PERITONEAL CLOSURE VERSUS NON-CLOSURE IN OPEN APPENDICECTOMIES

2021 ◽  
pp. 11-12
Author(s):  
V. Manmadha Rao M.S ◽  
D. N. S. Sai Kumar ◽  
K. Neelesh
Keyword(s):  
Acute Appendicitis ◽  
Hospital Stay ◽  
Wound Infection ◽  
Operative Time ◽  
Open Appendicectomy ◽  
Duration Of Hospital Stay ◽  
Peritoneal Closure ◽  
Post Operative Pain ◽  
Duration Of Surgery ◽  
King George Hospital

Acute Appendicitis is a common surgical emergency and Open Appendicectomy is widely performed. This study aims to analyze the difference of outcome in peritoneal closure versus Non closure in open appendicectomy. Adult patients (18- 65 years) admitted and operated for Acute appendicitis were studied prospectively from July 2019 to July 2020 at King George Hospital, Visakhapatnam. The intra operative time, post-operative pain, wound infection and duration of hospital stay were analyzed. Between July 2019 and July 2020 there were 86 patients with diagnosis of Acute appendicitis to the emergency casualty of KGH, Visakhapatnam and underwent Open appendicectomy. They were divided into two groups randomly, Group A: Open appendicectomy with peritoneal closure (39) and Group B: Open appendicectomy with non-closure of peritoneum (47). There was found to be a reduction in the duration of surgery, less post operative pain and shorter duration of hospital stay in patients who underwent non-closure of peritoneum compared to patients who underwent peritoneal closure. There was no difference in incidence of post-operative wound infection when compared to closure of peritoneum. Non closure of peritoneum is associated with shorter operative time, reduced requirement of post-operative analgesia and shorter duration of hospital stay and hence can be safely recommended.

scholarly journals Peritoneal closure or non-closure in open appendectomy: a reality or a myth

2018 ◽  
Vol 5 (9) ◽  
pp. 3102
Author(s):  
T. R. V. Wilkinson ◽  
Mahendra K. Chauhan ◽  
Isha Trivedi
Keyword(s):  
Hospital Stay ◽  
Operative Time ◽  
Open Appendectomy ◽  
Daily Basis ◽  
Wound Infections ◽  
Open Appendicectomy ◽  
Duration Of Hospital Stay ◽  
Peritoneal Closure ◽  
The Difference ◽  
Group B

Background: The objective of this study is to analyze the difference of outcome and complications in peritoneal closure versus non-closure in open appendicectomy.Methods: This was the prospective comparative study. 126 patients with the diagnosis of acute appendicitis undergoing open appendicectomy divided in two groups non-randomly. Group A: Open appendicectomy with closure of peritoneum (n=59) and Group B: Open appendicectomy with non-closure of peritoneum (n=67). Intra operative time and post-operative period for pain and complications like wound infections, hernia and duration of hospital stay were analyzed. Patients were shown ‘visual analogue scale’ on a daily basis and those who reported unbearable pain given additional analgesia.Results: Operative time, number of doses of analgesic required, wound infections and duration of hospital stay in both groups were compared. Difference in operative time between both the groups was found to be statistically significant (p< 0.0001).Conclusions: Non-closure of peritoneum in open appendicectomy is associated with lesser operative time, and shorter duration of hospital stay. Hence, it can be safely recommended.

scholarly journals LAPAROSCOPIC APPENDECTOMY;

2019 ◽  
Vol 26 (01) ◽  
Author(s):  
Sajid Malik ◽  
Kamran Zaib Khan ◽  
Iftikhar Ahmad
Keyword(s):  
Hospital Stay ◽  
Laparoscopic Appendectomy ◽  
Operative Time ◽  
Standard Procedure ◽  
Minimal Invasive ◽  
Time Duration ◽  
Duration Of Hospital Stay ◽  
Post Operative Pain ◽  
Scar Mark ◽  
Almost All

Background: Minimal invasive surgery (MIS) is a modern and safe improvement in field of laparoscopic surgery. Single incision laparoscopic appendectomy (SILA) is a major breakthrough in MIS and has become standard procedure for acute appendicitis in place of conventional three port laparoscopic appendectomy (CTLA). Objectives: To see the potential advantages in terms of operative time, duration of hospital stay, post-operative pain and cosmetic results in SILA and CTLA groups. Study Design: Randomized control study. Setting: Department of General Surgery in Allama Iqbal Medical College/ Jinnah Hospital Lahore. Period: July 2016 to June 2017. Materials and Methods: 48 patients were divided in two groups; group SILA (cases) and CTLA (control). Each group comprised 24 patients. All cases were performed by consultant who were competent enough and trained in MIS. Results: We found that there was statistically no difference in operative time (p>0.05) and post-operative pain (p>0.05) of both procedures but statistically significant outcome was observed in duration of hospital stay (p<0.005) and cosmetic result (p< 0.005). Post-operative analgesia usage was same in both groups with similar outcome of control. Surgical wound healed in all patients of both groups without complication but noticeably had shown no scar mark on three months follow up in patients of SILA group. Almost all patients in SILA group were discharged on same day on oral diet. Conclusion: This study showed that results of SILA are better in terms of cosmoses and less duration of hospital stay in the presence of non-significant operative time of two procedures. Staying with promise of minimizing in MIS to SILA, cosmetic satisfaction and minimal hospital stay are its comprehensible advantages.

scholarly journals Study of laparoscopic appendectomy: advantages, disadvantages and reasons for conversion of laparoscopic to open appendectomy

2017 ◽  
Vol 4 (3) ◽  
pp. 993
Author(s):  
Sujan Narayan Agrawal ◽  
Sunita Meshram ◽  
Kamlesh Dhruv
Keyword(s):  
Hospital Stay ◽  
Wound Infection ◽  
Laparoscopic Appendectomy ◽  
Open Appendectomy ◽  
Laparoscopic Approach ◽  
Normal Activity ◽  
Organ Injury ◽  
Cross Sectional ◽  
Duration Of Hospital Stay ◽  
Duration Of Surgery

Background:Good outcome has been reported with the laparoscopic approach in uncomplicated appendicitis, but a higher incidence of postoperative intraabdominal abscesses has been reported after laparoscopic appendectomy in complicated appendicitis. Objective was to study the efficacy of laparoscopic appendectomy.Methods: A Hospital based cross sectional study was carried out among of 302 patients. The study duration was from June 2004 to December 2006. Institutional Ethics Committee permission was obtained. Informed individual consent was taken. Out of 302 subjects, 236 underwent open appendectomy and 66 underwent laparoscopic appendectomy.Results:It was observed that in both the groups majority patients had retrocecal position of the appendix. The amount of blood loss, adjacent organ injury and duration of surgery were similar in both the groups. The difference in the incidence of wound infection in both groups was not found to be statistically significant. But the antibiotic use was significantly less in the LA group compared to OA group. It was found that time to resumptions of oral fees, duration of hospital stay and time to return to normal duties were significantly lesser in LA group compared to OA group. (p < 0.001). As per the cosmetic end result, majorities were satisfied in LA group and rated the surgery as excellent as compared to patients in OA group.Conclusions:Laparoscopic appendectomy was better than open appendectomy with respect to wound infection, tackling co-existing pathology, duration of hospital stay, earlier return to normal activity, excellent cosmetic end result, lesser use of antibiotics and earlier resumption of oral feeds.

scholarly journals A comparative study between onlay and sublay meshplasty in ventral hernias: a randomized controlled trial

2019 ◽  
Vol 6 (4) ◽  
pp. 1264
Author(s):  
Tharun Ganapathy Chitrambalam ◽  
Preetham Anguraj ◽  
Jeyakumar Sundaraj ◽  
Manimaran Pethuraj
Keyword(s):  
Hospital Stay ◽  
Wound Infection ◽  
Ventral Hernia ◽  
Controlled Study ◽  
Post Operative Pain ◽  
Duration Of Surgery ◽  
Group A ◽  
The Mean ◽  
Group B ◽  
Ventral Hernias

Background: Ventral hernias are one of the most common surgical problems of the modern age. About 15-18% of all the surgical procedures performed around the world comprises of hernia repair. This study aims to compare the two common options of mesh placement in open ventral hernia repairs; over the anterior rectus sheath, the ‘Onlay meshplasty’ and in the retrorectus plane, the ‘Sublay meshplasty’.Methods: A prospective controlled study was done between March 2017 to August 2018 on 150 patients with ventral hernia randomizing patients into 2 groups. Group A (Onlay meshplasty) and Group B (Sublay meshplasty). Duration of surgery, post-operative pain, wound infection, duration of hospital stay and recurrences were analysed with 12 months follow up.Results: The mean duration of surgery in group A was 48.49±0.71 minutes and in group B was 72.84±0.72 minutes. Group B experienced significantly lesser pain when compared with group A. The mean asepsis score in group A was 3.60±1.09 and in group B was 0.47±0.30 with a p value of 0.006. Group A had significantly longer hospital stay (9.39 days) than group B (5.71 days). The recurrences in both the groups were statistically insignificant (Group A- 2 patients; Group B- 1 patient).Conclusions: Sublay meshplasty although requires longer time to perform, proves to be a better alternate in terms of post-operative pain, wound infection and hospital stay.

scholarly journals Laparoscopic versus open appendicectomy: a non-randomized comparative study

2020 ◽  
Vol 7 (6) ◽  
pp. 1925
Author(s):  
Swatej Hanspal ◽  
M. Yunus Shah ◽  
Murtaza Akhtar
Keyword(s):  
Comparative Study ◽  
Hospital Stay ◽  
Wound Infection ◽  
Operative Time ◽  
Laparoscopic Approach ◽  
Length Of Hospital Stay ◽  
Conventional Technique ◽  
Laparoscopic Appendicectomy ◽  
Open Appendicectomy ◽  
Number Of Patients

Background: Appendicectomy is one of the most common surgical procedures performed in emergency surgery. Despite this, there is still lack of consensus about the most appropriate technique for appendicectomy. In this longitudinal analysis, we aimed to compare the outcomes of laparoscopic appendicectomy (LA) and the conventional technique or open appendicectomy (OA) in the treatment of acute appendicitis.Methods: A non-randomized longitudinal comparative study was conducted in NKP Salve Institute of Medical Sciences and Lata Mangeshkar Hospital, Nagpur, India. From November 2017 to October 2019, 53 patients underwent OA and 59 underwent LA, making a total number of patients included in this study to be 112 (n). The two groups were compared for operative time, length of hospital stay, postoperative pain, post-operative ileus and complication rate.Results: Laparoscopic appendicectomy was associated with a shorter hospital stay (4.34±1.37 days in LA and 5.09±1.71 days in OA, p<0.01), with a lower post operative pain score [VAS] (2.93±0.80 in LA and 4.62±0.92 in OA, p<0.001). Operative time was shorter in the open group (42.70±12.05 min in OA and 43.39±16.59 in LA). Complications were lesser in the LA group with a significantly lower incidence of wound infection (3.4% in LA and 13.2% in OA).Conclusions: Laparoscopic approach is safe and efficient in appendicectomy and it provides clinically advantages over open method (shorter hospital stays, lower post op pain, early food tolerance, earlier return to work and lesser wound infection) against only marginally longer operative time.

scholarly journals Retrospective immediate post-operative comparative study of sequential bilateral total knee replacement versus unilateral total knee replacement for knee primary osteoarthritis

2021 ◽  
Vol 7 (2) ◽  
pp. 189
Author(s):  
Sanil G. Kamat ◽  
Rohan Dessai
Keyword(s):  
Total Knee Replacement ◽  
Hospital Stay ◽  
Knee Replacement ◽  
Complication Rates ◽  
Duration Of Hospital Stay ◽  
Primary Osteoarthritis ◽  
Post Operative Pain ◽  
Duration Of Surgery ◽  
Total Knee ◽  
Group 1

<p class="abstract"><strong>Background:</strong> The study is to compare the immediate post operative outcomes of sequential bilateral versus unilateral total knee replacement (TKR) for the treatment of primary knee osteoarthritis. Study comprised of 96 cases of tricompartmental knee primary osteoarthritis who have undergone unilateral and sequential bilateral total knee arthroplasty at Manipal Hospital, Goa from January 2016 to December 2018. The observations for each group was analysed and duration of hospital stay, post operative mobilisation, fall in haemoglobin level immediate post operative, need for blood transfusion, post operative complications, post operative pain and duration of surgery was recorded. The results were statistically compared. The mean duration of hospital stay, post operative blood loss in terms of fall in HB, post operative pain control, need of transfusions and duration of surgery revealed statistically significant differences.</p><p class="abstract"><strong>Methods: </strong>Total 96 patients diagnosed with primary tricompartmental osteoarthritis were divided into two groups retrospectively. Group 1 operated with sequential bilateral TKR under single anaesthetic procedure and group 2 with unilateral TKR both operated by same surgeon and anaesthetist.</p><p class="abstract"><strong>Results: </strong>It was observed that longer duration of surgery and hospital stay, higher fall in HB levels, increased need of analgesics and higher requirement of blood transfusions were associated with group 1 as compared to 2. Complication rates and post op mobilisation was similar in both groups.</p><p class="abstract"><strong>Conclusions: </strong>Sequential bilateral TKR is a viable option for patient with symptomatic bilateral knees but patient selection and pre op counselling takes the priority.  </p><p class="abstract"> </p>

scholarly journals Is the laparoscopic approach superior to open approach for treatment of acute appendicitis? A hospital based experience

2017 ◽  
Vol 4 (5) ◽  
pp. 1726
Author(s):  
Anil Reddy Pinate ◽  
Mohammad Fazelul Rahman Shoeb ◽  
Shiva Kumar C. R.
Keyword(s):  
Acute Appendicitis ◽  
Hospital Stay ◽  
Operative Time ◽  
Laparoscopic Group ◽  
Laparoscopic Appendicectomy ◽  
Open Group ◽  
Open Appendicectomy ◽  
Group A ◽  
The Mean ◽  
Group B

Background: Laparoscopic appendicetomy remains controversial in Indian perspective. The objective was to compare the clinical outcome of open with laparoscopic appendicectomy.Methods: Prospectively collected data from 150 consecutive patients with acute appendicitis was studied. Patients undergoing surgery for acute appendicitis were alternately assigned into one of the two groups (Group-A patients underwent open appendicectomy and in Group B laparoscopic appendicectomy). The two groups were compared with respect to operative time, length of hospital stay, postoperative pain & wound complications.Results: The mean operative time in the open group was 84.40 minutes; for laparoscopic group, 95.20 minutes (p-0.001). Duration of paralytic ileus, tolerance to oral feeds, resumption of daily routine activity and ambulation of patients were started earlier in laparoscopic group than open group. Group A (OA) patients had pain at the mean of 2.66 days as compared group B (LA), in which patients had pain at the mean of 1.66 days.  Study also showed that the hospital stay for laparoscopic group was almost half of that for open group. Laparoscopic appendicectomy was safe as compared to open surgery in context to post-operative complications.Conclusions: Provided surgical experience and equipment are available, Laparoscopic appendicectomy is as safe and efficient than open appendicectomy.

scholarly journals Laparoscopic Versus Open Appendicectomy for Treatment of Acute Appendicitis

2019 ◽  
Vol 20 (1) ◽  
pp. 24-25
Author(s):  
Mohammad Ali ◽  
Kazi Lsrat Jahan
Keyword(s):  
Acute Appendicitis ◽  
Hospital Stay ◽  
Gold Standard ◽  
Operative Time ◽  
The Other ◽  
Laparoscopic Appendicectomy ◽  
Abdominal Abscess ◽  
Open Appendicectomy ◽  
Laparoscopic Skills ◽  
Operative Complications

Laparoscopic appendicectomy is not yet considered the "gold standard" in the treatment of acuteappendicitis because of its higher operative time, intra-abdominal abscess risk, and costscompared to open appendicectomy. On the other hand laparoscopic appendicectomy is associatedwith fewer post operative complications, shorter hospital stay, and nearly similar operative time,intra-abdominal abscess rate, and total costs, compared with open appendicectomy. With increasein the experience of the surgeon in laparoscopic skills pit falls will be much lower. Therefore, laparoscopicappendectomy can be recommended as preferred approach in acute appendicitis Journal of Surgical Sciences (2016) Vol. 20 (1) : 24-25

scholarly journals Comparative study on open appendicectomy versus laparoscopic appendicectomy in a tertiary care centre

2018 ◽  
Vol 5 (4) ◽  
pp. 1240
Author(s):  
Naraintran S. ◽  
Sandeep Kumar David S. ◽  
Raveendran K. ◽  
Eashwara Pilla B. K.
Keyword(s):  
Comparative Study ◽  
Hospital Stay ◽  
Wound Infection ◽  
Laparoscopic Appendicectomy ◽  
Open Group ◽  
Open Appendicectomy ◽  
Group 4 ◽  
Duration Of Surgery ◽  
Operative Complications ◽  
Post Operative Complications

Background: Appendicectomy is one of the most common procedure in general surgery, accounts for approximately 1% of all surgical operation. Laparoscopic appendicectomy are likely to have less postoperative pain, early discharge, decreased wound infection, better cosmesis and also early return to routine work. Laparoscopic procedure for appendicectomy is compared with open surgical technique with respect to duration of surgery, post operative pain, duration of analgesic, post operative complications, post operative length of hospital stay and return to routine work.Methods: This is a prospective and comparative study from September 2013 to August 2014 involved 100 cases, 50 open and 50 lap appendicectomy, which were randomly selected and were operated in department of surgery, Dr S. M. C. S. I. Medical College, Karakonam.Results: In present study pain score was 2.7±0.9 for open group as compared to 1.3±0.5 in lap group (P<0.05) because of longer incision stretch of muscles and wound infection. Post operative complications like vomiting was lower in laparoscopic group with 8% as compared with 36% in open group (P<0.05) and ileus was lower in lap group with 17.3±7.1 and for open group 30.8±8.9 with P<0.05 which were significant. There is significant reduction in incidence of post operative wound infection in lap group 4% as compared to open group 26% (P<0.05). Duration of post operative hospital stay was significantly low for lap group 2.8±0.9 as compared to open group 4±2.9. The return to normal activity was low for lap group 8±3.15 days as compared to open group 13.7±3.15 days. Duration of surgery for open appendicectomy was 48.2±12.4 and for lap appendicectomy was 68.5±20.3.Conclusions: Laparoscopic appendicectomy is better than open appendectomy in selected patients with acute or recurrent appendicitis.

scholarly journals Differences in Surgical Outcome in Near Total Thyroidectomy for Benign Nodular Goiter: A Comparison of LigaSure Vessel Sealer versus Conventional Clamp Knot Tie Technique

2021 ◽  
pp. 65-69
Author(s):  
Shiraz Shaikh ◽  
Champa Sushel ◽  
Ahsan Ali Laghari ◽  
Qamber Ali Laghari ◽  
Zameer Hussain Laghari ◽  
...  
Keyword(s):  
Hospital Stay ◽  
Total Thyroidectomy ◽  
Calcium Level ◽  
Operative Time ◽  
Nodular Goiter ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Post Operative Pain ◽  
Significant Difference ◽  
One Year

Objective: To compare the efficacy of LigaSure Vessel Sealer in Near Total Thyroidectomy versus Conventional Clamp Knot Tie Technique in terms of bleeding, operative time and postoperative drainage. Methodology: This comparative cross sectional study was conducted at Department of Surgery, Liaquat University of Medical and Health Sciences, Jamshoro. Study duration was one year from November 2019 to October 2020. All patients of any age with benign multinodular goiter and either of gender were included. The study subjects were grouped into two categories by randomization (odd / even). The odd numbers were given to patients operated for ligasure and even numbers were given to patients operated with conventional clamp knot tie technique.  Outcomes were observed with respect to post-operative calcium level, intra-operative bleeding, operative time, post-operative pain & post-operative hospital stay. All the data was recorded via study proforma. Data was analyzed by using SPSS version 20. Results: Total 55 patients were observed. Mean age was 33.25±10.60 years in clamp knot tie procedure group and 35.16±07.96 years in ligasure technique group; without significant difference (p-0.448). Pre and post-operative calcium levels were statistically insignificant among both groups (p-0.358 and 0.163), while loss of blood, hospital stay, post-operative pain and operative duration were significantly greater in clamp knot tie technique group in comparison to ligasure technique group (p-<0.001). Conclusion: LigaSure Vessel Sealer is a feasible and reliable surgical technique and significantly more effective as compared to conventional clamp knot tie technique in terms of post-operative bleeding, operative time, post-operative pain and post-operative hospital stay. However, calcium level was statistically insignificant.

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