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Retropubic Prostatectomy- Innovations to Reduce Complications Leading to Smooth Recovery
M. Subrahmanyam,
G. Vamshikrishna,
G. Harikrishna
Issue:
Volume 5, Issue 2, April 2017
Pages:
15-17
Received:
25 January 2017
Accepted:
9 March 2017
Published:
20 March 2017
Abstract: Introduction: Open prostatectomy/adenoma enucleation remains a valuable surgical option in treating large obstructing prostates in patients with large gland volume. We report our series of retropubic prostatectomies with innovative methods to reduce the complications and lead to smooth recovery. Patients and Methods: A total of 75 patients with B PH were treated by retropubic prostatectomy from 2005 to 2015. Patient’s demographical, clinical, pre- and postoperative data and final histology were recorded. 3 way Foley’s catheter before surgery was kept in the bladder and haemostasis was obtained by applying traction over the prostatic fossa. Results: The mean weight of prostatic adenoma was 82 gm., the smallest being 70gm. and the largest 192gm. Only 2 patients required intra operative blood transfusion. The catheter was removed on the 5th post-operative day. 94% of the patients voided with a good stream with little discomfort after one week. only one patient had incontinence of urine which improved subsequently over a period of 6 to 8 weeks. There was no mortality and no re-exploration for clot retention was required in any patient, Conclusion: Millin's prostatectomy popularized over half a century ago continues to be a valuable option for the surgical treatment of high-volume prostate glands with excellent outcomes for patients with innovative methods.
Abstract: Introduction: Open prostatectomy/adenoma enucleation remains a valuable surgical option in treating large obstructing prostates in patients with large gland volume. We report our series of retropubic prostatectomies with innovative methods to reduce the complications and lead to smooth recovery. Patients and Methods: A total of 75 patients with B P...
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Separated Axillary Tuberculous Lymphadenitis: A Case Report
Samer Makki Mohamed Al-Hakkak
Issue:
Volume 5, Issue 2, April 2017
Pages:
18-21
Received:
3 March 2017
Accepted:
14 March 2017
Published:
27 March 2017
Abstract: Tuberculosis (TB) still accounts for a high burden disease. It has been estimated that one third of the world population is infected with Mycobacterium tuberculosis, the most residing in developing countries. Separated axillary tuberculous lymphadenopathy is rare and described in patients without proof of previous or outstanding tuberculosis anywhere in the body. TB was supposed to be considered in the differential diagnosis of patients who present with axillary lymphadenopathy, especially in the endemic areas of Tuberculosis. Ultrasonography features of the axillary lymph node in our patient were not as helpful in diagnosis as the biopsy of the lymph node. Axillary tuberculous lymphadenitis diagnosis depends on the complete pathological examination. It remains both diagnostic and therapeutic challenge because it mimics other pathologic processes and yields inconsistent physical and laboratory findings. Diagnosis is difficult often requiring biopsy.
Abstract: Tuberculosis (TB) still accounts for a high burden disease. It has been estimated that one third of the world population is infected with Mycobacterium tuberculosis, the most residing in developing countries. Separated axillary tuberculous lymphadenopathy is rare and described in patients without proof of previous or outstanding tuberculosis anywhe...
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Role of MRI Fistulography with Gadopentate Enhancement in Assessment of Complex Anal Fistulas and Improving Surgical Outcomes
Mahmoud Abdelnaby,
Sameh Hany Emile,
Ahmad Sakr,
Alaa Magdy,
ElYamani Fouda,
Ahmed Abdel Mawla
Issue:
Volume 5, Issue 2, April 2017
Pages:
22-27
Received:
11 March 2017
Accepted:
20 March 2017
Published:
10 April 2017
Abstract: Preoperative assessment of complex fistula-in-ano (FIA) is crucial for decision making. Magnetic resonance imaging (MRI) has been used for assessment of perianal sepsis with various protocols and methods. The aim of the present study was to assess the concordance between MRI fistulography with gadopentate enhancement and the intraoperative surgical findings, and to study the impact of preoperative assessment with MRI on surgical outcomes including fistula recurrence and fecal incontinence (FI). Patients with complex and high FIA who were investigated by MRI fistulography preoperatively were reviewed. The concordance between the findings of MRI and the intraoperative findings on examination under anesthesia (EUA) was made using Kappa coefficient test. The accuracy and sensitivity of MRI were calculated regrading detection of the internal opening, primary and secondary fistula tracts. 95 patients (82% males) were included in the study. MRI fistulography had an accuracy of 89.4%, 96.8%, 96.8%, 98%, and 98% in detection of the internal opening, number of tracts, position of primary tract, secondary extensions, and presence of abscess cavities, respectively. Overall, there was very good concordance between MRI and EUA regarding the examined parameters (k= 0.847, 0.937, 0.908, 0.953, 0.957), respectively. Fistula recurrence and minor FI were recorded in 4.2% and 14.7% of patients. MRI fistulography is an effective diagnostic modality for the preoperative assessment of FIA. MRI had excellent accuracy and sensitivity in detection of the internal opening, primary tract, and secondary extensions of anal fistula with very good concordance with the intraoperative findings.
Abstract: Preoperative assessment of complex fistula-in-ano (FIA) is crucial for decision making. Magnetic resonance imaging (MRI) has been used for assessment of perianal sepsis with various protocols and methods. The aim of the present study was to assess the concordance between MRI fistulography with gadopentate enhancement and the intraoperative surgical...
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Conservative Hepatic Hydatid Cyst Surgery
Mohamed Salah Abdelhamid,
Tamer Mohamed Nabil,
Hesham Ahmed Nafady,
Amr Mohamed Ali,
Ahmed Mohamed Rashad,
Seham Anwar Emam,
Ibrahim Said Abdelaziz,
Tamer Elgaabary
Issue:
Volume 5, Issue 2, April 2017
Pages:
28-32
Received:
13 March 2017
Accepted:
23 March 2017
Published:
12 April 2017
Abstract: The principal objectives to be achieved by surgical treatment are total removal of all parasitic elements, avoidance of spillage of contents of the cyst and management of the residual pericyst cavity. Thirty four patients with thirty five hepatic hydatid disease were included in the study. The data for this work were collected between 9-2015 till 9 -2016. The mean age were 38.6+13.2 years. There were twenty female and fourteen males. The main presentation was upper abdominal mass, 25 (73.5%) were in the right lobe, 8 (23.5%) were in the left lobe and only one (3%) was bilaterally presented. Conservative surgery in the form of cystotomy (with or without omental packing), and external drainage were applied to 32 cysts (91.4%) while radical surgery were applied to three cysts (8.6%) in the form of pericystectomy and partial hepatectomy. LOS in the conservative group was 6.3+2.5 day while in the radical group was 13.3+8.3 day (P<0.001 HS). There were two cases of post operative bile leak in the omental pack group (22.2%) and only one case (33.3%) among the three cases of external drainage group, so in the conservative surgery there were three cases (9.3%) and they resolved spontaneously. There were two redo one in the cystotomy patients, the other in the pericystectomy patients. Conclusion: Conservative surgery could be done with success in hepatic hydatid disease and resection procedures are too radical and extensive for benign lesions.
Abstract: The principal objectives to be achieved by surgical treatment are total removal of all parasitic elements, avoidance of spillage of contents of the cyst and management of the residual pericyst cavity. Thirty four patients with thirty five hepatic hydatid disease were included in the study. The data for this work were collected between 9-2015 till 9...
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Diabetes Mellitus Related to Clinical Outcomes and Postoperative Bleeding of Total Knee Arthroplasty
Issue:
Volume 5, Issue 2, April 2017
Pages:
33-36
Received:
23 March 2017
Accepted:
5 April 2017
Published:
29 April 2017
Abstract: To investigate the effect of diabetes mellitus (DM) on the postoperative clinical outcomes and perioperative bleeding volume in patients with primary total knee arthroplasty. Clinical data of 49 patients with osteoarthritis underwent primary total knee arthroplasty (TKA) were collected and retrospectively analyzed from October 2015 and September 2016. Patients were set to two groups with (A) or without DM (B). Data were compared between 2 groups, including postoperative hemoglobin, hematocrit (Hct), Hb, dominant blood loss, hidden blood loss, theoretical total blood loss, range of joint motion, VAS score, increasing rate of circumference length above 10 cm of the knee, HSS score, the operation time and hospitalization days. The results showed that the Hb and Hct of A group was significantly less than the B group (P<0.05). The dominant blood loss, the hidden blood loss and theoretical total blood loss of A group was significantly higher than B group (P<0.05). The hospitalization days of A group was significantly longer than B group (P<0.05). The VAS score and the increasing rate of circumference length above 10 cm of the knee of A group was significantly higher than B group at 3 days (P<0.05). The patients were all followed up 12 weeks. The HSS score of A group was significantly lower than B group at 4 weeks (P<0.05). There was no significant difference in the HSS score between 2 groups at 12 weeks after operation (P>0.05). The prosthesis was in good position, without loosening, subsidence, or osteolysis. In general, patients with DM got TKA have a higher bleeding and longer hospitalization days. DM acts as an adverse impact on recent functional recovery after TKA.
Abstract: To investigate the effect of diabetes mellitus (DM) on the postoperative clinical outcomes and perioperative bleeding volume in patients with primary total knee arthroplasty. Clinical data of 49 patients with osteoarthritis underwent primary total knee arthroplasty (TKA) were collected and retrospectively analyzed from October 2015 and September 20...
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