scholarly journals Surgical site infection in Laparoscopic versus Open appendicectomy

2018 ◽  
Vol 7 (2) ◽  
pp. 39-43
Author(s):  
Ashok Koirala ◽  
Dipendra Thakur ◽  
Sunit Agrawal ◽  
Bhuwan Lal Chaudhary ◽  
Sagar Poudel

 Background: Acute appendicitis is very common surgical cause of acute abdomen and needs surgical removal either by laparoscopic or open appendicectomy. The aim of this study is to compare frequency of surgical site infection (SSI) in patients undergoing laparoscopic and open appendicectomy. Materials and Methods: The study was prospective study conducted in NMCTH, Biratnagar. Total 200 patients with diagnosis of acute appendicitis admitted through the emergency department of our hospital were included in the study. The patients were randomly allocated in two groups: Laparoscopic appendicectomy group (LA) and Open appendicectomy group (OA). Both groups underwent successful emergency appendicectomy. Wound infections in terms of surgical site infection (SSI) if present were recorded. All age groups and both sexes were included.  Results: Two hundred patients underwent appendicectomy, one hundred Laparoscopic appendicectomy (LA) and another hundred open appendicectomy (OA). The mean age of patients with acute appendicitis was 30.63±16.14 years with minimum of 6 years and maximum of 77 years. The highest number of patients were in age group of 10 to 20 years (29.5%). In LA group SSI noted in 3 patients (3%) whereas in OA group it was found in 12 patients (12%). Conclusion: Laparoscopic appendicectomy is better and offers great advantages in terms of SSI as compared to Open appendicectomy.  

2018 ◽  
Vol 5 (10) ◽  
pp. 3309
Author(s):  
Priyansh Pandey ◽  
Manish M. Swarnkar ◽  
S. C. Jain

Background: Diagnosis of acute appendicitis is mostly based on clinical features pointing towards appendicitis. Several biochemical parameters, such as the white blood cell (WBC) count, and neutrophil percentage, are currently used to aid clinical diagnosis.  Without immediate surgery, appendicitis may progress to perforation of the appendix. This study was carried out to determine rate of SSI in open versus laparoscopic appendicectomy for acute appendicitis and to identify independent risk factors for SSI.Methods: Appendicitis is a common cause of pain in right iliac fossa worldwide. The present study was carried out in the Department of General Surgery, Acharya Vinoba Bhave Rural Hospital, affiliated to Jawaharlal Nehru Medical College, Sawangi, Wardha, from August 2015 to July 2017. This study was conducted after the due clearance from Institutional Ethical committee. Total 132 patients admitted to the surgery ward with acute lower abdominal pain with clinical features of acute appendicitis on clinical examination, were studied prospectively.Results: In the present study, maximum patients were seen in less than 20 years of age and next commonest age group of presentation was 21-30 years. The male to female sex ratio was 1:1.3 in the laparoscopic appendectomy group while in the open appendectomy group was 1.81:1. The incidence of complicated intra-operative findings and mean white blood cell count was more in the open appendectomy group. The mean operative time, days for use of analgesics, time taken to return to soft diet and length of hospital stay for laparoscopic appendectomy group was less than the open appendectomy group. There were more cases of surgical site infection in the patients operated by open approach than laparoscopic approach.Conclusions: Wound class II versus III and NNIS index were found to be significantly associated with surgical site infection.


2016 ◽  
Vol 5 (2) ◽  
pp. 47-50 ◽  
Author(s):  
Ashok Koirala ◽  
Dipendra Thakur ◽  
Sunit Agrawal ◽  
Kamal Raj Pathak ◽  
Manoj Bhattarai ◽  
...  

Introduction Appendicular mass is one of the most common complications following acute appendicitis and seen in 2-6% of the patients. The treatment of appendicular mass is controversial with three general approaches. The aim of this study is to evaluate outcome of conservative approach.Material & Methods A retrospective analysis of the patients managed with appendicular mass from 1st January to 31st December 2014 was carried out in NMCTH, Biratnagar. A total of 173 patients with diagnosis of appendicular mass admitted in emergency and OPD of our hospital were studied. All age groups and both sex were included.Results Out of 496 patients with appendicitis, 173 patients [34.87%] were diagnosed with appendicular mass. Age range of the patient in the study varied between 4-84 years and maximum patients found in the age group of 21-30 years. Onset of symptoms was between 2-6 days and greater number of patients reporting between 5-6 days. During study period 10(5.7%) patients came with recurrence, 9 [5.2%] developed abscess, 35(20.23%) patients came for interval appendicectomy, whereas 119 [68.78%] failed to come for a follow up.Conclusion Our study concluded that the appendicular mass can be managed successfully by conservative approach, although few complications may arise which can be managed by surgical intervention.Journal of Nobel Medical College Vol.5(2) 2016; 47-50


2017 ◽  
Vol 4 (5) ◽  
pp. 1726
Author(s):  
Anil Reddy Pinate ◽  
Mohammad Fazelul Rahman Shoeb ◽  
Shiva Kumar C. R.

Background: Laparoscopic appendicetomy remains controversial in Indian perspective. The objective was to compare the clinical outcome of open with laparoscopic appendicectomy.Methods: Prospectively collected data from 150 consecutive patients with acute appendicitis was studied. Patients undergoing surgery for acute appendicitis were alternately assigned into one of the two groups (Group-A patients underwent open appendicectomy and in Group B laparoscopic appendicectomy). The two groups were compared with respect to operative time, length of hospital stay, postoperative pain & wound complications.Results: The mean operative time in the open group was 84.40 minutes; for laparoscopic group, 95.20 minutes (p-0.001). Duration of paralytic ileus, tolerance to oral feeds, resumption of daily routine activity and ambulation of patients were started earlier in laparoscopic group than open group. Group A (OA) patients had pain at the mean of 2.66 days as compared group B (LA), in which patients had pain at the mean of 1.66 days.  Study also showed that the hospital stay for laparoscopic group was almost half of that for open group. Laparoscopic appendicectomy was safe as compared to open surgery in context to post-operative complications.Conclusions: Provided surgical experience and equipment are available, Laparoscopic appendicectomy is as safe and efficient than open appendicectomy.


2021 ◽  
Vol 73 (1) ◽  
Author(s):  
Ahmed Ayuna ◽  
Ayyaz Sultan

Abstract Background Early diagnosis and treatment of ACS can reduce the risk of complications and death. Delay calling for help can increase morbidity and mortality. It is unclear which age group among patients with acute coronary syndrome tend to delay their call for help. Results Our observational retrospective study showed that men and women in their 50s and 40s respectively tend to delay their call for help from symptoms onset. For the former, the mean time delays (590 ± 71.1 min), whereas for the latter it was (1084 ± 120.1 min). Moreover, these groups tend to have a longer time delay between symptoms onset and arrival at the hospital. Among deaths, we observed that the death rate was proportional to the time delay, which is not unexpected. Next step, we plan to perform a qualitative study in the form of questionnaires to target the individuals with a high risk of CVD within these age groups. Conclusion Middle age group of both genders tend to delay their call for help when they experience symptoms of ACS; moreover, regardless of the age, the longer the delay, the higher the mortality rate. The results of this study gave us a better understanding of our local population and will pave the road for a well-structured teaching programme for them to minimise the time delay for calling for help.


2021 ◽  
Vol 15 (8) ◽  
pp. 2184-2186
Author(s):  
Ahmad Shah ◽  
Nazeer Ahmad Sasoli ◽  
Farrukh Sami

Objective: To compare the incidence of surgical site infection after appendectomy wound irrigation with regular saline solution and imipenem solution. Study Design: Comparative randomized control trial Place and Duration of Study: Department of Surgery Unit-1, Sandeman Provincial Hospital Quetta from 1st September 2020 to 30th April 2021. Methodology: Eighty patients of both genders were presented in this study. Patients detailed demographics age, sex and body mass index were recorded after taking informed written consent. Patients underwent for appendectomy wound irrigation were included. Patients were equally divided into two equal groups, I and II. Group I had 40 patients and received imipenem and group II irrigated with saline solution with 40 patients. Outcomes were surgical site infection, deep abscess formation was observed post-operatively. Results: The mean age of the patients in group I was 26.11±2.03 years with mean BMI 23.61±3.32 kg/m2 and in group II mean age was 25.14±3.12 years with mean BMI 22.14±4.88 kg/m2. In group I, 32 (80%) patients had inflamed appendix, perforated appendix was in 7 (17.5%) and gangrenous appendix in 1 (2.5%) while in group II inflamed appendix in 34 (85%), perforated appendix in 4 (10%) and gangrenous appendix 2 (5%). Surgical site infection in group I was 3 (7.5%) and abscess formation in 2 (5%) cases while in group II SSI in 6 (15%) and abscess formation in 3 (7.5%) cases. Conclusion: Imipenem irrigation after appendectomy reduces wound infection. Healthcare costs and patient suffering due to infection can be reduced. Keywords: Imipenem solution, Wound irrigation with saline, Appendectomy wound infection


2021 ◽  
Vol 19 (3) ◽  
pp. 23-29
Author(s):  
Yogita G Bavaskar ◽  

Background: Most of the countries including India have witnessed two or more waves of Covid 19 pandemic. The present study was conducted to compare the differences in clinico-demographic characteristics and outcomes of Covid 19 patients admitted in first and second wave of Covid 19 pandemic in a tertiary care hospital at Jalgaon, Maharashtra. Methods: A retrospective observational study was conducted at a tertiary care Dedicated Covid hospital for Covid 19 at Jalgaon, Maharashtra. All microbiologically proven corona positive patients were included in the study. The demographic records and clinical history was extracted from the case history sheets of the patients from first as well as second wave using standardized data collection form. Clinical outcome of the patients, i.e., development of complications, death or discharge was also recorded for each enrolled subject. Results: 3845 patients of Covid-19 admitted in the hospital during the first wave of epidemic and 2956 patients during second wave of the epidemic were included in the study. The mean age of patients admitted in the second wave was significantly lower as compared to first [48.77(15.31) years vs 50.23 (14.33) years, P<0.005]. There is increase in proportion of patients in the age group of < 15 years in second wave as compared to first wave (74/2956, 2.5% vs 52/3845, 1.3%). The number of patients requiring admission in ICU at the time of admission increased by 13% in second wave as compared to first wave. [827/2956 (28%) vs 577/3845(15%), P<0.0001]. More than half of the patients who got admitted for Covid 19 in first as well as second wave were having one or more comorbidities.But the proportion of the patients with previous co-morbities was significantly higher in second wave (1684/2956, 57% vs 1960/ 3845, 51%, P= 0.0004). The mortality was also higher in second wave (533/2956, 18.03% vs 541/3845, 14%, P=0.0004). Conclusions: The demographic, clinical characteristics and outcome of Covid 19 patients was different in first and second wave of pandemic with involvement of younger patients, increased rates of admission to ICU and more mortality in the second wave as compared to first wave of the pandemic.


2016 ◽  
Vol 46 (8) ◽  
pp. 1466-1471 ◽  
Author(s):  
Flor Diana Yokoay Claros Chacaltana ◽  
João Antonio Tadeu Pigatto ◽  
Ione Terezinha Denardin

ABSTRACT: The aim of this research was to measure the intraocular pressure (IOP) of normal chinchilla eyes using the rebound tonometer. A further aim was to assess whether there were differences in the values of intraocular pressure in relation to animals age, gender and time of day. Thirty-six chinchillas were divided into three groups of 12 chinchillas each, by age: Group I (2-6-month-old), Group II (20 and 34 months) and Group III (37 and 135 months). Ophthalmic examination was performed previously by Schirmer tear test, slit lamp biomicroscopy, indirect ophthalmoscopy and fluorescein test in all chinchillas. Three measurements of intraocular pressure were assessed on the same day (7, 12 and 19h). Tonometry was performed on both eyes using the rebound tonometer after calibration in "p" mode. Statistical analysis was performed with SigmaPlot for Windows. The mean IOP for groups I, II and III were 2.47±0.581mmHg, 2.47±0.581mmHg and 2.51±0.531mmHg, respectively. No significant differences were reported between age and IOP and no significant differences were reported between the time of day and IOP. The IOP in chinchillas did not differ significantly between genders or ages of the animals, and did not change with time of day.


Author(s):  
Sreelakshmi U. ◽  
Tushara Bindu V. ◽  
Subhashini T.

Background: Abnormal uterine bleeding is the most common and frequent presenting complaint in Gynaecology Outpatient Department in all age groups, especially in perimenopausal women. Objective of present study was clinicopathological evaluation and management of abnormal uterine bleeding in perimenopausal age group women.Methods: The present study was prospective analytical study conducted at Mallareddy Narayana Multi-speciality Hospital, reputed teaching hospital, in Obstetrics and gynaecology department in association with department of pathology from January 2015 to December 2016. Perimenopausal women in age group 45-55 years included in this study. Other age groups with abnormal uterine bleeding, isolated cervical or vaginal pathology, bleeding diathesis, and pregnancy related causes of bleeding excluded from this study. Endometrial tissue collected by sampling procedure such as dilatation and curettage. Proper counselling about management was given to all women related to medical and surgical interventional approaches.Results: A total of 135 women with abnormal uterine bleeding in perimenopausal age were examined after fulfilling criteria during study period of 2 years. The age of participants in mean±SD was 46.68±2.03 years (min 45 years and max 55 years). Maximum number of patients with abnormal uterine bleeding presented in age group of 45-50 years. The most common symptoms were heavy menstrual bleeding (83.7%), followed by frequent menstrual bleeding (26.6%). Proliferative endometrium was the most common histopathological (30.3%) study followed by secretory endometrium (27.4%). Surgical management was given to 94 patients.Conclusions: Heavy menstrual bleeding and frequent menstrual bleeding were mostly correlated with abnormal endometrial histopathological findings in this study. Gynaecologists should pay attention towards these abnormal bleeding patterns along with the evaluation of endometrial tissue for histopathological findings, which will help us to plan for successful management. 


Author(s):  
Agláia Moreira Garcia XIMENES ◽  
Fernando Salvo Torres MELLO ◽  
Zailton Bezerra de LIMA-JÚNIOR ◽  
Cícero Faustino FERREIRA ◽  
Amanda Dantas Ferreira CAVALCANTI ◽  
...  

BACKGROUND: The choice of surgical technique to approach the appendicular stump depends mostly on skill and personal preference of the surgeon or on the protocol used in the service, and the influence of this choice in hospitalization time is not evaluated. AIM: To evaluate the relation between surgical technique and postoperative hospitalization time in patients presenting with acute appendicitis. METHODS: Retrospective analysis of 180 patients who underwent open appendectomy. These where divided into three groups according to surgical technique: conventional appendectomy (simple ligation of the stump), tobacco pouch suture and Parker-Kerr suture. Data where crossed with hospitalization time (until three days, from four to six days and over seven days). RESULTS: A hundred and eighty patients with age from 15 to 85 years where included. From these, 95 underwent conventional technique, had an average hospitalization time of 3,9 days and seven had complications (surgical site infection, seroma, suture dehiscence and evisceration). In 67 patients, tobacco pouch suture was chosen and had average hospitalization time of 3,7 days and two complications (infection and seroma). In 18 Parker-Kerr suture was made, with average hospitalization time of 2,6 days, with no complication. Contingency coefficient between the variables hospitalization time and technique was 0,255 and Cramér's V was 0,186. CONCLUSION: There was tendency to larger hospitalization time and larger number of complications in conventional appendectomy, whereas in patients where Parker-Kerr suture was performed, hospitalization time was significantly smaller.


2021 ◽  
Vol 6 (2) ◽  
pp. 304-309
Author(s):  
Manzoor Ahmad Bhat

The study aimed to compare the Body Composition in Various Age Groups among Individual and Team Sport. A total of one hundred twenty (120) subjects, comprising 60 Individual and 60 Team sport of district Kulgam J&K, further out of 60 individual sports players 20 players were of the age group between 20-25, ( 20 ) players were of the age group between 25- 30 and 20 players were of the age group between 30-35. the same procedure was followed for 60 team sports players. The Subjects were selected by using purposive sampling. The age of the subjects ranged between 20-25, the second group 25-30, and the third group 30-35. To analyze and compare the Body Composition and fat percentage in three different age groups among individual sports and team sports, the Following equipment and test were used: the data related to Fat Percentage was measured by Skinfold Calipers. BMI: it was estimated by Stadiometer and weighing machine. ).the data that was collected after applying standard testing kits were written in separate columns and was cross-checked for all three different age groups. Individual and team sports of district kulgam. Then the analysis of data was carried out by applying various statistical techniques like average., standard deviation and through the application of formula of t-test to find out the significant difference of all selected physical variables I,e BMI and fat percentage in various age groups among individual and team sports players of kulgam district the level of significance as per norm was kept as (p<0.05). the mean and standard deviation of BMI in 20-25 age group individual game players is ( 22.02 ±2.20) respectively, and the mean and standard deviation of BMI in 20-25 age group of team sports players is (18.01 ±1.81), with an average difference of 4.01. ). Hence individual sports players were found with a higher BMI than team sports players under the 20-25 age group. BMI in the 25-30 age group individual game players is (23.09±1.76) respectively, and the mean and standard deviation of BMI in 25-30 age group of team sports players is (20.07±3.36), with an average difference of 3.02. ). Hence under this age group, the individual sports players were found with a higher BMI than team sports groups. The mean and standard deviation of BMI in 30-35 age group individual game players is (19.30±2.07) respectively, and the mean and standard deviation of BMI in 30-35 age group of team sports players is (22.17 ±3.47), with an average difference of 2.87. Hence, team sports players were found with a higher BMI under the age group than individual sports players. The mean and standard deviation of fat percentage in 20-25 age group individual game players is (11.09±4.83) respectively, and the mean and standard deviation of fat percentage in 20-25 age group of team sports players is (9.02±4.18), with an average difference of 2.17.).Hence under this age group, individual sports players were found fatty as compared to team sports players. The mean and standard deviation of fat percentage in 25-30 age group individual game players is (10.01±3.53) respectively, and the mean and standard deviation of BMI in 25-30 age group of team sports players is (14.04±7.48), with an average difference of 4.13. ). Hence under this age group, team sports players were found fatty as compared to individual sports players. The mean and standard deviation of BMI in 30-35 age group individual game players is (14.08±2.81) respectively, and the mean and standard deviation of fat percentage in 30-35 age group of team sports players is (18.01±5.64), with an average difference of 3.64. Hence under this age group, team sports players were found fatty as compared to individual sports players


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