scholarly journals Is the laparoscopic approach superior to open approach for treatment of acute appendicitis? A hospital based experience

2017 ◽  
Vol 4 (5) ◽  
pp. 1726
Author(s):  
Anil Reddy Pinate ◽  
Mohammad Fazelul Rahman Shoeb ◽  
Shiva Kumar C. R.
Keyword(s):  
Acute Appendicitis ◽  
Hospital Stay ◽  
Operative Time ◽  
Laparoscopic Group ◽  
Laparoscopic Appendicectomy ◽  
Open Group ◽  
Open Appendicectomy ◽  
Group A ◽  
The Mean ◽  
Group B

Background: Laparoscopic appendicetomy remains controversial in Indian perspective. The objective was to compare the clinical outcome of open with laparoscopic appendicectomy.Methods: Prospectively collected data from 150 consecutive patients with acute appendicitis was studied. Patients undergoing surgery for acute appendicitis were alternately assigned into one of the two groups (Group-A patients underwent open appendicectomy and in Group B laparoscopic appendicectomy). The two groups were compared with respect to operative time, length of hospital stay, postoperative pain & wound complications.Results: The mean operative time in the open group was 84.40 minutes; for laparoscopic group, 95.20 minutes (p-0.001). Duration of paralytic ileus, tolerance to oral feeds, resumption of daily routine activity and ambulation of patients were started earlier in laparoscopic group than open group. Group A (OA) patients had pain at the mean of 2.66 days as compared group B (LA), in which patients had pain at the mean of 1.66 days.  Study also showed that the hospital stay for laparoscopic group was almost half of that for open group. Laparoscopic appendicectomy was safe as compared to open surgery in context to post-operative complications.Conclusions: Provided surgical experience and equipment are available, Laparoscopic appendicectomy is as safe and efficient than open appendicectomy.

scholarly journals A comparative study of two operative procedures in anterior hypospadias repair: limited urethral mobilization and tubularized incised plate urethroplasty.

2021 ◽  
Vol 28 (11) ◽  
pp. 1578-1584
Author(s):  
Shafiq ur Rehman ◽  
Fareena Ishtiaq ◽  
Zarlish Fazal ◽  
Muhammad Anwar ◽  
Saad Fazal
Keyword(s):  
Hospital Stay ◽  
Functional Outcomes ◽  
Operative Time ◽  
Operation Time ◽  
Cosmetic Appearance ◽  
Tubularized Incised Plate ◽  
Group A ◽  
Tubularized Incised Plate Urethroplasty ◽  
The Mean ◽  
Group B

Objectives: This study is aimed to compare the results of limited urethral mobilization and tubularized incised plate urethroplasty in the management of anterior hypospadias, in terms of cosmetic and functional outcomes, complication rate, operative time, and hospital stay. Study Design: Prospective Randomized Controlled study. Settings: Department of Pediatric Surgery, DHQ Teaching Hospital Sahiwal. Period: January 2019 to December 2020. Material and Methods: A total of 89 patients with anterior hypospadias were included. Patients were divided randomly into two groups. In group A, limited urethral mobilization was performed and in group B, tubularized incised plate urethroplasty was carried out. A self-structured performa was used to collect the data of all patients. Both groups were compared in terms of the operation time, hospital stay, postoperative complications, cosmetic appearance, and functional outcomes. Results: Forty-five patients were included in group A, age ranged from 2.5 to 12 years (mean 4.83years). Forty-four patients were included in group B and their ages ranged from 3.5 to 11years (mean 4.76 years). The operation time was significantly less for group A than for group B. In group A, it ranged from 54 to 69 min with an average time of 60.51 min and in group B from 70 to 88 min, with an average of 79.34 min. The mean hospital stay period in group A was 7.37 days, ranged from 7 to 9 days, and in group B was 11.04 days, ranging from 10 to 13 days. The mean follow-up period in both groups was 7.45 months, ranging from 3 months to 12 months. Meatal stenosis was the most common complication in group A, which developed in 6.66% (n=3) patients. Urethrocutaneous fistula was the most common complication in group B, which developed in 6.81% (n=3) patients. Cosmetic appearance and functional outcome were good and comparable in both groups. Conclusion: Although both techniques, tubularized incised plate and limited urethral mobilization urethroplasty are acceptable modalities for the management of anterior hypospadias. But limited urethral mobilization urethroplasty seems to be a good option due to its simplicity, short hospital stay, significant shorter operative time, low fistula formation rate, and good cosmetic and functional outcomes.

scholarly journals RETROPERITONEAL LAPAROSCOPIC PYELOLITHOTOMY IN RENAL PELVIC STONE VERSUS OPEN SURGERY - A COMPARATIVE STUDY

2018 ◽  
Vol 91 (1) ◽  
pp. 85-91
Author(s):  
Rikki Singal ◽  
Siddharth Dhar
Keyword(s):  
Blood Loss ◽  
Hospital Stay ◽  
Open Surgery ◽  
Laparoscopic Group ◽  
Urinary Stone ◽  
Stone Disease ◽  
Laparoscopic Pyelolithotomy ◽  
Group A ◽  
The Mean ◽  
Group B

Background. The introduction of endourological procedures such as percutaneous nephrolithotomy and ureterorenoscopy have led to a revolution in the the management of urinary stone disease. The indications for open stone surgery have been narrowed significantly, making it a second- or third-line treatment option.Aims and Objectives. To study the safety and efficacy of retroperitoneal laparoscopic pyelolithotomy in retroperitoneal renal stone. We compared the results of laparoscopic and open surgery in terms of easy accessibility, operative period, renal injuries, and early recovery.Methods. This prospective study was conducted on renal pelvic stone cases from January 2009 to February 2016 in Suchkhand Hospital, Agra, India. The study included a total of 1700 cases with the diagnosis of solitary renal pelvic stones. In group A - 850 cases - retroperitoneal laparoscopic pyelolithotomy was performed, while group B - 850 cases – underwent open pyelolithotomy.Results. The mean operative time was less in group B than group A (74.83 min vs. 94.43 min) which was significant (p<0.001).The blood loss was less in the laparoscopic group than in the open group (63 mL vs. 103mL). There were statistically significant differences in the post-operative pain scores, and postoperative complications compared to group B (p<0.001). The mean hospital stay was less in group A (p<0.03), which was significant.Conclusion. Laparoscopic surgery reduces analgesic requirements, hospital stay, and blood loss. The disadvantages include the reduced working space, the cost of equipment and the availability of a trained surgeon.

scholarly journals A comparative study to evaluate milligan morgan hemorrhoidectomy versus pile suture method in management of haemorrhoids

2021 ◽  
Vol 8 (2) ◽  
pp. 664
Author(s):  
Aditya . ◽  
Kuldeep Raj ◽  
P. N. Agarwal ◽  
Md Abu Nasar
Keyword(s):  
Return To Work ◽  
Hospital Stay ◽  
Operative Time ◽  
Suture Technique ◽  
Pain Scores ◽  
Early Return ◽  
Suture Group ◽  
Group A ◽  
The Mean ◽  
Group B

Background: A pile suture technique was described originally by the Farag in 1978 was better in terms of post- operative pain, bleeding, hospital stay and early return to work which are the distressing effects of conventional Milligan Morgan  Hemorrhoidectomy which is well accepted surgical procedure for haemorrhoids. This study is designed to compare the pile suture and Milligan Morgan Hemorrhoidectomy.Methods: After fulfilling the criteria, 60 patients were randomly allocated to the group A (Pile Suture [PS] n -30) and group B (Milligan Morgan Hemorrhoidectomy [MM] n – 30). The techniques were evaluated with respect to the operative time, pain scores, bleeding, hospital stay, return to work, and recurrence.Results: The mean age of patients was 44.33 years and 42.77 years in the pile suture group and MM group respectively. Grade III or IV hemorrhoids were more common in men (i.e., 80% and 60% in the pile suture and MM group, respectively). The mean operative time was shorter in the PS 20.10 minutes versus 51.47 minutes in the MM group (P .001). The bleeding and pain scores were less in the PS. Mean hospital stay was 4 days and 6.6 days  in the PS and MM group, respectively. The patients in the pile suture group returned to their routine activities earlier (i.e., within 7.33 days) as compared with 16.87 days in the MM group.Conclusions: Therefore, pile suture method can be considered as less traumatic for the patients and method can be recommended as a safer alternative to Milligan Morgan haemorrhoidectomy. 

scholarly journals Comparison of Cohen and Lich-Gregoir ureteral reimplantation in the surgical management of primary unilateral vesicoureteral reflux in children

2020 ◽  
Vol 66 (4) ◽  
pp. 424-429
Author(s):  
Cemil Aydin ◽  
Ali Akkoc ◽  
Ramazan Topaktas ◽  
Aykut Bugra Senturk ◽  
Zeynep Banu Aydin ◽  
...  
Keyword(s):  
Hospital Stay ◽  
Vesicoureteral Reflux ◽  
Operative Time ◽  
Significant Risk ◽  
Operation Time ◽  
Ureteral Reimplantation ◽  
Macroscopic Hematuria ◽  
Group A ◽  
The Mean ◽  
Group B

SUMMARY OBJECTIVE Vesicoureteral reflux (VUR) represents one of the most significant risk factors for acute pyelonephritis in children. Various intravesical and extravesical techniques have been described for the surgical correction of VUR. The aim of our study was to compare the results of open intravesical and extravesical procedures for unilateral primary VUR in children. METHODS Between January 2012 and August 2018, 38 children with primary VUR who underwent open ureteral reimplantation surgery were retrospectively reviewed. The Cohen (intravesical) and the Lich-Gregoir (extravesical) approach were grouped as groups A and B, respectively. The groups were compared for age, gender, preoperative reflux grade, presence of lower urinary tract symptoms, operation time, discomfort and pain, analgesic requirements, duration of hematuria, postoperative complications, and hospital stay. All the parameters were statistically compared. RESULTS There were 38 patients in this study. Group A had 18 patients, and group B had 20 patients. The mean operative time was significantly shorter in group B than in group A. The mean hospital stay was also shorter in group B. The urethral foley stay period was 4.7±0.9 days 2±0 days (p = 0.000*), respectively, for group A and B. Macroscopic hematuria was seen in group A. The objective pain scale was worse after intravesical surgery. Analgesic requirements were higher in group A (p =0.131). CONCLUSION Intravesical and extravesical ureteroneocystostomy methods are equally successful and feasible in the treatment of primary unilateral VUR. The Cohen technique is associated with a longer and more painful hospital stay, gross hematuria, and longer operative time, compared to the Lich-Gregoir technique.

scholarly journals Laparoscopic Versus Open Appendicectomy for Treatment of Acute Appendicitis

2019 ◽  
Vol 20 (1) ◽  
pp. 24-25
Author(s):  
Mohammad Ali ◽  
Kazi Lsrat Jahan
Keyword(s):  
Acute Appendicitis ◽  
Hospital Stay ◽  
Gold Standard ◽  
Operative Time ◽  
The Other ◽  
Laparoscopic Appendicectomy ◽  
Abdominal Abscess ◽  
Open Appendicectomy ◽  
Laparoscopic Skills ◽  
Operative Complications

Laparoscopic appendicectomy is not yet considered the "gold standard" in the treatment of acuteappendicitis because of its higher operative time, intra-abdominal abscess risk, and costscompared to open appendicectomy. On the other hand laparoscopic appendicectomy is associatedwith fewer post operative complications, shorter hospital stay, and nearly similar operative time,intra-abdominal abscess rate, and total costs, compared with open appendicectomy. With increasein the experience of the surgeon in laparoscopic skills pit falls will be much lower. Therefore, laparoscopicappendectomy can be recommended as preferred approach in acute appendicitis Journal of Surgical Sciences (2016) Vol. 20 (1) : 24-25

scholarly journals Modified Percutaneous Achilles Tendon Lengthening by Triple Hemisection for Achilles Tendon Contracture

2019 ◽  
Vol 2019 ◽  
pp. 1-8 ◽  
Author(s):  
Yangjing Lin ◽  
Jin Cao ◽  
Changgui Zhang ◽  
Liu Yang ◽  
Xiaojun Duan
Keyword(s):  
Achilles Tendon ◽  
Recurrence Rate ◽  
Operative Time ◽  
Achilles Tendon Rupture ◽  
Tendon Lengthening ◽  
Group A ◽  
Achilles Tendon Lengthening ◽  
The Mean ◽  
Group B

Background. Both percutaneous Achilles tendon lengthening by triple hemisection and the traditional open Z-lengthening are effective methods for Achilles tendon contracture. This study aims to evaluate the efficacy and safety of this new therapeutic method, which is based on the percutaneous sliding technique with three hemi-cuts in the tendon, as compared with the traditional open Z-lengthening. Methods. Retrospective analysis of the Achilles tendon contracture cases in our hospital between January 2010 and September 2016 was conducted. Twenty-five cases received percutaneous Achilles tendon lengthening (group A), and 30 patients who underwent open Z-lengthening during the same period were in the control group (group B). Operative time and hospital stay were statistically analyzed. Incision complication, equinus recurrence rate and Achilles tendon rupture morbidity were recorded. The function was assessed by American Orthopaedic Foot & Ankle Society (AOFAS) score. All cases in group A received Magnetic Resonance Imaging (MRI) of ankle preoperatively and in the follow-ups. Results. The mean follow-up period was 42.04 months in group A and 61.7 months in group B. The entire operative time and the mean hospitalization days were lower in group A than in group B. No incision and infection complication occurred in group A. The infection rate in group B was 3.3%. Equinus recurrence rate was 4% in group A and the equinus recurrence rate in group B was 21.4%. In group A, the mean AOFAS score increased from 64 ± 10.16 points preoperatively to 96.08 ± 3.17 at final follow-up, while the score in group B increased from 63.48 ± 6.2 points to 85.4 ± 10.3. MRI showed continuity of the Achilles tendon and homogeneous signal in group A. Conclusion. Modified surgery can significantly reduce the risk of Achilles tendon rupture, provide better balance in soft tissue strength between ankle dorsiflexion and ankle plantarflexion, helping to avoid recurrence of the deformity.

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

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.

scholarly journals Comparative study between laparoscopic trans-abdominal preperitoneal and open mesh hernioplasty in repair of non-complicated inguinal hernia

2019 ◽  
Vol 7 (1) ◽  
pp. 24
Author(s):  
Waleed Yusif El Sherpiny
Keyword(s):  
Inguinal Hernia ◽  
Hernia Repair ◽  
Hospital Stay ◽  
Laparoscopic Hernia Repair ◽  
Laparoscopic Group ◽  
Routine Activities ◽  
Group A ◽  
Group B ◽  
Open Hernia Repair ◽  
Mesh Hernioplasty

Background: Inguinal mesh hernioplasty is one of the common procedures performed all over the world. It can be done either through open or laparoscopic techniques. The aim of this study was to compare the outcomes of Lichtenstein tension free hernioplasty versus laparoscopic transabdominal pre-peritoneal (TAPP) mesh repair considering, duration of the surgery, hospital stay, and duration to resume normal activity, degree of postoperative pain, wound infection, recurrence and complications.Methods: Adult patients presented to the general surgical OPD, with the diagnosis of inguinal hernia underwent either Lichtenstein repair or laparoscopic repair by TAPP.Results: Patients in Group A (open-repair) had significantly greater level of local pain during rest and during routine activities than those within Group B (laparoscopic group) during the postoperative period assessed on the visual-analogue scale. Mean operative time for open hernia repair was 43.7 minutes and for laparoscopic hernia repair was 59.03 minutes and the difference were statistically significant (p=0.0001). The mean duration of hospital stay for open hernia repair was 2.16 days and that for laparoscopic hernia repair was 1.08 days with a (p=0.00001) which was statistically significant. The time to resume routine activities was much shorter among Group B patients than patients in Group A. Only one recurrence (3.3%) was seen in Group B after 6 months follow up.Conclusions: It is concluded that laparoscopic TAPP repair of inguinal hernia in adults is safe and preferred operation as compared to open inguinal hernia repair.

scholarly journals ACUTE CHOLECYSTITIS

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.

Comparison of harmonic scalpel versus Milligan Morgan technique in haemorrhoidectomy patients

2021 ◽  
Author(s):  
Muhammad Ahmad ◽  
Syed Tatheer Abbas ◽  
Amna Javaid ◽  
Naveed Arshad ◽  
Falak Shair
Keyword(s):  
Wound Healing ◽  
Operative Time ◽  
Harmonic Scalpel ◽  
Controlled Trial ◽  
P Value ◽  
Randomized Controlled ◽  
Group A ◽  
The Mean ◽  
Complete Wound Healing ◽  
Group B

Objectives: To assess the comparison of harmonic scalpel versus Milligan Morgan technique in patients undergoing haemorrhoidectomy. Methodology: This randomized controlled trial study was conducted at General Hospital, Lahore, from March 2019 to September 2019. Informed consent was obtained from eligible 60 patients. Patients were randomly divided into two equal groups. In group-A, haemorrhoidectomy was conducted according to the harmonic scalpel method. In group-B, open haemorrhoidectomy was performed by the Milligan Morgan procedure. Data was assembled through a designed questionnaire and investigated via SPSS version 25. Data were stratified for descriptive statistics, level of haemorrhoids and period of haemorrhoids. Post-stratification, independent sample t-test was used. Results: Mean age of both groups patients were 44.6±7.6 and 43.8±8.2 years, respectively. In group-A, mean operative time was 20.8±2.8 minutes, while 26.5±2.8 minutes in group-B, which was statistically significant with p-value of 0.001. In group-A, mean convalescence period was 9.7±2.9 days, while 13.4±3.7 days in group-B, which was statistically significant with p-value of 0.001. The mean convalescence period with harmonic scalpel method was 7.4 days (range 5–14, SD 3.6) versus 18.6 days (range 7–30, SD 5.4) with Milligan Morgan technique (P?0.001). This research observed that harmonic scalpel method required almost six weeks for complete wound healing, whereas in  Milligan Morgan technique, complete wound healing was achieved after three months (P<0.05). Conclusion: Harmonic scalpel haemorrhoidectomy found an advantageous method when assessing the operative time and convalescence period. Hence, Harmonic scalpel haemorrhoidectomy can be adapted as a safe and effective alternative method for treating symptomatic haemorrhoids. Continuous...

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