Government Royapettah Hospital is a major state-owned hospital situated in Royapettah in Chennai, India. The hospital with 712 beds is funded and managed by the state government of Tamil Nadu. It was founded in 1911 and is attached to Directorate of Medical Education. It is the city's largest peripheral hospital, and its limit extends up to Chengalpattu.
Adequate lymph node (LN) retrieval during D2-gastrectomy is critical for staging accuracy in gastric cancer. Debate continues regarding the prognostic value of absolute LN yield versus other nodal parameters such as LN positivity ratio and nodal stage. A retrospective analysis of 70 patients undergoing D2-gastrectomy from 2019 to 2024 evaluated associations of LN yield, LN ratio, nodal stage, and surgery timing with mortality. Statistical tests included Fisher’s exact test and Mann–Whitney U. LN yield (< 30 vs. ≥ 30) was not associated with mortality (p = 0.628). LN ratio and nodal stage were significantly associated with mortality (p < 0.05). Multivariate analysis did not identify independent predictors, likely due to collinearity among nodal variables. LN positivity ratio and nodal stage outperform total LN yield as predictors of overall mortality. Incorporating LN ratio into staging systems may improve prognostic stratification.
Objectives: Laparoscopic pelvic lymph node dissection (LPLND) is an integral part of surgical staging and treatment of gynecologic malignancies. Although the laparoscopic approach has reduced postoperative morbidity compared to open surgery, lymphatic complications such as lymphorrhea, lymphocele, and lower limb lymphedema continue to occur. This study aimed to determine the incidence, pattern, and clinical outcome of lymphatic complications following LPLND in gynecological malignancies. Material and Methods: A prospective observational study was conducted, including 68 patients with carcinoma of the endometrium or cervix who underwent LPLND between January 2023 and April 2024 in a tertiary care oncology center. Results: Of 68 patients, 41 (60.3%) had carcinoma of the cervix and 27 (39.7%) had carcinoma of the endometrium. Lymphatic complications occurred in 7 patients (10.3%). Among them, 5 (7.3%) developed lower limb lymphedema, 4 (5.8%) developed lymphocele (with one symptomatic case requiring aspiration), and 1 (1.4%) experienced transient lymphorrhea. Six out of seven (85.7%) affected patients had received radiotherapy. The mean number of lymph nodes retrieved in the complication group was 11. The average time to presentation of lymphocele was 5 months. Conclusion: Lymphatic complications following LPLND are infrequent and mostly subclinical, and radiotherapy increases susceptibility. Regular postoperative imaging follow-up enables early detection and conservative management. Laparoscopic PLND remains a safe and effective approach with minimal lymphatic morbidity.
Elderly women with breast cancer frequently encounter challenges in completing multimodal treatment due to comorbidities, frailty, and treatment-related toxicity. The present study assessed the rate of treatment completion, reasons for non-completion, and the impact on survival and recurrence outcomes. A retrospective analysis was conducted among 104 women aged ≥ 70 years with histologically confirmed breast carcinoma treated between January 2020 and December 2023. Demographic, pathological and treatment details were reviewed. Completion of surgery, chemotherapy, radiotherapy, endocrine therapy, and anti-HER2 therapy was evaluated. Survival outcomes were analyzed using Kaplan–Meier methods and compared using the log-rank test; p < 0.05 was considered statistically significant. The mean age was 73.4 years, and 57.7
Breast tissue markers play a pivotal role in the management and treatment of breast cancers. These markers not only facilitate the accurate monitoring of lesions over time but also support surgical planning. Although there are many types of commercial clips and markers, they are relatively expensive and represent quite a considerable economic burden that warrants other low cost alternatives such as titanium vascular clips. This pilot study explores a novel technique to mark the tumor with titanium clips using coaxial needle under ultrasound guidance aiming to validate the accuracy of the technique. This prospective interventional pilot study was conducted between April 2023 and April 2024. All patients gave informed consent before enrolment in this study. Our study was approved by the Instituitional ethical committee. Patients were included when presenting with unifocal operable breast cancer confirmed by mammogram (stage T1 and T2) hormone receptor positive and subsequently planned for BCS or Mastectomy. Those with inflammatory breast cancer, metastatic disease, prior extensive breast surgery, tumor recurrence, multicentric or multifocal lesions, ECOG performance status > 2 were excluded from this study. Tumor marking done at the time of core biopsy of the lesion. Under aseptic precautions, the patient was positioned supine. A 17G coaxial needle was inserted into the tumor center under ultrasound guidance, and a Ligaclip-200 titanium clip was deployed using the blunt stylet. Placement was confirmed sonographically (hyperechoic reflection). Post-surgery specimen mammography confirmed clip retrieval, and the pathologist verified its location within the tumor during sectioning. Mean age was 51.1 ± 11.1 years. The right breast was involved in 60
Background and Aims: Lateral extra-articular tenodesis (LET) is increasingly used as an adjunct to anterior cruciate ligament reconstruction (ACLR) to reduce graft failure, particularly in high-risk patients. Multiple femoral fixation techniques for LET have been described; however, their relative effectiveness in improving graft survivorship and associated complications remains unclear. Materials and Methods: A systematic review and meta-analysis were performed in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Electronic databases were searched for studies comparing ACLR with and without LET using the modified Lemaire technique. Subgroup analyses were conducted based on femoral fixation method, graft type, reconstruction setting (primary vs. revision), and level of evidence. The primary outcome was anterior cruciate ligament (ACL) graft failure. Pooled odd ratios (ORs) were calculated using a random-effects model. Results: Eleven studies encompassing 2208 knees were included. Overall, ACLR augmented with LET significantly reduced graft failure compared with isolated ACLR (OR, 0.45; 95% confidence interval [CI], 0.30–0.68; p = 0.0002). Subgroup analysis demonstrated a significant reduction in failure rates with anchor fixation (OR, 0.31; 95% CI, 0.13–0.75) and staple fixation (OR, 0.43; 95% CI, 0.23–0.79). Screw, button, and suture fixation did not demonstrate statistically significant reductions in graft failure. No significant heterogeneity was observed across analyses. Conclusion: LET augmentation significantly improves ACL graft survivorship compared with ACLR alone. Anchor and staple femoral fixation methods demonstrate the greatest clinical benefit; however, overlapping confidence intervals preclude definitive superiority of one technique.
