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Comparison between strictureplasty and resection anastomosis in tuberculous intestinal strictures
Afsheen Zafar1, Abrar Maqbool Qureshi, Mohammad Iqbal
1Department of General Surgery, Unit I, Rawalpindi General Hospital, Rawalpindi. sheenopk@yahoo.com
Objective:
To compare the effectiveness, safety and morbidity of strictureplasty with resection anastomosis in patients with tuberculous small gut strictures.
Design:
Prospective comparison study.
Place And Duration Of Study:
Surgical Unit-I of Rawalpindi General Hospital from March 2000 to February 2002.
Patients And Methods:
Thirty patients who presented with intestinal obstruction due to tuberculous strictures, and underwent either resection anastomosis or strictureplasty were included in the study. Data was collected on a proforma and analyzed using software SPSS (version 8.0). Chi-square and t-test were used to test the hypothesis. Main outcome measures included the presence or absence of postoperative leakage anastomosis, wound infection, recurrence of intestinal obstruction and postoperative stay.
Results:
Chi-square test applied to see the effectiveness showed no significant difference (p>0.5) between the two procedures. t-Test on the score of morbidity also showed no significant difference (p>0.5) between the two procedures.
Conclusion:
Both procedures performed were equally effective and had equal morbidity in cases of intestinal tuberculous strictures. Strictureplasty is superior to resection anastomosis in cases of multiple strictures as it conserves gut length and can even be performed safely in cases with coexistent gut perforation.