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Category: Volume 05 Issue 12 December 2017
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Title: Clinical Profile and Management of Lower G.I. Malignancies

Authors: Prof Dr Braja Mohan Mishra, Prof Dr Bana Bihari Mishra, Dr Balabhadra Samantaray, Dr Dharbind Kumar Jha

 DOI:  https://dx.doi.org/10.18535/jmscr/v5i12.51

Abstract

Introduction: Lower GI malignancies though more common in the western part of world and are increasing in our country for the past decade. Colorectal cancer is the most common malignancy in the gastrointestinal tract. In the United States, colorectal cancer ranks fourth in terms of both gender-specific annual cancer incidence and cancer mortality (behind lung, prostate, and breast, respectively. Colonic tumors are important for two reasons:  they are frequent and account for both a significant mortality rate as well as high cumulative health care costs. The sequence of events leading from a normal mucosa to a manifest cancer occurs through largely preventable precursor stages over the course of several years. Therefore this study predominantly focuses on the detection, management, and prevention of these conditions.

Aims and Objective

The aim of the study is,

  • To study the clinical presentation of lower GI malignancies, including the incidence of emergencies.
  • To study the macroscopic and histopathological types of lower GI m
  • To evaluate various types of surgeries for lower GI malignancies being performed.

Materials and Methods

  • This study consists of patients admitted for the management of lower GI malignancies in Dept. of General Surgery, VSS Institute of Medical Science and Research, Burla, Odisha.
  • Period of Study – November 2015 to October 2017.
  • On admission all the patients were subjected to basic blood investigations, Test for fecal occult blood, USG Abdomen, Barium studies, CT abdomen and UGI scopy.
  • Following clinical and proctoscopic examination, Colonoscopy was done for all patients – except for emergency cases , biopsies were taken.
  • Bowel preparation was done preoperatively using plain oral fluids, and PEG preparation – the day before surgery.
  • Per operative findings regarding peritoneal implants, liver secondaries, peritoneal implants and tumour invasion to the nearby structures were noted.
  • Post operative course was closely observed until the first follow up visit.
  • Patients with permanent colostomy were followed up for colostomy care.

Observation: Results are analysed using suitable statistical tables, graphs and methods.

Conclusion: To conclude, any patient above 40 years of age, when complaints of altered bowel habits or bleeding per rectum, every effort should be made thoroughly to investigate him to find out if he harbors malignancy of lower GI tract and the goal of treatment should be to either cure the disease or to prevent the sequele of disease there by reducing morbidity and mortality.

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Corresponding Author

Dr Balabhadra Samantaray

Post Graduate Students, Department of General Surgery

Vimsar, Burla, Odisha, India

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