ABSTRACT
Background: The objective of the study was to study morbidity and mortality patterns in patients with carcinoma oesophagus who underwent minimally invasive esophagectomy (MIE) in a tertiary centre for oncology in South India.Methods: This was a retrospective observational study of 20 patients with carcinoma esophagus who underwent minimally invasive esophagectomy in center for oncology, Government Royapettah Hospital. Medical records of all these patients treated from September 2016 to August 2019 were collected from medical records department and details regarding the type of lesion, site of the lesion, preoperative chemoradiotherapy, type of surgery performed and post-operative complications were analyzed.Results: Out of 20 patients who underwent minimally invasive esophagectomy 13 were female and 7 were male. Among these 18 had squamous cell carcinoma, 2 had adenocarcinoma. Thirteen patients had lesion in middle third oesophagus and 7 patients had lesion in lower third oesophagus. Nineteen patients underwent surgery after chemoradiation and one patient underwent upfront surgery. Twelve patients underwent thoracolaparoscopic esophagectomy and 8 patients underwent trans hiatal esophagectomy. Perioperative complications were seen in 8 patients of whom pulmonary complications seen in 6 were most common. Anastomotic leaks occurred in 4 patients of which 2 patients were reoperated. One patient died within 30 days of surgery. Voice change and ECG abnormalities occurred in 2 patients each.Conclusions: Minimally invasive esophagectomy is safe and associated with comparable morbidity. Though the initial learning curve is steep, it helps in faster recovery of the patient. Also, the peri-operative outcome tends to improve with experience.
ABSTRACT
Background: An adverse blood transfusion reaction (ABTR) is an unfavorable, unwanted reaction to the transfused unit. It may be acute or delayed , immune or non immune and infections . Materials and methods A study was conducted to detect the frequency of various ABTRs (both immunologic and &infections) and associated morbidity in a surgical oncology tertiary care centre for the past 2 years. Results: A total 7823 units of blood and blood components was issued for entire hospital, out of these 1120 units of blood and blood products was transfused in surgical oncology department over a period of two years. In these transfusions one patient(0.89%) was developed ABTR for that transfusion immediately stopped. A total 30patients (2.67%) developed minor transfusion related reaction that was managed with antihistamine and steroids. The most common adverse event was allergic reactions –20/30(66.6%) followed by feile episodes – 10/30(33.3%). We noticed that out of 27 recently positive hepatitis virus patients 7 patients had previous blood transfusion history. Within the 7 patients 6 patients also received chemotherapy and 1 patient had previous history of surgery. Conclusion : The most common adverse reactions to blood transfusions reported here are allergic reactions and feile episodes. Clerical error is the commonest cause for mismatch transfusion. Hepatitis B&C virus may be transmitted during window period. It can be prevented by using nucleic acid tests (NAT) as screening tests to prevent window period transmission.
ABSTRACT
Background: Floor disinfection plays a major role in patient to patient transmission of infections in hospital environment. In our hospital, lysol based floor cleaner was routinely used for floor cleaning. In our study we compare alternative methods of disinfection using sodium hypochlorite (NaOCl) based floor cleaner and biological (cows urine based) floor cleaner with traditional Lysol based floor cleaner.Methods: Three floor cleaners were used in the study (Lysol, NaOCl, biological cleaner). Study was conducted in our institution between August 2018 to October 2018. These floor cleaners were used in different floors and swab was taken every month to determine their efficacy of disinfection.Results: After initial culture of all three floor cleaner samples, the Lysol solution was culture positive for clostridium tetani spore. In first month, Lysol was used in both floor 1 and floor 2. In second month, NaOCl floor cleaner in floor 2 and biological cleaner in floor 1 was used. In third month, NaOCl floor cleaner for floor 1 and biological cleaner for floor 2 was used. Swabs taken at the end of each month was negative for culture except clostridium tetani spores were grown in floor 2 in corridor floor in which biological cleaner was used in third month.Conclusions: Floor cleaning with alternative reagents like NaOCl and biological cleaners are non inferior in disinfection of hospital environment in comparison with traditional lysol floor cleaner