Przeglądanie według Autor "Dash, Sashibhusan"

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Incidental vs. non-incidental gallbladder cancer – a hospital-based clinicopathological study
(Publishing Office of the University of Rzeszow, 2024-09) Dash, Sashibhusan; Anirvan, Prajna; Samantaray, Sagarika; Rout, Niranjan; Ranjit, Manoranjan
Introduction and aim. Most gallbladder cancers (GBCs) are discovered incidentally after routine cholecystectomy. The clinicopathological characteristics and prognostic implications of incidental gallbladder cancer (IGBC) versus non-incidental gallbladder cancer (NIGBC) is not known. Material and methods. During this study, clinicopathological details compared between incidental and non-incidental GBC groups included age, sex, clinical presentation, preoperative radiological diagnosis, surgical management, and macroscopic and microscopic features. The primary outcome of the study was difference in overall survival (OS) between IGBC and NIGBC. Results. Among 348 surgically treated patients, 56.6% weren’t preoperatively suspected of GBC. Macroscopic examination showed characteristic thickened gallbladder wall without mass lesion (IGBC) vs. clear mass lesion (NIGBC) on imaging. Interestingly, NIGBC had higher LVI (27% vs. 14%) and T stage (68% T2b/T3 vs. 47% T1b/T2a) despite lower margin involvement (p < 0.001). The OS for all patients was 12.2 months (median). Among patients who underwent surgery with curative intent, the median survival time was 21.4 months. However, within this group, NIGBC cases had a worse median survival (17 months) compared to IGBC cases (21 months). Conclusion. Rising incidental GBC necessitates routine microscopic examination of all gallbladder specimens. Surgeons in high-risk areas should remain vigilant for GBC in patients with atypical clinical and ultrasound findings. Early detection and curative resection are paramount for long-term survival in gallbladder carcinoma, with IGBC potentially offering a survival benefit regardless of stage or tumor characteristics. Prospective studies including detailed pathology and molecular analysis are needed to confirm this observation.
Surgical management of upper cervical esophagus stricture caused by ingestion of corrosive substances – a single-center experience
(Publishing Office of the University of Rzeszow, 2024-03) Mishra, Haris Chandra; Mohapatra, Jyotiranjan; Dash, Sashibhusan; Dash, Sanghamitra
Introduction and aim. Corrosive strictures of the upper cervical esophagus and hypopharynx are hard to treat in the operating room because there is a high chance of aspiration during swallowing after a high-up or proximal esophageal anastomosis. In this cases, we aimed to evaluate the role of intraoperative dilatation of the proximal hypopharyngeal and cervical esophageal stumps during surgery. Material and methods. Patients who underwent surgery and had upper cervical esophageal and hypopharyngeal strictures from corrosive substance ingestion were included. Results. Out of total 27 patients, 10 had a cricopharyngeal or proximal cervical esophageal stricture with a long segment tho racic esophageal stricture that was treated with intra-operative dilatation (IOD) of the proximal hypopharyngeal stump. IOD was done in two cases with Hegar’s dilator and in three cases with wire-guided Savary Gillard dilators. In 74% (20/27) of the cases, the colon was frequently used as an esophageal substitute, while the stomach was only used in 10 cases. On follow-up, none of them developed repeated aspirations or required a tracheotomy. Conclusion. IOD of the proximal hypopharyngeal and cervical esophageal stumps during surgery for corrosive upper cervi cal esophageal or cricopharyngeal strictures helps to save the proximal stump and avoid frequent hospital stays and multiple surgeries.