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Non-Invasive Versus Invasive Blood Pressure Monitoring in Patients During Laparoscopic Bariatric Surgery: a Prospective Method-Comparison Study 腹腔镜减肥手术患者无创与有创血压监测的前瞻性方法比较研究
IF 0.2 Q4 SURGERY Pub Date : 2020-06-30 DOI: 10.46327/MSRJG.1.000000000000171
C. Ying, Loo Guo Hou, A. Izaham, R. Rajan, Zuraidah Che’Man, E. Kamaruzaman, N. Kosai
Intra-operative blood pressure monitoring in morbidly obese patients using standard non-invasive blood pressure (NIBP) oscillometric technique with upper arm cuffing is often inaccurate. Invasive arterial blood pressure (IABP) monitoring is the gold standard but is not without complications. The purpose of this study was done to assess the degree of agreement between the forearm and upper arm NIBP with the IABP during laparoscopic bariatric surgery. The study was conducted in our university hospital. A total of 36 morbidly obese patients undergoing laparoscopic bariatric surgery were studied. The radial artery was cannulated for IABP monitoring on one upper limb while NIBP monitoring was done on the contralateral upper arm and forearm. The NIBP and its corresponding IABP readings were recorded at selected time points at 10 minutes post-induction; 5, 15, and 30 minutes post-insufflation and 15 minutes postexsufflation. Results: The mean arterial pressure (MAP) has narrower limits of agreement compared to the systolic blood pressure (SBP) and diastolic blood pressure (DBP) for each method of measurement used. Forearm NIBP showed better agreement with IABP compared to upper arm NIBP. Repeated measures ANOVA showed a similar pattern of changes in SBP, DBP, and MAP measured by NIBP and IABP during the surgery. Conclusion: Similar patterns of blood pressure changes were observed with IABP, upper arm, and forearm NIBP measurements at all-time points. The forearm NIBP showed better agreement to IABP as compared to upper arm NIBP and may be adequate to monitor patterns of blood pressure changes during laparoscopic bariatric surgery.
在病态肥胖患者中,使用标准的无创血压(NIBP)示波技术和上臂袖带监测术中血压通常是不准确的。有创动脉血压(IABP)监测是金标准,但并非没有并发症。本研究的目的是评估腹腔镜减肥手术中前臂和上臂NIBP与IABP之间的一致程度。这项研究是在我们大学的医院进行的。对36例接受腹腔镜减肥手术的病态肥胖患者进行了研究。桡动脉插管用于对一侧上肢进行IABP监测,而对侧上臂和前臂进行NIBP监测。在诱导后10分钟的选定时间点记录NIBP及其相应的IABP读数;充气后5、15和30分钟以及排气后15分钟。结果:与使用的每种测量方法的收缩压(SBP)和舒张压(DBP)相比,平均动脉压(MAP)的一致性范围更窄。与上臂NIBP相比,前臂NIBP与IABP显示出更好的一致性。重复测量ANOVA显示手术期间NIBP和IABP测量的SBP、DBP和MAP的变化模式相似。结论:IABP、上臂和前臂NIBP测量在所有时间点都观察到类似的血压变化模式。与上臂NIBP相比,前臂NIBP与IABP表现出更好的一致性,并且可能足以监测腹腔镜减肥手术期间的血压变化模式。
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引用次数: 0
Patient Centered Care: Focus on Low and Middle Income Countries and Proposition of New Conceptual Model 以患者为中心的医疗:中低收入国家的关注与新概念模式的提出
IF 0.2 Q4 SURGERY Pub Date : 2020-06-30 DOI: 10.46327/msrjg.1.000000000000168
Said Bensbih, A. Souadka, Amalia Giuliani Diez, Otmane Bouksour
The health system is a fundamental building block of a country's social project. Approaches and strategies differ but some concepts such as Patient Centered Care (PCC) seem to be more and more popular nowadays as the customer centric advocated in the industry. The research has focused on this trend of PCC with several different definitions but without having a particular focus on the context of Low and Middle Income Countries (LMICs). The objective of this study is, through an extensive literature review, to analyze this concept, to unify the dimensions described by different authors, to define a concept that can be proposed to LMICs and to determine facilitating factors as well as obstacles for its implementation.
卫生系统是一个国家社会项目的基本组成部分。方法和策略各不相同,但一些概念,如以病人为中心的护理(PCC)似乎越来越受欢迎,因为业界提倡以客户为中心。研究以几种不同的定义关注PCC的这一趋势,但没有特别关注低收入和中等收入国家(LMICs)的背景。本研究的目的是通过广泛的文献综述来分析这一概念,统一不同作者所描述的维度,定义一个可以向中低收入国家提出的概念,并确定其实施的促进因素和障碍。
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引用次数: 4
Evaluation of the Decision-Making Mode during Digestive Oncology Multidisciplinary Meetings: a Prospective Study in a Moroccan Center 消化肿瘤多学科会议决策模式的评估:摩洛哥中心的一项前瞻性研究
IF 0.2 Q4 SURGERY Pub Date : 2020-06-30 DOI: 10.46327/msrjg.1.000000000000169bis
C. Charoui, A. Souadka, S. Saber, R. Latib, L. Rifai, L. Amrani, A. Benkabbou, R. Mohsine, M. Majbar
Introduction: The multidisciplinary team oncology meeting (MDT) has become a standard in oncology. The objective of this study was to evaluate the value of a validated tool, the Metric for the Observation of Decision-Making, in the evaluation of the decision-making mode during the digestive cancer MDT in order to reach recommendations for improvement.Results: Eight consecutive MDTs were observed (N = 228 patients). On average, 32 patients were discussed by MDT with an average of 2 min 55 s (interval: 30 s-10 min 16 s) per patient. A decision was reached in 84.6% of the cases. Although the medical information was judged to be of good quality, the psychosocial information (average 1.29) and the patients' point of view (average 1.03) were judged to be of low quality. For teamwork, the contribution of surgeons (average 4.56) and oncologists (average 3.99) was greater than radiologists (3.12), radiotherapists (1.74) and pathologists (1.02).Conclusions: The tool made it possible to identify a disparity in the quality of the different aspects of the information and in the participation of specialists, making it possible to identify specific improvement measures. Its regular use would improve the quality of patient care.Keywords: Decision making, Quality improvement, Multidisciplinary Concertation meeting, MDT-MODe, Morocco
多学科肿瘤学小组会议(MDT)已成为肿瘤学的标准会议。本研究的目的是评估一种经过验证的工具——决策观察指标(Metric for The Observation of decision)在评估消化道肿瘤MDT期间决策模式中的价值,以提出改进建议。结果:连续观察8例MDTs (N = 228例)。平均32例患者接受MDT讨论,平均每例患者2分钟55秒(间隔30秒-10分钟16秒)。审结率为84.6%。虽然医学信息质量较好,但心理社会信息(平均1.29)和患者观点(平均1.03)的质量较低。在团队合作方面,外科医生(平均4.56)和肿瘤科医生(平均3.99)的贡献高于放射科医生(3.12)、放射治疗师(1.74)和病理学家(1.02)。结论:该工具可以确定信息的不同方面的质量和专家参与的差异,从而可以确定具体的改进措施。它的定期使用将提高病人护理的质量。关键词:决策,质量改进,多学科集中会议,mdt模式,摩洛哥
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引用次数: 1
Myopia and CoVID-19 Confinement in Morocco: An Issue to be Considered? 摩洛哥的近视和CoVID-19隔离:一个需要考虑的问题?
IF 0.2 Q4 SURGERY Pub Date : 2020-06-19 DOI: 10.46327/msrjg.1.000000000000162
K. Belkhadir, O. Cherkaoui
...In Morocco, during the confinement period, the ophthalmic consultation activity was limited in large parts to emergencies. So, at the end of these three months of confinement, an increase in ophthalmic consultations for refractive disorders in children, adolescents and young adults should be expected...Keywords: CoVID-19, Confinement, e-learing, Morocco, Myopia
…在摩洛哥,在隔离期间,眼科咨询活动在很大程度上仅限于紧急情况。因此,在这三个月的监禁结束时,儿童,青少年和年轻人的屈光性疾病的眼科咨询应该会增加……关键词:CoVID-19,坐月子,电子学习,摩洛哥,近视
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引用次数: 0
Non-operative Management of Benign Colorectal Anastomotic Stenosis in Patients Undergoing Elective Surgery for Non-Metastatic Primary Rectal Cancer 非转移性原发性癌症择期手术治疗良性结直肠吻合口狭窄的非手术治疗
IF 0.2 Q4 SURGERY Pub Date : 2020-06-14 DOI: 10.22317/jcms.v6i3.768
Ümit Mercan, O. Ersen, C. Yüksel, Ö. Yalkın, Serkan Akbulut, Ekrem Ünal, S. Demirci
Introduction: Benign anastomosis stenosis may develop in postoperative or long term period due to many reasons such as anastomosis leakage and anastomosis ischemia after colorectal surgery. While surgical treatment was commonly used in benign anastomosis stenosis in the past, surgery has left its place to more minimally invasive methods such as endoscopic treatments. There is no gold standard treatment method in the management of benign anastomosis strictures in the literature. In this study, we aimed to present our clinical experience in the treatment of benign anastomosis strictures in patients undergoing elective surgery for nonmetastatic primary rectal cancer. Material and Methods: One hundred fifty-six (156) patients who underwent resection and colorectal anastomosis between January 2013 and January 2018 were included in the study. 22 patients developed benign anastomotic stenosis has been determined and etiological factors and treatment modalities applied has been compared retrospectively. Results: In 22 patients, 9 patients were treated with digital or balloon dilatation, at least 2 sessions and up to 5 sessions. Four patients were treated with dilatation followed by stenting. The remaining 9 patients were taken to surgical treatment. Among whole patients with stenosis, it has been determined that 15 of them had neoadjuvant therapy history, 5 had anastomosis leakage and in 16 of them 28 mm circular stapler have been used. Discussion and Conclusion: Neoadjuvant treatment history, the presence of anastomosis leakage and the usage of 28 mm circular stapler have been detected to be the most important etiological factors in development of benign anastomotic stenosis. Endoscopic treatments should be tried primarily to treat benign anastomotic stenosis. High success rates can be achieved with endoscopic methods and patient quality of life can be improved. With this approach, the need for surgery will be reduced and possible postoperative complications can be prevented.Keywords: Rectal Neoplasms, Stenosis, Laparoscopy, Anastomostic stenosis
导语:结直肠手术后,由于吻合口渗漏、吻合口缺血等多种原因,良性吻合口狭窄可能在术后或远期发展。虽然手术治疗在过去通常用于良性吻合口狭窄,但手术已将其位置留给了更微创的方法,如内镜治疗。文献中没有关于良性吻合口狭窄的金标准治疗方法。在本研究中,我们旨在介绍我们在非转移性原发性癌症择期手术患者中治疗良性吻合口狭窄的临床经验。材料和方法:在2013年1月至2018年1月期间接受切除和结肠直肠吻合的156名患者被纳入研究。对22例良性吻合口狭窄患者的病因和治疗方法进行了回顾性比较。结果:在22名患者中,9名患者接受了指扩张或球囊扩张治疗,至少2次,最多5次。四名患者接受了扩张术后支架置入术的治疗。其余9名患者接受了手术治疗。在所有狭窄患者中,已确定其中15人有新辅助治疗史,5人有吻合口瘘,其中16人使用了28mm圆形吻合器。讨论与结论:新辅助治疗史、吻合口瘘的存在和28mm环形吻合器的使用已被检测为良性吻合口狭窄发展的最重要病因。内镜治疗应主要用于治疗良性吻合口狭窄。内窥镜方法可以获得高成功率,并且可以提高患者的生活质量。通过这种方法,将减少手术的需要,并可以预防可能的术后并发症。关键词:直肠肿瘤,狭窄,腹腔镜,吻合口狭窄
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引用次数: 0
Resuming Elective Oncologic Surgery After CoVID-19 Outbreak: What Precautions Should be Taken? 新冠肺炎爆发后恢复选择性肿瘤手术:应采取哪些预防措施?
IF 0.2 Q4 SURGERY Pub Date : 2020-06-02 DOI: 10.46327/msrjg.1.000000000000161
A. Majbar, A. Benkabbou, R. Mohsine, A. Souadka
The COVID 19 outbreak has caused the cancellation of most elective oncological surgery around the world to limit the risk of virus dissemination. As we are exiting the crisis, surgical teams will face strong challenges while resuming normal elective surgery. The accumulation of cases will have to be managed by defining strong selection criteria, taking into account the patient and the disease conditions. In order to reduce the risk of infection, nonCOVID patients should be treated in dedicated non-COVID areas, preferably in separate buildings or hospitals. Departments, units and operative theaters should put in place rigorous actions and protocols to protect the patient and healthcare workers. Adequate protective equipment must be readily available for healthcare workers and patients. Finally, teams should keep an adaptive mindset by preparing strategies to maintain surgical activity in case of repeated COVID 19 waves.
2019冠状病毒病的爆发导致世界各地大多数选择性肿瘤手术被取消,以限制病毒传播的风险。随着我们摆脱危机,手术团队在恢复正常择期手术的同时将面临巨大挑战。病例的积累必须通过制定强有力的选择标准来管理,同时考虑到患者和疾病状况。为了降低感染风险,非新冠肺炎患者应在专门的非新冠地区接受治疗,最好在单独的建筑物或医院接受治疗。各部门、单位和手术室应制定严格的行动和规程,以保护患者和医护人员。必须为医护人员和患者提供足够的防护设备。最后,团队应保持适应性思维,制定策略,在反复出现新冠肺炎19波的情况下保持手术活动。
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引用次数: 1
Africa Against COVID-19: Can National Solidarity Complements Health System Weaknesses? -the Moroccan Experience- 非洲应对COVID-19:国家团结能否弥补卫生系统的弱点?-摩洛哥的经历-
IF 0.2 Q4 SURGERY Pub Date : 2020-05-09 DOI: 10.46327/10.46327/msrjg.1.000000000000160
A. Souadka, A. Benkabbou, M. Majbar, H. Essangri, L. Amrani, R. Mohsine, E. Akhnif
NA
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引用次数: 4
CoVID-19: a Digestive Disease! 新冠肺炎:一种消化系统疾病!
IF 0.2 Q4 SURGERY Pub Date : 2020-05-02 DOI: 10.46327/msrjg.1.000000000000159
Y. Cherradi
CoVID-19 is a Public Health Emergency of International Concern. Since the first case has been reported in Wuhan in China, evidence of associated severe acute respiratory syndrome is well established and the disease is accepted as a primarily respiratory infection. However, current available data are supporting a gastrointestinal tropism with great implications at multiple levels in the course of this disease. The gastrointestinal tract appears in the heart of the strategy for management of infected patients from diagnosis to post-recovery isolation policies. This review highlights the digestive aspects of CoVID-19.Keywords: ACE2, CoVID-19, Digestive, Endoscopy, Fecal transmission, Liver, Prognosis
CoVID-19是国际关注的突发公共卫生事件。自中国武汉报告首例病例以来,相关严重急性呼吸系统综合征的证据已得到充分确立,该疾病被公认为主要的呼吸道感染。然而,目前可获得的数据支持在该疾病的多个水平上具有重大意义的胃肠道倾向。从诊断到康复后的隔离政策,胃肠道是感染患者管理策略的核心。本综述重点介绍了CoVID-19的消化方面。关键词:ACE2, CoVID-19,消化,内镜,粪便传播,肝脏,预后
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引用次数: 4
Portal Cavernoma Complicating a Persistent Postoperative Bile Leak after Liver Hydatid Cyst Surgery: -a Report Case- 肝包虫囊术后门静脉海绵瘤并发持续性胆汁漏1例
IF 0.2 Q4 SURGERY Pub Date : 2019-12-01 DOI: 10.46327/msrjg.1.000000000000145
M. Bouzroud, B. Ait Idir, F. Strehlow, A. Benkabbou
Introduction: Hydatid cyst is a parasitic infection caused by the larval form of Echinococcus granulosus. Portal hypertension is an unusual postoperative complication after a liver hydatid cyst surgery. Case presentation: To illustrate this rare condition, we present the case of a 32-year-old patient operated for a liver hydatid cyst with late onset postoperative complications. The patient suffered from secondary digestive bleeding due to portal hypertension and was therefore treated with a distal splenorenal shunt (Warren). Conclusion: Surgery of hydatid cyst may cause severe complications like portal hypertension and in certain cases, distal splenorenal anastomosis might represent an important treatment option that needs to be performed in specialised centres.
简介:包虫病是一种由细粒棘球绦虫幼虫引起的寄生虫感染。摘要门脉高压是肝包虫囊手术后罕见的并发症。病例介绍:为了说明这种罕见的情况,我们提出一个32岁的患者手术治疗肝包虫囊肿,并出现晚发性术后并发症。患者因门静脉高压继发消化道出血,因此接受远端脾肾分流术(Warren)治疗。结论:包虫囊肿的手术可能会导致严重的并发症,如门静脉高压,在某些情况下,远端脾肾吻合可能是一种重要的治疗选择,需要在专门的中心进行。
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引用次数: 0
Mediastinum Lymph Node Hydatidosis. 纵隔淋巴结包虫病。
IF 0.2 Q4 SURGERY Pub Date : 2014-06-30 DOI: 10.46327/msrjg.1.000000000000009
Yassine Ouadnouni, M. Lakranbi, Mohamed Smahi
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引用次数: 1
期刊
Journal of Medical and Surgical Research
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