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Ulster Medical Journal最新文献

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Outcomes After Laparoscopic Transabdominal Pre-Peritoneal Repair (TAPP) For Groin Hernia In A Single Consultant Series. 腹腔镜经腹腹膜前修补术(TAPP)治疗腹股沟疝的结果
Q3 Medicine Pub Date : 2022-01-01 Epub Date: 2022-02-11
Waleed Riaz, Kevin Birmingham, Richard Thompson

Aim: TAPP repair is an established minimally invasive approach for groin hernia repair. The objective of this study was to report post-operative outcomes after TAPP repair in a single surgeon series and benchmark these against reported outcomes in the literature.

Methods: All patients who had an elective or emergency TAPP repair of a groin hernia from September 2016 to March 2020 in a district general hospital were retrospectively analysed from the electronic care record (ECR) for post-operative morbidity, re-admission, recurrence and length of hospital stay. The primary outcome of interest, chronic post-operative pain, was assessed via telephone interviews using the European Registry for Abdominal Wall Hernias Quality of Life (EuraHS-QoL) questionnaire.

Results: 164 patients, incorporating 190 hernia repairs were included. 155 (94.5%) were men and 9 (5.5%) were women. The median age was 51 (range: 20-81). 160 (97.6%) patients had an elective repair and 4 (2.4%) had an emergency repair. 157 (95.7%) patients underwent a primary inguinal hernia repair, of which 26 (15.8%) had a bilateral inguinal hernia repair. 7 (4.3%) patients had a femoral hernia repair. All procedures were performed by a single consultant surgeon. One emergency patient required conversion to open to allow for resection of ischaemic small bowel, however, the hernia itself was repaired laparoscopically. 94 (57.3%) patients were successfully contacted to provide EuraHS-QoL scores. 13/94 patients (13.8%) complained of chronic pain at rest on an average follow-up of 32.7 months (range: 16-43m). 2/94 (2.1%) patients had mild pain, 9/94 (9.6%) had moderate pain and 2/94 (2.1%) patients had severe pain at rest. 131 (79.9%) TAPP repairs were performed as day case procedures. Median length of stay in those patients who were not day cases was 1 day (range=1-11 days). Post-op morbidity rate was 7.9% (n=13), however, these were minor complications (Clavien-Dindo I/II). Incidence of seroma and haematoma was 1.8% (n=3) each. Re-admission rate was 3% (n=5). Mean follow-up of patients was 21 months (SD 12.6m, range=1-43m). Two patients (1.2%) had a recurrent groin hernia during this time period and one patient (0.6%) had a port site hernia.

Conclusion: The outcomes of chronic post-operative pain and rate of recurrence were comparable to those reported in the literature. Re-admission rate was low and there were no major complications. The majority of patients were performed as a day case.

目的:TAPP修补术是一种成熟的微创腹股沟疝修补术。本研究的目的是报告单个外科医生TAPP修复后的术后结果,并将这些结果与文献报道的结果进行比较。方法:回顾性分析2016年9月至2020年3月在某地区综合医院择期或紧急TAPP修复腹股沟疝的所有患者的电子护理记录(ECR),包括术后发病率、再入院、复发和住院时间。研究的主要终点是慢性术后疼痛,通过电话访谈采用欧洲腹壁疝生活质量(EuraHS-QoL)问卷进行评估。结果:164例患者纳入190例疝修补术。男性155人(94.5%),女性9人(5.5%)。中位年龄为51岁(范围:20-81岁)。160例(97.6%)患者进行了选择性修复,4例(2.4%)患者进行了紧急修复。157例(95.7%)患者行原发性腹股沟疝修补术,其中26例(15.8%)行双侧腹股沟疝修补术。7例(4.3%)患者行股疝修补术。所有手术均由一名顾问外科医生完成。一名急诊患者需要转开以切除缺血性小肠,然而,疝气本身是腹腔镜修复的。成功联系94例(57.3%)患者提供EuraHS-QoL评分。平均随访32.7个月(范围:16-43m), 94例患者中有13例(13.8%)在休息时抱怨慢性疼痛。2/94(2.1%)的患者有轻度疼痛,9/94(9.6%)的患者有中度疼痛,2/94(2.1%)的患者休息时有重度疼痛。131例(79.9%)TAPP修复作为日间手术进行。非日间病例患者的中位住院时间为1天(范围=1-11天)。术后发病率为7.9% (n=13),然而,这些都是轻微并发症(Clavien-Dindo I/II)。血肿和血肿的发生率分别为1.8% (n=3)。再入院率为3% (n=5)。患者平均随访21个月(SD 126m,范围1 ~ 43m)。2例(1.2%)患者在此期间发生复发性腹股沟疝,1例(0.6%)患者发生port部位疝。结论:术后慢性疼痛的预后和复发率与文献报道相当。再入院率低,无重大并发症。大多数患者为日间病例。
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引用次数: 0
Planning of the UK's National Health Service. 英国国民保健服务的规划。
Q3 Medicine Pub Date : 2022-01-01 Epub Date: 2022-02-11
John Hedley-Whyte, Debra R Milamed
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引用次数: 0
Case Based Learning Facilitator. 基于案例的学习促进者。
Q3 Medicine Pub Date : 2022-01-01 Epub Date: 2022-02-11
Paul K Hamilton
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引用次数: 0
The Rime of the Ancient Imager: Plato's Cave and Other Shadows Royal Victoria Hospital, September 2019. 古代成像者的时代:柏拉图的洞穴和其他阴影,维多利亚皇家医院,2019年9月。
Q3 Medicine Pub Date : 2021-09-01 Epub Date: 2021-11-11
Barry Kelly
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引用次数: 0
AXIOS STENTS: TRANSFORMING THE MANAGEMENT OF PANCREATIC FLUID COLLECTIONS. Axios支架:改变胰液收集的管理。
Q3 Medicine Pub Date : 2021-09-01 Epub Date: 2021-11-11
J Doyle, S McCain, R Scott, M Love
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引用次数: 0
MY MEMOIRS OF THE ROYAL VICTORIA HOSPITAL PACEMAKER IMPLANTATIONS IN THE WEST WING OVER HALF A CENTURY AGO! 我的回忆录是半个多世纪前在皇家维多利亚医院西翼植入心脏起搏器的!
Q3 Medicine Pub Date : 2021-09-01 Epub Date: 2021-11-11
John S Geddes
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引用次数: 0
Pituitary metastasis: a clinical overview. 垂体转移:临床综述。
Q3 Medicine Pub Date : 2021-09-01 Epub Date: 2021-11-11
Adam Henry, Ailish Nugent, Ian R Wallace, Bode Oladipo, Oonagh Sheehy, Philip C Johnston

The pituitary gland is an unusual site for metastatic spread and has been associated with a poor prognosis. Clinical presentation is variable but can include visual field defects, cranial nerve palsies, anterior pituitary dysfunction and/ or diabetes insipidus. Management options include surgery or radiotherapy, chemotherapy/immunotherapy or a conservative approach. The pituitary should not be overlooked as a site for metastasis in patients with known cancer and can be the first presentation of neoplastic disease in some patients. Given that patients are now living longer with cancer, clinicians should be alert to the varied presentation of pituitary metastasis. We provide a clinical overview of pituitary metastasis with the aid of illustrative clinical cases.

垂体是一个不寻常的部位转移扩散,并已与预后不良。临床表现多种多样,但可包括视野缺损、脑神经麻痹、垂体前叶功能障碍和/或尿崩症。治疗方案包括手术或放疗,化疗/免疫治疗或保守方法。垂体作为已知癌症患者的转移部位不应被忽视,并且在一些患者中可能是肿瘤疾病的第一个表现。鉴于现在癌症患者的生存时间更长,临床医生应该警惕垂体转移的各种表现。我们提供垂体转移的临床概况与说明性的临床病例的援助。
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引用次数: 0
The birth of the School of Medicine at Ulster University. 阿尔斯特大学医学院的诞生。
Q3 Medicine Pub Date : 2021-09-01 Epub Date: 2021-11-11
Louise Dubras
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引用次数: 0
C25 in QUB: a transformed curriculum for a transformed healthcare system. 昆士兰大学C25:转型医疗体系的转型课程。
Q3 Medicine Pub Date : 2021-09-01 Epub Date: 2021-11-11
Neil Kennedy, Pascal McKeown, Mairead Boohan
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引用次数: 0
MOVE YOUR FEET, LOSE YOUR SEAT. 移动你的脚,离开你的座位。
Q3 Medicine Pub Date : 2021-09-01 Epub Date: 2021-11-11
R Mayne, N Hart, N Heron
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引用次数: 0
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Ulster Medical Journal
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