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Vaidya, Mandar
- Comparative Study of Patient Satisfaction Between Traditional and Modified Plastibell Method for Circumcision in a Tertiary Care Centre
Abstract Views :315 |
PDF Views:82
Authors
Affiliations
1 Former PG Resident, Department of General Surgery, Dr. Vasantrao Pawar Medical College Hospital and Research Centre, Nashik - 422003, Maharashtra, IN
2 Associate Professor, Department of General Surgery, Dr. Vasantrao Pawar Medical College, Hospital and Research Centre, Nashik - 422003, Maharashtra, IN
1 Former PG Resident, Department of General Surgery, Dr. Vasantrao Pawar Medical College Hospital and Research Centre, Nashik - 422003, Maharashtra, IN
2 Associate Professor, Department of General Surgery, Dr. Vasantrao Pawar Medical College, Hospital and Research Centre, Nashik - 422003, Maharashtra, IN
Source
MVP Journal of Medical Sciences, Vol 7, No 2 (2020), Pagination: 170-174Abstract
Introduction: Phimosis is Inability to retract prepuce. At birth the foreskin is normally adherent to the glans penis. Incidence of pathological phimosis is 0.6%. Circumcision is a very old procedure. Any technique for surgery can be applied but rate of morbidity should be low. Materials and Methods: Study conducted in Department of surgery of a tertiary care hospital. Data collection of selected patients with relevant history, clinical examination, appropriate investigation and surgical intervention were included. Results: Study was conducted with 116 subjects with mean age of 3.1 years with surgery done by the dorsal slit method and mean age of 3.7 years by plastibell method. The average duration for dorsal slit procedure to complete is 15.7 minutes and for plastibell is 12.2 minutes. Mean blood loss occurred in dorsal slit method is 9.0 while that in plastibell is 6.0. Frequency of surgical site infection in dorsal slit method is 5.2% while that in plastibell method is 6.9%. Post-operative heamorrhage seen in dorsal slit method is 5.2% while that in plastibell is 1.7%. 89.7% of parents satisfied with dorsal slit method while 96.6% parents were satisfied with modified plastibell method. Conclusion: Study showed that plastibell has advantage of shorter time for surgery and relatively lower risk of post-operative bleeding when compared with dorsal slit method of circumcision. The cosmetic outcome as judged by parental satisfaction was also better with plastibell technique.Keywords
Dorsal Slit Method, Cosmetic Outcome, Modified Plastibell Method, PhimosisReferences
- Shahid SK. Phimosis in children. International Scholarly Research Notices. 2012; 2012. https://doi.org/10.5402/2012/707329
- Williams NS, Bulstrode CJK, O’Connell PR. Bailey & Love’s short practice of surgery. 26th edition. Boca raton: CRC Press: 2013. pp 1369
- DeMeo J. The truth seeker. The geography of genital mutilations. July/August 1989. pp 9–13.
- R.-A. Yegane, A.-R. Kheirollahi, N.-A. Salehi, M. Bashashati, J.-A. Khoshdel, and M. Ahmadi, “Late complications of circumcision in Iran.” Pediatric Surgery International. 2006; 22(5): 442–445. https://doi.org/10.1007/s00383-006-1672-1
- P. K. Drain, D. T. Halperin, J. P. Hughes, J. D. Klausner, and R. C. Bailey, “Male circumcision, religion, and infectious diseases: an ecologic analysis of 118 developing countries,” BMC Infectious Diseases. 2006; 6(172): 1–10. https://doi.org/10.1186/1471-2334-6-172
- Abdulwahab-Ahmed A, Mungadi IA. Techniques of male circumcision. Journal of surgical technique and case report. 2013; 5(1):1–7. https://doi.org/10.4103/2006-8808.118588
- American Academy of Pediatrics Task Force on Circumcision. Male circumcision. Pediatrics. Sep 2012; 130(3): e756. https://doi.org/10.1542/peds.2012-1990
- Algadiem EA, Aleisa AA, Alsubaie HI, Buhlaiqah NR, Algadeeb JB, Alsneini HA. Blood loss estimation using gauze visual analogue. Trauma monthly. May 2016; 21(2). https://doi.org/10.5812/traumamon.34131
- Leibowitz AA, Desmond K, Belin T. Determinants and policy implications of male circumcision in the US. Am J Pub Health 2009; 99: 138–45. https://doi.org/10.2105/ AJPH.2008.134403
- Hutcheson JC. Male neonatal circumcision: Indications, controversies and complications. Urol Clin North Am 2004; 31: 461–7. https://doi.org/10.1016/j.ucl.2004.04.011
- Barrie H, Huntingford PJ, Gough MH. The plastibell technique for circumcision. BMJ. 1965; 2(5456): 273–5. https://doi.org/10.1136/bmj.2.5456.273
- Khan AA, Rehan S, Shamim B, Shahzadi M, Ali MZ, Alvi S. Comparison of circumcision by plastibell versus open method. Pak Armed Forces Med J 2016; 66(4): 534–37.
- Abdullah LB, Mohammad AM, Anyanwu LC, Farinyaro AU. Outcome of male circumcision: A comparison between plastibell and dorsal slit methods. Nigerian Journal of Basic and Clinical Sciences. 2018 Jan 1; 15(1): 5. https://doi.org/10.4103/njbcs.njbcs_38_16
- Shinde ND, Moinuddin M, Danish AO. Plastibell circumcision in neonates and infants at tertiary care centre. Int J Surg. 23Mar 2018; 5(4): 1488–91. https://doi.org/10.18203/2349-2902.isj20181135
- Mousavi SA, Salehifar E. Circumcision complications associated with the Plastibell device and conventional dissection surgery: a trial of 586 infants of ages up to 12 months. Advances in Urology. 2008. https://doi.org/10.1155/2008/606123
- Comparison of Snodgrass Tubularised Incised Plate Urethroplasty and Duckett Onlay Transverse Preputial Patch Urethroplasty for Correction of Penile Hypospadias
Abstract Views :140 |
PDF Views:101
Authors
Affiliations
1 Associate Professor, Department of Surgery, Dr. Vasantrao Pawar Medical College, Hospital and Research Centre, Nashik - 422003, IN
2 Former PG Resident, Department of Surgery, Dr. Vasantrao Pawar Medical College, Hospital and Research Centre, Nashik - 422003, IN
3 Assistant Professor, Department of Surgery, Dr. Vasantrao Pawar Medical College, Hospital and Research Centre, Nashik - 422003, IN
1 Associate Professor, Department of Surgery, Dr. Vasantrao Pawar Medical College, Hospital and Research Centre, Nashik - 422003, IN
2 Former PG Resident, Department of Surgery, Dr. Vasantrao Pawar Medical College, Hospital and Research Centre, Nashik - 422003, IN
3 Assistant Professor, Department of Surgery, Dr. Vasantrao Pawar Medical College, Hospital and Research Centre, Nashik - 422003, IN
Source
MVP Journal of Medical Sciences, Vol 8, No 1 (2021), Pagination: 60-64Abstract
Introduction: Hypospadias is defined as a condition where the urethra opens on the ventral aspect of the penis. It is commonly associated with penile curvature, usually ventral and is one of the most common genital birth defects in males. Hypospadias can be treated with numerous different surgical approaches numbering upto 200, and historically has been treated with procedures like Trans-Verse Island Flap (TVIF) on lay, Tubularised Incised-Plate (TIP), vertical preputial island flap, tubularised preputial flap, vertical preputial flap with double skin island etc. Present study was conducted to compare Snodgrass Tubularised Incised Plate Urethroplasty (TIP procedure) and Duckett Onlay Transverse Preputial Patch Urethroplasty for penile hypospadias correction. Material and Methods: Male patients between the age of 2-14 years who underwent correction of penile hypospadias by either of the two techniques viz. TIP (procedure) Urethroplasty and Duckett Onlay Transverse Preputial Patch Urethroplasty were included in the present prospective observational study after written informed consent. Results: The study was carried out with 40 patients and sorted into two groups, i.e. Snodgrass (S) and Duckett (D) group with 20 patients each. No difference was observed among study groups withregards to incidence of individual complications like urethrocutaneous fistula, stricture, or wound infection (p>0.05). However, total complication rate was marginally higher (55%) in Snodgrass’ procedure as compared to Duckett’s procedure (35%). All the cases of stricture (10%) and wound dehiscence (5%) were reported in Snodgrass group.Keywords
Snodgrass Urethroplasty, Duckett Onlay, Transverse Preputial, Patch Urethroplasty, Penile, Hypospadias, Ventral Penile CurvatureReferences
- Nelson CP, Park JM, Wan J, Bloom DA, Dunn RL, Wei JT. The increasing incidence of congenital penile anomalies in the United States. J Urol. 2005; 174:1573-1576. https://doi. org/10.1097/01.ju.0000179249.21944.7e. PMid:16148654.
- Schnack TH, Poulsen G, Myrup C, Wohlfahrt J, Melbye M. Familial coaggregation of cryptorchidism and hypospadias. Epidemiology. 2010; 21:109-113. https://doi.org/10.1097/ EDE.0b013e3181c15a50. PMid:19901839.
- Keays MA, Dave S. Current hypospadias management: Diagnosis, surgical management, and long-term patientcentred outcomes. Canadian Urological Association Journal. 2017 Jan; 11(1-2Suppl1):S48. https://doi.org/10.5489/ cuaj.4386. PMid:28265319 PMCid:PMC5332236.
- van der Horst HJ, de Wall LL. Hypospadias, all there is to know. Eur J Pediatr. 2017; 176:435. https://doi.org/10.1007/ s00431-017-2864-5. PMid:28190103 PMCid: PMC5352742.
- Schneuer FJ, Holland AJ, Pereira G, Bower C, Nassar N. Prevalence, repairs and complications of hypospadias: an Australian population-based study. Arch Dis Child. 2015; 100:1038. https://doi.org/10.1136/archdischild- 2015-308809. PMid:26310454.
- Snodgrass W. Tubularised incised plate urethroplasty for distal hypospadias. J Urol. 1994; 151:464-465. https://doi. org/10.1016/S0022-5347(17)34991-1.
- Elder JS, Duckett JW, Snyder HM (1987) Onlay island flap in the repair of mid and distal penile hypospadias without chordee. J Urol. 138:376-379. https://doi.org/10.1016/ S0022-5347(17)43152-1.
- Santanelli F, D’Andrea F, Savanelli A, Molea G, Scuderi N. Reconstruction of hypospadias with a vertical preputial island flap. A follow-up study of 127 patients. Scand J Plast Reconstr Surg Hand Surg. 1990; 24:67-73. https://doi. org/10.3109/02844319009004523. PMid:2389126.
- Duckett JW Jr. Transverse preputial island flap technique for repair of severe hypospadias. Urol Clin North Am. 1980; 7:423-430. https://doi.org/10.1016/S0094- 0143(21)01243-X.
- Santanelli F. Vertical preputial flap with double skin island for correction of hypospadias with severe recurvatum. Ann Plast Surg. 1994; 33:305-312. https://doi. org/10.1097/00000637-199409000-00012. PMid:7985968.
- DeLair SM, Tanaka ST, Yap SA, Kurzrock EA. Training residents in hypospadias repair: Variations of involvement. J Urol. 2008; 179:1102-1106. https://doi.org/10.1016/j. juro.2007.10.090. PMid:18206935.
- Esposito C, Savanelli A, Escolino M, Giurin I, Iaquinto M, Alicchio F, Roberti A, Settimi A. Preputioplasty associated with urethroplasty for correction of distal hypospadias: A prospective study and proposition of a new objective scoring system for evaluation of esthetic and functional outcome. J Pediatr Urol. 2014; 10:294-299. https://doi. org/10.1016/j.jpurol.2013.09.003. PMid:24145174.
- Standoli L. Correzione dell’ipospadiain un unico tempo: Técnica dell’uretroplastica con lembo ad isolaprepuziale. Rass Ital Chir Pediatr. 1979; 21:82.
- Chen SC, Yang SS, Hsieh CH, Chen YT. Tubularised incised plate urethroplasty for proximal hypospadias. BJU Int. 2000; 86:1050-1053. https://doi.org/10.1046/j.1464- 410x.2000.00966.x. PMid:11119100.
- Baskin LS, Erol A, Jegatheesan P, Li Y, Liu W, Cunha GR. Urethral seam formation and hypospadias. Cell Tissue Res. 2001; 305:379. https://doi.org/10.1007/s004410000345. PMid:11572091.
- Baskin LS. Anatomical studies of the fetal genitalia: Surgical reconstructive implications. Adv Exp Med Biol. 2002; 511:239. https://doi.org/10.1007/978-1-4615-0621-8_14. PMid:12575765.
- Study of Different Methods of Midline Laparotomy Incision Closure and their Outcomes
Abstract Views :143 |
PDF Views:87
Authors
Affiliations
1 Associate Professor, Department of Surgery, Dr. Vasantrao Pawar Medical College Hospital and Research Centre, Nashik - 422003, Maharashtra, IN
2 Former PG Resident, Department of Surgery, Dr. Vasantrao Pawar Medical College Hospital and Research Centre, Nashik - 422003, Maharashtra, IN
1 Associate Professor, Department of Surgery, Dr. Vasantrao Pawar Medical College Hospital and Research Centre, Nashik - 422003, Maharashtra, IN
2 Former PG Resident, Department of Surgery, Dr. Vasantrao Pawar Medical College Hospital and Research Centre, Nashik - 422003, Maharashtra, IN
Source
MVP Journal of Medical Sciences, Vol 8, No 2 (2021), Pagination: 249–252Abstract
Background: The closure of such a laparotomy wound is important to minimize the postoperative complications like wound pain, infection, dehiscence and incisional hernia Aims: The objectives of this study was to study the various techniques of midline laparotomy incision closure and their outcomes like wound dehiscence, wound infection and incisional hernia up to six months. Materials and Methods: A total of 100 patients who were operated for midline laparotomy were included as subject material after they satisfied the inclusion and exclusion criteria. Results: Most common indication of laparotomy in the study was gastric ulcer perforation. Incidence rate of surgical site infection, wound dehiscence and incisional hernia was lower in cases of smaller bite length. Incidence rate of surgical site infection wound dehiscence and incisional hernia was lower with continuous suturing. Conclusion: The study results showed that best technique for midline laparotomy incision closure is small bite continuous suturing with mass closure. The small bites technique with continuous suturing showed better results than small bite technique with interrupted suturing. Present study thus recommends that small bite continuous suturing with mass closure should be considered as the standard closure technique for midline incisions.Keywords
Incisional Hernia, Small Bite Continuous Suturing with Mass Closure, Surgical Site Infection, Wound DehiscenceReferences
- Ellis H. Midline abdominal incision. Br J Obstet Gynecol.
- ; 91:1-2. https://doi.org/10.1111/j.1471-0528.1984.
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- Sutton G, Morgan S. Abdominal wound closure using a running, looped Monofilament polybutester suture: Comparison to Smead-Jones Closure in Historic Controls.
- Obstet Gynecol. 1992; 80(4):650-654.
- Gandhi JA, Shinde PH, Digarse RD. Evaluation of abdominal wall closure technique in emergency laparotomies at a tertiary care hospital. Int Surg J. 2016; 3:1796-1801. https:// doi.org/10.18203/2349-2902.isj20162813.
- Mahey R, Ghetla S, Rajpurohit J, Desai D, Suryawanshi S. A prospective study of risk factors for abdominal wound dehiscence. Int Surg J. 2017; 4:24-28. https://doi.
- org/10.18203/2349-2902.isj20163983.
- Gislason H, Viste A. Closure of burst abdomen after major gastrointestinal operations-comparison of different surgical techniques and later development of incisional hernia. Eur J Surg. 1999; 165:958-961. https://doi.
- org/10.1080/110241599750008071. PMid:10574104.
- Varghese F, Gamalial J, Kurien JS. Skin stapler versus sutures in abdominal wound closure. Int Surg J. 2017; 4:3062-3066.
- https://doi.org/10.18203/2349-2902.isj20173888.
- Inamdar MF, Singh AR, Inamdar NM. Incisional hernia: risk factors, clinical presentations, and pre-peritoneal polypropylene mesh repair. Int Surg J. 2017; 4:1189-1194.
- https://doi.org/10.18203/2349-2902.isj20170896.
- Deshmukh SN, Maske AN. Mass closure versus layered closure of midline laparotomy incisions: A prospective comparative study. Int Surg J. 2018; 5:584-587. https://doi.
- org/10.18203/2349-2902.isj20180357.
- Diener MK, Voss S, Jensen K, Büchler MW, Seiler CM.
- Elective midline laparotomy closure: the INLINE systematic review and meta-analysis. Ann Surg. 2010; 251(5):843.
- https://doi.org/10.1097/SLA.0b013e3181d973e4.
- PMid:20395846
- Study to Assess for Improvement in Renal Function following Anderson Hynes Pyeloplasty for Congenital Pelvi Ureteric Obstruction in Children
Abstract Views :164 |
PDF Views:92
Authors
Affiliations
1 Former PG Resident, Department of Surgery, Dr. Vasantrao Pawar Medical College Hospital and Research Centre, Nashik – 422003, Maharashtra, IN
2 Associate Professor, Department of Surgery, Dr. Vasantrao Pawar Medical College Hospital and Research Centre, Nashik – 422003, Maharashtra, IN
1 Former PG Resident, Department of Surgery, Dr. Vasantrao Pawar Medical College Hospital and Research Centre, Nashik – 422003, Maharashtra, IN
2 Associate Professor, Department of Surgery, Dr. Vasantrao Pawar Medical College Hospital and Research Centre, Nashik – 422003, Maharashtra, IN
Source
MVP Journal of Medical Sciences, Vol 8, No 2 (2021), Pagination: 278–282Abstract
Background: Pelvi Ureteric Junction Obstruction (PUJO) is defined as an obstruction to the free flow of urine from the renal pelvis to the proximal ureter1. It is the most common cause of obstructive uropathy in the paediatric age group. Aims: To check for improvement in renal function following Anderson Hynes pyeloplasty for congenital PUJ obstruction and to find out at what age should a child be operated for best improvement in renal functions. Material and Methods: A total of 20 patients undergoing Anderson Hynes Pyeloplasty were included after they satisfied the inclusion and exclusion criteria. Results: In this study it was observed that post Anderson Hynes pyeloplasty, a total of 60% children showed improvement in renal functions, in 30% there was no change in renal function while 10% showed deterioration in renal functions, requiring re-operation. The improvement was statistically significant Mean eGFR in cases improved from 32.25 to 38.5 mL/min/1.73 m2 after Anderson Hynes pyeloplasty. The improvement was statistically significant Mean renal functions in cases improved from 29.05% to 33.7% after Anderson Hynes pyeloplasty. No complications were reported in 85% of the cases after Anderson Hynes pyeloplasty. UTI developed in 2 cases (10%) while pyonephrosis was seen in 1 case (5%). Conclusion: Anderson Hynes Pyeloplasty is an effective treatment for congenital Pelvi Ureteric Junction obstruction in pediatric population. In this study it was observed that the earlier we operate the better is the improvement in function.Keywords
Anderson Hyles Pyeloplasty, Congenital, Hydronephrosis, Pelvi-ureteric ObstructionReferences
- Sikandar AM, Sirajuddin S. Pelvi-ureteric Junction Obstruction in children. Journal of Surgery Pakistan. 2008; 13(4):163–6.
- Lee H, Han SW. Uretero-pelvic Junction Obstruction: What we know and what we don’t know. Korean Journal of Urology. 2009; 50(5):423–31. https://doi.org/10.4111/ kju.2009.50.5.423
- Rodriguez MM. Congenital anomalies of the kidney and the urinary tract (CAKUT). Fetal Pediatr Pathol. 2014 Oct 1; 33(5-6):293–320. PMid: 25313840 PMCid: PMC4266037.
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- Mughal SA, Soomro SI. Pelvi-ureteric Junction Obstruction in children. Journal of Surgery Pakistan (International).
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- Rasool M, Sheikh HM, Ali S, Ahmed I. Pyeloplasty; Comparison of results of repair with and without stents.
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- Elafifi M, Eltatawy H, Haroon H, Gaber M, Farha MA.
- Evaluation of non-stented dismembered pyeloplasty in children suffering from Pelvic Ureteric Junction Obstruction. Ann Pediatr Surg. 2009; 5:52–7.
- Castagnetti M, Novara G, Beniamin F, Vezzú B, Rigamonti W, Artibani W. Scintigraphic renal function after unilateral pyeloplasty in children: A systematic review. BJU International. 2008 Oct; 102(7):862–8. PMid: 18336599.
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