Long-term Follow-up and Late Complications Following Treatment of Pediatric Urologic Disorders

2011 ◽  
Vol 95 (1) ◽  
pp. 15-25 ◽  
Author(s):  
Ardavan Akhavan ◽  
Jeffrey A. Stock
Keyword(s):  
Late Complications ◽  
Long Term Follow Up

Abstract 165: Pial Synangiosis in Patients with Moyamoya less than 2 Years of Age

Stroke ◽  
2012 ◽  
Vol 43 (suppl_1) ◽  
Author(s):  
Eric M Jackson ◽  
Ning Lin ◽  
Lissa Baird ◽  
R. Michael Scott ◽  
Edward R Smith
Keyword(s):  
Late Complications ◽  
High Risk Population ◽  
Consecutive Series ◽  
Ischemic Change ◽  
Initial Surgery ◽  
Long Term Follow Up ◽  
Progression Of Disease ◽  
Long Term Prognosis

Introduction: Moyamoya patients under two years of age represent a therapeutic challenge because of their frequent neurologic instability and concomitant anesthetic risks. We report our experience with pial synangiosis revascularization in this population. Methods: We reviewed the clinical and radiographic records of all patients with moyamoya syndrome in a consecutive series of patients under 2 years of age, who underwent cerebral revascularization surgery using pial synangiosis at a single institution. Results: During a 12-year period (1994-2005), thirty-four procedures (15 bilateral, 4 unilateral) were performed in 19 patients under two years of age (out of a total of 456 procedures in 240 patients). Eighteen of these patients presented with either stroke or TIA. Average age at first surgery was 1.4 years (range 6 months to 1.9 years). Unanticipated staged operations occurred in three patients, two due to persistent EEG changes during the initial surgery and one due to brain swelling during the procedure requiring ventriculostomy. There were two perioperative strokes; both patients had post-operative seizures but made clinical recoveries. The average follow-up was 7 years (range 1-14). In long term follow-up, 13 patients (68%) were clinically independent for their age, with 8 (42%) having no significant deficit. Late complications included subdural hygroma evacuation (1), additional revascularization procedures years later for frontal lobe ischemia (2), late infarction (1) and asymptomatic ischemic change on routine follow-up MRI studies (1). All patients who had both pre and post-operative angiography demonstrated progression of disease. Conclusions: Despite the challenges inherent to this population, the majority of children with moyamoya under 2 years of age have a good long-term prognosis. Our data support the use of pial synangiosis as a safe, effective and durable method for treatment of moyamoya for most children in this potentially high-risk population.

Neurological long-term follow-up in left atrial myxoma: Are late complications frequent or rare?

1992 ◽  
Vol 239 (3) ◽  
pp. 170-174 ◽  
Author(s):  
H. Reichmann ◽  
R. Romberg-Hahnloser ◽  
E. Hofmann ◽  
T. Becker ◽  
H. G. Mertens
Keyword(s):  
Left Atrial ◽  
Late Complications ◽  
Atrial Myxoma ◽  
Left Atrial Myxoma ◽  
Long Term Follow Up

Improving Surveillance of Traumatic Thoracic Aortic Injuries Repaired with Thoracic Endovascular Graft Placement

2018 ◽  
Vol 84 (7) ◽  
pp. 1129-1132
Author(s):  
Nathan A. Ludwig ◽  
Neal Bhutiani ◽  
Paul L. Linsky ◽  
Amit J. Dwivedi ◽  
Matthew C. Bozeman
Keyword(s):  
Injury Severity ◽  
Vascular Complications ◽  
Aortic Injury ◽  
Late Complications ◽  
Thoracic Aortic Injury ◽  
University Of Louisville ◽  
Long Term Follow Up ◽  
Aortic Injuries

The optimal follow-up protocol for patients undergoing thoracic endovascular aortic repair (TEVAR) for traumatic thoracic aortic injury remains unclear. The objective of this study was to assess follow-up patterns in such patients and present an approach to improve long-term follow-up in this cohort. The University of Louisville Trauma Registry was queried for patients who underwent TEVAR for traumatic thoracic aortic injuries between 2006 and 2016. Demographic, injury-specific, perioperative, and outcome measures were recorded for each patient. Follow-up evaluation and duration of follow-up were captured. Follow-up imaging was reviewed for any evidence of vascular complications. A total of 56 patients underwent TEVAR for traumatic thoracic aortic injury. Median age was 48 (range 18–86). Injury mechanism was largely blunt trauma (55 (98%)). Median injury severity score was 34 (range 17–43). Median length of stay was 12.5 days (range 1–40 days), and 51 patients (91%) survived to discharge. Of these, 30 (54%) made at least one follow-up appointment, and 21 of those 30 (70%) received a follow-up CT scan. Median time to last follow-up was one month (range 0–48 months), with 12 patients (21%) having follow-up beyond two months. No patients demonstrated any evidence of vascular complications on imaging at last follow-up. Despite the increased use of TEVAR to treat traumatic aortic injuries, limited follow-up data exist to predict the long-term outcomes of such interventions. Development of statewide or regional databases may help better track outcomes and identify late complications.

Immediate Gore-Tex Sling Suspension for Management of Facial Paralysis in Head and Neck Extirpative Surgery

2007 ◽  
Vol 137 (2) ◽  
pp. 228-232 ◽  
Author(s):  
Mia E. Skourtis ◽  
Stephen M. Weber ◽  
J. David Kriet ◽  
Douglas A. Girod ◽  
Terance T. Tsue ◽  
...  
Keyword(s):  
Head And Neck ◽  
Late Complications ◽  
Facial Reconstruction ◽  
High Rate ◽  
Wound Complications ◽  
Early Results ◽  
Aesthetic Results ◽  
Long Term Follow Up

OBJECTIVE: We sought to evaluate the functional and aesthetic outcomes of immediate facial reconstruction with a Gore-Tex (expanded polytetrofluoroethylene) sling in irradiated patients undergoing large head and neck tumor extirpation with facial nerve resection. STUDY DESIGN AND SETTING: We conducted a retrospective study of 17 patients at two academic institutions who underwent extirpative surgery with immediate Gore-Tex sling reconstruction and completed radiotherapy. Functional and aesthetic results were evaluated at three intervals. RESULTS: All patients had excellent immediate results and good or excellent intermediate-term results. At long-term follow-up, results were good to excellent in 47% and unacceptable in 35% of patients. CONCLUSION: In irradiated patients undergoing total parotidectomy with immediate facial reconstruction using Gore-Tex slings, early results are excellent, but there is a high incidence of major wound complications and unacceptable results in long-term follow-up. SIGNIFICANCE: There is a high rate of late complications associated with immediate facial reconstruction with Gore-Tex slings in irradiated patients.

Long-Term Follow up of Children with Apalstic Anemia Treated with Immunosuppressive Therapy.

Blood ◽  
2006 ◽  
Vol 108 (11) ◽  
pp. 997-997
Author(s):  
Bunchoo Pongtanakul ◽  
Prabodh K. Das ◽  
Yigal Dror
Keyword(s):  
Partial Response ◽  
Immunosuppressive Therapy ◽  
Late Complication ◽  
Complete Response ◽  
Late Complications ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Long Term Follow Up

Abstract Background: Immunosuppressive therapy (IST) is the alternative first line treatment in children with aplastic anemia (AA) who have no HLA match siblings available. The long-term outcome of patients with AA who survive after IST is unknown. We evaluated outcomes of children with AA treated with IST at long-term follow up. Methods: we retrospectively reviewed the hospital records of children with AA from 1984 to 2004, treated at our institution with horse-derived antithymocyte globulin (hATG) 160 mg/Kg over 4 days, short course of prednisone and cyclosporine (CS). Results: Forty two patients were treated with IST (25 boys, 18 girls). The median age at diagnosis was 8.5 years. Twenty nine (69%), eight (19%) and five (12%) patients were diagnosed with severe, very severe, and moderate AA, respectively. Nine patients (21%) had hepatitis associated AA. Twenty seven patients (64%) received one course of ATG and fifteen (36%) received 2 courses (8 received 2 courses of hATG and 7 received 1 course hATG and 1 course rabbit derived ATG). Eleven patients (26%) required G-CSF. Median follow up time was 53.3 months (range 3–244 months). Twenty six patients (62%) had a complete response (CR), eight (19%) had a partial response (PR) and eight (19%) had no response (NR). Two patients relapsed after one course of IST and needed a second course of IST and both of them had a partial response. Median time to discontinuation of CS was 13 months. Nine patients (21%) died (7 with NR and 2 with PR) and 33 patients (79%) are alive. Two patients developed myelodysplastic syndrome (MDS) 21 and 19 months post IST; both received long-term G-CSF (18 and 14 months) and had PR after 2 courses of IST. Five of 33 patients (15%) who survived had significant hypertension after CS was discontinued and one required continuous antihypertensive medication. Conclusion: The results of this study shows promising response in children with AA treated with IST. Hypertension and MDS are late complication. Longer follow up in these patients is warranted to definite the accurate rates of the late complications and risk factors.

scholarly journals Gastrostomy Placement and Management in Children: A Single-Center Experience

Nutrients ◽  
2019 ◽  
Vol 11 (7) ◽  
pp. 1555
Author(s):  
Grazia Di Leo ◽  
Paola Pascolo ◽  
Kamar Hamadeh ◽  
Andrea Trombetta ◽  
Sergio Ghirardo ◽  
...  
Keyword(s):  
Nutritional Status ◽  
Surgical Complications ◽  
Respiratory Infections ◽  
Late Complications ◽  
Gastrostomy Tube ◽  
Pulmonary Infections ◽  
Single Center Experience ◽  
Long Term Follow Up

BACKGROUND: To prevent malnutrition and food aspiration in children with chronic neuromuscular problems, enteral nutrition provided by gastrostomy is recommended. Long-term follow-up data about surgical and medical complications of PEG are available, but few papers have addressed all of the issues in the same series. METHODS: This retrospective study enrolled patients under 18 years who had a gastrostomy tube placed at our institution between 2003 and 2017. The aim is to evaluate outcomes after gastrostomy placement, focusing both on surgical complications (early and late), and its effect on their nutritional status, on the prevention of pulmonary infections, and their parents’ opinion. RESULTS: Eighty-four gastrostomies were placed in total (35 F; 49 M). Seventy-seven patients had a severe neurocognitive impairment (GMFCS 5). The principal indication for gastrostomy was severe dysphagia (53.3%). No gastrostomy-related death was observed. Early surgical complications were observed in five of 84 (5,9%) patients; late complications were observed in 15 of 84 (17.8%) patients. Twenty-two patients were diagnosed with subsequent gastroesophageal reflux; five patients developed dumping syndrome (6%). Complete medical follow-up data were available for 45 patients. A progressive improvement of nutritional status was observed in 29 patients, and 11 maintained the same percentile; the occurrence of respiratory infections and need for hospitalization decreased. In 90% of cases, parents were fully satisfied with the g-tube. CONCLUSION: This study confirms the positive nutritional outcomes of gastrostomy-tube with an associated small risk of surgical complications and a reduction in the number of respiratory infections, with most parents scoring their experience as positive.

scholarly journals TCT-242 Late Complications in Patients With Stent-Treated Coarctation of the Aorta: Long-Term Follow-Up

2021 ◽  
Vol 78 (19) ◽  
pp. B98
Author(s):  
Cristina Pericet Rodríguez ◽  
Miguel Ángel Romero Moreno ◽  
Soledad Ojeda ◽  
Javier Suárez de Lezo ◽  
Francisco Hidalgo ◽  
...  
Keyword(s):  
Coarctation Of The Aorta ◽  
Late Complications ◽  
Long Term Follow Up

Cladribine Alone and in Combination with Cyclophosphamide or Cyclophosphamide and Mitoxantrone in Previously Untreated Patients with Chronic Lymphocytic Leukemia (CLL): Long-Term Follow-up of the the Polish Adult Leukemia Group (PALG CLL2) Study,

Blood ◽  
2011 ◽  
Vol 118 (21) ◽  
pp. 3915-3915
Author(s):  
Tadeusz Robak ◽  
Jerzy Blonski ◽  
Krzysztof Jamroziak ◽  
Malgorzata Calbecka ◽  
Jadwiga Dwilewicz-Trojaczek ◽  
...  
Keyword(s):  
Late Complications ◽  
Long Term Results ◽  
Published Data ◽  
Secondary Neoplasms ◽  
Treatment Groups ◽  
Long Term Follow Up ◽  
Secondary Tumours ◽  
Richter’S Syndrome

Abstract Abstract 3915 Purpose. In 2006 we have published an early report of the prospective, randomized, multicenter study (PALG CLL2) comparing the efficacy and toxicity of cladribine alone and in combination with cyclophosphamide (CC) or cyclophosphamide plus mitoxantrone (CMC) in 508 previously untreated patients with progressive and advanced CLL (Blood. 2006;108:473–9). In this early analysis we found that CMC induced higher CR rate than CC (36% vs. 21%, p=0.004), but no differences in overall response (OR), progression-free survival (PFS) and overall survival (OS) among treatment groups were observed. The aim of the present study was to verify whether long-term follow-up might change originally published data on PFS or/and OS as well as to compare the rate of late complications including secondary neoplasms and Richter's syndrome. Methods. In PALG CLL2 study PFS was defined as the time from the end of first–line therapy to disease progression or death from any cause. OS was measured from the time of randomization to death or last contact. OS and PFS were calculated according to the method of Kaplan and Meier and compared between groups by the log-rank test. Only patients with pathologically-proven tumours diagnosed after chemotherapy initiation were considered as having secondary neoplasms or Richter's syndrome. Frequencies of secondary tumours were compared by chi2 test. Results. The median time of follow-up as of Januar y 2011 was 45.6 months (95% CI: 39.9–51.4). The results of comparison of survival times and late complications in different study arms are shown in Table 1 and Figure 1. Conclusions. Long term results for 508 r andomized patients confirm that cladribine alone, CC and CMC regimens produce comparable PFS and OS in previously untreated progressive CLL. The risk of secondary tumours does not differ in the investigated treatment groups. Disclosures: No relevant conflicts of interest to declare.

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