Laparoscopic assisted right hemicolectomy. An experience of laparoscopic assisted right hemicolectomy in benign disease -- tuberculosis

To assess the outcome of laparoscopic assisted right hemicolectomy in benign diseases like tuberculosis. Prospective observational study. Surgical unit-I of Jinnah Hospital Lahore. Jan 2009 and June 2010. This study included a series of twenty patients with preoperative clinical diagnosis of ileocecal tuberculosis. A three trocar technique was used to perform laparoscopic right hemi colectomy and anastomosis was performed outside the abdomen by extending the supraumbilical incision. Data of 20 patients who underwent laparoscopic assisted right hemicolectomy was analyzed. Mean age of the patients was 27.5 years with male to female ratio 4:1 [Table-I]. There was zero conversion [0%] to open surgery and no intra-operative complications [0%] were observed. Average hospital stay was 5.8 days. No patients had to be re operated. On histopathology of specimen final diagnosis was 95% ileo cecal tuberculosis and one patients [5%] turned out to be having lymphoma [Table-III]. The laparoscopic colon surgery can produce excellent results in selected patients of abdominal tuberculosis. Advantages of laparoscopic over open surgery include less postoperative pain, short-term postoperative ileus, earlier return to daily activity

phase II study of cisplatin and 5-fluorouracil combination chemotherapy and concurrent thoracic radiation in squamous cell carcinoma of lung

To evaluate the efficacy and toxicity of cisplatin, 5-fluorouracil combination chemotherapy and concurrent thoracic radiation in squamous cell carcinoma of lung. A prospective, non randomized, quasi-experimental, phase II study which was conducted in the Department of Clinical Oncology Mayo Hospital/KEMC Lahore. This study was conducted from September 2002 to May 2004. Twenty two patients of histopathologically confirmed squamous cell carcinoma of lung were enrolled. Stage III B or stage IV patients requiring radiation therapy for control of local symptoms were included. These patients were treated with chemotherapy and concurrent chest radiation. The treatment regimen included cisplatin 80mg/m2 on day one and day "28" and 5-FU 750mg/m2 day 1-4 and day "28-31". Radia-tion was started on day one and a tumor dose of 50 Gy was delivered in 25 fractions. Common Toxicity Criteria and RTOG criteria were used to assess toxicities. Miller's criteria were used for response evaluation. Responses were evaluated two weeks after the completion of concurrent chemoradiotherapy. All the twenty two patients completed the planned treatment. Complete response was not achieved in any patient. Partial response was seen in 15 patients [68.18%], stable disease in five patients [22.73%] and progressive disease was seen in two patients [9.09%]. CTC Grade-II nausea was seen in eight patients [36.36%], vomiting in five patients [22.73%] and mucositis in six patients [27.27%]. Grade-III neutropenia was observed in three patients [13.64%] and Grade-III mucositis and diarrhea in five patients [22.72%] each. Grade-IV neutropenia was seen in two patients [9.09%]. Cisplatin and 5-Fluorouracil combination chemotherapy concurrent with 50 Gy radiation is an effective and well tolerated treatment modality for this subset of lung cancer patients