A COMPARATIVE ANALYSIS OF PER AND POST-OPERATIVE COMPLICATIONS IN PATIENTS UNDERGOING EARLY AND DELAYED INTERVAL TONSILLECTOMIES

Abstract: Background: Peritonsillar abscess is most prevalent deep neck space infection and treatment is mainly medical and surgical. There are three major surgical procedures namely incision & drainage, interval tonsillectomy and needle aspiration. Aim: To compare per and post-operative complications in patients of PTA undergoing early and delayed interval tonsillectomies in respect of pain, hemorrhage and hospital stay. Material and Methods: It was a randomized control trial study of sixty patients of peritonsillar abscess. Among thirty patients early interval tonsillectomy was performed while other thirty patients underwent delayed interval tonsillectomy. The study was conducted in ENT Department of Lahore General Hospital, Lahore. Results: The age range in both groups was 13-46 years. The male to female ratio was 2.3:1 and 1.3:1 in group I and II respectively. Per-operative hemorrhage in group I, mild in 53.3% patients, moderate in 36.7% and severe in 10.0% patients while in group II, mild in 43.3%, moderate in 40.0% and severe in 16.7% patients. A Single case in group II had secondary hemorrhage. Post-operative pain in group I was mild in 66.7%, moderate in 26.7% and severe in 6.7% patients while in group II, it was mild in 26.7%, moderate in 56.7% and severe in 16.7% patients. The duration of hospital stay less than one week was 76.7% in group I and 13.3% in group II. Conclusion: Early interval tonsillectomy has a lower incidence of postoperative hemorrhage and pain with less hospital stay as compared to delayed interval tonsillectomy.

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Ep.Th.654Home Based Pre-Rehabilitation in Hepatic & Pancreatic Oncological Surgery- A Way Forward for Improved Patient Outcome

British Journal of Surgery ◽

10.1093/bjs/znab309.070 ◽

2021 ◽

Vol 108 (Supplement_7) ◽

Author(s):

Nauman Ahmed ◽

Rami Obeidallah ◽

Daren Subar

Keyword(s):

Hospital Stay ◽

Length Of Hospital Stay ◽

Cost Effective ◽

P Value ◽

Oncological Surgery ◽

Operative Outcomes ◽

Home Based ◽

Group I ◽

Operative Complications ◽

Group Ii

Abstract Aims To ascertain the impact of ‘’Cost effective home-based pre-rehabilitation’’ on post-operative outcomes in patients undergoing major hepatic and pancreatic oncological surgery. Methods In this non-randomized comparative study (2019-2021), we included 36 patients having pancreatic or hepatic malignancy. In group I, patients were signed up for home-based pre-rehabilitation program and dietary modification. Group II; included patients who did not have rehabilitation. The two groups were compared for post-operative outcomes (post-operative complications, length of ITU and hospital stay) Results Mean age was 69.05±9.68 years in group I and 67.50±8.75 years in group II (p-value 0.61). Open approach was used in 02 (11.0%) patients in group I and in 09 (50%) patients in group II (p-value 0.01). More patients in group II needed admission in intensive care unit (ICU); 18 (100%) versus 11 (61.1%) in group II (p-value 0.0003). The group I had shorter length of hospital stay as compared to Group II (p-value 0.0001). There was no significant difference in post-operative complications between the groups. Conclusion Home based pre-rehabilitation, has shown beneficial outcomes in terms of less requirement for ITU admission post operatively, shorter length of hospital stay and cost effective method of pre rehabilitation.

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Comparison of Complications between Manual Small Incision Cataract Surgery and Phacoemulsification

Pakistan Journal of Ophthalmology ◽

10.36351/pjo.v37i4.1317 ◽

2021 ◽

Vol 37 (4) ◽

Author(s):

Israr Ahmed Bhutto ◽

Maria Nazish Memon ◽

Irshad Ali ◽

Abdul Qadeem Soomro ◽

Abdul Haleem Mirani

Keyword(s):

Cataract Surgery ◽

Senile Cataract ◽

P Value ◽

Small Incision Cataract Surgery ◽

Small Incision ◽

Group I ◽

Significant Difference ◽

Operative Complications ◽

Group Ii ◽

Post Operative Complications

Purpose: To compare per-operative and early post-operative complications between Manual Small Incision cataract surgery and Phacoemulsification in patients with Senile Cataract. Study Design: Quasi experimental study. Place and Duration of Study: Al-Ibrahim Eye Hospital Karachi from December 2018 to October 2019. Methods: Two hundred and seventy patients with senile Cataract were recruited for this study by convenient sampling technique. They were divided equally into two groups. Group I underwent Manual Small Incision Cataract Surgery (MSICS), whereas Group II underwent Phacoemulsification. Per-operative and early post-operative complications were recorded on day 1 in both groups. Data was analyzed using SPSS 24.0. Independent t-test was carried out with P-value of ?0.05 was considered statistically significant. Results: Mean age group – I was 54.95 ± 11.0 and in Group – II was 57.09 ± 10.59 (p = 0.546). There were 72 (53.3%) males in group – I and 74 (54.8%) in group – II with a non-significant difference (p-value > 0.01). There was significant difference for posterior capsule rupture and striate keratitis between the two groups (p = 0.031 and 0.044 respectively). Rest of the study parameters was not statistically different in the both group. None of the groups had a nucleus drop and vitreous prolapse. No significant difference was seen between the two groups concerning iris trauma (p = 0.56), wound leakage (p = 0.15) and hyphema (p = 0.32). Conclusion: There is no significant difference between per-operative and early post-operative complications between MSICS and Phacoemulsification in patients with senile cataract except posterior capsular rupture and striate keratopathy which were more common in phacoemulsification group. Key Words: Cataract, Senile Cataract, Phacoemulsification, Small Incision Cataract Surgery.

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Is laparoscopic totally extra peritoneal repair of hernia (TEP) superior than trans-abdominal preperitoneal (TAAP) mesh repair of inguinal hernia- our experience from a tertiary care hospital, Kolkata

Asian Journal of Medical Sciences ◽

10.3126/ajms.v9i6.20415 ◽

2018 ◽

Vol 9 (6) ◽

pp. 20-24

Author(s):

Ambar Gangopadhyay ◽

Bikash Chandra Ghosh

Keyword(s):

Inguinal Hernia ◽

Hospital Stay ◽

Peritoneal Cavity ◽

Operative Time ◽

Duration Of Hospital Stay ◽

Tapp Repair ◽

Group I ◽

Operative Complications ◽

Mean Time ◽

Post Operative Complications

Background: The most common laparoscopic techniques for inguinal hernia repair are transabdominal preperitoneal (TAPP) repair and totally extraperitoneal (TEP) repair. In TAPP a mesh is placed through peritoneal incision over possible sites of hernia by going into peritoneal cavity, where as in TEP the peritoneal cavity is not entered and a mesh is used to seal the hernia from outside the peritoneum.Aims and Objectives: The aim of the current study was to compare the outcome of Total Extra- peritoneal (TEP) versus Trans-abdominal Pre-peritoneal (TAPP) repair of inguinal hernia, where both can be done.Materials and Methods: The current randomized control study was conducted among eighty patients of inguinal hernia. Of these, the sampling was done through random allocation of patients for TEP (Group-I) and TAPP (Group-II), comprising forty patients in each group. All patients irrespective of group were observed for pain (by VAS Score), mean operative time, duration of hospital stay, days taken to resume their normal activities, intra-operative and early post-operative complications and recurrence if any.Results: The pain in both groups was insignificant until one day but highly significant differences (p<0.0001) were observed by end of day 2 and 1 month, showing higher degree of pain in TAPP with respect to TEP procedure. The differences in mean operative time for surgery was highly significant (p<0.0001) with mean time of 86.72 min (TAPP) and 99.72 (TEP). The duration of hospital stay was higher in TAPP (5.2 days) compared to TEP (2.6 days). The mean time to return to normal activities was 10.8 days (TAPP) and 6.2 days (TEP) which was highly significant (p<0.0001). The recurrence though occurred only in one patient in TEP group which was negligible. The other post-operative complications was seroma (8 cases; TAPP) versus (1 case; TEP) and it was highly significant (p<0.0001). The port site infection was in 20 % patients (8/40) in TAPP compared to 2.5% (1/40) in TEP group.Conclusion: The TEP is comparatively superior than TAPP procedure in terms of post-operative complications, duration of hospital stay and return to normal activities.Asian Journal of Medical Sciences Vol.9(6) 2018 20-24

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Abdominal sacrohysteropexy UV prolapse and preservation of reproduction.

The Professional Medical Journal ◽

10.29309/tpmj/2021.28.05.4562 ◽

2021 ◽

Vol 28 (05) ◽

pp. 652-655

Author(s):

Robina Ali ◽

Riffat Ehsan ◽

Ghazala Niaz ◽

Fatima Abid

Keyword(s):

Hospital Stay ◽

Length Of Hospital Stay ◽

Uterovaginal Prolapse ◽

Prolapse Recurrence ◽

Gynecology And Obstetrics ◽

Duration Of Surgery ◽

Operative Complications ◽

Operative Recovery ◽

Post Operative Complications

Objectives: The purpose of this study was to assess the safety of sacrohystcopxy by determining intraoperative and post-operative complications and its effectiveness by pelvic organ prolapse recurrence on follow up. Study Design: Prospective study. Setting: Department of Gynecology and Obstetrics Unit-II DHQ Hospital PMC, Faisalabad. Period: Jan-2014 to Jan-2017. Material & Methods: Patients with uterovaginal prolapse, admitted through OPD were selected for abdominal sacrohysteropexy. Variables of study including duration of surgery, any intra-operative and post operative complications, need of intra operative blood transfusion, post operative hospital stay; recurrence of POP, number of pregnancies in 06 moths follow up were recorded. Results: During this study period, 319 patients were admitted with uterovaginal prolapse. 32 (10.03%) cases were selected for abdominal sacrohysteropexy. In these 32 patients, 03 (9.37%) were <30years of age, 21(65.62%) were between 30-35 years and 8 (25%) were between 35-40 years of age. About 2(6.25%) were unmarried, while 30(93.7%) were married. In these married women 14(43.75%) were multiparas, another 14(43.75%) were para 1 or 2, while 4(12.5%) were para 3 or more. Duration of surgery was 40-45 minutes in 31(96.87%) patients. In 28(87.5%) cases per operative blood loss was <150ml while in 4(12.5%) it was estimated to be >150ml but less than 300ml. Post operatively only 1(3.12%) case developed wound sepsis and it was the only one (3.12%) who was discharged on 7th post operative day, while rest 31(96.87%) were discharged on 3rd post operative day. No recurrence was noticed in 06 moths follow up, while 2(6.25%) patients became pregnant. Conclusion: Abdominal sacrohysteropexy is a safe and an effective treatment in terms of overall anatomical and functional outcome, complications, post operative recovery, length of hospital stay and sexual functioning, in women who desire uterine and hence fertility preservation.

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The impact of ureteral Double-J stent insertion following ureterorenoscopy in patients with ureteral stones accompanied by perirenal fat stranding

Archivio Italiano di Urologia e Andrologia ◽

10.4081/aiua.2018.1.15 ◽

2018 ◽

Vol 90 (1) ◽

pp. 15

Author(s):

Ercan Ogreden ◽

Ural Oguz ◽

Erhan Demirelli ◽

Erdal Benli ◽

Özkan Özen

Keyword(s):

Ureteral Stone ◽

Ureteral Stones ◽

Stent Insertion ◽

Female Ratio ◽

Group I ◽

Dj Stent ◽

Group Ii ◽

Fat Stranding ◽

The Impact ◽

Perirenal Fat

Objective: To evaluate the impact of ureteral stent insertion following semirigid ureterorenoscopy (URS) in patients with perirenal fat stranding (PFS) due to ureteral stones. Material and methods: Data of 600 patients who underwent URS were analyzed retrospectively. Seventy-two patients detected to have PFS accompanying ureteral stone were included. Patients who did not undergo double J (DJ) stent insertion following semirigid URS were classified as Group I (n: 52), while those who underwent stent insertion were classified as Group II (n: 20). Side distribution; localization of the stones, stone size, presence of fever, urinary tract infection (UTIs) and urosepsis rates were compared in the two groups. Results: The average age of the patients was 44.4 (20-71) years. Male/female ratio and side of the stone location showed similar distribution in both groups (p > 0.05). Fever occurred in 23 cases (44.2%) in Group I and in 15 cases (75%) in Group II (p = 0.038). UTIs occurred in 15 cases (28.9%) in Group I and in 12 cases (60%) in Group II (p = 0.03). Urosepsis presented in 3 (5.8%) and 5 (25%) of the patients in Group I and II, respectively (p = 0.033). Conclusions: According to our results, ureteral DJ stent insertion following URS in patients with PFS due to ureteral stone caused an increase on postoperative infection related complications.

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Excision with primary midline closure compared with Limberg flap in the treatment of sacrococcygeal pilonidal disease: a randomised clinical trial

Annals of The Royal College of Surgeons of England ◽

10.1308/rcsann.2018.0144 ◽

2019 ◽

Vol 101 (1) ◽

pp. 21-29 ◽

Cited By ~ 4

Author(s):

M Arnous ◽

H Elgendy ◽

W Thabet ◽

SH Emile ◽

SA Elbaz ◽

...

Keyword(s):

Clinical Trial ◽

Hospital Stay ◽

Recurrence Rate ◽

Primary Closure ◽

Randomised Clinical Trial ◽

Limberg Flap ◽

Complication Rates ◽

Cosmetic Results ◽

Group I ◽

Group Ii

BackgroundAlthough several surgical techniques for treatment of sacrococcygeal pilonidal sinus (SPND) have been described, there is no consensus on the optimal surgical procedure. In this study we compared excision with primary closure and Limberg flap in the treatment of SPND.MethodsThis was a prospective randomised clinical trial in patients with SPND who were randomly allocated to one of two groups: group I (excision and primary closure) and group II (Limberg flap technique). The primary outcome of the trial was recurrence of SPND whereas postoperative complications, return to work and cosmetic results were the secondary outcomes.ResultsSixty patients were included, with a mean age of 24.1 years and mean body mass index (BMI) of 26.8 kg/m2. Group 1 had significantly shorter operation time than group II. Both groups had similar hospital stay and comparable complication rates (43.3% vs 30%; P = 0.4). Group I had significantly higher recurrence rate (20% vs 0; P < 0.02) and significantly better cosmetic satisfaction score than group II. Being hairy (P = 0.04), positive family history (P = 0.03), diabetes mellitus (P = 0.005) and history of previous surgery for SPND (P = 0.01) were the significant predictors for recurrence.ConclusionsThe Limberg flap is an effective technique for the treatment of SPND with very low recurrence rate and comparable complication rate and hospital stay to excision and primary closure. Excision and primary closure offered the advantages of quicker healing time, earlier resumption of daily activities, better cosmetic results, which may render it more suitable for patients with low risk for recurrence.

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Short term versus conventional Catheterisation after Genital Prolapse Surgery

Bangladesh Journal of Obstetrics & Gynaecology ◽

10.3329/bjog.v26i2.13782 ◽

2013 ◽

Vol 26 (2) ◽

pp. 68-71 ◽

Cited By ~ 3

Author(s):

Khurshida Tahmin ◽

Shamsun Nahar Begum

Keyword(s):

Hospital Stay ◽

Urine Volume ◽

Genital Prolapse ◽

Prolapse Surgery ◽

Controlled Clinical Trial ◽

Group I ◽

Short Period ◽

Group Ii ◽

Catheter Urine ◽

Randomised Controlled

This Randomised controlled clinical trial was undertaken to determine the suitable time of catheter removal after urogenital prolapse surgery in order to reduce the catheter related UTI and its long term sequel. Method: Total 80 patients undergoing vaginal hysterectomy with pelvic floor repair were enrolled and randomised into two equal groups by lottery method. Trans-urethral catheter was removed on 2nd & 5th post operative day in group I (n=40) and in group II (n=40) respectively. Post voidal residual urine volume before operation and after removal of catheter was measured in all patients by ultrasound scanning. Re-catheterisation was done for three more days if residual volume > 200ml after removal of catheter. Urine samples were taken before removal of catheter and send for routine microscopic examination and culture & sensitivity test to detect UTI.Results: Removal of catheter on 2nd post-operative day lead to significant reduction of rate of UTI. The rate of UTI following removal of catheter was 7.5% versus 42.5% in group I and in group II (p<0.001). But need for recatheterisation was significantly higher in group I (15%) than in group II (2.5%). The mean duration of catheterisation was 47.63 (±0.628) and 119.35 (±0.864) hours in group I and group II respectively. Majority of the patients in group I did not require prolongation of catheterisation. Mean duration of hospital stay after operation was 5 days in group I and 7.95 days in group II (p<0.001). Conclusion: Short period catheterisation is associated with lower rate of UTI and shorter hospital stay. Disadvantages of prolonged catheterisation outweigh the advantages. Therefore removal of the catheter on the 2nd post-operative day after genital prolapse surgery is preferable than 5 days catheterization DOI: http://dx.doi.org/10.3329/bjog.v26i2.13782 Bangladesh J Obstet Gynaecol, 2011; Vol. 26(2) : 68-71

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APPENDICULAR MASS

The Professional Medical Journal ◽

10.29309/tpmj/2010.17.02.2341 ◽

2010 ◽

Vol 17 (02) ◽

pp. 180-184

Author(s):

SARDAR ALI ◽

HAFIZ MUHAMMED RAFIQUE

Keyword(s):

Conservative Treatment ◽

Acute Appendicitis ◽

Cost Effective ◽

Female Ratio ◽

Surgical Exploration ◽

Group I ◽

Variable Extent ◽

Group Ii ◽

Adhesive Intestinal Obstruction ◽

Appendicular Mass

Introduction: Appendicular mass is a common complication of acute appendicitis. The traditional treatment of this is conservative followed by delayed appendectomy. But now with advancement in all the fields of medicine early surgical exploration of the appendicular mass can be done with satisfactory results. Aims and objectives: A comparison of conservative treatment versus early surgical exploration of appendicular mass. Study Design: Experimental study. Material and Method: Two years study from December 2003 to November 2005 at district headquarters hospital Khanewal. Total 60 patients, both males and females between 12 to 65 years of age with symptoms and signs consistent with appendicular mass were included. They were randomly divided into group I (Early exploration) and group II (Conservative treatment) each containing 30 patients. A comparison of outcome between two groups was done statistically by applying studentChi-square test. Results: There was a peak incidence of acute appendicitis in Second and third decades of life. Male to female ratio was 2:1. More than 90% of patients had history of shifting of abdominal pain. 100% of the patients had inflamed appendix to variable extent on exploration. The complications in the form of adhesive intestinal obstruction; failure of treatment; lost follow up; misdiagnosis and re admissionwere less in group I. There was a significant less duration of hospital stay in group I as compared to Group II. The observations and outcome in this study are almost comparable and correspond with other studies done in this regard. Conclusion: Early surgical exploration of appendicular mass is safe and cost effective.

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Results of observation of the postoperative period in patients with surgical aortic pathology after surgical intervention using cardiopulmonary bypass

Reports of Vinnytsia National Medical University ◽

10.31393/reports-vnmedical-2019-23(2)-16 ◽

2019 ◽

Vol 23 (2) ◽

pp. 267-276

Author(s):

K. A. Khyzhniak ◽

Y. V. Volkova ◽

K. Y. Sharlai ◽

M. V. Khartanovych

Keyword(s):

Cardiopulmonary Bypass ◽

Hospital Stay ◽

Postoperative Period ◽

Surgical Intervention ◽

Infusion Therapy ◽

The Third ◽

Group I ◽

Aortic Pathology ◽

Number Of Patients ◽

Group Ii

The aim of the work was to analyze the results of the observation of the postoperative period in patients with surgical aortic pathology after surgical intervention using cardiopulmonary bypass. 118 patients with surgical aortic pathology (SAP) were examined. Patients were divided into 2 groups. Group I included 46 patients who were additionally prescribed a solution of meglumin sodium succinate (reamberin), group II included 46 patients who were additionally assigned a solution of D-fructose-1,6-diphosphate sodium hydrate salt (esophosphine). The control group (K) consisted of 26 patients who had surgical pathology of the aorta, all the criteria coincided with patients of groups I and II, but did not have additional substances as part of intensive care (IT) in order to prevent postoperative cognitive dysfunction (PСD). Analyzed the patient's condition on a scale of postoperative mortality prediction EuroSCORE II, the depth of anesthesia with a BIS monitor, the qualitative composition of the leukocyte formula, nasal and rectal temperature, blood gas composition, electrolyte level, glucose, lactate, coagulogram indices, hemolysis and phosphates; levels of autoantibodies to brain antigens (MBP, calcium binding protein S-100, NSE and GBA) were determined in the serum by ELISA a day before the operation and on the first, third, seventh and fourteenth day after surgery. The morphometric and functional properties of erythrocytes were investigated the day before the operation (starting level), 12:00 after the operation, and on the third day of hospital stay. The initial assessment of the cognitive abilities of the patients was made the day before the operation, on the third, seventh and fourteenth day of hospital stay. Used to determine the magnitude of the coefficient of linear Pearson correlation. In the analysis, no significant differences were found between the preliminary data on the phosphorus content in the patients' blood, however, the recovery dynamics of its numbers differed in the K, I and II patients. So, in group K and in group I, after 12:00 after surgery, the level of phosphatemia was 0.86 ± 0.21 mmol/l and 0.85 ± 0.18 mmol / l, on the 3rd day of hospital stay — 0,94 ± 0.08 mmol/l and 0.97 ± 0.04 mmol/l, on the 7th day — 1.04 ± 0.16 mmol/l and 1.07 ± 0.21 mmol/l and on The 14th day — 1.08 ± 0.12 mmol/l and 1.1 ± 0.14 mmol/l. It can be noted that the dynamics of blood phosphatemia in patients of groups K and I was identical, its figures almost coincided in terms of the level of phosphorus in the blood and the corresponding number of patients in the variation rows of patients in both groups. It may be noted that there is an unconditional positive effect on the course of the perioperative period of the option of infusion therapy in the IT complex in patients of group II.

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Evaluation of the effectiveness of vacuum-assisted closure in the treatment of Fournier gangrene

10.31083/jomh.2021.089 ◽

2021 ◽

pp. 1

Keyword(s):

Hospital Stay ◽

Wound Closure ◽

Length Of Hospital Stay ◽

Vacuum Assisted Closure ◽

Analgesic Requirement ◽

Vac Therapy ◽

Fournier Gangrene ◽

Group I ◽

Group Ii ◽

Closure Method

Background and objective: To evaluate the effectiveness of vacuum-assisted closure (VAC) in the treatment of Fournier gangrene (FG). Material and methods: Forty-eight male patients treated for Fournier gangrene were included in the study. The patients were divided into two groups (Group I: conventional dressing, Group II: VAC therapy). Characteristics of the patients, laboratory parameters, number of debridement procedures, daily number of dressings, visual analogue scale (VAS) during dressing, analgesic requirement, colostomy requirement, time from the first debridement to wound closure, wound closure method, length of hospital stay, and mortality rates were compared. Results: Group I comprised 33 patients and Group II comprised 15 patients. The number of dressings, VAS score and daily analgesic requirement were statistically significantly lower in Group II (p < 0.05) than in Group I. The number of debridement procedures, colostomy requirement, orchiectomy rate, time from first debridement to wound closure, length of hospital stay, wound closure method and mortality rate were similar between these two groups (p > 0.05). Conclusion: The clinical results of conventional dressing and VAC therapy were similar for treating FG. VAC therapy is an effective postoperative wound care method that offers less requirement for dressing changes, less pain, less analgesic requirement and more patient satisfaction compared to conventional dressing.

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