Clinico-pathological characteristics of colorectal carcinoma at university teaching hospital, Nepal

Introductions: Colorectal cancer is a major health problem in developingcountries. The purpose of this study was to analyze the clinico-pathologicalcharacteristics of colorectal carcinoma at Patan hospital, Nepal.Methods: A retrospective chart review was done for patients operatedfor colorectal carcinoma at Patan Hospital from May 2004 to April 2012.Demographic information, chief complains, site of primary cancer, andhistological types were analyzed.Results: There were 73 patients (37 males and 36 females) with colorectalcarcinoma. The mean age was 52 years. There were 21 (28.77%) patients below 40 years of age. Patients with rectal carcinoma presented with bleeding per rectum in 69.70% and 60% of patients with colon cancer presented with pain abdomen. Rectum was involved in 31 (42.47%) and right colon in 30 (41.10%). Adenocarcinoma was seen in 72 (98.63%).Conclusions: The colorectal carcinoma is not only the disease of old age. Wehad 29% of our patients below 40 year. Rectum and right colon were equallyaffected.Keywords: bleeding, colorectal carcinoma, pain abdome

Clinical profile and surgical outcome of abdominal hydatid cyst at a university hospital in Nepal

Introductions: Hydatid cyst is caused by the tapeworm. It is common in sheep and cattle rearing communities. Liver is the most common affected organ. There are various methods of surgical approaches for hydatid cyst. Methods: This was a retrospective descriptive study of patients operated for intra-abdominal hydatid cysts from July 2012 to June 2018 at Patan Hospital, Patan Academy of Health Sciences, Nepal. Ethical approval from institutional review committee was obtained. Patient files with incomplete data were excluded. Variables analyzed were, age, gender, site and numbers of cyst, methods of surgery, complications and mortality. Data were descriptively analyzed. Results: There were 19 patients of abdominal hydatid cysts who underwent surgery during the study period. Five records files could not be accessed and were excluded. In remaining 14, male were 6 (42.85%), female 8 (57.15%), mean age 39.57±17.35 years (14-70), cyst size 11±4.22 cm (5-21), complain of abdominal pain in 10 (71%). Open surgery for liver cyst was done in 11 and laparoscopic in one, and open splenectomy for two splenic cysts. One patient developed superficial wound infection. Four had cystobiliary communication of which one underwent ERCP. Post ERCP patient developed acute severe pancreatitis and expired. Mean hospital was 8.57±2.24 days (6-14). Conclusions: Liver was the main organ involved, abdominal pain and lump were main presenting complaints. Surgery had successful outcome. Open surgery was the mainstay of treatment. Keywords: echinococcus granulosus, hydatid cyst, hydatidosi

Clinicopathological profile of colorectal cancer managed at a university teaching hospital, Nepal

Introductions: Colorectal carcinoma is the third most common cancer worldwide. The incidence is increasing in developing countries including Nepal. The aim of this study is to find out the clinicopathological pattern of colorectal carcinoma locally.  Methods: Data were recorded retrospectively by reviewing the charts of the patients who were diagnosed and treated for in patients having colorectal cancer managed during three years period of 2016-9 at Patan Hospital, the university teaching hospital of Patan Academy of health sciences, Nepal. Clinicopathological profile, age, gender, surgery, histopathological findings were descriptively analised. Results:  There were 36 colorectal cancer patients, male 20 (56%) and females 16 (44%), mean age 56.9 years (range 24 to 89). Curative surgery was possible in 17 (47.2%) and adenocarcinoma of moderate differentiation was found in 25 (70%) of the resected specimen. Conclusions: Colorectal carcinoma was found in old age, slightly more in male than female, adenocarcinoma being most common histology type.  Keywords: adenocarcinoma, colorectal carcinoma (CRC), curative resectio

Spectrum of paediatric surgical cases and their outcome in tertiary care hospital: Pediatric surgical cases and their outcome

Introduction: Pediatric surgical cases are operated by general surgeon due to lack of pediatric surgeons. Complex cases in neonates and infants is being referred to other centers with pediatric surgical services. This study aims to compare the spectrum of pediatric surgical cases and their outcomes before and after the availability of pediatric surgeon. Method: This retrospective study was conducted at the Patan Hospital, Nepal, over a period of 4 years. Group 1 (G1) included surgeries during 1st 2 y before and Group 2 (G2) during 2nd 2 y period after the availability of pediatric surgeon. Ethical approval was obtained. Patient age, sex, diagnosis, operative procedure, type of surgery, and outcome were analyzed.  Result: Of 1157 cases, 369 were in G1 and 788 in G2. The male to female ratio was 2.8:1. Laparotomies 270(23.2%) was the most performed inpatient surgery and herniotomies (221(19.1%) in day care. There were 52 (4.5%) neonates; 2(4%) in G1 and 50(96%) in G2. Among total cases, the mortality rate was 8(0.7%) in G2, due to preterm birth, delayed presentation, and septicemia. Conclusion: Laparotomy and incision & drainage were the most commonly performed surgeries. There was a 96% increment in neonatal cases (50 v/s 2) after the availability of pediatric surgeon. Mortality was 8(0.7%) in group-2 due to delayed presentation and septicemia. Keywords: Daycare surgery, mortality, neonatal surgery, outcome, pediatric surgical services