Medicine
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This repository contains the published and unpublished research of the Faculty of Medicine by the staff members of the faculty
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Item Incidence of carcinoma among THY3 lesions of the thyroid(Sri Lanka Medical Association, 2016) Kumarasinghe, K.A.P.R.; Pinto, M.D.P.; Munasinghe, B.N.L.; Dissanayake, D.M.C.D.; Abeyrathne, I.G.K.P.; Amaraweera, P.C.; Fernando, R.INTRODUCTION AND OBJECTIVES: Ultra Sound Scan (USS) and Fine Needle Aspiration Cytology (FNAC) of thyroid nodules are carried out in patients with goitre. THY3 lesions cause diagnostic difficulty and risk of malignancy in such lesions is 20%. The objective of this study was to determine the incidence of carcinoma among THY3 lesions and to relate the findings to the size of the nodule. METHOD: All the patients who underwent thyroidectomy at the University Surgical Unit, Colombo North Teaching Hospital from November 2002 to December 2015 were analysed retrospectively. Histological and ultrasonic data in patients with THY3 lesions were analysed. RESULTS: There were 29 (5.68%) THY3 patients among 510 patients who had thyroidectomy. Only 6 (20.7%) patients were histologically proven to be malignant (follicular carcinoma – 3, papillary carcinoma - follicular variant- 2, mixed medullary papillary carcinoma - 1). All patients were females (age range 17y -52y). Pre-operative USS nodule size in the malignant group ranged from 2.6 cm to 6.8 cm (average - 4.25cm). 20 patients (68.9%) had benign histology (MNG - 18, thyroiditis-2). USS nodule size in the benign group ranged from 2.3 cm to 2.5 cm. Three patients (8.7%) were lost to follow up. CONCLUSIONS: About 20.7% of THY3 lesions had thyroid carcinoma. Lesions larger than 4.25 cm were more likely to harbour a malignancy.Item Does the retrosternal extension of a goitre and its relationghip to the aortic arch determines the surgical approach(Sri Lanka Medical Association, 2016) Kumarasinghe, K.A.P.R.; Pinto, M.D.P.; Munasinghe, B.N.L.; Dissanayake, D.M.C.D.; Abeyrathne, I.G.K.P.; Amaraweera, P.C.; Fernando, R.INTRODUCTION: Retrosternal extension (RSE) is defined as the enlargement of the thyroid below the thoracic inlet. The greatest challenge in embarking on surgery in RSE is to decide whether to involve an intra-thoracic approach (sternotomy or thoracotomy) or not, as this approach accounts for added morbidity & mortality. OBJECTIVES: The aim of this study is to analyse whether the relationship of the retrosternal component of a goitre to the aortic arch decides the surgical approach of total thyroidectomy. METHOD: A total of 527 thyroidectomies were performed at Colombo North Teaching Hospital professorial unit during the period from November, 2002 to February, 2016. There were 51 patients with radiological evidence of retrosternal goitre (6.27%). These patients were categorized into 2 groups according to the degree of RSE. Groups were defined as extension of goitre above the arch of aorta (AA) and below AA. RESULTS: 50 (98%) patients had RSE above the AA and 1 patient had RSE below the AA. RSE was seen on the right side of the mediastinum in 3 (5.88%) patients, on the left in 8 (15.68%) patients and bilaterally in 40 (78.43%). Total thyroidectomy was undertaken in all 50 patients with RSE above the AA, through cervical approach without an added morbidity. The patient with RSE beyond the AA underwent total thyroidectomy with axillary thoracotomy. CONCLUSIONS: Majority of the RSE is above the AA, which can be dealt with a cervical approach and extension below the AA may need an intra-thoracic approach.Item Rare cause for a non healing perianal fistula in an elderly male(College of Surgeons of Sri Lanka, 2011) Chandrasinghe, P.C.; Marasinghe, N.C.; Abeyrathne, I.G.K.P.; Sangar, T.P.Item Lymphangioma of the spleen in an asymptomatic patient(College of Surgeons of Sri Lanka, 2011) Chandrasinghe, P.C.; Abeyrathne, I.G.K.P.; Fernando, R.F.No Abstract Available