For the treatment of the Cystic Echinococcosis (CE) different surgical and non-surgical approaches are present. Laparoscopy has replaced the conventional open surgeries that were highly used in the past. This chronic liver infection is caused by the cestode. This disease is increasing the mortality and morbidity cases. Objective: To evaluate the treatment efficacy and complications in patients experienced during the postoperative period. The recurrence rate of the laparoscopic treatment was also calculated. Methods: A total of 24 patients visited the Islam Medical College Sialkot from June 2019 to March 2021 were included in the study. The patients were pre-treated with the albendazole (10mg/kg) for almost one week. Then the Palanivelu hydrated system was used for the laparoscopic partial peri cystectomy. Postoperative complication was classified on the basis of the Clavien-Dindo classification system. Results: The calculated mean age of the 24 patients that participated in the study was 34 ± 15.6 years. The included patient’s age was between 17-76 years. Out of 24, 17 were males and other 7 were females. The 21 patients belonged to the hilly areas. The 19 patients reported the complaint of abdomen pain. While cyst at the right side of the liver was observed in the 90% cases. Abdominal pain and cyst formation were the most common symptoms and pathology reported in the patients. The 10.4±3.1 was the calculated mean size of the cyst. The calculated mean operative time was 80.8±19.8 (60-20) minutes. According to WHO grading of cyst the 4 patients were included in the group with unilocular cyst, while the 7 patients were included in the CE1 hydatid group. Conclusions: The study proved that the laparoscopic treatment is an effective treatment for the hepatic CE. This treatment has reduced the risks of recurrences, mortality and conversion in the treated patients.

Aim: The study aim is to do the comparison of oncological and short-term results of open and laparoscopic surgery for colorectal cancer in emergency setting. Study Design: This retrospective cohort research was held in the Department of Surgery, Civil Hospital, Karachi and Sheikh Zayed Medical College/ Hospital, Rahim Yar Khan for two-years duration from January 2020 to December 2021. Patients and Methods: after approval of this study and an informed consent agreement was signed by each participant. We performed an emergency analysis on 55 consecutive patients who received emergency open (n=40) or laparoscopic (n=15) resection for colorectal cancer. Results: The gender, age, BMI, American Society of Anesthesiologists (ASA) score, tumor location and prior abdominal surgery history were not significantly different between the laparoscopic and open groups. The T4 pathological tumors were more frequent in the open surgery group (50% vs. 13.3%; p=0.031) than in the laparoscopic group. The open surgery group also experienced high proportion of perforation (42.5% vs. 33.3%) and obstruction (47.5% vs. 26.7%) cases. In the laparoscopic group, bleeding or anemia were much common (33.3% vs. 7.5%; p=0.032). The laparoscopic group did not experience any open conversions. The open surgery group had a high pervasiveness of Hartmann's surgery (35%), whereas the laparoscopic group had high pervasiveness of low anterior resection (26.7%; p=0.064). The complication ration at 30-days for laparoscopy (37.5%) and open surgery (33.3%) was comparable (p=0.900). Conclusions: In some individuals with colorectal cancer, emergency laparoscopic surgery has advantages in relation of short-term and oncologic outcomes. As a result, skilled laparoscopic surgeons may actively consider using laparoscopy in life-threatening situations. Keywords: Laparoscopy, colorectal cancer, and emergency.

Purpose of Study: To compare the short term outcome of Ligasure haemorrhoidectomy with Milligan Morgan technique for third and fourth degree haemorrhoids. Design of Study: The present study was a single-blind randomized controlled trial. Duration and Location of Study: This trial was conducted at Akhtar Saeed Trust Teaching Hospital, Lahore. Duration of study is 6 months June 2021 to December 2021. Patients and Methods: A total of 80 subjects suffering from 3rd or 4th degree haemorrhoids were enrolled in the study and divided into two groups using lottery method. An informed written consent was taken from all the patients. Patients in group A (LS group) underwent Ligasure haemorrhoidectomy while patients in group B (MM group) underwent Milligan Morgan haemorrhoidectomy. Mean and standard deviation was calculated for numerical variables like age, operation time and postoperative pain on VAS score. Frequency and percentage was calculated categorical variables like gender, disease severity, bleeding, occurrence of urinary retention, anal stenosis and necrosis. SPSS version 22.0 was used for data analysis. Results of the Study: The patients had a mean age of 41.54±6.380 years within age range of 35-62 years. Number of male participants was high as 49 (61.3%) while compared with females who were 31 (38.7%) in total study sample of 80 subjects with a male to female ratio of 1.58:1. Number of patients with 3rd degree haemorrhoids was 53 (66.3%) whereas 27 (33.8%) patients had 4th degree haemorrhoids. LS was found to have significantly less operation time as 15.03±1.928 vs. 20.40±2.228 minutes; p-value=0.000. Postoperative pain was significantly less in LS group than MM group (4.20±0.883 vs. 5.23±0.891; p-value=0.000). Frequency of postoperative bleeding was also significantly less in LS group than MM group (5.0% vs. 25.0%; p-value=0.013). Occurrence of urinary retention was high in the LS group but the difference was not significant (p=0.247). Frequency of anal stenosis and necrosis was also less in LS group than MM group but the difference was not statistically significant with p-value=0.077 and 0.500, respectively. Conclusion: Ligasure haemorrhoidectomy was found superior to Milligan Morgan hemorrhoidectomy in managing patients with third and fourth degree haemorrhoids because it has considerably less operation time, postoperative pain and bleeding. Thus, Ligasure haemorrhoidectomy should be favored in the treatment of such cases in future surgical practice on the basis of benefits of Ligasure haemorrhoidectomy. Keywords: Hemorrhoids, Ligasure Haemorrhoidectomy, Milligan Morgan Hemorrhoidectomy

Objective: To compare the recurrence rate of breast carcinoma between modified radical mastectomy and breast conservative surgery in patients of breast cancer. Material and methods: This randomized controlled was conducted at Department of Surgery, Akhtar Saeed Medical and Dental College Lahore from September 2020 to June 2021. Total 70 females with breast cancer from last 3 years (any stage), age between 30-60 years with ASA grade I, II and III were selected. In group A MRM was performed while in group B, conservative surgery was performed. Recurrence of breast cancer between the both groups was compared. Results: Mean age of patients was 44.47 ± 9.41 years with age range 30-60 years. Mean age of patients of study group A and B was 43.57 ± 9.89 years and 45.37 ± 8.95 years respectively. In study group A (MRM group), recurrence of breast cancer was found in 6 (17.14%) patients while in study group B (Conservative surgery group), recurrence of breast cancer was noted in 15 (42.86%) patients. Difference of recurrence of breast cancer between the both groups was significant with p value 0.019. Conclusion: Findings of this study showed higher frequency of recurrence of breast cancer in cases managed with conservative surgery as compared to MRM. Most of the cases belonged to 3rd decade of life. Among non-obese cases, significant difference of recurrence was seen. Most of the cancer cases were multiparas but difference of recurrence was not significant. Higher number of married cases were reported with breast cancer and difference between conservative surgery group and MRM group was significant. Keywords: Breast cancer, recurrence, MRM, conservative surgery