Current Issue : April - June Volume : 2018 Issue Number : 2 Articles : 7 Articles
Background. Surgery for pulmonary aspergilloma (PA), especially complex forms, is greatly challenging in a resource-poor setting\nsuch as Cameroon. We report our experience of surgical management of PA in this environment. Method. We prospectively\nassessed patients who underwent surgery for PA from January 2012 to May 2015, at the University Hospital Center of YaoundÃ?´e.\nRecords were reviewed for demographics, history and physical examinations, radiological findings, surgical procedures, and\noutcomes. The study has received approval from the institutional ethics committees. Results. In total, 20 patients (17 males and\n3 females (sex ratio, 5.66); mean age, 30 years; range, 23ââ?¬â??65 years) with a past history of tuberculosis were assessed. The median\nfollow-up was 21.5 months. The primary symptom was hemoptysis, followed by cough and chest pain. All patients underwent\nsurgical treatment and lung resection. Postoperative complications (bleeding, air leak, empyema, and severe anemia) occurred in\n4 patients and 1 patient died. Although 3 patients were lost to follow-up, the survival rate was 80% with improvement of the\npreoperative symptoms. Conclusion. Although surgery for complex aspergilloma is very challenging in environments such as ours,\nwe believe that it is the best treatment modality for symptomatic diseases in our setting....
Background and Aims. Small gastric or colorectal tumours can be visually undetectable during laparoscopic surgeries, and available\nmethods still do not provide a 100%localisation rate.Thus, newmethods for further improvements in tumour localisation are highly\ndesirable. In this study, we evaluated the usage of the Medical Tactile Endosurgical Complex (MTEC) in gastrointestinal surgery\nfor localisation of tumours. The MTEC provides the possibility of instrumental mechanoreceptoric palpation, which serves as an\nanalogue of conventional manual palpation. Methods.Ninety-six elective surgeries were performed, including 48 open surgeries, 43\nlaparoscopies, and 5 robot-assisted surgeries. The 20mmversion of the MTEC tactile mechanoreceptor was used in open surgeries,\nand the 10mm version in laparoscopic and robot-assisted surgeries. Results. The mean time of instrumental mechanoreceptoric\npalpation was 3 minutes 12 seconds for open surgeries, which constituted the early stage of the learning curve, and 3 minutes\n34 seconds for laparoscopic surgeries. No side effects or postoperative complications related to instrumental mechanoreceptoric\npalpation were observed, and this procedure provided data sufficient for tumour localisation inmore than 95% of cases. Conclusion.\nInstrumental mechanoreceptoric palpation performed using MTEC is a simple, safe, and reliable method for tumour localisation\nin gastrointestinal laparoscopic surgery....
In this review article, various preferences in breast plastic surgery particularly\nafter breast cancer will be discussed in view of the diverse indications for the\ndifferent construction procedures. The various conditions that necessitate the\nneed for reconstruction are appraised, the important reconstructive procedures\nare discussed. The most important indications procedures discussed in\nthis review include; Prophylactic subcutaneous mastectomy, Lumpectomy and\nRadiation, Modified Mastectomy with Axillary Sampling, Nipple reconstruction,\nand the contralateral breast. These procedures are discussed in view of\nplastic surgeon practice and patients acceptability in Saudi Arabia. Data from\nSaudi Arabia in particular was identified through searches of the EMBASE,\nand MEDLINE database, using the keywords: Saudi Arabia, breast plastic\nSurgery, breast reconstruction, autologous breast reconstruction, breast augmentation.\nAdvances in prosthetic technologies and modifications in autologous\nflap techniques, and the development of novel tissue alternatives have\nallowed for sustained developments in breast reconstruction results. A variety\nof attitudes has been accessible for addressing the difficulties that endure after\nresection of breast cancer in Saudi Arabia. Patients should be educated to accept\ndifferent process in this context....
Purpose. Parastomal hernia is a common complication following a stoma and may cause leakage or incarceration. No optimal\ntreatment has been established, and existing methods using mesh repair are associated with high recurrence rates and a considerable\nrisk for short- and long-term complications including death. A double-layer intraperitoneal on-lay mesh (IPOM), the\nParastomal Hernia Patch (BARDââ??¢), consisting of ePTFE and polypropylene, has been developed and tailored to avoid recurrence.\nTo evaluate the safety of and recurrence rate using this mesh, a nonrandomised prospective multicentre study was performed.\nMethod. Fifty patients requiring surgery for parastomal hernia were enrolled. Clinical examination and CTscan prior to surgery\nwere performed. All patients were operated on using the Parastomal Hernia Patch (BARD). Postoperative follow-up at one month\nand one year was scheduled to detect complications and hernia recurrence. Results. The postoperative complication rate at one\nmonth was 15/50 (30%). The parastomal hernia recurrence rate at one year was 11/50 (22%). The reoperation rate at one month\nwas 7/50 (14%), and further 5/50 (10%) patients were reoperated on during the following eleven months...
Introduction. Total calcium (TC) and albumin-corrected calcium (ACC) are easily accessible AP severity tests in the Primary\nHealth Care Center of Nepal. The aim of the study was to evaluate TC and ACC as prognostic severity markers in acute\npancreatitis (AP). Methods. All patients admitted in Tribhuvan University Teaching Hospital with the diagnosis of AP were\nstudied prospectively over a period of one year from January 2015 to January 2016. TC and ACC were measured in the first 24\nhours of admission in each patient. The modified Marshall score was determined at admission and at 48 hours and at any point of\ntime during admission as per the need of the patient. Severity of acute pancreatitis was defined as per the Revised Atlanta\nClassification 2012. Results. 80 patients of AP were included in the study. Among them, 14% were categorized as having severe AP.\nThe mean total calcium was 8.22, 7.51, and 6.98 for mild, moderate, and severe AP, respectively, which was significant at 0.001.\nConclusion. TC and ACC, measured within the first 24 hours, are useful severity predictors in acute pancreatitis....
Adrenal pseudocysts are rare entities and occurred in the 5th and the 6th decades of life. They are discovered accidentally, while\nappearing with nonspecific clinical and imaging findings. We report a case of a 28-year-old woman presented in our Emergency\nDepartment complaining about upper abdomen pain. Computed tomography revealed a hypodense cystic lesion containing\nhyperdense material. The size of a mass was 11. 7 Ã?â?? 9.3 Ã?â?? 6.6 cm in diameter close to the pancreas, but the origin was from the left\nadrenal gland. The mass was excised with surgical laparotomy. Giant adrenal pseudocysts are rare entities. Final diagnosis usually\nconfirmed with the pathology examination. Management of such adrenal lesions depends on the unique characteristics, the\nsurgeonââ?¬â?¢s experience, and local resources....
Objective. Recently, minimally invasive surgery (MIS) has been included among the treatment modalities for scoliosis. However,\nliterature comparing MIS to open surgery for scoliosis correction is limited.Theobjective of this study was to compare outcomes for\nscoliosis correction patients undergoing MIS versus open approach. Methods.We retrospectively collected data on demographics,\nprocedure characteristics, and outcomes for 207 consecutive scoliosis correction surgeries at our institution between 2009 and 2015.\nResults. MIS patients had lower number of levels fused (...
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