Reduced Pain, Shorter Hospital Stay And Early Return To Work In Pcnl: Comparative Study On Outcome Of Pcnl Versus Open Surgery In The Treatment Of Large Renal Calculi

2020 ◽  
Vol 16 (1) ◽  
pp. 16-20
Author(s):  
Syed Al Fasani ◽  
Akm Zamanul Islam Bhuiyan
Keyword(s):  
Comparative Study ◽  
Return To Work ◽  
Hospital Stay ◽  
Open Surgery ◽  
Renal Calculi ◽  
Postoperative Hospital Stay ◽  
P Value ◽  
Early Return ◽  
Significant Difference ◽  
Duration Of Surgery

Objective: To compare the outcome of PCNL & open surgery in the treatment of large renal calculi by assesing the amount of analgesia required to relief pain, mean hospital stay, & convalescence period. Materials & Methods: : This comparative study in during 80 patients diagnosed with kidney stone disease admitted in the NIKDU during the period of Jan’ to Dec’2009. They were divided conveniently into two groups. Intervention was done in the formPCNL(40) and open surgery (40). Clinical outcome like, duration of surgery, postoperative hospital stay,doses of narcotic analgesia required to relief pain and convalescence periodwere reviewed. In complete follow up 9 patients were missed in PCNL group resulting in 31 patients. There was no significant difference in preoperative variables such as age,sex, stone size in cm, stone number- single/multiple and stag horn Stone. Results : There were statistically significant difference in the parameters between the groups,( PCNL vs open surgery [mean ± SD]): duration of operation (min), 97.90 ± 24.89 vs 136.62 ± 23.54, postoperative hospital stay (days) ,4.77 ± 3.98 vs 9.55 ± 3.65, mean time return to work (days) , 3.09 ± 1.21vs 6.25 ± 1.53, ( p value is <0.001). The amount of analgesia required to relief pain was significantly reduced in PCNL vs open procedure ( no patient required > 2 doses vs 27 patient required 3 or >3 doses ), p value is <0.001. Conclusion: PCNL is relatively safe & better treatment option than open surgery in the treatment of large renal calculi. It has reduced pain, shorter hospital stay and more rapid return to work. Bangladesh Journal of Urology, Vol. 16, No. 1, Jan 2013 p.16-20

scholarly journals Comparative study on safety and Ifficacy of PCNL with open Surgery in the treatment of patients having large kidney stones

2020 ◽  
Vol 16 (2) ◽  
pp. 51-56
Author(s):  
Syed Al Fasani ◽  
Akm Zamanul Islam Bhuiyan ◽  
Md Zahid Hasan Bhuiyan
Keyword(s):  
Comparative Study ◽  
Return To Work ◽  
Open Surgery ◽  
Perioperative Complications ◽  
Intraoperative Complications ◽  
P Value ◽  
Open Procedure ◽  
Stone Clearance ◽  
Significant Difference ◽  
Duration Of Surgery

Objective : To compare the safety and efficacy of percutaneous nephrolithotomy (PCNL) and open surgery in the treatment of patients having large kidneystone (>2 cm ). Materials & Methods: This comparative study included 80 patients diagnosed with kidney stone disease admitted in the NIKDU during the period of Jan’ to Dec’2009 were divided conveniently into two groups. Intervention was done in the form PCNL(40) and open surgery (40). Clinical outcome like, perioperative complications,duration of surgery, mean hospital stay ,convalescence period, amount of analgesia required to relief pain, stone clearance rate were reviewed and compared between the groups. There was no significant difference in preoperative variables such as age,sex, stone size in cm, stone number- single/multiple and stag horn Stone. Results: There were statistically significant difference in the parameters between the groups,( PCNL vs opensurgery[mean ± SD]): duration of operation (min), 97.90±24.89 vs 136.62±23.54, postoperative hospitalstay (days) ,4.77 ± 3.98 vs 9.55 ± 3.65, mean time return to work (days), 3.09 ± 1.21vs 6.25 ± 1.53, ( p value is <0.001). Intraoperative complications like bleeding requiring blood transfusion are significantly lower in PCNL (11 cases 34.1%) than in open surgery( 18 cases 45.0%), (Chi-square = 4.82; p =0.049). The amount of analgesia required to relief pain was significantly reduced in PCNL vs open procedure (no patient required > 2 doses vs 27 patient required 3 or >3 doses ), p value is<0.001. The rate of stone clearance in percutaneous procedure,(25 cases,80%) is approaching to that of open procedure,(34 cases 85%), (p>0.05). Conclusion: PCNL is relatively safe& better treatment option than open surgery in the treatment of large renal calculi, It has almost similar stone free rate at discharge home but has definite advantages of lower morbidity, shorter convalescence and more rapid return to work. Bangladesh Journal of Urology, Vol. 16, No. 2, July 2013 p.51-56

scholarly journals Intraoperative Complications Are Significantly Less in Pcnl in the Treatment of Large Renal Calculi : A Prospective Randomized Controlled Trial

2020 ◽  
Vol 17 (2) ◽  
pp. 71-74
Author(s):  
Syed Alfasani ◽  
Zamanul Islam Bhuiyan
Keyword(s):  
Hospital Stay ◽  
Kidney Stone ◽  
Open Surgery ◽  
Controlled Trial ◽  
Intraoperative Complications ◽  
Renal Calculi ◽  
Stone Disease ◽  
Controlled Clinical Trial ◽  
P Value ◽  
Significant Difference

Objective: To compare the safety and efficacy of percutaneous nephrolithotomy (PCNL) and open surgery in the treatment of patients having large kidney stone(>2 cm ). Materials & Methods: A Randomised controlled clinical trial (RCT ) of 80 patients diagnosed with kidney stone disease admitted in the NIKDU during the period of Jan’ to Dec’2009 were divided conveniently into two groups. Intervention was done in the form PCNL(40) and open surgery (40). Clinical outcome like, peroperativecomplications,durationof surgery,mean hospital stay,convalescence period, amount of analgesia required to relief pain, stone clearance rate were reviewed and compared between the groups. There was no significant difference in preoperative variables such as age,sex, stone size in cm, stone number- single/multiple and stag horn Stone. Results: There were statistically significant difference in the parameters between the groups,( PCNL vs open surgery [mean ± SD]): duration of operation (min), 97.90 ± 24.89 vs 136.62 ± 23.54, postoperative hospital stay (days) ,4.77 ± 3.98 vs 9.55 ± 3.65, mean time return to work (days) , 3.09 ± 1.21vs 6.25 ± 1.53, ( p value is <0.001). Intraoperative complications like bleeding requiring blood transfusion are significantly lower in PCNL (11 cases 34.1%) than in open surgery( 18 cases 45.0%), (Chi-square = 4.82; p = 0.049). Conclusion: PCNL is relatively safe & better treatment option than open surgery in the treatment of large renal calculi, It has definite advantages of statistically less peroperative bleeding and lower morbidity. Bangladesh Journal of Urology, Vol. 17, No. 2, July 2014 p.71-74

scholarly journals TO EVALUATE EFFICACY OF LAPAROSCOPIC TRANSPERITONEAL PYELOLITHOTOMY FOR MANAGEMENT OF RENAL PELVIC STONES IN TERM OF POSTOPERATIVE HOSPITAL STAY

2022 ◽  
Vol 6 (1) ◽  
Author(s):  
Shivek Mohan ◽  
Ankit Panwar ◽  
Bharat Thakur ◽  
Ved Kumar Sharma
Keyword(s):  
Hospital Stay ◽  
Open Surgery ◽  
Laparoscopic Group ◽  
Normal Activity ◽  
Postoperative Hospital Stay ◽  
Medical College ◽  
Early Return ◽  
Gandhi Medical College ◽  
Laparoscopic Transperitoneal ◽  
Return To Activity

Background: To evaluate efficacy of laparoscopic transperitoneal pyelolithotomy for management of renal pelvic stones in term of postoperative hospital stay Methods: This study has been conducted in the Department of General surgery, Indira Gandhi Medical College, Shimla on selected patients of Renal pelvis stones admitted in institution Results: Mean hospital stay was 6.66 days in laparoscopic group and it was 8 days in laparoscopic completed by open method. Maximum no. of patients was discharged within 5 days.  6 (75 %) patients returned to normal activity in less than 30 days which included only successful laparoscopic group and 2 patients returned to normal activity in 40 days which included lap completed by open group. Conclusion: In the present study of Laparoscopic Transperitoneal Pyelolithotomy at Indira Gandhi Medical College, Shimla, the procedure showed a definite decrease hospital stay, early return to activity than who have undergone open surgery Keywords: Laparoscopic Transperitoneal Pyelolithotomy, Pelvic stone, Hospital stay.

scholarly journals Open versus primary repair following hemorrhoidectomy for Grade III hemorrhoids: a prospective comparative study

2018 ◽  
Vol 5 (10) ◽  
pp. 3377
Author(s):  
Abdul Ghader Barazandeh Moghadam ◽  
Shoaibuddin Mohammad ◽  
Bushra Khan
Keyword(s):  
Statistical Analysis ◽  
Comparative Study ◽  
Return To Work ◽  
Primary Repair ◽  
Anal Stenosis ◽  
P Value ◽  
Duration Of Surgery ◽  
Prospective Comparative Study ◽  
Open Versus ◽  
Grade Iii

Background: The debate on open versus primary closure following haemorrhoidectomy continues to be active.  Despite other methods like doppler guided haemorrhoidal artery ligation, sclerotherapy, cryotherapy, banding; open haemorrhoidectomy is performed at many places. The never-ending discussion on the better choice between open versus primary repair led to the initiation of this work.Methods: This is a prospective comparative study of a contiguous and continuous cohort of 105 cases. Alternate cases were assigned for either of the procedures. Only grade III haemorrhoids were included. Grade I and II haemorrhoids, cases treated earlier and recurrent haemorrhoids were excluded. Multiple parameters like duration of surgery, intraoperative and post-operative bleeding, pain duration and severity, time taken to return to work, use of dressings and sitz bath, wound healing time and stenosis were studied. A blinded statistical analysis was done by a third-party statistician. Results: Primary haemorrhoidectomy took a significantly longer time (P value- 0.0043). Pain was significantly less with open haemorrhoidecomy (P value- 0.0023). Post-operative pain was significant in primary repair. Pain was assessed using visual analogue scale and verbal rating scale. Open haemorrhoidectomy took a significantly longer time to heal (P value: 0.0004) and return to work (P value: 0.0001). Primary repair had stenosis requiring dilatation in a few cases. Statistical analysis was done in all cases. Conclusions: Primary repair seems to be preferred because of shorter duration of recovery despite more pain and occasional anal stenosis.

A COMPARITIVE STUDY OF ONLAY – SUBLAY MESHPLASTY (PHS) vs. LICHTENSTEIN MESHPLASTY OF INGUINAL HERNIA

2021 ◽  
pp. 56-58
Author(s):  
Chenna Dharma Kishore Raja ◽  
Sreerama Raja
Keyword(s):  
Inguinal Hernia ◽  
Hernia Repair ◽  
Return To Work ◽  
Hospital Stay ◽  
Mesh Repair ◽  
Age Distribution ◽  
P Value ◽  
Tension Free ◽  
Duration Of Surgery ◽  
Type Of Surgery

Introduction: A Hernia is the protrusion of part of the abdominal contents beyond the abdominal wall's normal connes. In this study, an attempt is made to compare the results of two different modalities of hernia repair–Lichtenstein repair and repair of hernia with Polypropylene hernia system. Aim: The study aims to ascertain the Polypropylene hernia system's safety and benets for hernia repair against conventional Lichtenstein tension-free mesh repair technique. Materials and methods: The prospective clinical study comprises 30 patients presenting with inguinal hernia attending OPD and admitted to the General Surgery Department of King George Hospital, Visakhapatnam, during the study period of September 2018 to October 2020. Results: Age distribution between 10-90, most of the 50-70 age group (14 cases). Visual analog scale (VAS) score for PMR 4.55 ± 1.18 and LMR 6.06 1.27 (p-value <0.05). Wound infection for PMR 1 case and LMR 2 cases. Duration of surgery for PMR 65.40 ± 7.84 and LMR 51.33 ± 13.51 (p-value <0.05). Type of surgery and duration of hospital stay for PMR 4.93 ± 1.27 LMR 6.73 ± 2.12. Type of surgery and return to work for PMR 5.93 ± 1.27 and LMR 7.73 ± 2.12(p-value <0.05).Recurrence in PMR 0 % and LMR 6.67%. Conclusion: PHS repair is superior to Lichtenstein mesh repair about safe, tension-free method, shorter hospital Stay, early return to work, least recurrence rates, and a high subjective success rate and satisfaction rate.

scholarly journals Harmonic scalpel versus titanium clips and l-hook in the ligation of cystic duct and artery and gall bladder dissection in laparoscopic cholecystectomy

2017 ◽  
Vol 5 (12) ◽  
pp. 5145
Author(s):  
Anand Vijayvargiya ◽  
S. K. Jain ◽  
Varsha Soni
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Gall Bladder ◽  
Hospital Stay ◽  
Cystic Duct ◽  
Harmonic Scalpel ◽  
P Value ◽  
Duration Of Hospital Stay ◽  
Significant Difference ◽  
Conversion To Open Cholecystectomy ◽  
Duration Of Surgery

Background: Laparoscopic cholecystectomy is a gold standard for gall bladder stone surgery. The Aim and objective of study was to compare the total duration of surgery, intraoperative complication like bile leak from cystic duct stump, spillage of bile from gallbladder and post op pain and abdomen distension and jaundice.Methods: Study was carried out in dept. of gen Surgery, Govt medical college Kota in yr. 2015-16 in a total of 50 patients with cholelithiasis with cholecystitis. Patient were equally divided randomly into two groups (a) Harmonic scalpel group and (b) Titanium Clip and L hook group. All patients with medical comorbidities, Concomitant CBD calculi, cirrhosis and portal HT were excluded from study. Intraoperatively adhesions, bile spillage from GB and cystic duct stump noted Postoperatively complain like pain abdomen, Jaundice, and fever were noted. Duration of hospital stay was observed. All results were statistically analyzed using Chi square and ANOVA test.Results: Both groups were comparable on the basis of age and sex distribution, as no statistically difference was noted (P value 0.867 and 0.999 respectively). Intraoperative findings were adhesions 5 in clip group and 7 in harmonic group. Spillage from gall bladder was 2 in Clip group and 3 in harmonic group. Mean duration of surgery was 65.20 min in clip group and 63.68 in harmonic group with no statistically significant difference in both the group (P Value 0.727). Average duration of hospital stay was similar in both the groups with a mean of 2.6 days. Postoperative complication was fever, abdomen pain and distension were 3,1,1 were respectively in the clip group and 3,2,2 respectively in harmonic group with the P value of 0.999 which was statistically insignificant. No CBD injury was noted in any case. Conversion to open cholecystectomy was not done in any case. On 1week and 1 month follow up 2 cases in clip group and 1 in HS group had collection in gall bladder fossa and none at I month.Conclusions: Harmonic scalpel offers an effective, alternative and safe method to cystic duct division and Gallbladder dissection from liver bed.

scholarly journals A comparative study of laparoscopic appendectomy versus open appendectomy

2019 ◽  
Vol 7 (1) ◽  
pp. 138
Author(s):  
Reina Khadilkar ◽  
Ashwini Anil Panditrao ◽  
Ramteja Inturi
Keyword(s):  
Acute Appendicitis ◽  
Comparative Study ◽  
Hospital Stay ◽  
Laparoscopic Appendectomy ◽  
Open Appendectomy ◽  
Research Centre ◽  
Total Leukocyte Count ◽  
College Hospital ◽  
Early Return ◽  
Duration Of Surgery

Background: Obstruction of appendiceal lumen resulting in acute appendicitis is diagnosed by clinical examination, supported by raised neutrophil count, computed tomography and/or ultrasonography.Appendectomy one of the most commonly done surgeries is the standard line of management for acute appendicitis. Trend is towards greater utilization of laparoscopic appendectomy despite lack of consensus on superiority of laparoscopic procedure, hence imperative to prove scientifically the effectiveness of the two methods. The aim of the present study was a comparative study of laparoscopic appendectomy versus open appendectomy.Methods: A prospective cohort study of 100 cases of acute appendicitis above 16 years of age with no co morbidities was carried out in Dr. D. Y. Patil Medical College, Hospital and Research Centre from July 2017 to September 2019.Results: Mean age was 28.82 years, 64 (64%) males and 36 (36%) females, pain in abdomen (100%) being most common complaint followed by fever (77%) with positive correlation with severity of appendicitis (Alvarado score) and with total leukocyte count. Mean duration of surgery and hospital stay in laparoscopic appendectomy was lesser than open and difference was statistically highly significant (p=0.000). No difference in pain score observed. Retrocaecal (58%) was the most common position, slightly higher rate of complications in open appendectomy, no conversion of laparoscopic to open. Subjective level of satisfaction score (0-10) in laparoscopic appendectomy was higher than in open and difference was statistically highly significant (p=0.000).Conclusions: Laparoscopic appendectomy had advantages like better cosmesis, shorter duration of procedure and hospital stay, fewer post-operative complications and early return to work with disadvantage of steep learning curve, while open appendectomy, does not require special instruments, and is performed under direct three-dimensional vision.

scholarly journals Three-port versus four-port laparoscopic cholecystectomy: a comparative study at a tertiary care centre in North India

2018 ◽  
Vol 5 (2) ◽  
pp. 426
Author(s):  
Peeyush Kumar ◽  
Anil K. S. Rana
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Return To Work ◽  
Hospital Stay ◽  
Tertiary Care ◽  
Gall Stone ◽  
North India ◽  
Duration Of Hospital Stay ◽  
Conversion Rates ◽  
Significant Difference ◽  
Duration Of Surgery

Background: Improvement of Laparoscopic Cholecystectomy (LC) technique in terms of reduction in size and number of ports is being tried to improve patient satisfaction and outcome. Present study was conducted to evaluate and compare the safety outcome and advantages of three-port and four-port LC. Methods: This prospective study included 90 patients presenting with symptomatic gall stone disease or gall bladder polyp more than 1cm at base. Patients with jaundice and choledocholithiasis were excluded. Patients were divided into two groups: A and B, who underwent three-port and four-port LC respectively. Outcomes of the two groups were assessed and compared in terms of duration of surgery, intra-operative and post-operative variables including rate and nature of complications, conversion rates, post-operative pain, duration of hospital stay, return to work and cosmetic outcome.Results: Statistically significant difference was found between the two groups in terms of Visual Analogue Score for pain at 6 and 24 hours, analgesic requirement, duration of hospital stay and return to work; all being less in the three- port LC group. Cosmetic outcome as perceived by patients was also better in the three-port group. Results of other variables were comparable in the two groups. Conclusions: Three-port procedure is safe and appears to be more cost effective than four-port LC. If LC is performed by an experienced surgeon, it can be started with three ports, if required, a fourth port can be inserted. 

scholarly journals A Comparative Study of Laparoscopically Assisted Vaginal Hysterectomy and Non-descended Vaginal Hysterectomy

2014 ◽  
Vol 6 (2) ◽  
pp. 101-103
Author(s):  
De Reena ◽  
Sebanti Goswami
Keyword(s):  
Comparative Study ◽  
Hospital Stay ◽  
Vaginal Hysterectomy ◽  
P Value ◽  
Medical College ◽  
Laparoscopically Assisted Vaginal Hysterectomy ◽  
Significant Difference ◽  
The Mean ◽  
The Difference ◽  
Prospective Longitudinal

ABSTRACT Introduction The present study was done to compare nondescended vaginal hysterectomy (NDVH) and laparoscopically assisted vaginal hysterectomy (LAVH) with reference to indications, operative complications and outcome. Materials and methods This prospective longitudinal comparative study was conducted in the Department of Obstetrics and Gynecology, Medical College and Hospital, Kolkata, from November 2010 to October 2011. Judging the inclusion and exclusion criteria a sample size of 36 patients for NDVH and 31 patients for LAVH were selected randomly. The outcome of each surgical procedure was analyzed by standard statistical methods. Appropriate test of significance was applied (t-test) with p < 0.05 as level of significance. Results The mean duration of NDVH was 65 minutes and that of LAVH was 93.87 minutes. The difference was highly significant as p value was 0.000. The mean pain score analyzed by visual analog scale (VAS) in NDVH was 2.334 and 2.581. This was not statistically significant (p = 0.636). There was no significant difference in hospital stay in either group. Conclusion Laparoscopically assisted vaginal hysterectomy has the advantage of visualization of the pelvic structure from above and occasional dissection and adhesiolysis. But NDVH supersedes in its approach through the naturally created route, being faster, less expensive and results in a similar hospital stay and convalescence. How to cite this article Reena D, Goswami S. A Comparative Study of Laparoscopically Assisted Vaginal Hysterectomy and Non-descended Vaginal Hysterectomy. J South Asian Feder Obst Gynae 2014;6(2):101-103.

scholarly journals Comparative study of laparoscopy and open surgery in the treatment by prosthesis of incisional hernia

2019 ◽  
Vol 5 (2) ◽  
pp. 74-78
Author(s):  
Alexis Mupepe Kumba ◽  
◽  
Filippo Banchini Banchini ◽  
Setondji GR Attolou ◽  
Enrico Banchini ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Incisional Hernia ◽  
Comparative Study ◽  
Hospital Stay ◽  
Open Surgery ◽  
P Value ◽  
Incisional Hernias ◽  
Spss Software

Purpose: authors aimed to compare laparoscopy and open surgery in prosthesis repair of incisional hernias. Methods: in this descriptive and analytical retrospective study of 4years, 179 cases were operated by prosthesis, 120 cases of open surgery and 59 cases of laparoscopy. We compared epidemiologic, anatomic and therapeutic variables using SPSS software. Results: programmed cases have more than 30% of chance of being operated by laparoscopy than by open surgery, OR [95% CI] = 0.3 [0.12-0.92]. Clean cases are statistically 8% more likely to be laparoscopically operated than open surgery (OR [95% CI] = 0.08 [0.01-0.68]). Patients operated by laparoscopy were 30% more likely to have less than 5 days of hospitalization compared to those operated by open surgery, hospital stay ≤5 days: OR [95% CI] = 0.3 [0.03- 2.81]. P-value was 0.42 for duration of intervention and 0.024 for complications. Conclusion: clean and programmed cases preferentially benefit from laparoscopy and the hospital stay is reduced. Open surgery is preferred in an infectious context

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