Experience of day care surgery at Peshawar

To evaluate the results of Day Care Surgery in our set-up. Retrospective study from Jan. 2003 to May 2005. Surgical 'C' Unit of Khyber Teaching Hospital, Peshawar. A total of 190 patients who underwent Day Care Surgery were included in this study. All patients were evaluated and counselled before hand, and asked to come on a given date. On the day of surgery they were shifted to the Operation Theatre, operated, kept under observation and sent home the same day with the advice to contact the concerned surgeon in case of any problem or complication. The patients were followed-up on the 3rd and 7th days, and examined for evidence of any local or distant complication. The patients were once again followed within a months time. Out of 190 patients, there were 131 male and 59 female patients, with an age range of two months to 65 years. All patients went home following surgery the same day except two, who were apprehensive and had to he kept for night. Twelve made telephone calls and were given advice. Five patients were readmitted with vomiting. two with severe pain and two with reactionary hemorrhage, and were discharged home the next day. One patient with hernia repair was readmitted after two days with scrotal oedema and treated. Day Care Surgery in uncomplicated cases is safe and cost effective. Majority of the patients were satisfied with this approach of early discharge

Arteriovenous fistula construction in chronic haemodialysis patients: comparison of end-to-side and side-to-side techniques

To compare the techniques of end-to-side and side-to-side anastomosis in arteriovenous fistulae construction in terms of success rate and immediate postoperative complications. Design: Comparative study. Place and Duration of Study: Ayub Hospital Complex, Abbottabad, from October 1999 to December 2002 and Khyber Teaching Hospital, Peshawar, from January 2003 to December 2003. Patients and One hundred and ninety patients with end stage renal disease [ESRD] were included in the study. Arteriovenous fistula was constructed in these patients by two techniques i.e. end-to-side and side-to-side anastomosis. The two methods were compared in terms of duration of surgery, immediate success rate and short-term complications. Among 190 patients, 118 [62%] were males and 72 [38%] females. The age ranged between 24 to 66 years with average age of 54 years. Side-to-side anastomosis was done in 120 [63%] patients while end-to-side in 70 [37%] patients. The average duration of surgery in side-to-side group was 50 minutes and in end-to-side group it was 75 minutes. Bleeding occurred in 4[5.7%] cases in end-to-side group and 2[1.7%] patients in side-to-side group requiring reexploration. The immediate failure rate of the procedure was 2.5% in side-to-side group and 7.5% in end-to-side group. Wound infection occurred in 1[1.4%] case in end-to-side group and 2[1.7%] cases in side-to-side group. In patients with end stage renal disease [ESRD] arteriovenous fistula construction by side-to-side anastomosis is less time-consuming and has less complications as compared to end-to-side technique