ABSTRACT
Background: Inguinal hernia repair is one of the most commonly performed procedures by general surgeons. Cyanoacrylate is the generic name for a family of fast acting adhesives. The aim of the present study done in Department of General Surgery, Safdarjung Hospital, New Delhi was to compare the newer emerging technique of mesh fixation.Methods: A total of sixty patients were included in the present study and were allotted in case and control group randomly by sealed envelope technique. In case (study) group, all the patients underwent mesh fixation by cyanoacrylate glue and in control group, by prolene 3-0 sutures.Results: Most frequency in age group 31-40 yrs, males:females ratio >1 and right sided inguinal hernia was more common. Bi-lateral hernia was common in elderly. Indirect: direct ratio 4.5:1. Operating time period for the patients of the case (study) group is less than control group. P value of post-operative pain in immediate post-operative period (day 1 and 2) and POD 30, 60 and 90 was not of clinical significance whereas the p-value on 6,120,150 and 180 post op day was of clinical significance. In our study, there was a case of incidental observation: a) reaction due to use of cyanoacrylate glue, b) rejection of mesh for which mesh had to be removed.Conclusions: There is no statistically significant difference between mesh fixation with cyanoacrylate glue and mesh fixation by prolene suture techniques in immediate post-operative pain. Statistically significant difference favoring mesh fixation by cyanoacrylate glue technique was seen with respect to operating time and post-operative groin pain with increasing post-operative duration.
ABSTRACT
Background: Thyroidectomy is a common surgical procedure performed worldwide by surgeons with varied training. It is the experience and the skills by which a surgeon performs, the indication of surgery and the extent of surgery which determines the outcome and the complication rates.Method: This study is a retrospective study performed from January 2012 to December 2018 when a total of 170 patients underwent total thyroidectomy via kocher’s incision for benign diseases with clinically in hypothyroid state at Safdarjung Hospital, New Delhi in a single unit of a tertiary care hospital.Results: The male: female ratio was 1:7.09 with average age of patients being 40years. The overall complication rate was 18.82% (32 patients). Postoperative transient hypocalcaemia being the most common complication. There was no case of permanent hypocalcaemia. There was no injury to any nerve (recurrent or superior laryngeal). Transient recurrent laryngeal paresis was noted in 4(2.35%) which resolved with conservative management. Complications like wound infection, sympathetic chain injury were not noted. The characteristic feature of this study was five cases of giant secondary retrosternal goitre which had average weight of greater than 500 grams which were operated using kocher’s incision. The average weight of other 165 patients was 70grams +/- 12 grams. There were no major post-operative complications except for post-operative recurrent laryngeal nerve paresis and seroma formation which was evacuated after 3 weeks of surgery.Conclusion: Hence, from this it is concluded that it is the surgical experience and skills of the surgeon which make total thyroidectomy a safe procedure providing permanent cure with a low post-operative morbidity risk even with large sized retrosternal thyroid glands which can be operated via neck incision.