Primary Resection - Anastomosis in Sigmoid Volvulus

Colonic volvulus is a disease of the geriatric population. It is common in the developing countries. The optimal management of this disease remains controversial. During the period from June 1999 to December 2002, 42 patients [29 males and 13 females] with left colonic obstruction that proved after exploration to be due to sigmoid volvulus were included in this study [their mean age was 67 years]. All cases underwent exploration and primary resection. After intraoperative colonic lavage, primary anastomosis without a defunctioning proximal colostomy was done for all cases. Of these cases, 43 passed the postoperative period smoothly without complications, while 5 cases showed a subclinical leakage and developed wound infection that was managed by conservative treatment. In this series, the mortality, due to unavoidable complications, was 7.1%. The postoperative hospital stay ranged from 8 to 18 days with a mean of 11 days. This study showed that primary resection-anastomosis in cases with sigmoid volvulus could shorten the hospital stay and avoid the morbidity of colostomy without any significant increase in mortality and morbidity

Intra - abdominal slipping of the corrugated rubber drain

During the period from 1995 until 2002, 400 cases of abdominal operations with prophylactic or obligatory corrugated rubber drains were reviewed to assess the intraperitoneal drain slippage. The diagnosis of a slipped drain into the abdomen was further confirmed by plain radiograph and/or ultrasound. In this series, seven prophylactic upper abdominal drains were slipped completely inside the abdomen on the second postoperative day. Another 14 cases were discovered on daily dressing to get partially sucked into the abdomen with a progressive disappearance of its external end. All the seven cases with total slippage were re-operated, as plain X-ray confirmed the diagnosis. The incompletely slipped drains were managed by daily shortening until the discharge became minimal. In this study, the complications of intraperitoneal drain slippage included sepsis, wound dehiscence and electrolyte imbalance. In such cases, the mortality rate was 28.6%. The direct causes of death were anesthetic injury and associated medical insult. The study also showed that mortality and morbidity were related to the delay in drain extraction

Bilateral varicocelectomy versus unilateral in management of oligoatheno - spermia

In this prospective study, the effects of unilateral operative interference on the affected side with bilateral surgery and the other clinically appearing free side were compared. The diagnoses were achieved clinically and confirmed by Doppler US, which was also used to detect a subclinical varicocele and to assess the degree of venous reflux. This comparative prospective study was based upon the results of pre and postoperative seminal analysis and Doppler studies US of venous drainage of both testes. The study included two groups of infertile males: Group I included 30 cases underwent unilateral surgery and group II included 30 cases underwent bilateral surgery. Three months postoperatively, seminal analysis of the studied cases showed an improvement in the number and initial motility as well as a decrease in the number of abnormal forms in 60% of group I and 90% in group II. Also, the study showed that there was a relation between the degree of reflux and the improvement in the seminal parameter