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Article
Coblation versus dissection tonsillectomy in children
Coblation مقابل تشريح اللوزتين عند الأطفال

Authors: Moyaser Abdul-Rahman Yaseen --- Sermed Ebdollatif Tahyr
Journal: Zanco Journal of Medical Sciences مجلة زانكو للعلوم الطبية ISSN: 19955588/19955596 Year: 2018 Volume: 22 Issue: 1 Pages: 25-31
Publisher: Hawler Medical Univeristy جامعة هولير الطبية

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Abstract

Background and objective: Tonsillectomy is the surgical procedure of removing the tonsils. Various methods of tonsillectomy have been practiced aimed at decreasing or eliminating intraoperative and postoperative morbidity. This study was conducted to determine the different outcomes of tonsillectomy surgery in both coblation and dissection techniques.Methods: A prospective control study was conducted with a total sample size of 66 patients. Each patient underwent tonsillectomy by using ArthroCare Coblator on the right side and dissection method on the left side. Children between the age of 3-12 years old were selected with indications of recurrent tonsillitis and/or kissing tonsil causing snoring and/or sleep apnea. Children with peritonsillar abscess, malignancy, bleeding disorder were excluded. Operative time and blood loss, postoperative pain, bleeding and healing process were compared between two methods. Operations performed by the same surgeon.Results: The intraoperative time was significantly shorter (P <0.001) and intraoperative blood loss was significantly lesser (P <00.01) in coblation as compared to dissection tonsillectomy, while there were no significant differences in the postoperative pain scores on 1st, 2nd, 7th and 14th postoperative days. There was a significant healing process in tonsillar fossa in favor of coblation rather than dissection. No primary or secondary postoperative bleeding was reported.Conclusion: Coblation tonsillectomy is a safe procedure with significantly less intraoperative time and less blood loss and better surgical wound healing with similar postoperative pain in comparison with dissection tonsillectomy.


Article
THE EFFECT OF LIMITED VERSUS EXTENDED AXILLARY LYMPH NODES DISSECTION IN THE DEVELOPMENT OF POST-MASTECTOMY MORBIDITY

Author: Ahmed N Abdulnabi
Journal: Basrah Journal of Surgery مجلة البصرة الجراحية ISSN: 16833589 / ONLINE 2409501X Year: 2019 Volume: 25 Issue: 1 Pages: 56-60
Publisher: Basrah University جامعة البصرة

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Abstract

THE EFFECT OF LIMITED VERSUS EXTENDED AXILLARY LYMPH NODES DISSECTION IN THE DEVELOPMENT OF POST-MASTECTOMY MORBIDITY Ahmed N Abdulnabi MB,ChB, CABS, Specialist of General Surgery, AL-Fayhaa Teaching Hospital, Basrah, IRAQ. Abstract Breast cancer is a common malignancy in female, modified radical mastectomy is widely used for the management of this tumour. Axillary lymph nodes dissection is accompanied by frequent postoperative morbidity including wound infection, paresthesia, seroma and upper limb lymphedema. This is a comparative study that was conducted to evaluate the frequency of postoperative morbidity in a limited and extended axillary lymph nodes dissection. One hundred and fifty patients were treated by modified radical mastectomy for invasive ductal carcinoma of the breast between January 2008 and October 2015 in Al-Fayhaa Teaching Hospital. This sample was divided into two groups; the first fifty patients were managed with limited N1 axillary dissection while the other one hundred patients with extended N2 axillary dissection. The postoperative morbidity in the form of wound infection, paresthesia, seroma formation and upper limb lymphedema were analyzed in respect to the N1 or N2 axillary lymph nodes dissection. The highest occurrence was in the age group between 36 and 45 years. Wound infection develops in 16% of patients in the first group and 12% in the second group. Seroma occurred in 20% in the first group and 23% in the second group. Paresthesia was obviously higher in the second group (19%) when compared with 4% in the first group. Lymphedema occurred more in the second group (26%), and less in the first group (4%). In conclusion, limited axillary lymph nodes dissection during modified radical mastectomy for patients with no or few axillary lymph nodes involvement is associated with low postoperative morbidity. Key words: Mastectomy,Axillary lymph nodes,Morbidity, Limited dissection, Extended dissection


Article
Electrocautery versus cold steel tonsillectomy comparison study

Authors: * Firas Baheej Abdul Aema , --- Laith Ali Mahmood Al-Tamimi
Journal: Al-Kindy College Medical Journal مجلة كلية الطب الكندي ISSN: 18109543 Year: 2019 Volume: 15 Issue: 1 Pages: 26-29
Publisher: Baghdad University جامعة بغداد

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Abstract

Objective: the objective of this study was to compare the intraoperative blood loss, intraoperative time, postoperative pain and secondary hemorrhage between electrodissection and cold steel dissection tonsillectomy.Methods: One hundred and six patients were enrolled in this study, the patients were randomly allocated into electrodissection group A (n=51) and cold steel dissection tonsillectomy group B (n=53). All patients are above 7 years and had history of recurrent tonsillitis and/or tonsillar hypertrophy with obstructive symptoms. Intraoperative parameters and postoperative outcome were assessed.Results: In group A patients had statically significant less operative time and blood loss than group B early postoperative pain was not differ significantly between the two groups, however late onset pain (pain on the 7th day) was significantly higher in group A. There was no significant difference between the groups regarding secondary hemorrhage.Conclusion: Electrodissection tonsillectomy is rapid, safe and effective method of tonsillectomy with obvious advantage of minimum perioperative blood loss, lower operative time and without early post-operative pain difference when compared to cold steel dissection tonsillectomy. Although it has some disadvantage of late postoperative pain.


Article
Limited Versus Complete Axillary Lymphatic Dissection as Part of The Overall Procedure of Modified Radical Mastectomy in The Management of Invasive Breast Cancer Patients

Authors: Musaa Faisal Al-Mahdawi --- Mustafa Adil Abbass --- Eman Mohammed Ali
Journal: Medical Journal of Babylon مجلة بابل الطبية ISSN: 1812156X 23126760 Year: 2016 Volume: 13 Issue: 1 Pages: 160 -166
Publisher: Babylon University جامعة بابل

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Abstract

Complete dissection of axillary lymph nodes (DALN) can be sidestepped in chosen cases of invasive breast cancer patients with confined lymph nodal disease and having conventional breast surgery, nevertheless, for node positive mastectomy patients, complete dissection of axillary lymph nodes remains the model procedure, Avoidance of complete dissection of axillary lymph nodes is reliable in many node-positive patients and can be substituted with limited axillary lymph node dissection which consists of elimination of Sentinel lymph nodes and other grossly palpable lymphatics without further axillary devastation. A prospective study of 55 women patients diagnosed with invasive breast cancer underwent mastectomy with conservative dissection of axillary lymph nodes between September 2012 and December 2014 in Al-yarmouk teaching hospital and private hospitals in Baghdad, the recorded information included patient age, menstrual history, drug history, family history, tumour staging, number of axillary lymph nodes excised, postoperative medical therapy, adjuvant radiotherapy, recurrence and local complications including lymphedema, Fifty five patients underwent mastectomy with limited axillary lymph node dissection, all are females, the mean age was 38 years, 43 patient (78.2%) were invasive ductal carcinoma and 12 patients (21.8%) invasive lobular carcinoma, the mean follow-up period was 2 years, a mean number of eight lymph nodes were removed, there were 1 patients (1.8) % with local chest wall recurrence but no single case of axillary recurrence. Lymphedema development occurred in 2 patients (3.6%) and was associated with significant number of the removed lymph nodes (P=0.05) and postoperative radiotherapy (P=0.005).


Article
ULTRASONIC DISSECTION VERSUS CONVENTIONAL LIGATION COAGULATION IN THYROIDECTOMY

Author: Abdulameer Muhsin Aldaraji
Journal: Basrah Journal of Surgery مجلة البصرة الجراحية ISSN: 16833589 / ONLINE 2409501X Year: 2017 Volume: 23 Issue: 1 Pages: 66-75
Publisher: Basrah University جامعة البصرة

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Abstract

ULTRASONIC DISSECTION VERSUS CONVENTIONAL LIGATION COAGULATION IN THYROIDECTOMYAbdulameer Muhsin AldarajiMB, ChB, FICMS, General Surgeon, Al-Faiha General Hospital, Basrah, IRAQ.Abstract Ligation and diathermy coagulation was the standard method of hemostasis in thyroid surgery for more than a century. New hemostatic techniques were developed in the 1990th. Ultrasonic dissector used for the first time in thyroidectomy in 1999 by Tokami. Many studies compared the conventional method of thyroidectomy with new ultrasonic dissector technique. These studies found many advantages of the new method including reduction of operative time, shorter incision, decrease blood loss, decrease post operative drainage, shorten hospital stay and decrease complications. This study compared the two methods of hemostasis regarding incision length, operative time and complications. Between March 2012 and March 2015, 143 patients underwent open thyroidectomy involved in a prospective study at Al-Faiha General Hospital. The patients were divided into 2 groups: Group 1, conventional thyroidectomy technique(clamp, tie and diathermy coagulation) included 104 patients. Group 2, ultrasonic dissection technique (sutureless thyroidectomy) included 39 patients. The patient characteristic and postoperative complications were reported. The incision length and the operative time was measured. All patients underwent surgery by the routine pre tracheal strap muscle cutting transeversly (not splitting). In group 2, the ultrasonic dissector was used in strap muscle cutting, sealing &section of the blood vessels and in the final resection of the gland. The surgical incision length and operative time were compared in both groups. In lobectomy, there was no significant reduction in the length of incision with use of ultrasonic dissector( z value<1.96)(p >0.05), while in subtotal, total or near total thyroidectomy there was significant reduction in the length of incision (p value<0.05) with use of ultrasonic dissector. There was significant reduction of operative time (p value<0.05) in lobectomy and total or near total thyroidectomy with use of ultrasonic dissector as compared to conventional thyroidectomy technique. There was no significant difference in the complications in both techniques apart from increased incidence of temporary recurrent laryngeal nerve paralysis in ultrasonic dissector technique (9.2% in USDT v s 3.7% in CT of thyroidectomy). This study found significant reduction of the surgical incision size similar to that obtained by Fabrizo who stated that thyroidectomy can be done with shorter incision. This improve patient satisfaction and cosmetic outcome. The operative time was significantly reduced in lobectomy, total or near total thyroidectomy by the use of ultrasonic dissector technique(USDT) as compared to the conventional technique (CT){lobectomy 44 minutes vs 55 minutes, total thyroidectomy 57 minutes vs 80 minutes}. Similar results were obtained by many other studies such as Micoli et al & Siperstein et al. this may save utilization of operation theatre and decrease waiting list. The USDT is safe as far as the complication rate was similar to that of CT apart from increase the incidence of temporary recurrent laryngeal nerve paralysis. Many studies confirmed the safety of USDT such as that of Tokami, Micolli, Siperstein etc . In conclusion, thyroidectomy can be performed safely by the USDT with advantage of smaller incision & shorter operative time as compared to conventional technique.


Article
Use of cervicopectoral flap as an access for radical neck dissection and reconstruction of facial defects

Authors: Balsam S. abdulhamed بلسم عبد الحميد --- Bassem T. Merry
Journal: Journal of baghdad college of dentistry مجلة كلية طب الاسنان بغداد ISSN: 16800087 Year: 2012 Volume: 24 Issue: 4 Pages: 71-76
Publisher: Baghdad University جامعة بغداد

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Abstract

Background: The problem of reconstruction after surgical extirpation of head and neck cancer remain a cornerstone that produce unique challenges to surgeon; surface defects are often contiguous with oral cavity requiringboth lining and covering.Patients and methods: This study was conducted on 20 patients (13♂:7♀), age rang (28-80years), whom suffered frommalignant tumors in different sits in oro-facial region and salivary gland, to evaluate the C.P.F. as an access forcervical lymphadenectomy during treatment of head/neck malignant tumor and its use as immediatereconstruction for closing the defect resulted from tumor resection at the same procedure.Results and Conclusions: The C.P.F. was successfully covered the moderate and large size defect resulted from tumorablation in the neck region with successful esthetic and function results


Article

Authors: Ammar Hadi Khammas --- Mohammed Radef Dawood --- Yaseen Adeeb Sakran**, --- Azad Mohammed Abdullah***
Journal: Iraqi Academic Scientific Journal المجلة العراقية للاختصاصات الطبية ISSN: 16088360 Year: 2014 Issue: 1 Pages: 128-133
Publisher: The Iraqi Borad for Medical Specialization المجلس العراقي للاختصاصات الطبية

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Abstract

ABSTRACT:BACKGROUND: Tonsillectomy is one of the most commonly performed surgical procedures in otolaryngology. There are several operative methods currently in use, but the superiority of one over another has not been clearly demonstrated.OBJECTIVE:To compare intraoperative efficiency and postoperative recovery between dissection and coblation tonsillectomy. PATIENTS AND METHODS: This prospective clinical study was conducted at Rizgary teaching hospital/ Erbil,and Baghdad private hospitals from 29th November 2011 to 17th July 2012. The study included 100 patients who underwent tonsillectomy, half of them by coblation and the other half by cold dissection technique. Both techniques performed under general anesthesia. Each tonsillectomy technique was assessed intraoperatively for amount of blood loss, and duration of operation. Postoperatively they were assessed for pain, hemorrhage, and day of return to normal activity and normal diet.RESULTS: Duration of operations was significantly shorter for the coblation group versus the dissection group (17.7min vs. 22.3 min, P= 0.000). Intraoperative blood loss was statistically lower for the coblation versus the dissection group (45.3 ml vs. 74.7 ml, P = 0.003) There was statistically significant difference in daily pain scores and return to normal diet and activity between the two groups (mean 5.7 day for coblation vs. 7.32 day for the dissection, P= 0.001). And only two patients (4%) in coblation group developed secondary bleeding. CONCLUSION: Coblation tonsillectomy offers better operative speed, intraoperative hemostasis, less postoperative pain scores and faster recoveries than dissection tonsillectomy especially in pediatric age group.


Article
Perceptions of medical students undergoing cadaveric training
تصورات طلاب الطب الذين يخضعون لتدريب على الجثث

Author: Maaroof Tahseen Hassan
Journal: Zanco Journal of Medical Sciences مجلة زانكو للعلوم الطبية ISSN: 19955588/19955596 Year: 2016 Volume: 20 Issue: 1 Pages: 1160-1166
Publisher: Hawler Medical Univeristy جامعة هولير الطبية

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Abstract

Background and objective: Anatomy education is a principal subject within international medical and scientific curricula. Evidence based literature suggests that cadaver dissection is highly effective in establishing and retaining anatomy concepts. This study aimed to examine the perceptions of medical students about socio-cognitive aspects of dissection of human body in the Department of Anatomy at the College of Medicine, Hawler Medical University, Erbil. More specifically, the study tried to find out perceptions and level of satisfaction of medical students with engagement factors that improve positive satisfaction in learning. Methods: This is a descriptive cross-sectional study that included 169 first year medical students in the College of Medicine, Hawler Medical University. A self-administered questionnaire was distributed to the medical students during their practical anatomy sessions in the Department of Anatomy. Results: More than half of the students (55%) felt normal on their first exposure to dissection. Almost around half of the students (48.6%) had increased value for fellow humans following cadaveric training. More than 95% of them thought that improvement is needed in the cadaveric training. About 40% of the respondents had a good adaptation to cadaveric training. Conclusion: The traditional dissection laboratory must remain the center for teaching and learning anatomy. It is necessary to examine the curriculum and the mode of teaching. Factors that improve positive perceptions and in learning, like helpful environment and adequate dissection instructors should be thoroughly engaged in the training of our future doctors.


Article
A COMPARATIVE STUDY OF THE SUPRAPERIOSTEAL AND THE SUBPERIOSTEAL DISSECTION IN THE V-Y ADVANCEMENT (ATASOY) FLAP FOR THE MANAGEMENT OF FINGERTIP INJURY

Journal: Basrah Journal of Surgery مجلة البصرة الجراحية ISSN: 16833589 / ONLINE 2409501X Year: 2007 Volume: 13 Issue: 1 Pages: 1-11
Publisher: Basrah University جامعة البصرة

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Abstract

The classical Atasoy depends on the cutting of the fibrous bands of the digital pulp in order to gain advancement of the flap to cover the fingertip injury defect. A new modification of Atasoy flap was studied in comparison to the classical Atasoy flap. Thirteen patients included in this study at Al Wasity hospital between September 2003 to April 2005 they were complaining of class III Allen's fingertip injury of different fingers,3 females and 10 males , 4 cutting and 9 crushing type injury. Seven patients underwent reconstruction by the new modified Atasoy flap and 6 patients by the classical Atasoy flap. The results show that the new modification of Atasoy flap is more fitted with the principles of pulp surgery. It improves flap viability, sensibility and aesthetic results reduce the troublesome hypersensitivity and produce more physiological cover to the bone. These results may be attributed to preservation of the fibrous septae of the pulp space and avoiding the injury of the vessels and nerves by passing subperiosteall in the flap dissection.

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