Przeglądaj wg Autor "Patel, Hardik"

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    Giant hepatic hemangioma with Kasabach-Merritt syndrome treated with right hepatectomy: a case report with literature review
    (Oficyna Wydawnicza AFM, 2023) Vasavada, Bhavin; Patel, Hardik
    Background: We present a case of giant hepatic hemangioma with Kasabach-Merritt syndrome. Material and methods: A thirty-seven-year-old female presented to us with a six-month history of recurrent abdominal pain and weight loss. A CT scan was suggestive of a huge right liver mass involving the entire right lobe, which was indicative of hemangioma. Her blood chemistry showed a platelet count of 68,000 and INR of 1.4, suggestive of Kasabach-Merritt syndrome. Results: In view of the size of the mass, symptoms and associated Kasabach-Merritt syndrome, the patient was offered surgical removal of the tumour. On exploration, the tumour covered the right lobe completely and so a right hepatectomy was performed. The hemangioma was 25 cm × 20 cm × 16 cm and weighed 1.8 kg. The postoperative course of the patient was uneventful. On day 3, the platelet count had improved to 98,000 and the INR had improved to 1.2. The patient was discharged on day five. Conclusions: A right hepatectomy for a giant hemangioma of the liver is a safe procedure and can be curative for associated Kasabach-Merritt syndrome.
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    Non-technical complications predict 30-day perioperative mortality in abdominal surgery. A propensity score matched analysis
    (Oficyna Wydawnicza AFM, 2020) Vasavada, Bhavin B.; Patel, Hardik
    Introduction: Surgical complications are a major cause of mortality and morbidity. Non-technical complications seem to be more dangerous than technique-related complications, however they are commonly neglected by surgeons. Aim: To study the relationship between non-technical complications and mortality after gastrointestinal and hepatobiliary surgery. Material and Methods: All gastrointestinal and hepatobiliary procedures performed over 3 years in one center were analysed. Non-technical postoperative complications were defi ned as perioperative complications related to patients’ physiological health or comorbidities, rather than surgical procedures or techniques. To avoid selection bias we conducted a 1:1 propensity score match analysis with non-technical complications as a dependent factor. The propensity scores were calculated using logistic regression. Preoperative confounding factors such as age, sex, American Society of Anesthesiologists (ASA) score and type of surgery were entered into our model as covariates. We used the nearest-neighbor protocol with a caliber of 0.2. The cases were not reusable after matching. The statistics were analyzed using SPSS version 23. Results: A total of 348 patients underwent gastrointestinal and HPB (Hepato Pancreatico Biliary) surgery in Hepatobiliary and Liver Transplant Department of Shalby Hospitals, India between April 2017 and March 2020. Twenty-four patients developed non-technical complications. ASA scores independently predicted non-technical complications (p=0.001, odds ratio 3.955, 95% C.I.: 1.774–8.813). After matching with 23 controls, non-technical complications were still signifi cantly correlated with mortality (p<0.0001). Intraoperative factors did not predict non-technical complications. Surgery-related complications were not associated with mortality after matching. Conclusion: Non-technical complications are associated with a signifi cant risk of mortality.
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    Open and laparoscopic approaches are associated with comparable 90-day morbidity and mortality following ERAS protocol
    (Oficyna Wydawnicza AFM, 2020) Vasavada, Bhavin B.; Patel, Hardik
    Introduction: The aim of this study is to compare 90-day mortality and morbidity between open and laparoscopic surgeries performed in one centre since the introduction of ERAS protocols. Material and Methods: All gastrointestinal surgeries performed between April 2016 and March 2019 at our institution after the introduction of ERAS protocols have been analysed for morbidity and mortality. The analysis was performed in a retrospective manner using data from our prospectively maintained database. Results: We performed 245 gastrointestinal and hepatobiliary surgeries between April 2016 and March 2019. The mean age of patients was 50.96 years. 135 were open surgeries and 110 were laparoscopic surgeries. The mean ASA score was 2.4, the mean operative time was 111 minutes and the mean CDC grade of surgery was 2.56. 40 were emergency surgeries and 205 were elective surgeries. Overall the 90-day mortality rate was 8.5% and the morbidity rate was around 9.79%. On univariate analysis morbidity was associated with a higher CDC grade of surgeries, a higher ASA grade, longer operating time, the use of more blood products, a longer hospital stay and open surgeries. HPB surgeries and luminal surgeries (non hpb gastrointestinal surgeries) were associated with 90-day post-operative morbidity. On multivariate analysis no factors independently predicted morbidity. On univariate analysis 90-day mortality was predicted by the grade of surgeries, a higher ASA grade, longer operative time, the use of more blood products, open surgeries and emergency surgeries. However on multivariate analysis only the use of more blood products was independently associated with mortality. Conclusion: The 90-day mortality and morbidity rates between open and laparoscopic surgeries after the introduction of ERAS protocol were similar.
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    Państwo i Społeczeństwo 2020, nr 2 Medycyna i zdrowie publiczne
    (Oficyna Wydawnicza AFM, 2020) Komorowski, Andrzej L.; Marino, Marco V.; Musak, Joanna; Vasavada, Bhavin B.; Patel, Hardik; Mituś, Jerzy W.; Vaccarella, Gianpaolo; Potapov, Oleksii; Mirabella, Antonello; Borkowski, Krzysztof; Różański, Waldemar; Pawłowski, Leszek; Kozłowska, Dagmara
    Z wprowadzenia: "Z ogromną przyjemnością oddaję w ręce Czytelników kolejny numer „Państwa i Społeczeństwa. Medycyna i Zdrowie Publiczne”, będący jednocześnie pierwszym numerem powstającym pod moim kierownictwem. Zmiana na stanowisku redaktora naczelnego zbiegła się niestety ze śmiercią cenionego wykładowcy Krakowskiej Akademii im. Andrzeja Frycza Modrzewskiego, ś.p. prof. Stanisława Spornego. Zachęcam do zapoznania się z otwierającym ten numer czasopisma biogramem Profesora, stanowiącym skromną formę pożegnania z tym wybitnym naukowcem."(...)
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    Państwo i Społeczeństwo 2020, nr 4 Medycyna i zdrowie publiczne
    (Oficyna Wydawnicza AFM, 2020) Komorowski, Andrzej L.; Lu, Pamela W.; Fields, Adam C.; Melnitchouk, Nelya; Macintyre, Iain; Vasavada, Bhavin B.; Patel, Hardik; Potapov, Oleksii; Kosiukhno, Sergii; Kalashnikov, Oleksandr; Todurov, Ivan; Iwańska, Ewa; Janeczek, Maja; Muzykiewicz, Konrad; Kosobucki, Radosław; Misiek, Marcin; Bodzek, Maciej; Blecharz, Paweł; Grolik-Kachnic, Marzena; Mazur, Jacek; Szlachetka, Bartłomiej; Brażnik, Aleksander; Kuczia, Marian; Dobrowolska, Beata; Kalemba-Drożdż, Małgorzata
    Z wprowadzenia: "Z wielką przyjemnością oddaję w Państwa ręce kolejny numer „Państwa i Społeczeństwa” poświęcony medycynie i zdrowiu publicznemu. Niektórzy autorzy i recenzenci bieżącego numeru pisali swoje teksty wykorzystując kwarantannę lub – jak niżej podpisany – izolację związaną z zakażeniem COVID-19. W ten sposób można przewrotnie powiedzieć, że środowisko akademickie nie tylko nie poddaje się epidemii, ale wręcz wykorzystuje ją do działań zmierzających do rozwijania nauki, nie tylko tej związanej bezpośrednio z zagadnieniami wirusologicznymi."(...)