Surgical management of malignant gastric tumours

The aim of our study was to highlight the importance of better surgical outcome if presentation is earlier. Gastric cancer is second most common malignancy of gastrointestinal tract after colorectal carcinoma. The common presentation is pain epigastrium, weight loss, vomiting and anorexia. Patients usually present in advanced disease and only palliative surgery is possible. Commonest type is adenocarcinoma. We conducted a case series of 60 patients who were treated for gastric carcinoma at Mayo Hospital, Lahore from March 2003 to March 2008. The objective of study was to assess the morbidity, mortality and outcome of surgical management. Out of 60 patients included in this study, 27 patients were male and 23 female. Commonest presentation was vomiting 69.9%. Most of the patients presented in advance disease. Operative procedures include Billroth-I and D1 resection, 20% Billroth II + L.N. dissection [16.6%], total gastrectomy along with reconstruction [6.7%]. Most of the patients [23.3%] had palliative procedure in the form of bypass or feeding jejunostomy [56.7%]. Only 30.1% presented in early stage of disease and its mortality rate was low. Postop complications recorded were diarrhea 30 patients, bilious vomiting in 24 patients, 2 patients underwent revisional surgery. Surgical outcome is directly related to stage of disease at presentation. Early presentation leads to better outcome

Penile fractures experience at Mayo Hospital, Lahore

With prompt diagnosis and expedient surgical management, Outcomes remain excellent and complications are minimal. In our setup general surgeons deal with the penile fractures. This Study presents a total number of thirteen cases presented to our emergency in last two years [from June 2004 To June 2006]. We managed to pass Foley catheter in all. Circumscribing degloving incision was made in all and corpora were repaired. Four had co existing urethral injuries which were repaired primarily

Surgical outcome after femoral vessels ligation in I/V drug users

Intravascular drug abuse is being practiced with increasing frequency in our country, resulting in dreadful complications. A common complication of intravenous drug users is traumatic damage to tissues and organs secondary to injections, which depends on a number of factors which are difficult to quantify, local drug practices, the skill of the injector and the susceptibility of the individual

Objective: To study the incidence, limb complications and indications for limb amputation in intravenous drug abusers

Methods: A descriptive study on nineteen intravenous drug abusers was carried out at department of Surgery, Mayo hospital Lahore

Results: Entire limb survived in Eleven patients, Four had toe amputations, Three ended in below knee amputation and One in above knee amputation

Conclusion: Most of the affected limbs can survive despite the major vessels being tied due to development of collateral circulation