Oluwasanmi Ajagbe

Virginal breast hypertrophy VBH with the sobriquet "gigantomastia" is an uncommon condition with sporadic presentation usually in adolescence. Case presentation: In this retrospective study, eight patients (three case summaries presented, while the clinicopathologic features of all the patients are presented in Table 1) were managed. Discussion: The age range in this retrospective cohort study is 13-34 years and the series consists predominantly of teenagers, a third had bilateral disease, and the symptoms triad of mastalgia, cosmetic concerns, and psychosocial/esteem issues were present in all the patients. With a third consenting to surgical intervention. We present what to our knowledge must be in the global literature, one of the few largest accruals of cases of gigantomastia, the VBH, seen over time in our surgical oncology practice. Conclusion: VBH should be appraised along with other BBD to exclude malignancies and provide prompt and appropriate care whilst limiting complications. A multidisciplinary approach is particularly important and incorporating care for perceived low self-esteem cannot be overemphasized .

Background: Cluster randomised controlled trials (cRCT) present challenges regarding risks of bias and chance imbalances by arm. This paper reports strategies to minimise and monitor biases and imbalances in the ChEETAh cRCT. Methods: ChEETAh was an international cRCT (hospitals as clusters) evaluating whether changing sterile gloves and instruments prior to abdominal wound closure reduces surgical site infection at 30 days postoperative. ChEETAh planned to recruit 12,800 consecutive patients from 64 hospitals in seven low-middle income countries. Eight strategies to minimise and monitor bias were pre-specified: (1) minimum of 4 hospitals per country; (2) pre-randomisation identification of units of exposure (operating theatres, lists, teams or sessions) within clusters; (3) minimisation of randomisation by country and hospital type; (4) site training delivered after randomisation; (5) dedicated ‘warm-up week’ to train teams; (6) trial specific sticker and patient register to monito...

Background: Adhesive Bowel Obstruction (ABO) is a major cause of intestinal obstruction globally and in the developing world. Although guidelines for its management lean towards initial non-operative management, it is important to identify factors that may predict the need for an operative intervention in the early phase of presentation. Method: This was a retrospective study of all adult cases of ABO managed at the University College Hospital (UCH), Ibadan from January 2016 to December, 2020. The sociodemographic and clinical data of the patients were obtained. Patients with incomplete data were excluded. Data was analysed using version 22 of the SPSS and statistical significance set at a p-value of <0.05. Results: The study population was eighty-four patients. The mean age was 43 ± 15.8 years with a M:F of 1:1.2. Thirty-five percent (n=29) of them had been previously admitted in other hospital prior to presentation at UCH. Ninety-five percent (n=80) had previous abdominal surgery. Majority of the previous surgeries (36.9%; n=31) were Obstetric and Gynecologic (O&G) and 55% of these O&G surgeries (n=17) were Caesarean section. The median time from previous surgery to development of symptom was 36 months (Inter-Quartile Range {IQR}=599). Operative management was done in 27.4% (n=23) patients, adhesiolysis with bowel resection and anastomosis being the most commonly performed procedure (52.2%; n=12). Hospital admission prior to presentation at UCH and previous abdominal/pelvic surgeries were significantly associated with the eventual mode of management. However, hospital admission prior to presentation was the only factor predictive of an operative intervention with those admitted in another hospital being 4 times at risk of requiring surgery (p=0.021). Conclusion: Hospital admission prior to presentation was associated with an operative intervention in adult patients with ABO.

Virginal breast hypertrophy VBH with the sobriquet "gigantomastia" is an uncommon condition with sporadic presentation usually in adolescence. Case presentation: In this retrospective study, eight patients (three case summaries presented, while the clinicopathologic features of all the patients are presented in Table 1) were managed. Discussion: The age range in this retrospective cohort study is 13-34 years and the series consists predominantly of teenagers, a third had bilateral disease, and the symptoms triad of mastalgia, cosmetic concerns, and psychosocial/esteem issues were present in all the patients. With a third consenting to surgical intervention. We present what to our knowledge must be in the global literature, one of the few largest accruals of cases of gigantomastia, the VBH, seen over time in our surgical oncology practice. Conclusion: VBH should be appraised along with other BBD to exclude malignancies and provide prompt and appropriate care whilst limiting complications. A multidisciplinary approach is particularly important and incorporating care for perceived low self-esteem cannot be overemphasized .

Background: Breast cancer subtypes are often used as therapeutic and prognostic measures; however, it is unclear whether there is an association between molecular subtypes and site-specific metastasis. Our study aimed to evaluate the relationship between molecular subtypes and developing metastasis in specific sites. Methods: We selected 118 breast cancer patients with immunohistochemistry confirmed molecular subtype diagnosed in 2020 and 2021 at the Department of Surgery, University College Hospital, Ibadan. We classified the molecular subtypes into four categories, HR+/HER2-, HR-/HER2+, HR+/HER2+, and triple negative (HR-/HER2-). The different sites of metastasis of interest were lungs, liver, brain, and bone. We used the chi-square test to determine the proportions and significance of the subtypes based on the different sites assessed. Results: According to our study, 45.50%, 18.20%, and 36.40% of patients presented with lungs, liver, and other (multiple organs and contralateral ...

Background: Gastrointestinal stromal tumors (GISTs) are characterized by specific immunohistochemical and genetic features. This study investigated the clinicopathologic features and surgical outcomes of 54 patients with GIST in a major referral hospital in sub-Sahara Africa. Methods: This retrospective cross-sectional single-center study describes 54 patients who underwent surgery for GIST between 1999 and 2019 in a Nigerian Tertiary Hospital. All cases were confirmed by immunohistochemistry and were analyzed for clinical characteristics, clinical management, and histopathologic data. The risk of recurrence was determined using the Fletcher National Institutes of Health criteria. Results: The mean age of the patients was 57.6 years ± 15.3 (11–81 years), and most patients (67%) underwent abdominal computed tomography scans preoperatively. The most common presentation was an abdominal mass (48%). The stomach was the most common site of GIST (37%). The mean tumor size was 8.9 cm (5–18...