scholarly journals Open versus primary repair following hemorrhoidectomy for Grade III hemorrhoids: a prospective comparative study

2018 ◽  
Vol 5 (10) ◽  
pp. 3377
Author(s):  
Abdul Ghader Barazandeh Moghadam ◽  
Shoaibuddin Mohammad ◽  
Bushra Khan
Keyword(s):  
Statistical Analysis ◽  
Comparative Study ◽  
Return To Work ◽  
Primary Repair ◽  
Anal Stenosis ◽  
P Value ◽  
Duration Of Surgery ◽  
Prospective Comparative Study ◽  
Open Versus ◽  
Grade Iii

Background: The debate on open versus primary closure following haemorrhoidectomy continues to be active.  Despite other methods like doppler guided haemorrhoidal artery ligation, sclerotherapy, cryotherapy, banding; open haemorrhoidectomy is performed at many places. The never-ending discussion on the better choice between open versus primary repair led to the initiation of this work.Methods: This is a prospective comparative study of a contiguous and continuous cohort of 105 cases. Alternate cases were assigned for either of the procedures. Only grade III haemorrhoids were included. Grade I and II haemorrhoids, cases treated earlier and recurrent haemorrhoids were excluded. Multiple parameters like duration of surgery, intraoperative and post-operative bleeding, pain duration and severity, time taken to return to work, use of dressings and sitz bath, wound healing time and stenosis were studied. A blinded statistical analysis was done by a third-party statistician. Results: Primary haemorrhoidectomy took a significantly longer time (P value- 0.0043). Pain was significantly less with open haemorrhoidecomy (P value- 0.0023). Post-operative pain was significant in primary repair. Pain was assessed using visual analogue scale and verbal rating scale. Open haemorrhoidectomy took a significantly longer time to heal (P value: 0.0004) and return to work (P value: 0.0001). Primary repair had stenosis requiring dilatation in a few cases. Statistical analysis was done in all cases. Conclusions: Primary repair seems to be preferred because of shorter duration of recovery despite more pain and occasional anal stenosis.

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 Comparative study on safety and Ifficacy of PCNL with open Surgery in the treatment of patients having large kidney stones

2020 ◽  
Vol 16 (2) ◽  
pp. 51-56
Author(s):  
Syed Al Fasani ◽  
Akm Zamanul Islam Bhuiyan ◽  
Md Zahid Hasan Bhuiyan
Keyword(s):  
Comparative Study ◽  
Return To Work ◽  
Open Surgery ◽  
Perioperative Complications ◽  
Intraoperative Complications ◽  
P Value ◽  
Open Procedure ◽  
Stone Clearance ◽  
Significant Difference ◽  
Duration Of Surgery

Objective : To compare the safety and efficacy of percutaneous nephrolithotomy (PCNL) and open surgery in the treatment of patients having large kidneystone (>2 cm ). Materials & Methods: This comparative study included 80 patients diagnosed with kidney stone disease admitted in the NIKDU during the period of Jan’ to Dec’2009 were divided conveniently into two groups. Intervention was done in the form PCNL(40) and open surgery (40). Clinical outcome like, perioperative complications,duration of surgery, mean hospital stay ,convalescence period, amount of analgesia required to relief pain, stone clearance rate were reviewed and compared between the groups. 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 opensurgery[mean ± SD]): duration of operation (min), 97.90±24.89 vs 136.62±23.54, postoperative hospitalstay (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). Intraoperative complications like bleeding requiring blood transfusion are significantly lower in PCNL (11 cases 34.1%) than in open surgery( 18 cases 45.0%), (Chi-square = 4.82; p =0.049). 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. The rate of stone clearance in percutaneous procedure,(25 cases,80%) is approaching to that of open procedure,(34 cases 85%), (p>0.05). Conclusion: PCNL is relatively safe& better treatment option than open surgery in the treatment of large renal calculi, It has almost similar stone free rate at discharge home but has definite advantages of lower morbidity, shorter convalescence and more rapid return to work. Bangladesh Journal of Urology, Vol. 16, No. 2, July 2013 p.51-56

scholarly journals A PROSPECTIVE COMPARATIVE STUDY OF OPEN VERSUS CLOSED METHOD OF CREATING PNEUMOPERITONEUM IN LAPAROSCOPIC SURGERY

2020 ◽  
pp. 1-3
Author(s):  
Akshar Patel ◽  
Shashank Desai
Keyword(s):  
Laparoscopic Surgery ◽  
Comparative Study ◽  
Tertiary Care ◽  
Needle Insertion ◽  
Care Hospital ◽  
Open Method ◽  
Group A ◽  
Prospective Comparative Study ◽  
Group B ◽  
Open Versus

Objective: The aim of the study was to compare open and closed method in terms of time require for creation of pneumoperitoneum and to ascertain safety in laparoscopic surgery. Methodology: This was a prospective comparative study carried out at a tertiary care hospital from January 2019 to December 2019.We selected 100 patients who were planned for laparoscopic surgery and divided them into two equal groups using the envelop method of randomization. Group A comprised of patients in whom we created pneumoperitoneum by classical veress needle insertion and in Group B by open method. Results: In our study, the mean time require for closed method was 6.92 minutes while by open method it was 4.36 minutes. Complication rate was 18% in closed and 16% in open method. Conclusion: open method is quick but comparable to closed method in terms of complications.

scholarly journals Comparative study of conventional versus microdebrider assisted endoscopic sinus surgery in sinonasal polyposis

2016 ◽  
Vol 2 (4) ◽  
pp. 197
Author(s):  
Bindia Ghera ◽  
Manish Munjal ◽  
Hemant Chopra
Keyword(s):  
Comparative Study ◽  
Endoscopic Sinus Surgery ◽  
Conventional Group ◽  
Sinus Surgery ◽  
P Value ◽  
Postoperative Results ◽  
Conventional Instruments ◽  
Duration Of Surgery ◽  
The Right ◽  
Sinonasal Polyposis

<p class="abstract"><strong>Background:</strong> Functional endoscopic sinus surgery, conventional or with powered instruments is the standard surgical modality in sinonasal polyposis refractive to medical therapy. The recent modality, microdebrider assisted endoscopic sinus surgery offers better therapeutic approach for patients when compared to endoscopic sinus surgery with the conventional instruments. The objective was to evaluate the utility of microdebrider in endoscopic sinus surgery versus conventional instruments and to compare the intraoperative and postoperative results in both the methods.</p><p class="abstract"><strong>Methods:</strong> A prospective, randomized, comparative study was conducted on 30 patients with bilateral sinonasal polyposis. The subjects were selected by applying all the inclusion and exclusion criteria and divided into two groups i.e. the right and left side of nose were operated and compared for efficacy of microdebrider and conventional instruments. Each patient served as his or her own control. This study emphasizes the utility of microdebrider. It compares the intraoperative and postoperative results in the conventional and microdebrider assisted endoscopic sinus surgery.  </p><p class="abstract"><strong>Results:</strong> The intraoperative mean blood loss and duration of surgery were significantly higher in the conventional group (p-value &lt;0.001) as compared to microdebrider group. Postoperative symptom and endoscopy scores (discharge, scarring, crusting and polyp recurrence) were significantly higher in the conventional group (p-value &lt;0.001) as compared to the microdebrider group in 6 months follow up.</p><strong>Conclusions:</strong> Microdebriders are more effective as compared to conventional endoscopic sinus surgery due to lesser intraoperative bleeding (relatively bloodless) and duration of surgery, better postoperative endoscopic and symptom scores, combine cutting and suction  in a single  tool, enabling accurate and precise tissue removal without damaging the surrounding mucosa , less scarring/synechiae, fewer complications.

STAPLED HEMORRHOIDOPEXY A BETTER AND SAFER ALTERNATIVE TO OPEN HEMORRHOIDECTOMY IN THE MANAGEMENT OF GRADE III & IV HEMORRHOIDS- A HOSPITAL BASED STUDY

2021 ◽  
pp. 39-42
Author(s):  
G.D. Yadav ◽  
Ramendra Kumar Jauhari ◽  
Nishant Saxena ◽  
Firoj Khan ◽  
Sunil Kumar Gupta
Keyword(s):  
Statistical Analysis ◽  
Postoperative Pain ◽  
Hospital Stay ◽  
Stapled Hemorrhoidopexy ◽  
Short Term ◽  
Open Hemorrhoidectomy ◽  
Continuous Scale ◽  
Duration Of Surgery ◽  
Grade 3 ◽  
Grade Iii

Background: Surgical hemorrhoidectomy is usual method for management in hemorrhoid grade III and IV. It is generally associated with postoperative pain, long hospital stay and a longer convalescence. Stapled hemorrhoidopexy is a newer minimally invasive alternative for the treatment of hemorrhoids. Aims: In this study, the above two methods were compared with respect to short term outcomes. Settings and Design: This was a prospective and randomized study. Methods: 60 patients having grade 3 or 4 hemorrhoids and who fullled the criteria were included in the study. Thirty patients underwent stapled hemorrhoidopexy and other thirty underwent open hemorrhoidectomy. All patients were reviewed immediately after surgery and at 1, 3 and6 weeks post-operatively. The two groups were compared in terms of duration of surgery, hospital stay, return to work and post-operative level of satisfaction . Statistical Analysis: The statistical analysis was done using SPSS (Statistical Package for Social Sciences) Version 15.0 statistical Analysis Software. Signicance was assessed at 5% level of signicance. Student t-test was used to nd the signicance of study parameters on continuous scale in parametric condition between two groups (inter group analysis) and Mann Whitney U test was used to nd the signicance of study parameters on continuous scale in non-parametric condition within each group. Chi-square/ Fisher Exact test were used to nd the signicance of study parameters on categorical scale between two groups. Results: The overall mean age of patients in our study was 41.35 ± 12.80. The majority of patients in the study were males (78.3%) and had grade 3 haemorrhoids (93.3%). Stapled hemorrhoidopexy group had shorter duration of surgery, less postoperative pain and need for analgesia, shorter duration of hospital stay and earlier return to work and a high patient satisfaction as compared with open hemorrhoidectomy group. Conclusions: Stapled hemorrhoidopexy is a minimally invasive, better and safer alternative to open hemorrhoidectomy with many short-term benets.

A COMPARITIVE STUDY OF ONLAY – SUBLAY MESHPLASTY (PHS) vs. LICHTENSTEIN MESHPLASTY OF INGUINAL HERNIA

2021 ◽  
pp. 56-58
Author(s):  
Chenna Dharma Kishore Raja ◽  
Sreerama Raja
Keyword(s):  
Inguinal Hernia ◽  
Hernia Repair ◽  
Return To Work ◽  
Hospital Stay ◽  
Mesh Repair ◽  
Age Distribution ◽  
P Value ◽  
Tension Free ◽  
Duration Of Surgery ◽  
Type Of Surgery

Introduction: A Hernia is the protrusion of part of the abdominal contents beyond the abdominal wall's normal connes. In this study, an attempt is made to compare the results of two different modalities of hernia repair–Lichtenstein repair and repair of hernia with Polypropylene hernia system. Aim: The study aims to ascertain the Polypropylene hernia system's safety and benets for hernia repair against conventional Lichtenstein tension-free mesh repair technique. Materials and methods: The prospective clinical study comprises 30 patients presenting with inguinal hernia attending OPD and admitted to the General Surgery Department of King George Hospital, Visakhapatnam, during the study period of September 2018 to October 2020. Results: Age distribution between 10-90, most of the 50-70 age group (14 cases). Visual analog scale (VAS) score for PMR 4.55 ± 1.18 and LMR 6.06 1.27 (p-value <0.05). Wound infection for PMR 1 case and LMR 2 cases. Duration of surgery for PMR 65.40 ± 7.84 and LMR 51.33 ± 13.51 (p-value <0.05). Type of surgery and duration of hospital stay for PMR 4.93 ± 1.27 LMR 6.73 ± 2.12. Type of surgery and return to work for PMR 5.93 ± 1.27 and LMR 7.73 ± 2.12(p-value <0.05).Recurrence in PMR 0 % and LMR 6.67%. Conclusion: PHS repair is superior to Lichtenstein mesh repair about safe, tension-free method, shorter hospital Stay, early return to work, least recurrence rates, and a high subjective success rate and satisfaction rate.

scholarly journals Single-layer versus double-layer intestinal anastomosis: A comparative study

2017 ◽  
Vol 13 (2) ◽  
pp. 134-143 ◽  
Author(s):  
Tuhin Shah ◽  
RK Agarwal ◽  
RK Gupta ◽  
CS Agrawal ◽  
S Khaniya
Keyword(s):  
Comparative Study ◽  
Double Layer ◽  
Intestinal Anastomosis ◽  
Single Layer ◽  
P Value ◽  
Layer Versus ◽  
Elective Setting ◽  
Prospective Comparative Study ◽  
Layer Groups ◽  
Mean Time

Background: Intestinal anastomosis is essential to maintain the continuity after resection. There has been constant controversy due to various repair options. Adequate apposition can be achieved by either single- or double-layer anastomosis which may affect the post-operative outcome.Objective: To compare the outcome of single-layer versus double-layer anastomosis of small and large intestine.Method: This prospective comparative study was conducted over a period of 16 months, and included 78 patients who underwent intestinal anastomosis (without diverting stoma) after fulfilling inclusion and exclusion criteria. They were randomized into double-layer and single-layer intestinal anastomosis groups by a computer generated series. Double layer anastomosis was constructed using inner continuous Polyglactin 3-0 and outer interrupted Silk 3-0, while single layer anastomosis was done with interrupted PDS 2-0.Result: The mean age was 39.79±17.78 years. A total of 59% were operated in emergency room while 41% in elective setting. Overall mean time for anastomosis was 31.81±6.03 (21-50) minutes. In double- and single-layer intestinal anastomosis mean time was 34.35±5.80 (26-50) and 29.13±5.08 (21-45) minutes respectively, which was statistically significant (p value < 0.05). Single-layer was completed 5 minutes earlier than double layer anastomosis in average. Clinical anastomotic leak was seen in six (7.7%) patients, three in each group. Eight (10.3%) patients had surgical site infection: 3 in double-layer and 5 in single-layer groups. One (1.3%) mortality was seen, from single-layer anastomosis group.Conclusion: Single-layer anastomosis can be constructed in significantly shorter time with similar complication rate when compared to doublelayer anastomosis.Health Renaissance 2015;13(2): 134-143

scholarly journals Pain Perception following Administration of Propofol with 7.5 mg Ephedrine, 15 mg Ephedrine, or Lignocaine— A Comparative Study

2017 ◽  
Vol 2 (2) ◽  
pp. 58-63
Author(s):  
Harprit Kaur Madan ◽  
Indrani H Chincholi ◽  
Sonali D Patira
Keyword(s):  
Statistical Analysis ◽  
Comparative Study ◽  
Repeated Measures ◽  
Pain Perception ◽  
Rating Scale ◽  
Elective Surgery ◽  
Rapid Onset ◽  
Injection Pain ◽  
P Value ◽  
Duration Of Action

ABSTRACT Introduction Propofol is the drug of choice for induction of anesthesia because of its rapid onset, easy titration, and short duration of action. However, pain on propofol injection is an unpleasant experience felt by many of our patients. Many factors have been investigated to decrease the pain on propofol injection but it is still a mystery. Aim To compare the effect of two doses of ephedrine (7.5 and 15 mg) and lignocaine on pain during injection of propofol and to compare their hemodynamic parameters and note for any complications. Materials and methods This study was a prospective, randomized, double-blinded, single-center study on 150 adult patients of both the sexes belonging to American Society of Anesthesiologists (ASA) grades I and II for elective surgery under general anesthesia. The aim was to compare the analgesic effect of lignocaine, ephedrine 7.5 and 15 mg in ameliorating propofol injection pain. About 50 patients were allocated to each of the three groups receiving lignocaine 2% (1.5 mL), ephedrine 7.5 mg, and ephedrine 15 mg intravenously admixed with propofol. The intensity of pain at the time of propofol injection was assessed using verbal rating scale (VRS) 4-point scale before the patient lost consciousness. Statistical analysis Statistical analysis was done by using Statistical Package for the Social Sciences (SPSS) version 22.0 software. The qualitative data were summarized as frequency and percentages. The Fischer exact test was used to analyze the data. The continuous data were summarized as mean and standard deviation. The group and intergroup analyses were done using repeated measures analysis of variance (ANOVA) test. A p-value <0.05 was considered significant. Results Median (interquartile range) of the pain score was 1 (2) in group E-7.5 mg, 0 (1) in group E-15 mg, and 0(1) in group L. Results were statistically significant. Conclusion Adding 15 mg ephedrine was as effective as adding lignocaine for the prevention of propofol injection pain and ephedrine had a better and stable hemodynamic profile. How to cite this article Chincholi IH, Madan HK, Patira SD. Pain Perception following Administration of Propofol with 7.5 mg Ephedrine, 15 mg Ephedrine, or Lignocaine—A Comparative Study. Res Inno in Anesth 2017;2(2):58-63.

scholarly journals Randomized comparison of stapled haemorrhoidopexy and open haemorrhoidectomy

2018 ◽  
Vol 5 (9) ◽  
pp. 3118
Author(s):  
Suresh Kumar Rulaniya ◽  
Soumitra Chandra
Keyword(s):  
Comparative Study ◽  
Conventional Method ◽  
Stapled Haemorrhoidopexy ◽  
Stapled Haemorrhoidectomy ◽  
Duration Of Surgery ◽  
Conventional Haemorrhoidectomy ◽  
Prospective Comparative Study ◽  
Vas Scores ◽  
The Mean

Background: Surgical management of haemorrhoids is reserved for stage III and IV haemorrhoids. Both Milligan-Morgan technique (CH-Conventional Haemorrhoidectomy) and stapled haemorrhoidopexy technique are used as surgical therapy. Our prospective, comparative study of conventional haemorrhoidectomy versus stapled haemorrhoidectomy was designed in present institution.Methods: This prospective randomised comparative study was carried out in present Surgery Dept from July 2016 to December 2017 with total 60 sample size. All data were analysed according to applicable statistical methods. The results were compared to previous studies so as to arrive at a conclusion.Results: The mean duration of surgery with stapled method was 30.76±3.13 minutes and with conventional method was 49.36±4.08 minutes which was significantly high in conventional method. VAS scores for pain at 12 hours, 24 hours, 72 hours and 7 days for stapled group were 2.63±0.76, 1.66±0.88, 0.90±0.71 and 0.50±0.43 while that for the conventional group were 5.63±0.72, 4.56±1.22, 3.26±1.25 and 2.00±0.69. At all points of time the VAS was significantly lower in stapled group. The mean duration of hospital stay of the patients with stapled method was 3.10±0.75 days and with conventional method was 6.06±0.94 days, which was significantly high in conventional method. The mean time to return to normal activities of the patients with stapled method was 8.16±1.93 days and with conventional method was 12.60±1.67 days, which also significantly high in conventional method.Conclusions: Present study inferred that stapled haemorrhoidopexy is faster, minimally invasive for treatment of haemorrhoids as compared to Conventional haemorrhoidectomy. It is associated less pain and provides a more satisfactory alternative to Conventional surgery because of reduced hospitalisation and earlier return of patient to daily activities, with no significant differences in short term follow up.

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