World journal of surgery
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World journal of surgery · Jul 2013
Utilisation of a Level 1 Trauma Centre in KwaZulu-Natal: appropriateness of referral determines trauma patient access.
Appropriate referral of major trauma patients to an accredited Level 1 Trauma facility is associated with improved outcome. A new Level 1 Trauma Centre was opened at Inkosi Albert Luthuli Central Hospital in March 2007. This study sought to audit the referral pattern of external consults to the trauma unit and ascertain whether the unit was receiving appropriate referrals and has adequate capacity. ⋯ Major multiorgan system trauma remains a significant public health burden in KwaZulu-Natal. A Level 1 Trauma Service is used appropriately in most circumstances. However, the additional need for more hospital facilities that provide such services across the whole province to enable effective geographical coverage for those trauma patients requiring such specialised trauma care is essential.
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World journal of surgery · Jul 2013
Video-assisted thoracoscopic surgery sleeve lobectomy with bronchoplasty.
We review our experiences with video-assisted thoracoscopic surgery (VATS) sleeve lobectomy with bronchoplasty for NSCLC. The safety, effectiveness, indications, and operation precautions of this approach were examined. ⋯ Video-assisted thoracoscopic surgery sleeve lobectomy with bronchoplasty is a safe and effective surgical approach in the treatment of non-small cell lung cancer. The operating incision placed at the 4th intercostal space on the anterior axillary line is convenient for anastomosis our experience shows that anastomosis combining simple continuous suture of the membranous part of bronchus and simple interrupted suture anastomosis of the cartilaginous part of the bronchus is fast and secure. Moreover, preserving the azygos vein does not affect the anastomosis.
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World journal of surgery · Jul 2013
The implementation of a pilot femur fracture registry at Komfo Anokye Teaching Hospital: an analysis of data quality and barriers to collaborative capacity-building.
Trauma registries are essential for injury surveillance and recognition of the burden of musculoskeletal injury in low- and middle-income countries (LMICs). The purpose of this study was to pilot a femur fracture registry at Komfo Anokye Teaching Hospital (KATH) to assess data quality and determine the barriers to research partnering in LMICs. ⋯ Data and data quality analyses highlighted characteristics of femur fracture patients presenting to KATH as well as the technological, administrative support, and hospital systems-based challenges of longitudinal data collection in LMICs.
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World journal of surgery · Jul 2013
Introducing video-assisted thoracoscopy for trauma into a South African township hospital.
The use of video-assisted thoracoscopic surgery (VATS) is well established in trauma practice. This modality is readily available to centers with well-equipped operating facilities but may be challenging to introduce into resource-constrained institutions such as many South African township hospitals. We implemented VATS for retained post-traumatic pleural collections in our institution in 2007, and we have now performed an audit of the first 3 years of our experience. ⋯ Introducing VATS for retained post-traumatic collections into a relatively resource-constrained township hospital in South Africa is safe and effective. Consideration should be given to performing VATS early and avoiding the use of a second and third chest drain for retained collections. This approach may lead to decreased incidence of empyema and shorter overall hospital stay.
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World journal of surgery · Jul 2013
Impact of preoperative organ failures on survival in intensive care unit patients with colectomy.
The present study aimed to evaluate the prognostic value of preoperative changes in sequential organ failure assessment (SOFA) score, daily norepinephrine (NE) dose, lactate, C-reactive protein, and white blood cell count among patients with colectomy in the intensive care unit (ICU). ⋯ It should be prospectively studied whether preoperatively increasing lactate level and NE dose are surrogate markers for early laparotomy among ICU patents with colitis.