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

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

Download Full-text

Stitch less, clip less, three ports laparoscopic cholecystectomy: experience of 300 cases

International Journal of Research in Medical Sciences ◽

10.18203/2320-6012.ijrms20193142 ◽

2019 ◽

Vol 7 (8) ◽

pp. 2899

Author(s):

Ritvik Resutra ◽

Neha Mahajan ◽

Rajive Gupta

Keyword(s):

Laparoscopic Cholecystectomy ◽

Postoperative Pain ◽

Hospital Stay ◽

Operative Time ◽

Normal Activity ◽

Duration Of Hospital Stay ◽

Bile Duct Injuries ◽

Early Return ◽

Routine Work ◽

Better Than

Background: 300 cases of cholelithiasis were operated by stitch less, clip less, three ports laparoscopic cholecystectomy at Maxx lyfe Hospital, near Bathindi morh, Sunjwan road, Jammu with effect from August 2017 to May 2019. The outcome measures in the form of safety of the technique, postoperative pain, need of postoperative analgesia, number of OT assistants needed, duration of hospital stay, recovery and return to routine work, cosmetic satisfaction of the patient were taken into consideration and were found to be better than in conventional four ports technique of laparoscopic cholecystectomy.Methods: In three port laparoscopic cholecystectomy, first 10 mm umbilical, second 5 mm subxyphoid and third 5 mm subcostal ports are used and telescope is passed into the peritoneal cavity through the umbilical port. Retraction of the gallbladder is done by the long grasping forceps through the 5 mm subcostal port, whereas dissection is accomplished through the subxyphoid port. The gallbladder is retrieved through the subxyphoid port.Results: Mean operative time was 40 minutes and mean duration of postoperative stay in the hospital was 18 hours. Days to return to normal activity was 4 days at an average.Conclusions: The 3-port laparoscopic cholecystectomy technique is safe and has better outcomes in the form of less postoperative pain, less duration of hospital stay, early return to routine work and more cosmetic satisfaction as compared to the conventional 4-port technique, with no obvious increase in bile duct injuries and it can be a viable alternative in the field of minimally invasive surgery.

Download Full-text

EARLY RESULTS OF INGUINAL HERNIA REPAIR BY THE “MESH PLUG” TECHNIQUE

Journal of Medicine and Pharmacy ◽

10.34071/jmp.2012.5.6 ◽

2012 ◽

pp. 43-51

Author(s):

Doan Van Phu Nguyen ◽

Loc Le ◽

Van Lieu Nguyen

Keyword(s):

Inguinal Hernia ◽

Postoperative Pain ◽

Operating Time ◽

Life Assessment ◽

Medium Size ◽

Mesh Plug ◽

Postoperative Rehabilitation ◽

Early Return ◽

Early Results ◽

Average Size

Background: In 1989, Lichtenstein I. L., Shulman A. G., Amid P. K., and Montlor M. M. presented an idea of using Mesh Plug to repair the defect inguinal canal. The new technique quickly became accepted by surgeons all over the world for several reasons: faster overall rehabilitation, less postoperative pain, less complication, shorter stay in the hospital and early return to normal activities and work. Materials and method: From Dec 2011 to July 2012, 42 patients with inguinal hernia were surgically treated with 48 Mesh Plugs applied at the Surgery Unit of Hue University of Medicine and Pharmacy. Result: The patients’ average age was 49.12±21.17. There were 25 patients over 40 years old, accounting for 59,5%, and 39 of the group were males, accounting for 92.8%. 10 cases were direct hernia, accounting for 20.8%, and 38 cases were indirect hernia accounting for 79.2%. Based on Nyhus’s classification, there were 33 cases of IIIA and IIIB (68.8%). Based on the position of protrusion, there were 30 cases of right inguinal hernia (62.5%), 18 cases of left inguinal hernia (37.5%), and 6 cases of hernia on both sides. The average size of the deep ring is 2.16±1.64cm. 24 cases used Mesh Plug of medium size (54.5%). The mean operating time was 35.75 minutes. The time of staying in the hospital was 3.52±1.14 days. Quality of life assessment after the surgery showed 46 very good and good cases 95.8% and 2 cases (4.2%) with satisfactory result. No case of bad outcome was recorded. Conclusion: Surgical treatment of inguinal hernia by the Mesh Plug technique is really effective, safe with faster postoperative rehabilitation, less postoperative pain, less complications, shorter hospital stay and early return to normal activities and work.

Download Full-text

INGUINAL HERNIA REPAIR BY THE “MESH PLUG” TECHNIQUE

Journal of Medicine and Pharmacy ◽

10.34071/jmp.2013.6.7 ◽

2014 ◽

pp. 40-46

Author(s):

Doan Van Phu Nguyen ◽

Loc Le ◽

Van Lieu Nguyen

Keyword(s):

Inguinal Hernia ◽

Postoperative Pain ◽

Operating Time ◽

Life Assessment ◽

Medium Size ◽

Mesh Plug ◽

Indirect Hernia ◽

Postoperative Rehabilitation ◽

Early Return ◽

Direct Hernia

Background:In 1989, Lichtenstein I. L., Shulman A. G., Amid P. K., and Montlor M. M. presented an idea of using Mesh Plug to repair the defect inguinal canal. The new technique quickly became accepted by surgeons all over the world for several reasons: faster overall rehabilitation, less postoperative pain, less complication, shorter stay in the hospital and early return to normal activities and work. Materials and method:From December 2011 to October 2012, 97 patients with inguinal hernia were surgically treated with 110 Mesh Plugs applied at the Surgery Unit of Hue University of Medicine and Pharmacy. Result:The patients’ mean age was 48.96±23.19. There were 60 patients over 40 years old, accounting for 61.9%, and 93 of the group were males, accounting for 95.8%. 24 cases were direct hernia, accounting for 21.8%, 86 cases were indirect hernia accounting for 78.2% and 11cases were direct hernia associated with indirect hernia. Based on Nyhus’s classification, there were 76 cases of IIIA and IIIB (69.1%). Based on the position of protrusion, there were 66 cases of right inguinal hernia (60.0%), 44 cases of left inguinal hernia (40.0%), and 13 cases of hernia on both sides. The average size of the deep ring is 2.19±1.54cm. 65 cases used Mesh Plug of medium size (59.1%). The mean operating time was 37.26 minutes. The time of staying in the hospital was 3.58±1.17 days. Quality of life assessment after the surgery showed 93 very good and good cases 95.8% and 4 cases (4.2%) with satisfactory result. No case of bad outcome was recorded. Conclusion: Surgical treatment of inguinal hernia by the Mesh Plug technique is really effective, safe with faster postoperative rehabilitation, less postoperative pain, less complications, shorter hospital stay and early return to normal activities and work. Key words: Inguinal hernia, Mesh Plug.

Download Full-text

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

Nepal Journal of Medical Sciences ◽

10.3126/njms.v3i2.13456 ◽

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

Download Full-text

Comparison of Totally Extraperitoneal versus Transabdominal Preperitoneal repair of inguinal hernias

Journal of Society of Surgeons of Nepal ◽

10.3126/jssn.v23i2.35835 ◽

2020 ◽

Vol 23 (2) ◽

pp. 47-51

Author(s):

Rohit Prasad Yadav ◽

Manish Gautam ◽

Ashok Koirala ◽

Sameer Bhattarai ◽

Sachhidanand Shah ◽

...

Keyword(s):

Inguinal Hernia ◽

Postoperative Pain ◽

Hospital Stay ◽

Operating Time ◽

Total Duration ◽

Recurrent Inguinal Hernia ◽

Transabdominal Preperitoneal ◽

Significant Difference ◽

Scrotal Hematoma ◽

Duration Of Operation

Introduction: Laparoscopic inguinal hernia repair is a tension-free mesh repair that is based on pre-peritoneal approach of repair. It provides mechanical advantage to the surgeon, by being able to place a large piece of mesh and by using the natural force of the abdominal wall to disperse the intra-abdominal pressure over a large area to support the mesh. This retrospective study is aimed to study the demography of inguinal hernia and to compare operating time, complications and postoperative pain between patients undergoing Total Extrapritoneal (TEP) or Transabdominal Preperitoneal (TAPP) repair.Methods: A retrospective comparative study was conducted in patients with inguinal hernia who underwent laparoscopic repair by either TEP or TAPP, between April 2019 to July 2020 at Nobel Medical Collage Teaching Hospital, Biratnagar, Morang. Age, sex, type of hernia, duration of operation, post-operative complications, severity of pain and duration hospital stay were analyzed between two groups of patients undergoingsurgery by either TEP or TAPP.Results: One hundred and five patients underwent either TEP or TAPP during study period. There were 96 males and 9 females. There were 50 patients with right, 40 with left and 6 patients with bilateral inguinal hernia. Four patients had left sided irreducible inguinal hernia, 2 patients had bilateral recurrent inguinal hernia, 2 patients had right sided recurrent inguinal hernia and 1 patient had left sided recurrent inguinal hernia.There was significant difference in duration of operation (TEP 64.43min) / (TAPP 84.46min), p<0. 001. Total duration of hospital stay and postoperative pain were not significant between patients operated with TEPor TAPP. Accidental pneumoperitoneum was noticed in 8 cases, 10 cases of subcutaneous emphysema, 5 cases of seroma and 1 case of scrotal hematoma in TEP group. In TAPP group scrotal hematoma occurred in 4 cases and seroma in 5 cases which was not significantly different from TEP group.Conclusion: TAPP had significantly longer operating time as compared to TEP. However, there was no significant difference in post-operative pain and hospital stay in both group.

Download Full-text

Laparoscopic cholecystectomy in Jordan

Eastern Mediterranean Health Journal ◽

10.26719/2001.7.4-5.838 ◽

2001 ◽

Vol 7 (4-5) ◽

pp. 838-840

Author(s):

A. Al Raymoony

Keyword(s):

Laparoscopic Cholecystectomy ◽

Postoperative Pain ◽

Return To Work ◽

Hospital Stay ◽

Operative Time ◽

Safe Procedure ◽

Short Hospital Stay ◽

Early Return ◽

The Mean ◽

Mean Time

This study was conducted on 100 patients with symptomatic gallbladder stones, aged 22-81 years with a mean of 51.5 years, who underwent cholecystectomy in Zarqa city, Jordan between July 1998 and July 1999. The success rate was 87% and the procedure was completed using the conventional method in 13 patients. The mean operative time was 60 minutes, complication rate was 5% and there were no deaths. The mean hospital stay was 1 day and mean time to return to work was 10 days. This study showed that laparoscopic cholecystectomy is a safe procedure with reasonable operative time, less postoperative pain, a short hospital stay, early return to work, and a low morbidity and mortality rate.

Download Full-text

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

International Journal of Medical and Biomedical Studies ◽

10.32553/ijmbs.v6i1.2389 ◽

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.

Download Full-text

Three Years Experience of Bilateral Simultaneous Percutaneous Nephrolithotomy – A Single Center Study in Pakistan

10.33169/uro.uoaoj-i-108 ◽

2020 ◽

Vol I (2) ◽

pp. 31-34

Author(s):

Shakeel Haseeb Uddin Siddique

Keyword(s):

Hospital Stay ◽

Operative Time ◽

Adult Population ◽

Data Entry ◽

Retrospective Chart Review ◽

Renal Calculi ◽

Normal Activity ◽

Transfusion Rate ◽

Early Return ◽

The Mean

Objective To study the outcomes of simultaneous bilateral PCNLs in adult population and discussing therapeutical benefits and complications. Design A Retrospective Study. Setting The Kidney Centre ( The Post Graduate Training Institute, Karachi). Duration of Study Three years from January 2017 to December 2019. Methodology A retrospective chart review at one of the large urology institute in Karachi was conducted. The aim was to document the demographics, operation dynamics, outcomes and complications of simultaneous bilateral PCNL in adult population. Record of 60 patients who underwent simultaneous bilateral PCNL between January 2017 and December 2019 in our hospital were evaluated. Preoperative, post-operative laboratory values, operative time, stone clearance, complications and hospital stay were recorded. SPSS IBM version 20 was used for data entry and analysis. Results The mean age was 40.0±15.1 years. The mean hospital stay was 3.5 days and mean operative time was 144 minutes. The transfusion rate was observed 16.7% and infracostal approach was most frequently used approach. Conclusion Simultaneous bilateral PCNL is a safe, efficacious, and cost-effective option in cases of bilateral renal calculi and should be considered an acceptable treatment option for patients with bilateral stones due to low morbidity, overall short hospital stays, comparable stone free rates, cost effectiveness and early return-to-normal activity time.

Download Full-text

Postoperative recovery; Stapled Hemorrhoidopexy versus Conventional haemorrhoidectomy.

The Professional Medical Journal ◽

10.29309/tpmj/2019.27.01.4098 ◽

2020 ◽

Vol 27 (01) ◽

pp. 166-171

Author(s):

Ashar Ahmad Khan ◽

Tania Mahar ◽

Muhammad Kashif Adnan ◽

Abdul Rasheed Surahio ◽

Abdul Manan ◽

...

Keyword(s):

Postoperative Pain ◽

Hospital Stay ◽

Postoperative Recovery ◽

Stapled Hemorrhoidopexy ◽

Anal Stenosis ◽

P Value ◽

Group A ◽

Conventional Haemorrhoidectomy ◽

Group B

Conventional haemorrhoidectomy, a usual procedure for hemorrhoids in our set up have many short and long term complications. Some patients complained pain many weeks after surgery and are unable to do their routine work. Anal stenosis and recurrence are long term issues. There is need for some other procedure which can decrease postoperative pain and hospital stay. Objectives: To compare the postoperative recovery between stapled hemorrhoidopexy and conventional hemorrhoidectomy. Study Design: Randomized Clinical trial. Setting: Surgery Department of Nishtar Medical University Multan. Period: from 01-01-2018 to 31-12-2018. Material & Methods: Randomly 02 equal groups of the patients, A and B were made. Stapled hemorrhoidopexy (SH) and conventional haemorrhoidectomy was done in group A and B respectively. SPSS version 20 used for data analysis. Mean and standard deviation were used for quantitative variables including postoperative pain, age and hospital stay. Independent Student t test used for comparison of hospital stay and postoperative pain. Effect modifier including gender, age, duration and grade of hemorrhoids were controlled by stratification and Chi square test was applied. P value less than 0.05 was taken as significant. Results: Out of 60 patients, 32 were males and 28 females. In Group A (Stapled Hemorrhoidopexy), mean age was 37.37 + 6.36 years and 39.17 + 5.53 years in Group-B. Postoperative pain in Group A was 3.60 + 1.27 and 6.03 + 1.73 in Group B. Postoperative pain was significantly high in Group B (CH) and P value =0.000. Mean hospital stay was 0.90 + 0.48 days in Group A and 1.87 + 0.57 days in Group B with P value= 0.000. Conclusion: Stapled hemorrhoidopexy is associated with shorter hospital stay and decrease postoperative pain irrespective of age, sex and grade of the hemorrhoids.

Download Full-text

Stapled haemorrhoidectomy versus openhaemorrhoidectomy: a prospective comparative study

Journal of Chitwan Medical College ◽

10.3126/jcmc.v4i4.11956 ◽

2015 ◽

Vol 4 (4) ◽

pp. 7-11

Author(s):

R S Bhandari ◽

P J Lakhey ◽

Y P Singh ◽

P R Mishra ◽

K P Singh

Keyword(s):

Postoperative Pain ◽

Comparative Study ◽

Operating Time ◽

Symptom Duration ◽

Short Term ◽

Term Outcome ◽

Short Term Outcome ◽

Early Return ◽

Sh Group ◽

Prospective Comparative Study

Open haemorrhoidectomy (OH) treatment has been reserved for prolapsing haemorrhoidal disease (third and fourth grade) and comprehends excision of haemorrhoidal tissue and is associated with significant postoperative pain. As an alternative approach, many randomized controlled trials have shown consistent advantage with haemorrhoidopexy (SH) in terms of postoperative pain, analgesic requirement, length of surgical procedure, short recovery time and early return to normal activities. This study has been conducted to compare the short-term outcome of SH with OH. A prospective comparative study, which included grade 3 and 4 haemorrhoids and comparing short Term outcomes between SH and OH was conducted in the Surgical Gastroenterology units of University Teaching Hospital. A total 44 patients, 22 in each group were compared. Age (SH 42±10.80 Vs. OH 45±13.30) and sex (SH, M:F-9:13 Vs. OH, M:F-14:8) distribution was comparable. Also, the groups were comparable in terms of symptom duration in years (SH, 3.20±2.26 Vs. OH, 2.31±2.47) and distribution of haemorrhoid grades. The SH group showed significant advantage in terms of postoperative pain (Average pain score SH, 2.73±1.20 Vs. OH, 5.20±1.91) and analgesic use (SH 2.32±0.94 Vs. OH 9.32±2.62). Similarly the operating time (time in minutes SH, 42±7.34 Vs. OH, 57.50±8.27), hospitals stay (days of stay SH, 2.90±0.68 Vs. OH, 3.77±0.86) and return to preoperative activity (days to return SH, 7.9±4.90 Vs. OH, 13.6±5.60) were also significantly shorter in the SH group than the OH group. The short-term complications were similar in both groups (P value >0.05). In conclusion, SH has better short-term outcome compared with OH and SH is a viable addition to the therapy options available for haemorrhoids.DOI: http://dx.doi.org/10.3126/jcmc.v4i4.11956

Download Full-text