A PROSPECTIVE OBSERVATIONAL STUDY ON SURGICAL INDICATIONS FOR SPLENECTOMY IN A TERTIARY CARE CENTER.

2021 ◽  
pp. 18-19
Author(s):  
Vijaya Bhaskara Reddy. M. G ◽  
Salman Ahmed. F ◽  
Santosh Kumar Rajput ◽  
Ganashyam. K. R

Background: Spleen mediates important immunologic, storage and hematologic functions. A person can undergo a splenectomy for various causes which includes both surgical and non surgical. The recent trend being towards spleen preservation, it is necessary to critically analyse the indications for splenectomy and assess if the desired post operative outcomes are achieved by splenectomy. Materials and Methods: This prospective observational study was carried out on patients of Department of General Surgery, Mysore Medical College and Research Institute, Mysore, from august 2017 to November 2019. 45 adult subjects (both male and females) aged ≥ 18 years, who underwent elective or emergency splenectomy for various indications were studied. Results: The most common indication for splenectomy was trauma in 27 patients(60%) followed by splenic abscess(15.6%). Most of the patients underwent emergency splenectomy i.e., 25 cases(55%) . In our study the majority received blood transfusion, 15.5% developed wound infection and 2 cases(4.4%) needed reexploration due to rebleeding.

2017 ◽  
Vol 7 (3) ◽  
pp. 134-139
Author(s):  
Nina M. Dadlez ◽  
Gabriella Azzarone ◽  
Mark J. Sinnett ◽  
Micah Resnick ◽  
H. Michael Ushay ◽  
...  

Author(s):  
SUPARNA GROVER ◽  
SUNITA MEENA ◽  
AJAY CHHABRA

Objectives: The objective of the study was to study the indications and risk factors for caesarean section (CS) and to study the caesarean rates in various patient groups as per Robson’s classification. Methods: This prospective observational study was conducted at Government Medical College Amritsar over a period of six months. All the patients admitted for delivery beyond 22 weeks were allotted to Robson groups on admission and the indications of all CS were recorded. The data collected were tabulated and analyzed statistically. Results: There were 553 deliveries in the study period, of which there were 241 CS amounting to a caesarean rate of 43.6%. Nulliparity, previous caesarean delivery and malpresentation were significant risk factors for CS but induction of labor was not associated with increased probability of caesarean delivery. Previous caesarean delivery was the most common indication of CS followed by foetal distress. Among Robson groups, group 10 had the biggest group size and biggest contribution to cesarean rates followed by group 5. Conclusion: Tertiary care government hospitals have a higher cesarean rates due to referral of high-risk pregnancies. Increasing the rates of trial of labour after caesarean is one of the interventions that may serve to decrease the caesarean rates in such institutions.


2021 ◽  
Vol 9 (02) ◽  
pp. 922-937
Author(s):  
Ankur Deshwali ◽  
◽  
Sanjay Prasad ◽  
Akhilesh Kumar Patel ◽  
Rohan Chaphekar ◽  
...  

Introduction :Surgical team always tries to provide consistently low incidence of major complications for patient undergoing any operation. Clavien-Dindo (CD) classification is the simplest way of reporting all complications. The main aim of this study was to test the usefulness of Clavien-Dindo classification in patients undergoing the abdominal surgery. In this study Clavien-Dindo classification has been used for assessment of postsurgical complications after major abdominal surgery. Material and method: It was an observational study of all perforation peritonitis patients admitted in sri aurobindo medical college and post graduate institute between november 2017 to may 2019 (1 and 1/2 Year) on the basis of Clavien-Dindo classification. Results :This was an observational prospective study was carried out in Department of General Surgery, Sri Aurobindo Medical College and P.G. Institute, Indore, which includes total 60 patients of perforation peritonitis admitted and treated in the department, During the period of November 2017 to May 2019. In our study Most common symptoms in patients presenting with perforation is Abdominal pain in 60 (100%) patients. 45(75%) patients had constipation & obstipation, 41 (68.33%) patients had vomiting ,33(55%) of patients had fever 17 (28.33%) patients had abdominal distensions the other common symptoms. Out of 60 patients, all 60(100%) patients had abdominal tenderness and guarding, 47 (78.33%) patients had absent bowel sounds, 42(70%) patients had tachycardia, 26 (43.33%) patients had hypotension, 23 (38.33%) patients had tachypnoea and 21 (35%) patients had low urinary output. In 16 (26.6%) patients comorbid conditions were present. In 10 (16.66%) patients multiple perforations were found out of which only 01 (10%) patient is haemodynamically stable and 09 (90%) patients were unstable. Complication occurred in 09(90%) patients and no complication were only in 01 (10%) patients. In this group 04(40%) patients got discharged and 6(60%) patient expired. P Value was 0.001 which is significant. In our study most common site of perforation was gastric perforation 30(49.18%) Complication according to clavien -dindo classification 14 out of 60 (23.33%) patients had no complications, 4 (6.66%) had grade I complication, 5 (8.33%) had grade II complications, 12 (20%) had grade III complications, 11 (18.33%) had grade IV complications, and 14 (23.33%) had grade V complication rates. Conclusion :Perforation peritonitis is a life-threatening condition and requires urgent hospital care, resuscitation and surgery. Early resuscitation and surgery are required to decrease morbidity and mortality. On the basis of risk stratification in Peritonitis patients its management requires lots of expensive modalities, skill, monitoring and treatment to provide better care to the patient. For the classification of complications, a new system is proposed by Clavien–Dindo which is very helpful during perforation surgery.Clavien- Dindo classification helps us to distinguish a normal postoperative course and the severity of complications, which allows us to compare postoperative morbidity and evaluate the outcomes. We also recommend a larger study with a bigger sample size for better analysis of clavien-dindo classification of complications and to confirm the findings of our study.


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