Lichtenstien repair of inguinal hernia under local anaesthesia - day case surgery

This prospective study was carried on 250 patients to study the complication and recurrence rate associated with Lichtenstien repair of inguinal hernia in our clinical and socioeconomic settings. The cost effectiveness and return to work after surgery were the other outcome measures. Two hundred and fifty patients underwent mesh repair of inguinal hernia at two different centers over a period of two years. All the patients were operated under local anesthesia. A bolus dose of preoperative antibiotic was given intravenously. The patients were followed up for two years and their post operative course was assessed according to a prescribed proforma. The rate of minor complications was in the range of 11.8%. The recurrence rate was 1.2%.There was minimal pain and the procedure was cost effective in terms of operative cost and less economic loss due to early return to work. It is concluded that Lichtenstien repair as a day case is safe and effective procedure to be performed by a trained general surgeon under local anesthesia. The infection rate and the recurrence rate are low. The compliance and acceptability of the patient and ease of carrying out the procedure under local anesthesia by surgeon is acceptable. In our view this type of hernial repair is an appropriate method in district hospital and tehsial headquarter hospitals where provision of anaesthesia facilities are yet to be fully developed and hospitals cater a major hernial load due to elderly patients with background of farming professions being admitted. The patient can be sent home on same day after surgery

Primary repair Vs ileostomy in patients with typhoid perforation

This is prospective study conducted in the department of Surgery, Mayo Hospital, Lahore over the period of four years. Comparative data was compiled on 100 patients divided in two equal groups. Efficacy of two operations was assessed in terms of morbidity and mortality. The final results were conclusive enough to show the benefits of ileostomy over the primary repair in cases of typhoid perforation

Management of acute pancreatitis: an experience at Mayo hospital, Lahore

This is a retrospective as well as prospective study of 46 patients with acute pancreaitis who were managed in North Surgical Unit of Mayo Hospital, Lahore. This study was carried out with special emphasis on need of surgical treatment and its outcome. No age group or sex was found immune to this disease. It was more common in 3rd to 4th decade of life and female sex. The commonest etiology is gall stones [54%] followed by alcohol [8%] and idiopathic [15%]. Pain epigastrium is a constant symptom. Judicious use of serum amylase urinary amylase and ultrasonography can help in early diagnosis of the acute pancreatitis. Complications are best diagnosed on CT scan. Majority of patients were treated successfully by conservative measures [44%] but developed complications which carried high morbidity and mortality. Surgical treatment of associated gall stones has prevented recurrent attacks of acute pancreatitis. Hence cholecystectomy for associated gall stones is recommended during same admission for mild to moderate pancretitis after resolution of symptoms