Results: Male to female ratio was 3.76:1 with median age of 35 years (range: 11-90 years). Median hospital stay was 2 days (24 hours-5 days) and longest 5 days after operation. 14 patients had 1 st degree haemorrhoids, 66 patients had 2 nd degree haemorrhoids, 104 patients had 3 rd degree haemorrhoids and 16 patients had 4 th degree haemorrhoids. Median time for the procedure was 25 minutes. Urgency of defecation was complained by 46 patients who ultimately felt comfortable within 2-4 weeks. 6 patients complained of annorectal pain who responded to conventional analgesics. Rest of the patients available after 8 weeks follow up were found to be fully satisfied. Conclusion:Contrary to open haemorrhoidectomy this procedure is associated with least chance of anal incontinence because of preservation of normal anal cushion. It can safely be concluded that stapled haemorrhoidopexy is a better option in treating primary haemorrhoidal disease.

Background: Complete rectal prolapse is a very distressing condition. In adults, the only potentially curative treatment for complete rectal prolapse is surgery either by transabdominal or perinea! approaches. Till date abdominal rectopexy is considered as the standard surgical treatment for complete rectal prolapse, which can be done laparoscopically or by open procedure. Objective: The purpose of the study was to observe the outcome of Laparoscopic rectopexy in the treatment of complete rectal prolapse by subjective assessment and to compare the result with that of conventional open abdominal rectopexy. Methodology: This randomized clinical trial was carried out in the Department of Surgery at Bangabandhu Sheikh Mujib Medical University, Dhaka, from July 2012 to June 2014 for a period of twenty four (24) months. Patients who presented with complete rectal prolapse with age ranging from 25 to 70 years irrespective of gender were selected as study population. Patients were randomized by lottery method into two groups as group I who underwent laparoscopic rectopexy (LR) and group II who underwent open rectopexy (OR). Result: A total number of 50 patients were recruited in this study of which 25 patients were. in group I and 25 patients were in group II. The mean (s.d.) age was 49.40 (13.22) years and 46.48(13.27) years in group I and group II respectively (p>0.05). The mean (s.d.) operative time was 115(19) minutes in group I and 75(12) minutes in group II (p<0.05). In this study 1(4.0%) patient and 6 (24.0%) patients had abdominal wound infection in group I and in group II respectively (p>0.05). Mean (s.d.) ambulation time was 1.96 (0.67) days in group I and 3.92(1.15) days in groups II (p<0.05). Postoperative hospital stay mean (s.d.) was 3.08(1.18) days in group I and 8.16(3.57) days in group II (p<0.05). Overall patients satisfaction were 92% and 76% in group I and group II respectively (p>0.05). Conclusion: Laparoscopic rectopexy is a better option than conventional open abdominal rectopexy for the treatment of complete rectal prolapse. Journal of Surgical Sciences (2015) Vol. 19 (1) : 3-7

Background: Colorectal cancer is the second most common malignancy in the western countries and the rectum is the most frequent site involved. Carcinoma of the lower part of the rectum involving the anal canal and carcinoma of the anal canal are now successfully managed by laparoscopic abdomino-perineal resection (APR) and postoperative morbidities are less and recovery is uneventful. In the current age of minimally invasive surgery, laparoscopic surgery for colon cancer has been established as equivalent to conventional open surgery in terms of oncological clearance. The purpose of the study is to compare the early outcomes of laparoscopic abdomino-perineal resection (LAPR) surgery in low rectal and anal cancer patients in terms of surgical site infections, postoperative pain, recovery, hospital stay and margin clearance of tumor with that of open abdomino-perineal resection (OAPR) surgery. Methods: This randomized controlled trial was carried out in the Colorectal Surgery Unit of Bangabandhu Sheikh Mujib Medical University, Dhaka from May, 2012 to April, 2013. 50 patients in low rectal and anal canal cancers were randomized into two groups with 25 patients in conventional open abdomino-perineal resection (OAPR) and rest 25 patients in laparoscopic abdomino-perineal resection (LAPR). Early outcome variables after surgery were evaluated. Results: Demographic data and baseline characteristics are equivalent in both groups of population. Tumors were more common in rectum (80% and 76%), most of the tumors were adenocarcinomas (80% and 72%) and most of the tumors were present in stage-II (40% and 48%) with grade-2 (64% and 52%) in LAPR and OAPR groups respectively. During early post-operative follow up, abdominal surgical site infection was found more in conventional open abdomino-perineal resection (OAPR) patients than that of laparoscopic abdomino-perineal resection (LAPR) patients (p =0.001). Other morbidity and colostomy related complications were not significant in early post-operative period in both groups of population. Degree of pain was also less after laparoscopic abdomino-perineal resection (p=0.001 ). Stoma function occurred earlier after Laparoscopic abdomino-perineal resection (p =0.017) and ambulation, feeding liquid and feeding solid all had no difference for both groups. Shorter mean length of postoperative hospital stay and early hospital discharge was possible after Laparoscopic abdomino-perineal resection (p =0.001 ). Oncologic parameters were equivalent to those with open procedures. Conclusion: The patients undergoing laparoscopic APR for low rectal and anal canal carcinoma have overall superior outcomes in terms of surgical site infection, postoperative pain, postoperative hospital stay and has equivalent oncological clearance as with those with open procedures. Journal of Surgical Sciences (2014) Vol. 18 (2) : 57-61

Although gastrointestinal stromal tumors (GISTs) frequently occur in the gastrointestinal tract, they are relatively rare in the rectum. Biopsy of the lesion and immunohistochemistry (IHC) confirm the diagnosis. Complete surgical resection is the principal curative procedure. In combination with surgery, immunotherapy with Imatinib shows cure in intermediate risk and improvement in high risk rectal GIST. We report a case of a 45-yearold female who  presented with constipation and generalized weakness, ultimately diagnosed to have rectal GIST. Journal of Surgical Sciences (2015) Vol. 19 (2) : 85-88

Background: Patients with ileostomies are well known to be susceptible to extracellular fluid volume depletion as a result of fluid and solute losses that are greater than intake. However, electrolyte disorders accompanying these episodes of volume depletion are not well delineated. Objective: To find out serum electrolytes changes observed in patients undergone permanent or temporary ileostomy. Method: This prospective observational study was carried out in the Department of Colorectal Surgery, BSMMU, Dhaka, from January 2018 to December 2018. Fifty patients underwent permanent or temporary ileostomy and postoperatively treated with intravenous fluid and electrolytes at least up to 3rd POD along with gradual resumption of oral intake or ileostomy feeding and managed at least for 5 days were included in this study. Electrolyte was measured preoperatively and 3rd and 5th POD and observed the changes. Result: Males were predominant than females (1.17:1). Most of the patients were in age group 31 – 40 years. Mean age was 42.4±12.5 years. Serum sodium (Na) and serum potassium (K) were reduced at POD 3 and at POD 5 compared to pre-operative level. Serum sodium concentration was 136.6±3.75 mmol/L pre operatively and reduced to 135.1 ±2.98 mmol/L at 3rd POD and 134.8±3.04 mmol/L at 5th POD. Similarly, serum potassium concentration was 4.0±0.49 mmol/L pre operatively and reduced to 3.8±0.70 mmol/L at 3rd POD and 3.8±0.50 mmol/L at 5th POD. Both serum Na and serum K level reduced significantly in POD 3 and in POD 5 in comparison to pre-operative values (p<0.05). Regarding serum Cl and serum HCO3 level no statistically significant difference were observed (p>0.05). Conclusion: Serum sodium and potassium concentration reduced statistically significantly after permanent ileostomy. Bangladesh Med Res Counc Bull 2021; 47(1): 78-81