Laparoscopic cholecystectomy in Jamaica: the initial experience

This review of all laparoscopic cholecystectomies performed between 1993 and 1995 in Jamaica records the experience of local surgeons following an accelerated training programme. Special attention was paid to operating time, conversions, complications, analgesic requirements, time to discharge and cost. Comparisons were made of the local experience with the international experience. Laparoscopic cholecystectomy has been found to be a safe and viable option for Jamaican patients with gall bladder disease.(AU)

Volvulus of the colon

Volvulus of the colon is a closed loop obstruction resulting from an axial rotation of the colon on its mesentry. It is one of the common causes for obstruction in Northern Iran, East Africa, Eastern Europe and India. It is probably related to the high roughage diet consumed in these communities. These diets are similar to the Jamaican diet. This retrospective study was undertaken to determine the frequency of this type of acute abdominal emergency seen at the University Hospital of the West Indies, (UHWI), Kingston, Jamaica. Colonic volvulus accounted for 8-9 percent of all intestinal obstruction seen at the UHWI between 1971-1976. All types of volvulus were seen with sigmoid volvulus being the most commonly encountered. A high incidence of compound volvulus was also noted. The high roughage diet is suggested as an etiological factor since it is similar to the diet in other countries where the incidence of volvulus is high. Colonic volvulus is an acute surgical emergency requiring prompt diagnosis and urgent treatment. (Summary)

Carcinoma of bladder - abstract

Fifty-four case records of Carcinoma Bladder seen at the Kingston Regional Hospital during the period 1974-1978 were studied. Forty-nine were primary tumour of the bladder and five were secondaries. Twenty-nine were females. The age group ranged from 40 - 82 years; peak incidence was 60-70 years. Presenting symptoms were haematuria 90 percent, dysuria 60 percent, back pain 20 percent. All females had dysuria. Cystoscopy and biopsy were performed in all cases. Hystologically they were:- transitional cell (39), squamous cell carcinoma (5), anaplastic adeno-carcinoma (2), adeno-carcinoma and transitional cell carcinoma (2), transition from transitional cell carcinoma to squamous cell carcinoma (1), secondary transitional cell carcinoma from renal pelvis (1), squamous cell carcinoma from cervix (4). Thirty-nine cases had cobalt therapy only; nine patients had per urethral electro resection of the bladder tumour followed by cobalt therapy; two had partial cystectomy and three had total cystectomy. All had cobalt therapy. One had ideal conduit and cobalt therapy for the tumour, as the lesion was not resectable. Five-year follow-up of all patients was difficult due to the shifting population. Three year survival was 60 percent. Age group; sex ratio and histological type is similar to that seen in other countries, but the majority of our patients presented with Grade III Carcinoma (AU)