Background: The experience of short term results of laparoscopic inguinal hernia repair using 3D mesh in a developing country is reviewed. Methods: From January 2012 to February 2014, 53 patients underwent laparoscopic inguinal hernioplasty. A retrospective case series of 53 consecutive patients undergoing TEP/TAPP by a single surgical team was followed prospectively with a focused physical examination and interview. 4 out of 53 patients had recurrent hernia following open repairs and 49 had primary hernias. Data collected included operative time, intraoperative bleeding, intraoperative difficulties, immediate postoperative pain, chronic groin pain, recurrence, sensory disturbance, activity or occupational limitation and personal satisfaction. Results: All the patients were male aged 32 to 75 years with a mean age of 53.5 years. Mean operative time was 37.4 minutes; intraoperative dissection, blood loss were less; and immediate postoperative pain was negligible as assessed by VAS. There was no mortality or major morbidity. Mean follow-up was 12 months (2 to 18 months). Follow-up was completed by interview and physical examination. Hernia was not found to recur during the follow up period. Chronic pain occurred in 2 patients (3.7%), which was mild in nature. Ninety-seven percent of patients were satisfied with their repair and would or had recommended TEP/TAPP to others using 3D Mesh. Conclusions: Short-term results of TEP/TAPP hernia repair using 3D mesh demonstrated to be an effective and safe procedure with low prevalence of chronic pain that is generally of a mild, infrequent nature. It was also concurred that there is decrease in operative time. Manipulation of mesh was significantly reduced. Intraoperative bleeding and use of post operative analgesia was reduced considerably. There was no recurrence, however the cost of the mesh increased the overall cost of the procedure acting as a limiting factor in a developing country.
ÖZET Amaç: Akut pankreatit sonucu tahmin etmede, akut pankreatit şiddeti (BISAP) skoru için doktor tutum endeksinin rolünü incelemektir.Yöntem: Bu tek hastaneye bağlı prospektif çalışma, belirtilerin başlangıcından itibaren 48 saat içerisinde kabul edilen 50 akut pankreatit hastasını içermektedir. Hastalar, kabuldeki BISAP skoruna göre iki gruba ayrılmıştır: BISAP skoru <3 olanlar (hafif akut pankreatit) ve BISAP skoru>3 olanlar (şiddetli akut pankreatit). BİSAP skorunun akut pankreatit hastalar için mortaliteyi, morbiditeyi ve hastanede yatmayı tahmin etmede yeteneği analiz edilmiştir.Çalışma Sonuçları: 3'den büyük BİSAP skoru, artan oranda geçici organ yetmezliği gelişimi, daimi organ yetmezliği ve pankreatik nekroz riski ile ilişkilendirilmiştir (istatiksel olarak anlamlı). BISAP ≥3 olan hasta grubunda mortalite %23,5 (4 hasta) idi ve bu istatiksel olarak BISAP skoru <3 olan (0 hasta) hasta grubundan daha yüksekti (p=0.019). BİSAP skoru <3 olan hastaların ortalama hastanede kalma süreleri 7.58 ± 4.04 gündü ve BİSAP skoru ≥3 olan hastalarda ise 15.35 ± 1.66 gündü (p=0.02).Sonuç: Akut pankreatitte şiddet için doktor tutum endeksi (BİSAP) skoru, kabül esnasında mortaliteyi, morbiditeyi ve hastanede kalma süresini tahmin etmede harika bir skordur ve bu yüzden akut pankreatit ile kabul edilen hastaların yönetim protokolünü için de kullanışlıdır.
ABSTRACTObjective: To investigate the role of Bedside index for severity of acute pancreatitis (BISAP) score in predicting the outcome of acute pancreatitis.
Methods:This single hospital based prospective study included fifty patients of acute pancreatitis admitted within 48 hours of onset of symptoms, who were divided into two groups ac-cording to admission BISAP score. BISAP score <3(mild acute pancreatitis) and BISAP score >3 (severe acute pancreatitis). The ability of BISAP score to predict mortality, morbidity and hospital stay in acute pancreatitis patients was analyzed.
Results:A BISAP score of >3 was associated with increased risk of development of transient organ failure, persistent organ failure and pancreatic necrosis (Statistically significant). Mortality in group with BISAP >3 was 23.5% (4 patients) which was statistically higher than group with BISAP score <3 (0 patients) (p=0.019).The mean duration of hospital stay of patients in group with BISAP score < 3 was 7.58 ± 4.04 days and in group with BISAP score >3 was 15.35 ± 1.66.(p=0.02).Conclusion: Bedside index for severity in acute pancreatitis (BISAP) score, at admission is an excellent score in predicting the mortality, morbidity and hospital stay and hence manage-ment protocol in patients admitted with acute pancreatitis.
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