp;Zahra Zainolabedini-Naeiny,&nbsp;Sepideh Miraj,&nbsp;Zabihollah Gharlipour","doi":"10.4103/jwas.jwas_290_22","DOIUrl":"10.4103/jwas.jwas_290_22","url":null,"abstract":"<p><strong>Background: </strong>Cultural differences can be seen in the birth and postpartum period, where some traditional practices are used to protect the postpartum women and their newborns. The aim of this study was to investigate the cultural beliefs and practices of postpartum women.</p><p><strong>Materials and methods: </strong>This was a qualitative study. Data were collected through semistructured in-depth interviews with a purposive sample of 20 mothers in Qom hospitals, Iran from 2019 to 2020. Interviews were transcribed verbatim and finally analysed through conventional content analysis.</p><p><strong>Results: </strong>Five themes of postpartum women's cultural beliefs and practices emerged from the data analysis including beliefs and practices related to public communications, women's postnatal care beliefs and practices, nutritional beliefs and practices, beliefs and practices pertaining to breastfeeding and infant care, as well as religious and traditional beliefs and practices. The most common cultural beliefs among women were beliefs related to public communications.</p><p><strong>Conclusion: </strong>Cultural and traditional postpartum beliefs and practices are common among postpartum women in Iran. To change postpartum behaviours, it is necessary to identify beliefs and practices first and then plan to correct wrong beliefs to achieve women's health in postpartum period.</p>","PeriodicalId":73993,"journal":{"name":"Journal of the West African College of Surgeons","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/82/89/JWACS-13-28.PMC10395854.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9935784","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Quality of Life and Life after Amputation among Amputees in Lagos, Nigeria.","authors":"George O Enweluzo,&nbsp;Chinyere N Asoegwu,&nbsp;Adaugo G U Ohadugha,&nbsp;Obinna I Udechukwu","doi":"10.4103/jwas.jwas_28_23","DOIUrl":"10.4103/jwas.jwas_28_23","url":null,"abstract":"<p><strong>Background: </strong>Amputation is a life-changing surgical procedure that can cause significant disruptions in the quality of life of an individual.</p><p><strong>Objectives: </strong>This study aimed to evaluate the quality of life of patients with limb amputations in Lagos.</p><p><strong>Materials and methods: </strong>This was a cross-sectional study carried out among amputees recruited from two tertiary institutions and roadsides in Lagos state. A structured interviewer-administered questionnaire was used to collect data on demography, medical history, and postamputation health status. Also, a short form (SF-12V2) health questionnaire was used to assess their quality of life.</p><p><strong>Results: </strong>Two hundred and fifty-four (254) subjects with extremity amputation, aged 18-75 years with a mean age of 47.82 ± 11.53 years were studied. The male-to-female ratio was 1.4:1. The commonest age group of the amputees was 45-60 years (52%). The commonest indication for amputation was diabetic gangrene (126 [49.6%]) and trauma (90 [35.4%]). Postamputation, 98 (38%) were employed, and 117 (75%) of those unemployed resorted to begging as a means of livelihood. While 57 (22.4%) used prostheses frequently, 68 (26%) did not want prostheses as they supposed that it negatively affected their begging business. Female amputees have a statistically significantly better quality of life than males in the physical (<i>r</i> = 0.03) and mental components (<i>r</i> = 0.04).</p><p><strong>Conclusions: </strong>A proper rehabilitation program, the use of prostheses, and adequate employment opportunities would improve the quality of life of amputees.</p>","PeriodicalId":73993,"journal":{"name":"Journal of the West African College of Surgeons","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/d0/0a/JWACS-13-71.PMC10395860.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9935785","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"First Presentation and Diagnosis of a Rare Advanced Gynaecological Cancer in Emergency Department: A Case Report.","authors":"Emeka Elosiuba,&nbsp;Olivia Layton,&nbsp;Ammar Salem","doi":"10.4103/jwas.jwas_27_23","DOIUrl":"10.4103/jwas.jwas_27_23","url":null,"abstract":"<p><p>A case of rare endometrial carcinosarcoma with locoregional spread and sigmoid fistula presenting for the very first time at a hospital emergency department (ED). A 56-year-old female presented with abdominal pain, diarrhea, fever, and pancytopenia, which was diagnosed as advanced gynaecological cancer following assessment, imaging, and tissue biopsy. Increased pressure on the ED owing to coronavirus disease 2019 pandemic may cause the first presentation of gynae-oncology cases to ED physician. A full return of all primary care services may reduce such pressure, improve early detection of gynaecological malignancies, allow early multidisciplinary team care, and result in better patient experience in the long run.</p>","PeriodicalId":73993,"journal":{"name":"Journal of the West African College of Surgeons","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/fd/fc/JWACS-13-116.PMC10395844.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9929718","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Outcome of Multiple Retinal Capillary Hemangioma Following Focal Laser and Intravitreal Bevacizumab Injection: A Case Report.","authors":"Saudatu Umar Madaki,&nbsp;Saudat Garba Habib,&nbsp;Musa Zainab Yero","doi":"10.4103/jwas.jwas_13_23","DOIUrl":"10.4103/jwas.jwas_13_23","url":null,"abstract":"<p><p>Retinal hemangioma has posed a therapeutic problem for ophthalmologists for almost a decade. The location of hemangioma in the retina is an important factor in determining the treatment options as well as the size of the tumor, clarity of media, and secondary features of the mass. A 22-year-old male presented to vitreoretina clinic at a tertiary eye hospital, with a history of sudden decrease of vision in the left eye for 1 year associated with mild ocular pains. Physical and systemic examination revealed no positive findings. On ocular examination, the visual acuity was 6/6 in the right eye and perception of light in the left eye, and there was no improvement with best correction. Anterior segment examination in both eyes was essentially normal. Dilated funduscopy revealed a well-circumscribed and elevated vascular orange reddish mass in the juxtapapillary area, temporal to the disc with dilated tortuous feeder blood vessels measuring 6.4 × 3.0 mm in the right eye and vitreous hemorrhage with tractional retinal detachment in the left eye. The small solitary lesion in the right eye was treated with focal laser. This was followed by intravitreal bevacizumab avastin 1.25 mg in 0.05 mL in the same eye, monthly three doses, with the aim of targeting the bigger lesion at the juxtapapillary area to reduce the risk of visual loss. Patient also had pars plana vitrectomy, endolaser photocoagulation, and silicon oil in the left eye. There was complete resolution of the tumor, which was not measurable after third dose of intravitreal avastin. Patient vision remained 6/6, and there was no recurrence at the last follow-up visit 3 years after treatment. Antivascular endothelial growth factors like avastin are effective in the treatment of retinal capillary hemangioma, thereby inducing complete tumor resolution as well as maintaining good vision in the early stages of the disease before complication occurs, as it is evident in this case study.</p>","PeriodicalId":73993,"journal":{"name":"Journal of the West African College of Surgeons","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/3f/63/JWACS-13-111.PMC10395852.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9935783","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessment of the Adequacy of Neurosurgery Teaching Methods among Medical Students in Enugu State, Nigeria.","authors":"Kelechi Uzodinma Imediegwu,&nbsp;Kelechi A Aham,&nbsp;Akuoma Martha Ezeaku,&nbsp;Elizabeth U Tietie,&nbsp;Chiamaka Q Onyebuchukwu,&nbsp;Ihechi D Nwagwu,&nbsp;Bassey Asuquo,&nbsp;Agatha O Odaman,&nbsp;Kosisochukwu C Okeke,&nbsp;Chibuike Daniel Onyejesi","doi":"10.4103/jwas.jwas_303_22","DOIUrl":"10.4103/jwas.jwas_303_22","url":null,"abstract":"<p><strong>Background: </strong>Various educational neurosurgery teaching methods are employed across few Nigerian universities, especially Enugu state.</p><p><strong>Aims: </strong>To determine the adequacy of current neurosurgery teaching methods, factors influencing eventual choice of neurosurgery amongst final year medical students in Enugu state, Nigeria and suggest improvement methods towards best global standards.</p><p><strong>Materials and methods: </strong>This was an online cross-sectional study conducted among final year medical students currently on Neurosurgery rotation in Enugu state, Nigeria using a validated questionnaire. Data was analyzed (inferential and deferential) using SPSS; chi-squares values were calculated. Significance was set at p value <0.05 and measures were put in place to limit bias.</p><p><strong>Results: </strong>106 students filled and submitted the form with a response rate of 72.60%. Most respondents revealed that their universities had mandatory neurosurgery rotations. Majority affirmed that a general poor learning environment (75%) was the major obstacle to standard teaching. About 49% had interest in specializing in surgery but only 18% have interest in neurosurgery as a future sub-specialty choice. Positively, majority (90.6%) alluded to having qualified teachers, with 43.4% of them advocating for improved training of the teachers. There was a significant correlation between choice of specialty and the students' monthly income (less than N10, 000 had a p: 0.003). Other factors that were positively correlated in eventual choice as their future desired subspecialty include poor exposure to clinical neurosurgery cases (p: 0.020) and little or no exposure of students to neurosurgery research opportunities (p: 0.024).</p><p><strong>Conclusion/recommendations: </strong>The current neurosurgical teaching methods in Enugu state are not fully optimal yet. There is a need for some improvement in current learning environment and teaching methods to improve the students' understanding of neurosurgery and eventual increased interest in final choice of neurosurgery as their desired subspecialty.</p>","PeriodicalId":73993,"journal":{"name":"Journal of the West African College of Surgeons","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/8c/ec/JWACS-13-36.PMC10395848.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9929713","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Closure of Fistula-in-Ano Using a Radial-Emitting Laser Probe: Initial Experience in Lagos, Nigeria.","authors":"Thomas Olagboyega Olajide,&nbsp;Christopher O Bode","doi":"10.4103/jwas.jwas_108_23","DOIUrl":"10.4103/jwas.jwas_108_23","url":null,"abstract":"<p><strong>Background: </strong>Fistula-in-ano treatment has remained quite challenging with high failure rates and a potential for damage to the anal sphincteric complex leading to flatal or faecal incontinence. The treatment of fistula-in-ano using the fistula laser closure (FiLaC) as a minimally invasive, sphincter-saving procedure for complex disease has recently been documented.</p><p><strong>Objectives: </strong>This review aimed to report the outcome of using it at the Lagos University Teaching Hospital.</p><p><strong>Patients and methods: </strong>The procedures were performed with a radially emitting laser fibre from Biolitec AG-CeramOptec (Bonn, Germany). The duration of symptoms, type of fistula, duration of the procedures, and postoperative complications were evaluated.</p><p><strong>Results: </strong>Eleven male patients had laser fistula-in-ano closure. The age range was 33-51 years, with a median age of 39 years and an interquartile range (IQR) of 37-47 years. Five patients were noted to have high fistula/e, whereas six had low fistula/e, seven had a single tract each, and three had three tracts each. The duration of surgery ranged, approximately from 3 to 60 min, with a median of 19 min and IQR of 9-33 min. Postoperative pain was mild in all patients and were all discharged as day case. There was no postoperative wound infection, anal incontinence, anal stenosis, and subcutaneous abscess. However, there was a recurrence in two patients.</p><p><strong>Conclusions: </strong>FiLaC has been demonstrated to be a reliable and safe sphincter-saving procedure for treating fistula-in-ano even for complex and high fistulae that is feasible in our subregion.</p>","PeriodicalId":73993,"journal":{"name":"Journal of the West African College of Surgeons","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/5f/a8/JWACS-13-101.PMC10395862.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9929716","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}