Advancing Surgical Oncology in Gandhidham: A Showcase of Complex Procedures and Collaborative Success

At the Surgical Oncology unit in Gandhidham, our recent focus has been on delivering advanced, complex procedures with successful outcomes, reflecting the synergy of a highly skilled team. We've seen a string of cases where meticulous surgical planning, adherence to Prehabilitation and Enhanced Recovery After Surgery (ERAS) protocols, and collaborative care have allowed us to perform challenging surgeries with minimal morbidity and effective hospital stays. Here's a closer look at some of our key achievements in recent months.

Radical Cystoprostatectomy with Ileal Conduit

We successfully performed three Radical Cystoprostatectomy with Ileal Conduit procedures, two of which involved laparoscopic resections with extracorporeal ileal conduit formation. One of the patients was an octogenarian, making the surgery particularly delicate. All three patients followed our ERAS protocols, with only 24 hours spent in the ICU. They were started on oral diets on the first postoperative day (POD1), had their Ryle's tubes removed early, and were discharged by POD7 with full oral intake and drains removed. This outcome demonstrates the safety and efficiency of complex surgical protocols when carefully managed.

Multivisceral Resection for Pelvic Tumors

In a recent case, a patient with recurrent vaginal vault high-grade serous carcinoma of endometrial origin underwent a multivisceral resection involving right hemicolectomy, partial rectal resection with primary closure, and cystostomy. This allowed us to achieve a complete (R0) resection while safeguarding the vesicoureteral junction (VUJ). Postoperative recovery was prompt, and the patient was discharged on POD7 with a full oral diet.

We also completed a primary cytoreductive surgery for carcinoma of the ovary involving an anterior resection for rectal involvement and a right distal ureteric resection with reimplantation. The patient's postoperative recovery was swift, and she was discharged within a week of surgery.

Surgical Repair of Rectovaginal Fistula

Another remarkable case involved the repair of a large low rectovaginal fistula using a gracilis flap. The patient had developed this fistula after definitive chemoradiotherapy for squamous cell carcinoma of the vagina and required a diverting loop colostomy. The gracilis flap reconstruction was pivotal in restoring vascularity to irradiated tissues, and the patient is now ready for stoma reversal following an excellent recovery.

Oral Cavity and Thyroid Surgeries

We are performing numerous oral cavity resections with appropriate reconstructions, consistently achieving early postoperative recovery and prompt resumption of oral intake. Additionally, our team has been conducting total thyroidectomies with outstanding results. We've successfully minimized postoperative hypocalcemia by addressing preoperative vitamin D deficiency and ensuring calcium supplementation. Our recent treatment of a rare case of papillary thyroid carcinoma arising in a thyroglossal cyst further underscores our commitment to managing rare and challenging cases.

Team Collaboration and Continuous Improvement

These achievements are made possible by the seamless collaboration of our oncology team. With support from Dr. Mohit Modi, Medical Oncologist, and Dr. Hiren Poojara, Radiation Oncologist, our multidisciplinary approach is improving patient outcomes across the board. Our team's commitment to optimal postoperative care, from the ICU to the wards, is bolstered by the contributions of intensivists, medical officers, and our exceptional nursing staff.

We've also initiated a weekly Tumor Board Meeting, where we discuss complex cases that require the input of all three specialties—surgery, medical oncology, and radiation oncology. This holistic approach ensures that each patient receives individualized, evidence-based treatment options.

The inputs from our Radilogists, Dr. Udit Raval & Dr. Ankita Dembla in providing assistance in surgical planning with review of imaging and a interactive correlation of preop and intraop findings. The pathology team at Sterling Accuris, Ahmedabad also is very supportive, despite being far geographically, showing excellent liasoning and co-ordination.

The anesthetist, Dr. Kishan Makdiya & Dr. Darshan Maheswari also plays crucial role with great intraoperative management of this long duration surgeries with excellent post anesthesia recovery and vigilance.

Patient Engagement

We recently conducted a stoma care meeting at Sterling Ramkrishna Multispecialty Hospital, Gandhidham, providing an interactive platform for patients and caregivers to discuss their challenges. The live demonstrations of stoma products and care techniques were highly appreciated by attendees, reflecting our commitment to patient education and support.

Conclusion

Our recent work in Surgical Oncology at Gandhidham demonstrates our ability to manage complex procedures with favorable outcomes, thanks to rigorous protocols, team synergy, and patient-centered care. By integrating innovative surgical techniques with collaborative efforts across specialties, we are delivering high-quality care that minimizes patient morbidity, shortens hospital stays, and enhances recovery. The future looks promising as we continue to refine our practices and set new standards for cancer treatment in the region.