scholarly journals Karydakis Flap: A preferred procedure for Sacrococcygeal Pilonidal Sinus Disease (SPNSD).

2020 ◽  
Vol 27 (11) ◽  
pp. 2284-2288
Author(s):  
Durr-I- Chaman ◽  
Tayyaba Fatima ◽  
Muhammad Akram ◽  
Bashir Ahmed ◽  
Sajid Rehman ◽  
...  
Keyword(s):  
Hospital Stay ◽  
Operative Time ◽  
Pilonidal Sinus Disease ◽  
Average Hospital ◽  
Surgical Department ◽  
Removal Time ◽  
Drain Removal ◽  
Flap Procedure ◽  
Rate Study

Objectives: To evaluate patients with SPNSD who underwent Karydakis Flap procedure with reference to operative time, drain removal time, hospital stay, complications and recurrence rate. Study Design: Prospective study. Setting: Surgical Department of Allied Hospital, Faisalabad. Period: September 2009 to January 2018. Material & Methods: A total of 117 patients underwent Karydakis Flap procedure. Data was collected according to the above said parameters .Patients were followed up for 12 months. Results:  The operative time was 35.5 minutes. Average Hospital stay was 2 days. Drain removed at median of 8 days.17 patients (14%) developed seroma. Wound Infection occurred in 5 patients (4%). Wound burst opened in 1 patient (0.8%).No recurrence was noted (0%) in any patient during a follow up of 1 year. Conclusion: Karydakis Flap procedure is a relatively simple and easy technique with minimal chances of recurrence.

scholarly journals Karydakis procedure for sacrococcygeal pilonidal sinus disease: Our experience

2014 ◽  
Vol 47 (03) ◽  
pp. 402-406 ◽  
Author(s):  
N. Arun Kumar ◽  
Prasenjit Sutradhar
Keyword(s):  
Hospital Stay ◽  
Pilonidal Sinus ◽  
Operative Time ◽  
Simple Procedure ◽  
Pilonidal Sinus Disease ◽  
Recurrence Rates ◽  
Sinus Disease ◽  
Stay Suture ◽  
Flap Procedure ◽  
Flap Repair

ABSTRACT Aim: The purpose of this study was to evaluate patients with sacrococcygeal pilonidal sinus disease (SPSD) who underwent Karydakis procedure at our centre with reference to the perioperative findings, early and late postoperative results and recurrence. Materials and Methods: A total of 103 patients presenting with SPSD at our centre underwent Karydakis flap repair from January 2001 to December 2010. These patients were then followed-up and evaluated with respect to operative time, drain use, hospital stay, suture removal, complications, and recurrence. Results: The mean operative time was 74.9 min with a median hospital stay of 5 days. Drains were removed at a median of 7 days and sutures at a median of 15 days. Twenty-one patients presented with serous collection in the wound. Six patients had wound infection. Patients were followed-up for a median of 29 months. No recurrences were noted in any of the cases. Conclusion: Karydakis flap procedure is a relatively simple procedure for SPSD with reproducible low recurrence rates.

Pilonidal sinus disease: Karydakis flap procedure in our patients

2020 ◽  
Vol 99 (8) ◽  
Keyword(s):  
Wound Healing ◽  
Pilonidal Sinus ◽  
Healing Process ◽  
Pilonidal Sinus Disease ◽  
Wound Complications ◽  
Limberg Flap ◽  
New Disease ◽  
Sinus Disease ◽  
Flap Procedure

Introduction: Despite the available guidelines, opinions of many surgeons are quite ambiguous when it comes to the therapy of pilonidal sinus disease. The treatment can be a frustrating problem both for the surgeon and the patient because it is associated with wound complications and high recurrence rate. The objective of this study was to analyze the results of patients with pilonidal sinus disease undergoing the Karydakis flap procedure. Methods: A total of 27 patients treated for primary and recurrent pilonidal disease using the Karydakis flap procedure at our department between October 23, 2018 and November 22, 2019 were analyzed prospectively. We evaluated postoperative wound healing, complications and recurrence of the disease in a short-term follow-up period. Disease recurrence was defined as prolonged healing or as a new disease requiring repeated surgery. Results: In December 2019 all 27 patients came for a follow-up visit. The result was a fully lateralized wound without any signs of a new disease in all patients. In May 2020 a follow-up visit by phone was performed. The median follow-up was 12 months. The healing process was free of any serious complications in 25 patients. Seroma formation cases were managed by puncture in the outpatient setting. Conclusion: According to the available evidence and guidelines, off-midline procedures – the Karydakis flap, Bascom cleft lift, and Limberg flap procedures – are associated with lower recurrence rates and better wound healing. An important goal is to achieve complete wound lateralization and to change the configuration of the gluteal cleft by reshaping it, which results in a nicely flattened gluteal crease.

scholarly journals Holmium laser enucleation of the prostate with Virtual Basket mode: faster and better control on bleeding

BMC Urology ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Giorgio Bozzini ◽  
Matteo Maltagliati ◽  
Umberto Besana ◽  
Lorenzo Berti ◽  
Albert Calori ◽  
...  
Keyword(s):  
Blood Loss ◽  
Hospital Stay ◽  
Operative Time ◽  
Randomized Study ◽  
Urine Volume ◽  
Holmium Laser ◽  
Laser Enucleation ◽  
Holmium Laser Enucleation ◽  
Irrigation Volume

Abstract Background To compare clinical intra and early postoperative outcomes between conventional Holmium laser enucleation of the prostate (HoLEP) and Holmium laser enucleation of the prostate using the Virtual Basket tool (VB-HoLEP) to treat benign prostatic hyperplasia (BPH). Methods This prospective randomized study enrolled consecutive patients with BPH, who were assigned to undergo either HoLEP (n = 100), or VB-HoLEP (n = 100). All patients were evaluated preoperatively and postoperatively, with particular attention to catheterization time, operative time, blood loss, irrigation volume and hospital stay. We also evaluated the patients at 3 and 6 months after surgery and assessed maximum flow rate (Qmax), postvoid residual urine volume (PVR), the International Prostate Symptom Score (IPSS) and the Quality of Life score (QOLS). Results No significant differences in preoperative parameters between patients in each study arm were found. Compared to HoLEP, VB-HoLEP resulted in less hemoglobin decrease (2.54 vs. 1.12 g/dl, P = 0.03) and reduced operative time (57.33 ± 29.71 vs. 42.99 ± 18.51 min, P = 0.04). HoLEP and VB-HoLEP detrmined similar catheterization time (2.2 vs. 1.9 days, P = 0.45), irrigation volume (33.3 vs. 31.7 l, P = 0.69), and hospital stay (2.8 vs. 2.7 days, P = 0.21). During the 6-month follow-up no significant differences in IPSS, Qmax, PVR, and QOLS were demonstrated. Conclusions HoLEP and VB-HoLEP are both efficient and safe procedures for relieving lower urinary tract symptoms. VB-HoLEP was statistically superior to HoLEP in blood loss and operative time. However, procedures did not differ significantly in catheterization time, hospital stay, and irrigation volume. No significant differences were demonstrated in QOLS, IPSS, Qmax and PVR throughout the 6-month follow-up. Trial Registration: Current Controlled Trials ISRCTN72879639; date of registration: June 25th, 2015. Retrospectively registred.

scholarly journals Laparoscopic repair of umbilical and paraumbilical hernias: a prospective and interventional study in government hospital

2019 ◽  
Vol 6 (9) ◽  
pp. 3283
Author(s):  
Kiren B. Patel ◽  
Mithun V. Barot
Keyword(s):  
Surgical Site Infection ◽  
Hospital Stay ◽  
Wound Infection ◽  
Ventral Hernia ◽  
Laparoscopic Repair ◽  
Umbilical Hernia ◽  
Operative Time ◽  
Postoperative Hospital Stay ◽  
Site Infection ◽  
Drain Removal

Background: Umbilical and ventral hernia occurs as a result of weakness in musculofascial layer of anterior abdominal wall. The most important causes are congenital, acquired, incisional and traumatic. UH and VH can be repair by open surgical procedure. A successful series of laparoscopic repair of umbilical hernia and VH was done by Le blanc in 1993. The cost can be optimised by selection of mesh and optimal uses of transabdominal suture and various fixation devices. This original article reveals methods, techniques, indication, contraindication, post-op pain, operative time, surgical site infection recurrence and outcome of laparoscopic umbilical hernia and paraumbilical hernia repair.Methods: A total of 21 patients of ventral hernia (umbilical, paraumbilical and incisional), who underwent laparoscopic hernia repair from October 2014 to October 2016, were selected have taken part in study with valid consent, in B.J. Medical College Ahmedabad Gujarat. All patient study regarding operative time, postoperative pain, postoperative hospital stay, surgical site infection like wound infection, seroma, hernia defect size, mean drain removal and recurrence.Results: Out of 21 patients male are 33% and female are 67%. Mean age of patients is 45 yrs with range being 18-65 yrs. 28%, 33.33%, and 38.1% of patient had umbilical, paraumbilical and incisional hernia respectively. Mean size defect was 7.8 cm2. Mean operative time in this study is 98.6 minute. Mean drain removal is 2.80 day. Mean postoperative hospital stay was 3.3 days. 4.7% had wound infection, 9.5% had seroma formation. There is 0% recurrence in present study.Conclusions: The laparoscopic approach appears to be safe, effective and acceptable. It is also effective in those who are obese, with co morbidities (complex) and who have recurrence from prior open repair and having ascites.

scholarly journals Acetabular Fracture: Retrospective Analysis of Thirty Three Consecutive Cases with Operative Management

2015 ◽  
Vol 12 (4) ◽  
pp. 279-287 ◽  
Author(s):  
D Shrestha ◽  
D Dhoju ◽  
R Shrestha ◽  
V Sharma
Keyword(s):  
Hospital Stay ◽  
Acetabular Fracture ◽  
Motor Vehicle ◽  
Demographic Data ◽  
Operative Management ◽  
Average Hospital ◽  
Vehicle Accidents ◽  
Radiographic Outcomes ◽  
Fracture Management

Background With the development of better imaging modalities including 3D CT scan and availability of technical expertise, operative management is increasingly performed for acetabular fracture but many patients in developing countries like Nepal, are still being treated with prolonged skeletal traction.Objective To analyses epidemiology, types of acetabular fracture and functional and radiological outcome of patients with acetabular fracture treated with open reduction and internal fixation (ORIF).Method Inpatients hospital records of patients treated with ORIF in between June 2007 to June 2014 were evaluated. Patient’s demographic data, mode of injury, injury hospital interval, injury surgery interval, associated injuries, surgical approach, total hospital stay and peri and post-operative complications were recorded and radiological and functional outcomes were evaluated.Result Thirty three patients (Male: 24 Female: 9) with average age 39 years (range: 21 to 65 years) were operated for acetabular fracture. Twenty one patients (63%) had injury related with motor vehicle accidents and nine (24%) of them had motorbike accidents. Injury hospital interval ranges from 7 to 36 days. Average injury-surgery interval was 21 days and average hospital stay was 22 days. Bicolumnar fractures were found in 15. Nine patients had dislocation of hip and 15 had concomitant other injuries. Biculumanr fixation was performed in 15 patients, posterior column and or wall in nine with Kocher Langenbeck approach and anterior column and or wall in other nine with ilio-inguinal approach. Radiological reduction was anatomical in 18; excellent/good functional outcome was in 26 and radiological outcomes were excellent in 14. Three patients had developed Hypertopic ossification. Follow up period ranged from 6 to 48 months and 15 patients (45%) had follow up >2 years.Conclusion Acetabular fractur can be effectively managed with ORIF and have predictable and comparable functional and radiographic outcomes. Upgrading the existing facilities and training of orthopedic surgeon for acetabular fracture management is important to shorten injury-surgery interval due to lack of such facilities.Kathmandu University Medical Journal Vol.12(4) 2014; 279-287

Outcomes of Primary Tibiotalocalcaneal Nailing for Complicated Diabetic Ankle Fractures

2019 ◽  
Vol 40 (12) ◽  
pp. 1382-1387 ◽  
Author(s):  
M. Pierce Ebaugh ◽  
Benjamin Umbel ◽  
David Goss ◽  
Benjamin C. Taylor
Keyword(s):  
Hospital Stay ◽  
Limb Salvage ◽  
Patient Population ◽  
Surgical Complication ◽  
Case Series ◽  
Ankle Fractures ◽  
Complication Rates ◽  
Average Hospital ◽  
The Mean

Background: Ankle fractures in patients with complicated diabetes have significantly increased the rates of complications and poorer functional outcomes when treated nonoperatively, and there have been only modest reductions when treated operatively. We hypothesized that the minimally invasive, robust construct that tibiotalocalcaneal fixation with an intramedullary nail offers would result in high rates of limb salvage, acceptable rates of complications, and less loss of function, in this difficult patient population. Methods: This was an institutional review board–approved retrospective study of 27 patients with complicated diabetes who underwent tibiotalocalcaneal nailing of their ankle fracture as a primary treatment without formal joint preparation. Patients with complicated diabetes were defined as having neuropathy, nephropathy, and/or peripheral vascular disease. The mean clinical follow-up was 888 days. Patients were screened for associated risk factors. Data were collected on surgical complications. The outcomes measured included length of hospital stay, loss of ambulatory level, amputation, and time to death. The mean age was 66 years with an average body mass index of 38 and hemoglobin A1c of 7.4. Six fractures were open. Results: The limb salvage rate was 96%. The average hospital stay was 6 days, and the mean time to weightbearing was 6.7 weeks. The fracture union rate was 88%. The surgical complication rate was 18.5%, with no instances of malunions, symptomatic nonunions, or Charcot arthropathy. Eight patients died by final follow-up (mean, 1048 days). An ambulatory level was maintained in 81% of the patients. Conclusion: With high limb salvage rates, relatively early weightbearing, maintained ambulatory level, and acceptable complication rates, we believe our technique can be considered an appropriate approach to increase the overall survivability of threatened limbs and lives in this patient population. Level of Evidence: Level IV, retrospective case series.

scholarly journals The extra 1.5 cm makes the differences: reduced incidence of vaginal intraepithelial neoplasia after modified hysterectomy for CIN3/adenocarcinoma in situ (AIS) patients

2021 ◽  
Author(s):  
Lei Li ◽  
Xiaoyan Song ◽  
Xiaojie Feng ◽  
Xiaofeng Li ◽  
Zhenzhong Zhang ◽  
...  
Keyword(s):  
Blood Loss ◽  
Hospital Stay ◽  
Operative Time ◽  
Disease Free Survival ◽  
Intraepithelial Neoplasia ◽  
Postoperative Recurrence ◽  
Adenocarcinoma In Situ ◽  
Stay Time

Abstract Objectives To assess whether modified hysterectomy can improve locoregional control compared to the standard extrafascial hysterectomy for cervical high grade intraepithelial neoplasia 3 (CIN3)/adenocarcinoma in situ (AIS) patients. Methods A total of 135 CIN3/AIS patients from May 2014 to March 2018 were enrolled and randomized to different hysterectomy group and finally 128 patients were eligible for analysis, in which 60 patients received standard extrafascial hysterectomy and 68 patients received modified hysterectomy by removing extra 1.5cm of vagina. Intra-operative variables including operative time, estimated amount of blood loss, urinary catheter time, hospital stay time and postoperative complications, most importantly the postoperative recurrence and disease free survival (DFS) were compared and analyzed. Results Age, BMI and histology grade were comparable between these two groups. No significant differences were found at median surgical times, blood loss and postoperative hospital stay neither laparoscopicly nor abdominally, and neither was found about the incidences of fistulas, or other surgical complications. No incidences of prolonged urinary retention were found in both groups. With a median follow-up of 47.3 months (range 11–64 months), the modified hysterectomy group and had a significantly improved in DFS rate compared to the standard extrafascial hysterectomy group (P = 0.026). No disease related death occurred in the follow-up time. Conclusion With similar intra-operative variables operative time, modified hysterectomy appeared to provide the most reliable specimens and significantly reduced the postoperative vaginal recurrence rate for CIN3/AIS patients who choose remove their uterus when compared with standard extrafascial hysterectomy.

scholarly journals Clinical justification for preventive surgeries for abdominal wall hernias and cholelithiasis in cardiovascular surgical patients

2018 ◽  
Vol 99 (2) ◽  
pp. 345-349
Author(s):  
S B Sangadzhiev ◽  
L E Slavin ◽  
R T Zimagulov ◽  
R R Yakhin ◽  
M S Sangadzhiev ◽  
...  
Keyword(s):  
Hospital Stay ◽  
Abdominal Wall ◽  
Heart Valve ◽  
Surgical Pathology ◽  
Lower Probability ◽  
Average Hospital Stay ◽  
Average Hospital ◽  
Surgical Department ◽  
Diagnostic Center

Aim. Clinical justification for the necessity of sanitation surgeries for cholelithiasis and abdominal wall hernias in patients intended for heart valve surgery. Methods. The study is based on the analysis of operative treatment results of 54 patients admitted to surgical department of Interregional clinical diagnostic center (Kazan) in 2007-2017 with cholelithiasis and abdominal wall hernias, who underwent laparoscopic cholecystectomy or herniotomy before or after an open heart surgery in cardiac surgical department No. 2 of the hospital. All patients were divided into two clinical groups. Group 1 consisted of 36 patients with a history of prosthetic heart valve, taking long-term warfarin. The comparison group included 18 patients, who at the first stage before cardiac surgery underwent sanitation surgeries for cholelithiasis and/or abdominal wall hernias. As part of the research, statistical analysis of intergroup differences was performed using non-parametric Mann-Whitney U-tests. Intergroup differences were determined by gender, age and type of cardiac and general surgical pathology. Results. The analysis of the study groups showed that the average hospital stay among patients with long-term use of indirect anticoagulants was 15±1 day and varied from 12 to 19 days. The results indicate more than two-fold increase of an average hospital stay compared to patients, who underwent the same surgeries before cardiac interventions (р <0.05). Conclusion. Before performing cardiac valve replacement with planned life-term or long-term use of anticoagulants with concomitant general surgical pathology (cholelithiasis, abdominal wall hernias with a tendency to strangulate), at the first stage, it is reasonable to perform so called sanitation surgeries aimed at eliminating abdominal pathology; such approach significantly decreases hospital stay of patients, and potentially contributes to lower probability of hemorrhagic complication incidences during the surgery and in the early post-operative period.

scholarly journals CHOLECYSTECTOMY;

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.

scholarly journals Defining the Pros and Cons of Open, Conventional Laparoscopy, and Robot-Assisted Pyeloplasty in a Developing Nation

2014 ◽  
Vol 2014 ◽  
pp. 1-6 ◽  
Author(s):  
Mrinal Pahwa ◽  
Archna R. Pahwa ◽  
Mohit Girotra ◽  
Rtika Ryfka Abrahm ◽  
Sachin Kathuria ◽  
...  
Keyword(s):  
Minimally Invasive ◽  
Hospital Stay ◽  
Operative Time ◽  
Conventional Laparoscopy ◽  
Drain Removal ◽  
Robotic Pyeloplasty ◽  
Significant Difference ◽  
Pros And Cons ◽  
Open Pyeloplasty ◽  
Complications Rate

Introduction. Congenital pelviureteric junction obstruction (PUJO) is one of the most common causes of hydronephrosis. Historically, open dismembered pyeloplasty has been considered the gold standard intervention for correcting PUJO. The aim of this study was to compare the surgical and functional outcomes of three different approaches, namely, open, conventional laparoscopy, and robotic pyeloplasty.Material and Methods. 60 patients underwent minimally invasive pyeloplasty (30 conventional laparoscopies and 30 robotics) for congenital PUJO at a tertiary health center in India. Demographic, perioperative, and postoperative data were prospectively collected and analyzed. The data of these patients were retrospectively compared with another cohort of 30 patients who had undergone open pyeloplasty.Results. There was significant difference in operative time, time to drain removal, hospital stay, pain score, and complications rate between open and minimally invasive pyeloplasty (P<0.05). SFI was considerably lesser in robotic as compared to conventional laparoscopy. The success rate in OP, CLP, and RP was 93.33, 96.67, and 96.67%.Conclusion. Robotic pyeloplasty is safe, effective, and feasible. It is associated with significantly lesser operative time, lesser blood loss, less pain, shorter hospital stay, and fewer complications. It is also associated with considerably lesser surgeon fatigue as compared to conventional laparoscopy pyeloplasty.

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