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Ways to Correct Indications for Surgical Treatment of Atherosclerotic Descending Aortic Aneurysms
Vladimir Petrovich Krylov,
Nikolay Andreevich Manak,
Valentina Nikolaevna Gayduk,
Nadezhda Vladimirovna Mankevich,
Leonid Ivanovich Reut
Issue:
Volume 5, Issue 3, June 2017
Pages:
31-35
Received:
13 February 2017
Accepted:
10 March 2017
Published:
3 May 2017
Abstract: Recent studies suggest that the development of atherosclerotic descending aortic aneurysms (DAA) is a complicated process, which occurs due to a polymorphic nature of aortic wall abnormalities. They overlap and contribute to a wide variety of clinical manifestations. The inflammatory process may be the main reason for a rapid growth and rupture of the aneurysm. It also involves a mechanism of complex adhesion comprising of acute-phase proteins to low-density lipoproteins (LDLPs) as atherosclerotic lesions. This process occurs in the presence of connective tissue disorders, aortic wall focal cystic medianecrosis, poor management of arterial hypertension, aging, and reduced compliance. Therefore, the surgical treatment modality to treat DAA becomes less appealing. Additionally, it is not feasible to make indications for surgery based solely on linear aneurysmal diameter. However, medical correction has no contraindications for use.
Abstract: Recent studies suggest that the development of atherosclerotic descending aortic aneurysms (DAA) is a complicated process, which occurs due to a polymorphic nature of aortic wall abnormalities. They overlap and contribute to a wide variety of clinical manifestations. The inflammatory process may be the main reason for a rapid growth and rupture of ...
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Primary Inguinal Hernia Repair Using TAPP with External Fixation (Abdelhamid Technique) Versus Prolene Hernia System
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 3, June 2017
Pages:
36-40
Received:
8 April 2017
Accepted:
19 April 2017
Published:
31 May 2017
Abstract: Purpose To asses TAPP with external fixation against PHS and to find which is more suitable in primary inguinal hernia repair. Inguinal hernia repair is the most frequently performed operation in general surgery and so even modest improvements in clinical outcomes are important. The most important criteria for the choice of method are safety (morbidity and mortality), recurrence rates and convenience for the patient, including the risk of chronic groin pain. In recent years, great importance has been placed on the short-term comfort of the patient, measured by post operative pain and the length of convalescence. This is a retrospective study for 250 patients done years ago at Al Hayat Hospital Jeddah, KSA, Bani-Suif University Hospital and Bani Suif Health Insurance Hospital. The study design and data collection were between 10 -2015 and 10 – 2016. We reported the patients for duration of operation, hospital stay, cost, recurrence, and return to work. The mean operative time in TAPP with external fixation was 70 min while in PHS was 55 min. The cost was less in PHS while long of stay [LOS] was the same. Recurrence was 1.5% in TAPP with external fixation on the other hand it was 4% in PHS. Patients returned back to work after 5 days in TAPP with external fixation and after 9 days in PHS. It is to be concluded that TAPP with external fixation is associated with longer operative time and higher cost but the incidence of recurrence is much less while return to work was earlier in TAPP with external fixation advocating it to be used as a primary option in primary inguinal hernia repair.
Abstract: Purpose To asses TAPP with external fixation against PHS and to find which is more suitable in primary inguinal hernia repair. Inguinal hernia repair is the most frequently performed operation in general surgery and so even modest improvements in clinical outcomes are important. The most important criteria for the choice of method are safety (morbi...
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Postoperative Use of Antibiotics in Adults with Non-perforated Appendicitis Subjected to Open Appendectomy
Issue:
Volume 5, Issue 3, June 2017
Pages:
41-44
Received:
2 April 2017
Accepted:
22 April 2017
Published:
31 May 2017
Abstract: Acute appendicitis is the most common cause of acute abdominal pain necessitating appendicectomy. The aim of this study was to determine the role of postoperative antibiotics in non-perforated appendicitis regarding; superficial site infections (SSIs), deep site infections (DSIs), complications and the length of hospital stay. This prospective study was carried out on 112 patients diagnosed as acute appendicitis at the Emergency Hospital, General Surgery Department, Tanta University Hospital from March 2014 to April 2016. The patients classified into two groups: Group 1: patients who received postoperative antibiotics, these included 55 patients and Group 2: patients who did not receive postoperative antibiotics and these included 57 patients. The patients subjected to open appendectomy through a standard Grid-Iron incision. The patients' characteristics, ultrasound findings, antibiotics regimen, operative diagnosis, length of hospital stay, wound infection, complications and histopathological findings were analysed using SPSS V 20. Out of 112 patients, 72 patients were male and 40 patients were female. The patients' age ranged from 18 to 55 years with a mean age of 26 years. There is no significant difference regarding patient's age, sex, medical comorbidities, fever, radiologic findings or operative time between the two groups. Treatment with postoperative antibiotics did not significantly reduce the risk of developing superficial SSIs, DSIs. The patients received postoperative antibiotics were significantly more likely to sustain urinary tract infection (P=0.03) a postoperative diarrhea (P = 0.02), increased risk of Clostridium difficile infection (P =0.01) with higher rates of both readmission (P= 0.08) and reoperation (P = 0.07) with a significantly longer hospital stay (2.6 vs 1.4 days, P = 0.001). The use of postoperative antibiotic treatment for nonperforated appendicitis did not reduce the infectious complications while increasing postoperative morbidity and increase the length of hospital stay.
Abstract: Acute appendicitis is the most common cause of acute abdominal pain necessitating appendicectomy. The aim of this study was to determine the role of postoperative antibiotics in non-perforated appendicitis regarding; superficial site infections (SSIs), deep site infections (DSIs), complications and the length of hospital stay. This prospective stud...
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