scholarly journals LAPAROSCOPIC CHOLECYSTECTOMY

2011 ◽  
Vol 18 (02) ◽  
pp. 237-242
Author(s):  
AWAIS SHUJA ◽  
ABID BASHIR ◽  
ABID RASHID
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Hospital Stay ◽  
Complication Rate ◽  
Conversion Rate ◽  
Gall Stone ◽  
Significant Difference ◽  
Group A ◽  
The Mean ◽  
Group B ◽  
The Impact

Laparoscopic cholecystectomy is the gold standard treatment for patients presenting with acute gall stone disease necessitating hospital admission. Objective: To assess the impact of timing of laparoscopic cholecystectomy on conversion rate, hospital stay and morbidity. Period: Jan 2008-2010. Setting: Department of Surgery, Independent University Hospital, Faisalabad. Study Design: Experimental study. Material & Methods: The subjects were included by consecutive sampling technique. 81 cases were divided into 3 groups. Group A (Surgery within 72 hrs of onset symptoms). Group B (surgery between 72hrs to 96 hours of onset of symptoms). Group C (surgery after 96 hours of onset of symptoms). Results: The mean age was 41-95 years. Female to male ratio was 4.5:1. The overall complication rate was 12.69%. Mean hospital stay was 2.85 days. The open conversion rate was 8.64%. In group A the complication rate was 6%, group B 11.5% and group C 12.8&. The mean hospital stay and conversion rate had no significant difference. Conclusions: The timing of laparoscopic cholecystectomy has no significant impact on the conversion rate and length of hospital stay in cases with acute cholecystitis. However the complication rate was higher when surgery performed after 72 hours of onset of symptoms.

Clinical Results Of A Lamina With Spinous Process And An Iliac Graft As Bone Grafts In The Surgical Treatment Of Single-Segment Lumbar Pyogenic Discitis: A Retrospective Cohort Study

2020 ◽  
Author(s):  
Weiyang Zhong ◽  
Xinjie Liang ◽  
Xiaolin Wang ◽  
Ke Tang ◽  
Tianji Huang ◽  
...  
Keyword(s):  
Hospital Stay ◽  
Spinous Process ◽  
Bone Grafts ◽  
Clinical Results ◽  
Single Segment ◽  
Significant Difference ◽  
Group A ◽  
The Mean ◽  
Group B ◽  
Segmental Angle

Abstract Background: A retrospective study investigated and compared the results of a lamina withspinous process (LSP) and an iliac graft (IG) as bone grafts in single-segment lumbar pyogenic discitis (LPD) through one-stage-posterior-only approach with radical debridement and internal instrumentation.Methods: Data from 37 patients were reviewed. A LSP was placed in 17 patients (group A), and an IG was implemented in 20 patients (group B). The surgery time, surgery hemorrhage, hospital stay, drainage, and follow-up (FU) were reviewed. The visual analogue scale (VAS), Oswestry Disability Index (ODI), erythrocyte sedimentation rate (ESR), C-reactive protein (CRP) level, segmental angle, intervertebral height and bony fusion time were compared preoperatively and at the final FU.Results: All patients were followed-up for a mean of 27.94±2.35 months in group A and 30.29±1.89 months in group B, without a difference. The mean age was younger in group A than in group B (P<0.05). The surgery time, surgery hemorrhage, and hospitalization cost were lower in group A than in group B (P<0.05), except for the hospital stay and drainage time. Fever occurred in 10 patients in group A and 12 patients in group B. The ESR, CRP level, and VAS and ODI scores were significantly decreased, and there were no significant differences between the groups at the final FU. The distribution of bacterial agents in blood culture was 1 case of Aerobacter cloacae, 2 of Staphylococcus aureus, 2 of Escherichia coli, and 1 of Streptococcus viridis in group A and 1 of S. aureus，1 of Staphylococcus warneri and 2 of Klebsiella pneumoniae in group B. Pyogenic infection was observed in the pathological findings of all patients. No significant difference was found in the mean segmental angle or mean intervertebral height preoperation and at the final FU between the groups.Conclusion: The use of LSP as a new bone graft is reliable, safe, and effective for surgical management for the LPD while surgery is proposed as a good management strategy for LPD in carefully selected patients.

scholarly journals The Impact of Preemptive Perianal Anaesthetic Block in Open Haemorrhoidectomy – a randomised controlled trial

2021 ◽  
Vol 15 (9) ◽  
pp. 2165-2167
Author(s):  
Wajeeha I. Andrabi ◽  
M Asadullah Khawaja ◽  
K. Fatima ◽  
S I. Hussain Andrabi ◽  
A. Shafique ◽  
...  
Keyword(s):  
Placebo Group ◽  
Hospital Stay ◽  
Pain Intensity ◽  
P Value ◽  
Open Hemorrhoidectomy ◽  
Group A ◽  
The Mean ◽  
Group B ◽  
The Impact ◽  
Mean Time

Background: the study was conducted to analyze the efficacy of 0.75% ropicaine at perianal block for open haemrrhoidectomy with regards to pain intensity, first demand of analgesia and hospital stay. Method: 50 patients were selected for open haemrrhoidectomy under GA which were divided into two groups.it was a randomized control trial in which sealed envelope method was used for the group delegation in which Group A was designated to the patients having the perianal block with 0.75% ropivacaine while the group B was the placebo group having normal saline injected in the perianal region. The variables compared were the first demand of analgesia, pain intensity and the duration of the hospital stay. In order to make the site of injection more authentic the injections were sited under ultrasound guidance. Results: The pain intensity which was analyzed with the visual analogue score (VAS) had a median of 3.8 (high=6, low=3) in group A while 5.5 (high=8, low=4) in the Group B with the p value of < 0.05. The mean time recorded for the first demand of analgesia was 6.20 ± 1.20 hours in the Group A which had improved from 1.20 ± 1.0 hours in the Placebo Group while the p value was < 0.001, while the mean time of hospital stay got reduced from 22.5±3.30 hours to 12.4 ± 3.10 hours with the significant p value of < 0.002. Conclusion: It was observed that with preemptive analgesia with 0.75% ropivacaine administered led to a substantial reduction in pain perception, request for an analgesic and hospital stay. Therefore it is appropriate to administer it before open hemorrhoidectomy. Keywords: preemptive anaesthesia, local anesthesia, postoperative pain, ropivacaine, open hemorrhoidectomy

scholarly journals HAEMORRHOIDECTOMY;

2017 ◽  
Vol 24 (01) ◽  
pp. 69-74
Author(s):  
Ahsan Nasim ◽  
Marriyum Baig ◽  
Reem Saad
Keyword(s):  
Hospital Stay ◽  
Harmonic Scalpel ◽  
Significant Difference ◽  
Group A ◽  
The Mean ◽  
Randomized Control ◽  
Group B ◽  
Mean Time ◽  
Surgical Unit ◽  
Closed Haemorrhoidectomy

Haemorrhoids are one of the most common anorectal disorders. Internalhaemorrhoids are symptomatic anal cushions and characteristically lie in the 3, 7 and 11 o’clockposition whereas external haemorrhoids relate to venous channels of the inferior haemorrhoidalplexus. Objectives: To compare the outcome of haemorrhoidectomy using harmonic scalpelversus conventional closed haemorrhoidectomy. Study Design: Randomized control trial.Setting: Department of Surgical unit II, Jinnah Hospital, Lahore. Period: Six months from 25thDecember 2014 to 24th June 2015. Methodology: A total of 140 patients were included inthis study. Patients were divided in two groups A & B. In Group A, (70 patients) conventionalhaemorrhoidectomy was performed by the Ferguson Technique (closed technique) whereasin Group B, (70 patients) suture less closed haemorrhoidectomy was performed by using theharmonic scalpel. Results: The mean age of the patients in group A was 43.3±8.2 years andin group B was 42.3±7.3 years. The mean time for surgery in group A was 23.8±4.2 minutesand in group B was 8.5±3.6 minutes. The mean pain score in group A was 5.3±1.8 VAS andin group B was 3.9±1.9 VAS. In group A, less than 1 day postoperative hospital stay was in 62(88.6%) patients and in group B, it was in 66 (94.3%) patients. Conclusions: It is concludedfrom this study that haemorrhoidectomy by harmonic scalpel results in decrease in operationtime and less postoperative pain although there is not much significant difference in less than 1day hospital stay as compared to the conventional closed haemorrhidectomy technique.

scholarly journals A study of the association of leukopenia with disease severity and mortality in patients diagnosed with COVID-19

2020 ◽  
Vol 7 (11) ◽  
pp. 1721
Author(s):  
Anant Parasher ◽  
Vishakha Saini ◽  
Ajay Saini ◽  
Rashmi Ranjan Barik ◽  
Abhinav Aggarwal ◽  
...  
Keyword(s):  
Hospital Stay ◽  
Disease Severity ◽  
Leukocyte Count ◽  
New Delhi ◽  
Blood Cell Count ◽  
Significant Difference ◽  
Group A ◽  
The Mean ◽  
Group B ◽  
Normal Leukocyte

Background: It has been observed in patients suspected with COVID-19 or presenting as confirmed cases of COVID-19 that a decreased total white blood cell count (leukopenia) is quite a common haematological presentation. In this study we aimed to determine the effect of leukopenia on the progress and severity of COVID-19, as well as to establish the association of leukopenia with disease severity and overall mortality.Methods: This was a longitudinal study conducted at Guru Teg Bahadur hospital, New Delhi from 1st July 2020 to 3rd August 2020. A sample size of 34 cases each in two groups (group A and B) was taken as one random case each day for the duration of the study; group A consisting of the patients presenting with leukopenia, while group B comprising of the patients with a normal leukocyte count.Results: The mean duration of hospital stay in group A was found to be 5.5±2.23 days, while the mean duration of stay in group B was found to be 2.9±1.17 days, showing a significant difference in the two groups with a p<0.001. It was also seen that a total of 8 out of 34 cases in group A and 2 out of the 34 cases in group B had expired during their hospital stay; a significant difference seen among the two groups with a p=0.04.Conclusions: Thus, in conclusion, this study demonstrates a definite and significant association between a decreased leukocyte count (leukopenia) and disease severity and mortality in patients with COVID-19.

scholarly journals A comparative evaluation of analgesic effects of using intravenous paracetamol versus intravenous diclofenac post-operatively in laparoscopic cholecystectomy patients in SMIH, department of surgery, Dehradun

2019 ◽  
Vol 6 (5) ◽  
pp. 1716
Author(s):  
Anurag Bijalwan ◽  
Pradeep Singhal ◽  
Syed Altamash
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Side Effects ◽  
Diclofenac Sodium ◽  
Analgesic Efficacy ◽  
Early Mobilization ◽  
P Value ◽  
Significant Difference ◽  
Group A ◽  
The Mean ◽  
Group B

Background: Post-operative adequate analgesia plays an important role in early mobilization, short hospital stay and patient satisfaction in laparoscopic cholecystectomy. The use of opioids for providing postoperative analgesia has been marked by side effects like vomiting, nausea, sedation, respiratory distress, etc. hence, alternate drugs like paracetamol (PCM) and diclofenac are commonly used. In this study, we have compared the analgesic efficacy and any associated side effects of the two commonly used non-opioid NSAIDS namely paracetamol and diclofenac.Methods: We compared 50 patients undergoing laparoscopic cholecystectomy in ASA I and II. They were randomly divided into two groups, Group A and Group B. Group A was administered intravenous PCM and Group B was administered injection diclofenac sodium. Postoperatively, these patients were assessed for pain, blood pressure, respiratory rate, and presence of any side effects like nausea, vomiting or any respiratory discomfort.Results: The mean DBP, MAP and VAS score was significantly (p-value <0.05) in Group A as compared to Group B patients at 4, 8, 12 and 24 hours postoperatively. There was no statistically significant difference in mean SBP and O2 saturation in both groups. The mean pulse rate was lower in Group A as compared to Group B at 8, 12 and 24 hours.Conclusions: This study concluded that postoperative PCM infusion provided better analgesia for a prolonged period of time with minimal side effects. 

scholarly journals Retrospective Study of Three-port versus Standard Four-port Laparoscopic Cholecystectomy: A Single Surgical Unit Experience of 1456 Patients

2020 ◽  
Author(s):  
Vivek Srivastava ◽  
Mumtaz Ahmad Ansari ◽  
Vijay Kumar Shukla ◽  
Somprakas Basu
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Postoperative Complications ◽  
Hospital Stay ◽  
Postoperative Period ◽  
Conversion Rate ◽  
Operating Time ◽  
Chronic Cholecystitis ◽  
Early Recovery ◽  
Significant Difference ◽  
The Mean

Introduction: Although laparoscopic surgeries have proven beyond doubt their benefit in terms of early recovery, better patient care and cost-effectiveness, the quest for reduction in either the size or number of ports still continues. Aim: To compare the safety, outcome, and advantages between three-port versus four-port Laparoscopic Cholecystectomy (LC) in acute and chronic cholecystitis. Materials and Methods: Medical records of 1456 patients that underwent LC (three- or four-port) for acute and chronic cholecystitis from January 2015 to December 2019 (60 months) were retrospectively analysed. All patients were given the same anaesthetic drugs for induction and maintenance, with standard anaesthetic protocol. The results were compared for both the techniques in terms of operating time, conversion rate, intraoperative complications, immediate postoperative complications, pain score, analgesic requirement and hospital stay. Results: Total 1456 patients underwent LC; 1282 were female and 174 were male. The mean age of the patients was 39.2 years (range 18-70 years). The three-port LC technique was performed on 816 (56.04%) patients, while the traditional four-port LC technique was performed on 640 (43.96%) patients. Visual Analog Score (VAS) in the postoperative period at six hour was 2.11±0.82 in three-port group versus 3.17±1.12 in four-port group, this suggests that there was a significant difference in pain in these two groups in the early postoperative period (p<0.001). In three-port group, the requirement of analgesic drug was significantly less as compared to four-port group (2.86±0.98 versus 3.22±0.87; p<0.001). There was no statistically significant difference in the mean operating time, duration of hospital stay, intra and postoperative complications, days to return to normal activity, satisfaction score and conversion rate (p=0.087, p=0.061, p=0.578, p=0.555, p=0.572 and p=0.145, respectively). Conclusion: Three-port LC is a feasible, effective and safe technique that further enhances the surgical outcome in terms of postoperative pain, fewer needs for analgesic medication.

scholarly journals Comparative study of peri-operative outcome following laparotomy versus laparoscopic technique of abdominal hysterectomy for benign gynaecological lesions

2018 ◽  
Vol 7 (6) ◽  
pp. 2270
Author(s):  
Satyajit P. Gavhane ◽  
Dhruval K. Bhavsar ◽  
Vidyadhar B. Bangal ◽  
Swati D. Gagare ◽  
Amey R. Kodlikeri
Keyword(s):  
Urinary Bladder ◽  
Hospital Stay ◽  
Laparoscopic Hysterectomy ◽  
Abdominal Hysterectomy ◽  
Laparoscopic Technique ◽  
Duration Of Surgery ◽  
Group A ◽  
The Mean ◽  
Group B ◽  
The Impact

Background: Laparoscopic technique of hysterectomy is becoming increasingly popular in developing and developed world. Laparoscopic hysterectomy is a minimal access procedure that allows patients to recover faster. The study was undertaken to assess the impact of two abdominal techniques (laparoscopic and conventional laparotomy) on various variables like operative time, hospital stay, complications and convalescence period.Methods: An observational longitudinal study was carried out at tertiary care centre. Two hundred and ten women, as per inclusion and exclusion criteria, who had undergone abdominal hysterectomy for benign uterine pathology, either by laparotomy (Group A) or by laparoscopic technique (Group B) during study period were included. Data was analyzed and compared by using different variables between two methods of hysterectomy, using percentages and Chi square test for normal distribution. P value less than 0.05 was considered significant.Results: The mean duration of surgery was 100 minutes in group A and 175 minutes in Group B. There were two cases (1.90%) of minor injury to urinary bladder in Group A and one case (0.95%) of thermal injury to urinary bladder in Group B. The mean blood loss was around 240 ml and 70 ml in Group A and B respectively. The need for postoperative analgesia was observed in 100% cases from Group A and 38.09% from group B. The average duration required for out of bed ambulation was 25 hours and 14 hours in Group A and B respectively. The mean hospital stay in group A and B was 7.5 days and 3.5 days respectively.Conclusions: Following laparoscopic hysterectomy, women had less morbidity, less need for post-operative pain relief, had early ambulation, short hospital stay and early resumption of routine activities at home as compared to women who had undergone abdominal hysterectomy by conventional method.

The Outcome Comparison of two Groups of total Extraperitoneal and Mesh Repair of Inguinal Hernia

2021 ◽  
Vol 15 (10) ◽  
pp. 2712-2714
Author(s):  
Muhammad Aamir Jamil ◽  
Muhammad Asif ◽  
Imran Yousaf ◽  
Muhammad Faheem Anwer ◽  
Muhammad Waseem Anwar
Keyword(s):  
Inguinal Hernia ◽  
Hospital Stay ◽  
Recovery Time ◽  
Mesh Repair ◽  
Operative Procedure ◽  
Total Extraperitoneal ◽  
Outcome Comparison ◽  
Group A ◽  
The Mean ◽  
Group B

Aim: The outcome comparison of total extraperitoneal versus mesh repair for inguinal hernia. Study design: Quasi experimental study. Place and duration of study: Department of Surgery, M. Islam Teaching Hospital, Gujranwala from March 2018 to March 2019. Methodology: After the approval of hospital ethical committee, a total of 50 patients were included and randomly divided into two groups equally. Group A (Total extraperitoneal), Group B (Mesh repair). An informed consent was taken from every patient about operative procedure and the outcome. A detailed history of the patient i.e. clinical examination, routine investigations (CBC, Urine R/E, urea, creatinine) and some specific investigations (chest X-ray, ECG and ultrasound abdomen and prostate) was done for surgery. All data of patients was collected on proforma and was analyzed with the help of a computer SPSS programme 20. Results: The mean age of patients was 34.22±11.54 years in group A and 35.63±11.25 years in group B. All male and female patients included in this study in both groups. Twelve (48%) of patients were direct inguinal hernia in group A 13(22%) were in group B and 14(56%) patients were in group A and 11(44%) patients were in group B. The mean±SD postoperative hospital stay was 24.48±4.62 in group A and 34.65±12.26 hours in group B (p 0.001). The mean±SD postoperative recovery time in weeks was 2.18±0.43 in group A and 2.90±0.46 weeks in group B (p 0.001). Only 2 (4%) patient had postoperative infection on first week and 4 (8%) patients had infection respectively. No recurrence was seen in group A and only 3% recurrence was in group B. Conclusion: It is concluded that group A had shorter hospital stay, recovery time, postoperative time and less infection rate as compared to group B. In group A 13% patients had severe pain and in group B 25% patients. Keywords: Inguinal Hernia, Total extraperitoneal, Mesh repair.

Risk of Damaging Anatomical Structures During Minimally Invasive Hallux Valgus Correction (Bösch Technique): An Anatomical Study

2018 ◽  
Vol 39 (11) ◽  
pp. 1355-1359 ◽  
Author(s):  
Martin Kaipel ◽  
Lukas Reissig ◽  
Lukas Albrecht ◽  
Stefan Quadlbauer ◽  
Joachim Klikovics ◽  
...  
Keyword(s):  
Minimally Invasive ◽  
Hallux Valgus ◽  
Complication Rate ◽  
Metatarsal Osteotomy ◽  
Anatomical Structures ◽  
Intensive Training ◽  
Increased Risk ◽  
Significant Difference ◽  
Group A ◽  
Group B

Background: Percutaneous, transverse distal metatarsal osteotomy with K-wire fixation (the Bösch technique) is an established technique for hallux valgus correction. Nevertheless, the risk of damaging the anatomical structures during the operation is unknown. Methods: Forty fresh-frozen anatomical foot specimens with hallux valgus deformity underwent a percutaneous corrective procedure. Specimens of group A (n = 20) were operated by an experienced surgeon while specimens of group B (n = 20) were done by untrained residents. Results: The dorsal cutaneous nerve was injured in 1 of 20 cases in group A and 6 of 20 cases in group B ( P = .037). There was a significant difference in overall complication rate between specimens of group A and group B ( P = .043). Conclusions: The results show an increased risk of perioperative injury of the dorsal cutaneous branch of the deep peroneal nerve as well as a significant effect of the surgeon’s experience on the overall complication rate. Clinical Relevance: Results of this study are highly relevant for all surgeons who perform percutaneous, minimally invasive hallux valgus surgery to avoid damage to the peripheral nerves. In addition, the data suggest an intensive training for surgeons before minimally invasive hallux valgus surgery is performed without supervision.

scholarly journals Comparison Between With Kirschner-wires Only And Combined Screw Fixation in Proximal Reverse Chevron osteotomy(PCMO) For Hallux Valgus Deformity

2017 ◽  
Vol 2 (3) ◽  
pp. 2473011417S0002
Author(s):  
Hwa Jun Kang ◽  
Hong-Geun Jung ◽  
Jong-Soo Lee ◽  
Sungwook Kim ◽  
Mao Yuan Sun
Keyword(s):  
Hallux Valgus ◽  
Screw Fixation ◽  
Fixation Method ◽  
Kirschner Wires ◽  
Significant Difference ◽  
Group A ◽  
The Mean ◽  
Group B ◽  
Severe Hallux Valgus

Category: Bunion Introduction/Purpose: Kirschner-wires fixation, sometimes we have encountered pin irritation or pull-out. This is the reason why we consider additional fixation. Moreover, there are few reports according to comparison of fixation method, and Most of them focused on comparison K-wires or screw fixation only. Purpose of study is to compare clinical and radiographic outcome between Kirschner-wires only and combined screw fixation. Methods: The study included two different groups according to fixation methods. One with Kirschner-wires fixation (KW group) included 117 feet(of 98 patients), the other with combined screw fixation (KWS group) 56 feet (of 40 patients) with moderate to severe hallux valgus. Clinically, the preoperative and final follow-up visual analog scale (VAS) pain scores, the preoperative and final follow-up American Orthopaedic Foot & Ankle Society (AOFAS) hallux metatarsophalangeal (MTP)-interphalangeal (IP) scores, and patient satisfaction after the surgery were evaluated. Radiographically, the hallux valgus angle (HVA), intermetatarsal angle (IMA), medial sesamoid position (MSP), and first to fifth metatarsal width (1-5MTW) were analyzed before and after surgery. Results: The mean AOFAS score improved preoperative 65.5 to 95.3 at final follow up in group A, while preoperative 56.5 to 88.6 at final follow up. Pain VAS decreased from 5.7 to 0.5 in group A, whereas from 6.2 to 1.6 in group B. The mean HVA all improved from preoperative 38.5 to 9.3 at final follow up in group A and 34.7 to 9.1 in group B. The mean IMA and MSP also improved significantly at final follow up. In comparative analysis, the IMA did not show significant difference between postoperative and final state in group A, while showed significant increase in group B. Conclusion: We achieved favorable clinical and radiographic outcomes with minimal complications in patient with moderate to severe hallux valgus in both groups. However, this study shows no statistically significant difference in IMA during follow-up period and lower recurrence rate. Therefore we need to consider combined fixation method to provide better stability and can expect lower recurrence rate.

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