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Raval surgery

Catherine Tsai, Cameron Hague, Wei Xiong, Manoj Raval, Ahmer Karimuddin, Carl Brown, P Terry Phang
ERUS and MRI are used for preoperative imaging of rectal cancer. Here, we compare ERUS and MRI for accuracy of CRM prediction at mid- and distal rectal locations. In retrospective review, 20 rectal cancer patients having TME surgery had both ERUS and MRI preoperatively: 8 mid rectum and 12 in distal rectum. Predicted CRM by ERUS and MRI were compared to TME pathology. Overall, predicted CRM was 6.5 ± 3.6 mm by ERUS, 7.7 ± 5.0 mm by MRI, and 6.0 ± 4.6 mm by pathology. Overall, correlation coefficients to pathology were 0...
March 27, 2017: American Journal of Surgery
Heather L Short, Helene B Fevrier, Jonathan A Meisel, Matthew T Santore, Kurt F Heiss, Mark L Wulkan, Mehul V Raval
INTRODUCTION: Prolonged operative time (OT) is considered a reflection of procedural complexity and may be associated with poor outcomes. Our purpose was to explore the association between prolonged OT and complications in children's surgery. METHODS: 182,857 cases from the 2012-2014 NSQIP-Pediatric were organized into 33 groups. OT for each group was analyzed by quartile, and regression models were used to determine the relationship between prolonged OT and complications...
March 20, 2017: Journal of Pediatric Surgery
Jay S Raval, Vijay S Gorantla, Jaimie T Shores, W P Andrew Lee, Raymond M Planinsic, Marian A Rollins-Raval, Gerald Brandacher, Karen E King, Joseph E Losee, Joseph E Kiss
BACKGROUND: Upper-extremity transplantation (UET) is a reality. Immunologic, functional, and graft survival outcomes have been encouraging. However, these complex reconstructions have unique considerations that pose distinct challenges. Transplant programs have reported morbidity and mortality due to significant intraoperative blood losses, but similar data are scant during other phases of recovery. We report experience from two centers on complete blood component demands and utilization with UET...
March 2017: Transfusion
Cherine H Kim, Devin W McBride, Ronak Raval, Prativa Sherchan, Karen L Hay, Eric C K Gren, Wayne Kelln, Tim Lekic, William K Hayes, Brian S Bull, Richard Applegate, Jiping Tang, John H Zhang
Perioperative bleeding is a potentially devastating complication in neurosurgical patients, and plasma fibrinogen concentration has been identified as a potential modifiable risk factor for perioperative bleeding. The aim of this study was to evaluate preconditioning with Crotalus atrox venom (Cv-PC) as potential preventive therapy for reducing perioperative hemorrhage in the rodent model of surgical brain injury (SBI). C. atrox venom contains snake venom metalloproteinases that cleave fibrinogen into fibrin split products without inducing clotting...
January 19, 2017: Scientific Reports
Heather L Short, Curtis Travers, Courtney McCracken, Mark L Wulkan, Matthew S Clifton, Mehul V Raval
BACKGROUND: Infants with congenital cardiac disease (CCD) often require gastrostomy tube placement (GT) and need antireflux procedures, such as fundoplications. Our purpose was to compare morbidity/mortality rates among infants with CCD undergoing GT, fundoplication, or both. METHODS: Using the NSQIP-Pediatric, we identified 4070 patients <1-year-old who underwent GT and/or fundoplication from 2012 to 2014. 2346 infants (58%) had CCD categorized as minor, major or severe...
December 30, 2016: Pediatric Surgery International
Pradyumna Raval, Ashish Vijayan, Arpit Jariwala
Synovial chondromatosis is a rare and benign condition of unknown cause. It is also known as synovial osteochondromatosis. It is characterized by involvement of the synovial tissue, which lines various joints of our body. Initial symptoms range from pain in the joint, locking of the joint at times, especially the knee, to arthritis of the joint that is a late feature of this condition. Although large joints such as the knee are commonly affected, involvement of the shoulder joint is a rare occurrence. Historically an open arthrotomy was preferred for removal of loose bodies coupled with a thorough synovectomy...
November 2016: Orthopaedic Surgery
Eric W Etchill, Sara P Myers, Jay S Raval, Adnan Hassoune, Anirban SenGupta, Matthew D Neal
Thrombocytopenia is prevalent in critical care, surgical, and trauma settings. Despite the fact that a significant proportion of these patients receive platelet transfusion during their hospital course, much work remains to be done with regard to development of platelet transfusion guidelines. Given the wide variety of platelet transfusion practices and the frequency with which patients present with thrombocytopenia, it is paramount to understand standards of care and to identify deficiencies that may exist...
May 2017: Shock
Heather L Short, Kurt F Heiss, Mark L Wulkan, Mehul V Raval
PURPOSE: Accidental puncture or laceration (APL) has been endorsed as a patient safety indicator and is being used to compare hospital performance and for reimbursement. We sought to determine the positive predictive value (PPV) of APL as a quality metric in a pediatric population. METHODS: We retrospectively reviewed all cases that met APL administrative criteria over 5years in a quaternary pediatric hospital system. Events were categorized as false positive (FP) or true positive (TP)...
January 2017: Journal of Pediatric Surgery
Ryan J McColl, Colleen E McGahan, Eric Cai, Rob Olson, Winson Y Cheung, Manoj J Raval, Paul Terry Phang, Ahmer A Karimuddin, Carl J Brown
BACKGROUND: The relationship between hospital volume and patient outcomes remains controversial for rectal cancer. METHODS: This is a population-based database study. Patients treated with surgery for a stage I to III rectal adenocarcinoma from 2003 to 2009 were identified. High-volume hospitals (HVH) were those centers performing 20 surgeries or more per year. Primary outcomes were operative and perioperative factors that have proven influence on patient outcomes...
February 2017: American Journal of Surgery
Julia K Shinnick, Heather L Short, Kurt F Heiss, Matthew T Santore, Martin L Blakely, Mehul V Raval
BACKGROUND: Enhanced recovery after surgery (ERAS), guidelines entail a strategy of perioperative management proven to hasten postoperative recovery and reduce complications in adult populations. Relatively few studies have investigated the applicability of this paradigm to pediatric populations. Our objective was to perform a systematic review of existing evidence regarding the use and efficacy of enhanced recovery protocols (ERPs) in the pediatric population. MATERIALS AND METHODS: Data were collected through a PubMed/MEDLINE literature search...
May 1, 2016: Journal of Surgical Research
Adam B Goldin, Kurt F Heiss, Matt Hall, David H Rothstein, Peter C Minneci, Martin L Blakely, Marybeth Browne, Mehul V Raval, Samir S Shah, Shawn J Rangel, Charles L Snyder, Charles D Vinocur, Loren Berman, Jennifer N Cooper, Marjorie J Arca
OBJECTIVES: To define the incidence of 30-day postdischarge emergency department (ED) visits and hospital readmissions following pediatric gastrostomy tube (GT) placement across all procedural services (Surgery, Interventional-Radiology, Gastroenterology) in 38 freestanding Children's Hospitals. STUDY DESIGN: This retrospective cohort study evaluated patients <18 years of age discharged between 2010 and 2012 after GT placement. Factors significantly associated with ED revisits and hospital readmissions within 30 days of hospital discharge were identified using multivariable logistic regression...
July 2016: Journal of Pediatrics
Vivek Pravin Dave, Avinash Pathengay, Sayan Basu, Namrata Gupta, Soumyava Basu, Vishal Raval, Taraprasad Das, Savitri Sharma, Annie Mathai, Raja Narayanan, Jay Chhablani, Pranjali Sharma, Mudit Tyagi, Divya Balakrishnan, Subhadra Jalali, Padmaja Kumari Rani, Rajeev Reddy Pappuru
PURPOSE: To report the clinical presentations, risk factors, and outcomes of endophthalmitis after pars plana vitrectomy at 4 tertiary eye care centers of an institute in South India. DESIGN: A retrospective case series. METHODS: The records of 38,591 patients undergoing vitrectomy were reviewed using the coding assigned by the medical records department. Consecutive cases diagnosed as endophthalmitis after pars plana vitrectomy (PPV) between 1990 and 2014 for various indications were analyzed...
May 2016: Asia-Pacific Journal of Ophthalmology
Christopher L Sudduth, Sarah J Hill, Mehul V Raval
Two of the most common types of congenital thoracic malformations are congenital pulmonary airway malformations (CPAMs) and bronchopulmonary sequestrations (BPS). Here we present the first known case of a hybrid lesion, with coexisting features of an extralobar sequestration (ELS) and CPAM type 2, with arterial inflow from the celiac trunk and venous outflow to the portal vein. The clinical presentation, investigative imaging and timing of surgery are discussed.
July 2016: Pediatric Surgery International
Tarun Madan, Manish Juneja, Abhishek Raval, Bhavesh Thakkar
Left ventricular pseudoaneurysm is a rare but serious complication of acute myocardial infarction and cardiac surgery. While surgical intervention is the conventional therapeutic option, transcatheter closure can be considered in selected patients with suitable morphology of the pseudoaneurysm. We report a case of successful transcatheter closure of a left ventricular pseudoaneurysm orifice and isolation of the sac using an Amplatzer septal occluder.
February 2016: Portuguese Journal of Cardiology: An Official Journal of the Portuguese Society of Cardiology
Prasad Ellanti, Pradyumna Raval, Paul Harrington
OBJECTIVE: The aim of this study was to ascertain the duration from time of surgery to resumption of driving after total knee arthroplasty (TKA) and to examine recommendations in the literature. METHODS: All patients who underwent primary unilateral TKA and were driving within 6 months preceding the arthroplasty were included. The patients' age, gender and side of the TKA were noted. The time taken to resume driving by each patient as well as the type of vehicle were noted...
2015: Acta Orthopaedica et Traumatologica Turcica
Amandeep Ghuman, Tiffany Chan, Ahmer A Karimuddin, Carl J Brown, Manoj J Raval, P Terry Phang
BACKGROUND: Surgical site infections of up to 27% are reported for colorectal surgery. Care bundles have been introduced to decrease surgical site infection rates, but are variable in composition. OBJECTIVE: This study aimed to determine whether the addition of a "Colorectal Closure Bundle" in our Enhanced Recovery After Surgery pathway decreased surgical site infection rates. DESIGN: This is a retrospective study of elective colon resections before and after the addition of a closure bundle...
November 2015: Diseases of the Colon and Rectum
Raj Rai, Rushik Raval, Rakshit Vijay Sinai Khandeparker, Swati K Chidrawar, Abdul Ahad Khan, Makne Sachin Ganpat
Within the precedent decade, a new field of "tissue engineering" or "tissue regeneration" emerge that offers an innovative and exhilarating substitute for maxillofacial reconstruction. It offers a new option to supplement existing treatment regimens for reconstruction/regeneration of the oral and craniofacial complex, which includes the teeth, periodontium, bones, soft tissues (oral mucosa, conjunctiva, skin), salivary glands, and the temporomandibular joint (bone and cartilage), as well as blood vessels, muscles, tendons, and nerves...
September 2015: Journal of International Oral Health: JIOH
Simon M Thompson, Anja Saso, Parag Raval, Mary Jones, Andrew M Williams
Autologous chondrocyte implantation (ACI) and mosaicplasty have become established operations used to treat full-thickness chondral lesions in the knee and elsewhere. Although complications of both have been documented, there are no previous reports of avascular necrosis (AVN) complicating these procedures. Awareness of AVN as a complication of ACI might have prompted an earlier diagnosis, with possible non-surgical treatment or more minor surgery being possible. At the very least, an appropriate form of management could have been initiated earlier, so shortening the period of disability and suffering for the patient...
May 2016: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
Shobhana Gupta, Dipak Raval, Mita Patel, Nirav Patel, Nehal Shah
BACKGROUND: This study was undertaken to evaluate the analgesic effect of the combination of epidural Clonidine with Bupivacaine versus epidural Bupivacaine alone in patients undergone knee replacement surgery. MATERIALS AND METHODS: A randomized double-blind design was used, and 60 adult patients (40-60 years) of ASA grade I and II scheduled for post-operative pain relief in total knee replacement surgeries by epidural Clonidine were studied. Patients received either an epidural Clonidine (1μg/kg) with Bupivacaine (1...
July 2010: Anesthesia, Essays and Researches
Scott G Hubosky, Amar J Raval, Demetrius H Bagley
BACKGROUND AND PURPOSE: Flexible ureteroscopy (URS) is widely implemented with a well-defined safety profile and low complication rates. Although rare, locked deflection of a flexible ureteroscope in the upper tract is a potentially serious complication with poorly understood etiology and is likely underreported. MATERIALS AND METHODS: We attempted to capture all cases of locked deflection during URS by performing an anonymous, online computer survey targeting members of the Endourological Society...
August 2015: Journal of Endourology
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