ABSTRACT
Background: In clinical practice all cases of locally advanced breast carcinoma (LABC) warrant chemotherapy followed by multimodality care. Neoadjuvant chemotherapy (NACT) has been the mainstay in the management of LABC. The main aim of NACT is to downstage and prevent systemic micrometastasis early.Methods: This was a prospective study conducted on 36 diagnosed cases of stage III locally advanced breast cancer coming to the Dept. of Surgery, Dr. D. Y. Patil Medical College and hospital, Pune for a period of 2 years from 2017-2019. The effectiveness of neoadjuvant chemotherapy was assessed based on clinical, pathological and radiological response.Results: Among 36 LABC cases, maximum number of patients fell in the 41-50 years (41.6%) and presented in the Infiltrating ductal carcinoma group with a clinical stage IIIA disease. The response to NACT showed that a total of 12 patients (33.3%) showed complete clinical response and 30 patients were downstaged after neoadjuvant chemotherapy which was statistically significant. Only 4 out of the total 12 complete clinical responders went for Breast conservative surgery. Seroma formation was found to be the most common post-operative complication.Conclusions: LABC subjected to neoadjuvant chemotherapy based on taxanes/Anthracyclines show good clinical and radiological response. Patients preferred modified radical mastectomy due to the lack of awareness and low socioeconomic strata.The type of surgery did not increase the chance of recurrence in the follow up period.
ABSTRACT
Background: Ventral hernias are defined as a protrusion of abdominal contents through the abdominal wall muscle. It can be categorised as spontaneous or acquired or by their location on the abdominal wall like epigastric hernia, umbilical hernia, para umbilical hernia etc. This original article reveals that laparoscopic trans abdominal pre peritoneal (TAPP) mesh placement for ventral hernia usually follows the current principle of hernia surgery and give better results from open pre peritoneal ventral hernia repair.Methods: A prospective study conducted in Dr. D. Y. Patil Medical College and Hospital, Pune for the period of 2017-2019 comparing laparoscopic TAPP vs. open preperitoneal ventral hernia repair. Total of 25 patients for laparoscopic TAPP repair and 25 patients for open preperitoneal repair were compared.Results: Total 50 cases were studies in which 25 for laparoscopic and 25 for open repair. Majority of patients were female than males. Incidence of para umbilical (56%) was found to be more. Intra operative, post-operative complications were found to be more in open repair than laparoscopic TAPP repair.Conclusions: Laparoscopic TAPP ventral hernia repair is safe with fewer complications. Therefore, offers successful treatment for ventral hernia repair with added benefits of laparoscopy such as better visualization and magnification of the hernia defects which are not clinically apparent and less chances of injury which is not possible by open technique. Laparoscopic TAPP ventral hernia repair gives equal results in terms of recurrence and less complications than open ventral hernia repair.