South African Journal of Surgery - Volume 42, Issue 3, 2004
Volume 42, Issue 3, 2004
Source: South African Journal of Surgery 42, pp 74 –75 (2004)More Less
Extracted from text ... 74 VOL 42, NO. 3, AUGUST 2004 SAJS SAJS Report - Surgical Research Society Congress The 32nd Surgical Research Society (SRS) meeting was hosted by MEDUNSA at the Eskom Convention Centre in Midrand on 20 - 21 May 2004. As usual the meeting was preceded by the Registrar's Symposium, generously sponsored by Ethicon. The meeting was hosted by Professor C Modiba (MEDUNSA), ably supported by Ms M Howard and the Ethicon staff. The invited international visitor was Dr Michael Wyatt (Newcastle, UK) who delivered two outstanding lectures entitled 'The current status of endovascular graft stenting for AAA' and 'Endovascular ..
Departments of Surgery in South Africa - legacies of the past, challenges for the future : editorialAuthor J.E.J. KrigeSource: South African Journal of Surgery 42, pp 76 –77 (2004)More Less
Extracted from text ... Among the most important constituencies of the South African Journal of Surgery are its readership and contributing authors. The needs and interests of our readers are being addressed in several ways. A new feature in this and the following issues of the Journal is a review highlighting one of the academic departments of general surgery in South Africa. Each of the eight heads of department has been invited to introduce and record the achievements and talents of his department in a remit that includes a synoptic background and biographical detail of previous opinion leaders and staff who have made ..
Author Brian L. WarrenSource: South African Journal of Surgery 42, pp 78 –80 (2004)More Less
Extracted from text ... 78 VOL 42, NO. 3, AUGUST 2004 SAJS Founding and early years The Department of Surgery and the then Faculty of Medicine of the University of Stellenbosch came into being simultaneously on 1 July 1956. Karl Bremer Hospital, today still a well-known landmark adjacent to the N1 highway as it sweeps over the foot of the Tygerberg, was made available by the Province of the Cape of Good Hope as a teaching facility. The Department - together with its parent Faculty - was the fifth to be established in South Africa, and the second to have the Afrikaans language ..
Femoro-distal bypass surgery at Groote Schuur Hospital - 4-year retrospective study : vascular surgerySource: South African Journal of Surgery 42, pp 81 –85 (2004)More Less
An analysis of the demographics and outcome of femoro-distal bypass in patients presenting with defined critical limb ischaemia at Groote Schuur Hospital, Cape Town, is presented. <br><I>Materials and methods.</I> A retrospective review was conducted between January 1998 and December 2001. During this period, 65 patients underwent femoro-distal bypass. Of these, 57 patients were analysed and 8 patients were excluded from the study because of incomplete medical records. <br><I>Results.</I> The median age of the patients in this study was 62 years, with a male-to-female ratio of 34:23. Twenty-eight patients (49%) were diabetic. An overall 2- year mortality of 19.2% was recorded. Reversed saphenous vein graft (RSVG) was used in 29 legs (50.9%) and <I>in situ</I> vein graft (ISVG) in 19 legs (33.3%). There was no statistically significant difference in the graft patency between the two methods (p = 0.39); the 2-year cumulative patency was 40% for the RSVG and 39% for the ISVG. In our unit only 2 factors influenced the outcome of femoro-distal bypass - local sepsis in the foot and an increased early postoperative ankle-brachial index (p < 0.05). Diabetes mellitus, gender, age and race had no influence on the outcome. This study showed that the site of the distal anastomosis had no effect on graft patency or limb salvage. At 2 years, the cumulative patency and limb salvage rates were 40% and 56% respectively. Of the 11 grafts with stenotic lesions requiring intervention, 6 were detected between 18 and 24 months. <br><I>Conclusion.</I> Management of critical limb ischaemia is a major part of the workload in our unit, with most patients undergoing primary amputation. The surgical outcome of femoro-distal bypass was largely influenced by local sepsis and early postoperative ABI. We found that more than half the stenotic lesions detected during graft surveillance occurred beyond 18 months postoperatively. This suggests that a graft surveillance programme should continue beyond 18 months.
Controversies and Problems in Surgery : Symposium held at the Faculty of Health Science, Pretoria, 1 - 2 October 2004 : registration formSource: South African Journal of Surgery 42 (2004)More Less
Extracted from text ... SAJS VOL 42, NO. 3, AUGUST 2004 85 CONTROVERSIES AND PROBLEMS IN SURGERY Symposium held at the Faculty of Health Science, Pretoria, 1 - 2 October 2004 Registration Form Please return a.s.a.p. to Ms Marie Cilliers, Department of Surgery, PO Box 667, Pretoria, 0001. Tel. (012) 354-1411, fax (012) 329-4589, e-mail firstname.lastname@example.org Prof/Dr/Mr/Ms . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ..
Is the incidence of gastroschisis rising in South Africa in accordance with international trends? : paediatric surgeryAuthor Marion ArnoldSource: South African Journal of Surgery 42, pp 86 –88 (2004)More Less
<I>Objectives.</I> Analysis of the incidence of gastroschisis compared with the incidence of exomphalos as a percentage of total paediatric surgical admissions. <br><I>Design.</I> Retrospective observational analysis using data from the ward admissions registers of the paediatric surgical wards of Pretoria Academic and Kalafong hospitals and from the weekly statistics sheets and audits thereof of the Paediatric Surgery Department at Pretoria Academic Hospital. Patient files from Pretoria Academic were used where available to confirm data. <br><I>Setting.</I> Pretoria Academic Hospital (PAH) and Kalafong Hospital (KH), Pretoria, from March 1981 to December 2001, excluding Kalafong Hospital data from February 1984 to 12 June 1984 and for 2001. <br><I>Results.</I> Forty-eight cases of gastroschisis and 139 cases of exomphalos were seen at PAH and KH out of 21 495 total paediatric surgery ward admissions. The average incidence of gastroschisis increased 35-fold from the 7-year period 1981 - 1987 to the 7-year period 1995 - 2001, while the average incidence of exomphalos compared across the same periods only showed a 1.82-fold increase. The incidence of gastroschisis rose above that of exomphalos in 1999 and remained so through to 2001. The incidence of exomphalos showed a general rising trend from 1981 to 2001 except for a sudden unexplained increase in 1995 and 1996. <br>Gastroschisis presenting at PAH was associated with a mortality rate of at least 38.7%. Reasons for this high mortality rate cannot be adequately evaluated owing to poor record keeping. <br><I>Conclusions.</I> The incidence of gastroschisis presenting at PAH and KH has risen dramatically relative to the incidence of the macroscopically similar exomphalos over the period 1981 - 2001, with the incidence of gastroschisis rising above the incidence of exomphalos. A larger scale study looking at birth prevalence of gastroschisis and exomphalos in South Africa is necessary to determine whether this represents a true differential change in the incidence of gastroschisis, reflecting internationally observed increases in the birth prevalence of this defect, or whether it is merely due to logistical changes within the administration of the Department of Health serving the area.
Results of treatment in children with anorectal malformations in Calabar, Nigeria : paediatric surgerySource: South African Journal of Surgery 42, pp 88 –90 (2004)More Less
Leading symptoms of anorectal malformation in the neonatal period are abdominal distention, non-passage of meconium and constipation. When present, vomiting is a late symptom. In a study in Calabar, Nigeria, patients were observed to present late, and teenage mothers in rural communities were mostly affected. Female neonates were affected more than males in a ratio of 1.5:1. Classification into low and high abnormality was adopted and proved practical in terms of identification of the pathology and treatment of the lesion. Patients with low abnormality (N = 24, 44.4%) were treated with perineal cut-down, while those with high abnormality (55.6%) had initial palliative colostomy before a definitive abdominal perineal pullthrough procedure. Faecal incontinence (13%), anal stenosis (11.1%), constipation (7.4%) and colostomy prolapse (5.6%) were noted to be associated complications. <br>Poverty and ignorance were noted to be the main factors affecting treatment outcome. A concerted public enlightenment campaign is therefore required.
Source: South African Journal of Surgery 42, pp 91 –106 (2004)More Less
Extracted from text ... 91 THE DETECTION AND DOCUMENTATION OF CAUSAL ASSOCIATIONS BETWEEN OCCUPATIONAL AND ENVIRONMENTAL EXPOSURES TO XENOBIOTICS AND DISEASE, WITH REFERENCE TO PANCREATITIS C Y Jeppe, M A Balabyeki, J J Mathebula, M D Smith Department of Surgery Helen Joseph and Chris Hani Baragwanath Hospitals Gauteng Department of Health Objectives: To identify occupational and environmental risk factors associated with pancreatitis and document exposures in patients presenting for pancreatic surgery. Design: Retrospective and prospective observational study. Setting and subjects: Sixty-four patients presenting at the J G Strijdom/Helen Joseph and Chris Hani Baragwanath Hospitals between 1991 and June 2002 for pancreatic surgery. Outcome ..
Gastrointestinal and Liver Tumors, ed. by W. Scheppach, R.S. Bresalier and G.N.J. Tytgat : book reviewAuthor G.J. OettleSource: South African Journal of Surgery 42, pp 107 –108 (2004)More Less
Extracted from text ... Book Reviews 107 SAJS VOL 42, NO. 3, AUGUST 2004 Gastrointestinal and Liver Tumors. Ed. by W. Scheppach, R.S. Bresalier and G.N.J. Tytgat. Pp. 334. 220 figs. Hardcover. US$ Berlin: Springer, 2004. ISBN 3-540-43462-3. Any book whose editors cheerfully admit that 'reading a book is still more delightful . . . than . . . manoeuvring through PC menus' evokes the sympathies of this crypto-Luddite reviewer. Digestive tract cancer accounts for more than one-third of all cancer deaths, and Springer has produced a comprehensive overview of these conditions. The book also functions as a valuable quick reference, with highlighted ..
Author Johan B. JanekeSource: South African Journal of Surgery 42 (2004)More Less
Extracted from text ... Letter to the Editor SAJS To the Editor: A bewildered 7-year-old girl presented with a smooth plastic bead impacted into the right ear canal. On examination the canal was swollen, irritated and tender owing to previous attempts to remove the bead. The bead, measuring 4 mm in diameter, was pushed almost against the eardrum. A further attempt to remove the bead resulted in an agonised yell - further attempts to remove the foreign body were aborted. The parents were unemployed and could not afford private hospitalisation, nor did they own a car for transport to a government hospital. The ..
Author J. SmilgSource: South African Journal of Surgery 42 (2004)More Less
Extracted from text ... Imaging of the Pancreas - Cystic and Rare Tumors. Ed. by C. Procacci, A.J. Megibow. Pp. 10 + 302. 255 figs. Hardcover. EUR 139.95. Heidelberg: Springer, 2003. ISBN 3-540-42742-2. This is definitely not a book for the faint-hearted or casual reader. As the title implies it covers a very specific topic, and it does so with remarkable depth and detail. This is an extensively researched academic text - to be used as a reference aid. The book is of interest to three main groups, viz. pathologists, radiologists and surgeons, more specifically to those within these groups with a particular ..
Vascular surgery. Cases, questions and commentaries, ed. by George Geroulakos, Hero van Urk, Robert W. II Hobson, and Keith Calligaro : book reviewAuthor M. VellerSource: South African Journal of Surgery 42 (2004)More Less
Extracted from text ... Vascular surgery. Cases, questions and commentaries. Ed. by George Geroulakos, Hero van Urk, Robert W. II Hobson, and Keith Calligaro. Pp. xxiv + 394. Hardcover. US$ 139. Heidelberg: Springer, 2003. ISBN 1-85233-533-5. The editors have devised a very interesting and unique book on vascular surgery. It comprises real-life case histories that highlight common clinical problems encountered in vascular surgery. Each is introduced with a short summary of the case. Thereafter a number of appropriate and searching questions are asked which address many of the important aspects regarding the disease and its management. Finally, the experts comment briefly on the ..