Comparative study of peri-operative outcome following laparotomy versus laparoscopic technique of abdominal hysterectomy for benign gynaecological lesions

Background: Laparoscopic technique of hysterectomy is becoming increasingly popular in developing and developed world. Laparoscopic hysterectomy is a minimal access procedure that allows patients to recover faster. The study was undertaken to assess the impact of two abdominal techniques (laparoscopic and conventional laparotomy) on various variables like operative time, hospital stay, complications and convalescence period.Methods: An observational longitudinal study was carried out at tertiary care centre. Two hundred and ten women, as per inclusion and exclusion criteria, who had undergone abdominal hysterectomy for benign uterine pathology, either by laparotomy (Group A) or by laparoscopic technique (Group B) during study period were included. Data was analyzed and compared by using different variables between two methods of hysterectomy, using percentages and Chi square test for normal distribution. P value less than 0.05 was considered significant.Results: The mean duration of surgery was 100 minutes in group A and 175 minutes in Group B. There were two cases (1.90%) of minor injury to urinary bladder in Group A and one case (0.95%) of thermal injury to urinary bladder in Group B. The mean blood loss was around 240 ml and 70 ml in Group A and B respectively. The need for postoperative analgesia was observed in 100% cases from Group A and 38.09% from group B. The average duration required for out of bed ambulation was 25 hours and 14 hours in Group A and B respectively. The mean hospital stay in group A and B was 7.5 days and 3.5 days respectively.Conclusions: Following laparoscopic hysterectomy, women had less morbidity, less need for post-operative pain relief, had early ambulation, short hospital stay and early resumption of routine activities at home as compared to women who had undergone abdominal hysterectomy by conventional method.

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The Impact of Preemptive Perianal Anaesthetic Block in Open Haemorrhoidectomy – a randomised controlled trial

10.53350/pjmhs211592165 ◽

2021 ◽

Vol 15 (9) ◽

pp. 2165-2167

Author(s):

Wajeeha I. Andrabi ◽

M Asadullah Khawaja ◽

K. Fatima ◽

S I. Hussain Andrabi ◽

A. Shafique ◽

...

Keyword(s):

Placebo Group ◽

Hospital Stay ◽

Pain Intensity ◽

P Value ◽

Open Hemorrhoidectomy ◽

Group A ◽

The Mean ◽

Group B ◽

The Impact ◽

Mean Time

Background: the study was conducted to analyze the efficacy of 0.75% ropicaine at perianal block for open haemrrhoidectomy with regards to pain intensity, first demand of analgesia and hospital stay. Method: 50 patients were selected for open haemrrhoidectomy under GA which were divided into two groups.it was a randomized control trial in which sealed envelope method was used for the group delegation in which Group A was designated to the patients having the perianal block with 0.75% ropivacaine while the group B was the placebo group having normal saline injected in the perianal region. The variables compared were the first demand of analgesia, pain intensity and the duration of the hospital stay. In order to make the site of injection more authentic the injections were sited under ultrasound guidance. Results: The pain intensity which was analyzed with the visual analogue score (VAS) had a median of 3.8 (high=6, low=3) in group A while 5.5 (high=8, low=4) in the Group B with the p value of < 0.05. The mean time recorded for the first demand of analgesia was 6.20 ± 1.20 hours in the Group A which had improved from 1.20 ± 1.0 hours in the Placebo Group while the p value was < 0.001, while the mean time of hospital stay got reduced from 22.5±3.30 hours to 12.4 ± 3.10 hours with the significant p value of < 0.002. Conclusion: It was observed that with preemptive analgesia with 0.75% ropivacaine administered led to a substantial reduction in pain perception, request for an analgesic and hospital stay. Therefore it is appropriate to administer it before open hemorrhoidectomy. Keywords: preemptive anaesthesia, local anesthesia, postoperative pain, ropivacaine, open hemorrhoidectomy

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A comparative study between onlay and sublay meshplasty in ventral hernias: a randomized controlled trial

International Surgery Journal ◽

10.18203/2349-2902.isj20191260 ◽

2019 ◽

Vol 6 (4) ◽

pp. 1264

Author(s):

Tharun Ganapathy Chitrambalam ◽

Preetham Anguraj ◽

Jeyakumar Sundaraj ◽

Manimaran Pethuraj

Keyword(s):

Hospital Stay ◽

Wound Infection ◽

Ventral Hernia ◽

Controlled Study ◽

Post Operative Pain ◽

Duration Of Surgery ◽

Group A ◽

The Mean ◽

Group B ◽

Ventral Hernias

Background: Ventral hernias are one of the most common surgical problems of the modern age. About 15-18% of all the surgical procedures performed around the world comprises of hernia repair. This study aims to compare the two common options of mesh placement in open ventral hernia repairs; over the anterior rectus sheath, the ‘Onlay meshplasty’ and in the retrorectus plane, the ‘Sublay meshplasty’.Methods: A prospective controlled study was done between March 2017 to August 2018 on 150 patients with ventral hernia randomizing patients into 2 groups. Group A (Onlay meshplasty) and Group B (Sublay meshplasty). Duration of surgery, post-operative pain, wound infection, duration of hospital stay and recurrences were analysed with 12 months follow up.Results: The mean duration of surgery in group A was 48.49±0.71 minutes and in group B was 72.84±0.72 minutes. Group B experienced significantly lesser pain when compared with group A. The mean asepsis score in group A was 3.60±1.09 and in group B was 0.47±0.30 with a p value of 0.006. Group A had significantly longer hospital stay (9.39 days) than group B (5.71 days). The recurrences in both the groups were statistically insignificant (Group A- 2 patients; Group B- 1 patient).Conclusions: Sublay meshplasty although requires longer time to perform, proves to be a better alternate in terms of post-operative pain, wound infection and hospital stay.

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LAPAROSCOPIC CHOLECYSTECTOMY

The Professional Medical Journal ◽

10.29309/tpmj/2011.18.02.2059 ◽

2011 ◽

Vol 18 (02) ◽

pp. 237-242

Author(s):

AWAIS SHUJA ◽

ABID BASHIR ◽

ABID RASHID

Keyword(s):

Laparoscopic Cholecystectomy ◽

Hospital Stay ◽

Complication Rate ◽

Conversion Rate ◽

Gall Stone ◽

Significant Difference ◽

Group A ◽

The Mean ◽

Group B ◽

The Impact

Laparoscopic cholecystectomy is the gold standard treatment for patients presenting with acute gall stone disease necessitating hospital admission. Objective: To assess the impact of timing of laparoscopic cholecystectomy on conversion rate, hospital stay and morbidity. Period: Jan 2008-2010. Setting: Department of Surgery, Independent University Hospital, Faisalabad. Study Design: Experimental study. Material & Methods: The subjects were included by consecutive sampling technique. 81 cases were divided into 3 groups. Group A (Surgery within 72 hrs of onset symptoms). Group B (surgery between 72hrs to 96 hours of onset of symptoms). Group C (surgery after 96 hours of onset of symptoms). Results: The mean age was 41-95 years. Female to male ratio was 4.5:1. The overall complication rate was 12.69%. Mean hospital stay was 2.85 days. The open conversion rate was 8.64%. In group A the complication rate was 6%, group B 11.5% and group C 12.8&. The mean hospital stay and conversion rate had no significant difference. Conclusions: The timing of laparoscopic cholecystectomy has no significant impact on the conversion rate and length of hospital stay in cases with acute cholecystitis. However the complication rate was higher when surgery performed after 72 hours of onset of symptoms.

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A COMPARATIVE STUDY BETWEEN ONLAY AND RETRORECTUS MESH REPAIR IN THE TREATMENT OF INCISIONAL HERNIAS

10.36106/gjra/6102014 ◽

2021 ◽

pp. 65-69

Author(s):

S. Yashwanth ◽

S. Dayakar

Keyword(s):

Postoperative Complications ◽

Incisional Hernia ◽

Hospital Stay ◽

Wound Infection ◽

Mesh Repair ◽

Duration Of Surgery ◽

Group A ◽

Onlay Mesh ◽

The Mean ◽

Group B

INTRODUCTION: Over the years, surgeons tried the placement of mesh at different locations like On-lay, Under-lay, Sub-lay and pre-peritoneal, retroperitoneal intraperitoneal, Inter-muscular, etc. with each procedure having its advantages and disadvantages. Commonly Onlay and sub lay mesh repairs are done. Though the literature says, sub lay procedures have fewer complications and a high success rate. However, in a few studies, the ideal position for mesh repair appears to be retro muscular, where the force of abdominal pressure holds the mesh against deep surfaces of muscles. In this study, a comparison of both Onlay and retro rectus procedures with regards to the duration of surgery, postoperative complications like seroma, wound infection, wound dehiscence, and also the period of postoperative stay in the hospital. The aim of the study is To compare 'Onlay' versus 'retro rectus' mesh repair in inuencing the outcome in incisional hernia with regards to Duration of surgery, Postoperative complications like seroma formation, wound infection, Postoperative stay, Recurrences. PATIENTS AND METHODOLOGY: Type of Study: A Prospective comparative study Study Setting: Department of general surgery, Narayana Medical College & Hospital, Nellore.Study Period: November 2018 to September 2020 Study Sample: 50 cases, divided into two groups by random allocation technique. Groups A and B with 25 patients in each group. RESULTS: The mean age of cases in Group A is 40.48 years. The mean age of patients in Group B is 44.08 years. Youngest was 31 years and 36 years in group A and group B, respectively, and the eldest was 51 years and 53 years in group A and group B, respectively. In Group A, 11 were male, and 14 were female, and in Group B, 11 were male, and 14 were female. The male to female ratio in the study was 1:1.27. The mean Operative Time in Group A was 1.93 Hrs, and that in Group B was 2.98Hrs. Nine patients (36%) in group A and one patient (4%) in group B had seroma formation. Eight patients (32%) in group A and one patient (4%) in group B had a wound infection. The mean Hospital Stay in Group A was 5.44 Days, and Group B was 4.88 days. No short-term recurrences were noted in either of the two groups when followed for six months. CONCLUSION : Retrorectus mesh repair is an excellent alternative to Onlay mesh repair that may apply to incisional hernia. The mesh-related overall complication rate like seroma wound infections and hospital stay is less than Onlay mesh repair.

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The Outcome Comparison of two Groups of total Extraperitoneal and Mesh Repair of Inguinal Hernia

10.53350/pjmhs2115102712 ◽

2021 ◽

Vol 15 (10) ◽

pp. 2712-2714

Author(s):

Muhammad Aamir Jamil ◽

Muhammad Asif ◽

Imran Yousaf ◽

Muhammad Faheem Anwer ◽

Muhammad Waseem Anwar

Keyword(s):

Inguinal Hernia ◽

Hospital Stay ◽

Recovery Time ◽

Mesh Repair ◽

Operative Procedure ◽

Total Extraperitoneal ◽

Outcome Comparison ◽

Group A ◽

The Mean ◽

Group B

Aim: The outcome comparison of total extraperitoneal versus mesh repair for inguinal hernia. Study design: Quasi experimental study. Place and duration of study: Department of Surgery, M. Islam Teaching Hospital, Gujranwala from March 2018 to March 2019. Methodology: After the approval of hospital ethical committee, a total of 50 patients were included and randomly divided into two groups equally. Group A (Total extraperitoneal), Group B (Mesh repair). An informed consent was taken from every patient about operative procedure and the outcome. A detailed history of the patient i.e. clinical examination, routine investigations (CBC, Urine R/E, urea, creatinine) and some specific investigations (chest X-ray, ECG and ultrasound abdomen and prostate) was done for surgery. All data of patients was collected on proforma and was analyzed with the help of a computer SPSS programme 20. Results: The mean age of patients was 34.22±11.54 years in group A and 35.63±11.25 years in group B. All male and female patients included in this study in both groups. Twelve (48%) of patients were direct inguinal hernia in group A 13(22%) were in group B and 14(56%) patients were in group A and 11(44%) patients were in group B. The mean±SD postoperative hospital stay was 24.48±4.62 in group A and 34.65±12.26 hours in group B (p 0.001). The mean±SD postoperative recovery time in weeks was 2.18±0.43 in group A and 2.90±0.46 weeks in group B (p 0.001). Only 2 (4%) patient had postoperative infection on first week and 4 (8%) patients had infection respectively. No recurrence was seen in group A and only 3% recurrence was in group B. Conclusion: It is concluded that group A had shorter hospital stay, recovery time, postoperative time and less infection rate as compared to group B. In group A 13% patients had severe pain and in group B 25% patients. Keywords: Inguinal Hernia, Total extraperitoneal, Mesh repair.

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ACUTE CHOLECYSTITIS

The Professional Medical Journal ◽

10.29309/tpmj/2010.17.02.2342 ◽

2010 ◽

Vol 17 (02) ◽

pp. 185-192

Author(s):

TARIQ HASSAN CH ◽

ASGHAR ALI ◽

MUNAWAR JAMIL

Keyword(s):

Hospital Stay ◽

Wound Dehiscence ◽

Biliary Tree ◽

Postoperative Hospital Stay ◽

Total Hospital ◽

Acute Calculous Cholecystitis ◽

Total Hospital Stay ◽

Group A ◽

The Mean ◽

Group B

Introduction: Gallstones are common biliary pathology. The Vast majority of subjects are asymptomatic. About 0.2% of the population suffering from gallstones develop acute cholecystitis every year. In case of acute calculous cholecystitis, cholecystectomy can be performed early i.e during the same admission or interval i.e after 6 weeks of conservative management. Objective: To compare the early and interval cholecystectomy in acute calculous cholecystitis for morbidity, postoperative hospital stay, total hospital stay and complications. Study Design: Quasi-experimental study. Setting: Department of Surgery Bahawal Victoria Hospital Bahawalpur. Duration of Study: Two year study from December 2007 to December 2009. Subject and Methods: Sixty patients fulfilling the inclusion criteria were selected for this study. The patients were divided into two groups. Group A patients were managed by early cholecystectomy and group B patients by intervalcholecystectomy. Postoperatively patients were evaluated for postoperative hospital stay, total hospital stay and postoperative complications. Results: The mean age of the patients in group A was 42.2 + 10.7 years and in group B was 42.2+ 10.7 years. The Male to female ratio was 1:4 in both groups. The mean postoperative hospital stay in group A was 4.0+ 1.8days and in group B was 3.8+ 1.4 days. The mean total hospital stayin group A was 6.5 + 1.7 days and in group B was 10.2 + 1.3 days. The P value was less than 0.001, which was significant. In distribution of postoperative complications, in group A there were 1(3.3%) injury to biliary tree, 4(13.3%) wound infection,1(3.3%) wound haematoma, 3 (10%) seroma and 1(3.3%) wound dehiscence. While in group B there were 1(3.3%) injury to biliary tree, 3(10%) wound infection,2 (6.7%) wound haematoma, 2(6.7%) & no patient of wound dehiscence. Conclusion: Our study suggests that early cholecystectomy is a better treatment option than interval cholecystectomy because it has less total hospital stay, needs single hospital visit and has no risk of developing complications during wait for surgery.

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Clinical Results Of A Lamina With Spinous Process And An Iliac Graft As Bone Grafts In The Surgical Treatment Of Single-Segment Lumbar Pyogenic Discitis: A Retrospective Cohort Study

10.21203/rs.3.rs-49502/v1 ◽

2020 ◽

Author(s):

Weiyang Zhong ◽

Xinjie Liang ◽

Xiaolin Wang ◽

Ke Tang ◽

Tianji Huang ◽

...

Keyword(s):

Hospital Stay ◽

Spinous Process ◽

Bone Grafts ◽

Clinical Results ◽

Single Segment ◽

Significant Difference ◽

Group A ◽

The Mean ◽

Group B ◽

Segmental Angle

Abstract Background: A retrospective study investigated and compared the results of a lamina withspinous process (LSP) and an iliac graft (IG) as bone grafts in single-segment lumbar pyogenic discitis (LPD) through one-stage-posterior-only approach with radical debridement and internal instrumentation.Methods: Data from 37 patients were reviewed. A LSP was placed in 17 patients (group A), and an IG was implemented in 20 patients (group B). The surgery time, surgery hemorrhage, hospital stay, drainage, and follow-up (FU) were reviewed. The visual analogue scale (VAS), Oswestry Disability Index (ODI), erythrocyte sedimentation rate (ESR), C-reactive protein (CRP) level, segmental angle, intervertebral height and bony fusion time were compared preoperatively and at the final FU.Results: All patients were followed-up for a mean of 27.94±2.35 months in group A and 30.29±1.89 months in group B, without a difference. The mean age was younger in group A than in group B (P<0.05). The surgery time, surgery hemorrhage, and hospitalization cost were lower in group A than in group B (P<0.05), except for the hospital stay and drainage time. Fever occurred in 10 patients in group A and 12 patients in group B. The ESR, CRP level, and VAS and ODI scores were significantly decreased, and there were no significant differences between the groups at the final FU. The distribution of bacterial agents in blood culture was 1 case of Aerobacter cloacae, 2 of Staphylococcus aureus, 2 of Escherichia coli, and 1 of Streptococcus viridis in group A and 1 of S. aureus，1 of Staphylococcus warneri and 2 of Klebsiella pneumoniae in group B. Pyogenic infection was observed in the pathological findings of all patients. No significant difference was found in the mean segmental angle or mean intervertebral height preoperation and at the final FU between the groups.Conclusion: The use of LSP as a new bone graft is reliable, safe, and effective for surgical management for the LPD while surgery is proposed as a good management strategy for LPD in carefully selected patients.

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Total Laparoscopic Hysterectomy with Prior Uterine Artery Ligation at Its Origin

International Journal of Reproductive Medicine ◽

10.1155/2014/420926 ◽

2014 ◽

Vol 2014 ◽

pp. 1-4 ◽

Cited By ~ 6

Author(s):

Vidyashree Ganesh Poojari ◽

Vidya Vishwanath Bhat ◽

Ravishankar Bhat

Keyword(s):

Blood Loss ◽

Uterine Artery ◽

Laparoscopic Hysterectomy ◽

Total Laparoscopic Hysterectomy ◽

Artery Ligation ◽

Uterine Arteries ◽

Uterine Artery Ligation ◽

Duration Of Surgery ◽

Group A ◽

Group B

We compared the duration of surgery, blood loss, and complications between patients in whom both uterine arteries were ligated at the beginning of total laparoscopic hysterectomy (TLH) and patients in whom ligation was done after cornual pedicle. Using a prospective study in a gynecologic laparoscopic center, a total of 52 women who underwent TLH from June 2013 to January 2014 were assigned into two groups. In group A, uterine arteries were ligated after the cornual pedicles as done conventionally. In group B, TLH was done by ligating both uterine arteries at the beginning of the procedure. All the other pedicles were desiccated using harmonic scalpel or bipolar diathermy. Uterus with cervix was removed vaginally or by morcellation. The indication for TLH was predominantly dysfunctional uterine bleeding and myomas in both groups. In group A, the average duration of surgery was 71 minutes, when compared to 60 minutes in group B(P<0.001). In group A, the total blood loss was 70 mL, when compared to 43#x2009;mL in group B (Pvalue < 0.001). There were no major complications in both groups. To conclude, prior uterine artery ligation at its origin during TLH reduces the blood loss and surgical duration as well as the complications during surgery.

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A comparative study of open cholecystectomy and laparoscopic cholecystectomy in patients with cholelithiasis

International Surgery Journal ◽

10.18203/2349-2902.isj20175905 ◽

2017 ◽

Vol 5 (1) ◽

pp. 253 ◽

Cited By ~ 1

Author(s):

Pramod Singh ◽

Sumit Kumar Gupta ◽

Mukesh Kumar

Keyword(s):

Laparoscopic Cholecystectomy ◽

Surgical Site Infection ◽

Hospital Stay ◽

Open Cholecystectomy ◽

City Hospital ◽

Site Infection ◽

First Choice ◽

Duration Of Surgery ◽

Group A ◽

Group B

Background: Cholelithiasis is a major cause of morbidity among Indians with a female preponderance. Most of the cases of gallstones are asymptomatic. For a long time, open cholecystectomy (OC) used to be the surgical treatment for cholelithiasis. But with the advent of laparoscopic cholecystectomy (LC) there has been a gradual shift in the treatment with most surgeons preferring LC over OC. Apart from the benefits of decreased hospital stay, lesser postoperative pain and earlier return to normal activity LC are also cosmetically better as compared to OC. Longer operative time and increased incidence of biliary leakage are some pitfalls of LC in initial phase of surgical practice.Methods: A prospective study of 100 patients was carried out in the department of surgery in IQ city medical college and Durgapur city hospital, Durgapur between January 2017 and August 2017 with the aim of comparing open cholecystectomy with laparoscopic cholecystectomy. The patients were randomly assigned into two groups. Group A consisted of patients who underwent laparoscopic surgery while Group B patients underwent open surgery for cholelithiasis.Results: Duration of surgery was longer in OC than LC (72.4min versus 44.7min.). Mean duration of post-operative pain was 18.3hrs in group A as compared to mean duration of 30.7hrs in group B patients. The mean period of post-operative hospital stay was 1.8 days in group A and 4.8 days in group B. Post-operative resumption of normal diet was possible in 2.1 days in OC while it took lesser time (1.2 days) in LC. The rate of surgical site infection was higher in OC as compared to LC.Conclusions: Laparoscopic cholecystectomy can be recommended as first choice operative treatment for patients with cholelithiasis as it provides better cosmetic results, lesser pain, lesser post-operative hospital stay and fewer incidence of surgical site infection.

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COMPARATIVE ANALYSIS OF NON-DESCENT VAGINAL HYSTERECTOMY VERSUSTOTALABDOMINAL HYSTERECTOMY IN BENIGN UTERINE DISORDERS AT DMCH, LAHERIASARAI, BIHAR

10.36106/ijsr/1532203 ◽

2020 ◽

pp. 1-2

Author(s):

Suchandra Suchandra ◽

Renu Jha ◽

Kumudini Jha ◽

Debarshi Jana

Keyword(s):

Postoperative Complications ◽

Vaginal Hysterectomy ◽

Intraoperative Complications ◽

Operating Time ◽

Early Mobilization ◽

Laparoscopic Hysterectomy ◽

Abdominal Hysterectomy ◽

Invasive Technique ◽

Group A ◽

Group B

Background: Hysterectomy is the most common operation performed by gynecologist, next to caesarean section. Currently, there are three main types of hysterectomy operations in practice for benign diseases-Abdominal hysterectomy (AH), vaginal hysterectomy (VH) and Laparoscopic hysterectomy (LH). Vaginal route for non-descentuterus is an acceptable method of hysterectomy. The objective of present study was to compare the operating time, intraoperative and postoperative complications between VH and TAH in non-descent uterus. Methods: The study was conducted in the Department of Obstetrics Gynaecology for a period of 18months at Darbhanga Medical College & Hospital, Laheriasarai, Bihar. Results: Over the study period 100 patients were taken, 50 patients underwent non-descent vaginal hysterectomy andlabelled as group A and 50 patients were under went total abdominal hysterectomy and labelled as group B. It wasseen that intraoperative complications and postoperative complications were less in group A patients and operating time is also less with group A patients when compared with group B patients. Conclusions: From the present study, it was concluded that NDVH is associated with less blood loss during surgery, quicker recovery, and early mobilization, less operative and less postoperative morbidity when compared to TAH. NDVH is a less invasive technique with shorter hospital stay and faster convalescence.

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