scholarly journals LO92: Factors contributing to the development of adverse drug events treated in emergency departments

CJEM ◽  
2017 ◽  
Vol 19 (S1) ◽  
pp. S59-S60 ◽  
Author(s):  
S. Woo ◽  
A. Cragg ◽  
M.E. Wickham ◽  
C.R. Ackerley ◽  
D. Villanyi ◽  
...  
Keyword(s):  
Adverse Drug Events ◽  
Treatment Guidelines ◽  
Tertiary Care ◽  
Patient Counseling ◽  
Contributing Factors ◽  
Recommended Treatment ◽  
Drug Regimens ◽  
System Factors ◽  
Systematic Selection

Introduction: Adverse drug events (ADEs), unintended and harmful events associated with medications, commonly cause or contribute to emergency department (ED) presentations. Understanding provider, patient and system factors that contribute to their development may assist in developing effective preventative strategies. Our objective was to identify factors that contributed to the development of ADEs that caused ED presentations. Methods: We reviewed the charts of ADE patients enrolled in 1 of 3 prospective studies conducted in 3 tertiary care and 1 urban community ED. In the parent studies, researchers enrolled patients by applying a systematic selection algorithm to minimize selection bias, and physicians and pharmacists evaluated patients prospectively to evaluate the causal associations between the drug regimens and patient presentations. Subsequently, a research pharmacist and physician independently reviewed the charts of ADE patients from these cohorts, abstracting data using electronic forms. Reviewers recorded patient, provider and system factors that contributed to the development of ADEs. The main outcome was the presence of at least one contributing factor in the development of an ADE. We used descriptive statistics with appropriate measures of variance. The sample size was determined by enrolment into the primary studies. Results: We reviewed the charts of 670 patients diagnosed with 725 ADEs. We identified ≥1 contributing factors in 62% (95%CI 58-65%) of ADEs. Multiple contributing factors were present in 17% of ADEs (95%CI 13-20%). The most common contributing factors were inadequate patient counseling or instructions about medication use (15%), insufficient laboratory monitoring or follow-up of monitoring tests (12%), lack of staff education (7%), lack of provider adherence with recommended treatment guidelines (7%), and delayed or inadequate clinical reassessment after a medication change (6%). Provider errors in drug administration contributed to 0.3% of ADEs (95%CI 0.0-0.7). Conclusion: Contributing factors were identified for most ADEs. They were often related to inadequate counseling and follow-up, and were rarely the result of errors. Further research is required to understand how communication of medication instructions can be improved. Investments in technologies to reduce provider errors may not significantly reduce the numbers of ADE patients presenting to EDs.

scholarly journals P061: Preventable adverse drug events in Canadian emergency departments

CJEM ◽  
2017 ◽  
Vol 19 (S1) ◽  
pp. S98-S99
Author(s):  
C.M. Hohl ◽  
S. Woo ◽  
A. Cragg ◽  
C.R. Ackerley ◽  
M.E. Wickham ◽  
...  
Keyword(s):  
Mental Health ◽  
Adverse Drug Events ◽  
Tertiary Care ◽  
Rater Agreement ◽  
Adherence Behavior ◽  
Drug Regimens ◽  
Ed Visits ◽  
Mental Health Diagnoses ◽  
Systematic Selection ◽  
Preventable Ades

Introduction: Adverse drug events (ADEs), unintended and harmful events associated with medications, cause or contribute to 2 million emergency department (ED) visits in Canada each year. Our objective was to determine the proportion of preventable ADEs by event type, severity, drug and drug class, and describe associated factors. Methods: We reviewed the charts of ADE patients enrolled in 1 of 3 prospective studies conducted in 3 tertiary care and 1 urban community ED. In the parent studies, researchers enrolled patients by applying a systematic selection algorithm to minimize selection bias, and physicians and pharmacists evaluated patients prospectively to evaluate causal associations between the drug regimens and patient presentations. After completion of the prospective study, a research pharmacist and physician independently reviewed the charts of all ADE patients, abstracted data using an electronic form and applied 3 preventability algorithms. The main outcome was a probably or definitely preventable ADE defined as avoidable by adhering to best medical practice, appropriate monitoring, taking a history of prior ADEs, compliance with recommended therapy, and avoidance of errors. Reviewers discussed discordant ratings until reaching consensus. We used kappa scores to evaluate between rater agreement, and investigated risk factors for preventability using logistic regression. Sample size was based on enrolment into the parent studies. Results: We reviewed the charts of 670 patients diagnosed with 725 ADEs. We excluded 44 patients with incomplete assessments. The inter-rater agreement in categorizing ADEs as preventable was 0.51 (95%CI 0.42-0.59). We deemed 61% (95%CI 57-65%) of ADEs preventable. Of preventable events, 30% were due to non-adherence, 24% to adverse reactions, and 15% to an excessive dose, and 29% required hospital admission. Among preventable events, 8% were due to warfarin, 5% hydrochlorothiazide, 3% acetylsalicylic acid, and 3% insulin. On multivariate analysis, mental health diagnoses were associated with preventable ADEs (OR 2.1, 95%CI 1.3-3.3, p=0.002). Conclusion: In this large multi-centre cohort, preventable events made up the majority of ADEs, and utilized substantial hospital resources. Strategies to reduce ED visits due to ADEs should target improving adherence behavior, and developing interventions for patients with mental health diagnoses and on high-risk medications.

scholarly journals LO91: Repeat exposures to culprit drugs contribute to adverse drug events in emergency department patients

CJEM ◽  
2017 ◽  
Vol 19 (S1) ◽  
pp. S59
Author(s):  
C.M. Hohl ◽  
S. Woo ◽  
A. Cragg ◽  
D. Villanyi ◽  
M.E. Wickham ◽  
...  
Keyword(s):  
Emergency Department ◽  
Adverse Drug Events ◽  
Tertiary Care ◽  
Inappropriate Drug ◽  
Drug Classes ◽  
Culprit Drug ◽  
Drug Regimens ◽  
Systematic Selection ◽  
Emergency Department Patients ◽  
Repeat Events

Introduction: Adverse drug events (ADEs), unintended and harmful events associated with medications, cause or contribute to 2 million annual emergency department (ED) visits in Canada. Australian data indicate that 27% of ADEs requiring admission are events caused by re-exposure to drugs that previously caused harm. Our objective was to estimate the frequency of repeat ADEs. Methods: We reviewed the charts of ADE patients who had been enrolled in 1 of 3 prospective studies conducted in 2 tertiary care and 1 urban community ED. In the parent studies, researchers enrolled patients by applying a systematic selection algorithm to minimize selection bias, and physicians and pharmacists evaluated patients prospectively to evaluate the causal association between the drug regimens and patient presentations. After completion of the parent studies, a research pharmacist and a physician independently reviewed the charts of ADE patients, abstracted data using electronic forms, and searched that hospital’s records for previously recorded ADEs. The main outcome was a repeat ADE, defined as a same or same-class drug re-exposure, or repeat inappropriate drug withdrawal, causing a same or similar presentation as a prior ADE. Sample size was based on enrolment into the parent studies. Results: We reviewed the charts of 614 ED patients diagnosed with 655 ADEs. Of these, 20% (133/665, 95%CI 17.0-23.0%) were repeat events. Most repeat ADEs were moderate (61%) or severe (32%) in nature, and 33% (95%CI 25.1-41.1%) required hospital admission. The most commonly implicated drugs were warfarin (10%), hydrochlorothiazide (4%) and insulin (4%), and the most commonly implicated drug classes were antithrombotics (17%), psychotropics (12%) and analgesics (9%). Repeat ADEs commonly required clinical monitoring (59%), additional medications to treat the ADE (50%) and follow-up lab testing (35%). Overall, 61% (95%CI 51.3-70.7%) of culprit drug re-exposures were deemed potentially or definitely inappropriate. Conclusion: Inappropriate re-exposures to previously harmful medications cause a substantial number of recurrent ADEs, and may represent an ideal target for prevention. We were unable to search for repeat ADEs in the records of other hospitals that our patients may have visited, and could not detect ADEs that were not documented in the medical record. As a result, we likely underestimated the frequency of repeat ADEs.

scholarly journals High Mortality in HIV-Associated Cryptococcal Meningitis Patients Treated With Amphotericin B–Based Therapy Under Routine Care Conditions in Africa

2018 ◽  
Vol 5 (11) ◽  
Author(s):  
Raju K K Patel ◽  
Tshepo Leeme ◽  
Caitlin Azzo ◽  
Nametso Tlhako ◽  
Katlego Tsholo ◽  
...  
Keyword(s):  
Amphotericin B ◽  
Cryptococcal Meningitis ◽  
Treatment Guidelines ◽  
Routine Care ◽  
Outcome Data ◽  
High Dose ◽  
Recommended Treatment ◽  
Amphotericin B Deoxycholate ◽  
Intravenous Amphotericin

Abstract Background Cryptococcal meningitis (CM) causes 10%–20% of HIV-related deaths in Africa. Due to limited access to liposomal amphotericin and flucytosine, most African treatment guidelines recommend amphotericin B deoxycholate (AmB-d) plus high-dose fluconazole; outcomes with this treatment regimen in routine care settings have not been well described. Methods Electronic national death registry data and computerized medical records were used to retrospectively collect demographic, laboratory, and 1-year outcome data from all patients with CM between 2012 and 2014 at Botswana’s main referral hospital, when recommended treatment for CM was AmB-d 1 mg/kg/d plus fluconazole 800 mg/d for 14 days. Cumulative survival was estimated at 2 weeks, 10 weeks, and 1 year. Results There were 283 episodes of CM among 236 individuals; 69% (163/236) were male, and the median age was 36 years. All patients were HIV-infected, with a median CD4 count of 39 cells/mm3. Two hundred fifteen person-years of follow-up data were captured for the 236 CM patients. Complete outcome data were available for 233 patients (99%) at 2 weeks, 224 patients (95%) at 10 weeks, and 219 patients (93%) at 1 year. Cumulative mortality was 26% (95% confidence interval [CI], 20%–32%) at 2 weeks, 50% (95% CI, 43%–57%) at 10 weeks, and 65% (95% CI, 58%–71%) at 1 year. Conclusions Mortality rates following HIV-associated CM treated with AmB-d and fluconazole in a routine health care setting in Botswana were very high. The findings highlight the inadequacies of current antifungal treatments for HIV-associated CM and underscore the difficulties of administering and monitoring intravenous amphotericin B deoxycholate therapy in resource-poor settings.

scholarly journals Preoperative Diagnosis predicts Outcomes in Patients with Concurrent Medullary and Papillary Thyroid Carcinoma

2017 ◽  
Vol 9 (3) ◽  
pp. 94-99 ◽  
Author(s):  
Insoo Suh ◽  
Quan-Yang Duh ◽  
Toni Beninato ◽  
Orlo H Clark ◽  
Wen T Shen ◽  
...  
Keyword(s):  
Papillary Thyroid Carcinoma ◽  
Thyroid Carcinoma ◽  
Preoperative Diagnosis ◽  
Recurrent Disease ◽  
Tertiary Care ◽  
Primary Objective ◽  
Papillary Thyroid ◽  
Patient Counseling ◽  
Incidental Discovery

ABSTRACT Aim This study examined patients with concurrent medullary thyroid carcinoma (MTC) and papillary thyroid carcinoma (PTC) with the primary objective of identifying factors that can determine the dominant subtype that will dictate recurrence. Materials and methods The cancer registry at our tertiary care referral center was reviewed to identify all patients from 1995 to 2015 who had been diagnosed with both MTC and PTC on initial total thyroidectomy. Patient demographic, pathology, and recurrence data were collected and reviewed. Results Nineteen patients met the inclusion criteria. Seventeen patients had separate foci of MTC and PTC, and two patients had mixed tumors of medullary and follicular or medullary and the follicular variant of PTC. Thirteen patients had a preoperative diagnosis of MTC, and all 13 had MTC as the higher stage tumor on final pathology. Of these, eight patients had recurrent disease, all of which recurred as MTC. In the six patients with concurrent MTC and PTC who did not have MTC as the preoperative diagnosis, the PTC was the higher stage tumor. Only one patient in this group recurred with PTC, none with MTC. No patients have had recurrent disease that was a different subtype from their preoperative diagnosis or the higher stage tumor. Conclusion The concurrent findings of MTC and PTC in the same patient may result in challenging patient counseling, management, and follow-up. In this series of 19 patients with concurrent PTC and MTC, the subtype of recurrence in all 9 patients with recurrent disease was determined by the preoperative diagnosis and higher stage tumor. Clinical significance The incidental discovery of a second subtype of differentiated thyroid cancer should not alter management of the primary tumor. Patients should be treated in accordance with the preoperative diagnosis and higher stage tumor. How to cite this article Beninato T, Kluijfhout WP, Drake FT, Shen WT, Suh I, Duh QY, Clark OH, Gosnell JE. Preoperative Diagnosis predicts Outcomes in Patients with Concurrent Medullary and Papillary Thyroid Carcinoma. World J Endoc Surg 2017;9(3):94-99.

Favorable Outcomes with Reduced Steroid Use in Juvenile Dermatomyositis

2021 ◽  
Author(s):  
Amir B. Orandi ◽  
Lampros Fotis ◽  
Jamie Lai ◽  
Hallie Morris ◽  
Andrew White ◽  
...  
Keyword(s):  
Disease Control ◽  
Median Duration ◽  
Treatment Guidelines ◽  
Juvenile Dermatomyositis ◽  
Tertiary Care ◽  
Primary Outcome Measure ◽  
High Dose ◽  
Day Range ◽  
Oral Steroids

Abstract Background High-intensity glucocorticoid regimens are commonly used to induce and maintain remission in Juvenile Dermatomyositis (JDM) but are associated with several adverse side-effects. Eminence-based treatment guidelines from CARRA and SHARE both advocate induction of intravenous pulse steroids followed by high dose oral steroids (2 mg/kg) tapered over 12 months. This study compares the time to disease control with reduced glucocorticoid dosing. Methods We retrospectively reviewed the records at a single tertiary-care children’s hospital of patients with JDM between 2000 and 2014 who had a minimum of 2 years of follow-up. The primary outcome measure was time to control of muscle and skin disease. Additional outcome measures included glucocorticoid dosing, effect of treatment on height, frequency of calcinosis and complications from treatment. Results Of the 69 patients followed during the study period, 31 fulfilled inclusion criteria. Median length of follow-up was 4.58 years, (3–7.5). Myositis control was achieved in a median of 7.1 months (range 0.9–63.4). Cutaneous disease control was achieved in a median of 16.7 months (range 4.3–89.5). The median starting dose of glucocorticoids was 0.85 mg/kg/day, (range 0.5–1.74). The median duration of steroid treatment was 9.1 months, (range 4.7–17.4), while the median duration of any pharmacotherapy was 29.2 months (range 10.4 to 121.3). Sustained disease control off medications was achieved in 21/31 (68%) patients by the end of review. Persistent calcinosis was identified in only one patient (3%). Conclusion Current accepted treatment paradigms for JDM include oral glucocorticoids beginning at 2 mg/kg/d reduced over 12 months; however, our results suggest that treatment using reduced doses and durations with early use of steroid-sparing agents are comparably effective in achieving favorable outcomes in JDM.

scholarly journals ANTIMALARIAL USE IN THE MANAGEMENT OF MALARIA IN PREGNANCY IN A TERTIARY CARE SETTING IN SOKOTO, NORTH WESTERN NIGERIA

2013 ◽  
Vol 1 (3) ◽  
Author(s):  
Jimoh AO ◽  
Shehu CE ◽  
Panti AA ◽  
Sani Z ◽  
Abubakar K ◽  
...  
Keyword(s):  
Treatment Guidelines ◽  
Artemisinin Combination Therapy ◽  
Tertiary Care ◽  
Malaria In Pregnancy ◽  
University Teaching ◽  
Health Concern ◽  
Prescribing Indicators ◽  
Recommended Treatment ◽  
Generic Prescribing ◽  
In Pregnancy

Background: Malaria in pregnancy still remains a public health concern that needs to be addressed; it ranks among the commonest causes of complications in pregnancy, leading to maternal morbidity and mortality. Objectives: This study is aimed at reviewing the pattern of antimalarial use in the management of malaria in pregnancy so as to determine the compliance of prescribers to recommended guidelines and policies of drug use in pregnancy, and review the core prescribing indicators. Methodology: This was a retrospective study conducted between 1st January 2012 to 31st December 2012 at the Department of Obstetrics and Gynecology Usmanu Danfodiyo University teaching hospital (UDUTH), Sokoto – Nigeria. Case notes of pregnant women seen and managed as a case of Malaria in pregnancy within the study period were retrieved. Data analysis was done using the statistical package for social sciences (SPSS) 17.0. Results: Four hundred and eighty two case folders were retrieved within the study period. The mean age was 26.8 ± 5.01 years. Artemisinin combination therapy (ACTs) were the most commonly prescribed drugs; Artemether-lumefantrine 68% (328), artemether 42 (8.7%), artesunate and artesunate-SP each 20 (4.1%) of the patients respectively. The diagnostic approach was clinical symptomatology (62.2%) and Laboratory confirmed in only (37.8%). Generic prescribing accounted for 48.9%, injectables and antibiotics accounted for 21.2% and 43.2% respectively. Conclusions and Recommendations: Optimum adherence to recommended treatment guidelines is advocated. ACTs were the most prescribed antimalarial irrespective of the trimester. There was lack of compliance with prompt parasitological confirmation by microscopy or Rapid Diagnostic Tests (RDTs) in many of the patients suspected of malaria. Core prescribing indicators were not in consonance with standard reference values in this study. An urgent need for continuing medical education and professiona

scholarly journals Favorable outcomes with reduced steroid use in juvenile dermatomyositis

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Amir B. Orandi ◽  
Lampros Fotis ◽  
Jamie Lai ◽  
Hallie Morris ◽  
Andrew J. White ◽  
...  
Keyword(s):  
Disease Control ◽  
Median Duration ◽  
Treatment Guidelines ◽  
Juvenile Dermatomyositis ◽  
Tertiary Care ◽  
Primary Outcome Measure ◽  
High Dose ◽  
Oral Steroids ◽  
Dose Oral

Abstract Background High-intensity glucocorticoid regimens are commonly used to induce and maintain remission in Juvenile Dermatomyositis but are associated with several adverse side-effects. Evidence-based treatment guidelines from North American and European pediatric rheumatology research societies both advocate induction with intravenous pulse steroids followed by high dose oral steroids (2 mg/kg/day), which are then tapered. This study reports the time to disease control with reduced glucocorticoid dosing. Methods We retrospectively reviewed the records at a single tertiary-care children’s hospital of patients diagnosed with Juvenile Dermatomyositis between 2000 and 2014 who had a minimum of 2 years of follow-up. The primary outcome measure was time to control of muscle and skin disease. Additional outcome measures included glucocorticoid dosing, effect of treatment on height, frequency of calcinosis, and complications from treatment. Results Of the 69 patients followed during the study period, 31 fulfilled inclusion criteria. Median length of follow-up was 4.58 years, (IQR 3–7.5). Myositis control was achieved in a median of 7.1 months (IQR 0.9–63.4). Cutaneous disease control was achieved in a median of 16.7 months (IQR 4.3–89.5). The median starting dose of glucocorticoids was 0.85 mg/kg/day, (IQR 0.5–1.74). The median duration of steroid treatment was 9.1 months, (IQR 4.7–17.4), while the median duration of any pharmacotherapy was 29.2 months (IQR 10.4 to 121.3). Sustained disease control off medications was achieved in 21/31 (68%) patients by the end of review. Persistent calcinosis was identified in only one patient (3%). Conclusion Current accepted treatment paradigms for Juvenile Dermatomyositis include oral glucocorticoids beginning at 2 mg/kg/day and reduced over a prolonged time period. However, our results suggest that treatment using reduced doses and duration with early use of steroid-sparing agents is comparably effective in achieving favorable outcomes in Juvenile Dermatomyositis.

scholarly journals Spectrum of congenital anomalies of neonates in a tertiary care hospital in Southern India

2018 ◽  
Vol 5 (2) ◽  
pp. 314
Author(s):  
Ananya S. L. Tenali ◽  
Santosh K. Kamalakannan ◽  
Kumutha K. Jayaraman
Keyword(s):  
Congenital Anomalies ◽  
Tertiary Care ◽  
Care Hospital ◽  
Patient Counseling ◽  
Frequency Pattern ◽  
Neonatal Deaths ◽  
Minor Anomalies ◽  
Difficult Challenge ◽  
Cns Anomalies

Background: Congenital anomalies contribute upto 11% of neonatal deaths globally. Neonates with multiple congenital malformations present a very difficult challenge to the treating physicians. This study was done to know the frequency, pattern of congenital anomalies and various presentations, which may help to develop strategies for patient counseling and management in our setting.Methods: Retrospective hospital based observational study from the period of June 2015 to June 2017. Neonates born in our hospital during the study period with documented congenital anomalies were included in the study and the data was classified as per European Surveillance of Congenital Anomalies and further analysed.Results: Total number of neonates with documented congenital anomalies was 40, of which 6 neonates (15%) had multiple anomalies. The anomalies in the study were divided into major and minor anomaly groups. 70% of the anomalies were classified as major anomalies while 30% were classified as minor anomalies. Multiparity and GDM were found to be major risk factors in the mother. Major anomalies identified involved the Musculoskeletal system (21.6%) and cardiovascular system (20%). Minor anomalies included skin disorders (27.7%) followed by Musculoskeletal (16.6%) and genitourinary system (16.6%). Of the 40 anomalous babies five babies expired soon after birthConclusions: Antenatal screening is an effective tool to detect Musculoskeletal and CNS anomalies. CVS anomalies may be missed by routine anomaly scan. Early intervention and effective follow up have shown that good outcomes are possible even in while managing some of the major anomalies. 

Maternal Noncompliance with Antibiotics during Breastfeeding

1993 ◽  
Vol 27 (1) ◽  
pp. 40-42 ◽  
Author(s):  
Shinya Ito ◽  
Gideon Koren ◽  
Thomas R. Einarson
Keyword(s):  
Cohort Study ◽  
Antimicrobial Therapy ◽  
Drug Information ◽  
Negative Impact ◽  
Antibiotic Prescription ◽  
Tertiary Care ◽  
Information Service ◽  
Pediatric Hospital ◽  
Drug Regimens

OBJECTIVE: To determine the incidence of antibiotic prescription failure in breastfeeding women, and to characterize breastfeeding patterns during antibiotic therapy. DESIGN: Prospective cohort study by telephone follow-up of 203 breastfeeding women who were prescribed antibiotics as monotherapy. SETTING: A teratogen/drug information service (the Motherisk Program) in a tertiary care, pediatric hospital in Toronto, Canada. MAIN OUTCOME MEASURES: Number of breastfeeding women who did not initiate the antimicrobial therapy, and breastfeeding patterns during therapy in women who started it. RESULTS: Of 203 breastfeeding women who consulted the Motherisk Program for information about the safety of antimicrobials during breastfeeding, 125 (62 percent) were followed within 32 weeks (median 11). Nineteen of the 125 (15 percent) did not initiate the antimicrobial therapy. Of the remaining 106 women, 7 (7 percent) stopped breastfeeding during therapy. Despite reassuring advice, 1 in 5 women either did not initiate therapy or did not continue breastfeeding. CONCLUSIONS: Physicians should be aware of the substantial rate of noncompliance with drug regimens among nursing women and the potential negative impact of drug therapy on breastfeeding.

Laparoscopic repair of inguinal hernia: Prospective evaluation at a tertiary care center

2020 ◽  
Vol 23 (2) ◽  
pp. 54-58
Author(s):  
ABM Mahbubur Rahman ◽  
Tamjeed Alam ◽  
AHM Shamsul Alam ◽  
Fahim Ferdaus ◽  
Gazi Gias Uddin
Keyword(s):  
Chronic Pain ◽  
Inguinal Hernia ◽  
Hernia Repair ◽  
Groin Hernia ◽  
Tertiary Care ◽  
Groin Hernia Repair ◽  
Groin Hernias ◽  
Laparoscopic Groin Hernia Repair ◽  
Repair Techniques

Background: Treatment of groin hernias continues to evolve. The emergence of laparoscopic inguinal hernia surgery has challenged the conventional gold standard Lichtenstein’s tension free mesh repair. Laparoscopic technique to achieve surgical correction over groin hernia is increasingly being practiced in our country, and it is imperative to test the overall outcome of this technique in a tertiary care setting. Objectives: Current study was aimed at evaluating the per-operative events, early and late outcomes of laparoscopic groin hernia repair techniques. End points of evaluation were postoperative pain, hospital stay, resumption of normal activities, chronic pain and recurrence. Methods: Within a 2-year period, 45 patients of groin hernias of different clinical types underwent laparoscopic inguinal hernia repair in Bangladesh Medical College Hospital were recruited in this prospective observational study. Preoperative findings, intraoperative course, postoperative and follow-up data were analyzed to evaluate the outcomes. Observations were made regarding operating time, operative hazards, postoperative pain, incidence of early post-operative morbidities, hospital stay, resumption of activities. Total 24 months follow-up was carried out with regards to normal activity, late complications notably chronic groin pain and recurrence. Results: The mean age of 38.1±11.1 years, 27(60%) patients underwent TEP repair whereas, TAPP procedure was carried out in 18 patients (40%). For unilateral hernia repair using TEP technique, mean operative time was 50.3±4.2 mints and 61.7±5.3 mints for direct and indirect variety (D/I), with the corresponding rates for TAPP repair being 65.0±2.2 mints and 72.8±3.2 mints (D/I) respectively. Conversion rate to other operative procedure was 6.67%. The overall surgery related early post-operative morbidity was 7.4% (TEP) and 16.8% (TAPP). 3 out of 45 patients (6.67%) experienced chronic pain in the groin in the study. However, there was no single incidence of recurrence observed during the follow up period. Conclusion: Laparoscopic groin hernia repair techniques are safe and feasible, offers the benefits of minimally invasive surgery and becoming the procedure of choice specially for bilateral and recurrent inguinal hernias. Journal of Surgical Sciences (2019) Vol. 23(2): 54-58

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