INTRODUCTIONBreast abscess is one of the commonest form of abscess surgical emergencies usually seen in lactating woman. 1,2 The frequency of occurrence is highly related to pregnancy and mainly caused due to nipple piercing by a child during feeding and bacterial colonization due to improper nursing technique and incomplete emptying of the breast.3,4 Immediate diagnosis and treatment is necessary if breast feeding is to be continued and for the prevention of further complications. 5Treatment of breast abscesses is a difficult clinical problem. 6 At an early stage, acute mastitis may be treated ABSTRACTBackground: Breast abscess is defined as an acute inflammatory lump which yields pus on incision/aspiration. The frequency of occurrence is highly related to pregnancy and caused due to nipple piercing by a child during feeding and bacterial colonization due to improper nursing technique and incomplete emptying of the breast. Non-lactational breast abscesses are entirely different from those occurring during breast feeding. They occur in the peri-areolar tissues, frequently recur, and infecting organisms are mixture of anaerobes. The present study compares the outcome and effectiveness of traditional treatment incision and drainage against needle aspiration in the treatment of breast abscess.Methods: This is a comparative study carried out in department of general surgery in a tertiary health care center, LTMMH and GH, Mumbai for a period of 2 years (May 2012 -May 2014) after taking approval from institutional ethics committee. 60 female patients of age between 18-65 years and diagnosed breast abscess with abscess size of less than 10 cm in diameter on ultrasonography were included in the study after taking written consent form. Of these 30 had undergone aspiration of the breast abscess (group A) and 30 had undergone incision and drainage of the breast abscess (group B). Results:The mean age of the female patients in the study were 18-42 years. 90% of the cases were lactating. S. aureus was the common organism isolated in both lactating and non-lactating cases, encountered in 34 patients (57.7%). Out of that 20 were in the aspirated group (66.7%). 14 patients were in the incised group (46.7%). The mean healing time and cosmetic outcome was significantly (p = 0.001) very good in patients treated with needle aspiration compared to incision and drainage. There was no recurrence of breast abscess observed in needle aspiration group during the study. There was 3.3% recurrence rate observed in the incision and drainage group. Conclusions: Breast abscess in patients with diameter of less than 7 cm can be treated with needle aspiration successfully and with a good cosmetic outcome.

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INTRODUCTIONAcute appendicitis is the most common surgical emergency and carries lifetime risk of 8%. 1 Appendectomy has been the primary treatment of choice for acute appendicitis, and although antibiotics have established some use but surgery remains the treatment of choice. Open surgery, laparoscopic appendectomy and now single port surgery for appendicitis has become routine approach.Laparoscopic surgery also called minimally invasive surgery (MIS), is a modern surgical technique in which operations in the abdomen are performed through small incisions (usually 0.5-1.5 cm) as opposed to the larger incisions needed in laparotomy and considered as gold standard treatment for acute appendicities.2-4 This technique has many advantages over open procedure like reduced pain due to smaller incisions and hemorrhage, and shorter recovery time. But this technique had a limitation of scars after surgery hence a novel technique has evolved called single incision laparoscopic surgery (SILS), preferably in the navel, with advantages of ABSTRACT Background: Appendicitis is the most common intra-abdominal condition requiring emergency surgery and it is approached by laparoscopic procedures. Innovative methods were developed that reduce tissue trauma and offer improved cosmetic results, one of such being the single-incision laparoscopic surgery (SILS) with advantages of reduced postoperative morbidity and almost invisible scar. Methods: 60 patients were included in the study after meeting inclusion criteria and divided into two groups 30 each. One group had undergone single incision laparoscopic appendectomy and other with multiple port laparoscopic appendectomy. Preoperative, intraoperative and postoperative parameters were collected. Data involving patients' demographics, operative time, length of hospital stay and both intraoperative and postoperative complications were collected. Results: The mean duration of surgery in multiple appendectomy was lesser compared to single port appendectomy and values are insignificant (p =0.1844) when compared between the two groups. None of the patients in both the groups did not have any intraoperative complication. Only one patient in single port appendectomy converted to open surgery. The mean postoperative pain VAS score was 2.00 in multiport appendectomy group which was significantly more as compared to 1.60 among single port appendectomy group after 24 hrs. The postoperative complications and the duration of stay in hospital were almost similar in both the groups. The complications observed during follow up in both the cases were minimal and statistically insignificant. Conclusions: The major advantage of SILS is cosmetic satisfaction, while the disadvantages of SILS are longer operative time and higher conversion rate.