AIMS:Study the efficacy of stapled haemorrhoidectomy using circular stapler in terms of benefits as duration of surgery, length of hospital stay, postoperative pain, time to return to normal daily or social activity and usefulness as for patient satisfaction. MATERIAL AND METHODS: Prospective study using circular stapler for grade II, grade III and grade IV haemorrhoids between age group 20 to 70 years was done over a period of Jun 2011 to Nov 2013. OBSERVATION AND RESULTS: Study enrolled 30 symptomatic patients. 21(70%) were males and 9(30%) females. Most common complaint was bleeding per rectum in 29 (96.66%) patients followed by itching 11 (36.66%) patients & constipation 8 (26.66%) patients. 19(63.33%) patients were grade III haemorrhoids, 6 (20%) were grade II and rest 5 (16.66%) grade IV. Mean operative time was 31.76 minutes for our team with same surgeon operating all cases. Postoperative pain recorded using VAS score was max 24 hours after the surgery with mean VAS 2.31 + 0.46(VAS -1 no pain). During stay 28(93.33%) patients required Step 1 pain analgesics (NSAIDS) while only 2(6.66%) were put on Step 2(opioids). Mean hospital stay of patients was 34.96 hours (1.45 days). 28(93.33%) patients were able to return to social activity by day 8 post operatively. 28(93.33%) were complication free while others had minor problems dealt accordingly. No recurrences in 6months follow up in all patients with 28(93.33%) patients reporting satisfaction for their treatment through the procedure. CONCLUSION: Haemorrhoids is a socially embarrassing disorder and this new procedure of stapler haemorrhoidectomy delivers a smile and dignity especially to Indian patients. Hence it should practiced and promoted for patients benefit.
Obesity has assumed a pandemic and is responsible for serious medical, social, psychological, and economic implications, affecting all ages and socioeconomic groups. Hence, this prospective study was carried out to study the surgical benefits in such patients. A Prospective interventional study was carried out from June 2010 to November 2012 at IGGMC Nagpur performing laparoscopic sleeve gastrectomy (LSG) in morbidly obese patients, and its efficacy was determined. A total of 56 patients were studied. 26 (46.42 %) being males and 30 (53.57 %) females. The maximum number of patient's, i.e., 32 (57.14 %) were in the range of BMI 40-44.99 kg/m(2) with mean BMI-43.25 kg/m(2). Mean weight was 117 kg (range 92-180 kg). Common comorbidities observed were hypertension in 43 (76.78 %), bronchial asthma in 31 (55.35 %), and diabetes in 21 (37.5 %). All patients treated with LSG had a mean operative time of 154.9 min (range 110-310 min) with 0 % leak, one conversion to open, and no mortality. Postoperative hospital stay was 3.54 days (range 3-7). Complications were minimal with prolonged vomiting seen significantly in 28 (50 %) patients. Follow up at 24 months showed mean weight 74.72 kg (68-81 kg) with mean excess weight loss of 67.71 % (62.79-71.05 %) causing a mean BMI of 28.42 kg/m(2) (26.56-30.44 kg/m(2)). It also reduced mean BP to 120.36 mmHg (110-144 mmHg) and mean fasting blood sugar to 100.63 mg/dl (80-146 mg/dl). Surgery for obesity is definitely an answer for this gift of modernization, and LSG is a safe and effective technique for achieving weight loss. Quality of life improves astonishingly and adds confidence to this mentally traumatic entity called "OBESITY".
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