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Abstract Introduction Thyroid nodules are common globally in almost one fifth of the adult population. The gold standard treatment for thyroid nodule is thyroid lobectomy or total thyroidectomy depending upon the diagnosis. Thyroidectomy has a few known complications but, as per the ATA consensus statement, it is a safe surgery to be done as a day care procedure. Objective To access the feasibility and safety of thyroid lobectomy as a day care surgery and its effect on decreasing overall financial burdens. Methods This retrospective chart review was done from 2006 to 2022. A total of 736 patients underwent thyroid lobectomy among which only 56 were done as day care surgery. Data analysis was done using the IBM SPSS Statistics for Windows, Version 23.0 (IBM Corp., Armonk, NY, USA). Results A total of 40% of the population was male. The mean age of the study population was 42 years. Bethesda II was the most encountered diagnosis, with a rate of 69%. The majority of patients were discharged after 6 hours of postoperative observation. The only complication encountered was seroma, which was seen in two patients. Conclusion Thyroid lobectomy appears to be a safe procedure with a drastic difference in overall cost as a day care procedure. We recommend switching the practice of inpatient thyroid lobectomy to a day care procedure in carefully selected candidates. The major hurdle in day care lobectomy can be approval from insurance.
ABSTRACT
Background: Daycare surgeries are those surgical procedures in which the patients are admitted and discharged on the same day. As daycare surgeries surged, there is a need to have an anaesthetic agent which can be efficient and also causes fewer side effects. This study effectively analyses the efficacy and safety profile of the two most popular anaesthetic agents used in daycare surgeries. Methods: This is a retrospective study that was conducted between January 2022 and March 2022. The included patients were between 25 years and 65 years old. The outcomes were based on several factors like the efficacy of the anaesthesia (based on 4-point scale, recovery time and appearance of any side effects. Results: The efficacy of the anaesthetic action was assessed by the 4-point scale of anaesthetic effect, which showed a better outcome with sevoflurane. The Recovery Time in Group 1 was 19.92�24 minutes while in Group 2 it was 25.04�03 minutes. The findings reveal that the numbers of patients with complications are more in Group 1 as compared to Group 2 patients. Conclusion: Daycare surgery has increased and so, there is need to find an anesthetic agent which can efficiently be used. Anaesthetic efficiency is quite higher in sevoflurane as compared to desflurane. In the case of each complication, sevoflurane proved to have lesser complications as compared to desflurane. Sevoflurane is a better alternative to desflurane in daycare surgery as the anaesthetic agent of choice.
ABSTRACT
Background: Optimum surgical intervention for low-grade haemorrhoids is unknown. Haemorrhoidal artery ligation (HAL) has been proposed as an efficacious, safe therapy while rubber band ligation (RBL) is a commonly used Out patient treatment.Methods: We compared recurrence after HAL versus RBL in patients with grade II-III haemorrhoids. The diagnosis of hemorrhoids is primarily based on the proctoscopic examination. The study evaluates comparative results of rubber band ligation (RBL) and hemorrhoidectomy. This study was conducted over a period of 1 year from January 2017 to December 2017. It includes 50 patients having second- or third-degree primary hemorrhoids who attended surgical OPD of Tertiary Care Hospital in Gujarat. These 50 patients were selected randomly and divided into two groups of 25 patients each (hemorrhoidectomy group and RBL group). Patients of fissure, fistulae, and malignancy were excluded. All parameters were recorded and finally analysed.Results: Hemorrhoidectomy and RBL are equally effective especially in second-degree hemorrhoids. However, RBL should be considered the first-line treatment in second-degree hemorrhoids because being an outpatient procedure, it is cost effective for the patients, saves many hospital beds for more sick patients, and takes the pressure off the surgical waiting list. Although RBL is not as effective as hemorrhoidectomy in third-degree hemorrhoid, it does improve bleeding and prolapse and is highly recommended for patients who are unfit for surgery.Conclusions: RBL should be considered as the first-line treatment for second-degree hemorrhoid. However, in the third-degree hemorrhoids, hemorrhoidectomy achieves better results, and RBL is recommend as the first-line treatment for those patients in whom there is contraindication for surgery or anesthesia.