Introductions: Colorectal carcinoma is the third most common cancer worldwide. The incidence is increasing in developing countries including Nepal. The aim of this study is to find out the clinicopathological pattern of colorectal carcinoma locally. Methods: Data were recorded retrospectively by reviewing the charts of the patients who were diagnosed and treated for in patients having colorectal cancer managed during three years period of 2016-9 at Patan Hospital, the university teaching hospital of Patan Academy of health sciences, Nepal. Clinicopathological profile, age, gender, surgery, histopathological findings were descriptively analised. Results: There were 36 colorectal cancer patients, male 20 (56%) and females 16 (44%), mean age 56.9 years (range 24 to 89). Curative surgery was possible in 17 (47.2%) and adenocarcinoma of moderate differentiation was found in 25 (70%) of the resected specimen. Conclusions: Colorectal carcinoma was found in old age, slightly more in male than female, adenocarcinoma being most common histology type.
Introductions: Colorectal cancer is a major health problem in developing countries. The purpose of this study was to analyze the clinico-pathological characteristics of colorectal carcinoma at Patan hospital, Nepal.Methods: A retrospective chart review was done for patients operated for colorectal carcinoma at Patan Hospital from May 2004 to April 2012. Demographic information, chief complains, site of primary cancer, and histological types were analyzed.Results: There were 73 patients (37 males and 36 females) with colorectal carcinoma. The mean age was 52 years. There were 21 (28.77%) patients below 40 years of age. Patients with rectal carcinoma presented with bleeding per rectum in 69.70% and 60% of patients with colon cancer presented with pain abdomen. Rectum was involved in 31 (42.47%) and right colon in 30 (41.10%). Adenocarcinoma was seen in 72 (98.63%).Conclusions: The colorectal carcinoma is not only the disease of old age. We had 29% of our patients below 40 year. Rectum and right colon were equally affected.
The thoracic kidney is the rarest form of an ectopic kidney that usually present on the left thoraxand twice more common in males. No case has been reported from Nepal and very few cases arereported worldwide. We report a 24 years-old female with right thoracic kidney with Bochdalekhernia diagnosed incidentally. We have included clinico-radiological and surgical findings of thecase with a review of the literature.
Introductions: Hydatid cyst is caused by the tapeworm. It is common in sheep and cattle rearing communities. Liver is the most common affected organ. There are various methods of surgical approaches for hydatid cyst. Methods: This was a retrospective descriptive study of patients operated for intra-abdominal hydatid cysts from July 2012 to June 2018 at Patan Hospital, Patan Academy of Health Sciences, Nepal. Ethical approval from institutional review committee was obtained. Patient files with incomplete data were excluded. Variables analyzed were, age, gender, site and numbers of cyst, methods of surgery, complications and mortality. Data were descriptively analyzed. Results: There were 19 patients of abdominal hydatid cysts who underwent surgery during the study period. Five records files could not be accessed and were excluded. In remaining 14, male were 6 (42.85%), female 8 (57.15%), mean age 39.57±17.35 years (14-70), cyst size 11±4.22 cm (5-21), complain of abdominal pain in 10 (71%). Open surgery for liver cyst was done in 11 and laparoscopic in one, and open splenectomy for two splenic cysts. One patient developed superficial wound infection. Four had cystobiliary communication of which one underwent ERCP. Post ERCP patient developed acute severe pancreatitis and expired.Mean hospital was 8.57±2.24 days (6-14). Conclusions: Liver was the main organ involved, abdominal pain and lump were main presenting complaints. Surgery had successful outcome. Open surgery was the mainstay of treatment.
Introduction: Pilonidal sinus is a common disease. Various surgical techniques for management of sacrococcygeal pilonidal sinus have been described. Among them, the most commonly used is the rhomboid excision with the Limberg flap. With this technique of flattening the natal cleft and tension-free repair is made using a wide, well-vascularized flap. It is reported the best treatment methods, with 0-16 % of surgical area-related complications and a recurrence rate of 0-5 %. We conducted a study to evaluate the patient’s profile and outcomes of the patients of pilonidal sinus treated with rhomboid excision and Limberg flap reconstruction at our center. Methods: Data were recorded retrospectively by reviewing the charts of patients who underwent rhomboid excision and Limberg flap operation for sacrococcygeal pilonidal sinus from September 2015 to September 2019. Results: Thirty-four patients were included in the study. Twenty-nine (85.4%) were males and 5 (14.7%) were females. The mean age was 25.29 years (range 17-40 years). Mean hospital stay was 4.5 days (range 3 – 7 days. Nine (26.5%) patients had surgical site infections. Two patients (5.9%) had a recurrence. Conclusion: Limberg flap for reconstruction after rhomboid excision of pilonidal sinus is an effective and feasible technique with good outcome.
Introduction: Perioperative strategies have been changing due to the COVID-19 pandemic to prevent the risk of postoperative complications and transmission of infection. This study was aimed to assess the outcome of gastrointestinal surgery and the risk of transmission by implementing COVID-19 testing criteria and surgical strategy. Method: This was a retrospective descriptive study conducted at the department of surgery at Patan Hospital, Nepal, during COVID-19 lock-down from 24 march to 15 June 2020. All patients who underwent gastrointestinal (GI) surgery were included. High-risk patients (as defined by the Hospital Incident Command System, HICS) were tested for COVID-19 preoperatively. Surgery was performed in COVID operating room with full protective gear. Low-risk patients were not tested for COVID-19 preoperatively and performed surgery in non-COVID OR. Data from patient’s case-sheets were analyzed descriptively for age, gender, comorbidities, hospital stay, RT-PCR results, surgeries, and postoperative complications. Result: There were total 44 GI surgeries performed; 31(70.5%) were emergency, 5(11.3%) semi-emergency and 8(18.2%) oncology. There were 11(25%) patients tested for COVID-19 preoperatively and were negative. Nine HCWs tested for COVID-19 randomly were negative. Severe postoperative complications developed in 3 patients, with one mortality. Conclusion: Among GI surgeries, there was no increase in postoperative complications and transmission of COVID-19 to the patients or HCWs following the implementation of standard testing criteria and surgical strategy.
Introduction: Paediatric surgical cases has been operated by general surgeon due to lack of paediatric surgeons. Complex cases in neonates and infants is being referred to other centres with paediatric surgical services. This study aims to compare the spectrum of paediatric surgical cases and their outcome before and after availability of paediatric surgeon. Method: This is the Retrospective study conducted at Patan Academy of Health Sciences over a period of 4 years. Group 1 included surgeries during 1st 2 y before and Group 2 during 2nd 2 y period after the availability of paediatric surgeon. Ethical approval was obtained. Patient age, sex, diagnosis, operative procedure, type of surgery and outcome data were collected from operative theater register and patients file from medical record section. Data analysis was done using SPSS 16. Result: Among 1157 cases, 369 cases were in group 1 and 788 in group 2. Male to female ratio was 2.8:1. Laparotomy 270(23.2%) was the most performed inpatient surgery and hernitomy 221(19.1%) in day care. There was total 52(4.5%) neonates, 2(4%) in group 1 and 50(96%) neonates in group 2. Among total cases mortality rate was 8(0.7%) in group 2, due to preterm birth, delayed presentation and septicemia. Conclusion: Lower GI tract and skin and soft tissue were most common system involved. Laparotomy and incision and drainage were most performed surgery before and after availability of paediatric surgeon. There was 96% increment in neonatal cases (50 v/s 2) after availability of paediatric surgeon. Mortality was 8(0.7%) in group-2 due to delayed presentation and septicemia.
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