On proper drainage by split drains in genito-urology surgery

A thorough statistical analysis of the results of drainage types and drain properties adopted in 3327 cases of genitourology operated upon in 5 years showed the following : 1. Due to rich vascularity of the genito urinary organs, the usual urine collection drainage has become a must. 2. Drain by plastic or silicon coated corrugated sheet or multiparous tubes gave better results 3. The suitable breadth of the sheet drain is of 3 corrugations while the optimum size of the tube or catheter is Fr 16 or 14. 4 Multiple tubular sheet silicon coated may not sensibly be the best drain, as pores are narrow. Besides, this was not available in this work. 5. Gauze drain is not suitable in urological drain as harbours infection due to presence of urine, thus should be avoided. 6. As regards the site of drain fixation, the split one i.e. from a stab incision about 1 inch from the wound incision is superior to the traditional drain from the wound incision itself. Moreover, the interior end of the drain should be located in the most dependent part of the depth of the operation. 7. The surface length of the drain should be neither too long to hinder dressing nor too short to retract inside the wound edges; 3 cm are satisfactory. 8. Consistency of the drain not to be too soft as it may impede drainage when compressed by oedema of the healing wound as well as it would be liable to cut off on removal. On the other hand, the hard drains are painful to the healing sensitive tissues of the operation on movement 9. Mulitplicity of individual drains may be helpful and necessary. However, it is contraindicated to use the drain by cleavage of its interior segment. 10. Drainage efficiency implies insinuating the drain into the most independent part of the operative wound to avoid blood and/ or urine collection. 11. Removal of the drain is to be experienced gently, if it resists extraction no force is exerted and is left for extra time till any probable unnoticeable catgut stitch hitching it, is absorbed. 12. The most suitable period of drainage is for 6 days. However, when intestine is involved as a step of operation, peritoneal drainage may be exceptional as long as 12 to 15 days. 13. The mean hospital stay is shortest in the second group of drainage [6 days period] with consequently less hospital running expenses, besides a more satisfaction to both the patient and the surgeon

Neuroblastoma versus Nephroblastoma in infancy and childhood

A thorough statistical analysis and study of the clinical presentations as well as the radiological findings of this work on Wilm's tumours [56 cases] and neuroblastomas [28 cases] in infancy and childhood showed the following conclusions : A] Statistical Analysis : 1. Wilm's tumours were of predominent occurance. 2. The peak age of Wilm's tumours was 2-4 years and that for neuroblastoma was 2-3 years. 3. Wilm's tumours nearly equally affected both males and females, while neuroblastomas affected the males more than females. B] Clinical Presentations :. A palpable mass was usually the main presentation of malignant abdominal tumours in infancy and childhood. However, the other malignant abdominal tumours usually presenting with malaise and abdominal pain. C] Radiological examinations : 1. Plain abdominal radiogram were essential in abdominal tumours that showed soft tissue mass. The neuroblastomas commonly showed calcifications. 2. Intravenous urography was essential in diagnosing tumours of renal [Wilm's] and of supra-renal [neuroblastomas] origin. 3. Barium meal undoubtedly helped in the diagnosis of upper abdominal tumours as barium enema did in lower abdominal tumours. 4. Selective arteriography was one of the diagnostic techniques to evaluate the features of malignancy in the turnours. 5. Skeletal survey especially for the skull and the extremities was essential to detect bony metastasis of neuroblastomas. 6. Chest radiogram to detect pulmonary metastasis was important radiological follow-up examination of abdominal malignant tumours