<strong>Background and objective:</strong> Pain is a major concern in the surgical environment, but its management remains insufficient due to several factors related to the nursing staff, the organization...<strong>Background and objective:</strong> Pain is a major concern in the surgical environment, but its management remains insufficient due to several factors related to the nursing staff, the organization of the structure or the patient himself. The objective of this study was to assess the knowledge of the nursing staff on postoperative pain at the Laquintinie Hospital in Douala. <strong>Methodology:</strong> This was a cross-sectional study carried out at the Laquintinie Hospital in Douala from September to December 2018. Participants were consecutively selected among members of nursing staff in charge of operated patients in the visceral surgery, trauma surgery, surgical reanimation, gynaecology and obstetrics services. Socio-professional data and data related to knowledge of postoperative pain were collected from this personnel using a pre-tested semi-structured questionnaire. <strong>Results:</strong> With regard to knowledge of postoperative pain, the proportion of correct answers to the knowledge questions was 61.4%. This proportion varied significantly with the specific training received on pain and the specialization of the nursing staff (p < 0.001). <strong>Conclusion:</strong> The results of the study reveal knowledge in this population that deserves to be improved with a view to better management of patients undergoing surgery.展开更多
Background: An Enterocutaneous fistula (ECF) is an abnormal connection between the intestinal tracts or stomach and the skin. They are a major catastrophe to the patient and surgeons and still have a high incidence of...Background: An Enterocutaneous fistula (ECF) is an abnormal connection between the intestinal tracts or stomach and the skin. They are a major catastrophe to the patient and surgeons and still have a high incidence of morbidity and mortality which varies between 6% - 33%;their management remains a big challenge. These patients frequently face complications, and a well-organized multidisciplinary approach must be implemented in their management to improve outcomes. Objectives: Our study aims to assess the prevalence, management and outcomes of enterocutaneous fistulas in Buea regional hospital and Laquintinie hospital of Douala over the past 5 years. Methods: This was a hospital-based retrospective study in Buea regional hospital and Laquintinie hospital of Douala. Records of patients who had enterocutaneous fistulas within the period of 1<sup>st</sup> January 2017 to 31<sup>st</sup> December 2020 in the surgical departments. Data included demographics, pre-operative diagnosis, comorbidities, type of fistula, management modality and means, the indication of operative treatment, length of stay in the hospital and outcomes. Data was analysed using SPSSv26. Results: The study constituted 1343 medical records of which 83 medical records of patients with enterocutaneous fistulas, giving a prevalence of 6.2%, female predominance at 59% (n = 49), 42.2% (n = 35) were referred cases from the periphery for better management. A vast majority (96.4%) occurred as post-operative complications with appendectomy the most common indication (18.8%). High output fistulas were predominant (43.4%). 59% (n = 47) were managed medically, 6% (n = 5) received both conservative and surgical modalities while 35% (n = 5) were managed surgically. 64.1% (n = 50) were placed on enteral nutrition while 35.9% (n = 28) were placed on parenteral nutrition. Peritonitis/infection 50% (n = 18) was the commonest indication of surgical treatment, followed by failure of medical treatment 25% (n = 9) then high output fistulas 16.7% (n = 6). Resection with end-to-end anastomosis was the preferred repaired work at 61% (n = 22). The mortality rate was 38.5% (n = 32), 29% (n = 24) healed after conservative treatment, 21.7% (n = 18) healed after surgery, 7.2% (n = 6) persisted after surgery while 3.6% (n = 3) persisted after conservative treatment. Anaemia, sepsis, electrolyte imbalance, dehydration and malnutrition were the commonest complications. Conclusion: The prevalence of enterocutaneous fistulas was high, with a female predominance and a mean age of 38 years. Most cases were seen as a referral from the periphery for better management. The greatest majority of fistulas occurred as a postoperative complications. Conservative management with enteral feedings was preferred, they had better outcomes and gave more chances of healing. The commonest indication of surgical treatment was an infection. Resection with end-to-end anastomosis was the preferred repaired work. The mortality rate was high, and anaemia, sepsis and electrolyte imbalance were the commonest complications.展开更多
Background: Survival of patients after rectal cancer surgery as well as their quality of life (QoL) has been little studied in Africa and never in our country in particular. Methods: We conducted a cross-sectional mul...Background: Survival of patients after rectal cancer surgery as well as their quality of life (QoL) has been little studied in Africa and never in our country in particular. Methods: We conducted a cross-sectional multicentre study in Yaoundé (Cameroon). We reviewed operating reports of the selected departments to identify patients operated from January 2010 to December 2019 for a rectal cancer. The outcome of patients enrolled had to be known until December 2020. Patients who were alive were contacted to evaluate their QoL using the EORTC QLQ C30 (European Organization for Research and Treatment of Cancer QoL questionnaire). Results: During the study period, rectal cancer was ranked 4<sup>th</sup> within the digestive cancers. We included 68 patients;their mean age was 49.74 years and 41.18% were under 45. The sex ratio was 1.19 in favour of males. The tumour was mainly located in the lower rectum (45.6%). The main surgical procedure implemented was abdomino-perineal resection (42.6%). Forty-one patients died, giving a mortality rate of 60.29%. The mean survival time was 13 months. The 5-year survival rate for the 32 patients operated from January 2010 to December 2015 was 21.87%. The overall QoL of the 27 living patients was good with a mean of 62.346 ± 15.907. Sexual complications and urinary disorders were found in 40.74% and 14.81% of patients, respectively. Conclusion: There is a low hospital incidence of rectal cancer in our context. The 5-year survival after rectal cancer surgery is poor while the QoL of living patients is good.展开更多
文摘<strong>Background and objective:</strong> Pain is a major concern in the surgical environment, but its management remains insufficient due to several factors related to the nursing staff, the organization of the structure or the patient himself. The objective of this study was to assess the knowledge of the nursing staff on postoperative pain at the Laquintinie Hospital in Douala. <strong>Methodology:</strong> This was a cross-sectional study carried out at the Laquintinie Hospital in Douala from September to December 2018. Participants were consecutively selected among members of nursing staff in charge of operated patients in the visceral surgery, trauma surgery, surgical reanimation, gynaecology and obstetrics services. Socio-professional data and data related to knowledge of postoperative pain were collected from this personnel using a pre-tested semi-structured questionnaire. <strong>Results:</strong> With regard to knowledge of postoperative pain, the proportion of correct answers to the knowledge questions was 61.4%. This proportion varied significantly with the specific training received on pain and the specialization of the nursing staff (p < 0.001). <strong>Conclusion:</strong> The results of the study reveal knowledge in this population that deserves to be improved with a view to better management of patients undergoing surgery.
文摘Background: An Enterocutaneous fistula (ECF) is an abnormal connection between the intestinal tracts or stomach and the skin. They are a major catastrophe to the patient and surgeons and still have a high incidence of morbidity and mortality which varies between 6% - 33%;their management remains a big challenge. These patients frequently face complications, and a well-organized multidisciplinary approach must be implemented in their management to improve outcomes. Objectives: Our study aims to assess the prevalence, management and outcomes of enterocutaneous fistulas in Buea regional hospital and Laquintinie hospital of Douala over the past 5 years. Methods: This was a hospital-based retrospective study in Buea regional hospital and Laquintinie hospital of Douala. Records of patients who had enterocutaneous fistulas within the period of 1<sup>st</sup> January 2017 to 31<sup>st</sup> December 2020 in the surgical departments. Data included demographics, pre-operative diagnosis, comorbidities, type of fistula, management modality and means, the indication of operative treatment, length of stay in the hospital and outcomes. Data was analysed using SPSSv26. Results: The study constituted 1343 medical records of which 83 medical records of patients with enterocutaneous fistulas, giving a prevalence of 6.2%, female predominance at 59% (n = 49), 42.2% (n = 35) were referred cases from the periphery for better management. A vast majority (96.4%) occurred as post-operative complications with appendectomy the most common indication (18.8%). High output fistulas were predominant (43.4%). 59% (n = 47) were managed medically, 6% (n = 5) received both conservative and surgical modalities while 35% (n = 5) were managed surgically. 64.1% (n = 50) were placed on enteral nutrition while 35.9% (n = 28) were placed on parenteral nutrition. Peritonitis/infection 50% (n = 18) was the commonest indication of surgical treatment, followed by failure of medical treatment 25% (n = 9) then high output fistulas 16.7% (n = 6). Resection with end-to-end anastomosis was the preferred repaired work at 61% (n = 22). The mortality rate was 38.5% (n = 32), 29% (n = 24) healed after conservative treatment, 21.7% (n = 18) healed after surgery, 7.2% (n = 6) persisted after surgery while 3.6% (n = 3) persisted after conservative treatment. Anaemia, sepsis, electrolyte imbalance, dehydration and malnutrition were the commonest complications. Conclusion: The prevalence of enterocutaneous fistulas was high, with a female predominance and a mean age of 38 years. Most cases were seen as a referral from the periphery for better management. The greatest majority of fistulas occurred as a postoperative complications. Conservative management with enteral feedings was preferred, they had better outcomes and gave more chances of healing. The commonest indication of surgical treatment was an infection. Resection with end-to-end anastomosis was the preferred repaired work. The mortality rate was high, and anaemia, sepsis and electrolyte imbalance were the commonest complications.
文摘Background: Survival of patients after rectal cancer surgery as well as their quality of life (QoL) has been little studied in Africa and never in our country in particular. Methods: We conducted a cross-sectional multicentre study in Yaoundé (Cameroon). We reviewed operating reports of the selected departments to identify patients operated from January 2010 to December 2019 for a rectal cancer. The outcome of patients enrolled had to be known until December 2020. Patients who were alive were contacted to evaluate their QoL using the EORTC QLQ C30 (European Organization for Research and Treatment of Cancer QoL questionnaire). Results: During the study period, rectal cancer was ranked 4<sup>th</sup> within the digestive cancers. We included 68 patients;their mean age was 49.74 years and 41.18% were under 45. The sex ratio was 1.19 in favour of males. The tumour was mainly located in the lower rectum (45.6%). The main surgical procedure implemented was abdomino-perineal resection (42.6%). Forty-one patients died, giving a mortality rate of 60.29%. The mean survival time was 13 months. The 5-year survival rate for the 32 patients operated from January 2010 to December 2015 was 21.87%. The overall QoL of the 27 living patients was good with a mean of 62.346 ± 15.907. Sexual complications and urinary disorders were found in 40.74% and 14.81% of patients, respectively. Conclusion: There is a low hospital incidence of rectal cancer in our context. The 5-year survival after rectal cancer surgery is poor while the QoL of living patients is good.
