Browsing by Author "Jyoti Swain"

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Completely Linear Stapled Versus Handsewn Cervical Esophagogastric Anastomosis After Esophagectomy
(Springer India, 2018) Tarun Kumar; Ravi Krishanappa; Esha Pai; Raxith Sringeri; T.B. Singh; Jyoti Swain; Sindhuri Kondapavuluri; Manoj Pandey
Very limited data is present which compares completely linear stapled to handsewn cervical esophagogastric anastomosis. Primary objective was to determine whether linearly stapled (LS) anastomosis has lower clinically apparent leaks, when compared to handsewn anastomosis (HS). Secondary objectives were morbidity, mortality, overall leak and stricture rates, and presence of a symptomatic cervical stricture. This is a comparative study of 77 patients who underwent LS (n = 29) and HS (n = 48) cervical anastomosis. Anastomotic leak was found to be 19.4% (15/77). In the HS group, 27.08% (13/48) and in the LS group, 6.89% (2/29), respectively, leaked (p = 0.03), relative risk (RR)—3.93 (95% CI 1.21–15.25). 32.5% (23/77) patients remained admitted for more than 14 days. 52.1% (25/48) patients in the HS group were discharged within 14 days of surgery; whereas; 93.1% (27/29) were discharged in LS group (p = 0.001), RR—6.95 (95% CI 2.13–25.94). Overall, 90-day mortality was 7.8% (6/77). In the HS group, 8.3% (4/48) patients died while in the LS group, 6.8% (2/29) patients died (p = 0.82), RR—1.21(95% CI 0.27–5.53). In the HS group, 6.25% (3/48) patients were diagnosed with stricture compared to 6.8% (2/29) patients in the LS group (p = 0.9), RR—0.91 (95% CI 0.19–4.44). Overall stricture rate was 6.4% (5/77). Cervical anastomosis done with linear staplers has less leak rates compared to handsewn anastomosis. © 2018, Association of Surgeons of India.
Primary lymphoma of the colon: Report of two cases and review of literature
(BioMed Central Ltd., 2019) Manoj Pandey; Jyoti Swain; Hema Malini Iyer; Mridula Shukla
Background: Gastrointestinal tract is the most frequent site of extranodal lymphoma accounting for approximately 40% of all extranodal lymphomas; out of these, non-Hodgkin's lymphoma (NHL) comprises 4% of total cases. Primary lymphoma arising in the colon is very rare comprising only 0.2-1% of all colonic malignancy. Patients and methods: We report two cases of 13- and 20-year-old boys with NHL of colon presenting with abdominal pain and weight loss and discuss the approach to colonic lymphoma after a review of world literature to provide an overview on colonic lymphoma. Results: Colonic NHL most commonly affects older age group with mean age of diagnosis being 55 years. Abdominal pain and weight loss are the two most common presentations with palpable abdominal mass as physical examination finding in half of the cases. Conclusions: Colonic lymphoma in young adolescence is rare. Multimodality approach involving both surgery and chemotherapy is the principal mode of treatment. Radiotherapy is used in selected cases. If diagnosed preoperatively, non-surgical management can be attempted. © 2019 The Author(s).