Introduction: Gastrectomy with proper lymphadenectomy is considered the cornerstone of treatment for potentially curable gastric cancer. Stomach cancer is one of the important leading causes of cancer related death in worldwide. Annually, it was diagnosed with 9, 89,600 new cases and 7, 38,000 deaths (10% of all cancer death) in worldwide. The overall prognosis is not very favorable. However, surgery in the form of gastrectomy is the only treatment modality for a chance of long term survival as well as hope for cure. Aim of the study: Aim of the study was to find outcome of Early Postoperative Outcome of D2 Gastrectomy. Material & Methods: This prospective study was conducted at the Department of Surgical Oncology, National Institute of Cancer Research & Hospital (NICRH), Dhaka, Bangladesh from January 2019 to December 2020. A total 80 number of gastric cancer patients who were underwent gastrectomy were considered in this study. Statistical Analysis was performed with help of Epi Info (TM) 7.2.2.2. EPI INFO is a trademark of the Centers for Disease Control and Prevention (CDC). Descriptive statistical analysis was performed to calculate the means with corresponding standard deviations. Results: The mean age (mean ± SD) of the patients was 49.10±8.32 years with range 28-66 years and the median age was 48.5 years. The age group 45-54 years (50.0%) were significantly higher than other age group (Z= 3.26; p<0.001). Only 5.0% were with age between 25-34 years and 27.5% of the patients were with age ≥55 years. Thus in this study the patients with age between were in higher risk of having gastric cancer. Proportion of males (75.0%) was significantly higher than that of females (25.0%) (Z=7.07; p<0.0001). Conclusion: Surgery for gastric cancer is the only hope for cure or long term survival in the arena of multimodal management of cancers. It provides quick symptom relief by loco regional control, adds to survival of the individual, cure in case of early gastric cancer and proper staging for planning of subsequent adjuvant treatment.
Background: Lumpectomy and mastectomy remain the main surgical procedure of breast cancer as a part of treatment as well as management. This study was aimed to compare the early post-operative outcomes of lumpectomy (BCS) versus mastectomy (MRM). Methods: It was an observational study conducted at the Department of Surgical Oncology of National Institute of Cancer Research and Hospital (NICRH), Mohakhali, Dhaka, Bangladesh during the period from October 2016 to January 2019. The study sample consisted of 264 cancer patients who admitted in the hospital. The purposive sampling was done following inclusion criteria. Having collection of data, chi-square test was done to see the association of breast cancer among female patients. Results: Out of 264, 200 (75.75%) patients underwent mastectomy (MRM) and remaining percentage of patients underwent lumpectomy. The mean age of the patients was 37.69 (SD±10.31) and 44.82 (SD±7.65) in lumpectomy and mastectomy group respectively. Wound infection was present among 12.5% and 24% lumpectomy and mastectomy patients. Subsequently, seroma was present among 18.75% and 54% patients who underwent lumpectomy (BCS) and mastectomy (MRM) respectively which was statistically significant (P<0.014). Flap necrosis was found only among 16% mastectomy patients (P<0.04). There was significant difference in income and education among lumpectomy and mastectomy patients. However, the mean duration of hospital stay was 6.06±0.85 days and 17.70±4.70 days in lumpectomy (BCS) and mastectomy (MRM) group respectively which was statistically significant (P< 0.05). Conclusion: This study showed that lumpectomy (BCS) had early recovery and better post-operative treatment progress than mastectomy (MRM).
Introduction: Primary retroperitoneal liposarcoma is a rare variety of tumors accounting for 0.07%–0.2% of all malignancies. This type of sarcoma often causes diagnostic and therapeutic challenges due to its delayed presentation and anatomical location. Though there are some oncological measures like chemotherapy and radiotherapy still persist, complete surgical resection is the mainstay of treatment. However, the recurrence rate is very high in the case of retroperitoneal sarcomas. Case presentation: A 34-year-old male patient presented to our surgery department with abdominal distension, a lumpy feeling in his upper abdomen, and a significant weight loss over the past 3 months. On examination, there was a large intraabdominal mass measuring about 20 × 15 cm in the epigastric, left hypochondriac, umbilical, and left lumber region, which was partially mobile, partly hard, and partly cystic in consistency; the surface was smooth, and the margin was regular. After diagnostic and radiological workup, our primary suspicion was, it might be a case of retroperitoneal liposarcoma. Computed tomography (CT) guided fine needle aspiration tomography (FNAC) reveals, it was a spindle cell sarcoma. However, after six cycles neoadjuvant chemotherapy, resection was performed. Complete resection (R0) was done with extraction of a soft tissue mass of 12.5 kg, followed by adjuvant chemotherapy for three cycles. No recurrence is found after 3-month follow-up. Conclusion: Though retroperitoneal sarcoma may challenge the surgeon’s skill, complete marginal clearance along with oncological consultation may delay the recurrence and improve the quality of life of the patients. However, careful and long-term follow-up is required to detect early recurrence and increase the life expectancy of the patients.
Hemolymphangioma, a rare type of lymphangioma, is a benign hamartoma of the blood vessels and lymphatic system. Considered to be extremely rare among adults with infrequent occurrence in abdominal regions, lymphangioma involving mesentery accounts for <1 % of cases and only 0.05 % involve the GI tract. Due to the absence of typical clinical presentation, making a confirmatory preoperative diagnosis is challenging.An 18-year-old Bangladeshi man visited the hospital with the complaints of epigastric and umbilical pain for 15 days which was insidious in onset. Physical examination revealed an ill defined lump that was palpable on the right side of the abdomen. Ultrasonography showed multiloculated cystic mass having septation approximately 13 × 6 cm in size. An abdominal CT scan showed cystic lesion with septations measuring about 14.5 × 12.3 cm, compressing the bowel loops towards left, that was suggestive of mesenteric lymphangioma. The patient underwent partial surgical resection. The excised mass was sent for histopathology. Histopathology disclosed a benign tumor composed of proliferation of blood vessels of different sizes lined by endothelium in a fibromuscular stroma.Mesenteric lymphangiomas are infrequent malformations and very few cases of mesenteric hemolymphangioma have been reported in adults. Histopathology is required for confirmatory diagnosis and immunohistochemistry is required to differentiate the tumor subtype. Surgical resection is deemed a standard treatment modality.We report an extremely rare case of mesenteric hemolymphangioma to bring it to concern that even with the vague clinical presentations and involvement of age groups beyond the status quo, surgeons must be vigilant about abdominal MCL/hemolymphangioma and proceed accordingly.
