PD3-07 CONTINENT VESICOSTOMY - LONG-TERM FUNCTIONAL RESULTS AND PATIENT SATISFACTION

AbstractDespite advances in coloanal anastomosis techniques, satisfactory procedures completed without complications remain lacking. We investigated the effectiveness of our recently developed ‘Short stump and High anastomosis Pull-through’ (SHiP) procedure for delayed coloanal anastomosis without a stoma. In this retrospective study, we analysed functional outcomes, morbidity, and mortality rates and local recurrence of 37 patients treated using SHiP procedure, out of the 282 patients affected by rectal cancer treated in our institution between 2012 and 2020. The inclusion criterion was that the rectal cancer be located within 4 cm from the anal margin. One patient died of local and pulmonary recurrence after 6 years, one developed lung and liver metastases after 2 years, and one experienced local recurrence 2.5 years after surgery. No major leak, retraction, or ischaemia of the colonic stump occurred; the perioperative mortality rate was zero. Five patients (13.51%) had early complications. Stenosis of the anastomosis, which occurred in nine patients (24.3%), was the only long-term complication; only three (8.1%) were symptomatic and were treated with endoscopic dilation. The mean Wexner scores at 24 and 36 months were 8.3 and 8.1 points, respectively. At the 36-month check-up, six patients (24%) had major LARS, ten (40%) had minor LARS, and nine (36%) had no LARS. The functional results in terms of LARS were similar to those previously reported after immediate coloanal anastomosis with protective stoma. The SHiP procedure resulted in a drastic reduction in major complications, and none of the patients had a stoma.

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Long-term outcomes after penile prosthesis placement for the Management of Erectile Dysfunction: a single-Centre experience

Basic and Clinical Andrology ◽

10.1186/s12610-021-00123-x ◽

2021 ◽

Vol 31 (1) ◽

Author(s):

Valentine Frydman ◽

Ugo Pinar ◽

Maher Abdessater ◽

William Akakpo ◽

Pietro Grande ◽

...

Keyword(s):

Patient Satisfaction ◽

Erectile Dysfunction ◽

Penile Prosthesis ◽

Perioperative Outcomes ◽

Single Centre ◽

Satisfactory Outcome ◽

Single Centre Experience ◽

Life Threatening ◽

Few Data

Abstract Background Penile prothesis (PP) is the gold-standard treatment of drug-refractory erectile dysfunction (ED). While postoperative outcomes have been widely described in the literature, there are few data about patient satisfaction and intraoperative events. We aimed to assess long-term patient satisfaction and perioperative outcomes after PP implantation in a single-centre cohort of unselected patients using validated scales. Results A total of 130 patients received a PP (median age: 62.5 years [IQR: 58–69]; median International Index of Erectile Function (IEEF-5) score: 6 [IQR: 5–7]). Median follow-up was 6.3 years [IQR: 4–9.4]. Thirty-two (24.6%) patients underwent surgical revision, of which 20 were PP removals (15.4%). Global PP survival rate was 84.6% and previous PP placement was a risk factor for PP removal (p = 0.02). There were six (4.6%) non-life-threatening intraoperative events including two which resulted in non-placement of a PP (1.5%). EAUiaic grade was 0 for 124 procedures (95.4%), 1 for four procedures (3.1%) and 2 for two procedures (1.5%). Of patients who still had their PP at the end of the study, 91 (80.5%) expressed satisfaction. Conclusions PP implantation is a last-resort treatment for ED with a satisfactory outcome. PPs are well accepted by patients.

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Long-Term Results of a Standard Algorithm for Intravenous Port Implantation

Journal of Personalized Medicine ◽

10.3390/jpm11050344 ◽

2021 ◽

Vol 11 (5) ◽

pp. 344

Author(s):

Ching-Feng Wu ◽

Jui-Ying Fu ◽

Chi-Tsung Wen ◽

Chien-Hung Chiu ◽

Ming-Ju Hsieh ◽

...

Keyword(s):

Operative Time ◽

Functional Results ◽

Long Term Results ◽

Related Complication ◽

Standard Algorithm ◽

Port Implantation ◽

Male Patients ◽

Catheter Fracture ◽

Guided Puncture

Intravenous ports serve as vascular access and are indispensable in cancer treatment. Most studies are not based on a systematic and standardized approach. Hence, the aim of this study was to demonstrate long-term results of port implantation following a standard algorithm. A total of 2950 patients who underwent intravenous port implantation between March 2012 and December 2018 were included. Data of patients managed following a standard algorithm were analyzed for safety and long-term outcomes. The cephalic vein was the predominant choice of entry vessel. In female patients, wire assistance without use of puncture sheath was less likely and echo-guided puncture via internal jugular vein (IJV) with use of puncture sheath was more likely to be performed, compared to male patients (p < 0.0001). The procedure-related complication rate was 0.07%, and no pneumothorax, hematoma, catheter kinking, catheter fracture, or pocket erosion was reported. Catheter implantations by echo-guided puncture via IJV notably declined from 4.67% to 0.99% (p = 0.027). Mean operative time gradually declined from 37.88 min in 2012 to 23.20 min in 2018. The proposed standard algorithm for port implantation reduced the need for IJV echo-guided approach and eliminated procedure-related catastrophic complications. In addition, it shortened operative time and demonstrated good functional results.

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Hybrid treatment of fibroadipose vascular anomaly: A case report

Open Medicine ◽

10.1515/med-2020-0228 ◽

2020 ◽

Vol 15 (1) ◽

pp. 890-897

Author(s):

Francesco Stillo ◽

Federica Ruggiero ◽

Antonio De Fiores ◽

Rita Compagna ◽

Bruno Amato

Keyword(s):

Patient Satisfaction ◽

Vascular Anomaly ◽

Rare Type ◽

Complete Excision ◽

Hybrid Treatment ◽

Constant Pain ◽

Additional Surgery ◽

Ethanol Embolization

AbstractBackgroundFirst identified in 2014, fibroadipose vascular anomaly (FAVA) is a very rare type of venous and lymphatic malformation. Marked by tough fibrofatty tissue in the extremities overtaking portions of the muscles, it is associated with constant pain and contracture of the affected extremity. There is a paucity of literature, and no guidelines on treatment procedure are available. This case highlights the role of hybrid treatment with primary ethanol percutaneous ethanol embolization and additional surgery for radicality in excision of FAVA lesions.Case summaryA 9-year-old girl with FAVA underwent the hybrid treatment. The achievements of complete excision, clinical response, and patient satisfaction in long-term follow-up were assessed. Following the hybrid treatment, the patient experienced significant improvement in pain. Concurrent symptoms of physical limitation, leg swelling, and skin hyperesthesia also improved. The clinical benefit, supported by postoperative physiotherapy, was well stabilized at 6-month follow-up, resulting in complete patient satisfaction at 12- and 36-month follow-ups. No major complications were encountered.ConclusionEthanol embolization plus surgery is a safe, effective, and long-term hybrid treatment of symptomatic FAVA lesions.

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Caudal Extension Graft of the Lower Lateral Cartilage: Technique and Aesthetic and Functional Results

Facial Plastic Surgery ◽

10.1055/s-0041-1726025 ◽

2021 ◽

Author(s):

Juliano de Oliveira Sales ◽

Wolfgang Gubisch ◽

Rodrigo Ribeiro Ferreira Duarte ◽

Aline Souza Costa Teixeira Moreno ◽

Felipe Marques de Oliveira ◽

...

Keyword(s):

Patient Satisfaction ◽

Age Groups ◽

Functional Results ◽

First Year ◽

Lateral Cartilage ◽

Lower Lateral Cartilage ◽

Alar Retraction ◽

Outcomes Evaluation ◽

A New Technique ◽

Extension Graft

AbstractHere we describe a new technique to deal with alar retraction, a highly undesirable imperfection of the nose. The procedure involves placing a caudal extension graft below the vestibular portion of the lower lateral cartilage (LLC) after its detachment from the vestibular skin. The graft is fixed to the cartilage and, subsequently, to the vestibular tissue. The present retrospective study included 20 patients, 11 females and 9 males, with a mean age of 28.90 years. Follow-up ranged from 1 to 18 months. Surgery improved alar notching to a smoother dome shape and nostril exposure was reduced in every patient. The caudal extension graft of the LLC contributed to rise in overall patient satisfaction, as revealed by the postoperative increase of the Rhinoplasty Outcomes Evaluation (ROE) mean score from 40.0 to 79.17 (p < 0.0001). It also contributed to and improved functional outcomes, as indicated by the decrease of the Nasal Obstruction Symptom Evaluation (NOSE) mean score from 52.75 to 13.25 (p = 0.0001). Sex did not affect the mean ROE and NOSE scores. Thus, increased patient satisfaction measured by the ROE is present in both sexes and at both age groups but it is better detected in the first year after surgery. Functional improvements analyzed with NOSE are best detected in patients aged ≥ 30 years and in follow-ups of 11 months. The caudal extension graft of the LLC technique described herein effectively and safely corrects alar retraction and the collapse of the nasal valve while filling the soft triangle.

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