Complex surgery performed in DMCH during covid crisis

Ludhiana: Ever since COVID pandemic has started spreading its tentacles in the country, there has been a considerable decrease in surgical cases due to fear of getting infected while undergoing operation.      

In such critical situation, Dr Arvind Goyal (Associate Professor of Urology) and his team from the Department of Urology has performed complex surgery of ‘Cystectomy’ which includes removal of urinary bladder from 67 years old male patient.

According to Dr Goyal, the patient Surjit Singh (name changed) had excessive pus collection and granulomatous changes in kidney and ureters which needed to be removed without any delay for the safety of patient.  This additional procedure added complexity to already extra major surgery and the patient was successfully discharged after one week of hospitalization stay.
Cystectomy is performed to treat invasive or recurrent non-invasive bladder cancer. In men, removing the entire bladder (radical cystectomy) typically includes removal of the prostate and seminal vesicles. In women, radical cystectomy also involves removal of the uterus, ovaries and part of the vagina. After having bladder removed, the ureters are disconnected from the bladder and urinary diversion is created. The 5 year survival rate for people who have bladder cancer is 75%. Adjuvant therapy may be needed following a Total Cystectomy which may include radiation therapy, chemotherapy. Cystectomy provides the best survival outcomes and the lowest local recurrence rates for muscle-invasive disease.
 
According to Dr Arvind Goyal, Urinary bladder cancer is the 4th most common cancer in men and  the eighth most common in women, a leading cause of cancer deaths.  However, approximately 25% of these patients will have muscle-invasive bladder cancer at time of diagnosis. Moreover, of those who initially present with superficial disease, more than 10% will progress to invasive disease. Gross or microscopic hematuria is the initial presenting sign in 80-90% of patients with bladder cancer. Approximately 20% of patients have symptoms such as urinary urgency, dysuria, or frequency.

The leading risk factor for bladder cancer is smoking, including second hand smoke. Occupations with high exposure to these carcinogens include the dye, rubber and painting industry. When treated early and appropriately, most bladder cancers are potentially curable. A coordinated individualized treatment approach is needed for each patient and close communication between patient and Urologist is crucial.

Secretary of DMCH Managing Society Prem Kumar Gupta lauded the efforts of doctors, nursing staff and other staff members in carrying out medical services with utmost dedication and professional commitment.