scholarly journals Sacrospinous colpopexy versus McCall’s culdoplasty during vaginal hysterectomy in stage 3 and 4 prolapse for prevention of vault prolapse

2021 ◽  
Vol 10 (7) ◽  
pp. 2825
Author(s):  
S. S. Gulati ◽  
Samta Gupta ◽  
Neha Khan ◽  
Shelly Agarwal ◽  
Naima Afreen ◽  
...  
Keyword(s):  
Vaginal Hysterectomy ◽  
Bladder Injury ◽  
Rectal Injury ◽  
Sacrospinous Ligament ◽  
Vault Prolapse ◽  
Operative Complications ◽  
Sacrospinous Colpopexy ◽  
Group A ◽  
Group B ◽  
Post Operative Complications

Background: Pelvic organ prolapse is a common condition seen in women due to weakening of support of pelvic organs. Different surgical procedures have been adopted for suspension of vaginal vault during vaginal hysterectomy to restore vault to near normal anatomic position as preventive measures for vault prolapse. The aim of study was to compare the efficacy of the McCall’s culdoplasty and sacrospinous ligament colpopexy in stage 3 and 4 prolapse (POP-Q).Methods: This prospective study comprised 100 women presenting with stage 3 and 4 prolapse (POP-Q). They were divided into two equal groups of 50 each. The patients were randomized to undergo McCall’s culdoplasty (Group A) or sacrospinous ligament fixation (Group B) with vaginal hysterectomy based on note contained in an envelope comparative analysis was done, and patients were evaluated for intra-operative difficulties and immediate (48 hours) post-operative complications using SPSS-version 23 for statistical analysis. The patients were followed up at one month and one year to evaluate symptomatically and objectively.Results: In group A, patients with 3-degree prolapse 1 woman had hemorrhage and 1 woman had bladder injury intraoperatively. Whereas in group B, 5 women had hemorrhage and 1 woman had rectal injury intraoperatively. All complications were dealt successfully. No other major intra- and post-operative complications occurred.Conclusions: Vaginal hysterectomy with sacrospinous colpopexy resulted in better outcomes after surgery. Hence, it was concluded that unilateral or bilateral SSLF may be added to vaginal hysterectomy in patients of stage 3 or 4 prolapse.

scholarly journals Comparison of Intra-Operative and Post-Operative Complications between Non-Descent Vaginal Hysterectomy and Total Abdominal Hysterectomy

2018 ◽  
Vol 8 (3) ◽  
pp. 128-134
Author(s):  
Sayma Afroz ◽  
Gulshan Ara
Keyword(s):  
Blood Loss ◽  
Hospital Stay ◽  
Vaginal Hysterectomy ◽  
Abdominal Hysterectomy ◽  
Operative Blood Loss ◽  
Operative Complications ◽  
Abdominal Route ◽  
Group A ◽  
Group B ◽  
Post Operative Complications

Background: Hysterectomy is one of the most common surgical procedures performed by the gynaecologists and can be done through abdominal and vaginal routes. Vaginal hysterectomy technique has been introduced and performed centuries back, but is less popular due to lack of experience and misconception that the abdominal route is easier and safer. Worldwide gynaecologists continue to use abdominal route for hysterectomy that could be performed vaginally which is less invasive and has minimal complications.Objective: To compare the complications during intra-operative and post-operative period between vaginal hysterectomy and abdominal hysterectomy in non-descent uterus.Materials and Methods: This prospective randomised study was performed in Enam Medical College & Hospital, Savar, Dhaka during a period of one year. Sixty consecutive patients requiring hysterectomy for benign diseases were included in this study. Group A (n=30) underwent vaginal hysterectomy (non-descent vaginal hysterectomy) and were compared with Group B (n=30) who underwent abdominal hysterectomy. The primary outcome measures were operative time, intra-operative blood loss, post-operative complications like wound infection, febrile morbidity, post-operative systemic infection and hospital stay. Secondary outcome measures were conversion of vaginal to abdominal route and re-laparotomy. Data were collected in structured questionnaire and analysed by computer using R programming version 3.4.3.Results: Baseline characteristics were similar in two groups. There were no intra-operative complications in either group. Intra-operative blood loss was significantly more in Group B than in Group A. The overall complication rate was significantly higher with abdominal hysterectomy with a rate of 56.67% against 30% for vaginal hysterectomy. Wound infection (23.33%) was significantly higher in Group B as compared to Group A (0%). Post-operative hospital stay was significantly higher in Group B (7.03 days) than in Group A (4.57 days).Conclusion: Considering intra-operative blood loss, post-operative complications and hospital stay, vaginal route was found safer than abdominal route in this study.J Enam Med Col 2018; 8(3): 128-134

Laparoscopic versus open partial nephrectomy for the management of highly complex renal tumors with PADUA score ⩾10: A single center analysis.

2021 ◽  
pp. 039156032110016
Author(s):  
Francesco Chiancone ◽  
Marco Fabiano ◽  
Clemente Meccariello ◽  
Maurizio Fedelini ◽  
Francesco Persico ◽  
...  
Keyword(s):  
Partial Nephrectomy ◽  
Operation Time ◽  
Renal Tumors ◽  
Open Partial Nephrectomy ◽  
Estimated Blood Loss ◽  
Significant Difference ◽  
Operative Complications ◽  
Group A ◽  
Group B ◽  
Post Operative Complications

Introduction: The aim of this study was to compare laparoscopic and open partial nephrectomy (PN) for renal tumors of high surgical complexity (PADUA score ⩾10). Methods: We retrospectively evaluated 93 consecutive patients who underwent PN at our department from January 2015 to September 2019. 21 patients underwent open partial nephrectomy (OPN) (Group A) and 72 underwent laparoscopic partial nephrectomy (LPN) (Group B). All OPNs were performed with a retroperitoneal approach, while all LPNs were performed with a transperitoneal approach by a single surgical team. Post-operative complications were classified according to the Clavien-Dindo system. Results: The two groups showed no difference in terms of patients’ demographics as well as tumor characteristics in all variables. Group A was found to be similar to group B in terms of operation time ( p = 0.781), conversion to radical nephrectomy ( p = 0.3485), and positive surgical margins ( p = 0.338) while estimated blood loss ( p = 0.0205), intra-operative ( p = 0.0104), and post-operative ( p = 0.0081) transfusion rates, drainage time ( p = 0.0012), pain score at post-operative day 1 (<0.0001) were significantly lower in Group B. The rate of enucleation and enucleoresection/polar resection was similar ( p = 0.1821) among the groups. Logistic regression analysis indicated that preoperative factors were not independently associated with the surgical approach. There was a statistically significant difference in complication rate (<0.0001) between the two groups even if no significant difference in terms of grade ⩾3 post-operative complications ( p = 0.3382) was detected. Discussion: LPN represents a feasible and safe approach for high complex renal tumors if performed in highly experienced laparoscopic centers. This procedure offers good intraoperative outcomes and a low rate of post-operative complications.

scholarly journals COMPARISON OF OUTCOMES BETWEEN EARLY AND DELAYED LAPAROSCOPIC CHOLECYSTECTOMY IN ACUTE CALCULOUS CHOLECYSTITIS

2021 ◽  
Vol 71 (3) ◽  
pp. 796-800
Author(s):  
Muhammad Ismail ◽  
Nasir Mehmood Wattoo ◽  
Muhammad Qasim Butt ◽  
Fareeha Naz
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Hospital Stay ◽  
Operation Time ◽  
Acute Calculous Cholecystitis ◽  
Delayed Laparoscopic Cholecystectomy ◽  
Operative Complications ◽  
Group A ◽  
Group B ◽  
Calculous Cholecystitis ◽  
Post Operative Complications

Objective: To compare early versus delayed laparoscopic cholecystectomy in acute calculous cholecystitis in terms of mean operative time, hospital stay, conversion rate to open surgery and post-operative complications. Study Design: Quasi experimental study. Place and Duration of Study: Army Liver Transplant Unit, Department of Surgery, Pak-Emirates Military Hospital Rawalpindi, from Jul to Dec 2018. Methodology: A total of 170 patients (85 in each group) diagnosed as a case of acute calculous cholecystitis who met the sample selection criteria were included. Group A patients underwent early laparoscopic cholecystectomy within 72 hours of admission while group B patients underwent conservative management followed by delayed laparoscopic cholecystectomy after 6 weeks. All patients were followed for operative time, hospital stay, per-operative difficulties encountered and post-operative complications. Results: Group A had a mean operation time of 43.9 ± 11.1 minutes, while group B had a mean operation time of 45.8 ± 10.1 minutes (p=0.83). The mean duration of hospitalization was 2.8 ± 1.1 days in group A and 5.3 ± 0.8 days in group B (p<0.001). Complications were measured at a frequency of 14.1% in group A and 5.9% in group B (p=0.07). Conclusion: Early laparoscopic cholecystectomy is better than delayed laparoscopic cholecystectomy in acute calculous cholecystitis in terms of hospital stay and per-operative difficulties faced. The post-operative complications between the two groups are comparable.

Comparison of Post-Operative Complications Between Sublay and Onlay Mesh Repair in Incisional Hernia

2021 ◽  
Vol 15 (12) ◽  
pp. 3384-3386
Author(s):  
Azizullah Khan Sherani ◽  
Saleem Javed ◽  
Muhammad Idrees Achackzai
Keyword(s):  
Incisional Hernia ◽  
Wound Infection ◽  
Mesh Repair ◽  
Seroma Formation ◽  
Onlay Technique ◽  
Sublay Technique ◽  
Operative Complications ◽  
Group A ◽  
Group B ◽  
Post Operative Complications

Objective: To compare the post-operative complications between sublay and onlay mesh repair in incisional hernia. Materials & Methods: This randomized controlled trial was conducted at Department of Surgery, Sandeman Provincial Hospital Quetta from May 2019 to November 2019. Total 250 patients with incisional hernias for more than 3 months, having age 20-40 years either male or female were selected. Then selected patients were placed randomly into two groups i.e. Group A (Sublay group) & Group B (Onlay group), by using lottery method. Patients were called for follow up 15th day for post-operative complications in term of wound infection and seroma formation. Results: The mean age of patients in group A was 34.73 ± 4.32 years and in group B was 34.51 ± 4.67 years. Out of these 250 patients, 161 (64.40%) were female and 89 (35.60%) were males with female to male ratio of 1.8:1. Wound infection was seen in 07 (5.60%) patients in group A (Sublay technique) and 17 (13.60%) patients in group B (Onlay technique) with p-value of 0.033. Seroma formation was seen in 09 (7.20%) patients in group A (Sublay technique) and 26 (20.80%) patients in group B (Onlay technique) with p-value of 0.002. Conclusion: This study concluded that rate of wound infection and seroma formation is less after sublay mesh repair for incisional hernia as compared to onlay repair. Keywords: Hernia, incisional, onlay, sublay, seroma.

Round Block Technique versus Grisotti Technique in Juxta Areolar Breast Cancer

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Mohamed Ahmed Helmy Shehab ◽  
Karim Fahmy Abd Elmoaty ◽  
Mahmoud Refaat Mohamed Elsebaai
Keyword(s):  
Breast Cancer ◽  
Operating Time ◽  
Breast Cancer Patients ◽  
Areola Complex ◽  
Operative Complications ◽  
Group A ◽  
Cosmetic Outcomes ◽  
Group B ◽  
Slight Advantage ◽  
Post Operative Complications

Abstract Background Breast cancer is the most common cancer in women all over the world representing 18% of all women reported cases of cancer. It represents the leading cause of women mortality as representing 23% of all women cancer deaths. Objectives To compare aesthetic and surgical outcome of Round block technique and Grisotti technique in juxta areolar breast cancer. Patients and Methods In our study 20 breast cancer patients are subdivided into group (A) 10 females which underwent round block technique and group (B) 10 femaleswhich underwent grisotti technique. Patient and tumor criteria including age, co morbidities, tumor size and distance between tumor and nipple-areola complex were considered to be nonsignificant between 2 groups so the only difference is the surgical technique. Results The study shows that the round block technique and grisotti technique have the same results regarding operative time, intra-operative blood loss, post operative complications and re-excision rates with slight advantage to round block technique because of its slightly better cosmetic outcomes. So, the round block technique is slightly preferred for selected cases. Conclusion When to compare between round block technique and grisotti technique In treatment of juxta areolar breast cancer, there in no evident difference in operating time, post operative complications or need of re-excision between these two groups of patients

125I Seed-Loaded Stents and 125I Seed Strips for the Treatment of Unresectable Malignant Obstructive Jaundice

2020 ◽  
Vol 12 (3) ◽  
pp. 418-425
Author(s):  
Wenhui Wang ◽  
Shuangxi Li ◽  
Baohua Li
Keyword(s):  
Biliary Obstruction ◽  
Malignant Biliary Obstruction ◽  
125I Seed ◽  
Malignant Obstructive Jaundice ◽  
Operative Complications ◽  
Group A ◽  
Group B ◽  
Single Blind ◽  
Post Operative Complications

Brachytherapy can provide longer obstruction-free time and prolonged survival in patients with unresectable malignant biliary obstruction (MBO). A randomized, single-blind, single-center trial was performed to compare the safety and efficacy of 125I seed-loaded stents to 125I seed strips for the treatment of unresectable MBO. Subjects diagnosed with MBO were divided randomly into two groups. Patients in group A were treated with 125I seed-loaded stents, patients in group B were treated with 125I seed strips. Study outcomes included post-operative complications, quality of life (QOL), time without biliary obstruction and survival. There were no significant differences in complications and morbidity that developed perioperatively. However, the incidence of post-operative complications was significantly higher in group B (n = 20) compared to group A (n = 19) (P < 0.05). Apart from those assessing pain (P = 0.91) and nausea and vomiting (P = 0.07), EORTC-QLQC30 scores in patients in group A were significantly higher than those reported for group B. The median time to relief of biliary obstruction was 144 ± 107 days (95% CI, [92.5–195] days) for group A and 231 ± 150 days (95% CI, [160.92–301.58] days) for group B (P = 0.045). Median survival time was 272.58 ± 258.73 days (95% CI, [147–397] days) for group A and 268 ± 143 days (95% CI, [201–335] days) for group B (P = 0.992). We observed no significant differences with respect to survival were. Although administration of 125I seed strips resulted in a prolonged period without biliary obstruction, use of the 125I seed-loaded stent implant was associated with a lower rate of complications and significantly improved QOL.

scholarly journals Outcome of Laser Urethrotomy in Comparison with Optical Internal Urethrotomy in Recurrent Stricture Urethra Following Perineal Anastomotic Urethroplasty for PUDD

2020 ◽  
Vol 23 (2) ◽  
pp. 181-187
Author(s):  
Ripan Debnath ◽  
Md Nabid Alam ◽  
Md Towhid Belal ◽  
Prodyut Kumar Saha ◽  
Uttam Karmaker ◽  
...  
Keyword(s):  
Internal Urethrotomy ◽  
Average Hospital ◽  
Recurrent Stricture ◽  
Stricture Urethra ◽  
Operative Complications ◽  
Group A ◽  
Group B ◽  
Optical Internal Urethrotomy ◽  
Anastomotic Urethroplasty ◽  
Post Operative Complications

Objective: To compare the outcome of laser urethrotomy and optical internal urethrotomy(OIU) for the treatment of recurrent stricture urethra following perineal anastomotic urethroplasty for posterior urethral distraction defect. Materials and methods: The study was conducted in Dhaka Medical College Hospital from January 2013 to December 2014.Male patients presented with obstructed voiding symptoms following perineal anastomotic urethroplasty were evaluated by their history, physical findings and investigations (urinalysis, uroflowmetry, retrograde urethrogram and micturiting cystourethrogram ) & primarily 64 patients are selected by purposive sampling. Patients are divieded again by random allocation into group A and group B and underwent for OIU and laser urethrotomy respectively. Results: Comparison was made to find out the better method between optical urethrotomy and laser urethrotomy. Overall per-operative complications (bleeding, extravasations of irrigating fluid, false passage and broken knife) in the former group were 31.3% compared to none in the latter group. Post-operative complications like bleeding, haematoma, penile oedema and erectile dysfunction were found only in Group-A (p=0.002). The mean duration of postoperative catheterization and average hospital stay were observed to be much higher in Group-A than that in Group-B (p=0.000008; p=0.0006). Comparison of final outcome (development of stricture) between groups at 1 year of evaluation in Group-A and Group-B was not significant (p= 0.320). Conclusion: Laser urethrotomy is better than optical urethrotmy in regards of peroperative and post-operative complications. Bangladesh Journal of Urology, Vol. 23, No. 2, July 2020 p.181-187

scholarly journals Comparison of tubeless versus tubed percutaneous nephrolithotomy

2018 ◽  
Vol 8 (1) ◽  
pp. 24-31
Author(s):  
Rajiv Shah ◽  
Nirmal Lamichhane ◽  
Sudeep Raj K.C.
Keyword(s):  
Hospital Stay ◽  
Percutaneous Nephrolithotomy ◽  
Renal Calculi ◽  
P Value ◽  
Transfusion Rate ◽  
Operative Complications ◽  
Group A ◽  
Group B ◽  
Tubeless Pcnl ◽  
Post Operative Complications

Percutaneous nephrolithotomy (PCNL) is an effective treatment for large renal calculi and usually a nephrostomy tube is placed in the kidney at the end of procedure to avoid post operative complications. This is to compare the outcome of tubeless PCNL versus tubed PCNL. In a randomized prospective study of sixty-four consecutive patients were enrolled and divided into two groups; A being tubeless group and B being nephrostomy group with 32 patients in each arm divided by quota sampling restricted block method with allocation ratio of 1:1. The mean age in group A was 36.69 ± 13.65 years and in group B was 38.09 ± 13.18 years with no significant p value (p = 0.501). Duration of hospital stay in group A was 3.63 ± 1.04 days and in group B was 6.34 ± 1.71 days with a significant p value (p = 0.001). In group A 31 (96.9%) and in group B 24 (75%) cases were not transfused with blood while 1 (3.1%) and 8 (25%) cases were transfused with blood with a significant p value (p = 0.026). The post operative complications were comparable in between two groups. Therefore tubeless PCNL reduces the hospital stay and blood transfusion rate with no obvious post operative complications.

scholarly journals TP9.2.8Conservative versus surgical management of complicated diverticulitis - a retrospective study of long-term outcomes

2021 ◽  
Vol 108 (Supplement_7) ◽  
Author(s):  
Emily Durrity ◽  
Grace Elliott ◽  
Tabitha Gana
Keyword(s):  
Complicated Diverticulitis ◽  
Long Term Outcomes ◽  
Stoma Reversal ◽  
Operative Complications ◽  
Group A ◽  
Grade 3 ◽  
Group B ◽  
Post Operative Complications

Abstract Introduction The management of complicated diverticulitis has evolved over the years, with a shift towards a conservative approach. The aim of this study was to evaluate the feasibility and long-term outcomes of conservative management of an episode of complicated diverticulitis. Method We retrospectively evaluated patients presenting with perforated colonic diverticulitis between 2013 and 2017. Demographic, presentation and management data was recorded. CT grading system and Clavien-Dindo classification of complications was used. Results Ninety-two patients were included, with a male-to-female ratio of 1:2. Forty patients had a Hartmann’s procedure on the first admission (Group A), the remaining 52 patients were managed conservatively with antibiotics +/- radiological drainage (Group B). Mean follow-up was 64.9 months (range 3-7 years). CT Grade 3 and 4 disease was observed in 65% of Group A and in 40.4% of Group B patients. 14 (26.9%) patients re-presented with recurrent diverticulitis in Group B, 12 (23.1%) of whom required surgical resection in the course of follow-up. Group A had significantly increased morbidity and poorer outcomes compared to Group B with a longer median length of stay (23.5 vs 10.2 days). Post-operative complications affected 72.5% (29 patients), with 40% being grade III or higher. Stoma reversal was performed in 10 (25.8%). Conclusion In carefully selected cases, complicated diverticulitis including CT grade 3 and 4, can be managed conservatively with acceptable rates of recurrence. Better overall outcomes were observed compared to surgical intervention, which is associated with high rates of post-operative complications (72.5%) and low stoma reversal rates 25.8%.

scholarly journals Role of Mechanical Bowel Preparation in Preventing Anastomotic Leakage in Elective Colo-rectal Surgery

2018 ◽  
Vol 13 (1) ◽  
pp. 8-11
Author(s):  
Molla Sharfuddin Ahmad ◽  
Swapan Kumar Biswas
Keyword(s):  
Anastomotic Leakage ◽  
Bowel Preparation ◽  
Rectal Surgery ◽  
Mechanical Bowel Preparation ◽  
Electrolyte Imbalance ◽  
Operative Complications ◽  
Group A ◽  
Group B ◽  
Post Operative Complications

Mechanical bowel preparation is routinely done before colorectal surgeries to reduce morbidity and mortality all over the world. The role of mechanical bowel preparation in preventing complications is recently disputed. The aim of the study was to assess whether elective colorectal surgery can be performed without mechanical bowel preparation. This cross sectional comparative study was carried out to assess the role of mechanical bowel preparation in post-operative complications in elective colon and rectal surgery in the department of surgery of Bangabandhu Sheikh Mujib Medical University, Dhaka Medical College Hospital and SSMC-Mitford Hospital during the period of 1st January 2007 to 31st December 2007. Fifty patients undergoing surgery for carcinoma of colon and rectum were included in the study. Patients were allocated in two groups by non-probability convenient consecutive technique-one group with mechanical bowel preparation with polyethylene glycol and one group with no preparation before surgery. All patients in the study group were followed up for at least one month after surgery for wound infection, anastomotic leakage and intra-abdominal infection. Total 50 patients were randomly divided into two groups (group A, 25 patients & Group B, 25 patients). Group A was the preparatory group and Group B was the non-preparatory group. The type of surgical procedure and the type of anastomosis did not differ significantly between two groups. Sixty percent patients of group A developed post-operative complications; on the other hand 40% patients of group B developed post-operative complications. My study proved that no advantage is gained by pre-operative mechanical bowel preparation and can be easily avoided in order to save the patient from unwanted events like nausea, vomiting, electrolyte imbalance and also increased chance of post-operative complication.Faridpur Med. Coll. J. Jan 2018;13(1): 8-11

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