Open Access Case study

Ulnar Nerve Entrapment in the Guyon’s Canal Secondary to Compression by a Ganglion Cyst: A Case Report

M. Jlidi, Y. Trabelsi, L. Essid, W. Bouaicha, S. Daas, A. Khorbi, M. A. Sbai

Asian Journal of Research in Surgery, Page 1-5

Ulnar nerve compression in the Guyon’s canal is in most cases secondary to repeated trauma, fracture of the hamate or a thrombosis or arterial aneurism of the ulnar artery. Tumoral etiologies such as a compression by a lipoma or a ganglion cyst are uncommon.

The development of a ganglion cyst in the Guyon’s canal as a possible cause of ulnar nerve entrapment needs to be considered in the case of a sudden onset of hand grip weakness.

We believe that an early surgical decompression by removing the ganglion is essential for a full recovery.

Open Access Review Article

Harmonic Scalpel Versus Bipolar Diathermy in Trans -areolar Thyroidectomy

M. S. Abdelhamid, H. A. Nafady, A. Z. Garib, A. M. Rashad, S. S. Soliman, T. M. EL – Gaabary

Asian Journal of Research in Surgery, Page 1-5

Background: Years ago the LigaSure device and Harmonic scalpel were tried in thyroid surgery. It was found to be superior to hand-tying techniques. The aim was to assess bipolar diathermy against harmonic scalpel regarding operation time, cost and complications.

Videoscopic neck surgery is developing despite the fact that only potential spaces exist in the neck. These approaches are more appealing since the size of the incision of the conventional approach seems to be out of proportion compared to the small size of the tumours.

Purpose: to assess the applicability of bipolar diathermy in transareolar thyroidectomy.

Patients and Methods: The interventions were led at Beni-suef University Hospital between January 2017 and December 2017, after the patients fitted both the inclusions and exclusions criteria. This study enrolled 30 co-operative patients aged 18-60 years with unilateral thyroid lobe nodule, nodules or diffused swelling with the largest diameter less than 4 cm. A total of 30 patients went with the transareolar thyroid lobectomy, 20 went with the harmonic scalpel and 10 with the bipolar diathermy. Thyroid nodules were less than 4-cm in their largest transverse diameter. Thyroid gland volume was less than 20-ml as estimated by US. Cranio-caudal axis of the lobes must not exceed 7-cm.

Results: Mean operating time was 90 min (57 -135) with the harmonic scalpel while it was 105 min (70-145) minutes. No significant post-operative bleeding was seen in both groups. LOS was same in both groups. Marked reduction in the cost was reported.

Conclusion: Transareolar thyroidectomy with bipolar diathermy is associated with a marked reduction in cost compared to transareolar thyroidectomy with harmonic and this worth the long operating time.

Open Access Review Article

Different Methods of Jaw Reconstruction and Implants

Majid Zolfagharikhorshaneh, Maryam Hassannia, Juan F. SudcalenJr.

Asian Journal of Research in Surgery, Page 1-6

Introduction: Jaw bones are one of the most important part of human body, since they play a vital role in the appearance, respiration, speech, deglutition and mastication of an individual. Each year, many people need to reconstruct these bones because of trauma, tumors and congenital disorders. This study intends to investigate different jaw reconstruction methods.

Materials and Methods: The present study is a review-library study was conducted by searching the key words of jaw implants, Mandibular Reconstruction and reconstruction in scientific data bases such as Science Direct, Google Scholar and PubMed from 1994 to 2018.

Results: The results of investigating various researches and articles indicated that action taken in order to fix the jaw problems and defects often are classified into two parts: reconstruction and rehabilitation; however, it worth mentioning that reconstruction part is superior to rehabilitation. The reason behind reconstruction is to use different flaps for therapeutic actions.

Conclusion: There are various techniques for reconstruction and rehabilitation of jaw defects, for example, doing a surgery with the use of flaps for reconstructing the jaw is a promising and very useful method, and using new prosthetics, especially titanium prosthesis, improve rehabilitation of an individual greatly and return the patient’s esthetic appearance to a great extent.

Open Access Original Research Article

Esophageal Atresia and Tracheoesophageal Fistula, is Waterston`s Classification Still Valid?

Allauddin ., Saqeel Ahmed, Aurangzaib ., Helmand Khan Tareen, Mahikan Baloch, Zahidullah ., Muhammad Samsoor Zarak

Asian Journal of Research in Surgery, Page 1-6

Aim: Due to advances in the operative techniques and neonatal care, the Waterston's system of prognostic classification for oesophageal atresia (EA) is no longer followed in the developed-world.

Objective: The aim of this study was to evaluate the validity of risk stratification according to the Waterston`s Classification system for the repair of EA/TEF in the developing-countries.

Methods: This is a retrospective study, in which all 30 cases of congenital EA/TEF admitted to Bolan Medical-College Hospital, Quetta from July 2013 to January 2018 were studied. Risk-stratification was done according to the Waterston’s classification system. Institutional review board of bolan medical college authorized the study.

Results: Among the 30 records reviewed in this study, 90% of the patients were born outside BMCH. The diagnosis was made postnatally by means of nasogastric tube and chest X-ray (83%). The most common type of TEF was Type C (98%). The most common post-operative complication was pneumonia (43%). Overall survival rate was 83%. Cardiac-anomalies were the major associated cause of mortality. All patients who died had major cardiac anomalies p -<0.05.

Risk stratification according to Waterston’s-classification system showed 100% survival in Groups A, 82% in Group B and 75 % in Group C.

Conclusion: We conclude that the risk stratification according to Waterston’s-classification, which is now being considered obsolete in the developed world, is still valid in the developing countries like Pakistan because it is a relevant prognostic indicator it helps in deciding the surgical intervention, and has better correlation with survival than the other factors.

Open Access Original Research Article

Comparison of Plastibell Circumcision with Conventional Circumcision in Infants at Tertiary Care Centre

Mohammed Moinuddin, Nandkishor Shinde, Ravindra Devani, Ashfaq Ahmad

Asian Journal of Research in Surgery, Page 1-7

Objective: Evaluate two methods in terms of the incidence of complications in infants.

Materials and Methods: The present study was conducted on 560 infants who were brought for religious or ritual circumcision to the Pediatric Surgery unit. Infants were randomly divided into two groups, Plastibell group and conventional group based on the type of intervention. Randomization was done in all cases unless the parents insisted on a particular method for circumcision. Plastibell circumcision and conventional circumcision were done as an outpatient procedure in all the cases. Follow up was done on 3rd day, 15th day and on day of separation of the plastibell in plastibell group and were told to contact earlier, in case of any complication.

Results: During the study period, a total of 560 children with age less than 12 months fulfilling the inclusion criteria were analyzed. Out of 560 cases, 310 cases were of Plastibell circumcision group and 250 cases were of conventional circumcision group. The mean number of days for plastibell to separate was 6.2 days (3-12 days); Cosmetic results were similar in both the methods. Out of the total 560 cases, the successful rate of circumcision without any complication, were recorded in 475 (84.82%) cases. A total of 65 cases out of 310 in Plastibell group and 20 cases out of 250 in conventional group developed complications. Complications like bleeding, localized superficial infection occurred most commonly in Plastibell circumcision group.

It was concluded that the Plastibell device is a satisfactory method for circumcising children of this age group.