Esophagectomy for Cancer of the Esophagus- GMC Jammu Experience

We retrospectively reviewed a data of 202 patients, who underwent esophagectomy for cancer of the esophagusover 12 years at GMC, Jammu. Out of 262 patients, 202 patients underwent esophagectomy, mean age was53 years, ranging between 31-75 years. 160 patients had squamous cell carcinoma and 31 patients hadadenocarcinoma. 148 patients underwent transhiatal esophagectomy (Orringer’s procedure), whereas 18patients underwent McKeown’s three incision procedure and 10 patients underwent transthoracic esophagectomy(Ivor lewis) procedure. It was observed that mid third tumors accounted for 40%, lower third tumorsaccounted for 55 % and GE junction tumors 5% of the cases. Squamous cell carcinoma was the mostcommon histology (79.5 %). The overall morbidity (significant complications leading to prolonged hospitalization)was 38 %. Perioperative mortality was 13(6.43%). We hereby conclude that esophagectomy is a majorsurgical operation and gives palliation of dysphagia to patient and our experience with it has been with acceptablemorbidity and with favorable short-term results.

Empyema Thoracis- Our Ten Years Experience.

Empyema still remains one of the serious problems and challenge for a thoracic surgeon , despite the wide spread use of antibiotics and other surgical modalities its treatment is controversial with or without bornchpleural fistulae. Our experience in 200 patients of empyema with or without bronchopleural fistula was retrospectively reviewed. The causes of empyema were as follows. Parapneumonic (n=140), post tubercular empyema (n=20), following trauma (n=16), Post surgical (n=10), subdiaphragmatic pathology (n=2), oesophageal rupture (N=5) and underdetermined + 17. Broncho- pleural fisyula was found to be present in 20 % of these patients. Therapeutic thoracentesis was carried out successfully in 22 patients and closed tube thoracostomy in 178 patients and success was obtained in 89 patients (50 %) decortication alone in 60 patients (30 %). Thoracoplsty with muscle with muscle flap interposition in n=13, open drainage with rib resection (Eloesser flap) in ten patients , six patients refused any surgical intervention .

Phalangeal Osteosarcoma Mistaken for Tuberculosis: A Case Report

We report a 21-year old female patient who presented with an 18-month history of a swelling in the distal phalanx of her right little finger. Although the history, clinical features and MRI were suggestive of a benign tumour or a tuberculous lesion, the histo-pathological examination of the swelling was reported as a conventional osteosarcoma. Osteosarcoma of the hand is very rare. This article highlights the possibility of a seemingly benign lesion seen in a routine clinic could well turn out to be malignant, and the need to maintain a high index of suspicion

Foreign Body in the Wharton’s Duct

A case of unusual presentation of a vegetative foreign body in the Wharton’s duct is reported. The patient presented with history and clinical findings of recurrent left submandibular sialadenitis. Surgical excision of the submandibular gland was performed and during the ligation of the Wharton’s duct, a wooden splinter was found inside the lumen of the duct. Retrospectively, patient gave the history of ingestion of the same wooden splinter, lodging in the Wharton’s duct and subsequently causing recurrent attack of sialadenitis.