Near total thyroidectomy; role of drain

To evaluate the role of surgical drains in near total thyroidectomy. It was a Randomized clinical trial conducted at department of surgery, DHQ teaching Hospital, Dera Ghazi Khan from Jun 2012 to May 2013. Patients were randomized into two groups by lottery method. Group A were those in which drains were placed and Group B patient were operated and no drains were placed. Inclusion criteria included all patients presenting for near total thyroidectomy for benign diseases. Those with massive goiters or nodules larger than 6 cm were excluded. 40patients were enrolled in the study. Complications, length of hospital stay, and overall cost were evaluated. In the Group B [no drain group], there was 03 days mean hospital stay with no increase in postoperative complications like swelling. While Group A [drain group] mean hospital stay was 06 days. Thyroid surgery without the use of a drain decreases the length of hospital stay, with no increase in patient morbidity. The overall cost is significantly reduced

Enterocutaneous high output fistulae; octreotide an effective tool in management

Enterocutaneous fistula is an abnormal communication between epithelial lined lumen of Gl tract and epithelium of an adjacent viscous or skin. To find out role of octreotide in the management of high enterocutaneous fistula. Case study. Department of Surgery unit-ll Punjab Medical College and A and E Department of Jinnah Hospital /AIMC Lahore. From Jan 2007 to Dec 2008. 479 laparotomies were carried out due to trauma. Out of these 21 i.e. 4.38% developed high out put enterocutaneous fistula. All patients were put on similar conservative management including, TPN, antibiotics, fluid electrolyte replacement and stoma care. Patients were split into two groups alternatively. There were no statistical difference between the study groups with regard to the age [p-value=0.515]. Group I contains 11 patients [octreotide] received additionally 100mg octreotide S/C 8 hourly, showed decrease of volume from 680 to 150ml within 10 days. Spontaneous closure was observed in 8 [72.72%] patient and surgery was required in 2 [18.18%] patients. Death was 1 [9.09%]. In Group II remaining 10 patients[without octreotide], fistula discharge volume decreased form 650mg to 150ml in 20 days. Spontaneous closure was noted in 5 [50%] cases. Surgery was required in 3 [30%], while death rate was 2 [20%]. It is concluded that Octreotide, an analogue of somatostatin with longer half life is effective in treatment of high output fistula

Shouldice versus lichtenstein repair

To compare the results of tissue based Shouldice repair with the Lichtenstein tension free repair of inguinal hernia. A prospective randomized controlled trial. From Jan 2004 to Dec 2006. Surgical Unit-II, Allama lqbal Medical College /Jinnah Hospital Lahore, Pakistan. A total of 156 patients were included in this study were equally divided into two groups. The mean age was 45 years. After a follow up of upto 2 years there was significant difference in the recurrence rate. It was 5% in the Shouldice group and 1.28% in the Lichtenstein group. Similarly chronic pain was also much higher i.e. 5% in the Shouldice group compared to 1.28% in Lichtenstein Group. The rate of hematoma and seroma formation was the same [1.28%] in both groups, however infection was seen slightly more in Lichtenstein repair [3.84%] as compared to Shouldice repair [2.56%]. Tension free Lichtenstein technique was found to be superior to the tissue based Shouldice repair with respect to post operative complications and recurrence