Background: With the introduction of mesh for repair of inguinal hernia, the focus of surgeons has shifted to postoperative pain and quality of life (QOL). As compared to open procedures, laparoscopic procedures have been found to be associated with less pain and faster recovery. The present study was designed to assess whether this holds true when open Lichtenstein repair is done using lightweight mesh (LWM) because, in previous studies where laparoscopic inguinal hernia repair is compared to open Lichtenstein repair, heavyweight mesh (HWM) was used for both techniques. HWM was used for total extraperitoneal (TEP) in the current study because of higher recurrence associated with LWM. Materials and Methods: This prospective randomized study was done on 60 patients divided into two groups: the Lichtenstein group and the TEP group. Patients were followed at 1 week, 1 month, and 6 months for any postoperative complication. QOL was assessed using hernia-specific Carolinas Comfort Scale. Results: No statistically significant difference was observed between the two groups with regard to various postoperative complications. Only one recurrence was detected at 1 month in TEP group. The mean groin pain was significantly less in TEP group at 24 h, 1 week, and 1 month (P < 0.05). The sensation of mesh was significantly less in Lichtenstein group at 24 h and 1 week (P ≤ 0.001) but comparable to TEP at 1 month and 6 months. The difference in movement limitation was not significant at any time between the two groups. Conclusion: Except for less pain in the early postoperative period TEP does not offer any advantage and Lichtenstein repair using LWM can still be considered as the best option for inguinal hernia repair, especially in countries where resources are limited.
{"title":"Lichtenstein repair using lightweight mesh versus laparoscopic total extraperitoneal repair using polypropylene mesh in patients with inguinal hernia: A randomized study","authors":"Sanjay Gupta, S. Goyal, Rajeev Sharma, A. Attri","doi":"10.4103/ssj.ssj_27_19","DOIUrl":"https://doi.org/10.4103/ssj.ssj_27_19","url":null,"abstract":"Background: With the introduction of mesh for repair of inguinal hernia, the focus of surgeons has shifted to postoperative pain and quality of life (QOL). As compared to open procedures, laparoscopic procedures have been found to be associated with less pain and faster recovery. The present study was designed to assess whether this holds true when open Lichtenstein repair is done using lightweight mesh (LWM) because, in previous studies where laparoscopic inguinal hernia repair is compared to open Lichtenstein repair, heavyweight mesh (HWM) was used for both techniques. HWM was used for total extraperitoneal (TEP) in the current study because of higher recurrence associated with LWM. Materials and Methods: This prospective randomized study was done on 60 patients divided into two groups: the Lichtenstein group and the TEP group. Patients were followed at 1 week, 1 month, and 6 months for any postoperative complication. QOL was assessed using hernia-specific Carolinas Comfort Scale. Results: No statistically significant difference was observed between the two groups with regard to various postoperative complications. Only one recurrence was detected at 1 month in TEP group. The mean groin pain was significantly less in TEP group at 24 h, 1 week, and 1 month (P < 0.05). The sensation of mesh was significantly less in Lichtenstein group at 24 h and 1 week (P ≤ 0.001) but comparable to TEP at 1 month and 6 months. The difference in movement limitation was not significant at any time between the two groups. Conclusion: Except for less pain in the early postoperative period TEP does not offer any advantage and Lichtenstein repair using LWM can still be considered as the best option for inguinal hernia repair, especially in countries where resources are limited.","PeriodicalId":420307,"journal":{"name":"Saudi Surgical Journal","volume":"21 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127177786","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 is to establish the diagnostic accuracy of triple test in assessing breast pathologies in women above 20 years of age taking their histopathological report as standard. Patients and Methods: In our analytical study, we included women presenting with a complaint of breast lump or change in breast texture in an age group of above 20 years. Systematic clinical examination was done followed by mammography and finally fine-needle aspiration cytology (FNAC) for tissue sampling. Lesions were considered triple test positive, if lesions were FNAC positive and any one of the remaining two modalities also gave a positive (malignant) interpretation, supporting FNAC, but each of three components must be negative for labeling triple test as negative. Postoperatively, cumulative results were compared with histopathology reports and statistical parameters such as specificity, sensitivity, positive predictive value, negative predictive value, and accuracy of triple test were calculated. Results: We have obtained 100% sensitivity using triple test in all age groups when each element was interpreted as malignant and 100% specificity (P < 0.001) when each element was interpreted as benign with diagnostic accuracy of almost 100% in concordant cases. It was recommended that in cases, where all three modalities are not in agreement for benign pathology and in FNAC positive cases where other two parameters are not in agreement, and lesion is interpreted as suspicious on triple test, the nature of the lesion must be ascertained by excision biopsy. Conclusion: Triple test of breast pathologies is a reliable method and allows detection of breast pathologies in an effective manner, and undue delay in treatment can be minimized by using this modality in limited resource country.
{"title":"Diagnostic accuracy of triple test in breast pathologies of women above 20 years of age","authors":"Anurag Jain, R. Jain","doi":"10.4103/ssj.ssj_15_19","DOIUrl":"https://doi.org/10.4103/ssj.ssj_15_19","url":null,"abstract":"Background: This study is to establish the diagnostic accuracy of triple test in assessing breast pathologies in women above 20 years of age taking their histopathological report as standard. Patients and Methods: In our analytical study, we included women presenting with a complaint of breast lump or change in breast texture in an age group of above 20 years. Systematic clinical examination was done followed by mammography and finally fine-needle aspiration cytology (FNAC) for tissue sampling. Lesions were considered triple test positive, if lesions were FNAC positive and any one of the remaining two modalities also gave a positive (malignant) interpretation, supporting FNAC, but each of three components must be negative for labeling triple test as negative. Postoperatively, cumulative results were compared with histopathology reports and statistical parameters such as specificity, sensitivity, positive predictive value, negative predictive value, and accuracy of triple test were calculated. Results: We have obtained 100% sensitivity using triple test in all age groups when each element was interpreted as malignant and 100% specificity (P < 0.001) when each element was interpreted as benign with diagnostic accuracy of almost 100% in concordant cases. It was recommended that in cases, where all three modalities are not in agreement for benign pathology and in FNAC positive cases where other two parameters are not in agreement, and lesion is interpreted as suspicious on triple test, the nature of the lesion must be ascertained by excision biopsy. Conclusion: Triple test of breast pathologies is a reliable method and allows detection of breast pathologies in an effective manner, and undue delay in treatment can be minimized by using this modality in limited resource country.","PeriodicalId":420307,"journal":{"name":"Saudi Surgical Journal","volume":"11 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124127520","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. Maghrabi, Saleh Aldagal, Abdullah Sultan, N. Zaidi, M. Aljiffry, Moaz Abulfaraj, Wisam H. Jamal
Acquired bronchoesophageal fistula (BEF) and tracheoesophageal fistula are rare disorders that result from medical disease or secondary to a complication of a procedure, most commonly due to the prolonged high-pressure endotracheal or tracheostomy cuffs in the presence of nasogastric tube in the esophagus. Rarely, esophageal injuries can result in BEF; presentation is usually after 1 week of the procedure, and the treatment is esophageal stenting or clips in the early phase, and failure will need definitive surgical management. Here, we present our case of a complex BEF post laparoscopic sleeve gastrectomy that required endoscopic and surgical management. This is a case report and literature review.
{"title":"Bronchoesophageal fistula, a rare complication post laparoscopic sleeve gastrectomy: A case report and literature review","authors":"A. Maghrabi, Saleh Aldagal, Abdullah Sultan, N. Zaidi, M. Aljiffry, Moaz Abulfaraj, Wisam H. Jamal","doi":"10.4103/ssj.ssj_41_19","DOIUrl":"https://doi.org/10.4103/ssj.ssj_41_19","url":null,"abstract":"Acquired bronchoesophageal fistula (BEF) and tracheoesophageal fistula are rare disorders that result from medical disease or secondary to a complication of a procedure, most commonly due to the prolonged high-pressure endotracheal or tracheostomy cuffs in the presence of nasogastric tube in the esophagus. Rarely, esophageal injuries can result in BEF; presentation is usually after 1 week of the procedure, and the treatment is esophageal stenting or clips in the early phase, and failure will need definitive surgical management. Here, we present our case of a complex BEF post laparoscopic sleeve gastrectomy that required endoscopic and surgical management. This is a case report and literature review.","PeriodicalId":420307,"journal":{"name":"Saudi Surgical Journal","volume":"69 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114575646","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. Roy, S. Bhat, R. Bhushan, N. Ansari, P. Mishra, Maham Ahmad, N. Mehrotra, C. Rawat
Introduction: Choledochal cysts are a relatively uncommon disease of the bile duct which is the cystic dilatation of the intra- or extrahepatic bile ducts. Literature is scarce on its clinicopathological behavior among children and adults and its comparison. Methods: The retrospective study was aimed to study the clinical characteristics, management, and complications between pediatric and adult patients with choledochal cysts. Results: There was higher female preponderance with male to female ratio of 3:17 in pediatric age group while 1:4 in adult age. Abdominal pain was more common among adults, while palpable mass was more common among pediatrics population (P < 0.05). Jaundice was more evident in the pediatric age group, yet the classic triad of choledochal cyst (abdominal pain, jaundice, and a palpable mass) was not observed in any age group. About 76% of the cysts were type 1 cysts, which was more common among pediatric age group (40% vs. 90% P < 0.05) while with adults presented more with a type IVA cyst (60% vs. 10% P > 0.05). No patients with type II, type III, type IVB cysts, or type V were found. Sixteen patients underwent Lilly technique, with resection of the choledochal mucosa and Roux-en-Y hepaticojejunostomy, while nine patients underwent resection of the choledochal cyst and Roux-en-Y hepaticojejunostomy. Patients who received total excision had fewer surgical complications in both groups. Conclusion: Although there is a significant difference in the clinical characteristics of choledochal cysts between children and adults, yet early detection and necessary surgery is essential for patients with choledochal cysts.
胆总管囊肿是一种比较少见的胆管疾病，是指肝内或肝外胆管的囊性扩张。关于其在儿童和成人中的临床病理行为及其比较的文献很少。方法:回顾性分析小儿和成人胆总管囊肿的临床特点、处理及并发症。结果:儿童年龄组男女比例为3:17，成人为1:4，女性优势明显。腹痛以成人多见，可触及肿块以儿科多见(P < 0.05)。黄疸在儿童年龄组中更为明显，而胆总管囊肿的典型三联征(腹痛、黄疸和可触及的肿块)在任何年龄组中均未观察到。约76%的囊肿为1型囊肿，儿童年龄组以1型囊肿较多(40%比90% P < 0.05)，成人以IVA型囊肿较多(60%比10% P > 0.05)。未发现II型、III型、IVB型或V型囊肿患者。16例患者行Lilly技术，切除胆总管粘膜，Roux-en-Y型肝空肠吻合术;9例患者行胆总管囊肿切除，Roux-en-Y型肝空肠吻合术。两组接受全切除的患者手术并发症较少。结论:虽然儿童胆总管囊肿的临床特征与成人有显著差异，但对于胆总管囊肿患者，早期发现并进行必要的手术治疗是必要的。
{"title":"Experiences of choledochal cyst in pediatric and adult population: A case series","authors":"A. Roy, S. Bhat, R. Bhushan, N. Ansari, P. Mishra, Maham Ahmad, N. Mehrotra, C. Rawat","doi":"10.4103/ssj.ssj_46_18","DOIUrl":"https://doi.org/10.4103/ssj.ssj_46_18","url":null,"abstract":"Introduction: Choledochal cysts are a relatively uncommon disease of the bile duct which is the cystic dilatation of the intra- or extrahepatic bile ducts. Literature is scarce on its clinicopathological behavior among children and adults and its comparison. Methods: The retrospective study was aimed to study the clinical characteristics, management, and complications between pediatric and adult patients with choledochal cysts. Results: There was higher female preponderance with male to female ratio of 3:17 in pediatric age group while 1:4 in adult age. Abdominal pain was more common among adults, while palpable mass was more common among pediatrics population (P < 0.05). Jaundice was more evident in the pediatric age group, yet the classic triad of choledochal cyst (abdominal pain, jaundice, and a palpable mass) was not observed in any age group. About 76% of the cysts were type 1 cysts, which was more common among pediatric age group (40% vs. 90% P < 0.05) while with adults presented more with a type IVA cyst (60% vs. 10% P > 0.05). No patients with type II, type III, type IVB cysts, or type V were found. Sixteen patients underwent Lilly technique, with resection of the choledochal mucosa and Roux-en-Y hepaticojejunostomy, while nine patients underwent resection of the choledochal cyst and Roux-en-Y hepaticojejunostomy. Patients who received total excision had fewer surgical complications in both groups. Conclusion: Although there is a significant difference in the clinical characteristics of choledochal cysts between children and adults, yet early detection and necessary surgery is essential for patients with choledochal cysts.","PeriodicalId":420307,"journal":{"name":"Saudi Surgical Journal","volume":"11959 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131417053","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. Alhaizaey, A. Azazy, M. Asiry, M. Alsayed, Mustafa Abbass, Abdulrhman Hassan, A. Gamil, Musaed Alghamdi
Objective: The objective was to assess the prevalence and risk factors of abdominal aorta aneurysms (AAAs) in the general population. Materials and Methods: We carried out a prospective, interventional study with patients aged over 60 years screened in the Asir Central Hospital Vascular Department from March 2017 to March 2018. Ultrasound was used to AAA screening. The maximal anteroposterior (AP) and transverse (LL) diameters of the suprarenal and infrarenal aorta were measured in each patient. AAA was defined as aortic dilatation >29 mm in the AP or LL plane. All cases with an aortic diameter >25 mm were included in the study. Results: Our study included 701 patients (531 male, 170 female; age 60–102 years). Most were Saudi nationals (87.6%). There were some smokers (1.3%), 277 (39.5%) had diabetes mellitus, and 233 (31.8%) had hypertension. Fifty-one percent of patient had ischemic heart disease (7.3%), and 13.4% had hypercholesterolemia. Patients were classified into three groups: normal aortic size of 657 patients (93.7%); aortic ectasia 26–29 mm of 24 patients (3.4%); and AAA ≥30 mm of 20 patients (2.9%). The overall prevalence of AAA was ≥30 mm (2.9%) and there is significant relation with hypertension (P < 0.05). Conclusion: Asymptomatic AAA is prevalent in our area. We may need to implement a regular screening program for men aged >60 years, especially high-risk patients to reduce AAA rupture, emergency AAA repair, and mortality.
{"title":"Prevalence of abdominal aorta aneurysm and associated risk factors in Abha city, Saudi Arabia","authors":"A. Alhaizaey, A. Azazy, M. Asiry, M. Alsayed, Mustafa Abbass, Abdulrhman Hassan, A. Gamil, Musaed Alghamdi","doi":"10.4103/ssj.ssj_19_19","DOIUrl":"https://doi.org/10.4103/ssj.ssj_19_19","url":null,"abstract":"Objective: The objective was to assess the prevalence and risk factors of abdominal aorta aneurysms (AAAs) in the general population. Materials and Methods: We carried out a prospective, interventional study with patients aged over 60 years screened in the Asir Central Hospital Vascular Department from March 2017 to March 2018. Ultrasound was used to AAA screening. The maximal anteroposterior (AP) and transverse (LL) diameters of the suprarenal and infrarenal aorta were measured in each patient. AAA was defined as aortic dilatation >29 mm in the AP or LL plane. All cases with an aortic diameter >25 mm were included in the study. Results: Our study included 701 patients (531 male, 170 female; age 60–102 years). Most were Saudi nationals (87.6%). There were some smokers (1.3%), 277 (39.5%) had diabetes mellitus, and 233 (31.8%) had hypertension. Fifty-one percent of patient had ischemic heart disease (7.3%), and 13.4% had hypercholesterolemia. Patients were classified into three groups: normal aortic size of 657 patients (93.7%); aortic ectasia 26–29 mm of 24 patients (3.4%); and AAA ≥30 mm of 20 patients (2.9%). The overall prevalence of AAA was ≥30 mm (2.9%) and there is significant relation with hypertension (P < 0.05). Conclusion: Asymptomatic AAA is prevalent in our area. We may need to implement a regular screening program for men aged >60 years, especially high-risk patients to reduce AAA rupture, emergency AAA repair, and mortality.","PeriodicalId":420307,"journal":{"name":"Saudi Surgical Journal","volume":"53 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127105173","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}
Context: The study was undertaken to compare developing breast cancer-related lymphedema between those who underwent mastectomy with reconstruction and mastectomy alone. Aims: One of the most feared consequences after a mastectomy is breast cancer-related lymphedema (BCRL). However, few papers have questioned whether breast reconstruction impacts the development of lymphedema. This study aims to determine if breast reconstruction has an effect on the incidence of BCRL. Furthermore, the effect of the time (immediate vs. delayed) and type (implant based vs. autologous) of breast reconstruction on the development of BCRL will be evaluated. Settings and Design: We conducted a retrospective cohort study on 320 patients who underwent mastectomy with reconstruction and mastectomy alone between January 1, 2007, and December 31, 2017, at King Abdulaziz Medical City – Jeddah. Subjects and Methods: We conducted a retrospective cohort study on 320 patients who underwent mastectomy with or without breast reconstruction between January 2007 and December 2017. We reviewed patient medical records progressively to extract patients' characteristics, operative details, and lymphedema information. We divided our sample into two main groups: patients who underwent mastectomy with reconstruction and mastectomy alone. Mastectomy with reconstruction group was subdivided into immediate or delayed reconstruction and autologous or implant-based reconstruction. Statistical Analysis Used: Statistical analysis was performed using the Statistical Package for the Social Sciences version 20. Results: Of the total sample size 320, only 78 (24.4% (underwent mastectomy with breast reconstruction (Group 1), while the rest 242 (75.6%) underwent mastectomy alone (Group 2). From both the groups, 24 (7.5%) patients developed lymphedema; there was no significant difference between the breast reconstruction and development of lymphedema (P = 0.67). We subdivided Group 1 (patients who underwent mastectomy with breast reconstruction) into immediate breast reconstruction (40 patients, [51%]) and delayed breast reconstruction (38 patients, [49%]). In comparison between immediate versus delayed breast reconstruction, there was no significant difference between immediate and delayed breast reconstruction (P = 0.67). In terms of the type of reconstruction, we further subdivided Group 1 (patients who underwent mastectomy with breast reconstruction) into implant-based breast reconstruction (42 patients, [54%]), and autologous breast reconstruction (36 patients, [46%]). In comparison between implant-based versus autologous breast reconstruction, there was no significant difference between implant-based and autologous breast reconstruction (P = 0.66). Conclusions: Although our result is insignificant, it suggests that patients who underwent mastectomy with reconstruction have a lower incidence of BCRL in comparison with those who underwent mastectomy alone. Moreover, our result suggests that immedia
{"title":"A comparison of developing breast cancer-related lymphedema between mastectomy with reconstruction and mastectomy alone among breast cancer patients in Saudi Arabia","authors":"Malik Almailabi, Mamoon Daghistani, Muhammad Khan","doi":"10.4103/ssj.ssj_8_19","DOIUrl":"https://doi.org/10.4103/ssj.ssj_8_19","url":null,"abstract":"Context: The study was undertaken to compare developing breast cancer-related lymphedema between those who underwent mastectomy with reconstruction and mastectomy alone. Aims: One of the most feared consequences after a mastectomy is breast cancer-related lymphedema (BCRL). However, few papers have questioned whether breast reconstruction impacts the development of lymphedema. This study aims to determine if breast reconstruction has an effect on the incidence of BCRL. Furthermore, the effect of the time (immediate vs. delayed) and type (implant based vs. autologous) of breast reconstruction on the development of BCRL will be evaluated. Settings and Design: We conducted a retrospective cohort study on 320 patients who underwent mastectomy with reconstruction and mastectomy alone between January 1, 2007, and December 31, 2017, at King Abdulaziz Medical City – Jeddah. Subjects and Methods: We conducted a retrospective cohort study on 320 patients who underwent mastectomy with or without breast reconstruction between January 2007 and December 2017. We reviewed patient medical records progressively to extract patients' characteristics, operative details, and lymphedema information. We divided our sample into two main groups: patients who underwent mastectomy with reconstruction and mastectomy alone. Mastectomy with reconstruction group was subdivided into immediate or delayed reconstruction and autologous or implant-based reconstruction. Statistical Analysis Used: Statistical analysis was performed using the Statistical Package for the Social Sciences version 20. Results: Of the total sample size 320, only 78 (24.4% (underwent mastectomy with breast reconstruction (Group 1), while the rest 242 (75.6%) underwent mastectomy alone (Group 2). From both the groups, 24 (7.5%) patients developed lymphedema; there was no significant difference between the breast reconstruction and development of lymphedema (P = 0.67). We subdivided Group 1 (patients who underwent mastectomy with breast reconstruction) into immediate breast reconstruction (40 patients, [51%]) and delayed breast reconstruction (38 patients, [49%]). In comparison between immediate versus delayed breast reconstruction, there was no significant difference between immediate and delayed breast reconstruction (P = 0.67). In terms of the type of reconstruction, we further subdivided Group 1 (patients who underwent mastectomy with breast reconstruction) into implant-based breast reconstruction (42 patients, [54%]), and autologous breast reconstruction (36 patients, [46%]). In comparison between implant-based versus autologous breast reconstruction, there was no significant difference between implant-based and autologous breast reconstruction (P = 0.66). Conclusions: Although our result is insignificant, it suggests that patients who underwent mastectomy with reconstruction have a lower incidence of BCRL in comparison with those who underwent mastectomy alone. Moreover, our result suggests that immedia","PeriodicalId":420307,"journal":{"name":"Saudi Surgical Journal","volume":"80 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130121036","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}
B. Al-Jiffry, Mohamed Al Saeed, Majed Al-Mourgi, Samir Badr, T. Abdel-Rahman, Abdel-Hafez Shweel, A. Younes, Abdullah Al-Sawat, Aseel Abu-Duruk, Owaid Al-Malki, Mohamed Hatem, M. EL-mETEINI
Background and Aim of the Work: Early management of postlaparoscopic nonvascular biliary injuries by an expert team is essential to achieve a good outcome. In this article, we would evaluate the results of this prospective multicentric study in the management of postlaparoscopic nonvascular biliary injuries. Patients and Methods: This prospective multicentric study enrolled 168 patients with iatrogenic nonvascular bile duct injury (BDI). In all cases, endoscopic retrograde cholangiopancreatography (ERCP) was performed, and further management was done according to Strasberg type of injury. Results: Intra-abdominal biliary collection was managed by ultrasound-guided drainage. Type A (19%) was diagnosed and treated by ERCP. Types B and C (20.2%) were treated by duct reconstruction of the isolated segment and Roux-en-Y hepaticojejunostomy (RYHJ), respectively. Strasberg type D nondevascularized partial injury (7.1%) was treated by primary repair around stent. In complete type D patients and E (10.7% and 43%, respectively), Roux en-Y hepaticojejunostomy with lowering the hilar plate was performed. After ERCP, 78% of patients developed hyperamylasemia and only 4.8% developed pancreatitis. After HJ, 9.7% of patients developed stricture and were treated by percutaneous transhepatic cholangial dilatation. Conclusion: This study proved the safety and efficacy of the management of iatrogenic BDI by an expert team implementing different diagnostic and treatment modalities such as ultrasound, computed tomography scan, and ERCP in addition to different surgical options, particularly the use of right end-to-side and left side-to-side RYHJ, with lowering the hilar plate and anterior anastomosis.
{"title":"Management of nonvascular postlaparoscopic bile duct injury","authors":"B. Al-Jiffry, Mohamed Al Saeed, Majed Al-Mourgi, Samir Badr, T. Abdel-Rahman, Abdel-Hafez Shweel, A. Younes, Abdullah Al-Sawat, Aseel Abu-Duruk, Owaid Al-Malki, Mohamed Hatem, M. EL-mETEINI","doi":"10.4103/ssj.ssj_4_19","DOIUrl":"https://doi.org/10.4103/ssj.ssj_4_19","url":null,"abstract":"Background and Aim of the Work: Early management of postlaparoscopic nonvascular biliary injuries by an expert team is essential to achieve a good outcome. In this article, we would evaluate the results of this prospective multicentric study in the management of postlaparoscopic nonvascular biliary injuries. Patients and Methods: This prospective multicentric study enrolled 168 patients with iatrogenic nonvascular bile duct injury (BDI). In all cases, endoscopic retrograde cholangiopancreatography (ERCP) was performed, and further management was done according to Strasberg type of injury. Results: Intra-abdominal biliary collection was managed by ultrasound-guided drainage. Type A (19%) was diagnosed and treated by ERCP. Types B and C (20.2%) were treated by duct reconstruction of the isolated segment and Roux-en-Y hepaticojejunostomy (RYHJ), respectively. Strasberg type D nondevascularized partial injury (7.1%) was treated by primary repair around stent. In complete type D patients and E (10.7% and 43%, respectively), Roux en-Y hepaticojejunostomy with lowering the hilar plate was performed. After ERCP, 78% of patients developed hyperamylasemia and only 4.8% developed pancreatitis. After HJ, 9.7% of patients developed stricture and were treated by percutaneous transhepatic cholangial dilatation. Conclusion: This study proved the safety and efficacy of the management of iatrogenic BDI by an expert team implementing different diagnostic and treatment modalities such as ultrasound, computed tomography scan, and ERCP in addition to different surgical options, particularly the use of right end-to-side and left side-to-side RYHJ, with lowering the hilar plate and anterior anastomosis.","PeriodicalId":420307,"journal":{"name":"Saudi Surgical Journal","volume":"12 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"117188480","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}
S. Alqahtani, S. Al-Shehri, T. Alshehri, S. Al-zahrani, S. Alqahtani
Background: Residents of surgical specialties have a high risk of sharp injuries. The reporting behaviors have a critical step in prophylaxis and early treatment. Aim: The aim of this study is to assess the prevalence of sharp injuries in the operative room among surgical residents and their behavior. Methodology: A descriptive cross-sectional study was conducted including 166 surgical specialty residents who involved in operating procedures from seven hospitals in the southern region of Saudi Arabia. A self-administrating questionnaire about sharp injuries, predisposing factors for sharp injuries, and practice of universal precautions during the surgical procedures was used for data collection. The study questionnaire was developed by the researchers after intensive literature review and another research tool from a previous similar study which was conducted in King Abdul-Aziz University Hospital in Jeddah city of Saudi Arabia. Results: About 64% of the residents have had at least one sharp injury in the last year. Most of these injuries (53.3%) occurred while suturing and 76.6% claimed the reason was due to fatigue. Most of the recent injuries (86%) were self-induced injuries caused with a solid needle (65.4%). The most common action post the injury was replacing the gloves and the needle (36.7%). Only 9% of them have reported all of their injuries to the concerned authorities, and 56% claimed the reason that they were not bothered. About 75.3% of them were aware of their local policies. Conclusion: Sharp injuries and needlestick are common among surgical residents, but they have weak reporting behavior. More educational training program about the sharp-related safety program may improve their attitude and behavior regarding sharp injuries.
{"title":"The prevalence of sharp injuries in the operative room among surgical residents and their behavior to them in the southern region of Saudi Arabia","authors":"S. Alqahtani, S. Al-Shehri, T. Alshehri, S. Al-zahrani, S. Alqahtani","doi":"10.4103/ssj.ssj_1_19","DOIUrl":"https://doi.org/10.4103/ssj.ssj_1_19","url":null,"abstract":"Background: Residents of surgical specialties have a high risk of sharp injuries. The reporting behaviors have a critical step in prophylaxis and early treatment. Aim: The aim of this study is to assess the prevalence of sharp injuries in the operative room among surgical residents and their behavior. Methodology: A descriptive cross-sectional study was conducted including 166 surgical specialty residents who involved in operating procedures from seven hospitals in the southern region of Saudi Arabia. A self-administrating questionnaire about sharp injuries, predisposing factors for sharp injuries, and practice of universal precautions during the surgical procedures was used for data collection. The study questionnaire was developed by the researchers after intensive literature review and another research tool from a previous similar study which was conducted in King Abdul-Aziz University Hospital in Jeddah city of Saudi Arabia. Results: About 64% of the residents have had at least one sharp injury in the last year. Most of these injuries (53.3%) occurred while suturing and 76.6% claimed the reason was due to fatigue. Most of the recent injuries (86%) were self-induced injuries caused with a solid needle (65.4%). The most common action post the injury was replacing the gloves and the needle (36.7%). Only 9% of them have reported all of their injuries to the concerned authorities, and 56% claimed the reason that they were not bothered. About 75.3% of them were aware of their local policies. Conclusion: Sharp injuries and needlestick are common among surgical residents, but they have weak reporting behavior. More educational training program about the sharp-related safety program may improve their attitude and behavior regarding sharp injuries.","PeriodicalId":420307,"journal":{"name":"Saudi Surgical Journal","volume":"28 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124920323","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}
Importance: Nonpsychiatric physicians often encounter body dysmorphic disorder (BDD) which is a common psychiatric disorder. In the general population, BDD is estimated to affect 1%–2%. In esthetic specialties, however, rates are markedly higher. Objective: This study aims to quantify the prevalence of BDD among people seeking facial plastic surgeries in Saudi Arabia because the literature is sparse in this field. Design: This is a cross-sectional study, conducted in 2018 (October–December). Setting: A self-administered web-based questionnaire was administered on 453 individuals, aged 18 years and older, of Saudi residence. Participants: A total of 453 individuals, aged 18 years and older, of Saudi residence, were enrolled in the study. Main Outcome(s) and Measure(s): The study has three main measures which are: (1) sociodemographic data, (2) previous and future plastic surgeries, and (3) the Body Dysmorphic Disorder Questionnaire. Results: A total of 453 individuals were enrolled in this study. Of the total sample, 34.2% reported their desire to go for a facioplastic surgery in future, of which 14.19% fulfilled the criteria of BDD. Twenty-two individuals who fulfilled the criteria were all females (100%). All were relatively young, with 54.5% aging between 18 and 24 years of age, followed by 45.5% aging between 25 and 34 years of age. The majority were married 54.5%, with the rest being single. The majority of individuals (59.1%) live in cities, followed by 36.4% living in villages and 4.5% living in outskirts. Nearly 68.2% hold a college degree, followed by 27.3% holding a high school degree. The vast majority reported the desire to undergo a rhinoplasty (54.5%), followed by facial implants (9.1%), facelift (4.5%), eyebrow lift (4.5%), and cheek/jaw contouring (4.5%). Conclusion: We report a prevalence of 14.19% among people seeking facial plastic surgery. This prevalence is warring, requiring special attention by facioplastic surgeons, plastic surgeons, and dermatologists, when dealing with patients. We recommend the screening of all patients to be a standard practice to ensure the best outcome possible.
{"title":"Prevalence of body dysmorphic disorder among Saudis seeking facial plastic surgery","authors":"Z. S. A. Shuhayb","doi":"10.4103/SSJ.SSJ_11_19","DOIUrl":"https://doi.org/10.4103/SSJ.SSJ_11_19","url":null,"abstract":"Importance: Nonpsychiatric physicians often encounter body dysmorphic disorder (BDD) which is a common psychiatric disorder. In the general population, BDD is estimated to affect 1%–2%. In esthetic specialties, however, rates are markedly higher. Objective: This study aims to quantify the prevalence of BDD among people seeking facial plastic surgeries in Saudi Arabia because the literature is sparse in this field. Design: This is a cross-sectional study, conducted in 2018 (October–December). Setting: A self-administered web-based questionnaire was administered on 453 individuals, aged 18 years and older, of Saudi residence. Participants: A total of 453 individuals, aged 18 years and older, of Saudi residence, were enrolled in the study. Main Outcome(s) and Measure(s): The study has three main measures which are: (1) sociodemographic data, (2) previous and future plastic surgeries, and (3) the Body Dysmorphic Disorder Questionnaire. Results: A total of 453 individuals were enrolled in this study. Of the total sample, 34.2% reported their desire to go for a facioplastic surgery in future, of which 14.19% fulfilled the criteria of BDD. Twenty-two individuals who fulfilled the criteria were all females (100%). All were relatively young, with 54.5% aging between 18 and 24 years of age, followed by 45.5% aging between 25 and 34 years of age. The majority were married 54.5%, with the rest being single. The majority of individuals (59.1%) live in cities, followed by 36.4% living in villages and 4.5% living in outskirts. Nearly 68.2% hold a college degree, followed by 27.3% holding a high school degree. The vast majority reported the desire to undergo a rhinoplasty (54.5%), followed by facial implants (9.1%), facelift (4.5%), eyebrow lift (4.5%), and cheek/jaw contouring (4.5%). Conclusion: We report a prevalence of 14.19% among people seeking facial plastic surgery. This prevalence is warring, requiring special attention by facioplastic surgeons, plastic surgeons, and dermatologists, when dealing with patients. We recommend the screening of all patients to be a standard practice to ensure the best outcome possible.","PeriodicalId":420307,"journal":{"name":"Saudi Surgical Journal","volume":"48 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127781637","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}
K. Alshehri, W. Alqulayti, O. Saggaf, Maryam Z. Enani, Abdulrahman K. Bahatheq, Lujain K. Abdalwassie, H. Marzouki
Objective: The objective of this study was to assess the level of awareness regarding primary home management of epistaxis among high- and middle-school students and their teachers. Materials and Methods: This cross-sectional study was conducted in December 2018 by distributing a paper-based questionnaire to high-and middle-school students and teachers in Jeddah, Saudi Arabia. Results: The study included 706 individuals (53.4% males and 46.6% females) with a mean age of 16.58 ± 5.57 years. Based on the correlation between our variables, 57.5% of the participants had a good knowledge score, while only 3.5% had an excellent score. Male high-school students were significantly more knowledgeable than female middle-school students. Conclusion: Awareness of first-aid management of epistaxis was fair. However, more integrated educational resources should be made available for the general population and school students and teachers.
{"title":"Awareness of first-aid management of epistaxis among school students in Jeddah, Saudi Arabia","authors":"K. Alshehri, W. Alqulayti, O. Saggaf, Maryam Z. Enani, Abdulrahman K. Bahatheq, Lujain K. Abdalwassie, H. Marzouki","doi":"10.4103/ssj.ssj_26_19","DOIUrl":"https://doi.org/10.4103/ssj.ssj_26_19","url":null,"abstract":"Objective: The objective of this study was to assess the level of awareness regarding primary home management of epistaxis among high- and middle-school students and their teachers. Materials and Methods: This cross-sectional study was conducted in December 2018 by distributing a paper-based questionnaire to high-and middle-school students and teachers in Jeddah, Saudi Arabia. Results: The study included 706 individuals (53.4% males and 46.6% females) with a mean age of 16.58 ± 5.57 years. Based on the correlation between our variables, 57.5% of the participants had a good knowledge score, while only 3.5% had an excellent score. Male high-school students were significantly more knowledgeable than female middle-school students. Conclusion: Awareness of first-aid management of epistaxis was fair. However, more integrated educational resources should be made available for the general population and school students and teachers.","PeriodicalId":420307,"journal":{"name":"Saudi Surgical Journal","volume":"41 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132337855","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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