Colonic Cancer in Occlusion: The Choice Between Synchronous and Sequential Surgery
Rasataharifetra Hanta,
Rahantasoa Finaritra Casimir Fleur Prudence,
Razafindraibe Vanona Barijaona,
Mahavory Marc Joel,
Samison Luc Herve,
Rakotoarijaona Armand Herinirina
Issue:
Volume 8, Issue 6, December 2022
Pages:
80-83
Received:
2 November 2022
Accepted:
23 November 2022
Published:
9 January 2023
Abstract: Introduction: Emergency tumor resection in monobloc is the most common. The alternative is to perform an emergency digestive bypass by a near upstream stoma if the patient's condition does not allow carcinological surgery. The objective of this study was to evaluate the results of single- versus multistage surgery in occluded colorectal cancer. Method: A single-center, cross-sectional study had included colonic cancers in occlusion operated on between 2015 and 2019 regardless of the evolutionary stage of the lesion. Patients operated in emergency for acute intestinal occlusion due to a colon tumor and whose histological result corresponded to a cancer were included. Results: The median age was 54.45 years (17 years; 78 years). The sex ratio was 0.93. The main surgical procedures were resection with immediate anastomosis in right hemicolectomies (n = 12) - left colectomy (n = 3), resection with two-stage anastomosis (segmental colectomy with colorectal anastomosis and/or colocolic anastomosis with protective ileostomy (n = 10), Hartmann procedure (n = 6)). The postoperative mortality rate was 3% (n = 1) of which one patient had an elective discharge colostomy. Mortality was more associated with the AFC score (age, urgency, nutritional and neurological status) than with the choice of surgery. Conclusion: One-stage surgery seems to show a slight superiority on the prognosis even in the context of occlusion. Diagnostic and therapeutic management still encounter difficulties in our context.
Abstract: Introduction: Emergency tumor resection in monobloc is the most common. The alternative is to perform an emergency digestive bypass by a near upstream stoma if the patient's condition does not allow carcinological surgery. The objective of this study was to evaluate the results of single- versus multistage surgery in occluded colorectal cancer. Me...
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Evaluation of Uric Acid and Its Correlation with Decline in Estimated Glomerular Filtration Rate among the Chronic Kidney Disease Patients
Fikadu Seyoum Tola,
Belay Zawdie,
Maekel Belay
Issue:
Volume 8, Issue 6, December 2022
Pages:
84-91
Received:
5 December 2022
Accepted:
16 January 2023
Published:
31 January 2023
Abstract: Chronic kidney disease is one of the most serious public health burdens globally, with significant morbidity, mortality, and compromise patient life expectancy. Many sub-Saharan African countries face double-burden challenges in the treating of chronic kidney disease and its associated complications. The current study aims to evaluate serum uric acid, and its correlation with estimated glomerular filtration rate as well as other risk factors among the chronic kidney disease patients on follow-up at renal clinic of Jimma University specialized referral hospital. An Institution-based cross-sectional study was conducted at Jimma University referral from August 6, 2022, to November 13, 2022. A consecutive sampling technique was employed to recruit the study participants into the current study. Data were collected using interviewer-based structured questionnaires and patient’s record reviews. The collected data were analyzed by SPSS version 25.0. Pearson’s correlation analyses was used to check the correlation between estimated glomerular filtration rate and uric acid. Univariate and multivariate linear regression model was used to test predictors of serum uric acid in the study participants. The total study participants were 140 individuals. Subjects included (54.3% [n=76]) men and (45.7% [n=64]) women, respectively. The mean (SD) age of study subjects was 51.04±9.02 years. The mean value of serum uric acid was 7.2±2.1mg/dl whereas the mean of estimated glomerular filtration rate (eGFR) was 54.2±31 mL/min/1.73m2. Furthermore, the mean values of serum creatinine and blood urea nitrogen among participants in this study were 3.2±1.4 and 67.8±35.8 mg/dL respectively. In the current study, estimated glomerular filtration rate (eGFR) value was negatively correlated (r=-0.912, P<0.001) with uric acid. However, systolic blood pressure was positively correlated (r=0.584, P<0.001) with uric acid. Moreover, the eGFR value was negatively associated (β=-0.060, P=<0.001) with uric acid among study participants. Based on the current study finding, an increase in serum uric acid was associated with a decrease in eGFR value. Increased serum uric acid, increased body mass index and high blood pressure are independent risk factors for disease progression in patients with CKD.
Abstract: Chronic kidney disease is one of the most serious public health burdens globally, with significant morbidity, mortality, and compromise patient life expectancy. Many sub-Saharan African countries face double-burden challenges in the treating of chronic kidney disease and its associated complications. The current study aims to evaluate serum uric ac...
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