BACKGROUND Gastrointestinal anastomosis plays a pivotal role in gastrointestinal surgeries. GI anastomosis can be done either by hand-sewn or stapler method. Recently stapling devices have created a great impact in GI anastomosis. Aim of this study is to compare the outcome of stapler versus hand-sewn anastomosis in elective GI surgeries. MATERIALS AND METHODS In this study, 50 patients requiring elective GI surgeries were included after satisfying the inclusion criteria. Patients were divided into four groups based on the site of anastomosis. Comparison between hand-sewn and stapled anastomosis in each group in terms of duration of anastomosis, duration of surgery, return of bowel activity, starting of oral feeds, acute postoperative complications and length of post-operative hospital stay were done. RESULTS In this study, we found significant difference between hand-sewn and stapler anastomosis in each group in terms of duration of anastomosis, duration of surgery, return of bowel activity, oral feeds starting day and length of postoperative hospital stay. It was stapled anastomosis that took lesser time for anastomosis, total operating time, return of bowel activity and length of hospital stay. Chi-square test was used to differentiate acute post-operative complications, which was insignificant between hand-sewn and stapler method with p-value > 0.05. CONCLUSION Due to shortened operating time, staplers are favourable for patients with poor general condition who would not tolerate prolonged anaesthesia. The insignificant difference in acute postoperative complications suggests both hand-sewn and stapled method can be done with same safety and accuracy when done with proper technique.
Background: Inguinal hernia surgery has continued to evolve historically from tissue repair to the present tension free repair by using mesh. Various tension free mesh repair have been demonstrated throughout the years after lichten stiens tension free meshplasty but inguinodynia continues to be a problem with all hernioplasties. All-in-one mesh hernioplasty showed zero incidence of inguinodynia in 50 patients who underwent this novel procedure. The primary aim of the study was to compare between all in one meshplasty vs conventional open meshplasty in inguinal hernia in tertiary care setup.Methods: Our study was done in SRM Medical college and research center attached to SRM University in Kattankullathur, Chennai for one and half year. It was comparative study between all in one meshplasty verses conventional meshplasty. A sample size of 100 patients was the part of this study, out of which 50 underwent mesh fixation by all in one meshplasty and 50 patients underwent mesh fixation by conventional meshplasty.Results: All-in-one meshplasty can be considered superior to conventional meshplasty in view of incidence of post-op neuralgia, operative time, duration of stay in hospital.Conclusions: All-in-one meshplasty can be considered as a good replacement for conventional hernioplasty in inguinal hernia repair expecting lesser post-operative morbidity and a better quality of life post-operatively.
Triple assessment of breast is based on clinical examination, histological and radiological study where in our study, the pattern of breast swelling in a premenopausal and postmenopausal woman was compared. A total of 150 female patients with palpable breast lump went through clinical examination, FNAC, USG breast while mammogram & core needle biopsy was done in selected patients. Histopathological examination of the specimen was done for all post-operative patients. Benign & malignant breast lesion accounted for 82(54.6%) & 68(45.3%) respectively. Based on the incidence of benign breast lump & malignant breast lump among pre menopausal women, it was 79% & 21% respectively while in post menopausal women it was 21.9% & 78.1%. The most common type of breast lump among the pre and post menopausal women was fibroadenoma 56.9% & Invasive ductal carcinoma 59.3% respectively. The most common benign breast lump & malignant breast lesion based on the histological pattern among the premenopausal women was fibroadenoma 72% & Invasive ductal carcinoma 50% while in postmenopausal women it was fibroadenosis 71.4% & Invasive Ductal Carcinoma 76%. Based on the hormonal status(ER/PR) of pre and postmenopausal women positivity was seen majorly in post menopausal women 82.3% compared to premenopausal women 17.7%. In our study, the malignant breast disease was more common in post menopausal, while benign breast disease was common in pre menopausal women. Triple assessment in evaluating a breast lump is per se a reliable & valid tool in the armamentarium of treating clinician with very high diagnostic accuracy.
Worldwide, breast cancer is the most frequently diagnosed life-threatening cancer in women and the leading cause of cancer death in women. In India, breast cancer accounts for 19% of all cancers in women and is second only to lung cancer as a cause of cancer deaths. Many early breast carcinomas are asymptomatic; pain or discomfort is not usually a symptom of breast cancer. Breast cancer is often first detected as an abnormality on a mammogram before it is felt by the patient or healthcare provider. Surgery and radiation therapy, along with adjuvant hormone or chemotherapy when indicated, are now considered the primary treatment for breast cancer. For many patients with low-risk early-stage breast cancer, surgery with local radiation is curative. In India, Breast cancer is the second most common malignancy among women next to the Ca cervix. Since it presents as a painless lump, patients neglect and come to the hospital often late. This study is an attempt has been made to study the various risk factors, the natural history of the disease, clinical features, and mode of spread, pathological types, staging and management of breast cancer. Since most cases presented to us either in the Early or Locally Advanced stage, they were included in the study. For the diagnosis of breast lesions, Triple Assessment should be involved to characterize the lesions, which include clinical examination, imaging and FNAC/ Biopsy for histopathological correlation.
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