IntroductionMost of the patients with rectal prolapse complain of fecal incontinence followed by constipation. Surgery is the only definitive treatment option for rectal prolapse. There are two approaches: either transanal/perineal or transabdominal. The abdominal procedures can be done in the open laparotomy method or laparoscopically. Suture rectopexy is a very old and popular method of treating rectal prolapse. Nowadays, rectopexy by laparoscopic approach is considered the gold standard treatment for rectal prolapse. The study has been conducted to compare both the procedures and their outcomes in terms of conditions associated with rectal prolapse. MethodsAll consecutive patients with full-thickness rectal prolapse who had attended the surgery outpatient department were included in the study. The patients had undergone either open suture rectopexy or laparoscopic rectopexy after randomization. Assessment of postoperative pain, mean days of hospital stay, constipation, and incontinence score along with operative time, recurrence within six months of follow-up, and time to resume bowel activity were done. The patients were followed up for 18 months at regular intervals. ResultsA total of 58 patients were included in the study: 27 in the open group and 31 in the laparoscopic group. The operative time was 102 minutes versus 129 minutes (p=0.0001) in the open and laparoscopic groups, respectively. The laparoscopic group had an earlier resumption of bowel activity (3.1 days vs. 1.4 days [p=0.0001]); fewer days of hospital stay (6.8 days vs. 2.5 days [p=0.0001]), less postoperative pain (mean visual analogue scale score for pain on postoperative day one 4.0 versus 3.1 [p=0.0035] and on postoperative day two 3.8 versus 2.2 [p=0.0001]). There was no significant difference in postoperative constipation score and incontinence score between the two groups. ConclusionLaparoscopic rectopexy results in lesser postoperative pain, lesser hospital stay, and better patient satisfaction than open rectopexy.
Single incision laparoscopic surgery is an emerging branch of minimally assess surgery to reduce scar and post-operative pain. Appendicitis is a common general surgical problem encountered in day to day practice. Different methods of appendectomy have been described by different surgeons from open to laparoscopic and now single incision laparoscopic surgery has been practised. This is a prospective study carried out in our Department of General Surgery SCB Medical College, Cuttack from February 2019 to March 2020; 60 patients had undergone the procedure and the results are published noted under headings of post-operative pain at (6 hours, 12 hours, 24 hours and 48 hours), post-operative requirement of analgesia (diclofenac) at (6 hours, 12 hours, 24 hours and 48 hours), operative time, days to resume bowel activity, days of hospital stay, post-operative complication in accordance to Clavien-Dindo classification.
Introduction: Superficial parotidectomy is an effective management for benign and malignant tumours of the superficial lobe of the parotid gland. Frey's syndrome is one of the most common complications observed after parotidectomy. The objective of our study was to find the incidence of Frey's syndrome 6 months and 1 year postoperatively after doing posterior belly of the digastric flap during superficial parotidectomy. Materials and Methods: This is an observational prospective study done in the Department of General Surgery of the Institute from November 2018 to December 2020. Thirty-eight patients with parotid swellings (both due to benign or malignant causes) were evaluated preoperatively and planned for superficial parotidectomy with a posterior belly of digastric muscle (PBDM) flap to prevent the occurrence of Frey's syndrome. They were followed up in 6 months and 1 year. Minor's test was done in each visit to look for the occurrence of Frey's syndrome. Results: Two patients (5.2%) out of 38 patients developed asymptomatic Frey's syndrome after 6 months postoperatively out of which one patient (2.6%) developed symptomatic Frey's syndrome after 9 months postoperatively with symptoms such as sweating, flushing, and redness over the parotid area during chewing. Discussion: PBDM flap following superficial parotidectomy in a single-stage surgery is an effective and easy method to prevent Frey's syndrome. This procedure is easy to perform and requires no complex dissection. There have not been many studies regarding the use of this flap; hence, this study may be considered as a pilot study.
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