Publications by authors named "Fourie L"

Background: Anastomotic ulcers (AU) at the gastroenterostomy are a common postoperative complication after laparoscopic Roux-en-Y gastric bypass (LRYGB). Possible risk factors for ulcer formation include active smoking, the use of non-steroidal anti-inflammatory drugs, increased tension or ischemia at the anastomosis, or factors that increase the acid secretion of the gastric pouch. Therefore, a longer gastric pouch may increase risk of AU formation after LRYGB.

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Abstarct: BACKGROUND: Early recurrence after esophagectomy is often used as a surrogate for aggressive tumor biology and treatment failure. However, there is no standardized definition of early recurrence, and predictors for early recurrence are unknown. Therefore, we aimed to define an evidence-based cutoff to discriminate early and late recurrence and assess the influence of neoadjuvant treatment modalities for patients with esophageal or gastroesophageal-junction adenocarcinoma (EAC).

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Introduction: Preoperative diagnostic protocols vary worldwide, some prioritizing safety while others question routine procedures. Building on prior research, this study explores the impact of diverse preoperative findings on bariatric management and procedure selection.

Methods: In a retrospective analysis of prospective data of over 1000 bariatric surgery patients from January 2017 to December 2022 undergoing primary laparoscopic Roux-en-Y gastric bypass (LRYGB) or sleeve gastrectomy (LSG) were analyzed.

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Purpose: This exploratory study investigates the possible relationship between inflammation and thrombosis in cervical cancer patients in South Africa, highlighting the need for improved thrombotic risk profiling.

Methods: Thromboelastography (TEG) was used to assess coagulation parameters in platelet-poor plasma (PPP) from a small cohort of late-stage (III and IV) cervical cancer patients (n = 19) and healthy controls (n = 15). Parameters assessed included clotting time, clot formation speed, and clot strength.

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Background: In South Africa, infants who are HIV-exposed are tested for HIV at birth and 10 weeks of age. The COVID-19 pandemic lockdown restrictions resulted in reduced access to healthcare services and uncertain impact on early infant HIV testing.

Objectives: To describe the effects of the COVID-19 pandemic lockdown restrictions on early infant HIV testing and diagnosis in Cape Town, South Africa.

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Article Synopsis
  • The study focuses on comparing the long-term quality of life (QoL) outcomes between two surgical methods for esophageal cancer: open Ivor Lewis esophagectomy (Open-E) and a hybrid approach (hRob-E) that combines laparotomy and robot-assisted surgery.
  • Patients were evaluated 36 to 40 months post-surgery using specific QoL questionnaires, revealing that both groups had similar emotional and cognitive functioning, but noticeable differences in physical functioning and pain.
  • Results suggest that while global health status remains stable post-surgery, hRob-E patients may experience better physical functioning and less pain compared to those who underwent Open-E, indicating potential advantages of the hybrid approach.
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Boomslang (Dispholidus typus) bites are rare in South Africa. This snake's venom is known to be potently haemotoxic, producing a consumptive coagulopathy through the activation of clotting factors II, X, and possibly IX. Monovalent Boomslang antivenom, produced by the South African Vaccine Producers, is highly effective in treating patients who present with haemotoxic envenomation.

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Background: New evidence has emerged since latest guidelines on the management of paraesophageal hernia, and guideline development methodology has evolved. Members of the European Association for Endoscopic Surgery have prioritized the management of paraesophageal hernia to be addressed by pertinent recommendations.

Objective: To develop evidence-informed clinical practice recommendations on paraesophageal hernias, through evidence synthesis and a structured evidence-to-decision framework by an interdisciplinary panel of stakeholders.

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Objectives: The objective was to provide evidence for age-dependent use of neoadjuvant treatment by clinical comparisons of young (lower quartile, <56.6 years) versus old (upper quartile, >71.3 years) patients with esophageal and esophagogastric-junction adenocarcinoma.

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Background: COVID-19 precipitated a plethora of mental health difficulties, particularly for those with pre-existing mental health concerns such as depression or addictive tendencies. For some, the distress that emanated from the experience of the pandemic prompted excessive engagement in the safety of online interactions on social media. The present study examined whether variation in individuals' sense of control explained the association between depression and addictive social media use.

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Article Synopsis
  • Medical students need to learn how to cope with failure in clinical training, as it's an inevitable part of becoming a physician, but curricula rarely address this topic effectively.
  • A workshop was conducted by surgical consultants and a life coach, incorporating various teaching methods, aiming to help students identify, communicate about, and reflect on failures while developing coping strategies.
  • Participants rated the workshop positively, feeling more prepared to handle future challenges and appreciating the opportunity to discuss failure in a safe environment, which could help reduce stigma in medical education.
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Background/aim: Esophagectomy for esophageal cancer is a complex surgical procedure with predefined surgical steps. Anatomical anomalies can offer additional challenges in case of surgical treatment. We present three cases of esophageal carcinoma with thoracic anatomical anomalies affecting the treatment strategy.

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Background: Point-of-care ultrasound (POCUS) improves patient outcomes. The current POCUS curriculum of the Emergency Medicine Society of South Africa is based on guidelines from the United Kingdom with a different burden of disease (BoD) and available resources than encountered locally.

Aim: To determine which modules of the POCUS curriculum should be implemented to better equip doctors working at a district hospital in the West Coast District (WCD), South Africa.

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Unlabelled: Noma is an infectious disease affecting mostly children aged 0-10. Although it has almost completely disappeared from the Western world, it is still prevalent in many developing regions, mainly Africa's Sahel region. The infection behaves like a necrotizing fasciitis of the face, originating from the gums and progressively expanding into the cheek, nose, or eye regions.

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Article Synopsis
  • Laparoscopic Heller myotomy (HM) is the standard treatment for achalasia, but there's ongoing debate about whether robotic-assisted laparoscopic (RAL) HM offers better outcomes than traditional laparoscopic surgery (LSC).
  • A study tracked 43 patients over several years to compare intraoperative results, complications, and long-term quality of life using a specific health-related quality of life questionnaire.
  • Results indicated that while RAL had longer operation times and a similar number of complications compared to LSC, long-term satisfaction and quality of life were comparable in both groups, although the follow-up period was notably longer for LSC patients.
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Indocyanine green fluorescence angiography (ICG-FA) allows for real-time intraoperative assessment of the perfusion of the gastric conduit during esophagectomy. The aim of this study was to investigate the effect of the implementation of ICG-FA during robot-assisted minimally invasive esophagectomy (RAMIE) with an intrathoracic anastomosis. In this prospective cohort study, a standardized protocol for ICG-FA was implemented in a high-volume center in December 2018.

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We present two patients with right lower quadrant pain during the 36th week of pregnancy. In both cases, the challenges in diagnosing acute appendicitis in late pregnancy is underlined by misleading imaging results, revealing fluid in the lower abdomen, suggesting an appendicitis. Surgery was performed.

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Background: Esophageal cancer surgery is technically highly demanding. During the past decade robot-assisted surgery has successfully been introduced in esophageal cancer treatment. Various techniques are being evaluated in different centers.

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Article Synopsis
  • Focal nodular hyperplasia (FNH) is usually a benign liver tumor, but this study explores its rare co-occurrence with hepatocellular carcinoma (HCC).
  • A 74-year-old woman's liver tumor containing both FNH and HCC was analyzed using histology and whole exome sequencing to understand their relationship.
  • The results indicate that the FNH is genetically related to the HCC, suggesting that FNH can potentially transform into HCC due to genetic changes and selection, challenging the belief of FNH's benignity.
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Managing aesthetic expectations for patients post facial operations can be challenging in the high-income countries, yet alone in low-income countries. This cohort study involved patients undergoing facial operations during the October 2018 Facing Africa charitable surgical trip at the Nordic Medical Centre in Addis Ababa, Ethiopia. Twenty-one patients were shown pre and postoperative photographs of patients who had operations for similar facial pathologies on a prior surgical mission.

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Introduction And Importance: Abdominal pain in the right upper quadrant is very common for patients to present in the emergency department. Finding the correct diagnosis seems straightforward in most cases but can be challenging.

Case Presentation: We present the case of a 75-year-old male with a rare differential diagnosis for right upper quadrant and back pain, initially diagnosed as symptomatic cholelithiasis.

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Purpose: Robotic-assisted procedures are increasingly used in esophageal cancer surgery. We compared postoperative complications and early oncological outcomes following hybrid robotic-assisted thoracoscopic esophagectomy (Rob-E) and open Ivor Lewis esophagectomy (Open-E), performed in a single mid-volume center, in the context of evolving preoperative patient and tumor characteristics over two decades.

Methods: We evaluated prospectively collected data from a single center from 1999 to 2020 including 321 patients that underwent Ivor Lewis esophagectomy, 76 underwent Rob-E, and 245 Open-E.

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