scholarly journals Study of 46 nephrectomies in rural India

2021 ◽  
Vol 8 (10) ◽  
pp. 3036
Author(s):  
Pratik Gond ◽  
Mayur Gangwal ◽  
Gokul J. Jorwekar ◽  
Hrushikesh Wagholikar ◽  
Ruchita Talreja

Background: The first planned nephrectomy was performed by the German surgeon Gustav Simon on August 2, 1869 in Heidelbergs since then nephrectomy has been an essential part of urologic practice. Elective nephrectomy is done for both benign and malignant diseases of the kidney. The objective of this study was to know the various causes their pre-op factors like age, gender, laterality of disease, and intra operative factors like duration of surgery, blood loss and post-operative complications and histopathological report of the nephrectomy specimens of elective nephrectomy in a rural medical college of IndiaMethods: In our series, we have studied all the elective nephrectomies done in Pravara Rural Hospital, Loni during a span of three years from January 2018 to March 2021.Results: We have analyzed 46 cases of nephrectomies regarding their pre-op factors like age, gender, laterality of disease, and intra operative factors like duration of surgery, blood loss and post-operative complications and histopathological report of the nephrectomy specimens. Out of 46 cases, 21 were males and 26 females. Comparing the laterality right nephrectomy was done in 41% cases and left nephrectomy in 59% cases. In our series, 76% cases of nephrectomies were done for benign causes and 24% cases for malignant causes. Among the benign causes, pyelonephritis was the leading cause followed by neglected renal calculi and resultant non-functional kidney. On the other hand, renal cell carcinoma was the most common malignant pathology requiring nephrectomy.Conclusions: In our series, majority cases of nephrectomies were done for benign causes.

Author(s):  
Rameshkumar R. ◽  
Sahana N. Naik ◽  
Dhanalakshmi .

Background: Non Descent Vaginal Hysterectomy (NDVH) is removal of uterus through vagina in non-prolapsed uterus. The objective of the present study was to assess safety and feasibility of NDVH in patients with large uterus (>12 weeks size uterus).Methods: Retrospective study was conducted in Department of Obstetrics and Gynecology of Shree Dharmasthala Manjunatheshwara (SDM) College of Medical Sciences and Hospital, Dharwad, India from May2014 to May 2017. Effort was made to perform hysterectomies vaginally in women with benign conditions with large uterine size. Information regarding age, parity, uterine size, blood loss, duration of operation, number of fibroids, other surgical difficulties encountered, intra–operative and post-operative complications were recorded.Results: Total of 65 cases was selected for NDVH with large uterine size. All successfully underwent NDVH. 25 patients had uterus of 10-12 weeks size, 17 had uterine size of 12-14 weeks size. Mean duration of surgery was 90 min. Mean blood loss was 300ml. Post-operative complications were minimal. All patients had early mobility with faster resumption to daily activities. Mean hospital stay was 4-5 days.Conclusions: Non descent vaginal hysterectomy is safe, cost effective method of hysterectomy in women with large uterus requiring hysterectomy for benign conditions with less complications, shorter hospital stay and less morbidity.


2021 ◽  
Vol 28 (05) ◽  
pp. 652-655
Author(s):  
Robina Ali ◽  
Riffat Ehsan ◽  
Ghazala Niaz ◽  
Fatima Abid

Objectives: The purpose of this study was to assess the safety of sacrohystcopxy by determining intraoperative and post-operative complications and its effectiveness by pelvic organ prolapse recurrence on follow up. Study Design: Prospective study. Setting: Department of Gynecology and Obstetrics Unit-II DHQ Hospital PMC, Faisalabad. Period: Jan-2014 to Jan-2017. Material & Methods: Patients with uterovaginal prolapse, admitted through OPD were selected for abdominal sacrohysteropexy. Variables of study including duration of surgery, any intra-operative and post operative complications, need of intra operative blood transfusion, post operative hospital stay; recurrence of POP, number of pregnancies in 06 moths follow up were recorded. Results: During this study period, 319 patients were admitted with uterovaginal prolapse. 32 (10.03%) cases were selected for abdominal sacrohysteropexy. In these 32 patients, 03 (9.37%) were <30years of age, 21(65.62%) were between 30-35 years and 8 (25%) were between 35-40 years of age. About 2(6.25%) were unmarried, while 30(93.7%) were married. In these married women 14(43.75%) were multiparas, another 14(43.75%) were para 1 or 2, while 4(12.5%) were para 3 or more. Duration of surgery was 40-45 minutes in 31(96.87%) patients. In 28(87.5%) cases per operative blood loss was <150ml while in 4(12.5%) it was estimated to be >150ml but less than 300ml. Post operatively only 1(3.12%) case developed wound sepsis and it was the only one (3.12%) who was discharged on 7th post operative day, while rest 31(96.87%) were discharged on 3rd post operative day. No recurrence was noticed in 06 moths follow up, while 2(6.25%) patients became pregnant. Conclusion: Abdominal sacrohysteropexy is a safe and an effective treatment in terms of overall anatomical and functional outcome, complications, post operative recovery, length of hospital stay and sexual functioning, in women who desire uterine and hence fertility preservation.


2020 ◽  
Vol 7 (10) ◽  
pp. 3294
Author(s):  
Manju Singh ◽  
Amit Agarwal ◽  
Kush Pandey

Background: Haemorrhoids are one of most common benign anorectal malformation worldwide. There are various surgical treatment modalities for 3rd and 4th degree haemorrhoids. Open haemorrhoidectomy was the most widely practiced and is considered the current gold standard. In search of a newer surgical technique, stapler has been introduced for haemorrhoidectomy and has revolutionised operative procedures over the last decade world-wide due to its ease and simplicity and lesser post-operative complications. The following study was done to evaluate the outcome of open versus stapled haemorrhoidectomy in terms of post-operative pain, postoperative bleeding, duration of surgery, duration of hospital stays in a medical college hospital at Raipur, Chhattisgarh.Methods: This was a prospective follow-up study, in patients undergoing surgery for grade III/IV haemorrhoids conducted in the Department of Surgery, Dr BRAM Hospital, Raipur, from August 2017 to July 2018. Fourteen patients underwent stapled haemorrhoidopexy and eighteen underwent open haemorrhoidectomy. All patients were reviewed immediately after surgery, at discharge and at 1, 3 and 10 weeks post-operatively. The two groups were compared for post-operative outcomes and complications.Results: The majority of patients in the study were males and had grade 4 haemorrhoids. Stapled haemorrhoidopexy group had shorter duration of surgery, less postoperative pain, shorter duration of hospital stays as compared with open haemorrhoidectomy group. There were no major post-operative complications in the follow up period of 10 weeks in the stapled group.Conclusions: Stapled haemorrhoidopexy is a safer alternative to open haemorrhoidectomy with many short-term benefits.  


KYAMC Journal ◽  
2017 ◽  
Vol 6 (2) ◽  
pp. 637-641
Author(s):  
Arifa Akter Zahan ◽  
Kh Shahnewaz ◽  
Ummay Salma

Aims: To evaluate the rational approach of non-descent vaginal hysterectomy in advancing gynaecology practice.Study Design: Retrospective study and period from 1st July 2013 to 31st June 2014. Setting Kumudini Women's Medical College & Hospital, Mirzapur, Tangail.Patients: All selective patients requiring hysterectomy for benign gynecological disorders who did not have any uterine prolapse were recruited for this study. In bigger size uterus morcellation techniques like bisection, debulking, myomectomy, slicing, or combination of these were used to remove the uterus.Main outcome measures: Data regarding indication, age, parity, uterine size, estimated blood loss, length of operation, complication and hospital stay were recorded.Results: A total of 50 cases were selected for non-descent vaginal hysterectomy all of them successfully underwent non-descent vaginal hysterectomy. Commonest age group was (41-45 years) i.e. 46%. All patients were parous. Uterus size was less then 8 wks 21 cases, 8wks to 12 wks in 27 cases, more then 12 wks 02 cases. Commonest indication was DUB of uterus (44%). Mean duration of surgery was 50.5 minutes. Mean blood loss was 100ml. Blood transfusion was required in four cases. Average duration of hospital stay was 3.1 days. Complications were minimal which included UTI and Vault infection.Conclusions: NDVH is safe feasible and patient friendly. We suggest that our modern gynecologist will be more expertise and familiar to this procedure in near future.KYAMC Journal Vol. 6, No.-2, Jan 2016, Page 637-641


2019 ◽  
Vol 17 (1) ◽  
pp. 20-22
Author(s):  
Durga BC ◽  
Aseem Sharma ◽  
Binod Mahaseth ◽  
Nirmala Sharma

Background: Hysterectomy is a common surgery performed by gynecologist worldwide. It can be done either by vaginal, abdominal or laparoscopic route. Non decent vaginal hysterectomy (NDVH) is less invasive, less time consuming and scar less surgery. The blood loss during surgery, intra-operative and post-operative complications are less in NDVH compare to TAH (total abdominal hysterectomy). Aim and objective: to compare the clinical outcome between NDVH and TAH. Method: A hospital based prospective study was done at Nepalgunj medical collage Kolhapur between March 2018–March 2019, 60 cases fulfilling selection criteria were selected, 30 cases underwent NDVH next 30 cases underwent TAH. Outcome is measured on the basis of operating time, blood loss during surgery, hospital stay and post-operative complications. Result: The most common indication for hysterectomy was fibroid uterus in both the groups (NDVH and TAH). The operating time, blood loss, hospital stay and post-operative complications were less in NDVH as compare to TAH. Conclusion: NDVH is a choice of surgery over TAH for freely mobile uterus with benign pathology and uterus size less than twelve weeks and without adenexal pathology.


2022 ◽  
Vol 13 (1) ◽  
pp. 123-128
Author(s):  
Pranita Somani ◽  
Priyanka Singh ◽  
Mangala Shinde

Background: Removal of the uterus through vagina when performed in a case without uterine descent or prolapse is known as “non-descent vaginal hysterectomy” or NDVH. Vaginal route is preferred as compared to laparoscopic and abdominal methods. The advantages of vaginal hysterectomy being fewer complications, less post-operative stay, cost effective, and useful in bulky uterus. Aims and Objectives: The aims of the study were as follows: (1) To study the intraoperative and post-operative complications encountered during NDVH and their management. (2) To assess the intraoperative blood loss, the operative time, and post-operative hospital stay. (3) To study and check the feasibility of vaginal route as the primary route for all hysterectomies in the absence of uterine prolapse. Materials and Methods: A total of 50 patients were included in the study. Detailed history was taken including obstetric history and menstrual history and clinical examination was performed. After taking written, informed consent and doing proper pre-operative preparation, the patient was posted for NDVH. Post-operative complications were noted. Patients were asked to come for follow-up after 15 days. Results: In 92% of cases operated, no intraoperative complications were found suggesting low morbidity associated with the procedure. Hemorrhage requiring blood transfusion was found in 4% of cases. Average operative time was 61.2 ± 27.89 min, average blood loss was 170 ± 81.44 ml, and average hospital stay was 5.94 ± 4.95 days. On histopathological examination, 40% were having leiomyoma and dysfunctional uterine bleeding was seen in 22% of cases. Pain was the most common complication seen in 30% of cases while vaginal discharge was seen in just 4% of cases. About 80% of patients were discharged on post-operative day 5. Conclusion: In 92% of NDVH cases, no intraoperative complications were found suggesting low morbidity associated with the procedure. The post-operative hospital stay was restricted to 5 days in 80% of cases which indicates early discharge of the patient. Post-operative complications such as vaginal discharge and fever were seen only in 4% of cases. NDVH should, therefore, be considered as the primary route for all hysterectomies unless contraindicated in the absence of prolapse.


2020 ◽  
Vol 40 (5) ◽  
Author(s):  
Fang Hao ◽  
Liyan Yue ◽  
Xiaoyan Yin ◽  
Xiaotong Wang ◽  
Chunguang Shan

Abstract Laryngeal papillomatosis is a benign disease in the larynx but with the potential to develop into significant complications as a result of its high recurrence rate. CO2 laser and radiofrequency controlled ablation (coblation) have been used to treat recurrent respiratory papillomatosis, but detailed comparisons of their respective treatment outcomes are not fully investigated. This retrospective study examines the procedure time, time interval between interventions, blood loss during operation, post-operative complications and pain scores among patients who received either CO2 laser or radiofrequency coblation interventions for laryngotracheal recurrent respiratory papillomatosis. Compared with CO2 laser intervention, radiofrequency coblation significantly reduced operation time, time interval between interventions, blood loss during operation and number of times bipolar electrocoagulation needed in each procedure. Post-operatively, pain scores after radiofrequency coblation were significantly lower than those after CO2 laser intervention. Incidence rates of post-operative complications, in terms of palate pharyngeal mucosa damage, bleeding and subcutaneous emphysema, were also significantly reduced after radiofrequency coblation. Low-temperature radiofrequency coblation is a superior intervention compared with CO2 laser against laryngotracheal recurrent respiratory papillomatosis.


2019 ◽  
Vol 6 (7) ◽  
pp. 2514
Author(s):  
Anantha Kumar Nateson ◽  
Suresh Nayak Basavanayak ◽  
Sudarsansrikanth .

Background: Lichtenstein’s hernioplasty is the commonly done surgery for inguinal hernias. The present study is aimed to study the Lichtenstein’s hernioplasty and its postoperative complications for different types of inguinal hernia.Methods: This prospective study was conducted at Department of General Surgery, MVJ Medical College and Research Hospital, Hoskote, Bangalore Rural, Karnataka. A total of 90 patients were selected for this study. Subjects with the age of 21 to 75 years with inguinal hernia are included in the study. A pre-designed proforma was used to collect their details. All selected cases were studied up to discharge regarding the type of hernia and followed up in OPD for 1 year regarding post-operative complications.Results: Immediate post-op complications like seroma/hematoma was observed in 10 (11.1%), wound infection was in 5 (5.5%) and orchitis was in 2 (2.2%). Post-operative complications like stiffness in lower abdomen was observed in 21 (23.3%) patients. Long term complications like forein body sensation was experienced by 22 (24.4) patients post-operatively at 1 month follow up, 8 (8.8%) patients at 3 months follow up and 3 (3.3) patients at 1 year follow up.  Chronic pain was experienced by 17 (18.8%) patients at the end of 1 month follow up, at 3 month follow up, 13 (14.4%) patients and at the end of 1 year of follow up 4 (4.4%) patients at operated site. Recurrence was not observed in any of the patient.Conclusions: The study findings indicate that Lichtenstein’s hernioplasty was safe and reliable procedure for inguinal hernia repair. 


Author(s):  
Anjali Soni ◽  
Pawan Kumar Soni ◽  
Chanderdeep Sharma ◽  
Suresh Verma ◽  
Shivani Vashasit

Background: Hysterectomy for benign indications is one of the common surgical procedures performed on women worldwide. Despite the available evidence favouring vaginal surgery still abdominal route is preferred in majority of women in rural India. Hence, this pilot study was done to determine the feasibility of Non-descent vaginal hysterectomy (NDVH) in rural India.Methods: All women planned for hysterectomy for benign indications (with no or minimal pelvic organ prolapse) during a period of six months were enrolled after taking informed consent and subsequently, underwent NDVH. Data was analyzed retrospectively with respect to duration of surgery, average blood loss, complications of surgery and duration of stay in the hospital.Results: All except one woman out of 37 women enrolled for the study had an un-eventful surgery with median duration of surgery [median 30 minutes; (range 30-55 minutes)], median hospital stay [(median 2 days) range 2-7 days], and minimal blood loss [median 50 ml (range 50-200 ml)]. There was one case of inadvertent cystotomy (diagnosed and repaired intra-operatively), and discharged in healthy condition on seventh post-operative day.Conclusions: NDVH is a safe option for hysterectomy (in women without pelvic organ prolapse) for benign indications even in rural India. It has been found to be associated with short hospital stay, minimal blood loss and short recovery time.


2017 ◽  
Vol 4 (10) ◽  
pp. 3358
Author(s):  
Chandrasekhar S. Neeralagi ◽  
Yogesh Kumar ◽  
Surag K. R. ◽  
Lakkanna Suggaiah ◽  
Preetham Raj

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.


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