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Awardees and forthcoming events

July-December 2018, 1(2):60-60
  1 1,877 213
Perineal scar endometriosis
Arshad Ahmed Baba, Asif Mehraj Dar, Arshed A Parray, Mudassir Ahmed Khan, Mushtaq Ahmed Laway, Nisar Ahmed Chowdri
January-June 2018, 1(1):30-33
Endometriosis is defined as the presence of endometrial tissue outside the uterus and is common in fertile women. Pelvis is the most frequent location of the endometriosis. Endometriosis is mostly found in peritoneal surfaces but can also involve the vagina, vulva, rectovaginal septum, and perineum usually postobstetric, gynecological, or other surgical trauma. Extrapelvic endometriosis has been reported in any region of the body including bowel, bladder, lung, kidney, extremities, perineum, and umbilicus. We present a case of a patient perineal surgical scar endometriosis. The endometriotic scar nodule was surgically excised. Postoperatively, The patient was treated with gonadotropin-releasing hormone analogs. The surgical outcome was successful, and the patient is on our close follow-up and reports that she is asymptomatic during subsequent menstrual periods unlike before.
  1 3,334 340
A rare case of small-bowel obstruction due to broad ligament herniation
Dilip Rajasekharan, Devapatla Shanthakumar, Srinath Subbarayappa, Jayanth Bannur Nagaraja
July-December 2018, 1(2):57-59
Small-bowel obstruction is a common cause of acute abdomen throughout the world. Internal hernia as the cause of small-bowel obstruction is exceedingly rare and accounts for only about 1% of all acute obstructions. Of this, a very small fraction may occur through defects in the broad ligament, whether congenital or iatrogenic. The symptomatology is consistent with that of small-bowel obstruction due to any other cause rendering preoperative diagnosis extremely difficult. Most cases are recognized intraoperatively. The complications are dreaded, as bowel gangrene and perforation secondary to prolonged herniation are well documented. A high index of suspicion is, thus, needed. In this case report, we present a patient of jejunal loop herniation into broad ligament who presented with acute intestinal obstruction.
  1 2,312 193
Recurrence rates and fecal incontinence after fistulotomy or fistulectomy
Qaidzohar Kanchwala, Dinesh Jain, Deepak Phalgune
July-December 2018, 1(2):43-47
Background: In spite of the availability of various treatments for fistula-in-ano, consensus cannot be reached as to the best form of treatment with regards to recurrence and incontinence. Fistulotomy and fistulectomy remain the two most commonly practiced surgeries. The study was undertaken to compare the recurrence rates and fecal incontinence in patients undergoing fistulotomy or fistulectomy. Materials and Methods: Hundred and ten patients with primary or recurrent fistula-in-ano of low anal type were included. Fistulectomy and fistulotomy were performed in 53 and 57 patients, respectively. The final follow-up at 6 months postoperative was done to assess any recurrence. The patients were required to fill Wexner's questionnaire at the monthly follow-up to monitor incontinence. Statistical significance of the difference of categorical and continuous variables was tested using the Chi-square test and unpaired t-test, respectively. Paired t-test was used for intra-group comparison. Results: At 6th month follow-up, Wexner's score was normal in 49/53 (92.5%) and 52/57 (91.2%) fistulectomy and fistulotomy patients, respectively, which was not statistically significant (P = 0.564). Mean Wexner's score at 6 months follow-up was significantly less as compared to 1st week follow-up in both fistulotomy and fistulectomy groups. Recurrence rate was 5/57 (9.4%) and 7/53 (12.3%) in fistulectomy and fistulotomy patients, respectively, at 6 months follow-up which was not statistically significant (P = 0.763). Conclusion: Fistulotomy and fistulectomy are equally effective in the treatment of low anal fistulas with acceptable rates of recurrence and fecal incontinence at 6 months follow-up after surgery.
  1 7,556 334
Role of lateral pelvic lymph node dissection in rectal cancer: A systematic review and meta-analysis
Ashwin Rajendiran, Sachin Shenoy, Ahmed Shalaby, Y KS Viswanath, Venkatesh Shanmugam
May-August 2020, 3(2):41-51
Introduction: Total Mesorectal excision (TME) is globally accepted as the standard treatment for rectal cancer. Lateral lymph node dissection (LLND) is still an oncological debate among colorectal surgeons and practiced routinely in some centers of the Eastern world (Japan and Korea) based on limited evidence. Aims: This review aims to determine the oncological and survival benefit of adding LLND to standard TME and also the additional morbidity associated. Outcomes Measured: The primary outcomes are local recurrence, 5-year overall survival and disease-free survival. The secondary outcomes are the incidence of urinary and sexual dysfunction. Materials and Methods: A systematic review protocol was followed. A structured search was run across MEDLINE, OVID, and COCHRANE databases. Five articles from three randomized trials were included. Meta-analysis was performed using Revman 5.3™. Results: No difference was noted between TME and TME + LLND for local recurrence (odds ratio [OR] 0.77, 0.44, 1.35), disease-free survival (OR 1.04, 0.81, 1.34), and overall survival (OR 1.05, 0.79, 1.41). The degree of heterogeneity was within acceptable limits. The OR for urinary dysfunction (OR 2.02, 0.45, 9.11) and male sexual dysfunction (OR 3.96, 0.54, 28.82) had wide confidence intervals and significant heterogeneity; the overall effect was not statistically significant. Conclusion: Our study included only randomized controlled trials and noted no difference in the oncological or survival outcomes. Previous reviews have included nonrandomized studies in a desperate attempt to produce evidence for or against LLND. A carefully arranged International controlled trial is necessary to settle this East-West controversy.
  1 1,807 154
Surgery for hemorrhoids: A review
Kum Kum Singh
January-June 2018, 1(1):14-16
There are various surgical options available for treatment of heamorrhoids. It essentially depends on the grade of heamorrhoids. Each option has its pros and cons. This article reviews the various surgical options
  1 4,176 406
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