Biomedical subjects

Kasaya Tantiphlachiva

Publications and source records attributed to Kasaya Tantiphlachiva.

4 recordsLinked to original sources

PubMed2006

Closed vs ligasure hemorrhoidectomy: a prospective, randomized clinical trial.

OBJECTIVE: To compare the operative time, postoperative complications, and analgesic requirement between closed hemorrhoidectomy and Ligasure hemorrhoidectomy. MATERIAL AND METHOD: The study was conducted in a prospectively randomized controlled fashion. Forty-seven patients with grade 3 or 4 hemorrhoids plus external component or skin tag were operated on by either hemorrhoidectomy with Ligasure (24 patients) or closed hemorrhoidectomy (23 patients). One patient in each group was lost to follow up. The operative time, postoperative verbal numeric pain score, analgesic requirement, bleeding, and wound dehiscence between the two groups were compared Unpaired t-tests, Mann-Whitney U tests, or Fisher's Exact tests were used where appropriate. RESULTS: Demographic and clinical data between two groups were comparable. Operative time for the Ligasure hemorrhoidectomy was significantly shorter than the closed hemorrhoidectomy group (21.70 +/- 11.76 vs 35.68 +/- 14.25 min, p < 0. 001), while the number of resected hemorrhoids in the study group were 2.91 versus 2.18 in the control group. However, there were no differences in post-operative pain score, analgesic requirement, bleeding, or wound dehiscence between the two groups. CONCLUSION: Ligasure hemorrhoidectomy is superior to closed hemorrhoidectomy in terms of reducing the operative time without affecting postoperative complications.

Adult↗

PubMed2005

Laparoscopic versus open surgery for rectosigmoid and rectal cancer.

OBJECTIVES: The aim of this study was to evaluate feasibility and safety of laparoscopic surgery for rectosigmoid cancer and rectal cancer. MATERIAL AND METHOD: Twenty four patients who underwent laparoscopic surgery for rectosigmoid cancer or rectal cancer were retrospectively evaluated. Results were compared with those of 25 patients who had open surgery at the same period. The procedures of both groups were anterior resection, low anterior resection, coloanal anastomosis, abdominoperineal resection and subtotal colectomy. RESULTS: The mean operative time was significantly increased in the laparoscopic group. However, this group showed faster recovery of bowel function. There were no differences in the distal margin and yield of harvested lymph nodes of resected specimens. Although anastomotic leakage was comparable between 2 groups, surgical wound infection was significantly higher in open surgery group. CONCLUSION: Laparoscopic surgery for rectosigmoid cancer and rectal cancer is feasible and can be performed safely with comparable oncological clearance.

Digestive System Surgical Procedures↗

PubMed2005

The new laparoscopic proctocolectomy training (in soft cadaver).

OBJECTIVES: The purpose of the present study was to evaluate the quality of preservation (tissue plane, named vessels identification, consistency of colon and rectum), quality of performing procedures, difficulties and problems and finally the satisfaction of surgeons in laparoscopic proctocolectomy in soft cadaver. SETTING: Colorectal Division, Department of Surgery and Surgical Training Center Department of Anatomy, Faculty of Medicine, Chulalongkorn University. DESIGN: Prospective descriptive study MATERIAL AND METHOD: 10 soft cadavers were scheduled for laparoscopic proctocolectomy. The procedures (colon-rectum mobilization and named vessels identification) were performed by 14 experienced surgeons (8 colorectal surgeons) and assisted by surgical residents. The quality of preservation, successfulness and the satisfaction in performing the procedures were recorded using questionnaires for evaluation. RESULTS: The preservation was very good in every aspect especially tissue plane between colon, mesocolon and retroperitoneum which was clearly dissected, same asfasciapropria of rectum. The named vessels and the tissue consistency were very well preserved and tolerated to laparoscopic equipment handling. The surgeons were satisfied with the tissue handling and dissections. There were two difficulties, the first was air leakage but simply corrected with purse string suture and the second was unflavored smell which was not concerned. Laparoscopic proctocolectomy could be completely performed in soft cadaver. CONCLUSION: Laparoscopic proctocolectomy could be performed in soft cadavers with great satisfaction. Repeated practice is possible, so the surgeons can gain their experiences outside the operating theatre. This success may shorten the learning curve and may be the new era in cadaver-based training.

Attitude of Health Personnel↗

PubMed2005

Perineum push-up device to facilitate transabdominal suturing of the lower rectum.

Pressure on the perineum by the fist facilitates the placement of sutures into the rectal remnant, but put the assisting surgeon on an awkward and strenuous posture. The perineum push-up device to facilitate transabdominal suturing of the lower rectum was invented. The assisting surgeon can push up the perineum more comfortably with his abdominal wall or thigh. The device was tested in fifteen patients. The average distance that can be pushed up is 4.2 cm, which is a significant distance, facilitating in the maneuver of the distal rectal stump.

Anastomosis, Surgical↗