S Afr J Surg
-
We present a case of acute upper airway obstruction secondary to angio-oedema. The patient underwent emergency percutaneous tracheotomy. Other options available for emergency surgical airway are discussed.
-
Comparative Study
Cerebral monitoring during carotid endarterectomy--a comparison between electroencephalography, transcranial cerebral oximetry and carotid stump pressure.
Various modalities are used for cerebral monitoring during carotid endarterectomy (CEA). The aim of this study was to evaluate whether transcranial cerebral oximetry (TCO) and carotid stump pressure (SP) are as accurate as electroencephalography (EEG) for monitoring cerebral ischaemia during carotid cross-clamping. ⋯ Compared with EEG, TCO is a practical and non-invasive monitoring system with a high sensitivity (100%) but a low specificity. TCO is more sensitive to a drop in BP and responds earlier to these changes than EEG. SP should not be used as the sole predictor for shunting during CEA.
-
To report our experience with thoracoscopic pericardial window (TPW) for occult penetrating cardiac injury. ⋯ TPW is a feasible, although in our setting not cost-effective, diagnostic option for occult penetrating cardiac injuries.
-
To determine the impact of prognostic variables on local control in patients with aggressive fibromatosis treated with or without radiation. ⋯ Surgery with or without radiation therapy gave excellent local control. The addition of radiation therapy to surgery as well as other known prognostic parameters did not impact on local control. The morbidity of radiation treatment is considerable, as noted in this series, and adjuvant radiation therapy should therefore be considered only in situations where the risk of recurrence and the morbidity of re-excision are high.