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Article
Mini-Cholecystectomy

Author: Nezar A. Al-Mahfooz
Journal: Basrah Journal of Surgery مجلة البصرة الجراحية ISSN: 16833589 / ONLINE 2409501X Year: 2003 Volume: 9 Issue: 1 Pages: 123-126
Publisher: Basrah University جامعة البصرة

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Article
MICROLAPAROSCOPY (Needlescopic Laparoscopy)‎

Author: Nezar A. Al-Mahfooz
Journal: Basrah Journal of Surgery مجلة البصرة الجراحية ISSN: 16833589 / ONLINE 2409501X Year: 2004 Volume: 10 Issue: 2 Pages: 113-118
Publisher: Basrah University جامعة البصرة

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Article
ELECTRO-CAUTERY VERSUS SCALPEL INCISION IN ABDOMINAL SURGERY

Authors: Nezar A. Al-Mahfooz --- Ahmed M. Taha Al-Abayachii
Journal: Basrah Journal of Surgery مجلة البصرة الجراحية ISSN: 16833589 / ONLINE 2409501X Year: 2005 Volume: 11 Issue: 1 Pages: 31-37
Publisher: Basrah University جامعة البصرة

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Abstract

Electrocautery is used increasingly for tissue dissection; fears of excessive scaring and poor wound healing curtailed its use for skin incisions. This study compared electrocautery incision with traditional scalpel incision for abdominal operations in general surgery. Two groups of 62 patients in each were compared prospectively, in one of them electrocautery knife used and in the other traditional scalpel used to incised the abdominal wall layers starting from the skin. Parameters measured included, the time needed to complete the incision with all the necessary hemostasis, the wound length, the macroscopic tissue response, the incidence of infection, the final tissue scar. The electrocautery knife is quicker than the traditional scalpel 4.2Cm/Minute in electrocautery knife versus 2.7Cm/Minute in scalpel; there was little increase in macroscopic tissue response in the first 3-4 days, which do not differ in both groups in the 4th5th day. There was no difference in the incidence of infection and the final scar after one year between the two groups. Electrocautery can be used as alternative to scalpel in creating abdominal skin incisions, with the advantages of shortening the time, and decreasing the blood loss without affecting wound healing or incidence of infection and the scar formation. Incidence.

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ELECTRO-CAUTERY


Article
Mesh Hernioplasty for Inguinal Hernias

Authors: Wala’ N. Majeed --- Nezar A. Al-Mahfooz --- Wadhah M. Al-Badir
Journal: Basrah Journal of Surgery مجلة البصرة الجراحية ISSN: 16833589 / ONLINE 2409501X Year: 2002 Volume: 8 Issue: 2 Pages: 190
Publisher: Basrah University جامعة البصرة

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Abstract

A prospective study was performed at Saddam Teaching Hospital in Basrah over a thirteen months period to evaluate the use of mesh hernioplasty for repairing inguinal hernias. Forty-eight patients with inguinal hernias repaired electively with mesh hernioplasty. The age distribution was (17–79) years. Three of them were diabetics, three hypertensive, two with chronic obstruction airway diseases and one with bleeding tendency. Perioperatively, the hernias were classified according to Gilbert's classification. Forty-seven primary hernias repaired according to Lichtenstein technique and one through preperitoneal approach (recurrent hernia). Forty-six hernias repaired under general anaesthesia and two under local anaesthesia. Prophylactic antibiotic was given as a single dose at induction of anaesthesia and a single postoperative dose. There were thirty patients (62.5%) indirect hernias, thirteen patients (27%) of direct hernias, five patients (10.4%) of pantallon type. The mesh used was polypropylene either as plug in one patient (2%) or plug with on-lay mesh in thirty-three patients (68.75%) or as on-lay mesh in fourteen patients (29.1%). In six patients closed suction drainage used if there was unsatisfactory haemostasis, there were few post operative complications, all patients complained of mild postoperative pain that did not require strong analgesia. No urinary difficulty detected. Six patients (12.5%) developed scrotal oedema mainly at the beginning of the study, one scrotal haematoma (2%), four (8.3%) wound seroma and one (2%) superficial wound infection, neither chronic sinus nor orchitis. No recurrence with a follow up period of 2 – 12 months were recorded

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Article
Chemical Sphincterotomy for Anal Fissure

Authors: Kadhim H. Al-Temimy --- Nabeel A. J. Ali --- Nezar A. Al-Mahfooz
Journal: Basrah Journal of Surgery مجلة البصرة الجراحية ISSN: 16833589 / ONLINE 2409501X Year: 2003 Volume: 9 Issue: 1 Pages: 78-83
Publisher: Basrah University جامعة البصرة

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Abstract

Six hundred and forty patients (65 of them were children) with acute and chronic anal fissure were randomized to receive topical 0.2%-0.8% Glyceryl trinitrate (G.T.N.) or Isosorbide dinitrate (ISDN) 1%-3% three times daily digitally applied ointment. Patients were followed for 6-26 months. A course of 2-6 weeks treatment was needed. Resting and maximum anal sphincter pressure (MARP) were measured by manometry for 40 patients and showed a very significant decrease in maximum anal sphincter pressure after application of ointment with progress of days of treatment (p =0.02). After 1-2 weeks of treatment 90.4% of acute fissure patients were free of symptoms and 83.73% of them were later cured. Four to eight weeks of treatment were needed to abolish pain in 85.5% chronic fissure patients, and cure was clear in 80% of them (p = 0.008). Side effects of treatment were negligible. Recurrence rate was 4%, while 24 patients (3.8%) were sent for internal sphincterotomy and 81 patients (12.6%) requested revision of medical treatment. In this study we concluded that surgery can be avoided in most cases of anal fissure, and it kept for recurrent cases. Recurrent cases after surgery can also be treated medically

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Article
5- BEST METHOD TO MINIMIZE POST APPENDECTOMY WOUND INFECTION

Authors: The late Haider T Al-Baaj --- Issam Merdan --- Nezar A Al-Mahfooz
Journal: Basrah Journal of Surgery مجلة البصرة الجراحية ISSN: 16833589 / ONLINE 2409501X Year: 2008 Volume: 14 Issue: 1 Pages: 19-22
Publisher: Basrah University جامعة البصرة

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Abstract

Despite numerous methods of wound care post appendectomy, no definite technique documentedto be the best. Wound irrigation under pressure with syringe is regarded recently as anacceptable physical and biological way to prevent post appendectomy wound infection. Thisstudy compares the best of several method of wound infection prevention on 418 patients subjectedto appendectomy and divided in different groups, including the use of systemic antibiotic,local antibiotic, povidone iodine, and saline pressure irrigation. We concluded that: syringepressure irrigation to the wound significantly decrease post operative infection, and isbest incomparison to other methods.

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Article
INTRAOPERATIVE IMPRINT CYTOLOGY ‎

Author: Nezar A. Al-Mahfooz*, Jasim M. Al-Diab@ and Rafid Abdul-Jabbar ‎Mohammed#‎
Journal: Basrah Journal of Surgery مجلة البصرة الجراحية ISSN: 16833589 / ONLINE 2409501X Year: 2004 Volume: 10 Issue: 2 Pages: 26-29
Publisher: Basrah University جامعة البصرة

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Abstract

A prospective study was conducted on 60 specimens; 33 breast lumps and 27 lymph nodes, to assess the value of ‎intraoperative imprint cytology as an aid in surgical decision especially in the absence of the facility of frozen ‎section examination. Imprint cytological examinations were done intraoperatively by a single pathologist. The ‎results were ready after a period of 15-25 minutes. In all 60 specimens, 50 (83%) were correctly diagnosed, 8 were ‎diagnosed as suspicious of malignancy and 2 were misdiagnosed.‎The sensitivity was 97%, the specificity was 94.4% and the accuracy rate was 96.1%. We concluded that imprint ‎cytology is a very simple technique and it remains a useful and cost effective tool, can aid in the surgical decision.‎

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