of 51
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Census 2008(1st Jan 31st Dec)
Surgery Unit I,
Department of Surgical Disciplines,AIIMS
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No. of Admissions 1085
No. of Surgeries 867
Elective Cases 762
Emergency Cases 105
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Total -867
Elective 615
Emergency 105
Day care 147
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Distribution of cases- Type of
AnaesthesiaAnaesthesia No. of cases
GA / SA 720
Local 147
Total 867
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ELECTIVE
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System Wise Distribution
Head and Neck 113
Hepatobiliary 152
Breast 117
Hernia 33
Adrenal 8
Vascular 43Soft tissue tumour 18
Thoracic Surgery 4
GI Surgery 62
Dermatological malignancies 12
Splenectomy 19
Genito-urinary Surgery 15
Miscellenous 19
TOTAL 615
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Breast operations-117
Modified Radical Mastectomy 58
MRM + LD flap 2
MRM + DIEAP fasciocutaneous free flap 2
MRM + TRAM flap 2
WLE + SLNB +/- ALND 25
WLE + SLNB +/- ALND + Brachytherapy ports insertion 2
Wire guided WLE 1
Radical mastectomy 2Simple mastectomy Pagets disease 2
Axillary Lymph Node Dissection 2
Simple mastectomy + Axillary sampling 1
Breast Cancer - 99
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Cont.
Male Breast cancer- Radical mastectomy 2
Reduction Mammoplasty 2
GynaecomastiaSubcutaneous mastectomy 3
Inferior dermoglandular flap mastectomy 1
4
Simple mastectomy- Phylloides tumor 2
Giant fibroadenoma 5
? Malignancy TB abscess 1
Radical duct excision 2
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Thyroid-81
Hemithyroidectomy 35
Sub-total thyroidectomy 11
Total thyroidectomy 13
Near total thyroidectomy 4
Completion thyroidectomy 7
Total thyroidectomy + MRND 4
Total thyroidectomy + Central compartment excision 1
T
otal thyroidectomy+T
racheostomy 2Reexploration for high drain output 2
Total thyroidectomy+ Adrenalectomy 1
Total thyroidectomy +Neck paraganlioma excision 1
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NeckParathyroid
Miniparathyroidectomy 15Neck exploration 2
Video assisted parathyroidectomy 1
Salivary gland operationsParotid Surgeries
Superficial parotidectomy 5
Total parotidectomy 1
Total parotidectomy + P.major flap 1Superficial parotidectomy+ Enucleation (B/L) 1
Incision and Drainage for abscess 1
9
Excision of Submandibular gland 2
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Neck Contd...
Others
Neck dissections-MRND
(Already mentioned)
5
Cystic hygroma 1
Torticollis 1
Paraganglioma 1
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Biliary-145Laparoscopic cholecystectomy 110
Lap to Open Cholecystectomy 9
Open Cholecystectomy
On anticoagulants (post valve replacement) 3
? CAGB 2
GB polyp 1
6
Lap cholecystectomy+ Other procedures
(Vaginal Hysterectomy, Tubal ligation,
Ovarian cyst excision, Umbilical hernia)
7
CBD Exploration+ T-tube 1
CBD Exploration + Choledochoduodenostomy 8
Excision of choledochal cyst + Hepaticojejunostomy 2
Hepaticojejunostomy for Biliary stricture 1
Explorative laparotomy + Biopsy -?CaGB 1
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Hydatid Cyst of liver DeroofingLaparoscopic 2
Open 3
5
Simple Liver Cyst laparoscopic drainage 1
Liver-6
Pancreas-1
Whipples procedure 1
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Splenectomy-19
Idiopathic Thrombocytopenic purpura 9
Haemolytic anaemia + Gall stone disease
(Splenectomy + Cholecystectomy)
5
Hereditary Spherocytosis 3
Diagnostic ( Isolated NHL of Spleen) 1
Sarcoidosis ( Hypersplenism) 1
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Colorectal -22Hemicolectomy
Ileocaecal tuberculosis 2Carcinoma 3
? Malignancy 2
7
Segmental resection and anastomosis for Colonic
polyp
1
Carcinoma rectum
Abdomino perineal resection 4
Low anterior resection 2
Lap assisted sigmoid colostomy 1
Explorative laparotomy + abandoned 1
8
Colostomy closure 4
Rectal Prolapse
Delormes procedure
2
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Minor Anorectal procedures-3
Haemorrhoids
Stappler haemorrhoidectomy 1
1
Fistula in AnoKharsutra insertion 1
Lay open 1
2
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Oesophagus-1
Transhital Oesophagectomy for CarcinomaOesophagus
1
Stomach-4
Gastrojejunostomy for Gastric outlet obstructionLiposarcoma 1
Carcinoma stomach 1
2
Gastrojejunostomy + Truncal vagotomy for
Gastric outlet obstruction
1
Trichobezoar
Gastrotomy and removal
1
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Small bowel-22Ileostomy closure 6
Stricture Tuberculosis
Stricturoplasty 2Resection and anastamosis 3
5
Delayed fecal fistula post mesh hernioplasty
Mesh removal + resection and anastamosis 2
2
Subacute intestinal obstruction
Mesh removal + adhesiolysis 1
Adhesiolysis 1
2
Malrotation -Ladds procedure 2
Heterotopic pancreas
Resection and anastamosis 1
1
Explorative laparotomy + Biopsy
TB abdomen 2
2
Meckels diverticulum 1
Duodenal Leak Tube duodenostomy + Feeding jejunostomy
( Operated case of Paraganglioma)
1
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Interval Appendicectomy
Laparoscopic 5
Open 5
10
Appendix-10
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Abdomen- 14
Adrenalectomies
Phaeochromocytoma 3
Cushings syndrome 2
Incidentaloma 2
Adrenal carcinoma 2
Adrenalectomy + Parathyroidectomy 1
8
Pack removal post adrenalectomy 1
Paraganglioma
Explorative laparotomy+ Biopsy of paraganglioma 1
Excision of paraganglioma + Rt.Nephrectomy +IVC excision+
reconstruction+ Lt.renal vein reimplantation 1
Excision 1
3
Retroperitoneal tumor
Unresectable 1
? Neurofibroma 1
2
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Genito-Urinary-15
Radical Nephrectomy 5
Penile disorders
Partial penectomy 1
Total Penectomy 1Circumcision 1
3
Testicular disorders
Orchidopexy 5
T
high pouch Implantation of testes forFourniers gangrene 1
6
Ilioinginal block dissection for Osteosarcoma of
Thigh
1
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Herniae -33
Incisional 20
Umbilical 4
Epigastric 1
InguinalMesh hernioplasty + Orchidectomy 1
Recurrent Hernia 2
7
Port site Hernia following Lap Adrenalectomy 1
Mesh removal (already mentioned)
Fecal Fistula 2
Sub acute intestinal Obstruction 1
Recurrent inguinal hernia 1
4
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Arterial - 24
Arterial Pseudoaneurysm 2
Arterio Venous Malformation 8
Arterio Venous Fistula 4
Aorto-Femoral Bypass 1
Aorto-Bifemoral Bypass 1
Stem Cell Therapy for PAD 2
Endovascular Interventions ( Coils and grafts) 5
Abandoned Femoropopliteal Bypass 1
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Venous - 19
SFJ/SPJ Ligation + Perforator Ligation
+/- Stab avulsion
14
Subfascial Endoscopic Ligation of Perforators
(SEPS)
4
Venous Pseudoaneurysm 1
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Soft Tissue Tumors-18
Wide local Excision + Split Skin Thickness grafting 1
Wide Local Excision + Flap 3
Wide Local Excision + Primary Closure 2
Reconstruction for Raw area post excision - Flap 2Excision of lipoma forearm post radical
mastectomy for carcinoma breast
1
Above Knee Amputation
Malignant Fibrous Histiocytoma 1Neurofibroma with deformed foot 1
2
Split Skin Thickness grafting 5
Lipomatosis of Abdominal wall 1
Neurofibroma excision 1
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Thorax - 4
Hydatid Cyst Lung
Wedge Resection 1
Excision of sac 1
2
Hydatid cyst of Erector Spinae- Excision 1
Bullectomy 1
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Dermatological Malignancies-12
BCC WLE + Rotation flap 6
SCC- WLE + Reconstruction 5
Malignant melanoma- Digit amputation+ALND 1
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Surgeries in other Units/Departments-13
Resection and Anastamosis ( Gyn) 5
Ileostomy (Gyn) 1
Adhesiolysis (Gyn) 3
Choledochoduodenostomy ( SUR-3) 1
Total Thyroidectomy (SUR-3) 1
Mesh Hernioplasty (Gyn) 1
Sigmoid Volvulus (Gyn) 1
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Reexplorations( Already mentioned)
Thyroid
High Drain Output 2
Stridor- Tracheostomy 2
4
Post MRM + DIEAP flap necrosis 1
Post WLE + Bleeding for Breast Cancer 1
Post Lap Cholecystectomy + Bleeding 1
Post Bullectomy Pneumonectomy 1
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EMERGENCIES
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Emergencies-105
Oesophageal Perforation 1
Gastric Perforation 2
Duodenal Perforation 17Jejunal Perforation
Resection and anastamosis 1
Exteriorization + feeding Jejunostomy 2
3
Ileal PerforationRepair 2
Ileostomy 13
15
Rectal Perforation- Repair + Loop Ileostomy 1
SMA Infarction Laparostomy 1
Perforation peritonitis 40
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Cont..Open Appendicectomy 13
Intestinal ObstructionObstructed Herniae 5
- Inguinal Herniae 2
- Umbilical Herniae 2
- Femoral Hernia 1
Adhesions 2
Rectal cancer 2Stricture (Resection and Anastamosis) 2
11
Post lap cholecystectomy bleeding 1
Rt. Hemicolectomy
Lower GI bleed 1
Fecal fistula post Appendicectomy(operated PVT) 1
2
Rectus sheath haematoma 1
Feeding jejunostomy 2
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Cont
Neck exploration post Thyroidectomy +
Tracheostomy
2
Total thyroidectomy + Tracheostomy(Emergency) 1
Tracheostomy (Prolonged intubation) 4
Debridement
Necrotizing fascitis 4
Fourniers gangrene 1
Flap necrosis 2
7
Incision and drainage
Pyomyositis 2Gluteal abscess 2
4
Post Wide local excision Breast carcinoma -bleeding 1
Post bullectomy-Pneumonectomy 1
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Cont.
Above knee amputation 3
Below Knee amputation 7
Fore foot amputation 1
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Day care
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Day care-147
Radical Duct Excision 24
Microdochectomy 1
Fibroadenoma 5
Inguinal Herniae 46
Hydrocele 1
Pilonidal Sinus 3Varicocele- High ligation of testicular veins 3
SFJ Ligation+/- stab avulsion 19
Ray/ digit/ toe Amputations 10
Sinus tract exploration 5
Ksharsutra Insertion 4
Debridement 10
Chemoport Insertion 4
Miscellaeneous 12
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Mortality
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Mortality-Data
No. of Operated Elective cases - 6
No. of Operated Emergency cases - 14
No. of Non-operated Elective cases -2
No. of Non-operated Emergency cases -12
Average age group of patients- 51.58 years
Average duration of stay of operated cases- 12.6 days
Average duration of stay of non operated cases- 8 days
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Sl.
No.
Cause No. of
Cases
Operated (20) Non-operated(14)
1 Septicemia 25 Perforation peritonitis 7
Pyogenic liver abscess - 1
Diabetic Foot 2
Necrotizing Fascitis 2
Gastric carcinoma-1
Faecal fistula -1
Strangulated hernia-1
SMA infarct-1
Perforation Peritonitis 2
Diabetic foot-1
Necrotizing fascitis - 3
Pneumonia 2
Faecal fistula -1
2 Advanced
Malignancies
7 Retroperitoneal tumor -2
Osteosarcoma-1
Adrenal carcinoma-1
Breast - 2
HCC-1
3 Aspiration
pneumonia
2 Carcinoma Stomach- 1
Carcinoma Rectum- 1
Cause of Death
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S.No. Age/
Sex
Hospital
stay
Surgery
performed
Cause of
death
Predisposing factors
1. 17/M 5 Perforation
peritonitis
Septicaemia Perforation jejunal, On
Steroids for Minimal change
disease and anticoagulants for
EHPVO
2. 81/M 12 Modifidgrahams
patch
Septicaemia Duodenal perforation,Bronchial asthma on steroid,
CAD
3. 68/M 4 Explorative
Laporotomy+
sigmoid loop
colostomy
Septicaemia Sigmoid perforation
COPD
4. 14/F 11 Explorative
laparotomy +
peritoneal
lavage +
ileostomy
Septicaemia Perforation peritonitis, TB
Perforation Peritonitis Operated
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S.No. Age/ Sex Hospital
Stay
Surgery
performed
Cause of
death
Predisposin
g factors
5. 54/F 35 Resection
and
anastomosis
Septicaemia
shock
Perforation
peritonitis,
Rheumatoid
arthritis +Steroid+post
THR
6. 62/F 22 Grahams
patch repair
Septicaemia Duodenal
perforation,
Post CABG
7. 65/F 2 Explorative
laparotomy+
Ileostomy
Septicaemia Carcinoma
GB with
infiltration
of hepatic
flexure
Perforation Peritonitis Operated
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S.No. Age/
Sex
Hospital
Stay
Surgery performed Cause of
death
Predisposing
factors
8. 48/M 9 Explorative laparotomy Septicaemia SMA embolus
9. 65/M 20 Explorative laporotomy +
resection anastamosis
ileostomytracheostomy
Septicaemia
(Fungal)
ECF post mesh
hernioplasty for
Incisional hernia
COPD
10. 67/M 9 Subtotal gastrectomy+
Gastrojejunostomy
Septicaemia Duodenal blow
out, COPD
11. 42/M 15 Explorative
laparotomy+peritoneallavage
Septicaemia Ruptured Pyogenic
liver abscess,COPD
12. 50/F 36 Strangulated umbilical
hernia+Resection
anastamosis;decompressi
on craniectomy
Septicaemia Strangulated
umbilical hernia,
CAD post
angioplasty, ARF,
MI,CVA
Septicaemia Operated
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S.No. Age/Sex
Hospital Stay
Surgery performed Cause of death Predisposing factors
13. 26/F 15 - Septicaemia Faecal fistula
( Operated PVT)
14. 65/M 17 - Septicaemia Caecal perforation with
status ileostomy ,
COPD
15. 48/M 1 B/L drains Septicaemia Perforation peritonitis
COPD
Septicaemia Nonoperated
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S.No. Age/ Sex Hospita
l Stay
Surgery
performed
Cause of
death
Predisposing factors
16. 50/M 1 Debridement Septicaemia Necrotizing fascitis
17. 50/M 1 Debridement Septicaemia Necrotizing fascitis
18. 52/M 2 - Septicaemia Gangrene , Rt. CIA occlusion
CAD
19. 65/M 1 - Septicaemia Necrotizing fascitis, COPD
20. 70/F 2 - Septicaemia Necrotizing fascitis+DM+
ARF
CAD post angioplasty
Necrotizing fascitis Operated and Nonoperated
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S.No. Age/ Sex Hospital
Stay
Surgery
performed
Cause of
death
Predisposing
factors
21. 72/F 8 - Pneumonia Idiopathic
noncardiogenic
pulmonary oedema, DM,GSD
22. 35/F 24 - PUO Carcinoma breast 3
cycles of NAC
Ventilator Assosciated Pneumonia Nonoperated
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S.No. Age/ Sex Hospital
Stay
Surgery
performed
Cause of
death
Predisposin
g factors
23. 56/M 18 B/K
amputation
Septicaemia Diabetic
foot,
CHF,CRF,CVA, CAD
24. 60/M 21 A/K
amputation
Septicaemia Diabetic
foot,
DM,Hyperte
nsion, PAD
25. 73/M 26 Dressing Septicaemia Diabetic
foot , CRF,
pace maker
insitu, CAD
Diabetic foot Operated and Nonoperated
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S.No. Age/ Sex HospitalStay
Surgeryperformed
Cause of death Predisposingfactors
26. 36/F 1 - Disseminated
malignancy
Metastatic
Carcinoma
breast
27. 35/F 1 - Disseminated
malignancy
Septicaemia ,
Metastatic
disease
28. 56/M 1 - Disseminated
malignancy
HCC rupture
HCV
Disseminated Malignancies Nonoperated
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S.No. Age/
Sex
Hospital
Stay
Surgery performed Cause of
death
Predisposing
cause
29. 35/F 17 Resection of
ilioinguinal lymph
nodal mass
Disseminat
ed
metastases
0steosarcoma
Metastatic
disease
30. 52/M 8 Explorativelaparotomy+incisiona
l Bx
DVT +pulm.
emboliosm
Retroperitoneal tumor
31. 35/M 10 Palliative
Gastrojejunostomy
Advanced
carcinoma
Metastatic
liposarcoma
32. 28/M 7 Adrenalectomy Recurrence
with
metastases
Adrenal
carcinoma
Metastatic
disease
Disseminated Malignancies Operated
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S.No. Age/ Sex Hospital
Stay
Surgery
performed
Cause of
death
Predisposi
ng cause
33. 75/M 8 - Aspiration
pneumonia
Metastatic
carcinoma
stomachCOPD
34. 70/M 4 - Aspiration
pneumonia
Ca. Rectum
COPD
Aspiration Nonoperated
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Thank You
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Complications
Wound infections Thyroid 6
CBD exploration 1
Breast cancer 8
Umbilical mesh hernioplasty 1
Others 6
Flap necrosis
Breast 10 Thoraco epigastric flap 2
LD flap 1
Others 6