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Biomedical subjects

A N Gangopadhyay

Publications and source records attributed to A N Gangopadhyay.

At least 19 recordsLinked to original sources
PubMed2005

Management of anorectal malformations in Varanasi, India: a long-term review of single and three stage procedures.

To compare the results of the staged procedure (Group A) with the primary single stage posterior sagittal anorectoplasty (PSARP) procedure (Group B) for high and intermediate anorectal anomalies. Four hundred ninety cases of primary single stage procedure done over a period of seven years (1996-2003) were compared with 458 out of 763 cases of staged procedure (Historical control) that underwent all three stages done from 1989 to 1996. Two hundred cases that had been in regular follow up in Group A and 254 cases in Group B who had attained three years of age were evaluated for continence by Kelly's method. The approximate cost of treatment was also calculated. Continence was good in 90 cases (45%), fair in 66 cases (33%) and poor in 44 cases (22%) in Group A while it was good in 204 cases (80% ), fair in 38 cases (15%) and poor in 12 cases (5%) in Group B. In Group A, the mortality was high as only 40% cases completed all the three stages of operation. The mortality was 4.5% in Group B. Primary PSARP is recommended as the better treatment option for intermediate and high-anorectal anomalies with superior results in terms of morbidity, mortality, continence and cost.

Anal Canal↗
PubMed2005

Single-stage management of all pouch colon (anorectal malformation) in newborns.

BACKGROUND/PURPOSE: The standard procedure in the management of pouch colon is the staged procedure (SP), which has well-known disadvantages. We believe that staging is unnecessary and primary single-stage procedure (PSSP) can be done. METHODS: Patients with pouch colon who underwent PSSP (102 cases from 1997 to 2003) and SP (98 cases from 1991 to 1997), 63 and 42 of whom, respectively, were in regular follow-up for more than 3 years, were evaluated. RESULTS: In PSSP, male/female ratio was 94:8; in SP, 89:9. Mean age in PSSP was 4.6 days and in SP 26 months. The distribution of cases into types I, II, III, and IV was 10, 24, 14, and 15 in PSSP, and 8, 20, 10, and 4 in SP, respectively. The ratio of PSSP/SP for total pouch colon (I and II) was 34:28 and for partial pouch colon (III and IV) was 29:14. The ratio of PSSP/SP in terms of continence, mortality, and cost was 75:48, 11:47, and 1:4, respectively. CONCLUSIONS: Primary single-stage procedure gives better continence and cosmesis, with low morbidity and mortality at a low cost, and hence is recommended.

Anal Canal↗
PubMed2004

Tracheoesophageal fistula and amastia with other anomalies: an unusual association.

An unusual association of esophageal atresia (EA) and tracheoesophageal fistula (TEF) with left amastia and multiple congenital anomalies is presented because of its rarity and successful management. The other associated congenital anomalies included a high variety of anorectal malformation (high-ARM), hypospadias and absent left pectoral muscles with weak shoulder girdle. This case was successfully managed by multi-staged operations to tackle the various associated congenital anomalies. Such a rare association has not been reported previously in the literature.

Abnormalities, Multiple↗
PubMed2004

Anatomical variations in termination of the axillary artery and its clinical implications.

Variations in the termination of the axillary artery (AA) were observed in 51 out of 356 axilla during routine dissections. The incidence of variation was higher on the right axilla in 17.42% cases (CI: 11.60-22.51) than the left axilla 11.24% cases (CI: 6.46-15.55) and was found to be 12.33% in male and 40.63% in female cadavers. The variations were divided into four groups. The first group showed that the terminal end of the AA divided into lateral and medial divisions in 6.16% (CI: 2.21-9.82) male and in 15.63% (CI: 2.76-25.25) female cadavers. The second group variation showed that the terminal end of the axillary artery divided into deep and superficial divisions in 2.74% (CI: 0.10-5.27) male and in 6.25% (CI: -1.87-13.13) female cadavers. The third group showed that the terminal end of the AA divided into three branches in 2.74% (CI: 0.10-5.27) male and in 6.25% (CI: -1.87-13.13) female cadavers. The fourth group showed the tapering of the terminal end of AA in 0.68% (CI: -0.63-1.99) male and 12.50% (CI: 0.97-21.46) female cadavers. The variable origin of the circumflex humeral, subscapular and profunda brachii arteries was also observed. These variations in the terminal end of the axillary artery are not only of significant clinical importance to orthopaedic and reconstructive surgeons but also have very significant medico-legal implications.

Axilla↗
PubMed2002

Pig bite of prolapsed rectum in a child.

A case of pig bite to the prolapsed rectum in a 2(1/2) year old boy is reported because of its rarity and successful management in spite of delayed presentation.

Age Factors↗
PubMed2000

Hydatid disease in children may have an atypical presentation.

Although there is voluminous literature describing various aspects of hydatid disease in children, little attention has been paid to the small group of patients whose symptoms result in atypical presentation. This article addresses this problem, describing the features in ten children aged from 2 to 12 years. The sites of involvement were within a choledochal cyst (1). the pelvic cavity (1), the spleen (1), and transverse mesocolon. Albendazole was efficacious in the treatment of one recurrent case, as well as in preventing recurrence.

Adolescent↗
PubMed2000

Sigmoid volvulus in childhood: report of six cases.

Sigmoid volvulus is a common cause of large-bowel obstruction in elderly individuals, but is quite rare in childhood. We report six cases in patients under 20 years of age. One had Hirschprung's disease. Gangrenous sigmoid colon was found in three cases and resection was performed. Sigmoidopexy (one case) and extraperitonealization (two cases) were performed for viable sigmoid colon. There were no recurrences after 5.7 years of follow-up.

Abdominal Pain↗
PubMed2000

Posterior sagittal approach for repair of rectourethral fistula occurring after perineal surgery for imperforated anus at birth.

PURPOSE: Posterior sagittal approach was used for the repair of 11 cases of rectourethral fistula between 1992 and 1998. METHODS: All these patients had rectourethral fistula as a result of perineal procedure performed for imperforate anus at the time of birth. In addition to the fistula repair, an associated anorectal stenosis (3 cases) and urethral stricture 11 case) also were corrected with this approach. All the patients underwent surgery under cover of a protective colostomy. RESULTS: Successful repair was achieved in all patients, and the follow-up period ranged from 10 months to 7 years. As far as bladder and bowel control, urinary control was normal in all 11 patients, whereas bowel control was normal in 10 cases. One patient who had severe scarring of anal sphincters caused by infection in the previous surgery still suffers occasional perianal soiling after 18 months of follow-up. CONCLUSIONS: Posterior sagittal approach not only gives adequate exposure but also suits the basic principles of fistula repair, namely, completely separating the rectum from urethra and leaving normal rectal wall behind the urethral sutures thus eliminating the possibility of recurrence. In addition to fistula repair, one can also correct associated problems like anorectal stenosis or urethral stricture, and a mislocated rectum can be relocated within the sphincter complex.

Adult↗
PubMed1999

Appendicostomy as a venting enterostomy for colonic atresia.

Colonic atresia is usually managed surgically by resection and end-to-end anastomosis but preferably with a venting enterostomy, if presentation is delayed. A new technique of appendicostomy was performed as a venting enterostomy in eight cases of colonic atresia with good results in our children's hospital during the period 1990-1995.

Appendix↗
PubMed1998

Management of congenital and acquired H-type anorectal fistulae in girls by anterior sagittal anorectovaginoplasty.

METHODS: Thirteen girls with congenital or acquired H-type anorectal fistulae underwent surgery between 1991 and 1996. In all cases, besides a normally placed anal canal, there was a fistulous communication between the anorectum and the genital tract. On the basis of the level of fistulous communication, these cases were divided into three groups: high, intermediate, and low (perineal canal). All patients underwent anterior sagittal anorectovaginoplasty. Surgical technique included division of all intervening tissue in midline between the perineal skin and the fistula. The whole fistulous tract was excised, and the remaining surrounding tissue was repaired in different layers. Of 13 patients, 12 were operated on without a protective colostomy. RESULTS: There was no recurrence in any case, and all patients had good cosmetic results with a normal sphincter control. Although various techniques have been suggested for the surgical correction of H-type anorectal fistulae, most of them are applicable only to the low-lying fistula (perineal canal). CONCLUSIONS: To date, there is no satisfactory method available for correction of high fistula. The methods suggested for high fistula (abdominoperineal pull-through and endorectal pull-through) appear to be too extensive for this condition. Our technique of anterior sagittal anorectovaginoplasty can be used not only for low fistula but can also be used for intermediate and high types of fistulae. This technique is simple, safe, takes less time, and achieves good anatomic and functional reconstruction of the perineum.

Adolescent↗
PubMed1997

An unusual variant of rectal atresia with rectovestibular fistula.

Isolated rectal atresia in the girl with a normal anal canal is extremely rare, and its association with a fistula has not been reported in the literature. A 6-year-old girl who had a unique combination of rectal atresia and rectovestibular fistula was treated successfully by a posterior sagittal approach.

Anastomosis, Surgical↗
PubMed1997

Covered exstrophy: a rare variant of classical bladder exstrophy.

Covered exstrophy is an extremely rare variant of exstrophy-epispadias complex. It is less distressing and easier to manage than classical exstrophy of the bladder. We report three cases of this entity, two associated with anorectal malformation and one with unilateral renal agenesis, along with a review of the literature.

Abnormalities, Multiple↗
PubMed1997

A new variant of esophageal atresia with tracheoesophageal fistula and duodenal atresia: a diagnostic dilemma.

A new variant of esophageal atresia (EA) with tracheoesophageal fistula (TEF) associated with duodenal atresia is reported. The TEF was between the lower pouch and the trachea, with a cystic dilatation in the midportion. The tracheal end of the fistula was obstructed by a membranous septum at both ends of a cystic dilatation, leading to a diagnosis of pure EA (gasless abdomen). After the lower pouch was opened beyond the cystic dilatation, 100 ml nonbilious fluid was obtained. A laparotomy revealed a type III atresia of the first part of the duodenum.

Duodenal Obstruction↗