Long‐term follow‐up of two randomized trials comparing laparoscopic Nissen 360° with anterior 90° partial fundoplication

2019 ◽  
Author(s):  
R. J. Hopkins ◽  
T. Irvine ◽  
G. G. Jamieson ◽  
P. G. Devitt ◽  
D. I. Watson
Keyword(s):  
Randomized Trials ◽  
Partial Fundoplication ◽  
Long Term Follow Up ◽  
Laparoscopic Nissen

Prevention of distal embolization in patients undergoing mechanical revascularization for acute myocardial infarction

2006 ◽  
Vol 96 (12) ◽  
pp. 700-710 ◽  
Author(s):  
Harry Suryapranata ◽  
Massimo Chiariello ◽  
Giuseppe De Luca
Keyword(s):  
Randomized Trials ◽  
Scientific Session ◽  
Primary Angioplasty ◽  
Review Literature ◽  
Distal Embolization ◽  
Early Administration ◽  
Long Term Follow Up ◽  
Mechanical Devices

SummaryDistal embolization is a relatively common complication in primary angioplasty and is associated with poor perfusion and higher mortality. The aim of this article is to critically review literature on pharmacological and mechanical therapies to prevent distal embolization in patients undergoing primary angioplasty. The literature was scanned by formal searches of electronic databases (MEDLINE, Pubmed) from January 1990 to March 2006 and scientific session abstracts (from January 1990 to March 2006) and oral presentation and/or expert slide presentations (from January 2002 to March 2006) (on TCT, AHA, ESC, ACC and EuroPCR websites). No language restrictions were enforced. Several pharmacological and mechanical therapies have been investigated to prevent distal embolization.Abciximab has been shown to reduce mortality,and its early admin-istration may provide additional benefits in outcome due to improvement in preprocedural reperfusion.The results of randomized trials on adjunctive mechanical devices remain controversial. Even though they reduce distal embolization and improve myocardial perfusion, no benefits have been observed in terms of 30-day survival. Adjunctive abciximab has improved survival, and its early administration is to be recommended, particularly when transportation to a primary PCI center is needed. Pending the results of large randomized trials with long-term follow-up data, the routine use of adjunctive mechanical devices to prevent distal embolization cannot be recommended, though selective use of these devices might be considered when large thrombotic burden is present.

What is the Correct Period of Bandaging following Sclerotherapy?

1986 ◽  
Vol 1 (3) ◽  
pp. 217-220 ◽  
Author(s):  
P. Reddy ◽  
J. Wickers ◽  
T. Terry ◽  
P. Lamont ◽  
J. Moller ◽  
...  
Keyword(s):  
Scoring System ◽  
Randomized Trials ◽  
Varicose Veins ◽  
Objective Assessment ◽  
Injection Sclerotherapy ◽  
Additional Advantage ◽  
Long Term Follow Up ◽  
Primary Varicose Veins

Two consecutive randomized trials following injection sclerotherapy for varicose veins compared 3 and 6 weeks bandaging in 148 patients and 1 to 3 weeks bandaging in 130 patients. Objective assessment and patient's symptoms, using a scoring system, correlated well and showed that there was no difference whatsoever between 3 and 6 weeks' bandaging after a 6 year follow-up. In the second trial, the patients who were bandaged for 3 weeks were significantly better (P < 0.001) than after only one week of bandaging at a maximum follow up of 4 years. Long term follow up of injection sclerotherapy for primary varicose veins suggests that 3 weeks is superior to 1 week bandaging, but that there is no additional advantage in continuing bandaging for six weeks.

766 PROPHYLAXIS OF POST-FUNDOPLICATION SIDE EFFECTS AFTER LAPAROSCOPIC NISSEN EXTRA SOFT FUNDOPLICATION.

2021 ◽  
Vol 34 (Supplement_1) ◽  
Author(s):  
Yevhen Haidarzhi ◽  
Andrii Nykonenko
Keyword(s):  
Side Effects ◽  
Standard Procedure ◽  
Surgical Techniques ◽  
Partial Fundoplication ◽  
Absorbable Sutures ◽  
Postoperative Reflux ◽  
Total Fundoplication ◽  
Laparoscopic Nissen

Abstract   Laparoscopic Nissen Fundoplication (LNF) is well-established surgical treatment of GERD with best long-term postoperative outcomes in controlling reflux. Usually it is associated with a high risk of dysphagia, flatulence, inability to belch, bloating, which appear due to total over-tight wrap around esophagus. Partial fundoplication can avoid these effects, but unfortunately does not have the same long-term postoperative reflux control. So, new approach to prophylaxis of post-fundoplication side effects during LNF is needed. Methods Modified extra-soft LNF for GERD during 2016–2020 years were proposed in 75 patients. Prior to the fundoplication wrap formation the operation was performed according to the standard procedure. The proposed surgical techniques were: performing of an extra mobilization of the stomach (mandatory fundus and more ½ part of a large curvature) by crossing the gastro-splenic ligament completely and the gastro-colonic ligament partially and formation of a short extra-soft fundoplication wrap around the esophagus less 1.5 cm in the length with no more than 3 non-absorbable sutures with obligatory fixation to the esophagus. We examined twelve months follow-up. Results Along with the disappearance of GERD symptoms, no post-fundoplication dysphagia, flatulence, inability to belch and bloating were marked in any patient. Routine application of the above-described techniques allowed us to perform a modified LNF in all 75 patients by the extra mobilization of the stomach and formation of an extra-soft total fundoplication wrap with obligatory fixation to the esophagus without mandatory use of a thick (56–60 Fr) gastric fundoplication tube. Conclusion According to our study, in comparison with standard LNF, the proposed surgical techniques is effective in the prevention of post-fundoplication complications (dysphagia, flatulence, inability to belch, bloating) and support routine use of this modified Laparoscopic Nissen Extra Soft Fundoplication in treatment of GERD.

Long-term follow-up of three prospective randomized trials comparing different antibody induction protocols

2002 ◽  
Vol 21 (1) ◽  
pp. 167-168
Author(s):  
A Zuckermann ◽  
D Dunkler ◽  
M Czerny ◽  
J Ankersmit ◽  
C Holzinger ◽  
...  
Keyword(s):  
Randomized Trials ◽  
Long Term Follow Up ◽  
Antibody Induction

Clinical outcome after surgical clipping or endovascular coiling for cerebral aneurysms: a pragmatic meta-analysis of randomized and non-randomized trials with short- and long-term follow-up

2016 ◽  
Vol 9 (3) ◽  
pp. 264-277 ◽  
Author(s):  
Alberto Falk Delgado ◽  
Tommy Andersson ◽  
Anna Falk Delgado
Keyword(s):  
Clinical Outcome ◽  
Randomized Trials ◽  
Meta Analysis ◽  
Lower Mortality ◽  
Controlled Trials ◽  
Short Term ◽  
Unruptured Aneurysms ◽  
Long Term Follow Up

BackgroundTwo randomized trials have evaluated clipping and coiling in patients with ruptured aneurysms. Aggregated evidence for management of ruptured and unruptured aneurysms is missing.ObjectiveTo conduct a meta-analysis evaluating clinical outcome after aneurysm treatment.MethodsPubMed, Cochrane Central Register of Controlled Trials, and Clinicaltrials.gov were searched for studies evaluating aneurysm treatment. The primary outcome measure was an independent clinical outcome (modified Rankin scale 0–2, Glasgow Outcome Scale 4–5, or equivalent). Secondary outcomes were poor outcome and mortality. ORs were calculated on an intention-to-treat basis with 95% CIs. Outcome heterogeneity was evaluated with Cochrane's Q test (significance level cut-off value at <0.10) and I2(significance cut-off value >50%) with the Mantel–Haenszel method for dichotomous outcomes. A p value <0.05 was regarded as statistically significant.ResultsSearches yielded 18 802 articles. All titles were assessed, 403 abstracts were evaluated, and 183 full-text articles were read. One-hundred and fifty articles were qualitatively assessed and 85 articles were included in the meta-analysis. Patients treated with coiling (randomized controlled trials (RCTs)) had higher independent outcome at short-term follow-up (OR=0.67, 95% CI 0.57 to 0.79). Independent outcome was favored for coiling at intermediate and long-term follow-up (RCTs and observational studies combined—OR=0.80, 0.68 to 0.94 and OR=0.81, 0.71 to 0.93, respectively). Independent outcome and lower mortality was favored after coiling in unruptured aneurysms (database registry studies) at short-term follow-up (OR=0.34, 0.29 to 0.41 and OR=1.74, 1.52 to 1.98, respectively).ConclusionsThis meta-analysis evaluating clinical outcome after coiling or clipping for intracranial aneurysms, indicates a higher independent outcome and lower mortality after coiling.

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