No abstract

Highlights Bronchogenic cysts are rare primitive foregut derived developmental aberrations in early embryonic life. Typically occur in the mediastinum. They arise from an abnormal budding of the tracheobronchial anlage. A Retroperitoneal location of bronchogenic cysts is exceptionally unusual. They are mostly asymptomatic. Due to continued epithelial secretion, these lesions have a tendency to become larger as the patients get older.

IntroductionAs we proceed towards more and more day care surgeries we always need to choose patients and procedures within a great deal of safety margin. Anti reflux surgeries are gaining more popularity and awareness and Laparoscopic Nissen Rosetti fundoplication is a safe and effective method of performing them.Methods and observationsOur case series of 25 patients who underwent day care Laparoscopic Nissen Rossetti fundoplication done over a period of 3 years suggests the feasibility and safety of performing day care anti reflux surgeries with no complications.DiscussionSurgical outcomes of procedure are unaffected and the main challenge faced remains pain relief and which can be effectively tackled by local blocks or plain NSAIDs.ResultsLaparoscopic Nissen Rossetti fundoplication is a safe procedure to be offered as day care anti-reflux surgery. We encourage more studies in this regards with appropriate blinding to enforce its possibility as day care surgery and help patients with early recovery and decreasing cost of surgeries.

Background. Patients with more than two prior kidney transplant procedures pose unique surgical challenges. Once both the right and left retroperitoneal spaces have been dissected, intra-abdominal implantation is usually necessary. If the external iliac arteries have been used previously, it is sometimes necessary to use the aorta and vena cava for implantation. Gaining safe exposure in these cases can be complicated by history of prior laparotomy, adhesive disease, and other surgical histories. Case Presentation. A 58-year-old female with type 1 diabetes and end-stage renal disease presented for surgical evaluation for kidney transplant. Surgical history was notable for prior simultaneous kidney-pancreas transplant followed by both a living donor kidney transplant and a pancreas after kidney transplant. She had undergone both an allograft nephrectomy and an allograft pancreatectomy and currently had a nonfunctioning kidney in the left retroperitoneal position and a nonfunctioning pancreatic allograft on the right common iliac artery. The entire distal aortoiliac system was surgically inaccessible. She was listed for transplantation, and a cadaveric graft was allocated. Intraoperatively, severe lower abdominal and pelvic adhesions prevented any use of the iliac system. A left native nephrectomy was performed, and the allograft was implanted in the left orthotopic position. The native left renal vein was used for outflow, the donor renal artery was joined end-to-side to the infrarenal aorta, and a uretero-ureterostomy was created. The operation was uneventful. The allograft functioned without delay, and almost one year later, the GFR is approximately 50 mg/dL. Conclusion. The left orthotopic position can be a good choice for kidney transplant candidates with histories of prior complex lower abdominal surgery.

Background: From the time it was declared as a pandemic by WHO, COVID-19 infection caused by corona virus (SARS-CoV-2) has drastically changed how we look at and manage patients all around the world across all faculties. Here, we wrote about a single centre experience of how surgical emergencies were managed at our institute.Methods: We have collected data retrospectively from 2019 (pre-lockdown) and 2020 (lockdown) for the months of April through July based on 281 emergency room admissions to the department of general surgery. Collected data was categorised into the two cohorts and analysed for multiple variables including days of symptoms, diagnosis arrived at, management modality being conservative or operated.Results: The most common diagnosis was found to be abscesses followed by appendicitis. Management was found to be significantly different for appendicitis in between 2019 and 2020. Other diagnosis also were analysed and found to be having an inclination towards conservative management over operative management even though the difference was not significant. The number of emergency room admissions were less in 2020 than in 2019, which was contrasting to our anticipation. On comparing with similar articles, we found that conservative management was preferred in the lockdown period, which was in concurrence with our results.Conclusions: And the patient outcome was also better when the patient was managed conservatively and taken up for surgery electively.