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Idiopathic Granulomatous Mastitis: Dilemmas in Diagnosis and Treatment 特发性肉芽肿性乳腺炎:诊断和治疗的困境
Pub Date : 2019-11-05 DOI: 10.3329/jss.v20i1.43793
A. Hossain
Abstract not available Journal of Surgical Sciences (2016) Vol. 20 (1) :2
外科科学杂志(2016)Vol. 20 (1):2
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引用次数: 0
Urolithiasis Associated with Renal Impairment: Management and its Outcome 尿石症与肾脏损害相关:管理及其结果
Pub Date : 2019-11-05 DOI: 10.3329/jss.v20i1.43797
Jamal E Rabby, M. Zaman, M. Ali, Kabirul Hassan, Shohidul Lslam, Mustafizur Rahman, Atm Asbaduzzaman
Background: Urolithiasis may be associated with various degree of renal impairment secondaryto a combination of obstruction, urinary infection, long standing calculus, stone burden,frequent surgical intervention, and co-existing medical diseases. Objective: The purpose of the study is to predict the factors those have a significant impact foroutcome of the patients with renal impairment following treatment of urolithiasis. Methods: Fifty patients of urolithiasis with renal impairment were enrolled in this prospectivestudy, carried out between 1st July, 2008 and 30th June, 2009, at department of Surgery,Shaheed Ziaur Rahman Medical College Hospital, Bogra. Patients with renal impairment wasdefined as a baseline serum creatinine of >1.2mg/dl and/or on the basis of DTPA isotoperenogram findings (mild, moderate or severe impairment). Definite management was carriedout by means of open surgery, ESWL or in combinations available at study place. Follow-up after3 months, the postoperative renal functional outcome was defined as improved (>20% fall inserum creatinine), stabilized (<20% rise or <20% fall in serum creatinine), or deteriorated(>20% rise in serum creatinine). Renal function was also assessed by the impression madefrom the graph of DTPA isotope renogram (normal functioning or mild, moderate and severeimpairment). Predictive factors to be evaluated for the stone clearance and renal functionaloutcome were age of the patients, duration of symptomatology and urolithiasis, associateddiseases (hypertension and diabetes mellitus), stone burden, stone number and associatedurinary infection. Results: After 3 months of follow-up, the overall stone clearance rate was 76%. Out of 50patients, 27 patients (54%) showed improvement, 19 patients (38%) showed stabilization, and04 patients (08%) showed deterioration in their renal function. Age <40 years, duration ofsymptoms <6 months, stone burden <5 cm2 and single urinary stone were significant predictorsof subsequent good renal functional outcome. Conclusion: The renal recoverability rate after treatment of urinary stone disease could bepredicted by age, duration of symptoms, stone burden and stone number Journal of Surgical Sciences (2016) Vol. 20 (1) : 18-23
背景:尿石症可能与梗阻、尿路感染、长期结石、结石负担、频繁手术干预和并存内科疾病共同引起的不同程度肾功能损害有关。目的:探讨影响尿石症患者肾功能损害预后的主要因素。方法:在2008年7月1日至2009年6月30日期间,在Bogra Shaheed Ziaur Rahman医学院附属医院外科进行了50例伴有肾功能损害的尿石症患者的前瞻性研究。基线血清肌酐为>1.2mg/dl和/或基于DTPA同位素显像结果(轻度、中度或重度损害)来定义肾功能损害患者。通过开放手术、体外冲击波治疗或研究地点的联合治疗进行明确的治疗。随访3个月后,术后肾功能结果定义为改善(血肌酐下降20%),稳定(血肌酐上升20%)。通过DTPA同位素肾图的印象来评估肾功能(功能正常或轻度、中度和重度损害)。评估结石清除和肾功能结局的预测因素包括患者的年龄、症状和尿石症的持续时间、相关疾病(高血压和糖尿病)、结石负担、结石数量和相关泌尿系统感染。结果:随访3个月后,结石总清除率为76%。50例患者中,27例(54%)患者肾功能改善,19例(38%)患者肾功能稳定,04例(08%)患者肾功能恶化。年龄<40岁、症状持续时间<6个月、结石负担<5 cm2和单一尿路结石是随后良好肾功能结局的重要预测因素。结论:年龄、症状持续时间、结石负担、结石数量等因素可预测尿路结石治疗后肾脏康复率。中华外科杂志,2016,Vol. 20 (1): 18-23
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引用次数: 0
Outcome if Neoadjuvant Chemotherapy in Locally Advanced Breast Cancer: A Tertiary Care 11 Center Experience 局部晚期乳腺癌新辅助化疗的结果:三级护理中心的经验
Pub Date : 2019-11-05 DOI: 10.3329/jss.v20i1.43796
S. Rahman, P. Akhter, N. Khatun, Hasanuzzaman, M. Rahman, Nabir Hossen, A. U. Haque, A. Bhattacharjee
Background: Breast cancer is the most common cancer of Bangladeshi women. Almost allpresent with palpable lump and 40% of them are with locally advanced breast cancer.Neoadjuvant chemotherapy is the standard choice of treatment for the patients. Objective: To observe the clinical and pathological response of locally advanced breastcancer after four cycles of chemotherapy and surgery. Methods: This prospective study was carred over the newly diagnosed locally advancedbreast cancer (LABC) patients from January 2010 to December 2014. Before going toneoadjuvant chemotherapy each patient was evaluated clinically, radiologically and withother relevant investigations. The size of primary tumor and axillary node was measured andrecorded. Chemotherapy schedule with Cyclophosphamide 600mg/m2 and Doxorubicin60mg/m2 (AC) and compared with the previous record. After 3-4 weeks of completion ofchemotherapy, the patients was prescribed and carried out three weekly for four cycles.Primary tumor size and axillary nodal size was measured who were undergone mastectomyand axillary dissection. Histopathology was done to see then the pathological response ofprimary tumor and axillary node. Other biological marker such as estrogen receptor (ER),progesterone receptor (PR) and Human epidermal growth receptor (HER-2) was done. Aftercompletion of study the data was compiled and analyzed. Results: Total 220 cases of LABC were enrolled in this study. After four cycles of chemotherapywith AC, 194 patients (88%) responded clinically, 29 patients (13%) showedcomplete clinical response (cCr)-and 165 patients (75%) partial response (pCr). Surgicalspecimen showed complete pathological response (cPr) in 22 patients (10%). Conclusion: Neoadjuvant chemotherapy with AC is the standard chemotherapy schedule forlocally advanced breast cancer and radical surgery was possible in 75% of the patients. Journal of Surgical Sciences (2016) Vol. 20 (1) : 13-17
背景:乳腺癌是孟加拉国妇女最常见的癌症。几乎所有患者都有可触及的肿块,其中40%为局部晚期乳腺癌。新辅助化疗是患者治疗的标准选择。目的:观察局部晚期乳腺癌经4个周期化疗和手术治疗后的临床和病理反应。方法:对2010年1月至2014年12月新诊断的局部晚期乳腺癌(LABC)患者进行前瞻性研究。在进行辅助化疗之前,每位患者都进行了临床、放射学和其他相关检查。测量并记录原发肿瘤及腋窝淋巴结的大小。化疗方案:环磷酰胺600mg/m2 +阿霉素60mg/m2 (AC),并与既往记录比较。化疗完成3-4周后,患者按规定每周进行3次化疗,共4个周期。对行乳房切除术和腋窝清扫的患者进行原发肿瘤大小和腋窝淋巴结大小的测量。通过组织病理学观察原发肿瘤和腋窝淋巴结的病理反应。其他生物标志物如雌激素受体(ER)、孕激素受体(PR)和人表皮生长受体(HER-2)。研究完成后,对数据进行整理和分析。结果:本研究共纳入LABC 220例。在4个化疗周期后,194例(88%)患者有临床反应,29例(13%)患者有完全临床反应(cCr), 165例(75%)患者有部分反应(pCr)。手术标本显示完全病理反应(cPr) 22例(10%)。结论:AC新辅助化疗是局部晚期乳腺癌的标准化疗方案,75%的患者可进行根治性手术。外科杂志(2016)Vol. 20 (1): 13-17
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引用次数: 0
Gastric Lipoma
Pub Date : 2019-11-04 DOI: 10.3329/jss.v18i2.43760
Mustafizur Rahman, A. Kutubi, M. S. Khan, Mansurul Lslam, Kamruzzaman Al Mahmud, Sharmin Lslam
Lipoma, a universal tumor of adult fat cells is usually encountered in the subcutaneous plane. However no part of human body is spared of having lipomas. Gastrointestinal lipomas though rare, may prove to be more dangerous and needs special attention for diagnosis and treatment. Here, we report a 55 year old female with gastric lipoma who presented with upper abdominal pain, dyspepsia and acute upper gastrointestinal bleeding. Journal of Surgical Sciences (2014) Vol. 18 (2) : 74-77
脂肪瘤是一种常见的成人脂肪细胞肿瘤,通常发生在皮下。然而,人体没有一个部位能幸免于脂肪瘤。胃肠道脂肪瘤虽然罕见,但可能被证明是更危险的,需要特别注意诊断和治疗。在此,我们报告一位55岁女性胃脂肪瘤患者,表现为上腹部疼痛、消化不良和急性上消化道出血。外科杂志(2014)Vol. 18 (2): 74-77
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引用次数: 0
Outcome of Laparoscopic Versus Open Abdominal Rectopexy for the Treatment of Complete Rectal Prolapse-Our experience in Bangabandhu Sheikh Mujib Medical University 腹腔镜下与开放式腹部直肠切除术治疗完全性直肠脱垂的疗效——我们在Bangabandhu Sheikh Mujib医科大学的经验
Pub Date : 2019-11-04 DOI: 10.3329/jss.v19i1.43769
K. N. Naznin, S. H. Sheikh, A. Habib, Rashidul Lslam, A. Alam, G. Salahuddin, R. Rahman
Background: Complete rectal prolapse is a very distressing condition. In adults, the only potentially curative treatment for complete rectal prolapse is surgery either by transabdominal or perinea! approaches. Till date abdominal rectopexy is considered as the standard surgical treatment for complete rectal prolapse, which can be done laparoscopically or by open procedure. Objective: The purpose of the study was to observe the outcome of Laparoscopic rectopexy in the treatment of complete rectal prolapse by subjective assessment and to compare the result with that of conventional open abdominal rectopexy. Methodology: This randomized clinical trial was carried out in the Department of Surgery at Bangabandhu Sheikh Mujib Medical University, Dhaka, from July 2012 to June 2014 for a period of twenty four (24) months. Patients who presented with complete rectal prolapse with age ranging from 25 to 70 years irrespective of gender were selected as study population. Patients were randomized by lottery method into two groups as group I who underwent laparoscopic rectopexy (LR) and group II who underwent open rectopexy (OR). Result: A total number of 50 patients were recruited in this study of which 25 patients were. in group I and 25 patients were in group II. The mean (s.d.) age was 49.40 (13.22) years and 46.48(13.27) years in group I and group II respectively (p>0.05). The mean (s.d.) operative time was 115(19) minutes in group I and 75(12) minutes in group II (p<0.05). In this study 1(4.0%) patient and 6 (24.0%) patients had abdominal wound infection in group I and in group II respectively (p>0.05). Mean (s.d.) ambulation time was 1.96 (0.67) days in group I and 3.92(1.15) days in groups II (p<0.05). Postoperative hospital stay mean (s.d.) was 3.08(1.18) days in group I and 8.16(3.57) days in group II (p<0.05). Overall patients satisfaction were 92% and 76% in group I and group II respectively (p>0.05). Conclusion: Laparoscopic rectopexy is a better option than conventional open abdominal rectopexy for the treatment of complete rectal prolapse. Journal of Surgical Sciences (2015) Vol. 19 (1) : 3-7
背景:完全性直肠脱垂是一种非常痛苦的疾病。在成人中,唯一可能治愈的治疗完全直肠脱垂的方法是经腹或会阴手术!方法。迄今为止,腹部直肠固定术被认为是治疗完全性直肠脱垂的标准手术方法,可以通过腹腔镜或开放手术进行。目的:通过主观评价,观察腹腔镜直肠固定术治疗完全性直肠脱垂的效果,并与常规开腹直肠固定术的效果进行比较。方法:该随机临床试验于2012年7月至2014年6月在达卡Bangabandhu Sheikh Mujib医科大学外科进行,为期24(24)个月。年龄在25至70岁之间,不分性别,表现为完全性直肠脱垂的患者被选为研究人群。采用抽签法将患者随机分为两组:I组采用腹腔镜直肠固定术(LR), II组采用开放式直肠固定术(OR)。结果:本研究共招募了50例患者,其中25例患者。1组25例,2组25例。I组和II组患者的平均(s.d)年龄分别为49.40(13.22)岁和46.48(13.27)岁(p>0.05)。I组平均手术时间为115(19)min, II组平均手术时间为75(12)min (p < 0.05)。组平均(s.d)下床时间分别为1.96(0.67)天和3.92(1.15)天(p0.05)。结论:腹腔镜直肠固定术是治疗完全性直肠脱垂的较好方法。外科杂志(2015)Vol. 19 (1): 3-7
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引用次数: 0
Crossed Testicular Ectopia in a 65-year-old man 65岁男性交叉睾丸异位
Pub Date : 2019-11-04 DOI: 10.3329/jss.v19i1.43777
S. Islam, S. Hossain, A. Mamun, S. M. Reza, Tushit Kumar Barua
Crossed testicular ectopia (CTE) is an extremely rare anomaly in which deviation of testicular descent results in unilateral location of both testes. It usually presents as an inguinal hernia on the side of a fully descended testis and an impalpable testis with undeveloped hemiscrotum on the contralateral side. Most often the diagnosis of CTE is not made until surgical exploration. Few reports are available regarding CTE in infants or younger children. Though the patients of CTE usually present at a younger age, we report a case of crossed testicular ectopia in a 65-year-old male who was admitted in the department of surgery, Shaheed Suhrawardi Medical College Hospital (ShSMCH) with right sided inguinal hernia. Journal of Surgical Sciences (2015) Vol. 19 (1) : 39-41
交叉睾丸异位(CTE)是一种极为罕见的异常,其中睾丸下降偏差导致双睾丸单侧位置。它通常表现为完全下降的睾丸一侧的腹股沟疝和对侧未发育的半阴囊无法触及的睾丸。大多数情况下,CTE的诊断是在手术探查后才做出的。很少有关于婴儿或幼儿CTE的报道。虽然CTE的患者通常出现在较年轻的年龄,我们报告一个65岁的男性交叉睾丸异位,谁住进了外科,沙希德苏赫瓦迪医学院医院(ShSMCH)右侧腹股沟疝。外科杂志(2015)Vol. 19 (1): 39-41
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引用次数: 0
Is Single-stage Primary Transanal Endorectal Pull through (TEP) feasible for Short Segment Hirschsprung's Disease in Neonates?- Our Experience in a Tertiary Hospital 单期经肛门直肠内牵引术治疗新生儿短节段先天性先天性巨结肠是否可行?——我们在三级医院的经验
Pub Date : 2019-11-04 DOI: 10.3329/jss.v18i2.43755
Shahjahan, K. M. N. Ferdous, M. Lslam
Background: The surgical management of Hirschsprung's Disease (HD) includes so many procedures. TransanalEndorectal Pull through (TEP) represents the latest development in the concept of the minimally invasive surgery for HD. The purpose of this study was to evaluate the out come of the procedure in neonates. Methods: This retrospective study was carried out in a tertiary pediatric hospital during the period from January 2007 to December 2012 (5 years). The study included neonates of both sex, weight more than 2 kg, who were clinically suspected HD, radiologically transition zone at rectosigmoid and midsigmoid region and rectal biopsy proven HD and no evidence of sepsis or entrocolitis. Short segment HD with associated anomalies, and operated cases with less than 6 months' or irregular follow up were excluded. Results: During study period, single-stage transanalendorectal pull through (TEP) operation was done for short segment HD in 63 neonates, 9 patients were excluded from the study for irregular follow up. The mean operative time, mean blood loss, postoperative hospital stay, follow up period were 113 minutes, 20ml, 6.8 days and 19.6 months respectively. Transverse colostomy was needed in 6 patients for anastomotic leakage, thereafter developed anastomotic stricture, managed with regular anastomotic dilatation. Conclusion: Advancement in pediatric anesthesia, improvement of pediatric surgical expertise, perioperative management and nursing care has made single-stage primary transanalendorectal pull-through a feasible and safe surgical procedure for the treatment of short segment Hirschsprung's disease in neonate. Journal of Surgical Sciences (2014) Vol. 18 (2) : 45-50
背景:先天性巨结肠病(HD)的外科治疗包括很多步骤。经肛门直肠内拉通(TEP)代表了HD微创手术概念的最新发展。本研究的目的是评估新生儿手术的结果。方法:回顾性研究于2007年1月至2012年12月(5年)在某三级儿科医院进行。研究对象为新生儿,性别不限,体重大于2kg,临床疑似HD,影像学上乙状结肠直肠和乙状结肠中部有过渡区,直肠活检证实HD,没有败血症或结肠炎的证据。排除伴有异常的短节段HD,以及术后随访时间少于6个月或随访不规律的病例。结果:研究期间,63例短段HD新生儿行单期经肛管直肠牵引(TEP)手术,9例因不定期随访而被排除在研究之外。平均手术时间113分钟,平均失血量20毫升,术后住院时间6.8天,随访时间19.6个月。6例因吻合口瘘行结肠横切面造口术,术后发生吻合口狭窄,行吻合口常规扩张术。结论:儿科麻醉技术的进步、儿科外科专业知识的提高、围手术期管理和护理的完善,使单期经肛管内牵引术成为治疗新生儿短节段先天性巨结肠的一种可行、安全的手术方法。外科杂志(2014)Vol. 18 (2): 45-50
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引用次数: 0
Cavernous Hemangioma of Sigmoid Colon and Ano-Rectum: A Rare Cause of Haematochezia 乙状结肠和无直肠海绵状血管瘤:一种罕见的赤血病病因
Pub Date : 2019-11-04 DOI: 10.3329/jss.v18i2.43767
T. Khan, S. H. Sheikh, A. Habib, L. Lima, R. Rahman, Nigar Nahid, Omar Faruk
Cavernous hemangioma of colon and rectum is a rare disease, with no more than 200 cases reported in the literature so far. The rectosigmoid is the most common site of this disease in the gastrointestinal tract. We report a case of a 32-year-old male with recurrent episodes of per-rectal bleeding, who was finally diagnosed of cavernous hemangioma of sigmoid colon and ano-rectum. The lesion, 23 cm in length, occupied the whole circumference of the sigmoid colon and rectum extending up to the margin of the anal sphincter. Ultra-low anterior resection with hand-sewn colo-anal anastomosis and temporary loop ileostomy was carried out. The patient is in regular follow up. He is now symptom free. Journal of Surgical Sciences (2014) Vol. 18 (2) : 83-86
结直肠海绵状血管瘤是一种罕见的疾病,目前文献报道的病例不超过200例。直肠乙状结肠是本病在胃肠道中最常见的部位。我们报告一个32岁男性复发性直肠出血的病例,他最终被诊断为乙状结肠和无直肠海绵状血管瘤。病变长23厘米,占据乙状结肠和直肠的整个周长,一直延伸到肛门括约肌边缘。采用手工缝合结肠肛管吻合术和临时回肠袢造口的超低前切除术。病人定期接受随访。他现在没有症状了。外科杂志(2014)Vol. 18 (2): 83-86
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引用次数: 0
Synchronous Adenocarcinoma and Gastrointestinal Strom al Tumour (GIST) of the Stomach 胃同步性腺癌和胃肠道肿瘤(GIST)
Pub Date : 2019-11-04 DOI: 10.3329/jss.v19i1.43775
S. M. Reza, M. Rahman, A. Mamun, M. Hoque, S. Hossain, F. Ahmad, Sharmin Lslam
Gastrointestinal stromal tumours are rare mesenchymal neoplasms of gastrointestinal tract with a malignant potential and unpredictable behavior and stomach is the commonest location involved. However coexistence of gastric carcinoma and GIST is very rare. A 32- year-old male patient who presented with upper abdominal dyspeptic symptoms, was evaluated with Upper GI Endoscopy which revealed an ulcerated lesion in the antral part of the stomach. Biopsy was taken and histopathological examination revealed the lesion as poorly differentiated adenocarcinoma. Distal radical gastrectomy revealed another 3cm of submucosal mass of GIST along with the existing adenocarcinoma. Journal of Surgical Sciences (2015) Vol. 19 (1) : 31-34
胃肠道间质瘤是一种罕见的胃肠道间质肿瘤,具有恶性潜能和不可预测的行为,胃是最常见的部位。然而,胃癌与GIST共存是非常罕见的。一个32岁的男性病人,表现为上腹部消化不良症状,通过上消化道内镜检查,发现胃中段有溃疡性病变。活检及病理检查显示病变为低分化腺癌。远端根治性胃切除术在原有腺癌的同时发现另一3cm的胃肠道间质瘤粘膜下肿物。外科杂志(2015)Vol. 19 (1): 31-34
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引用次数: 0
Fascioliasis-An Uncommon Cause of Recurrent Cholangitis 筋膜吸虫病-复发性胆管炎的罕见原因
Pub Date : 2019-11-04 DOI: 10.3329/jss.v19i1.43776
B. Das, A. Khan, Saief Uddin, M. Chowdhury, Khan Zr
We report a case of Fascioliasis presented with recurrent cholangitis in a female necessitating multiple consultations and hospitalizations over a period of two years. Investigative profile failed to confirm any definite diagnosis prior to her admission in Hepato-Biliary-Pancreatic Surgery Division of the Department of Surgery of Bangabandhu Sheikh Mujib Medical University where she was provisionally diagnosed as a case suffering from extrahepatic cholagiocarcinoma. With the intent of extrahepatic excision with Rouxen-Y hepaticojejunostomy abdomen was explored and surprisingly 28 mature liver flukes (fasciola hepatica) were found lodged in the extra and intrahepatic biliary tree. Although fasciola hepatica infestation is more common in far East Asia, this case may represent the tip of an iceberg of endemic infestation of this trematode in Bangladesh which warrants further investigations. Journal of Surgical Sciences (2015) Vol. 19 (1) : 35-38
我们报告一个病例片形吸虫病表现为复发性胆管炎在女性需要多次咨询和住院超过两年的时间。在她被Bangabandhu Sheikh Mujib医科大学外科肝胆胰外科收治之前,调查资料未能证实任何明确的诊断,在那里她被暂时诊断为肝外胆道癌。采用Rouxen-Y肝空肠吻合术进行肝外切除,腹部探查,意外地发现28个成熟肝吸虫(肝片吸虫)卡在肝外和肝内胆道树中。尽管肝片形吸虫感染在远东亚更为常见,但本病例可能只是孟加拉国这种吸虫地方性感染的冰山一角,值得进一步调查。外科杂志(2015)Vol. 19 (1): 35-38
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引用次数: 1
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Journal of Surgical Sciences
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