Comparison of outcome of Sutureless Thyroidectomy by Ligasure small jaw verses conventional technique.

Background: Thyroid is a highly vascular gland and hemostasis is a key limiting factor in morbidity and mortality in thyroid surgery. Hemostasis has always been a challenge and various techniques have been used. Vessel sealers like Ligasure are now gaining popularity. Objectives: The objective of this study is to compare thyroidectomy by Ligasure with conventional technique in terms of mean operative time and post-operative blood loss. Study Design: It is a Randomized Control Trial. Setting: Surgical Department of Allied Hospital Faisalabad. Period: Six months (March 2017 to August 2017). Material & Methods: After approval of study from ethical review committee and informed consent, the patients were subjected to complete history and clinical examination in addition to baseline investigations. Total 135 patients of multinodular goiter (MNG) and euthyroid were divided in two groups by simple random sampling. All surgeries were performed under general anesthesia with orotracheal intubation and procedure offered to each patient was subtotal thyroidectomy. Both techniques were compared by measuring the time from opening of pretracheal fascia till its closure in minutes by stop watch and mean was calculated. Post operative blood loss was measured in graduated drain placed in thyroid bed for 24 hours. Results: Mean operative time was recorded as 62.11+4.07 minutes in Ligasure technique group and 73.05+4.01 minutes in conventional technique group. Mean blood loss was recorded as 57.28+3.42 ml in Ligasure technique group and 70.85+4.12 ml in conventional technique group. Conclusion: We concluded that mean operative time and post operative blood loss is significantly lower in cases undergoing thyroidectomy with Ligasure as compared to conventional technique.

Download Full-text

Comparison of surgical outcomes of Ultrasonic technique (Harmonic Focus™) with Conventional technique in open hemithyroidectomy

Journal of Kathmandu Medical College ◽

10.3126/jkmc.v2i4.11774 ◽

2014 ◽

Vol 2 (4) ◽

pp. 175-180

Author(s):

Deepak Regmi ◽

Toran KC ◽

Meera Bista ◽

Sangita Shrestha

Keyword(s):

Blood Loss ◽

Hospital Stay ◽

Surgical Outcomes ◽

Operative Time ◽

Conventional Technique ◽

Ultrasonic Technique ◽

Operative Blood Loss ◽

Incision Size ◽

Post Operative Pain ◽

Harmonic Focus

Background: The option for dissection and haemostasis during thyroid surgery include either the modern ultrasonic technology (Harmonic Focus™) or the conventional technique using knot and ties, monopolar or bipolar electrocautery. Comparison between the surgical outcomes of open hemithyroidectomy using these two modalities was done.Objective: To compare the surgical outcomes of ultrasonic technique using Harmonic Focus™ (HS) with Conventional technique (CT) in open hemithyoidectomy.Method: Twenty consecutive patients undergoing open hemithyroidectomy for benign solitary thyroid nodule of ≤ 3 cm were randomly assigned into two groups; group HS (n=10) and group CT (n=10). Analysis of surgical outcomes performed by these two techniques, particularly: operative time, intra-operative blood loss, post operative pain, incision size, complications and hospital stay were done.Results: The age, sex and pathologies were comparable in both the groups. For the group HS, mean operative time was (mean ± SD=55 ± 5 min) 15 minutes shorter than group CT (mean ± SD= 70 ± 10 min) (P<0.01). Mean operative blood loss was (mean ± SD=20 ±10 ml) 16 ml less in group HS than CT (mean ± SD= 36 ±12 ml) (P<0.01). The group HS experienced less post operative pain (mean ± SD=4 ± 0.94 VAS) than CT (mean ± SD= 7 ± 0.81 VAS) (P<0.001). The incision size at the time of skin closure was 1.6 cm shorter in group HS ((mean ± SD= 3.95 ±0.61 vs. 5.5 ± 0.78cm) (P<0.01). Hospital stay (mean ± SD= 2.30 ± 0.48 vs. 4.20 ±0.42 days) was statistically significant (P<0.01) in group HS than CT. There were no major complications.Conclusion: In patients undergoing open hemithyroidectomy, HS is a faster, better cosmetic, safe and less morbid tool than CT. Its use reduces operative time, blood loss, post operative pain, scar size, along with hospital stay.DOI: http://dx.doi.org/10.3126/jkmc.v2i4.11774 Journal of Kathmandu Medical CollegeVol. 2, No. 4, Issue 6, Oct.-Dec., 2013Page: 175-180

Download Full-text

Nonstructural bone graft for single-segment lumbar tuberculosis: surgical indications, clinical efficacy, and preliminary experiences in 34 patients

Journal of International Medical Research ◽

10.1177/0300060520982780 ◽

2021 ◽

Vol 49 (1) ◽

pp. 030006052098278

Author(s):

Xing Du ◽

Yunsheng Ou ◽

Guanyin Jiang ◽

Yong Zhu ◽

Wei Luo ◽

...

Keyword(s):

Blood Loss ◽

Hospital Stay ◽

Bone Graft ◽

Cobb Angle ◽

Clinical Efficacy ◽

Operative Time ◽

Bone Grafts ◽

Surgical Indications ◽

Operative Blood Loss ◽

The Mean

Objective This study was performed to evaluate the surgical indications, clinical efficacy, and preliminary experiences of nonstructural bone grafts for lumbar tuberculosis (TB). Methods Thirty-four patients with lumbar TB who were treated with nonstructural bone grafts were retrospectively assessed. The operative time, operative blood loss, hospital stay, bone graft fusion time, erythrocyte sedimentation rate (ESR), C-reactive protein (CRP) concentration, visual analog scale (VAS) score, Oswestry Disability Index (ODI), American Spinal Injury Association (ASIA) impairment grade, and Cobb angle were recorded and analyzed. Results The mean operative time, operative blood loss, hospital stay, Cobb angle correction, and Cobb angle loss were 192.59 ± 42.16 minutes, 385.29 ± 251.82 mL, 14.91 ± 5.06 days, 9.02° ± 3.16°, and 5.54° ± 1.09°, respectively. During the mean follow-up of 27.53 ± 8.90 months, significant improvements were observed in the ESR, CRP concentration, VAS score, ODI, and ASIA grade. The mean bone graft fusion time was 5.15 ± 1.13 months. Three complications occurred, and all were cured after active treatment. Conclusions Nonstructural bone grafts may achieve satisfactory clinical efficacy for appropriately selected patients with lumbar TB.

Download Full-text

Intravenous Carbetocin to decrease blood loss during open myomectomy: a randomized placebo-controlled study

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20175827 ◽

2017 ◽

Vol 7 (1) ◽

pp. 27

Author(s):

Hany F. Sallam ◽

Nahla W. Shady

Keyword(s):

Placebo Group ◽

Blood Loss ◽

Operative Time ◽

Uterine Leiomyomas ◽

Reproductive Age ◽

Controlled Study ◽

Benign Tumors ◽

Operative Blood Loss ◽

Abdominal Myomectomy ◽

To Receive

Background: Uterine leiomyomas are benign tumors of the uterus, which represent the most common neoplasms in women of reproductive age, and have a lifetime incidence of approximately 70% in the general population. The objective of this study was to assess the effect of using a single pre-operative dose of IV 100 μg Carbetocin on intra-operative blood loss in abdominal myomectomy surgeries.Methods: In a randomized double-blind placebo-controlled trial, 86 women undergoing abdominal myomectomy for symptomatic uterine leiomyomas were randomly assigned to receive a single dose of pre-operative of IV 100 μg Carbetocin (n = 43) or placebo (n = 43) just before the operation. The primary outcome was intra-operative blood loss.Results: Intra-operative blood loss was significantly lower in those women randomized to receive IV Carbetocin versus the placebo group (714.19±186.27 ml versus 1033.49±140.9 ml), p = 0.0001 The incidence of blood transfusion was increased in placebo group (69.8%) compared with (18.6%) in Carbetocin group, (P = 0.0001). Also, there was a significant reduction in operative time in Carbetocin group (66.35%±10.18) compared with placebo group (95.95±9.16), (P = 0.0001).Conclusions: A single pre-operative dose of IV Carbetocin (100 μg) is a simple applicable method for reducing intra-operative blood loss and operative time in abdominal myomectomy.

Download Full-text

The faciocervicopectoral flap for non-oncological cases of cheek reconstruction

Annals of The Royal College of Surgeons of England ◽

10.1308/003588413x13629960048406 ◽

2013 ◽

Vol 95 (6) ◽

pp. 397-400

Author(s):

RM Makkar

Keyword(s):

Wound Healing ◽

Blood Loss ◽

Operative Time ◽

Operative Blood Loss ◽

Cosmetic Results ◽

Cosmetic Appearance ◽

Facial Defect ◽

Long Time ◽

Covering Technique ◽

Cheek Defect

Introduction Major facial defect has been a challenging case for plastic surgeons in terms of wound healing and covering technique for a long time. Methods Eight faciocervicopectoral (FCP) flaps were performed for reconstruction of major cheek defects due to handmade explosive and gun injuries. They were evaluated perioperatively and postoperatively with regard to operative time and operative blood loss as well as the function and cosmetic appearance. Results The technique showed marvellous cosmetic results but encountered minor postoperative flap complications. Conclusions The FCP flap is one of the best solutions for coverage of a simple or complex cheek defect. Application of the FCP flap is easy and rapid.

Download Full-text

Comparison between the vascular control technique and conventional technique for reducing operative blood loss during robot‐assisted myomectomy

International Journal of Medical Robotics and Computer Assisted Surgery ◽

10.1002/rcs.2038 ◽

2019 ◽

Vol 15 (6) ◽

Author(s):

Taejong Song ◽

Young Gi Han ◽

Ji‐Hee Sung

Keyword(s):

Blood Loss ◽

Conventional Technique ◽

Control Technique ◽

Vascular Control ◽

Operative Blood Loss ◽

Robot Assisted

Download Full-text

Transverse Versus Longitudinal Uterine Incision in Abdominal Myomectomy: A Randomized Controlled trial

QJM ◽

10.1093/qjmed/hcaa056.025 ◽

2020 ◽

Vol 113 (Supplement_1) ◽

Author(s):

A Elguindy ◽

H Hemeda ◽

M Esmat ◽

M Nawara ◽

A M F Metwally

Keyword(s):

Blood Loss ◽

Operative Time ◽

Controlled Trial ◽

Demographic Data ◽

Operative Blood Loss ◽

Postoperative Fever ◽

Abdominal Myomectomy ◽

Randomized Controlled ◽

Uterine Incision ◽

Significant Difference

Abstract Objective The Aim of the study is to compare between transverse and longitudinal uterine incision in abdominal myomectomy regarding intraoperative blood loss Design: A randomized Controlled interventional study. Setting Ain Shams Maternity teaching hospital. Patients and methods 52 patients undergoing abdominal myomectomy for single myoma were involved The patients were randomized into two groups that showed no significant difference in demographic data, characters of myoma or indication of surgery Results Our results proved that there was no significant difference between both incisions regarding intra-operative blood loss, need for blood transfusion, post-operative Hgb drop, operative time or incidence of postoperative fever. Conclusion Transverse uterine incision for myomectomy does not cause more blood loss than longitudinal incision. There is no difference between both incisions in operative time or postoperative complications Trial identifier: NCT03009812, MY-789

Download Full-text

The Hand-Assisted Laparoscopic Approach to Resection of Pancreatic Mucinous Cystic Neoplasms: An Underused Technique?

The American Surgeon ◽

10.1177/000313481808400123 ◽

2018 ◽

Vol 84 (1) ◽

pp. 56-62

Author(s):

Lauren M. Postlewait ◽

Cecilia G. Ethun ◽

Mia R. Mcinnis ◽

Nipun Merchant ◽

Alexander Parikh ◽

...

Keyword(s):

Blood Loss ◽

Minimally Invasive ◽

Hospital Stay ◽

Distal Pancreatectomy ◽

Operative Time ◽

Operative Blood Loss ◽

Specimen Length ◽

Cystic Neoplasms ◽

Invasive Approach ◽

Mucinous Cystic Neoplasms

Pancreatic mucinous cystic neoplasms (MCNs) are rare tumors typically of the distal pancreas that harbor malignant potential. Although resection is recommended, data are limited on optimal operative approaches to distal pancreatectomy for MCN. MCN resections (2000–2014; eight institutions) were included. Outcomes of minimally invasive and open MCN resections were compared. A total of 289 patients underwent distal pancreatectomy for MCN: 136(47%) minimally invasive and 153(53%) open. Minimally invasive procedures were associated with smaller MCN size (3.9 vs 6.8 cm; P = 0.001), lower operative blood loss (192 vs 392 mL; P = 0.001), and shorter hospital stay(5 vs 7 days; P = 0.001) compared with open. Despite higher American Society of Anesthesiologists class, hand-assisted (n = 46) had similar advantages as laparoscopic/robotic (n = 76). When comparing hand-assisted to open, although MCN size was slightly smaller (4.1 vs 6.8 cm; P = 0.001), specimen length, operative time, and nodal yield were identical. Similar to laparoscopic/robotic, hand-assisted had lower operative blood loss (161 vs 392 mL; P = 0.001) and shorter hospital stay (5 vs 7 days; P = 0.03) compared with open, without increased complications. Hand-assisted laparoscopic technique is a useful approach for MCN resection because specimen length, lymph node yield, operative time, and complication profiles are similar to open procedures, but it still offers the advantages of a minimally invasive approach. Hand-assisted laparoscopy should be considered as an alternative to open technique or as a successive step before converting from total laparoscopic to open distal pancreatectomy for MCN.

Download Full-text

CHOLECYSTECTOMY;

The Professional Medical Journal ◽

10.29309/tpmj/2014.21.01.1782 ◽

2014 ◽

Vol 21 (01) ◽

pp. 005-009

Author(s):

Iram Hassan ◽

Muhammad Sohaib Khan ◽

Naveed Akhtar Malik ◽

Jahangir Sarwar Khan ◽

Saadia Zaman ◽

...

Keyword(s):

Laparoscopic Cholecystectomy ◽

Postoperative Pain ◽

Blood Loss ◽

Hospital Stay ◽

Operative Time ◽

Operation Time ◽

Randomised Control Trial ◽

Surgical Department ◽

Class A ◽

Pugh Class

Objective: To compare the operative time, blood loss, postoperative pain andlength of hospitalization between open (OC) and laparoscopic cholecystectomy (LC) in Livercirrhotic patients with Child –Pugh class A & B. Study Design: Randomised Control Trial (RCT).Setting and Duration: This study was conducted at Surgical department, Holy Family Hospital,Rawalpindi from Jan 2010 to Dec 2011. Subjects and Methods: A total of 142 patients havingLiver cirrhosis secondary to Hepatitis A & Hepatitis B, who presented in OPD and ER with signsand symptoms of gall stones were randomly allocated into two groups for open (OC) andlaproscopic cholecystectomy (LC). All of them were either in Child–Pugh class A or B. Data on theabove two groups( LC &OC) was collected and analyzed for operative time, blood loss andlength of hospitalization after operation. Results: The mean blood loss in LC group was61.33+39.64 ml vs 90.84+29.88 ml in OC group, Mean operation time was 50.49+18.26 min inLC group vs 59.22+15.66 in OC group which is statistically significant (p<.05). In LC group, themean hospital stay was 1.8+.97 days, while in OC group is 2.4+.91 days which is alsostatistically significant. Conclusions: LC (laparoscopic cholecystectomy) is a safe and effectiveapproach for the treatment of symptomatic cholelithiasis in patients with mild cirrhosis with lessblood loss, less postoperative pain, shorter operative time and decreased hospital stay.

Download Full-text

A comparative study between harmonic scalpel hemostasis and conventional hemostasis in total thyroidectomy

International Surgery Journal ◽

10.18203/2349-2902.isj20201372 ◽

2020 ◽

Vol 7 (4) ◽

pp. 954

Author(s):

Waleed Yusif El Sherpiny

Keyword(s):

Blood Loss ◽

Hospital Stay ◽

Thyroid Surgery ◽

Operative Time ◽

Harmonic Scalpel ◽

Randomized Study ◽

Conventional Technique ◽

Endocrine Surgery ◽

Intraoperative Blood Loss ◽

Conventional Thyroidectomy

Background: Thyroidectomy is the most commonly performed procedure in endocrine surgery. Since the thyroid gland is highly vascular, therefore, rapid and absolute hemostasis is extremely required. Conventional thyroidectomy is commonly used with acceptable outcomes, however, it is time‑consuming and resulted in significant intraoperative blood loss with the possible risk of postoperative hemorrhage, injury to parathyroid glands and laryngeal nerves. The advent of focus harmonic devices was encouraging for improving safety, effectiveness, and reduction of operative time, especially in thyroid surgery. Aim of this study: The purpose of this study was to analyze the effectiveness and surgical outcomes of using ultrasonic harmonic scalpel for thyroid surgery compared to conventional techniques.Methods: This was a prospective, randomized study in which 60 patients with various types of goiters presented for thyroidectomy. The patients were divided into two comparable groups. Group A (30 patients) included patients who had focus harmonic thyroidectomy and Group B (30 patients) included patients who underwent conventional thyroidectomy.Results: Focus harmonic thyroidectomy showed a significant reduction in operative time, intraoperative blood loss, volume of postoperative fluid drainage and meantime for hospital stay compared with conventional thyroidectomy. There were no significant differences in the incidence of postoperative hypocalcemia, seroma, hematoma, wound infection and laryngeal nerve injury between both groups.Conclusions: Focus harmonic thyroidectomy was a safe, effective, faster, and appealing alternative to conventional technique since it reduced the operative time, intraoperative blood loss, postoperative drainage and hospital stay with comparable postoperative complications.

Download Full-text

Comparison of microdebrider assisted adenoidectomy and adenoid curette adenoidectomy

International Journal of Otorhinolaryngology and Head and Neck Surgery ◽

10.18203/issn.2454-5929.ijohns20181669 ◽

2018 ◽

Vol 4 (3) ◽

pp. 819

Author(s):

Shaweta . ◽

Ramesh K. Azad ◽

R. S. Minhas ◽

Shobha Mohindroo

Keyword(s):

Blood Loss ◽

Operative Time ◽

Symptomatic Relief ◽

Complete Removal ◽

Operative Blood Loss ◽

Left Behind ◽

Adenoid Tissue ◽

Group A ◽

Residual Tissue ◽

Group B

Background: Adenoidectomy is the surgical procedure to remove the adenoids. It is conventionally performed using the curettage method. The aim is to compare between adenoid curette adenoidectomy and microdebrider assisted adenoidectomy.Methods: From April 2016 to March 2017, 50 patients (34 males and 16 females), requiring adenoidectomy were randomized into two groups each of twenty five. Group A underwent microdebrider assisted adenoidectomy. Group B underwent conventional adenoidectomy using the curettage method. The parameters studied were intra-operative time, blood loss, residual tissue, associated trauma, and post-operative symptomatic relief and complications. Results: Microdebrider assisted adenoidectomy was significantly better in terms of residual tissue left behind as compared to adenoid curette adenoidectomy (p<0.001), similar operative blood loss and operative time with no difference in complications.Conclusions: Microdebrider-assisted adenoidectomy is a safe and effective alternative to curettage method as it allows complete removal of adenoid tissue under direct vision.

Download Full-text