Objective: To analyze diagnostic and surgical outcomes in patients with extremely large ovarian cysts treated by laparoscopic surgery. Methods: A total of 120 cases of large adnexal masses and suspected for malignancy were treated laparoscopically at the at general surgery department of Liaquat University of Medical & Health Sciences. Under endotracheal anesthesia, all surgeries were performed using nasogastric tubes in the stomach. An incision of approximately 1.5 centimeter was made at the supraumbilical or umbilical region and peritoneal cavity was approached. The intra-abdominal approach in all cases was cautiously standardized. The resection of the adnexal mass was performed as per routine method. Results: 12 females were premenopausal and 8 were postmenopausal. 12 women presented with the signs of urinary retention, urinary urgency and abdominal pain. Incidental sonography detected cysts in 8 patients which were asymptomatic. The average volume of the resected cystic fluid was 3000ml (range 900 to 9000 ml). The specimens of frozen section were obtained within the surgical procedure in all patients except 2 patients having para-ovarian cysts. The histopathology presented mucinous benign cystadenoma. There was no blood loss and related other complications reported in all operations. Conclusion: Laparoscopic management of large ovarian cyst observed to a effective, feasible and less complicated surgical option. However accurate selection and diagnosis of the patients, the any ovarian cyst size can be treated easily via laparoscopic surgery.
Objective: This study was conducted at the Department of Surgery of Liaquat University of Medical & Health Sciences, Jamshoro, Sindh, Pakistan for comparing the effectiveness of both methods: hand sewn and stapled intestinal anastomosis and to find a better comparatively to be more efficient. Methods: A total of 70 patients were encompassed who underwent intestinal anastomoses from proximal jejunum to 2/3rd of proximal distal rectum. All patients were assigned to two different groups A and B each encompassing of 35 cases. In group A, the single layer continuous and in group B single layer patients intervallic serosubmucosal anastomosis was made by implementing the stitches approximately 6 mm at a distance integrating around 5.5 mm of the gut in its stretched direction axis evading individual mucosa. The patients were observed post operatively for anastomotic fiasco such as leakage. Results: Fourteen (14) out of 35 (2.5%) patients in group A developed anastomotic leakage . In group B, the interrupted serosubmucosal anastomoses were made in 26 patients in emergency and remaining were operated schedule wise. Five (7%) patients exhibited anastomotic leakage in group B. In group A, the continuous leakage in serousubmucosal anastomosis was 2.5% while in group B interrupted serousubmucosal anastomosis was 7%. Conclusion: It has observed in past studies that single layer interrupted stitches leakage is higher as compared to continuous. It is clear that anastomotic failure in group A is greater than group B but it not considerably substantial and hence both are remarkably efficient.
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