scholarly journals Cost effectiveness of TAPP (trans-abdominal pre-peritoneal inguinal hernia repair) over open inguinal Lichtenstein meshplasty

2018 ◽  
Vol 5 (5) ◽  
pp. 1812
Author(s):  
Manish Kashyap Kashyap ◽  
Pravin Singhade ◽  
Riddhi Bora ◽  
Gaurav Batra ◽  
Ishant Rege ◽  
...  
Keyword(s):  
Cost Effectiveness ◽  
Hospital Stay ◽  
Lichtenstein Repair ◽  
Hernia Surgery ◽  
Cost Of Treatment ◽  
Duration Of Hospital Stay ◽  
Tapp Repair ◽  
Post Operative Pain ◽  
Group A ◽  
Group B

Background: Hernia surgery has undergone tremendous refinement in technique of various methods have been advocated by different authors but each has got its own merit. Laparoscopic Trans-abdominal Pre-Peritoneal inguinal meshplasty (TAPP) is a newer technique which results in less post-operative pain, better cosmetic result, improves recovery time. The aim of the study was to compare cost effectiveness and duration of hospital stay that occurs from both laparoscopic TAPP repair and Lichtenstein repair in patients of inguinal hernia.Methods: The present study comprises 25 cases underwent open Lichtenstein mesh repair and 25 cases underwent laparoscopic (TAPP) repair. After surgery all patients were monitored carefully for pain, infection, cost effectiveness and hospital stay.Results: In present study, Group A is having significantly more cost of treatment than Group B in unilateral. The hospital stay was significantly low in group A than Group B.Conclusions: TAPP repair is more expensive compared to Lichtenstein’s meshplasty, TAPP repair is associated with faster recovery as compared to open Lichtenstein meshplasty, hospital stay is lesser in TAPP as compared to open inguinal meshplasty. 

scholarly journals Comparison of In-Hospital Outcomes Between Patients With or Without Acute Kidney Injury Developed After Hospitalization Following Acute Coronary Syndrome

2020 ◽  
Vol 16 (1) ◽  
pp. 3-10
Author(s):  
Md Sajjad Safi ◽  
Msi Tipu Chowdhury ◽  
Tanjima Parvin ◽  
Khurshed Ahmed ◽  
Md Ashraf Uddin Sultana ◽  
...  
Keyword(s):  
Heart Failure ◽  
Acute Kidney Injury ◽  
Serum Creatinine ◽  
Cardiogenic Shock ◽  
Hospital Stay ◽  
Kidney Injury ◽  
Duration Of Hospital Stay ◽  
Group A ◽  
Hospital Stays ◽  
Group B

Background: Acute Kidney Injury (AKI), a common complication of acute coronary syndromes (ACS), is associated with higher mortality and longer hospital stays. ACS patients with renal impairment during hospitalization are associated with adverse in-hospital outcomes in the form of heart failure, cardiogenic shock, arrhythmia, dialysis requirement and mortality. Objective: To compare the in-hospital adverse outcomesof patients with ACS with or without AKI. Materials and Methods: This prospective comparative study was conducted in the Department of Cardiology, BSMMU, Dhaka, during the period of August 2017 to July 2018. A total of 70 eligible patients were included in this study of which 35 patients were included in group A (ACS with AKI) and 35 patients were included in group B (ACS without AKI). AKI was diagnosed, on the basis of increased serum creatinine level 0.3mg/dL from baseline within 48 hours after hospitalization. They were subjected to electrocardiography, blood test for serum creatinine (on admission, 12 hours, 48 hours and at the time of discharge), lipid profile, 2-D echocardiography along with serum troponin, CK MB and electrolytes. Results: It was observed that mean age was 58.0±8.5 years in group A and 55.6±12.3 years in group B. Heart failure was more common in group A than in Group B (74.3% vs 34.2% p=0.001 respectively) and arrhythmia was more common in group A than in Group B (100% vs 74.2% respectively). 7(20%) patients of group A required dialysis. The mean duration of hospital stay was significantly higher in Group A than in the Group B (9.4±2.3 vs 7.2±0.6; p=0.001) days. Multiple logistic regression analysis revealed that heart failure, cardiogenic shock, duration of hospital stay were found to be the independently significant predictors of outcome of the patients with AKI with odds ratio being 5.53 (p=0.001), 4.353 (p=0.001) and 6.92 (p=0.001) Conclusion: This study shows that, heart failure, cardiogenic shock, arrhythmia, dialysis requirement, were more common in the patients with AKI (group A) than in the patients without AKI (group B). The duration of hospital stays were longer in patients with AKI (group A) than in the patients without AKI (group B). Therefore, an important research target is the identification of high-risk patients with ACS experiencing AKI, thereby appropriate medication and follow-up should be implemented. University Heart Journal Vol. 16, No. 1, Jan 2020; 3-10

scholarly journals HEMORRHOIDECTOMY;

2017 ◽  
Vol 24 (09) ◽  
pp. 1316-1321
Author(s):  
Shibber Ahmed ◽  
Ishtiaq Ahmad ◽  
Humayun Amjid ◽  
Aamir Furqan
Keyword(s):  
Hospital Stay ◽  
Severe Pain ◽  
Conventional Technique ◽  
Categorical Variables ◽  
P Value ◽  
Chi Square ◽  
Post Operative Pain ◽  
Group A ◽  
And Gender ◽  
Group B

Objectives: Is to compare outcomes in terms of mean post-operative pain andhospital stay between stapled versus conventional hemorrhoidectomy. Hypothesis: There isa difference in mean post-operative pain and hospital stay between stapled and conventionalhemorrhoidectomy, stapled technique is better than conventional technique. Study Design:Randomized control trial. Setting: Department of General Surgery Bakhtawar Amin MemorialHospital Multan. Period: February 2016 February 2017. Methodology: A total number of 60patients enrolled in the study, both genders. Statistical software SPSS ver.23 was used toanalyze the data. Mean and SD were calculated and presented for numerical variables likeduration of hemorrhoids, age and pain score while frequencies and percentage were calculatedand presented for categorical variables like ender and grade of hemorrhoids. Independent t-testand chi square test were applied to see effect modification. P value ≤0.05 was considered assignificant. Results: Total number of 60 (100%) patients in the study, 32 (53.3%) were maleand 28 (46.7 %) were female. Mean hospital stay in group A was 1.63 ± 0.71 and in groupB means duration of hospital stay was 1.73 ± 0.74. A P value was 0.001. On stratification ofdata it is concluded that in group A 9 patients have no pain 6 have mild and 6 have moderatepain and 5 patients have severe pain, similarly in group B, 3 patients have no pain 2 have mildpain 1 have moderate pain and no patient have severe pain. P value for male patients was2.65. Conclusion: This study confirms that stapled hemorrhoidectomy is associated with lesspostoperative pain with no effect of age and gender on outcome.

scholarly journals Feasibility of local anaesthesia in lateral internal anal sphincterotomy for chronic anal fissure

2018 ◽  
Vol 5 (7) ◽  
pp. 2578
Author(s):  
Bhimanagouda Venkanagouda Goudar ◽  
Eshwar B. Kalburgi ◽  
Yamanur P. Lamani ◽  
Veerabhadra Gowd Y. C.
Keyword(s):  
Hospital Stay ◽  
Local Anaesthesia ◽  
Primary Outcome ◽  
Treatment Options ◽  
Fissure In Ano ◽  
Post Operative Pain ◽  
Group A ◽  
Prospective Comparative Study ◽  
The Common ◽  
Group B

Background: Fissure in Ano is one of the common and most painful anorectal conditions encountered in surgical practice. Inspite of several conservative treatment options, surgical treatment in the form of Lateral Anal Spincterotomy (LAS) remains the gold standard of treatment for Chronic Anal Fissures (CAF).Methods: Prospective comparative study conducted on 90 patients randomly divided into two groups Group A under Local anaesthesia (LA) and Group B under Spinal anaesthesia (SA) respectively. The primary outcome variables studied were postoperative pain, hospital stay, and cost effectiveness.Results: A total of 90 patients randomly divided into 45 patients in each group. There was no statistically difference in the pain at surgery, but post-operative pain was significantly less in LA group at 5th hour, 24 hours after surgery. Hospital stay in LA group is significantly less when compared to SA group (1.92, 3.75 respectively).Conclusions: LAS can be comfortably performed under LA with added advantages.

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

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.

scholarly journals Evaluation of the use of subcutaneous drains to prevent wound complications in abdominal surgeries

2018 ◽  
Vol 5 (4) ◽  
pp. 1368
Author(s):  
G. V. Manoharan ◽  
T. Sivakumar ◽  
M. Ashok Kumar
Keyword(s):  
Hospital Stay ◽  
Abdominal Wall ◽  
Subcutaneous Tissue ◽  
Wound Dehiscence ◽  
Wound Complications ◽  
Skin Closure ◽  
Abdominal Wall Closure ◽  
Duration Of Hospital Stay ◽  
Group A ◽  
Group B

Background: Wound complications like surgical site infections (SSI) and wound dehiscence are common following abdominal surgery for peritonitis. Drains have been used to remove collections from the early days of surgery. The use of drains to remove subcutaneous collections to prevent wound complications needs to be studied.Methods: Sixty patients who underwent surgery for peritonitis were selected for the study. 30 patients underwent conventional abdominal wall closure while the other 30 had suction drains inserted in the subcutaneous tissue. Wounds were observed for complications and time for healing.Results: The incidence of SSI was significantly less in Group A (23%) than in Group B (60%). Similarly, wound dehiscence occurred in 43% of SSI cases in Group A as against 89% of SSI cases in Group B, the difference of which was statistically significant. The mean duration of hospital stay was significantly less when subcutaneous suction drain was placed (9 days).Conclusions: Subcutaneous suction drainage tube is an effective method of abdominal wall closure in cases of peritonitis when compared to conventional primary skin closure as it significantly reduces the incidence of SSI, wound dehiscence, wound secondary suturing and duration of hospital stay. 

Comparative Analysis of Early versus Late Enteral Feeding after Gastrointestinal Surgeries

2021 ◽  
Vol 15 (8) ◽  
pp. 2050-2053
Author(s):  
Amnah Ilyas Khan ◽  
Nazish Masood ◽  
Usman Ilyas ◽  
Zahra Raza ◽  
Jehangaiz Khan
Keyword(s):  
Enteral Nutrition ◽  
Hospital Stay ◽  
Anastomotic Leak ◽  
Enteral Feeding ◽  
Controlled Trial ◽  
Gastrointestinal Surgery ◽  
Early Enteral Nutrition ◽  
Duration Of Hospital Stay ◽  
Group A ◽  
Group B

Background: Despite of widespread belief, clinical studies and animal experiments have suggested that initiation of early feeding after surgery has many advantages. Present study was planned for comparing outcomes of early and late enteral feeding in patients who were undergoing gastrointestinal surgeries in our settings. This would help the surgeons to select better option for earlier recovery after surgery Objective: To compare the outcome of early versus late enteral feeding in patients undergoing gastrointestinal surgeries. Design: It was a randomized controlled trial. Study Settings: The study was conducted at Department of General Surgery, PIMS Islamabad for a period of six months w.e.f 20-12-2017 to 19-06-2018. Patients and Methods: A total of two hundred (n=200) patients of both gender between age 15-70 years, who had been scheduled for elective or emergency gastrointestinal surgery were enrolled in the study. Patients were randomized early (Group A, <24 hours after surgery) and late enteral feeding (Group B, <24 hours after surgery). Outcomes were estimated in terms of infection, anastomotic leak and duration of hospital stay in both groups. Results: Mean age of the patients was 36.8±11.2. There were total 85 females and 115 males with female to male ratio of 1:1.35. Mean duration of hospital stay was 2.62 days ± 0.71 in group A and it was 6.55 days ± 0.71 2.93SD in groups B (P=0.001). Wound infection rate (8% vs 33%, P=0.001) and anastomotic leak rate (0% vs 10%, P=0.001) was also significantly lower in group A when compared with group B. Conclusion: Initiation of early enteral feeding (within 24 hours post operatively) in patients undergoing gastrointestinal surgeries has an immediate advantage of caloric intake and results in faster recovery with fewer complications. Similar results are found in the literature. We recommend early initiation (within 24 hours after surgery) of enteral feeding in patients undergoing gastrointestinal surgeries. Keywords: Anostomotic leak, early enteral nutrition (EEN), late enteral nutrition (LEN).

scholarly journals 1124. Effects of Co-infection on the Severity, Response to Treatment and Duration of Hospital Stay in Patients with Clostridium difficile Infection

2018 ◽  
Vol 5 (suppl_1) ◽  
pp. S336-S337
Author(s):  
Muhammad Shafiq ◽  
Hani Alturkmani ◽  
Yousaf Zafar ◽  
Vishal Mittal ◽  
Hafsa Lodhi ◽  
...  
Keyword(s):  
Clostridium Difficile ◽  
Hospital Stay ◽  
Infection Group ◽  
P Values ◽  
Duration Of Hospital Stay ◽  
Potential Pathogen ◽  
Group A ◽  
Definition Of ◽  
Group B ◽  
Treatment Escalation

Abstract Background According to the multicenter evaluation of the FilmArray® multiplex gastrointestinal (GI) panel for etiologic diagnosis of infectious gastroenteritis, the GI panel detected at least one potential pathogen in 53.5% of the stool specimens that were collected. Out of the positive samples, 31.5% tested positive for more than one potential pathogen. The samples that were co-infected showed that Clostridium difficile infection (CDI) was present in 53.4% of them. This lead to the idea of our project to determine whether the presence of another GI infection affects CDI outcomes in terms of severity, treatment escalation, duration of hospital stay and recurrence. Methods Inclusion criteria: 18-year-old and above patients. Exclusion criteria are GI panel performed on outpatient basis, presence of any co-founder that had independent effect on the outcomes such as end-stage renal disease, cirrhosis, presence of non-GI infection (pneumonia, urinary tract infection, osteomyelitis etc.), and recurrent CDI. Out of the 2,576 GI panels performed from January 1, 2015 until December 31, 2016; only 235 patients were selected for retrospective chart review based on the above criteria. Out of 235 patients, 38 patients had co-infection (CDI + another GI infection = Group A) and reminder had only CDI (Group B). Chi-square test, Fisher’s exact test (for severity, treatment escalation and recurrence) and Independent T-test (for duration of hospital stay) were used to compare Group A with Group B. Alpha criterion was 0.05. Results The P-values for each outcome are given below: (a) 0.16 for severity according to definition of American College of Gastroenterology. (b) 0.77 for severity according to definition of Infectious Disease Society of America. (c) 0.23 for treatment escalation. (d) 0.41 for duration of hospital stay. (e) 0.49 for CDI recurrence. Conclusion All the resulted P-values are greater than 0.05. These results are suggestive of the fact that presence of another GI infection does not affect the outcomes for CDI in terms of severity, treatment escalation, duration of hospital stay, and recurrence. As there were only 38 patients in co-infection group, it limits the ability to determine the effect of individual infectious agent on the outcomes of CDI. Disclosures All authors: No reported disclosures.

scholarly journals Effect of perioperative alpha1-blocker on non-stented ureteroscopic laser lithotripsy for ureteric stones

QJM ◽  
2020 ◽  
Vol 113 (Supplement_1) ◽  
Author(s):  
M S Mohammed ◽  
A M Tawfeek ◽  
H S Shaker
Keyword(s):  
Hospital Stay ◽  
Operative Time ◽  
Laser Lithotripsy ◽  
University Hospitals ◽  
Pain Medications ◽  
Post Operative Pain ◽  
Urinary Tract Symptoms ◽  
Group A ◽  
Group B ◽  
Ureteric Dilatation

Abstract Background Nowadays, ureteroscopy is the first line of surgical treatment of ureteric stones and holmium YAG laser is commonly used in stone fragmentation. Guidelines 2018 recommended not fixing ureteric stent in uncomplicated ureteroscopy. Therefore, when we decrease intra-operative dilatation, we may decrease the complicated ureteroscopy. Objective To assess the safety, efficacy and outcome of peri-operative alpha1 blockers on non-stented ureteroscopic laser lithotripsy for ureteric stones. Patients and Methods Our study was conducted at Urology Department, Ain Shams University Hospitals and National Institute of Urology and Nephrology starting from September 2017 to December 2018. Sixty patients with lower ureteric stone included in this study underwent non-stented laser lithotripsy and were divided into two equal groups; group A (tamsulosin) and group B (no tamsulosin). Results Our study revealed that using peri-operative tamsulosin statistically reduced the need for ureteric dilatation, mean operative time, mean hospital stay, post-operative pain, the need for pain medications and post-operative lower urinary tract symptoms. Conclusion Administration of peri-operative tamsulosin seems to significantly decrease the need for intra-operative dilatation, post-operative LUTs, post-operative pain and the need for analgesia and shorten operative time and hospital stay.

scholarly journals Clinical Outcome of Posterior Fossa Tumor Surgery Without Preoperative Ventriculo-peritoneal Shunt

1970 ◽  
Vol 40 (1) ◽  
pp. 43-47 ◽  
Author(s):  
MR Islam ◽  
KMT Islam ◽  
M Hossain ◽  
MH Rashid ◽  
S Dhakhal ◽  
...  
Keyword(s):  
Hospital Stay ◽  
Posterior Fossa ◽  
Final Outcome ◽  
Posterior Fossa Tumor ◽  
Tumor Surgery ◽  
Duration Of Hospital Stay ◽  
Group A ◽  
Group B ◽  
Ventriculo Peritoneal Shunt

The aim of the study was to assess the clinical outcome of surgically treated patients with posterior fossa tumor with hydrocephalus with symptoms and sings of raised intracranial pressure without pre-operative ventriculo-peritoneal shunt by comparing two groups (one group-with pre-operative ventriculo-peritoneal shunt and other group-without preoperative ventriculo-peritoneal shunt) in respect to complications, duration of hospital stay and final outcome at 1 month post-operative follow up. This clinical study was carried out at the department of neurosurgery, BSMMU from November 2008 to April 2010 on patients with posterior fossa tumor with hydrocephalus with symptoms and signs of raised intracranial pressure (ICP) who underwent surgery without preoperative ventriculo-peritoneal shunt. A total of 32 patients were included in this study. Patients were divided into two groups, control group (group-A) underwent ventriculoperitoneal shunt prior to tumor surgery and experimental group (group-B) were not treated with ventriculo-peritoneal shunt prior to tumor surgery. Both groups were followed up during hospital stay and after 1 month of tumor resection. Clinical studies include analysis of the following parameters: i) duration of hospital stay, ii) post-operative complications include cerebrospinal fluid leakage, pseudomeningocele, seizure, meningitis, and shunt blockage and, iii) final outcome at 1 month follow up in modified karnofsky performance scale. We also observed whether or not, use of ventriculo-peritoneal shunt to drain cerebrospinal fluid was useful and safe. The mean duration of hospital stay were 95.1±12.6 days with ranged from 70 to 120 days and 71.5±12.6 days ranged from 36 to 88 days in group-A and group-B respectively. The majority of the patients had no complications in both group, which were 12(70.6%) and 9 (60.0%) in group A and group B respectively. Final outcome at 1 month follow up in modified karnofsky performance scale in both groups were similar. DOI: http://dx.doi.org/10.3329/bmj.v40i1.9963 BMJ 2011; 40(1): 43-47

scholarly journals Primary closure versus T-tube drainage after laparoscopic choledocholithotomy: a prospective randomized study

2017 ◽  
Vol 4 (5) ◽  
pp. 1762 ◽  
Author(s):  
Jugendra Pal Singh Shakya ◽  
Neelabh Agrawal ◽  
Arun Kumar ◽  
Archana Agrawal ◽  
Akash Singh ◽  
...  
Keyword(s):  
Hospital Stay ◽  
Primary Closure ◽  
Randomized Study ◽  
Tube Placement ◽  
Tube Drainage ◽  
Operative Complication ◽  
T Tube ◽  
Duration Of Hospital Stay ◽  
Group A ◽  
Group B

Background: Traditionally laparoscopic common bile duct exploration is followed by T-tube placement because of which patients suffer problems related to T-tube thereby increasing the morbidity of patients. Primary closure of CBD following laparoscopic choledocholithotomy is now being considered as an alternative superior to the traditional method. This study is designed to analyse the outcome of primary CBD repair in terms of mean operation time, duration of hospital stay and post-operative morbidity.Methods: A prospective randomized study was done in which 40 patients at our institute and associated hospitals were divided into two groups to compare the results of primary closure to T-tube placement following laparoscopic choledocholithotomy.Results: 40 patients were included in this study. The mean operating time was observed to be 65±14.05 mins in Group A (primary closure) patients while that in case of Group B (T-tube drainage) patients was 95.25±9.66 mins with a p-value 0.0001 which is considered statistically significant. The average duration of hospital stay in Group A (primary closure) was 8.2 days which was much shorter than that of Group B (T-tube drainage) patients which was of 15.7 days. The post-operative complication was observed in 1 patient of Group A (primary closure) while post-operative complication occurred in 3 patients of Group B (T-tube drainage).Conclusions: This study indicates that primary repair following laparoscopic choledocholithotomy is a safer and more effective method than T-tube drainage and we strongly recommend this procedure in clinical practice.

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