Mortality at Ibn sina surgical gastroenterology unit as predicted by possum with brief literature review

Failure to identify the high ris k factors for surgery and/or anesthesia is a serious medico-legal pitfall particularly if unexpected consequences ensue. Compare the mortality rate at Ibn Sina Surgical gastro-intestinal unit using POSSUM predicted mortality with the observed mortality. A prospective collection of data for patients admitted in 6-month period. Demographic data, symptoms, co-morbid illnesses, physical examination, results of investigations, operative findings were recorded as well as the follow up for one month. The data was fed to a POSSUM computer program to determine the predicted mortality. The univariate and multivariate analysis was done with SPSS. 252 patients were studied. They were 132 [52.4%] males. Mean [ +/- SD] age 49[ +/- 12.29] range 10-90 years. 216 [85.7%] patients underwent suigrey. The overall observed mortality was 32 [12.7%] patients. 10 [27.8%] patients died before surgery. The highest mortality was 9 [27.3%] in cases of carcinoma head of pancreas. Carcinoma of the stomach has observed mortality of 6 [42.9%] patients while its predicted mortality range from 1.7% to 35.7% with mean of 17.9%. Multivariate analysis showed that factors which have significant association with the observed mortality are the physiological score P 0.0001, age P 0.0001, predicted mortality P 0.0001 and inoperability P 0.0020. POSSUM has under-predicted mortality in gastric, oesophageal and cholangiocarcinoma. The out come of management of other types of cancer as oesophageal and colorectal cancer as well as the benign diseases of the gastrointestinal tract is consistent with the predicted values of the POSSUM. Therefore POSSUM is a good risk adjusted criteria for predicting mortality in GIT surgical diseases at Ibn Sina Hospital

Audit of advanced gastric cancer at Ibn sina Hospital khartoum Sudan

Worldwide, gastric cancer is the second most common cancer [second to lung cancer]. In Sudan incidence and prevalence are not clear because of absence of National Cancer Registry. To find out the frequency of the gastric mesenchymal tumours, whether gender and age influences [the clinico-pathological] features of gastric cancer and to audit the outcome of management of advanced gastric cancer at Ibn Sina Hospital. This is a retrospective study in 139 gastric cancer patients admitted from May 1997 through November 2004. Demographic data, details of the clinical, endoscopic features of gastric cancer, as well as the operative details, and histopathology, the post-operative complication, and hospital mortality were analysed. Available data on fami ly history of cancer; smoking and alcohol consumption was also collected. Mesenchymal tumours account for 15 [10.9%] of all gastric cancer. Lymphoma alone constituted 5.8% while leiomyosarcoma constituted 4.4%. Hospital mortality rate was zero%, 2.8%, and 3.6% in distal subtotal, proximal subtotal and total gastrectomy respectively. Hospital mortality was 18 [12.9%] patients. Age and sex have no significance on the clinicopathological features of advanced gastric cancer