Short Term Outcome of Urethroplasty for Distal Hypospadias with Interrupted Suture Compared to continuous Suture

2013 ◽  
Vol 2 (1) ◽  
pp. 26-30
Author(s):  
MMR Shibli ◽  
S Hoque ◽  
AM Shahinoor ◽  
MAB Akan ◽  
S Zabeen
Keyword(s):  
Continuous Suture ◽  
Urethrocutaneous Fistula ◽  
Short Term ◽  
Term Outcome ◽  
Meatal Stenosis ◽  
Interrupted Suture ◽  
Short Term Outcome ◽  
Number Of Patients ◽  
Group A ◽  
Group B

Background: Hypospadias is one of the most common congenital anomalies, occurring approximately 1in 200 to 1in 300 live birth. Urethrocutaneous fistula (U-C fistula), and meatal stenosis are the most common complication of hypospadias surgery. To reduce these complications there are different surgical procedures. Snodgrass technique is now the popular technique for its low complication rate and better cosmetic outcome. Objective: To explore the short term outcome of interrupted suture compared to continuos suture in snodgrass technique urethroplasty for distal penile hypospadias. Method: It was a randomized control trial study carried out in the department of Paediatric surgery, BSMMU during the period of June 2008 to September 2009. 32 patients with distal penile hypospadias were selected according to set inclusion and exclusion criteria. Subjects who included in the study were randomly distributed in two groups. In group A odd number of patients and in group B even number of patients were included for randomization. Group A (interrupted suture) was treated as interventional group and Group B (continuous suture) as control group. Penile stent was removed on 8th and 10th POD after snodgrass technique of urethroplasty in coronal and subcoronal hypospadias respectively and observed for 4 weeks for two common complications- Urethrocutaneous fistula (U-C fistula), and meatal stenosis. Unpaired t test, Fisher’s exact test were used to see the level of significance. Result: In group A out of 16 subjects; 2 subjects (12.5%) develop Urethrocutaneous fistula and 1 subject (6.3%) had developed meatal stenosis. In group B out of 16 subjects 6 subjects (37.5%) had developed Urethrocutaneous fistula and 3 subjects (18.8%) developed meatal stenosis. Conclusion: Urethrocutaneous fistula (U-C fistula), and meatal stenosis are the most common complication of hypospadias repair and the occurrence of these two complications are less in interrupted suture than that of continuous suture in Snodgrass technique urethroplasty for distal hypospadias. DOI: http://dx.doi.org/10.3329/jpsb.v2i1.15160 Journal of Paediatric Surgeons of Bangladesh (2011) Vol. 2 (1): 26-30

scholarly journals Popliteal Artery Injury: Short Term Outcome With or Without Skeletal Trauma

2012 ◽  
Vol 7 (1) ◽  
pp. 16-18 ◽  
Author(s):  
Md Saifullah Khan ◽  
Sanurul Alam ◽  
Nasir Uddin Ahmed
Keyword(s):  
Popliteal Artery ◽  
Limb Amputation ◽  
Skeletal Trauma ◽  
Short Term ◽  
Term Outcome ◽  
Artery Injury ◽  
Short Term Outcome ◽  
Group A ◽  
Group B ◽  
Trauma Group

Short term outcome of popliteal artery injury with or without skeletal trauma was studied during the period from January 2005 to December 2005, in the department of cardiovascular surgery, National Institute of Cardiovascular Diseases, Dhaka, Bangladesh. Thirty patients undergoing surgical management for popliteal artery injury were divided equally into two groups, 15 patients with skeletal trauma (Group A) and 15 patients without skeletal trauma (Group B). Study shows that seven patients had postoperative complications in entire group, 6 in group A and one in group B. Postoperative infection was the most common complication (16.7% of total patients) in both groups accounting for 4 (26.6% within group) patients in group A and in one patient (6.7% within group) in group B respectively. Limb amputation is the most important parameter of outcome, which was needed in two patients (13.3% within group) of group A and in none of group B. Other complications were thrombosis, neurological deficit and absent distal pulse, all of which occurred exclusively in group A. DOI: http://dx.doi.org/10.3329/uhj.v7i1.10204 UHJ 2011; 7(1): 16-18

scholarly journals Caries Spine: A Comparative Study between Medical Management Alone with Combined Medical and Surgical Management

2020 ◽  
Vol 24 (3) ◽  
Author(s):  
Syed Saleem Shah ◽  
Farrukh Javeed ◽  
Lal Rehman ◽  
Ali Afzal ◽  
Munwar Ali ◽  
...  
Keyword(s):  
Medical Management ◽  
Surgical Intervention ◽  
Neurological Status ◽  
Antituberculous Therapy ◽  
Short Term ◽  
Term Outcome ◽  
Short Term Outcome ◽  
Group A ◽  
Caries Spine ◽  
Group B

Objective:  To compare short term outcome of combined surgical and medical management versus medical management alone in caries spine.Material and Methods:  This study was conducted from August 2015 to August 2018, on 68 patients randomly divided into two groups of 34 each. All were diagnosed cases of Caries spine based on history, clinical examination, ESR and imaging appearances. Group A underwent surgical intervention along with Anti-Tuberculous Treatment (ATT) while Group B received medical treatment (ATT) alone.  Results:  There were 37 (54.41%) males and 31 (45.59%) females with mean age of 34.84 ± 10.6 years. The thoracic spine was the commonest site in 33 (48.5%) patients, followed by lumbar in 20 (20.8%), dorso-lumbar in seven (10.3%) and cervical in four (5.88%) patients. The ESR fell from 85mm/hr to 24.46mm/hr in Group A and to 41.92mm/hr in Group B (p = 0.0124). Overall improvement in Frankel grade was seen in 25 (73.5%) patients in Group A and 12 (35.3%) in group B. In group A, improvement seen from grade A in two (8%), grade B in three (12%), grade C in 12(48%), Grade D in seven (28%) patients, (p = 0.000) while eight (23.5%) patients remained same and only one (2.5%) deteriorated from baseline neurological status. In Group B, 16 (47%) patients remained same and six (17.6%) deteriorated. Conclusion:  Surgery combined with antituberculous therapy was found to be beneficial in patients suffering from caries spine and to be recommended to patients desiring rapid recovery

Impact of Age of Patient and Experience of Surgeon on the Outcome after Kasai Portoenterostomy: Can We Delay the Surgery?

2020 ◽  
Author(s):  
Kin Wai Edwin Chan ◽  
Kim Hung Lee ◽  
Hei Yi Vicky Wong ◽  
Siu Yan Bess Tsui ◽  
Jennifer Wai Cheung Mou ◽  
...  
Keyword(s):  
Kasai Portoenterostomy ◽  
Short Term ◽  
Term Outcome ◽  
Short Term Outcome ◽  
Native Liver ◽  
Initial Work ◽  
Group A ◽  
Group B ◽  
The Impact ◽  
Work Up

Abstract Introduction Age of patient and experience of biliary atresia (BA) center are well-known factors associated with early jaundice clearance (EJC) after Kasai portoenterostomy (KPE) in infants with BA. This study focused on the impact of age and surgeon factor on the short-term outcome after KPE within a single center. Materials and Methods Fifty-four consecutive infants (18 boys and 36 girls) who underwent KPE from January 2010 to January 2020 were reviewed. KPE was performed in the earliest available operative session once the initial work-up was completed. In group A (n = 41), KPE was performed by surgeon A. In group B (n = 13), KPE was performed by specialists under the supervision of surgeon B (who is the mentor of surgeon A) when surgeon A was not available for operation. The demographics of patients, the EJC (total bilirubin <20 μmol/L within 6 months of KPE), and 2-year native liver survival (NLS) between the two groups were studied. Results The median age at operation was 52 days (range 26–135 days). The overall EJC rate and 2-year NLS were 85.2 and 89.4%, respectively. Group A (p = 0.015) and male gender (p = 0.029) were statistically associated with EJC but not the age at operation (p = 0.101). Group A was also statistically associated with superior 2-year NLS (p = 0.047). Conclusion Balancing between the impact of age at operation and the experience of surgeon on the outcome after KPE, our result suggested that KPE may be deferred until a more experienced surgeon to operate.

Prognosis of Schizophrenia Before and After Pharmacotherapy: II. Three-Year Follow-Up

1967 ◽  
Vol 113 (505) ◽  
pp. 1353-1359 ◽  
Author(s):  
Michael Pritchard
Keyword(s):  
Length Of Stay ◽  
Short Term ◽  
Term Outcome ◽  
Short Term Outcome ◽  
Before And After ◽  
Schizophrenic Patients ◽  
Group A ◽  
Group B

In the previous paper a comparison was made between short-term outcome of two groups of 50 schizophrenic patients each, admitted to the Professorial Unit of the Maudsley Hospital before and after the introduction of reserpine and phenothiazines into treatment. It was shown that patients admitted in 1956/57 (Group B) had a better prognosis in terms of condition on discharge and length of stay in hospital than those admitted in 1952/53 (Group A).

scholarly journals Short Term Outcome of Urethroplasty with or without Urethral Stent: A Comparative Study

2013 ◽  
Vol 24 (1) ◽  
pp. 23-26
Author(s):  
SM Rezaul Karim ◽  
Sheikh Md Abdullah ◽  
Bablu Kumar Shaha ◽  
Md Matiur Rahman ◽  
Md Ruhul Amin
Keyword(s):  
Urinary Retention ◽  
Short Term ◽  
Cutaneous Fistula ◽  
Term Outcome ◽  
Short Term Outcome ◽  
Group A ◽  
Urethral Stent ◽  
Medicine Today ◽  
Group B ◽  
Stented Group

Urethroplasty is the surgery for Hypospadias. The most  common complication of Hypospadias surgery is  urethro-cutaneous (U-C) fistula. We designed this study to  compare the short term outcome of Urethroplasty with or  without urethral stent postoperatively. A total 30 patients of  distal penile hypospadias except glnular variety have been  studied prospectively in Pediatric Surgery Department of  Banga Bandhu Sheikh Mujib Medical University, Dhaka for a  period of 20 months, from March 2005 to October 2006. All  patients were divided into Group-A (pt with stent) and Group-  B (pts without stent). Age ranges of all patients were 2-12  years. After operation no patient developed urinary retention  in stented group (Group-A) and 3 patients developed urinary  retention which was managed by suprapubic puncture. 5  patients developed urethra-cutaneous fistula in stented group  (Group- A) and 2 patients developed fistula in non stented  group (Group-B). Calibration was done in all patients after 2  weeks of operation. Before calibration 2 patients came to us  with narrow urinary stream of Group-B. After analyzing the  result, it was concluded that the short term outcome of  Urethroplasty without postoperative urethral stent is better  than with stent specially in terms of Urethro-cutaneous fistula. DOI: http://dx.doi.org/10.3329/medtoday.v24i1.14110 Medicine TODAY Vol.24(1) 2012 pp.23-26

scholarly journals Comparison of Dartos flap and spongioplasty in Snodgrass urethroplasty in distal penile hypospadias

2021 ◽  
Vol 4 (3) ◽  
pp. e000294
Author(s):  
Anju Verma ◽  
Shahid Murtaza ◽  
Vijay Kumar Kundal ◽  
Amita Sen ◽  
Divya Gali
Keyword(s):  
Urethrocutaneous Fistula ◽  
Meatal Stenosis ◽  
Tubularized Incised Plate ◽  
Group A ◽  
Dartos Flap ◽  
The Difference ◽  
Group B ◽  
Good Cosmesis ◽  
Hypospadias Surgery ◽  
Single Technique

BackgroundHypospadias surgery has been continuously evolving, although there is no single technique which can be said to be perfect and suitable for all types of hypospadias. Tubularized incised plate (TIP) urethroplasty (Snodgrass procedure) is presently the most common surgical procedure performed for distal penile hypospadias (DPH). The aim of this study was to compare the outcome of TIP urethroplasty using Dartos flap (DF) and spongioplasty as second layer in DPH.MethodsA total of 30 patients of DPH were repaired using TIP urethroplasty with DF or spongioplasty as second layer from January 2017 to June 2018. Out of 30 patients, TIP with DF was done in 15 patients (group A) and TIP with spongioplasty was done in the remaining 15 patients (group B). Preoperative mean age and weight were comparable in both groups. Postoperative complications, namely, postoperative edema, residual chordee, urethrocutaneous fistula (UCF), meatal stenosis and final cosmesis, were recorded.ResultsIn both groups, complications included postoperative edema (Gp A-1Gp B-1), residual chordee (Gp A-1, Gp B-1), UCF (Gp A-3, Gp B-4), meatal stenosis (Gp A-1, Gp B-5) and poor cosmesis (Gp A-3, Gp B-4). Wound infection was managed with appropriate antibiotics, and meatal stenosis responded to calibration in five patients.Although it seems that DF has a better outcome clinically, the difference between the two techniques was statistically not significant.ConclusionDF as an additional cover to TIP is associated with an acceptable complication and has good cosmesis compared with spongioplasty; however, the difference is not statistically significant.

scholarly journals Does the early removal of urethral stent can reduce postoperative complications of Snodgrass urethroplasty for hypospadias repair? A prospective randomized trial

2017 ◽  
Vol 4 (12) ◽  
pp. 3839 ◽  
Author(s):  
Hussein Lafta Hashim ◽  
Ahmed Al Adhami ◽  
Ali Hussain Abid
Keyword(s):  
Postoperative Complications ◽  
Wound Infection ◽  
Hypospadias Repair ◽  
Urethrocutaneous Fistula ◽  
Meatal Stenosis ◽  
Early Removal ◽  
Significant Difference ◽  
Group A ◽  
Urethral Stent ◽  
Group B

Background: Hypospadias is a relatively common congenital defect of the male external genitalia. The objective of this study was to evaluate whether the early removal of urethral stent following TIP Snodgrass repair of hypospadias can reduces postoperative complications of this procedure.Methods: In Al-Yarmouk teaching hospital, the surgical procedure included 61 tabularized incised plate (TIP) repairs for penile hypospadias. The patients were prospectively observed over 36 months and randomized into 2 groups, group (A) was 30 patients where the urethral stent was removed after 24 hours of operation, and group (B) was 31 cases where the stent removed in the 6th postoperative day. Suprapubic urinary diversion was done for all patients. All of the operations were performed by the same surgeon. Complications and cosmetic appearance were documented at last follow-up.Results: The average age of the patients was 3.9 years, urethrocutaneous fistula was observed in 2 cases in group A (6.6 %), while 11 patients had fistula in group B (35.4 %) with a statistically significant difference (p < 0.05).  meatal stenosis was reported in 4 patients in (group A) (13.3%), while 12 patients had such complication in group B (38.7%) with a statistically Significant difference as (P< 0.05). 6.6 % of group A developed wound infection, while 32.2 % had wound infection postoperatively in group B with a statistically significant difference (P< 0.05). Complete surgical failure when wound dehiscence occurs, it was found that no significant difference between the 2 groups (P value=0.1).Conclusions: TIP repair is a versatile operation that can be performed in almost all cases of penile hypospadias. We believe that early stent removal after 1 day of surgery for hypospadias repair simplifies postoperative care, highly reduces risk of development of urethrocutaneous fistula, meatal stenosis and wound infection, so obviates the need for antibiotics.

scholarly journals To Evaluate the Role of Vascularised Dorsal Dartos Flap in Snodgras Urethroplasty

2013 ◽  
Vol 2 (1) ◽  
pp. 31-35
Author(s):  
M Anisuzzaman ◽  
MAB Akan ◽  
R Ara ◽  
MM Hasan ◽  
MN Zaman ◽  
...  
Keyword(s):  
Fistula Formation ◽  
Urethrocutaneous Fistula ◽  
Pedicle Flap ◽  
Number Of Patients ◽  
Postoperative Fistula ◽  
Group A ◽  
Dartos Flap ◽  
Group B ◽  
Interventional Group

Background: Hypospadias is a common congenital anomaly of male urethra. Surgical repair is the only treatment of this defect, but there is no single, universally acceptable technique for its repair . Snodgrass technique is now popular for its low complication rate, shorter operative time, vertically oriented slit like meatus and better cosmetic outcome. Objective: To evaluate the role of vascularized dorsal dartos pedicle flap over the neourethra in terms of postoperative urethrocutaneous fistula formation between two groups of patients of distal penile hypospadias. Methodology: Thirty two patients were included in this study. They were divided in group A and group B on the basis of serial number of patients. Snodgrass urethroplasty was done in group A considered as control and in group B, Snodgrass urethroplasty was done with additional dorsal dartos flap by buttonhole technique considered as interventional group. The outcome of both groups in terms of post operative urethrocutaneous fistula were evaluated. Results: In this study in group A, urethrocutaneous fistula developed in 6 patients out of 16 patients. Among the fistulas, 5 were situated at the coronal level and 1 at the hypospadiac meatus level. In group B, urethrocutaneous fistula developed in 1 patient out of 16 patients and the fistula occurred at the coronal level. In either group, all the fistulas are developed after removal of the catheter. In terms of post operative urethrocutaneous fistula formation in between the two groups, the results were statistically significant. Conclusion: Snodgrass urethroplasty with additional dorsal dartos flap by buttonhole technique have better outcome than without additional dorsal dartos flap in terms of postoperative fistula formation. DOI: http://dx.doi.org/10.3329/jpsb.v2i1.15161 Journal of Paediatric Surgeons of Bangladesh (2011) Vol. 2 (1): 31-35

scholarly journals Short term outcomes of three dimensional versus two-dimensional laparoscopic cholecystectomy

2020 ◽  
Vol 37 (1) ◽  
Author(s):  
Abdul Razaque Shaikh ◽  
Aaijaz Ahmed Shaikh ◽  
Mujib Rehman Abbasi
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Open Cholecystectomy ◽  
Three Dimensional ◽  
Port Site ◽  
Two Dimensional ◽  
Short Term ◽  
Term Outcome ◽  
Conversion To Open Cholecystectomy ◽  
Group A ◽  
Group B

Objective: To compare the short-term outcomes of three dimensional (3D) versus two dimensional (2D) laparoscopic procedures used for cholecystectomy. Methods: This study was conducted at minimally invasive surgery center of Liaquat University of Medical Health and Sciences (LUMHS) Jamshoro Pakistan, between 15th May 2017 to 16th December 2017 after taking informed consent. All patients were diagnosed cases of cholelithiasis without any complications. Patients having risk factors for inability to get access to gall bladder via laparoscope and in whom the chances of conversion to open cholecystectomy were greater were not included as part of study. One group of patients underwent cholecystectomy under 3D laparoscopy while other group underwent 2D laparoscopy. Surgeons included in the study were all well-trained. The short-term outcome noted were intraoperative and postoperative complications, conversion to open, operative time, mortality and hospital stay. Visual strain and headache for the surgeon in three D laparoscopic cholecystectomy. Results: A total of one hundred forty patients were included in the study. Group-A consists of sixty two females and eleven males whereas Group-B comprised of fifty eight females and fifteen males. Eight percent of patients in Group-A whereas in Group-B two percent had gallbladder rupture. Fifteen percent of patients in Group-A whereas 5.4% from Group-B had bleeding from liver bed. One patient from Group-A had CBD (Common Bile Duct) injury. Post-operatively two (2.73%) patients from Group-A had port site bleeding. Six (8.21%) patients had port site infection in Group-A. Conclusion: Three dimensional was found to have low incidence of intra-operative and post-operative complications compared to 2D laparoscopic cholecystectomy. doi: https://doi.org/10.12669/pjms.37.1.3721 How to cite this:Shaikh AR, Shaikh AA, Abbasi M. Short term outcomes of three dimensional versus two-dimensional laparoscopic cholecystectomy. Pak J Med Sci. 2021;37(1):162-166. doi: https://doi.org/10.12669/pjms.37.1.3721 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Prognosis of Schizophrenia Before and After Pharmacotherapy: I. Short Term Outcome

1967 ◽  
Vol 113 (505) ◽  
pp. 1345-1352 ◽  
Author(s):  
Michael Pritchard
Keyword(s):  
Mental Hospital ◽  
Short Term ◽  
Short Term Treatment ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Short Term Outcome ◽  
Number Of Patients ◽  
Before And After ◽  
Hospital Statistics

This study, in two parts, compares the immediate and more long-term outcome of two groups of schizophrenic patients admitted to hospital before and after the introduction of pharmacotherapy in the form of reserpine and the phenothiazines. There have been differences of opinion as to whether the undoubted improvement which has occurred in the prognosis of schizophrenia, at least in the short term, since the introduction of chemotherapy has been due to the use of these drugs, to changes of administrative treatment, or to both. There has been evidence from mental hospital statistics (Shepherd et al., 1961) that changes in outcome began before the introduction of the drugs and were almost certainly related to the changes of administrative treatment or institutional management which have occurred in the mental hospitals over the same period. It may well be that the use of drugs has facilitated these changes as well as having a more direct effect oh prognosis, but the relative importance of these two factors is difficult to assess from mental hospital statistics. Comparison between results obtained in different hospitals is also of limited value because of the number of uncontrolled variables. There would seem, therefore, to be an advantage in the more detailed examination and comparison of a smaller number of patients admitted to the same hospital, and the present investigation is of this type. The material consists of two groups, of 50 patients each, admitted to the Professorial Unit at the Maudsley Hospital in the years 1952/53 and 1956/57 respectively. Since the policy throughout has been to admit only non-compulsory patients for relatively short-term treatment, administrative changes in this hospital between the two periods are likely to have been minimal. The aim was to compare both immediate and long-term outcome in the two groups and to examine the effect of a number of variables on this. The short-term outcome will be considered in the first and the long-term outcome in the second paper.

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