1
|
Al Jazzar RI, Alzahrani N, Eltayeb MM, Satti AK, Omar H, Arrowaili A. Super super obesity with a BMI of 98 kg/m 2: a case report. J Surg Case Rep 2024; 2024:rjad690. [PMID: 38213410 PMCID: PMC10781934 DOI: 10.1093/jscr/rjad690] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2023] [Accepted: 12/04/2023] [Indexed: 01/13/2024] Open
Abstract
Standards of care in regards to super-super obese patients are yet to be evolving due to the sparsity of this weight category along with the high morbidity and mortality rates attributed to it. We report a successful case of laparoscopic sleeve gastrectomy for a 35 years old lady with a body mass index (BMI) of 98 kg/m2.
Collapse
Affiliation(s)
- Ragad I Al Jazzar
- College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
| | - Nayef Alzahrani
- Department of Surgery, King Abdulaziz Medical City, Ministry of National Guard Health Affairs, Riyadh, Saudi Arabia
| | | | - Ahmed K Satti
- Department of Surgery, Riyadh Care Hospital, Riyadh, Saudi Arabia
| | - Hussain Omar
- Department of Surgery, Riyadh Care Hospital, Riyadh, Saudi Arabia
| | - Arief Arrowaili
- College of Medicine, Al Imam Mohammad Ibn Saud Islamic University, Riyadh, Saudi Arabia
| |
Collapse
|
2
|
AlAli MN, Essa MS, Alasheikh M, Alrashed M, Albdah AM, Arrowaili A. A Rare Case and Presentation of Traumatic Penetrating Aortic Arch Injury: A Case Report and Literature Review. Cureus 2022; 14:e31069. [DOI: 10.7759/cureus.31069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/03/2022] [Indexed: 11/06/2022] Open
|
3
|
Chowdhury S, Bahatheq S, Alkaraawi A, Falatah MM, Almutairi RF, Alfadhel S, Alruwili GM, Arrowaili A, Mitra B, Fitzgerald M. Surgical site infections after trauma laparotomy. An observational study from a major trauma center in Saudi Arabia. Saudi Med J 2019; 40:266-270. [PMID: 30834422 PMCID: PMC6468209 DOI: 10.15537/smj.2019.3.24005] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023] Open
Abstract
OBJECTIVES To determine the incidence of surgical site infection (SSI) after trauma laparotomy and evaluate variables on presentation to the emergency department (ED) associated with the development of SSI. Methods: A retrospective cohort study was undertaken of patients presenting directly from the scene who underwent trauma laparotomy between January 2016 and December 2017. The primary outcome variable was SSI, as defined by the Centers for Disease Control and Prevention guideline. A univariate assessment with demographics, vital signs, and acute management was reported. Results: A total of 70 patients were included for data analysis. Of these, 9 (12.9%; 95% confidence interval (CI): 6.9-22.7%) patients developed SSI, including 5 patients with bowel injury (small bowel; n=3, colonic injuries; n=2). Most cases were diagnosed after 7 days in the hospital. All patients developed superficial incisional (skin and subcutaneous tissue) SSI. No predetermined variables, including bowel injury (p=0.08) or duration of surgery (p=0.09), demonstrated a statistically significant association with the development of SSI. Conclusion: Rates of SSI after trauma laparotomy were similar to previous reports from other centers. Surgical site infection after trauma laparotomy was diagnosed at a delayed time point after surgery, and patient demographics, injury characteristics, and acute surgical management did not appear to be associated with subsequent diagnosis of SSI.
Collapse
Affiliation(s)
- Sharfuddin Chowdhury
- Department of Trauma Surgery, King Saud Medical City, Riyadh, Kingdom of Saudi Arabia. E-mail.
| | | | | | | | | | | | | | | | | | | |
Collapse
|
4
|
Parikh R, Shah S, Dhurandhar V, Alzahrani N, Fisher OM, Arrowaili A, Liauw W, Morris D. An analysis of the morbidity associated with abdominal wall resection and reconstruction after cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (CRS/HIPEC). Eur J Surg Oncol 2019; 45:394-399. [PMID: 30638806 DOI: 10.1016/j.ejso.2018.12.020] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2018] [Revised: 11/21/2018] [Accepted: 12/27/2018] [Indexed: 12/11/2022] Open
Abstract
PURPOSE CRS/HIPEC has evolved as an effective method for management of selected patients with peritoneal metastatic disease. Abdominal wall resection (AWR) is often required, and may require complex reconstructions, such as component separation (CST) leading to wound dehiscence (WD) and wound complications (WC). The purpose of our study was to analyse factors contributing to wound complications and wound recurrence (WR). METHODS Retrospective review of a prospective database of 1074 patients undergoing CRS/HIPEC procedures from 1996 to 2017 at St George Hospital. RESULTS AWR and reconstruction for abdominal wall metastases was performed in 197 (18.3%) patients. Tumour types included mesothelioma, appendiceal, colorectal and ovarian cancers. Grade III WC were found in 21 (10.6%). WD was found in 14 (7.1%) compared to 30 (3.4%) in 877 patients without AWR (p = 0.028). Midline WR was seen in 26 (13.3%) with AWR and mean time to recurrence of 18 months. Multivariable' regression analysis showed age (OR 1.06, 95%CI 1.01-1.11, p = 0.022) and CST (OR 9.63, 95%CI 2.55-36.23, p = 0.001) were independent predictors of Grade III WC, and CST (OR 4.19, 95%CI 1.27-13.86, p = 0.019) was an independent predictor of WD after AWR. The presence of a higher prior surgical score (PSS) 2-3 (OR 2.74, 95%CI 1.16-6.49, p = 0.022) was an independent predictor of midline WR post AWR. CONCLUSION This study demonstrates that patients undergoing AWR have a higher incidence of postoperative WD. CST was associated with an increased incidence of Grade III WC and WD. Patients with a higher PSS were more likely to develop midline wound recurrence.
Collapse
Affiliation(s)
- Roneil Parikh
- Peritonectomy and Liver Unit, Department of Surgery, St George Hospital, Kogarah, NSW, 2217, Sydney, Australia; St George Hospital Clinical School, University of New South Wales, Chapel Street, Kogarah, NSW, 2217, Sydney, Australia.
| | - Sanjana Shah
- Gosford Hospital, Holden Street, Gosford, NSW, 2250, Sydney, Australia.
| | - Vikrant Dhurandhar
- Royal Prince Alfred Hospital, 50 Missenden Road, Camperdown, NSW, 2050, Sydney, Australia.
| | - Nayef Alzahrani
- Peritonectomy and Liver Unit, Department of Surgery, St George Hospital, Kogarah, NSW, 2217, Sydney, Australia; College of Medicine, Al Imam Mohammad Ibn Saud Islamic University (IMSIU), Riyadh, Saudi Arabia.
| | - Oliver M Fisher
- Peritonectomy and Liver Unit, Department of Surgery, St George Hospital, Kogarah, NSW, 2217, Sydney, Australia.
| | - Arief Arrowaili
- College of Medicine, Al Imam Mohammad Ibn Saud Islamic University (IMSIU), Riyadh, Saudi Arabia.
| | - Winston Liauw
- Peritonectomy and Liver Unit, Department of Surgery, St George Hospital, Kogarah, NSW, 2217, Sydney, Australia; Cancer Care Centre, St George Hospital, Kogarah, NSW, 2217, Sydney, Australia.
| | - David Morris
- Peritonectomy and Liver Unit, Department of Surgery, St George Hospital, Kogarah, NSW, 2217, Sydney, Australia; St George Hospital Clinical School, University of New South Wales, Chapel Street, Kogarah, NSW, 2217, Sydney, Australia.
| |
Collapse
|
5
|
Affiliation(s)
- Sharfuddin Chowdhury
- Department of General Surgery, King Saud Medical City, Riyadh, Kingdom of Saudi Arabia. E-mail.
| | | | | | | |
Collapse
|
6
|
Huang Y, Alzahrani NA, Liauw W, Arrowaili A, Morris DL. Survival difference between mucinous vs. non-mucinous colorectal cancer following cytoreductive surgery and intraperitoneal chemotherapy. Int J Hyperthermia 2018; 35:298-304. [PMID: 30130987 DOI: 10.1080/02656736.2018.1496486] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND It is believed that the oncologic behavior of mucinous colorectal adenocarcinoma (MC) is different from non-mucinous adenocarcinoma (NMC). The aim of the study is to compare long-term survivals between patients with MC and those with NMC following cytoreductive surgery (CRS) and intraperitoneal chemotherapy (IPC). METHODS This was a retrospective study of prospectively collected data of patients with peritoneal metastases of colorectal origin following CRS and IPC. Group I included patients with MC which was defined as being composed of >50% extracellular mucin. Group II included those with NMC. Subgroup analysis was performed according to the location of primary tumor. RESULTS A total of 213 patients were included in this study. The two groups had similar hospital mortality, high dependency unit stay. MC group had a significantly longer mean intensive care unit (ICU) stay (p = .037) and total hospital stay (p = .037). There was no significant difference in overall survival (OS) and disease-free survival (DFS) between two groups (p = .657 and p = .938, respectively). Multivariate analysis showed that the presence of mucin was not an independent negative prognostic factor for OS (p = .190). CONCLUSION In summary, patients with MC had a similar long-term survival outcome with those with NMC following CRS and IPC.
Collapse
Affiliation(s)
- Yeqian Huang
- a Department of Surgery , University of New South Wales, St George Hospital , New South Wales , Australia
| | - Nayef A Alzahrani
- a Department of Surgery , University of New South Wales, St George Hospital , New South Wales , Australia.,b College of Medicine , Al Imam Muhammad Ibn Saud Islamic University (IMSIU) , Riyadh , Saudi Arabia
| | - Winston Liauw
- c Department of Medical Oncology , University of New South Wales, St George Hospital , Sydney , New South Wales , Australia
| | - Arief Arrowaili
- b College of Medicine , Al Imam Muhammad Ibn Saud Islamic University (IMSIU) , Riyadh , Saudi Arabia
| | - David L Morris
- a Department of Surgery , University of New South Wales, St George Hospital , New South Wales , Australia
| |
Collapse
|
7
|
Kozman MA, Fisher OM, Rebolledo BAJ, Parikh R, Valle SJ, Arrowaili A, Alzahrani N, Liauw W, Morris DL. CEA to peritoneal carcinomatosis index (PCI) ratio is prognostic in patients with colorectal cancer peritoneal carcinomatosis undergoing cytoreduction surgery and intraperitoneal chemotherapy: A retrospective cohort study. J Surg Oncol 2017; 117:725-736. [PMID: 29266235 DOI: 10.1002/jso.24911] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2017] [Accepted: 10/15/2017] [Indexed: 12/25/2022]
Abstract
BACKGROUND AND OBJECTIVES Serum tumor markers are prognostic in patients with colorectal cancer peritoneal carcinomatosis (CRPC) undergoing cytoreductive surgery (CRS) and intraperitoneal chemotherapy (IPC). Assessment of the ratio of tumor marker to volume, as depicted by peritoneal carcinomatosis index (PCI), and how this may affect overall (OS) and recurrence free survival (RFS) has not been reported. METHODS Survival effect of this ratio was analyzed in patients with CRPC managed from 1996 to 2016 with CRS and IPC. RESULTS Of 260 patients included, those with low CEA/PCI ratio (<2.3) had longer median OS (56 vs 24 months, P = 0.001) and RFS (13 vs 9 months, P = 0.02). The prognostic impact of CEA/PCI ratio was most pronounced in patients with PCI ≤ 10 (OS of 72 vs 30 months, P < 0.001; RFS of 21 vs 10 months, P = 0.002). In multivariable analysis, elevated CEA/PCI ratio was independently associated with poorer OS (adjusted HR 1.85, 95%CI 1.11-3.10, P = 0.02) and RFS (adjusted HR 1.58, 95%CI 1.04-2.41, P = 0.03). CONCLUSION CEA/PCI ratio is an independent prognostic factor for OS and RFS in CRPC. This novel approach allows both tumor activity and volume to be accounted for in one index, thus potentially providing a more accurate indication of tumor biological behavior.
Collapse
Affiliation(s)
- Mathew A Kozman
- Hepatobiliary and Surgical Oncology Unit, Department of Surgery, St George Hospital, Kogarah, NSW, Australia.,St George Hospital Clinical School, University of New South Wales, Sydney, NSW, Australia
| | - Oliver M Fisher
- Hepatobiliary and Surgical Oncology Unit, Department of Surgery, St George Hospital, Kogarah, NSW, Australia.,St George Hospital Clinical School, University of New South Wales, Sydney, NSW, Australia.,School of Medicine, University of Notre Dame, Sydney, NSW, Australia
| | - Bree-Anne J Rebolledo
- Hepatobiliary and Surgical Oncology Unit, Department of Surgery, St George Hospital, Kogarah, NSW, Australia
| | - Roneil Parikh
- Hepatobiliary and Surgical Oncology Unit, Department of Surgery, St George Hospital, Kogarah, NSW, Australia
| | - Sarah J Valle
- Hepatobiliary and Surgical Oncology Unit, Department of Surgery, St George Hospital, Kogarah, NSW, Australia
| | - Arief Arrowaili
- College of Medicine, Al-Imam Mohammad Ibn Saud Ismalic University, Riyadh, Saudi Arabia
| | - Nayef Alzahrani
- Hepatobiliary and Surgical Oncology Unit, Department of Surgery, St George Hospital, Kogarah, NSW, Australia.,St George Hospital Clinical School, University of New South Wales, Sydney, NSW, Australia.,College of Medicine, Al-Imam Mohammad Ibn Saud Ismalic University, Riyadh, Saudi Arabia
| | - Winston Liauw
- St George Hospital Clinical School, University of New South Wales, Sydney, NSW, Australia.,Cancer Care Centre, St George Hospital, Kogarah, NSW, Australia
| | - David L Morris
- Hepatobiliary and Surgical Oncology Unit, Department of Surgery, St George Hospital, Kogarah, NSW, Australia.,St George Hospital Clinical School, University of New South Wales, Sydney, NSW, Australia
| |
Collapse
|