Precautions against anastomotic leakage after low colorectal anastomosis

Low colorectal and coloanal anastomosis have become popular methods in several surgical procedures. However, because it is undertaken in the deepest part of the pelvis, it is liable to many imperfections which predispose to faecal leak with consequent serious morbidity and mortality. The present study is based on a series of 90 consecutive cases of low colorectal anastomosis. The pathogenesis of dehiscence and leakage from this anastomosis is discussed. Technical aspects to prevent leakage are mentioned

significance of regional denervation in the development of inguinal hernia

Electromyographic studies of the most inferior fibers of the transverse abdominis muscle were performed upon 30 inguinal hernias patients. EMG abnormalities signifying partial denervation were found in only three patients. They did not correlate with previous abdominal incisions. The low frequency of this abnormality in this series is taken as evidence that relative denervation does not play a significant role in the development of primary inguinal hernias

Tuberculous breast lumps: a retrospective clinico-pathological study

A retrospective study of 11 patients with tuberculous breast lumps was conducted, with special attention to the diagnostic problem. All were females ranging in age from 20 to 57 years. The tuberculous nature was suggested clinically in 2 cases while in 9 cases, the initial diagnosis was a suspected carcinoma. The histopathological examination diagnosed the breast lump to be tuberculous in the 11 cases. In 9 cases with enlarged ipsilateral axillary lymph nodes, these were proved tuberculous on pathological examination. However, demonstration of the tubercle bacilli in the histologic sections was possible in only 2 out of the 9 lymph node specimens and in none of the 11 breast lumps. The bacteriologic confirmation through culture was positive in 6 cases, ngeative in 3 cases and could not be done in 2 eases. The results emphasize the importance of clinical awareness that tuberculosis can be a cause of a breast lump and the reliability of the histopathological diagnosis of tuberculosis particularly the demonstration of caseation. In all cases, satisfactory treatment was achieved by antituberculous drugs. The role of surgery was limited to complete excision of the breast lump and biopsying the enlarged axillary lymph nodes

Gastric varices: a comprehensive study

Retrospective study of 49 cases of esophagogastric varices, including 5 isolated gastric varices and prospective study of 72 cases of oesophagogastric varices including 5 isolated gastric varices. Analysis of the result shows an incidence of 6.64% with higher incidence among cases of oesophageal varices, grade III and IV 25/34 and 52/67 with a range of 73.5% to 77.61%. Although endoscopic diagnosis can be sufficient to manage the case, yet splenoportography is a valid procedure and be of value in suspected splenic vein thrombosis or undetected site of bleeding. A plan of treatment and choice between sclerotherapy and surgery is put with a demand for the necessity of control trial. Both sclerotherapy and devascularization procedure are recommended for treatment while Warren procedure is not favourable

Modified thyroidectomy

Three modifications in the standard thyroidectomy technique were implemented in 58 patients of different thyroid pathology excluding malignancy. A comparable group was operated upon by the same surgeon using the classical thyroidectomy technique. These modifications are+ADs- Non reflection of the upper flap of the collar incision and routine cutting of the strap muscles. Division of the thyroid isthmus at the beginning of the lobectomy. Intraglandular ligation of the branches of the inferior thyroid artery instead of ligation in continuity of the inferior thyroid artery. These modifications proved to be valid and reliable in all thyroid cases excluding malignancy. It is as good exposure as the classic thyroidectomy technique and decreases both of surgery and the postoperative morbidity