Background: Microvascular free flaps are the standard of care in the reconstruction of head and neck resection defects, however they need a significant surgical expertise and increase the operative time. Supraclavicular artery island flap (SCAIF) is a versatile fasciocutaneous flap that offers the advantage of both, a regional flap (easy to harvest) and a free flap (thin and pliable) in the head and neck reconstruction.Methods: In this study we analysed the utility of this flap for the oral cavity cancer defect reconstruction done in 12 consecutive cases.Results: There were 8 males and 4 females with a mean age of 54.75 years. The oral cavity subsites were as follows: buccal 3 (25%); tongue 3 (25%); lower alveolus 2 (16.66%); floor of mouth 1 (8.33%); gingivobuccal sulcus 2 (16.66%); retromolar trigone 01(8.33%).The excisional defect size ranged from 4×2 cm to 6×3 cm with a mean size of 5×3 cm. The mean harvest time was 45 minutes (range 35 min - 65 min). We had complete flap loss in 2 (16.66%) patients and partial flap loss in 1 (8.33%) patient. Donor site wound gape was noted in 2 (16.66%) patients. The hospital stay ranged from 7 days to 10 days in non-complicated cases. The mean follow up period was of 8.58 months.Conclusions: SCAIF is versatile, easy to harvest, safe and reliable in selective cases of oral cavity cancers and a potential alternative regional flap in head and neck reconstruction.
Bilateral primary synchronous ovarian neoplasms are rarely encountered in clinical practice. Both ovaries harboring neoplasms is predominantly appreciated as, metastasis from a distant primary or secondary from an advanced primary ovarian neoplasm. However in both the above instances, the histomorphological evaluation is of paramount importance. We encountered an incidental left ovarian, International Federation of Gynecology and Obstetrics grade 2, endometrioid carcinoma in a patient presenting with a right ovarian mass immunohistopathologically proven to be clear cell carcinoma. The documentation of such rare occurrence is of utmost importance for better understanding of histogenesis of ovarian cancers, which may impact management strategies.
Background: Comprehensive surgical staging and surgical cytoreduction is the primary modality of treatment in early and advanced epithelial ovarian cancer respectively, followed by systemic chemotherapy in most of the patients. The aim of the present study was to evaluate the role of surgery and its impact on disease free and overall survival in patients with epithelial ovarian cancer.Methods: A retrospective analysis of 38 patients of biopsy proven epithelial ovarian cancer was performed. Patient’s demographic data, details of surgical procedure, post-operative complications, histopathological findings, staging and pattern of recurrence were collected from the medical records.Results: Six (15.8%) patients had early disease (stage I-II) at presentation while 30 (94.7%) patients advanced disease (stage III-IV). Staging laparotomy was done in six (15.8%) patients, primary cytoreduction in eight (21.05%) patients, interval cytoreduction in 17 (81.6%) patients and secondary cytoreduction in two (5.3%) patients. Five (13.2%) patients were inoperable. The median follow up time was in the range of 2 to 56 months (median 26 months). The three years overall survival in advanced stage was 73.74%. Disease free survivals in primary and interval cytoreduction groups were 80% and 58.67% respectively. The disease free survival in patients with optimal cytoreduction was 72.9%.Conclusions: The present study indicates that in the majority of patients with advanced ovarian cancer, surgery can lead to optimal cytoreduction with acceptable disease-free and overall survival.
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