ABSTRACT
This study reports the first 13 cases of biopsy-proven low rectal carcinoma treated by transanal electrocoagulation using a locally manufactured instrument. At the University Hospital of the West Indies, over a 16-year period, 9 patients were treated for cure, six of whom have no clinical evidence of recurrence for one to 12 years. Four cases who were offered this procedure for palliation defaulted after a single treatment. Transanal electrocoagulation provides an additional option for treating patients with small, mobile low rectal cancers, following careful screening for evidence of nodal or distant spread. The procedure can also be used in the local control of disease in patients with distant spread or in whom a major operation is not feasible.
Subject(s)
Adenocarcinoma/surgery , Electrocoagulation , Rectal Neoplasms/surgery , Adult , Aged , Electrocoagulation/instrumentation , Electrocoagulation/methods , Female , Humans , Male , Middle AgedABSTRACT
This study reports the first 13 cases of biopsy-proven low rectal carcinoma treated by transanal electrocoagulation using a locally manufactured instrument. At the University Hospital of the West Indies, over a 16-year period, 9 patients were treated for cure, six of whom have no clinical evidence of recurrence for one to 12 years. Four cases who were offered this procedure for palliation defaulted after a single treatment. Transanal electrocoagulation provides an additional option for treating patients with small, mobile low rectal cancers, following careful screening for evidence of nodal or distant spread. The procedure can also be used in the local control of disease in patients with distant spread or in whom a major operation is not feasible.
Subject(s)
Humans , Male , Female , Adult , Middle Aged , Adenocarcinoma/surgery , Electrocoagulation , Rectal Neoplasms/surgery , Electrocoagulation/instrumentation , Electrocoagulation/methodsABSTRACT
This review of all laparoscopic cholecystectomies performed between 1993 and 1995 in Jamaica records the experience of local surgeons following an accelerated training programme. Special attention was paid to operating time, conversions, complications, analgesic requirements, time to discharge and cost. Comparisons were made of the local experience with the international experience. Laparoscopic cholecystectomy has been found to be a safe and viable option for Jamaican patients with gall bladder disease.
Subject(s)
Cholecystectomy, Laparoscopic/statistics & numerical data , Adolescent , Adult , Aged , Child , Cholecystectomy, Laparoscopic/adverse effects , Cholecystectomy, Laparoscopic/economics , Education, Medical, Continuing , Female , General Surgery/education , Humans , Jamaica , Length of Stay , Male , Middle Aged , Operating Rooms/organization & administration , Prospective Studies , Treatment OutcomeABSTRACT
Papillary cystic tumour is an uncommon neoplasm of the pancreas which has only been described recently. This report describes five such cases seen at the University Hospital of the West Indies (UHWI). The clinico-pathological features were typical in all these cases. The literature of this condition is also reviewed.
Subject(s)
Carcinoma, Papillary/pathology , Pancreatic Cyst/pathology , Pancreatic Neoplasms/pathology , Adolescent , Adult , Carcinoma, Papillary/surgery , Female , Humans , Jamaica , Pancreatic Cyst/surgery , Pancreatic Neoplasms/surgeryABSTRACT
A case of thoracic outlet syndrome (TOS) treated at the University Hospital of the West Indies, Jamaica, is presented. The diagnosis, investigation and management of TOS are discussed.
Subject(s)
Thoracic Outlet Syndrome , Adolescent , Female , Hospitals, University , Humans , Jamaica , Ribs/surgery , Thoracic Outlet Syndrome/diagnosis , Thoracic Outlet Syndrome/surgeryABSTRACT
Gallstone ileus is a rare cause of mechanical bowel obstruction. The attendant lack of awareness by the clinician will not only result in the diagnosis being made intraoperatively but will also affect the adequacy of the preoperative preparation of these ill patients. These patients are often elderly, septic and have significant concomitant medical illnesses. Recently two patients with gallstones ileus were managed with enterolithotomy and primary repair of the cholecyst-duodenal fistula at the University Hospital of the West Indies, Jamaica. Their clinical presentations and progress are described along with a review of the classical clinical course, radiological features, and operative choices available.
Subject(s)
Biliary Fistula/surgery , Cholelithiasis/complications , Duodenal Diseases/surgery , Gallbladder Diseases/surgery , Intestinal Fistula/surgery , Intestinal Obstruction/etiology , Aged , Biliary Fistula/complications , Cholecystectomy , Cholelithiasis/surgery , Duodenal Diseases/complications , Duodenum/surgery , Female , Humans , Intestinal Fistula/complications , Intestinal Obstruction/surgery , Middle AgedABSTRACT
A total colectomy and a mucosal proctectomy with ileo-anal anastomosis (c-mp-iaa) effectively removes all debilitating, potentially malignant colonic mucosa. Preservation of the anorectal sphincter predictably results in good to excellent anal continence with a low mortality and acceptable morbidity. Since 1983 at the University Hospital of the West Indies (U.H.W.I.), Jamaica, five (5) patients have undergone c-mp-iaa for colonic mucosal disease. All have good to excellent anal continence with an average of 2-6 continent, formed stools per day. There were no operative deaths. The five (5) cases are described and a plea is made for the earlier use of this definitive surgical procedure where indicated.
Subject(s)
Anal Canal/surgery , Colonic Diseases/surgery , Ileum/surgery , Proctocolectomy, Restorative , Adolescent , Adult , Anastomosis, Surgical , Child , Female , Humans , Male , Middle Aged , Proctocolectomy, Restorative/methodsABSTRACT
The pathological records of appendicectomy specimens from patients with suspected acute appendicitis at the University Hospital of the West Indies during the 5-year period 1984-1988 were studied. The numbers of cases, their ages, sex and seasonal incidence were similar to those of other studies. The overall false positive diagnosis rate was 25% (16% in males, 38% in females). The main diagnostic difficulty was in young females in whom surgery for suspected appendicitis often proved unnecessary.
Subject(s)
Appendectomy , Appendicitis/diagnosis , Acute Disease , Adolescent , Adult , Aged , Appendicitis/epidemiology , Appendicitis/pathology , Child , Child, Preschool , False Negative Reactions , False Positive Reactions , Female , Hospitals, University , Humans , Incidence , Infant , Male , Middle Aged , Retrospective Studies , Sex Factors , Time Factors , West Indies/epidemiologyABSTRACT
The pathological records of appendicectomy specimens from patients with suspected acute appendicitis at the University Hospital of the West Indies during the 5-year period 1984-1988 were studied. The numbers of cases, their ages, sex and seasonal incidence were similar to those of other studies. The over-all false positive diagnosis rate was 25%(16%in males, 38%in females). The main diagnostic difficulty was in young females in whom surgery for suspected appendicitis often proved unnecessary.
Subject(s)
Humans , Infant , Child, Preschool , Child , Adolescent , Adult , Middle Aged , Male , Female , Appendectomy/statistics & numerical data , Appendicitis/diagnosis , Appendicitis/pathology , Sex Factors , Retrospective Studies , Diagnosis, Differential , Diagnostic ErrorsABSTRACT
Two patients with high voltage electrical injury involving the trunk are presented. Both injuries were complicated by visceral damage; and one patient died from sepsis secondary to bowel perforation. The rarity of this complication is examined in light of the pathophysiology of electrical injury; and its management is discussed with reference to previously published reports on this condition.