3 research outputs found
Etiology and endoscopic profile of dysphagia in adults - Single center study at a tertiary care center in South India.
No full textBackground: Dysphagia is defined as difficulty in deglutition. It can be either structural or motility abnormality in the passage of food from the oral cavity to the stomach. Upper GI endoscopy is the most important tool to diagnose dysphagia and rule out premalignant and malignant lesions. The purpose of the study was to classify various causes of dysphagia.
Methods: This prospective observational study was conducted on 206 patients with complaints of dysphagia. Detailed history, physical examination was done. Upper GI endoscopy was done in all cases, and biopsies were taken if required. Oropharyngeal and neurological dysphagia were excluded from the study. The statistical analysis was performed using Microsoft Excel. The mean, percentage and proportions were calculated.
Results: Two hundred and six patients were included in the study. Out of 206 patients, 127 were females, and 79 were males. The mean age was 43.62 years. The commonest age group was 21- 40 years contributing 41.7% cases, followed by 41-60 years contributing to 30.8% cases. Benign etiology (n= 141) was more common than that of malignant (n= 65). The commonest benign etiology was reflux esophagitis (n =54) followed by esophageal candidiasis (n= 38). The commonest malignant etiology was adenocarcinoma of the esophagus (n= 38), followed by squamous cell carcinoma (n= 24).
Conclusions: The upper GI endoscopy is effective and safe modality to diagnose dysphagia. Benign etiologies were more common among females, but malignant causes were more common among males. The incidence of esophageal malignancy increases with advanced age
Feasibility of implementing fast-track surgery in pancreaticoduodenectomy with pancreaticogastrostomy for reconstruction – A prospective cohort study with historical control
No full textAbstractIntroductionFast track programmes have been introduced in pancreatic surgery, but the data are sparse. The aim of this prospective study was to analyse the feasibility of implementing fast track rehabilitation protocol in PD with pancreaticogastrostomy, using historical control for comparison.Materials and methodsBetween April 2012 and December 2012, twenty patients who underwent PD (with pancreaticogastrostomy) were managed by a fast-track rehabilitation protocol. These patients were compared with an equal number of historical controls treated according to the traditional protocol.ResultsPatients in the fast track group were able to tolerate liquid (p = 0.0005) and solid diet (p = 0.0001) earlier, and they passed stools earlier (p = 0.02). Delayed gastric emptying (DGE) was significantly reduced in the fast track group (p = 0.02). There was no difference in the rates of pancreatic fistula (PF), post pancreatectomy haemorrhage (PPH) and mortality between the two groups. Length of hospital stay was reduced in the fast track group (median 14 vs 18.5, p = 0.007).ConclusionFast track programme appears to be feasible in PD, even with pancreatico-gastric anastomosis. It is associated with early recovery, reduced DGE and reduced hospital stay
