Browsing by Author "Sudipta Bera"

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Analysis of clinical and patient-reported outcomes in post-ELAPE perineal reconstruction with IGAP flap – A 5-year review
(Elsevier Ltd, 2022) Ashwin Alke Pai; Quillan Young-Sing; Sudipta Bera; Kavish Maheshwari; Alok Misra
Background: Extralevator abdominoperineal excisions (ELAPE) are now the accepted treatment option for low rectal cancers, which result in large perineal defects necessitating reconstruction. The aim of our study was to assess the clinical outcomes as well as the quality-of-life parameters (QOLP) following these reconstructions. Methods: A series of 27 patients who underwent ELAPE and immediate reconstruction with inferior gluteal artery perforator flaps (IGAP) between December 2013 to December 2018 were retrospectively analysed on patient demographics, disease and treatment, complications, and QOLP. Results: With a mean age of 71.6 years, all patients had low rectal cancers and underwent ELAPE (24 open, 3 lap-assisted) and immediate IGAP flap reconstruction. The follow-up period was 1 year. The overall perineal early minor complication rate was 25.9% and the early major complication rate of 14.8%. QOLP, such as tolerance to sit, perineal pain, perineal aesthetics, showed high patient satisfaction of 77.7%, 40.74%, and 66.6%, respectively at 1 year. The perineal hernia rate was 14.8% with all patients being female (p 0.0407; significant). Conclusion: IGAP flaps are a reliable option for reconstructing post-ELAPE defects with good patient satisfaction and outcomes. © 2022 The Author(s)
Comparison of palatal lengthening and perioperative outcomes of Furlow’s Z-plasty versus von Langenbeck’s palatoplasty in children with complete, non-syndromic cleft palate: a randomized controlled trial in India
(Korean Cleft Palate-Craniofacial Association, 2025) Nishank Manohar; Altaf Mir; N. Nasida Fathima; Madhubari Vathulya; Dr Akshay Kapoor; Sudipta Bera; Taruna Singh; Debarati Chattopadhyay
Background: Cleft palate results from incomplete fusion of the palatine shelves during embryonic development and varies in severity. It affects speech, hearing, and feeding, often leading to complications such as nasal regurgitation and recurrent infections. The condition is common worldwide and frequently coexists with cleft lip. Surgery remains the primary treatment, aiming to restore both palatal length and function. In this study, Furlow’s double Z-plasty and von Langenbeck palatoplasty have been compared for their effectiveness in minimizing complications and improving outcomes. Methods: This study included 22 children aged 6 to 18 months with non-syndromic complete cleft palates, randomly assigned into two groups. Group A underwent von Langenbeck’s palatoplasty with intravelar veloplasty, while Group B underwent Furlow’s double opposing Z-plasty. Results: Preoperative palatal measurements were comparable between the two groups. Cleft width did not significantly affect surgical outcomes, and both techniques effectively achieved tension-free closure. Von Langenbeck’s repair with intravelar veloplasty was as effective as Furlow’s palatoplasty in achieving palatal lengthening, while offering the additional advantage of being an anatomically based repair associated with lower fistula rates. Conclusion: Von Langenbeck’s repair with intravelar veloplasty is as effective as Furlow’s palatoplasty in achieving palatal lengthening and provides the advantage of an anatomically sound repair with a reduced fistula rate. © 2025 Korean Cleft Palate-Craniofacial Association.
End-to-Side Venous Anastomosis with IJV: Improving Outcomes of Microvascular Anastomosis in Head and Neck Reconstruction
(Georg Thieme Verlag, 2024) Anupam Golash; Sudipta Bera; Aditya V. Kanoi; Swaraj Hanspal; Abhijit Golash
Background End-to-side (ES) venous anastomosis is an established approach for head and neck reconstruction and has several benefits over conventional end-to-end (EE) anastomosis. However, this is not preferred by all, which may be due to technical preferences for an EE anastomosis by many surgeons. We present here our experience of routine ES venous anastomosis for head and neck reconstruction over the past 8 years. Materials and Methods All consecutive head and neck malignancy patients reconstructed with free flap and our routine ES internal jugular vein (IJV) anastomosis approach between 2015 and 2023 have been included in this study. Flap-related variables are reviewed retrospectively. Results Reconstruction was done with a total of 585 free flaps including 303 radial forearm flaps (RFFs), 143 osteocutaneous fibula flaps (OCFFs), and 139 anterolateral thigh (ALT) flaps. The flap survival rate was 573/585 (97.95%). Re-exploration and salvage rates were 45/585 (7.69%) and 38/45, respectively (84.44%). Conclusion Routine use of ES anastomosis simplifies microvascular anastomosis by avoiding efforts related to the selection of recipient vessels, providing a single large-caliber venous outlet, the favorable geometric orientation of the pedicle, and ease of re-exploration. The vascular anastomosis for RFF, ALT, and OCFF flap is feasible with 7-0 sutures and under 4.5X loupe magnification with this approach quite conveniently with similar outcomes to the reported flap survival rate in the contemporary practice. © 2024. Association of Plastic Surgeons of India. All rights reserved.
High-resolution ultrasonography as an adjuvant diagnostic tool in preoperative assessment of acute forearm lacerations
(Elsevier Ltd, 2025) Umesh Kumar; Sudipta Bera; Shikha Jaiswal; Shivi Jain; Akash Mishra
Background/purpose: Forearm lacerations are frequently associated with involvement of tendon, nerve, and vessel injuries. An accurate diagnosis and timely intervention are critical to avoid any functional impairment, but clinical examination alone may not always be reliable, particularly in combined injuries or uncooperative patients. High-resolution ultrasound (USG) is a useful tool for the rapid assessment of these injuries. This study aims to evaluate the effectiveness of pre-operative USG in diagnosing tendon, nerve, and vascular injuries in acute trauma cases, using surgical exploration as the gold standard. Methods: This prospective observational study was conducted at the Department of Plastic Surgery of a tertiary care Trauma centre, between April 2022 and July 2024. Thirty-eight patients with forearm lacerations were included. All patients underwent clinical examination followed by USG (3–15 MHz) for injury assessment. The cases were examined by the operating surgeon. USG findings were compared with intraoperative findings to assess the diagnostic accuracy. Results: USG demonstrated diagnostic accuracy of 99.62 % in tendon injuries, with a high sensitivity (98.61 %) and specificity (100 %). It identified nerve injuries with a accuracy of 96.49 %, and interpreting arterial injuries was more challenging, with an accuracy of 90.7 %. The outcome of evaluation with high resolution USG with clinical examination was better than that of isolated clinical examination for tendon and neurovascular injuries. The mean time for an USG diagnosis in forearm laceration was 9.53 min. Conclusion: High-resolution ultrasound is an effective, non-invasive tool for a quick assessment of forearm lacerations. It offers a high sensitivity and specificity for tendon and nerve injuries, aiding in targeted surgical interventions. While it is less sensitive for vascular injuries, it remains valuable for surgical planning in combined injuries. This study supports its integration into routine trauma care to improve diagnostic accuracy and better outcomes. Level of evidence: Level IIIA, Prospective observational study. © 2025 Elsevier Ltd
Novel incision to debulk eyelids in a case of Orbital Periorbital Plexiform Neurofibroma (OPPN): A case report
(IP Innovative Publication Pvt. Ltd., 2023) Umesh Kumar; Sudipta Bera; Shikha Jaiswal; K Cheruvu Natraj Navya; Vivek Vijay Kumar; Rajendra P. Maurya
Background: Plexiform neurofibroma with neurofibromatosis 1 is a autosomal dominant condition and a relatively rare condition. It is also termed as Von Recklinghausen disease. PN involving the structures like eyelid, orbit, periorbital and facial structures are labelled as orbital-periorbital PN(OPPN). These are slowly progressing lesions and are present since birth but increase in size during childhood and are locally infiltrating in nature. Aim: To describe a lid incision to simultaneously debulk both upper and lower eyelid, preserving the vascularity in a case of Orbital Periorbital Plexiform Neurofibroma (OPPN). Case Presentation: We report a case of 22 year male who presented with a disfiguring swelling of right side of face since childhood. After thorough clinical and radiological evaluation it was diagnosed to be a OPPN. Staged debulking was planned and after stage 1 debulking, tissue was sent for HPE which revealed overgrowth of peripheral nerve components and connective tissue dermis showing infiltrating tumour composed of oval to spindle cells with pleomorphic nuclei and moderate cytoplasm. Staged debulking with lid reduction surgery was performed. Discussion: Neurofibroma is a rare entity with plexiform neurofibroma occurring in 5-15% of patients. OPPN infiltrates locally without respecting the anatomical planes but follows the trigeminal nerve distribution usually. Indications for debulking procedure are usually the disfigurement and optimal timing is also not certain because the extent and rate of growth cannot be predicted. Conclusion: The facial appearance and outcome in patients with OPPN can be significantly improved through lid reduction surgery. © 2023 Author(s), Published by Innovative Publication.
Volumetric assessment of the nose after primary unilateral cleft rhinoplasty using Laberge's technique
(Churchill Livingstone, 2023) Debarati Chattopadhyay; Akshay Kapoor; Madhubari Vathulya; Sudipta Bera
Background: There is a lack of standardized surgery for cleft rhinoplasty. We felt that the technique described by Dr Louise Caouette Laberge is an ideal way to approach this problem, thus we tried to quantify the outcome of surgery by volumetric assessment. Material and method: We recorded 3D images using an Artec scanner and performed volume calculations of the cleft side and noncleft side of the nose. These readings were taken once in the preoperative and then 2 weeks postoperative. Another scan of the face was performed 2 years after the surgery to compare the volumes of the cleft and noncleft side nostril. Results: Of the 31 patients with unilateral cleft lip operated on (mean age 3–8 months), we found a significant increase in the cleft side volume at 3 weeks postoperative from 3.95 mm3 to 5.65 mm3 (p < 0.001 on paired t-test). A repeat scan done on the study population at 2 years postoperative found that the mean volume of the cleft side was 30.43 mm3 (standard deviation [SD], 2.49) and that of the normal side was 30.82 mm3 (SD, 2.51). An independent t-test found that there was no significant difference between the two volumes (p > 0.05) Conclusion: The use of volumetric data in the evaluation of postoperative outcomes provides an objective criterion for assessing the aesthetics as well as the growth. Our study concludes that the Laberge technique provides a good aesthetic outcome with minimal scarring for the management of cleft nose and lip with the anterior palate. © 2023 British Association of Plastic, Reconstructive and Aesthetic Surgeons