Rhomboid flap- a primary cure for pilonidal sinus

To assess the complications, days off work, analgesia requirement and recurrence rate of radical excision and rhomboid flap reconstruction for treatment of sacro-coccygeal pilonidal sinus. Prospective. Al-Amiri Hospital, Kuwait. Two hundred and fifteen patients admitted for surgery of pilonidal sinus. Radical excision of pilonidal sinus with reconstruction using rhomboid flap under general anesthesia in prone position was performed. The patients were usually discharged 24 hours after surgery. Patients were followed up postoperatively for an average of 20 months [range 10-56 months]. They were observed for complications related to the procedure, recurrence, return to work and analgesia requirements. One hundred and seventy eight [82.2%] patients had primary healing, five [2.3%] had recurrence, fourteen [6.5%] had superficial wound infection, eight [3.7%] developed wound seroma and ten [4.65%] developed deep wound infection. The mean duration of follow up was twenty months. The return to work was within two weeks. The analgesia requirement was minimal. Treatment of pilonidal sinus using the rhomboid flap is a simple and safe procedure with low morbidity and recurrence rate

Laparoscopic cholecystectomy in 2,750 cases in a teaching hospital in Kuwait

To retrospectively analyse all laparoscopic cholecystectomies performed between April 1992 and May 1999. Medical records of 2,750 patients, clinically diagnosed with gall bladder disease, were reviewed. We analysed the operative time, length of postoperative hospital stay, conversion rate, intra- and postoperative complications as well as management outcome. The mean operative time was 59.2 min, and the mean postoperative hospital stay was 1.46 days. However, the majority of our patients [66.8%] were discharged after 1 day. The conversion rate was 3.8%, which was mainly due to acute gall bladder pathology. The postoperative complication rate was 4.6%; all cases were managed successfully with no mortality or delayed morbidity. Our findings indicate that laparoscopic cholecystectomy appears to be a safe and effective procedure with low morbidity and no mortality. Therefore, it should be considered as the procedure of choice for patients with gall bladder disease