Oesophageal cancer is one of the most aggressive neoplasms of the digestive tract, with high morbidity and mortality. According to histology, squamous cell carcinoma and adenocarcinoma are among the most common, constituting 90% of esophageal neoplasms patients with unresectable tumors with metastasis presence or with medical contraindications for surgical treatment with a less than three month survival; there are several palliative therapies available for this kind of patients in order to improve swallowing as much as possible, as well as the placement of multiple self-expanding metal esophageal stents to improve digestive transit in cases of stenosis and recurrence of dysphagia due to tumor overgrowth. A case report is presented with the aim of assessing the effectiveness of multiple self-expanding prostheses placement in a patient with esophageal tumor overgrowth. The patient was continuously assessed over a period of three years. According to the international literature, it has been shown that the insertion of new coated prostheses prevents or delays obstruction. The patient was assessed by a follow-up study: a week, a month and six months later. Then, she was regularly assisted in the outpatient department with this aim, the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Core 30 (EORTC QLQ-C30) and its EORTC QLQ-OES18 (European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Oesophagus-specific-18) EORTC complement were applied, in order to improve the life quality according to the patient's perception.
Wounds and their management are fundamental to the practice of surgery. In any elective surgery or in the surgery of trauma, the surgeon’s task is to minimize the adverse effects of the wound, remove or repair damaged structures and enhance the process of wound healing to restore function. Because of unavoidable contamination of wounds that occurs at the time of surgery, surgeons have used a number of methods of wound management. Use of subcutaneous drains at the site of surgery is one of them. The study was carried out prospectively on patients of contaminated abdominal surgeries to assess the role of placement of negative suction drains in wounds subcutaneously on the incidence of incisional Surgical Site Infections (SSIs). This study was a prospective, open and comparative cohort study. Patients were divided into two groups by random sampling. Total sample size was 300 patients with 150 in each group. Subcutaneous suction drains were inserted in one group (cases) and no drains were inserted in another group (control). The results from the present study show that use of negative suction drain in subcutaneous plane during laparotomy for class III wounds reduces the incidence of postoperative surgical site of infection, seroma formation and wound dehiscence. It was concluded that insertion of subcutaneous suction drains at the end of operation could provide effective drainage of the wound collections and wound seroma, thereby preventing SSI and wound dehiscence.
Objective: We evaluated the efficiency of 3-dimensional Computed Tomographic Angiography (3D CTA) performed with 64-channel Multidetector Computed Tomography (MDCT) to assess vascular anatomy before laparoscopic gastrectomy.Materials and Methods: 20 patients with early gastric cancer scheduled for laparoscopic gastrectomy were evaluated. Dual phase IV contrast CTA was performed before laparoscopic gastrectomy. Arterial and venous phase images were obtained after rapid infusion of contrast agent with an interval of 15 seconds serially during single breath hold of 31 seconds.Results: In all patients, 3D CTA showed Left Gastric Artery (LGA), Left Hepatic Artery (LHA), Right Gastric Artery (RGA) and Left Coronary Vein (LCV) with celiac trunk. Celiac trunk branching pattern was classified according to Michel’s method and in 18 cases, Michel’s type 1, in 2 cases Michel’s type 2 were identified. RGA was originated from Gastro Duodenal Artery (GDA) in 16 cases, from Superior Mesenteric Artery (SMA) in 2 cases and from Proper Hepatic Artery (PHA) in 2 cases. LCV was draining into Superior Mesenteric Vein (SMV) in 18 cases and into Portal Vein (PV) in 2 cases. In 12 of the cases LCV was coursing dorsal to PHA, Common Hepatic Artery (CHA) and Splenic Artery (SA), in 6 cases LCV was coursing ventral to these vessels and was joined to SMV. In 2 cases whose LCV was draining into PV, it was coursing ventral to CHA.Conclusion: Dual phase CTA is successful to define perigastric vascular structures and reduces the risk of vascular injuries when performed before laparoscopic gastrectomy.
Gastrointestinal (GI) tract also known as alimentary canal started from mouth till to the anus which is responsible for transportation, digestion of the food, and absorption procedure. Various micro-organisms are present in the digestive tract which is responsible for these processes but imbalance in gut microbiota can lead to various digestive disorders for example constipation, diarrhea, skin irritations, autoimmune conditions, food intolerance etc. It is believed that unhealthy gut microbiome may lead to Inflammatory Bowel Disease (IBD) which is an Autoimmune Disorder. IBD is the inflammatory condition of colon and intestine. Ulcerative colitis and Crohn’s disease are the type of inflammatory bowel disease. Ulcerative colitis specifically affects the colon and rectum whereas Crohn’s disease affects small intestine as well as large intestine. In this review, recently associated disorders linked with ulcerative colitis have been discussed in brief along with the comparison of UC and Crohn’s disease. It is very important to understand the differences between both of them as symptoms are most likely the same.
