IMPORTANCE OF PEROPERATIVE CLOSURE OF ABDOMEN WITH INLAY PROLENE MESH IN POST TRANSVESICAL PROSTATECTOMY IN PATIENTS OF LARGE BPH WITH COPD
Journal Title: Journal of Evolution of Medical and Dental Sciences - Year 2018, Vol 7, Issue 36
Abstract
BACKGROUND Those with comorbid conditions like COPD, diabetes, HTN etc. are selected apart from the consideration of advanced age and BPH. Lot of clinical work has to be done for the study. In the light of conventional surgery, the new approach is designed for better results. While most of the elderly patients of 65 - 70 years present with symptoms of BPH, those with urinary retention are selected for surgery after screening. Aim- To know the importance and efficacy of large inlay mesh, while closing the abdomen after transvesical prostatectomy to prevent second major surgery in elderly BPH patients operated for large prostate. MATERIALS AND METHODS It is a prospective observational study. The total number of cases was 53. They were divided into 2 groups, X and Y. X group contains 23 cases and Y group contains 30 cases and conclusions were drawn. Statistical analysis was done by using Tukey’s test and Chi-square test using SPSS software 22.0 version. The study was done over a period of 3 years from 2015 to 2018. Cases are of highly selective nature, involved to fulfil the criteria of advanced age, large size of Benign Prostatic Hypertrophy (BPH), Chronic Obstructive Pulmonary Disease (COPD), Diabetes and Hypertension. The method of surgery chosen was open-operative procedure and not endoscopic type like TURP. Among the open operative type procedures, the comparison is made between mesh and without mesh closure of the abdomen in one sitting during the course of transvesical prostatectomy total procedure. The sample size was taken for convenience during the study. RESULTS Of the many cases of BPH, 53 patients of large BPH with urinary retention of age between 65 and 75 years with Chronic Obstructive Pulmonary Disease (COPD) and diabetes are selected for the current study. Twenty-three cases without mesh closure and 30 patients with mesh of abdominal closure are compared and conclusions drawn. CONCLUSION Routine peroperative closure of abdomen in infraumbilical laparotomy for transvesical prostatectomy in elderly patients with COPD and diabetes obviates the need for second major surgery and reduces morbidity, enhances recovery and minimises hospital stay. These concluding remarks are very valuable in planning open abdominal surgery in patients with COPD and diabetes. In the absence of COPD, there can be occasional chances of lack of wound dehiscence in certain individuals, though with hypertension but not with diabetes. But in this study, COPD is the main criterion to choose cases for this comparative study with a novel procedure.
Authors and Affiliations
Kodandarao K, Rameshbabu B
Keywords
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- EP ID EP544959
- DOI 10.14260/jemds/2018/886
- Views 73
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