Stapled Haemorrhoidopexy in the Treatment of Haemorrhoidal Disease: A Prospective Study

2020 ◽  
Vol 38 (3) ◽  
pp. 126-134
Author(s):  
Md Jahangir Hossan Bhuiyan ◽  
AMM Yahia ◽  
Farhana Begum ◽  
Mainuddin Ahmed ◽  
Nafiz Imtiaz Uddin Ahmed
Keyword(s):  
Hospital Stay ◽  
Stapled Haemorrhoidopexy ◽  
Patient’S Satisfaction ◽  
Haemorrhoidal Disease ◽  
Duration Of Surgery ◽  
Duration Of Hospitalization ◽  
Short And Long Term ◽  
The Mean ◽  
Grade 3 ◽  
A Prospective Study

Background: Haemorrhoids are usually managed by open haemorrhoidectomy which is associated with postoperative pain, prolong hospital stay, longer convalescence and late return to normal activities. Stapled haemorrhoidopexy is a newer alternative for the treatment of haemorrhoid. The present study was designed to evaluate this technique in terms of duration of surgery & hospital stay, complications, convalescence, time return to normal activities, cost effectiveness and patient’s satisfaction. Materials and methods: One hundred and sixty patients of either sex who fulfilled the criteria were included in this study. More than 90% of the patients were in grade 3 & 4. All data were prospectively collected and examined. The patients were evaluated in terms of demographic properties, complaints on admission and postoperative complication. Results: 69.4% were male and 30.6% were female. Mean age was 40.93 years. Grade 3 haemorrhoid was present in 73.75% cases, Grade 4 was 18.12% cases, Grade 1 and Grade 2 were in 8.13% cases. The mean duration of surgery was 30 minutes. The mean duration of hospitalization was 36 hours. Intraoperative bleeding was observed in 9.38% patients. Reactionary haemorrhage was seen in 3.75% patients. Postoperative mild pain in 3.12% patients and residual prolapse in 1.25% cases. Conclusion: Stapled haemorrhoidopexy is safer alternative to open haemorrhoidotectomy with many short and long term benefits. J Bangladesh Coll Phys Surg 2020; 38(3): 126-134

scholarly journals Stapled hemorrhoidopexy versus open hemorrhoidectomy: a comparative study of short term results

2017 ◽  
Vol 4 (2) ◽  
pp. 472 ◽  
Author(s):  
Idoor D. Sachin ◽  
Om Prakash Muruganathan
Keyword(s):  
Postoperative Pain ◽  
Return To Work ◽  
Hospital Stay ◽  
Stapled Hemorrhoidopexy ◽  
Short Term ◽  
Open Hemorrhoidectomy ◽  
Duration Of Surgery ◽  
The Mean ◽  
Grade 3

Background: Hemorrhoids are usually managed by surgical hemorrhoidectomy which is associated with postoperative pain, long hospital stay and a longer convalescence. Stapled hemorrhoidopexy is a newer alternative for the treatment of hemorrhoids. In this study, the two methods were compared for short term outcomes.Methods: Hundred patients having grade 3 or 4 hemorrhoids and who fulfilled the criteria were included in the study from June 2012 to May 2014. Fifty patients underwent stapled hemorrhoidopexy and other fifty underwent open hemorrhoidectomy. All patients were reviewed immediately after surgery and at 1, 3, 6 weeks and 6 months post-operatively. The two groups were compared for duration of surgery, hospital stay, return to work and post-operative complications.Results: The mean (S.D.) age was 40.06 (10.33) in our study. The majority of patients in the study were males and had grade 4 haemorrhoids. Stapled hemorrhoidopexy group had shorter duration of surgery, less postoperative pain and need for analgesia, shorter duration of hospital stay and earlier return to work and a high patient satisfaction as compared with open hemorrhoidectomy group. There were no major post-operative complications, recurrence, residual prolapse or incontinence in the follow up period of six months in the stapled group.Conclusions: Stapled hemorrhoidopexy is a safer alternative to open hemorrhoidectomy with many short-term benefits.

scholarly journals Outcomes of endoscopic suturectomy with postoperative helmet therapy in bilateral coronal craniosynostosis

2016 ◽  
Vol 18 (3) ◽  
pp. 281-286 ◽  
Author(s):  
S. Alex Rottgers ◽  
Subash Lohani ◽  
Mark R. Proctor
Keyword(s):  
Hospital Stay ◽  
Head Circumference ◽  
Major Complication ◽  
Csf Leak ◽  
Perioperative Morbidity ◽  
Syndromic Craniosynostosis ◽  
Duration Of Surgery ◽  
Coronal Synostosis ◽  
The Mean

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.

scholarly journals Evaluation of Clinicopathological Findings and Postoperative Outcomes of Modified Radical Mastectomy in a Tertiary Care Center in Lahore, Pakistan

2021 ◽  
Vol 10 (2) ◽  
pp. 89-94
Author(s):  
Usman Ali Rahman ◽  
Khalil Ahmad ◽  
Umair Nazir ◽  
Shabbar Hussain Changazi ◽  
Ayesha Choudary ◽  
...  
Keyword(s):  
Breast Carcinoma ◽  
Neoadjuvant Chemotherapy ◽  
Hospital Stay ◽  
Ductal Carcinoma ◽  
Radical Mastectomy ◽  
Modified Radical Mastectomy ◽  
Clinicopathological Findings ◽  
Duration Of Surgery ◽  
The Mean ◽  
One Year

Background: Modified radical mastectomy (MRM) remains the mainstay of breast cancer surgery in under-developed countries like Pakistan as it reduces the morbidity and mortality associated with radical surgery. This study aims to delineate the clinicopathological findings and postoperative outcomes of patients undergoing modified radical mastectomy for breast carcinoma in a local setting.Material and Methods: This cross-sectional study was conducted in Gulab Devi hospital Lahore, Punjab Pakistan, from January 2016 to December 2019. Patients (n=70) with carcinoma breast planned for modified radical mastectomy were included in the study. Two suction drains were placed (in the axilla and under the flap) and removed when drainage was less than 30 cc in 24 hours. The patients were followed-up weekly for one month and then at monthly intervals for up to one year. Independent t-test and chi-square test were used to study associations between different variables. A P-value less than .05 was considered statistically significant.Results: The mean age of the patients was 48.43 ± 12.3 years. Most of the patients (42.86%) had stage-II, grade-I carcinoma (50%) with invasive ductal carcinoma as the most frequent histological variety (80%). Majority of the patients (n=60; 85.57%) were ER/PR positive. Mean duration of surgery was 124.8 ± 20.33 minutes, the mean duration of drains was 3.5±4.5 days, and the mean length of hospital stay was 4.67 ± 1.07 days. Most common complications of mastectomy were wound infection (23.57%) and seroma formation (20%). Six (8.57%) developed recurrence of disease in one year follow-up. Neoadjuvant chemotherapy increased the mean duration of surgery and drains placement (P<.05) but had no effect on mean hospital stay and complications associated with surgery (P>.05).Conclusions: Grade-I invasive ductal carcinoma with ER/PR positive receptor status was the most frequent variety of breast carcinoma. Neoadjuvant chemotherapy was associated with increased operative time and increased duration of drain placement.

scholarly journals Comparative analysis of resection and draining interventions in patients with cystic pancreatic lesions

2020 ◽  
Vol 48 (3) ◽  
pp. 18-22
Author(s):  
A. P. Koshel ◽  
S. S. Klokov ◽  
T. V. Dibina ◽  
E. S. Drozdov ◽  
Yu. Yu. Rakina
Keyword(s):  
Long Term Results ◽  
Pancreatic Pseudocysts ◽  
Cystic Lesions ◽  
Long Term Outcomes ◽  
Duration Of Surgery ◽  
Short And Long Term ◽  
The Mean ◽  
Cystic Pancreatic Lesions ◽  
Length Of Hospitalization

Aim of study: to evaluate the results of draining and resection interventions in patients with pancreatic cystic lesions. Materials and methods. A retrospective analysis of the treatment of 50 patients with pancreatic cystic lesions of various etiologies was conducted. All patients included in the study underwent surgical treatment, namely 20 (40.0%) resection interventions (RI) and 30 (60.0%) draining interventions (DI). Comparison of short- and long-term outcomes of treatment between the two groups was carried out. Results. There were no statistically significant differences in body mass index in the compared groups. The average duration of surgery in DI group was significantly lower than in RI group (142.5±4.9 and 278.5±6.9, p<0.001). The mean intraoperative blood loss, as well as the length of hospitalization, was significantly lower in DI group as compared with RI (390±28.4 ml, 500±27.4 ml, p=0.008; 8.5±0.9 days, 13.8±3.9 days, p<0.001). The severity of postoperative complications was proved to be significantly higher in RI group (p<0.05). However, when analyzing long-term results, the attacks-free course of the disease was observed only in RI group. Conclusion. If technically possible, DI is more preferable than RI in patients with pancreatic pseudocysts. RI should be performed in patients with cystic neoplasia.

scholarly journals Desarda’s versus Lichtenstein technique of inguinal hernia repair

2017 ◽  
Vol 5 (1) ◽  
pp. 92
Author(s):  
Obaid Syed
Keyword(s):  
Inguinal Hernia ◽  
Hernia Repair ◽  
Hospital Stay ◽  
Complication Rate ◽  
Mesh Repair ◽  
Post Operative Pain ◽  
Significant Difference ◽  
Duration Of Surgery ◽  
Operative Complications ◽  
The Mean

Background: Ideal method for modern hernia surgery should be simple, cost effective, safe, tension free and permanent. The Lichtenstein operation to a great extent achieves this entire goal. The Lichtenstein mesh repair is associated with complications, postoperative dysfunction and high cost composite meshes. Desarda's technique, became a new surgical option for tissue-based inguinal hernia repair. The present study was designed to evaluate and compare the effectiveness and complications of the Desarda’s repair with Lichtenstein tension-free mesh repair for treatment of inguinal hernia in a developing country.Methods: 200 patients with unilateral, primary, reducible inguinal hernia were selected. Included patients were randomly divided into two groups. Studied parameters were Duration of surgery, intra operative complications, post-operative Pain, Duration of hospital stay, return to normal activities, post-operative complications and recurrences.Results: There were a total of 100 patients each group. There was no statistically significant difference in duration of surgery and complication rate between the two groups. Difference in mean VAS was not statistically significant. The mean hospital stay in Desarda’s technique was 2.5 days while it was 2.6 days in Lichtenstein’s group. The mean time to return to basic physical activity in the Desarda’s technique was 12.6 days while it was 13.3 days in the Lichtenstein’s group. There were no recurrences in either group. Chronic inguinal pain (>1month) was more frequent in Lichtenstein’s group.Conclusions: There is no significant difference in duration of surgery, intra operative complication rate, post-operative pain, complications and recurrence, between Desarda’s technique and Lichtenstein’s technique. However chronic inguinal pain is less in Desarda’s technique. Desarda’s repair must be considered in young patients (<30 years). Its long-term efficacy needs to be studied with larger, prospective double-blind randomized trials, with longer follow-up.

scholarly journals Laparoscopic Urological Surgery: Our Initial Experiences

2020 ◽  
Vol 23 (1) ◽  
pp. 17-23
Author(s):  
Shiba Prasad Nandy ◽  
AKM Akramul Bari ◽  
Anirban Ghose ◽  
Hasmot Ali Mia ◽  
Md Alamgir ◽  
...  
Keyword(s):  
Laparoscopic Surgery ◽  
Hospital Stay ◽  
Radical Nephrectomy ◽  
Open Surgery ◽  
Renal Cyst ◽  
Conversion To Open Surgery ◽  
Cyst Excision ◽  
Excellent Outcome ◽  
Duration Of Surgery ◽  
The Mean

Introduction and Objective: Laparoscopic surgery is increasingly exercised in urology due to improvements in technical capabilities and experience. It comes with many advantages compared to open surgery such as lesser degree of pain and haemorrhage, shorter hospital stay and better cosmetic results. This study is carried out to evaluate the outcomes and complications of urological laparoscopic surgery cases performed Chittagong Medical College Hospital, Chattogram, Bangladesh. Methods: This was a hospital based prospective observational study of total 29 patients, who received laparoscopic surgery of different kinds between January 2017 and September 2019 for urological causes with a minimum one month follow-up. Included patients were assessed in terms of demographic characteristics, preoperative diagnosis, type of laparoscopic approach, duration of surgery and hospitalization, complications after surgery and need for conversion to open surgery. Results: The mean age was 45.03 years where 12 patients were women and 17 were male. All patients underwent trans-peritoneal procedures where2 patients received renal cyst excision, 4 simple nephrectomy, 5 ureterolithotomy, 9 radical nephrectomy, 1 radical cystectomy, 2 adrenalectomy, 3 pyelolithotomy and 3 pyeloplasty. Three of the 29 patients required conversion to open surgery. Except these patients, no major complication or mortality was encountered. The mean duration of surgery for the most commonly applied procedures were as follows: renal cyst excision 87.5 (70-105) min, simple nephrectomy 141.25 (120-170) min, ureterolithotomy 120 (100-140) min, radical nephrectomy 215.56 (180-260) min, pyelolithotomy 120 (100-140) min, and pyeloplasty 156.67 (130-190) min. The mean hospital stay was 4.59±1.7 (2-8) days. Conclusions: The success and complications rate of the laparoscopic urological surgeries performed in our hospital were consistent with those reported in the literature. In the light of technological advances and increasing experience, we believe that laparoscopic surgery is an effective technique with excellent outcome along with a safe and feasible alternative to open surgery in the field of urology. Bangladesh Journal of Urology, Vol. 23, No. 1, January 2020 p.17-23

scholarly journals Prevalence of hyponatremia in pulmonary tuberculosis

2019 ◽  
Vol 7 (1) ◽  
pp. 63
Author(s):  
Manoranjan Dash ◽  
Ranjan Kumar Sen ◽  
Bibhu P. Behera ◽  
Swapna Sarit Sahu
Keyword(s):  
Pulmonary Tuberculosis ◽  
Electrolyte Abnormality ◽  
Medicine Department ◽  
Mortality And Morbidity ◽  
Medical College ◽  
Low Sodium ◽  
Duration Of Hospitalization ◽  
The Mean ◽  
A Prospective Study ◽  
Common Infection

Background: Tuberculosis is one of the most common infection in India and is associated with high mortality. India ranks 14th out of top 22 countries who are burdened with TB infections.Methods: It is a prospective study after getting the ethical committee clearance from the institute. The patients admitted to Chest and TB, Medicine Department of SLN medical college and Hospital, Koraput, Odisha from Jan 2019 to December 2019 with pulmonary tuberculosis were included in the study.Results: A total of 65 adult patients with active PTB were included in this study with age ranging from 15 to 69 years. The mean age of patients was 38.80 + 15.03 years. The total mean serum sodium levels among the subjects was 135.5+7.23. Among 65 patients, 26 (40%) patients had low sodium levels which was less than 135mmol/l out of which 21 (42%) were males and 5 (33%) were females. In all the groups of hyponatremias, majority were found to be males when compared to the females in their respective groups.Conclusions: Hence patients with PTB have to be evaluated for hyponatremia as early detection and treatment of underlying electrolyte abnormality can potentially reduce mortality and morbidity associated with tuberculosis and also can shorten the duration of hospitalization.

scholarly journals Fundus first laparoscopic cholecystectomy in patients with gall stone disease and the Fitz-Hugh-Curtis syndrome

2020 ◽  
Vol 8 (6) ◽  
pp. 2062
Author(s):  
Alexander F. Ale ◽  
Mercy W. Isichei ◽  
Danaan J. Shilong ◽  
Solomon D. Peter ◽  
Andrew H. Shitta ◽  
...  
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Hospital Stay ◽  
Gall Stone ◽  
Operating Time ◽  
Stone Disease ◽  
Duration Of Hospital Stay ◽  
Duration Of Surgery ◽  
Gall Stone Disease ◽  
The Mean ◽  
Fitz Hugh Curtis Syndrome

Background: To present this experience using the fundus-first technique during laparoscopic cholecystectomy for the management of symptomatic gall stone disease with an intra-operative finding of Fitz-Hugh-Curtis syndrome.Methods: This is a prospective review of patients who had the fundus-first dissection during laparoscopic cholecystectomy. The study was carried out at the Jos University Teaching Hospital (JUTH), and FOMAS hospital, both of which are tertiary hospitals located in Jos. Patients were recruited from January 2017 - January 2019. All patients undergoing laparoscopic cholecystectomy who had an intraoperative diagnosis of Fitz-Hugh-Curtis syndrome, and who had the fundus-first dissection, were included in the study. Patients who had fundus-first dissection for indications other than Fitz-Hugh-Curtis syndrome, were excluded from the study. Demographic and clinical information of patients included age, sex, duration of surgery, complications, and duration of hospital stay. Descriptive statistics were applied.Results: A total of 76 patients had elective laparoscopic cholecystectomies over the study period. Of that number, 17 (22.4%) patients had an intra- operative diagnosis of Fitz-Hugh-Curtis syndrome, and had the fundus-first dissection. The mean patient age was 46.3 years (SD = 11.7 years). All patients were female. The mean operating time was 70 minutes (SD = 23 minutes). The duration of hospital stay was 24 hours. There was one conversion due to uncontrollable intraoperative bleeding.Conclusions: This study revealed that the fundus-first dissection is suitable for removing the gall bladder during laparoscopic cholecystectomy in patients with gall stone disease, and an intraoperative finding of Fitz-Hugh-Curtis syndrome.

STAPLED HEMORRHOIDOPEXY A BETTER AND SAFER ALTERNATIVE TO OPEN HEMORRHOIDECTOMY IN THE MANAGEMENT OF GRADE III & IV HEMORRHOIDS- A HOSPITAL BASED STUDY

2021 ◽  
pp. 39-42
Author(s):  
G.D. Yadav ◽  
Ramendra Kumar Jauhari ◽  
Nishant Saxena ◽  
Firoj Khan ◽  
Sunil Kumar Gupta
Keyword(s):  
Statistical Analysis ◽  
Postoperative Pain ◽  
Hospital Stay ◽  
Stapled Hemorrhoidopexy ◽  
Short Term ◽  
Open Hemorrhoidectomy ◽  
Continuous Scale ◽  
Duration Of Surgery ◽  
Grade 3 ◽  
Grade Iii

Background: Surgical hemorrhoidectomy is usual method for management in hemorrhoid grade III and IV. It is generally associated with postoperative pain, long hospital stay and a longer convalescence. Stapled hemorrhoidopexy is a newer minimally invasive alternative for the treatment of hemorrhoids. Aims: In this study, the above two methods were compared with respect to short term outcomes. Settings and Design: This was a prospective and randomized study. Methods: 60 patients having grade 3 or 4 hemorrhoids and who fullled the criteria were included in the study. Thirty patients underwent stapled hemorrhoidopexy and other thirty underwent open hemorrhoidectomy. All patients were reviewed immediately after surgery and at 1, 3 and6 weeks post-operatively. The two groups were compared in terms of duration of surgery, hospital stay, return to work and post-operative level of satisfaction . Statistical Analysis: The statistical analysis was done using SPSS (Statistical Package for Social Sciences) Version 15.0 statistical Analysis Software. Signicance was assessed at 5% level of signicance. Student t-test was used to nd the signicance of study parameters on continuous scale in parametric condition between two groups (inter group analysis) and Mann Whitney U test was used to nd the signicance of study parameters on continuous scale in non-parametric condition within each group. Chi-square/ Fisher Exact test were used to nd the signicance of study parameters on categorical scale between two groups. Results: The overall mean age of patients in our study was 41.35 ± 12.80. The majority of patients in the study were males (78.3%) and had grade 3 haemorrhoids (93.3%). Stapled hemorrhoidopexy group had shorter duration of surgery, less postoperative pain and need for analgesia, shorter duration of hospital stay and earlier return to work and a high patient satisfaction as compared with open hemorrhoidectomy group. Conclusions: Stapled hemorrhoidopexy is a minimally invasive, better and safer alternative to open hemorrhoidectomy with many short-term benets.

Hysterectomy by Vaginal Route: Not a Pressure

2017 ◽  
Vol 5 (1) ◽  
pp. 8-10
Author(s):  
Radha Vembu ◽  
Sithara Dharmalingam
Keyword(s):  
Postoperative Complications ◽  
Hospital Stay ◽  
Vaginal Hysterectomy ◽  
Rating Scale ◽  
Tertiary Care ◽  
Safe Procedure ◽  
Vaginal Route ◽  
Early Return ◽  
Duration Of Surgery ◽  
The Mean

ABSTRACT Introduction Vaginal route of hysterectomy is a safe procedure with less morbidity and hospital stay. So, there is a need to expand the indication for vaginal hysterectomy beyond uterovaginal prolapse. Aims To determine the feasibility and outcome of nondescent vaginal hysterectomy (NDVH) and to assess the pre- and postoperative complications, duration of surgery, and hospital stay. Materials and methods A prospective observational study was conducted between 2012 and 2014 at a tertiary care center. A total of 256 patients satisfying the selection criteria of hysterectomy for benign gynecological conditions, uterus size <16 weeks, and excluding stage IV endometriosis, genital tract malignancy, and uterine prolapse were included. The NDVH was performed by the standard technique, and the following parameters of age, parity, indication for surgery, duration of surgery, intraoperative and postoperative complications, and hospital stay were recorded. The data were analyzed using Statistical Package for the Social Sciences version 16.0 by frequency and percentage analysis and Chi-square test. Results All 256 patients were analyzed. The mean age was 44.4 ± 6.1 years; fibroid uterus was the commonest indication. About 89.4% had a uterine size ≤12 weeks and 59% had uterine volume <200 cm3. The mean duration of surgery was 83.5 ± 11.0 minutes; salpingo-oophorectomy was performed in 25.8% of the patients. Intraoperatively, 1.2% had bladder injury and 0.4% required conversion to laparotomy for pelvic hematoma. The mean duration of hospital stay was 4.9 ± 2.2 days, and the mean pain score in numerical rating scale pain scale was 3.0 ± 0.3. Intraoperative blood transfusion was required in 1.9% of the patients only. Conclusion The NDVH is a safe and feasible procedure for benign gynecological disorders. Clinical significance The NDVH is a boon in this techno-savvy era by reducing the morbidity and promising early return to work. How to cite this article Vembu R, Dharmalingam S. Hysterectomy by Vaginal Route: Not a Pressure. J South Asian Feder Menopause Soc 2017;5(1):8-10.

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