scholarly journals The risk factors of laparoscopic and open repair surgery of inguinal hernia in a tertiary care center

2020 ◽  
Vol 7 (4) ◽  
pp. 1174
Author(s):  
Ashish Goenka ◽  
Mahesh Ijjapawar
Keyword(s):  
Risk Factors ◽  
Inguinal Hernia ◽  
Laparoscopic Repair ◽  
Open Repair ◽  
Care Center ◽  
Tertiary Care ◽  
Laparoscopic Group ◽  
Group A ◽  
The Mean ◽  
Repair Group

Background: The purpose of the present study to investigate the incidence of inguinal hernia and risk factors of laparoscopic and open repair surgery.Methods: The present study contained 3 bilateral,17 right-sided and 7 left-sided hernia in the laparoscopic group and 2 bilateral, 19 right-sided and 6 left-sided hernia in open repair group. A total of 54 patients had an inguinal hernia, 27 underwent open repair and 27 underwent laparoscopic to open repair.Results: The age group of patients of open repair is 51-60 years, whereas 41-50 years in laparoscopic repair. The mean age was 47 years in open repair against 43 years in the laparoscopic repair.Conclusions: Among them, eight patients from open repair (1-COPD, 3-asthma,1-hypertension, 3-smoking) and five patients with the laparoscopic repair (2- COPD, 2-asthma, 1-hypertension) had one of the above-mentioned risk factors. 

scholarly journals Comparison between Laparoscopic and Open Repair of Umbilical and Paraumbilical Hernia: A Randomized Controlled Trial Study

2021 ◽  
pp. 127-135
Author(s):  
Arti Mitra ◽  
Unmed Chandak ◽  
Shiv Kumar Sahu ◽  
Yuvraj Pawaskar ◽  
Akanksha Waldia
Keyword(s):  
Laparoscopic Repair ◽  
Open Repair ◽  
Tertiary Care ◽  
Laparoscopic Approach ◽  
Laparoscopic Group ◽  
Open Group ◽  
Paraumbilical Hernia ◽  
Early Return ◽  
Open Mesh Repair ◽  
The Mean

Background: Laparoscopic repair of umbilical and paraumbilical hernia has largely replaced conventional (Open) repair. The purpose of the study was to compare the effectiveness of laparoscopic vs. open repair of umbilical & para umbilical hernia in a tertiary care government hospital. Methods: A total 50 patients of age >18 years diagnosed with umbilical and paraumbilical hernia who underwent laparoscopic and open hernia repair from May2018 to Nov 2020 were enrolled and divided into two groups of 25 patients in each. The patients were followed up in the post-operative period in the wards during daily rounds till the time of discharge; 1 and 6 months after discharge and yearly. Results: The mean age for open group was 44.24±7.68years while the mean age for laparoscopic group was 50.0±11.82years. Operative time was more in laparoscopic repair (81.68±18.37min) as compared to open (55.44±16.54min). Post-operative pain (VAS score) was greatest in the open group in comparison to lap group at 6 hr, 24 hr, day 8 and at 1month. Postoperative overall complication rate (Infection, seroma and recurrence) was 12% in the laparoscopic group and 28% in the open group. Recovery was faster with laparoscopic repair with a mean postoperative hospital stay of 3.28days as compared to 5.88days for open mesh repair. Patients treated with laparoscopic repair were early return to routine activity and work. Conclusion: The laparoscopic approach appears to be safe, effective and acceptable. It is a complex but very efficient method in experienced hands and it offered a significant advantage over open repair.

scholarly journals MON-667 Prevalence and Predictors of Diabetic Retinopathy Among Type 2 Diabetes Patients at a Tertiary Care Center

2020 ◽  
Vol 4 (Supplement_1) ◽  
Author(s):  
Khaled Ahmed Baagar ◽  
Fahmi Khan ◽  
Mahmoud Zirie ◽  
Sara Darwish ◽  
Ahmed K A Mohammed ◽  
...  
Keyword(s):  
Risk Factors ◽  
Type 2 Diabetes ◽  
Diabetic Retinopathy ◽  
Care Center ◽  
Tertiary Care ◽  
Tertiary Care Center ◽  
Vitamin D Levels ◽  
Significant Difference ◽  
The Mean

Abstract Objective: Diabetic retinopathy (DR) is one of the most common microvascular complications of type 2 diabetes (T2D). The reported prevalence of DR from different populations in the last decade was 13 - 38.1%. A report from our center 17 years ago showed that DR prevalence was 43.6%. With the all accumulated evidence showing that diabetes control decreases DR risk and the introduction of new drugs that helped better T2D control, we aimed to assess the current prevalence and predictors of DR among patients with T2D attending out-patient department at our tertiary care center. Methods: We conducted a cross-sectional study involving 638 patients. We collected information about their baseline characteristics, confirmed DR with its severity and maculopathy diagnosis, age at T2D diagnosis, duration of T2D, and averages of HbA1C, blood pressure (BP), cholesterol, and vitamin D levels over the previous year. A statistical analysis was performed using the software SPSS 23.0. A multivariate logistic regression analysis examined the independent predictors of DR development. Results: The mean age of the patients was 55.8 ± 10.3 years, and 42.8% were males. The mean BMI was 32.4 ± 12.4 kg/m2 with 58% had obesity. The mean duration of T2D was 11.5 ± 7.7 years, and the mean age at T2D diagnosis was 44.0 ± 9.98 years. The mean HbA1C was 8.3 ± 1.6 % with 77% had average HbA1C above 7% and 51.3% had average HbA1c above 8%. The mean systolic and diastolic BP were 136.37 ± 15.01 mmHg and 74.12 ± 8.078 mmHg, respectively. DR was diagnosed in 223 cases (35%). Of the 638 patients, 24.5% had non-proliferative DR, 9.2% had proliferative DR, and 4.2% had maculopathy. There was no significant difference in DR prevalence between males (36%) and females (34.1%) (P = 0.59). Predictors of DR development were age above 40 years, duration of T2D more than 10 years, early age of T2D diagnosis, average HbA1C more than 8%, and hypertension. Discussion: T2D is a major health challenge to our community with its very high prevalence. The prevalence of DR in T2D patients attending our institution was significant (more than one-third, 35%) in comparison to reports from other centers. However, we showed an improvement in DR development in our patients from 43.6% to 35%, probably due to better T2D and BP control. Similar to previous reports, T2D patients with older age, long T2D duration, younger age at T2D diagnosis, uncontrolled diabetes, and uncontrolled BP were more likely to develop DR. Conclusion: Physicians treating T2D patients should ensure regular retina screening especially for those with risk factors for DR. Also, they should fix the modifiable risk factors of DR; diabetes and BP control. References: (1) Alaboud et al. Saudi Med J 2016; Vol. 37 (12): 1408–1411.doi: 10.15537/smj.2016.12.17062. (2) Lim MC et al. Ann Acad Med Singapore. 2008 Sep;37(9):753–9. (3) Hammes H-P et al. PLoS ONE 10(7): e0132492. doi:10.1371/journal. pone.0132492

scholarly journals Comparison of Laparoscopic VS Open Inguinal Hernioplasty in a Tertiary Care Hospital

2020 ◽  
Vol 10 (1) ◽  
pp. 17-22
Author(s):  
Md Mahfuzul Momen ◽  
Ashok Kumar Sarker ◽  
Deb Prosad Paul ◽  
Debasis Das ◽  
Sonia Akhter ◽  
...  
Keyword(s):  
Inguinal Hernia ◽  
Surgical Treatment ◽  
Hernia Repair ◽  
Inguinal Hernia Repair ◽  
Tertiary Care ◽  
Laparoscopic Group ◽  
Open Group ◽  
Care Hospital ◽  
Laparoscopic Hernioplasty ◽  
The Mean

Background: Inguinal hernia repair is one of the most common surgical procedures in Bangladesh. The option of surgical treatment remains controversial. Laparoscopic hernia repair has all the benefits of a tension free repair. We aimed to compare postoperative outcome and cost between laparoscopic and open inguinal hernia repair. Objective: This study was conducted with an objective to compare the effectiveness of each procedure and complications if any. Materials and Methods: Fifty cases of inguinal hernia admitted in the tertiary care center were selected by nonprobability (purposive) sampling method. All patients with uncomplicated hernia treated by open or laparoscopic method were included. The age/sex, incidence, mode of presentation, surgical treatment and postoperative complications were evaluated and compared with standard published literature. Results: Postoperative wound infection developed in three cases of open hernioplasty and one case in laparoscopic surgery. Hematoma and seroma at the operated site were found in one case of laparoscopic hernioplasty and in two cases of open hernioplasty. Orchitis was more prevalent in the laparoscopic hernioplasty patient with incidence among two cases as compared to one in open group. The mean duration of hospitalization was 59.62±6.11 hours in case of laparoscopic hernioplasty while 53.33±8.26 hours in open hernioplasty. The mean duration of procedure was 72.33 minutes in laparoscopic group while 64.62 minutes in open surgery. The mean cost for the laparoscopic repair group was around taka 63000/= whereas in the open group it was around 42000/= only with significant difference. Prolonged groin pain was seen in four cases in open group as compared to one in laparoscopically operated cases. Conclusion: There were less post-operative complications in the laparoscopic group. J Enam Med Col 2020; 10(1): 17-22

scholarly journals Comparative study of laparoscopic and conventional (Lichtenstein tension free) inguinal hernia repair in a tertiary care institute

2019 ◽  
Vol 6 (10) ◽  
pp. 3739
Author(s):  
Nitish Dhawan ◽  
Kirti Savyasacchi Goyal ◽  
Tejinder Pal Singh Sodhi ◽  
Manu Chaudhary
Keyword(s):  
Inguinal Hernia ◽  
Hernia Repair ◽  
Inguinal Hernia Repair ◽  
Laparoscopic Repair ◽  
Common Complication ◽  
Tension Free ◽  
Significant Difference ◽  
Group A ◽  
Group B ◽  
Repair Group

Background: Inguinal hernia repair is the most frequently performed operation in general surgery. The standard method for inguinal hernia repair had changed little over a hundred years.Methods: Present study was conducted on 60 patients having inguinal hernia and were operated by two different methods i.e. Lichtenstein tension free inguinal hernia repair (Group A) and laparoscopic hernia repair (Group B). Aim of the study conducted was to compare the various observations and complications in post-operative period.Results: There was no statistically significant difference in the age group, side and type of hernia in the two groups. Laparoscopic repair was a longer procedure than Lichtenstein inguinal hernia repair and it was statistically significant (p<0.05). Postoperatively urinary retention was the most common complication in Group A. Other complications were genital oedema (13.33%), haematoma (13.33%), seroma (13.33%) and wound infection (6.67%) which led to increased post-operative hospital stay. In Group B, pneumoscrotum was the most common complication. Other complications included subcutaneous emphysema (6.67%) and seroma (6.67%).Conclusions: Lichtenstein tension free inguinal hernia repair is safe, efficient and cheaper procedure with no extra equipment being required while Laparoscopic repair takes more time, laparoscopic equipment and training in minimal access surgery. 

scholarly journals LAPAROSCOPIC VERSUS OPEN REPAIR OF INGUINAL HERNIA

2017 ◽  
Vol 27 (1) ◽  
pp. 28-34
Author(s):  
Žilvinas Dambrauskas ◽  
Lina Pankratjevaitė ◽  
Vaidotas Bogusevičius ◽  
Antanas Mickevičius
Keyword(s):  
Inguinal Hernia ◽  
Laparoscopic Surgery ◽  
Postoperative Pain ◽  
Hernia Repair ◽  
Inguinal Hernia Repair ◽  
Laparoscopic Repair ◽  
Open Repair ◽  
Laparoscopic Hernia Repair ◽  
Laparoscopic Group ◽  
Open Hernia Repair

Background and objective. Inguinal hernia repair is one of the most common general surgery procedures. Laparoscopic repair is technically more demanding, though it has been shown to be superior in terms of pain and discomfort, however, there is no apparent difference in recurrence between laparoscopic and open mesh methods of hernia repair. Over the years we see a relatively slow increase of laparoscopic procedures and even scepticism of the patients; thus we decided to test the hypothesis that more demanding and costly laparoscopic surgery has little benefits over the open procedure. The aim of our study was to compare postoperative pain, short- and long-term outcomes after laparoscopic hernia repair and conventional open hernia repair. Results. Laparoscopic procedure was significantly more often performed for the patients, who were younger, had shorter history of disease. The mean operative time for laparoscopic inguinal hernia repair was significantly longer than for open repair (p=0.02). The pain score for laparoscopic surgery was significantly lower according to VAS on day 1, 2, 3 (overall p≤ 0.002). The patients in the laparoscopic group required significantly lower doses of narcotic analgesics on the third postoperative day; the doses of nonsteroidal anti-inflammatory drugs were also significantly lower on the second and third postoperative day in this group. The postoperative hospital stay was shorter after laparoscopic repair (p=0.01). Sixty-four patients (71.11%) completed follow-up at one year after the operation. Nine (14.06%) of them had postoperative complications and eight of them were after open hernia repair. Two patients (3.1%) were re-operated (both patients were treated by Lichtenstein hernioplasty): one for inguinal hernia recurrence, another for testicular necrosis. Conclusions. The patients from laparoscopic group had significantly shorter postoperative pain duration (p=0.019), returned to daily activity slightly earlier and had better satisfaction with the operation comparing with the patients who undergone open surgery (p=0.915, p=0.893), but the duration of the sick leave (time off from work) was similar in both hernia repair group (p=0.260). Data shows that laparoscopic hernia repair has advantages in terms of post-operative pain intensity and duration, as well as risk of complications and patient satisfaction.

scholarly journals Laparoscopic Repair of Inguinal Hernia : Early Experience in A Tertiary Care Hospital

2016 ◽  
Vol 4 (1) ◽  
pp. 19-22
Author(s):  
Sharmistha Roy ◽  
Samiron Kumar Mondal ◽  
Tapas Kumar Maitra
Keyword(s):  
Inguinal Hernia ◽  
Hernia Repair ◽  
Inguinal Hernia Repair ◽  
Laparoscopic Repair ◽  
Open Repair ◽  
Laparoscopic Group ◽  
Normal Activity ◽  
Laparoscopic Inguinal Hernia Repair ◽  
Open Group ◽  
Laparoscopic Inguinal Hernia

Background : The introduction of laparoscopic techniques has added a new dimension to groin hernia surgery. The laparoscopic repair of inguinal hernia has had a staggering beginning in the surgical arena. Laparoscopic repairs have had to compete with the current gold standard for inguinal hernia repair ie Liechtenstein repair. This study shows the results of laparoscopic inguinal hernia repair in comparison to open repair in a similar group of patients.Methods and materials : This is a prospective study done on 50 male patient of inguinal hernia aging from 18- 65years. Among 50 patients selected for study 25 patient underwent open hernioplasty and 25 patient underwent laparoscopic hernioplasty. In the laparoscopic group, in 20 patients (80%) TAPP procedure was done & in 5 patients (20%) TEP procedure was done.Aims and Objective : The aim of this study is to compare the effectiveness and safety of laparoscopic and conventional open repair, in the treatment of inguinal hernia.Results : Average operating time in open procedure was 55±12 minutes, and in laparoscopic procedure 65±10 minutes. Opoid analgesics were required in 36% patient in open group and 16% in laparoscopy group. Within 7 days most of the patient (76%) in laparoscopic group returned to their normal activity, but in the open group 92% patient required more than 7 days to return to normal activity. Post operative complication like hematoma formation (8%), Testicular pain (8%), retention of urine (3%), and mesh infection (4%) was more in open repair than in laparoscopic repair. In Laparoscopic group 1patient (5%) had bladder injury, and 1 patient (5%) developed illeus.Conclusion : Early results of laparoscopic inguinal hernia repair are encouraging, but the chance of organ injury like bladder, or major vessel injury are more. So laparoscopic repair of inguinal hernia should only be practiced with adequate training and experience in laparoscopic surgery.Bangladesh Crit Care J March 2016; 4 (1): 19-22

LAPAROSCOPIC REPAIR OF PERFORATED DUODENAL ULCER PATCH VERSUS CONVENTIONAL SURGERY

2019 ◽  
Vol 3 (1) ◽  
Author(s):  
Dr. Anil Kumar Saxena ◽  
Dr. Devi Das Verma
Keyword(s):  
Duodenal Ulcer ◽  
Laparoscopic Repair ◽  
Open Repair ◽  
Wound Dehiscence ◽  
Duodenal Perforation ◽  
Perforated Duodenal Ulcer ◽  
Conventional Surgery ◽  
Duodenal Ulcers ◽  
Duration Of Operation ◽  
Repair Group

Introduction: For many surgeries for duodenal ulcer Laparoscopic repair has become gold standard for many elective procedures such as ant reflux procedures, laparoscopic cholecystectomy and in colorectal surgery. Although in the emergency setting such as in the management of perforated duodenal ulcer Laparoscopic repair has been slow and limited. Since 1990, for the treatment of perforated peptic ulcer Laparoscopic repair has been used which has been widely accepted as an effective method. Duodenal ulcer is defined as a peptic ulcer which develops in the first part of the small intestine called duodenum and usually present as a perforation of acute abdomen. In perforated duodenal symptoms as severe and sudden onset abdominal pain that is worse in right upper quadrant and epigastrium and usually followed by nausea and vomiting. In this situation there is rapid generalization of pain and in examination shows peritonitis with lack of bowel sounds. Aim: The main objective of this study is to evaluate outcome of laparoscopic surgery in comparison with conventional surgery. Material and methods: All the patients with clinically diagnosed with perforated duodenal ulcers presenting within 24 hours of symptoms and undergoing surgery were included during the study period. Total 50 patients were included with age group 15-65 years. All the patients with perforated duodenal ulcers were included which go through either conventional open or laparoscopic without omental patch repair. Result: Total 50 patients were included in these studies which were divided into two group with 25 patients in each group as laparoscopic duodenal perforation repair group and conventional open repair group. Mean duration of operation (in minutes) was 105.4±10.4 in laparoscopic duodenal perforation repair group whereas mean duration of operation (in minutes) was 67.3±8.6 in conventional open repair group. Mean duration of number of doses of analgesics required in laparoscopic group and conventional open group as 9.5±1.7 and 17.2± 3.1 respectively. Out of 25 patients in each group of laparoscopic duodenal perforation repair group and the conventional open repair group the outcome were noted with their post operative complication as shown in table no 5 below.   In Post-operative complications 21(84%) patients in laparoscopic duodenal perforation repair group and 14(56%) patients in conventional open repair group had no complications. 4 (16%) patients in the laparoscopic duodenal perforation repair group and 2(8%) patients in conventional open repair group showed Post-operative complications as chest infection. In the conventional open repair group  patients present with wound dehiscence and wound infection and Wound dehiscence and chest infection were 4(16%) and 5(20%) respectively whereas nil in Laparoscopic duodenal perforation repair group. Conclusion: Duodenal ulcer perforation is a life-threatening emergency which required urgent management for the patients. Due to the advance in duodenal ulcer perforation closure by laparoscopy it becomes popular and favorite choice. With certain criteria, laparoscopic closure of perforated duodenal ulcer is safe and effective though it was associated with longer operating time and had no impact on the outcome. Hence laparoscopic closure was better in comparison to open repair for the earlier returns to normal daily activities. Keywords:  Duodenal ulcer, Laparoscopic repair, Post-operative analgesia, conventional surgery

Study of risk factors of eclampsia in a tertiary care center

2019 ◽  
Vol 12 (2) ◽  
pp. 31-35
Author(s):  
Padma Chandavathu ◽  
◽  
Akurathi Krishna Rao ◽  
Keyword(s):  
Risk Factors ◽  
Care Center ◽  
Tertiary Care ◽  
Tertiary Care Center

scholarly journals Clinical profiles of diabetic foot ulcer patients undergoing major limb amputation at a tertiary care center in North-eastern Tanzania

BMC Surgery ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Ahmed Shabhay ◽  
Pius Horumpende ◽  
Zarina Shabhay ◽  
Andrew Mganga ◽  
Jeff Van Baal ◽  
...  
Keyword(s):  
Blood Glucose ◽  
Diabetic Foot ◽  
Care Center ◽  
Tertiary Care ◽  
Limb Amputation ◽  
Foot Ulcers ◽  
Diabetic Foot Ulcers ◽  
Random Blood Glucose ◽  
North Eastern ◽  
The Mean

Abstract Background Diabetic foot ulcers complications are the major cause of non-traumatic major limb amputation. We aimed at assessing the clinical profiles of diabetic foot ulcer patients undergoing major limb amputation in the Surgical Department at Kilimanjaro Christian Medical Centre (KCMC), a tertiary care hospital in North-eastern Tanzania. Methods A cross—sectional hospital-based study was conducted from September 2018 through March 2019. Demographic data were obtained from structured questionnaires. Diabetic foot ulcers were graded according to the Meggitt-Wagner classification system. Hemoglobin and random blood glucose levels data were retrieved from patients’ files. Results A total of 60 patients were recruited in the study. More than half (31/60; 51.67%) were amputated. Thirty-five (58.33%) were males. Fifty-nine (98.33%) had type II diabetes. Nearly two-thirds (34/60; 56.67%) had duration of diabetes for more than 5 years. The mean age was 60.06 ± 11.33 years (range 30–87). The mean haemoglobin level was 10.20 ± 2.73 g/dl and 9.84 ± 2.69 g/dl among amputees. Nearly two thirds (42/60; 70.00%) had a haemoglobin level below 12 g/dl, with more than a half (23/42; 54.76%) undergoing major limb amputation. Two thirds (23/31; 74.19%) of all patients who underwent major limb amputation had mean hemoglobin level below 12 g/dl. The mean Random Blood Glucose (MRBG) was 13.18 ± 6.17 mmol/L and 14.16 ± 6.10 mmol/L for amputees. Almost two thirds of the study population i.e., 42/60(70.00%) had poor glycemic control with random blood glucose level above 10.0 mmol/L. More than half 23/42 (54.76%) of the patients with poor glycemic control underwent some form of major limb amputation; which is nearly two thirds (23/31; 74.19%) of the total amputees. Twenty-eight (46.67%) had Meggitt-Wagner classification grade 3, of which nearly two thirds (17:60.71%) underwent major limb amputation. Conclusion In this study, the cohort of patients suffering from diabetic foot ulcers treated in a tertiary care center in north-eastern Tanzania, the likelihood of amputation significantly correlated with the initial grade of the Meggit-Wagner ulcer classification. High blood glucose levels and anaemia seem to be also important risk factors but correlation did not reveal statistical significance.

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