المؤلفون: Sangeeta Tiwari, Ashutosh Chauhan, Pallab Chaterjee, Mohammed T Alam

المصدر: Journal of Minimal Access Surgery, Vol 9, Iss 2, Pp 65-71 (2013)

مصطلحات موضوعية: General anaesthesia, laparoscopic cholecystectomy, spinal anaesthesia, Surgery, RD1-811, Diseases of the digestive system. Gastroenterology, RC799-869

الوصف: Context: Spinal anaesthesia has been reported as an alternative to general anaesthesia for performing laparoscopic cholecystectomy (LC). Aims: Study aimed to evaluate efficacy, safety and cost benefit of conducting laparoscopic cholecystectomy under spinal anaesthesia (SA) in comparison to general anaesthesia(GA) Settings and Design: A prospective, randomised study conducted over a two year period at an urban, non teaching hospital. Materials and Methods: Patients meeting inclusion criteria e randomised into two groups .Group A and Group B received general and spinal anaesthesia by standardised techniques. Both groups underwent standard four port laparoscopic cholecystectomy. Mean anaesthesia time, pneumoperitoneum time and surgery time defined primary outcome measures. Intraoperative events and post operative pain score were secondary outcome measure. Statistical Analysis Used: The Student t test, Pearson′s chi-square test and Fisher exact test. Results: Out of 235 cases enrolled in the study, 114 cases in Group A and 110 in Group B analysed. Mean anaesthesia time appeared to be more in the GA group (49.45 vs. 40.64, P = 0.02) while pneumoperitoneum time and corresponding the total surgery time was slightly longer in the SA group. 27/117 cases who received SA experienced intraoperative events, four significant enough to convert to GA. No postoperative complications noted in either group. Pain relief significantly more in SA group in immediate post operative period (06 and 12 hours) but same as GA group at time of discharge (24 hours). No late postoperative complication or readmission noted in either group. Conclusion: Laparoscopic cholecystectomy done under spinal anaesthesia as a routine anaesthesia of choice is feasible and safe. Spinal anaesthesia can be recommended to be the anaesthesia technique of choice for conducting laparoscopic cholecystectomy in hospital setups in developing countries where cost factor is a major factor.

وصف الملف: electronic resource

العلاقة: http://www.journalofmas.com/article.asp?issn=0972-9941;year=2013;volume=9;issue=2;spage=65;epage=71;aulast=TiwariTest; https://doaj.org/toc/0972-9941Test; https://doaj.org/toc/1998-3921Test

الوصول الحر: https://doaj.org/article/6269dbac7cce43b6884073769a889fb5Test

المؤلفون: Mala Mathur Sharma, Ashutosh Chauhan

المصدر: Medical Journal Armed Forces India. 72:12-18

مصطلحات موضوعية: medicine.medical_specialty, Breast conservation, business.industry, Breast surgery, medicine.medical_treatment, Incidence (epidemiology), Tumor resection, General Medicine, 030230 surgery, Surgery, Resection, Oncoplastic Surgery, 03 medical and health sciences, 0302 clinical medicine, 030220 oncology & carcinogenesis, medicine, Positive Margins, Original Article, business, Early breast cancer

الوصف: Background The aim of this study was to determine whether oncoplastic breast surgery (OBS) ensures better tumour resection than conventional breast conservation surgery (BCS). Methods A prospective comparative study, conducted over a 3-year period, enrolled patients with early breast cancer who underwent OBS. The total volume of glandular resection, tumour volume resection and width of the margins obtained were noted. The incidence of complications, requirement of revision surgery and locoregional recurrence during follow-up period were also noted. The data were compared with matched controls who had undergone convention BCS in the past. Results Thirty-three patients underwent oncoplastic surgery and the data was compared with 46 patients of conventional breast conservation. The mean volume of specimen was higher in the oncoplastic group (173.5 cm 3 vs 101.4 cm 3 , p = 0.03) though the tumour volume excised was similar (43.2 cm 3 vs 36.4 cm 3 , p = 0.14). The mean margin widths were larger in the oncoplastic group (14 mm vs 6 mm, p = 0.01). There were more instances of close and positive margins seen in conventional BCS groups. The incidence of complication rate was similar. Median follow-up 18 months for oncoplasty group showed no cases of locoregional recurrence while in median follow-up of 38 months for conventional BCS group, six cases of locoregional relapse were noted. Conclusions Oncoplastic surgery results in excision of larger volume of breast tissue and correspondingly obtain wider surgical margins as compared to conventional BCS. Longer follow-up is required to determine if wider resection translates into better locoregional control.

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::e39436a4207bbd6b390f7883cf02632dTest
https://doi.org/10.1016/j.mjafi.2015.11.001Test

المؤلفون: Prashant Bobhate, Swapnil Sharma, Saista Amin, Kapildev Yadav, Vinay Kumaran, Ashutosh Chauhan, S. Maheshwari, Vibha Varma, Sorabh Kapoor, Shailesh Sable, Suneed Kumar

المصدر: Indian journal of gastroenterology : official journal of the Indian Society of Gastroenterology. 37(4)

مصطلحات موضوعية: Adult, Male, medicine.medical_specialty, Adolescent, medicine.medical_treatment, India, Vena Cava, Inferior, 030204 cardiovascular system & hematology, Liver transplantation, Iliac Vein, Single Center, Asymptomatic, Diagnosis, Differential, 03 medical and health sciences, 0302 clinical medicine, Mesenteric Veins, medicine, Internal iliac vein, Humans, Portasystemic Shunt, Surgical, Familial Primary Pulmonary Hypertension, Diagnostic Errors, Child, Retrospective Studies, business.industry, Portal Vein, Gastroenterology, medicine.disease, Pulmonary hypertension, Surgery, Shunt (medical), Liver Transplantation, Child, Preschool, Inferior mesenteric vein, 030211 gastroenterology & hepatology, Female, Presentation (obstetrics), medicine.symptom, business, Tomography, X-Ray Computed

الوصف: Abernethy malformation is a rare congenital anomaly in which there is direct communication between the portal and systemic venous circulation. The clinical presentation ranges from asymptomatic with incidental detection on imaging to secondary complications of disease or related to associate anomalies. This is a retrospective analysis of data from nine patients with Abernethy malformation at a single center. This is a referral center for Pediatric Cardiology and for Hepatobiliary and Pancreatic Surgery. The patients presented to the Pulmonary Hypertension Clinic/the Hepatobiliary Surgery Clinic. Out of nine patients, four were male. Type II Abernethy malformation was present in five patients whereas three patients had type I malformation. One of the patients had communication between inferior mesenteric vein and internal iliac vein. Five out of nine patients were erroneously diagnosed as idiopathic primary pulmonary hypertension and were treated with vasodilators. One patient required living donor liver transplant. One patient was managed with surgical shunt closure whereas two patients required transcatheter shunt closure. The rest of the patients were managed conservatively. Abernethy malformation is more common than previously thought and the diagnosis is often missed. There are various management options for Abernethy malformation, which includes surgical or transcatheter shunt closure and liver transplant. Management of Abernethy malformation depends upon type, presentation, and size of shunt.

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::5a969d9caf23c76f995daa35b4e6d714Test
https://pubmed.ncbi.nlm.nih.gov/30187299Test

المؤلفون: Kapildev Yadav, Sorabh Kapoor, Swapnil Sharma, Vinay Kumaran, S. Maheshwari, Shailesh Sable, Ashutosh Chauhan, Vibha Varma

المصدر: Indian journal of gastroenterology : official journal of the Indian Society of Gastroenterology. 37(2)

مصطلحات موضوعية: Adult, Male, medicine.medical_specialty, Time Factors, Computed tomography, 030230 surgery, Partial hepatectomy, Living donor, 03 medical and health sciences, Young Adult, 0302 clinical medicine, Internal medicine, medicine, Retrospective analysis, Living Donors, Hepatectomy, Humans, International Normalized Ratio, Retrospective Studies, medicine.diagnostic_test, business.industry, Gastroenterology, Bilirubin, Organ Size, Hepatology, Middle Aged, Liver regeneration, Tissue Donors, Surgery, Liver Regeneration, Liver Transplantation, Liver, Cohort, 030211 gastroenterology & hepatology, Female, Living donor liver transplantation, business, Biomarkers

الوصف: Right lobe living donor (2/3rd partial hepatectomy) model is the best way to accurately study liver regeneration process in human beings. We aimed to study the kinetics of liver regeneration after 2/3rd partial hepatectomy in donors. Retrospective analysis of prospectively maintained volumetric recovery data in donors was performed in 23 donors, who underwent 29 contrast-enhanced computed tomography within 3 months for various clinical indications. The absolute volumetric growth percentages were as follows: 37.60 ± 21.74 at 1st week, 92 ± 53.27 at 2nd week, 115.55 ± 59.65 at 4th week, and 110.79 ± 64.47 at 3 months. On sub-group analysis of our cohort, we found that 4.3%, 17%, 30.4%, and 39% donors attended ≥ 90% volumetric recovery at 1st, 2nd, 4th week, and 3 months, respectively. One patient at 4th week revealed 128% volumetric recovery. There was one more patient who exceeded original total liver volumes (TLV) (111% of TLV) at 2.5 months. The serum bilirubin and INR values peaked at postoperative day (POD) 3rd and then started showing a downward trend from POD 5th onwards. Our study is the first to document complete volumetric recovery in donors as early as 3 weeks. Two of the donors overshot their original TLV during the early regenerative phase.

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::36670cb9c535145a970a3ccf8ae464f6Test
https://pubmed.ncbi.nlm.nih.gov/29594724Test

المؤلفون: Shailesh Sable, Vinay Kumaran, Jaydeep Palep, Sorabh Kapoor, Ashutosh Chauhan, Abhaya Kumar, Nidhi Khandelwal, Vibha Varma, Kapildev Yadav, Swapnil Sharma, Suneed Kumar

المصدر: Indian journal of gastroenterology : official journal of the Indian Society of Gastroenterology. 36(3)

مصطلحات موضوعية: Sleeve gastrectomy, medicine.medical_specialty, Diet therapy, medicine.medical_treatment, Bariatric Surgery, India, 030230 surgery, Living donor, Diabetes Complications, End Stage Liver Disease, 03 medical and health sciences, Liver disease, 0302 clinical medicine, Gastrectomy, Non-alcoholic Fatty Liver Disease, Internal medicine, Diabetes mellitus, medicine, Living Donors, Humans, Obesity, Metabolic Syndrome, business.industry, Stomach, Gastroenterology, Hepatology, Middle Aged, medicine.disease, Surgery, Liver Transplantation, medicine.anatomical_structure, Treatment Outcome, Liver, 030211 gastroenterology & hepatology, Female, Metabolic syndrome, business

الوصف: Nonalcoholic steatohepatitis (NASH) with morbid obesity and metabolic syndrome is now a common cause of end-stage liver disease (ESLD). These patients are high-risk candidates for liver transplant, and require bariatric surgery to prevent recurrent disease in the new liver. Data reports bariatric surgery after transplant, which maybe difficult because of adhesions between the stomach and liver in living donor liver transplant (LDLT) recipient. We report the first case of combined LDLT with sleeve gastrectomy (SG) from India. A morbidly obese diabetic woman with NASH-related ESLD was planned for combined right lobe LDLT with open SG, in view of failed diet therapy, musculo-skeletal complaints, and restricted mobility. Postoperatively, with liver graft functioning adequately, bariatric diet restrictions resulted in maximum reduction of 25% weight, achieving a target BMI below 30 kg/m2 within 2 months, along with complete cure of diabetes and better ambulation. Thus, combination of LDLT and bariatric surgery in the same sitting is safe and effective in management of metabolic syndrome and associated NASH-related ESLD.

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::da45cf3f3734bfd981832b79b7ca48b6Test
https://pubmed.ncbi.nlm.nih.gov/28560633Test

المؤلفون: Manomoy Ganguly, Anuj Kumar Sharma, Ashutosh Chauhan

المصدر: Indian J Surg Oncol

مصطلحات موضوعية: medicine.medical_specialty, Chemotherapy, Disease entity, business.industry, medicine.medical_treatment, fungi, 030232 urology & nephrology, Port site, Sequela, medicine.disease, Surgery, 03 medical and health sciences, 0302 clinical medicine, Oncology, Surgical oncology, 030220 oncology & carcinogenesis, Mean Survival Time, medicine, Gall bladder carcinoma, Original Article, Gallbladder cancer, business

الوصف: Port site metastasis (PSM) is a known sequela of laparoscopic cholecystectomy in carcinoma gallbladder. While they are associated with poor prognosis, isolated PSM may represent a subset with better outcomes. We conducted a clinical audit of 33 cases of PSMs treated over a 6-year period. This included 26 cases of isolated PSM and 7 cases of PSM with systemic metastases. The mean time interval between index surgery and appearance of PSM was longer in the patients with isolated PSM (33.11 vs 25.5 months, p = 0.041). Isolated PSMs were treated with surgery and chemotherapy while the others were treated with palliative chemotherapy only. Two out of 27 cases (7 %) of isolated PSM had disease progression during therapy while 3 out of the 6 cases (50 %) of PSM with other sites of recurrences had disease progression while on treatment. Time to disease progression was significant more in cases of isolated PSM (17.14 vs 7.66 months, p = 0.034). The mean survival time too was significantly more in these cases (25.33 vs 15.66 months, p = 0.015). Isolated PSMs in case of gallbladder cancer may represent a distinct disease entity. Aggressive surgical management in addition to systemic chemotherapy may result in a reasonable survival advantage.

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::dea857a79aef8ab0234df979a281ac21Test
https://europepmc.org/articles/PMC9478060Test/

المؤلفون: Ashutosh Chauhan, Pallab Chaterjee, Sangeeta Tiwari, Mohammed T Alam

المصدر: Journal of Minimal Access Surgery
Journal of Minimal Access Surgery, Vol 9, Iss 2, Pp 65-71 (2013)

مصطلحات موضوعية: medicine.medical_specialty, lcsh:Surgery, Context (language use), General anaesthesia, Group B, symbols.namesake, Pneumoperitoneum, medicine, lcsh:RC799-869, Fisher's exact test, laparoscopic cholecystectomy, business.industry, Spinal anesthesia, Postoperative complication, lcsh:RD1-811, spinal anaesthesia, medicine.disease, Surgery, Anesthesia, symbols, Secondary Outcome Measure, lcsh:Diseases of the digestive system. Gastroenterology, Original Article, business

الوصف: Context: Spinal anaesthesia has been reported as an alternative to general anaesthesia for performing laparoscopic cholecystectomy (LC). Aims: Study aimed to evaluate efficacy, safety and cost benefit of conducting laparoscopic cholecystectomy under spinal anaesthesia (SA) in comparison to general anaesthesia(GA) Settings and Design: A prospective, randomised study conducted over a two year period at an urban, non teaching hospital. Materials and Methods: Patients meeting inclusion criteria e randomised into two groups .Group A and Group B received general and spinal anaesthesia by standardised techniques. Both groups underwent standard four port laparoscopic cholecystectomy. Mean anaesthesia time, pneumoperitoneum time and surgery time defined primary outcome measures. Intraoperative events and post operative pain score were secondary outcome measure. Statistical Analysis Used: The Student t test, Pearson′s chi-square test and Fisher exact test. Results: Out of 235 cases enrolled in the study, 114 cases in Group A and 110 in Group B analysed. Mean anaesthesia time appeared to be more in the GA group (49.45 vs. 40.64, P = 0.02) while pneumoperitoneum time and corresponding the total surgery time was slightly longer in the SA group. 27/117 cases who received SA experienced intraoperative events, four significant enough to convert to GA. No postoperative complications noted in either group. Pain relief significantly more in SA group in immediate post operative period (06 and 12 hours) but same as GA group at time of discharge (24 hours). No late postoperative complication or readmission noted in either group. Conclusion: Laparoscopic cholecystectomy done under spinal anaesthesia as a routine anaesthesia of choice is feasible and safe. Spinal anaesthesia can be recommended to be the anaesthesia technique of choice for conducting laparoscopic cholecystectomy in hospital setups in developing countries where cost factor is a major factor.

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::f0405d5232ebeb67f45773bec5e129d6Test
http://europepmc.org/articles/PMC3673576Test

المؤلفون: Ashutosh Chauhan, Kishore Kumar, Mala Mathur Sharma

المصدر: Indian journal of surgical oncology. 7(4)

مصطلحات موضوعية: Chemotherapy, medicine.medical_specialty, business.industry, medicine.medical_treatment, Breast surgery, Incidence (epidemiology), Retrospective cohort study, medicine.disease, Surgery, 03 medical and health sciences, 0302 clinical medicine, Breast cancer, Oncology, Surgical oncology, 030220 oncology & carcinogenesis, Breast-conserving surgery, Medicine, Original Article, 030212 general & internal medicine, Complication, business

الوصف: The purpose of this study was to compare early oncologic outcomes of oncoplastic breast surgery and conventional breast conservation surgery in patients of locally advanced breast cancer. A single-center, prospective, non-randomized study enrolled select cases of locally advanced breast cancer (TNM T3/T4, N0/1/2) who after neoadjuvant chemotherapy, were considered for breast conservation surgery with oncoplasty techniques. The specimen volume resected, the mean margins and mean closest margin obtained were noted. The re-surgery rates, complication rates, and incidence of locoregional recurrence were also noted. Variables were compared with a retrospective cohort of similar patients who had undergone conventional breast conservation surgery. Fifty-seven patients underwent OBS (group 1) and were compared with 43 cases that had undergone conventional BCS (group 2). Majority of the patients in group 1 (73 %) had cT3 with N0 or N+ and a minority (17 %) were with limited skin involvement (cT4 and N0/N+). Relatively larger sized, post-NACT tumors could undergo OBS(4.4 vs 2.3 cm). Relatively greater proportion of tumors in central and lower quadrants were addressed by oncoplasty than traditional BCS (17/57, 29 % vs 4/43, 9 %, p = 0.04). The mean specimen volume excised in group 1 was more than that in group 2. (187.54 vs 125.19; p = 0.01). The mean of the margins were obtained more in group 1 (1.04 vs 0.69 cm); p

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::d87355655f12cd41c8b032516d708fe5Test
https://pubmed.ncbi.nlm.nih.gov/27872528Test

المؤلفون: Niladhar S. Hadke, Shaji Thomas, Ashutosh Chauhan, Prem Kumar Bishnoi

المصدر: Digestive Surgery. 24:28-32

مصطلحات موضوعية: Adult, Male, medicine.medical_specialty, Adolescent, Manometry, Anal Canal, Hemorrhoids, law.invention, Pathogenesis, Randomized controlled trial, law, Sclerotherapy, Pressure, medicine, Humans, In patient, Ligation, business.industry, Gastroenterology, Middle Aged, medicine.disease, Surgery, Treatment Outcome, Prolapsed hemorrhoids, Female, business

الوصف: Background: Increased maximum resting anal pressures (MRAP) have been found in patients with large prolapsed hemorrhoids undergoing hemorrhoidectomy, but their pathogenic role is controversial especially in view of the sphincteric damage that occurs with open and stapled procedures. This prospective randomized clinical trial was conducted to compare anal pressure changes in early symptomatic hemorrhoidal disease before and after successful treatment with band ligation or injection sclerotherapy, and to compare these pressures with those in normal asymptomatic controls. Methods: 32 patients with symptomatic grade II hemorrhoids were randomized to treatment with either band ligation or injection sclerotherapy. Anal manometry was done before treatment and 8 weeks after completion of treatment, and compared with 20 normal age-matched controls. Results: The pretreatment values in both study groups were similar to each other (69.38 cm H2O, 95% CI 58.67–80.08, vs. 67.75 cm H2O, 95% CI 56.86–78.64; p = 0.790), but were significantly higher (p = 0.0001 in both groups) than in the controls (45.25 cm H2O, 95% CI 38.36–52.14). After successful completion of treatment, there was a highly significant drop in the MRAP in both study groups (p = 0.0001 in group A, and p = 0.001 in group B) reaching normal values. Conclusions: Our study shows that even in early-stage hemorrhoids, the anal pressures are significantly raised, but after successful treatment with band ligation or injection sclerotherapy, these pressures return to normal, showing that they do not play a pathogenic role but are secondary to the congested hemorrhoidal cushions.

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::71c6df74f1232f7b76fe88ec58f72162Test
https://doi.org/10.1159/000100915Test

المؤلفون: Pramod Nath, Manomoy Ganguly, Ashutosh Chauhan, NC Chakarborty

المصدر: International Journal of Head and Neck Surgery. 2:61-63

مصطلحات موضوعية: Nasal cavity, medicine.medical_specialty, business.industry, Electronic journal, Induction chemotherapy, medicine.disease, Small-cell carcinoma, Surgery, Paranasal sinuses, medicine.anatomical_structure, Esthesioneuroblastoma, medicine, Immunohistochemistry, Histopathology, business

الوصف: Primary sinonasal small cell carcinomas are extremely rare lesions. We present a case of 29-year-old male patient, who initially presented with recurrent right sided nasal obstruction and occasional epistaxis, but came to medical attention when he developed progressive deterioration of vision in ipsilateral eye. Radiological examination showed a tumor with epicenter in right nasal cavity with extensive local infiltration. The histopathology picture and immunohistochemistry profile of the tumor showed it to be a primary small cell neuroendocrine tumor. Extensive imaging studies revealed no other site of primary. He was treated with induction chemotherapy followed by concomitant chemoradiotherapy. Complete clinical response was seen and the patient has been disease free since last 20 months. The report discusses the diagnostic criteria which differentiates this extremely rare but aggressive tumor from a much more common and more indolent tumor, esthesioneuroblastoma.

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_________::ba6ce19aeca9d4ddd5202699b7ff1bbbTest
https://doi.org/10.5005/jp-journals-10001-1050Test