O’CONOR (TRANSABDOMINAL) REPAIR: IS IT ALWAYS NECESSARY TO INTERPOSE A FLAP IN SIMPLE VESICO-VAGINAL FISTULA? A COMPARATIVE STUDY

Objective: To assess morbidity and success of transabdominal (O’Conor) repair of vesicovaginal fistula with orwithout interposition of flap between vagina and urinary bladder. Study Design: Prospective comparative study. Place and Duration of Study: Armed Forces Institute of Urology, Rawalpindi, from Mar 2016 to Jan 2019. Methodology: Fifty five patients were randomized into group A & B by lottery method. An inclusion criterionwas single fistulous opening of ≤3cm. Complex and recurrent fistulae were excluded. Patients in group A underwent O’Conor repair without interpositional flap while in group B vesicovaginal fistulae were repaired with flap interposition. Results: Twenty two patients were randomized in group A while 27 in group B. Mean age of patients was 41.65± 11.93 years. Gynecological and obstetrical surgery was the main cause of fistula. Mean duration of surgerywas 162.7 ± 18.49 minutes. Per-operative ureteric catheterization was done in 9 (16.8%) patients. Seventeen(30.6%) patients had paralytic ileus. There was transient fever in 4 (7.6%) of cases and wound infection was seenin 3 (5.8%) of patients. Mean hospital stay was 3.4 ± 2.3 days. Cystogram was done in 35 (64.5%) of patients before the removal of per-urethral catheter. The overall success rate was 92.9%. Ten (18.2%) of patients developed denovo urgency which was managed conservatively. There was no statistical difference in both groups in terms of morbidity and success. Conclusion: In simple Vesico-vaginal fistulae repair, interposition of flap can be omitted and it does not affect the outcomes in terms of success and morbidity.

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Modified Lift Versus Cutting Seton for Transphincteric Fistula -Experience at Tertiary Care Hospital

10.53350/pjmhs2115123257 ◽

2021 ◽

Vol 15 (12) ◽

pp. 3257-3260

Author(s):

Muhammad Najam Iqbal ◽

Ashfaq Nasir

Keyword(s):

Comparative Study ◽

Anal Incontinence ◽

Complete Healing ◽

Fistula Tract ◽

Fistula Closure ◽

Fistula In Ano ◽

Group A ◽

Prospective Comparative Study ◽

Cutting Seton ◽

Group B

Background: Fistula in ano is a common disease which has high recurrence rate and high fecal incontinence rate after surgery. We compared modified LIFT (Ligation of the intersphincteric fistula tract (LIFT) through lateral approach ) with cutting seton for transphincteric fistula. Aim: This study is aimed at which procedure is better with respect to postoperative complications Study design: It was a prospective comparative study. Methods: This was a prospective comparative study from 01-01-2019 to 30-06-2021 which was conducted on 50 patients who presented with transsphincteric fistula in ano (FIA) in surgical ward of Bahawal Victoria Hospital Bahawalpur. Patients were divided into two groups .Patients of Group A underwent modified lift procedure and patients of group B underwent cutting seton procedure. Data was collected on a proforma which included patients’ name ,age ,sex, age group, comorbid disease like diabetes mellitus ,chronic liver disease, cardiovascular disease and chronic renal failure, fistula tract involving less than 50% or more than 50% external sphincter ,procedure done, healing time of wound, complications like recurrence and incontinence. Patients were followed for 6 months for healing rate ,recurrence and incontinence. Data was analysed on spss 22 version Results: In Group A, complete healing (fistula closure without recurrence) was achieved in 20 patients (80%) out of 25. There was no case of anal incontinence after the procedure. 5 (20%) patients experienced recurrence in 6 months . In Group B, complete healing (fistula closure without recurrence) was achieved in 21 patients (84%), in 6 months follow up . 4(16%) patients were diagnosed as a case of anal incontinence. There were 4 (16%) patients with recurrence. Conclusion: Modified LIFT is better in terms of incontinence where as cutting seton is better in terms of recurrence.it is suggested that for high lying fistula modified LIFT is better procedure and for low lying fistula involving less than 50% sphincter cutting seton is better procedure.. Keywords: Modified LIFT (ligation of ineter sphincteric fistula tract) ,Cutting seton , transphincteric fistula.

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A PROSPECTIVE COMPARATIVE STUDY OF OPEN VERSUS CLOSED METHOD OF CREATING PNEUMOPERITONEUM IN LAPAROSCOPIC SURGERY

10.36106/paripex/7904461 ◽

2020 ◽

pp. 1-3

Author(s):

Akshar Patel ◽

Shashank Desai

Keyword(s):

Laparoscopic Surgery ◽

Comparative Study ◽

Tertiary Care ◽

Needle Insertion ◽

Care Hospital ◽

Open Method ◽

Group A ◽

Prospective Comparative Study ◽

Group B ◽

Open Versus

Objective: The aim of the study was to compare open and closed method in terms of time require for creation of pneumoperitoneum and to ascertain safety in laparoscopic surgery. Methodology: This was a prospective comparative study carried out at a tertiary care hospital from January 2019 to December 2019.We selected 100 patients who were planned for laparoscopic surgery and divided them into two equal groups using the envelop method of randomization. Group A comprised of patients in whom we created pneumoperitoneum by classical veress needle insertion and in Group B by open method. Results: In our study, the mean time require for closed method was 6.92 minutes while by open method it was 4.36 minutes. Complication rate was 18% in closed and 16% in open method. Conclusion: open method is quick but comparable to closed method in terms of complications.

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DCP vs LCDCP in forearm fractures: a comparative study of functional outcomes

International Journal of Research in Orthopaedics ◽

10.18203/issn.2455-4510.intjresorthop20191783 ◽

2019 ◽

Vol 5 (3) ◽

pp. 454

Author(s):

Aaron R. D’souza ◽

Vamsi M. Krishna ◽

Kaushik S. Eswaran ◽

Shailesh Kumar

Keyword(s):

Comparative Study ◽

Functional Outcomes ◽

Forearm Fractures ◽

Group A ◽

Prospective Comparative Study ◽

Diaphyseal Fractures ◽

Both Bones ◽

Group B ◽

Limb Fractures ◽

Upper Limb Fractures

Background: Forearm fractures in general, and diaphyseal fractures in specific, are one of the most common fractures which accounts for about 31% of upper limb fractures seen in emergency. Early reduction and fixation is necessary in order to restore the function of forearm so as to be able to carry out their daily activities. The objective of this study was to compare the functional outcomes of forearm fractures fixed with DCP and LC DCP.Methods: The present study was a hospital based study, and a prospective, comparative study. A total of 40 patients with fracture of both bones forearm were taken up for the study, and randomly divided into 2 groups of 20 patients each. They were followed up for a period of 1 year.Results: The majority of patients were males (31 males and 9 females), involving age group 21-30. The left side was more common than right in both groups. The site of fracture was middle one-third of forearm in both groups (60% in group A and 65% in group B). The time for union was on average 4 weeks for LC DCP and DCP. ROM was full in 85% in DCP group and 90% in LC DCP group. Overall results were comparable in both groups. Excellent in 34 cases (18 in LC DCP, 16 in DCP), satisfactory in 5 cases (2 in LC DCP, 3 in DCP) and unsatisfactory in one case treated with DCP.Conclusions: LC DCP provides slightly better functional outcome in terms of time taken for union, early mobilisation and range of motion. However, it is more expensive than DCP.

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Single Layer Extra-Mucosal Interrupted Anastomoses; Revalidated

Journal of Gandhara Medical and Dental Science ◽

10.37762/jgmds.2-1.59 ◽

2015 ◽

Vol 2 (1) ◽

pp. 22-26

Author(s):

Bilal Khattak ◽

Faiz -Ur- Rahman ◽

Irfan -Ul-Islam Nasir ◽

Muhammad Iftikhar ◽

Imtiaz Ahmad Khattak ◽

...

Keyword(s):

Comparative Study ◽

Double Layer ◽

Intestinal Anastomosis ◽

Single Layer ◽

P Value ◽

Burst Abdomen ◽

Group A ◽

Prospective Comparative Study ◽

Anastomosis Leakage ◽

Group B

Objective:To evaluate the safety regarding anastomotic failure of single layer interrupted extra mucosal intestinal anastomosis in comparison with double layer intestinal anastomosisMethodology:This prospective comparative study was conducted in surgical A unit of Lady reading Hospital Peshawar from 1st June 2007 to 1st February 2008 (8 months).Patients were divided into two groups, each comprising 60 patients. First 60 consecutive patients were included in Group A, for single layer extra mucosal anastomosis while Group B included last 60 consecutive patients for double layer inverting anastomosis (continuous inner and interrupted outer Lambert sutures). All the cases were admitted through OPD and emergency. The safety of two techniques of anastomosis was analyzed by comparing the outcome in terms of complications.Results:In this study, anastomosis leakage occurred only in 4 (3.33%) patients, one (1.67%) in group A and three (5%) in group B with a P-Value 0.138. Mean age of patient in group A was 36.15 years (+/- 6.0 years) and in group B was 33.25 years (+/- 5.5 years).Conclusion:Single layer extra-mucosal anastomosis has least anastomotic leakage and other complication like wound infection, septicemia, and collection and burst abdomen than in patients with double layer investing anastomosis.

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Laparoscopic appendectomy versus laparoscopic assisted appendectomy: a hospital based comparative study

International Surgery Journal ◽

10.18203/2349-2902.isj20202408 ◽

2020 ◽

Vol 7 (6) ◽

pp. 1935

Author(s):

Gopal Sharma ◽

Barinder Kumar

Keyword(s):

Comparative Study ◽

Laparoscopic Appendectomy ◽

Operating Time ◽

Laparoscopic Technique ◽

Average Operating ◽

Group A ◽

Prospective Comparative Study ◽

Average Operating Time ◽

Group B ◽

Laparoscopic Assisted

Background: Laparoscopic appendectomy is more expensive and time consuming as compared to open technique. On the other hand, laparoscopic assisted appendectomy has the advantages of both the open and laparoscopic methods.Methods: This was a prospective comparative study of patients that underwent appendectomy by laparoscopic or laparoscopic assisted techniques.Results: A total of 40 patients were selected for the study. Standard laparoscopic technique was performed in 20 patients and laparoscopic assisted appendectomy was performed in 20 patients. The average operating time was 25.4±15 minutes in laparoscopic assisted appendectomy while it was 46.20±10.90 minutes in standard laparoscopic appendectomy which was statistically significant. Mean hospital stay in group A was 2.70±0.70 and in group B it was 2.10±0.70 which was not statistically significant.Conclusions: The laparoscopic-assisted method of appendix removal can be performed as efficiently as laparoscopically. It is fast and easy to perform, and it is expected to decrease the overall cost of laparoscopic appendectomy.

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Feto-maternal outcomes following caesarean section: a prospective comparative study at tertiary care centre in North-Western Rajasthan

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20182341 ◽

2018 ◽

Vol 7 (6) ◽

pp. 2311

Author(s):

Neha Kuntal ◽

Madhu Patni Bhat ◽

Amit Nimawat ◽

Munmun Yadav ◽

Mahendra Kumar Verma

Keyword(s):

Caesarean Section ◽

Comparative Study ◽

Tertiary Care ◽

Maternal Outcomes ◽

Data Types ◽

Common Indication ◽

Group A ◽

Prospective Comparative Study ◽

Group B ◽

North Western

Background: Caesarean section (CS) is employed when vaginal delivery is not feasible or hazardous to the mother and/or her baby. The procedure, however, is not without risk. We determined the fetomaternal outcomes of CS conducted at P.B.M Tertiary hospital situated in the North-Western region of Rajasthan.Methods: This is a Hospital based prospective comparative study of all CSs performed for various indications at the Dept. of Gynaecology and Obst., S.P. Medical College and P.B.M Hospital, Bikaner, India, from August 01, 2016, to July 31, 2017. All patients who had CS at any time within the 24 h period were noted and followed up until discharge. The sociodemographic data, types of CS, indications, and feto-maternal outcomes were documented in a proforma. Statistical analysis was carried out using the SPSS version 24.Results: There were 16386 deliveries out of which 4456 (27.1%) were by LSCS. The age range of the group A was 21-25 years while in group B it was 26-30 years. The mean age group A was 22.4, and group B it was 27.9 years. Total 6572 primigravida patients delivered and 32.1% had LSCS. Total 9814 multigravida patients delivered and 12.6% had primary LSCS. In group A, 119(79.3%) LSCS were elective as compared to group B where only 19(12.7%) were elective and this difference was found statistically highly significant (p<0.001). Indication of LSCS is different in both the groups. Fetal distress was most common indication in group A (53.3%) while in group B most common indication was APH (35.9%). Perinatal mortality/morbidity was significantly higher in group B (7.3%) as compared to group A (2.7%).Conclusions: The CS rate in this study was 27.1%. Although primary caesarean section in multipara constitutes only a small percentage of total deliveries and caesarean, they are associated with high maternal and perinatal morbidity. The reason for these complications is many. Beside obstetrical causes, factors like lack of antenatal care, low socioeconomic status, anaemia, malnutrition and illiteracy also play a major role obstructed labor and previous CS among Maternal and perinatal complications were more frequent with emergency CS and in the referred cases.

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Prospective comparative study of hypospadias surgical repair with and without the use of fibrin sealant

International Surgery Journal ◽

10.18203/2349-2902.isj20193315 ◽

2019 ◽

Vol 6 (8) ◽

pp. 2722

Author(s):

Tamer A. Sultan ◽

Tamer A. Faktry ◽

Ahmad Nabil ◽

Mohammed Z. Shenishn

Keyword(s):

Comparative Study ◽

Urethral Stricture ◽

Fibrin Sealant ◽

Tertiary Care ◽

Hypospadias Repair ◽

Flap Necrosis ◽

Significant Difference ◽

Group A ◽

Prospective Comparative Study ◽

Group B

Background: Hypospadias is the most common congenital malformation of the penis, affecting about 4-6 males per 1000 male births, and ranging in severity from a urethral meatus that is slightly off-center to a meatus in the perineal area, The aim of this study was to evaluate whether the application of fibrin sealant over the suture lines of neo-urethra reduces complications and improve overall outcome in children hypospadias repair.1,2 Methods: It was a prospective comparative study conducted in a tertiary care center (Department of pediatric surgery - Menoufia University), we included the patients age more than 6 months and less than 4 years presented with hypospadias to our department in this study. A total 30 patients of coronal, sub coronal, mid shaft hypospadias and distal hypospadias were studied and were divided into two groups, group (A) 15 cases and group (B) 15 cases. All patients underwent a tabularized incised plate (TIP) repair with a Dartos vascularized pedicle flap to cover the neo-urethra, In group (B) a thin layer of fibrin sealant applied over the suture line of neo-urethra but no sealant was used in group (A).Results: Postoperative surgical complications: urethra cutaneous fistula, flap dehiscence, flap necrosis and urethral stricture were recorded. Urethrocutaneous fistula flap dehiscence and flap necrosis were lower in group (B) patients. There was no significant difference in postoperative urethral stricture between two groups. Conclusions: Use of fibrin sealant in hypospadias repair is safe and can reduce complications.

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A prospective comparative study of ureterorenoscopy with and without DJ stenting for the management of ureteric stones

International Surgery Journal ◽

10.18203/2349-2902.isj20214753 ◽

2021 ◽

Vol 8 (12) ◽

pp. 3606

Author(s):

Dinesh Prasad ◽

Yogesh Satani ◽

Shivam Singh ◽

Darpen Gajera

Keyword(s):

Comparative Study ◽

Hospital Stay ◽

Operative Time ◽

Ureteral Stones ◽

Safe Alternative ◽

Stone Free Rate ◽

Group A ◽

Prospective Comparative Study ◽

Group B ◽

Free Rate

Background: Urolithiasis is the most common urological disease. Surgical treatment of ureteral stones consists of four minimally invasive modalities including ESWL, URS, PCNL, and laparoscopic or robotic-assisted stone surgery. URS and ESWL are the most widely used techniques. However, the use of ureteral stents for the treatment of ureteral stones is still controversial. Herein, we did a comparative study of URS with and without DJ stenting for the management of ureteric stones. Objectives of current study were to compare prevalence of post-operative complications in patients undergoing ureterorenoscopy without ureteral stenting as compared to patients undergoing stenting procedure, to study the frequency of morbidity in patients during post -operative period in both ‘stent’ and ‘no stent’ groups. Stone free-rate, operative time, complications, hospital stay and need for re-treatment in both groups will be determined.Methods: 50 patients with ureteric stones admitted in our hospital-SMIMER fulfilling our inclusion and exclusion criteria were randomly divided in two groups- patients in group A (25) underwent URS without DJ stenting and group B (25) underwent URS with DJ stenting.Results: URS without DJ stenting had less operative time, less postoperative complications like pain, requirement of analgesia, hematuria, UTI, dysuria, fever, less readmission rate and less hospital stay, similar stone free rate compared to URS with DJ stenting but it requires higher surgical endoscopy skills with urological expertise.Conclusions: Thus, after adequate training, URS without DJ stenting can be recommended as a safe alternative procedure than URS with DJ stenting for management of ureteric stones.

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Efficacy of Closed-System Drainage in Treating Chronic Subdural Hematoma: A Prospective Comparative Study

Neurosurgery ◽

10.1227/00006123-199005000-00006 ◽

1990 ◽

Vol 26 (5) ◽

pp. 771-773 ◽

Cited By ~ 109

Author(s):

Susumu Wakai ◽

Kazuyoshi Hashimoto ◽

Naofumi Watanabe ◽

Satoshi Inoh ◽

Chikayuki Ochiai ◽

...

Keyword(s):

Comparative Study ◽

Recurrence Rate ◽

Closed System ◽

Subdural Hematoma ◽

Chronic Subdural Hematoma ◽

Burr Hole ◽

Treatment Modalities ◽

Group A ◽

Prospective Comparative Study ◽

Group B

Abstract The authors conducted a prospective comparative study on the recurrence rate of chronic subdural hematoma after the use of two different treatment modalities: burr-hole irrigation of the hematoma cavity with (Group A) and without closed-system drainage (Group B). Thirty-eight patients were studied. Patients were assigned to groups sequentially upon admission. There were no significant differences between the two groups for age, sex, preoperative hematoma volume, and density on computed tomographic scan. One patient in Group A (5%) suffered a recurrence as opposed to 6 in Group B (33%). The difference in recurrence rate between the two groups was statistically significant (p < 0.05). The authors conclude that closed-system drainage after burr-hole irrigation reduces the recurrence rate of chronic subdural hematoma.

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EARLY MORTALITY & MORBIDITY IN MITRAL VALVE REPLACEMENT WITH TOTAL SUB-VALVULAR APPARATUS PRESERVATION, PARTIAL PRESERVATION AND NO PRESERVATION - A COMPARATIVE STUDY

Pakistan Armed Forces Medical Journal ◽

10.51253/pafmj.v70isuppl-4.6006 ◽

2021 ◽

Vol 70 (Suppl-4) ◽

pp. S715-20

Author(s):

Muhammad Ashfaq ◽

Nasir Ali ◽

Asif Mahmood Janjua ◽

Naser Ali Khan ◽

Muhammad Imran Ashgar ◽

...

Keyword(s):

Mitral Valve ◽

Comparative Study ◽

Valve Replacement ◽

Mitral Valve Replacement ◽

Statistical Difference ◽

Armed Forces ◽

Cross Sectional ◽

Group A ◽

Group B ◽

Preservation Technique

Objective: To compare the early morbidity & mortality of total sub-valvular apparatus preservation technique vs partial preservation technique and no preservation technique in mitral valve replacement. Study Design: Cross-sectional comparative study. Place and Duration of Study: Department of Cardiac Surgery, Armed Forces Institute of Cardiology Rawalpindi, from Jan 2017 to Dec 2018. Methodology: One hundred fifty seven patients who underwent Mitral valve replacement were included in study. These patients were divided into three groups; group “A” comprised of those patients with total subvalvular apparatus preservation (n1=46), group “B” comprised of those patients with partial sub-valvular apparatus preservation (n2=70), group “C” comprised of those patients with no sub-valvular apparatus preservation(n3=41). Results: There were no statistical difference in the pre-operative data of the patients. No statistical difference noted in cross clamp & bypass time (p>0.05). The early morbidity in terms of ICU stay, Ventilation time, Inotropic supports, post-operative bleeding, Blood transfusion, postoperative rhythm abnormality & Re-exploration were statically significant (p<0.05). The mortality rate of patients with total sub-valvular apparatus preservation was 2.17% which is significantly less than those with partial preservation (2.85%) & no preservation (9.75%). Conclusions: Mitral valve replacement with total subvalvular apparatus preservation had low postoperative morbidity & mortality in comparison with partial and no preservation techniques.

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