scholarly journals EARLY EXCISION AND GRAFTING VERSUS CONSERVATIVE TREATMENT IN THE MANAGEMENT OF MAJOR BURNS: A COMPARATIVE STUDY

2019 ◽  
pp. 1-5
Author(s):  
Kinkar Munian ◽  
Utpal Kumar Bit ◽  
Warke Ameya Vasudeo
Keyword(s):  
Conservative Treatment ◽  
Comparative Study ◽  
Hospital Stay ◽  
Standard Procedure ◽  
Surgical Removal ◽  
Blood Transfusions ◽  
Full Thickness ◽  
Bacterial Collagenase ◽  
The Mean

Background : 1 Full thickness burns lose their eschar in 2-6 weeks through bacterial collagenase production and daily mechanical debridement . The practice of leaving these dead tissues only serves as a nidus for infection that can lead to the patient's death. Hence the standard procedure is surgical removal of eschar with grafting techniques. Methods:Atotal of 50 patients divided in 25 patients in each group were included first group was managed conservatively and second underwent th early excision and grafting within 5 day upto 10% TBSA. Results: Early excision and grafting patients required significantly (p=0.04) more blood transfusions than conservatively managed patients. The mean hospital stay was significantly (p=0.05) lower by 10 days in early excision and grafting than conservatively managed. Conclusion : Early Excision and Grafting group was found to have significantly shorter hospital stay with decresed painful debridement but required more blood transfusions than conservatively managed patients.

scholarly journals EARLY EXCISION AND GRAFTING VERSUS CONSERVATIVE TREATMENT IN THE MANAGEMENT OF MAJOR BURNS: A COMPARATIVE STUDY.

2019 ◽  
pp. 1-5
Author(s):  
Kinkar Munian ◽  
Utpal Kumar Bit ◽  
Warke Ameya Vasudeo
Keyword(s):  
Conservative Treatment ◽  
Comparative Study ◽  
Hospital Stay ◽  
Standard Procedure ◽  
Surgical Removal ◽  
Blood Transfusions ◽  
Full Thickness ◽  
Bacterial Collagenase ◽  
The Mean

Background : 1 Full thickness burns lose their eschar in 2-6 weeks through bacterial collagenase production and daily mechanical debridement . The practice of leaving these dead tissues only serves as a nidus for infection that can lead to the patient's death. Hence the standard procedure is surgical removal of eschar with grafting techniques. Methods:Atotal of 50 patients divided in 25 patients in each group were included first group was managed conservatively and second underwent th early excision and grafting within 5 day upto 10% TBSA. Results: Early excision and grafting patients required significantly (p=0.04) more blood transfusions than conservatively managed patients. The mean hospital stay was significantly (p=0.05) lower by 10 days in early excision and grafting than conservatively managed. Conclusion : Early Excision and Grafting group was found to have significantly shorter hospital stay with decresed painful debridement but required more blood transfusions than conservatively managed patients.

185 Vascular Hitch Procedure for Accessory Lower Pole Vessels

2021 ◽  
Vol 108 (Supplement_2) ◽  
Author(s):  
O Fashina ◽  
A Rajimwale
Keyword(s):  
Hospital Stay ◽  
Standard Procedure ◽  
Royal Infirmary ◽  
Lower Pole ◽  
Pelvic Wall ◽  
Stable Renal Function ◽  
The Mean ◽  
Leicester Royal Infirmary ◽  
Functional Magnetic Resonance Urography

Abstract Introduction The gold standard procedure for pelvi-ureteric junction obstruction has been the Anderson-Hynes dismembered pyeloplasty; involving the repositioning of the ureter and ureteropelvic anastomosis. However, the Hellstroem 'Vascular Hitch Procedure’ dictates the superior translocation of the accessory vessel and its fixation to the anterior pelvic wall. The latter has an estimated success rate >90%. Method During 2016-2020, at Leicester Royal Infirmary, 16 operations occurred on paediatric patients with pelvi-ureteric junction obstruction. The dismembered pyeloplasty was performed on 5 patients, 9 patients underwent the vascular hitch procedure, and 2 patients are currently awaiting the latter operation. All patients had a pre-operative functional magnetic resonance urography (fMRU) to identify and localise the accessory lower pole vessel. Results The mean hospital stay for the vascular hitch procedure was 1.5 days (range=1-2) in comparison to 4 days (range=3-5) for the dismembered pyeloplasty. The follow-up period ranged from 6 months to 3 years. Overall, it was noted that the patients were asymptomatic, had markedly reduced hydronephrosis on imaging as well as stable renal function noted on the MAG 3 renogram scan. Conclusions The laparoscopic vascular hitch procedure appears to be the superior operation for the management of pelvi-uteric junction obstruction as the patients had notably reduced hospital stay lengths.

scholarly journals Early versus Delayed Laparoscopic Cholecystectomy in Acute Calculus Cholecystitis in Southern Odisha - A Prospective Comparative Study

2021 ◽  
Vol 8 (20) ◽  
pp. 1484-1488
Author(s):  
Manoj Kumar Sethy ◽  
Siva Rama Krishna M ◽  
Jagannath Subudhi S ◽  
Biswa Ranjan Pattanaik ◽  
Manita Tamang ◽  
...  
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Conservative Treatment ◽  
Hospital Stay ◽  
Acute Cholecystitis ◽  
Morbidity And Mortality ◽  
Early Laparoscopic Cholecystectomy ◽  
Delayed Laparoscopic Cholecystectomy ◽  
Conversion To Open Cholecystectomy ◽  
The Mean ◽  
Antibiotic Coverage

BACKGROUND Acute cholecystitis is a pathology of inflammatory origin, usually associated with cholelithiasis, with a high incidence in the world. Its treatment involves an important socioeconomic impact. There are two surgical therapeutic options: early laparoscopic cholecystectomy (ELC) done within 72 hours of onset of pain or delayed laparoscopic cholecystectomy (DLC) done after 6 weeks of conservative treatment. The present study intends to compare between the effectiveness of ELC vs DLC in the management of acute cholecystitis in a tertiary care setup. METHODS The study sample included 65 patients who were clearly documented and radiologically proven cases of acute calculous cholecystitis, met the inclusion criteria, admitted to the surgery department of MKCG MCH, Berhampur, between August 2018 and July 2020. Out of 65 patients, 33 and 32 patients were selected randomly for ELC and DLC respectively. In ELC group surgery was done within 72 hours of the onset of pain while in DLC group surgery was done after 6 weeks of initial conservative treatment. The study was conducted using a case record proforma, prepared in their local language. The questionnaire included timing of cholecystectomy, duration of antibiotic coverage, mean duration of hospital stay, number of intraoperative and postoperative complications, conversion to open cholecystectomy, and follow-up. The data was compiled and tabulated in MS ® Excel and statistically analysed using IBM ® SPSS 22.0. RESULTS The overall morbidity and mortality were less in ELC compared to DLC. The mean duration of surgery was less in ELC (47.36 minutes) compared to DLC (65.75 minutes). The mean duration of antibiotic coverage was lesser in ELC (3.58 days) compared to DLC (5.50 days).The mean hospital stay was less in ELC (4.67 days) to DLC (6.50 days). The overall morbidity and mortality were less in ELC. CONCLUSIONS ELC is considered to be a safe modality of treatment in patients with acute cholecystitis and leads to an economical treatment. KEYWORDS Acute Calculus Cholecystitis, Early Laparoscopic Cholecystectomy, Delayed Laparoscopic Cholecystectomy

scholarly journals A comparative study between open lichtenstein mesh repair and laparoscopic totally extra peritoneal repair of inguinal hernia

2018 ◽  
Vol 5 (5) ◽  
pp. 1733
Author(s):  
Karthik Pooraneson ◽  
Chandrashekar N. ◽  
Ved Prakash Ranjan ◽  
Yamuna V. S.
Keyword(s):  
Inguinal Hernia ◽  
Comparative Study ◽  
Hospital Stay ◽  
Mesh Repair ◽  
Tep Repair ◽  
Duration Of Hospital Stay ◽  
Post Operative Pain ◽  
The Mean ◽  
Operative Recovery ◽  
Study Participants

Background: The study was conducted to compare and assess the duration of procedure, complications encountered, post-operative pain and recovery, duration of hospital stay, and time taken in resumption to work between two techniques of open Lichtenstein mesh repair (OLMR) and Totally extra peritoneal (TEP) repair in the low resource settings.Methods: A cross sectional comparative study was conducted among 50 male patients admitted for surgical repair of hernia. After considering the inclusion and exclusion criteria, the subjects were randomly assigned to the groups of OLMR and TEP and were assessed for pain in the post-operative period was rated using a Visual Analogue Scale. Total duration of the procedure, complications, duration of hospital stay, and time taken in resumption to work were elicited between two techniques. A p-value of <0.05 was taken as statistically significant.Results: The mean duration of surgery among the study participants in TEP (49.60+3.62 mins) group was significantly higher compared to OLMR (45.96+4.63 mins) group (p=0.003). The median of post-operative pain scores in TEP group was significantly lower compared to OLMR group. The mean duration of post-operative recovery time (3.08+0.4 days), for resumption to work (5.08+0.28 days) among the study participants in TEP group was significantly lower compared to OLMR (5.00+0.00 days), (10.08+0.76 days) (p<0.001) respectively. The complications were significantly higher among the OLMR group (100.0%) compared to the TEP group (p<0.05).Conclusions: Though the procedure of TEP repair for inguinal hernia takes a little longer time and complications of general anaesthesia cannot be ruled out, it is a better procedure compared to open type.

scholarly journals A Prospective Comparative Study: Stapler Hemorrhoidopexy vs Laser Hemorrhoidoplasty in the Treatment of Hemorrhoids

2020 ◽  
pp. 10-23
Author(s):  
Anshuman Kaushal ◽  
Aakanksha Aggarwal ◽  
Amanpriya Khanna ◽  
Rajesh Agarwal ◽  
Dhruv N. Kundra ◽  
...  
Keyword(s):  
Postoperative Pain ◽  
Comparative Study ◽  
Hospital Stay ◽  
Postoperative Bleeding ◽  
Early Return ◽  
Severe Postoperative Pain ◽  
Prospective Comparative Study ◽  
Grade Ii ◽  
The Mean ◽  
Group 2

Aims: Stapler hemorrhoidopexy (SH) has evolved over time as a procedure of choice over conventional surgery due to less postoperative pain. Laser hemorrhoidoplasty (LH) is a novel procedure aimed at shrinking the terminal branches of hemorrhoidal arteries with fewer complications. The present study is aimed to compare these procedures (SH and LH). Study Design: Prospective comparative study. Place and Duration of Study: Patients operated for hemorrhoids at the Department of General, MI & Bariatric Surgery, Artemis Hospitals, Gurgaon from April 2018 to March 2019. Methodology: 50 patients with grade II-III hemorrhoids were allocated to two groups: Stapler hemorrhoidopexy (SH) and Laser hemorrhoidoplasty (LH) with 25 patients in each group. Results were compared and patients were followed up for minimum period of 3 months. Results: The mean operative time was 24.6 min (LH) and 28.6 min (SH) (P =.122). The average blood loss was 8.32 ml (LH) and 11.64 ml (SH) (P <.05). The mean hospital stay 21.44 hours (LH) and 32.64 hours (SH) (P <.05). Mean postoperative pain score (VAS) at 12 hours was 2.64 (LH) and 4.76 (SH) (P <.05), at 24 hours was 1.88 (LH) and 3.6 (SH) (P <.05), at 1 week was 0.36 (LH) and 0.88 (SH) (P =.054) and at 3 months 0.04 (LH) and 0.12 (SH) (P =.53). One patient in LH (4%) had postoperative bleeding on 4th postoperative day. In SH group, 2 (8%) had severe postoperative pain with VAS > 8, requiring longer hospital stay, 2 (8%) had bleeding on the same day, 1 (4%) had bleeding on follow up and 1 (4%) had recurrence. Conclusion: In terms of early postoperative pain and complications, LH offers better results as compared to SH. It was associated with a shorter hospital stay and early return to work. No significant complications were noted in LH compared to SH. LH is an extremely viable alternative to the popular SH for grade II-III hemorrhoids.

scholarly journals A COMPARATIVE STUDY ON OUTCOMES OF OPEN & LAPAROSCOPIC REPAIR IN INGUINAL HERNIA IN A TERTIARY CARE CENTRE

2020 ◽  
pp. 23-25
Author(s):  
Konkena Janardhana Rao ◽  
K. Meghana ◽  
N. Prahalada Reddy ◽  
J. Ramanaiah ◽  
Mamatha. V ◽  
...  
Keyword(s):  
Inguinal Hernia ◽  
Hernia Repair ◽  
Comparative Study ◽  
Hospital Stay ◽  
Laparoscopic Hernia Repair ◽  
Female Ratio ◽  
Duration Of Surgery ◽  
The Mean ◽  
Operative Recovery ◽  
Lichtenstein Operation

Background: Over the last decade, the field of hernia surgery got a new transformation, with exponential growth in mesh technology. Laparoscopic hernia repair has remained a contentious issue since its inception. Though a variety of procedures performed; none can be termed as an ideal procedure as each one is accompanied by varied early and late complications. The most scientific way to conclude the superiority of one method over others is evidence-based medicine. Hence, we have conducted a study in our institute, to compare Lichtenstein tension-free open hernioplasty with Transabdominal pre-peritoneal repair (TAPP) comparing the intraoperative and early postoperative complications. Methods: Our study was a single-centre, prospective comparative study conducted on sixty-one patients, over a period of 2 years from August 2018 to August 2020. All the cases included in the study were uncomplicated inguinal hernias. A detailed history of the symptoms, thorough clinical examination and investigations were done, which were analysed. Results: Most of the patients presented in the 5th decade. Male to female ratio of incidence of inguinal hernia was 11.2:1. Majority of the patients presented with unilateral hernia with right inguinal hernia being the most frequent presentation. The mean duration of surgery for TAPP is more when compared to Lichtenstein operation. The mean duration of hospital stay for open hernioplasty is more when compared to the laparoscopic hernia repair. TAPP is associated with lesser complications when compared to Lichtenstein's hernioplasty. Seroma, hematoma, and wound infection were the common complications noted. Conclusion: TAPP repair is a better procedure when compared to Lichtenstein operation in terms of hospital stay, post- operative recovery, intra-operative and post-operative complications.

scholarly journals Outcomes of Percutaneous Nephrolithotripsy With or Without Nephrostomy Tube: A Comparative Study

2020 ◽  
Vol 18 (1) ◽  
pp. 96-99
Author(s):  
Naresh Man Shrestha
Keyword(s):  
Hospital Stay ◽  
Renal Stone ◽  
Standard Procedure ◽  
Operation Time ◽  
P Value ◽  
Nephrostomy Tube ◽  
Group I ◽  
The Mean ◽  
Tubeless Pcnl ◽  
Percutaneous Nephrolithotripsy

Introduction: Percutaneous Nephrolithotripsy (PCNL) is one of the most accepted surgical modality for removal of renal stone. Placement of a nephrostomy tube at the end of PCNL is a standard procedure for PCNL, however many reports have showed the safety and efficacy of tubeless PCNL for the removal of renal stone. Aims: The present study aimed to report the outcomes of PCNL with or without nephrostomy tube. Methods: It is Prospective Hospital Study conducted from June 2017 to April 2020 in the Department of Urology Nepalgunj Medical College. Total 153 patients under inclusion criteria were divided into two groups. Group 1 (75 patients) was allocated to patients who were   being treated under standard PCNL procedure while Group 2 (78 patients) was allocated for patients who were being treated under Tubeless PCNL procedure. The two groups were compared for operation time (minutes), hospital stay (days), post operative dose of analgesic (mg), post operative complications such as, leakage (%), bleeding (%) and infection (%). Data were analyzed from SPSS and p-value less than 0.5 was considered as significant. Results: In Group II the mean hospital stay, analgesic dose and rate of leakage was significantly lesser than Group I (p<0.05) whereas, the mean operation time, rate of infection and bleeding were not significantly different between two groups (p>0.05). Conclusion:  Tubeless PCNL procedure causes more rapid recovery and earlier discharge from the hospital, reduction in postoperative pain and no leakage when compared to standard tubless PCNL.

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 A comparative study of suturing technique of intestine between extra-mucosal single layer interrupted and continuous all layers: a single center experience

2021 ◽  
Author(s):  
Manoranjan Kar ◽  
Somu Singhal ◽  
Bismoy Mondal ◽  
Arijit Roy
Keyword(s):  
Comparative Study ◽  
Hospital Stay ◽  
Intestinal Anastomosis ◽  
Single Layer ◽  
P Value ◽  
Bowel Anastomosis ◽  
Duration Of Hospital Stay ◽  
Group A ◽  
The Mean ◽  
Group B

Background: Gastrointestinal anastomosis has been excited interest in our day to day surgical practice. We have compared efficacy, advantages, disadvantages, and complications following intestinal resection-anastomosis using extra-mucosal interrupted single layer suturing or continuous all layer suturing.Methods: This comparative study included 50 cases (either in emergency or elective undergoing bowel resection and anastomosis), comprising of 2 Groups (25 cases in each Group) between January 2019 to June 2021 at Midnapore Medical College and Hospital. Patients data, operative findings, duration of anastomosis and length of hospital stay, post-operative complications of all patients were followed till discharge.Results: Our comparative study have shown that- the mean duration for intestinal anastomosis in Group A (extra-mucosal interrupted single layer) and Group B (continuous all layers) were 21.43 minutes and 14.35 respectively. Considering duration of the anastomosis continuous all layers intestinal anastomosis appears to represent in shorter duration, anastomotic leak was noted in 3 patients (6%). Anastomotic leak was observed in 1 patient extra-mucosal interrupted single layer bowel anastomosis whereas two patients in the Group of continuous all layered bowel anastomosis had leak (p value 0.5-not significant) and the mean duration of hospital stay in the Group A and Group B were 7.32 days and 7.92 days respectively. (p value -insignificant).Conclusions: Duration required to perform a continuous all layer bowl anastomosis is lesser when compared to an extra-mucosal interrupted single layer intestinal anastomosis. There is no significant difference in complications, final outcome and duration of hospital stay between two Groups.

scholarly journals Thyroidectomy with and without drains: a clinical comparative study

2019 ◽  
Vol 6 (5) ◽  
pp. 1584
Author(s):  
Shaileshkumar M. Emmi ◽  
M. Amarnath Reddy
Keyword(s):  
Comparative Study ◽  
Hospital Stay ◽  
Tertiary Care ◽  
Length Of Hospital Stay ◽  
Early Discharge ◽  
General Surgeon ◽  
Hematoma Formation ◽  
Closed Suction Drain ◽  
Drain Group ◽  
The Mean

Background: Thyroid surgery is one of the most commonly performed procedures by a general surgeon, and almost every surgeon tends to use closed suction drain at the end of surgery, with an intention of preventing the most dangerous complication i.e., suffocating haematoma, which may be not necessary as suggested by many studies. The objective of the study was to assess the benefit of drain use after thyroidectomy by determining; length of hospital stay, post operative pain and wound sepsis.Methods: This prospective clinical comparative study was undertaken at tertiary care teaching Hospital, for duration of one year from September 2017 to August 2018.Results: A total of 44 patients were evaluated. There were 29 females (65.90%) and 15 males (34.09%). The mean age for the drain group was 35.45 years and 33.79 years for the no drain group. Most participants were female. Mean duration of hospital stay after thyroidectomy was significantly higher among the drain arm as compared with the no drain arm. Seven patients developed complications in the drain group and one developed complication in the no drain group. The mean hospital stay of the drain group was 3.15 days which in the no drain group was 2.51 days.Conclusions: Thyroidectomy without drains causes less discomfort, early discharge, hence has lesser expenses, without increasing the risk of post operative including haemorrhage and hematoma formation. Meticulous haemostasis and an adequate surgical technique are the keys for avoiding haemorrhage and hematoma formation.

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