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Background: A range of surgical techniques are used for perineal wound closure following Abdominoperineal Excision of the Rectum (APER). The aim of this study was to assess the safety and effectiveness of using a biological mesh for perineal wound closure and to compare the outcomes following conventional suture and mesh closure of the perineal wound.Methods: A single-centre retrospective study of a cohort of patients undergoing surgery for low rectal cancer between January 2013 and December 2018. Patient records were analysed for outcomes including perineal complication rates, length of hospital stay and impact of patient factors on complication rates in mesh vs no mesh group.Results: Of the total 43 patients included in the study, 13 (30%) had a conventional perineal closure whereas 30 patients (70%) had a biological mesh reconstruction. Early perineal wound complications were seen in 21/43 (49%) patients. Of those, 6 (29%) patients were in the no mesh group compared to 15 (71%) patients in the mesh group (p = 0.81). 84% of the patients who received neo adjuvant radiotherapy (NART) developed perineal wound infection. There was no statistically significant difference in the mesh and no mesh groups. None of the patient factors, other than preoperative anaemia, had a statistically significant association with the rate of complications in either of the groups.Conclusions: There was no statistically significant difference in the complication rate between primary and biological mesh closure. Biological mesh is safe for perineal reconstruction following APER.

Background: The aim of the work was the clinical characteristics and analysis of preliminary results for surgical treatment of pancreatic neuroendocrine tumors (PNETs). This article deals with the classification of the Pancreatic Neuroendocrine Tumors (PNETs) and discusses their presentation, behaviour, treatment and prognosis. Methods: This was a retrospective study of 70 patients of PNET done over a period of 3 years in The Gujarat Cancer and Research Institute, Ahmedabad. 24 patients who underwent surgical treatment for PNET were further evaluated for surgical outcome, 5yr disease free survival and overall survival. Results: In this study of 70 patients, 61(87.14%) were non-functional. Approximately 77% of PNETs were advanced on presentation (57% metastatic and 20% locally advanced). 20 patients had disease resectable on presentation (11 NF + 9 F). These 20 patients belong to stage I and II of TNM staging system. Only 4 out of 40 metastatic diseases had locally resectable tumor. Of 24 patients who underwent surgery, 12 underwent pancreatico-duodenectomy, 6 underwent enucleation and 6 underwent distal pancreatectomy. Conclusions: PNETs are uncommon tumor of pancreatic origin with presentation more commonly in males than females, usually in the 5th decade. Approximately 77% of patients are advanced or metastatic at presentation. Among those resectable, the Overall Survival for FPNETs and NFPNETs was 90% and 94% respectively and 5yr Disease Free Survival for the same was 100% and 84% respectively.

Cystic lymphangiomas are rare neoplasms. A 49 year old male patient presented with complaints of lump in abdomen weight loss since 1 month. On examination, patient had a diffuse visible lump above the umbilicus. Ultrasonography of abdomen and pelvis showed a well-defined smoothly marginated anechoic to hyperechoic lesion in midline and left side of abdomen. CECT of abdomen and pelvis was suggestive of pedunculated small bowel leiomyoma desmoid tumor. Exploratory laparotomy with resection of affected loop of jejunum and the supplying mesentery containing the tumor and resection and anastomosis of adjacent small bowel was done. Histologically, the tumor was diagnosed as mesenteric lymphangioma.