فهرست مطالب

  • Volume:7 Issue:2, 2019
  • تاریخ انتشار: 1398/04/19
  • تعداد عناوین: 5
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  • Jaime Ruiz, Tovar * Page 1
    For most patients with colorectal cancer, laparoscopic surgery is considered the gold-standard approach as it features the advantages of minimally invasive surgery and is as oncologically safe as the conventional approach. However, during the past decades, there has been major controversy about the indications and feasibility of the laparoscopic approach for patients with colorectal neoplasm. In this paper, we review the evolution of laparoscopy in the treatment of colorectal cancer.
    Keywords: Colorectal Cancer, Laparoscopy, Minimally Invasive Approach
  • Bang Guy Aristide *, Nana Oumarou Blondel , Savom Eric Patrick , Bwelle Moto Georges , Essomba Arthur Georges Page 2
    Background
    Peritonitis is a quite common surgical emergency. For this condition, many reports have shown that laparoscopic surgery is associated with lower morbidity and mortality. However, the laparoscopic approach to the management of peritonitis remains marginalized in low and middle-income countries (LMICs) due to financial and technical limitations.
    Methods
    We conducted a seven-year prospective study on patients with acute generalized peritonitis in Yaoundé, Cameroon. Inclusion criteria were an age range of between 5 to 55 years, admission within 48 hours after the onset of symptoms, hemodynamic stability, and no major comorbidities. Excluded from this study were patients with colonic perforation, prior history of abdominal surgery, or primary and localized peritonitis after proper resuscitation. The patients included were managed via laparoscopy; operative and postoperative data were collected and analyzed. Some technical artifices were used to circumvent the lack of standard equipment.
    Results
    The study involved twenty-five patients with a mean age of 32.1 years. The etiology of peritonitis was identified as appendicitis in 20 cases, perforated duodenal ulcer in 2 cases, gastric ulcer perforation in 2 cases, and jejunal perforation in 1 case. In two cases (8%), the operation was converted to laparotomy. The postoperative course was uneventful in 21 cases (84%), whereas morbidity was seen in 4 cases (16%); no mortality was recorded. The mean length of hospital stay was 5.5 days.
    Conclusions
    This study demonstrates that the laparoscopic management of acute generalized peritonitis in African LMICs is a feasible, safe, and effective surgical option in properly selected patients.
    Keywords: Acute Generalized Peritonitis, Laparoscopy, Africa, Morbidity, Low, Middle-Income Country
  • Francesco Cantarella *, Enrico Magni Page 3
    Occult rectal prolapse is a pathological condition that mainly affects women and is frequently associated with obstructed defecation. Numerous surgical procedures have been advocated for treating patients with obstructed defecation. In this study, we performed a retrospective analysis of the short-term surgical outcomes of combining internal mucosal resection with transverse perineal support in a single center with expertise in anorectal surgery. Resolution in obstruction symptoms was achieved with low morbidity. The use of sleeve resection of the rectal mucosa is a well-known and established procedure for occult rectal prolapse in obstructed defecation syndrome patients. Transverse perineal support operation has been recently adopted to correct defects of the perineum. In our preliminary experience, we report a combination in surgical techniques never described in the literature. Our preliminary results suggest that the technique is feasible, safe and reproducible. More patients and longer follow-up are required to be able to draw stronger conclusions.
    Keywords: Rectal Prolapse, Outlet Obstruction, Delorme’s Procedure, Mesh Perineal Support
  • lpaslan Tanoglu *, Omer Tekin, Tolga Duzenli, Muammer Kara, Mustafa Kaplan, Irfan Kucuk, Onur Ozari, Yusuf Yazgan Page 4
    Ulcerative colitis is a chronic inflammatory disease affecting mainly the colon and presenting with diarrhea, bloody defecation and abdominal pain. Although cardiac and/or pulmonary involvement has been reported in patients with ulcerative colitis, it rarely involves both the pleura and pericardium at the same time. Also, it is difficult to determine whether pulmonary or cardiac disease is secondary to the ulcerative colitis drugs or to the underlying disease process. Here we present a rare case of pleuropericardial effusion in a patient newly diagnosed with ulcerative colitis. In ulcerative colitis, the simultaneous involvement of the respiratory and cardiovascular systems is uncommon yet potentially dangerous.
    Keywords: Pleuropericardial Effusion, Ulcerative Colitis, Mesalazine
  • Viroj Wiwanitkit * Page 5