Surgical Disorders Research Articles

An evidence-based nursing practice affects stress state, coagulation, complications and quality of life in patients with upper gastrointestinal bleeding in the emergency department: a retrospective observational study

BackgroundAcute gastrointestinal bleeding (GIB) is a common surgical emergency digestive system disorder with high morbidity and mortality.AimThis study sought to explore effects of evidence-based nursing practice (ENP) procedures on stress state, coagulation function, complications in patients with upper GIB (UGIB) and quantify of life in emergency department.MethodsThis study was a retrospective analysis and a total of 120 patients with UGIB were enrolled and divided into an experimental group with ENP interventions and a reference group with traditional nursing according to different nursing programs. The physiological stress indicators (epinephrine, norepinephrine, plasma cortisol), psychological stress indicators [anxiety self-assessment scale (SAS), depression self-assessment scale (SDS)], coagulation function indicators [prothrombin time (PT), prothrombin time (TT), D-dimer (D-D), fibrinogen (FIB)], complication rate and quality of life were analyzed.ResultsAfter nursing intervention, epinephrine, norepinephrine and plasma cortisol, SDS and SAS scores were decreased in the experimental group relative to the reference group (all P < 0.001). After nursing intervention, the levels of PT, TT and D-D in both groups were lower and the FIB was higher than before intervention (all P < 0.001), and the improvement of coagulation function indexes in experimental group after nursing was better than that in reference group (P < 0.001). The incidence of complications in the experimental group was lower than that in the reference group (P = 0.04). The higher quality of life scores after nursing intervention was validated in the experimental group relative to the reference group (P < 0.001).ConclusionENP improved stress response, coagulation function, quality of life, and reduced incidence of complications in UGIB patients, indicating potential for clinical application.

Evaluation of the Role of Ultrasonography in Predicting a Metachronous Contralateral Inguinal Hernia in Children

Abstract Background Inguinal hernia remains one of the most common surgical disorders in children. Almost all pediatric hernias are indirect. The incidence of pediatric inguinal hernia is highest during the first year of life and then gradually decreases thereafter. The incidence of contralateral occurrence of an inguinal hernia after unilateral herniorrhaphy has been reported as 5.6 to 22%. The management of the contralateral inguinal hernia in a child with unilateral CIH has been always debated. Routine contralateral exploration of the inguinal canal has been practiced by many surgeons. Routine contralateral exploration may be associated with a high incidence of negative exploration and lengthening of the operative time in addition to possible increasing morbidity in those patients. Aim of the Work This study aims to evaluate the role of preoperative assessment by ultrasonography in predicting contralateral inguinal hernia in children with unilateral inguinal hernia without clinical evidence of contralateral inguinal hernia. Patients and Methods Fifty infants and children presented to pediatric surgery clinic at Ain Shams University and Nasr City Health Insurance Hospitals aged 1 month till 12 years of age complaining of unilateral inguinal hernia without clinical evidence of contralateral inguinal hernia underwent preoperative US. Results Cases with a width of the contralateral side &amp;gt;3.5 mm at the level of the internal ring determined using the US are likely to be at high risk of developing a contralateral hernia with a sensitivity of 80.0%, specificity of 77.5%, and area under the curve (AUC) of 78.4%. Conclusion Ultrasonography is a rapid, sensitive, convenient, and non-invasive method for screening patients with contralateral occult CIH. It is a reliable tool for preventing unnecessary exploration or additional operations at a later stage. It can be performed in all cases of inguinal hernia to determine the necessity for contralateral exploration. Children having a width of contralateral side &amp;gt;3.5 mm at the level of the internal ring determined using the US are likely to be at high risk of developing a contralateral hernia with a sensitivity of 80.0%, specificity of 77.5%, and area under the curve (AUC) of 78.4%.Therefore, we recommend routine preoperative use of ultrasonography for all patients with unilateral CIH to determine which patient should be subjected to a contralateral exploration.

Acute Intestinal Obstruction Due to an Anomalous Ileosigmoid Band – A Case Report

We report a case of a 30-year-old female who presented with symptoms and signs of intestinal obstruction. The patient reported no previous history of abdominal surgery or trauma while clinical and radiographic examinations were not diagnostic. Patient planned for exploratory laparotomy in view of complete intestinal obstruction. Exploratory laparotomy with limited resection of gangrenous segment with primary closure of abnormal ileosigmoid communication with proximal ileostomy with distal mucous fistula. Intraoperatively distal 60cm of ileum, caecum and part of ascending colon was gangrenous there was a fibrous band extending from parities to ileum approximately 60 cm proximal to IC junction. Congenital bands are extremely rare. Their exact incidence is still unknown and usually observed in childhood. This case, therefore, represents an unusual surgical problem in an older individual in which the diagnosis was clinically unexpected. Small bowel obstruction is the most common surgical disorder of the small intestine. Adhesions are by far the most frequent causes followed by hernias, tumors, intussusception, foreign bodies, gallstones, and inflammatory bowel disease. Obstruction by a congenital band is extremely rare and usually observed in childhood. This report presents a 30-year-old female with symptoms of intestinal obstruction, subsequently treated by ligation and division of a congenital band.

Intestinal Obstruction Due to a Congenital Band: Two Cases of Congenital Bands in Adults

Small bowel obstruction is the most common surgical disorder of the small intestine. Adhesions are by far the most frequent causes followed by hernias, tumors, intussusception, foreign bodies, gallstones, and inflammatory bowel disease. During embryogenesis, abnormal adhesion of the peritoneal folds induces a congenital band which can cause small bowel obstruction. It is extremely rare and usually observed in childhood. We report two cases of small bowel obstructions in adults due to congenital bands. The first patient is a woman of 47 years-old admitted for chronic abdominal pain, and the second one is a 20 years-old man admitted for the etiological assessment of chronic constipation. Surgical exploration was performed revealing a small bowel obstruction due to congenital band with complete resolution of the symptoms after surgery.

Is refractive error a factor affecting scoliosis?

Scoliosis is one of the most common surgical disorders of the pediatric spine. Refractive errors are commonly associated with vision impairment worldwide. However, it is currently unclear whether refractive error correlates directly with the development of scoliosis. A cross-sectional study was performed in 2023, and a stratified cluster sampling technique was employed among school-aged students in Nantong City, China. Univariate and multivariate logistic regression analyses were used to investigate specific correlations between scoliosis and related parameters; various types of refractive errors were also included in the study. The prevalence of scoliosis among school-aged students was 2.2% in Nantong city. Multiple logistic regression analyses showed that myopia, hyperopia, astigmatism, and anisometropia were not correlated with the development of scoliosis (all, p≥0.05). Lower body mass index (BMI) [adjusted odds ratio (aOR) = 0.92; 95% confidence interval (CI): 0.88-0.95; p<0.001], living in rural areas (aOR = 1.40; 95% CI: 1.05-1.86; p = 0.020), and older age (aOR = 1.32; 95% CI: 1.25-1.38; p<0.001) had significantly higher risks of scoliosis. Refractive errors did not correlate with the development of scoliosis. However, BMI, living in rural areas and older age did correlate with the development of scoliosis.

Inpatient disease spectrum and clinical characteristics of surgical disorders in pediatric and adolescent gynecology: A single-institute study of 12 years data from China.

Inpatient disease spectrum and clinical characteristics of surgical disorders in pediatric and adolescent gynecology: A single-institute study of 12 years data from China.

Prevalence of surgical affections of sheep in Mymensingh division of Bangladesh

Background: This study aimed to investigate the occurrence of surgical conditions in sheep and analyze their distribution based on age, sex, sheep, and seasonal variation. Methods: Retrospective data on surgical conditions in sheep were compiled from Upazila Livestock Offices and Veterinary Hospitals within Mymensingh division between January 2021 and December 2021. Simple descriptive statistics were used for data analysis. Results: A total of 788 surgical cases in sheep were documented. The predominant surgical conditions observed in sheep included wounds (29.18%), myiasis (15.10%), bloat (14.08%), subcutaneous cysts (12.56%), and foot rot (8.24%). In addition, there were instances of abscesses (6.47%), horn fractures (4.56%), atresia ani (3.93%), dermoid cysts (1.64%), dog bites (1.90%), overgrown hooves (1.52%), and gangrenous mastitis (0.63%). Surgical affections were more prevalent in adult sheep (73.35%) compared to young ones (26.64%). Among adult sheep, myiasis, bloat, subcutaneous cysts, and foot rot showed higher prevalences. In females, myiasis, subcutaneous cysts, bloat, and abscesses occurred more frequently than in male sheep. The occurrence of surgical affections was relatively higher in adult sheep during the rainy season, followed by summer, autumn, and winter during the rainy season followed by summer, autumn, and winter. Conclusion: The findings of this study highlight the variable demographic distribution of surgical affections in sheep. The observed patterns suggest that the surgical disorders pose a substantial threat to sheep rearing in the study areas.

Clinico-pathologic profile and outcomes of pediatric endocrine patients managed by endocrine surgeons: Experience over three decades in a tertiary center in India.

Pediatric endocrine disorders requiring surgical intervention are rare and so are experienced surgeons dealing with these. The aim of the current study was to investigate disease profile and perioperative outcome of pediatric patients with surgical endocrine disorders in an endocrine surgery unit. This retrospective study (Sep 1989-Aug 2019) consisted of pediatric endocrine surgery patients (<18years) who were managed by a team of pediatric endocrinologists and endocrine surgeons at our center. Patients were divided into three cohorts consisting of a decade each. Clinico-pathologic variables, perioperative events operative and follow-up details were recorded. A total of 332 children were included and their mean age was 14.6±3.9years (M:F=1:1.6). Thyroid disorders were most prevalent (59.8%), followed by adrenal (28.2%), parathyroid (10.4%), and pancreas (1.5%). Incidence of benign, malignant, and congenital/developmental disorders were 65.4, 28.1 and 8.3, respectively. Familial association was observed in 8.9% children, which is highest among pheochromocytoma patients. Overall, 201 thyroidectomies+associated procedures, 35 parathyroidectomies, 96 adrenal and paraganglioma resections, and 5 pancreatic procedures were performed. Median hospital stay was 5.6±4.1days. The number of cases increased significantly over 3decades. Clinical profile and outcome did not vary except for significant decrease in incidence of malignant pathology (p=0.04) and increase in VHL cases (p=0.04) in the last decade though overall increase in familial cases was nonsignificant (p=0.11). No perioperative mortality was observed except for 3% after adrenalectomy. A team of dedicated endocrine surgeons and pediatric endocrinologists is effective in management of pediatric endocrine surgery.

Prevalence of diseases and its associated risk factors in crossbred Friesian calves

The aim of this study was to determine the prevalence of diseases and its associated risk factors in crossbred Friesian calves in a dairy farm in Bangladesh. Date of birth, birth weight, age and sex of 194 calves up to three months old, season of disease occurrence, date of illness and the percentage of IgG in colostrum were recorded. The prevalence of calf diseases was 33.5%, of which 30.1% were suffering from medical conditions, 19.6% having enteritis: only 5% had surgical disorders. Calves up to 21 days old had significantly higher disease prevalence (22.2%) than calves aged 22-90 days (11.3%). The prevalence of diseases was significantly higher (43.1%) in calves with birth weight up to 29 kg than calves with birth weight 30 kg or more (28.7%). The prevalence of diseases was higher in male calves (38.0%) than female (28.7%). The prevalence of diseases was significantly higher (72.4%) in calves consumed colostrum containing 22-24% IgG compared to calves given colostrum containing 28-30% IgG. The prevalence of diseases was significantly higher in rainy season (64.2%) than in summer (29.5%) and in winter (6.1%). &#x0D; Bang. vet. 2023. Vol. 40, No. 1 – 2, 37 – 45

Botox Treatment: A Comprehensive Review

An exotoxin called botulinum toxin, or Botox, is isolated from Clostridium botulinum. It prevents the cholinergic nerve end plates from releasing acetylcholine, which causes the innervated muscles or glands to become inactive. Botox has proven to be effective for improving facial cosmetics, but new research has shown that it can also be used to treat a variety of surgical and medical disorders that aren't cosmetic. This article examines the available data regarding Botox use for non-cosmetic head and neck problems too. Because of its quick, distinct and long-lasting outcomes for the reduction of facial fine lines and wrinkles and cosmetic rejuvenation, injectable treatments like botulinum toxin are gaining popularity. Excessive sweating or hyperhidrosis can also be treated with Botox. Botox treatment can reduce the frequency of migraines, with chronic migraines requiring treatment in every three months. Additionally, Botox can help in reducing urinary incontinence caused by an overactive bladder. However, the usage of pure botulinum toxin dosages employed by certified healthcare professionals are strictly to be done under the stringent medical guidelines. When handled properly, botulinum toxins utilized in medicine are non- hazardous.

Complications of testicular prosthetics: analysis of causes, surgical tactics, ways of prevention

Background. Testicular prosthetics, despite the apparent simplicity of the technique of performing the operation, often leads to complications. At the same time, the spread of data from different authors on the frequency and structure of complications is extremely large. At the same time, the factors indicated by the authors as the causes of complications often contradict each other, and, as a rule, are not analyzed, therefore, methods of prevention and therapeutic tactics are not clearly defined today.Aim. To analyze the frequency and structure of complications during testicular prosthetics in patients over 18 years of age and adolescent children, as well as to suggest optimal ways to prevent the identified complications.Materials and methods. The results of testicular prosthetics were analyzed in 292 patients aged 12–59 years in the period 2007–2022. Various complications were found in 27 patients (9.24 %), including in the adolescent group (12–17 years) – in 13 (8.33 %) patients out of 156, in adults – in 14 (10.29 %) out of 136. MIT implants were used in 116 cases (adults – 54, adolescents – 62) and Promedon implants – in 176 cases (adults – 80, adolescents – 96). Data processing was carried out in the Statistica 20.0 program. The p &lt;0.05 level was considered statistically significant.Results. The most common complications include implant extrusion (22.2 %) and surgical hemostasis disorders (29.6 %), they are also the most difficult to correct and often lead to the need to remove the implant. The use of antibacterial therapy by the course does not reduce the risk of complications, the absence of antibiotic prophylaxis increases the incidence of complications by 3.9 % in the adult group and by 2.28 % in the adolescent group. The most rational single perioperative antibiotic prophylaxis. The frequency of complications when using MIT implants is higher (n = 17) than Promedon (n = 10). The incidence of complications is significantly higher in the group of patients who underwent prosthetics for more than three years after primary orchectomy or in an initially hypoplasized scrotum.Conclusion. Complications of testicular prosthetics are 8.33–10.29 %. The structure is dominated by complications of hemostasis and implant extrusion, they are also the cause of the greatest number of repeated interventions and the reason for the removal of the implant. A number of factors influence the formation of complications – access, the scheme of antibacterial therapy/prevention, the implantable material, the period after the initial operation. The most rational is the use of a modern silicone implant for prosthetics 6–12 months after orchectomy with suprascrotal access with a single perioperative antibiotic prophylaxis. The risk of the most dangerous and frequent complications can be leveled by using preventive measures.

In Memoriam: Valerii Semenovych Ponomarchuk

In Memoriam: Valerii Semenovych Ponomarchuk

Conceptual Study of Shatkriyakala and Its Applicability in Surgical Diseases

: In Ayurveda, "shatkriyakal" sanchaya, prakopa, prasara, sthanasanshraya, vyakti, and bheda explains the causes of diseaseprogression, or its etiopathogenesis. These six stages represent the six opportunities for a doctor to treat the condition beforeit becomes severe. It is a composite expression of the words Kriya and Kala. Kriya denotes the choice of therapy (medication,diet, and daily routine) used to treat the Dosha disruption, and Kala denotes the stage of a disease's progression. The idea ofKriyakala has been described by the ancient Indian surgeon Sushruta. Many authors have tried writing and compiling thereferences or information in classical texts. Still, there is no single article that not only compiles the textual references but alsoexplains its appropriate applied aspect or correlates its stages in the progression of surgical disorders. The present study alsotries to correlate to stages of disease progression in modern medicine with examples to show its importance today. Theobjective of this study is to review all the literature related to Shatkriyakala in classical texts of Ayurveda and compile it in asingle place to gain comprehensive knowledge about its applied aspects and make readers mind-research oriented to think ofmanagement of disease in that stage to prevent complication. The study can be used for easy referencing for conducting furtherresearch. As this review includes a step-by-step explanation and correlation of the pathogenesis of surgical diseases, there willbe an opportunity for practitioners to provide some evidence-based medicine to incept the disease in that stage to preventdisease progression and further complications.

Study on the relationship between scoliosis and vision problems: A narrative review.

Adolescent scoliosis is one of the most common surgical disorders of the pediatric spine. With timely detection and early treatment, most scoliotic children can avoid major and expensive surgery. Vision problems are also frequently found at an early age and can take a toll on individuals quality of life. However, scoliosis, a severe health hazard to adolescents, is often accompanied by vision problems clinically, including myopia, astigmatism, strabismus, amblyopia, horizontal paralysis, and blindness. And people with genetic defects have a higher probability of suffering both spinal problems and vision problems than those with nongenetic defects. However, many individuals viewed scoliosis and vision problems as 2 irrelevant diseases. This review searched PubMed, China National Knowledge Infrastructure, and Web of Science for studies on adolescent, scoliosis, eye diseases, myopia, strabismus, spinal disorders, and vision problems for almost 3 decades, and thus confirmed the potential relationship between adolescent scoliosis and vision problems.

Control of Paneth cell function by HuR regulates gut mucosal growth by altering stem cell activity.

Rapid self-renewal of the intestinal epithelium requires the activity of intestinal stem cells (ISCs) that are intermingled with Paneth cells (PCs) at the crypt base. PCs provide multiple secreted and surface-bound niche signals and play an important role in the regulation of ISC proliferation. Here, we show that control of PC function by RNA-binding protein HuR via mitochondria affects intestinal mucosal growth by altering ISC activity. Targeted deletion of HuR in mice disrupted PC gene expression profiles, reduced PC-derived niche factors, and impaired ISC function, leading to inhibited renewal of the intestinal epithelium. Human intestinal mucosa from patients with critical surgical disorders exhibited decreased levels of tissue HuR and PC/ISC niche dysfunction, along with disrupted mucosal growth. HuR deletion led to mitochondrial impairment by decreasing the levels of several mitochondrial-associated proteins including prohibitin 1 (PHB1) in the intestinal epithelium, whereas HuR enhanced PHB1 expression by preventing microRNA-195 binding to the Phb1 mRNA. These results indicate that HuR is essential for maintaining the integrity of the PC/ISC niche and highlight a novel role for a defective PC/ISC niche in the pathogenesis of intestinal mucosa atrophy.

Perinatal outcome of maternal deaths at Chris Hani Baragwanath Academic Hospital, Johannesburg, South Africa, January 2014 - June 2019.

Maternal death is a tragic event. Of maternal deaths worldwide, 99% occur in low- and middle-income countries. Perinatal outcome is related to maternal wellbeing. Maternal death has a negative impact on fetal and neonatal outcome in the short and long term. To determine the perinatal outcomes of pregnancies that ended in a maternal death at Chris Hani Baragwanath Academic Hospital (CHBAH), Johannesburg, South Africa, over a 5-year period, to describe the causes of maternal death, and to determine the stillbirth rate (SBR) and early neonatal death (ENND) rate in this population. This was a retrospective cross-sectional study of maternal deaths in women with a viable pregnancy from January 2014 to June 2019 at CHBAH. All maternal deaths with gestation >26 weeks or fetal weight >500 g were included in the study. Information on demographics, booking status, antenatal care, pregnancy outcome, and fetal and neonatal outcome was extracted from maternal and neonatal files. Of a total of 183 maternal deaths during the study period, 147 were included in the study. The institutional maternal mortality ratio was 135 deaths per 100 000 live births. Hypertension was the main direct cause of death (36.5%; n=27/74), followed by pregnancy related sepsis (27.4%; n=21/74) and obstetric haemorrhage (20.6%; n=15/74). Non-pregnancy-related infections, of which 91.4% were HIV and HIV-related complications, comprised 47.9% (n=35/73) of indirect causes of death, followed by medical and surgical disorders. Of a total of 151 babies, including two sets of twins and one set of triplets, 137 were delivered and 14 were undelivered at the time of maternal death. Ninety-one babies (61.9%) were born alive and 51 (34.6%) were stillbirths. Of the 91 liveborn infants, 6 (6.5%) had an ENND. Of the 51 stillbirths, 14 (27.5%) were undelivered and 11 (21.6%) were delivered by perimortem caesarean section. The SBR was 347 per 1 000 maternal deaths and the ENND rate 66 per 1 000 live births. The perinatal mortality rate (PMR) was 388 per 1 000 maternal deaths, which is 12 times higher than the PMR per 1 000 live births for the general population. Women who experience maternal death have babies with very poor perinatal outcomes, with a very high SBR, ENND rate and PMR. The health of the mother has a direct and significant effect on fetal and neonatal outcomes.

Predictors of Long-Term Healing for Endorectal Advancement Flap for Anorectal Fistulas

Abstract Introduction Anorectal fistulas are some of the commonest surgical proctologic disorders treated by surgeons. Despite the recent introduction of various sphincter preserving techniques, the search for the optimal operation continues. The purpose of this study was to determine the predictors of long-term healing for the endorectal advancement flap Methods A retrospective review of a single surgeon experience with the endorectal advancement flap for anorectal fistulas over an 18-year period. The impact of various patient and fistula related factors were analyzed for their impact on the primary endpoint of long-term fistula healing Results 87 patients underwent endorectal advancement flap (Male/Female 42.5/57.5%). Median age was 41 years. Sixty-nine patients (79.3%) had anal fistula while 18 patients had rectal fistula (20.7%). An anterior based fistula was noted in 45 patients (51.7%). The most common etiology was cryptoglandular disease (87.4%). The median operative time was 75 minutes (range 36-250). Postoperative septic complications were noted in 4 patients (4.6%). Fistula healing was documented in 80 patients (93%). During a median follow-up of 4 months (range 1-38, 1 patient lost to follow-up), recurrence was noted in 8 patients (9.3%), yielding an overall long-term success rate of 83.7%. The long-term healing rate was higher in patients with fistulas from cryptoglandular etiology (86.6%) compared to fistulas from other etiologies (63.6%) [p = 0.027]. Conclusions The endorectal advancement is associated with a high healing rate, a low postoperative septic complication rate, and infrequent risk for recurrence. Long-term healing without recurrence is achieved more frequently in patients with cryptoglandular etiology of the fistula compared to patients with non-cryptoglandular etiology.

Artificial intelligence-based approaches for the detection and prioritization of genomic mutations in congenital surgical diseases.

Genetic mutations are critical factors leading to congenital surgical diseases and can be identified through genomic analysis. Early and accurate identification of genetic mutations underlying these conditions is vital for clinical diagnosis and effective treatment. In recent years, artificial intelligence (AI) has been widely applied for analyzing genomic data in various clinical settings, including congenital surgical diseases. This review paper summarizes current state-of-the-art AI-based approaches used in genomic analysis and highlighted some successful applications that deepen our understanding of the etiology of several congenital surgical diseases. We focus on the AI methods designed for the detection of different variant types and the prioritization of deleterious variants located in different genomic regions, aiming to uncover susceptibility genomic mutations contributed to congenital surgical disorders.

Effects of Corrective Exercises on Work-Related Musculoskeletal Disorders and Quality of Life in Surgical Residents: A Pilot, Quasi-Experimental Study

Work-related musculoskeletal disorders (WMSDs) are one of the most important reasons for absenteeism, high costs of health care and human injuries; the latter are very common in medical staff. The present study was designed to evaluate the effects of corrective exercises on quality of life and work-related musculoskeletal disorders in surgical residents. In a quasi-experimental study with a one-group pretest-posttest design, we assessed the eligibility of 135 surgical assistants. All recruited participants performed corrective exercises and were followed for 12 months. The primary outcome of the study was any change in the surgical residents' work-related musculoskeletal disorders, which was assessed using the Nordic Musculoskeletal Questionnaire(NMQ) and the Numerical Pain Rating Scale (NPRS) prior to, and 3, 6, and 12 months after intervention. The secondary outcome was any change in the surgical residents' quality of life (QOL) score, which was assessed at baseline, 6 and 12 months after the intervention using the World Health Organization Quality of Life - BREF (WHOQOL-BREF) questionnaire. One hundred eligible surgical residents were enrolled, of whom 67 (67%) completed the study. At baseline the majority of the participants were female and >30 years of age. Fifty-five percent of them used analgesic drugs. The use of analgesic drugs per week fell by 14.7% from baseline to 12 months; the change was statistically significant (p = 0.042). The effect of corrective exercises on the intensity of pain in the shoulder (p = 0.002), hand/wrist (p = 0.001), upper back (p = 0.03), lower back (p = 0.02) and knee (p = 0.01) was significant. Corrective exercises also led to a significant rise in the quality-of-life score (p < 0.019). This study demonstrated the effectiveness of corrective exercises in reducing work-related musculoskeletal disorders and improving quality of life among surgical residents.

A Comparative Study of Conventional Suture and Stapler Anastomosis for Gastro-intestinal Surgery in Dogs

Background: Gastro-intestinal anastomosis is mostly performed to correct the gastro-intestinal surgical disorders like gastro-intestinal obstruction, abdominal trauma, perforated bowel, intussusception and intestinal neoplasia etc. In early periods conventional intestinal anastomosis was followed which evolved into a seromuscular pattern of suture technique in recent years. Stapled anastomosis have a higher tensile strength than sutured anastomosis, since they heal by primary intention with minimal inflammation. Taking above facts into consideration, this study was undertaken to compare the conventional suture with stapler anastomosis of gastro-intestinal surgery in dogs. Methods: Clinical cases of dogs which were reported to Small Animal Out-Patient (Surgery Unit) of Madras Veterinary Teaching Hospital, Chennai, with the symptoms of gastro-intestinal obstruction due to multifactorial causes formed the study material that were randomly divided into two groups of 6 dogs each. Group I Cases were treated with conventional suture, Group II were treated with gastrointestional anastomosis staplers. Plain and contrast radiography, ultrasonography, intestional anastomosis time, resumption of oral feeding, matrix metalloproteinase were performed. Result: Stapler technique was found to be superior, accurate and most effective than the conventional technique in terms of anastomotic constructing time, less bowel manipulation, tissue trauma, anaesthetic exposure, risk of peritoneal contamination, early resumption of gastro-intestinal motility and oral feeding, rapid healing at the anastomotic site and reduced hospital stay. Moreover the procedure was easy to perform and simple.