Maher Jabbar

Anal stricture is a rare but serious complication of anorectal surgery, most commonly seen after hemorrhoidectomy (1-2 months postoperatively). Simple cases with anal stricture can be managed conservatively with stool softeners or fiber supplements, otherwise surgery is indicated, meanwhile anal stricture may be prevented with the use of certain antioxidants (zinc sulphate) locally.Thirty five patients aged 20– 45years; 11 female 24 male, with hemorrhoidectomy surgery randomly allocated as a control , group A; (15 cases) with frequent manual dilatation, 2 weeks postoperatively for 3 weeks , matching with group  B (20 cases) had frequent  manual dilatation along with application of zinc sulphate ointment  5% four times daily , 2 weeks postoperatively for 3 weeks. Compared with control group, group B showed no incidence of stricture following hemorroidectomy cases while in other cases within group A, there were 2 cases had stricture treated by dilatation and sphincterotomy (surgery) later. Zinc sulphate ointment 5% seemed to be effective in preventing anal stricture along with frequent manual dilatation two weeks postoperatively for at least two weeks.

Thyroid surgery commonly associated with perioperatively and postoperative bleeding and some initial pain on swallowing after surgery, and these are a common problems encountered till now. The use of certain medications might help to minimize blood loss during and after surgery with reduction of pain and operative time. The aim is to have a better surgical field with a good analgesia.A randomized study in Al Karkh hospital was performed including 22 cases submitted to bilateral subtotal thyroidectomy surgery divided into 2 groups; group A; 10 patients had the usual type of surgery with using the combination of bupivacaine 0.25% and adrenaline 1:200000 after induction of anesthesia to be injected in the operative site. The second group B involves the other 12 patients who were operated on without local infiltration. This study was designed to compare differences in both groups regarding to total blood loss, analgesic effect and duration of surgery Our study included 20 females and 2 male with enlarging goiter involving both lobes, with less blood loss in suction apparatus and drains as well as there was a less scores regarding pain relief during and after surgery in group A than group B. No significant statistical differences in term of morbidity and mortality for both groups regarding the local bleeding control during thyroid, peri-incisional infiltration provided better pain relief in early postoperative period. Key words: Thyroid surgery, Bupivacaine, Adrenaline, Pain scores, Bleeding and Suction drains, suction apparatus