Browsing by Author "Baigrie, R J"

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    The Incidence of Inguinal hernia recurrence after Laparoscopic herniorrhaphy - a retrospective multicentre cohort study of patients operated on at a private practice in Cape Town
    (2012) MacGuire, Colin Iain; Kahn, D; Baigrie, R J
    The primary outcome will be the incidence of hernia recurrence. Secondary outcomes will be the incidence of post-operative and long-term pain and complications.
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    The incidence of recurrence after Delorme's procedure for full thickness rectal prolapse - a retrospective private-public cohort study
    (2016) Plaskett, Jeremy John; Baigrie, R J; Goldberg, Paul A; Kahn, D
    Background: Delorme's perineal repair has remained a procedure reserved for full-thickness rectal prolapse in elderly or co-morbid patients due to its low morbidity and complications. Reported recurrence rates are higher than in abdominal approaches. Aim: The study assesses long-term outcomes after Delorme's procedure (DP), specifically recurrence and postoperative bowel function, in both a multi-surgeon public hospital and a single surgeon cohort in the private sector (Groote Schuur Hospital and Kingsbury Hospital). Patients and Methods: This retrospective cohort study includes all patients who underwent DP between February 2001 and March 2014 at both study sites. The primary outcome was absence of recurrence. Secondary outcomes were bowel function (incontinence and constipation), postoperative mortality and morbidity and length of hospital stay. Patient data was collected from electronic records (Kingsbury Hospital) and paper folders/op notes (Groote Schuur Hospital) and current status was acquired by telephonic interview with either the patient, a family member or caregiver, as appropriate. Results: Seventy patients underwent DP: 37 private and 33 public, mean age 71yrs. There were 16 (23%) recurrences (7 private, 9 public), of which 8 (11%) underwent reoperation. Mean time to recurrence was 30 months (48 private; 15 public). There were 2 postoperative deaths (pneumonia, myocardial infarction), 6 major complications (rectal bleeding requiring transfusion or reoperation, bowel obstruction, pneumonia, myocardial infarction), and 6 minor complications (rectal pain, rectal bleeding not requiring reoperation or transfusion, urinary retention, confusion, hyponatraemia). The mean postoperative hospital stay was 4 days. Conclusion: Long-term outcome from this large series compares favorably with most other published series, specifically a low recurrence rate. Proposed reasons for this will be presented, within the context of the published literature.
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    Modern management of colorectal cancer
    (South African Academy of Family Physicians, 2013) Baigrie, R J
    Colorectal cancer affects approximately 1:20 of the population and in South Africa is largely managed by general surgeons. Management of this disease has undergone very significant changes over the last two decades. Until very recently, only two academic general surgery departments included a specialist colorectal unit, and this remains so in the majority of our universities. This has resulted in a generation of surgical graduates who are unfamiliar with, and unskilled in current best management practices for this disease. Rectal cancer is particular challenging and attracts extremely high morbidity and mortality, with poor oncological outcomes. Repeatedly, outcome has been shown to be worse in the hands of generalists, rather than specialist colorectal surgeons, of whom there are very few in the country. This review presents the most important advances of the last 20 years and highlights current controversies and frontiers.