Background: The present study is designed to deal with an indication of various stoma surgery, type of stoma formed, and various ju=of General surgery, RG Kar Medical College and hospital, Kolkata, from June 2020 to May 2021 The study includes patients 12 years and <65 years of populations All data were collected in a prospective manner with a questionnaire and analyzed. Aims and Objectives: The aim of the study was to study various type of stoma and their indication and to identify the various complication encountered that occurs after the construction of intestinal stomas to assess the ways in which these complication can be minimized and managed in a better way. Materials and Methods: This was a prospective and observational study conducted in the Department of General Surgery, R.G.KAR Medical College and Hospital both the emergency and elective department. The study was approved by the Institutional Ethics Committee. Results: From the study, it was observed that among the study population, most were male 32 (80%) than female 8 (20%). There were two peak age group found to undergo stoma surgery most of which is 31–40 years consisting of 25 (27.5%) and 51–60 years consisting of 25 (27.5%). Most of the stoma surgery was found to be done in emergency 31 (77.5%) than in elective 9 (22.5%) setting. The most common cause of stoma formation was found to be hollow viscous perforation 12 (30%). Among the type of stoma ileostomy is more common than colostomy. Loop stoma formations are more common than end stoma and double barrel stoma. The most common complication following stoma surgery was found to be skin excoriation 30%. Conclusion: Stoma surgery was associated with a high rate of complication irrespective of the surgical expertise, surgical setup, and per operative planning resulting in higher morbidity. With meticulous dissection, post-operative stoma care, early detection, and management of complications, also patient education helps to achieve good outcomes following stoma surgery.
Background: Gastric adenocarcinoma is a leading cause of cancer and cancer related death among Asian countries. Although there is considerable improvement in chemoradiation, surgery still remains the primary curative modality with special emphasis on lymphadenectomy. Aims and Objectives: The aim of the study was to assess and compare post-operative morbidity and mortality, anastomotic dehiscence, and length of hospital stay between D1 and modified D2 gastrectomy in adenocarcinoma of the stomach. Materials and Methods: A prospective, open labeled, and comparative analysis was done in patients with adenocarcinoma of stomach at a tertiary care hospital in Eastern India for 15 months. Total (n=50) patients were divided into two groups and undergone D1(n=24) and modified D2 gastrectomy (n=26) operation, respectively. Post-operative assessment was done for 6 months following the operations. Results: In the study, (n=35) patients presented with antral growth of which 18 (51.4%) patients underwent D1and 17 (48.6%) patients modified D2 gastrectomy. Most of the Stage III cases were dealt by modified D2 surgery (62.5%) whereas Stage I by D1 surgery (68.2%). Incidences of hematemesis noted around 9 (34.6%) in D1 group patients and lesser in modified D2 group 6 (25%) with P=0.545. However, the incidences of melena were observed that more 11 (45.8%) in modified D2 group in the study patients was compared to D1 group 6 (23.0%) which was statistically insignificant (P=0.130).Post-operative complication (mainly wound dehiscence) was more in D1 surgery group 12 (46.1%) as compared to modified D2 group 8 (33.3%) and the finding was statistically insignificant (P=0.399). There were 4 (33.3%) cases of mortality in modified D2 group as compared to 8 (66.7%) cases in D1 group.The duration of hospital stays,that is,>14days was observed longer in the modified D2 surgery cases as compared to the other group (<8 days)and this difference was statistically very significant (P<0.001).Conclusion: Outcome of modified D2 operation in adenocarcinoma of stomach is better than D1 gastrectomy with lesser post-operative morbidity and mortality with longer duration of hospital stays and possibly a better chance of survival.
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