scholarly journals Stapled hemorrhoidopexy versus Milligan-Morgan haemorrhoidectomy: a paradigm shift in the management of 3rd and 4th degree hemorrhoids

2017 ◽  
Vol 5 (1) ◽  
pp. 209
Author(s):  
Sudhir Kumar Panigrahi ◽  
Chinmaya Ranjan Behera ◽  
Subrajit Mishra ◽  
Abinash Kanungo
Keyword(s):  
Return To Work ◽  
Hospital Stay ◽  
Operative Procedure ◽  
Stapled Hemorrhoidopexy ◽  
Injection Sclerotherapy ◽  
Related Complication ◽  
Patient’S Satisfaction ◽  
Early Return ◽  
Post Operative Pain ◽  
A Prospective Study

Background: Hemorrhoids being a common anorectal problem with its well known morbidity and complications is treated since long by conservative measures, injection sclerotherapy or rubber banding for 1st and 2nd degree and by open Miligan Morgan hemorrhoidectomy or closed Fergusson hemorrhoidectomy for 3rd and 4th degree. However, since 1998, the adoption of Stapled Hemorrhoidopexy has proved over time to be a better alternative in terms of lesser postoperative complication and an overall patient satisfaction.Methods: A prospective study conducted on 114 patients at Department of General Surgery, Kalinga institute of Medical Sciences, Bhubaneswar, Odisha from May 2014 to December 2016.Results: Our study showed stapled hemorrhoidopexy, significantly reduced the time taken for the operative procedure (p <0.001), post operative pain (p <0.01), hospital stay along with early return to work and a better patient satisfaction.Conclusions: Stapled hemorrhoidopexy is an effective alternative to open Miligan-Morgan procedure in treating 3rd and 4th degree hemorrhoids, in terms of lesser time taken for the operative procedure, post operative pain, use of analgesics, hospital stay and early return to work, better post operative patient’s satisfaction and reduced procedure related complication.

scholarly journals A comparative study of short term results of open haemorrhoidectomy and stapler haemorrhoidopexy

2017 ◽  
Vol 4 (10) ◽  
pp. 3358
Author(s):  
Chandrasekhar S. Neeralagi ◽  
Yogesh Kumar ◽  
Surag K. R. ◽  
Lakkanna Suggaiah ◽  
Preetham Raj
Keyword(s):  
Surgical Treatment ◽  
Postoperative Pain ◽  
Return To Work ◽  
Hospital Stay ◽  
Stapled Hemorrhoidopexy ◽  
Short Term ◽  
Post Operative Pain ◽  
Duration Of Surgery ◽  
Operative Complications ◽  
Post Operative Complications

Background: Haemorrhoids are the most common benign anorectal problems worldwide. Treatments of third and fourth degree hemorrhoids include surgical haemorrhoidectomy. Milligan Morgan haemorrhoidectomy (MMH) as described in 1937 has remained the most popular among many techniques proposed. In order to avoid the postoperative drawbacks of Milligan Morgan haemorrhoidectomy, a new surgical treatment for prolapsing haemorrhoids has been described by Longo in 1995, procedure called stapled haemorrhoidopexy which is associated with less postoperative pain and a quicker recovery. The objective of this study was to compare the short-term outcome between stapled hemorrhoidopexy and Milligan-Morgan hemorrhoidectomy.Methods: Prospective randomized study of 120 patients with grade 3 and grade 4 haemorrhoids requiring surgical treatment either MMH or SH, 60 in each group for the period of 18 months from June 2014 to November 2015. Post-operative pain, duration of surgery, duration of hospital stays, post-operative complications and time taken to return to work were compared with mean follow up period of 6 months.Results: Duration of surgery is significantly low in stapled group with P <0.001, duration of hospital stay is significantly low in stapled group with P <0.001, post-operative pain low in staple group with P <0.05, time taken to return to work is significantly early in stapled group with P <0.001. Post-operative complications incontinence not found in the present study but recurrence of two cases in each group noted.Conclusion: Stapled hemorrhoidopexy is associated with less postoperative pain, shorter duration of surgery and hospital stay, earlier return to work as compared with Milligan-Morgan open hemorrhoidectomy. The procedure is not associated with major post-operative complications.

scholarly journals Laparoscopic cholecystectomy in Jordan

2001 ◽  
Vol 7 (4-5) ◽  
pp. 838-840
Author(s):  
A. Al Raymoony
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Postoperative Pain ◽  
Return To Work ◽  
Hospital Stay ◽  
Operative Time ◽  
Safe Procedure ◽  
Short Hospital Stay ◽  
Early Return ◽  
The Mean ◽  
Mean Time

This study was conducted on 100 patients with symptomatic gallbladder stones, aged 22-81 years with a mean of 51.5 years, who underwent cholecystectomy in Zarqa city, Jordan between July 1998 and July 1999. The success rate was 87% and the procedure was completed using the conventional method in 13 patients. The mean operative time was 60 minutes, complication rate was 5% and there were no deaths. The mean hospital stay was 1 day and mean time to return to work was 10 days. This study showed that laparoscopic cholecystectomy is a safe procedure with reasonable operative time, less postoperative pain, a short hospital stay, early return to work, and a low morbidity and mortality rate.

Reduced Pain, Shorter Hospital Stay And Early Return To Work In Pcnl: Comparative Study On Outcome Of Pcnl Versus Open Surgery In The Treatment Of Large Renal Calculi

2020 ◽  
Vol 16 (1) ◽  
pp. 16-20
Author(s):  
Syed Al Fasani ◽  
Akm Zamanul Islam Bhuiyan
Keyword(s):  
Comparative Study ◽  
Return To Work ◽  
Hospital Stay ◽  
Open Surgery ◽  
Renal Calculi ◽  
Postoperative Hospital Stay ◽  
P Value ◽  
Early Return ◽  
Significant Difference ◽  
Duration Of Surgery

Objective: To compare the outcome of PCNL & open surgery in the treatment of large renal calculi by assesing the amount of analgesia required to relief pain, mean hospital stay, & convalescence period. Materials & Methods: : This comparative study in during 80 patients diagnosed with kidney stone disease admitted in the NIKDU during the period of Jan’ to Dec’2009. They were divided conveniently into two groups. Intervention was done in the formPCNL(40) and open surgery (40). Clinical outcome like, duration of surgery, postoperative hospital stay,doses of narcotic analgesia required to relief pain and convalescence periodwere reviewed. In complete follow up 9 patients were missed in PCNL group resulting in 31 patients. There was no significant difference in preoperative variables such as age,sex, stone size in cm, stone number- single/multiple and stag horn Stone. Results : There were statistically significant difference in the parameters between the groups,( PCNL vs open surgery [mean ± SD]): duration of operation (min), 97.90 ± 24.89 vs 136.62 ± 23.54, postoperative hospital stay (days) ,4.77 ± 3.98 vs 9.55 ± 3.65, mean time return to work (days) , 3.09 ± 1.21vs 6.25 ± 1.53, ( p value is <0.001). The amount of analgesia required to relief pain was significantly reduced in PCNL vs open procedure ( no patient required > 2 doses vs 27 patient required 3 or >3 doses ), p value is <0.001. Conclusion: PCNL is relatively safe & better treatment option than open surgery in the treatment of large renal calculi. It has reduced pain, shorter hospital stay and more rapid return to work. Bangladesh Journal of Urology, Vol. 16, No. 1, Jan 2013 p.16-20

scholarly journals Laparoscopic versus open surgical management of idiopathic varicocele: a study on 100 patients

2017 ◽  
Vol 4 (9) ◽  
pp. 3071
Author(s):  
Deepak Verma ◽  
Chhanwar Lal ◽  
Avdhesh Sharma ◽  
Manoj Sirwi
Keyword(s):  
Surgical Technique ◽  
Prospective Study ◽  
Hospital Stay ◽  
Operating Time ◽  
Common Condition ◽  
Analgesic Requirement ◽  
Surgical Practice ◽  
Post Operative Pain ◽  
Grade Ii ◽  
A Prospective Study

Background: Idiopathic varicocele is common condition encountered in surgical practice requiring surgical correction. Open surgical technique had been in use for long but laparoscopic varicocelectomy is another choice for its management.Methods: This is a prospective study on 100 patients. 70 patients were subjected to laparoscopic and 30 to open inguinal varicocelectomy.Results: Majority of patients were between 16 to 25 years of age. 55% were asymptomatic and 10% had infertility. Grade II varicocele was observed in 50% patients. All patients had left side involvement with bilateral varicocele in 2% patients. Mean operating was 13.8 min in unilateral and 17.3 min in bilateral laparoscopic varicocelectomy whereas it was 27.55 min in unilateral and 49.7 min in bilateral open varicocelectomy. 5.7% and 6.6% had secondary hydrocele and hospital stay was 1.25 and 3.4 days in laparoscopic and open group respectively.Conclusions: Laparoscopic varicocelectomy is safe, effective procedure with less post-operative pain and analgesic requirement. It also has shorter operating time and post-operative hospital stay. Procedures like opposite varicocele, herniotomy, adhesiolysis or orchiopexy can also be done.

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 Outcome comparison study between laparoscopic appendisectomy and conventional open appendisectomy

2019 ◽  
Vol 6 (5) ◽  
pp. 1520
Author(s):  
Mimamaychet B. Sangma ◽  
Selvakumaran Selvaraju ◽  
Pratheeba Natarajan ◽  
Fremingston Marak ◽  
Simon David Dasiah
Keyword(s):  
Return To Work ◽  
Hospital Stay ◽  
Operative Time ◽  
Meta Analysis ◽  
Operation Time ◽  
Significant Finding ◽  
Medical College ◽  
Early Return ◽  
Outcome Comparison ◽  
Gandhi Medical College

Background: Open appendisectomy (OA) had been the procedure of choice for acute appendisectomy for a century since Mc Burney introduced in 1884. Laprascopic appendisectomy (LA) didn’t gain popularity and many studies had been conducted to see the superiority of one over the other. Recent meta-analysis studies, found overall benefits in favour of LA. So, we have done comparative study with the aim to compare the benefits of LA over OA.Methods: Total of 90 appendisectomies was done, 45 each in OA and LA group and compared over a period of 1-year from October 2016 to October 2017 in Indira Gandhi Medical College and RI, Pondicherry. Outcome parameters were compared between the 2-groups in relation to operative time, analgesia used, length of post-operative hospital stay, return to work, resumption of a regular diet, post-operative scar and post-operative complications.Results: Mean age of LA was 35 years, OA was 30 years. Male preponderance observed in OA (67%), female in LA (60%). Post-operative short hospital stay was 3-days in LA, 5-days in OA. Early return to work was 9-days in LA, 15-days in OA. Operative time was significantly shorter in LA which was 30-minutes and 40-minutes in OA. In laprascopic group, no complications was observed, in open group we had two post-operative infections.Conclusions: LA is an effective and safe option and the procedure of choice for most patients regardless of age, sex and BMI, with a statistically significant finding in regards to operation time in LA compared to conventional OA group.

scholarly journals COMPARISON OF RADIOFREQUENCY ABLATION TO CONVENTIONAL HIGH LIGATION AND STRIPPING IN TRUNCAL VARICOSITIES

2021 ◽  
pp. 1-3
Author(s):  
Sharath Chandra B. J ◽  
Ganesh G Gowda ◽  
Sanjay Natarajan
Keyword(s):  
Radiofrequency Ablation ◽  
Return To Work ◽  
Varicose Veins ◽  
Postoperative Outcome ◽  
Visual Analogue Score ◽  
High Ligation ◽  
P Value ◽  
Early Return ◽  
Post Operative Pain ◽  
Severity Scores

Introduction Both High Ligation/ Stripping and Radiofrequency ablation have been accepted as a standard in the management of varicose veins and are being performed by general and vascular surgeons. Objectives To compare the postoperative outcome in terms of timing of return to daily activities, post-operative pain scoring, incidence of hematoma, thrombophlebitis and improvement in Venous Severity scores among patients undergoing High Ligation/ Stripping and Radiofrequency Ablation Methodology This study was conducted in JSS Hospital in the departments of general and vascular surgery. A total of 72 patients with Duplex confirmed truncal varicosities were included in the study and 36 underwent High Ligation/ Stripping while 36 underwent Radiofrequency Ablation. Follow up was done at POD1, 3, 5, 7, 30 and at the end of 3 months. Results There was no recurrence in the two groups but RFA group had significantly lesser duration of hospital stay (P value <0.0001), lesser postoperative Visual Analogue Score for pain (1.17 ± 0.94 on day 7) and earlier return to work (3.56 ± 1.87 days), P <0.0001. Conclusion Patients who underwent RFA had lesser post-operative pain scores, lesser duration of hospitalization, early return to work but there was no recurrence in both groups at the end of 3 months.

scholarly journals ANALYSIS AND EVALUATION OF ADVANTAGES FROM LAPAROSCOPIC APPENDECTOMY

2022 ◽  
Vol 28 (1) ◽  
pp. 4183-4185
Author(s):  
Konstantin Kostov ◽  
Keyword(s):  
Postoperative Complications ◽  
Hospital Stay ◽  
Laparoscopic Appendectomy ◽  
Laparoscopic Approach ◽  
Length Of Hospital Stay ◽  
Analysis And Evaluation ◽  
Early Return ◽  
Post Operative Pain ◽  
Male Patients ◽  
Concomitant Factors

Purpose: The aim of the study is to evaluate the advantages of laparoscopic appendectomy fromour clinical experience in UMHATEM "Pirogov" which resulted in reduced postoperative complications, pain, length of hospital stay, and early return to work. Material and Methods: Data from a study of a patient group in the Department of General, Visceral and Emergency Surgery of UMBALSM "H. I. Pirogov "for the six-month period (01.01.2019 до 01.07.2019) were collected.Eighty-one patients with acute appendicitis who underwent laparoscopic appendectomy were selected. Indicators characterizing basic clinical and pathological features (epidemiology, demography, degree of pathological impairment), surgical approach and its outcomes (postoperative complications, postoperative duration), influence of concomitant factors were studied. Results: The study included 81 patients. The majority of patients were women - 46 (56.79%), men- 35 (43.21%). The mean age of male patients was 31.4 years and for female-28.6 years respectively. Hospitalization times are usually short - most patients are given up to 72 hours (70- 86.42%). Only eleven patients (13.58%) had an extended hospital stay for observation and additional therapy. Conclusion: Laparoscopic appendectomy was verified as an optimal and safe surgical procedure. Laparoscopic approach reduces post-operative pain, shortens hospital stay, reduces complications, and thereby reducing treatment costs.

scholarly journals STUDY OF PREOPERATIVE CLINICAL AND INVESTIGATIVE FACTORS PREDICTING DIFFICULT LAPAROSCOPIC CHOLECYSTECTOMY

2020 ◽  
Vol 8 (3) ◽  
pp. 207-213
Author(s):  
Deepak Verma ◽  
Ratan ◽  
Nemi Chand
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Hospital Stay ◽  
Wall Thickness ◽  
Past History ◽  
Anatomical Variation ◽  
Cost Effective ◽  
Liver Function Tests ◽  
Early Return ◽  
Post Operative Pain ◽  
History Of

Background: Laparoscopic cholecystectomy is one of the most commonly performed surgical procedure with the advantage of short hospital stay, cosmetic, less post-operative pain and early return to work and thus ultimately cost effective. However, certain factors can make the procedure difficult and such patients many do not enjoy benefit of laparoscopic procedure particularly longer hospital stay. Aim: To determine various factors on clinical, pathological and radiological grounds to predict difficult laparoscopic cholecystectomy. Material and Method: 200 patients admitted in surgical ward with a diagnosis of Chronic Calculus cholecystitis to be selected for laparoscopic cholecystectomy were subject of this study. Age, Sex, BMI, number of previous attack, previous abdominal surgery, past history of pancreatitis and jaundice, signs of acute cholecystitis, leucocytosis, CRP, Liver function tests, serum amylase and lipase, GB wall thickness,  presence of pericholecystic fluid , status of  GB and anatomical variation were various factors studied. Results: Age > 50 years, male sex, BMI>30, more than 4 attacks, signs of cholecystitis, leucocytosis > 11,000/cu mm, increased GB wall thickness, presence of pericholecystic fluid and overdistended or contracted gall bladder are associated with difficult laparoscopic cholecystectomy.

Stapled Haemorrhoidopexy in the Treatment of Haemorrhoidal Disease: A Prospective Study

2020 ◽  
Vol 38 (3) ◽  
pp. 126-134
Author(s):  
Md Jahangir Hossan Bhuiyan ◽  
AMM Yahia ◽  
Farhana Begum ◽  
Mainuddin Ahmed ◽  
Nafiz Imtiaz Uddin Ahmed
Keyword(s):  
Hospital Stay ◽  
Stapled Haemorrhoidopexy ◽  
Patient’S Satisfaction ◽  
Haemorrhoidal Disease ◽  
Duration Of Surgery ◽  
Duration Of Hospitalization ◽  
Short And Long Term ◽  
The Mean ◽  
Grade 3 ◽  
A Prospective Study

Background: Haemorrhoids are usually managed by open haemorrhoidectomy which is associated with postoperative pain, prolong hospital stay, longer convalescence and late return to normal activities. Stapled haemorrhoidopexy is a newer alternative for the treatment of haemorrhoid. The present study was designed to evaluate this technique in terms of duration of surgery & hospital stay, complications, convalescence, time return to normal activities, cost effectiveness and patient’s satisfaction. Materials and methods: One hundred and sixty patients of either sex who fulfilled the criteria were included in this study. More than 90% of the patients were in grade 3 & 4. All data were prospectively collected and examined. The patients were evaluated in terms of demographic properties, complaints on admission and postoperative complication. Results: 69.4% were male and 30.6% were female. Mean age was 40.93 years. Grade 3 haemorrhoid was present in 73.75% cases, Grade 4 was 18.12% cases, Grade 1 and Grade 2 were in 8.13% cases. The mean duration of surgery was 30 minutes. The mean duration of hospitalization was 36 hours. Intraoperative bleeding was observed in 9.38% patients. Reactionary haemorrhage was seen in 3.75% patients. Postoperative mild pain in 3.12% patients and residual prolapse in 1.25% cases. Conclusion: Stapled haemorrhoidopexy is safer alternative to open haemorrhoidotectomy with many short and long term benefits. J Bangladesh Coll Phys Surg 2020; 38(3): 126-134

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