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Department of General, GI and Minimal Access Surgery, St Isabel's Hospital, Chennai, Tamil Nadu
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Manickavasagam K. S.M. Chandramohan. Natl Med J India 2020;33:311-312
(16 October 1957–6 July 2020)
Professor S.M. Chandramohan MS, MCh, FACS, FRCS, FAIS, FIMSA was the Founder Director of the Institute of Surgical Gastro-enterology, Centre of Excellence for Upper GI Surgery, Rajiv Gandhi Government General Hospital and Madras Medical College, Chennai, Tamil Nadu, India.
After receiving his medical degree in 1979 from Thanjavur Medical College in Thanjavur, Tamil Nadu, he completed his postgraduate training at Madras Medical College and Government General Hospital, Chennai. He was the best outgoing candidate for the state of Tamil Nadu and was honoured with the Madras University Gold Medal in 1984. Later, he worked at a rural primary health centre, which catered to 47 seaside villages of Thanjavur district. He stood first in the entrance examination and was selected for the prestigious MCh Surgical Gastroenterology course at Madras Medical College under the Late Professor N. Rangabashyam. He was the seventh person in the country to qualify with an MCh Surgical Gastroenterology degree.
He was the founder of the Department of Surgical Gastroenterology at the Institute of Non-Communicable Diseases at Government Royapettah Hospital and became a full Professor at Government Kilpauk Medical College in 2000. Considering his pioneering work, he was promoted as Head, Department of Surgical Gastroenterology, Rajiv Gandhi Government General Hospital and Madras Medical College. In recognition of his work on upper gastrointestinal (GI) disorders the department was upgraded to the ‘Centre of Excellence in Upper GI Surgery’. Due to his untiring efforts the Centre evolved to the Institute of Surgical Gastroenterology. The institute has been recognized as the regional referral centre for upper GI disorders.
Professor Chandramohan’s clinical interests included surgery for upper GI disorders encompassing both benign and malignant oesophagogastric disorders. He had a special interest in the management of gastric cancer, oesophageal cancer and gastro-oesophageal junction tumours. His pioneering work in the management of caustic injuries of the upper GI tract is widely acknowledged. His innovative surgical techniques in the management of complex pharyngo-oesophagogastric strictures due to corrosives are followed all over the world. Several hundred patients live to tell their story.
His research interests included epidemiological aspects and newer operative strategies to optimize the outcome of patients with gastric and oesophageal cancer and the management of postoperative complications. He participated in the development of minimally invasive, endoscopic and laparoscopic operations. His department pursued active research in managing advanced gastric, gastro-oesophageal junction and oesophageal malignancies and complex corrosive strictures of the oesophagus and stomach. His research projects included research on tissue biomarkers for gastric cancer; tumour budding in oesophageal and gastric cancer, role of Octamer-4 (Oct-4) in gastric cancer, sarcopenia in oesophageal and gastric cancer, program cell death ligands (PDL) in gastric cancer, epidermal growth factor receptor overexpression in gastric cancer; tissue carcinoembryonic antigen as a biomarker in gastric cancer, metabolic tumour volume in oesophageal cancer to mention a few.
His technique of coloplasty for reconstruction, using stomach for reconstruction in the presence of antral stricture; taking the conduit to the neck using a camera sheath technique; the partial stapling technique of the anastomosis; totally stapled pharyngo-caecoplasty; strategies to be adopted for failed conduits; revision anastomosis technique in the neck, self-dilatation can be done by the patient themselves, have created a major impact in simplifying the management of these complex problems. He defined a new entity called ‘Gastrocoele’ in patients with double strictures. He described a new working classification for ‘Isolated gastric strictures’, which won the Hari Om Ashram Award from the Association of Surgeons of India for the best research work.
New concepts in surgical training and education was a major focus of his academic interest. He authored more than 300 scientific presentations, papers, editorials, textbook chapters, abstracts and video productions. He was an invited speaker for more than 100 regional, national and international lectures on the subject of oesophagogastric surgery and laparoscopic surgery. He served as member of the board of studies in surgical specialties, in the Tamil Nadu Dr M.G.R. Medical University, Chennai. He was director for more than 50 courses and workshops on advanced gastro-oesophageal surgery. He was instrumental in increasing the postgraduate seats for MCh Surgical Gastroenterology from two to six per year in the department he headed, the largest number in the country. He was instrumental in encouraging postgraduate and even undergraduate students in doing original research and presenting their work in national and international forums fetching them awards and grants from well-recognized societies.
He was a council member of the International Gastric Cancer Association (IGCA); Education Committee member of the International Society for Diseases of Esophagus (ISDE); Scientific Committee member of OESO and president of the Asia Pacific Gastro Esophageal Cancer Congress (APGCC).
Encouraging research on oesophagus and stomach
As founder and president of ESOINDIA, the non-governmental organization (NGO) he founded and in the capacity of Director, International Student Programme at Sri Ramachandra Institute of Higher Education and Research (SRIHER), he initiated more than 25 research projects on oesophagus and stomach and a few of them have already won international and national awards.
Reaching out to the community
In parallel with his efforts at surgical intervention and innovation to save those who attempt to take their own lives by drinking acid, he worked for over two decades to create awareness about good GI health, cancer, suicide prevention, drug abuse and other societal concerns. What began as a crusade spirit at the turn of the century has today become an established movement, aided and pursued by ESOINDIA (www.esoindia.org).
In the initial phase, Professor Chandramohan took his team of doctors and professionals to conduct health camps in remote centres such as Coonoor in the Nilgiris (2001) and Nagapattinam in the aftermath of the Tsunami (2004). He later cast his net wide, involving students and youth, for a variety of awareness programmes using the medium of essay writing, speech contests and art displays. Prize winners among the essayists and contributors were chosen for making original, distinct contributions on how cancer of the GI tract could be prevented, identified early, treated and managed.
Several camps were held every year to mark important days observed by the WHO and competitions held on those themes. The prize-winning entrants were chosen from all over Tamil Nadu. Hundreds of entries were received in areas such as prevention of gastric cancer, awareness about drug abuse and mental health. The scores of winners then got an opportunity at the special awareness programmes to interact with a wide audience, as well as meet survivors of cancer and acid-drinking.
The most recent event was held in Chennai on 15 August 2019, while a mega outreach camp was also conducted in 2019 at Kotagiri in the Nilgiris district of Tamil Nadu to help the tribal population.
As a persuasive speaker in Tamil, Professor Chandramohan coined the clarion call ‘Vizhithezhu’ (Arise, Awaken) to galvanize civil society in the state to participate in cancer awareness programmes. Programmes under this banner were held in Chennai and Kodaikanal, where prominent musicians and actors participated along with youth and students who took part in the contests.
He formed the Gastric Cancer Help Group and Esophageal Patients’ Support Organisation with Survivor Volunteers and Supporters and they played a pivotal role in conducting the awareness programmes.
For the energetic, community-focused Professor Chandramohan, these two decades of efforts only marked a beginning, and higher levels of engagement with patients and community was a constant pursuit. All these he did as an individual with a social commitment with the help of survivor volunteers and ESOINDIA. His food and fitness protocols were highly disciplined despite his hectic schedule. He clocked a minimum of 8 km of walk every day till 5 July 2020.
He suffered an anterior wall myocardial infarction during the wee hours of 6 July 2020 and breathed his last. It was a tremendous loss to the surgical and research fraternity, students, patients and society at large.
He is survived by his wife Professor Rema Chandramohan, Professor of Paediatrics, Institute of Child Health, Egmore, Chennai and his daughters, Drs Asmita and Apsara Chandramohan.