S. Kurunkar, R. Prabhu, C. Kantharia, S. Pujari, V. Chaudhari, A. Supe
Background: Pharyngoesophageal stricture with laryngeal involvement due to corrosive ingestion is rare, and limited literature is available regarding management. Outcome is unpredictable due to progressive scaring of anastomosis and associated respiratory complications. Here, we share our experience of managing this challenging entity. Materials and Methods: Of 57 corrosive ingestion patients, we reviewed 15 patients of isolated pharyngoesophageal stricture managed in our unit of a tertiary care center between 2008 and 2016. The medical records, initial management, operative data, postoperative course, and follow-up data of these 15 patients were reviewed. These 15 patients divided into Group A of endless string insertion and dilatation and Group B of five patients who underwent additional colonic interposition. Results: Of 15 patients, 10 patients belonged to Group A of endless string insertion and dilatation and five patients belonged to Group B with additional coloplasty. All the 10 patients were successfully dilated with endless string insertion, whereas in coloplasty group, four patients out of five are taking normal diet, and one patient succumbed due to nonoperative cause. All 15 patients had no respiratory complication postoperatively, and five patients who were on tracheostomy before surgery are weaned off completely. All 14 patients have no dysphagia, have no respiratory complications, and have gained weight. Conclusion: Severe upper aerodigestive injury is rare and its management is herculean task, but satisfactory functional reconstruction can be achieved in the majority of patients without the need for permanent tracheostomy or feeding jejunostomy by our technique giving good quality of life.
{"title":"Corrosive pharyngoesophageal stricture – A challenge to surgeon: A tertiary center experience","authors":"S. Kurunkar, R. Prabhu, C. Kantharia, S. Pujari, V. Chaudhari, A. Supe","doi":"10.4103/SSJ.SSJ_55_17","DOIUrl":"https://doi.org/10.4103/SSJ.SSJ_55_17","url":null,"abstract":"Background: Pharyngoesophageal stricture with laryngeal involvement due to corrosive ingestion is rare, and limited literature is available regarding management. Outcome is unpredictable due to progressive scaring of anastomosis and associated respiratory complications. Here, we share our experience of managing this challenging entity. Materials and Methods: Of 57 corrosive ingestion patients, we reviewed 15 patients of isolated pharyngoesophageal stricture managed in our unit of a tertiary care center between 2008 and 2016. The medical records, initial management, operative data, postoperative course, and follow-up data of these 15 patients were reviewed. These 15 patients divided into Group A of endless string insertion and dilatation and Group B of five patients who underwent additional colonic interposition. Results: Of 15 patients, 10 patients belonged to Group A of endless string insertion and dilatation and five patients belonged to Group B with additional coloplasty. All the 10 patients were successfully dilated with endless string insertion, whereas in coloplasty group, four patients out of five are taking normal diet, and one patient succumbed due to nonoperative cause. All 15 patients had no respiratory complication postoperatively, and five patients who were on tracheostomy before surgery are weaned off completely. All 14 patients have no dysphagia, have no respiratory complications, and have gained weight. Conclusion: Severe upper aerodigestive injury is rare and its management is herculean task, but satisfactory functional reconstruction can be achieved in the majority of patients without the need for permanent tracheostomy or feeding jejunostomy by our technique giving good quality of life.","PeriodicalId":420307,"journal":{"name":"Saudi Surgical Journal","volume":"14 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129941898","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}
Sangameshwar Patil, R. Devani, V. Radhakrishna, M. Patil
Introduction: The use of electrocautery in incising the skin was hypothesized to be questionable. It is believed to cause deep burns, excessive scarring and poor wound healing. However, many of the recent studies show that the electrosurgery has advantages of faster dissection, quicker hemostasis, reduced blood loss, and reduced operative time. Most of these studies included a homogeneous group of surgeries. Hence, a study was conducted to assess whether the electrosurgery can be used to incise skin. Materials and Methods: A prospective nonrandomized study was conducted in a tertiary center from December 2009 to May 2011. Patients were divided into electrosurgery and skin scalpel groups. Moreover, these were compared regard to duration of the incision, blood loss, operative and postoperative complications, and postoperative pain using visual analog scale. Results: A total of 60 patients were studied. Electrosurgery group and steel scalpel group both had 30 patients (50%) each in their group. The electrosurgery group had a significantly low blood loss (18.1 g ± 16.1 g vs. 35.8 g ± 16.9 g; t = 4.1; P = 0.0001) and lesser incision time (4.7 min ± 1.9 min vs. 6.6 min ± 3.1 min; t = 2.8; P = 0.006; Student's t-test) compared to steel scalpel group. Electrosurgery group also had a significantly lesser postoperative pain score at 6 h, 12 h, and 24 h. There was no statistical significance found between the groups regard to wound infection (P = 1; Fischer's exact test). Conclusion: Electrosurgery was superior to steel scalpel for incising skin, hence, can be used a primary choice to incise the skin.
导言:使用电灼术切开皮肤被假设是有问题的。据信，它会导致深度烧伤、过度疤痕和伤口愈合不良。然而，近年来的许多研究表明，电外科手术具有更快的剥离、更快的止血、更少的出血量、更短的手术时间等优点。这些研究大多包括一组相同的手术。因此，我们进行了一项研究，以评估电手术是否可以用于皮肤切割。材料与方法:2009年12月至2011年5月在某三级中心进行前瞻性非随机研究。患者分为电刀组和皮肤手术刀组。此外，使用视觉模拟量表对切口持续时间、出血量、手术和术后并发症以及术后疼痛进行比较。结果:共研究60例患者。电刀组和钢刀组各30例，各占50%。电手术组出血量明显低(18.1 g±16.1 g vs 35.8 g±16.9 g);T = 4.1;P = 0.0001)和较短的切口时间(4.7 min±1.9 min vs. 6.6 min±3.1 min;T = 2.8;P = 0.006;学生t检验)与钢制手术刀组比较。电手术组术后6 h、12 h、24 h疼痛评分均显著低于对照组。两组间伤口感染差异无统计学意义(P = 1;费舍尔的确切测试)。结论:电刀对皮肤的切开优于钢刀，可作为皮肤切开的首选。
{"title":"Electrosurgery versus steel scalpel for elective surgery: A prospective study","authors":"Sangameshwar Patil, R. Devani, V. Radhakrishna, M. Patil","doi":"10.4103/SSJ.SSJ_76_17","DOIUrl":"https://doi.org/10.4103/SSJ.SSJ_76_17","url":null,"abstract":"Introduction: The use of electrocautery in incising the skin was hypothesized to be questionable. It is believed to cause deep burns, excessive scarring and poor wound healing. However, many of the recent studies show that the electrosurgery has advantages of faster dissection, quicker hemostasis, reduced blood loss, and reduced operative time. Most of these studies included a homogeneous group of surgeries. Hence, a study was conducted to assess whether the electrosurgery can be used to incise skin. Materials and Methods: A prospective nonrandomized study was conducted in a tertiary center from December 2009 to May 2011. Patients were divided into electrosurgery and skin scalpel groups. Moreover, these were compared regard to duration of the incision, blood loss, operative and postoperative complications, and postoperative pain using visual analog scale. Results: A total of 60 patients were studied. Electrosurgery group and steel scalpel group both had 30 patients (50%) each in their group. The electrosurgery group had a significantly low blood loss (18.1 g ± 16.1 g vs. 35.8 g ± 16.9 g; t = 4.1; P = 0.0001) and lesser incision time (4.7 min ± 1.9 min vs. 6.6 min ± 3.1 min; t = 2.8; P = 0.006; Student's t-test) compared to steel scalpel group. Electrosurgery group also had a significantly lesser postoperative pain score at 6 h, 12 h, and 24 h. There was no statistical significance found between the groups regard to wound infection (P = 1; Fischer's exact test). Conclusion: Electrosurgery was superior to steel scalpel for incising skin, hence, can be used a primary choice to incise the skin.","PeriodicalId":420307,"journal":{"name":"Saudi Surgical Journal","volume":"69 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128723778","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}
R. Porwal, Amit Singh, Atul Jain, Ghanshyam Kumawat
Aim: Gastrointestinal (GI) perforation repair is a commonly performed surgery worldwide. Postoperative septic conditions are frequently accompanied by cholestasis and postoperative jaundice. Our study was conducted to evaluate the risk factors and outcome of postoperative hyperbilirubinemia in patients with perforation peritonitis. Materials and Methods: A prospective observational study of 100 patients was conducted between January 2013 and December 2014; they underwent surgery for generalized peritonitis caused by GI perforations in the Department of Surgery of JLN Medical College and Associated Group of Hospitals, Ajmer, Rajasthan, India. Postoperative hyperbilirubinemia is defined as serum total bilirubin level of ≥5 mg/dl within 1 month after surgery. In all the patients with postoperative hyperbilirubinemia, risk factors and outcome were assessed. Data analyses done with Fisher's exact test, Mann–Whitney test, Chi-square test, Student's t test, and repeated-measures analysis of variance were used for statistical comparisons. Results: In our study of 100 patients, M:F ratio was 2.12. Sixteen percent of the total patients belonged to hyperbilirubinemia group and 84% belonged to no hyperbilirubinemia group. In the hyperbilirubinemia group, anemia was seen in 37.5%, poor nutrition in 44%, and shock in 62.5%, and these patients also had increased total leukocyte count counts, bilirubin level, aspartate aminotransferase level, and decreased platelet count, whereas in the no hyperbilirubinemia patients anemia was seen in 11%, poor nutrition in 15%, and shock in 15% cases and all of them had normal blood investigations. Postoperatively, in the hyperbilirubinemia group, cardiac and respiratory support was needed in 62% and 72% cases, respectively, renal insufficiency in 56% cases, prolonged paralytic ileus in 72%, and mortality in 62% cases. Infection-related complications developed in 20 patients (12 patients of hyperbilirubinemia group and 8 patients of no hyperbilirubinemia group). Conclusion: In our study, we concluded that in cases of perforation peritonitis, hyperbilirubinemia was associated with advanced age, poor nutritional status, and prolonged time until surgical intervention, and these patients with postoperative hyperbilirubinemia showed higher morbidity and mortality after surgery.
{"title":"Evaluation of risk factors associated with hyperbilirubinemia after surgery of perforation peritonitis","authors":"R. Porwal, Amit Singh, Atul Jain, Ghanshyam Kumawat","doi":"10.4103/SSJ.SSJ_54_17","DOIUrl":"https://doi.org/10.4103/SSJ.SSJ_54_17","url":null,"abstract":"Aim: Gastrointestinal (GI) perforation repair is a commonly performed surgery worldwide. Postoperative septic conditions are frequently accompanied by cholestasis and postoperative jaundice. Our study was conducted to evaluate the risk factors and outcome of postoperative hyperbilirubinemia in patients with perforation peritonitis. Materials and Methods: A prospective observational study of 100 patients was conducted between January 2013 and December 2014; they underwent surgery for generalized peritonitis caused by GI perforations in the Department of Surgery of JLN Medical College and Associated Group of Hospitals, Ajmer, Rajasthan, India. Postoperative hyperbilirubinemia is defined as serum total bilirubin level of ≥5 mg/dl within 1 month after surgery. In all the patients with postoperative hyperbilirubinemia, risk factors and outcome were assessed. Data analyses done with Fisher's exact test, Mann–Whitney test, Chi-square test, Student's t test, and repeated-measures analysis of variance were used for statistical comparisons. Results: In our study of 100 patients, M:F ratio was 2.12. Sixteen percent of the total patients belonged to hyperbilirubinemia group and 84% belonged to no hyperbilirubinemia group. In the hyperbilirubinemia group, anemia was seen in 37.5%, poor nutrition in 44%, and shock in 62.5%, and these patients also had increased total leukocyte count counts, bilirubin level, aspartate aminotransferase level, and decreased platelet count, whereas in the no hyperbilirubinemia patients anemia was seen in 11%, poor nutrition in 15%, and shock in 15% cases and all of them had normal blood investigations. Postoperatively, in the hyperbilirubinemia group, cardiac and respiratory support was needed in 62% and 72% cases, respectively, renal insufficiency in 56% cases, prolonged paralytic ileus in 72%, and mortality in 62% cases. Infection-related complications developed in 20 patients (12 patients of hyperbilirubinemia group and 8 patients of no hyperbilirubinemia group). Conclusion: In our study, we concluded that in cases of perforation peritonitis, hyperbilirubinemia was associated with advanced age, poor nutritional status, and prolonged time until surgical intervention, and these patients with postoperative hyperbilirubinemia showed higher morbidity and mortality after surgery.","PeriodicalId":420307,"journal":{"name":"Saudi Surgical Journal","volume":"12 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122375907","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}
Leiomyosarcoma (LMS) overall comprises 5%–10% of all soft-tissue sarcoma. Subcutaneous LMS accounts only for 1%–2% of all superficial soft-tissue sarcoma. Usually, subcutaneous LMS occur in lower extremity; however, it may occur anywhere in the body. Its occurrence in the abdominal wall is extremely rare. Here, we report a case of recurrent LMS of anterior abdominal wall in a 25-year-old female.
{"title":"Subcutaneous leiomyosarcoma of anterior abdominal wall in young girl: Rare case report","authors":"Anil Kumar, S. Paswan, S. Chumber, B. Kumar","doi":"10.4103/SSJ.SSJ_3_18","DOIUrl":"https://doi.org/10.4103/SSJ.SSJ_3_18","url":null,"abstract":"Leiomyosarcoma (LMS) overall comprises 5%–10% of all soft-tissue sarcoma. Subcutaneous LMS accounts only for 1%–2% of all superficial soft-tissue sarcoma. Usually, subcutaneous LMS occur in lower extremity; however, it may occur anywhere in the body. Its occurrence in the abdominal wall is extremely rare. Here, we report a case of recurrent LMS of anterior abdominal wall in a 25-year-old female.","PeriodicalId":420307,"journal":{"name":"Saudi Surgical Journal","volume":"39 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123412983","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}
Aim: The aim of this study is to demonstrate the relation between tonsillectomy and weight gain in children, we hypothesize tonsillectomy may cause increase body weight in children. Methods and Materials: It is a comparative prospective study conducted in King Abdul Aziz Specialist Hospital, Taif, Saudia Arabia, between January 2013 and December 2015 between study group (tonsillectomy with or without adenoidectomy) and control (grommets insertion, adenoidectomy, turbinate reduction, evaluation under anesthesia nasal cavity). Patients were randomly selected, weight before and after the procedure, and reviewed 6-week postoperatively. Incomplete data, failure to follow up, and more than 60-days follow-up were excluded from the study. Results: A total of 96 patients were involved in the study, of whom 14 not fulfilling the criteria, were excluded. test group were 54 (65.8%) (male 44 [81.5%] and 18 females [22.7%]) and control group 28 (34.15%). Minimal and maximum ages were 1.11 and 12.4 years, respectively. The minimum and maximum follow-ups were 16 and 58 days, respectively, an average of 43.8 days. Weight gain calculated (< 0.5 kg, 0.5 – 1 kg, >1 kg) in study group was 14,4%, 24.3%, and 24.3% while the control group 7.6%, 12.7%, and 12.7%, respectively. The total accumulated Weight gain in the test group was 49.6 kg, Whereas in control group 33.4 kg. There was no difference noted between the two, however, both gained weight above the norm. Conclusion: Weight gain post tonsillectomy cannot be proven to be a sequence in children; however, both groups gained weight above the normal, further studies are require to exclude other factors.
{"title":"Tonsillectomy and weight gain in children: A prospective study","authors":"S. Al Kindy, A. Alzahrani","doi":"10.4103/SSJ.SSJ_22_17","DOIUrl":"https://doi.org/10.4103/SSJ.SSJ_22_17","url":null,"abstract":"Aim: The aim of this study is to demonstrate the relation between tonsillectomy and weight gain in children, we hypothesize tonsillectomy may cause increase body weight in children. Methods and Materials: It is a comparative prospective study conducted in King Abdul Aziz Specialist Hospital, Taif, Saudia Arabia, between January 2013 and December 2015 between study group (tonsillectomy with or without adenoidectomy) and control (grommets insertion, adenoidectomy, turbinate reduction, evaluation under anesthesia nasal cavity). Patients were randomly selected, weight before and after the procedure, and reviewed 6-week postoperatively. Incomplete data, failure to follow up, and more than 60-days follow-up were excluded from the study. Results: A total of 96 patients were involved in the study, of whom 14 not fulfilling the criteria, were excluded. test group were 54 (65.8%) (male 44 [81.5%] and 18 females [22.7%]) and control group 28 (34.15%). Minimal and maximum ages were 1.11 and 12.4 years, respectively. The minimum and maximum follow-ups were 16 and 58 days, respectively, an average of 43.8 days. Weight gain calculated (< 0.5 kg, 0.5 – 1 kg, >1 kg) in study group was 14,4%, 24.3%, and 24.3% while the control group 7.6%, 12.7%, and 12.7%, respectively. The total accumulated Weight gain in the test group was 49.6 kg, Whereas in control group 33.4 kg. There was no difference noted between the two, however, both gained weight above the norm. Conclusion: Weight gain post tonsillectomy cannot be proven to be a sequence in children; however, both groups gained weight above the normal, further studies are require to exclude other factors.","PeriodicalId":420307,"journal":{"name":"Saudi Surgical Journal","volume":"84 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124489856","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}
A. Habeebullah, Aroub Kaaki, M. Aljiffry, T. Hamid, A. Maghrabi
Thymoma is the most common primary mediastinal neoplasm. It is well known to have a strong association with autoimmune diseases, but associated cutaneous disorders are considerably rare presentation of thymoma as paraneoplastic manifestation. Thymectomy is an optional treatment in some autoimmune diseases such as myasthenia gravis. We describe a 51-year-old male with a history of thymoma for 6 years accompanied by generalized severe purpuric rash, which was completely resolved after thymectomy.
{"title":"Resolution of paraneoplastic skin lesion after thymectomy","authors":"A. Habeebullah, Aroub Kaaki, M. Aljiffry, T. Hamid, A. Maghrabi","doi":"10.4103/SSJ.SSJ_46_17","DOIUrl":"https://doi.org/10.4103/SSJ.SSJ_46_17","url":null,"abstract":"Thymoma is the most common primary mediastinal neoplasm. It is well known to have a strong association with autoimmune diseases, but associated cutaneous disorders are considerably rare presentation of thymoma as paraneoplastic manifestation. Thymectomy is an optional treatment in some autoimmune diseases such as myasthenia gravis. We describe a 51-year-old male with a history of thymoma for 6 years accompanied by generalized severe purpuric rash, which was completely resolved after thymectomy.","PeriodicalId":420307,"journal":{"name":"Saudi Surgical Journal","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121241378","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}
Hassan M. Bukhari, Khaled Albazli, Saud Almaslmani, F. Najjar, Nabilah Sulaimani, H. Al-Maghrabi
Introduction: Trauma is a major health problem in Saudi Arabia and the number one cause of mortality. Tremendous effort is needed to improve the quality of care to decrease the burden of this health problem on national hospitals. To be able to establish a new trauma system, we need to have a better insight into the current level of care and practice. This study aims to shed light on trauma patients presenting to the largest emergency department (ED) in Makkah, Saudi Arabia, and determine the length of stay (LOS) for all trauma patients. Methodology: During the 31-day study period, 1984 trauma visits in Alnoor Specialist Hospital in Makkah have been analyzed. The LOS of all the patients presented to ED is calculated and then compared to the LOS of all nontrauma patients. Results: The analysis showed a significant increase in LOS of trauma patients. Several factors have been identified as the major causes of prolonged stay. A priceless insight of the current care provided to trauma patients is described in this study. Further efforts should be focused on the need of advanced trauma care to improve patient's care.
{"title":"Do trauma patients have to wait longer in emergency department?","authors":"Hassan M. Bukhari, Khaled Albazli, Saud Almaslmani, F. Najjar, Nabilah Sulaimani, H. Al-Maghrabi","doi":"10.4103/SSJ.SSJ_20_17","DOIUrl":"https://doi.org/10.4103/SSJ.SSJ_20_17","url":null,"abstract":"Introduction: Trauma is a major health problem in Saudi Arabia and the number one cause of mortality. Tremendous effort is needed to improve the quality of care to decrease the burden of this health problem on national hospitals. To be able to establish a new trauma system, we need to have a better insight into the current level of care and practice. This study aims to shed light on trauma patients presenting to the largest emergency department (ED) in Makkah, Saudi Arabia, and determine the length of stay (LOS) for all trauma patients. Methodology: During the 31-day study period, 1984 trauma visits in Alnoor Specialist Hospital in Makkah have been analyzed. The LOS of all the patients presented to ED is calculated and then compared to the LOS of all nontrauma patients. Results: The analysis showed a significant increase in LOS of trauma patients. Several factors have been identified as the major causes of prolonged stay. A priceless insight of the current care provided to trauma patients is described in this study. Further efforts should be focused on the need of advanced trauma care to improve patient's care.","PeriodicalId":420307,"journal":{"name":"Saudi Surgical Journal","volume":"60 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134317202","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}
Wael Al-shelfa, M. Marie, A. Hashem, Shymaa Yahia, S. Mansour, S. Saddick, A. Ibrahim
Background: Malignant obstruction due to left-sided colonic malignant lesions is an acute emergent situation which is always dealt with by emergent celiotomy and colostomy for salvage of patient life. Colostomy is considered life-saving in such situations, yet it is of undesirable psychological feedback impressions for patients. The aim of this work is to describe our experience with the use of colonic stent in left-sided malignant obstruction, as a good step to relieve the obstruction, and hence to proceed for one-step resection anastomosis with primary repair without the need for colostomy, which is in itself of good impact for psychological satisfaction and salvage of patient. Patients and Methods: Out of 20 patients with left-sided colonic obstruction, 9 patients were dealt with colonic stent, of them 7 patients had one-step procedure with either left hemicolectomy or sigmoidectomy, and 11 had emergent surgical interference with colostomy. Results: Seven of nine patients had a successful laparoscopic colonic stent, and followed by a successful one-step surgical procedure, two of nine patients had unsuccessful laparoscopic stent with emergent exploration and colostomy. Conclusion: Colonic stent for the left malignant obstruction represents a valuable procedure for one-step resection and primary anastomosis without the need for colostomy.
{"title":"Acute obstructing left-sided colonic lesions: Role of preoperative endoscopic colonic stent insertion","authors":"Wael Al-shelfa, M. Marie, A. Hashem, Shymaa Yahia, S. Mansour, S. Saddick, A. Ibrahim","doi":"10.4103/SSJ.SSJ_59_17","DOIUrl":"https://doi.org/10.4103/SSJ.SSJ_59_17","url":null,"abstract":"Background: Malignant obstruction due to left-sided colonic malignant lesions is an acute emergent situation which is always dealt with by emergent celiotomy and colostomy for salvage of patient life. Colostomy is considered life-saving in such situations, yet it is of undesirable psychological feedback impressions for patients. The aim of this work is to describe our experience with the use of colonic stent in left-sided malignant obstruction, as a good step to relieve the obstruction, and hence to proceed for one-step resection anastomosis with primary repair without the need for colostomy, which is in itself of good impact for psychological satisfaction and salvage of patient. Patients and Methods: Out of 20 patients with left-sided colonic obstruction, 9 patients were dealt with colonic stent, of them 7 patients had one-step procedure with either left hemicolectomy or sigmoidectomy, and 11 had emergent surgical interference with colostomy. Results: Seven of nine patients had a successful laparoscopic colonic stent, and followed by a successful one-step surgical procedure, two of nine patients had unsuccessful laparoscopic stent with emergent exploration and colostomy. Conclusion: Colonic stent for the left malignant obstruction represents a valuable procedure for one-step resection and primary anastomosis without the need for colostomy.","PeriodicalId":420307,"journal":{"name":"Saudi Surgical Journal","volume":"20 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114741718","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}
Rajkumar Sankaran, D. Raman, A. Shankar, Bader Al Hadhrami
Laparoscopic bariatric surgery though growing rapidly in the past two decades has a high degree of immediate postoperative complications. We present three emergent complications in our series of first 100 cases in a private hospital in Oman which were tackled appropriately by our team of professionals. These complications were one staple line hemorrhage in laparoscopic sleeve gastrectomy, twist of gastric pouch in mini gastric bypass and leakage of gastrojejunal anastomosis in Roux-en-Y gastric bypass. In all the three cases, thorough postoperative vigil has been stressed upon as an important factor in postoperative bariatric surgical care. In the gastric bypass case, despite the absence of definite findings in the radiological investigations, patient was taken to the operating room on high degree of clinical suspicion as a part of diagnostic algorithm.
{"title":"Emergency reoperations in bariatric surgery – Our experience in the first 100 cases in a private hospital in Oman","authors":"Rajkumar Sankaran, D. Raman, A. Shankar, Bader Al Hadhrami","doi":"10.4103/ssj.ssj_29_17","DOIUrl":"https://doi.org/10.4103/ssj.ssj_29_17","url":null,"abstract":"Laparoscopic bariatric surgery though growing rapidly in the past two decades has a high degree of immediate postoperative complications. We present three emergent complications in our series of first 100 cases in a private hospital in Oman which were tackled appropriately by our team of professionals. These complications were one staple line hemorrhage in laparoscopic sleeve gastrectomy, twist of gastric pouch in mini gastric bypass and leakage of gastrojejunal anastomosis in Roux-en-Y gastric bypass. In all the three cases, thorough postoperative vigil has been stressed upon as an important factor in postoperative bariatric surgical care. In the gastric bypass case, despite the absence of definite findings in the radiological investigations, patient was taken to the operating room on high degree of clinical suspicion as a part of diagnostic algorithm.","PeriodicalId":420307,"journal":{"name":"Saudi Surgical Journal","volume":"12 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"117165827","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}
M. Alghamdi, Mosab M Abbas, Majed O Shafei, Abdulrahman O Alali, M. S. Alshareef, F. A. Aljabri, N. Zaidi, M. Aljiffry
Background and Objective: Surgical residents are at high risk of sustaining sharp injuries. Our aim is to identify predisposing factors of sustaining sharp injuries in operating rooms among surgical residents and their attitudes and behaviors in dealing with sharp injuries. Methods: In this cross-sectional study, a random sampling technique was adopted to recruit a representative sample of surgical residents who were involved in operative procedures in King Abdulaziz University Hospital. Data were collected between September and December 2016 by completing a self-administered questionnaire on attitude toward the most recent sharp injuries, predisposing factors for sharp injuries, and practice of universal precautions during the surgical procedures. Results: Among the 78 recruited residents, 46 (58.9%) had sharp injuries during surgical procedures. Most of the injuries (60%) were self-induced, and (72.9%) of the injuries took place while suturing. Twenty (43.5%) of those who had injuries did not report any injury, 15 (32.6%) reported some, and 11 (23.9%) claim that they reported all their sharp injuries. 44.9% of the participants are fully aware of sharp injuries local policy and procedures in the hospital. Most of the injured participants during surgeries did not follow each step of the local sharp injury policy. The perceived causes of sharp injuries among the participants were due to rushed (61.1%), fatigue (43%), lack of skills (19.4%), lack of assistance (15.3%), lack of sleep (13.9%) and (16.7%) though it is not preventable. 55.1% of all participants have never participated in any sharp-related safety training. 10.2% practiced all three universal precautions of double-gloving, face shields, and hands-free technique. Conclusions: Sharp injuries are common among the surgical residents but are not reported by most of them. Target training about sharp injuries during residency may improve their attitude and behavior toward prevention of sharp injuries in the operative room.
{"title":"Sharp injuries in the operative room among residents in surgical specialties: A cross-sectional study","authors":"M. Alghamdi, Mosab M Abbas, Majed O Shafei, Abdulrahman O Alali, M. S. Alshareef, F. A. Aljabri, N. Zaidi, M. Aljiffry","doi":"10.4103/SSJ.SSJ_43_17","DOIUrl":"https://doi.org/10.4103/SSJ.SSJ_43_17","url":null,"abstract":"Background and Objective: Surgical residents are at high risk of sustaining sharp injuries. Our aim is to identify predisposing factors of sustaining sharp injuries in operating rooms among surgical residents and their attitudes and behaviors in dealing with sharp injuries. Methods: In this cross-sectional study, a random sampling technique was adopted to recruit a representative sample of surgical residents who were involved in operative procedures in King Abdulaziz University Hospital. Data were collected between September and December 2016 by completing a self-administered questionnaire on attitude toward the most recent sharp injuries, predisposing factors for sharp injuries, and practice of universal precautions during the surgical procedures. Results: Among the 78 recruited residents, 46 (58.9%) had sharp injuries during surgical procedures. Most of the injuries (60%) were self-induced, and (72.9%) of the injuries took place while suturing. Twenty (43.5%) of those who had injuries did not report any injury, 15 (32.6%) reported some, and 11 (23.9%) claim that they reported all their sharp injuries. 44.9% of the participants are fully aware of sharp injuries local policy and procedures in the hospital. Most of the injured participants during surgeries did not follow each step of the local sharp injury policy. The perceived causes of sharp injuries among the participants were due to rushed (61.1%), fatigue (43%), lack of skills (19.4%), lack of assistance (15.3%), lack of sleep (13.9%) and (16.7%) though it is not preventable. 55.1% of all participants have never participated in any sharp-related safety training. 10.2% practiced all three universal precautions of double-gloving, face shields, and hands-free technique. Conclusions: Sharp injuries are common among the surgical residents but are not reported by most of them. Target training about sharp injuries during residency may improve their attitude and behavior toward prevention of sharp injuries in the operative room.","PeriodicalId":420307,"journal":{"name":"Saudi Surgical Journal","volume":"27 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115828090","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}
京公网安备 11010802042870号
京ICP备2023020795号-1
扫码关注我们
求助内容：
应助结果提醒方式：