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Cutaneous burns in children: Clinical and therapeutic aspects in the general surgery department of Hôpital Ignace Deen, CHU de Conakry (Guinea) 儿童皮肤烧伤:Hôpital普外科的临床和治疗方面
Pub Date : 2023-01-01 DOI: 10.33545/surgery.2023.v7.i3b.1019
Mohamed Saliou Bangoura, Dr. Ansoumane Conde, Youssouf Sow, Aboubacar Sidiki Bangoura, Emile Camara, Mariame Guirassy, Moїse Loua, Houssein Fofana ET Aboubacar Toure
Aim: To contribute to the improvement of the quality of care of children with burns in the General Surgery Department of the Ignace Deen National Hospital, CHU Conakry.Patients and Methods: This was a retrospective, descriptive study, lasting 3 years from January 2020 to December 2022, covering the consecutive records of children (0 to 15 years) with burns received in the general surgery department of the Ignace Deen National Hospital.Results: During the three (3) years, we identified 55 burn patients. The mean age was 3.16 ± 2.85 years. Males accounted for 60% of the burns, with a sex ratio of 1.5. Burns were accidental in 100% of cases, occurred at home in 92.73% of cases, and were thermal in 94.55% of cases, dominated by hot liquids (85.45%). Burns were second degree (92%). The upper extremities (58.18%) were most affected. The mean surface area burned was 12.21±3.75%, and 60% were severe burns. Patients had received dressings (100%), analgesics (100%), antibiotics (100%) and vascular filling (72.73%). The mortality rate was 12.73% (N=7). The mean hospital stay was 9.7 days.Conclusion: Skin burns in children are a common occurrence. It concerns male children under 5 years of age, burned by a hot liquid, largely related to their environment (home).
目的:为提高科纳克里伊格纳斯迪恩国立医院普通外科烧伤患儿的护理质量做出贡献。患者和方法:这是一项回顾性描述性研究,持续3年,从2020年1月到2022年12月,涵盖了在Ignace Deen国家医院普通外科接收的烧伤儿童(0至15岁)的连续记录。结果:在三(3)年中,我们确定了55例烧伤患者。平均年龄3.16±2.85岁。男性占60%,性别比为1.5。意外烧伤占100%,家中烧伤占92.73%,热烧伤占94.55%,以热液体烧伤为主(85.45%)。二级烧伤(92%)。上肢受影响最大(58.18%)。烧伤面积平均为12.21±3.75%,重度烧伤占60%。患者使用敷料(100%)、止痛药(100%)、抗生素(100%)和血管填充(72.73%)。死亡率为12.73% (N=7)。平均住院时间为9.7天。结论:儿童皮肤烧伤是常见病。它涉及5岁以下的男孩,被热液体烧伤,主要与他们的环境(家庭)有关。
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引用次数: 0
Don’t let musculo-skeletal pain hold you back: A monumental hurdle, especially in young cardiothoracic and vascular surgeons 不要让肌肉骨骼疼痛阻碍你:这是一个巨大的障碍,尤其是对年轻的心胸和血管外科医生来说
Pub Date : 2023-01-01 DOI: 10.33545/surgery.2023.v7.i4a.1022
Dr. Mohammed Nadeem Nazim
Surgeons, especially the cardio-vascular and thoracic surgery residents have been facing this unaddressed and hazardous working conditions due to ergonomic deficits found throughout their learning and career duration in operating theatres. As a result of holding awkward or stationary positions throughout protracted surgeries throughout a career, more than 80% of surgeons have passed away from a work-related sickness or accident. While the patient is the procedure's main emphasis, good posture and spinal stability are not given much consideration at the same time. Even when discomfort is there, signs are frequently disregarded. This causes a decline in output and could ultimately jeopardise surgical careers. Often, surgeons are not aware of suggestions or instructions intended to increase their comfort while performing. Additionally, there is a notable dearth of formal ergonomic instruction.In the operating room, a number of controllable risk factors can be changed to create a safer working environment. In addition, to enhance the surgeon's posture and musculoskeletal health, strengthening, stability, and exercise programmes under the guidance of a qualified therapist may be used.It is alarming when you learn that a lot of CVTS surgeons struggle with long-term Musculo-skeletal issues because of the strenuous physical demands of our work. Similar to professional athletes, surgeons need to be in shape in order to perform at their finest. To ensure that we can perform at our best and sustain career longevity, we must enhance our working environment and maintain our physical health.
外科医生,特别是心血管和胸外科住院医生,一直面临着这种未解决的和危险的工作条件,因为他们在手术室学习和职业生涯中发现了人体工程学缺陷。在整个职业生涯中,由于在长时间的手术中保持尴尬或静止的姿势,超过80%的外科医生死于与工作有关的疾病或事故。虽然病人是手术的主要重点,但良好的姿势和脊柱稳定性并没有同时得到太多的考虑。即使有不适的迹象,也经常被忽视。这会导致产出下降,并最终危及外科手术生涯。通常情况下,外科医生不知道建议或指示,旨在增加他们的舒适,而执行。此外,正式的人体工程学教学明显缺乏。在手术室中,可以通过改变一些可控的危险因素来创造一个更安全的工作环境。此外,为了增强外科医生的姿势和肌肉骨骼健康,可以在合格治疗师的指导下进行强化、稳定和锻炼计划。当你了解到许多CVTS外科医生由于工作中对身体的强烈要求而与长期的肌肉骨骼问题作斗争时,你会感到震惊。和专业运动员一样,外科医生也需要保持良好的身材才能发挥出最佳水平。为了确保我们能以最佳状态工作,维持职业生涯,我们必须改善工作环境,保持身体健康。
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引用次数: 0
Small bowel volvulus with large mesenteric defect in paediatric patient: An unusual presentation of acute abdomen 小儿小肠扭转伴大肠系膜缺损:急腹症的不寻常表现
Pub Date : 2023-01-01 DOI: 10.33545/surgery.2023.v7.i3a.1006
Dr. Rohit Mittal, Dr. Vinita Chaturvedi, Dr. Neeraj Tuteja, Dr. Atul Kumar Khare
Introduction: In children, internal herniation with small bowel strangulation due to the cause of a mesenteric defect is a rare cause of intestinal obstruction. So early diagnosis and early treatment in the pediatric emergency department are important factor for this disease. Aim: This case report, aim is to study the small bowel volvulus with large mesenteric defect in pediatrics patient, which is very rare. Methods and materials: A male child of 2 year and 8-month-old came to the emergency department of our institute with complains of abdominal pain, vomiting (bilious) and not passing stool for 2 days. On radiographic findings shows that, internal herniation is gaseous distension of the bowel loops in the upper abdominal area with a paucity of gas in the lower abdomen. Primarily patient vitally stabilized and plan for emergency operation. Exploratory laparotomy done and large mesenteric defect closed. Gangrenous segment resected and end ileostomy done with distal mucous fistula formation. Patient discharged successfully on 6th pod. Conclusion: Early diagnosis and treatment is very important in these patients. The most important step for this disease is early diagnosis of acute intestinal obstruction sign and symptoms like-tenderness, guarding and rigidity also vomiting and painful abdomen. So, it is very important that, Internal herniation should be considered in differential diagnoses of acute abdomen in the Pediatric Emergency Department.
简介:在儿童中,由于肠系膜缺陷引起的小肠绞窄的内疝是一种罕见的肠梗阻原因。因此,早期诊断和早期治疗是小儿急诊科治疗本病的重要因素。目的:本病例报告,目的是研究小儿小肠扭转合并大肠系膜缺损,这是一种非常罕见的病例。方法与材料:1例2岁零8个月男患儿以腹痛、呕吐(胆汁)、不大便2天就诊于我院急诊科。x线表现显示,内疝是上腹部肠袢的气体膨胀,下腹部气体缺乏。主要是病人生命稳定和紧急手术计划。剖腹探查,大肠系膜缺损闭合。坏疽节段切除,末端回肠造口,远端粘液瘘形成。患者于第6次顺利出院。结论:早期诊断和早期治疗是重要的。治疗此病最重要的一步是早期诊断急性肠梗阻的体征和症状,如压痛、僵硬、呕吐和腹部疼痛。因此,在小儿急诊科急腹症的鉴别诊断中,应重视腹内疝的诊断。
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引用次数: 0
The clinical study and management of operated cases of acute intestinal obstruction in adults 成人急性肠梗阻手术病例的临床研究与处理
Pub Date : 2023-01-01 DOI: 10.33545/surgery.2023.v7.i3a.998
Dr. Zarkar Aniket Nandkumar, Dr. MY Bapaye
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引用次数: 0
Hepatocellular carcinoma: A case report 肝细胞癌1例
Pub Date : 2023-01-01 DOI: 10.33545/surgery.2023.v7.i1a.971
Dr. Mohuarani Ashokkumar Adakk, Dr. Shushma B, D. Mh
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引用次数: 0
Lateral abdominal wall hernia: A surgeon’s dilemma 腹壁外疝:外科医生的困境
Pub Date : 2023-01-01 DOI: 10.33545/surgery.2023.v7.i3a.999
Dr. Binoy Kumar Behera, Dr. Neelanjana Ghosh, D. J. G. Bhatt, D. J. G. Vagadia
Flank and lateral abdominal wall defects are a rare as well as challenging entity for surgeons as they differ vastly in regard to their anatomy, etiology, and pathophysiology. They remain an infrequent topic of discussion in the literature despite the potential of causing fatal consequences. Various approaches have been practiced and reviewed in details which have produced promising results. But, despite this, there is no general consensus regarding the proper method of repair of these hernias. Lateral wall defects typically result from iatrogenic causes, trauma, and are rarely congenitally acquired. In this article, we aim to highlight on the various operative methods we have performed for individual patient presenting with lateral abdominal wall hernia which have been tailored according to the patient’s requirement a nd all have shown satisfactory results
侧腹和侧腹壁缺陷是一种罕见且具有挑战性的实体,因为它们在解剖学、病因学和病理生理学方面有很大的不同。尽管有可能造成致命的后果,但它们仍然是文献中很少讨论的话题。已经实践和详细审查了各种方法,这些方法产生了有希望的结果。但是,尽管如此,对于修补这些疝的正确方法还没有普遍的共识。侧壁缺损通常由医源性原因、外伤引起,很少是先天性的。在这篇文章中,我们的目的是强调我们根据患者的需求量身定制的各种手术方法,这些方法都显示出令人满意的结果
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引用次数: 0
A comparative study between bipolar cuttery and conventional suture ligation for hemostasis in total thyroidectomy for benign thyroid disease 良性甲状腺疾病全甲状腺切除术中双极刀与常规缝合结扎止血的比较研究
Pub Date : 2023-01-01 DOI: 10.33545/surgery.2023.v7.i3b.1018
Anmar Abdulkadhum Ajaj, Ali K Shaaeli
Background: Over the last years many surgeons have begun to use energy based devices to perform thyroid surgery, several literatures have demonstrated the benefits of these devices over traditional techniques, they can provide a combined dissection and hemostatic effect and particularly advantageous in reduction of incision length, operative time, operative blood loss and complications. Aim of study: Compare bipolar cautery to traditional suture ligation in hemostasis during complete thyroidectomy in nerve damage, operating time, hypocalcemia, post-operative blood loss and hematoma development, and hospital stay. Patients and Method: In this study 61 patients who underwent total thyroidectomy, they were divided into two groups according to the type of hemostasis: bipolar cautery hemostasis group and conventional suture ligation hemostasis group, different diseases were included (multinodular goiter, solitary thyroid nodule), these groups were compared in regard to operative time, complications and length of hospital stay. Results: The bipolar cautery hemostasis group had a shorter operation time (67.36±9.77 min) and a lower post-operative blood loss (55.78±14.45 ml) than the conventional suture ligation group (91.09±27.37 ml). Other outcomes included post-operative hematoma formation, recurrent laryngeal nerve injury, and post-operative hypoxia. Conclusion: Using bipolar cautery device in total thyroidectomy reduced the operative time and post-operative blood loss, without any change in the incidence of recurrent laryngeal nerve injury, post-operative hypocalcemia, hematoma formation, and the length of hospital stay.
背景:在过去的几年里,许多外科医生已经开始使用基于能量的装置来进行甲状腺手术,一些文献已经证明了这些装置比传统技术的好处,它们可以提供联合的解剖和止血效果,特别是在减少切口长度,手术时间,手术失血和并发症方面具有优势。研究目的:比较双极烧灼与传统缝合结扎在甲状腺全切除术中对神经损伤、手术时间、低钙血症、术后出血量和血肿发展、住院时间等方面的止血效果。患者与方法:本研究将61例甲状腺全切除术患者按止血方式分为双极烧灼止血组和常规缝合结扎止血组,分别针对不同疾病(多结节性甲状腺肿、孤立性甲状腺结节),比较两组患者手术时间、并发症及住院时间。结果:双极烧灼止血组手术时间(67.36±9.77 min)短于传统缝合结扎组(91.09±27.37 ml),术后出血量(55.78±14.45 ml)少。其他结果包括术后血肿形成、喉返神经损伤和术后缺氧。结论:双极烧灼装置在甲状腺全切除术中的应用减少了手术时间和术后出血量,对喉返神经损伤发生率、术后低血钙、血肿形成及住院时间无明显影响。
{"title":"A comparative study between bipolar cuttery and conventional suture ligation for hemostasis in total thyroidectomy for benign thyroid disease","authors":"Anmar Abdulkadhum Ajaj, Ali K Shaaeli","doi":"10.33545/surgery.2023.v7.i3b.1018","DOIUrl":"https://doi.org/10.33545/surgery.2023.v7.i3b.1018","url":null,"abstract":"Background: Over the last years many surgeons have begun to use energy based devices to perform thyroid surgery, several literatures have demonstrated the benefits of these devices over traditional techniques, they can provide a combined dissection and hemostatic effect and particularly advantageous in reduction of incision length, operative time, operative blood loss and complications. Aim of study: Compare bipolar cautery to traditional suture ligation in hemostasis during complete thyroidectomy in nerve damage, operating time, hypocalcemia, post-operative blood loss and hematoma development, and hospital stay. Patients and Method: In this study 61 patients who underwent total thyroidectomy, they were divided into two groups according to the type of hemostasis: bipolar cautery hemostasis group and conventional suture ligation hemostasis group, different diseases were included (multinodular goiter, solitary thyroid nodule), these groups were compared in regard to operative time, complications and length of hospital stay. Results: The bipolar cautery hemostasis group had a shorter operation time (67.36±9.77 min) and a lower post-operative blood loss (55.78±14.45 ml) than the conventional suture ligation group (91.09±27.37 ml). Other outcomes included post-operative hematoma formation, recurrent laryngeal nerve injury, and post-operative hypoxia. Conclusion: Using bipolar cautery device in total thyroidectomy reduced the operative time and post-operative blood loss, without any change in the incidence of recurrent laryngeal nerve injury, post-operative hypocalcemia, hematoma formation, and the length of hospital stay.","PeriodicalId":14421,"journal":{"name":"International Journal of Surgery Science","volume":"17 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135549413","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
A clinical study of laser fistulectomy for high and low anal fistula in ANO 激光肛瘘切除术治疗肛瘘的临床研究
Pub Date : 2023-01-01 DOI: 10.33545/surgery.2023.v7.i3b.1016
Dr. Ritvik Jaykar, Dr. Pradip Kasabe, Dr. Prajakta Kamat, Dr. Tejas Mhatre
Aims1.To find the age and sex incidence of fistula in ano 2.To study the various modes of clinical presentation of fistula in ano3.To evaluate short term and long-term recovery with post-operative pain, persistence of fistula, anal incontinence and bleeding 4.To study the efficacy of laser fistulectomy Materials and Methodology: This is a prospective observational study in Shri Chhatrapati Shivaji Maharaj Sarvopchar Rugnalay, Solapur. Total 30 patients who will be treated for fistula in ano at our tertiary hospital will be analyzed in this study. Patient will undergo routine hematological and radiological investigations. Patients will be operated for laser fistulectomy. Post-operative complications like pain, discharge, fecal incontinence, length of hospital stay, recurrence will be analyzed. Patients will be followed for a period of three months.Results 1.Age distribution: Majority of the patients belonged to the age group of 30-39 years (30%). Mean age was 40.8 with standard deviation of 13.01.2.Gender distribution: 80% patients were males as opposed to 60%. 3.Type of fistula: Patients had extra-sphincteric fistula whereas 23% had inter-sphincteric fistula; 13% had trans-sphincteric fistula o 20% females concluding that fistula in ano is more common in males.4.Co-morbidities: Hypertension was the most common co-morbidity encountered, followed by Diabetes, Coronary artery disease.5.Clinical presentation: Most common presenting complaints were discharge (38%) followed by pain (34%) and itching (14%) followed by swelling (7%).6.History of previous surgery: 10% patients had a history of surgery for perianal abscess, were associated tran-sphincteric type of fistula in ano. 6% patients underwent fistulotomy for extra-sphincteric fistula.7.Hospital stay: 56% patients were discharged on Day 2 post-operatively, followed by 30% patients on day 4 and 5 and 13% on more than day 5.8.Post-operative complications: Post-operatively 63% patients experienced pain, followed by 26.6% of the patients who discharge and 13.3% had had recurrence in a period of 3 months.Conclusion: Ideal surgical treatment for anal fistula should aim to eradicate sepsis and promote healing of the tract, whilst preserving the sphincters and the mechanism of continence. For the simple and most distal fistulae, conventional surgical options such as laying open of the fistula tract seem to be relatively safe and therefore, well accepted in clinical practice. However, for the more complex fistulae where a significant proportion of the anal sphincter is involved, great concern remains about damaging the sphincter and subsequent poor functional outcomes, which is quite inevitable following conventional surgical treatment.For this reason, over the last two decades, many sphincter-preserving procedures for the treatment of anal fistula have been introduced with the common goal of trying to minimize the injury to the anal sphincters and preserving optimal function FiLaC uses a laser probe which
Aims1。目的:了解肛瘘的年龄和性别发生率。探讨肛瘘的各种临床表现模式。评估术后疼痛、瘘管持续、肛门失禁和出血的短期和长期恢复情况。研究激光瘘管切除术的疗效材料和方法:这是Shri Chhatrapati Shivaji Maharaj Sarvopchar Rugnalay, Solapur的一项前瞻性观察研究。本研究将分析我院三级医院收治的30例肛瘘患者。病人将接受常规血液学和放射学检查。患者将接受激光瘘管切除术。术后并发症如疼痛、排泄、大便失禁、住院时间、复发等将进行分析。对患者进行为期三个月的随访。结果1。年龄分布:30-39岁年龄组占多数(30%)。平均年龄40.8岁,标准差13.01.2。性别分布:男性占80%,男性占60%。3.瘘类型:患者为括约肌外瘘,23%为括约肌内瘘;13%的患者有经括约肌瘘,20%的患者有经括约肌瘘,结论是阴道瘘在男性中更为常见。合并症:高血压是最常见的合并症,其次是糖尿病、冠状动脉疾病。临床表现:最常见的主诉是分泌物(38%),其次是疼痛(34%),瘙痒(14%),最后是肿胀(7%)。既往手术史:10%患者有肛周脓肿手术史,均伴有经括约肌型瘘管。6%的患者因括约肌外瘘行瘘管切开术。住院时间:56%的患者术后第2天出院,30%的患者术后第4、5天出院,13%的患者术后第5.8天以上出院。术后并发症:63%的患者术后出现疼痛,26.6%的患者出院,13.3%的患者术后3个月复发。结论:肛瘘理想的手术治疗应以根除脓毒症和促进尿道愈合为目标,同时保留括约肌和尿失禁机制。对于单纯性和最远端的瘘管,传统的手术选择,如打开瘘道似乎是相对安全的,因此在临床实践中被广泛接受。然而,对于涉及肛门括约肌很大比例的更复杂的瘘管,仍然非常关注对括约肌的损伤和随后的功能不良后果,这在常规手术治疗后是不可避免的。因此,在过去的二十年中,许多用于肛瘘治疗的保留括约肌的手术已经被引入,其共同目标是尽量减少对肛门括约肌的损伤并保持最佳功能,FiLaC使用激光探针,这种探针更容易独立插入,也可以用于留置腔,通过诱导瘘管腔的纤维化重塑来帮助初级尿道成熟。FiLaC本质上是
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引用次数: 0
Comparison between laparoscopic sleeve gastrectomy versus laparoscopic gastric bypass management of type 2 diabetes mellitus obese patients 腹腔镜袖胃切除术与腹腔镜胃旁路治疗2型糖尿病肥胖患者的比较
Pub Date : 2023-01-01 DOI: 10.33545/surgery.2023.v7.i4a.1026
Ahmed Raafat Saad Abdeen, Samir Ahmed Abd El Majeed, Abd El Hafeez Hosny Mohamed
{"title":"Comparison between laparoscopic sleeve gastrectomy versus laparoscopic gastric bypass management of type 2 diabetes mellitus obese patients","authors":"Ahmed Raafat Saad Abdeen, Samir Ahmed Abd El Majeed, Abd El Hafeez Hosny Mohamed","doi":"10.33545/surgery.2023.v7.i4a.1026","DOIUrl":"https://doi.org/10.33545/surgery.2023.v7.i4a.1026","url":null,"abstract":"","PeriodicalId":14421,"journal":{"name":"International Journal of Surgery Science","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134979822","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Surgical management of low flow vascular malformations 低流量血管畸形的外科治疗
Pub Date : 2023-01-01 DOI: 10.33545/surgery.2023.v7.i3a.1009
Mohammed Hassan Abdelaty, Ahmed Ibrahim Badran, A. Aborahma, Mohammed Ahmed El Heniedy, A. Kamhawy
{"title":"Surgical management of low flow vascular malformations","authors":"Mohammed Hassan Abdelaty, Ahmed Ibrahim Badran, A. Aborahma, Mohammed Ahmed El Heniedy, A. Kamhawy","doi":"10.33545/surgery.2023.v7.i3a.1009","DOIUrl":"https://doi.org/10.33545/surgery.2023.v7.i3a.1009","url":null,"abstract":"","PeriodicalId":14421,"journal":{"name":"International Journal of Surgery Science","volume":"12 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87096369","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
期刊
International Journal of Surgery Science
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