Browsing by Author "Bernon, Marc"

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    A Clinical Approach to Common Surgical Scenarios: A Handbook for Students and Junior Doctors
    (The Authors, 2020-01) Panierie, Eugenio; Cairncross, Lydia; Boutall, Adam; Bernon, Marc; Malherbe, Francois; Panieri, Eugenio; Malherbe, Francois
    Aimed at students and junior doctors, the purpose of this book is to provide a guide to the evaluation of common surgical problems as well as test diagnostic and troubleshooting skills when there is nobody to help or ask for advice.
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    The profile and outcomes of patients with Hepatocellular Carcinoma treated with curative intent at Groote Schuur Hospital, a Tertiary Referral Centre in South Africa
    (2022) Chilton, Gareth Harvey; Bernon, Marc; Jonas, Eduard
    Introduction: HCC is a common cause of cancer-related death in sub-Saharan Africa (SSA). Whereas several papers have reported on HCC in the South African context, very few studies have evaluated treatment options and subsequent survival data. Objective: To identify the clinical characteristics of patients with HCC presenting to Groote Schuur Hospital and present survival data on patients treated with curative intent. Methodology: All patients who presented with HCC from 1 July 2015 to 30 June 2020 were included in the study. Data was extracted from a faculty approved, prospectively maintained registry. Information collected included demographics, clinical characteristics, grading of liver dysfunction according to the Child-Pugh Score (CPS) and Model for end stage liver disease (MELD) score, disease stage according to the Barcelona Clinic Liver Cancer (BCLC) grading system and treatment received. Variables were assessed for the total patient cohort as well as for the palliative and curative intended patient groups. Survival data was collected for the curative intended treatment group up to 31st of August 2021. Results: A total of 152 patients were included in the study. Chronic hepatitis B infection (60.5 %) was the most common aetiological factor. Twenty-one patients (13.8%) were treated with curative intent. The median survival of the entire curative intended cohort was 45.5 months (range 0.1-72.5). The median survival for the transplantation, resection and local ablation groups were 54.3, 23.0 and 45.5 months respectively. Conclusion: Only 13.8% of patients were treated with curative intent. Survival data in the patients treated with curative intent is comparable to other reported series. The findings highlight the need for improved screening of high risk patients and appropriate referral of patients for curative intended treatment.
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    The role of serial lactate and liver enzyme dynamics in predicting post hepatectomy liver failure
    (2022) Soldati, Vuyolwethu Sonwabile; Bernon, Marc; Jonas, Eduard
    Background: Post-hepatectomy liver failure (PHLF) is an important cause of morbidity and mortality following liver resection. Current prognostic models only allow for the detection of PHLF on post-operative day 5. Earlier detection and intervention may improve outcomes. To date, no studies have evaluated serial post-operative lactate and liver function tests (LFT) to predict PHLF. Aim: This study evaluated the prognostic utility of serial lactate concentrations and LFTs to predict PHLF following hepatectomy. Methods: All major liver resections (≥ 3 Couinaud segments) undertaken at Groote Schuur Hospital and UCT Private Academic Hospital from May 2018 to April 2021 were included. Lactate levels were measured 4-hourly for the first 24 hours post hepatectomy and daily LFTs for the first 5 days. Associations between baseline patient characteristics and lactate dynamics in PHLF as well as the predictive value of lactate, INR and bilirubin were determined. Results: Forty-seven patients, mean age 56.5 (±13.2) years, of whom 24 were males were assessed. Five (10.6%) patients had PHLF and were older (67.4 ± 12.2) and were predominantly men (80%)...