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Objectif : Déterminer la fréquence et les facteurs associés à la dénutrition en postopératoire dans deux hôpitaux universitaires publics au Bénin. Méthode : Il s'agissait d'une étude observationnelle transversale descriptive et analytique, qui s'est déroulée de mai à juillet 2022. Un recrutement exhaustif des patients devant être pris en charge chirurgicalement pour une pathologie digestive et ayant consenti à l'étude, a été effectué. Des données anthropométriques et de consommation alimentaire, des données cliniques ont été recueillies grâce à un questionnaire standardisé. Résultats : Un total de 51 patients a été inclus, avec une prédominance d'adultes âgés de moins de 50 ans (70,6%), un sex-ratio de 0,9 ; 72,5% avait un niveau d'instruction ≥ secondaire, 60,8% vivait en couple. Le niveau de revenu était inférieur au salaire minimum interprofessionnel garanti (SMIG) dans 52,9% des cas. La fréquence de la dénutrition était de 29,4% à l'admission contre 54% en postopératoire. Seuls les patients dénutris avaient présenté des complications postopératoires (36%). L'évaluation de l'état nutritionnel n'avait été consignée dans aucun des dossiers médicaux. En analyse multivariée, l'insuffisance en apport protéique et un bas niveau de revenu étaient associées à la dénutrition postopératoire (p = 0,002). Conclusion : La dénutrition en chirurgie digestive est une réalité dans les hôpitaux publics du Bénin et constitue un facteur de risque de complications postopératoires. Son dépistage et sa prise en charge doivent être systématiques et consignés dans le dossier médical du malade
Objective: To determine the frequency and factors associated with postoperative undernutrition in two public teaching hospitals in Benin. Method: This was a descriptive and analytical cross-sectional observational study conducted from May to July 2022. An exhaustive recruitment of patients to be managed surgically for a digestive pathology and who consented to the study, was carried out. Anthropometric, food consumption and clinical data were collected using a standardized questionnaire. Results: A total of 51 patients were included, with a predominance of adults under 50 years of age (70.6%), a sex ratio of 0.9; 72.5% had an educational level ≥ secondary, 60.8% were living as a couple. Income was below the guaranteed minimum wage in 52.9% of cases. The incidence of undernutrition was 29.4% on admission, compared with 54% postoperatively. Only the undernourished patients (36%) presented postoperative complications. Assessment of nutritional status was not recorded in any of the medical register. In multivariate analysis, insufficient protein intake and low income were associated with postoperative undernutrition. Conclusion: Undernutrition in digestive surgery is a reality in public hospitals in Benin, and constitutes a risk factor for postoperative complications. Its detection and management must be systematic and recorded in the patient's medical register.
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Humans , Male , Female , BeninABSTRACT
Since the establishment of the Chinese Journal of Digestive Surgery, progress has been made by generations of experts together with the journal. In November 2017, Chinese Journal of Digestive Surgery established the first session 'Elite Group of Chinese Digestive Surgery', and the author was fortunate to become one member of the Colorectal Surgery Group. Under the leadership of the group leader, Professor Yao Hongwei, heated academic discussions was carried out on the topics of colorectal surgery. Time flies, in the last few years, the author took part in the review work of the Chinese Journal of Digestive Surgery. In the process of reviewing articles, the author saw splendid researches and new outlook in the digestive surgery field with a lot of harvest, and was awarded twice with the title of excellent reviewing experts. With the rapid development of the Chinese Journal of Digestive Surgery, the author have gradually opened up new orientation in media and education. The author not only opened accounts on we-media platforms, but also actively participated in TV programs, striving to popularize health science knowledge to the general public. In July 2021, the second inaugural conference and the first plenary meeting of the 'Elite Group of Chinese Digestive Surgery' was successfully held in Chongqing. The author was honored to be the leader of the Media and Education Group. Together with all the other members, the author summari-zed experience in science popularization and media and share it with the fellow gastroenterology colleagues. At the first working meeting of the Media and Education Group of the 'Elite Groups of Chinese Digestive Surgery', members shared their practical experience and future work plans, and gained a lot of new inspiration. Now, The Chinese Journal of Digestive Surgery has celebrated its 20 th anniversary. The author sincerely wishes the Chinese Journal of Digestive Surgery with a marvelous future and popularization of health science promoting the development of colorectal surgery.
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The Chinese Journal of Digestive Surgery has been constantly innovating and gradually developing into the top scientific and technological journals in China since its inception in 2002. It has made important contributions to promote the digestive surgery. The journal always adheres to the policy of "focusing on improvement and popularization"，attaches great importance to the quality of the content，and becomes a good partner of surgeons. It has created a high-quality academic platform to promote innovation. Furthermore，it has formed the Elite Group of Chinese Digestive Surgery to provide a broad stage for young talents. Young scholars have cooperated and innovated on this platform，inputting infinite vitality into the journal.
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Minimally invasive technology has entered China for 30 years. With the rapid development of minimally invasive surgery, the laparoscopic vision system has gone from standard definition to high definition, then to ultra high definition, from two-dimensional vision to three-dimensional vision, then to fluorescent visualization navigation. Laparoscopic surgery has ranged from the removal or functional repair of benign diseased organs to the radical treatment of malig-nant tumors, then to more functional protection on the basis of radical treatment. The application scope of laparoscopic surgery has also been popularized in various specialized fields of digestive surgery. The author reviews the development of minimally invasive technology in the past 30 years, sums up the experiences, and looks forward to the future, in order to pay tribute to the 20 years of working together with the Chinese Journal of Digestive Surgery.
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Gallstone ileum represents an unusual cause of intestinal obstruction as a result of the presence of stones that cause mechanical obstruction. It has an incidence of less than 4%. Reaching mortality up to 25% of cases. It is a difficult suspicion, with characteristic signs that guide its presence such as pneumobilia, occlusion, and the presence of stone in radiological studies. Management should include surgical extraction as well as revision of the entire intestine with a suitable subsequent repair. Authors present the case of a 70-year-old patient with the presence of surgically resolved biliary ileum.
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There are two-way factors which will play important roles in the growth and development of surgeons in digestive surgery,namely their own efforts and guidance and training from chief surgeons.The eternal core of the process could be summarized as 3N:never ignore responsibility; never too old and too much to learn; never forget the past,otherwise,would be condemned.
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To produce good digestive surgeons,the following 5 training steps need to be done right:(1) Undergraduate education.The basic requirements in the qualities of good undergraduate medical training students at the end of the training should possess are:① Good medical ethics and attitudes to their patients; ② Good medical knowledge and skills; ③ Good core competencies in communication,decision-making,collaboration,leadership,health advocation,teaching and professionalism.(2) Basic surgical training.Developed countries have evolved to train surgeons using a structural training program in both basic and higher surgical training for the whole country.After completion of basic training and passing an unified examination for the country,a candidate can enter into higher surgical training in a specialty of which general surgery is one of these specialties.(3) General surgical training.The training of general surgery in Hong Kong is similar to that in the United Kingdom.After completion of general surgery training,the candidate can sit for a conjoint examination held by the College of Surgeons of Hong Kong (CSHK) and the Royal College of Surgeons of Edinburgh (RCSEd).After passing the examination,the candidate receives qualifications from these two Colleges.CSHK and RCSEd now have accredited 14 training centers in Mainland China for surgical training.The trainees from these 14 centers can sit for the conjoint examination held by these 2 Colleges and obtain the qualifications after passing the examination.(4) Digestive surgical training.Digestive surgery is a subspecialty of general surgery.The training of digestive surgery in Hong Kong,like in many developed countries,has not yet evolved into a structured subspecialty training and examination system.There are still a lot of debates on whether digestive surgery should evolve into a structured subspecialty training program.(5) Continuing medical education (CME).CME is very important.There have been a lot of discussions internationally on CME,continuing professional development,continuing professional education,revalidation and recertification.To produce good digestive surgeons,a solid foundation in surgical training should first be established.A structural training and examination program is important for a country to produce good surgeons.
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Objective To investigate the academic level and influence of the Chinese Journal of Digestive Surgery from the point of articles published and the authors.Methods The articles and authors of Chinese Journal of Digestive Surgery from 2002 to 2012 were retrieved from the Wanfang database and the China National Knowledge Internet database.The full texts were browsed and saved,and then the data were input to Excel for bibliometric analysis.Results There were 1917 articles were published in the Chinese Journal of Digestive Surgery during the past 11 years,and the average number of articles per issue was 29.05.The rate of articles with funded projects was 30.62％,and the citation rate was 58.52％.Authors were from 32 provinces,municipalites and Hong Kong.The numbers of articles contributed by authors from Chongqing,Beijing and Shanghai ranked top 3,which were 446(23.27％),240(12.52％) and 203(10.59％),and followed by authors from Sichuan,Jiangshu and Guandong.The number of articles from affiliated hospitals of Medical Schools was 1382 (72.09％).The cooperation rate was 4.37,and the coauthor rate was 90.03％.Conclusions Chinese Journal of Digestive Surgery is an academic journal with high quality and strong influence.The distribution of authors of the Chinese Journal of Digestive Surgery is wide,and the cooperative rate of authors is high,while the distribution of authors is disproportionate.
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With the development of hardware and software in engineering,the medical robotic techniques makes up for the shortage of conventional laparoscopy,and has good prospect in the field of surgery.In this paper,the application of medical robotic techniques in digestive surgery was focused.Extraneous medical robotic system and intrinsic miniature medical robot are 2 main categories.Most digestive operations,such as cholecystectomy,pancreaticoduodenectomy,lobectomy,antireflux surgery could be carried out by the extraneous medical robotic system,and the intrinsic miniature medical robot is still under research.Benefiting from the cooperation of the surgeons and the engineers,it is certain that the medical robotic techniques could play a more important role in digestive surgery.
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With advances in surgical techniques,laparoseopic surgical instruments and constant equipment innovation,minimally invasive surgery has become the main stream of this century.Wide range of applications of endoscopy and laparoscopy as the representative of the revolutionary changes in diagnosis and treatment of digestive diseases since the second half of last century is the main symbol.Patients obtained benefits from the minimally invasive technique to reduce the trauma and pain,shorten the course of treatment,and gain rapid recovery.Singleincision laparoscopic surgery (SILS) is proposed in recent years.It differs from conventional multiports laparoscopic surgery,with only a small 2-3 cm incision at the body's natural scar-umbilicus as the approach to assist laparoscope and surgical instruments into the abdomen cavity.In this paper,the surgical experiences of SILS based on 800 cases and understanding of the SILS at home and abroad were presented to talk about the application of SILS technique in digestive surgery.
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Although natural orifice transluminal endoscopic surgery provides excellent cosmesis,it is not being widely accepted because of the restriction in aspects of technology,instruments and ethics.As a bridge,laparoendoscopic single site surgery(LESS)has been widely applied in digestive surgery,including bariatric,gastric,hepatobiliary and colorectal surgery.Although LESS provides excellent cosmetic results,and its safety and feasibility seems similar to conventional laparoscopy in most procedures,its effectiveness in the treatment of malignant tumors still needs to be proved. Compared with conventional laparoscopy,LESS has the drawbacks of longer operation time and higher demand in experience.Besides,because digestive tract reconstruction is often needed after resection,more convenient and applicable instruments need to be invented for the development of LESS.
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Introducción: A pesar de efectuarse una gran cantidad de operaciones en nuestro país, se desconoce la real cifra de estas intervenciones. Objetivo: Determinar por una parte cuales son las operaciones de patología benigna más frecuente y por otra parte, el número de pacientes con diversos cánceres del tracto gastrointestinal proximal. Material y Método: Se solicitó al Departamento de Estadísticas del Ministerio de Salud los egresos hospitalarios totales del país, los egresos por sistema público y privado y el total de operados de ambos sistemas de salud para el cáncer gástrico, esofágico, pancreático, vesícula biliar, hepático y vías biliares. También el número total de operados de las 3 patologías quirúrgicas benignas más frecuentes: apendicectomía, colecistectomía y herniorrafia. Resultados: El sistema público de salud representa cerca del 90 por ciento de los egresos hospitalarios de cáncer gástrico, de vesícula biliar y esofágicos, mientras que para el cßncer pancreático y hepático el sistema privado de salud muestra un importante aumento en egresos anuales. La tasa global de operabilidad para estos cánceres varia entre 15 y 35 por ciento. Durante el año 2005 se realizaron en el Sistema Público de Salud (SPS) 710 gastrectomías por cáncer gástrico, 63 esofaguectomías por cáncer esofágico, 90 pancreatoduodenectomías por cáncer de páncreas y 40 lobectomías hepáticas por cáncer hepático. La apendicectomía fue la operación más frecuente en el SPS, seguido de la colecistectomía y la herniorrafia. A lo largo de Chile se apreció una diferencia muy importante en la tasa de colecistectomías laparoscópicas, la que varió entre 15 por ciento y 87 por ciento. Conclusiones: Dada la baja frecuencia observada en algunos cánceres digestivos (esófago, páncreas, hepático) se puede plantear una mayor concentración en pocos centros para lograr resultados acordes al concepto de "alto volumen quirúrgico". Respecto a la colecistectomía laparoscópica, debe hacerse un esfuerzo...
Background: Twenty five years ago, biliary surgery accounted for 30 to 50 percent of all operations performed in a general surgical service. We have no information of the changes in the frequency in surgical interventions in the last years. Aim: To determine, using hospital discharge data, which are the most common surgical interventions in Chile. Material and Methods: Databases with hospital discharge data from all the hospitals in Chile during 2004 and 2005, available at the Ministry of Health website, were consulted. Colorectal operations were exduded from the analysis. Results: In public hospitals during 2005, 710 gastrectomies for gastric cancer, 63 esophagectomies for esophageal cancer, 90 pancreatoduodenectomies for pancreatic cancer and 40 lobectomies for liver cancer, were performed. Appendectomy was the most common operation performed in the private health system, followed by cholecystectomy and hernia repair. The rate of laparoscopic cholecysctectomy varied from 15 to 87 percent in different regions of Chile. Ninety percent of hospital discharges for gastric cancer occur in the public health system, whereas an important increase in discharges for pancreatic and liver cancer, is observed in the private sector. The global operability rate for these tumors varied between 15 and 35 percent. Conclusions: Due to the low number of operations registered for certain digestive tumors, these interventions should be concentrated in high volume centers to increase the efficiency of the system. An effort is required to implement laparoscopic cholecystectomy in some regions of the country.