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Table of Content - Volume 4 Issue 1- October 2016


A study of the outcome and prognosis of various thoracic surgeries performed on patients with respiratory conditions

 

Bharat Toshniwal*, Himanshu Pophale**, Gauri Godbole***

 

*Assistant Professor, **Associate Professor, ***Professor and HOD, Department of Respiratory Medicine SKNMC and GH Narhe Pune, Maharashtra, INDIA.

Email: bharattosh@gmail.com

 

Abstract              Background: India is a vast country with an enormously variable population. There are large differences in geographical, environmental, ethnic, religious, cultural and socioeconomic parameters in different population groups in India which affect the human health and disease occurrence. Therefore, the study of disease epidemiology in India is singularly difficult. Aims: a) To study various surgeries performed on patients with respiratory diseases at tertiary health care center b) To study Outcomes of the surgeries c) To study prognosis of the patients who underwent surgical procedures and factors associated with prognosis among the patients of respiratory diseases. Methodology: This was retrospective study patients with various respiratory diseases like Ca. Lung,, Neurofibromatosis, Thymoma, RTA, Empyema, Mediastinal tumor, Teratoma, Tracheo Oesophageal fistula, Chest wall abscess, Kyphoscoliosis, etc. requiring surgical interventions, admitted under department of Respiratory medicine at SKNMC andGH Pune from January 2011 to June 2017. Out of total 52 operated patients were followed up for the study period and their five year survival rate post operative death and other clinic laboratory parameters was considered and prognosis was categorized into Excellent, Good, Poor prognosis. Result: The various surgeries performed were Thoracotomy + Lobectomy in 21.15%, followed by, Thoracotomy + Ligation of Fistula + Esophagotomy+ Gastrectomy in 17.31%, Thoracotomy + Decortication in 13.46%, Thoracotomy + Excision of Lump in 9.62%, Thoracotomy + Excision of Cyst, In 5.77%, Thoracotomy + Excision of Teratoma in 5.77%, Thoracotomy + Excision of tumor in 5.77%, Thoracotomy + Rib resection in 3.85%, Thoracoscopy + LN biopsy in 3.85%, Thoracoscopy + Thymectomy in 3.85%, Decortication in 3.85%, Lobectomy in 1.92%, VATS + Decortication in 1.92%, VATS in 1.92%. The overall outcome patients Improved in 86.54%, Deaths occurred in 9.62 %, and DAMA ( Discharge against Medical advise) done in 3.85%. As per the Prognosis Excellent prognosis was in 61.54% patients followed by Good prognosis in 23.08% and Poor prognosis in 15.38%. The factors associated with the poor prognosis were Old age in 13.46% followed by History of Smoking - 9.62, Ca-Lung in 9.62%, Associated with Diabetes in 5.77%, Obesity (BMI > 30) in 5.77%, COPD in 3.85%, Immunocompromised In 1.92%, Anemia in 1.92%. Conclusion: It can be concluded from our study that the majority of the patients underwentThoracotomy plus Lobectomy procedure, the majority of the patients improved, The factors associated with the poor prognosis were Old age, History of Smoking, Ca-Lung Diabetes, Obesity (BMI > 30), COPD, Immunocompromised(HIV andHBsAg), Anemia etc.

Key Words: Ca. Lung, Thymoma, Empyema, Mediastinal tumor, Thoracic surgery, Poor prognosis of thoracic surgery.