Perianal fistula is a common disease and surgery is the only treatment option. Many surgical techniques have been described. Ligation of intersphincteric fistula tract (LIFT) is a sphincter saving surgical technique in which fistula tract is ligated and excised through intersphincteric approach. The aim of study is to present our experience of first 50 LIFT procedures particularly healing rate, recurrence rate and complications from the procedure. This is a prospective observational study started from March 2018 on whom underwent LIFT procedure for primary complex perianal fistula of infective origin at Faridpur Central Hospital and Faridpur Medical College Hospital. In this study, 50 patients (42 male and 8 female) of average age of 39±7.6 years with complex fistula were included. The mean operative time was 34.7±5.67 minutes and most of the fistulas were transsphincteric variety (90%). Median wound healing time was 21.45±6.34 days for intersphincteric wound and 26.78±6.93 days for the external opening of the fistula. Mean follow up period was 10.5 months. Seven patients of our series developed recurrent fistula, making the overall success of 86%. None of the patient in our series developed incontinence. LIFT procedure has the advantage of preservation of anal sphincter, minimal tissue injury, shorter healing time, relatively easy to perform, and high success rate. It's a good choice for treatment of complex perianal fistula. Faridpur Med. Coll. J. Jan 2020;15(1): 3-7

Not Available Faridpur Med. Coll. J. Jul 2019;14(2): 57

Halstedian radical mastectomy is practiced over 40 years as surgical treatment of breast cancer. For the last twenty years, breast conserving surgery (BCS) has been more practiced in the treatment of breast cancer as it provides oncological safety as well as cosmesis. Non palpable breast lesions are being increasingly diagnosed in the recent years as a result of introduction of breast cancer screening, high quality digital mammography and increase in public awareness. Accurate localisation of small, nonpalpable breast lesions is mandatory for accurate surgical management. The purpose of this article is to review the techniques systematically those have been used to locate non-palpable breast lesions which could easily be introduced in Bangladesh. Breast conserving surgery means complete removal of the tumour with a concentric margin of surrounding healthy tissue with maintenance of acceptable cosmesis. It should be followed by radiation therapy (RT) to achieve an acceptably low rate of local recurrence. Breast conserving surgery with radiotherapy has same survival benefit as mastectomy. BCS plus RT provided better outcome than mastectomy for early breast cancer and should be offered as a preferred treatment option. Experience, logistical support, and multidisciplinary approach is key to success. Radiological support with ultrasound or stereotactic localization with wires and /or ultrasound skin marking are key to have accurate wide local excision of non palpable lesions which is gold standard. Other newer techniques such as radio guided occult lesion localisation (ROLL), magnetic seeds, radiofrequency seeds localisation are a feasible and safe method of breast lesion localization as well and gaining popularity slowly. Faridpur Med. Coll. J. Jul 2019;14(2): 93-99

A 28-year-old lady presented with 3.5 cm lump in her right breast and normal axilla. Histopathologically the lump revealed as invasive duct cell cancer (IDC), Grade II with ER negative, PR positive and HER2 equivocal. On genetic testing, BRCA1 & BRCA2were found negative but p53 was positive with pathogenic variant. She received neoadjuvant chemotherapy while waiting for genetic testing. As she had TP53 mutation and considered high risk for developing contralateral breast cancer, bilateral mastectomy and immediate reconstruction with implant using acellular dermal matrix was performed on 9th of March,2020 at our Breast Unit during 2nd live surgery & workshop on oncoplastic breast surgery, organized by Breast Care Unit and Research Centre, Department of Surgery, Anwer Khan Modern Medical college. This is the first reported case of a breast cancer patient with TP53 mutation who has undergone nipple skin sparing mastectomy with immediate implant/ADM reconstruction and creates a milestone in the history of modern breast cancer management in Bangladesh. Journal of Surgical Sciences (2020) Vol. 24 (2) : 77-82

Gastrointestinal Stromal Tumours (GISTs) are a rare group of mesenchymal tumour arising in gastrointestinal tract. The clinicopathological features are variable and surgical resection with chemotherapy is the main modality of treatment. We retrospectively analyzed 20 different types of GIST patients over a period of 9 years to understand clinical presentation, pathological features, treatment and survival. The tumour was most commonly seen in the patients (75%) of age range of 30-60 years. Twelve (60%) were male and 8 (40%) were female patient. Forty percent of the tumours were located in the stomach followed by small intestine (35%) and omentum (20%). Abdominal mass (70%), abdominal pain (45%) and GIT bleeding were the common clinical presentation. The size of the tumours ranged from 3 to 22 cm. All patients of our series underwent surgical excision of tumour. NIH risk categorization showed 15 (75%) patients belong to low risk category, 2(10%) patients were of intermediate risk group and 3 (15%) were of high risk group. Out of 20 cases CD117 positivity was seen in 17 (85%) cases offered adjuvant Imatinib mesylate. No patient in our series offered neo adjuvant chemotherapy. Postoperative follow up was done 6 monthly. GIST's are most common non epithelial tumour of the GIT. It is common in 4 th and 5 th decades. Abdominal mass and abdominal bleeding are the most common clinical presentation. Stomach is the most common site. Surgical resection is the best modality of treatment. Imatinib mesylate is used for adjuvant therapy. Regular follow up helps in diagnosing disease recurrence.