AAn Evaluation of the Choice of the Treatment for the Acute Appendicitis An Original Research.

Introduction: The findings of previous studies in the management of acute appendicitis with peritonitis complications are debatable. Thus, in this study, we aim to evaluate two surgical procedures in the management of acute appendicitis. Material and Methods: We piloted an observational prospective study on 50 subjects of both genders with acute appendicitis and peritonitis complication. They were divided equally into two groups who received laparoscopic and conventional open surgery. The data were collected for the various clinical parameters, the complications that followed, and the success rates. The data were analyzed using the t test deliberating P < 0.05 as significant. Results: We observed a similar distribution of genders, and the mean was 41 ± 0.5 years. We observed that among the laparoscopic group, the longer the surgical time, the shorter the stay at the hospital. Lower complications though not significant were noted than the open method. Conclusion: The laparoscopic approach may be suggested for the management of patients with acute appendicitis and with peritonitis. This method showed early patient discharge and fewer post-surgical complications.

Ultrasonographic Evaluation of Gallbladder Diseases: An Original Study.

Introduction: The diagnostic accuracy for the diseases of the gall bladder is high for the Ultrasound. Hence, in the present study, we aimed to evaluate the application of the ultrasound as a major diagnostic aid for the gallbladder diseases. Materials and Methods: We piloted observational study among 100 patients with gallbladder diseases. The clinical, ultrasonograhic, and the histopathological parameters were compared to check the validity of the tests using t-test deliberating P < 0.05 as significant. Results: We observed that number of the cases that were positively identified radiographically were 93 out of 82 actual cases and 67 identified by the Fine Needle Aspiration Cytology (FNAC). There was no significant difference between the clinical, pathological diagnosis and the ultrasonograhic diagnosis indicating a accuracy similar to the clinical and FNAC methods. Conclusion: Ultrasonograhic diagnosis performed similar to the other forms of diagnosis and can be suggested as a convenient and accurate diagnostic test for the diseases of gallbladder.

Short-Term Outcome in Patients Undergoing Gastrectomy with D2 Lymphadenectomy for Carcinoma Stomach.

The safety and feasibility of D2 lymphadenectomy for gastric cancer in Western patients have been shown by Italian Gastric Cancer Study Group (IGCSG). In our center at Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), we have been doing D1 lymphadenectomy all these years. Hence, this study was taken up to assess the feasibility of gastrectomy with D2 lymphadenectomy in patients with gastric cancer at JIPMER, Puducherry, India. Of the 148 carcinoma stomach patients explored, a total of 52 patients (35.13%) underwent resection with D1 (34 patients) or D2 (18 patients) lymphadenectomy, who formed the study groups. Patients were admitted and investigated by upper gastrointestinal endoscopy (UGIE) and other appropriate investigations including contrast-enhanced computed tomography (CECT) of the abdomen. Eligible patients had no serious comorbid cardiorespiratory disease that would preclude a safe D2 procedure. Two-third of the patients in both the groups belonged to the 50-75 age group. The mean number of nodes dissected was 6.44 ± 5.3 in the gastrectomy with D1 lymphadenectomy group versus 21.67 ± 5.3 in the gastrectomy with D2 lymphadenectomy group. There was no difference in the intraoperative blood loss, the number of units of blood transfused and the duration of surgery between D1 and D2 lymphadenectomy in our study. There was no difference between the postoperative stay and overall stay between the D1 and D2 lymphadenectomy. There was no significant difference between the overall morbidity and mortality or when the surgical complications were analysed individually. Intraoperative blood loss, the number of units of blood required for transfusion and the duration of surgery were not increased in D2 lymphadenectomy. The number of lymph nodes harvested was significantly more in D2 lymphadenectomy that resulted in a better staging. Postoperative morbidity or mortality in patients undergoing D2 lymphadenectomy was the same as in D1 lymphadenectomy. Hence, gastrectomy with D2 lymphadenectomy could be done safely.