Safety of single layer continuous extra mucosal gut anastomosis in emergency

To evaluate the safety and complications of a single layer continuous extra mucosal gut anastomosis in emergency. This descriptive study was conducted in emergency department of Lady Reading Hospital Peshawar over a period of ten months from September 2007 to July 2008. Study comprised of fifty consecutive patients after fulfilling the inclusion and exclusion criteria. The safety of anastomosis technique was analysed by postoperative complications of morbidity and mortility. Among 50 patients 80% were male and 20% were female, mainly young adults. Patients with anastomotic leakage were 8%. The rate of wound infection was 34%. Mean hospital stay was 7.22 days. Mortality was 8% due to septicemia and hypovolemic shock. Single layer continuous extra mucosal anastomosis is safe and with less anastomosis-related morbidity and mortality

Various surgical options for emergency management of sigmoid volvulus

The objective of this study was to compare the outcome of various surgical options for the emergency surgical management of sigmoid volvulus. This comparative study was conducted in emergency department of postgraduate medical institute Lady Reading Hospital, Peshawar over a period of one year from February 2007 to January 2008. Study comprised of hundred cases to have sigmoid volvulus on clinical and radiological grounds operated in casualty department with various surgical options and outcomes of these procedures were determined postoperatively. Out of 100 cases, 79% were males and 21% females. Majority 51% patients were in the age range of 41-60 years, 36% patients were in age group of 61-80 years. Resection and Hartman's procedure was performed in 52% cases, resection with primary anastomosis with covering colostomy in 18% cases, resection and primary anastomosis in 15% cases, and resection with double barrel colostomy [Paul Mikulicz] in 15% cases. Wound infection/ dehiscence occurred in 21% cases, intra-abdominal abscess in 9% cases, anastomosis leakage in 6% cases. Colostomy complications included bleeding in 7% cases, retraction in 7% patients, prolapse in 4% cases. Resection and Hartmann procedure was performed in majority of patients. Wound infection/dehiscence, intra-abdominal abscess, anastomosis leakage were common postoperative complications with various frequencies