scholarly journals A cohort comparative study between laparoscopic and open appendectomy in pregnant women

2019 ◽  
Vol 6 (11) ◽  
pp. 4086
Author(s):  
Srujan Kumar Bellapu
Keyword(s):  
Pregnant Women ◽  
Laparoscopic Appendectomy ◽  
Open Appendectomy ◽  
Oral Intake ◽  
Obstetric Outcomes ◽  
Postoperative Complication Rate ◽  
Duration Of Surgery ◽  
The Mean ◽  
Mean Time ◽  
Delivery Type

Background: Despite the initial absolute contraindication of laparoscopic surgery during pregnancy, in the last decade, laparoscopic appendectomy (LA) has been performed in pregnant women but to compare the outcomes of LA compared with open appendectomy (OA). The objective of the study was to evaluate the safety and efficacy of LA compared with OA in pregnant women.Methods: A cohort study was conducted among pregnant women with a diagnosis of acute appendicitis who were undergoing LA or OA between June 2013 to July 2014. Pre-operative data and post-operative complication were monitored. Epi-info 7 was used for analysis.Results: Sixty patients (20 LA and 40 OA) enrolled in our study. There were no significant differences in duration of surgery, postoperative complication rate and obstetric outcomes, including incidence of preterm labour, delivery type. The mean time to normal bowel movement in the LA group was significantly shorter than that in the OA group. Also, the mean time to adequate oral intake in the LA group was earlier than in the OA group (2.1±0.4 d v. 4.1±1.8 d, p=0.02). Duration of hospital stay in the LA group was 4.1±2.6 days, and that of the OA group was 6.6±3.2 days (p=0.04).Conclusions: Laparoscopic appendectomy is a clinically safe and current procedure in all trimesters of pregnancy and should be well-thought-out as a standard treatment alternative to OA.

scholarly journals Laparoscopic versus open appendectomy retrospective study

2017 ◽  
Vol 4 (3) ◽  
pp. 620
Author(s):  
Haitham S. Rbihat ◽  
Khaled M. Mestareehy ◽  
Mohammad S. Al lababdeh ◽  
Talal M. Jalabneh ◽  
Mohammad E. Aljboor ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Postoperative Pain ◽  
Laparoscopic Appendectomy ◽  
Open Appendectomy ◽  
Advantages And Disadvantages ◽  
Abdominal Abscesses ◽  
Zero Rate ◽  
The Mean ◽  
The Cost ◽  
Mean Time

Background: Laparoscopic cholecystectomy is taken into account as a standard method of performing cholecystectomy and has substituted the old method throughout the world, while laparoscopic appendectomy still not attaining that reputation. In this paper, a retrospective study was done to compare between both laparoscopic and open appendectomy.Methods: Two hundred eighty-five patients were analyzed after appendectomy using either open or laparoscopic procedures. The data was compared over a period of 36 months. Surgical technique was the same among 6 surgeons, standard postoperative care for all patient groups. The outcome measures included comparing of mean operative time, days of hospitalization, postoperative pain and rate of wound infection.Results: Concerning open appendectomy the mean time was 28 minutes with 2 days of hospitalization. The postoperative pain extent was for 36 hours and rate of wound infection was 8/159. While in laparoscopic appendectomy the mean time was 55 minutes with one day hospitalization. The postoperative pain was for 12 hours and zero rate of wound infection.Conclusions: In general laparoscopy has plenty of gains over open surgery as discussed before but laparoscopic appendectomy is not easier, nor does it avoid general anesthesia. The cost for laparoscopic appendectomy is higher than for open appendectomy. The operative and post-operative complications are more critical (e.g.: intra-abdominal abscesses & perforation of bowel) as compared to open appendectomy. We have to assess the advantages and disadvantages, indications and contraindications when taking a decision for laparoscopic surgery. We suppose it would be very early to say that laparoscopic appendectomy is superior or can replace open appendectomy.

The relation between second-trimester placental elasticity and poor obstetric outcomes in low-risk pregnancies

2020 ◽  
Vol 0 (0) ◽  
Author(s):  
Murat Akbas ◽  
Faik Mumtaz Koyuncu ◽  
Burcu Artunç-Ülkümen ◽  
Gökce Akbas
Keyword(s):  
Birth Weight ◽  
Pregnant Women ◽  
Value Added ◽  
Shear Wave Elastography ◽  
Multiple Regression Model ◽  
Low Risk ◽  
Obstetric Outcomes ◽  
Second Trimester ◽  
The Mean ◽  
Random Measurements

AbstractObjectivesIncreased placental stiffness is associated with various pathological conditions. Our objective was to evaluate the relation between the second-trimester placental elasticity value in low-risk pregnant women and poor obstetric outcomes.MethodsA total of 143 pregnant women were enrolled. Placental elasticity values were measured using the transabdominal point shear wave elastography method. 10 random measurements were obtained from different areas of the placenta. The mean was accepted as the mean placental elasticity value. Logistic regression analyses were performed to identify independent variables associated with obstetric outcomes.ResultsSecond-trimester placental elasticity value was significantly and positively associated with the poor obstetric outcomes (p=0.038). We could predict a poor outcome with 69.2% sensitivity and 60.7% specificity if we defined the placental elasticity cut-off as 3.19 kPa. Furthermore, in the multiple regression model, the placental elasticity value added significantly to the prediction of birth weight (p=0.043).ConclusionsOur results showed that the pregnancies with a stiffer placenta in the second trimester were associated with an increased likelihood of exhibiting poor obstetric outcomes. Also, placental elasticity was independently associated with birth weight.

Association of Wound Infection with Various Surgical Technique Applied for Appendectomy in Diabetic and Hypertensive Patients

2021 ◽  
Vol 15 (8) ◽  
pp. 2163-2165
Author(s):  
Muhammad Armughan ◽  
Imran Sadiq ◽  
Shafqat Mukhtar ◽  
Hafiz Ahmad Altaf
Keyword(s):  
Wound Infection ◽  
Laparoscopic Appendectomy ◽  
Surgical Procedure ◽  
Open Appendectomy ◽  
Perforated Appendicitis ◽  
Diabetic Patients ◽  
Wound Infections ◽  
Hypertensive Patients ◽  
Duration Of Surgery ◽  
Perforated Appendix

Background: Perforated appendix in diabetic as well as hypertensive patients is associated with elevated risks of postoperative infectious complications such as wound infection and intra-abdominal abscess. Objective: To identify better appendectomy procedure for diabetic and hypertensive patients. Study Design: Randomized Controlled Trial Place and Duration of Study: Department of Surgery, Unit l, Bahawal Victoria Hospital Bahawalpur from 10th October 2020 to 9th April 2021. Methodology: Ninety eight patients meeting the criteria of perforated appendix were divided in two groups; one group consisted of 49 patients who were managed by open surgical procedure. Second group was consisted of 49 patients who were managed by laparoscopic surgical procedure. Patient outcomes in-terms of wound infections, operative time and duration of surgery was assessed. Results: Mean age of patients was 25.49±6.03 years. There were 17 hypertensive while 15 diabetic patients. Wound infection was seen in 21% and 28% open surgery diabetic and hypertensive patients respectively in comparison to 10%and 8% in laparoscopic appendectomy diabetic and hypertensive patients respectively (p<0.001). Conclusion: Laparoscopic appendectomy (LA) is associated with significantly lower rates of post-operative wound infections and shorter hospital stay in comparison to open appendectomy in diabetic and hypertensive patients of perforated appendicitis. Key Words: Perforated appendix, laparoscopic, open appendectomy

Comparison of stapler and handsewn anastomosis techniques in creating an ileal conduit following radical cystectomy

2021 ◽  
pp. 1
Keyword(s):  
Postoperative Complications ◽  
Ileal Conduit ◽  
Perioperative Complications ◽  
Movement Time ◽  
Oral Intake ◽  
Total Cost ◽  
Handsewn Anastomosis ◽  
Significant Difference ◽  
The Mean ◽  
Mean Time

Background and objective: Ileal conduit for urinary diversion can be completed using either end-to-end handsewn or stapled anastomosis. This study aimed to compare stepled and handsewn anastomosis methods in terms of complications, hospitalization and cost. Materials and methods: Forty-three patients were included in the hand-sewn and 44 patients in the stapler group. After creating an ileal conduit, continuity of the loop was achieved either with handsewn or stapler method. Patients' demographic data, time to onset of bowel movement, time to transit to oral intake, time to removal of the drain, perioperative and postoperative complications, mortality and total costs were retrospectively recorded and compared between the two groups. Results: There was no statistically significant difference between the groups in terms of the mean to the onset of bowel movements (p = 0.51) and the mean time to transit to oral intake (p = 0.23). The mean time to removal of the drain was significantly lower in the stapler group (p = 0.023). Perioperative complications were seen in eight patients in the handsewn group, while none of the patients in the stapler group developed perioperative complication (p = 0.003). Postoperative complications were similar between both groups (p = 0.75). The duration of hospitalization was statistically significantly lower in the stapler group (p = 0.004) and the mean total cost was statistically significantly more advantageous (p < 0.001). Conclusion: No significant difference was found between stapler and handsewn anastomosis techniques in terms of postoperative complications. On the other hand, hospitalization and total cost were in favour of stapler technique, showing that this technique can be used safely.

scholarly journals Different rates of tramadol infusion for peri and postoperative analgesia in dogs undergoing orthopedic surgery

2019 ◽  
Vol 71 (1) ◽  
pp. 127-136
Author(s):  
V.N.L.S. Oliva ◽  
V.B. Albuquerque ◽  
B.P. Floriano ◽  
T.M. Meneghetti ◽  
C.J.X. Abimussi ◽  
...  
Keyword(s):  
Postoperative Analgesia ◽  
Pain Scale ◽  
Inhalation Anesthesia ◽  
Surgical Incision ◽  
Perioperative Analgesia ◽  
Duration Of Surgery ◽  
The Mean ◽  
Mean Time ◽  
Dose Dependent ◽  
Rate Infusion

ABSTRACT The study aimed to determine the continuous rate infusion of tramadol associated with peri- and postoperative analgesia for orthopedic surgeries in dogs, as well as cardiorespiratory and adverse effects. Thirty dogs aged 4.2±1.2 years and weighing 15.1±0.9kg were enrolled in the study, premedicated intramuscularly with acepromazine (0.04mg kg-1) and tramadol (2mg kg-1); anesthesia was induced with propofol and maintained with isoflurane in oxygen. Three infusion rates were compared, comprising three experimental groups: G2: 2.0mg kg-1 h-1; G2.5: 2.5mg kg-1 h-1; and G3: 3.0mg kg-1 h-1. Surgery was initiated 15 minutes following the start of tramadol infusion. During anesthesia, animals were monitored in predefined time points: immediately after tracheal intubation and start of inhalation anesthesia (T0); surgical incision (TSI); final suture (TFS) and end of tramadol infusion (TEI), which was maintained for at least 120 minutes and prolonged according to the duration of surgery. Postoperative analgesia was evaluated through an interval pain scoring scale and the Melbourne pain scale. The mean time of tramadol infusion was greater than 120 minutes in all groups and no differences were found among them (141±27 minutes in G2, 137±27 minutes in G2.5 and 137±30 minutes in G3). Perioperative analgesia was regarded as short and did not correlate with infusion rates. Tramadol infusion provided adequate analgesia with cardiorespiratory stability Analgesia was not dose-dependent, however, and residual postoperative effects were short-lasting, which warrants proper postoperative analgesia following tramadol infusion. Additional studies are required using higher infusion rates and standardized nociceptive stimulation in order to determine how doses influence tramadol analgesia and whe therthereis a limit to its effect in dogs.

scholarly journals Correction of flatfoot deformity by subtalar arthrodesis through single medial approach

2017 ◽  
Vol 2 (3) ◽  
pp. 2473011417S0004
Author(s):  
Guang-Rong Yu ◽  
Mingzhu Zhang
Keyword(s):  
Subtalar Joint ◽  
Clinical Results ◽  
Posterior Tibial Tendon ◽  
Triple Arthrodesis ◽  
Medial Approach ◽  
Posterior Tibial ◽  
Duration Of Surgery ◽  
The Mean ◽  
Mean Time ◽  
Neurovascular Structures

Category: Hindfoot Introduction/Purpose: To study the clinical results using isolate medial approach to correct flatfoot deformity in subtalar joint arthrodesis. Methods: 14 patients with flatfoot deformity were treated using isolated subtalar joint arthrodesis from March 2011 to March 2014. There were 3 males and 11 females with an average age of 60.81 years (ranged from 51 to 75 years). They are all cases of posterior tibial tendon dysfunctions, 9 of Myerson type Ⅲ, 3 of Ⅱ(b) and 2 of Ⅱ(c). Results: The mean duration of surgery was 100.54 minutes (range, 91-124 minutes). 12 patients were followed up for 20.25 months in average (range from 12 to 48 months). All of the cases have healed well, and the mean time of bone union was 9.53 weeks (ranged from 8 to 17 weeks). No infection was found in any cases. A complication was observed 1 patient which is painful fixation. None of the patients experienced a nonunion or an adverse event related to the medial neurovascular structures. The mean Kitaoka score increased from 43.67 to 80.81 Conclusion: Based on our experience with the procedure, the isolate subtalar joint arthrodesis is a useful alternative to triple arthrodesis for the correction of mild and some moderate flatfoot deformity.

scholarly journals Prevalence of Cesarean Section and Analysis of Neonatal Apgar Score and the Mean Time of Second Phase of Labor in Pregnant Women

2019 ◽  
Vol 73 (6) ◽  
pp. 399
Author(s):  
Maryam Shokrpour ◽  
Parisa Reza ◽  
Mehrzad Sharifi ◽  
Alireza Kamali
Keyword(s):  
Cesarean Section ◽  
Pregnant Women ◽  
Apgar Score ◽  
Second Phase ◽  
The Mean ◽  
Mean Time

scholarly journals Acute Appendicitis in Pregnant Women: Our Clinical Experience

2016 ◽  
Vol 39 (6) ◽  
pp. 159 ◽  
Author(s):  
Ahmet Türkan ◽  
Metin Yalaza ◽  
Mehmet Tolga Kafadar ◽  
Gürka Değirmencioğlu
Keyword(s):  
Abdominal Pain ◽  
Surgical Treatment ◽  
Acute Appendicitis ◽  
Pregnant Women ◽  
Laparoscopic Appendectomy ◽  
Open Appendectomy ◽  
Fetal Loss ◽  
University Research ◽  
Lower Quadrant ◽  
Right Lower Quadrant

Purpose: The purpose of this study was to analyse 13 patients who were treated in our clinic due to acute appendicitis during pregnancy. Methods: Records of the patients who received appendectomy with appendicitis diagnosis in our Turgut Özal University Research and Application Hospital between January 2007 and December 2015 have been analyzed retrospectively. Results: Appendectomies were performed on 13 pregnant patients with an acute appendicitis diagnosis. Average age of the patients was 27.69 years (between 22-37 years). Most frequent complaint of the patients was abdominal pain and most frequent examination finding was tenderness at right lower quadrant. Ultrasonography was used in all cases for diagnosis. Surgery was decided with clinical diagnosis for five cases (38.5%) where appendix had not been identified with ultrasonography. While laparoscopic appendectomy was applied in one case (7.7%) and open appendectomy was applied using a McBurney incision in 12 cases (92.3%). Average hospitalization duration was 1.69 days. All patients were tracked together through the Gynaecology Department for two weeks after they had been discharged from the hospital. Preterm delivery, maternal and fetal loss did not occur. Conclusion: It is considered appropriate to apply ultrasonography routinely to all pregnant patients in whom acute appendicitis is suspected. Concern for maternal or fetal complication that may occur in consequence of an unnecessary surgery should not be at a level that will delay surgical treatment needed by the patient.

scholarly journals Study of laparoscopic appendectomy: advantages, disadvantages and reasons for conversion of laparoscopic to open appendectomy

2017 ◽  
Vol 4 (3) ◽  
pp. 993
Author(s):  
Sujan Narayan Agrawal ◽  
Sunita Meshram ◽  
Kamlesh Dhruv
Keyword(s):  
Hospital Stay ◽  
Wound Infection ◽  
Laparoscopic Appendectomy ◽  
Open Appendectomy ◽  
Laparoscopic Approach ◽  
Normal Activity ◽  
Organ Injury ◽  
Cross Sectional ◽  
Duration Of Hospital Stay ◽  
Duration Of Surgery

Background:Good outcome has been reported with the laparoscopic approach in uncomplicated appendicitis, but a higher incidence of postoperative intraabdominal abscesses has been reported after laparoscopic appendectomy in complicated appendicitis. Objective was to study the efficacy of laparoscopic appendectomy.Methods: A Hospital based cross sectional study was carried out among of 302 patients. The study duration was from June 2004 to December 2006. Institutional Ethics Committee permission was obtained. Informed individual consent was taken. Out of 302 subjects, 236 underwent open appendectomy and 66 underwent laparoscopic appendectomy.Results:It was observed that in both the groups majority patients had retrocecal position of the appendix. The amount of blood loss, adjacent organ injury and duration of surgery were similar in both the groups. The difference in the incidence of wound infection in both groups was not found to be statistically significant. But the antibiotic use was significantly less in the LA group compared to OA group. It was found that time to resumptions of oral fees, duration of hospital stay and time to return to normal duties were significantly lesser in LA group compared to OA group. (p < 0.001). As per the cosmetic end result, majorities were satisfied in LA group and rated the surgery as excellent as compared to patients in OA group.Conclusions:Laparoscopic appendectomy was better than open appendectomy with respect to wound infection, tackling co-existing pathology, duration of hospital stay, earlier return to normal activity, excellent cosmetic end result, lesser use of antibiotics and earlier resumption of oral feeds.

scholarly journals Comparison between laparoscopic and open appendectomy in pregnant women

2017 ◽  
Vol 4 (5) ◽  
pp. 1623
Author(s):  
Subba Rao Dova ◽  
Sankara Rao Pagoti ◽  
Manoj Kumar Mannem
Keyword(s):  
Acute Appendicitis ◽  
Pregnant Women ◽  
Laparoscopic Appendectomy ◽  
Open Appendectomy ◽  
Fetal Loss ◽  
P Value ◽  
Open Approach ◽  
Open Procedure ◽  
Gestational Age At Delivery ◽  
Group 2

Background: Acute appendicitis is the most common indication for surgical emergency in normal patients and also in pregnant women. The objective of this study was to study the clinical significance of a laparoscopic over an open approach to appendicectomy pregnant population.Methods: Total 46 cases patients with acute appendicitis confirmed the diagnosis by clinical examination and ultrasonography. The patients were divided into two groups laparoscopic appendectomy (group 1) n=21 and Open appendectomy (group 2) n=25. We retrospectively analyzed the medical records to compare the 2 groups.Results: All the demographic details are not significant when compared with each other. Laparoscopic appendectomy is significantly i.e. <p-value <0.05 less time for operation, length of stay in hospital and complication when compared with open procedure. Time to first flatus, leucocyte and neutrophil ratio are not significantly when compared laparoscopic appendectomy and open appendectomy. Preterm delivery, birth weight, APGAR score, gestational age at delivery, delivery type, fetal loss and maternal death were not significant when compared laparoscopic appendectomy and open appendectomy.Conclusions: Laparoscopic procedure is safe and effective technique for the treatment of appendicitis during pregnancy with nearly similar rates of complications compared to open procedure. Laparoscopic appendectomy associated with shorter hospital stay, faster return to daily activities and shorter time to first flatus.

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