Journal of Surgical Sciences <p>As far as we are aware, this journal is no longer being published.</p><p>Official Publication of the Society of Surgeons of Bangladesh.</p> Society of Surgeons of Bangladesh en-US Journal of Surgical Sciences 1728-2152 <p>No part of the materials published in this Journal may be reproduced, stored in a retrieval system or transmitted in any form or by any means electronic, mechanical, photocopying, recording or otherwise without the prior written permission of the publisher. Reprints of any article in file Journal will be available from the publisher.</p> Surgical Education in Bangladesh <p>DOI: <a href=""></a></p> <p>Journal of Surgical Sciences (2012) Vol. 16 (1) : 1-2</p> Humayun Kabir Chowdhury ##submission.copyrightStatement## 2013-04-05 2013-04-05 16 1 1 2 10.3329/jss.v16i1.14440 Nutritional Indicators for Postoperative Morbidity in Elective Oncological Surgery <p><strong>Objective:</strong> This study was to establish the nutritional risk factors for morbidity following cancer surgery to reduce the incidence of related postoperative complications. Therefore this study was undertaken to assess the morbidity and to identify nutritional risk factors following cancer surgery in Bangladeshi population.</p> <p><strong>Method:</strong> This cross-sectional observational study included 312 patients with malignancy who were waiting for surgery or within 60 days of postoperative period were enrolled for the study from indoor of surgical oncology department, NICR&amp;H. Then the patients were submitted for further study to evaluate the preoperative fitness in terms of nutrition assessment – both clinical and biological. All the clinical (pre &amp; post-operative including complication, if any), investigation findings were recorded accordingly.</p> <p><strong>Results:</strong> Statistical correlation was discovered between BMI and morbidity but no statistical correlation was found between WL &gt;10% and major surgical complications of either infectious or noninfectious origin (p = NS). No statistically significant correlation was found between nutritional condition or oedema and surgical morbidity. Conversely, a substantial statistical correlation was found between skin thickness or Hb% or albumin &lt;30 g/l and major surgical complications (either infectious or noninfectious) (p= S).</p> <p><strong>Conclusion:</strong> The best nutritional factor for detecting the risk of MC is albumin levels below 30 g/l.</p> <p>DOI: <a href=""></a></p> <p>Journal of Surgical Sciences (2012) Vol. 16 (1) : 3-10</p> AKMMU Bhuiyan MJ Kabir MM Rahman ##submission.copyrightStatement## 2013-04-05 2013-04-05 16 1 3 10 10.3329/jss.v16i1.14441 Laparoscopic Cholecystectomy for Acute Gallbladder Disease During Index Admission- 11 the Optimum Timing for Surgery <p><strong>Background:</strong> Laparoscopic cholecystectomy, initially considered a contraindication for the treatment of acute gallbladder disease, is now being practiced for treating acute cholecystitis worldwide. The purpose of the study is to evaluate the outcome of laparoscopic procedure in the management of acute gallbladder disease during the index admission in terms of safety and feasibility, hospital stay and the rates of complications and conversion to open cholecystectomy.</p> <p><strong>Methods:</strong> Between January 2009 to December 2011, 174 patients (103 female, 71 male) with median age 43.5 years (range 27-73 years) with the diagnosis of acute gallbladder disease underwent laparoscopic cholecystectomy. Diagnosis of acute cholecystitis was made from history, physical findings and ultrasound evidence of acute inflammatory changes.</p> <p><strong>Results:</strong> Median time from onset of symptoms to surgery was 70 hours. Median operative time was 76.5 minutes. Conversion rate was 1.7%. Minor post-operative complications occurred in 13.5% cases of laparoscopic procedure, which did not require further intervention. Median post-operative hospital stay was 2.5 days and total length of hospital stay was median 4.4 days. There was no mortality.</p> <p><strong>Conclusion:</strong> In expert hands laparoscopic cholecystectomy for acute gallbladder disease during the index admission is safe with better clinical results, shorter hospital stay and an acceptable conversion and complication rates with additional financial benefit to the patients.</p> <p>DOI: <a href=""></a></p> <p>Journal of Surgical Sciences (2012) Vol. 16 (1) : 11-17</p> Md Ibrahim Siddique Md Atiar Rahman Md Shahadot Hossain Sheikh Khander Manzoor Murshed Samia Mubin Muhammad Ali Siddiqui Krisna Rani Majumder ##submission.copyrightStatement## 2013-04-05 2013-04-05 16 1 11 17 10.3329/jss.v16i1.14442 Tubeless & Stentless PCNL in Selected Cases – Our Experience in Bangladesh <p><strong>Introduction:</strong> PCNL is well-accepted method of management of renal stone. In PCNL post operatively usually Nephrostomy tube and JJ stent are used. But Nephrostomy tube and JJ stent has some morbidity. Tubeless and JJ stentless PCNL in selected cases reduces the morbidity. This study will evaluate the results of PCNL with and without Nephrostomy tube and JJ stent in the management of renal stone in selected cases.</p> <p><strong>Methods:</strong> From July 2008 to June 2010 total 70 cases of renal stone were managed by PCNL dividing into two groups Group A -PCNL with nephrostomy tube and JJ stent, Group B- Nephrostomy tubeless and JJ stent less PCNL with only ureteric catheter for 24 – 48 hour post operatively. All cases were operated in Urology department of Bangladesh Medical College Hospital, and two other private hospitals located in Dhaka. In all cases initially placed a ureteric catheter and at the end of the procedure compression at renal angle about 10 min in Group –B, in Group A Procedure ended with Nephrostomy tube and JJ stent. Ureteric catheter was removed 24 hour-48 hour after operation. JJ stent was removed 3 weeks after operation. Exclusion criteria for the tubeless and JJ stentless approach were more than one percutaneous access, significant perforation of the collecting system, large residual stone burden, significant postoperative bleeding, ureteral obstruction and renal anomaly. The incidence of complication, length of hospitalization, analgesics requirement and interval to return to normal activities were evaluated.</p> <p><strong>Results:</strong> All 70 percutaneous procedures were performed without significant complication, none of the patients demonstrated urinoma in postoperative renal Ultrasound scan. In Group- B length of hospital stay was &lt; 3 days, the average analgesia requirement was 98 mg of Inj.Pethedin, patient return to normal activity earlier then Group -A.</p> <p><strong>Conclusion:</strong> Nephrostomy tubeless and JJ stent less Percutaneous Nephrolithotomy with ureteric catheter for 24- 48 hours post operatively is a safe and effective procedure. Hospital stay and analgesia requirements are less and returns to normal activities are faster.</p> <p>DOI: <a href=""></a></p> <p>Journal of Surgical Sciences (2012) Vol. 16 (1) : 18-25</p> NI Bhuiyan MF Islam SA Khan ZH Bhuiyan KMH Towhid NIU Ahmed K Salahuddin MA Arafat ##submission.copyrightStatement## 2013-04-05 2013-04-05 16 1 18 25 10.3329/jss.v16i1.14443 Open Tension Free Mesh Repair of Inguinal Hernias: The Lichtenstein Technique- 26 Our Experience for Last Ten Years <p><strong>Objective :</strong> Recurrences following hernia repair is one of the significant problem for both patient &amp; surgeon. Open tension free mesh techniques of inguinal hernia repair offers good results. Prosthetic materials have been increasingly used in hernia repair to prevent recurrences. Their use has been associated with several advantages, such as less postoperative pain, rapid recovery and low recurrence rates.</p> <p><strong>Materials and method :</strong> In this retrospective study, 1050 tension-free inguinal hernia repairs were performed between January 2001 and December 2010 in various medical institutes including BSMMU, DMCH &amp; some private clinics in Dhaka city, using a polypropylene mesh (Lichtenstein technique). The main outcome measure was early and late morbidity and especially recurrence.</p> <p><strong>Results :</strong> Inguinal hernia was indirect in 76 % of cases (798 patients), direct in 22% (231 patients) and of the pantaloon (mixed) type in 2 % (21 patients). Mean patient age was 44.5 years (range, 18 – 85). Follow-up was completed in 630 patients (60 %) by clinical examination or phone call. The median follow-up period was 2.5 years (range 1 – 5 years). Seroma and hematoma formation requiring drainage was observed in 25 and 8 patients respectively, while transient testicular swelling occurred in15 patients. Infection was found in 9 patients. Rejection of mesh occurred in 4 patients. There was 6 recurrence of the hernia (in one of these patients with late mesh rejection) (recurrence rate = 0.57 %). Postoperative neuralgia was observed in 25 patients (2.38 %).</p> <p><strong>Conclusion :</strong> Lichtenstein tension-free mesh repair of inguinal hernia is a simple, safe, comfortable, effective method. Tension free repair using synthetic meshes have been reported to result in better patient comfort and lower recurrence rates compared with the conventional procedures like Shouldice’s or Bassini’s operation<sup>2-4</sup>. Therefore it is the preferred method for hernia repair since 1994.</p> <p>DOI: <a href=""></a></p> <p>Journal of Surgical Sciences (2012) Vol. 16 (1) : 26-29</p> MA Rahman MSH Sheikh MI Siddique KM Morshed AKM Ahsan Ullah Md Shahidul Islam ##submission.copyrightStatement## 2013-04-05 2013-04-05 16 1 26 29 10.3329/jss.v16i1.14444 Stapled Haemorrhoidopexy - the better option for surgical treatment of idiopathic haemorrhoids- 30 Our experience in BSMMU <p><strong>Objective:</strong> Idiopathic haemorrhoidal disease is a common problem in colorectal practice. Conventional open haemorrhoidectomy is associated with significant pain and an open wound for a long time to heal interfering normal day to day activities. Stapled haemorrhoidopexy is expected to have less pain and without a wound. This study reflects our experience with stapled haemorrhoidopexy in our population.</p> <p><strong>Methods</strong>: Two hundred consecutive patients with primary haemorrhoidal disease of different degrees underwent stapled haemorrhoidopexy in BSMMU since January 2009 to April 2011. All the patients were evaluated by history, clinical examination and Proctosigmoidoscopy. With adequate preoperative preparation they underwent stapled haemorrhoidopexy under spinal anaesthesia. They were followed up post-operatively for a median 2 months duration.</p> <p><strong>Results:</strong> Male to female ratio was 3.76:1 with median age of 35 years (range: 11-90 years). Median hospital stay was 2 days (24 hours-5 days) and longest 5 days after operation. 14 patients had 1st degree haemorrhoids, 66 patients had 2nd degree haemorrhoids, 104 patients had 3rd degree haemorrhoids and 16 patients had 4th degree haemorrhoids. Median time for the procedure was 25 minutes. Urgency of defecation was complained by 46 patients who ultimately felt comfortable within 2-4 weeks. 6 patients complained of annorectal pain who responded to conventional analgesics. Rest of the patients available after 8 weeks follow up were found to be fully satisfied.</p> <p><strong>Conclusion:</strong> Contrary to open haemorrhoidectomy this procedure is associated with least chance of anal incontinence because of preservation of normal anal cushion. It can safely be concluded that stapled haemorrhoidopexy is a better option in treating primary haemorrhoidal disease.</p> <p>DOI: <a href=""></a></p> <p>Journal of Surgical Sciences (2012) Vol. 16 (1) : 30-34</p> Md Shahadot Hossain Sheikh Md Ibrahim Siddique Md Atiar Rahman Samia Mubin Kazi Nasid Naznin Md Saiful Islam ##submission.copyrightStatement## 2013-04-05 2013-04-05 16 1 30 34 10.3329/jss.v16i1.14445 Management of Intrathoracic Sepsis- A Review Article <p>DOI: <a href=""></a></p> <p>Journal of Surgical Sciences (2012) Vol. 16 (1) : 35-38</p> Mostafizur Rahman Omar Sadeque Khan ##submission.copyrightStatement## 2013-04-05 2013-04-05 16 1 35 38 10.3329/jss.v16i1.14446 Primary closure of the Urinary Bladder, Urethra and Anterior Abdomen of Classical and Cloacal 39 Exstrophy - A Preliminary Experience of Three Consecutive Cases <p>A 4 years old female and 1.5 months old male with classical exstrophy and a 2 days old male child with cloacal exstrophy were admitted in Paediatric Surgery Department of Sher-e-Bangla Medical College Hospital (SBMCH), Barisal. The mothers of all children had complaints of protrusion of fleshy mass in lower abdomen from birth. They always remain wet producing smell of urine.</p> <p>The cloacal exstrophy case had a prolapsed ileum that was discharging stool. He had no anus too.</p> <p>All of the cases underwent one stage closure of urinary bladder and urethra and lower abdomen without osteotomy and patient was discharged. After 8 months of first operation the female patient underwent repair of the wound dehiscence. At the time of discharge her urinary bladder capacity was 10 ml and remained dry for 5 minute after manual evacuation. The male patient with classical exstrophy developed urethrocutaneous fistula on 15th post-operative day. The cloacal exstrophy case was discharged with end ileostomy on 10th post-operative day.</p> <p>DOI: <a href=""></a></p> <p>Journal of Surgical Sciences (2012) Vol. 16 (1) : 39-43</p> AK Mostaque MS Huq T Islam SM Haque MM Rahman ##submission.copyrightStatement## 2013-04-05 2013-04-05 16 1 39 43 10.3329/jss.v16i1.14447 Penile Fracture Due to Manipulation <p>A 24 year old young patient presented in the emergency department of Shaheed Monsur Ali Medical College Hospital, Uttara, Dhaka with swollen, curved and flaccid penis after forceful bending of his erect penis. The patient was anxious with normal vital sign. Rolling sign was positive. There was no bleeding at external urethral orifice, scrotum &amp; testicle were found normal. On the above facts, penile fracture was diagnosed clinically. The penis was degloved upto the root of the penis &amp; after evacuation of the haematomas, transverse tears were detected in Bucks fascia &amp; tunica albugenia of the left corpus cavernosum, which were repaired by interrupted suture. In the post operative period sedative was given &amp; recovery was uneventful. The aim of this case report is to increase the awareness of the condition which should be regarded seriously and treated expeditiously and to draw attention to its possible complications.</p> <p>DOI: <a href=""></a></p> <p>Journal of Surgical Sciences (2012) Vol. 16 (1) : 44-46</p> KABM Taiful Alam Md Sayedul Islam Toufiqul Haque Shamim Hossain Tazul Islam Humayun Rashid Md Atiqur Rahman ##submission.copyrightStatement## 2013-04-05 2013-04-05 16 1 44 46 10.3329/jss.v16i1.14448 Asymtomatic Angiomyolipoma of the Right Adrenal Gland <p>Angiomyolipoma are commonly found in Kidney but extrarenal sites are also mentioned. It arising in adrenal is very rare entity, usually asymptomatic, diagnosed incidentally on radiological investigation of abdomen for other conditions. We report our experience with a 37-year-old man who presented with sudden feeling of jerking discomfort and generalized weakness. An USS showed adrenal mass, computerised tomography (CT) scan confirmed and outlined the adrenal mass.Adrenalectomy was performed and the histopathological features confirmed the diagnosis of adrenal angiomyolipoma. The patient recovered without any complications following surgery.</p> <p>DOI: <a href=""></a></p> <p>Journal of Surgical Sciences (2012) Vol. 16 (1) : 47-48</p> I Monowarul ATM Amanullah AKMK Alam ##submission.copyrightStatement## 2013-04-05 2013-04-05 16 1 47 48 10.3329/jss.v16i1.14449 Sebaceous Carcinoma of Scalp- Rare Skin Cancer - A Case Report <p>DOI: <a href=""></a></p> <p>Journal of Surgical Sciences (2012) Vol. 16 (1) : 49-51</p> Md Burhan Uddin Khan Abul Kalam Md Nazrul Islam Farhana Amin ASM Qamrul Hasan ##submission.copyrightStatement## 2013-04-05 2013-04-05 16 1 49 51 10.3329/jss.v16i1.14450