Background: Informed consent is the process by which a patient learns about and understands the purpose, bene fi ts, and potential risks of a medical or surgical intervention and then agrees to receive the treatment. It is a legally required process before performing any medical or surgical procedure. In most setups where surgical services are being provided, most components of informed consent are not always complete. The aim of this study is to assess the quality of informed consent among surgical patients admitted to the surgical ward of SPHMMC (St. Paul ’ s Hospital Millennium Medical College) from March 4 to April 12, 2019, G.C. Methods and Materials: This is an institution-based prospective cross-sectional study done on patients admitted to the surgical ward of SPHMMC from March 4 to April 12, 2019, G.C. A total of 135 patients were selected by simple random sampling and were interviewed after their surgeries and before discharge. Results: The informed consent form does not have any of the essential components of surgical informed consent. Out of 135 respondents, only 8.1% of the patients received the minimum required components of informed consent (a good quality informed consent). 85.9% were told their diagnosis, 55.6% knew the bene fi ts of the surgery, and 60.7% knew the consequences of not doing the surgery. Only 26.7% of respondents received explanations about the risk of the procedure. 44.4% of patients were told alternative options of treatment. Conclusion: The quality of informed consent is poor in the surgical ward of SPHMMC. The hospital administration (surgical department) should develop a protocol on the amount of information disclosed to patients before surgery and train all medical personnel.
背景:知情同意是指患者了解并理解医疗或手术干预的目的、益处和潜在风险，然后同意接受治疗的过程。在进行任何医疗或外科手术之前，这是一项法律规定的程序。在提供手术服务的大多数机构中，知情同意的大多数组成部分并不总是完整的。本研究的目的是评估2019年3月4日至4月12日在SPHMMC (St. Paul ' s Hospital Millennium Medical College)外科病房住院的外科患者的知情同意质量。本研究是一项基于机构的前瞻性横断面研究，研究对象为2019年3月4日至4月12日在北京师范大学医学院外科病房住院的患者，采用简单随机抽样的方法，选取135例患者，在术后和出院前进行访谈。结果:知情同意书不包含任何手术知情同意书的必要组成部分。在135名受访者中，只有8.1%的患者获得了知情同意的最低要求组成部分(高质量的知情同意)。85.9%的人被告知他们的诊断，55.6%的人知道手术的好处，60.7%的人知道不做手术的后果。只有26.7%的受访者得到了手术风险的解释。44.4%的患者被告知其他治疗方案。结论:我院外科病房知情同意质量较差。医院管理部门(外科)应制定在手术前向患者披露信息数量的协议，并对所有医务人员进行培训。
{"title":"Quality of Informed Consent Among Patients Who Underwent Major Surgical Procedure in a Tertiary Care Hospital, Addis Ababa, Ethiopia","authors":"W. Chane, Bethlehem Birhanu, Yisihak Suga","doi":"10.2147/oas.s250532","DOIUrl":"https://doi.org/10.2147/oas.s250532","url":null,"abstract":"Background: Informed consent is the process by which a patient learns about and understands the purpose, bene fi ts, and potential risks of a medical or surgical intervention and then agrees to receive the treatment. It is a legally required process before performing any medical or surgical procedure. In most setups where surgical services are being provided, most components of informed consent are not always complete. The aim of this study is to assess the quality of informed consent among surgical patients admitted to the surgical ward of SPHMMC (St. Paul ’ s Hospital Millennium Medical College) from March 4 to April 12, 2019, G.C. Methods and Materials: This is an institution-based prospective cross-sectional study done on patients admitted to the surgical ward of SPHMMC from March 4 to April 12, 2019, G.C. A total of 135 patients were selected by simple random sampling and were interviewed after their surgeries and before discharge. Results: The informed consent form does not have any of the essential components of surgical informed consent. Out of 135 respondents, only 8.1% of the patients received the minimum required components of informed consent (a good quality informed consent). 85.9% were told their diagnosis, 55.6% knew the bene fi ts of the surgery, and 60.7% knew the consequences of not doing the surgery. Only 26.7% of respondents received explanations about the risk of the procedure. 44.4% of patients were told alternative options of treatment. Conclusion: The quality of informed consent is poor in the surgical ward of SPHMMC. The hospital administration (surgical department) should develop a protocol on the amount of information disclosed to patients before surgery and train all medical personnel.","PeriodicalId":56363,"journal":{"name":"Open Access Surgery","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2020-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2147/oas.s250532","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47648446","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}
Z. Abraham, A. Kahinga, K. B. Mapondella, E. Massawe, D. Ntunaguzi
{"title":"Indications and Postoperative Outcomes of Pediatric Adenotonsillectomy at a Private Hospital in Dar es Salaam, Tanzania","authors":"Z. Abraham, A. Kahinga, K. B. Mapondella, E. Massawe, D. Ntunaguzi","doi":"10.2147/oas.s249844","DOIUrl":"https://doi.org/10.2147/oas.s249844","url":null,"abstract":"","PeriodicalId":56363,"journal":{"name":"Open Access Surgery","volume":"1 1","pages":""},"PeriodicalIF":1.0,"publicationDate":"2020-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2147/oas.s249844","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41460531","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}
G. Molteni, A. Sacchetto, L. Sacchetto, D. Marchioni
: The pharyngocutaneous fi stula (PCF) is one of the most common post-operative complications in patients undergoing laryngectomy. Up till now, there is no universally accepted algorithm for managing of PCFs and several treatment modalities are used for wound healing. The English language literature was searched using PUBMED databases with the keywords “ laryngectomy ” , “ pharyngocutaneous ” , “ fi stula ” , “ treatment ” , and “ management ” from January 1, 1999 to June 1, 2019; we selected 35 studies according to inclusion criteria and we conducted a systematic review of the articles. The analysis of the international literature shows a high variability of treatment approaches; there is no consensus about conservative treatment and waiting time, and neither about the indication for surgical treatment or the ideal surgical technique. A fi rst attempt of a conservative measure is mandatory in all cases of PCF. In case of failure of conservative measures surgical treatment should be considered: direct closure and local fl ap are suitable for small defects, pedicled or free fl aps showed good to excellent results in closure of large and complex cervical defects. Other non-invasive treatment such as hyperbaric oxygen therapy (HBOT) and negative pressure wound therapy (NPWT) showed promising results but in limited case series. interventions. Patient care around the peri-operative period and patient outcomes post-surgery are key topics for the journal. All grades of surgery from minor cosmetic interventions to major surgical procedures are covered. Novel techniques and the utilization of new instruments and materials, including implants and prostheses that optimize outcomes constitute major areas of interest. The manuscript management system is completely online and includes a very quick and fair peer-review system, which is all easy to use. Visit http://www.dovepress.com/testimonials.php to read real quotes from published authors.
{"title":"Optimal Management of Post-Laryngectomy Pharyngo-Cutaneous Fistula","authors":"G. Molteni, A. Sacchetto, L. Sacchetto, D. Marchioni","doi":"10.2147/oas.s198038","DOIUrl":"https://doi.org/10.2147/oas.s198038","url":null,"abstract":": The pharyngocutaneous fi stula (PCF) is one of the most common post-operative complications in patients undergoing laryngectomy. Up till now, there is no universally accepted algorithm for managing of PCFs and several treatment modalities are used for wound healing. The English language literature was searched using PUBMED databases with the keywords “ laryngectomy ” , “ pharyngocutaneous ” , “ fi stula ” , “ treatment ” , and “ management ” from January 1, 1999 to June 1, 2019; we selected 35 studies according to inclusion criteria and we conducted a systematic review of the articles. The analysis of the international literature shows a high variability of treatment approaches; there is no consensus about conservative treatment and waiting time, and neither about the indication for surgical treatment or the ideal surgical technique. A fi rst attempt of a conservative measure is mandatory in all cases of PCF. In case of failure of conservative measures surgical treatment should be considered: direct closure and local fl ap are suitable for small defects, pedicled or free fl aps showed good to excellent results in closure of large and complex cervical defects. Other non-invasive treatment such as hyperbaric oxygen therapy (HBOT) and negative pressure wound therapy (NPWT) showed promising results but in limited case series. interventions. Patient care around the peri-operative period and patient outcomes post-surgery are key topics for the journal. All grades of surgery from minor cosmetic interventions to major surgical procedures are covered. Novel techniques and the utilization of new instruments and materials, including implants and prostheses that optimize outcomes constitute major areas of interest. The manuscript management system is completely online and includes a very quick and fair peer-review system, which is all easy to use. Visit http://www.dovepress.com/testimonials.php to read real quotes from published authors.","PeriodicalId":56363,"journal":{"name":"Open Access Surgery","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2020-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2147/oas.s198038","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43922115","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}
Joshua A. Bloom, K. Patel, Stephanie Cohen, A. Chatterjee, Christopher Homsy
{"title":"Prepectoral Breast Reconstruction: An Overview of the History, Technique, and Reported Complications","authors":"Joshua A. Bloom, K. Patel, Stephanie Cohen, A. Chatterjee, Christopher Homsy","doi":"10.2147/oas.s201298","DOIUrl":"https://doi.org/10.2147/oas.s201298","url":null,"abstract":"","PeriodicalId":56363,"journal":{"name":"Open Access Surgery","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2020-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2147/oas.s201298","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44838238","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. Karmacharya, B. Shrestha, B. Shrestha, Anjana Singh, N. Bhandari, P. Dhakal, S. Dahal
{"title":"Varicose vein invasive intervention at university hospital of Nepal, our experience in the last six years","authors":"R. Karmacharya, B. Shrestha, B. Shrestha, Anjana Singh, N. Bhandari, P. Dhakal, S. Dahal","doi":"10.2147/oas.s214962","DOIUrl":"https://doi.org/10.2147/oas.s214962","url":null,"abstract":"","PeriodicalId":56363,"journal":{"name":"Open Access Surgery","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2019-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2147/oas.s214962","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48785342","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}
: Retrosternal goiter (RSG) occurs in 2 – 26% of thyroidectomies. We do not know why some goitres grow “ outwards ” , and others grow “ inwards ” . The features of RSG will be discussed, including the assessment and indications for surgery. Most RSGs can be removed trans-cervically. A novel shaver debulking technique is often effective, so sternotomy or thoracotomy is rarely required.
{"title":"Techniques, considerations and outcomes for surgical treatment of retrosternal goiter","authors":"S. Kleid","doi":"10.2147/oas.s166057","DOIUrl":"https://doi.org/10.2147/oas.s166057","url":null,"abstract":": Retrosternal goiter (RSG) occurs in 2 – 26% of thyroidectomies. We do not know why some goitres grow “ outwards ” , and others grow “ inwards ” . The features of RSG will be discussed, including the assessment and indications for surgery. Most RSGs can be removed trans-cervically. A novel shaver debulking technique is often effective, so sternotomy or thoracotomy is rarely required.","PeriodicalId":56363,"journal":{"name":"Open Access Surgery","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2019-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2147/oas.s166057","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47008800","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}
Dayang Anita Abdul Aziz, Marjmin Osman, Mohd Fadli Abdullah, Felicia Lim, Rufinah Teo, F. Cheah, S. Ishak, Rohana Jaafar, S. Tang, Bilkis Banu Abdul Aziz, H. Abdul Latif, Z. Abdul Latiff
Dayang Anita Abdul Aziz Marjmin Osman Mohd Fadli Abdullah Felicia Lim Rufinah Teo Fook Choe Cheah Shareena Ishak Rohana Jaafar Swee Fong Tang Bilkis Abdul Aziz Hasniah Abdul Latif Zarina Abdul Latiff 1Department of Surgery, UKM Medical Centre, 56000 Cheras, Kuala Lumpur, Malaysia; 2Department of Anaesthesia, UKM Medical Centre, 56000 Cheras, Kuala Lumpur, Malaysia; 3Department of Pediatrics, UKM Medical Centre, 56000 Cheras, Kuala Lumpur, Malaysia Background: In pediatric patients, video-assisted thoracoscopic surgery (VATS) is usually carried out using three to five working ports. The port-less technique (PLT) means only one or two ports are used; in most cases only the telescope would require a port. At our center, the VATS services were started in 2008, initially using the standard three-ports technique but shortly after this was replaced with PLT for all neonatal and pediatric VATS. The rationale of doing PLT was so that working instruments could move easier in the pediatric thoracic cavity. Furthermore, budget constraints did not allow us to purchase trocars of different sizes. Patients and methods: A review of all PLT cases was carried out at our institution from January 2008 to September 2018. We documented the diagnosis and type of surgery performed, age at surgery, number of ports used, conversion rate, morbidity and mortality as well as gross chest wall growth. Results: A total of 46 PLT cases were carried out; 16 were in neonates (34.7%). Conversion to thoracotomy occurred in five patients (10.8%). Diagnosis ranged from congenital anomalies like esophageal atresia to infective cause like empyema thoracis. Immediate morbidity occurred in four patients (8.7%) and there was one perioperative mortality (2.2%). The majority of PLTs (54%) were using two ports, and another 46% of PLTs were successfully carried out using one port. All neonatal and infant PLT cases were using one port (46%). Maximum follow-up was for 5 years and gross growth of chest wall was good. Conclusion: PLT is a feasible and safe technique for a variety of cases for neonatal and pediatric surgical intrathoracic pathology. We recommend PLT for all neonatal and pediatric VATS.
Dayang Anita Abdul Aziz Marjmin Osman Mohd Fadli Abdullah Felicia Lim Rufinah Teo Fook Choe Cheah Shareena Ishak Rohana Jaafar Swee Fong Tang Bilkis Abdul-Aziz Hasniah Abdul Latif Zarina Abdul Latiff 1马来西亚吉隆坡Cheras 56000 UKM医疗中心外科；2麻醉科，UKM医疗中心，56000 Cheras，吉隆坡，马来西亚；3马来西亚吉隆坡Cheras 56000 UKM医疗中心儿科背景：在儿科患者中，电视胸腔镜手术（VATS）通常使用三到五个工作端口进行。无端口技术（PLT）意味着只使用一个或两个端口；在大多数情况下，只有望远镜需要一个端口。在我们的中心，VATS服务于2008年开始，最初使用标准的三端口技术，但不久后，所有新生儿和儿童VATS都被PLT取代。PLT的基本原理是使工作器械在儿童胸腔中更容易移动。此外，由于预算限制，我们无法购买不同尺寸的套管车。患者和方法：2008年1月至2018年9月，我们对所有PLT病例进行了审查。我们记录了诊断和手术类型、手术年龄、使用的端口数量、转换率、发病率和死亡率以及胸壁毛生长。结果：共进行PLT 46例；新生儿16例（34.7%）。5例（10.8%）转为开胸手术。诊断范围从先天性异常（如食道闭锁）到感染性原因（如胸积脓）。4名患者（8.7%）立即发病，1例围手术期死亡（2.2%）。大多数PLT（54%）使用两个端口，另有46%的PLT使用一个端口成功进行。所有新生儿和婴儿PLT病例均使用一个港口（46%）。最大随访时间为5年，胸壁大体生长良好。结论：PLT是一种可行且安全的技术，适用于各种新生儿和儿童胸内手术病理。我们建议对所有新生儿和儿童胸腔镜进行PLT。
{"title":"Port-less technique (PLT) in pediatric video-assisted thoracoscopic surgery (VATS): a 10-year experience at National University of Malaysia","authors":"Dayang Anita Abdul Aziz, Marjmin Osman, Mohd Fadli Abdullah, Felicia Lim, Rufinah Teo, F. Cheah, S. Ishak, Rohana Jaafar, S. Tang, Bilkis Banu Abdul Aziz, H. Abdul Latif, Z. Abdul Latiff","doi":"10.2147/OAS.S195184","DOIUrl":"https://doi.org/10.2147/OAS.S195184","url":null,"abstract":"Dayang Anita Abdul Aziz Marjmin Osman Mohd Fadli Abdullah Felicia Lim Rufinah Teo Fook Choe Cheah Shareena Ishak Rohana Jaafar Swee Fong Tang Bilkis Abdul Aziz Hasniah Abdul Latif Zarina Abdul Latiff 1Department of Surgery, UKM Medical Centre, 56000 Cheras, Kuala Lumpur, Malaysia; 2Department of Anaesthesia, UKM Medical Centre, 56000 Cheras, Kuala Lumpur, Malaysia; 3Department of Pediatrics, UKM Medical Centre, 56000 Cheras, Kuala Lumpur, Malaysia Background: In pediatric patients, video-assisted thoracoscopic surgery (VATS) is usually carried out using three to five working ports. The port-less technique (PLT) means only one or two ports are used; in most cases only the telescope would require a port. At our center, the VATS services were started in 2008, initially using the standard three-ports technique but shortly after this was replaced with PLT for all neonatal and pediatric VATS. The rationale of doing PLT was so that working instruments could move easier in the pediatric thoracic cavity. Furthermore, budget constraints did not allow us to purchase trocars of different sizes. Patients and methods: A review of all PLT cases was carried out at our institution from January 2008 to September 2018. We documented the diagnosis and type of surgery performed, age at surgery, number of ports used, conversion rate, morbidity and mortality as well as gross chest wall growth. Results: A total of 46 PLT cases were carried out; 16 were in neonates (34.7%). Conversion to thoracotomy occurred in five patients (10.8%). Diagnosis ranged from congenital anomalies like esophageal atresia to infective cause like empyema thoracis. Immediate morbidity occurred in four patients (8.7%) and there was one perioperative mortality (2.2%). The majority of PLTs (54%) were using two ports, and another 46% of PLTs were successfully carried out using one port. All neonatal and infant PLT cases were using one port (46%). Maximum follow-up was for 5 years and gross growth of chest wall was good. Conclusion: PLT is a feasible and safe technique for a variety of cases for neonatal and pediatric surgical intrathoracic pathology. We recommend PLT for all neonatal and pediatric VATS.","PeriodicalId":56363,"journal":{"name":"Open Access Surgery","volume":"1 1","pages":""},"PeriodicalIF":1.0,"publicationDate":"2019-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2147/OAS.S195184","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44456715","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}
php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License (http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms (https://www.dovepress.com/terms.php). Open Access Surgery 2019:12 1–5 Open Access Surgery Dovepress
{"title":"Surgical outcome of orbital cavernous hemangioma: a case series","authors":"N. Golden, T. Mahadewa, C. Ryalino","doi":"10.2147/OAS.S186268","DOIUrl":"https://doi.org/10.2147/OAS.S186268","url":null,"abstract":"php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License (http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms (https://www.dovepress.com/terms.php). Open Access Surgery 2019:12 1–5 Open Access Surgery Dovepress","PeriodicalId":56363,"journal":{"name":"Open Access Surgery","volume":"1 1","pages":""},"PeriodicalIF":1.0,"publicationDate":"2018-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2147/OAS.S186268","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45248499","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}
D. Aziz, Marjmin Osman, Felicia Lim, Rufinah Teo, Z. Latiff, R. A. Manaf
Background: In pediatric patients, recurrent inguinal hernia (IH) after laparoscopic repair mostly occurs secondary to incomplete closure of the patent processus vaginalis (PPV). The “external squeeze test” (EST) is a simple on-table assessment tool to check completeness of closure of PPV during laparoscopic IH repair. Patients and methods: A review of effectiveness of EST and recurrence of IH was carried out at our institution from December 2007 to December 2017. Closure of PPV was achieved with creation of purse string over pre-peritoneal fascia of the deep inguinal ring with avoidance of important structures; EST was then performed, that is, a gentle squeeze on the scrotum or labia majora while the telescope remains focused at the pursed area. If the closure was incomplete, EST would result in escape of CO 2 from within the scrotum or labia back into the peritoneal cavity, visualized as air bubbles internally and taken as a positive EST. A complete closure of PPV would not produce any bubbles internally upon external pressure; this would be taken as a negative EST. All patients had 1- to 12-month follow-up. Results: A total of 874 PPVs were repaired. EST was performed in 870 PPVs (99.5%). There were five recurrences of PPVs consistent with recurrent IH (0.57%); one was in a patient with negative EST, attributed to a slipped ligature; the other four did not have EST performed ( p < 0.000000). All the recurrences were re-repaired laparoscopically. Conclusion: EST is a simple, useful on-table assessment tool which significantly detects completeness of closure of PPV which may prevent recurrence of IH. We highly recommend EST in pediatric laparoscopic hernia repair, especially in large PPV. Patient care around the peri-operative period and patient outcomes post surgery are key topics for the journal. All grades of surgery from minor cosmetic interventions to major surgical procedures are covered. Novel techniques and the utilization of new instruments and materials, including implants and prostheses that optimize outcomes constitute major areas of interest. The manuscript management system is completely online includes a very quick and fair peer-review system,
{"title":"External squeeze test during pediatric laparoscopic hernia repair: a novel on-table assessment to ensure complete closure of patent processus vaginalis","authors":"D. Aziz, Marjmin Osman, Felicia Lim, Rufinah Teo, Z. Latiff, R. A. Manaf","doi":"10.2147/OAS.S163265","DOIUrl":"https://doi.org/10.2147/OAS.S163265","url":null,"abstract":"Background: In pediatric patients, recurrent inguinal hernia (IH) after laparoscopic repair mostly occurs secondary to incomplete closure of the patent processus vaginalis (PPV). The “external squeeze test” (EST) is a simple on-table assessment tool to check completeness of closure of PPV during laparoscopic IH repair. Patients and methods: A review of effectiveness of EST and recurrence of IH was carried out at our institution from December 2007 to December 2017. Closure of PPV was achieved with creation of purse string over pre-peritoneal fascia of the deep inguinal ring with avoidance of important structures; EST was then performed, that is, a gentle squeeze on the scrotum or labia majora while the telescope remains focused at the pursed area. If the closure was incomplete, EST would result in escape of CO 2 from within the scrotum or labia back into the peritoneal cavity, visualized as air bubbles internally and taken as a positive EST. A complete closure of PPV would not produce any bubbles internally upon external pressure; this would be taken as a negative EST. All patients had 1- to 12-month follow-up. Results: A total of 874 PPVs were repaired. EST was performed in 870 PPVs (99.5%). There were five recurrences of PPVs consistent with recurrent IH (0.57%); one was in a patient with negative EST, attributed to a slipped ligature; the other four did not have EST performed ( p < 0.000000). All the recurrences were re-repaired laparoscopically. Conclusion: EST is a simple, useful on-table assessment tool which significantly detects completeness of closure of PPV which may prevent recurrence of IH. We highly recommend EST in pediatric laparoscopic hernia repair, especially in large PPV. Patient care around the peri-operative period and patient outcomes post surgery are key topics for the journal. All grades of surgery from minor cosmetic interventions to major surgical procedures are covered. Novel techniques and the utilization of new instruments and materials, including implants and prostheses that optimize outcomes constitute major areas of interest. The manuscript management system is completely online includes a very quick and fair peer-review system,","PeriodicalId":56363,"journal":{"name":"Open Access Surgery","volume":"11 1","pages":"1-3"},"PeriodicalIF":1.0,"publicationDate":"2018-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2147/OAS.S163265","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42333318","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. Hoffmann, Dina Siebrasse, E. Schlöricke, R. Bouchard, T. Keck, C. Benecke
php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License (http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms (https://www.dovepress.com/terms.php). Open Access Surgery 2017:10 45–54 Open Access Surgery Dovepress
{"title":"Long-term outcome of laparoscopic and open surgery in patients with Crohn’s disease","authors":"M. Hoffmann, Dina Siebrasse, E. Schlöricke, R. Bouchard, T. Keck, C. Benecke","doi":"10.2147/OAS.S142112","DOIUrl":"https://doi.org/10.2147/OAS.S142112","url":null,"abstract":"php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License (http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms (https://www.dovepress.com/terms.php). Open Access Surgery 2017:10 45–54 Open Access Surgery Dovepress","PeriodicalId":56363,"journal":{"name":"Open Access Surgery","volume":"10 1","pages":"45-54"},"PeriodicalIF":1.0,"publicationDate":"2017-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2147/OAS.S142112","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48238664","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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