Surgical Residency Training in Nigeria: An Audit Through the Lenses of the Trainee and Trainer.

Introduction: Resident doctors constitute an important workforce of the Nigerian healthcare system wherein they undergo structured training to become competent specialists in different fields of medicine. The aim of this survey was to audit the surgical residency training process, incorporating both the trainer's and the trainee's perspectives, with a view to improving both residency training and overall patient care.

Methods: This was a multicenter descriptive cross-sectional study involving consultant surgeons and surgical trainees in selected tertiary healthcare institutions in Nigeria.

A RARE METACHRONOUS COLONIC VOLVULUS.

Introduction: Colonic volvulus is a common cause of large bowel obstruction with the sigmoid colon most commonly affected. Volvulus of the transverse colon is an uncommon occurrence. Rarer still is a transverse colon volvulus developing after surgery for a sigmoid colon volvulus.

SPONTANEOUS TRANSVAGINAL INTESTINAL EVISCERATION IN AN ELDERLY WOMAN.

Introduction: Transvaginal intestinal evisceration is a rare surgical emergency that is associated with morbidity and mortality. Only a few cases of transvaginal evisceration have so far been described. The predisposing risk factors associated with this clinical condition are multifactorial.

PERIOPERATIVE MORBIDITY AND MORTALITY AFTER EMERGENCY AND ELECTIVE COLON AND PROXIMAL RECTAL SURGERY IN IBADAN.

Objective: While the epidemiology of benign colonic pathologies has not significantly changed in our region, colorectal cancer has steadily increased with a majority of patients presenting with late stage disease particularly large bowel obstruction. This study reviews the outcome of emergency and elective colon and proximal rectal cases with regards to perioperative morbidity and mortality.

Setting: All patients who had surgery for symptoms of lower gastrointestinal tract disease (caecum and proximal rectum) between January 2008 and January 2018 at University College Hospital, Ibadan were included.

Fecal Immunochemical Test as a Screening Method for Colorectal Cancer in University College Hospital Ibadan, Nigeria.

Purpose: Colorectal cancer (CRC) is a disease of public health importance because of the increasing incidence of the disease and presentation in advanced stage of the disease in Western Africa. CRC is amenable to screening because of the long course of premalignant lesions before final development of the disease. Despite this, the practice of CRC screening is inadequate at the sites in this study.

Medical Treatment: An Emerging Standard in Acute Appendicitis?

Appendicectomy has been accepted as the gold standard for the management of appendicitis over the years, but there has been an increasing evidence and trend toward the conservative approach to the management of appendicitis. The aim of this review is to search existing literature and to evaluate and compare the conservative and operative approaches to the management of appendicitis. An electronic search of published literature was conducted through Pubmed, Google Scholar, Embase, and Medline using a variety of search items to find relevant observational studies, randomized clinical trials, systematic reviews, and meta-analyses.

A symptom-based model to predict colorectal cancer in low-resource countries: Results from a prospective study of patients at high risk for colorectal cancer.

Background: Colorectal cancer (CRC) rates in low-resource countries, which typically lack CRC screening programs, are rising. This study determined whether a risk model for patients with rectal bleeding could identify patients with curable CRC.

Methods: This prospective, cross-sectional study evaluated a model constructed from data from 1 hospital and validated at 2 other hospitals.

Microsatellite Instability Is Common in Colorectal Cancer in Native Nigerians.

Background: Colorectal cancer (CRC) is the fifth most common cancer in Africa, with significant differences in incidence, biology and clinical behavior from other populations.

Materials And Methods: We studied prevalence and clinicopathological features of microsatellite instability (MSI) and young onset CRC in 83 archival samples from the University of Ibadan, Nigeria.

Results: Nigerian cases of CRC were MSI-high in 43% and MSI-high CRC had significantly lower histological heterogeneity than microsatellite-stable CRC (20% vs.

Emergence of Colorectal Cancer in West Africa: Accepting the Inevitable.

It seems not too long ago that colon and rectal cancer is a "rare" disease in rural Africa; however, over the last 30 years in West Africa, published evidence has shown decade by decade increases in the incidence of colorectal cancer (CRC). Therefore, CRC should now be accepted as a recognized disease in native Africans; nevertheless, we must acknowledge that the incidence is a fraction of what obtains in the developed countries of Europe and America. This presentation will attempt to examine the emergence of CRC within the West African axis over the last four decades.

OUTCOME OF LAPAROTOMY FOR PERITONITIS IN 302 CONSECUTIVE PATIENTS IN IBADAN, NIGERIA.

Background: Peritonitis is a life-threatening condition and requires urgent surgical management. Despite improvements in the care of patients with peritonitis, its management is still challenging and associated with significant morbidity and mortality. The aim of this study was to determine factors influencing the outcome in patients managed for peritonitis in a tertiary health institution in Nigeria.

ADULT ABDOMINAL WALL HERNIA IN IBADAN.

Background: Abdominal wall hernias are very common diseases encountered in surgical practice. Groin hernia is the commonest type of abdominal wall hernias. There are several methods of hernia repair but tension-free repair (usually with mesh) offers the least recurrent rate.

Pregnancy, parturition, parity and position in the family. Any influence on the development of paediatric inguinal hernia/hydrocele?

Aim: To see if pre-partum factors have a relationship to the development of inguinal hernia in children.

Method: A prospective study on children with hernia. On first contact, the affected child was examined and data like the age, sex, weight, blood group, the diagnosis, side of the lesion and other co-morbid conditions was recorded.

Under-reporting of gossipiboma in a third-world country. A sociocultural view.

The paper looks at the reason for the low incidence of retained abdominal packs following an abdominal operation in a third world country like Nigeria. It is generally agreed that this unfortunate situation is underreported. The reason for under-reporting is now given a socio-cultural perspective.

Abdomino-Perineal Resection for Low Rectal and Anal Malignancies in Ibadan, SOUTHWEST NIGERIA.

Background: Colonic tumours are the third most common tumours in the Nigerian cancer registry after breast and cervical carcinoma. Tumours involving the distal rectum and anus are increasingly a significant portion of all colorectal and anal malignancies in Nigeria. The patients frequently present with advanced disease.

Colorectal carcinoma: why is there a lower incidence in Nigerians when compared to Caucasians?

Carcinoma of the colon and rectum is the 2nd commonest cancer in the United States; the leading cancer being lung cancer. It has been estimated that 130,200 new cases of colorectal cancer will be diagnosed annually while 56,300 sufferers will die from the disease (Murphy et al., 2000).

Outcome of one hundred and forty-nine consecutive breast biopsies in Ibadan, Nigeria.

Objective: To study the outcomes of one hundred and forty nine consecutive breast biopsies in both male and female patients in one arm of the general surgery division of the department of surgery, university college hospital Ibadan.

Methodology: A retrospective study of the case files and histopathology reports of 149 patients who had biopsies of the breast from May 1996 to September 2004.

Results: The study showed that below the age of 30 years, there was no malignancy detected in 85 breast biopsies, however as the age increased it was seen that less than one out of four biopsies were malignant when the patients were aged between 31 and 40 years, rising to one out of four biopsies for the 41-50 and 51-60 age-groups.

A review of posttraumatic bowel injuries in ibadan.

Background. Bowel injuries are a leading cause of morbidity and mortality following trauma. Evaluating patients who sustained abdominal trauma with bowel injury may pose a significant diagnostic challenge to the surgeon.

Gastrointestinal stromal tumour in Ibadan, Nigeria: a case report and review of current treatment.

Gastrointestinal stromal tumours (GIST), though rare, present to the gastric surgeon not infrequently making a heightened awareness of this condition a pre-requisite of prompt recognition and timely treatment.. We describe the presentation, diagnosis and the limitations of treatment and follow up of a patient with GIST in a developing country.

A review of the current profile of gastric cancer presentation in the university college hospital Ibadan, a tertiary health care institution in the tropics.

Introduction: Gastric cancer is the fourth commonest malignancy and the second leading cause of cancer-related death. Although gastric carcinoma is less common throughout Africa than in Europe, there are considerable variations in its incidence and pattern. It accounts for about 5% of cancer-related death.

Diaphragm disease of the ileum: an unexpected cause of small bowel obstruction.

Diaphragm disease of the intestine is a rare entity that is commonly associated with long-term non-steroidal anti-inflammatory drug (NSAID) usage. There are reports on those that also occur without appreciable NSAID usage. Resection and anastomosis of the affected segment is the approved treatment.

Mucinous cystadenoma of the appendix: a case report.

Tumours of the appendix are emerging as diseases of increasing concern due to a rising incidence1. We present a case of mucinous cystadenoma of the appendix in an elderly patient. To our knowledge, this is the first report of mucinous cystadenoma of the appendix from Nigeria.

Review of fine needle aspiration cytology in the management of goitres in Ibadan, Nigeria.

Objective: The use of Fine Needle Aspiration Cytology (FNAC) in the investigation of goitres was introduced into our practice more than a decade ago. This is a review of its diagnostic accuracy for thyroid carcinoma seven years after the first evaluation and following the establishment of the 'FNAC Clinic'.

Method: This is a retrospective study of patients who had FNAC of goitres and the histopathology of their thyroidectomy specimens between 1995 and 2004.