Ogilvie’s Syndrome – A Post-Operative Emergency in a Case of Carcinoma Rectum

Acute colonic pseudo obstruction or Ogilvie’s syndrome is a rare entity that is characterized by acute dilatation of the colon without any mechanical obstruction. It is usually associated with medical disease or surgery and rarely occurs spontaneously. If not diagnosed early, Ogilvie’s syndrome may cause bowel ischemia and perforation. Its early diagnosis and prompt treatment are the keystones to avoid any subsequent fatal complications. We report a case of acute intestinal pseudo obstruction causing post-operative wound dehiscence in a patient who underwent colostomy reversal following a Hartman’s procedure for a rectal carcinoma. We also review the clinical characteristics, diagnostic methods, and management of Ogilvie’s syndrome with reference to literature.

Laparoscopic Radical Hysterectomy for Early Stage Cervical Cancers – A Single Team Experience

Current evidence on the efficacy and safety of Laparoscopic Radical Hysterectomy for early stage cervical cancer is adequate to support the use of this procedure provided that normal arrangements are in place for clinical governance, consent and audit. This study aims to present our single unit experience of Laparoscopic Radical Hysterectomy performed for early stage cervical cancers. Methods: 74 laparoscopic radical hysterectomies performed for early stage cervical cancers from 2012 to 2017 were reviewed. Results: Key efficacyoutcomes evaluated were completing the procedure without conversion to open surgery ( conversion rate – 3/74),the mean operating time (144 mts), intra operative complications ( rectal injury 2/74, primary hemorrhage 1/74), post operative complications ( ureteric fistula 2/74, vescico vaginal fistula 1/74 , port site hernia 1/74), number of LN removed ( mean - 14 LN on each side), recovery time (6 hrs on average ) and length of hospital stay (average – 5days); lone term outcomes viz recurrence rate and % year survival are under study. Conclusion: Our initial experience indicate that laparoscopic radical hysterectomy is safe ,feasible and effective with low morbidity and with comparable outcome to open approach; It does not compromise oncological radicality of resection; short term results are promising; long term results are awaited.