Journal of the College of Physicians and Surgeons--Pakistan : JCPSP
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J Coll Physicians Surg Pak · Mar 2021
Comparison of Patients with and Without Hiatal Hernia Repair during Laparoscopic Sleeve Gastrectomy: Single-centre Experience.
To evaluate whether the concomitant repair of hiatal hernias during laparoscopic sleeve gastrectomy has an effect on the outcome of the surgery in patients with hiatal laxity and gastroesophageal reflux disease (GERD) symptoms during preoperative preparations. ⋯ Thirty-five patients were included in the study. The mean age of the included patients was 36.0 ± 9.8 (range, 21- 54) years, 80% of them were female. The preoperative median BMI was 43.9 (IQR, 41-50.7), and the postoperative mean BMI was 31.3 ± 5.1 (range, 23.2-40.6) Kg/m2. The median calculated RSI of the patients in the preoperative period was 8 (IQR, 2-13), and the postoperative median was 5.1 (IQR, 0-8) (p = 0.028). It was observed that 24 (68.6%) of the patients had improvement in their symptoms, 7 (20%) patients had worsening, 3 (8.6%) patients did not experience a change, and only one (2.9%) patient developed de novo GERD symptoms. Conclusion: No statistically significant difference was observed in individuals undergoing LSG and known to have GERD, hiatal hernia repair and cruroraphy in addition to LSG regarding reduction of GERD symptoms. Key Words: Sleeve gastrectomy, Reflux symptom index score, Gastroesophageal reflux disease.
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J Coll Physicians Surg Pak · Mar 2021
Comparison of Guy's, S.T.O.N.E. and CROES Scoring Systems for Predicting Percutaneous Nephrolithotomy Outcomes in Eldery Patients.
To evaluate the efficacy and reliability of Guy's (GSS), S.T.O.N.E., and CROES scoring systems developed to predict percutaneous nephrolithotomy (PCNL) outcomes in aged patients. Study Design: Descriptive study. ⋯ PCNL is an effective and safe treatment method with high stone-free rates in the treatment of large renal stones, but care should be taken in terms of cardiac risks. The results of this study showed that GSS and S.T.O.N.E. scoring systems were effective and reliable in predicting stone-free status. Key Words: Aged, Nephrolithotomy, Percutaneous, Comorbidity, Stone-free status, Treatment outcome, Complications, Scoring systems.
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J Coll Physicians Surg Pak · Mar 2021
Is Intraoperative Leak Test Required in Laparoscopic Sleeve Gastrectomy?
To investigate the efficacy of intraoperative leak test (IOLT) by methylene blue to identify the presence of leak during standardised sleeve gastrectomy (SG) procedure. ⋯ The routine use of an IOLT did not reduce the incidence of postoperative leak. IOLT should not be routinely performed, rather it would be appropriate for selected patients. Key Words: Laparoscopic sleeve gastrectomy, Intraoperative leak test, Stapler line leak.
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J Coll Physicians Surg Pak · Mar 2021
Review Case ReportsMorel-Lavallée Lesion in a 35-year Female.
Morel-Lavallée lesion is a post-traumatic degloving cyst, usually filled with blood, lymph or necrotic tissue, which mostly develops in the area around greater trochanter. Early diagnosis and prompt treatment is essential to prevent further complications, such as compression of surrounding structures. X-rays have limited use and magnetic resonance imaging (MRI) is the modality of choice in diagnosing the lesion. ⋯ Given the chronicity of lesion and extensive tissue involvement, the patient underwent surgical excision of the lesion with favourable long-term outcomes. In this case report and literature review, we discuss the pathophysiology, clinical presentation, radiological findings and management options for Morel-Lavallée lesion. Key Words: Morel-Lavallée lesion, Post-traumatic cyst, Degloving Injury, Tangential cyst.