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Article
ROUX-EN-Y ESOPHAGOJEJUNOSTOMY AFTER TOTAL GASTRECTOMY FOR GASTRIC MALIGNANCY …51

Authors: HASHIM S KHAYAT --- SAFWAN A TAHA
Journal: Basrah Journal of Surgery مجلة البصرة الجراحية ISSN: 16833589 / ONLINE 2409501X Year: 2006 Volume: 12 Issue: 2 Pages: 51-56
Publisher: Basrah University جامعة البصرة

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Abstract

ROUX-EN-Y ESOPHAGOJEJUNOSTOMY AFTER TOTAL GASTRECTOMY FOR GASTRICMALIGNANCY.Hashim S Khayat# & Safwan A Taha**CABS. Professor, Dept. of Surgery, University of Basrah, College of Medicine; #FRCS Ed. Consultant Surgeon and Chairman, Basrah General Hospital, Basrah; IRAQ.AbstractOut of 62 patients who underwent total gastrectomy for gastric malignancy, 40 patients had roux-en-y esophagojejunostomy. Their age ranged from 32 to 70 years. Seventeen patients were less than 60 years old and 27 were older. There were 23 males and 17 females. Operations were done through thoraco-abdominal incisions in 28 patients and upper midline incisions in 12. The anastomoses, on the other hand, were hand sewn in 34 patients and stapled in the other 6. The procedure included splenectomy in 37 patients, distal pancreatectomy in 6 and transverse colectomy in 2 patients. Postoperative complications included chest infection (8 patients), wound infection (7 patients) and anastomotic leak (1 patient). Eleven patients died postoperatively, the leading cause being pulmonary embolism, respiratory failure and over-whelming sepsis. Out of our surviving patients, 4 (10%) are still alive 5 years or more after surgery and are enjoying good health. Our results are well within the international figures although we think that the outlook could have improved had we gained access to certain facilities like hyperalimentation, chest physiotherapy units and measures that could prevent deep venous thrombosis. Roux-en-y esophagojejunostomy is a safe method to restore the continuity of the alimentary tract after gastrectomy. It requires less time than “pouch-forming” procedures, has less incidence of anastomotic leakage, produces acceptable morbidity and mortality, gives good nutritional value and does not require the special expertise needed to perform the “pouch-forming” procedures.

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Article
13- HEPATIC TUBERCULOSIS: A REPORT OF TWO CASES

Authors: Mohammed H Saeed --- Hashim S Khayat
Journal: Basrah Journal of Surgery مجلة البصرة الجراحية ISSN: 16833589 / ONLINE 2409501X Year: 2008 Volume: 14 Issue: 1 Pages: 62-65
Publisher: Basrah University جامعة البصرة

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Abstract

During the second half of the 20th century, as a result of improved nutrition, reduced crowding,public health measures, and effective chemotherapy, a dramatic decrease in the incidence oftuberculosis was seen in the world. But in recent years, increased incidence of tuberculosis hasbeen attributed to several causes, including AIDS epidemic, intravenous drug abuse andincrease in the number of immunocompromised. Hepatic tuberculosis is the most commonmanifestation of upper abdominal parenchymatous organ tuberculosis and its incidence hasbeen increasing. Lack of familiarity with this condition was apparently responsible for thediagnosis of hepatic tuberculosis being made at autopsy or surgery in the past. Sincetuberculosis remains a potentially curable disease, an awareness of its protean manifestationsis essential.

Keywords

HEPATIC --- TUBERCULOSIS


Article
ENTERAL TUBE FEEDING AFTER SURGERY FOR UPPER GASTROINTESTINAL MALIGNANCIES

Authors: Hashim S Khayat --- Jawad R. Khersani --- Jawad R. Khersani --- Talaat S Shani
Journal: Basrah Journal of Surgery مجلة البصرة الجراحية ISSN: 16833589 / ONLINE 2409501X Year: 2005 Volume: 11 Issue: 1 Pages: 67-72
Publisher: Basrah University جامعة البصرة

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Abstract

Patients with major upper gastrointestinal (UGI) resections that were made nil by mouth for 7-10 days postoperatively with pre-existing weight loss and depleted energy reserves in addition to increased metabolic rate needs nutritional support which serves to shorten the postoperative recovery phase and minimizes the number of complications. This may be supplemented by total parenteral nutrition (TPN) which is not available in our hospitals for over a decade. This problem led us to use a feeding jejunostomy tube after major resections for UGI malignancies.This is a prospective study conducted between May 1999 and December 2004 at First Surgical Unit, Basrah General Hospital. The study aimed to examine the efficacy of Enteral Tube Feeding (ETF) as a method of nutritional support in patients with major resections for UGI malignancies.A total of 76 patients, 42 males and 34 females. Mean age, 50 years (range, 27-72 years) underwent major UGI resections for gastric(64), oesophageal (10) and pancreatic(2) malignancies. ETF lasted for 12-41 days with diarrhoea and abdominal discomfort were the major complications in 14 and 8 patients respectively. .Diarrhoeal tolerance was established in 12 out of 14 patients and controlled in the other two by antidiarrhoeal drugs. There were improved body weight and serum albumin level after ETF and no septic complications or related mortality. ETF is a safe, feasible, cost effective, with few controllable complications rendering it a satisfactory alternative to total parenteral nutrition.

Keywords

ENTERAL --- TUBE --- FEEDING


Article
ENTERAL TUBE FEEDING AFTER SURGERY FOR UPPER GASTROINTESTINAL MALIGNANCIESIVE STUDY0

Authors: Hashim S Khayat --- Jasim D Saud --- Jawad R. Khersani --- Talaat S Shani
Journal: Basrah Journal of Surgery مجلة البصرة الجراحية ISSN: 16833589 / ONLINE 2409501X Year: 2005 Volume: 11 Issue: 1 Pages: 67-72
Publisher: Basrah University جامعة البصرة

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Abstract

Patients with major upper gastrointestinal (UGI) resections that were made nil by mouth for 7-10 days postoperatively with pre-existing weight loss and depleted energy reserves in addition to increased metabolic rate needs nutritional support which serves to shorten the postoperative recovery phase and minimizes the number of complications. This may be supplemented by total parenteral nutrition (TPN) which is not available in our hospitals for over a decade. This problem led us to use a feeding jejunostomy tube after major resections for UGI malignancies.This is a prospective study conducted between May 1999 and December 2004 at First Surgical Unit, Basrah General Hospital. The study aimed to examine the efficacy of Enteral Tube Feeding (ETF) as a method of nutritional support in patients with major resections for UGI malignancies.A total of 76 patients, 42 males and 34 females. Mean age, 50 years (range, 27-72 years) underwent major UGI resections for gastric(64), oesophageal (10) and pancreatic(2) malignancies. ETF lasted for 12-41 days with diarrhoea and abdominal discomfort were the major complications in 14 and 8 patients respectively. .Diarrhoeal tolerance was established in 12 out of 14 patients and controlled in the other two by antidiarrhoeal drugs. There were improved body weight and serum albumin level after ETF and no septic complications or related mortality. ETF is a safe, feasible, cost effective, with few controllable complications rendering it a satisfactory alternative to total parenteral nutrition.

Keywords

ENTERAL --- TUBE --- FEEDING --- MALIGNANCIESE


Article
PREOPERATIVE GABAPENTIN IN LAPAROSCOPIC CHOLECYSTECTOMY

Authors: Mohammed H Saeed --- Anna W Krikor --- Zaineb A Yaquob --- Mustafa W Yihya --- et al.
Journal: Basrah Journal of Surgery مجلة البصرة الجراحية ISSN: 16833589 / ONLINE 2409501X Year: 2013 Volume: 19 Issue: 1 Pages: 24-29
Publisher: Basrah University جامعة البصرة

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Abstract

Facts in gabapentin use are known about its effect on neuropathic pain management while its clinical significance as analgesic in laparoscopic cholecystectomy has not been studied much to clarify its importance and to know how and when it could be used or if this new analgesic strategy can be an alternative to others or be as a part of multimodal analgesic therapy in postoperative management. We conducted a prospective study to evaluate the significance of pre-emptive single dose gabapentin to reduce postoperative pain following laparoscopic cholecystectomy. Study group of hundred patients were analyzed in prospective study; Fifty of them were gabapentin group and another fifty were placebo group. Age, sex, body mass index, operation time and length of hospital stay were comparable in both groups. Analgesic requirements were recorded and pain assessment using 100 visual analogue scale in both groups were studied at three times intervals of 8,12 and 24 hours after surgery. In addition we studied the incidence of certain postoperative side effects in both groups as nausea, vomiting and drowsiness. Age, sex, body mass index, operation time and hospital stay were comparable in both groups.Opioid requirement two hours after surgery was significantly lower in gabapentin group than in placebo group (p<0.05). Also, significant difference was seen between gabapentin and placebo groups concerning the pain scores which were seen more in placebo as compared with gabapentin group in all study intervals (p<0.05). Significant difference between gabapentin and placebo groups was noticed regarding number of analgesic doses administered on the first 24 hours postoperatively which were more in placebo group (p<0.05). Insignificant difference was seen between gabapentin and placebo groups concerning certain postoperative side effects as nausea, vomiting and drowsiness (p>0.05). In conclusion, our work shows that a single preoperative dose of gabapentin has a significant effect on postoperative pain after a laparoscopic cholecystectomy.

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Article
EARLY COMPLICATIONS FOLLOWOING LAPAROSCOPIC CHOLECYSTECTOMY IN BASRAH GENERAL HOSPITAL
المضاعفات المبكرة ما بعد عملية استئصال المرارة بالناظور في مستشفى البصرة العام

Author: Hashim S Khayat, Jawad Ramadhan Fadhl, Hisham Salman د.هشام الخياط ,د.جواد رمضان فاضل ,د.هشام سلمان
Journal: Thi-Qar Medical Journal مجلة ذي قار الطبية ISSN: 19929218 Year: 2014 Volume: 8 Issue: 1 Pages: 94-108
Publisher: Thi-Qar University جامعة ذي قار

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Abstract

ABSTRACT:Background: Gall stone disease is one of the commonly encountered diseases among the general population. Laparoscopic cholecystectomy has been replaced open surgery and it is now considered the "golden standard". Numerous complications might be encountered.Objectives: To assess and evaluate the specific early postoperative complications and its management and to assess the factors that might influence the development of such complication.Patients and methods: A prospective consecutive observational study was conducted in Basrah General Teaching Hospital from January 2011 to December 2011. All adult patients with symptomatic gall stone were included in this study. The entire demographic, preoperative, operative and postoperative patient's data were collected and evaluated.Results: A 546 patients were underwent laparoscopic cholecystectomy during the study period, 454(83.2%) were female and 92(16.8%) were males. The mean age were 40 years+/- 13.7. Gall bladder perforation with bile leak(with or without gall stone spillage) was the commonest intraoperative complication that occurred in 49(8.97%) patients. Intraoperative bleeding reported in 26(4.76%) patients. Intraoperative bile leak reported in 2(0.36%) patients. The conversion rate was 4.76% (26 patients).The commonest postoperative complication was wound related complication, which was reported in 13 (2.38%) patients. Using logistic regression analysis, we found that the age < 60years, male sex , acute gall bladder status, operation time < 60 min and usage of drain were influenced the development of intraoperative complication on the other hand all the factors failed to affect the development of postoperative complication.

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