Background: Nasal septum collections (hematoma and abscess) can lead to structural and functional abnormalities. Our objective was to assess the clinical characteristics, management and complications of nasal septal collections, and document factors associated with their complications. Methods: This was a retrospective study of patients managed for nasal septal collections. Socio-demographic and clinical information was recorded, and the main investigations and results noted. Follow-up and complications of septal collections were documented and the clinical factors associated with the complications explored. Results: Twenty-four patients records were studied: male: female ratio=2:1, mean age 40.1±13.1years,62.5% presented with complaints of nasal obstruction, 66.7% had antecedent nasal trauma, presentation was from 2 to 13 days,25%had co-morbid disease(s). All patients had incision and drainage of the septal collection within 1–7 h; 41.2% of the aspirated collections cultured microorganisms, 20.8% developed complications. Increased age above 45 years, co-morbidity, delayed presentation, culture-positive aspirate was all significantly associated with development of complications. Conclusion: Nasal septal collections were more common in adult males with antecedent nasal trauma; 20% developed complications associated with the presence of culturepositive abscesses, increased age, and duration of septal collection.
{"title":"Management and Complications of Nasal Septal Collections","authors":"O. Sogebi, E. A. Oyewole","doi":"10.4314/AAS.V18I2.4","DOIUrl":"https://doi.org/10.4314/AAS.V18I2.4","url":null,"abstract":"Background: Nasal septum collections (hematoma and abscess) can lead to structural and functional abnormalities. Our objective was to assess the clinical characteristics, management and complications of nasal septal collections, and document factors associated with their complications. Methods: This was a retrospective study of patients managed for nasal septal collections. Socio-demographic and clinical information was recorded, and the main investigations and results noted. Follow-up and complications of septal collections were documented and the clinical factors associated with the complications explored. Results: Twenty-four patients records were studied: male: female ratio=2:1, mean age 40.1±13.1years,62.5% presented with complaints of nasal obstruction, 66.7% had antecedent nasal trauma, presentation was from 2 to 13 days,25%had co-morbid disease(s). All patients had incision and drainage of the septal collection within 1–7 h; 41.2% of the aspirated collections cultured microorganisms, 20.8% developed complications. Increased age above 45 years, co-morbidity, delayed presentation, culture-positive aspirate was all significantly associated with development of complications. Conclusion: Nasal septal collections were more common in adult males with antecedent nasal trauma; 20% developed complications associated with the presence of culturepositive abscesses, increased age, and duration of septal collection.","PeriodicalId":37442,"journal":{"name":"Annals of African Surgery","volume":"18 1","pages":"79-84"},"PeriodicalIF":0.0,"publicationDate":"2021-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43275842","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}
Background: The use of wedge inferior pubectomy can be challenging to many urethral surgeons. Our objective was to introduce a bone-nibbling technique to accomplish a partial inferior pubectomy (PIP) in a resource-poor setting, and to report the mediumto longterm outcome of using the technique. Methods: Five patients were recruited (mean age: 38.8 years) who presented, over a 30-month period, with posterior urethral fibrosis from a pelvic fracture urethral injury (PFUI). One had failed a previous attempt at posterior urethral reconstruction elsewhere. The length of urethral defect was from 2 to 4 cm. We describe a bone-nibbling technique used to carry out PIP for the delayed repair of PFUI in these patients. The outcomes in the medium to long term of surgical procedures done with this technique are presented. Results: Immediate postoperative complications in all were essentially a Clavien–Dindo grade I. Peak flow rate assessed 12 weeks’ post operation was between 20 mL/s and 23 mL/s (mean: 21 mL/s). The longest duration of follow-up was 34 months, and all patients were voiding satisfactorily. Conclusions: A satisfactory and durable outcome can be obtained from nibbling at the bone from the inferior margin of the pubic bone to achieve PIP. This is of interest to lower urinary tract reconstructive surgeons who have concerns with chiseling-out wedge of the inferior pubis.
{"title":"Partial Inferior Pubectomy in the Delayed Repair of Pelvic Fracture Urethral Injury: Adopting a Bone-nibbling Technique","authors":"I. Nnabugwu, F. Ugwumba, Anthony Alex Ilukwe","doi":"10.4314/AAS.V18I2.2","DOIUrl":"https://doi.org/10.4314/AAS.V18I2.2","url":null,"abstract":"Background: The use of wedge inferior pubectomy can be challenging to many urethral surgeons. Our objective was to introduce a bone-nibbling technique to accomplish a partial inferior pubectomy (PIP) in a resource-poor setting, and to report the mediumto longterm outcome of using the technique. Methods: Five patients were recruited (mean age: 38.8 years) who presented, over a 30-month period, with posterior urethral fibrosis from a pelvic fracture urethral injury (PFUI). One had failed a previous attempt at posterior urethral reconstruction elsewhere. The length of urethral defect was from 2 to 4 cm. We describe a bone-nibbling technique used to carry out PIP for the delayed repair of PFUI in these patients. The outcomes in the medium to long term of surgical procedures done with this technique are presented. Results: Immediate postoperative complications in all were essentially a Clavien–Dindo grade I. Peak flow rate assessed 12 weeks’ post operation was between 20 mL/s and 23 mL/s (mean: 21 mL/s). The longest duration of follow-up was 34 months, and all patients were voiding satisfactorily. Conclusions: A satisfactory and durable outcome can be obtained from nibbling at the bone from the inferior margin of the pubic bone to achieve PIP. This is of interest to lower urinary tract reconstructive surgeons who have concerns with chiseling-out wedge of the inferior pubis.","PeriodicalId":37442,"journal":{"name":"Annals of African Surgery","volume":"18 1","pages":"69-74"},"PeriodicalIF":0.0,"publicationDate":"2021-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41338514","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}
Background: Our objective was to evaluate the clinical and epidemiological profile of maxillofacial trauma in patients attended to at the Maputo Central and Nampula Central hospitals in 2016. Methods: A descriptive cross-sectional retrospective study based on clinical records of all patients with maxillofacial trauma who attended consultations or were admitted to wards of the maxillofacial surgery services from January to December 2016. Statistical tests looking for significance levels of 5% were performed in SPSS. Results: Trauma accounted for 482 (35.65%) patients treated at the central hospitals of Maputo and Nampula: of these patients 373 (77.4%) fell in the 15–44-year age group, 363 (75.31%) were male, and 430 (89.21%) were ethnically African. Most patients (259 or 53.77%) treated at these hospitals were outpatients. The most frequent cause of trauma (albeit without statistical significance) was physical violence. The lower floor of the face was more frequently involved (279 or 57.88%), and the most common treatment was closed reduction (238 or 49.38%). Conclusion: The characteristic clinical and epidemiological profile of patients with maxillofacial trauma is mainly fractures of the lower floor of the face. These types of injuries are usually severe, and developing preventative and multidisciplinary conducts and treatment protocols for these patients is imperative.
{"title":"Clinical and Epidemiological Profile of Oral and Maxillofacial Trauma at Two Quaternary Hospitals in Mozambique in 2016","authors":"Nádia Armindo Henriques Fortes, Prem Yohannan","doi":"10.4314/AAS.V18I2.5","DOIUrl":"https://doi.org/10.4314/AAS.V18I2.5","url":null,"abstract":"Background: Our objective was to evaluate the clinical and epidemiological profile of maxillofacial trauma in patients attended to at the Maputo Central and Nampula Central hospitals in 2016. Methods: A descriptive cross-sectional retrospective study based on clinical records of all patients with maxillofacial trauma who attended consultations or were admitted to wards of the maxillofacial surgery services from January to December 2016. Statistical tests looking for significance levels of 5% were performed in SPSS. Results: Trauma accounted for 482 (35.65%) patients treated at the central hospitals of Maputo and Nampula: of these patients 373 (77.4%) fell in the 15–44-year age group, 363 (75.31%) were male, and 430 (89.21%) were ethnically African. Most patients (259 or 53.77%) treated at these hospitals were outpatients. The most frequent cause of trauma (albeit without statistical significance) was physical violence. The lower floor of the face was more frequently involved (279 or 57.88%), and the most common treatment was closed reduction (238 or 49.38%). Conclusion: The characteristic clinical and epidemiological profile of patients with maxillofacial trauma is mainly fractures of the lower floor of the face. These types of injuries are usually severe, and developing preventative and multidisciplinary conducts and treatment protocols for these patients is imperative.","PeriodicalId":37442,"journal":{"name":"Annals of African Surgery","volume":"18 1","pages":"85-89"},"PeriodicalIF":0.0,"publicationDate":"2021-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42246067","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}
Duplex renal system, a common congenital anomaly of the kidney and urinary tract, is preferably identified through screening. For obstructed symptomatic duplications, prompt relief of obstruction to forestall renal parenchymal loss is recommended. We present a case of neglected obstruction of the right upper moiety in an adult female with discordant bilateral renal duplex system. A 49-year-old female with a 10-year history of recurrent right flank pain and fever presented for clinical evaluation and treatment. She had no such symptoms in early childhood. A diagnosis was made of obstructed right upper renal moiety in bilateral discordant renal duplication with complete moiety parenchymal destruction. She had right renal exploration with complete excision of the hydronephrotic sac and the grossly dilated moiety ureter down to the obstruction at the fusion of both upper and lower moiety ureters. Her postoperative period was uneventful. She is symptomfree and her urinary tract is structurally intact. Hitherto asymptomatic renal duplication can become symptomatic in early adulthood from intrinsic moiety ureter obstruction, suggesting a need for lifetime monitoring of persons with duplex renal systems. Late presentation with neglected symptoms, and consequent renal moiety destruction as seen here, is a result of the absence of such monitoring.
{"title":"Obstructed Right Upper Moiety in a Bilateral Partial Duplex Renal System in an Adult","authors":"S. Anyimba, I. Nnabugwu, Chinwe A. Nnabugwu","doi":"10.4314/AAS.V18I2.11","DOIUrl":"https://doi.org/10.4314/AAS.V18I2.11","url":null,"abstract":"Duplex renal system, a common congenital anomaly of the kidney and urinary tract, is preferably identified through screening. For obstructed symptomatic duplications, prompt relief of obstruction to forestall renal parenchymal loss is recommended. We present a case of neglected obstruction of the right upper moiety in an adult female with discordant bilateral renal duplex system. A 49-year-old female with a 10-year history of recurrent right flank pain and fever presented for clinical evaluation and treatment. She had no such symptoms in early childhood. A diagnosis was made of obstructed right upper renal moiety in bilateral discordant renal duplication with complete moiety parenchymal destruction. She had right renal exploration with complete excision of the hydronephrotic sac and the grossly dilated moiety ureter down to the obstruction at the fusion of both upper and lower moiety ureters. Her postoperative period was uneventful. She is symptomfree and her urinary tract is structurally intact. Hitherto asymptomatic renal duplication can become symptomatic in early adulthood from intrinsic moiety ureter obstruction, suggesting a need for lifetime monitoring of persons with duplex renal systems. Late presentation with neglected symptoms, and consequent renal moiety destruction as seen here, is a result of the absence of such monitoring.","PeriodicalId":37442,"journal":{"name":"Annals of African Surgery","volume":"18 1","pages":"119-122"},"PeriodicalIF":0.0,"publicationDate":"2021-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44514724","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}
Masawa K. Nyamuryekung’e, A. Athar, Miten R. Patel, Aidan Njau, Omar Sherman, A. Jusabani, Allie Zehr
Background: Acute appendicitis (AA) has a lifetime risk of 8.3% with a consequent 23% lifetime risk of emergency appendectomy. In atypical presentation, making a clinical diagnosis is difficult, leading to a high perforation rate (PR) or misdiagnoses and high negative appendectomy rates (NAR). This study aimed to establish NAR and explore the associated factors and possible attainable solutions to reduce it in urban referral hospitals in Tanzania. Methods: This was a crosssectional study with 91 consecutive patients, aged 10 years and older undergoing appendectomy for suspected AA with histological evaluation of specimens. The study was powered to detect the NAR at 95% confidence level and 80% power. Results: The histological NAR was 38.5% and the perforation rate was 25.3%. The Alvarado score (AS) was rarely applied (6%), despite a demonstrated ability in this study to decrease the NAR by half. Females were four times more likely to undergo negative appendectomy than males. Conclusion: The NAR is clinically significant as about two out of every five patients undergoing emergency appendectomy for suspected AA do not require the procedure. The AS is underutilized despite a demonstrated ability to decrease the NAR. We recommend that the AS be incorporated in the management of patients with suspected appendicitis.
{"title":"Negative Appendectomy Rate in Urban Referral Hospitals in Tanzania: A Cross-sectional Analysis of Associated Factors","authors":"Masawa K. Nyamuryekung’e, A. Athar, Miten R. Patel, Aidan Njau, Omar Sherman, A. Jusabani, Allie Zehr","doi":"10.4314/AAS.V18I2.9","DOIUrl":"https://doi.org/10.4314/AAS.V18I2.9","url":null,"abstract":"Background: Acute appendicitis (AA) has a lifetime risk of 8.3% with a consequent 23% lifetime risk of emergency appendectomy. In atypical presentation, making a clinical diagnosis is difficult, leading to a high perforation rate (PR) or misdiagnoses and high negative appendectomy rates (NAR). This study aimed to establish NAR and explore the associated factors and possible attainable solutions to reduce it in urban referral hospitals in Tanzania. Methods: This was a crosssectional study with 91 consecutive patients, aged 10 years and older undergoing appendectomy for suspected AA with histological evaluation of specimens. The study was powered to detect the NAR at 95% confidence level and 80% power. Results: The histological NAR was 38.5% and the perforation rate was 25.3%. The Alvarado score (AS) was rarely applied (6%), despite a demonstrated ability in this study to decrease the NAR by half. Females were four times more likely to undergo negative appendectomy than males. Conclusion: The NAR is clinically significant as about two out of every five patients undergoing emergency appendectomy for suspected AA do not require the procedure. The AS is underutilized despite a demonstrated ability to decrease the NAR. We recommend that the AS be incorporated in the management of patients with suspected appendicitis.","PeriodicalId":37442,"journal":{"name":"Annals of African Surgery","volume":"18 1","pages":"109-114"},"PeriodicalIF":0.0,"publicationDate":"2021-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45595522","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}
Background: In intestinal ischemia, reperfusion towards the injured intestine can cause further injury to the intestine itself and to remote organs. This research aimed to evaluate the influence of intestinal strangulation release (SR) before resection on the intestine outside margin of the strangulated intestine compared with subjects without intestinal strangulation release (WSR). Methods: Fourteen male Sprague Dawley rats were subjected to strangulation of one loop of the distal ileum for 4 h. In the SR group, the strangulated intestine was released for 5 min and then resected for necrotic parts. In the WSR group, the strangulated intestine was immediately resected WSR. The control group received a sham laparotomy. Four hours after the second laparotomy, the animals were sacrificed, and intestinal samples were taken for histomorphological analysis and measurement of intestinal malondialdehyde (MDA) level. Results: The injury on the histomorphological intestinal mucosa and intestinal MDA level were insignificantly higher in the SR group than in the WSR group (p>0.05). Conclusion: Intestinal SR before resection causes more tissue injury and oxidative stress on the intestine outside the strangulation section, but the difference is not statistically significant.
{"title":"Influence of Intestinal Strangulation Release on Ischemiareperfusion Injury in Sprague Dawley Rats","authors":"A. Yani, D. Dorothy, Rizky Amaliah","doi":"10.4314/AAS.V18I2.6","DOIUrl":"https://doi.org/10.4314/AAS.V18I2.6","url":null,"abstract":"Background: In intestinal ischemia, reperfusion towards the injured intestine can cause further injury to the intestine itself and to remote organs. This research aimed to evaluate the influence of intestinal strangulation release (SR) before resection on the intestine outside margin of the strangulated intestine compared with subjects without intestinal strangulation release (WSR). Methods: Fourteen male Sprague Dawley rats were subjected to strangulation of one loop of the distal ileum for 4 h. In the SR group, the strangulated intestine was released for 5 min and then resected for necrotic parts. In the WSR group, the strangulated intestine was immediately resected WSR. The control group received a sham laparotomy. Four hours after the second laparotomy, the animals were sacrificed, and intestinal samples were taken for histomorphological analysis and measurement of intestinal malondialdehyde (MDA) level. Results: The injury on the histomorphological intestinal mucosa and intestinal MDA level were insignificantly higher in the SR group than in the WSR group (p>0.05). Conclusion: Intestinal SR before resection causes more tissue injury and oxidative stress on the intestine outside the strangulation section, but the difference is not statistically significant.","PeriodicalId":37442,"journal":{"name":"Annals of African Surgery","volume":"18 1","pages":"90-95"},"PeriodicalIF":0.0,"publicationDate":"2021-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45083517","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}
Chylous leakage is a rare complication following mastectomy and axillary dissection. We report a case of a 46-year-old female who underwent modified radical mastectomy and developed chylous leakage. She was treated successfully with conservative management.
{"title":"Chylous Leakage Post-mastectomy and Axillary Dissection","authors":"Matheka Mwongeli, R. Wasike","doi":"10.4314/AAS.V18I2.12","DOIUrl":"https://doi.org/10.4314/AAS.V18I2.12","url":null,"abstract":"Chylous leakage is a rare complication following mastectomy and axillary dissection. We report a case of a 46-year-old female who underwent modified radical mastectomy and developed chylous leakage. She was treated successfully with conservative management.","PeriodicalId":37442,"journal":{"name":"Annals of African Surgery","volume":"18 1","pages":"123-125"},"PeriodicalIF":0.0,"publicationDate":"2021-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43186514","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}
Lodhia Jay, P. Rune, Wapalila Daudi, Sadiq Adnan, Amsi Patrick, M. David, Herman Ayesiga
Acute perforated appendicitis is rare in neonates and is associated with high morbidity and mortality. This is mainly because the rarity of the pathology and the abnormal clinical features cause delays in diagnosis and definitive management. We report a case of a premature neonate who presented with sudden onset of abdominal distension associated with an inability to pass stools. The initial abdominal X-ray showed free air under the right hemi-diaphragm. An emergency laparotomy was performed revealing a perforation at the appendicular tip. An appendectomy was done, and the neonate recovered well with a mild surgical site infection during the course of recovery. Neonatal perforated appendicitis is rare, and clinicians need to consider it as a differential diagnosis due to the atypical presentations. This preterm neonate presented with clinical features of intestinal obstruction and was found at laparotomy to have a perforated appendix at the tip due to neonatal appendicitis.
{"title":"Perforated Appendix in a Neonate: A Review of Literature and a Case Report from Northern Tanzania","authors":"Lodhia Jay, P. Rune, Wapalila Daudi, Sadiq Adnan, Amsi Patrick, M. David, Herman Ayesiga","doi":"10.4314/AAS.V18I2.10","DOIUrl":"https://doi.org/10.4314/AAS.V18I2.10","url":null,"abstract":"Acute perforated appendicitis is rare in neonates and is associated with high morbidity and mortality. This is mainly because the rarity of the pathology and the abnormal clinical features cause delays in diagnosis and definitive management. We report a case of a premature neonate who presented with sudden onset of abdominal distension associated with an inability to pass stools. The initial abdominal X-ray showed free air under the right hemi-diaphragm. An emergency laparotomy was performed revealing a perforation at the appendicular tip. An appendectomy was done, and the neonate recovered well with a mild surgical site infection during the course of recovery. Neonatal perforated appendicitis is rare, and clinicians need to consider it as a differential diagnosis due to the atypical presentations. This preterm neonate presented with clinical features of intestinal obstruction and was found at laparotomy to have a perforated appendix at the tip due to neonatal appendicitis.","PeriodicalId":37442,"journal":{"name":"Annals of African Surgery","volume":"18 1","pages":"115-118"},"PeriodicalIF":0.0,"publicationDate":"2021-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43514169","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}
Background: This study aimed to determine the differences in postoperative complications experienced by patients with inguinoscrotal hernia after laparoscopic versus open repair, and the association of risk factors to development of postoperative complications. Methods: We retrospectively reviewed the charts of all patients with inguinoscrotal hernias who had either Lichtenstein repair or totally extraperitoneal laparoscopic (TEP) repair from January 2014 to December 2017. Results: The study was performed on evaluable data that could be extracted for 49 patients: 14 were offered TEP repair and 35 Lichtenstein repairs. There was no statistical difference in the mean operative time and mean time taken to return to normal activities between the two groups. The length of hospital stay was one day for both groups. Two patients from the TEP repair group and one patient from the Lichtenstein repair group developed recurrence. Three patients from the TEP group and one patient from the Lichtenstein repair group developed chronic groin pain. One patient from the totally extraperitoneal laparoscopic repair group developed a seroma. Conclusion: Our study demonstrated a trend towards better postoperative outcomes in the Lichtenstein repair group than in the TEP group. Keywords: Open tension-free mesh repair, Totally extraperitoneal laparoscopic repair, Inguinoscrotal hernias
{"title":"Comparison of Outcomes of Open Tension-free Mesh Repair and Totally Extraperitoneal Laparoscopic Repair of Inguinoscrotal Hernias","authors":"B. Shazi, M. Koto, C. Osuagwu, H. Schoeman","doi":"10.4314/AAS.V18I1.6","DOIUrl":"https://doi.org/10.4314/AAS.V18I1.6","url":null,"abstract":"Background: This study aimed to determine the differences in postoperative complications experienced by patients with inguinoscrotal hernia after laparoscopic versus open repair, and the association of risk factors to development of postoperative complications. \u0000Methods: We retrospectively reviewed the charts of all patients with inguinoscrotal hernias who had either Lichtenstein repair or totally extraperitoneal laparoscopic (TEP) repair from January 2014 to December 2017. \u0000Results: The study was performed on evaluable data that could be extracted for 49 patients: 14 were offered TEP repair and 35 Lichtenstein repairs. There was no statistical difference in the mean operative time and mean time taken to return to normal activities between the two groups. The length of hospital stay was one day for both groups. Two patients from the TEP repair group and one patient from the Lichtenstein repair group developed recurrence. Three patients from the TEP group and one patient from the Lichtenstein repair group developed chronic groin pain. One patient from the totally extraperitoneal laparoscopic repair group developed a seroma. \u0000Conclusion: Our study demonstrated a trend towards better postoperative outcomes in the Lichtenstein repair group than in the TEP group. \u0000Keywords: Open tension-free mesh repair, Totally extraperitoneal laparoscopic repair, Inguinoscrotal hernias","PeriodicalId":37442,"journal":{"name":"Annals of African Surgery","volume":"18 1","pages":"29-33"},"PeriodicalIF":0.0,"publicationDate":"2021-02-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45117854","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}
E. Mogere, J. Githaiga, F. Owilla, M. Mungania, D. Ojuka
Background: Ki67 levels have been shown to have good predictive value in breast cancer treatment. There is paucity of data on Ki67 levels in predicting response to neoadjuvant chemotherapy (NACT) in Kenya. This study evaluated the utility of Ki67 in predicting response to NACT. Methods: This was a prospective observational study carried out at Kenyatta National Hospital between December 2017 and January 2019 onpatients with locally advanced breast cancer. We recruited 61 women through consecutive sampling technique. Data collected included patient demographics, pre-treatment tumor size, Ki67 levels and tumor biology. After 3 cycles of first-line chemotherapy, ultrasonography was used to determine response. Data were analyzed by SPSS for proportion of change in tumor size. The response was correlated with tumor biology and pretreatment levels of Ki67 using chisquare at a 95% confidence interval. A p-value <0.05 was considered statistically significant. Results: The response rate after 3 cycles of NACT was 39.4%, sensitivity and specificity of Ki67 levels were 70.8% and 43.2% respectively with a cut-off value of 32.5%. Conclusions: Ki67 was found to predict response in our context at a rate of 39.4% at 20% cutoff after 3 cycles. Keywords: Ki67, Breast cancer, Neoadjuvant chemotherapy
{"title":"Predicting Response to Neoadjuvant Chemotherapy in Women with Locally Advanced Breast Cancer in Kenya: Utility of Ki67","authors":"E. Mogere, J. Githaiga, F. Owilla, M. Mungania, D. Ojuka","doi":"10.4314/AAS.V18I1.5","DOIUrl":"https://doi.org/10.4314/AAS.V18I1.5","url":null,"abstract":"Background: Ki67 levels have been shown to have good predictive value in breast cancer treatment. There is paucity of data on Ki67 levels in predicting response to neoadjuvant chemotherapy (NACT) in Kenya. This study evaluated the utility of Ki67 in predicting response to NACT. Methods: This was a prospective observational study carried out at Kenyatta National Hospital between December 2017 and January 2019 onpatients with locally advanced breast cancer. We recruited 61 women through consecutive sampling technique. Data collected included patient demographics, pre-treatment tumor size, Ki67 levels and tumor biology. After 3 cycles of first-line chemotherapy, ultrasonography was used to determine response. Data were analyzed by SPSS for proportion of change in tumor size. The response was correlated with tumor biology and pretreatment levels of Ki67 using chisquare at a 95% confidence interval. A p-value <0.05 was considered statistically significant. Results: The response rate after 3 cycles of NACT was 39.4%, sensitivity and specificity of Ki67 levels were 70.8% and 43.2% respectively with a cut-off value of 32.5%. Conclusions: Ki67 was found to predict response in our context at a rate of 39.4% at 20% cutoff after 3 cycles. Keywords: Ki67, Breast cancer, Neoadjuvant chemotherapy","PeriodicalId":37442,"journal":{"name":"Annals of African Surgery","volume":"47 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-02-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86703789","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}
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