Browsing by Author "Singh, YP"
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Publication Post Operative Diagnosis of Early Gastric Cancer in a Low Risk Population and the Possibility of Risk Stratified Screening(Kathmandu University, 2014) Ghimire, B; Singh, YP; Timalsina, SABSTRACT Background Gastric cancer is the second commonest cause of cancer related mortality worldwide. Though its incidence is more in Eastern Asia, it is increasing in the South Asian subcontinent. The diagnosis of early gastric cancer (EGC) confined to the mucosa or submucosa, is an important concern due to a better outcome at this stage where five year survival rates could increase by 90 percent. Though mass screening is done in few countries, it has not been applied in developing countries like Nepal. Preoperative diagnosis of EGC is rare in Nepal. The aim of this study is to analyze the clinico- pathological features of postoperative cases of gastric cancer managed in a tertiary care university hospital of Nepal. Methods All patients with histological diagnosis of gastric cancer admitted in the Department of Surgery, Tribhuvan University Teaching Hospital, Kathmandu, Nepal during the three year period (September 2010 to August 2013) were analyzed retrospectively. Results Ninety two patients with endoscopic diagnosis of gastric cancers were admitted during the past three years. The mean age was 60 years ranging from 28 years to 85 years with the male to female ratio of 2.8:1. Five patients were younger than 40 years and all were in advanced stage. Thirty five percent of the patients belonged to Janajatis (Hill) community though they comprise only 23% of the population and about 65% of them belonged to an area involving 25% of the country. Seventy six cases were operated. Out of 92 patients, 4 patients were diagnosed as early gastric cancer post operatively. All patients with early gastric cancer were above 50 years with CT Scan abdomen revealing focal thickening without lymphadenopathy. Conclusion Over the years, the incidence of gastric cancer is increasing in Nepal. Though 92% are advance gastric cancers, few have been diagnosed and treated early. A screening program in a country like Nepal with diverse ethnicity and difficult terrain might be helpful if it targets high risk people in high risk areas. KEY WORDS Advanced gastric cancer, early gastric cancer, ethnicity, low riskPublication Round Block Technique in Management of Breast Lesions(Kathmandu University, 2019) Khanal, S; Singh, YP; Sharma, R; Pandit, KABSTRACT The basic tenets of oncoplastic surgery essentially includes volume displacement and volume replacement. The round block technique, so-called donut mastopexy or Benelli mastopexy, is frequently used as a volume displacement technique in breast conserving surgery for benign multicentric fibroadenomas and early breast cancers. Such techniques are still underused in Nepal. In this article we present on four cases managed with original round block technique and followed prospectively with their outcome. KEY WORDS Breast cancer, Fibroadenoma, Oncoplasty, Sentinel lymph nodePublication Simple Oncoplastic Breast Conserving Surgery for Breast Cancer in a University Hospital(Kathmandu University, 2023) Khanal, S; Singh, N; Singh, YPABSTRACT Background The principle of oncoplastic surgery is the removal of tumors with negative margins as well as maintaining the contour of the breast. The goals are to achieve local control and best cosmesis. Objective The objective of this study was to assess patients’ satisfaction with different techniques of simple oncoplastic breast conserving surgery (BCS) for early breast cancer. Method This was a retrospective study of early breast cancer cases operated during the period 2009 to 2017. All the patients were under regular follow up for at least five years after surgery. Original Harvard/NSABP/RTOG scale was used to evaluate cosmesis at one year after surgery. Result Median age of the patients was 43 years with median size of tumor being 2.5 cm. All of the patients had good to excellent cosmetic outcome. One patient (4.5%) had margin positivity. All patients were disease free and happy with the cosmesis at five years although one patient did not have whole breast radiotherapy. Conclusion Simple oncoplastic breast conserving surgery techniques in upper part of breast are simple, feasible and improve cosmetic outcome with low margin positivity and good disease-free five-year survival. KEY WORDS Breast cancer, Breast conserving surgery, Mammaplasty