|Year : 2012 | Volume
| Issue : 2 | Page : 110-111
Abstracts from the 61 st Meeting of the Nigerian Surgical Research Society Calabar Nigeria, July 2012
|Date of Web Publication||2-Nov-2012|
Source of Support: None, Conflict of Interest: None
|How to cite this article:|
. Abstracts from the 61 st Meeting of the Nigerian Surgical Research Society Calabar Nigeria, July 2012. Niger J Surg 2012;18:110-1
| 1 st Scientific Session|| |
Risk Factors for Inguinal Hernia Among Adults in Uyo
Udo IA, Umoh MS, Ndoma-Egba R
Departments of Surgery, University of Uyo Teaching Hospital, University of Calabar Teaching Hospital, Nigeria
Background: Inguinal hernia is a common pathology seen by the general surgeon. Specific risk factors for its causation are known. Objective: To identify and audit the common risk factors for inguinal hernia among adult patients with uncomplicated inguinal hernias presenting to an out-patient clinic. Materials and Methods: Study involved adults presenting over a 1 year period at a surgical clinic with a clinical diagnosis of inguinal hernia. Data on age, sex, occupation, family history, constipation, chronic cough, previous hernia surgery as well as signs of urethral stricture, prostate gland enlargement and intra-abdominal mass were recorded into a format. Analysis was done with SPSS version 17. Results: Sixty five patients enrolled into the study comprising fourty nine males (75.4%) and sixteen females (24.6%), M:F = 3:1. The mean age was 45.6 years (SD±16.9). The 16-40 year age group had the highest incidence of twenty nine cases (44.6%) of inguinal hernia. A family history of inguinal hernia thirty one cases (47.7%) and history of previous surgery fifteen cases (23.1%) were the commonest risk factors for inguinal hernia. Ten of the patients with previous surgery presented with a contralateal hernia and 5 with a recurrence. Other factors were chronic constipation ten cases, smoking 9 cases, chronic cough 8 cases, dysuria 7 cases, enlarged prostate 6 cases, abdominal mass 4 cases and urethral stricture 1 case. Conclusion: Inguinal hernia is common among young and middle aged adults in our series and a M:F of 3:1 suggests an unusually high prevalence among females. Family history and past inguinal hernia surgery were important risks for developing an inguinal hernia.
Risk Factors for Inguinal Hernia in Adult Male Nigerians: A Case Controlled Study
Ashindoitiang JA, Ibrahim NA 1 , Akinlolu OO
General Hospital, Ikorodu, Lagos State and 1 Lagos State University College of Medicine and Teaching Hospital, Ikeja, Lagos State, Nigeria
Background: Inguinal hernia is one of the common surgical problems in Nigeria. Significant proportion among our patients with this condition either present late or with complications. We therefore sought to evaluate selected risk factors for development of inguinal hernia in adult male Nigerians in a hospital based case control study. The aim was to identify the risk factors for this condition in our population. This may assist in instituting appropriate preventive measures towards early detection and treatment. Materials and Methods: All male patients aged eighteen years and above who presented with primary inguinal hernia at the General Surgical clinic of Ikorodu General Hospital between April 2009 and March 2011 were enrolled into the study as cases.6 Control subjects were selected randomly from the general out-patient clinic and were age and sex matched with the cases. Participants were interviewed during their first clinic attendance by the attending physician among the authors using a standardised questionnaire to record their biodata and the presence or absence of the risk factors. All study cases had hernia repair and the type of hernia, whether indirect or direct was determined and documented. SPSS version 15.0 was used in the statistical analysis and the risk factors among the cases and controls were compared using univariate and multivariate logistic regression analysis. Results: A total number of four hundred four male patients were interviewed. Two hundred two were the cases while the remaining two hundred two were the controls. Age range for the cases was from 16-80 years with mean age of 47.34 (SD ±16.33). Significant risk factors for inguinal hernia in this study were positive family history of inguinal hernia (P < 0.001 and strenuous work activities (P < 0.001). Among the cases, one hundred thirty two (65.3%) had indirect hernia while the remaining seventy (34.7%) had direct hernia. Positive family history and straining during urination or defecation were the factors significantly associated with the type of hernia. Higher percentage of direct hernia was observed in patients who strain during urination or defecation (P = 0.047) while three-quarter among patients with positive family history of inguinal hernia developed indirect hernia (P = 0.011). Conclusion: Family history of inguinal hernia and strenuous work activity are the significant risk factors for this condition in our setting. Public health initiatives targeting those at higher risk of hernia development may help early detection and treatment; thereby reducing morbidity and mortality from this condition.
Routine Laparoscopic Surgery: Why Not?
Ray-Offor E, Fiebai PO 1
Departments of Surgery and 1 Obstetrics/Gynaecology, University of Port-Harcourt Teaching Hospital Port-Harcourt, Nigeria
Background: There has been a paradigm shift in the past three decades of surgical practice from open to minimal access surgery. This comprises diagnostic and interventional techniques by less intrusive methods with similar and oft better outcome. The armamentarium of surgeons and gynaecologists in our environment is not complete without a good knowledge and practice of laparoscopy. Aims: To study the knowledge, attitude and practice of laparoscopy amongst surgeons and gynaecologists. Materials and Methods: A cross-sectional cohort study was conducted in the Surgery and Obstetrics and Gynaecology departments of University of Port-Harcourt Teaching Hospital. A pretested questionnaire was randomly assigned to surgeons, gynaecologists and their trainees seen during department activities with sixty respondents. Socio-demographic characteristics, knowledge, attitude and practice of laparoscopy were assessed. Analysis of the result was by simple percentages. Results: Majority of respondents had not participated in a laparoscopic procedure 39 (56.5%) nor refer patients for laparoscopy 52 (75.4%). Knowledge was inadequate as 34 (49.3%) could not accurately define laparoscopy and 15 (21.8%) did not know the abdomen as the body part involved in laparoscopy. The drawbacks to routine laparoscopy were considered surmountable by 61 (88.4%) respondents. Conclusion: An increased awareness and practice of diagnostic and therapeutic laparoscopic procedures will invariably crystallize similar benefits enjoyed in developed countries. The requisite training in laparoscopy is needed in the curriculum of our current residency training program.
Zaria Univesal Oxygenator Holder-Phase I
Edaigbini SA, Delia IZ, Aminu MB
Department of Surgery, Division of Cardiothoracic Surgery, Ahmadu Bello University Teaching Hospital, Zaria
Background: The conduct of cardiopulmonary bypass surgery requires the use of several equipment and devices like the oxygenator. The oxygenator comes in different makes depending on the manufacturer and each manufacturer customizes the carrier or 'holder' of this device specific to their design. Aim: This paper presents an innovation designed to overcome the need to purchase a different holder for every oxygenator thereby cutting cost. Materials and Methods: A sheet of iron measuring 1.9 cm (width) ×0.1 cm (thickness) was used to design the holder circular main frame. Another sheet measuring 2 cm (width) ×0.6 cm (thickness) ×24 cm (length) was used to construct a V-shaped handle with the arms of the V attached to the main frame 7 cm apart. At the narrow base of the handle is a latch requiring two 13-gauge screws to attach the holder to the heart-lung machine. Within the circumference of the main frame are four T-shaped side arms which grip the oxygenator; located at 2, 5, 7 and 11 O'clock positions. The stem of the T consist of a 0.6 cm (thickness) ×13 cm (length) rod drilled through the main frame. The cross of the T consists of variable lengths of the same sheet as the mainframe attached to the stem by a screw mechanism. At the base of the T, is attached a circular handle (4 cm in diameter) made of 0.4 cm iron rod. Results: A metallic device with a circular main frame which holds the oxygenator within its circumference centrally and a side arm designed to attach the Holder-Oxygenator complex to the bypass machine. It weighs 1.75 kg with a total length of 54 cm (the diameter of the mainframe is 30 cm). Its advantages Include (i) affordability (ii) materials are readily available and locally accessible (iii) versatility (iv) reproducibility. The disadvantages include; (i) it requires some time to fit (ii) extreme caution is required in fitting the oxygenator to avoid breakage (iii) a spanner is required to lock the latch. Conclusion: The concept of a universal oxygenator holder is pertinent especially in resource poor environments to avoid purchasing a new holder whenever the usual oxygenator common to the centre is unavailable. This device is amenable to further modifications to meet unforeseen challenges.