scholarly journals Sutureless hemorrhoidectomy vs open hemorrhoidectomy: a prospective study in a regional hospital of Western Nepal

2015 ◽  
Vol 3 (2) ◽  
pp. 121-123
Author(s):  
P Ghimire ◽  
NV Gurung ◽  
PK Upadhaya ◽  
S Shrestha ◽  
A Gurung ◽  
...  
Keyword(s):  
Hospital Stay ◽  
Demographic Data ◽  
Operating Time ◽  
Operation Time ◽  
Regional Hospital ◽  
Time Duration ◽  
Duration Of Symptoms ◽  
Sutureless Technique ◽  
Open Hemorrhoidectomy ◽  
Early Return

Background: The aim of this study is to compare sutureless Hemorroidectomy with Conventional Open Hemorrhoidectomy in terms of safety and clinical efficacy.Method: A prospective analytical study of 60 operated patients (a nonrandomized cohort) was carried out by following up from admission to 1 month period after hospital discharge in between July, 2013 to February, 2014 in Western Regional Hospital, Pokhara, Nepal. Demographic data, clinical data, mean operation time, duration of hospital stay, number of parenteral analgesic injections and post-operative complications between the two groups were recorded and analyzed.Result: There were no statistically significant differences between the two groups in terms of age, gender, duration of symptoms, grade of the hemorrhoid(s), or number of hemorrhoids resected. The mean operating time for LigaSure sutureless hemorrhoidectomy was significantly shorter than that for the Open hemorrhoidectomy (P < 0.001). Patients treated with the LigaSure technique had less blood loss, a better pain score (P < 0.001), less parenteral analgesic requirement (P < 0.001), shorter hospital stay (P < 0.001), and early return to work (P < 0.01). Conclusion: Sutureless Technique is safe and effective as compared to Conventional Open Hemorrhoidectomy for grade III and IV hemorrhoids.Nepal Journal of Medical Sciences Vol.3(2) 2014: 121-123

scholarly journals Endoscopic, Single-Session Management of Encrusted, Forgotten Ureteral Stents

Medicina ◽  
2019 ◽  
Vol 55 (3) ◽  
pp. 58 ◽  
Author(s):  
Volkan Ulker ◽  
Orcun Celik
Keyword(s):  
Hospital Stay ◽  
Treatment Options ◽  
Operating Time ◽  
Operation Time ◽  
Ureteral Stents ◽  
Single Session ◽  
Extracorporeal Shock Wave ◽  
Clavien Grade ◽  
Grade Ii ◽  
The Mean

Background and Objectives: Remained or forgotten ureteral double-J stents may cause serious complications. Removing of an encrusted, forgotten stent can be challenging. We present our experience with heavily encrusted ureteral stents and discuss the endourologic treatment options as well as their effectivity. Materials and Methods: Eleven men and six women (mean 48.58 ± 14.48 years of age) with 18 encrusted forgotten stents (mean 16.4 ± 13.25 months of indwelling) were treated at our clinic. All patients underwent the operation after negative urine cultures were obtained. Their medical records were retrospectively reviewed and analyzed in terms of number of interventions required to remove the stent, operation time, complications, hospital stay and stone-free rate. Results: According to the Forgotten-Encrusted-Calcified (FECal) classification, the most common form of stent encrustation was grade III (64.7%) and 17.6% of the stents were fragmented. Four of 17 patients were initially treated with extracorporeal shock-wave lithotripsy. The patients required a mean of two endoscopic interventions for removing the encrusted stent and all stents were removed endoscopically in a single session. The mean operating time was 63.3 ± 41.8 minutes. Cystolithotripsy followed by ureteroscopy was the most common intervention (41.1%). Of the 17 patients, peroperative and postoperative complications were Clavien grade I in two, grade II in two and grade IIIb in one. The mean hospital stay was 1.3 ± 0.99 days. All patients were stone-free after a month of stent removal. Conclusions: The endourological removal of the encrusted forgotten stents in a single session is feasible and effective with a minimal morbidity. The treatment strategy should be to minimize the number of interventions.

scholarly journals Prospective study on standard and totally tubeless percutaneous nephrolithotomy

2019 ◽  
Vol 6 (11) ◽  
pp. 3972
Author(s):  
V. Vishnu Vardhana Reddy ◽  
Amar Kumar Repaka
Keyword(s):  
Percutaneous Nephrolithotomy ◽  
Elective Surgery ◽  
Demographic Data ◽  
Operation Time ◽  
Patient Comfort ◽  
Standard Group ◽  
Early Return ◽  
Significant Difference ◽  
Analgesia Requirement ◽  
Tubeless Percutaneous Nephrolithotomy

Background: With the improvement of instrumentation and experience of percutaneous nephrolithotomy (PCNL), several modifications to the procedure have taken place in order to reduce the morbidity and early return to normal lifestyle. This study aimed to compare the totally tubeless percutaneous nephrolithotomy and standard percutaneous nephrolithotomy techniques.Methods: It is a prospective randomized, clinical trial done on 60 patients was patients older than 20 years and younger than 60 years who were chosen for elective surgery of kidney stones via the PCNL technique. Patients were divided into two groups, standard PCNL (with a nephrostomy tube) and totally tubeless PCNL (no ureter stents or ureteric catheters).Results: Demographic data is matched in two groups of patients. The mean operation time was slightly longer in the standard group (108 minutes) than in the totally tubeless group (102 minutes), but there was no statistically significant difference. There was no significant difference between the two groups with regard to serum creatinine change or blood loss. Haemoglobin drop, hospital stay, Pain score and analgesia requirement was significantly less in the totally tubeless group. 4 patients in each group had bleeding postoperatively. Only five patients developed pyrexia in the postoperative period. The differences in the need for blood transfusion and postoperative pyrexia were not found to be statistically significant. 19 in standard group and 2 patients in totally tubeless group developed urine leak, found to be statistically significant.Conclusions: Author can conclude that the tubeless procedure has fewer complications, improved postoperative patient comfort, shorter hospitalization, and a reduced need for analgesics. 

scholarly journals Evaluation of Outcome Between Excisional Haemorrhoidectomy and Longo's Technique (PPH)

2019 ◽  
Vol 17 (2) ◽  
pp. 66-72
Author(s):  
Md Atiar Rahman ◽  
Md Shahidul Lslam ◽  
Md Shahadot Hossain Sheikh ◽  
Md Ibrahim Siddique ◽  
Md Ahsan Ullah ◽  
...  
Keyword(s):  
Postoperative Pain ◽  
Hospital Stay ◽  
Operating Time ◽  
Normal Activity ◽  
Controlled Study ◽  
Anal Stenosis ◽  
Recurrent Prolapse ◽  
Time Frequency ◽  
Early Return ◽  
Rapid Healing

Objective: The introduction of a Longo’s technique for the treatment of haemorrhoids has the potential for less postoperative pain, a short operating time, rapid healing and an early return to full activity. The outcome of Longo’s technique was compared with that of current standard surgery in a randomized controlled study, and followed up two years. Methods: In a prospective randomized study, 140 patients requiring surgical treatment for haemorrhoids grade 2, 3 and 4 were assigned to either MMF (Milligan-Morgan, Park Ferguson) or PPH (Procedure for prolapse and haemorrhoids) 70 each. Operating time, frequency of postoperative analgesic intake, hospital stay, time to return to normal activity and postoperative complications were also recorded. Results: The Longo’s group had a shorter operating time, less frequent postoperative analgesia intake, and earlier return to normal activity. Postoperative pain at rest and during defecation was less important after PPH if no resection of external piles or skin tags was associated. After a mean follow-up of 24 months (12-46), recurrent haemorrhoidal symptoms, mostly mild and temporary, were reported after both MMF and PPH (Table-3). Four patients (5.71 %) complained of recurrent prolapse and/or external swelling after PPH, requiring re-do surgery in 3 of them between 18 to 32 months. Recurrent prolapse or external piles were also observed in 5 patients (7.14%) after MMF and re-do surgery was needed in 3 of them between 14 and 41 months. Long term patient's satisfaction after PPH was more or less same like after MMF. None of the patients had anal stenosis, incontinence, fecal urgency or sepsis. Conclusions: Postoperative pain is less after PPH. This advantage disappears if any resection is associated with the stapling. Use of a Longo's technique in the treatment of haemorrhoidal disease promotes rapid healing, shorter hospital stay and early return to normal activities. Journal of Surgical Sciences (2013) Vol. 17 (2) :66-72

scholarly journals Retrograde Intrarenal Surgery vs. Miniaturised Percutaneous Nephrolithotomy to Treat Lower Pole Renal Stone < 2 cms Diameter in Western Part of Odisha

2021 ◽  
Vol 8 (19) ◽  
pp. 1347-1351
Author(s):  
Ashok Kumar Nayak ◽  
Sanjay Kumar Mahapatra ◽  
Braja Mohan Mishra ◽  
Dipti Ranjan Dhar ◽  
Biswajit Sahu
Keyword(s):  
Hospital Stay ◽  
Percutaneous Nephrolithotomy ◽  
Operating Time ◽  
Operation Time ◽  
Renal Stones ◽  
Analysis Data ◽  
Lower Pole ◽  
Medical Sciences ◽  
Retrograde Intrarenal Surgery ◽  
The Mean

BACKGROUND We wanted to compare the outcomes of retrograde intrarenal surgery (RIRS) and miniaturized percutaneous nephrolithotomy (mini-PCNL) in treating lower pole (LP) renal stones with a diameter of < 2 cm in terms of safety, efficacy, and stonefree rate (SFR). METHODS In a retrospective analysis data of 39 patients who underwent mini-PCNL (N = 19) or RIRS (N = 20) for LP stones with a diameter of < 2 cm were reviewed between November 2018 and November 2020 at the Department of Urology in Veer Surendra Sai Institute of Medical Sciences and Research (VSSIMSAR), Odisha. The mean age, sex, stone size, operating time, complications, hospital stay, and SFR were compared between the groups. The success of the procedure was defined as the absence of residual stones or small residuals of size 3mm or less on computed tomography at 12 weeks postoperatively. RESULTS Significant differences were found in the hospital stay duration in hours (103.3 ± 11.7 vs. 145.2 ± 16.4, P < 0.028) between the RIRS and mini - PCNL groups. The mean operation time (in minutes) was also significantly different between the RIRS group (82.5 ± 3.44) and mini PCNL group (86.21 ± 5.90, P = 0.021). The stonefree rates in the postoperative period at three months (RIRS vs. mini - PCNL: 95 % vs. 94 %, P = 0.47) were not significantly different. CONCLUSIONS RIRS and mini-PCNL are both safe and effective methods for treating LP stones with a diameter of < 2 cm. RIRS can be considered as a less invasive alternative to PCNL for the treatment of LP stones of < 2 cm with reasonable SFR with shorter hospital stay. KEYWORDS Retrograde Intrarenal Surgery, Percutaneous Nephrolithotripsy, Lower Pole Kidney Stones, Miniaturized Percutaneous Nephrolithotomy

scholarly journals Characteristics and Outcomes of Acute Appendicitis Cases During the COVID-19 Pandemic

2020 ◽  
Author(s):  
Murat Başer ◽  
Mehmet Kağan Katar
Keyword(s):  
Acute Appendicitis ◽  
Hospital Stay ◽  
Open Surgery ◽  
Open Appendectomy ◽  
Length Of Hospital Stay ◽  
Operation Time ◽  
Complication Rates ◽  
Duration Of Symptoms ◽  
Conversion To Open Surgery ◽  
Group B

Abstract Background: Our aim in this study was to investigate the effects of the COVID-19 pandemic on acute appendicitis cases.Methods: This study was designed as a single-center, retrospective, and observational study. The patients were divided into three groups relative to the date of the first COVID-19 case in Turkey, which was March 10, 2020 (Group A: before the pandemic; Group B: pandemic period; Group C: the same period one year before the pandemic). A total of 413 patients were included in the study.Results: In terms of treatment modality, the rate of open appendectomy was significantly higher in group B (p<0.001). Rates of conversion to open surgery, as well as rates of complicated appendicitis were also significantly higher in group B (p=0.027, p=0.024, respectively). While there was no difference between the groups in terms of preoperative hospitalization duration (p=0.102), it was found that the duration of symptoms, operation time, and postoperative length of hospital stay were significantly higher in Group B (p<0.001, p=0.011, p=0.001, respectively). In addition, the complication rate in group B (8.9%) was also significantly higher than in the other two groups (p=0.023).Conclusion: We found that the rate of open surgery, the rate of conversion of laparoscopic surgery to open surgery, complication rates, mean operation time, and postoperative hospital stay were significantly higher in acute appendicitis patients that underwent surgery during the COVID-19 pandemic period. We believe that the main reason for this negative outcome is the late admission of the patients to the hospital.

scholarly journals Predictors of Length of Hospital Stay after Total Hip Replacement

2011 ◽  
Vol 19 (3) ◽  
pp. 284-287 ◽  
Author(s):  
Kashif Abbas ◽  
Masood Umer ◽  
Irfan Qadir ◽  
Jaweria Zaheer ◽  
Haroon ur Rashid
Keyword(s):  
Hospital Stay ◽  
Total Hip Replacement ◽  
Hip Replacement ◽  
Demographic Data ◽  
Operating Time ◽  
Length Of Hospital Stay ◽  
Prolonged Hospital Stay ◽  
Prolonged Stay ◽  
Total Hip ◽  
Prolonged Hospital

Purpose. To identify variables affecting length of hospital stay after total hip replacement (THR) while controlling for potential confounders. Methods. Records of 199 consecutive elective unilateral THRs were reviewed. Clinical and demographic data including age, gender, body mass index, comorbidities, surgical factors (surgical approach, type of prosthesis, use of cement, operating time), anaesthetic factors (type of anaesthesia, ASA physical status), and length of hospital stay were recorded. Results. 64% of patients left hospital within 12 days, 28% within 3 weeks, and 8% after 3 weeks. The median length of hospital stay was longer in women than men (11.5 vs. 9 days, p=0.009), in patients aged >65 years than those younger (13 vs. 9 days, p<0.0001), and in those with American Society of Anesthesiologists (ASA) grades 3 and 4 than grades 1 or 2 (14 vs. 9 days, p<0.0001). A greater proportion of women than men (45% vs. 27%, p=0.007), patients aged >65 years than those younger (61% vs. 37% or 24%, p<0.0001), and those with ASA grades 3 and 4 than grades 1 and 2 (68% vs. 25%, p<0.0001) stayed 12 days or longer. In the multiple regression analysis, the predictors for prolonged hospital stay (≥12 days) were patient age >65 years (p<0.003), female gender (p<0.05), and ASA grades 3 and 4 (p<0.0001). Of the 72 patients with prolonged stay, 7% had no, 26% had one, 42% had 2, and 25% had all 3 predictors. Conclusion. Prolonged hospital stay after THR is largely predetermined by case mix. Our study helps to identify individuals who need longer rehabilitation and more care.

scholarly journals Comparison of Surgical Results of the Bridge Crane Technique Versus Laminectomy for the Treatment of Thoracic Myelopathy Caused by Ossification of the Ligamentum Flavum

2021 ◽  
pp. 219256822199668
Author(s):  
Kaiqiang Sun ◽  
Xiaofei Sun ◽  
Jian Zhu ◽  
Fei Huang ◽  
Le Huan ◽  
...  
Keyword(s):  
Ligamentum Flavum ◽  
Demographic Data ◽  
Japanese Orthopaedic Association ◽  
Operation Time ◽  
Bridge Crane ◽  
Thoracic Myelopathy ◽  
Duration Of Symptoms ◽  
Postoperative Hematoma ◽  
Csf Leakage

Study Design: A retrospective study. Objectives: This study aimed to evaluate the safety and effectiveness of the bridge crane technique versus laminectomy for the treatment of thoracic myelopathy caused by ossification of the ligamentum flavum (OLF). Methods: Totally 41 patients who underwent surgical decompression due to thoracic OLF from May 2017 to June 2018 in our institution were enrolled in this study and were divided into group BG (bridge crane technique, n = 19) and group L (laminoectomy, n = 22). Demographic data was collected from medical records and the modified Japanese Orthopaedic Association (JOA) scoring system was used to evaluate the neurological outcomes during the follow-up. Surgery-related complications were analyzed. Results: The mean duration of follow-up was comparable between group BG (19.4 ± 1.5 months) and group L (19.6 ± 1.4 months). No statistical differences were observed between two groups in terms of gender, age, duration of symptoms, preoperative occupying rate, involved levels, operation time, intraoperative blood loss, and complications. The JOA score significantly increased at the final follow-up in both groups. However, patients in group BG had higher JOA score and recovery rate ( P < 0.05). Four patients in group L experienced complications, including 3 cerebrospinal fluid (CSF) leakage and one postoperative hematoma. Only one patient in group BG had CSF leakage. Conclusion: The results of this study suggested that bridge crane technique may be relatively safe and effective for patients with symptomatic thoracic OLF with more satisfactory clinical improvement. However, high-quality studies are still required to validate the results of this study.

scholarly journals LAPAROSCOPIC CHOLECYSTECTOMY

2010 ◽  
Vol 17 (03) ◽  
pp. 373-378
Author(s):  
JAHANGIR SARWAR KHAN ◽  
MOHAMMAD IQBAL ◽  
HAMID HASAN
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Hospital Stay ◽  
Demographic Data ◽  
Operating Time ◽  
Abdominal Ultrasound ◽  
Safe Procedure ◽  
Accident And Emergency ◽  
Set Up ◽  
Cbd Injury ◽  
Surgical Unit

Objective: To determine the frequency of common bile duct (CBD) injury in laparoscopic cholecystectomy in our settings, in my last 500 cases, after going through the learning curve associated CBD injuries. Design: Descriptive study. Place and Duration of Study: Surgical Unit-I, Rawalpindi General Hospital and the author’s Surgical Clinics from January 2003 to December 2008. Patients and Methods: Five hundred patients undergoing laparoscopic cholecystectomy by the same surgeon were included. The important variables included demographic data, intra operative time and findings, frequency of CBD injury and post operative hospital stay. Results: There were 419(83.8%) females and 81(16.2%) males with mean age 45.04±11.03 years. 294(58.8% )patients had chronic cholecystitis with Cholelithiasis and were admitted through Out Patient Department whereas 206(41.2%) were admitted through Accident and Emergency Department with acutecholecystitis. Abdominal ultrasound showed multiple calculi in 351(70.2%) patients and 149(29.8%) patients had single calculus preoperatively. Empyema was found in 97(19.4%) cases whereas adhesions were present in 182( 36.4%) patients. In our study frequency of CBD injury was 1%. Mean operating time was 35 minutes. 96.8 % of the patients were discharged within 48 hrs of operation. Conclusion: LaparoscopicCholecystectomy in our set up proved to be a safe procedure, having frequency of CBD injury of only 1% and a short hospital stay 493(96.8% )being discharged in less than 2 days.

scholarly journals Outcome comparison study between laparoscopic appendisectomy and conventional open appendisectomy

2019 ◽  
Vol 6 (5) ◽  
pp. 1520
Author(s):  
Mimamaychet B. Sangma ◽  
Selvakumaran Selvaraju ◽  
Pratheeba Natarajan ◽  
Fremingston Marak ◽  
Simon David Dasiah
Keyword(s):  
Return To Work ◽  
Hospital Stay ◽  
Operative Time ◽  
Meta Analysis ◽  
Operation Time ◽  
Significant Finding ◽  
Medical College ◽  
Early Return ◽  
Outcome Comparison ◽  
Gandhi Medical College

Background: Open appendisectomy (OA) had been the procedure of choice for acute appendisectomy for a century since Mc Burney introduced in 1884. Laprascopic appendisectomy (LA) didn’t gain popularity and many studies had been conducted to see the superiority of one over the other. Recent meta-analysis studies, found overall benefits in favour of LA. So, we have done comparative study with the aim to compare the benefits of LA over OA.Methods: Total of 90 appendisectomies was done, 45 each in OA and LA group and compared over a period of 1-year from October 2016 to October 2017 in Indira Gandhi Medical College and RI, Pondicherry. Outcome parameters were compared between the 2-groups in relation to operative time, analgesia used, length of post-operative hospital stay, return to work, resumption of a regular diet, post-operative scar and post-operative complications.Results: Mean age of LA was 35 years, OA was 30 years. Male preponderance observed in OA (67%), female in LA (60%). Post-operative short hospital stay was 3-days in LA, 5-days in OA. Early return to work was 9-days in LA, 15-days in OA. Operative time was significantly shorter in LA which was 30-minutes and 40-minutes in OA. In laprascopic group, no complications was observed, in open group we had two post-operative infections.Conclusions: LA is an effective and safe option and the procedure of choice for most patients regardless of age, sex and BMI, with a statistically significant finding in regards to operation time in LA compared to conventional OA group.

scholarly journals Laparoscopic vs Open Appendectomy : A Comparative Study

2014 ◽  
Vol 2 (1) ◽  
pp. 5-8
Author(s):  
Sardar Rezaul Islam ◽  
Kamal Pasha ◽  
Shahinur Rahman ◽  
Emdad Nasir ◽  
Emon Hanif ◽  
...  
Keyword(s):  
Hospital Stay ◽  
Laparoscopic Appendectomy ◽  
Open Appendectomy ◽  
Operation Time ◽  
Oral Feeding ◽  
Narcotic Analgesic ◽  
Safe Procedure ◽  
Analgesic Requirement ◽  
College Hospital ◽  
Early Return

Backgraound: Open appendectomy (OA) has been the treatment of choice for acute appendicitis since its introduction by Mc-burney in 1884. Laparoscopic appendectomy(LA) though widely practiced, has not gained universal approval. LA was first described in 1983. Some early studies showed equivocal results about benefit of LA. Recent studies showed overall benefit in favour of LA. So far no such a large study was done in any Bangladeshi hospital. So, we decided to do this study with a view to evaluate the therapeutic benefit of LA by comparing with conventional OA.Materials and methods: We collected data of 763 appendectomies done in Jahurul Islam medical college hospital from July 2007 to June 2012 for a period of 5 years. Out of them 448 had conventional OA and 315 had LA. We compared the mean operation time, time of first oral feeding, narcotic analgesic requirement, duration of post operative hospital stay.Results: We found that mean operation time was 33±5.8 minute and 37± 7.5 minute in LA and OA respectively. Duration of post operative hospital stay was 1.2 days shorter in Laparoscopic group. LA required 1.1 shots of  less analgesic than OA. Oral feeding was resumed 21 hours earlier following LA compared to OA. Laparoscpic appendectomy was safely performed in paediatric patient without any adverse effect. We also found that, in female patient, concurrent ovarian cysts, tubal pregnancy and endometriosis can be diagnosed and managed laparoscopically in the same sitting.Conclusion: Our study found that laparoscopic appendectomy is an effective and safe procedure irrespective of age and sex of the patient. LA has added advantage of early return of bowel movement, less post-op hospital stay and less requirement of narcotic analgesic.

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