scholarly journals Pediatric Herniotomy: A 2-year Follow-up Study at Nepal Medical College and Teaching Hospital

2021 ◽  
Vol 23 (1) ◽  
pp. 55-59
Author(s):  
Giridhar Bahadur Nhuchhe Pradhan ◽  
Sunil Shrestha ◽  
A Chalise ◽  
S Shrestha

Repair of inguinal hernia is one of the most commonly performed pediatric surgical procedures. The standard of treatment has been open herniotomy (OH). Recent trends have shown promising results with use of laparoscopy (LH) for the same. The aim of this study was to compare laparoscopic herniotomy with the standard of care at the time of the study, which has become an increasingly common procedure at our center. This was a prospective follow-up study conducted at the Department of Surgery at Nepal Medical College and Teaching Hospital. A total of sixty-four patients who underwent herniotomy were included in the study and followed up for a total duration of two years post-operatively. Immediate post-op pain was assessed with the use of visual analogue scales. Complications, recurrence, and metachronous herniation were noted in the follow up visits. Use of laparoscopy resulted in a longer operative time (36.68 min vs 22.5 min for OH, P <0.001). Pain scores were similar at immediate post-op period (LH 4.18 vs OH 3.93) but decreased significantly for LH compared to OH at 6 hours (3.68 vs 4.31, P = 0.018), 12 hours (2.71 vs 3.62, P <0.001), and 24 hours (2 vs 3.03, P <0.001). Difference in the mean hospital stay was statistically significant (LH 2.02 days vs OH 2.34 days, P <0.001). No recurrences occurred during the follow up period of the study. No patients developed contralateral metachronous hernia during the follow-up period. The cost of OH compared to LH was significantly less. LH is a safer and better alternative to OH for management of pediatric inguinal hernia when comparing post-op pain and hospital stay. However, duration of surgery and cost for the procedure favor OH at present in our setup.

2020 ◽  
Vol 21 (2) ◽  
pp. 137-139
Author(s):  
Mohammad Mahfuzur Rahman Chowdhury ◽  
AKM Shahadat Hossain ◽  
Rifat Zaman ◽  
Prodyut Kumar Saha ◽  
Hafiz Al Asad ◽  
...  

Introduction and objective: Over the last decade laparoscopic surgery has been popularized and developed to such an extent that it can be considered gold standard for many types of procedures in urology. Currently the majority of operations in urologic field can be performed by laparoscopy. This is because it is as effective as open surgery, but associated with less postoperative pain, shorter hospital stay, faster recovery and has better cosmetic result. The aim of the study is to evaluate the results of our experience of treating symptomatic renal cysts by laparoscopy. Materials and methods: This prospective study was conducted from January 2015 to December 2017 in the Department of Urology in a single unit of Dhaka Medical College Hospital. All the patients were admitted through out-patient department. Among them those who fulfilled the criteria were selected for laparoscopic surgery. All patients were diagnosed by ultrasonography and computed tomography to determine the Bosniak classification of the cyst & informed written consent was taken. Total five laparoscopic decortication of renal cysts were performed and the results of our experience were compared with data from published article. Pain and cyst recurrence were assessed during the follow-up. Results: Our study described the results of 05 laparoscopic decortication of renal cysts. All procedures were completed successfully by transperitoneal approach, with no major intraoperative and postoperative complications. There was a placement of drain tube in one patient. The mean (range) operative duration was 68 (40–110) min, affected by the site and number of cysts decorticated. The mean post operative hospital stay was 1.8 (1- 3) days. All patients were symptom-free and no sign of recurrence during the follow-up. Conclusion: Laparoscopic decortication of symptomatic renal cysts should be the standard of care and it is feasible with conventional laparoscopic instruments and gives a better cosmetic outcome. Bangladesh Journal of Urology, Vol. 21, No. 2, July 2018 p.137-139


2019 ◽  
Vol 6 (11) ◽  
pp. 3889 ◽  
Author(s):  
Faiz Manzar Ansari ◽  
Tariq Hameed ◽  
Sudhir Kumar Jain ◽  
Amrita Dua ◽  
Adiba Nizam

Background: Complicated inguinal hernia is a common problem faced by surgeons across the world. Various methods of surgical repair have been described. It is important to identify the best repair technique of inguinal hernia to have better post-operative outcome.Methods: This randomised controlled study consisted of 84 cases of complicated inguinal hernias presenting to surgical emergency department of Maulana Azad Medical College. Patients were randomly allocated to two repair groups- Desarda and Bassini and various intra/post-operative parameters were compared.Results: Duration of surgery and postoperative pain scores were less in Desarda group. Time to return to strenuous daily activities was also less with Desarda repair. Desarda repair was associated with less incidence of chronic inguinodynia and post-operative complications.Conclusions: Desarda repair was found to be superior to Bassini group due to shorter duration of surgery. Patients required less analgesics following Desarda repair as compared to Bassini group. There was no recurrence in any group at four months follow up. 


2021 ◽  
Vol 3 (9) ◽  
pp. 01-05
Author(s):  
Pedro Rolando Lòpez Rodrìguez ◽  
Eduardo Garcia Castillo ◽  
Olga Caridad Leòn Gonzàlez ◽  
Jorge Agustin Satorre Rocha ◽  
Luis Marrero Quiala ◽  
...  

Introduction: The objective of this study is to compare the outcomes of Desarda repair no mesh and Lichtenstein repair for inguinal hernia. Methods: This is a prospective randomized controlled trial study of 2793 patients having 2936 hernias operated from January 2002 to December 2020.1434 patients were operated using Lichtenstein repair and 1359 using Desarda repair. The variables like age, sex, location, type of hernia, tolerance to local anesthesia, duration of surgery, pain on the first, third and fifth day, hospital stay, complications, re-explorations, morbidity and time to return to normal activities were analyzed. Follow up period was from 1-10 years (median 6.5 years). Results: There were no significant differences regarding age, sex, location, type of hernia, and pain in both the groups. The operation time was 53 minutes in Desarda group and 43 minutes in the Lichtenstein group that is significant (p<0.05).The recurrence was 0.4 % in Desarda group and 0.4 % in Lichtenstein group. But, there were 14 cases of infection to the polypropylene mesh in the Lichtenstein group, 7 of this required re-exploration. The morbidity was also significantly more in Lichtenstein group (5,1 %) as compared to Desarda group (3.1 %). The mean time to return to work in the Desarda group was 8.26 days while a mean of 12.58 days was in the Lichtenstein group. The mean hospital stay was 29 hrs. In Desarda group while it was 49 hours in the Lichtenstein group in those patients who were hospitalized. Conclusions: Desarda repair scores significantly over the Lichtenstein repair in all respects including re-explorations and morbidity. Desarda repair is a better choice as compared with Lichtenstein repair.


2021 ◽  
Vol 5 (2) ◽  

Introduction: The objective of this study is to compare the outcomes of Desarda repair no mesh and Lichtenstein repair for inguinal hernia. Methods: This is a prospective randomized controlled trial study of 2793 patients having 2936 hernias operated from January 2002 to December 2020.1434 patients were operated using Lichtenstein repair and 1359 using Desarda repair. The variables like age, sex, location, type of hernia, tolerance to local anesthesia, duration of surgery, pain on the first, third and fifth day, hospital stay, complications, re-explorations, morbidity and time to return to normal activities were analyzed. Follow up period was from 1-10 years (median 6.5 years). Results: There were no significant differences regarding age, sex, location, type of hernia, and pain in both the groups. The operation time was 53 minutes in Desarda group and 43 minutes in the Lichtenstein group that is significant (p<0.05). The recurrence was 0.4 % in Desarda group and 0.4 % in Lichtenstein group. But, there were 14 cases of infection to the polypropylene mesh in the Lichtenstein group, 7 of this required re-exploration. The morbidity was also significantly more in Lichtenstein group (5,1 %) as compared to Desarda group (3.1 %). The mean time to return to work in the Desarda group was 8.26 days while a mean of 12.58 days was in the Lichtenstein group. The mean hospital stay was 29 hrs. In Desarda group while it was 49 hours in the Lichtenstein group in those patients who were hospitalized. Conclusions: Desarda repair scores significantly over the Lichtenstein repair in all respects including re-explorations and morbidity. Desarda repair is a better choice as compared with Lichtenstein repair


2016 ◽  
Vol 18 (3) ◽  
pp. 281-286 ◽  
Author(s):  
S. Alex Rottgers ◽  
Subash Lohani ◽  
Mark R. Proctor

OBJECTIVE Historically, bilateral frontoorbital advancement (FOA) has been the keystone for treatment of turribrachycephaly caused by bilateral coronal synostosis. Early endoscopic suturectomy has become a popular technique for treatment of single-suture synostosis, with acceptable results and minimal perioperative morbidity. Boston Children's Hospital has adopted this method of treating early-presenting cases of bilateral coronal synostosis. METHODS A retrospective review of patients with bilateral coronal craniosynostosis who were treated with endoscopic suturectomy between 2005 and 2012 was completed. Patients were operated on between 1 and 4 months of age. Hospital records were reviewed for perioperative morbidity, length of stay, head circumference and cephalic indices, and the need for further surgery. RESULTS Eighteen patients were identified, 8 males and 10 females, with a mean age at surgery of 2.6 months (range 1–4 months). Nine patients had syndromic craniosynostosis. The mean duration of surgery was 73.3 minutes (range 50–93 minutes). The mean blood loss was 40 ml (range 20–100 ml), and 2 patients needed a blood transfusion. The mean duration of hospital stay was 1.2 days (range 1–2 days). There was 1 major complication in the form of a CSF leak. The mean follow-up was 37 months (range 6–102 months). Eleven percent of nonsyndromic patients required a subsequent FOA; 55.6% of syndromic patients underwent FOA. The head circumference percentiles and cephalic indices improved significantly. CONCLUSIONS Early endoscopic suturectomy successfully treats the majority of patients with bilateral coronal synostosis, and affords a short procedure time, a brief hospital stay, and an expedited recovery. Close follow-up is needed to detect patients who will require a secondary FOA due to progressive suture fusion or resynostosis of the released coronal sutures.


2021 ◽  
Vol 28 (05) ◽  
pp. 652-655
Author(s):  
Robina Ali ◽  
Riffat Ehsan ◽  
Ghazala Niaz ◽  
Fatima Abid

Objectives: The purpose of this study was to assess the safety of sacrohystcopxy by determining intraoperative and post-operative complications and its effectiveness by pelvic organ prolapse recurrence on follow up. Study Design: Prospective study. Setting: Department of Gynecology and Obstetrics Unit-II DHQ Hospital PMC, Faisalabad. Period: Jan-2014 to Jan-2017. Material & Methods: Patients with uterovaginal prolapse, admitted through OPD were selected for abdominal sacrohysteropexy. Variables of study including duration of surgery, any intra-operative and post operative complications, need of intra operative blood transfusion, post operative hospital stay; recurrence of POP, number of pregnancies in 06 moths follow up were recorded. Results: During this study period, 319 patients were admitted with uterovaginal prolapse. 32 (10.03%) cases were selected for abdominal sacrohysteropexy. In these 32 patients, 03 (9.37%) were <30years of age, 21(65.62%) were between 30-35 years and 8 (25%) were between 35-40 years of age. About 2(6.25%) were unmarried, while 30(93.7%) were married. In these married women 14(43.75%) were multiparas, another 14(43.75%) were para 1 or 2, while 4(12.5%) were para 3 or more. Duration of surgery was 40-45 minutes in 31(96.87%) patients. In 28(87.5%) cases per operative blood loss was <150ml while in 4(12.5%) it was estimated to be >150ml but less than 300ml. Post operatively only 1(3.12%) case developed wound sepsis and it was the only one (3.12%) who was discharged on 7th post operative day, while rest 31(96.87%) were discharged on 3rd post operative day. No recurrence was noticed in 06 moths follow up, while 2(6.25%) patients became pregnant. Conclusion: Abdominal sacrohysteropexy is a safe and an effective treatment in terms of overall anatomical and functional outcome, complications, post operative recovery, length of hospital stay and sexual functioning, in women who desire uterine and hence fertility preservation.


Author(s):  
Yashpal Ramole ◽  
Badri Patel ◽  
M. C. Songara ◽  
Ishant Chaurasia

The study was conducted in the Department of General Surgery, Gandhi Medical College, Bhopal over the period of one & half year. Evaluation started with History and clinical examination including range of movement of joints. Scar was scored as per Clinical Assessment Score. Range of movement was measured using goniometer. Although most patients came for follow up and were compliant with the rehabilitation protocol, their compliance needs to be re-evaluated at every follow up and they should be encouraged to follow the advices strictly. Also they must be counseled that contracture may not be corrected to the full extent despite best of treatment and compliance with rehabilitation protocol but a good level of improvement can be achieved. Keywords: Burn, Surgery, Rehabilitation & Recurrence.


1973 ◽  
Vol 122 (567) ◽  
pp. 141-150 ◽  
Author(s):  
Colin P. McEvedy ◽  
A. W. Beard

In 1955 an epidemic occurred among the staff of a London Teaching Hospital group. The nature of the epidemic remains uncertain. One view is that the illness was a viral encephalomyelitis (Medical Staff Report, 1957); an alternative is that it was a manifestation of anxiety spreading through a population consisting largely of young women (McEvedy and Beard, 1970). This paper reports the results from the follow-up study carried out in 1968–69 on the nuclear group affected by the epidemic and on a matched series of controls.


KYAMC Journal ◽  
2017 ◽  
Vol 6 (2) ◽  
pp. 637-641
Author(s):  
Arifa Akter Zahan ◽  
Kh Shahnewaz ◽  
Ummay Salma

Aims: To evaluate the rational approach of non-descent vaginal hysterectomy in advancing gynaecology practice.Study Design: Retrospective study and period from 1st July 2013 to 31st June 2014. Setting Kumudini Women's Medical College & Hospital, Mirzapur, Tangail.Patients: All selective patients requiring hysterectomy for benign gynecological disorders who did not have any uterine prolapse were recruited for this study. In bigger size uterus morcellation techniques like bisection, debulking, myomectomy, slicing, or combination of these were used to remove the uterus.Main outcome measures: Data regarding indication, age, parity, uterine size, estimated blood loss, length of operation, complication and hospital stay were recorded.Results: A total of 50 cases were selected for non-descent vaginal hysterectomy all of them successfully underwent non-descent vaginal hysterectomy. Commonest age group was (41-45 years) i.e. 46%. All patients were parous. Uterus size was less then 8 wks 21 cases, 8wks to 12 wks in 27 cases, more then 12 wks 02 cases. Commonest indication was DUB of uterus (44%). Mean duration of surgery was 50.5 minutes. Mean blood loss was 100ml. Blood transfusion was required in four cases. Average duration of hospital stay was 3.1 days. Complications were minimal which included UTI and Vault infection.Conclusions: NDVH is safe feasible and patient friendly. We suggest that our modern gynecologist will be more expertise and familiar to this procedure in near future.KYAMC Journal Vol. 6, No.-2, Jan 2016, Page 637-641


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