Pelvic exenteration is a surgery done to achieve margin negative resection in locally advanced re... more Pelvic exenteration is a surgery done to achieve margin negative resection in locally advanced rectal cancer infiltrating pelvic organs anterior to it. A retrospective observational study of patients undergoing pelvic exenteration for locally advanced rectal cancer was done at a single surgical unit of a tertiary care cancer centre. The period of study was from 1st January 2019 to 30th June 2021. A total of twelve patients underwent pelvic exenteration for locally advanced rectal cancer during the study period. The median duration of surgery was 310 min (range 250 to 380 min). The median duration of hospital stay was 14 days (range 12 to 30 days). Seven patients had documented postoperative complications, either major or minor, with a complication rate of 58.3%. Three patients required re-admission for complications. Two patients had COVID19 infection in the postoperative period but had uneventful recovery. Margin negative resection (R0) was achieved in eight patients (66.67%). Pelvic exenteration for locally advanced rectal cancer is a definitive surgery associated with a high morbidity rate.
International Journal of Molecular & Immuno Oncology, 2020
Objectives: Esophageal cancer both squamous cell (SCC) and adenocarcinoma have poor outcomes with... more Objectives: Esophageal cancer both squamous cell (SCC) and adenocarcinoma have poor outcomes with high morbidity and mortality. Our hospital-based registry for the year 2017–2018 showed that esophageal cancer constituted 22.7% of the annual caseload. The main objective of this study was to determine the presence of HER-2 receptors in patients with esophageal carcinoma in our region. Material and Methods: From September 2018 to September 2019, data regarding the expression of HER-2 receptors was analyzed in 133 patients of esophageal carcinoma. Data were statistically described as frequencies (number of cases) and percentages where appropriate. Chi-square and Fischer’s exact test was used to find out the association between categorical variables. A P < 0.05 was considered as statistical significant at 95% confidence interval. The statistical analysis was performed using SSPS software version 17.0. Results: A total of 133 patients were taken into study. The majority of patients wer...
In this study, we aimed to compare the surgical volume and outcomes between this COVID-19 period ... more In this study, we aimed to compare the surgical volume and outcomes between this COVID-19 period and data from non-COVID-19 period of last year. A retrospective observational study was done in one single surgical unit of a dedicated oncology center in a peripheral location in India. The comparison was done between patients undergoing major cancer surgery during the COVID-19 pandemic period of 1st April to 30th June 2020, when a nationwide lockdown was in force, to a comparable period of last year. Statistical analysis was done using SPSS software 20.0. A total of 72 patients underwent major cancer surgery during this period, with surgery for breast cancer (n = 26) being the major sub-site operated. This was a significant decrease from the total 209 major cancer surgeries performed during a similar period of last year (2019) (p < 0.05). There were several reasons for the decrease in surgical numbers, including the difficulty in travel and accommodation during the lockdown period. The mean distance of patient's residence from the treating hospital was 45.7 km (range 4 to 165 km). Public transport was in a limbo and interstate travel was restrictive with mandatory quarantine rules in effect. Morbidity associated with major surgeries was observed to be significantly less during the COVID-19 period compared to the pre-COVID-19 times (8.3% vs 17.2% with a p value of < 0.05), which can probably be attributed to the lesser number of complex surgical procedures being performed. There was no significant difference between the total mortality percentages (2.8% vs 3.8%). A total of 156 PPE kits were used (3-4/per patient) throughout the in-hospital care of the surgical patients included in this study. In the midst of a pandemic, the delivery of surgical cancer care is an essential service and although the surgical volume is significantly hampered due to various reasons, the outcomes are largely unaffected.
Background Esophageal cancers, both squamous cell and adenocarcinoma, have poor outcomes with hig... more Background Esophageal cancers, both squamous cell and adenocarcinoma, have poor outcomes with high morbidity and mortality. Our hospital-based registry for the year 2017 to 2018 showed that esophageal cancer constituted 22.7% of annual caseload. Most of our patients present in advanced stages. The aim of this article was to study the role of hormonal receptors in patients with esophageal cancer. Methods This is a single-institution, prospective, observational study in patients with esophageal carcinoma. Hormonal receptors (estrogen receptor [ER]-α and progesterone receptors) were studied in tumor tissue. Of 160 patients, receptor status was analyzed in 133 patients. Chi-square test was used for the correlation of categorical variables. The value of p < 0.05 was considered as statistically significant. Results A total of 133 patients was taken into the study of which 96 were males and 37 were females. The mean age of patients was 52 years. Carcinoma esophagus was predominantly see...
Indian Journal of Pathology and Microbiology, 2021
Background: Oesophageal cancer both squamous cell [SCC] and adenocarcinoma have poor outcomes wit... more Background: Oesophageal cancer both squamous cell [SCC] and adenocarcinoma have poor outcomes with high morbidity and mortality. Our hospital-based registry for year 2017–2018 showed that oesophageal cancer constituted 22.7% of annual case load. The main objective of this study was to determine the presence of HER-2 receptors in patients with oesophageal carcinoma in our region. Methodology: From September 2018 to September 2019, data regarding expression of HER-2 receptors was analysed in 133 patients of oesophageal carcinoma. Data were statistically described as frequencies (number of cases) and percentages where appropriate. Chi-square and Fischer's exact test was used to find out the association between categorical variables. A P value less than 0.05 was considered as statistical significant at 95% confidence interval. The statistical analysis was performed using SSPS [statistical package for the social sciences] software version 17.0. Results: A total of 133 patients were t...
Background Esophageal cancers, both squamous cell and adenocarcinoma, have poor outcomes with hi... more Background Esophageal cancers, both squamous cell and adenocarcinoma, have poor outcomes with high morbidity and mortality. Our hospital-based registry for the year 2017 to 2018 showed that esophageal cancer constituted 22.7% of annual caseload. Most of our patients present in advanced stages. The aim of this article was to study the role of hormonal receptors in patients with esophageal cancer. Methods This is a single-institution, prospective, observational study in patients with esophageal carcinoma. Hormonal receptors (estrogen receptor [ER]-α and progesterone receptors) were studied in tumor tissue. Of 160 patients, receptor status was analyzed in 133 patients. Chi-square test was used for the correlation of categorical variables. The value of p < 0.05 was considered as statistically significant. Results A total of 133 patients was taken into the study of which 96 were males and 37 were females. The mean age of patients was 52 years. Carcinoma esophagus was predominantly ...
Indian Journal of Otolaryngology and Head & Neck Surgery, 2021
Background Approximately 1–2% of all scalp tumours are malignant, but they comprise up to 13% of ... more Background Approximately 1–2% of all scalp tumours are malignant, but they comprise up to 13% of all malignant cutaneous neoplasms. The current study presents our experience of reconstruction of scalp and forehead for malignant tumours treated at our centre. Methods This is a single institutional observational study conducted at a tertiary cancer centre in North East India. Post-operative outcomes related to quality of life of patients were measured with help of FACE-Q scales. Face-Q –Satisfaction with outcome and FACE-Q- appearance related psychosocial distress scores were analysed. Histograms were used for descriptive statistics. Data were checked for normality using Kolmogorov–Smirnova and Shapiro–Wilk test. For non-normal data Wilcoxon test was used. A p value less than 0.05 was considered as statistically significant at 5% level of significance. Results Mean age of patients was 57.6 ± 14.2 years. The mean defect size was 89.036 ± 81.77 cm2. The mean satisfaction with outcome sc...
Inguinal lymph nodal dissection is notoriously associated with high morbidity. Various risk facto... more Inguinal lymph nodal dissection is notoriously associated with high morbidity. Various risk factors and technical modifications have been described in the past to overcome complications like lymphedema, wound breakdown, and infection which adversely affect the postoperative outcome and quality of life of the patient. This is a retrospective observational study from 1 January 2016 to 31 December 2019 of patients who underwent inguinal/ilio-inguinal block dissection for malignancy. Lymphedema was the most frequent morbidity seen (24%). The mean hospital stay of patients following surgery was 9.7 days (range 4 to 28 days). The inguinal drain was removed on a mean of 17.7 days (range 4 to 21 days), while mean iliac drain removal time was 11.7 days (range 4 to 21 days).
There is misrepresentation of details of the last patient in table-1 (i.e 10 year male with Ewing... more There is misrepresentation of details of the last patient in table-1 (i.e 10 year male with Ewings sarcoma who has undergone vascularised fibular graft). Patient had expired on 9 th postoperative month (status-dead). This patient developed both local recurrence and distant metastasis (LR: Yes, DM: Yes). Publisher's Note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Postoperative pancreatic fistula (POPF) is an important cause of major morbidity and mortality af... more Postoperative pancreatic fistula (POPF) is an important cause of major morbidity and mortality after pancreaticoduodenectomy. We intend to estimate the incidence and study the risk factors and outcomes of patients who developed this dreaded complication.
A cancer is termed as an index where there is no history of any invasive cancer [1]. A second pri... more A cancer is termed as an index where there is no history of any invasive cancer [1]. A second primary cancer is defined as a second de novo malignant neoplasm occurring with known cancer [2]. The term multiple primary malignant tumors (MPMT) refer to simultaneously or successively occurring two or more independent primary malignancies in the same individual. MPMT is divided into two main categories namely synchronous MPMT and metachronous MPMT. When both the primaries are diagnosed simultaneously or within 6 months, it is termed as synchronous MPMT, and when the second malignancy is diagnosed after 6 months of diagnosis of the index cancer, it is termed as metachronous MPMT [3, 4]. According to a report, 76% of the MPMT cases occur in different sites of the body, and the remaining 24% occur in the same site as primary cancer [5]. Although MPMT is not a common condition and has a low prevalence rate, in recent years, the reported cases are increasing. One of the oldest articles published in 1921 reported 4.7% of cases of MPMT among 3000 cancer patients [6]. The prevalence rate of MPMT reported in the literature varies between 2 and 17% [7–9]. This difference may be due to the adoption of different definitions of MPMT, the use of different diagnostic and treatment technologies, and different epidemiological factors. However, the risk factors and the mechanisms that underlie MPMT disease pathogenesis are little known. MPMT sometimes may be overlooked or misdiagnosed because of its low incidence rate and insidious onset. Currently, there are no international guidelines or consensus for the diagnosis and treatment of MPMT. The presence of synchronous squamous cell carcinomas in the head and neck region and esophagus has been reported in many pieces of literature. But synchronous squamous cell carcinoma of the esophagus and adenocarcinoma of the gastrointestinal system is rare. In this report, we describe a case of synchronous malignancy of squamous cell carcinoma of the esophagus and the gallbladder adenocarcinoma. To the best of our knowledge, this is the first report describing a case of synchronous malignancy of squamous cell carcinoma of the esophagus and adenocarcinoma of the gallbladder.
Background and Aim Carcinoma of the stomach is one of the leading causes of mortality worldwide. ... more Background and Aim Carcinoma of the stomach is one of the leading causes of mortality worldwide. Surgery for gastric cancer in the form of total or distal gastrectomy is definitive treatment. Feeding jejunostomy (FJ) though improves postoperative nutritional status and outcome, it is not devoid of its complications. In this study, we present the outcomes of nasojejunal (NJ) feeding and FJ and complications associated with them. Materials and Methods It is both retrospective and prospective observational study in patients with gastric cancer undergoing surgery. Patients were divided into two groups: those who underwent FJ and those who underwent NJ route of feeding placed intraoperatively. Results A total of 279 patients of gastric cancer who underwent surgery were taken into study, of which, 165 were male and 114 females. FJ was done in 42 and NJ in 237 patients, respectively. Gastrectomy + NJ was done in 128 patients, gastrectomy + FJ in 27 patients, gastrojejunostomy + NJ in 109 p...
Background Primary mucinous epithelial ovarian adenocarcinoma (mEOC) constitutes a small percenta... more Background Primary mucinous epithelial ovarian adenocarcinoma (mEOC) constitutes a small percentage (2–5%) of ovarian cancer. Our aim is to understand the clinicopathological characteristics and survival results of patients with mEOC after a long-term follow-up. Materials and Methods This is a retrospective study of primary mEOC cases treated at a tertiary cancer center in India, from January 1, 2005, to December 31, 2012. Results Out of 958 malignant ovarian tumors, 52 (5.43%) were mucinous adenocarcinoma. Nearly 71.2% of cases were of early-stage disease, and the remaining were of advanced-stage disease. After a follow-up period of 63 months (range: 1–138 months), the 5-year actuarial overall survival for stages I, II, III, and IV was 92.5, 70, 38.5, and 0%, respectively. Among advanced-stage tumors, half of them progressed without undergoing cytoreductive surgery and died. Conclusion Most of the mEOC cases present in early stages and have good clinical outcome. Patients with adva...
Lymph node dissection in gastric cancer had been controversial, but recent data have led us to th... more Lymph node dissection in gastric cancer had been controversial, but recent data have led us to the conclusion that D‐2 dissection should be the standard of care for potentially curable advanced gastric carcinoma. In this study, we present our single‐institution experience of D‐2 lymph node dissection.
Anastomotic leak from cervical esophagogastric anastomoses is a serious problem after esophagecto... more Anastomotic leak from cervical esophagogastric anastomoses is a serious problem after esophagectomy. We explored the efficacy of partial or total mechanical anastomoses accomplished with the endoscopic linear cutting and stapling device as an alternative to hand-sewn anastomotic techniques. Along that we compared various clinical outcomes associated with the same.
Background: Breast cancer is one of the most common malignancy among women but it is not common i... more Background: Breast cancer is one of the most common malignancy among women but it is not common in men. Male breast cancer (MBC) is a rare disease and accounts for ∼1% of all cancers in men. There is lack of data related to MBC. The objective was to study the clinic-pathological characteristics and outcome of MBC patients at this institute.Methods: It is a retrospective study. Author analyzed clinico-pathological factors, management and follow up details of all patients with MBC from 2012 to 2018 at the cancer centre.Results: Total 20 patients were included in the study. No risk factor identified in any patient. The median age at diagnosis was 57.5 years. Most common location was central quadrant. Most common stage at presentation was stage 3. Fifteen patients underwent upfront surgery while neoadjuvant chemotherapy was given to two patients. One patient had complete pathological response (cPR). The median follow up was 24 months (4-60 months). Three patients developed local recurre...
Iatrogenic tracheal injuries are uncommon, but potentially lethal and associated with significant... more Iatrogenic tracheal injuries are uncommon, but potentially lethal and associated with significant morbidity. During esophagectomy the proximity of the trachea to esophagus makes it vulnerable to injury. The reported incidence of tracheal injury during esophagectomy ranges between 1-5%. Various methods for repairing tracheal injuries have been described in the literature. Most preferred mode of repair described is the reinforcement of the primary repair with flap cover. Most common autologous flaps used are pericardium, pleura, extra thoracic muscle flaps and intercostal muscle flaps. Other described methods for repairing tracheal injuries are primary repair without buttressing, and buttressing with gatric conduit serosal patch, graft and glue. In this study we reviewed different methods and outcome of repair described in the literature and our experienced of managing three cases.
Purpose: Locally advanced colorectal cancer may require an en bloc resection of surrounding organ... more Purpose: Locally advanced colorectal cancer may require an en bloc resection of surrounding organs or structures to achieve complete tumor removal. This decision must weigh the risk of complications of multivisceral resection against the potential survival benefit. The purpose of this study is to review a single-center experience of feasibility of en bloc multivisceral resections for locally advanced colorectal carcinoma and to examine the effect of surgical experience on immediate outcome and rate of R0 resections. Methods: This is a study of 27 patients who underwent multivisceral resection for locally advanced colorectal carcinoma which was performed at our institute from January 2016 to December 2019. Among the 27 patients aged between 21 and 76 years (mean age, 48.67 ± 7.3 years), 13 were males and 14 were females. Overall 18 patients had primary colon carcinoma and 9 had primary rectal carcinoma. All rectal cancer patients received neoadjuvant chemoradiation. All patients underwent surgery with curative intent. All patients underwent open surgery of which 66.7% underwent colectomy, 14.8% underwent anterior resection, 11.1% underwent Miles procedure, and 7.4% underwent pelvic exenteration. Results: The mean operative time was 268.14 ± 72.2 minutes and the median amount of blood units transfused was 2.07 units. The mean hospital stay was 13.67 ± 3.4 days. Histologically, 44.4% of patients had well-differentiated adenocarcinoma and 55.6% had moderately differentiated adenocarcinoma. The final histopathological examinatio n revealed malignant infiltration of the adjacent organs in 19/27 patients (70.4%). Pathological complete response was seen in 2 patients. R0 resection rate achieved was 96.3%. Lymph node metastasis was seen in 66.7% of patients with colon cancer and 11.1% with rectal cancer with overall mean number of harvested lymph nodes being 12.44 ± 3.01. Postoperative complications were identified in 7 patients (25.9%), while mortality was seen in 2 (7.4%). Conclusion: Multivisceral resection for advanced colorectal cancer invading into the adjacent organ may be performed with acceptable morbidity and mortality.
Pelvic exenteration is a surgery done to achieve margin negative resection in locally advanced re... more Pelvic exenteration is a surgery done to achieve margin negative resection in locally advanced rectal cancer infiltrating pelvic organs anterior to it. A retrospective observational study of patients undergoing pelvic exenteration for locally advanced rectal cancer was done at a single surgical unit of a tertiary care cancer centre. The period of study was from 1st January 2019 to 30th June 2021. A total of twelve patients underwent pelvic exenteration for locally advanced rectal cancer during the study period. The median duration of surgery was 310 min (range 250 to 380 min). The median duration of hospital stay was 14 days (range 12 to 30 days). Seven patients had documented postoperative complications, either major or minor, with a complication rate of 58.3%. Three patients required re-admission for complications. Two patients had COVID19 infection in the postoperative period but had uneventful recovery. Margin negative resection (R0) was achieved in eight patients (66.67%). Pelvic exenteration for locally advanced rectal cancer is a definitive surgery associated with a high morbidity rate.
International Journal of Molecular & Immuno Oncology, 2020
Objectives: Esophageal cancer both squamous cell (SCC) and adenocarcinoma have poor outcomes with... more Objectives: Esophageal cancer both squamous cell (SCC) and adenocarcinoma have poor outcomes with high morbidity and mortality. Our hospital-based registry for the year 2017–2018 showed that esophageal cancer constituted 22.7% of the annual caseload. The main objective of this study was to determine the presence of HER-2 receptors in patients with esophageal carcinoma in our region. Material and Methods: From September 2018 to September 2019, data regarding the expression of HER-2 receptors was analyzed in 133 patients of esophageal carcinoma. Data were statistically described as frequencies (number of cases) and percentages where appropriate. Chi-square and Fischer’s exact test was used to find out the association between categorical variables. A P < 0.05 was considered as statistical significant at 95% confidence interval. The statistical analysis was performed using SSPS software version 17.0. Results: A total of 133 patients were taken into study. The majority of patients wer...
In this study, we aimed to compare the surgical volume and outcomes between this COVID-19 period ... more In this study, we aimed to compare the surgical volume and outcomes between this COVID-19 period and data from non-COVID-19 period of last year. A retrospective observational study was done in one single surgical unit of a dedicated oncology center in a peripheral location in India. The comparison was done between patients undergoing major cancer surgery during the COVID-19 pandemic period of 1st April to 30th June 2020, when a nationwide lockdown was in force, to a comparable period of last year. Statistical analysis was done using SPSS software 20.0. A total of 72 patients underwent major cancer surgery during this period, with surgery for breast cancer (n = 26) being the major sub-site operated. This was a significant decrease from the total 209 major cancer surgeries performed during a similar period of last year (2019) (p < 0.05). There were several reasons for the decrease in surgical numbers, including the difficulty in travel and accommodation during the lockdown period. The mean distance of patient's residence from the treating hospital was 45.7 km (range 4 to 165 km). Public transport was in a limbo and interstate travel was restrictive with mandatory quarantine rules in effect. Morbidity associated with major surgeries was observed to be significantly less during the COVID-19 period compared to the pre-COVID-19 times (8.3% vs 17.2% with a p value of < 0.05), which can probably be attributed to the lesser number of complex surgical procedures being performed. There was no significant difference between the total mortality percentages (2.8% vs 3.8%). A total of 156 PPE kits were used (3-4/per patient) throughout the in-hospital care of the surgical patients included in this study. In the midst of a pandemic, the delivery of surgical cancer care is an essential service and although the surgical volume is significantly hampered due to various reasons, the outcomes are largely unaffected.
Background Esophageal cancers, both squamous cell and adenocarcinoma, have poor outcomes with hig... more Background Esophageal cancers, both squamous cell and adenocarcinoma, have poor outcomes with high morbidity and mortality. Our hospital-based registry for the year 2017 to 2018 showed that esophageal cancer constituted 22.7% of annual caseload. Most of our patients present in advanced stages. The aim of this article was to study the role of hormonal receptors in patients with esophageal cancer. Methods This is a single-institution, prospective, observational study in patients with esophageal carcinoma. Hormonal receptors (estrogen receptor [ER]-α and progesterone receptors) were studied in tumor tissue. Of 160 patients, receptor status was analyzed in 133 patients. Chi-square test was used for the correlation of categorical variables. The value of p < 0.05 was considered as statistically significant. Results A total of 133 patients was taken into the study of which 96 were males and 37 were females. The mean age of patients was 52 years. Carcinoma esophagus was predominantly see...
Indian Journal of Pathology and Microbiology, 2021
Background: Oesophageal cancer both squamous cell [SCC] and adenocarcinoma have poor outcomes wit... more Background: Oesophageal cancer both squamous cell [SCC] and adenocarcinoma have poor outcomes with high morbidity and mortality. Our hospital-based registry for year 2017–2018 showed that oesophageal cancer constituted 22.7% of annual case load. The main objective of this study was to determine the presence of HER-2 receptors in patients with oesophageal carcinoma in our region. Methodology: From September 2018 to September 2019, data regarding expression of HER-2 receptors was analysed in 133 patients of oesophageal carcinoma. Data were statistically described as frequencies (number of cases) and percentages where appropriate. Chi-square and Fischer's exact test was used to find out the association between categorical variables. A P value less than 0.05 was considered as statistical significant at 95% confidence interval. The statistical analysis was performed using SSPS [statistical package for the social sciences] software version 17.0. Results: A total of 133 patients were t...
Background Esophageal cancers, both squamous cell and adenocarcinoma, have poor outcomes with hi... more Background Esophageal cancers, both squamous cell and adenocarcinoma, have poor outcomes with high morbidity and mortality. Our hospital-based registry for the year 2017 to 2018 showed that esophageal cancer constituted 22.7% of annual caseload. Most of our patients present in advanced stages. The aim of this article was to study the role of hormonal receptors in patients with esophageal cancer. Methods This is a single-institution, prospective, observational study in patients with esophageal carcinoma. Hormonal receptors (estrogen receptor [ER]-α and progesterone receptors) were studied in tumor tissue. Of 160 patients, receptor status was analyzed in 133 patients. Chi-square test was used for the correlation of categorical variables. The value of p < 0.05 was considered as statistically significant. Results A total of 133 patients was taken into the study of which 96 were males and 37 were females. The mean age of patients was 52 years. Carcinoma esophagus was predominantly ...
Indian Journal of Otolaryngology and Head & Neck Surgery, 2021
Background Approximately 1–2% of all scalp tumours are malignant, but they comprise up to 13% of ... more Background Approximately 1–2% of all scalp tumours are malignant, but they comprise up to 13% of all malignant cutaneous neoplasms. The current study presents our experience of reconstruction of scalp and forehead for malignant tumours treated at our centre. Methods This is a single institutional observational study conducted at a tertiary cancer centre in North East India. Post-operative outcomes related to quality of life of patients were measured with help of FACE-Q scales. Face-Q –Satisfaction with outcome and FACE-Q- appearance related psychosocial distress scores were analysed. Histograms were used for descriptive statistics. Data were checked for normality using Kolmogorov–Smirnova and Shapiro–Wilk test. For non-normal data Wilcoxon test was used. A p value less than 0.05 was considered as statistically significant at 5% level of significance. Results Mean age of patients was 57.6 ± 14.2 years. The mean defect size was 89.036 ± 81.77 cm2. The mean satisfaction with outcome sc...
Inguinal lymph nodal dissection is notoriously associated with high morbidity. Various risk facto... more Inguinal lymph nodal dissection is notoriously associated with high morbidity. Various risk factors and technical modifications have been described in the past to overcome complications like lymphedema, wound breakdown, and infection which adversely affect the postoperative outcome and quality of life of the patient. This is a retrospective observational study from 1 January 2016 to 31 December 2019 of patients who underwent inguinal/ilio-inguinal block dissection for malignancy. Lymphedema was the most frequent morbidity seen (24%). The mean hospital stay of patients following surgery was 9.7 days (range 4 to 28 days). The inguinal drain was removed on a mean of 17.7 days (range 4 to 21 days), while mean iliac drain removal time was 11.7 days (range 4 to 21 days).
There is misrepresentation of details of the last patient in table-1 (i.e 10 year male with Ewing... more There is misrepresentation of details of the last patient in table-1 (i.e 10 year male with Ewings sarcoma who has undergone vascularised fibular graft). Patient had expired on 9 th postoperative month (status-dead). This patient developed both local recurrence and distant metastasis (LR: Yes, DM: Yes). Publisher's Note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Postoperative pancreatic fistula (POPF) is an important cause of major morbidity and mortality af... more Postoperative pancreatic fistula (POPF) is an important cause of major morbidity and mortality after pancreaticoduodenectomy. We intend to estimate the incidence and study the risk factors and outcomes of patients who developed this dreaded complication.
A cancer is termed as an index where there is no history of any invasive cancer [1]. A second pri... more A cancer is termed as an index where there is no history of any invasive cancer [1]. A second primary cancer is defined as a second de novo malignant neoplasm occurring with known cancer [2]. The term multiple primary malignant tumors (MPMT) refer to simultaneously or successively occurring two or more independent primary malignancies in the same individual. MPMT is divided into two main categories namely synchronous MPMT and metachronous MPMT. When both the primaries are diagnosed simultaneously or within 6 months, it is termed as synchronous MPMT, and when the second malignancy is diagnosed after 6 months of diagnosis of the index cancer, it is termed as metachronous MPMT [3, 4]. According to a report, 76% of the MPMT cases occur in different sites of the body, and the remaining 24% occur in the same site as primary cancer [5]. Although MPMT is not a common condition and has a low prevalence rate, in recent years, the reported cases are increasing. One of the oldest articles published in 1921 reported 4.7% of cases of MPMT among 3000 cancer patients [6]. The prevalence rate of MPMT reported in the literature varies between 2 and 17% [7–9]. This difference may be due to the adoption of different definitions of MPMT, the use of different diagnostic and treatment technologies, and different epidemiological factors. However, the risk factors and the mechanisms that underlie MPMT disease pathogenesis are little known. MPMT sometimes may be overlooked or misdiagnosed because of its low incidence rate and insidious onset. Currently, there are no international guidelines or consensus for the diagnosis and treatment of MPMT. The presence of synchronous squamous cell carcinomas in the head and neck region and esophagus has been reported in many pieces of literature. But synchronous squamous cell carcinoma of the esophagus and adenocarcinoma of the gastrointestinal system is rare. In this report, we describe a case of synchronous malignancy of squamous cell carcinoma of the esophagus and the gallbladder adenocarcinoma. To the best of our knowledge, this is the first report describing a case of synchronous malignancy of squamous cell carcinoma of the esophagus and adenocarcinoma of the gallbladder.
Background and Aim Carcinoma of the stomach is one of the leading causes of mortality worldwide. ... more Background and Aim Carcinoma of the stomach is one of the leading causes of mortality worldwide. Surgery for gastric cancer in the form of total or distal gastrectomy is definitive treatment. Feeding jejunostomy (FJ) though improves postoperative nutritional status and outcome, it is not devoid of its complications. In this study, we present the outcomes of nasojejunal (NJ) feeding and FJ and complications associated with them. Materials and Methods It is both retrospective and prospective observational study in patients with gastric cancer undergoing surgery. Patients were divided into two groups: those who underwent FJ and those who underwent NJ route of feeding placed intraoperatively. Results A total of 279 patients of gastric cancer who underwent surgery were taken into study, of which, 165 were male and 114 females. FJ was done in 42 and NJ in 237 patients, respectively. Gastrectomy + NJ was done in 128 patients, gastrectomy + FJ in 27 patients, gastrojejunostomy + NJ in 109 p...
Background Primary mucinous epithelial ovarian adenocarcinoma (mEOC) constitutes a small percenta... more Background Primary mucinous epithelial ovarian adenocarcinoma (mEOC) constitutes a small percentage (2–5%) of ovarian cancer. Our aim is to understand the clinicopathological characteristics and survival results of patients with mEOC after a long-term follow-up. Materials and Methods This is a retrospective study of primary mEOC cases treated at a tertiary cancer center in India, from January 1, 2005, to December 31, 2012. Results Out of 958 malignant ovarian tumors, 52 (5.43%) were mucinous adenocarcinoma. Nearly 71.2% of cases were of early-stage disease, and the remaining were of advanced-stage disease. After a follow-up period of 63 months (range: 1–138 months), the 5-year actuarial overall survival for stages I, II, III, and IV was 92.5, 70, 38.5, and 0%, respectively. Among advanced-stage tumors, half of them progressed without undergoing cytoreductive surgery and died. Conclusion Most of the mEOC cases present in early stages and have good clinical outcome. Patients with adva...
Lymph node dissection in gastric cancer had been controversial, but recent data have led us to th... more Lymph node dissection in gastric cancer had been controversial, but recent data have led us to the conclusion that D‐2 dissection should be the standard of care for potentially curable advanced gastric carcinoma. In this study, we present our single‐institution experience of D‐2 lymph node dissection.
Anastomotic leak from cervical esophagogastric anastomoses is a serious problem after esophagecto... more Anastomotic leak from cervical esophagogastric anastomoses is a serious problem after esophagectomy. We explored the efficacy of partial or total mechanical anastomoses accomplished with the endoscopic linear cutting and stapling device as an alternative to hand-sewn anastomotic techniques. Along that we compared various clinical outcomes associated with the same.
Background: Breast cancer is one of the most common malignancy among women but it is not common i... more Background: Breast cancer is one of the most common malignancy among women but it is not common in men. Male breast cancer (MBC) is a rare disease and accounts for ∼1% of all cancers in men. There is lack of data related to MBC. The objective was to study the clinic-pathological characteristics and outcome of MBC patients at this institute.Methods: It is a retrospective study. Author analyzed clinico-pathological factors, management and follow up details of all patients with MBC from 2012 to 2018 at the cancer centre.Results: Total 20 patients were included in the study. No risk factor identified in any patient. The median age at diagnosis was 57.5 years. Most common location was central quadrant. Most common stage at presentation was stage 3. Fifteen patients underwent upfront surgery while neoadjuvant chemotherapy was given to two patients. One patient had complete pathological response (cPR). The median follow up was 24 months (4-60 months). Three patients developed local recurre...
Iatrogenic tracheal injuries are uncommon, but potentially lethal and associated with significant... more Iatrogenic tracheal injuries are uncommon, but potentially lethal and associated with significant morbidity. During esophagectomy the proximity of the trachea to esophagus makes it vulnerable to injury. The reported incidence of tracheal injury during esophagectomy ranges between 1-5%. Various methods for repairing tracheal injuries have been described in the literature. Most preferred mode of repair described is the reinforcement of the primary repair with flap cover. Most common autologous flaps used are pericardium, pleura, extra thoracic muscle flaps and intercostal muscle flaps. Other described methods for repairing tracheal injuries are primary repair without buttressing, and buttressing with gatric conduit serosal patch, graft and glue. In this study we reviewed different methods and outcome of repair described in the literature and our experienced of managing three cases.
Purpose: Locally advanced colorectal cancer may require an en bloc resection of surrounding organ... more Purpose: Locally advanced colorectal cancer may require an en bloc resection of surrounding organs or structures to achieve complete tumor removal. This decision must weigh the risk of complications of multivisceral resection against the potential survival benefit. The purpose of this study is to review a single-center experience of feasibility of en bloc multivisceral resections for locally advanced colorectal carcinoma and to examine the effect of surgical experience on immediate outcome and rate of R0 resections. Methods: This is a study of 27 patients who underwent multivisceral resection for locally advanced colorectal carcinoma which was performed at our institute from January 2016 to December 2019. Among the 27 patients aged between 21 and 76 years (mean age, 48.67 ± 7.3 years), 13 were males and 14 were females. Overall 18 patients had primary colon carcinoma and 9 had primary rectal carcinoma. All rectal cancer patients received neoadjuvant chemoradiation. All patients underwent surgery with curative intent. All patients underwent open surgery of which 66.7% underwent colectomy, 14.8% underwent anterior resection, 11.1% underwent Miles procedure, and 7.4% underwent pelvic exenteration. Results: The mean operative time was 268.14 ± 72.2 minutes and the median amount of blood units transfused was 2.07 units. The mean hospital stay was 13.67 ± 3.4 days. Histologically, 44.4% of patients had well-differentiated adenocarcinoma and 55.6% had moderately differentiated adenocarcinoma. The final histopathological examinatio n revealed malignant infiltration of the adjacent organs in 19/27 patients (70.4%). Pathological complete response was seen in 2 patients. R0 resection rate achieved was 96.3%. Lymph node metastasis was seen in 66.7% of patients with colon cancer and 11.1% with rectal cancer with overall mean number of harvested lymph nodes being 12.44 ± 3.01. Postoperative complications were identified in 7 patients (25.9%), while mortality was seen in 2 (7.4%). Conclusion: Multivisceral resection for advanced colorectal cancer invading into the adjacent organ may be performed with acceptable morbidity and mortality.
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Papers by Gaurav Das