Aim: Retroperitoneal soft-tissue sarcomas are relatively uncommon diseases, and the most frequent histotype, ranging from 20 to 45% of all cases, is represented by liposarcoma, which is a hard-to-treat condition for its local aggressiveness and clinical aspecificity. Presentation of case: We report a case of a 69-year-old woman who underwent surgical resection for a giant pleomorphic retroperitoneal liposarcoma. Discussion: Currently, chemotherapy for retroperitoneal soft-tissue sarcomas is not effective, and radiotherapy has limited efficacy due to the toxicity affecting adjacent intra-abdominal structures and showed validity only in case of high-grade malignancy by reducing local recurrence but with no advantage in overall survival. Nowadays, complete surgical resection remains the most important predictor of local recurrence and overall survival. Conclusion: The removal of a retroperitoneal sarcoma of remarkable size is a challenge for the surgeon owing to the anatomical site, the absence of an anatomically evident vascular-lymphatic peduncle, and the adhesions contracted with the contiguous organs and great vessels. Therefore, we believe that, particularly for large-sized diseases associated with high-grade malignancy, a complete surgical resection with the removal of the contiguous intra-and retroperitoneal organs when infiltrated represents the only therapeutic option to obtain a negative margin and therefore an oncological radicality.

Background: The optimal strategy of abdominal wall closure after midline laparotomy has remained an issue of ongoing debate to minimize incidence of incisional hernia which occurs in 10 to 23% cases postoperatively. The main objective of the study was to evaluate the efficacy of small bites versus large bites suture technique in reduction of incidence of the complications like pain, wound infection, wound dehiscence, seroma formation and incisional hernia by using polydioxanone no.1.Methods: The present study was conducted on 100 patients undergoing elective surgery who were randomly allocated into group A and B. Group A were the patients in which midline abdominal wound closure was done with small bites and group B were the patients in which midline abdominal wound closure was done with large bites. Then the patients were followed up for 6 months to observe any complications.Results: A mean additional closure time of 9 minutes was seen with the small bites technique. The mean suture length was more in small bites group as compared to large bites technique. There was no difference in the visual analog scale score between the two groups. No significant difference was seen in the incidence of major and minor wound infection postoperatively in both the groups. Small bites technique reduced the incidence of suture sinus and incisional hernia compared to conventional large bites technique.Conclusions: It can be concluded that the small bites suture technique is more effective than the traditional large bites technique for prevention of all post-operative complications.

Background: Calculus biliary tract disease continues to be a major health concern. It is normal to see predisposing factors such as cirrhosis, ileal resection in the West; while infection predominates in South East Asia as a cause. We prospectively examined gall stones in this study to investigate the causes and role of bacteria in the disease of gall stone disease.Methods: This is a cross sectional study conducted in department of surgery, Sri Guru Ram Das University of Health Sciences, Sri Amritsar, India, from November 2018-August 2020. Total 50 cases were selected and operated by lap/open cholecystectomy were included in this study. During cholecystectomy bile was aspirated and was sent to laboratory for culture. Gallstone retrieved from the specimen was classified based on morphological appearance. Results: Gallstone disease found to be common in female 92% and in the age group of 4-50 years. Bile of gallstones patients is often infected. In this study though morphologically cholesterol stones were commonest but mixed stones were associated with highest infection rates. Most common bile infecting bacterium in all kinds of stones was found to be E. coli 60.8% followed by klebsiella 17.3% and proteus 17.3%. All the organisms cultured were sensitive to cephalosporins, quinolones, aminoglycosides and penicillin group of antibiotics.Conclusions: Bile culture was positive in 46% of the cases. Morphologically cholesterol stones were commonest 52% but mixed stones were associated with highest infection rates (80%). Most common bile infecting bacterium in all kinds of stones was found to be E. coli.

Background: Surgical site infection (SSI) are one of the most frequently reported health care associated infections. They are commonly associated with greater morbidity, readmissions, ICU admissions, long-term surgical site complications and mortality. Multiple global studies have shown level 1A clinical evidence that the use of triclosan coated suture reduces the incidence of SSI by 30%.Methods: In the proposed prospective study, 100 cases undergoing elective surgery were randomly allocated into Group A and B. Group A were the patients in which wound closure was done using triclosan coated vicryl (vicryl plus) and group B were the patients in which wound closure was done using uncoated vicryl. Then, the patients were followed up for 30 days to observe any signs and symptoms of surgical site infection.Results: Duration as well as severity of pain was decreased in vicryl plus group as compared to uncoated vicryl. Other signs of inflammation such as erythema, swelling, induration and fever were also less in patients who had wound closure using vicryl plus. Wound dehiscence was not observed in either of the groups. Discharge was seen in 1 patient in vicryl plus group but it was seen in 5 patients in uncoated vicryl group. Surgical site infection was seen only in 1 patient in the vicryl plus group, but it was seen in 10 patients uncoated vicryl group.Conclusions: It can be concluded that triclosan coated vicryl (vicryl plus) is better than uncoated vicryl for the prevention of surgical site infection.