Aim: To compare the number of attempts at creating pneumoperitoneum for laparoscopic cholecystectomy using direct trocar versus veress needle insertion techniques. Design: Randomized controlled trial Place and Duration of Study: Department of Surgery, Allama Iqbal Memorial Hospital Sialkot and Govt. Sardar Begum Teaching Hospital, Sialkot from 27th September 2017 to 26th September 2020. Methodology: Six hundred and eight patients of both male and female patients, having uncomplicated cholelithiasis were selected. All participants were randomized into two equal groups, Group A (direct trocarInsertion) and the Group B (veress needle insertion). All trocars and veress needle used were disposable, with a safety shield. All procedures were carried out by the single experienced surgeons and his team. Data was noted, regarding age, sex, body mass index (BMI) and the number of attempts to create the successful pneumoperitoneum. Results: The number of attempts to create successful pneumoperitoneum in DTI group was significantly feweras compared to VNI group (p=0.026) but we found no statisticallysignificant difference between age, gender, and body mass index. Conclusion: The direct trocar insertion is a safe alternative to veress needle insertion in laparoscopic cholecystectomy because it requires fewernumber of attempts for successful creation of pneumoperitoneum as compared to the veress needle. Key words: Laparoscopic cholecystectomy, Veress needle insertion, Direct trocar insertion, Pneumoperitoneum
ABSTRACT… Objectives:To compare the effectiveness of triamcinolone alone and triamcinolone mixed with 5-flourouracil used for intralesional injection to treat symptomatic hypertrophic scars and keloids. Study Design: Prospective study. Place & duration of study: Departments of Plastic and General Surgery, Khawaja Muhammad Safdar Medical College, Sialkot from January 2014 to September 2016. Material and Methods: Plastic and general surgery outpatients with symptomatic keloids and hypertrophic scars fulfilling inclusion criteria were registered. Adult patients irrespective of gender, areas involved and size of the keloids were included. Patients refusing treatment, pregnant and lactating women were excluded; similarly the patients not completing the follow up for at least 3 months were dropped from the statistical analysis. Patients' response to treatment was judged by the reduction in the physical size of keloids and subjective improvement in symptoms of itching, discomfort, pain, deformity or redness. Minimum of three sessions of treatment was must for assessment of outcome. Data was entered and analysis done by SPSS v 22. Results: Of the 293 outpatients 115 were treated by the mixed triamcinolone and 5 flourouracil while 178 patients were injected with triamcinolone only. Female patients were more in number with ratio of 2.8:1. Good response to treatment with Triamcinolone alone was obtained in 69 (38.76%) while good response was seen in 62 (53.91%) of patients with intralesional Triamcinolone mixed with 5-flourouracil. Conclusion:The intra-lesional steroid injection commonly used as its treatment has convincing response. The presently used mixture of steroids and 5-flourouracil has more promising results as regards patients' improvement in symptomatology as well as physical reduction in the size. Key words:5-fluorouracil, Triamcinolone, Intraleisional, Keloids, Hypertrophic scar.
Objectives: To compare the effectiveness of triamcinolone alone andtriamcinolone mixed with 5-flourouracil used for intralesional injection to treat symptomatichypertrophic scars and keloids. Study Design: Prospective study. Place & duration of study:Departments of Plastic and General Surgery, Khawaja Muhammad Safdar Medical College,Sialkot from January 2014 to September 2016. Material and Methods: Plastic and generalsurgery outpatients with symptomatic keloids and hypertrophic scars fulfilling inclusion criteriawere registered. Adult patients irrespective of gender, areas involved and size of the keloidswere included. Patients refusing treatment, pregnant and lactating women were excluded;similarly the patients not completing the follow up for at least 3 months were dropped from thestatistical analysis. Patients’ response to treatment was judged by the reduction in the physicalsize of keloids and subjective improvement in symptoms of itching, discomfort, pain, deformityor redness. Minimum of three sessions of treatment was must for assessment of outcome.Data was entered and analysis done by SPSS v 22. Results: Of the 293 outpatients 115 weretreated by the mixed triamcinolone and 5 flourouracil while 178 patients were injected withtriamcinolone only. Female patients were more in number with ratio of 2.8:1. Good responseto treatment with Triamcinolone alone was obtained in 69 (38.76%) while good response wasseen in 62 (53.91%) of patients with intralesional Triamcinolone mixed with 5-flourouracil.Conclusion: The intra-lesional steroid injection commonly used as its treatment has convincingresponse. The presently used mixture of steroids and 5-flourouracil has more promising resultsas regards patients’ improvement in symptomatology as well as physical reduction in the size.
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