A prospective study to evaluate access to elective surgical services in a urology unit of Sri Lanka

Ambegoda, Madura; Weligamage, W.A.S.; Ishak, M.C.M.; Gobi, U.; Suvendiran, Swarna; Mahadeva, S.; Mahesh, Paras; Jayawardene, Malaka; Abeygunasekera, Anuruddha M

doi:10.4038/sljs.v36i1.8474

Cited by 3 publications

(3 citation statements)

References 10 publications

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“…This is important to prevent unnecessary postponement of other surgeries in a busy urological theatre schedule. 6 Moreover, SA provides better postoperative analgesia and minimises catheter pain. However, randomised prospective study is necessary to assess the true efficacy and safety of GA over SA and ONB for high risk patients undergoing TURBT for better quantitative assessment.…”

Section: Discussionmentioning

confidence: 99%

Outcome of transurethral resection of bladder tumour under spinal anaesthesia combined with obturator nerve block in Sri Lanka

et al. 2022

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Purpose: Transurethral resection of bladder tumour (TURBT) is done under general anaesthesia (GA) with muscle relaxation to prevent obturator jerk and bladder perforation. TURBT under spinal anaesthesia (SA) with obturator nerve block (ONB) may prevent the obturator jerk while eliminating the disadvantages of GA. Objectives: To assess the outcome of TURBT under SA and ONB. Methods: Patients undergoing TURBT for lateral wall tumours from 01.11.2017 to 30.10.2020 were prospectively studied. Anterior branch of obturator nerve with plain Bupivacaine was blocked with the guidance of an ultrasound scan and a nerve stimulator. Significant obturator jerk which necessitated conversion to GA was defined as failed ONB. Results: Out of 72 patients with mean age of 66.7 years underwent ONB, 61 (84.7%) were men. Fifty two (72.2%) had unilateral and 20 (27.8%) had bilateral blocks. Sixty one (84.7%) patients had no obturator jerk whereas 5 (7%) had a mild jerk which did not preclude safe resection. Six patients (8.3%) had a failed ONB requiring conversion to GA. None had a bladder perforation requiring laparotomy, developed neurovascular injury or anaesthetic toxicity and only one patient required intensive care monitoring. Conclusion: SA with anterior branch of ONB is an effective and safe alternative to GA with muscle relaxation for TURBT although a randomized trial is necessary to determine the true efficacy and safety over the other.

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Section: Discussionmentioning

confidence: 99%

Outcome of transurethral resection of bladder tumour under spinal anaesthesia combined with obturator nerve block in Sri Lanka

et al. 2022

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“…Although urological services have expanded throughout all the districts in the country, little change is seen in patient behaviour in seeking urological services in the district they reside. This has led to over burdening of long standing units and providing an acceptable urological care for the population living within the jurisdiction even more difficult [3]. Although development of trust among patients as a new unit which can provide safe urological care is a time-honoured endeavour, most such units are hampered by maldistribution of theatre time, shortage of human resources and specialized basic urological armamentarium.…”

Section: Discussionmentioning

confidence: 99%

Cancer audit of a urology unit from a teaching hospital in Sri Lanka – 2019

et al. 2020

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“…Although breast and thyroid are commonest cancers in Sri Lanka, there are no dedicated breast and endocrine cancer centers. Furthermore, there are no centralized and dedicated cancer centers for urological malignancies manned by urological surgeons specialized in uro-oncology [28]. Lack of community-based nursing care service essential for stoma management, tracheostomy care, and wound care is an unmet need.…”

Section: Diagnosis and Treatmentmentioning

confidence: 99%

Cancer services in Sri Lanka: current status and future directions

Jayarajah

Abeygunasekera

2021

J Egypt Natl Canc Inst

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Background The burden of cancer in Sri Lanka is on the rise. The overall incidence of cancer in Sri Lanka has doubled over the past 25 years with a parallel rise in cancer-related mortality. Cancer has become the second commonest cause of hospital mortality in Sri Lanka. In this review, we aim to provide an overview of the current status and future direction of cancer care in Sri Lanka. Main body In Sri Lanka, cancer services are predominantly provided by the state sector free of charge to the general public. With the establishment of national cancer policy on cancer prevention and control, there has been a commendable improvement in the cancer services provided island-wide. An increasing number of breast, oropharyngeal, thyroid, oesophageal, colorectal, lung, and gastric cancers are being diagnosed and treated annually. Primary prevention measures include restrictions in tobacco and HPV vaccination. Screening programs for selected cancers such as breast, oral and cervical cancers are delivered. Medical oncology units with facilities for systemic therapy and adequately supported by surgical, pathology, and radiology departments have been established in each district general hospital island-wide. Although the current progress is commendable, future changes are necessary to overcome the current limitations and to cater the ever increasing burden of cancer. Measures are necessary to enhance the coverage of Sri Lanka Cancer Registry. Timely high-quality research and audits are essential. Community participation in planning strategies for cancer prevention and treatment is minimal. Community-based palliative care facilities and radiation and other systemic therapy should be made available in all provinces. A culture of multi-disciplinary care with proper referral pathways would help to improve the current setting. Conclusion In conclusion, Sri Lanka has a reasonably balanced and continuously expanding program for prevention, screening, and treatment of cancers. Emphasis on preventive strategies related to reducing tobacco smoking, chewing betel, and obesity, making cancers a notifiable disease, involving the community in planning cancer care and prevention strategies, conducting research to evaluate cost-effectiveness of existing treatment and increasing radiotherapy facilities would further improve the cancer services in Sri Lanka.

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A prospective study to evaluate access to elective surgical services in a urology unit of Sri Lanka

Cited by 3 publications

References 10 publications

Outcome of transurethral resection of bladder tumour under spinal anaesthesia combined with obturator nerve block in Sri Lanka

Outcome of transurethral resection of bladder tumour under spinal anaesthesia combined with obturator nerve block in Sri Lanka

Cancer audit of a urology unit from a teaching hospital in Sri Lanka – 2019

Cancer services in Sri Lanka: current status and future directions

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