Validity of surgical bypass in un-resectable pancreatic cancer

To evaluate the efficacy of surgical bypass as a palliative procedure in patients with pancreatic cancer. This prospective descriptive analytical study was conducted at Liaquat University of Medical and Health Sciences, Jamshoro, Sind, Pakistan from January 2005 to December 2010. All patients with obstructed jaundice and gastric outlet obstruction, later on diagnosed as pancreatic cancer are included in the study. LFT'S, Blood CP, Ultrasound abdomen, CT scan abdomen, and x-ray chest were performed in all patients. Surgical treatment was planned after assessing the resectability of the tumor. The variables studied included presentation, procedure performed, post operative complications and follow up after discharge from the hospital. The Chi square test is applied and data were statistically analyzed on SPSS v17. Forty three patients with a mean age of 62.09 +/- 6.782, with advance carcinoma of head of pancreas were operated and bypass surgical palliation was done. The morbidity, mortality and efficacy of various surgical bypass operations are evaluated. Bilio-gastric bypass still offers a reasonably safe and effective method of billiary decompression and duodenal obstruction caused by inoperable pancreatic cancer

Identification of recurrent laryngeal nerve during thyroidectomy decreases the risk of nerve injury

To determine the effect of Recurrent Laryngeal Nerve [RLN] exposure on the incidence of nerve injury, and compare the injury rate with that when nerve is not exposed during thyroid surgery. This prospective observational study was carried out in department of general surgery, at Liaquat University of Medical and Health Sciences, Jamshoro, from January 2005 to December 2006. A total of 120 patients were included, with 24 males and 96 females [male: female of 1: 4]. Mean age of our patients was 30.85 years [range 14-68 years]. The different surgical procedures, performed on thyroid gland included total thyroidectomy 23, near total thyroidectomy 58, subtotal thyroidectomy 28, and hemi-thyroidectomy 11. The RLN was exposed in 60 patients, in other group of 60 patients thyroidectomy was carried out without exposing RLN, and incidence of nerve injury was compared between two groups. RLN identification decreased the nerve injury incidence from 5% to 1.6%. When recurrent laryngeal nerve is not identified during thyroid surgery the chance to incur damage to RLN is statistically significant [Chi square at 1df 0.000] We believe that RLN identification during thyroidectomy would be the best approach to avoid nerve injury

audit of renal cell carcinoma at Hyderabad

To audit the patients of Renal Cell Carcinoma treated in Surgical Unit-IV, Liaquat University Hospital Jamshoro, Hyderabad. Prospective interventional study conducted from Jan. 2000 to Dec. 2004. Department of Surgery, Liaquat Medical University Hospital, Jamshoro. All patients who presented with Renal Cell Carcinoma during the study period. The history and examination findings of all these patients was recorded. Complete blood picture, urine analysis, liver function tests, ultrasound abdomen, IVU and CT scan was done in all the cases. Staging was done according to the TNM classification and surgery performed in fit patients. A total of 39 cases of Renal Cell Carcinoma were seen during the study period, with a male to female ratio of 3.3:1 and a mean age of 46 years. Most [61.53%] patients presented with a mass in the abdomen; 51.28% were in Stage-II and 25. 64% in stage-III. Thirty four [87.18%] cases were operated, the rest being unfit. Radical nephrectomy was done in 51.28% cases, simple nepherectomy in 10.26%, debulking surgery in 20.51% and biopsy only in 5.13% cases. Three [8.8%] patients died due to postoperative complications. Radical surgery is the curative treatment for Renal Cell Carcinoma. Cases should be diagnosed early in order to decrease the morbidity and mortality of the disease