scholarly journals Presentation of gallbladder carcinoma and its surgical management

2016 ◽  
Vol 12 (2) ◽  
Author(s):  
Tariq Waqar ◽  
Rasheed Ahmed
Keyword(s):  
Gallbladder Carcinoma ◽  
Economic Status ◽  
Gall Stone ◽  
Stage Iv ◽  
Palliative Surgery ◽  
Etiological Factor ◽  
Female Ratio ◽  
Extended Cholecystectomy ◽  
Surgical Methods ◽  
Operative Findings

Objective:- To study the mode of presentation, age and sex distribution, socio-economic status and evaluation of various surgical methods adopted for treatment of localized and advanced gallbladder carcinoma. Design:- It was a prospective type of study. Place and duration of study: This study was conducted in the Department of Surgery Nishtar Hospital, Multan from January 2004 to June 2005. Patients and methods: Twenty five patients of all ages and both sex were taken from all surgical units. On the basis of history, examination and laboratory investigations they were suspected of having gallbladder cancer. All the patients were operated and were divided into three groups on the basis of operative findings and stage of disease. Results:- There were 4 males and 21 female with a male to female ratio of 1:5. Presenting feature in decreasing order of frequency were; pain in right hypochondrium in 88%, nausea and vomiting in 60%, weight loss in 40%, jaundice in 28%, anorexia in 28%, mass in right hypochondriu m in 24%, pruritis in 20%, fever in 12% and ascites in 4% patients. Preoperative diagnosis of carcinoma of gallbladder was possible in 12 (48%) patients with the help of ultrasound and CT scan but all were of advanced age of disease. Gall stone were the most important etiological factor in 20 (80%) patients, obesity was found in 7 (28%) and chronic typhoid infection in 2 (8%) patients. All patients were operated. Simple cholecystecytomy was done in 4 patients of stage I and II. Extended cholecystectomy done in 6 patients of stage III. Laparotomy and biopsy of the mass and/or palliative surgery for drainage of bile was done in 15 cases of stage IV and V disease. Adenocarcinoma was the most common histological type found in 22 (88%) cases. Conclusion:- Gallstone are the most important etiological factor in gall bladder carcinoma.

scholarly journals P129 The utility of routine operative swab culture in uncomplicated peri-anal abscesses

BJS Open ◽  
2021 ◽  
Vol 5 (Supplement_1) ◽  
Author(s):  
Apoorva Khajuria ◽  
Tuba Rahim ◽  
Mariam Baig ◽  
Kai Leong ◽  
Apoorva Khajuria
Keyword(s):  
Inflammatory Bowel Disease ◽  
Perianal Abscess ◽  
Female Ratio ◽  
Incision And Drainage ◽  
Common Presentation ◽  
History Of ◽  
Inflammatory Bowel ◽  
Operative Findings ◽  
The Cost ◽  
Male To Female

Abstract Introduction Despite perianal abscess being a common presentation, certain aspects of its management remain controversial, especially the routine use of intra-operative swab cultures. Methods A retrospective review of patients that underwent incision and drainage procedures for a perianal abscess over a six-month period was undertaken. Results Over 6 months, 50 patients were identified. The male to female ratio was 3:1 and median ASA score was 1. Only 6/50 patients presented with recurrent abscess and 1 patient had history of inflammatory bowel disease. On the basis of operative findings, 39 patients (78%) had uncomplicated abscess (not associated with cellulitis, sinus or fistula); swab cultures were performed in 26 (67%) of these patients. All patients were discharged on the same day; microbiology reports did not impact the treatment and no patients were followed up in clinic post-operatively or presented with recurrence. The number of unnecessary microbiology swabs undertaken in this cohort equates to approximately 52 unnecessary swabs a year. The cost of one swab is £10.10p, which means £520 could potentially be saved annually. Conclusion Routine intra-operative swab cultures do not impact management decisions, add to unnecessary costs and therefore should not be undertaken in uncomplicated or first presentation of peri-anal abscesses.

scholarly journals Clinicopathological Profile of Wilms’ Tumour in Children

2014 ◽  
Vol 32 (1) ◽  
pp. 5-8
Author(s):  
M Mazumder ◽  
A Islam ◽  
N Farooq ◽  
M Zaman
Keyword(s):  
Wilms Tumor ◽  
Stage Iv ◽  
Abdominal Distension ◽  
Stage Ii ◽  
Stage Iii ◽  
Wilms Tumour ◽  
Female Ratio ◽  
Male Female Ratio ◽  
Clinicopathological Profile ◽  
Treatment Objective

Introduction: Wilms’ tumor is the most common primary malignant renal tumor of childhood. It is important to pick up the children with wilms’ tumor earlier as early stages has excellent outcomes after treatment. Objective : To find out the common clinical presentations and pathological profile of Wilms’ tumor in children. Methods and Materials : A hospital based prospective study done with twenty diagnosed patients of Wilms tumour enrolled from department of Pediatric haemato-oncology, BSMMU, Dhaka in the period between January to December 2008. Results- The peak incidence of Wilms’ tumor was in 1 to 5 years age group (80%,n=16). Median age at presentation was 49 months with male: female ratio 1.8:1.The most common presentation was abdominal swelling (80%,n=16),followed by flank mass (75%,n=15), abdominal pain (55%,n=11), haematuria (15%,n=3), hypertension (10%,n=2). Thirteen raised from right kidney, ratio of right to left involvement 1.8:1. Histologically 13(65%) patients had triphasic histology having blastemal, stromal and epithelial elements, 7(35%) was biphasic having blastema and epithelia. All had favourable histological pattern. Most patients presented in stage III (55%,n=11) followed by stage II (25%,n=5), Stage IV(10%,n=2), Stage I(10%,n=2). No bilateral presentation. Conclusions : Most of the patients of Wilms’ tumor presented within 1 to 5 years of age(80%) with abdominal distension(80%) and flank mass(75%), few associated with haematuria(15%) and hypertension(10%). Histologically all were favourable and maximum presented in stage III (55%) followed by stage II(25%). DOI: http://dx.doi.org/10.3329/jbcps.v32i1.21015 J Bangladesh Coll Phys Surg 2014; 32: 5-8

scholarly journals Evaluation of P53, E-cadherin, Cox-2, and EGFR protein imunnoexpression on prognostic of resected gallbladder carcinoma

2014 ◽  
Vol 27 (2) ◽  
pp. 126-132 ◽  
Author(s):  
Sergio Renato PAIS-COSTA ◽  
José Francisco de Matos FARAH ◽  
Ricardo ARTIGIANI-NETO ◽  
Sandro José MARTINS ◽  
Alberto GOLDENBERG
Keyword(s):  
Gallbladder Carcinoma ◽  
Radical Resection ◽  
Total Sample ◽  
Palliative Surgery ◽  
Over Expression ◽  
Dismal Prognosis ◽  
Gallbladder Adenocarcinoma ◽  
Independent Variable ◽  
Cox 2 ◽  
E Cadherin

BACKGROUND: Gallbladder carcinoma presents a dismal prognosis. Choice treatment is surgical resection that is associated a high levels of both morbidity and mortality. Best knowledgement of prognostic factors may result a better selection of patients either for surgical or multimodal treatment. AIM: To evaluate tecidual immunoexpression of P53, E-cadherin, Cox-2, and EGFR proteins and to correlate these findings with resected gallbladder adenocarcinoma survival. METHODS: Clinical, laboratorial, surgical, and anatomopathological reports of a series of gallbladder adenocarcinoma patients were collected by individualized questionary. Total sample was 42 patients. Median of age was 72 years (35-87). There were seven men and 35 women. Lesion distribuition in according TNM state was the following: T1 (n=2), T2 (n=5), T3 (n=31), T4 (n=4). Twenty-three patients underwent radical resection (R0), while 19 palliative surgery (R1-R2). A block of tissue microarray with neoplasic tissue of each patient was confected. It was performed evaluation of P53, E-Caderine, COX-2, and EGFR proteins imunoexpression. These findings were correlated with overall survival. RESULTS: Five-year survival was 28%. The median of global survival was eight months. Only immunoexpression of EGFR protein was considered independent variable at multivariated analysis. CONCLUSION: Final prognosis was influenced by over-expression of EGFR protein in tumoral tissue.

Aggressive surgery for stage IV gallbladder carcinoma; what are the contraindications?

2007 ◽  
Vol 14 (4) ◽  
pp. 351-357 ◽  
Author(s):  
Hideki Nishio ◽  
Masato Nagino ◽  
Tomoki Ebata ◽  
Yukihiro Yokoyama ◽  
Tsuyoshi Igami ◽  
...  
Keyword(s):  
Gallbladder Carcinoma ◽  
Stage Iv

scholarly journals Malignant Extracranial Germ Cell Tumours: A First Report by the South African Children’s Cancer Study Group

2021 ◽  
Author(s):  
Marc Hendricks ◽  
Annibale Cois ◽  
Jennifer Geel ◽  
Jan du Plessis ◽  
Mairi Bassingthwaighte ◽  
...  
Keyword(s):  
Germ Cell ◽  
South African ◽  
Economic Status ◽  
Clinical Stage ◽  
Elevated Serum ◽  
Treatment Protocol ◽  
Stage Iv ◽  
Germ Cell Tumours ◽  
Advanced Clinical Stage ◽  
Risk Of Death

OBJECTIVE  To determine the overall survival (OS) and prognostic factors influencing outcomes in children and adolescents with malignant extracranial germ cell tumours (MEGCTs) in preparation for the development of a harmonised national treatment protocol.METHODS A retrospective folder review was undertaken at nine South African paediatric oncology units to document patient profiles, tumour and treatment-related data and outcomes for all children with biopsy proven MEGCTs from birth up to and including 16 years of age. RESULTS Between 1 January 2000 and 31 December 2015, 218 patients were diagnosed with MEGCTs. Female sex (HR 0.284 p=0.037) and higher socio-economic status (SES) (HR 0.071; p=0.039) were associated with a significantly lower risk of death. Advanced clinical stage at diagnosis significantly affected 5-year OS: stage I -96%; stage II - 94.3%; stage III -75.5%; (p=0.017) and stage IV (60.1%; p<0.001). There was a significant association between earlier stage at presentation and higher SES (p=0.03). Patients with a serum AFP level of more than 33,000 ng/ml at diagnosis had significantly poorer outcomes (p=0.002). The use of chemotherapy significantly improved survival, irrespective of the regimen used (p<0.001). CONCLUSIONS The cohort demonstrated a 5-year OS of 80.3% with an EFS of 75.3%. Stage, the use of chemotherapy and an elevated serum AFP level of more than 33,000ng/ml were independently predictive of outcome. The relationship between SES and outcome is important as the implementation of the new national protocol hopes to standardise care across the socio-economic divide.

scholarly journals Social characteristics associated with outcome of paediatric human immunodeficiency virus admissions

2019 ◽  
Vol 6 (4) ◽  
pp. 1620
Author(s):  
Olusola Adetunji Oyedeji ◽  
Olasunkanmi Oladapo Olubanjo ◽  
Gabriel Ademola Oyedeji
Keyword(s):  
Human Immunodeficiency Virus ◽  
Parental Education ◽  
Economic Status ◽  
Tertiary Hospital ◽  
Social Characteristics ◽  
Background Information ◽  
Female Ratio ◽  
Immunodeficiency Virus ◽  
The Status ◽  
The Mean

Background: Information on social characteristics in human immunodeficiency virus (HIV) infected Nigerian children is scarce. The association between social characteristics such as single parenthood, low socio-economic status, polygamy and lack of parental education on the outcome of paediatric HIV admissions has been under studied.Methods: Information was obtained from the case notes of HIV infected children between the year 2006 and 2012 at a Nigerian tertiary hospital. Details of the information extracted include socio-demographics, diagnoses and outcome of management. Data was analysed with the SPSS 18 software.Results: Fifty (1.73%) of the total 2897 paediatric admissions were due to HIV disease. The mean age of the children studied was 3.7±2.9years and the 50 children were made up by 27 boys and 23 girls, giving a male to female ratio of 1:0.9. The mean age of the mothers and fathers were 28.7 and 36.7 years respectively. Pneumonia, septicaemia and tuberculosis accounted for more than 60% of admissions. Five (10.0%) children were from the upper, 12 (24.0%) from the middle and 33 (766.0%) from the lower socioeconomic classes. Twenty-four parents (couples) were both sero-positive for HIV and 7 discordant. Nineteen (38.0%) could not be classified because the status of the father was unknown. Of the 7 sero-discordant parents, 3 sero-negative fathers neglected their families. Thirty-nine children were from monogamous homes, nine from polygamous and two were raised by single parents. There were two discharges against medical advice and eleven deaths. The average number of siblings of the children studied was 2.57±2.1. Mortalities on admission were significantly associated with, parental financial constraints and the admitted HIV infected child having more than one sibling (p<0.05).Conclusions: It was concluded that appropriate interventions to manage these associations will most likely improve the outcome of admissions. Strategies of improving disclosure and prevention of negative outcome of disclosures, such as family neglect in sero-discordant couples also need to be identified. 

scholarly journals Prognostic Factors in Paranasal Sinus Squamous Cell Carcinoma and Adenocarcinoma: A SEER Database Analysis

2018 ◽  
Vol 80 (03) ◽  
pp. 258-263 ◽  
Author(s):  
Sumit Jain ◽  
Yan Li ◽  
Edward C. Kuan ◽  
Bobby A. Tajudeen ◽  
Pete S. Batra
Keyword(s):  
Squamous Cell Carcinoma ◽  
Multivariate Analysis ◽  
Prognostic Factors ◽  
Cell Carcinoma ◽  
Paranasal Sinus ◽  
Squamous Cell ◽  
Case Series ◽  
Stage Iv ◽  
Retrospective Case ◽  
Female Ratio

Background Outcome studies on sinonasal malignancy are limited to retrospective case series, often with inclusion of diverse histology and short follow-up. The objective of this study was to identify key predictive variables that independently impact survival for paranasal sinus squamous cell carcinoma (SCC) and adenocarcinoma (AC) and to compare these variables in the context of these two distinct clinicopathologic entities. Methods: Analysis was conducted using the Surveillance, Epidemiology, and End Results database from 1973 to 2012 to identify key variables that impact survival for SCC and AC. Results A total of 3,714 cases were included. There were 2,895 SCC cases and 819 AC cases. The mean age at diagnosis was 64.1 years. The male to female ratio for SCC and AC was 1.85 and 1.04, respectively. Patients with SCC and AC were most often diagnosed with stage IV disease in 61.8 and 63.4% of cases, respectively. The majority of patients received combined surgery and radiation (52% for SCC and 43.1% for AC). For SCC, increased age (p < 0.001) and stage (p < 0.001) were negative predictors, and surgery improved survival (p < 0.001) on multivariate analysis. For AC, prognostic factors associated with worse survival include increased age (p < 0.001) and grade (p < 0.001) on multivariate analysis. Overall survival was significantly higher in AC compared with SCC at 5 years (p = 0.001). Conclusion SCC and AC of the paranasal sinuses are both aggressive malignancies with poor survival. For both histological subtypes, increased age predicts worse survival and grade also closely links to survival in AC. These data have important potential implications for treatment planning and pretreatment counseling.

Early Gallbladder Carcinoma: A Single-Center Experience

2006 ◽  
Vol 92 (6) ◽  
pp. 487-490 ◽  
Author(s):  
Vincenzo Cangemi ◽  
Enrico Fiori ◽  
Cristina Picchi ◽  
Alessandro De Cesare ◽  
Roberto Cangemi ◽  
...  
Keyword(s):  
Gallbladder Carcinoma ◽  
Tnm Classification ◽  
Muscularis Propria ◽  
Surgical Approaches ◽  
Term Survival ◽  
Simple Cholecystectomy ◽  
Single Center Experience ◽  
Appropriate Treatment ◽  
Extended Cholecystectomy

Aims and background Controversy continues regarding the best surgical treatment for early gallbladder carcinoma defined as a tumor confined to the mucosa (pT1a) or to the muscularis propria (pT1 b) according to the TNM classification. This study evaluates the effectiveness of different surgical approaches in patients with early gallbladder carcinoma in terms of long-term survival. Materials and methods From 1980 to 2001, 175 patients with gallbladder carcinoma were admitted to our department. Fifteen of them underwent resections for early gallbladder carcinoma: 4 patients for pT1a tumors and 11 patients for pT1b tumors. All patients with pT1a tumors and 8 patients with pT1b tumors underwent simple cholecystectomy. The remaining 3 patients with pT1 b tumors underwent extended cholecystectomy. Results The 5-10 year cumulative survival rate was 100% for patients with pT1a tumors, 37.5% for patients with pT1b tumors who underwent simple cholecystectomy, and 100% for patients with pT1b tumors who underwent extended cholecystectomy. Conclusions Simple cholecystectomy is the appropriate treatment for patients with pT1a tumors, whereas patients with pT1b tumors require an extended cholecystectomy.

Follow-up patterns and associated risk factors after paediatric cataract surgery: observation over a 5-year period

2018 ◽  
Vol 102 (11) ◽  
pp. 1550-1555 ◽  
Author(s):  
Pratik Chougule ◽  
Shamsiya Murat ◽  
Ashik Mohamed ◽  
Ramesh Kekunnaya
Keyword(s):  
Cataract Surgery ◽  
Economic Status ◽  
Socioeconomic Group ◽  
Female Ratio ◽  
Logarithmic Curve ◽  
Age At Surgery ◽  
Developmental Cataract ◽  
Associated Risk Factors ◽  
Paediatric Cataract

PurposeTo study the pattern of compliance to follow-up of children less than 5 years of age undergoing surgery for congenital and developmental cataract over a period of 5 years.MethodsIt is a retrospective study of children less than 5 years of age undergoing cataract surgery between January and December 2010 for congenital or developmental cataract and followed up until 31 December 2015. Age, sex, distance from hospital and urban or rural habitat, delay in presentation, socioeconomic status, laterality, morphology and type of cataract, implantation of intraocular lens and interventions done were noted. Compliance to follow-up at postoperative 1 week, 1 month, 3 months, 6 months, 1 year and then once a year until 5 years were recorded.Results169 patients were included in the study. The median follow-up was 22 months. Median age at surgery was 10 months and had a negative correlation with total follow-up. Male-to-female ratio was 1.82. Logarithmic curve of follow-up was noticed with 85%, 61%, 55%, 52%, 39% and 28% patients attending 1 month, 3 months, 6 months, 1 year, 3 years and 5 years of follow-up, respectively. Low socioeconomic group had poor follow-up compared with higher socioeconomic group (P=0.009), but the curve of follow-up was similar in both groups; multiple interventions group had better follow-up (P<0.0001).ConclusionCurve of loss to follow-up is logarithmic in children undergoing paediatric cataract surgery. Age at surgery and low economic status are the most important factors associated with poor follow-up.

Multivariate analysis of factors affecting overall survival in minority-based population of young colorectal cancer patients: A single-institution experience.

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. e14186-e14186
Author(s):  
Shivi Jain ◽  
Kireet Agrawal ◽  
Shinoj Pattali ◽  
Abhijai Singh ◽  
Kamal Agrawal ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Overall Survival ◽  
Multivariate Analysis ◽  
Family History ◽  
Cancer Patients ◽  
Stage Iv ◽  
Female Ratio ◽  
Stage Iv Colorectal Cancer ◽  
Significant Difference ◽  
Colorectal Cancer Patients

e14186 Background: Overall survival in colorectal cancer is influenced by obesity, age, gender and stage at diagnosis. However, in minority based populations, effect of the above factors on overall survival has not been studied in any detail. Hence, we undertook this retrospective study to evaluate effect of above factors on overall survival in young colorectal cancer patients. Methods: 1,195 subjects with colorectal cancer treated at John H. Stroger Hospital of Cook County between 2000 and 2008 were retrospectively analyzed. 179 subjects with age 50 years and younger were identified. 146 of 179 subjects with available Body Mass Index (BMI) in kg/m2 were included in the study. Effect of BMI, age, sex, race, LDH and CEA levels, stage, site of tumor, smoking and family history on overall survival was evaluated using standard statistical multivariate analysis. Results: In our population, 22 of 146(15%) were underweight (BMI<20), 56 of 146(38.4%) were normal weight (BMI 20-24.9), 46 of 146(31.5%) were overweight (BMI 25-29.9) and 22 of 146(15%) were obese (BMI >30). Male: female ratio was 1.4:1. 75 of 146(51.7%) were African American, 23 of 146(15.9%) were Caucasians. 50 of 146(34.2%) were stage IV colorectal cancer at diagnosis. On univariate analysis, BMI<20(p=0.031, HR 2.1, 95% CI 1.15-3.82), CEA >4ng/ml (p=0.005, HR 1.93, 95% CI 1.21-3.08) and stage IV colorectal cancer (p<0.001, HR 6.1, 95% CI 2.42-15.53) were significantly associated with decreased overall survival. LDH<200 U/L was significantly associated with improved overall survival (p 0.029, HR 0.6, 95% CI 0.391-0.950). On multivariate analysis, stage IV colorectal cancer was a single significant independent predictor of overall survival (p=0.001, 95% CI 2.47-27.78). CEA>4ng/ml was marginally significant for decreased overall survival (p=0.06, 95% CI 0.978-3.015). On the contrary, no statistically significant difference was found on overall survival with age, BMI>20, gender, race, tumor location, smoking and family history. Conclusions: Advanced stage and CEA >4ng/ml are independent prognostic variables for decreased overall survival in minority based population of young colorectal cancer.

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