scholarly journals LAPAROSCOPIC AND OPEN APPENDECTOMY

2016 ◽  
Vol 23 (11) ◽  
pp. 1305-1310
Author(s):  
Nawaz Ali Dal ◽  
Qamber Ali Lighari ◽  
Zameer Hussain Laghari
Keyword(s):  
Postoperative Pain ◽  
Hospital Stay ◽  
Laparoscopic Appendectomy ◽  
Iliac Fossa ◽  
Open Appendectomy ◽  
Normal Activity ◽  
University Hospital ◽  
Rebound Tenderness ◽  
Co Morbidity ◽  
The Mean

Objectives: Objectives of this study are to compare the outcome of thelaparoscopic with open appendectomy in terms of postoperative pain, postoperativecomplications and hospital stay. Study Design: Randomized control trial. Place and Periodof Study: This study was held in Surgical Unit-III, Liaquat University Hospital Jamshoro, fromSeptember 2013 to March 2014. Methodology: This study comprised of sixty patients admittedvia outpatient department, and also through casualty department of LUHMS Jamshoro/Hyderabad. Cases were categorized into 2 groups. Group-A for open appendectomy andgroup-B for laparoscopic appendectomy. Comprehensive History was obtained from eachpatient. Right iliac fossa site was particularly assessed for tenderness assessment at Mc: Burney’spoint rigidity rebound tenderness and documented through proforma. A comprehensive reviewwas as well performed to observe any co-morbidity. Inclusion criteria comprised of all thosepatients of acute appendicitis who give written consent for study after counseling, irrespectiveof their age and sex. Criteria for exclusion included each patient with aspects of specifiedperitonitis, cases with obvious mass within right iliac fossa as well as cases with pre-operativehistory of lower abdomen or caesarean section. Outcomes were documented in the term ofterms of postoperative pain, postoperative complications and hospital stay and recorded onPerforma. Data analyzing was carried out with SPSS software. Results: From totally 60 casesin our study 40 patients males (66.67%) and 20 were females (33.33%); with female to maleproportion of 1:3. There was an extensive variation in age from 10 to 70 years among bothgroups. The mean age was 26.78 years. Both groups were symptomatically nearly similar withpain in RIF, pain initiating around umbilicus, nausea, vomiting, anorexia, fever, and modifiedbowel behavior, in 59 (98.33%), 45 (75%), 50 (83.33%), 35 (58.33%), 25 (41.67%), 22 (36.67%),20 (33.33%) respectively. Clinical assessment of cases exposed tenderness at Mc Burney’spoint in 59 (98.33%) cases, muscle guarding in 52 (86.67%) cases, rebound tenderness in55 (91.67%) cases and fever in 20 (33.33%) patients. Operative period in each group wasdocumented that ranged from 30 to 90 min. in each group. The mean operative period in OAgroup was 38.90+15.90 where as it was 26.30+12.96 minutes LA group. Post-operative painseverity in each group was documented. Mild pain was found in 5(16.67%) in OA group casesand 21 (70%) in LA group cases was noted, moderate pain in 22(73.33%) OA group casesand 9(30%) LA group cases was noted, severe pain was described by 3 (10%) patients in OA.The period of return to normal activity in open appendectomy ranged from 7-25 days (mean14.8 days) as contrasted to laparoscopic appendectomy (LA) group where it varied from 7-15days. Conclusion: In conclusion, we exhibited that LA has significant

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.

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 COMPLICATED APPENDICITIS;

2017 ◽  
Vol 24 (01) ◽  
pp. 82-88
Author(s):  
Awais Shuja ◽  
Professor M Ramzan ◽  
Nadia Sharif
Keyword(s):  
Hospital Stay ◽  
Laparoscopic Appendectomy ◽  
Operating Time ◽  
Open Appendectomy ◽  
Complicated Appendicitis ◽  
Open Approach ◽  
Number Of Patients ◽  
Analgesia Requirement ◽  
Group A ◽  
The Mean

Appendectomy is the most common surgical procedure performed in surgicalemergency. The advent of minimal invasive surgery has massively influenced the field of surgery.Laparoscopic surgery might offer clinical benefits in perforated and complicated appendicitis.Objective: To compare laparoscopic appendectomy and open appendectomy as treatment ofcomplicated appendicitis in terms of mean requirement of post-operative analgesia, operativetime and hospital stay. Study design: Randomized control trial. Setting: All subjects for thestudy were recruited from Department of Surgery, Independent University Hospital, Faisalabad.Duration: The duration of study was of 6 months duration from February 2012 to august 2012.Results: In this study the divided into two groups, group A for open appendectomy (OA)and group B for Laparoscopic Appendectomy (LA). Both groups had 43 patients each. Theoperating time for open appendectomy group A had mean operating time 37.21 minutes .Thehospital stay in OA group was 2.63 days. The mean dosage of analgesia requirement was 258mg of diclofenac. The operating time for open appendectomy group A had mean operatingtime 39.16 minutes. The hospital stay in OA group was 2.95 days. The mean dosage of was258.14 mg of diclofenac. Conclusion: Our study concludes that both approaches laparoscopicand open approach have proved to be similar in terms of post-operative hospital stay, operatingtime and analgesia requirement. Where as LA is superior in terms of cosmesis and surgicalsite infection. Further studies with more number of patients are recommended to asscess thebenefits of laparoscopic approach in complicated appendicitis.

scholarly journals Comparative Study of Surgical Site Infection between Laparoscopic Appendectomy and Open Appendectomy

2017 ◽  
Vol 29 (1) ◽  
pp. 6-11
Author(s):  
Md Salim ◽  
Jashim Uddin Ahmed ◽  
Nur Hossain Bhuyian ◽  
Mahmudur Rahman ◽  
Monirul Alam ◽  
...  
Keyword(s):  
Postoperative Pain ◽  
Surgical Site Infection ◽  
Hospital Stay ◽  
Laparoscopic Appendectomy ◽  
Open Appendectomy ◽  
Length Of Hospital Stay ◽  
Postoperative Recovery ◽  
Wound Infection Rate ◽  
Site Infection ◽  
College Hospital

Surgical site infection (SSI) is defined as infection at surgical site within 01 month after surgery (or within a year in case of implant). Surgical-site infection requires microbial contamination of the surgical wound to occur. LA provides considerable benefits over OA, including a shorter length of hospital stay, less postoperative pain, earlier postoperative recovery, and a lower complication rate. This was a prospective observational study conducted inpatient department of Chittagong Medical College Hospital and private hospitals and clinics in Chittagong city. The patients were interviewed face to face by the researcher for the purpose of collection of data and were examined by the researcher for certain signs recorded in the fixed protocol. Collected data was classified, edited, coded and entered into the computer for statistical analysis by using SPSS-22. Out of 200 cases mean age was found 33.76 ± 23.35 years in OA group and 32.21 ± 16.51 years in LA group. Male was found 58% in OA group and 53% in LA group. Female was found 42% and 47% in OA and LA group respectively. Mean operative time was found 41.2±8.5 minutes in OA group and 49.3±8.9 minutes in LA group. Alternate pathology were more frequently detected in LA due to wide area of vision. Superficial incisional SSI was found 10% in OA group and 5% in LA group. Deep incisional SSI was found 2% in OA group and 2% in LA group. Organ/space SSI was 2% and 3% in OA group and LA group respectively. Staphylococcus aureus is the commonest organism isolated form the surgical wounds from 41.34% followed by Pseudomonas 21.26%, no growth 11.1%, E.coli 9.6%, others 9.4%, Klebsiella 7.0%. Laparoscopic appendectomy was better than open appendectomy with respect to wound infection rate, postoperative pain, postoperative hospital stay and return to normal activities.Medicine Today 2017 Vol.29(1): 6-11

EVALUATION OF LONGO’S HEMORRHOIDECTOMY AT HUE UNIVERSITY HOSPITAL

2012 ◽  
pp. 79-85
Author(s):  
Van Lieu Nguyen ◽  
Doan Van Phu Nguyen ◽  
Thanh Phuc Nguyen
Keyword(s):  
Hospital Stay ◽  
Perioperative Complications ◽  
University Hospital ◽  
Anal Pain ◽  
Stapled Hemorrhoidectomy ◽  
Fourth Degree ◽  
Duration Of Hospital Stay ◽  
The Mean ◽  
Good For

Introduction: Since Longo First described it in 1998, Stapled Hemorrhoidectomy has been emerging as the procedure of choice for symtomatic hemorrhoid. Several studies have shown it to be a safe, effective and relative complication free procedure. The aim of this study was to determine the suitability of (SH) as a day cas procedure at Hue University Hospital. Methods: From Decembre 2009 to April 2012, 384 patients with third- degree and fourth-degree hemorrhoids who underwent Stapled Hemorrhoidectomy were included in this study. Parameters recorded included postoperative complications, analegic requirements, duration of hospital stay and patient satisfaction. Follow-up was performed at 1 month and 3 months post-operative. Results: Of the 384 patients that underwent a Stapled Hemorrhoidectomy 252 (65,7%) were male and 132 (34,3%) were female. The mean age was 47,5 years (range 17-76 years. Duration of hospital stay: The mean day was 2,82 ± 1,15 days (range 1-6 days). There were no perioperative complications. There was one case postoperative complication: hemorrhage; Follow-up after surgery: 286 (74,4%) patients had less anal pain, 78 (20,3%) patients had moderate anal pain, 3 (0,8%) patients had urinary retention; Follow-up after one month: good for 325 (84,6%) patients, average for 59 (15,4%) patients; Follow-up after three months: good for 362 (94,3%) patients, average for 22 (5,7%) patients. Conclusion: Our present study shows that Stapled Hemorrhoidectomy is a safe, reduced postoperative pain, shorter hospital stay and a faster return to unrestricted daily activity

EARLY RESULTS OF SINGLE-PORT LAPAROSCOPIC APPENDECTOMY

2017 ◽  
pp. 103-106
Author(s):  
Minh Duc Pham
Keyword(s):  
Laparoscopic Appendectomy ◽  
Single Port ◽  
Operation Time ◽  
Invasive Procedure ◽  
Minimal Invasive ◽  
University Hospital ◽  
Early Results ◽  
Sils Port ◽  
The Mean ◽  
A New Technique

Background: Conventional three–port laparoscopic appendectomy is becoming popular for the treatment of acute appendicitis. In this report, we present the early results of a new technique of laparoscopic appendectomy conducted through a single-port. Patients and Methods: From March 2011 to October 2013, we have performed 86 operations Single Port Laparoscopic Appendectomy at Hue University Hospital and Hue Central Hospital. SILS Port (Covidien) is used, it can be performed with basic laparoscopic instruments. Results: In this study, 86 patients underwent Single-Port laparoscopic appendectomy, among them 52.33% were femele, 47.67% were male, female/male ratio was 1.09. The mean age was 33.09. An orther trocar insertion was required in 2 patients (2.33%). The mean operation time was 42.03 minutes and mean postoperative hospital stay 3.37 days. Postoperative complication occurred in 2 case (2.33%) was of omphalitis. During 2 weeks follow up, 2 case (2.33%) was of omphalitis. Conclusions: Single - port intracorporeal appendectomy is a safe, minimal invasive procedure with excellent cosmetic results. Key words: Single Port Laparoscopic Appendectomy, appendectomy

scholarly journals Intravenous paracetamol vs. ketoprofen for pain management after the abdominal aortic surgery – pharmacokinetics and therapeutics

2016 ◽  
Vol 85 (4) ◽  
pp. 254-263
Author(s):  
Jowita Rosada-Kurasińska ◽  
Alicja Bartkowska-Śniatkowska ◽  
Agnieszka Bienert ◽  
Małgorzata Grześkowiak ◽  
Paweł Sobczyński ◽  
...  
Keyword(s):  
Plasma Concentration ◽  
Postoperative Pain ◽  
Aortic Surgery ◽  
Venous Pressure ◽  
Intensive Therapy ◽  
University Hospital ◽  
Abdominal Aortic Surgery ◽  
Abdominal Aortic ◽  
Intravenous Paracetamol ◽  
The Mean

Introduction. Acute postoperative pain continues to be a dilemma to patients and clinicians.Aim. To define the efficacy, tolerability and pharmacokinetics of paracetamol and ketoprofen in patients after the abdominal aortic surgery. Setting and design in University hospital – intensive therapy unit (clinical part), clinical pharmacy and biopharmacy unit (biochemical part), and pharmaceutical company (statistical part). Prospective randomized study.Material and Methods. 40 adult patients (50–84 years) undergoing abdominal aortic surgery were randomized equally into two groups. After extubation the patients in group 1 (G1) were administered a 1 g paracetamol infusion, and in group 2 (G2) – a 100 mg ketoprofen infusion, both within 15 minutes. All the patients received an epidural infusion of bupivacaine with fentanyl. The following parameters were recorded: mean arterial pressure (MAP), heart rate (HR), central venous pressure (CVP), plasma concentration of paracetamol and ketoprofen. Postoperative pain was assessed with the visual analogue scale (VAS).Results. The mean values of the MAP, HR and CVP were within normal limits in the both groups. No significant differences were noticed in the assessment of postoperative pain and total use of an opioid. The mean therapeutic plasma concentration of paracetamol and ketoprofen remained up to 180 minutes and up to 120 minutes, respecively.Conclusions. The study enabled us to conclude that intravenous paracetamol as well as ketoprofen have good effectiveness and tolerability. There is no need to modify dosage of these drugs to elderly patients. After paracetamol infusion the therapeutic plasma concentration remains longer than after the ketoprofen infusion.

scholarly journals Effects of the COVID-19 Pandemic on the Epidemiology of Knee and Shoulder Arthroscopy

2021 ◽  
Vol 58 ◽  
pp. 004695802110560
Author(s):  
Krystian Kazubski ◽  
Łukasz Tomczyk ◽  
Piotr Morasiewicz
Keyword(s):  
Hospital Stay ◽  
Shoulder Arthroscopy ◽  
Demographic Data ◽  
Epidemiological Data ◽  
University Hospital ◽  
Female Ratio ◽  
Duration Of Hospital Stay ◽  
The Mean ◽  
Orthopedic Patients ◽  
Male To Female

The purpose of our study was to comprehensively assess the effect of the COVID-19 pandemic on knee and shoulder arthroscopy performed in an orthopedic department of a university hospital in Poland. This study compared the data on all shoulder and knee arthroscopy procedures performed in two different periods: The period of the COVID-19 pandemic in Poland (from March 4, 2020, to October 15, 2020) and the corresponding period prior to the pandemic (March 4, 2019, to October 15, 2019). The study evaluated epidemiological data, demographic data, and hospital stay duration. The total number of arthroscopy procedures conducted in the evaluated period in 2020 was approximately 8.6% higher than that in the corresponding 2019 period. The mean duration of hospital stay for orthopedic patients after their knee or shoulder arthroscopy was 3.1 days in 2020 and 2.8 days in 2019. Our study revealed the mean age of arthroscopy patients during the pandemic to be lower at 48.4 years than the 51.2 years recorded in 2019. The male-to-female ratio was shown to be lower at .85 during the pandemic, having decreased from 1.5 in 2019. The COVID-19 pandemic did not reduce the number of arthroscopy performed at our center, and the mean age of the patients did not change. However, the pandemic had a marked effect on the mean duration of hospital stay and male-to-female ratio.

scholarly journals Outcomes of Retrograde Intra-Renal Surgery

2019 ◽  
Vol 2 (2) ◽  
pp. 220-223 ◽  
Author(s):  
Samir Shrestha ◽  
Pukar Maskey
Keyword(s):  
Postoperative Pain ◽  
Hospital Stay ◽  
Renal Stone ◽  
Operative Time ◽  
Renal Calculi ◽  
Renal Surgery ◽  
Surgical Morbidity ◽  
Retrograde Intrarenal Surgery ◽  
Stone Clearance ◽  
The Mean

Introduction: Miniaturization of endoscopic instruments has gained wide popularity in the treatment of renal calculi. Retrograde intra-renal surgery and holmium laser in combination has already proven its superiority when compared to other modalities in the treatment of renal calculi. This study was conducted to assess the outcome of retrograde intra-renal surgery in renal stone disease.Materials and Methods: This retrospective study analyzed the outcome of retrograde intra-renal surgery in renal stone less than 2 cm size in the adults above 18 years of age from September 2018 to August 2019 at Patan Hospital, Nepal. The outcome was assessed descriptively on postoperative pain and fever, stone localization, stone size, stone clearance, urosepsis, operative time, hospital stay, mortality, need of the second procedure.Results: A total of 62 patients underwent retrograde intrarenal surgery, out of which 48 cases were included. The mean age of the study population was 32.4± 14 years (19-68 years). Similarly, the mean operative time was 68± 12 (48-124 minutes) and mean hospital-stay was 3.2± 1.1 days. Postoperative pain and fever were observed in 14 (29.16%) & 4(8.33%) patients respectively. Hematuria occurred in 6(12.50%) and urosepsis in 2(4.16%) of the patients. Complete stone clearance was achieved in 34(70.83%) and residual stones were present in 8(16.66%) and clinically insignificant radiological fragments were present in 6(12.50%) patients.Conclusions: Retrograde intrarenal surgery is a technically safe and effective procedure for the treatment of renal calculi, with minimal post-surgical morbidity.

Changes in Incidence and Management of Acute Appendicitis in Children—A Population-Based Study in the Period 2000–2015

2020 ◽  
Author(s):  
Grith Laerkholm Hansen ◽  
Jakob Kleif ◽  
Christian Jakobsen ◽  
Anders Paerregaard
Keyword(s):  
Acute Appendicitis ◽  
Hospital Stay ◽  
Laparoscopic Appendectomy ◽  
Pediatric Population ◽  
Open Appendectomy ◽  
Postoperative Mortality ◽  
Population Based ◽  
Postoperative Hospital Stay ◽  
Population Based Study ◽  
Registration System

Abstract Introduction Recent studies suggest that the epidemiology and management of appendicitis have changed during the last decades. The purpose of this population-based study was to examine this in the pediatric population in Denmark. Materials and Methods Data were retrieved from the Danish National Patient Registry, the Danish Civil Registration System, and the Statbank Denmark. Patients aged 0 to 17 years diagnosed with appendicitis and appendectomized during the period 2000 to 2015 were included. The primary outcome was the annual incidences of appendicitis. Secondary outcomes were the annual percent of patients with appendicitis having a laparoscopic appendectomy, delay from admission to surgery, length of postoperative hospital stay, and 30-day postoperative mortality. Results A total of 24,046 pediatric cases of appendicitis were identified. The annual incidence steadily declined until 2008 (–29%, all ages) and then remained stable. The surgical approach of choice changed from being open appendectomy in 2000 (97%) to laparoscopic appendectomy in 2015 (94%). Simultaneously, the duration of postoperative hospital stay declined from 41 hours (median) to 17 hours. Delay from admission until surgery did not change during the period. Only one child died within the 30-day postoperative period. Conclusion In accordance with other recent studies from Western countries, we found significant changes in the incidence of acute appendicitis including a decline in all age groups except those below 5 years of age, a shift toward laparoscopic appendectomy, and decreasing time spent in the hospital during the years 2000 to 2015.

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