Can rubber band ligation replace hemorrhoidectomy as a treatment of choice for 3rd degree hemorrhoids: a review

Hemorrhoids are a common cause of rectal bleeding with a prevalence of 4 to 40% worldwide, varying in different geographical locations. The current treatment modality for 3rd degree hemorrhoids includes hemorrhoidectomy, but newer methods like rubber band ligation are rapidly gaining popularity. The purpose of our review was to establish if rubber band ligation can replace the traditional hemorrhoidectomy for the treatment of 3rd degree hemorrhoids.All databases were searched for relevant studies. A total of sixteen studies were included in the review. Current national and international literature points out that the results of rubber band ligation are comparable to hemorrhoidectomy and there are lesser complications associated with rubber band ligation.Reviewing the current recommendations, results, evidence and literature, our study recommends rubber band ligation as the treatment of choice for 3rd degree hemorrhoids

Is routine histopathology of gall bladder after laparoscopic cholecystectomy needed?: a local perspective

Background: Laparoscopic Cholecystectomy is one of the most commonly performed routine operation in modern general surgery. All surgical specimens are routinely sent for histopathology. A wide spectrum of variations is seen under the microscope. Rarely, carcinoma is discovered on histopathological examination. The purpose of the article was to identify and elaborate the major histopathological findings of gallbladder after laparoscopic cholecystectomy in a tertiary health care hospital in Pakistan

Methods: This was a retrospective study and included histopathological specimens of gall bladder after cholecystectomy from February 2004 to April 2013. Data was analysed using MS Excel and SPSS 19.0

Results: Total number of cases: 8376, Chronic Cholecystitis: 7705, Acute or chronic cholecystitis with empyema, mucocele or gangrene: 554, Adenocarcinoma: 91, Adenomatous polyp: 3, Squamous cell carcinoma: 5, Papillary carcinoma: 3, Clear cell carcinoma: 4, Adenosquamous carcinoma: 2, Xanthogranulomatous changes: 54, Dysplasia: 13 and Cholesterosis: 1050

Conclusion: Considering the evidence from our study and the evidence from the literature reviewed, it can be concluded that prevalence of all kinds of gall bladder disease, benign or malignant including carcinoma is no different from the rest of the world. Routine histopathology of gall bladder can be omitted without compromising patient safety as proven and practiced by many centers across the globe