Starting Gynaec-Oncology Services in a Medical College

Abstract

Purpose Gynaec-Oncology Division was started within the Department of Obstetrics and Gynaeology in a private Medical College hospital on 01-01-2015 with the existing resources. The purpose was to provide specialized care to women afflicted with gynaecological malignancies, and also to train residents-the future practitioners, in GynaecOncology. At the end of 1 year, a retrospective analysis of patient outcomes was carried out to determine the feasibility of having a Gynaec-Oncology Division within the Department of Obstetrics and Gynaecology in a Medical College hospital. Methods It was decided to locate the Gynaec-Oncology Out-Patient Department (OPD)/Clinic adjacent to Radiation Oncology and Medical Oncology OPDs. Admissions were made in Obstetrics and Gynaecology wards under the three respective units. Patients were posted for surgery in the common Obstetrics and Gynaecology operation theatre. Postoperative monitoring was done by the same staff in charge of the common postoperative ward. Results There was an increase in the number of outpatients and inpatients as compared to the previous year. More complex and challenging cases were performed, with comprehensive staging being performed as a routine. The most common postoperative complication encountered was wound gape. Burst abdomen was the most serious complication encountered. There were no cases of injuries to vital structures, massive transfusion, fistulae and patient deaths. All the patients eventually went home in good health.Conclusions A Gynaec-Oncology Division can very well be started within the Department of Obstetrics and Gynaecology of Medical Colleges without any additional infrastructure and without any compromise on quality of care. Though radical surgeries are known to have much higher complication rates, it also depends to a large extent on the doctor's personal involvement and quality of postoperative care. In a country like India where Institutions have to stretch themselves beyond their means to provide care to its growing population, medical fraternity must try and provide the maximum by optimally utilizing the existing facilities.