Colorectal cancer is the third most common carcinoma worldwide and is second leading cause of death in the developed world. Early detection of tumor staging may lead to opting proper management plan and increase chances of survival. Objective: To determine diagnostic accuracy of MRI in evaluating preoperative tumor staging of colorectal carcinoma. Methods: The cross-sectional study was conducted at, Liaquat University Hospital - Hyderabad/Jamshoro from Jan 2022 to July 2022 on a sample of 204 patients of either gender with aged between 20 to 80 years and presenting with suspected colorectal cancer, diagnosed on the basis of clinical symptoms and physical examination. Patients were enquired about age, gender, duration of symptoms, history of per-rectal bleeding and pain. Preoperative MRI scan along with the Postoperative histopathological assessment of colorectal carcinoma staging of all patients was done. Results: Out of 204 patients, 60% of sample i.e. 123 patients were male and 81 (40%) were females with a median age of 68 (29-92) years. Most of the patients had well differentiated colorectal cancers i.e. 175 (85.8%) with 2/3rd sample had more than 5 cm height of primary tumor from the anal verge. T3 tumor stage was found to be highest in number (50.5%), followed by T2 (30.9%) and T4 (11.3%). The diagnostic parameters of preoperative MRI in detecting tumor staging was found to be good when correspondent to postoperative histological findings. Conclusion: The study showed that the accuracy of MRI in staging colorectal cancer is significantly high when compared with postoperative histopathological staging.
Background: The harmonic scalpel, commonly used in laparoscopic surgery, now has promise for MRM dissection. The harmonic scalpel's high frequency mechanical vibrations cut and coagulate intraoperatively at the same time, generating less heat injury than electrocautery. Objective: To compare the outcome of modified radical mastectomy using harmonic scalpel versus electrocautery at tertiary care teaching hospital. Methodology: The randomized controlled trial was conducted from 12th September 2018 11th March 2019 at Department of Surgery, Liaquat University of Medical and Health Science, Jamshoro. A total of 128 patients with infiltrating ductal carcinoma undergoing modified radical mastectomy, 20 to 50 years of age were included. Chronic Hepatitis, diabetes, and neo-adjuvant treatment patients were excluded. Modified radical mastectomy employing harmonic scalpel for Group A and electrocautery for Group B. Postoperative problems such as seroma development, postoperative hematoma, marginal necrosis, lymphedema, and wound infection were also observed. Results: The mean age of women in group A was 39.81 ± 6.73 years and in group B was 39.45 ± 6.60 years. Mean duration of disease was 5.41 ± 1.91 months. The frequency of seroma formation in harmonic scalpel group as 7.81% vs 26.56% in electrocautery group, p=0.005), frequency of pain is 53.13% vs 68.75% respectively, p=0.070, frequency of hematoma is 1.56% vs 17.19% respectively, p=0.002), frequency of marginal necrosis was 0.0% vs 7.81% respectively, p=0.023), lymphedema 3.13% vs 14.06% respectively, p=0.027) and wound infection 17.19% vs 35.94% respectively, p=0.016. Conclusion: This research indicated that harmonic scalpel is superior to electrocautery in modified radical mastectomy.
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