Trans Tracheal Approach to the Oesophagus: Case Report

Hypopharyngeal squamous cell carcinoma (SCC) is a rare form of malignancy and treatment approach is most commonly with chemo-radiotherapy or total pharyngolaryngoesophagectomy. We report a case of hypopharyngeal SCC managed with local resection and larynx preservation in a 77-year-old-woman. Total pharyngolaryngoesophagectomy renders patients with an alteration in both voice and ability to swallow hence carrying signifi cant post-operative morbidity. We review the literature for similar larynx-preserving operations and illustrate a novel approach to the management of this rare malignancy.</p

Pancreaticoduodenectomy in a low-resection volume region: a population-level study examining the impact of hospital-volume on surgical quality and longer-term survival

Background: An association between higher hospital-volume and better “quality of surgery” and long-term survival has not been reported following pancreatic cancer surgery in low resection-volume regions such as in Australia. Using a population-level study, we compare “quality of surgery” and two-year survival following pancreaticoduodenectomy between Australian hospitals grouped by resection-volume. Methods: Data on all patients undergoing pancreaticoduodenectomy for adenocarcinoma in the Australian state of Queensland, between 2001 and 2015, were obtained from the Queensland Oncology Repository. Hospitals were grouped into high (≥6 resections annually) and low

Laparoscopic versus open appendectomy: Prospective randomized trial

A prospective randomized trial comparing laparoscopic appendectomy with open appendectomy in patients with a diagnosis of acute appendicitis was conducted between October 1992 and April 1991. Of the 158 patients randomized, 7 patients were excluded because of protocol violations (conversion to laparotomy in 4, appendix not removed in 3). The 151 patients randomized to either a laparoscopic (n = 79) or an open appendectomy (n = 72) showed no difference in sex, age, American Society of Anesthesiology (ASA) rating, or previous abdominal surgery. The histologic classification of normal, catarrhal, inflamed, suppurative, and gangrenous appendicitis was not different between the two groups. Conversion from laparoscopic to open appendectomy was necessary in seven patients (9%) who had advanced forms of appendiceal inflammation, When compared to open appendectomy the laparoscopic group had a longer median operating time (63 minutes versus 40 minutes), fewer wound infections (2% versus 11%), less requirement for narcotic analgesia, and an earlier return to normal activity (median 7 days versus 14 days). There was no difference in morbidity, and both groups had a median time to discharge of 3 days. Laparoscopic appendectomy is as safe as open appendectomy; and despite the longer operating time, the advantages such as fewer wound infections and earlier return to normal activity make it a worthwhile alternative for patients with a clinical diagnosis of acute appendicitis