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Study Objective Assessment of safety and feasibility of total laparoscopic hysterectomy in a high-volume tertiary care centre. Design Retrospective study design. Setting Tertiary care centre: Galaxy care Hospital, Pune, India. Materials and MethodsThis is a retrospective observational study conducted in a tertiary care resident training hospital in Pune which is a high-volume teaching hospital. 1200 total laparoscopic hysterectomy patients between July 2013 and June 2019 operated by a group of trained surgeons were analysed, and parameters, namely demography, indication of surgery, surgical time, intra-operative blood loss, post-operative complications, duration of hospital stay, discharge and follow-up, were studied. Result(s) A total of 1200 women who underwent total laparoscopic hysterectomy for various indications were included in the study. TLH was successfully performed in all women. Mean age of women was 45 years. 72.00% had a BMI between 18.5 and 24.9, 16.08% had a BMI between 25 and 29.9, 3.92% had a BMI of > 29.9 while 8% had a BMI < 18.5. Indications for surgery included uterine fibroid (33.08%), adenomyosis (22.25%), endometrial hyperplasia (14.33%), endometrial polyp (7%), endometriosis (3.33%), postmenopausal bleeding (9.25%), chronic PID (5.25%), prolapse (4.25%) and risk reduction surgery in 1.25%. 2.00% had intra-operative complications while 7.58% had post-operative complications which were identified and managed successfully. Conclusion(s)Advances and innovation in equipment, energy sources and surgical training have made TLH a well-tolerated and efficient surgery. Irrespective of the previous morbidity, pathology and uterine size, TLH is a duplicable and safe in a well-trained high-volume centre.

Background: Cancer Antigen 15-3 (CA 15-3) is a tumour-associated antigen used as serum marker for breast cancer surveillance in patients and for monitoring the response to treatment. Aim of this study was to prospectively evaluate CA 15-3 as a prognostic factor in early detection of breast cancer relapse, recurrence and early detection of distant metastasis as well as to analyse the statistical correlation between CA 15-3 levels and clinical-pathological parameters including tumour size, lymph node, histological type, grading, hormonal receptors.Methods: Sera of 85 women with breast carcinoma obtained pre-treatment, post-treatment and follow-up at 6 months were assayed for CA 15-3 by solid phase enzyme-linked immunosorbent assay (ELISA).Results: Author founds that the mean serum CA 15-3 levels in patients before treatment were significantly higher (50.59U/ml) compared with those of CA 15-3 after treatment (24.07U/ml) and follow-up at 6 months (21.07U/ml). Author also found that elevated pre-treatment serum levels of CA 15-3 were significantly correlated with poor prognosis of patients. In particular, among 16/85 patients (18.8%) that displayed over cut-off (>24.95U/ml) pre-treatment levels of CA 15-3, 2 patients (2.35%) developed recurrence,2 patients (2.35%) developed residual tumour, 2 patients (2.35%) developed advanced disease (metastases to distant sites) and 10 (11.76%) patients expired during and after study. Chi-square correlation analysis revealed that the presences of increased serum levels of CA 15-3 after treatment are significant risk factors for poor prognosis in patients.Conclusions: Elevated pre-treatment concentrations of CA 15-3 may be a useful prognostic factor for cancer progression in patients.

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