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South African Journal of Surgery. Suid-Afrikaanse Tydskrif Vir Chirurgie

journal
https://www.readbyqxmd.com/read/29638091/five-year-review-of-open-radical-nephrectomies-at-a-regional-hospital-in-south-africa-room-for-improvement
#1
A Singh, R J Urry, T C Hardcastle
BACKGROUND: To review the presentation and outcomes of patients undergoing open radical nephrectomy (ORN) for renal cell carcinoma (RCC) at a regional hospital in KwaZulu-Natal, South Africa. METHOD: A retrospective chart review was performed of patients having undergone nephrectomy at St Aidan's hospital between 2010 and 2015, focusing on those with RCC. Demographic, operative, histopathology and outcomes data were collected. RESULTS: Fifty-two patients (51%) had ORN for suspected malignant disease...
March 2018: South African Journal of Surgery. Suid-Afrikaanse Tydskrif Vir Chirurgie
https://www.readbyqxmd.com/read/29638090/distal-malignant-biliary-obstruction-a-prospective-randomised-trial-comparing-plastic-and-uncovered-self-expanding-metal-stents-in-the-palliation-of-symptomatic-jaundice
#2
M M Bernon, J Shaw, S Burmeister, G Chinnery, S Hofmeyr, J C Kloppers, E Jonas, J Ej Krige
BACKGROUND: The aim of this study was to determine the safety and clinical effectiveness of 10Fr plastic biliary stents compared to uncovered self-expanding metal stents (SEMS) for palliative treatment of patients with inoperable extra-hepatic malignant biliary obstruction in a public hospital in South Africa. METHOD: From January 2009 to December 2013, 40 patients who were admitted to a tertiary academic centre because of distal malignant biliary obstruction were enrolled in a prospective randomized study...
March 2018: South African Journal of Surgery. Suid-Afrikaanse Tydskrif Vir Chirurgie
https://www.readbyqxmd.com/read/29638089/pattern-of-mismatch-repair-protein-loss-and-its-clinicopathological-correlation-in-colorectal-cancer-in-north-india
#3
A Kumar, M Jain, A Yadav, N Kumari, N Krishnani
BACKGROUND: To determine the mismatch repair (MMR) protein loss in colorectal cancer (CRC) in north Indian patients and its clinicopathological correlation. METHOD: A prospective study on patients with colorectal cancer from a tertiary level hospital conducted between May 2014 and June 2015. MMR protein loss was determined using immunohistochemistry for MLH1, MSH2, PMS2 and MSH6. RESULTS: 52 patients (38 male and 14 females) of CRC, with median age of 52...
March 2018: South African Journal of Surgery. Suid-Afrikaanse Tydskrif Vir Chirurgie
https://www.readbyqxmd.com/read/29638088/malignant-and-pre-malignant-oesophageal-pathology-in-a-south-african-teaching-hospital
#4
E Loots, P K Ramdial, B Sartorius, C M Mulder, D L Clarke
BACKGROUND: South Africa (SA) has one of the highest global incidences of squamous cell carcinoma of the oesophagus (SCC). A decreasing incidence of oesophageal SCC in SA has been suggested. The study aimed to assess whether the incidence of these malignant histopathological subtypes has changed in this setting. METHOD: A retrospective review of histopathological reports on pre-malignant and malignant oesophageal lesions over three time periods (TP), namely: 2003-4 (TP1), 2008-9 (TP2) and 2013-14 (TP3) was carried out at Inkosi Albert Luthuli Central Hospital, Durban, South Africa...
March 2018: South African Journal of Surgery. Suid-Afrikaanse Tydskrif Vir Chirurgie
https://www.readbyqxmd.com/read/29638087/where-are-general-surgeons-located-in-south-africa
#5
A J Dell, D Kahn
BACKGROUND: Human resources are the backbone of health-care delivery systems and the lack of surgical workforce in developing countries is often the greatest challenge to providing surgical care. The workforce availability and composition is an important indicator of the strength of the health system. This study aimed to analyse the distribution of general surgeons within South Africa. METHOD: A descriptive analysis of the general surgical workforce in South Africa was performed...
March 2018: South African Journal of Surgery. Suid-Afrikaanse Tydskrif Vir Chirurgie
https://www.readbyqxmd.com/read/29638086/can-an-enhanced-recovery-after-surgery-eras-programme-improve-colorectal-cancer-outcomes-in-south-africa
#6
R L Oodit, O Ljungqvist, J Moodley
Colorectal cancer (CRC) is the third most common cancer worldwide and the fourth most common cause of cancer related deaths. It is estimated that CRC is amongst the top five malignancies in South Africa (SA) with an age standardised incidence rate of 10.2 and 6.1 per 100 000 for males and females respectively. The incidence is projected to increase in South Africa as a result of ageing, a growing population and an increase in prevalence of risk factors.
March 2018: South African Journal of Surgery. Suid-Afrikaanse Tydskrif Vir Chirurgie
https://www.readbyqxmd.com/read/29638085/a-perspective-on-paediatric-surgical-training-opportunities-and-challenges
#7
N Patel, J Loveland
Globally, the training of paediatric surgeons is facing numerous challenges. Exposure to rare and complex index pathology is vital in the training of competent paediatric surgeons, but it is this rarity and complexity that creates a fundamental challenge to training programmes the world over.
March 2018: South African Journal of Surgery. Suid-Afrikaanse Tydskrif Vir Chirurgie
https://www.readbyqxmd.com/read/29227056/the-value-of-supplementary-anatomy-workshops-for-improving-undergraduate-performance
#8
J Scott, G Louw, D Kahn
BACKGROUND: With many anatomy courses within the medical curriculum suffering reductions in lecture and dissection time, supplementary programs in anatomy have shown to improve performance of medical students. This study was conducted to evaluate the efficacy of anatomy workshops on undergraduate anatomy grade performance. METHOD: From 2012 to 2014, mean anatomy and physiology scores of medical students who attended anatomy workshops were compared to those who did not attend...
November 2017: South African Journal of Surgery. Suid-Afrikaanse Tydskrif Vir Chirurgie
https://www.readbyqxmd.com/read/29227055/does-the-reporting-of-gastro-intestinal-endoscopy-meet-the-minimal-terminology-standard-at-king-edward-viii-hospital
#9
S P Maharaj, M A Noorbhai, T E Madiba
BACKGROUND: The Minimal Standard Terminology (MST) was developed to standardise endoscopic reporting. This study is aimed at assessing current reporting at a tertiary hospital and whether it meets this Minimal Standard Terminology. METHOD: This was a retrospective observational study of upper endoscopy reports between January and December 2014. The data extracted were compared to the current reporting standard listed in the MST. To assess and grade the quality of reporting we developed a Gastrointestinal Reporting Score, which incorporates MST variables in addition to demographic details, indication for endoscopy, report legibility, sedation and the use of classification systems to describe pathology...
November 2017: South African Journal of Surgery. Suid-Afrikaanse Tydskrif Vir Chirurgie
https://www.readbyqxmd.com/read/29227054/auditing-surgical-service-provision-at-a-south-african-tertiary-institution-implications-for-the-development-of-district-services
#10
G L Laing, D L Skinner, J L Bruce, C Aldous, V Govindasamy, S R Thomson, D L Clarke
BACKGROUND: The optimal management of resources within South African state hospitals has been hampered by a paucity of data due to a lack of robust auditing information systems. This study reviews the use of a Hybrid Electronic Medical Record (HEMR) system to capture and aggregate data pertaining to the inpatient service demands on a South African tertiary surgical service. This dataset was used to analyse the appropriateness of tertiary surgical resource utilisation. METHOD: The HEMR system was implemented at Greys Hospital, in the city of Pietermaritzburg, Kwa-Zulu Natal, South Africa on 1 January 2013...
November 2017: South African Journal of Surgery. Suid-Afrikaanse Tydskrif Vir Chirurgie
https://www.readbyqxmd.com/read/29227053/quantifying-the-funding-gap-for-management-of-traumatic-brain-injury-at-a-major-trauma-centre-in-south-africa
#11
V Y Kong, J J Odendaal, J L Bruce, G L Laing, E Jerome, B Sartorius, P Brysiewicz, D L Clarke
BACKGROUND: Trauma is an eminently preventable disease. However, prevention programs divert resources away from other priorities. Costing trauma related diseases helps policy makers to make decisions on re-source allocation. We used data from a prospective digital trauma registry to cost Traumatic Brain Injury (TBI) at our institution over a two-year period and to estimate the funding gap that exists in the care of TBI. METHOD: All patients who were admitted to the Pietermaritzburg Metropolitan Trauma Service (PMTS) with TBI were identified from the Hybrid Electronic Medical Registry (HMER)...
November 2017: South African Journal of Surgery. Suid-Afrikaanse Tydskrif Vir Chirurgie
https://www.readbyqxmd.com/read/29227052/laparoscopy-or-clinical-follow-up-to-detect-occult-diaphragm-injuries-following-left-sided-thoracoabdominal-stab-wounds-a-pilot-randomized-controlled-trial
#12
G F Malherbe, P H Navsaria, A J Nicol, S Edu, S Chowdhury
BACKGROUND: The purpose of this study was to determine whether patients with left-sided thoracoabdominal (TA) stab wounds can be safely treated with clinical and chest X-ray follow up. METHOD: A prospective, randomized control study was conducted at Groote Schuur Hospital from September 2009 through to November 2014. Patients with asymptomatic left TA stab wounds included in the trial were randomized into two groups. Group A underwent diagnostic laparoscopy and Group B underwent clinical and radiological follow-up...
November 2017: South African Journal of Surgery. Suid-Afrikaanse Tydskrif Vir Chirurgie
https://www.readbyqxmd.com/read/29227051/serum-alcohol-levels-correlate-with-injury-severity-and-resource-utilization
#13
A I Elshiere, M A Noorbhai, T E Madiba
BACKGROUND: Alcohol consumption leads to violence and poor judgement. The resultant trauma is the leading cause of emergency department visits. In South Africa, alcohol-related emergency visits can be as high as 57%. The purpose of this prospective study was to establish the prevalence of positive blood alcohol and Blood Alcohol Concentration (BAC) at a tertiary trauma unit in Durban, and to correlate it with injury severity, length of hospital stay and resource utilization. METHOD: A total of 100 patients from King Edward trauma unit were analysed prospectively during the period December 2014 to February 2015...
November 2017: South African Journal of Surgery. Suid-Afrikaanse Tydskrif Vir Chirurgie
https://www.readbyqxmd.com/read/29227050/barriers-to-accessing-atls-provider-course-for-junior-doctors-at-a-major-university-hospital-in-south-africa
#14
J J Odendaal, V Y Kong, T Liu, B Sartorius, G V Oosthuizen, D L Clarke
BACKGROUND: Advanced trauma life support (ATLS) is the international standard of care and forms the basis of trauma training in South Africa. Previous local studies demonstrated a low completion rate among junior doctors (JD). This study was designed to determine the reasons and identify possible barriers of JDs to accessing the ATLS course at a major university hospital. METHOD: This was a prospective study utilising a structured survey that included all JDs who were undertaking their internship training...
November 2017: South African Journal of Surgery. Suid-Afrikaanse Tydskrif Vir Chirurgie
https://www.readbyqxmd.com/read/29227049/rib-fracture-fixation-in-a-south-african-public-trauma-service
#15
G V Oosthuizen, J De Wet, J L Bruce, D L Clarke
BACKGROUND: Rib fractures and flail chests have traditionally been treated nonoperatively. Current literature suggests that it is not only safe and feasible but also desirable to perform fixation of severe rib fractures. Our unit in the Pietermaritzburg public sector adopted rib fracture fixation in 2014 and in this audit we assess its feasibility in our setting. METHODS AND RESULTS: We audited our first nine cases of rib fracture fixation performed to date, of which seven were males...
November 2017: South African Journal of Surgery. Suid-Afrikaanse Tydskrif Vir Chirurgie
https://www.readbyqxmd.com/read/28876614/significant-clinical-and-patient-reported-outcomes-at-6-months-following-hernia-repair-with-an-absorbable-fixation-device
#16
H Bougard, C Doerhoff, S Bringman, M Chudy, C Romanowski, P Jones
BACKGROUND: Surgeons utilise various mesh fixation methods during hernia repair which may include tacks/straps and/or sutures. One of these tack/strap choices, is an absorbable fixation device, Securestrap® (ETHICON, Somerville, NJ), consisting of polydioxanone and L (-)-lactide/glycolide copolymer. The 6 month clinical results and patient outcomes with Securestrap® fixation are reported. METHOD: The International Hernia Mesh Registry, prospective multi-centre registry, designed to collect patient reported, longitudinal data on hernia mesh products and fixation methods...
September 2017: South African Journal of Surgery. Suid-Afrikaanse Tydskrif Vir Chirurgie
https://www.readbyqxmd.com/read/28876613/management-and-outcomes-from-appendectomy-an-international-prospective-multicentre-study
#17
J Camilleri-Brennan, T Drake, R Spence, A Bhangu, E Harrison
BACKGROUND: To identify variation in surgical management and outcomes of appendicitis across low, middle and high Human Development Index (HDI) country groups. METHOD: Multi-centre, international prospective cohort study of consecutive patients undergoing emergency appendectomy over a 6-month period. Follow-up lasted 30 days. Primary outcome measure was overall complication rate. RESULTS: 4546 patients from 52 countries underwent appendectomy (2499 high, 1540 middle and 507 low HDI groups)...
September 2017: South African Journal of Surgery. Suid-Afrikaanse Tydskrif Vir Chirurgie
https://www.readbyqxmd.com/read/28876612/laparoscopic-ventral-hernia-repair-a-single-surgeon-study-using-a-circumferential-transfascial-suture-technique
#18
G Campbell, R P Mills
BACKGROUND: The ideal technique for ventral primary and incisional hernia repair is unclear. There is a paucity of literature from South African authors. In this report, a standardised technique of intraperitoneal mesh placement and fixation is described. METHOD: A retrospective study of 152 patient records. Each patient underwent laparoscopic ventral hernia repair between 2007 and 2016 by a single surgeon. A standardised technique was used in every operation. In each case a circumferential mesh overlap of 5 centimetres from the defect was achieved...
September 2017: South African Journal of Surgery. Suid-Afrikaanse Tydskrif Vir Chirurgie
https://www.readbyqxmd.com/read/28876611/construction-and-validation-of-low-cost-laparoscopic-simulator-using-android-smartphone-and-pop-cast-and-a-laptop
#19
A Vyas, G Goel
Minimal invasive surgery training requires a lot of practice and for this purpose innovative tools are needed to develop methods for practice and training skills outside the operating room. Commercially available devices are readily available but cost effectiveness and availability are major limiting factors in resource limited setting. We present an innovative and cost effective laparoscopic simulator which can be easily manufactured and used for practice of laparoscopic surgery. Using a free android application, such as IP webcam we can relay video to laptop without the use of any cables and uniquely we use the flash of a camera as the light source and a selfie stick for movement of the camera...
September 2017: South African Journal of Surgery. Suid-Afrikaanse Tydskrif Vir Chirurgie
https://www.readbyqxmd.com/read/28876610/the-open-retrorectus-and-transversus-abdominus-release
#20
H Bougard
The open retrorectus approach to the repair of incisional hernias remains the gold standard approach despite the availability of multiple options. The addition of a transverses abdominus release to the procedure increases the number of patients and the complexity of the cases for which this approach is suitable. It facilitates midline closure in almost all cases, avoids significant neuromuscular bundle injury and dissection of poorly vascularized subcutaneous tissue, and allows the placement of a very large but simple mesh in a space outside the peritoneal cavity...
September 2017: South African Journal of Surgery. Suid-Afrikaanse Tydskrif Vir Chirurgie
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