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C Tanphiphat

Publications and source records attributed to C Tanphiphat.

12 recordsLinked to original sources
PubMed1998

Laparoscopic vs open inguinal hernia repair. A randomized, controlled trial.

BACKGROUND: The role of laparoscopic inguinal hernia repair is controversial. The aim of this study was to find out whether it is justified to switch from the predominantly modified Bassini repair which the authors had been using to laparoscopic repair. METHODS: Randomized controlled trial in 120 eligible patients admitted for elective hernia repair in a university hospital. RESULTS: Sixty patients underwent laparoscopic transabdominal preperitoneal mesh repair; the other 60 patients had an open repair, mostly with the modified Bassini technique. Operative time for laparoscopic repair was significantly longer, mean (s.d.) 95 (28) min vs 67 (27) min (p < 0.001). The mean analogue pain score during the first 24 h after surgery was 36.2 (20.2) in the laparoscopic group and 49.3 (24.9) in the open group (p = 0.006). The requirement for narcotic injections and postoperative disability in walking 10 m and getting out of bed were also significantly less following laparoscopic repair. The postoperative hospital stay was not significantly different, mean 2.6 (1.2) days for laparoscopic repair and 3.0 (1.5) days for open repair (p = 0.1). Patients were able to perform light activities without pain or discomfort sooner after laparoscopic repair, median interquartile range 8 (5-14) days vs 14 (8-19) days (p = 0.013). Patients also resumed heavy activities sooner, but not significantly, after laparoscopic repair, median 28 (17-60) days vs 35 (20-56) days (p = 0.25). The return to work was not significantly different, median 14 (8-25) days after laparoscopic repair and 15 (11-21) days after open repair (p = 0.14). After a mean follow-up of 32 months one patient developed a recurrent hernia 3 months after a laparoscopic repair. Laparoscopic repair was more costly than open repair by approximately $400. CONCLUSIONS: Laparoscopic inguinal hernia repair was associated with less early postoperative pain and disability and earlier return to full activities than open repair, but there were no benefits regarding postoperative hospital stay and return to work; laparoscopic repair was also more costly.

Adult↗
PubMed1993

Can unnecessary operations for abdominal stab would be safely reduced? A review of 255 patients.

Records of 255 patients who underwent laparotomies for stab wounds to the abdomen and lower chest were reviewed. Criteria for laparotomy were clinical and followed the conventional lines. Seventy-six patients (30%) were classified as having had an unnecessary laparotomy. Univariate analysis with the Chi-square test revealed 8 variables which differed significantly between the necessary and unnecessary laparotomy groups. Further stepwise discriminant analysis demonstrated 4 variables which had independent significance; they are the type of injury, generalized abdominal tenderness, haemoperitoneum and active intraabdominal bleeding. A mathematical model utilizing these 4 variables may be able to predict the need for laparotomy more accurately than utilizing any single variable. A prospective study is needed to test this hypothesis.

Abdominal Injuries↗
PubMed1990

Intestinal obstruction due to phytobezoars.

Seven adults and four children with phytobezoar obstruction to the small bowel were reported. All adult patients had undergone previous laparotomies, six of which were gastric operations. Phytobezoar obstruction was not suspected in any of the adult patients and surgery was necessary to relieve the obstruction. Abnormal gastric function may predispose phytobezoars, and surgeons should be aware of the possibility in patients with previous gastric surgery. The children had been previously healthy, but all had a history of eating an excessive amount of fruit or seeds before the onset of symptoms. The obstruction was found to be incomplete and could be relieved by conservative treatment, including the use of colonic washouts. In children with intestinal obstruction a good dietary history should lead to the correct diagnosis so that surgery may be avoided.

Aged↗
PubMed1987

Adhesive small bowel obstruction. A review of 321 cases in a Thai hospital.

A retrospective study was carried out on 321 cases of adhesive small bowel obstruction in 289 patients admitted at the Chulalongkorn Hospital over an 8 year period. Appendectomy was the most common operation preceding the obstruction. Early operation was performed in 54 cases with two deaths, and nonviable and borderline bowel was found in 30.2 percent. Continuous abdominal pain, generalized tenderness, guarding, and distension appeared to influence the attending surgeons' decisions to operate early. A trial of conservative treatment with nasogastric decompression was carried out in 267 cases with one death. Conservative treatment was successful in 126 cases, but in 140 cases, there was no improvement or the condition became worse and a delayed operation was required. There was no mortality in the delayed operation group and nonviable and borderline bowel was found in 22.8 percent of cases. The incidence of nonviable and borderline bowel did not increase with the length of delay, but was more frequent in those whose condition grew worse after conservative treatment. No preoperative factors that could reliably predict bowel strangulation were found. However, the results in this series justify a trial of conservative treatment with close observation in patients without clinical evidence of strangulation or marked abdominal distension.

Female↗
PubMed1985

Surgical treatment of perforated duodenal ulcer: a prospective trial between simple closure and definitive surgery.

Seventy-eight patients with perforated duodenal ulcer were prospectively studied between 1977 and 1982. Patients were alternately allocated to receive simple closure (Group I, 33 patients) and definitive surgery (Group II, 32 patients). High-risk patients and those whose conditions dictated a definitive operation were excluded. All patients in Group II had a truncal vagotomy and drainage except one who had a proximal gastric vagotomy. There was no death in Group I or Group II; the complication rate and postoperative course were similar. Twenty-seven patients in Group I and 26 patients in Group II were available for follow-up 12 to 80 months after operation, mean 39 months. Good/excellent results were achieved in 30 per cent of Group I compared with 81 per cent of Group II (P less than 0.01). Eighty-five per cent of Group I patients developed recurrent ulcer symptoms and 33 per cent had already had a second definitive operation. Two patients (8 per cent) in Group II were reoperated upon for recurrent ulcer due to an incomplete vagotomy. In a population of patients where long-term follow-up and medical treatment for duodenal ulcer is unsatisfactory, truncal vagotomy with drainage should be the treatment of choice for perforation. Simple closure should be reserved for high-risk patients or when the surgeon is inexperienced.

Adolescent↗
PubMed1978

Wound infection in emergency appendicectomy: a prospective trial with tropical ampicillin and antiseptic solution irrigation.

A randomized controlled trial in 374 patients requiring emergency appendicectomy to determine the value of topical ampicillin and an antiseptic solution of chlorhexidine and cetyl trimethyl ammonium bromide (Savlon) in preventing wound infection is reported. The application of 1 g of ampicillin powder to the wound significantly reduced wound infection in perforated appendicitis, but not in unperforated appendicitis. Wound irrigation with 1% cetyl trimethyl ammonium bromide was ineffective in preventing wound infection in all grades of appendicitis. When wound contamination is difficult to avoid, as in perforated appendicitis, topical ampicillin should be used to reduce the rate of wound infection.

Administration, Topical↗
PubMed1976

Lobar dearterialization in liver trauma.

Two cases of blunt liver trauma managed by hepatic artery ligation are reported. Lobar dearterialization is a simple and effective method of achieving haemostasis in exsanguinating wounds of the liver. The postoperative management and scope of this procedure are discussed.

Adult↗