Objective: To conduct a systematic review on the utilization of the Enhanced Recovery After Surgery (ERAS) concept in the peri-operative nursing care for patients having spontaneous ventilation video-assisted thoracic surgery (SV-VATS), and present a reference for formulating clinical pathways suited to the domestic context. Methods: A comprehensive literature review was carried out to obtain and examine research regarding ERAS implementation in SV-VATS perioperative care. Results: Present evidence shows that through optimizing pre-operative assessment and preparation, intra-operative nursing cooperation, and post-operative rehabilitation actions, ERAS protocols can efficiently shorten the post-operative hospital stay, lower complication rates, and remarkably enhance patients quality of life. Conclusion: Currently, no unified standard exists for the specific implementation of ERAS in the peri-operative phase of SV-VATS. Future high-level research is needed to improve ERAS strategies and establish standardized evaluation criteria.
Metabolic and bariatric surgery (MBS) is an effective treatment for obesity and associated metabolic disease, while social media has become an important environment in which patients encounter information, professional communication, peer experience, and commercial promotion. This narrative review examined the opportunities, risks, and governance implications of social media in MBS. Peer-reviewed literature was primarily identified through targeted searches of PubMed and the China National Knowledge Infrastructure (CNKI), supplemented by relevant professional, regulatory, and platform documents obtained from official sources. Publications were selected purposively according to their conceptual and clinical relevance and were synthesized thematically around information quality, patient decision-making, professional communication, social support, stigma, privacy, and regulation. Social media can expand access to health information, facilitate clinician-patient communication, and strengthen peer support; however, available evidence does not support treating social media exposure as a deterministic cause of health behavior. Its influence varies according to platform design, source credibility, health and digital literacy, demographic and cultural context, offline relationships, and access to clinical care. Important risks include misinformation, selective presentation of favorable outcomes, commercially driven promotion, weight stigma, and privacy breaches. MBS-specific governance should require credential verification, disclosure of commercial interests, balanced communication of benefits, risks, alternatives, and long-term follow-up requirements, and robust consent procedures for patient-related content. Future studies should evaluate causal pathways, population differences, and professionally led social media interventions.
Introduction: Giant emphysematous bulla is defined as an intrapulmonary air collection occupying 30% or more of a hemithorax. Klingman's classification categorizes bullae according to the quality of the underlying lung parenchyma, with type 1 characterized by a giant bulla surrounded by normal lung. Case Report: Female patient, 54 years old, black woman, from an urban area, with no history of smoking, tuberculosis or chronic obstructive pulmonary disease, with a history of controlled arterial hypertension for approximately 10 years, who started about three months ago with slight progressive dyspnea associated with mild exertion, accompanied by chest discomfort. After normal cardiological examinations, chest radiography revealed increased hyperlucency in the right hemithorax. At the general surgery consultation, the respiratory physical examination demonstrated decreased chest expansion, decreased vocal vibrations and decreased vesicular breath sounds in the right hemithorax, with respiratory rate of 22 breaths/minute. Chest radiography confirmed a type 1 emphysematous bulla according to Klingman's classification, and chest computed tomography confirmed the radiological diagnosis. The patient underwent open bullectomy by the Naclerio and Langer technique (1947). The patient remained hospitalized for 14 days due to a postoperative pleural effusion that was promptly treated, with favorable post-operative course. Discussion: This case is particularly relevant as it represents an idiopathic giant emphysematous bulla in a non-smoker female patient, with no history of tuberculosis or chronic obstructive pulmonary disease, resulting inthe first case report of this pathology in Angola. The epidemiological literature review in Africa revealed few reported cases, predominantly associated with spontaneous pneumothorax or other pulmonary comorbidities. Conclusion: Bullectomy by the Naclerio and Langer technique constitutes an effective surgical approach for the treatment of type 1 giant emphysematous bullae, even in patients without classical risk factors. This case represents the first documented report of this pathology in Angola, contributing to the knowledge of the disease's epidemiology in Africa.
Introduction: The aim was to evaluate the management of postoperative complications of colonic surgery at the Ignace DEEN University Hospital (CHU) in Conakry. Materials and Methods: A two-year retrospective descriptive study (January 2023 to December 2024) conducted in the general surgery department of Ignace Deen University Hospital. All records of patients admitted and operated on in our department who presented with complications from colon surgery and those referred for colon complications after surgery in other facilities meeting our criteria were included in the study. Incomplete records were excluded. The variables analysed were sociodemographic, therapeutic and evolutionary characteristics. Results: The study examined 56 cases of patients with complications from colon surgery, representing 18.48% of the department's total activity. The average age was 35 years, with extremes of 20 and 90 years. We noted a predominance of the male sex (66.07%) with a sex ratio (M/F) of 1.94. Pelvic colon volvulus was the most common initial pathology (64.28%), followed by dolichocolon (32.14%). The initial surgical procedure consisted of a left hemicolectomy with immediate restoration of colorectal digestive continuity in 47 cases (83.93%), followed by the Hartmann procedure in 7 cases (12.50%) and right hemicolectomy with immediate restoration of digestive continuity in 2 cases (3.93%). The average time to the occurrence of complications was 21 days, with extremes of 3 and 19 days. Surgical site infection was the most frequent (46.43%), followed by digestive fistula (19.64%), postoperative peritonitis (16.07%). Staphylococcus aureus was the most frequently encountered germ (41.66%). Non-surgical treatment was carried out in more than half of our patients (58.93%), and re-laparotomy was necessary in 23 patients (41.07%). Postoperative outcomes were uncomplicated in 83.93%. The average length of stay was 30 days, with a range of 6 to 102 days. Conclusion: Postoperative complications of colonic surgery are frequent and serious. Early diagnosis and appropriate management help reduce morbidity and mortality.
Objective This study explored the efficacy of paracetamol mannitol injection combined with TAPB for postoperative pain relief in elderly patients after laparoscopic radical gastrectomy, as this combined regimen also reduces postoperative complications including delirium, nausea, vomiting and impaired wound healing, offering a novel strategy for postoperative pain management in such patients. Methods This prospective study included 150 elderly patients (≥65 years) undergoing laparoscopic radical gastrectomy, who were randomly assigned to three groups: sufentanil alone (S), sufentanil plus TAPB (ST), and sufentanil combined with TAPB and paracetamol mannitol (STA). All patients received routine vital sign and BIS monitoring with standardized vascular access establishment before anesthesia. Each group received corresponding preoperative interventions, and multiple perioperative indicators were compared, including opioid consumption, hemodynamic parameters, surgical and anesthetic variables, postoperative pain scores, adverse events, recovery outcomes and patient satisfaction. Results No significant intergroup differences were found in baseline demographics, perioperative indicators, intraoperative vital signs, vasoactive agent use, postoperative adverse reactions, gastrointestinal recovery indicators and bile acid levels among the three groups (all P>0.05). Compared with Group S and ST, the STA group presented decreased intraoperative consumption of sufentanil, remifentanil and propofol, reduced postoperative morphine requirement, prolonged time to the first moderate-severe pain, lower postoperative visual analogue scale (VAS) pain scores, higher early postoperative Confusion Assessment Method (CAM) scores without postoperative delirium, superior patient satisfaction, milder shoulder pain, earlier out-of-bed activity and shorter hospital stay; additionally, the ST group consumed fewer intraoperative anesthetics and exhibited better analgesic effects than the S group, while the slight difference in morphine consumption between the STA and ST groups was not statistically significant. Conclusions Combined application of TAPB and paracetamol mannitol can effectively alleviate early postoperative pain, cut down opioid consumption, relieve pain-induced restrictions on out-of-bed activity and improve satisfaction in elderly patients undergoing laparoscopic radical gastrectomy, which greatly optimizes postoperative pain management; meanwhile, paracetamol mannitol brings no extra risks to gastrointestinal function recovery or gastrointestinal bleeding, ensuring its safe application for postoperative analgesia in this elderly patient population.
Background: Gastroesophageal reflux disease (GERD) is a prevalent condition with significant impact on quality of life. When medical therapy fails, surgical intervention—most commonly Nissen (NF) or Toupet fundoplication (TF)—is indicated. The optimal technique, however, remains debated. Aim: To compare the efficacy, functional outcomes, and complication profiles of Nissen and Toupet fundoplication in the surgical management of GERD. Methods: A systematic review was conducted in accordance with PRISMA guidelines. PubMed/MEDLINE, Cochrane, SciELO, and LILACS databases were searched for studies published between 2002 and 2025. Randomized controlled trials and cohort studies comparing NF and TF with at least 12 months of follow-up were included. Primary outcomes were postoperative dysphagia and reflux control. Secondary outcomes included proton pump inhibitor (PPI) use, quality of life (QoL), patient satisfaction, and reoperation rates. Results: Nine studies comprising 2,130 patients were included, including six randomized controlled trials. Both techniques provided effective and sustained reflux control. Nissen fundoplication demonstrated higher postoperative lower esophageal sphincter pressure and slightly better objective acid suppression in some studies; however, this did not translate into superior long-term clinical outcomes. Toupet fundoplication was associated with lower rates of early postoperative dysphagia and better preservation of esophageal motility. Long-term outcomes—including PPI use, QoL, and patient satisfaction—were comparable between techniques. Differences in dysphagia diminished over time. Conclusion: Nissen and Toupet fundoplication offer equivalent long-term control of GERD. While NF provides greater sphincter augmentation, TF achieves similar clinical outcomes with fewer early functional side effects. Surgical decision-making should prioritize esophageal motility and patient-specific characteristics rather than maximal acid suppression alone.
Aim: The aim of this study was to investigate the epidemiological, anatomo-clinical and therapeutic aspects of cancers of the digestive tract. Material and Methods: This was a retrospective descriptive study lasting 6 years (January 1, 2014 to December 31, 2019), based on the complete records of patients hospitalized and operated on for histologically proven digestive tract cancers. Results: Out of 4681 patient records, we collected 297 cases of digestive cancers (6.34%). The mean age was 52.70 years. Male predominance was noted, with a sex ratio of 1.17. Fifty-seven percent of patients resided in Conakry, and 64.30% of cases were treated at the Donka oncology unit. Housewives were most represented, with a predominance of married patients; alcohol was the most common vice (7.07%). Gastro-duodenal ulcer was the most common comorbidity. The average consultation time was 9.86 ±10.4 months; 29.62% of patients were seen after more than 9 months. The clinical picture was dominated by epigastralgia, nausea and vomiting. The stomach was the predominant site, followed by the colon. For histological analysis, surgical specimens were the most common. Adenocarcinoma was the most frequent histological type, and macroscopically, the infiltrating type was the most common. Surgical treatment was the most common, with tumor resection the most frequently performed procedure. Follow-up was uncomplicated in 71.04% of cases, with morbidity of 5.05% and mortality of 23.91%. Conclusion: Cancers of the digestive tract are frequent, of late diagnosis and of poor prognosis. Equipping hospitals, screening and early treatment, as well as raising public awareness, could improve prognosis.
Objective: To report on the experience of the general surgery department at Ignace Deen National Hospital, Conakry University Hospital (Guinea), in the surgical management of colon cancer complicated by acute intestinal obstruction. Patients and methods: This was a retrospective descriptive study conducted over a seven-year period (January 2017-December 2023). All patients who underwent emergency surgery for histologically confirmed occluded colon cancer were included. The data analyzed included sociodemographic characteristics, ASA status, intraoperative data, surgical procedures performed, and postoperative outcomes. Statistical analysis was performed using EPI Info 7.2.3.1 software. Results: Seventy-eight patients were included, with a mean age of 59.2 ± 28.7 years and a predominance of males (sex ratio = 1.52). The majority of patients were classified as ASA III (44.9%). The left colon, particularly the sigmoid colon, was the most common tumor location (51.3%). The main surgical procedures performed were right hemicolectomy with immediate restoration of continuity (48.7%) and left colectomy with stoma (44.9%). Postoperative morbidity was 19.2% and mortality was 26.9%. The average length of hospital stay was 16.4 days. Conclusion: Surgical treatment of colon cancer with obstruction remains associated with high mortality. An individualized treatment strategy, taking into account the patient's condition, tumor location, and available resources, remains essential to improve prognosis.
Objective. The objective of this study was to evaluate the results of emergency colectomies for acute intestinal obstruction due to pelvic colon volvulus. Patients and methods. This was a two-year prospective study involving 48 cases of pelvic colon volvulus operated on in the General Surgery Department of Ignace DEEN National Hospital between January 1, 2021, and December 31, 2022. This study involved 38 men and 10 women, with a mean age of 49.5 years. All patients presented with clear signs of occlusive syndrome consistent with pelvic colon volvulus. All patients underwent median xyphopubic laparotomy. Patients were divided into two groups. Group I consisted of 34 patients who had undergone an ideal colectomy, and group II consisted of 14 patients who had undergone a colectomy combined with a Bouilly-Volkman or Hartmann colostomy (n = 14), followed by restoration of colonic continuity. Mortality and morbidity were compared for the two groups. The overall mortality rate was 14% (7/48). In group I, this rate was 20% (7/34) and 7.14% (1/14) in group II. Conclusion. In this study, the mortality rate was higher after ideal colectomy than after two-stage colectomy. We recommend conducting a prospective study on a larger sample and encourage two-stage emergency colectomy in the management of pelvic colon volvulus.
Background: Positive teamwork attitudes are crucial components of effective interprofessional collaboration, which is crucial to promoting patient safety and quality healthcare, with these attitudes being developed and influenced during the formative years of professional education. Aim: The aim of this study was to analyse the determinants of positive teamwork attitudes, specifically examining the influence of age, gender, and academic progression among Nigerian nursing students. Methods: A descriptive cross-sectional design was used to examine 218 clinical nursing students from level two to five at the University of Port Harcourt, Nigeria. Each participant was selected using a stratified random sampling to ensure impartial. Data was collected using a structured, self-administered questionnaire that was adapted from Huyen's (2010) questionnaire. Each instrument had a section focusing on socio-demographic characteristics of each student and an attitude scale to measure their perceptions of teamwork learning skills. The data was analysed using descriptive statistics and Analysis of Variance (ANOVA) to check whether or not any associations between the determinants and attitude scores were significant with SPSS version 27.0. <0.05 was considered statistically significant. Results: The collective disposition towards teamwork was highly positive (Mean score = 34.15 ± 4.40 on a range of 8 to 40). A one-dimensional analysis of covariance (after evaluating covariant homogeneity using Levene's test) showed that age (F=2.816, p=0.026), gender (F=7.791, p=0.006), and level of study (F=2.887, p=0.037) were all statistically significant determinants of attitudes towards teamwork. Female students reported significantly more positive attitudes (M=34.72 ± 2.83) than their male counterparts (M=32.97 ± 6.42). Age generally had a positive linear relationship with attitudes toward teamwork, with the most positive attitudes reported among students older than 23 years (M=36.64 ± 1.81). There was no discernable linear relation with level of study, but attitudes peaked among 3rd year students (M=34.91 ± 2.91), and then dropped among 4th year students (M=32.16 ± 4.18). Conclusion: Age, gender, and academic transition appear to be important factors that influence the teamwork beliefs of Nigerian nursing students. The results highlight the variability of teamwork attitudes among groups of students and within the same cohort of students as they progress through the program. Nursing education programs should adopt specific and considered longitudinal approaches to building and maintaining positive collaborative attitudes in consideration of these factors to prepare students for contemporary healthcare practice.
Synthetic absorbable meshes have emerged as a viable alternative to acellular dermal matrices (ADMs) in prosthetic breast reconstruction, offering potential advantages in safety, cost, and handling. Safil® Mesh, a synthetic absorbable polyglactin mesh, has been increasingly adopted in clinical practice; however, real-world data on its performance remain limited. This study aimed to evaluate the safety and clinical performance of Safil® Mesh in breast reconstruction procedures performed at Hospital Universitario de Salamanca. Most patients were classified as ASA II. Safil® Mesh was predominantly used for post-mastectomy breast reconstruction, accounting for 92.2% of cases, with breast cancer as the primary indication in 89%. The mean operative time was approximately 200 minutes, and no intraoperative complications were reported. During follow-up, postoperative complications occurred in 13.6% of surgeries, most commonly prosthesis extrusion (3%), infection (2%), and hematoma (2%), with no complications directly attributed to the mesh. Surgical reintervention was required in 8% of patients, mainly due to implant-related issues. These findings are consistent with previously published long-term observational data on synthetic absorbable meshes, which demonstrate comparable or lower complication rates relative to ADM-based reconstructions. Overall, Safil® Mesh demonstrated a favorable safety profile, with no intraoperative complications and a low incidence of postoperative adverse events. The absence of mesh-related complications and outcomes comparable to those reported in the literature support Safil® Mesh as a reliable alternative to ADMs. Further prospective, multicenter studies are warranted to confirm these findings and assess long-term outcomes.
This review systematically analyzed the risk factors for perioperative vision loss (POVL) and temporary perioperative vision loss (TPOVL) from the perspectives of anatomy and pathophysiology in non-ophthalmic surgeries. The study confirmed that in cases of POVL, the prognosis of TPOVL is the best, because the damaging factors causing TPOVL are reversible and can heal on their own under medical intervention or without intervention, while POVL may lead to irreversible severe consequences because its damaging factors are irreversible. This article also summarizes the current effective treatment plans for individual cases. The conclusion emphasizes that the development of postoperative POVL has strong individual differences. Patients undergoing different surgeries not only share common perioperative POVL risk factors, but also have different risk characteristics and unique pathophysiological features. Personalized strategies should be developed based on the individual patient's condition and surgical method to control risk factors, thereby reducing the incidence of POVL or converting it into TPOVL, and ultimately achieving the best therapeutic effect. At the same time, in the future, with more data support, it may be possible to establish a risk prediction model for POVL and TPOVL, so that more precise medical interventions can be taken during the perioperative period to reduce the probability of occurrence of these two complications and evaluate the prognosis. This is one of our important future work directions.
Objective: This study aims to investigate the effects of different weight-bearing exercise therapies combined with conventional drug treatment on knee biomechanics and functional outcomes in patients with early-stage knee osteoarthritis (KOA), conduct comparative analyses, clarify the clinical value of progressive load training, and provide evidence-based support for optimizing conservative treatment strategies for early-stage KOA. Methods: A total of 150 patients with unilateral KOA meeting Kellgren-Lawrence grade I-II criteria were enrolled and randomly assigned to three groups: conventional drug therapy (control group), non-weight-bearing exercise therapy, and progressive weight-bearing exercise therapy, with 50 patients in each group. The intervention period lasted 12 weeks. Patients underwent assessments of Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) scores, Visual Analogue Scale (VAS) scores, Timed Up and Go Test (TUG), Stair Climbing Test (SCT), and isometric quadriceps strength testing at baseline and at weeks 4, 8, and 12. The progressive loading group incorporated 5-pound and 10-pound resistance bands during training. Results: Patients in the progressive resistance group demonstrated the most significant improvements in WOMAC scores, VAS scores, TUG, SCT, and isometric strength tests (P<0.01). Compared to the conventional therapy group, the non-resistance exercise group also showed some improvement, but the effect was inferior to that of the progressive resistance group. Gait parameter analysis revealed that the progressive resistance group exhibited marked improvements in stride length and stance time, indicating superior knee stability and lower limb function. Conclusion: Progressive weight-bearing exercise therapy combined with conventional drug treatment significantly enhances quadriceps strength, improves joint function, alleviates pain, and optimizes gait mechanics in patients with early-stage KOA. This approach demonstrates superior safety, efficacy, and practicality compared to traditional drug therapy and non-weight-bearing exercise interventions, making it suitable for widespread adoption in primary care facilities and rehabilitation centers.
Background: Pediatric musculoskeletal surgical conditions pose a major public health challenge in Ethiopia, similar to other low-middle income countries. There is a dearth of information about a pattern of pediatric musculoskeletal surgical diseases. Understanding the burden of these disorders in children will inform capacity building efforts, resource allocation and training. This study aimed to assess the pattern and magnitude of pediatric orthopedic surgical disorders among patients admitted to Tikur Anbessa Specialized Hospital (TASH), Addis Ababa, Ethiopia. Methods: Clinical records that included the admission and discharge registry data were retrospectively reviewed for pediatric orthopedic patients (0- 15 years) admitted at TASH between September2017 and August 2021. Data recorded were age, sex, diagnosis, treatment and discharge recommendations. Results: A total of 726 children were admitted to the pediatric orthopedic unit during the study period. Of these 482 (66.4%) were male and 244 (33.6%) were female. The most common diagnoses were trauma (n=278, 38.3%, infection (n=161, 22.2%), musculoskeletal tumors (n=95, 13.0%), and congenital anomalies (n=78, 11.0.3%). Conclusions: Findings demonstrate a wide spectrum and pattern of pediatric orthopedic conditions that require surgical admission at TASH. As the largest national specialized teaching and tertiary referral center in the country, these findings give insight into different types of musculoskeletal surgical disorders in children. This highlights the need to increase the capacity to care for specific musculoskeletal conditions in the pediatric population of Ethiopia.
Colorectal cancer is the most common form of digestive cancer. The aim of this study was to investigate the therapeutic aspects of colon cancer. Patients and method: This was a descriptive study with retrospective data collection, from January 2020 to June 2023 (3 years and 6 months), including all patients treated in the digestive surgery department of the Brazzaville University Hospital for colon cancer. Results: During the study period, 64 patients were treated for colon cancer, representing a frequency of 2.9% of all hospitalised patients. The average age of our patients was 54.8 ± 14.02 years (extremes 29 and 79 years), with a predominance of males (sex ratio 1.8). Most patients were referred to us by gastroenterologists. Cancer was diagnosed preoperatively in 20 patients. Thoracic-abdominopelvic CT scans in 82% of patients showed irregular thickening of the colonic wall. All patients underwent laparotomy. Right colectomy with tumour removal was performed in 20 patients; left colectomy in 29 patients; right colectomy combined with antrectomy with tumour removal as a single block in one patient; left colectomy combined with antrectomy and caudal pancreatectomy with tumour removal as a single block in one patient; and left segmental colectomy (sigmoidectomy) was performed in 8 patients. Lymph node dissection was satisfactory in 42 patients and inadequate in 9. The resection limits were healthy in all our patients. Post-operative management was straightforward in most patients. Conclusion: Colonic cancers are the most common cancers of the digestive tract. It is treated surgically. when operated on at an early stage, it improves survival.
To investigate the risk factors for intraoperative femoral metaphyseal fractures during primary hip hemiarthroplasty (HHA). A retrospective analysis was conducted on patients who underwent primary HHA at our hospital from February 2013 to February 2023. Patients who sustained intraoperative femoral metaphyseal fractures were included in the study group, while those without fractures were included in the control group. Patient data, including age, sex, body mass index (BMI), surgical indication, Dorr classification of the femoral canal, Singh index, and pre- and postoperative Harris scores, were analyzed to identify risk factors for intraoperative fractures. A total of 2,795 cases were followed up, of which 103 experienced intraoperative femoral metaphyseal fractures, with an incidence rate of 3.6%. The Dorr classification of the femoral canal and the Singh index were identified as risk factors for intraoperative fractures during HHA. Further multivariate logistic regression analysis showed That the Dorr classification was an independent risk factor for intraoperative femoral fractures. For patients with preoperative risk factors undergoing primary HHA, careful preoperative planning and adequate intraoperative exposure are essential to minimize the occurrence of femoral metaphyseal fractures.
Background: Our previous publication in RAS, Research Article: The Lavender Way - Lavender Procedure, a Way to Defeat Breast Cancer Without Surgery, Chemotherapy, or Radiation. A Clarion Call for Radical Change, did not detail what we consider to be an extremely valuable contribution of treating breast cancer with cryoablation aka The Lavender Procedure. That contribution is the dramatic positive change in the patient’s psychology in their journey to defeat breast cancer. While our primary focus was to adequately kill the cancer, we failed to recognize the dramatic change in our patient’s attitude until months later. We continued to observe this positive change for years. This paper details those changes. Materials and Methods: Our practice is divided into two separate entities, The Lavender Way, which enables The Lavender Procedure. The Lavender Way encompasses multiple non-radiation diagnostic modalities plus mammography, when necessary, that permits us to ferret out nascent breast cancers before many attain the capacity to metastasize (5-8 mm). Please review the above paper. Our intent is to humanize the entire experience of the diagnosis and treatment of breast cancer. This approach changes everything. Conclusion: It has been our experience that by humanizing the diagnosis and treatment of breast cancer, the horrific psychological side effects of breast cancer such as anxiety, fear of dying, fear of disfigurement, fear of loss of femininity, fear of losing a husband and fear of leaving children behind all dissipate. These positive effects are permanent. It all stems from the humanization at our Visionary Breast Center years before a cancer occurs. We incorporate family members into pre-procedural activities as well as the procedure itself.
Introduction: The aim of the study was to evaluate the management of eviscerations in the general surgery department. Materials and methods: retrospective, descriptive study over one year (January to December 2024), conducted in the general surgery department of CHU Ignace Deen. All patient records admitted and operated on in the department who experienced postoperative evisceration and those received for postoperative evisceration were included in the study. The variables were sociodemographic, clinical, therapeutic, and evolutionary. Results: during the study, post-operative eviscerations accounted for 3.9% of all service activities (N= 1424). The average age was 36.3 years, with extremes of 12 and 75 years. There was a female predominance (78.57%), with a sex ratio (M/F) of 0.27. The coverage of care-related expenses was provided by the family (75%). The initial diagnosis was dominated by cesarean sections (42.86%), followed by generalized acute peritonitis (25%). The average time to evisceration occurrence was 8.2 ±23 days, with extremes of 3 and 18 days. The postoperative complication that occurred before the onset of evisceration was infection of the surgical site (39.29%) and fistula (12.5%). Abdominal pain was the main reason for consultation (100%). The site of evisceration was median supra and infraumbilical (21.43%). The most eviscerated organ was the small intestine (64.29%). All patients were operated on (100%). Patients were operated on urgently in 64.29% of cases. An intestinal suture was performed in 7 patients (12.5%), intestinal resection in one patient (1.78%), a layer-by-layer wall repair was performed in 53 patients (94.64%), and the Paletot technique was used in 3 patients (5.36%). The postoperative outcomes were uncomplicated in 41 patients (73.21%), we noted an infection at the surgical site in 9 patients (16.07%) and a re-evisceration in one patient (1.79%). We recorded 3 deaths (5.36%). The average length of hospital stay was 18±3.2 days. The postoperative outcomes were uncomplicated in 41 patients (73.21%), we noted an infection at the surgical site in 9 patients (16.07%) and a re-evisceration in one patient (1.79%). We recorded 3 deaths (5.36%). The average length of hospital stay was 18±3.2 days. Conclusion: eviscerations are quite common and most often occur in an emergency context.
Introduction: The goal the aim of this study was to describe the epidemiological, therapeutic and prognostic factors of digestive surgical emergencies at the Kindia regional hospital. Methodology: This was a prospective descriptive study lasting 6 months on patients admitted and operated on for a digestive surgical emergency in the general surgery department of the Kindia regional hospital. Results: We recorded 103 cases of digestive surgical emergencies among the 219 patients admitted and operated on, i.e. a frequency of 31.9%. The average age of the patients was 30 years ± 5 years (10 and 64 years). The sex ratio was 1.5. Pupils/students were the most frequent (33.01%). Direct admissions constituted 64.07%. The majority of patients (73.83%) consulted more than 24 hours after the onset of symptoms. Abdominal pain was the main symptom, i.e. 100. More than half of the patients (69.90%) were operated on within 24 hours of admission. Appendectomies were the main techniques performed. We recorded 25.24% complications and 7.77% deaths. Delay in consultation and treatment were factors of poor prognosis. Conclusion: Digestive surgical emergencies constitute a public health problem in our context; raising public awareness and improving the technical platform would contribute to significantly reducing the morbidity and mortality rate.
Background: Commonly, primary hyperparathyroidism is caused by a single parathyroid adenoma; a smaller fraction are hyperplasia, or multigland disease. Prelocalization of the diseased parathyroid gland is key to effective parathyroidectomy. Focused parathyroidectomy has become the standard treatment for selected patients with primary hyperparathyroidism. The aim is to assess the role of preoperative localization before doing focused parathyroidectomy. Methods: From July 2022 to June 2023, this cross-sectional study was conducted at Bangabandhu Sheikh Mujib Medical University's general surgery department in Dhaka. 14 patients with primary hyperparathyroidism had focused parathyroidectomy. Statistical analysis of the results was obtained by using window-based computer software with IBM SPSS statistics (Version 22). Results: The male-to-female ratio was 2.5:1, and the mean age was 32.36 years (SD = 9.76). The sensitivity, specificity, and accuracy for the ultrasound’s validity test were 75.0%, 50.0%, and 71.4%, respectively. The validity test for the Sestamibi scan has an accuracy of 85.7%, a specificity of 0.0%, and a sensitivity of 100.0%. The biochemical frozen section validity test's sensitivity, specificity, accuracy, and positive and negative predictive values were all 100%. The majority of individuals (85.7%) in the histopathology study investigation had parathyroid adenoma. The range of the postoperative hospital stay was 2 to 19 days, with an average of 8.2±6.26 days. Not all patients who underwent surgery had ugly scars. Conclusion: Preoperative localization enables patients to have focused parathyroidectomy, which is potentially cost effective, reduce postoperative complication, hospital stay with good cosmesis and patient satisfaction; ultimately improve postoperative outcome.
