ABSTRACT
Background: Hydatid disease is endemic mainly in the Mediterranean countries, the Middle East, South America, India, Northern china and other sheep rearing areas. Liver is the commonest site of affection (55-70 %) followed by lung (18-35%). In the last decade, laparoscopic treatment of hepatic hydatid disease has been increasingly popular and has undergone a revolution parallel to the progress in laparoscopic surgery. This study presented our experience with 42 cases of liver hydatid cyst comparing laparoscopic approach and open approach for surgery during a period of one and a half years at our institute. Objectives: The main objective of the present study was to study retrospectively, the merits of laparoscopy over that of open approach for surgery during a period of one and a half years at our institute. Objectives: The main objective of the present study was to study retrospectively, the merits of laparoscopy over that of open surgery in treatment of hydatid cyst of liver. Material and methods: This study comprised of 42 patients who diagnosed to have liver hydatid cyst treated during the period of January 2013 to June 2014 at our Hospitals. They were treated either by laparoscopic approach or by open method for liver hydatid cyst. Patients not fitting into inclusion criteria were excluded from study. Predefined proforma was filled up and results were analyzed. Results: Conversion to open surgery occurred in two cases (4.84 %). The mean cyst diameter was 6.62 cm (range, 2–15 cm) in group 1 and 7.23 cm (range, 2-18 cm)in group 2 (p = 0.699). The mean operative time was 90 min (range, 70-110 min) in group 1 and 110 min (range,90-130 min) in group 2 (p\0.001). The general complication rate and abdominal wound complication rate were respectively 0 % and 0 % in group 1 (p = 0.023) compared with 5.23 and 8.72 % in group 2 (p =0.015). The mean hospital stay was 6.42 days (range, 1-21 days) in group 1 and 11.7 days (range, 4–80 days) in group 2 (p = 0.001). The mean follow-up period was 24.2 months (range,6-32 months) in group 1 and 28.4 months (range, 6-40 months) in group 2. No recurrences were observed in either group during this period. Conclusions: Laparoscopic surgery provides a safe and efficacious approach for almost all types of hepatic hydatid cysts. Large, prospective, randomized trials are needed to confirm its superiority.
ABSTRACT
Background: Laparoscopic appendectomy has gradually become widespread especially in the last decade. Although laparoscopic techniques are similar, different instruments, such as endoscopic stapler, endoscopic clip, monopolar hook cautery, harmonic scalpel, and vessel sealing instrument, can be used in appendiceal mesentery dissection 1, 2. BVS is an effective and safe system to be used at the dissection of appendiceal mesentery and haemostasis and is definitely effective in decreasing the operation period. Objectives: The main objective of the present study was to studyretrospectively, the effects of using monopolar cautery and vessel sealing system on the operation period in the appendix mesentery dissection. Methods: Hundred patients, operated laparoscopically for acute appendicitis in between June 2010 and June 2011, are evaluated retrospectively. Monopolar cautery was used in 50 patients and bipolar vessel sealer was used in 50 patients. No intraoperative or postoperative complication was seen in any of the patients. None of the patients required conversion to open surgery due to dissection problems of the appendiceal mesentery. Results and Interpretation: The mean duration of operation was 51.08 min in the monopolar cautery group whereas 36.68 minutes in the bipolar vessel sealing system group. Conclusion: Bipolar vessel sealeris safer and time saving as compared toMonopolar cauteryin laparoscopic appendectomy.