Long-Term Implications of Oophorectomy at the Time of Hysterectomy for Benign Disease

Oesophagectomies and gastrectomies are performed predominantly for the treatment of malignant disease. However, in this case series, we describe three patients with benign disease who had a laparoscopic oesophagogastrectomy with gastroduodenal detachment and Roux-en-Y biliary diversion, and discuss the operative feasibility and consequent patient outcomes. Our aim was to modify the procedure using an established reconstruction already practised in gastric and bariatric surgery, thereby preventing operative sequelae that lead to a poor quality of life (eg reflux oesophagitis and vomiting). During the first postoperative year, our first two patients experienced weight loss, indigestion and lower bowel symptoms with no apparent improvement in gastric function compared with a standard gastric tube pull-up reconstruction. In the longer term, in both patients, the gastric tube interpositions appeared to function well and there was no evidence of gastro-oesophageal reflux disease, delayed gastric emptying or troublesome indigestion. Our third patient, who had lifelong severe reflux symptoms, was eating normally three months after the operation with no need for antacid medication. We therefore conclude that laparoscopic Ivor–Lewis oesophagogastrectomy with Roux-en-Y bypass is a more complex reconstruction with added risks but may in the long term result in better overall outcomes and satisfaction for patients, particularly those with benign disease.

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Relapse recovery

Neurology Neuroimmunology & Neuroinflammation ◽

10.1212/nxi.0000000000000653 ◽

2019 ◽

Vol 7 (2) ◽

pp. e653 ◽

Cited By ~ 4

Author(s):

Orhun H. Kantarci ◽

Burcu Zeydan ◽

Elizabeth J. Atkinson ◽

Brittani L. Conway ◽

Carmen Castrillo-Viguera ◽

...

Keyword(s):

Term Treatment ◽

Benign Disease ◽

Good Recovery ◽

Class Iii ◽

Early Recovery ◽

Double Blind ◽

Delayed Treatment ◽

Long Term Treatment ◽

Edss Score

ObjectiveTo determine whether basing the decision to initiate immediate vs delayed disease-modifying therapy (DMT) on extent of recovery after initial relapse affects long-term disability accumulation in a multiple sclerosis (MS) evidence-based setting.MethodsWe analyzed the double-blind, placebo-controlled interferon beta-1a 30 mc once a week in clinically isolated syndrome and 10-year-follow-up extension trial. Good recovery after presenting relapse was defined as (1) full early recovery within 28 days of symptom onset (Expanded Disability Status Scale [EDSS] score of 0 at enrollment maintained ≥6 months) and (2) delayed good recovery (EDSS score > 0 at enrollment and improvement from peak deficit to 6th-month or 1-year visit ≥ median). Time from recovery assignment to future disability (EDSS score ≥ 2.5 or ≥4.0) was studied on a relapse-recovery-stratified age axis and immediate vs 3-year delayed treatment initiation with Kaplan-Meier statistics and hazard ratios (HRs).ResultsOne hundred seventy-five/328 patients had good recovery (94 immediate and 81 delayed treatment); 153 did not have good recovery (77 immediate and 76 delayed treatment). HRs for EDSS score ≥2.5 outcome were: delayed treatment without good recovery as reference (HR = 1.0), delayed treatment with good recovery (HR6th-month: 0.67, p = 0.207; HR1st-year: 0.40, p = 0.027), immediate treatment without good recovery (HR6th-month: 0.56, p = 0.061; HR1st-year: 0.40, p = 0.011), and immediate treatment with good recovery (HR6th-month: 0.43, p = 0.014; HR1st-year: 0.48, p = 0.034). Placebo patients were switched to long-term treatment after 3 years, and insufficient EDSS score ≥4.0 outcome events were available to study.ConclusionsIn patients with MS presenting without good recovery after the initial relapse, immediate DMT initiation favorably influences the likelihood of more ambulatory-benign disease akin to patients with good recovery after the initial relapse.Classification of evidenceThis study provides Class III evidence that for patients with MS without good recovery after the initial relapse, immediate DMT initiation increases the likelihood of a benign disease course.

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Long-term outcome of cholecystoenterostomy as a definitive biliary drainage procedure for benign disease

World Journal of Surgery ◽

10.1007/bf00294736 ◽

1995 ◽

Vol 19 (4) ◽

pp. 616-619 ◽

Cited By ~ 9

Author(s):

Andrew J. Oishi ◽

Michael G. Sarr ◽

David M. Nagorney ◽

Michael D. Traynor ◽

Peter Mucha

Keyword(s):

Biliary Drainage ◽

Benign Disease ◽

Drainage Procedure ◽

Term Outcome ◽

Long Term Outcome

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Management of long-term failure after colon interposition for benign disease

The American Journal of Surgery ◽

10.1016/s0002-9610(02)00827-9 ◽

2002 ◽

Vol 183 (5) ◽

pp. 544-546 ◽

Cited By ~ 26

Author(s):

John S. Domreis ◽

Blair A. Jobe ◽

Ralph W. Aye ◽

Karen E. Deveney ◽

Brett C. Sheppard ◽

...

Keyword(s):

Benign Disease ◽

Colon Interposition

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Severe Nutritional Risk Predicts Decreased Long-Term Survival in Geriatric Patients Undergoing Pancreaticoduodenectomy for Benign Disease

Journal of the American College of Surgeons ◽

10.1016/j.jamcollsurg.2014.06.017 ◽

2014 ◽

Vol 219 (6) ◽

pp. 1149-1156 ◽

Cited By ~ 16

Author(s):

Dominic E. Sanford ◽

Angela M. Sanford ◽

Ryan C. Fields ◽

William G. Hawkins ◽

Steven M. Strasberg ◽

...

Keyword(s):

Geriatric Patients ◽

Benign Disease ◽

Nutritional Risk ◽

Term Survival ◽

Long Term Survival

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Long-term results of morbidity after parotid gland surgery in benign disease

The Laryngoscope ◽

10.1002/lary.20822 ◽

2010 ◽

Vol 120 (4) ◽

pp. 724-730 ◽

Cited By ~ 74

Author(s):

Michael Koch ◽

Johannes Zenk ◽

Heinrich Iro

Keyword(s):

Parotid Gland ◽

Benign Disease ◽

Long Term Results

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Hepaticojejunostomy for Benign Disease: Long-Term Stricture Rate and Management

The American Surgeon ◽

10.1177/000313481908501228 ◽

2019 ◽

Vol 85 (12) ◽

pp. 1350-1353 ◽

Cited By ~ 1

Author(s):

Shannon M. Zielsdorf ◽

John J. Klein ◽

Vidya A. Fleetwood ◽

Martin Hertl ◽

Edie Y. Chan

Keyword(s):

Success Rate ◽

Benign Disease ◽

Success Rates ◽

Transplant Patients ◽

Stricture Rate ◽

Anastomotic Strictures ◽

The Mean ◽

Radiological Intervention

The objective of the study was to determine the long-term stricture rate of hepaticojejunostiomy (HJ) performed for benign disease, to compare stricture rates for transplant patients and non-transplant patients, and to compare the success rates of procedural and surgical treatment options. Hospital charts of 135 consecutive patients undergoing HJ between 1998 and 2016 were analyzed retrospectively. The primary outcome was stricture formation. Secondary outcomes were time to stricture diagnosis and success rates of various interventions. The anastomotic stricture rate was 13.3 per cent (18). The mean follow-up period was 4.3 years. The mean time to stricture diagnosis was 2.3 years. Stricture rates were similar between the transplant (19.2%) and nontransplant, non-Whipple group (13%). Strictures were treated with radiological intervention with a 44.4 per cent success rate; each required multiple interventions. Mortality from liver disease after failure of nonoperative management of HJ strictures reached 30 per cent (3). Five of ten patients who failed radiological intervention underwent HJ revision; the success rate was 80 per cent. Anastomotic strictures of HJ performed for benign disease occur in 13 per cent of patients and typically develop within 2.5 years postoperatively. Yet, given the dangerous sequelae of chronic biliary obstruction and potential delay in presentation, a follow-up is recommended for up to 10 years. When strictures occur, HJ revision should be considered early, after two failed radiological interventions.

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