Background: Fistula in ano is one of the common anorectal condition, which is easy to diagnose but difficult to manage because of post-operative complications like incontinence and recurrence. Also numerous procedures have been described for its treatment so as to individualize treatment options.The aim of the study was to assess the efficacy of different treatment modalities in fistula in ano.Methods: This is a prospective study carried out in a tertiary medical college hospital where 75 patients with fistula in ano are analysed for clinical features and surgical modalities compared.Results: Total 75 patients are studied. 82.70% patients presented with discharge in perianal region. Posterior fistulas are seen in 93.30% and anterior in 6.70% patients. 94.70% patients have low level fistula, 84% patients had simple fistula & 16% had complex fistula. 49.30% patients were treated with fistulectomy. 36.0% have undergone fistulotomy. 8.0% had LIFT and 6.7% had SETON. Recurrence is seen in 6.70% of patients.70.70% patients have stayed 4-6 days.Conclusions: Most of the fistulas are simple, posterior and low level fistulas. Fistulectomy is the most common procedure performed. Newer procedures like LIFT and Seton application show promising results with less complications.

Background: The incidence of parotid tumours is between 1-3/100000 per year, most of them are benign and 80% benign tumours are pleomorphic adenoma. Their management is more troublesome because of their late presentation, poor economic condition and lack of awareness of health.Methods: This is a prospective observational study carried out from August 2016 to march 2018 in the Department of General Surgery, S.V.R.R.G.H., Tirupati. Detailed pre-operative workup done operative findings and post-operative complications were noted and biopsy reports analyzed.Results: Total 30 patients were included in the study of which 28 were pleomorphic adenoma and 2 were Warthin’s tumor. Post-operative complications and histopathology were studied and analyzed.Conclusions: Pleomorphic adenoma was most common benign tumor. Conservative superficial parotidectomy was the common surgical procedure done. Most common complication was temporary facial nerve palsy. No recurrence was seen in 6 months follow up.

Background: Gallstones are among one of the most common diseases affecting the digestive system requiring hospitalisation with a prevalence of 11% to 36%. Until 2 decades ago, patients presenting with acute cholecystitis were treated conservatively and a delayed interval cholecystectomy was performed after 6 weeks, now a days laparoscopic cholecystectomy was gaining popularity in acute cholecystitis. It cannot be said with certainty preoperatively whether the cholecystectomy is going to be easy or difficult. The aim of the study was to evaluate safety and outcomes of emergency laparoscopic or open cholecystectomy in acute cholecystitis.Methods: This is a prospective, observational, single centre study conducted in the Department of General Surgery, S.V. Medical College/ SVRRGG hospital, Tirupati, for a period of one year from the time of approval of IEC. All patients undergoing emergency laparoscopic or open cholecystectomy for acute cholecystitis and its related complications are studied for various clinical, radiological and other variables.Results: Total 100 patients who presented with acute cholecystitis and undergone cholecystectomy are studied. Age, sex, BMI, comorbities, clinical and usg criteria and intra-operative findings and post-operative complications are analysed.Conclusions: Difficult dissection in cholecystectomy can be predicted using pre-operative parameters like increasing age, male gender, multiple attacks in the past, gallbladder wall thickness >3 mm, and presence of pericholecystic fluid. Surgery performed within 72 hrs had good prognosis and few intra op complications due to good place of dissection due to inflammation.

Femoal hernia has always been one of the most challenging disease a surgeon will face in his career. Open method of repair has been the traditionally followed method for many years. This study compares the results of herniorrhaphy with hernioplasty in RIMS, Kadapa. MATERIALS AND METHODS: This is a retrospective study of all the patients who have undergone femoral hernia surgery in RIMS, Kadapa from 2012. RESULTS: 18 cases of unilateral femoral hernia were operated by herniorrhaphy/hernioplasty. Post-operative analysis and follow up reveals no significant difference in the morbidity, mortality and recurrence, either operated by herniorrhaphy or hernioplasty. CONCLUSION: Femoral hernia cases both reducible and non-reducible were operated by open technique. All the safety precautions and utmost care is taken for successful outcome. All patients recovered and all are doing well. There is no recurrence either operated by herniorrhaphy or hernioplasty.

Background: An anal fissure is an extremely common condition which is also one of the most painful condition. It can be very troubling because, if acute, the severity of patient discomfort and extent of disability far exceed that which would be expected from a seemingly trivial lesion. This study compares two most commonly done procedures for anal fissure, manual anal dilatation (MAD) and lateral internal anal sphincterotomy (LAS). Methods: This is a prospective cohort study comparing MAD and LAS in the treatment of chronic anal fissure at Sri Venkateswara Medical College, Tirupati, from December 2017 to December 2018. A total of 60 patients who met inclusion criteria were randomized to undergo either MAD or LAS and analyzed for post-operative pain, postoperative complications, hospital stay, recurrence rates and compliance. Results: Total 60 patients were randomized to MAD and LAS. The patients who have undergone LAS have better pain relief and slightly increased risk of infection. Those who have undergone MAD have less risk of infection and recurrence rates and complications are not significantly less than LAS. Conclusions: MAD and LAS are both equally effective and safe for treatment of acute anal fissure with less chances of recurrence. However postoperative pain was slightly more in MAD group.