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

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https://read.qxmd.com/read/30264945/the-college-of-nuclear-physicians-of-south-africa-practice-guidelines-on-peptide-receptor-radionuclide-therapy-in-neuroendocrine-tumours
#1
I Lawal, L Louw, J Warwick, N Nyakale, R Steyn, T Lengana, T Lengana, A Ellmann, T Kotze, M Vangu, M Vorster, M Sathekge
BACKGROUND: Peptide receptor radionuclide therapy (PRRT) for metastatic or inoperable neuroendocrine tumours (NETs) is a systemic therapy which targets somatostatin receptors overexpressed by differentiated NETs for endoradiotherapy. This guideline has been compiled by the College of Nuclear Physicians of the Colleges of Medicine of South Africa, with endorsement by the South African Society of Nuclear Medicine and the Association of Nuclear Physicians to guide Nuclear Medicine Physicians in its application during the management of these patients...
September 2018: South African Journal of Surgery. Suid-Afrikaanse Tydskrif Vir Chirurgie
https://read.qxmd.com/read/30264944/tympanoplasty-surgery-a-retrospective-audit-of-surgical-outcomes-at-a-regional-hospital
#2
S Naidoo, O Edkins, V Naran, S Liebenberg
BACKGROUND: Chronic Suppurative Otitis Media (CSOM) is a common condition in our setting, resulting in tympanoplasty surgery being one of the common surgical procedures performed. Little is published regarding outcomes of tympanoplasty surgery in patients living with Human Immunodeficiency Virus (HIV), which has a high prevalence in South Africa. METHODS: A retrospective review of all tympanoplasty surgeries performed at our institute. Outcomes of surgery according to patient demographics, documented HIV status, seniority of surgeon, type and techniques of graft placement and hearing outcomes were reviewed...
September 2018: South African Journal of Surgery. Suid-Afrikaanse Tydskrif Vir Chirurgie
https://read.qxmd.com/read/30264943/human-immunodeficiency-virus-hiv-infection-in-men-with-penile-carcinoma-is-associated-with-increased-prevalence-of-human-papilloma-virus-infection-and-younger-age-at-presentation
#3
S W Wentzel, L P Vermeulen, C A Beukes, J Thiart, G Joubert, J Goedhals
BACKGROUND: We investigated the prevalence of HIV and human papilloma virus (HPV) infection in men with penile carcinoma. METHODS: This retrospective study investigated all men with penile carcinoma at the Universitas Academic Hospital in Bloemfontein, South Africa (January 2000-December 2008). Patients' age, HIV status, histological type of carcinoma and evidence of HPV infection were recorded. Statistical analyses included Student's t-test and Fisher's exact test where appropriate (2-tailed p-value < 0...
September 2018: South African Journal of Surgery. Suid-Afrikaanse Tydskrif Vir Chirurgie
https://read.qxmd.com/read/30264942/fournier-s-gangrene-outcome-analysis-and-prognostic-factors
#4
C S Meki, T I Mangwiro, J Lazarus
BACKGROUND: Fournier's gangrene is an infective necrotising fasciitis of the external genitalia and perineum associated with significant morbidity and mortality. The factors associated with non survival have been described but are not universally accepted. The identification of prognostic factors remains critical to improve outcomes. OBJECTIVE: To determine the hospital based mortality and factors associated with non-survival among subjects with a clinical diagnosis of Fournier's gangrene...
September 2018: South African Journal of Surgery. Suid-Afrikaanse Tydskrif Vir Chirurgie
https://read.qxmd.com/read/30264941/evaluation-of-locally-manufactured-patient-specific-custom-made-implants-for-cranial-defects-using-a-silicone-mould
#5
A J Vlok, S Naidoo, A S Kamat, D Lamprecht
BACKGROUND: Cranial vault defects can pose a significant problem for neurosurgeons where autologous bone is no longer available for cranioplasty. Numerous materials exist to create implants which include polymethyl methacrylate (PMMA) and titanium. A technique using 3-dimensional CT scan reconstruction of a cranial defect and creating a silicon mould which can be autoclaved in theatre to create a PMMA implant was developed. OBJECTIVE: The aim of this study is to evaluate the efficacy, cosmetic result, safety and cost-effectiveness of this procedure and compare this to existing techniques...
September 2018: South African Journal of Surgery. Suid-Afrikaanse Tydskrif Vir Chirurgie
https://read.qxmd.com/read/30264940/the-causes-of-burn-wounds-among-adult-patients-treated-at-pelonomi-tertiary-hospital-bloemfontein
#6
B Daffue, D Moolman, S Ferreira, L Roos, L Schoeman, S Ja Smit, G Joubert
BACKGROUND: Burn injuries account for approximately 180 000 deaths per annum, mostly in low- and middle-income countries. METHOD: This was a prospective, cross-sectional study. The target population consisted of adult patients, hospitalised for burn wounds at Pelonomi Tertiary Hospital in Bloemfontein, between July 2016 and early January 2017. Relevant data was collected by means of a structured interview using a questionnaire. RESULTS: A total of 49 patients were interviewed during the study period...
September 2018: South African Journal of Surgery. Suid-Afrikaanse Tydskrif Vir Chirurgie
https://read.qxmd.com/read/30264939/requiem-for-nigro-or-is-anal-squamous-carcinoma-still-a-surgical-problem-abdominoperineal-excision-rather-than-a-defunctioning-stoma
#7
J C Kloppers, B Robertson, P A Goldberg, E Dt Coetzee
BACKGROUND: Combined multimodal treatment (CMT) is the preferred treatment for anal squamous carcinoma with radical surgery reserved for treatment failure. Some patients require a defunctioning stoma prior to CMT. Successful closure of such a stoma is unlikely. Abdominoperineal excision (APE) may be suitable as primary treatment in these patients. METHOD: A retrospective review of all patients with anal squamous carcinoma was undertaken. Patients who required defunctioning colostomies prior to CMT were analysed for potential resectability of tumour prior to CMT and rate of permanent stoma...
September 2018: South African Journal of Surgery. Suid-Afrikaanse Tydskrif Vir Chirurgie
https://read.qxmd.com/read/30264938/demographic-and-histological-subtypes-of-hurthle-cell-tumours-of-the-thyroid-in-a-south-african-setting
#8
V Malith, I Bombil, N Harran, T E Luvhengo
BACKGROUND: Report of Hurthle cells following fine needle aspiration cytology from a thyroid nodule raises possibility of Hurthle cell carcinoma (HCC), which is a distinct entity and accounts for 3-10% of thyroid malignancies. AIM: To determine if there are demographic and histopathological features which may be used to differentiate HCC from Hurthle cell adenoma (HCA). METHOD: Histopathology records of patients who had thyroidectomy from January 2001 to October 2015 were reviewed...
September 2018: South African Journal of Surgery. Suid-Afrikaanse Tydskrif Vir Chirurgie
https://read.qxmd.com/read/30264937/spectrum-of-disease-and-outcome-of-primary-amputation-for-diabetic-foot-sepsis-in-rural-kwazulu-natal
#9
S Cheddie, C G Manneh, B Pillay
BACKGROUND: Primary amputation (stump closure) for diabetic foot sepsis is perceived to have a higher re-amputation rate due to stump sepsis. A guillotine amputation with elective stump closure is widely practised due to the lower risk of stump sepsis and re-amputation. AIMS: To provide an epidemiological analysis of the spectrum of disease and outcomes of primary amputation for diabetic foot sepsis in a regional rural hospital. METHODS: A prospective cohort study of 100 patients who underwent surgery for diabetic foot sepsis over a 5-year period was undertaken at Madadeni Provincial Hospital, in northern KwaZulu-Natal...
September 2018: South African Journal of Surgery. Suid-Afrikaanse Tydskrif Vir Chirurgie
https://read.qxmd.com/read/30264936/surgery-for-giant-tumours-of-the-breast-a-15-year-review
#10
M Daya, T Balakrishnan
BACKGROUND: Giant tumours of the breast tend to occur in the adolescent age group. Racial predilection has been noted in the literature. The mass often occupies most of the breast, leading to its distortion. Many authors have advocated a mastectomy for benign tumours that severely distort the breast. Giant benign tumours when treated by simple excision risk persistence of asymmetry. To avoid this asymmetry, some authors have resorted to excision and immediate reduction mammaplasty. The aim of this retrospective study was a report on giant tumours of the breast presenting to a plastic surgery unit and to analyse demographic factors, clinical presentations, tumour pathology, management, complications, as well as patient and breast outcomes...
September 2018: South African Journal of Surgery. Suid-Afrikaanse Tydskrif Vir Chirurgie
https://read.qxmd.com/read/30264935/surgical-resources-in-south-africa-a-review-of-the-number-of-functional-operating-theatres
#11
A J Dell, D Kahn
BACKGROUND: Surgery has previously been neglected as a development initiative, despite the obvious effect of surgical illnesses on morbidity and mortality. Recently, greater attention has been given to surgical services, as there is growing evidence of cost-effectiveness of surgical interventions. Operating theatre numbers have been used as a measure of surgical capacity, despite there being limitations associated with this use of this metric. This study aims to analyse part of the surgical resources in South Africa...
September 2018: South African Journal of Surgery. Suid-Afrikaanse Tydskrif Vir Chirurgie
https://read.qxmd.com/read/30010267/investigating-racial-differences-in-clinical-and-pathological-features-of-prostate-cancer-in-south-african-men
#12
M Dewar, L Kaestner, Q Zikhali, K Jehle, S Sinha, J Lazarus
BACKGROUND: Men with West African ancestry living in Europe and North America are at higher risk of being diagnosed with prostate cancer, are diagnosed at a younger age, and have more severe disease characteristics. Published reports present a conflicting picture of the disease in sub-Saharan Africa. We aimed to study the clinical and pathological features of men undergoing prostate biopsy from different racial backgrounds in South Africa in an attempt to characterise the disease locally...
June 2018: South African Journal of Surgery. Suid-Afrikaanse Tydskrif Vir Chirurgie
https://read.qxmd.com/read/30010266/open-versus-laparoscopic-appendicectomy-in-acute-appendicitis-results-of-a-district-general-hospital
#13
D Zosimas, P M Lykoudis, A Pilavas, J Burke, P Leung, G Strano, V Shatkar
BACKGROUND: Despite multiple studies comparing the two methods, the real advantages of laparoscopic appendicectomy (LA) compared to open appendicectomy (OA) are still unclear. Purpose of the current study was to compare the results between the two techniques in a district general hospital. METHODS: The electronic records of all patients who underwent OA or LA in a one year period were reviewed retrospectively. The comparative data points assessed included age, gender, overall complications, length of stay and Clavien-Dindo Classification of Surgical Complications, including the rates of the main types of complications...
June 2018: South African Journal of Surgery. Suid-Afrikaanse Tydskrif Vir Chirurgie
https://read.qxmd.com/read/30010265/association-between-crural-vessel-patency-and-successful-transmetatarsal-amputation-a-single-centre-experience
#14
Dariush Kamali, Matthew Thomas, Peter Van Loo, Ian Nichol
BACKGROUND: Transmetatarsal amputation (TMA) has a reputation for failure, centred around wound breakdown. No study has looked at the direct association between the patency of individual crural arteries and the healing of TMA. TMA relies on a posterior skin flap which derives its blood supply from the posterior tibial (PT) artery. We investigated the association between PT patency and achievement of successful TMA. METHODS: A retrospective review of all patients undergoing TMA for complications of peripheral arterial occlusive disease in a regional vascular tertiary referral centre over a 9 year period (2006-2015)...
June 2018: South African Journal of Surgery. Suid-Afrikaanse Tydskrif Vir Chirurgie
https://read.qxmd.com/read/30010264/suture-material-use-and-procurement-an-audit-of-a-public-hospital-surgical-system-in-gauteng-south-africa
#15
B Puttergill, D Kruger, M Brand, M G Veller
BACKGROUND: Surgical systems are integral to successful, safe and cost effective clinical practice and must balance surgical demands on consumable items and their costs. Suture material is a key consumable resource, and was evaluated in an audit of consumable use and cost as well as the procurement systems within the South African Gauteng public health care sector. AIMS: To determine suture use and cost in the four commonest general surgical procedures - abdominal wall closure, mastectomy, appendicectomy and inguinal hernia repair - in three academic Gauteng hospitals...
June 2018: South African Journal of Surgery. Suid-Afrikaanse Tydskrif Vir Chirurgie
https://read.qxmd.com/read/30010263/resection-of-biliary-mucinous-cystic-neoplasms-of-the-liver-a-prospective-cohort-series-of-13-consecutive-patients
#16
J C Kloppers, J Ej Krige, M M Bernon, S Burmeister, E Jonas, S R Thomson, P C Bornman
BACKGROUND: Biliary mucinous cystic neoplasms (BMCNs) are uncommon neoplastic septated intrahepatic cysts which are often incorrectly diagnosed and have the potential for malignant transformation. OBJECTIVE: To assess the outcome of surgical resection of BMCNs. METHOD: A prospective liver surgery database was used to identify patients who underwent surgery at Groote Schuur Hospital Complex for BMCN from 1999 to 2015. Demographic variables including age and gender were documented as well as detailed preoperative imaging, location and size, operative treatment, extent of resection, histology, postoperative complications and outcome...
June 2018: South African Journal of Surgery. Suid-Afrikaanse Tydskrif Vir Chirurgie
https://read.qxmd.com/read/30010262/an-evaluation-of-mini-laparotomy-cholecystectomy-in-the-laparoscopic-era-a-rural-experience
#17
A Balasubramanian, S Cheddie, N M Naidoo, B Singh
BACKGROUND: Laparoscopic cholecystectomy (LC) is the gold standard for the management of symptomatic cholelithiasis and complications of gallstone disease. Mini laparotomy cholecystectomy (MOC) may be a more appropriate option in the resource constrained rural setting due to its widespread applicability and comparable outcome with LC. The study aimed to provide an epidemiological analysis of gallstone disease in the rural population and to evaluate the outcome of MOC in a rural hospital...
June 2018: South African Journal of Surgery. Suid-Afrikaanse Tydskrif Vir Chirurgie
https://read.qxmd.com/read/30010261/sonar-guided-focused-parathyroidectomy-under-cervical-block
#18
I Bombil, L Louw, C Mitchell, F Mahlobo, R A Muganza, N R Madima
BACKGROUND: Presentation of hyperparathyroidism varies and is highly non-specific. The automated calcium analyzer has made the diagnosis easy. Similarly, the advent of Sestamibi scan has paved the way to minimally invasive parathyroidectomy indicated for parathyroid adenoma. There is no uniformity in the extent of minimally invasive parathyroidectomy that is done through limited incision under radio or sonar guidance and endoscopically. In this study, we are presenting the focused parathyroidectomy performed under sonar guidance and superficial cervical block (SCB)...
June 2018: South African Journal of Surgery. Suid-Afrikaanse Tydskrif Vir Chirurgie
https://read.qxmd.com/read/30010260/the-effect-of-pregnancy-and-delivery-on-anal-function-in-black-africans-and-indians
#19
T D Naidoo, J Moodley
BACKGROUND: Occult anal sphincter disruption, following childbirth may contribute to the development of anal incontinence (AI). The type and mechanism of injury may differ between first and subsequent deliveries. OBJECTIVES: To describe the effect of pregnancy and delivery on the endosonographic morphology of the anal sphincter and on anal sphincter pressures, and to highlight any differences in these between nulliparous and multiparous Black African and Indian women...
June 2018: South African Journal of Surgery. Suid-Afrikaanse Tydskrif Vir Chirurgie
https://read.qxmd.com/read/30010259/surgical-resources-in-south-africa-an-analysis-of-the-inequalities-between-the-public-and-private-sector
#20
A J Dell, J Klopper
BACKGROUND: The full extent of the global burden of surgical disease is largely unknown, however, the scope of the problem is thought to be large. Despite the substantial burden of surgical disease, surgical services are inaccessible to many of those who need them most. There are disparities between public and private sectors in South Africa, which compound inequitable access to surgical care. This study forms part of a series analysing surgical resources in South Africa. METHOD: This study involved a descriptive analysis of surgical resources and included the total number of hospitals, of hospital beds, the number of surgical beds, the number of general surgeons (specialist and non-specialist), and the number of functional operating theatres in South Africa...
June 2018: South African Journal of Surgery. Suid-Afrikaanse Tydskrif Vir Chirurgie
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