Nigerian Journal of Surgery : Official Publication of the Nigerian Surgical Research Society

BACKGROUND: An exponential rise in the prevalence of obesity and the associated type 2 diabetes mellitus (T2DM) has led to an explosion in the field of bariatric surgery worldwide. It has been proposed that laparoscopic sleeve gastrectomy (LSG) not only results in excess weight loss (EWL) but also leads to excellent glycemic control. AIMS: However, not every patient benefits from the bariatric surgery. Furthermore, bariatric surgery is currently indicated based on body mass index (BMI), but BMI solely does not predict diabetes remission after the surgery...

Background: In adults, the majority of cases of intussusception are due to malignancy. Aims: The aim of the study is to describe the pattern of intussusception in the adult population diagnosed and treated at a tertiary care center. Subjects and Methods: Study Design: This is a retrospective cross-sectional study based on chart review, and data collection was made from the computer database and inpatient case records. Study Setting: Adult intussusception cases diagnosed and treated at a tertiary care referral center in South India...

Aim: Tracheomalacia is a potentially life-threatening, but a rare complication of thyroidectomy. In previous studies, the incidence rate was very different. Considering the relatively high prevalence of goiter and thyroidectomy in the West Azerbaijan region, we designed this study to determine the tracheomalacia incidence in patients who underwent thyroidectomy within a 10-year interval. Materials and Methods: This retrospective study was done in Urmia Imam Khomeini Hospital in West Azarbayjan Province...

Background: There is generally a lack of awareness among professional motorcycle riders on the risk of noise-induced hearing loss; due to a variety of factors, they are exposed to by the nature of their job. This study, therefore, aimed to determine the prevalence, awareness, and factors associated with noise-induced hearing loss among motorcycle riders in Ido-Ekiti, Ekiti State, Nigeria. Methodology: A cross-sectional descriptive study was conducted between February and March 2019 among 420 motorcycle riders in Ido-Ekiti, Ekiti State, Southwestern Nigeria...

Background: Postoperative pancreatic fistula (POPF) or leak from pancreaticojejunostomy (PJ) is one of the most common complications after pancreaticoduodenectomy (PD), with an incidence of 5%-30%. Various techniques have been advocated to bring down the incidence of POPF, but there is still none that can be called the "gold standard". Peng's binding PJ (BPJ) was proposed as a good method of performing PJ with low fistula rates; we present our results with BPJ. Methods: The data of all patients who underwent PD with BPJ between January 2016 and March 2018 were retrospectively analyzed for demographics, clinical features, type of procedure performed, complications (especially POPF), hospital stay, morbidity, and mortality...

Background: Postoperative pain varies from an individual to individual. It also varies with types and extent of surgery. In general, postoperative pain is inadequately managed in most centers worldwide, especially in developing countries. Therefore, this study presents the perception and satisfaction of postoperative pain management in emergency surgeries. Methods: A 1-year prospective study of the 891 patients who underwent emergency general surgeries at Ahmadu Bello University Teaching Hospital, from January to December 2018 is hereby presented...

Background: Breast cancer is the leading female malignancy in the world and now the most common cancer in Nigeria. The evaluation of patients with breast cancer requires stepwise diagnostic approach to achieve a combined diagnostic information required to make an enhanced decision on how best to approach management. The aim of this study is to evaluate the role of fine needle aspiration cytology (FNAC) in the triple assessment of patients with malignant breast lumps in our center. Patients and Methods: This is a descriptive prospective study of patients with palpable breast lumps over an eighteen-month period...

Background: Extremity fracture is an important component of musculoskeletal injury worldwide. The distributions of etiological factors and types of extremity fractures vary from and within subregions and have implications in preventive and treatment strategies. This study aimed at determining the incidence and pattern of extremity fractures seen in accident and emergency department (A and ED) of a teaching hospital in a developing country. Patients and Methods: This was a prospective study of all patients with extremity fractures seen in A and ED of Federal Teaching Hospital Abakaliki over 12 months between February 1, 2016 and January 31, 2017...

Background: The success rate of dental implants depends on the amount of crestal bone around the implants. Crestal module is the transosteal region of implant that is designed to receive the prosthetic component. The design of crestal module influences the crestal bone loss around implants. Aim: The purpose of this study was to evaluate and compare the crestal bone loss around implants with smooth collar and implants with micro threaded rough collar design. Materials and Methods: A total of 150 individuals received 100 dental implants...

Background: Decision-making in patients suspected of having acute appendicitis has remained a diagnostic challenge worldwide despite the advances in imaging and appendiceal surgery. There have been efforts to improve the diagnosis of appendicitis using clinical scoring systems. Aim: We evaluated and compared the diagnostic accuracy and role of Alvarado score (AS) and two of its modification (Kalan and Al-Fallouji) in the preoperative diagnosis of acute appendicitis...

Background: Breast cancer is the leading cancer in women. The most common histologic type of breast cancer is infiltrating ductal carcinoma. The mainstay of the treatment of breast cancer is surgery when the tumor is localized, followed by chemotherapy as well as radiotherapy (when indicated) and in estrogen receptor and progesterone receptor positive tumors, adjuvant hormonal therapy. Aims and Objectives: The aim of this study is to correlate tumor site and size with the level of axillary lymph node involvement (ALNI) in early and locally advanced breast cancer...

About 1.7 billion children and adolescents most of whom are in low- and middle-income countries lack access to safe and affordable surgical and anesthesia care when needed. 43% of Nigeria's population of 199 million are below the age of 15 years. In 2015, Nigeria had a pediatric surgeon workforce deficit of 693 for children <15 years. While threats and constraints to achieving universal health coverage in Nigeria have been highlighted, the role of research is often not included. Over the years, there has been a slow but progressive increase in pediatric surgical workforce and research output, both locally and with international collaborations, and in trainee involvement in research as lead authors...

Avulsion injuries of domes of the diaphragm are rare injuries and may occur following lateral thoracoabdominal trauma. We share our experience of two cases of avulsion injuries of the right dome of the diaphragm. Our first case presented within a week following blunt trauma to the abdomen, and on thoracotomy, an effective repair was performed by restoring attachment of the diaphragm to the parietes. Our second case presented with severe respiratory distress, 1½ months after sustaining blunt injury chest and abdomen in a road traffic accident and on thoracotomy was found to have a completely necrosed right hemidiaphragm, and hence, no repair could be performed...

The risk factors for abdominal wall hernia after surgery are an increase in body mass index, midline incision, incisional surgical-site infection, preoperative chemotherapy, blood transfusion, increasing age, female sex, and increasing thickness of subcutaneous tissue. Reconstructing the abdominal wall defect becomes a challenge in multiple risk factor patients. Many new mesh implants have been invented, but all fail in case of infections. We modified and re-evoked an old technique of fascia lata free graft reinforced with tensor fascia lata pedicled flap...

Dermoid cysts are developmental cysts, arising from entrapped midline ectodermal tissue lined by epidermis, with skin appendages present in the fibrous wall when the 1st and 2nd branchial arches of each side fuse and the entrapped tissues then undergo proliferation and cystic transformation. A 27-year-old male reported with a single large swelling in the submental region of 1-year duration, which was diagnosed as dermoid cyst after surgical excision using extraoral approach.

Blunt abdominal trauma is most frequent in the pediatric population. Duodenal lesions after abdominal trauma in children are infrequent and tend to be secondary to traffic accidents. It is up to five times more frequent in males, with an average age between 16 and 30 years. Bicycle accidents continue to lead to morbidity and mortality in children, representing between 5% and 14% of total blunt abdominal injuries. The diagnosis of duodenal injuries after trauma is difficult and requires a high index of clinical suspicion...

Background: Traditional clinical examination is perceived to be biased and to overcome this, objective structured clinical examination (OSCE) was introduced. Aims: The aim was to assess the students' exposure and perception of OSCE as well as its strengths and weaknesses in comparison to conventional clinical examination. Subjects and Methods: A cross-sectional study of students who had surgical OSCE was conducted from July 2018 to October 2018 in Ahmadu Bello University, Zaria...

Background: Glucose transporter-1 (GLUT-1) is a GLUT protein whose expression is upregulated in malignant cells where enhanced uptake of glucose is observed. Aim: The aim of this study is to evaluate the expression of GLUT-1 protein in oral squamous cell carcinoma (OSCC) tissue sections using immunohistochemistry and to describe the relationship between increased metabolic status and the grades of OSCC. Materials and Methods: This is cross-sectional study with 76 formalin-fixed paraffin-embedded tissue blocks of OSCC, obtained from the archives of the department...

Aim: To assess the role of red cell distribution width as a marker to predict tumor burden in gallbladder cancer (GBC). Methods: One hundred and twenty-eight patients with newly diagnosed GBC were included in the study. Peripheral blood samples were obtained, and red cell distribution width (RDW) was assessed. Tumor markers and other biochemical parameters were also recorded. Statistical Analysis: Quantitative variables were summarized using mean and standard deviation or median and interquartile range based on the normality of the distribution...

Background: Safe Surgery Saves Lives. Patient safety is a fundamental of good quality health care, and complications due to the health-care system are well-documented and constitute an important public health problem. Implementation of the checklist in medicine and surgery can help to decrease the risk of adverse events thus can improve patient safety. Materials and Methods: After the Institutional Ethical Committee clearance, a total of 500 patients were enrolled and divided into two equal groups...