TEAM OCHRI removes Huge ovarian mass in post Covid patient with High D dimer levels in Covid times

TEAM OCHRI removes Huge ovarian mass in post Covid patient with High D dimer levels in Covid times                  
Collaborative Coordination plays a distinct role in managing such patient- Team OCHRI

Recently one 29-year-old female from Chandrapur was referred to Nagpur based multi super speciality Orange City Hospital & Research Institute, Nagpur (a unit of Ravi Nair Hospitals Private Limited). She was admitted under care of Dr. Bindu Marar- Senior Gynecologist. She has complaints of abdominal pain and distension of abdomen since 2 months. She was investigated and was found to have Huge Rt. Ovarian mass of size 27x27cm with very High D-Dimer levels with Post Covid status. The primary treatment for huge ovarian mass (Tumor) is surgery; which aims at maximal safe resection of tumor and depending on grade and type of tumor further management of chemo and radiotherapy is decided. Inspite of high risk surgery her relatives having complete faith on treating doctor and OCHRI Team, consented for major surgical intervention during ongoing Covid period. In view of very high D-Dimer and being a major pelvic surgery there was higher chances of active thrombosis so surgery was delayed to reduce D-Dimer and probability of perioperative thrombotic complication. Dr. Nikhil Balankhe & Dr. Devayani Buche- Senior Physicians and Dr. Nishad Dhakate-Hematologist were included in treating team to minimize the risk of perioperative thrombosis. Accordingly, relatives were counselled and prognosis was explained to them. With due high risk guarded prognosis and relative’s consent; surgery was done.

Dr. Nikhil Balankhe said that “Being a Post Covid status with high D-Dimer, proposed supra-major pelvic surgery, probable malignancy and high platelets, surgery was very high risk. We tried to reduce the D-Dimer but after even 3 weeks D-Dimer levels significantly remained high but with due high risk she was posted for surgery as it could not be further extended.”

Dr. Devyani Buche added that an understanding team work and total faith of relatives is crucial in managing such patients and with availability of around 100 plus specialists from various specialties, it becomes very advantageous to serve such patients at OCHRI with diverse complications.

After detail workup; the patient was taken for elective surgery. The intricate surgery for resection of tumor was performed by Dr. Mukund Thakur- Senior Surgeon and Dr. Bindu Marar- Senior Gynecologist. Dr. Smita Harkare -Anesthetist provided necessary anesthesia while Sr. Geetanjali assisted them.

Dr. Bindu Marar informed that “Due to the size of the tumor and the fact that malignancy was suspected; complete resection along with Total Abdominal hysterectomy with Salpingo-oopherectomy with Appendicectomy with omentectomy was done without any complications.”

The great challenge was accepted and accomplished by Team OCHRI and it was indeed a great team-effort. After uneventful & successful surgery, Dr. Nikhil Balankhe and Dr. Devayani Buche managed the pre & post-operative medical management of patient.  Dr. Milind Pande- Pathologist and Dr. Nishikant Lokhande – Radiologist and their teams rendered diagnostic support while full time round the clock team of intensivists namely Dr. Akshay Burlawar, Dr. Roshan Jawlekar, Dr. Shital Chavan and Dr. Mohit Gharpure provided necessary post-operative care. Dr. Honey Khandelwal and Dr. Vivek Salok, Post Graduate residents supported the team. Smt. Nisha Ashok, Sr. Preethy Joseph and Sr. Manju Maliye led nursing & paramedical team in Operation theatre, ICU, OBGY along with other paramedical & nursing Staff.

RNHPL management led by Shri. Uday Bhaskar Nair- Chairman, Dr. Usha Nair, Dr. Vidya Nair, Smt. Divya Nair, Dr. Vinaya Nair- Directors and Dr. Anup Marar- OCHRI Director congratulated OCHRI Team Gynecology, Surgery, Medicine, Haematology, Anesthesia, Pathology and Radiology for showing exemplary team work and undertaking this risky but lifesaving procedure. Medical Community from Nagpur along with relatives of patient congratulated the entire team for successful outcome and implementation of skills and technology humanely during this Covid times.