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McCarthy E, Gough BL, Johns MS, Hanlon A, Vaid S, Petrelli N. A Comparison of Colectomy Outcomes Utilizing Open, Laparoscopic, and Robotic Techniques. Am Surg 2020; 87:1275-1279. [PMID: 33345569 DOI: 10.1177/0003134820973384] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
INTRODUCTION Robotic colectomy could reduce morbidity and postoperative recovery over laparoscopic and open procedures. This comparative review evaluates colectomy outcomes based on surgical approach at a single community institution. METHODS A retrospective review of all patients who underwent colectomy by a fellowship-trained colon and rectal surgeon at a single institution from 2015 through 2019 was performed, and a cohort developed for each approach (open, laparoscopic, and robotic). 30-day outcomes were evaluated. For dichotomous outcomes, univariate logistic regression models were used to quantify the individual effect of each predictor of interest on the odds of each outcome. Continuous outcomes received a similar approach; however, linear and Poisson regression modeling were used, as appropriate. RESULTS 115 patients were evaluated: 14% (n = 16) open, 44% (n = 51) laparoscopic, and 42% (n = 48) robotic. Among the cohorts, there was no statistically significant difference in operative time, rate of reoperation, readmission, or major complications. Robotic colectomies resulted in the shortest length of stay (LOS) (Kruskal-Wallis P < .0001) and decreased estimated blood loss (EBL) (Kruskal-Wallis P = .0012). Median age was 63 years (interquartile range [IQR] 53-72). 54% (n = 62) were female. Median American Society of Anesthesiologists physical status classification was 3 (IQR 2-3). Median body mass index was 28.67 (IQR 25.03-33.47). A malignant diagnosis was noted on final pathology in 44% (n = 51). CONCLUSION Among the 3 approaches, there was no statistically significant difference in 30-day morbidity or mortality. There was a statistically significant decreased LOS and EBL for robotic colectomies.
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Affiliation(s)
| | | | | | | | - Sachin Vaid
- Christiana Institute of Advanced Surgery, Newark, DE, USA
| | - Nicholas Petrelli
- Helen F. Graham Cancer Center & Research Institute, Christiana Care Health System, Newark, DE, USA
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Johns MS, Gough B, McCarthy E, Vaid S, James Petrelli N. Cost Comparison of Laparoscopic and Robotic Colon Resections at a Hybrid Academic/Community Institution. J Am Coll Surg 2020. [DOI: 10.1016/j.jamcollsurg.2020.08.238] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Vaid S, Chandorkar A, Atre A, Shah D, Vaid N. Differentiating recurrent tumours from post-treatment changes in head and neck cancers: does diffusion-weighted MRI solve the eternal dilemma? Clin Radiol 2016; 72:74-83. [PMID: 27789026 DOI: 10.1016/j.crad.2016.09.019] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2016] [Revised: 09/16/2016] [Accepted: 09/28/2016] [Indexed: 11/25/2022]
Abstract
AIM To evaluate the utility of diffusion-weighted imaging (DWI) in differentiating post-treatment changes from tumour recurrence in head and neck cancers and to establish a threshold apparent diffusion coefficient (ADC) value to differentiate the two conditions. MATERIALS AND METHODS This was a prospective study of 80 treated head and neck cancer patients. The patient cohort consisted of a wide spectrum of head and neck sites, including the oral cavity, oropharynx, larynx, hypopharynx, paranasal sinuses, orbits, salivary glands, and infra-temporal fossa. Qualitative analysis of the diffusion images and quantitative analysis of the corresponding ADC maps was performed and the data were correlated with histopathological findings and clinical examinations. RESULTS The mean ADC value of recurrent tumours in the present cohort was 0. 932±0.19×10-3 mm2/s and the mean ADC value of lesions representing post-treatment changes was 1.394±0.32×10-3 mm2/s. A threshold ADC value of 1.2×10-3mm2/s used to differentiate post-treatment changes from recurrent head and neck cancers showed the highest combined sensitivity of 90.13%, specificity of 82.5%, accuracy of 86.4%, positive predictive value of 84.4%, negative predictive value of 88.9%, and mean kappa measurement of agreement of 72.8. CONCLUSION Combined qualitative and quantitative analysis of DWI is a useful non-invasive technique to differentiate recurrent head and neck malignancies from post-treatment changes using a threshold ADC value.
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Affiliation(s)
- S Vaid
- Head and Neck Imaging Division, Star Imaging and Research Center, Connaught Place, Bund Garden Road, Pune 411001, India.
| | - A Chandorkar
- Head and Neck Imaging Division, Star Imaging and Research Center, Connaught Place, Bund Garden Road, Pune 411001, India
| | - A Atre
- Head and Neck Imaging Division, Star Imaging and Research Center, Connaught Place, Bund Garden Road, Pune 411001, India
| | - D Shah
- Head and Neck Imaging Division, Star Imaging and Research Center, Connaught Place, Bund Garden Road, Pune 411001, India
| | - N Vaid
- Dept of Otorhinolaryngology, K. E. M. Hospital, Rastapeth, Pune 411011, India
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Vaid S, Park JS, Sinnott RJ. Outcomes of Recurrent Rectal Cancer after Transanal Excision. Am Surg 2016; 82:152-155. [PMID: 26874138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Successful surgical salvage after transanal excision (TAE) of rectal cancers has historically been considered feasible, but results vary. We examine our experience in surgical salvage of locally recurrent rectal cancers after TAE. A retrospective review of patients undergoing salvage surgery for locally recurrent early-stage rectal cancer after TAE from March 1990 to March 2008 at our institution is presented here. Seventy-eight patients underwent TAE for tumor invades submucosa (T1) rectal cancer. Average age of patients was 68.3 years. Recurrence occurred in 17 patients (21.8%). Median number of months between the first operation and the recurrence was 41 months. Sixteen out of 17 patients recurred locally whereas one had only distant recurrence. Fourteen were eligible for surgical salvage. Ten patients underwent abdominoperineal resection, whereas four underwent repeat local excision. Eleven deaths were noted and the median survival after the first operation was 70.3 months. Disease-free survival after salvage surgery was 53 per cent (9/17), with a median follow-up of 68 months from the original surgery. Disease-specific mortality was 47 per cent (8/17), with a median survival of 72 months from the original surgery. Five-year survival in the recurrence group was 11/16 (69%). In conclusion, TAE for T1 rectal cancer carries a higher risk of recurrence. Of the local recurrences, 87.5 per cent underwent microscopic negative margins (R0) resection at the time of salvage and had a five-year survival of 69 per cent. Long-term surveillance is encouraged, as recurrence can be seen even after 10 years from initial treatment. TAE can be considered for T1 rectal tumor with reasonable outcomes.
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Abstract
Successful surgical salvage after transanal excision (TAE) of rectal cancers has historically been considered feasible, but results vary. We examine our experience in surgical salvage of locally recurrent rectal cancers after TAE. A retrospective review of patients undergoing salvage surgery for locally recurrent early-stage rectal cancer after TAE from March 1990 to March 2008 at our institution is presented here. Seventy-eight patients underwent TAE for tumor invades submucosa (T1) rectal cancer. Average age of patients was 68.3 years. Recurrence occurred in 17 patients (21.8%). Median number of months between the first operation and the recurrence was 41 months. Sixteen out of 17 patients recurred locally whereas one had only distant recurrence. Fourteen were eligible for surgical salvage. Ten patients underwent abdominoperineal resection, whereas four underwent repeat local excision. Eleven deaths were noted and the median survival after the first operation was 70.3 months. Disease-free survival after salvage surgery was 53 per cent (9/17), with a median follow-up of 68 months from the original surgery. Disease-specific mortality was 47 per cent (8/17), with a median survival of 72 months from the original surgery. Five-year survival in the recurrence group was 11/16 (69%). In conclusion, TAE for T1 rectal cancer carries a higher risk of recurrence. Of the local recurrences, 87.5 per cent underwent microscopic negative margins (R0) resection at the time of salvage and had a five-year survival of 69 per cent. Long-term surveillance is encouraged, as recurrence can be seen even after 10 years from initial treatment. TAE can be considered for T1 rectal tumor with reasonable outcomes.
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Affiliation(s)
- Sachin Vaid
- Christiana Hospital, Newark, Delaware
- St. Francis Hospital, Wilmington, Delaware
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Vaid S, Vaid N. Imaging for cochlear implantation: Structuring a clinically relevant report. Clin Radiol 2014; 69:e9-e24. [DOI: 10.1016/j.crad.2014.03.011] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2014] [Revised: 02/19/2014] [Accepted: 03/13/2014] [Indexed: 11/25/2022]
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Vaid S, Bell T, Grim R, Ahuja V. Predicting risk of death in general surgery patients on the basis of preoperative variables using American College of Surgeons National Surgical Quality Improvement Program data. Perm J 2013; 16:10-7. [PMID: 23251111 DOI: 10.7812/tpp/12-019] [Citation(s) in RCA: 83] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
OBJECTIVES To use the American College of Surgeons (ACS) National Surgical Quality Improvement Program (NSQIP) database to develop an accurate and clinically meaningful preoperative mortality predictor (PMP) for general surgery on the basis of objective information easily obtainable at the patient's bedside and to compare it with the preexisting NSQIP mortality predictor (NMP). METHODS Data were obtained from the ACS NSQIP Participant Use Data File (2005 to 2008) for current procedural terminology codes that included open pancreas surgery and open/laparoscopic colorectal, hernia (ventral, umbilical, or inguinal), and gallbladder surgery. Chi-square analysis was conducted to determine which preoperative variables were significantly associated with death. Logistic regression followed by frequency analysis was conducted to assign weight to these variables. PMP score was calculated by adding the scores for contributing variables and was applied to 2009 data for validation. The accuracy of PMP score was tested with correlation, logistic regression, and receiver operating characteristic analysis. RESULTS PMP score was based on 16 variables that were statistically reliable in distinguishing between surviving and dead patients (p < 0.05). Statistically significant variables predicting death were inpatient status, sepsis, poor functional status, do-not-resuscitate directive, disseminated cancer, age, comorbidities (cardiac, renal, pulmonary, liver, and coagulopathy), steroid use, and weight loss. The model correctly classified 98.6% of patients as surviving or dead (p < 0.05). Spearman correlation of the NMP and PMP was 86.9%. CONCLUSION PMP score is an accurate and simple tool for predicting operative survival or death using only preoperative variables that are readily available at the bedside. This can serve as a performance assessment tool between hospitals and individual surgeons.
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Abstract
Abdominoperineal resection is associated with significant morbidity. The perineal wound poses a unique risk and complications are common, including skin breakdown, abscess, sinus tracts, perineal herniation, and evisceration. A 2-component fibrin sealant made from pooled human plasma has been proven to achieve hemostasis and tissue sealing. We report a case series of 5 consecutive patients in whom we used this fibrin sealant during perineal wound closure. Of our patients, 2 patients (40%) were diabetic and 4 patients (80%) received preoperative radiotherapy. The median body mass index was 32 (calculated as weight in kilograms divided by height in meters squared). The patients were at increased risk of perineal wound dehiscence and infection. Median follow-up was 6 months, and no patients had perineal wound complications. A fibrin sealant could be used as an alternative to more invasive procedures, such as flap reconstruction, in patients at high risk of perineal wound dehiscence.
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Affiliation(s)
- Sachin Vaid
- Department of Surgery, York Hospital, York, PA 17405, USA.
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Vaid S, Tucker J, Bell T, Grim R, Ahuja V. Cost analysis of laparoscopic versus open colectomy in patients with colon cancer: results from a large nationwide population database. Am Surg 2012; 78:635-641. [PMID: 22643256] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
Laparoscopic colectomy (LC) is a safe and reliable option for patients with colon cancer. This study examined factors associated with LC use and cost differences between LC and open colectomy (OC). Using the Cost & Utilization Project National Inpatient Sample database (2008), patients with colon cancer undergoing elective LC or OC were selected. Chi square and Mann-Whitney tests were used to assess differences between LC and OC. Logistic and multiple regression analysis was used to determine variables associated with LC and predictors of cost. All analysis was weighted. A total of 63,950 patients were identified (LC 8.1%, OC 91.9%). The majority was female (52.7%), white (61.4%), using Medicare (61.1%), and had surgery performed at a large (64.2%), nonteaching (56.9%), urban (87.3%) hospital in the South (37.7%). Mean age was 70 years. On unadjusted analysis, LC was associated with a lower mortality rate (1.7 vs 2.4%), fewer complications (18.9 vs 27.1%), shorter length of stay (5 vs 7 days), and lower total charges ($41,971 vs $43,459, all P < 0.001). LC is a less expensive but less popular surgical option for colon cancer. Stage, race, Charlson score, teaching status, location, and hospital size influence the use of a laparoscopic approach. LC is associated with fewer complications and decreased mortality which contribute to its lower cost as compared with OC.
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Affiliation(s)
- Sachin Vaid
- Department of Surgery, York Hospital, York, Pennsylvania, USA.
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Vaid S, Tucker J, Bell T, Grim R, Ahuja V. Cost Analysis of Laparoscopic versus Open Colectomy in Patients with Colon Cancer: Results from a Large Nationwide Population Database. Am Surg 2012. [DOI: 10.1177/000313481207800614] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Laparoscopic colectomy (LC) is a safe and reliable option for patients with colon cancer. This study examined factors associated with LC use and cost differences between LC and open colectomy (OC). Using the Cost & Utilization Project National Inpatient Sample database (2008), patients with colon cancer undergoing elective LC or OC were selected. Chi square and Mann-Whitney tests were used to assess differences between LC and OC. Logistic and multiple regression analysis was used to determine variables associated with LC and predictors of cost. All analysis was weighted. A total of 63,950 patients were identified (LC 8.1%, OC 91.9%). The majority was female (52.7%), white (61.4%), using Medicare (61.1%), and had surgery performed at a large (64.2%), nonteaching (56.9%), urban (87.3%) hospital in the South (37.7%). Mean age was 70 years. On unadjusted analysis, LC was associated with a lower mortality rate (1.7 vs 2.4%), fewer complications (18.9 vs 27.1%), shorter length of stay (5 vs 7 days), and lower total charges ($41,971 vs $43,459, all P < 0.001). LC is a less expensive but less popular surgical option for colon cancer. Stage, race, Charlson score, teaching status, location, and hospital size influence the use of a laparoscopic approach. LC is associated with fewer complications and decreased mortality which contribute to its lower cost as compared with OC.
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Affiliation(s)
- Sachin Vaid
- Department of Surgery, York Hospital, York, Pennsylvania
| | - James Tucker
- Department of Surgery, York Hospital, York, Pennsylvania
| | - Ted Bell
- Department of Surgery, York Hospital, York, Pennsylvania
| | - Rod Grim
- Department of Surgery, York Hospital, York, Pennsylvania
| | - Vanita Ahuja
- Department of Surgery, York Hospital, York, Pennsylvania
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Mehta C, Vaid S, Adedeji A, Vibhakar D, Bell T, Grim R, Ahuja V. Epidemiology of Clostridium Difficile Colitis in Hospitalized Patients in the United States. J Surg Res 2012. [DOI: 10.1016/j.jss.2011.11.063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
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Abstract
Minimally invasive parathyroidectomy (MIP) for primary hyperparathyroidism can be successfully performed using preoperative sestamibi scan and intraoperative radioguidance without the need of measurement of intraoperative parathyroid hormone (PTH) levels. The purpose of our study was to review the outcomes of MIPs performed in a community hospital without measuring PTH levels intraoperatively and to demonstrate that this is an effective therapeutic modality with comparable success rates. We performed a retrospective medical record review of patients undergoing MIPs from April 1, 1998, through May 31, 2005, in a 500-bed community hospital. A total of 188 parathyroidectomies for primary hyperparathyroidism were performed by a single surgeon during the study period, 111 of which were MIPs. In this series of 111 patients, we found 2 recurrences, achieving a success rate of 98.2%. Higher preoperative PTH levels and gland weight had a direct correlation with the successful performance of MIP.
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Affiliation(s)
- Sachin Vaid
- Department of Surgery, York Hospital, York, PA 17405, USA.
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Vaid S, Wallet J, Litt J, Bell T, Grim R, Ahuja V. Application of a tertiary referral scoring system to predict nonreversal of Hartmann's procedure for diverticulitis in a community hospital. Am Surg 2011; 77:814-819. [PMID: 21944340] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
Riansuwan et al. at Cleveland Clinic developed a scoring system to quantify the risk of Hartmann's nonreversal based on age, preoperative transfusion, pulmonary comorbidity, American Society of Anesthesiologists score, perforation, and anticoagulation. Our study validates the scoring system in a community hospital setting. Patients undergoing Hartmann's procedure for diverticulitis (2006 to June 2009) were identified from our hospital's database. Two groups were formed based on Hartmann's reversal within 1 year and those with nonreversal. An independent-sample t test and logistic regression using score and nine other variables as predictors of Hartmann's nonreversal were run. Sixty-three of 93 patients (67.7%) had a Hartmann's reversal. Higher scores and higher mean age were seen in the nonreversal group (15.5 ± 3.0 vs 12.1 ± 2.5 and 73 ± 15 vs 63 ± 14 years, respectively). Patients with scores 18 or above were not reversed; 43 of 49 patients (88%) with scores of 13 or less were reversed. Logistic regression confirmed that the only predictive variable for nonreversal is a higher score. The scoring system is predictive of nonreversibility of Hartmann's procedure for acute diverticulitis. This will be useful in allowing surgeons to strategize accurately and to counsel patients realistically. Higher scores may allow both the surgeon and patient to have a low threshold for exploring alternatives to Hartmann's procedure.
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Affiliation(s)
- Sachin Vaid
- Department of Surgery, York Hospital, York, Pennsylvania, USA.
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Vaid S, Wallet J, Litt J, Bell T, Grim R, Ahuja V. Application of a Tertiary Referral Scoring System to Predict Nonreversal of Hartmann's Procedure for Diverticulitis in a Community Hospital. Am Surg 2011. [DOI: 10.1177/000313481107700712] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Riansuwan et al. at Cleveland Clinic developed a scoring system to quantify the risk of Hartmann's nonreversal based on age, preoperative transfusion, pulmonary comorbidity, American Society of Anesthesiologists score, perforation, and anticoagulation. Our study validates the scoring system in a community hospital setting. Patients undergoing Hartmann's procedure for diverticulitis (2006 to June 2009) were identified from our hospital's database. Two groups were formed based on Hartmann's reversal within 1 year and those with nonreversal. An independent-sample t test and logistic regression using score and nine other variables as predictors of Hartmann's non-reversal were run. Sixty-three of 93 patients (67.7%) had a Hartmann's reversal. Higher scores and higher mean age were seen in the nonreversal group (15.5 ± 3.0 vs 12.1 ± 2.5 and 73 ± 15 vs 63 ± 14 years, respectively). Patients with scores 18 or above were not reversed; 43 of 49 patients (88%) with scores of 13 or less were reversed. Logistic regression confirmed that the only predictive variable for nonreversal is a higher score. The scoring system is predictive of nonreversibility of Hartmann's procedure for acute diverticulitis. This will be useful in allowing surgeons to strategize accurately and to counsel patients realistically. Higher scores may allow both the surgeon and patient to have a low threshold for exploring alternatives to Hartmann's procedure.
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Affiliation(s)
| | | | | | - Ted Bell
- York Hospital, York, Pennsylvania
| | - Rod Grim
- York Hospital, York, Pennsylvania
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Vaid S, Vaid N, Rawat S, Ahuja AT. An imaging checklist for pre-FESS CT: framing a surgically relevant report. Clin Radiol 2011; 66:459-70. [PMID: 21288796 DOI: 10.1016/j.crad.2010.11.010] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2010] [Revised: 11/14/2010] [Accepted: 11/16/2010] [Indexed: 11/24/2022]
Abstract
The reference standard for preoperative imaging in functional endoscopic sinus surgery (FESS) is multiplanar high-resolution computed tomography (HRCT). Surgeons require a precise preoperative anatomical road map, and hence it is essential for radiologists to be familiar with the normal three-dimensional sinonasal anatomy and the normal variants encountered in this region. Sagittal imaging has recently emerged as an important tool to visualize additional details in this critical anatomical region. Radiologists also need to report these examinations with special focus on the surgeon's expectations. Constant communication between the radiologist and the surgeon helps to resolve specific issues and improve the overall quality of reports. This results in better preoperative patient counselling and in predicting postoperative improvement in clinical status. This review provides a basic structured format for reporting pre-FESS CT, which can be tailored to meet individual requirements. The CT reporting format follows the order in which the sinonasal structures are approached during surgery.
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Affiliation(s)
- S Vaid
- Department of Radiology and Imaging, Grant Medical Foundation, Pune, India.
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Vaid S, Lee Y, Rawat S, Luthra A, Shah D, Ahuja A. Re: Tuberculosis in the head and neck — A forgotten differential diagnosis. A reply. Clin Radiol 2010. [DOI: 10.1016/j.crad.2010.03.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Atre A, Jagtap M, Nanivadekar A, Vaid S, Rawat S. Spontaneous vertebral artery dissection. Indian J Radiol Imaging 2006. [DOI: 10.4103/0971-3026.32343] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Atre A, Jagtap M, Nanivadekar A, Vaid S, Rawat S. Spontaneous vertebral artery dissection. Indian J Radiol Imaging 2005. [DOI: 10.4103/0971-3026.29178] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Kulkarni S, Uddar M, Deshpande SG, Vaid S, Wadia RS. Renal cell carcinoma as significant manifestation of tuberous sclerosis complex. J Assoc Physicians India 2000; 48:351-3. [PMID: 11229127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/19/2023]
Abstract
We present a case of renal cell carcinoma diagnosed in 1982; aged 20 years. Regular follow up of the abdomen by USG noted first the presence of 2 nodules in the remaining kidney in 1994, age 30 and more lesions in 1997, aged 35. These were suspected to be angiomyolipomas on USG. The radiologist on this basis raised the question of tuberous sclerosis. Subsequent evaluation by internist/neurologist showed few adenoma sebaceum lesions a single ash leaf macule, a shagreen patch on the back, and characteristic multiple subependymal calcifications diagnostic of tuberous sclerosis on CT scan brain. The mentation was normal, there was history of only a single fit in childhood. The renal cell carcinoma was thus the first significant manifestation of tuberous sclerosis complex (TSC).
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Affiliation(s)
- S Kulkarni
- Ruby Hall Clinic, 40 Sassoon Road, Pune 411 001
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