One year experience of treating carcinoma oesophagus

To audit one year of esophageal workload in a Cardiothoracic unit Material and This study was conducted at Cardiothoracic unit Lady Reading hospital peshawer from 1st January to 31st December 2003, and it comprised of 146 patients presenting with spontaneous dysphagia. Barium swallow and endoscopy/biopsy were done for diagnoses; C.T scan was used to stage the disease and offer possible treatment. Ca esophagus constituted 25.84% of total operative work load in one year. Disease was more common in males; mean age at presentation was 56 years. High incidence was found in Afghan nationals. The common presenting clinical features were dysphagia and weight loss. Barium swallow detected the abnormality in almost all advanced cases. C.T scan was found accurate in[36/41] 87.80% cases in staging the disease. In majority of cases disease arose in the lower 2/3 of the organ and most frequently it was sqamous cell carcinoma.[105/146] 71.91% were inoperable; surgery offered good in operable cases. Carcinoma oesophagus is not uncommon in this part of the world; Efforts should be made to diagnose the disease early, as the treatment is possible and give good in the early stage of disease

Surgical treatment of pulmonary hydatid disease

To study the outcome of surgical treatment of pulmonary hydatid disease.This study comprised of two hundred patients, operated for pulmonary hydatid disease in Cardiothoracic unit, LRH, Peshawar form 01.07.1990 to 30.06.2000. The preoperative work up, apart from history and examination included FBC, LFTs, Blood grouping, chest X-ray PA and Lateral views, Casoni's test, haemagghitination test. Ultra sound abdomen and chest, and CT thoracic. Patients were operated for cystectomy, lobectomy decortication, thoracoplasty and combined pulmonary and hepatic cystectomy as required. All patients were put on post operatively mebendazole for at least 28 days. Patients were followed up for complication. Two hundred patients underwent surgery for pulmonary hydatid cyst over a ten years period. Operations performed were cystectomy 168, lobectomy 24, [primary 18, revision 6], decortications 13 and 1 thoracoplasty. Mortality was 4/200 i.e. 2%. The main/ major morbidity was air leak for which 9/200 patients were re-explored, with resuturing in 3 cases and secondary lobectomy in 6. Cystectomy, without needle aspiration, was found to be the procedure of choice for pulmonary hydatid