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9.Salim M Albassam:ACUTE APPENDICITIS, IS IT POSSIBLE TO CURE WITHOUT SURGERY؟

Author: 9.Salim M Albassam
Journal: Basrah Journal of Surgery مجلة البصرة الجراحية ISSN: 16833589 / ONLINE 2409501X Year: 2014 Volume: 20 Issue: 2 Pages: 102-105
Publisher: Basrah University جامعة البصرة

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Abstract

The aim of this trial is to evaluate the protocol of treating selected cases of adult acute appendicitis by non-surgical measures. Appendicitis is the most common cause of acute abdomen, for many years the adapted treatment of this disease is by immediate surgery to avoid the serious morbidity and mortality, now a small study suggest that using non-surgical treatment using antibiotic may give same result in curing patients and avoidance of surgery may eliminate the possible morbidity and even mortality in selected patients. This is a prospective non-randomized study of 84 adult patients with acute appendicitis, clinically diagnosed, from both genders were treated in Basra General Hospital from 2005-2009, by intravenous anti biotic, nothing by mouth and clinical monitoring. From the 35 female patients, only six cases did not show clinical improvement, surgery revealed perforated appendicitis in two, pathology other than appendicitis in four (salpingitis, ectopic gestation, ruptured graafian follicle, twisted ovarian cyst respectively). From the 49 male patients, five cases did not show clinical response, operations showed gangrenous and perforated appendicitis in two, other pathology in three (pelvic lymphadenitis, gastroenteritis and urinary tract infection). In conclusion, the non operative regime for treatment of early acute appendicitis is successful, it can be used to treat certain types of patients including high risk patients and when surgical facilities are not available.

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11- LAPAROSCOPIC CHOLECYSTECTOMY, TRUE OUTPATIENT PROCEDURE (Is it possible to shorten the hospital stay?)

Authors: Hamid Boserwel --- Salim M ALBassam --- Abdulhadi Mossa Mohamad
Journal: Basrah Journal of Surgery مجلة البصرة الجراحية ISSN: 16833589 / ONLINE 2409501X Year: 2009 Volume: 15 Issue: 1 Pages: 67-71
Publisher: Basrah University جامعة البصرة

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Abstract

Laparoscopic cholecystectomy is currently considered the gold standard for the managment ofgallbladder stones. Many hospitals have employed short stay wards for monitoring patients aftersurgery. The meaning of the early discharge as true outpatient surgery is controversial. Toachieve this objective there is a need to shorten the hours of hospital stay by: Appropriateselection criteria and discharge protocol, Peroperative technical modification and manipulation,Procedures to control pain, nausea and vomiting. This study was carried at EndosurgeryCentre, Ibensena University Hospital, Sirte, libya.


Article
8- LAPAROSCOPIC CHOLECYSTECTOMY IN SICKLE CELL DISEASE: IS IT A SAFE PROCEDURE?

Authors: Hashim S Alkhayat --- Jassim H Salim --- Mohammad M Mohammad --- Salim M Albassam
Journal: Basrah Journal of Surgery مجلة البصرة الجراحية ISSN: 16833589 / ONLINE 2409501X Year: 2011 Volume: 17 Issue: 1 Pages: 54
Publisher: Basrah University جامعة البصرة

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Abstract

Salim M Albassam*, Mohammad M Mohammad@, Jassim H Salim@&Hashim S Alkhayat@*Department of surgery, Basrah Medical College, Iraq. @Department of surgery, Basrah GeneralHospital, Iraq.Correspondence to: Dr. Salim M Albassam, e-mail: albassamsalim@yahoo.caAbbreviation: Hb= Hemoglobin. ACS = Acute Chest Syndrome. ASA = American Society of AnesthesiologistsAbstractThe aim of this trial is to determine the safety of laparoscopic cholecystectomy for treatment ofgall bladder stones in patients with sickle cell anemia (a controversial issue). Sixty patients fromboth sexes, between 19-35 years old with sickle cell anemia, all of them having gall bladderstones were included in this study in Endosurgery Center in Basrah General Hospital. Thepatients were divided into three groups, group one (19 patients) were selected for laparoscopiccholecystectomy on random preoperative background, the same thing was applied in group two(21 patients) whose patients were subjected to open cholecystectomy while patients in groupthree (20 patients) were selected for laparoscopic cholecystectomy on conditioned selection.Three mortalities and two serious morbidities were encountered in the group one and one mildmorbidity seen in group two and no mortalities or morbidities in group three. Laparoscopiccholecystectomy in sickle cell patients is a debatable issue, an increasing controversy aboutserious perioperative and postoperative morbidity were mentioned. The procedure itself wasaccused and an entirely opposed results were emerged from different studies all are debatable.In this study we noticed the big influence of the risk factors, preparation of patients for surgeryand the adherence to the principle anesthetic rules on the outcome after laparoscopiccholecystectomy in patients with sickle cell disease. This influence was limited in openprocedure. The controversy in the different trials lies on wither the problem is confined to thedisease itself or to the surgical method used for cholecystectomy or both.According to the results obtained from our study we believe that both the severity of the diseaseand the surgical procedure affecting the results, application of intra and post operative protocol(blood transfusion if Hb less than 9gm/dI, rehydration, oxygenation and respecting generalanesthesia rules are mandatory for the safety of the patients.

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