ABSTRACT… Background: An intestinal stoma is an opening of intestine on the anterior abdominal wall made surgically. The commonly performed procedures include colostomy and ileostomy. The purpose of the present study was to identify indications for commonly performed intestinal stomas and to study complications related to it. Objective: To identify indications for commonly performed intestinal stomas and to study complications related to it. Study Design: Observational study. Setting: Department of General Surgery, Unit-B, Lady reading Hospital, Peshawar. Period: 1 st Jan 2013, to 31 st Dec 2013. Subjects and Method: A total of 106 patients who underwent surgery and ended up in intestinal stomas, ileostomy or colostomy, were included in the study. Indications, immediate and late complications of stomas were recorded. Results: A break up of 106 patients of different intestinal stomas. Majority (61.32%) of patients were males. There were 49 ileostomies and 57 cases of colostomy making a total of 106 patients. Main indications of Ileostomy were enteric perforation (55.10%), and intestinal tuberculosis (20.40%). Main indications of colostomy were penetrating injuries (50.88%), and intestinal obstruction. In a total of 106 stomas local complications appeared in 23 (21.69%). Skin excoriation, ulceration, lap and wound infection were the most common respectively. Seventy eight stomas including 36 ileostomies and 42 colostomies were closed on an average of 3 months after primary operation. There were 7 cases of wound infection, 2 anastamotic leak-ages and one mortality (1.3%) in the stoma reversal group. Conclusion: Common indications for intestinal stomas were abdominal penetrating trauma, enteric perforation, intestinal obstruction and intestinal tuberculosis. Main complications included local skin problems, wound infection and retraction.

Objective: To compare outcomes of side to side staple versus hand-sewn esophago-gastric anastomosis in esophagectomy patients with carcinoma of esophagus after subtotal esophagectomy along with gastric tube reconstruction. Study Design: Retrospective cross-sectional study. Place and Duration of Study: Lady Reading Hospital, Peshawar Pakistan, from July 2019 to June 2020. Methodology: After ethical approval, medical records of patients that underwent stapled/hand sewn gastro esophageal anastomosis due to carcinoma esophagus were included. Inoperable Ca esophagus and with thoracic anastomosis were excluded. Each anastomotic technique was applied on 50 patients randomly. The variables of study included demographic,anastomotic leak, anastomotic stricture, operative time, and other complications. All the cases were followed up for 1 year.SPSS version 26.0 was used for data analysis. Result: From 100 patients, 56 were males and 34 females. Age ranged from 15 to 80 years with mean age of 48.5 and 51.1 respectively in two groups. In 42 cases tumor was present in lower end, middle third in 30 and middle lower third of gastro esophageal junction in 28 cases. Histo-pathologically 58 cases were adenocarcinoma, 31 squamous cell carcinoma and 11 adeno squamous carcinoma. The anastomosis time in group I was 6.8±.22 minutes while in group II was 13.2±1.71 minutes (p0.04). None of the patients in group I, having stapled anastomosis were found to have anastomotic leakage or stricture formation after 1 year of follow up while 04 patients in group II were reported to have anastomotic leakage and 06 patients had anastomotic stricture formation (p-<0.01). Conclusion: Side by side stapled anastomosis technique was far superior to hand-sewn technique in terms of the time taken for anastomosis to be completed and patient outcomes (anastomotic leakage and stricture formation).

Objectives: To determine the frequency of choleducholethiasis in patientswith symptomatic gall stone disease and evaluation of primary closure of common bile ductwithout T-Tube placement after open exploration as a treatment modality in its management.Study Design: Prospective (descriptive) study. Setting: Surgical Unit of Postgraduate MedicalInstitute, Lady Reading Hospital, Peshawar. Period: One year from 15-03-2013 to 15-03-2014. Subjects and methods: Total 0f 206 patients of symptomatic gallstones disease wereincluded in the study to find out frequency of choledcholithias and patients with common bileduct (CBD) stones were subjected to open choledochotomy and primary choledochorrhaphy,and follow up of patients was done to find out any post operative complication. Results: Atotal of 206 patients underwent open cholecystectomy during the study period. The age ofthe patients ranged from 17 to 70 years with mean of 44.24±1.23 years. Most of the patientswith symptomatic gall stones disease were female in the age range of 41-50 years. Frequencyof choledocholethiasis was 24 out of 206 constituting 11.65%. Among the patients with CBDstones 4 were male constituting 16.6% and 20 were female that is 83.33% with male to femaleratio of 1:4 respectively. Mean hospital stay of the patients in which open CBD explorationand primary repair was performed was 7.25±1.45 days. Complications developed in only 4patients constituting 16.66%. Complications were wound infection in 2 (8.33%) patients, intraabdominalpus collection in 1 (4.16%) patient and bile leak in 1 (4.16%). One patient lost fromfollow up. In none of the patients retained CBD stones and stricture observed. Conclusions:There should be low

Introduction: The hernioplasty or Open herniorrhaphy procedures have typically been used to repair inguinal hernias. The advent of minimal access surgery in the past ten years has changed the trends. Aim: The goal of this study is to govern the efficacy of minimal access surgery (Laparoscopic repair) in the treatment of inguinal hernia repair. Methods: This prospective descriptive study was held in the General Surgery department, Lady Reading Hospital, Peshawar during the period from January 2022 September 2022. All patients above the age of 18 who presented with inguinal hernias had the choice of either laparoscopic or open surgery. In the study, those who opted for laparoscopic repair were included. Results: Seventy patients having 18-65 years of age with 32 years of median age at admission were included. Out of them 65 were male and 5 females. Most of the patients had age group 31–40 years, followed by 41–50 years. Ten (14.3%) patients had bilateral hernias, 45 (64.3%) unilateral right hernias, and 15 (21.4%) unilateral left hernias . Just 8 hernias (11.4%) were direct, while the remaining of hernias 62,( 85.7%) were indirect.

Objective: To investigate the early complications, associated comorbidities and risk factors associated with modified radical mastectomy in patients suffering from breast cancer. Study Design: Prospective Cohort study. Setting: Department of Surgery, Khyber Medical University, Institute of Medical Sciences, District Headquarter Hospital, Kohat. Period: January 2021 to December 2022. Material & Methods: A total of 65 patients diagnosed with breast cancer who were planned to undergone through radical mastectomy during the study period were analyzed. Demographical and clinical characteristics of all patients were noted. Early complications, associated comorbidities and related risk factors were recorded. Results: In a total of 65 patients, the mean age was 47±13 years (ranging 50-65 years). At the time of enrollment, 25 (38.5%) patients had painful lump in their breasts while remaining 40 (47.7%) patients reported that they were had swelling in their axillary region. There were 30 (46.2%) patients who had had stage-III breast cancer whereas other 34 (52.3%) were suffering from stage-II breast cancer. Formation of seroma was most commonly associated complication reported in 30 (46.2%) patients whereas 10 (15.4%) patients reported infections of wound. Twenty (30.8%) patients reported that they were having pain on the site of surgery along with paresthesia on the medial side of arm. Five (7.7%) patients had associated diabetes while 8 (12.3%) patients were overweight with their body mass index (BMI) value between 25-29.9 kg/m2. Nine 9 (13.8%) patients were hypertensive. Conclusion: Most common early complications associated with modified radical mastectomy included infection of the surgical site, paresthesia and pain.