RESUMO
Study Design: Prospective, randomized
Place:Surgical-3 Jinnah Hospital/ Allama Iqbal MedicalCollege, Lahore
Duration: Two years,January2009-December 2011
Methods: Patientsbetween 10-50 years, waiting for ileal stomareversal were re-investigated and were prepared onout door basis. Admissions were done one daybefore operation of stoma reversal. All operationswere undertaken on elective lists by the same gradeof surgeons. Patients were randomly allocated oneof the two groups. Each group consisted of 60patients. Group-1 patients were allowed to take clearliquids 4 hours after surgery and fluid diet wasgiven on first postoperative day and weredischarged from hospital 24 hours after operation.Patients of group-2 were kept NPO for 4 days withnasogatric tube in situ. Clear fluids were allowed on4th postoperative day. Fluid diet was permitted on 5thpostoperative day and were discharged fromhospital on 6-7th postoperative day
Inclusioncriteria: Loop ileostomy
Exclusion criteria: Endileostomy, Extremes of age
Results: Sample size ofthe research was 120 patients with random divisionin two groups. Group-1 consisted of 60 patientsundergoing protocol of short stay hospitalizationwhereas 60 patients of group-2 were managed withconventional method of intravenous fluid and nil bymouth for 4-5 day. The demographic characteristicsof group-1 and group-2 were similar. Theindications of constructing of ileostomy wereabdominal tuberculosis, typhoid perforation,obstetrical trauma, firearm injury, iatrogenicintestinal injury during adhenolysis and strangulatedhernia with gangrenous intestine. The indicationswere almost identical in both groups. Majority ofpatients of group-1[70%] were able to go home onfirst postoperative day with total hospital stay of 2days. In group-2, 66.6% of the total patients hadhospital stay of 8 days with p value of .674 [p=.674]which is insignificant statistically. Similarly thestatistics of postoperative complications weresimilar with p value of .805 [p=.805] which is againnot significant
Conclusion: Short stayhospitalization is safe and feasible in majority of thepatients undergoing ileostomy reversal
RESUMO
To evaluate the efficacy of caudal epidural anaesthesia in selected patients having anorectal surgical conditions. A prospective randomized study. Department of Anesthesia and Department of Surgery Lahore General Hospital, Lahore from September 2001 to August 2003. The study includes 90 pts having common anorectal surgical conditions recruited with consent over 2 years. All patients were subjected to surgery planned under caudal block. Seventy nine patients [87%] were satisfied with the method of anesthesia and eighty three [92%] patients showed their satisfaction with the post operative pain control. Seventy six patients [84%] were contended with the preoperative information and seventy nine patients [87%] showed their willingness to choose this type of anaesthesia if required again. In ten patients there was failure of block resulted in a failure rate of about 11.11%. The cost effectiveness, minimal requirement, satisfactory anaesthesia an[high patients acceptability make caudal anaesthesia a usefull option for minor anal surgery