Preoperative Versus Postoperative Chemoradiation in Stage III Cancer Rectum: A Single Institution Experience

The optimal management of locally advanced rectal cancer requires a multidisciplinary strategy involvingsurgical resection with total mesorectal excision and combined use of radiotherapy and chemotherapy. Thesequence of treatment can either be preoperative chemoradiation followed by surgery or upfront surgeryfollowed by postoperative chemoradiation. This study compared survival outcomes of these two aforementionedapproaches in 76 stage III rectal cancer patients, identified in the hospital database and treated between 2008and 2014. The median locoregional recurrence free survival in the preoperative group was 34 months whereasit was 33 months in the postoperative group (p=0.583). The median distant metastases free survival was 17months in the preoperative group versus 38 months in the postoperative group (p=0.039). The mean survivalin the whole cohort was 46.97 months with 27 deaths reported at the time of last follow up. The meansurvival in the preoperative group was 35.927 months versus 51.519 months in the postoperative radiotherapygroup (p=0.129). In our set of patients, the sequence of chemoradiation whether preoperative or postoperativedoes not lead to differential survival.

Role of laparoscopy in the diagnosis and management of benign adnexal masses

Background: Adnexal masses are frequent findings in women of all age groups. It consists of the ovaries, fallopian tubes and uterine ligaments. Women can present with various gynaecological complaints and adnexal masses could be detected while examining and investigating for these complaints. The aim was to study the role of laparoscopy in diagnosis and management of benign adnexal masses.Methods: The study was conducted on 48 women of reproductive age group. Per speculum examination was done and PAP smear was taken before bimanual examination was done. A complete per vaginum examination was done and the adnexal mass was assessed for its size, side, consistency, laterality and tenderness. Laparoscopy was done to confirm preoperative diagnosis and appropriate procedure done depending on diagnosis.Results: Pain in the lower abdomen was the commonest chief complaint seen in 87.5% cases. 41.67% cases were suspected to have endometriosis while on laparoscopy it was seen in 47.92%, 33.33% were suspected to have ovarian cyst which decreased to 25% on laparoscopy, ectopic pregnancy in 16.67% cases both pre-operative and on laparoscopic examination and tubo-ovarian mass in 8.33% cases pre-operatively and 2.08% on laparoscopy.Conclusions: This study has shown that if proper preoperative evaluation was done, author can select the appropriate patients for laparoscopic approach.