Background Many surgeons routinely place intraperitoneal drains after elective colorectal surgery. However, enhanced recovery after surgery guidelines recommend against their routine use owing to a lack of clear clinical benefit. This study aimed to describe international variation in intraperitoneal drain placement and the safety of this practice. Methods COMPASS (COMPlicAted intra-abdominal collectionS after colorectal Surgery) was a prospective, international, cohort study which enrolled consecutive adults undergoing elective colorectal surgery (February to March 2020). The primary outcome was the rate of intraperitoneal drain placement. Secondary outcomes included: rate and time to diagnosis of postoperative intraperitoneal collections; rate of surgical site infections (SSIs); time to discharge; and 30-day major postoperative complications (Clavien–Dindo grade at least III). After propensity score matching, multivariable logistic regression and Cox proportional hazards regression were used to estimate the independent association of the secondary outcomes with drain placement. Results Overall, 1805 patients from 22 countries were included (798 women, 44.2 per cent; median age 67.0 years). The drain insertion rate was 51.9 per cent (937 patients). After matching, drains were not associated with reduced rates (odds ratio (OR) 1.33, 95 per cent c.i. 0.79 to 2.23; P = 0.287) or earlier detection (hazard ratio (HR) 0.87, 0.33 to 2.31; P = 0.780) of collections. Although not associated with worse major postoperative complications (OR 1.09, 0.68 to 1.75; P = 0.709), drains were associated with delayed hospital discharge (HR 0.58, 0.52 to 0.66; P < 0.001) and an increased risk of SSIs (OR 2.47, 1.50 to 4.05; P < 0.001). Conclusion Intraperitoneal drain placement after elective colorectal surgery is not associated with earlier detection of postoperative collections, but prolongs hospital stay and increases SSI risk.

No abstract

Background: Inguinal hernia repair is a commonly performed general surgical procedure that constitute more than 95% of all groin hernia repairs. However, in developing countries, quite a considerable percentage of it is not repaired or delayed repaired and that lead to a higher incidence of morbidity and mortality. so, we planned to conduct this study to understand the clinic-epidemiologic profile of inguinal hernia in a tertiary care hospital of Bangladesh. Objective: To evaluate the clinical, epidemiological profile and associated risk factors for inguinal hernia. Methodology: This observational study was conducted among 100 patients during January 2018 to January 2019 who admitted in the surgery department of a tertiary care center for inguinal hernia surgery . All the study subjects were examined and their clinical and epidemiological profiles studied, tabulated and analyzed. Result: Among the 100 patients, most of them (94%) were men with a age of 57.02 ± 12.87, farmer (36%) by occupation.61% patients were in low saocio-ecenomic status. Most of the patients (60%) were in the age group of 40-60 years followed by less than 30 years (21%). On query regarding symptoms of inguinal hernia, all of them (100%) complaints of groin swelling. More than half of the patients complaints of groin pain and sensation of heaviness in groin. On clinical examination, right sided, left sided, bilateral hernias were found in 49%,45% and 6% study patients respectively. Direct hernias, indirect, pantaloons hernias were seen in57%,30%,7% study patient respectly. Most of hernias (81%) were reducible and were incomplete (88%). Most of the patients (75%) presented late to the health care center due to the lack of awareness of the disease and were initially treated by homeopath medicine. During query about risk factors for inguinal hernia,46% patients were more than 50 years of age and 26% patients were smoker. In this study, most common hernia repair procedure was Lichtenstein's procedure (63%) followed by modified Bassini's procedure (11%). Total open procedure were 93% and laparoscopic hernia repairs were done only in 7% patients.

Background: Management of temporary ileostomy cases is very important considering the outcomes. Objective: The purpose of the present study was to observe the surgical complications of temporary ileostomy patients. Methodology: This prospective cohort study was conducted in the Department of Surgery at Sir Salimullah Medical College & Mitford Hospital, Dhaka, Bangladesh over a period of six months from July, 2011 to December, 2011. All patients who had undergone temporary ileostomy after admission were selected as the study population. Patients with temporary ileostomy at any age in both male and female were included in this study. The surgical complications like prolapse, retraction, stenosis, necrosis, skin excoriation, parastomal hernia, bleeding and wound infection were recorded.   Result: A total number of 100 patients were selected for observation and management of complications of temporary ileostomy. Their ages ranging from 15 to 65 years with mean age 33.9±11.92 years. Complications were developed in majority cases of cases (52.0%). Several systemic complications were recorded like electrolytes imbalance (31%), hypoproteinaemia (14%), RTI (6%) and significant weight loss (4%). Skin excoriation was the more frequent local complication developed in 32 (32%) patients. However, 36 patients developed laparotomy wound related complication. Conclusion: In conclusion high frequency of complications are found among the temporary ileostomy patients. Journal of Current and Advance Medical Research, January 2021;8(1):65-69

Background: Generalized peritonitis as a result of gastrointestinal perforation is a common surgical emergency and one of important morbidity is surgical site infection (SSI). Objectives: to evaluate the incidence of SSI after emergency laparotomy for perforation peritonitis.