ABSTRACT
Background: Appendectomy is the most common surgicalprocedure performed in emergency surgery. Appendectomy isstill being performed by both open (OA) and laparoscopic (LA)methods as no other technique is formulated. In this study, weaimed to compare the laparoscopic procedure and thestandard technique in the treatment of acute appendicitis.Methods: Retrospectively collected data from 60 consecutivepatients with acute appendicitis were studied. These comprised30 patients who underwent conventional appendectomy and 30patients treated laparoscopically. The two groups werecompared for Intra operative parameters like duration ofsurgery, conversion, complications, and post-operativeparameters like pain, requirement of pain medications, woundcomplications, hospital stay, any other complications, andcosmetic outcome.Results: In our study Laparoscopic Appendectomy have ashorter hospital stay (Mean duration of hospital stay aftersurgery was 3.1 & 1.9 day in OA & LA group respectively),Operative time was significantly less in the open group (Meanduration of surgery was 71.2 minutes in OA group and 48.8minutes in LA group). Total number of complications werefewer in the LA group with a significantly less incidence ofwound infection (5 Vs 11, P <0.04).Conclusion: The laparoscopic method is a safe andcompetent operative method in appendicectomy. Postoperativepain in our study is notably lesser in laparoscopic group ascompared to open appendectomy, also post-operativecomplication especially wound infections are less frequent inlaparoscopic group of patients. Patient’s recovery fromoperation is also better in laparoscopic appendicectomy groupwhich includes early bowel activity, minimum hospital stay andearly return to work. Overall cosmetic outcome is preferable inlaparoscopic group of patients.
ABSTRACT
Objectives: The purpose of the study was to place cadaverdermal allograft in patients with burn and non-healing ulcerwounds and observe their biologic response.1. To identify clinical success rate of take of cadavericdermal allograft2. To evaluate infection / rejection rate of cadaveric dermalallograft3. To confirm take of allograft by histological features andneovascularization after applying cadaveric dermalallograft.Method: This study was done on 50 patients suffering fromburn and nonhealing ulcer wounds. Patients of all age groupsand both sexes were taken. Dermal allografts were harvestedfrom cadaver after taking consent from relatives. These graftswere applied to wound sites after treating it with glycerol andcryopreservation and their biological responses wereassessed.Results: In this study, on follow up for 2 months, out of 50patients, the graft was survived in 41 (82%) patients andrejected in 9 (18%) patients. Out of 41 patients, the graft wasdetached and wounds were completely healed in 33(66%)patients and graft was still intact in 8(16%) patients. Graft takeup success was assessed by histopathologically showingneovascularization.Conclusion: It was observed that epidermis depleted allografthas proved to be an effective material for wound coverage dueto absence of langerhans cells. Further cryopreservationincreased its viability and reduced immune reaction. Glycerolacted as an effective virucidal agent.
ABSTRACT
Background: Bariatric surgery is seen as one of the most successful option for the control of morbid obesity and obesity related complications. Although, there are many surgical options available the Lincey Alexida, Xiaohua Qi, Patrick B. Asdell, José M. Martínez Landrón, Samarth B. Patel, Faustino Allongo. Frederick Tiesenga. Laparoscopic Adjustable Gastric Band as a Revision Surgery for Failed Vertical Gastric Sleeve or Roux-en-Y Gastric Bypass. IAIM, 2017; 4(12): 37-42. Page 38 laparoscopic vertical sleeve gastrectomy and the Roux-en-Y gastric bypass are among the most selected treatment methods. Even though the sleeve gastrectomy and the gastric bypass has proven to be efficacious in weight reduction in morbid obesity there are still some reported failures. Aim: This study main objective is to see if an adjustable gastric band can be offered as a sensible option for patients who have had a previously failed vertical sleeve gastrectomy or the Roux-en-Y gastric bypass surgery. The procedure will be classified as a revision surgery to increase the possibilities of additional weight loss not achieved with the sleeve gastrectomy or gastric bypass surgery alone. Method: A retrospective review of the charts for all the bariatric patients from April 2012 to April 2017 was conducted. The chart review yielded 12 patients who underwent either adjustable band over a previously failed vertical sleeve procedure or the adjustable band over a previously failed Roux-enY gastric bypass procedure. The patients were divided into two groups, group A and B. Group A is comprised of the 8 out 12 patients who had a previous failed gastric sleeve procedure. Group B has the remaining 4 patients who had a failed gastric bypass procedure. Observation: Both groups who underwent adjustable gastric band laparoscopically as a revision procedure after a two year follow up appointment showed Group A had a mean estimate weight loss of 30.75 lbs. (11%) with a mean Body Mass Index of 40.7 kg/m2 and Group B had a mean estimate weight loss of 42 lbs. (15%) with a mean Body Mass Index of 36.77 kg/m2 . Group A had an Excess Body Weight Loss of 27% at 1 month and 33% at the 2 year follow up and Group B had an Excess Body Weight Loss of 42.2%. Group B had an Excess Body Weight Loss of 15.1 % at 1 month and 42.2% at the 2 year follow up. Conclusion: Group A had an average of 27% Excess Body Weight Loss and Group B had an Excess Body Weight Loss of 15.1% after 1 month on follow up. Our study was limited by the small sample size. We suggest that further investigational studies, with greater and more diverse sample sizes, be conducted to assure the benefit of using the adjustable gastric band as a revision surgery. Based on our results we conclude that the adjustable gastric band as a revision surgery is a promising and sensible alternative treatment option for patients with a previously failed laparoscopic vertical sleeve gastrectomy or a failed Roux-en-Y gastric bypass.