Long-Term Results of Primary Scalenotomy in the Treatment of Thoracic Outlet Syndrome

1994 ◽  
Vol 19 (2) ◽  
pp. 229-233 ◽  
Author(s):  
M. GOCKEL ◽  
M. VASTAMÄKI ◽  
H. ALARANTA
Keyword(s):  
Surgical Treatment ◽  
Thoracic Outlet Syndrome ◽  
Long Term Results ◽  
Factory Workers ◽  
Age At Surgery ◽  
The Mean ◽  
Selection For ◽  
Pain At Rest

A total of 107 patients with thoracic outlet syndrome were reviewed an average of 4.1 years (range 2–11 years) after primary scalenotomy. The sample included 86 women and 21 men, and the mean age at surgery was 41.9 years (range 16–59 years). The three most disturbing pre-operative symptoms were pain at rest (87%), numbness (66%) and lack of power (55%). The post-operative success rate diminished from 71% 1 month after operation to 63% at follow-up. The retirement frequency increased from 6% up to 33% during the follow-up time. It was highest among factory workers at 60%. Of the patients older than 45 years at surgery, 68% were retired at follow-up. The importance of careful selection for operation is emphasized, and also the need to consider vocational rehabilitation before resorting to surgical treatment of thoracic outlet syndrome. We recommend surgical treatment for this disabling disorder, especially for younger patients with clear evidence of thoracic outlet syndrome who are engaged in occupations demanding little repetitive work. The best results have occurred in this group.

Gamma Knife thalamotomy for treatment of essential tremor: long-term results

2010 ◽  
Vol 112 (6) ◽  
pp. 1311-1317 ◽  
Author(s):  
Ronald F. Young ◽  
Francisco Li ◽  
Sandra Vermeulen ◽  
Robert Meier
Keyword(s):  
Surgical Treatment ◽  
Essential Tremor ◽  
Gamma Knife ◽  
Surgical Intervention ◽  
Long Term Results ◽  
The Mean ◽  
Lost To Follow Up ◽  
Deep Brain

Object The goal of this report was to describe the safety and effectiveness of nucleus ventralis intermedius (VIM) thalamotomy performed with the Leksell Gamma Knife (GK) for the treatment of essential tremor (ET). Methods One hundred seventy-two patients underwent a total of 214 VIM thalamotomy procedures with the Leksell GK between February 1994 and March 2007 for treatment of disabling ET. Eleven patients were lost to follow-up less than 1 year after the procedures, so that in this report the authors describe the results in 161 patients who underwent a total of 203 thalamotomies (119 unilateral and 42 bilateral). Results There were statistically significant decreases (p < 0.0001) in tremor scores for both writing and drawing. The mean postoperative follow-up duration for all patients was 44 ± 33 months. Fifty-four patients have been followed for more than 60 months posttreatment. There were 14 patients who suffered neurological side effects that were temporary (6) or permanent (8), which accounted for 6.9% of the 203 treatments. All complications were related to lesions that grew larger than expected. Conclusions A VIM thalamotomy with the Leksell GK offers a safe and effective alternative for surgical treatment of ET. It is particularly applicable to patients who are not ideal candidates for deep brain stimulation but can be offered to all patients who are considering surgical intervention for ET.

Dupuytren’s Contracture: The Long-Term Results after Day Surgery

1991 ◽  
Vol 16 (3) ◽  
pp. 272-274 ◽  
Author(s):  
E. A. MÄKELÄ ◽  
H. JAROMA ◽  
A. HARJU ◽  
S. ANTTILA ◽  
J. VAINIO
Keyword(s):  
Surgical Treatment ◽  
Day Surgery ◽  
High Rate ◽  
Long Term Results ◽  
Dupuytren’S Contracture ◽  
Central Hospital ◽  
Dupuytren's Contracture ◽  
The Mean

220 operations in 211 hands in 160 consecutive patients suffering from Dupuytren’s contracture were performed from 1976 through 1984 at the Kuopio University Central Hospital in Finland. 179 operations were carried out as day cases. The mean follow-up was 3.2 years. Sub-total fasciectomy resulted in good immediate and long-term improvement in 86% of patients. The recurrence rate was 27%. Surgical treatment of Dupuytren’s contracture was well-suited to day surgery. A properly planned follow-up programme is suggested because of the relatively high rate of recurrence, which usually appeared within two years after operation.

Osteochondritis Dissecans of the Talus: Long-Term Results of Surgical Treatment

Foot & Ankle ◽  
1989 ◽  
Vol 10 (3) ◽  
pp. 161-163 ◽  
Author(s):  
Peter Angermann ◽  
Peter Jensen
Keyword(s):  
Surgical Treatment ◽  
Osteochondritis Dissecans ◽  
Long Term Results ◽  
Short Term ◽  
Time Of Surgery ◽  
Pain At Rest ◽  
Results Of Surgery ◽  
Generalized Osteoarthritis

Twenty patients with osteochondritis dissecans of the ankle were reviewed for a clinical and radiographical follow-up 9 to 15 years after surgery including multiple drilling of the lesion combined with excision of loose fragments. The short-term results of surgery were satisfactory: 85° of the patients were improved or cured. At follow-up, more than half of the patients had some degree of pain during activity, and swelling of the ankle, but only a few had locking or pain at rest. Only one of the 18 patients without osteoarthritis at the time of surgery had developed generalized osteoarthritis at the followup. Although the initial good results of surgery were demonstrated to deteriorate with time, the procedure can still be recommended in patients with longstanding symptoms.

scholarly journals Reconstruction of the Aortic Arc through Left Thoracotomy in Patients with Isolated Coarctation and Aortic Arch Hypoplasia

2021 ◽  
pp. 70-74
Author(s):  
Y. Truba ◽  
I. Dziuryi ◽  
O. Motrechko ◽  
O. Golovenko
Keyword(s):  
Surgical Treatment ◽  
Aortic Arch ◽  
Median Sternotomy ◽  
Long Term Results ◽  
Aortic Cross Clamp Time ◽  
Left Thoracotomy ◽  
The Mean ◽  
Aortic Arch Hypoplasia

Background. The choice of surgical approach for the reconstruction of aortic arch hypoplasia is a rather controversial issue. Traditionally, left lateral thoracotomy is used to correct aortic coarctation with hypoplasia of one or more arc seg-ments. However, in recent years, more and more clinics have begun widespread use of median sternotomy for the surgical treatment of aortic arch hypoplasia. The purpose of the research was to analyze the immediate and long-term results of surgical treatment of isolated hypoplasia of the aortic arch in infants through left thoracotomy. Materials and methods. From 2010 to 2019, 159 infants with coarctation and hypoplasia of one or more segments of the aortic arch underwent reconstruction of the aortic arch at the National Amosov Institute of Cardiovascular Surgery of the NAMS of Ukraine and Ukrainian Children’s Cardiac Center. The study included only patients with biventricular physiology and subsequent biventricular correction. There were 108 male patients (68%) and 51 female patients (32%). The mean age of the patients was 2.4 ± 0.9 months, the mean body weight was 4.7 ± 2.0 kg. The main method of diagnosis, i.e. determining the defect and assessing the immediate and long-term results, was echocardiographic examination. The study group consisted of 155 patients (97.5%) in whom the reconstruction of the aortic arch was performed through left thoracotomy, in the remaining 4 patients (2.5%) the intervention was performed through median sternotomy.   Results. In-hospital mortality was 0.6% (n = 1). The average time of the operation was 126 ± 40 minutes, the aortic cross-clamp time was 24.7 ± 5.1 minutes. The mean duration of mechanical ventilation after the surgery was 41 ± 15.9 hours. The mean follow-up period ranged from 1 month to 13 years. There were no deaths in the long-term period. Ten (6.4%) patients developed aortic arch restenosis in the postoperative period. In 8 patients, the narrowing was treated by endovascular dilatation. Two patients underwent repeated aortic arch repair using median sternotomy. There were no cases of compression of the trachea, main bronchi, neurological complications in the follow-up period.   Conclusions. Reconstruction of the aortic arch hypoplasia through left thoracotomy is an effective and safe treatment option in infants associated with good immediate and long-term results. The study indicates that this surgical strategy can be used in most patients with hypoplasia of the isthmus and distal aortic arch.

Surgical treatment of trigonocephaly: technique and long-term results in 48 cases

2011 ◽  
Vol 7 (3) ◽  
pp. 300-310 ◽  
Author(s):  
Fatma Ozlen ◽  
Ali Metin Kafadar ◽  
Bashar Abuzayed ◽  
Mustafa Onur Ulu ◽  
Cihan Isler ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Early Postoperative Period ◽  
Frontal Bone ◽  
Long Term Results ◽  
Surgical Reconstruction ◽  
Structural Abnormality ◽  
Hospitalization Period ◽  
The Mean

Object The authors present their experience in the surgical treatment of metopic synostosis by orbital bandeau remodeling and frontal bone rotation. The pitfalls and advantages of the surgical technique are discussed, along with the long-term clinical results in 48 consecutive cases. Methods Forty-eight consecutive patients in whom trigonocephaly was diagnosed between 1990 and 2009 were treated with frontal bone rotation and frontoorbital bandeau remodeling. Of these patients, 38 (79%) were boys and 10 (21%) were girls. The age at the time of surgical treatment ranged between 4 and 42 months (mean ± SD 11.4 ± 8.7 months). The average follow-up period was 5.5 ± 4.2 years (range 5 months–19 years). The preoperative and latest postoperative photographs of the patients were evaluated for the following features: 1) shape of the forehead; 2) hypotelorism; and 3) temporal depression. Scores of 0, 1, or 2 were assigned for each item: 0 was normal, 1 meant moderate deformity, and 2 denoted severe deformity. Results In the early postoperative period, no complications were documented. The average hospitalization period was 4 days. Follow-up radiographs or 3D CT scans were obtained at regular intervals. The mean preoperative scores for the evaluated items were 1.38 ± 0.49 for the shape of the forehead, 1.33 ± 0.48 for hypotelorism, and 1.7 ± 0.46 for the temporal depression. The mean postoperative scores were 0.06 ± 0.24 for the shape of the forehead, 0.21 ± 0.4 for hypotelorism, and 0.67 ± 0.48 for the temporal depression. Overall, the total preoperative score dropped from 4.4 to 0.93 postoperatively (p < 0.05). All the patients were contented with the cosmetic results. Conclusions Early detection and treatment of metopic suture synostosis has a significant, favorable influence on the outcomes. Good understanding of the structural abnormality and the pathophysiological mechanisms of the possible complications is very important for performing proper surgical reconstruction.

Clinical Experience with a New Nitinol Self-Expanding Stent in Peripheral Arteries

1996 ◽  
Vol 3 (4) ◽  
pp. 369-379 ◽  
Author(s):  
Michel Henry ◽  
Max Amor ◽  
Rafael Beyar ◽  
Isabelle Henry ◽  
Jean-Marc Porte ◽  
...  
Keyword(s):  
Long Term Results ◽  
Lesion Length ◽  
Secondary Patency ◽  
Peripheral Arteries ◽  
External Compression ◽  
Nitinol Stent ◽  
Nitinol Stents ◽  
The Mean

Purpose: To evaluate a new self-expanding nitinol coil stent in stenotic or occluded peripheral arteries. Methods: Seventy-three symptomatic patients (58 men; mean age 67 years) were treated with nitinol stents for lesions in the iliac artery (9 stenoses); superficial femoral artery (SFA) (39 stenoses, 6 occlusions); popliteal artery and tibioperoneal trunk (9 stenoses, 7 occlusions); and 3 bypass grafts. Mean diameter stenosis was 84.4% ± 9.9% (range 75% to 100%), and mean lesion length was 45 ± 23 mm (range 20 to 120 mm). Results: Eighty-eight 40-mm-long stents with diameters between 5 and 8 mm were implanted percutaneously for suboptimal dilation (n = 45); dissection (n = 21); and restenosis (n = 7). All stents but one were implanted successfully; the malpositioned stent was removed, and another stent was successfully deployed. There were 3 (4.1%) failures due to thrombosis at 24 hours. During the mean 16-month follow-up (range to 44 months), 4 restenoses (3 femoral, 1 popliteal) have occurred; 2 were treated with repeat dilation and 2 underwent bypass. Primary and secondary patency rates at 18 months were 87% and 90%, respectively, for all lesions (iliac: 100% for both; femoral: 85% and 88%; popliteal: 87% and 100%). Conclusions: This new nitinol stent seems to be safe and effective with favorable long-term results, even in distal SFA lesions and popliteal arteries. Its flexibility and resistance to external compression allow its placement in tortuous arteries and near joints.

scholarly journals Surgical treatment of pulmonary artery sarcoma: a report of 17 cases

2021 ◽  
Vol 11 (1) ◽  
pp. 204589402098639
Author(s):  
Wu Song ◽  
Long Deng ◽  
Jiade Zhu ◽  
Shanshan Zheng ◽  
Haiping Wang ◽  
...  
Keyword(s):  
Pulmonary Artery ◽  
Survival Rates ◽  
Tumor Resection ◽  
Long Term Results ◽  
Pulmonary Endarterectomy ◽  
Pulmonary Artery Sarcoma ◽  
The Mean ◽  
Operative Findings

Pulmonary artery sarcoma (PAS) is a rare and devastating disease. The diagnosis is often delayed, and optimal treatment remains unclear. The aim of this study is to report our experience in the surgical management of this disease. Between 2000 and 2018, 17 patients underwent operations for PAS at our center. The medical records were retrospectively reviewed to evaluate the clinical characteristics, operative findings, the postoperative outcomes, and the long-term results. The mean age at operation was 46.0 ± 12.4 years (range, 26–79 years), and eight (47.1%) patients were male. Six patients underwent tumor resection alone, whereas the other 11 patients received pulmonary endarterectomy (PEA). There were two perioperative deaths. Follow-up was completed for all patients with a mean duration of 23.5 ± 17.6 months (1–52 months). For all 17 patients, the median postoperative survival was 36 months, and estimated cumulative survival rates at 1, 2, 3, and 4 years were 60.0%, 51.4%, 42.9%, and 21.4%, respectively. The mean survival was 37.0 months after PEA and 14.6 months after tumor resection only ( p = 0.046). Patients who had no pulmonary hypertension (PH) postoperatively were associated with improved median survival (48 vs. 5 months, p = 0.023). In conclusion, PAS is often mistaken for chronic pulmonary thromboembolism. The prognosis of this very infrequent disease remains poor. Early detection is essential for prompt and best surgical approach, superior to tumor resection alone, and PEA surgery with PH relieved can provide better chance of survival.

scholarly journals Clinical results of the Metha short hip stem: a perspective for younger patients?

2013 ◽  
Vol 5 (4) ◽  
pp. 34 ◽  
Author(s):  
Fritz Thorey ◽  
Claudia Hoefer ◽  
Nima Abdi-Tabari ◽  
Matthias Lerch ◽  
Stefan Budde ◽  
...  
Keyword(s):  
Bone Ingrowth ◽  
Long Term Results ◽  
Harris Hip Score ◽  
Femoral Revision ◽  
Term Survival ◽  
Younger Patients ◽  
The Mean ◽  
Short Stems

In recent years, various uncemented proximal metaphyseal hip stems were introduced for younger patients as a bone preserving strategy. Initial osteodensitometric analyses of the surrounding bone of short stems indicate an increase of bone mass with secondary bone ingrowth fixation as a predictor of long-term survival of these types of implants. We report the outcome of 151 modular Metha short hip stem implants in 148 patients between March 2005 and October 2007. The mean follow-up was 5.8±0.7 years and the mean age of the patients was 55.7±9.8 years. Along with demographic data and co-morbidities, the Harris Hip Score (HHS), the Hip dysfunction and Osteoarthritis Outcome Score (HOOS), and also the results of a patient-administered questionnaire were recorded pre-operatively and at follow-up. The mean HHS increased from 46±17 pre-operatively to 90±5 the HOOS improved from 55±16 pre-operatively to 89±10 at the final follow-up. A total of three patients have been revised, two for subsidence with femoral revision and one for infection without femoral revision (Kaplan Meier survival estimate 98%). The radiological findings showed no radiolucent lines in any of the patients. The modular Metha short hip stem was implanted in younger patients, who reported an overall high level of satisfaction. The clinical and radiographic results give support to the principle of using short stems with metaphyseal anchorage. However, long-term results are necessary to confirm the success of this concept in the years to come.

scholarly journals Long term results after transepiphysal ACL reconstruction in children and adolescent

2018 ◽  
Vol 6 (4_suppl2) ◽  
pp. 2325967118S0001
Author(s):  
Christian Eberle ◽  
Wolfgang Schopf ◽  
Andree Ellermann
Keyword(s):  
Acl Reconstruction ◽  
Cartilage Damage ◽  
Long Term Results ◽  
Angular Deformity ◽  
Leg Length ◽  
Growth Disturbance ◽  
Children And Adolescent ◽  
The Mean

The aim of our study was to review the long term clinical and radiological (MRI) outcomes of adult patients who underwent ACL reconstruction as children or adolescent with emphasize to the features of growth disturbance, angular deformity, meniscal and cartilage damage and revision rate We retrospectively evaluated patient who underwent ACL reconstruction in our clinic with arthroscopic transepiphyseal technique using hamstrings graft in childhood or adolescence between the years 1997 and 2009. A total of 43 Patients were assessed. 25 male and 18 female. The average age at time of surgery was 13,5 years (8 - 16 y.), at time of assessement 22,4 years (18 - 30 y.) . The mean follow up was 10 years (4 - 16 years). The physical development of the patients was assessed with the Lysholm score and the Cincinnati Knee score scale, their satisfaction was recorded on the basis of the IKDC subjective knee evaluation form and the Tegner activity score . Leg deformity or leg length discrepancy was evaluated clinically by the observers. The instrumented Lachman test using KT1000 and manual Pivot shift test was performed to assess knee stability. MRI was used to detect graft integrity, cartilage and meniscal damages. No significant leg deformities or leg length discrepancy had been detected. The average Lysholm score was 91 points (83 - 100), the Cincinnati Knee Score was 90,4 (79 - 100) points on average . The mean IKDC score was 92 points (82 -100). The Tegner-Activity-Score changed from preop 6,8 (2-10) to post op 5,8 (2-9). 2 Patient underwent revision ACL reconstruction due to rerupture (3 and 9 years post op). 2 Patients underwent meniscal surgery during follow up (1 resection and one refixation). KT1000 evaluation showed 67% excellent, 21% good and in 12% bad results. The MRI scan showed 42 intact grafts and one unverifiable graft. One patient with cartilage damage up to 3° (ICRS), 3 patients with meniscal degeneration up to grade 2. Each patient showed a free range of motion Our data underlines that transepiphyseal ACL reconstruction in children and adolescent with hamstrings is a save procedure leading to good long term results without causing angular deformity or growth disturbance

Anterior Palatoplasty for the Treatment of OSA

2009 ◽  
Vol 141 (2) ◽  
pp. 253-256 ◽  
Author(s):  
Kenny P. Pang ◽  
Raymond Tan ◽  
Puravi Puraviappan ◽  
David J. Terris
Keyword(s):  
Body Mass Index ◽  
Clinical Stage ◽  
Long Term Results ◽  
Apnea Hypopnea Index ◽  
Type I ◽  
Obstructive Sleep ◽  
The Mean ◽  
Anterior Palatoplasty

OBJECTIVE: Review long-term results of the modified cautery-assisted palatoplasty (mod CAPSO)/anterior palatoplasty for the treatment of mild-moderate obstructive sleep apnea (OSA). STUDY DESIGN: Prospective series of 77 patients. All patients were >18 years old, type I Fujita, body mass index (BMI) < 33, Friedman clinical stage II, with apnea-hypopnea index (AHI) from 1.0 to 30.0. The mean follow-up time was 33.5 months. The procedure involved an anterior soft palatal advancement technique with or without removal of the tonsils. The procedure was done under general or local anesthesia. RESULTS: There were 69 men and eight women; the mean age was 39.3 years old; and mean BMI was 24.9 (range 20.7–26.8). There were 38 snorers and 39 OSA patients. The AHI improved in patients with OSA, 25.3 ± 12.6 to 11.0 ± 9.9 ( P < 0.05). The overall success rate for this OSA group was 71.8 percent (at mean 33.5 months). The mean snore scores (visual analog score) improved from 8.4 to 2.5 (for all 77 patients). Lowest oxygen saturation also improved in all OSA patients. Subjectively, all patients felt less tired. CONCLUSION: This technique has been shown to be effective in the management of patients with snoring and mild-moderate OSA.

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