Long-Term Outcomes of Surgical Treatment in 181 Patients with Supratentorial Cerebral Cavernous Malformation–Associated Epilepsy

2017 ◽  
Vol 108 ◽  
pp. 869-875 ◽  
Author(s):  
Kangmin He ◽  
Shize Jiang ◽  
Jianping Song ◽  
Zehan Wu ◽  
Liang Chen ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Cavernous Malformation ◽  
Cerebral Cavernous Malformation ◽  
Long Term Outcomes

scholarly journals Outcome after conservative management or surgical treatment for new-onset epilepsy in cerebral cavernous malformation

2017 ◽  
Vol 126 (4) ◽  
pp. 1303-1311 ◽  
Author(s):  
Philipp Dammann ◽  
Karsten Wrede ◽  
Ramazan Jabbarli ◽  
Salome Neuschulte ◽  
Katja Menzler ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Cavernous Malformation ◽  
Cerebral Cavernous Malformation ◽  
Seizure Outcome ◽  
Operative Morbidity ◽  
Conservative Group ◽  
Class 1 ◽  
New Onset

OBJECTIVE The aim of this study was to determine seizure outcome, functional outcome, and the withdrawal of antiepileptic drugs (AEDs) after conservative or surgical treatment of patients with new-onset cavernoma-related epilepsy (CRE). METHODS The authors conducted a retrospective comparative observational study of 79 consecutive patients, each with a single sporadic cerebral cavernous malformation (CCM) and new-onset CRE. RESULTS Forty-one patients underwent initial surgery (IS), and 38 patients underwent initial conservative (IC) treatment. Of those in the latter group, 19 underwent delayed surgical (DS) treatment. At the last follow-up, 88%, 32%, and 79% of patients in the respective groups had been seizure free for at least 2 years (International League Against Epilepsy [ILAE] Class 1; IS vs IC, p < 0.0001) and 78%, 8%, and 58%, respectively, had been off AEDs (IS vs IC, p < 0.0001). The cumulative probability of staying seizure free (ILAE Class 1) during a 5-year period was 73% (mean seizure-free follow-up 49.8 ± 2.7 months, 95% CI 44.4–55.1 months) for the IS group, 22% (mean 31.8 ± 3.6 months, 95% CI 24.8–38.8 months) for the IC group, and 68% (mean 48.6 ± 4.3 months, 95% CI 40.1–57.1 months) for the DS group (IS vs IC p < 0.001). Long-term operative morbidity was 3%, and long-term morbidity in the conservatively treated group was also 3%. CONCLUSIONS Patients with CCM and new-onset CRE who underwent IS treatment showed better results in seizure control and the discontinuation of AEDs than the conservatively treated patients. Operative morbidity was comparable to the morbidity from symptomatic CCM hemorrhage in the conservative group. Half of the patients who started with conservative treatment underwent subsequent surgical treatment; however, a longer duration of epilepsy prior to surgery did not worsen postoperative seizure outcome.

scholarly journals Results of surgical treatment of moderate ischemic mitral regurgitation: A propensity analysis

2020 ◽  
Author(s):  
Jiyoung Lee ◽  
Kan Kajimoto ◽  
Taira Yamamoto ◽  
Kenji Kuwaki ◽  
Yuki Kamikawa ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Surgical Treatment ◽  
Mitral Valve ◽  
Propensity Score ◽  
Artery Bypass ◽  
Long Term Outcomes ◽  
Artery Disease ◽  
The Impact

Background and Aim of the Study: Ischemic mitral valve regurgitation (IMR) in patients undergoing coronary artery bypass grafting (CABG) is associated with worse long-term outcomes. The aim of this study was to assess the impact of mitral valve repair with CABG in patients with moderate IMR. Method: This observational study enrolled 3,215 consecutive patients from the Juntendo CABG registry with moderate IMR and multivessel coronary artery disease who underwent CABG between 2002 and 2017. The CABG alone and CABG with mitral valve surgery (MVs) groups were compared. The propensity score was calculated for each patient. Long-term all-cause death, cardiac death, and major adverse cardiac and cerebrovascular events (MACCEs) were compared between the two groups. Results: A total of 101 patients who underwent CABG had moderate IMR in our database. Propensity score matching selected 40 pairs for final analysis. MVs was associated with increased risks of postoperative atrial fibrillation, blood transfusion, and longer hospitalization. There were no differences between the two groups in long-term outcomes, including all-cause mortality, cardiac mortality, and the incidence of MACCEs. Conclusions: Surgical treatment of moderate IMR combined with CABG was as safe as CABG alone, with no differences in long-term outcomes. Further studies are needed to determine the effects of MVs in patients with moderate IMR and severe coronary artery disease.

scholarly journals Hypoplasia of the aortic arch

2015 ◽  
Vol 17 (2) ◽  
pp. 68 ◽  
Author(s):  
Yu. S. Sinelnikov ◽  
A. V. Gorbatykh ◽  
S. M. Ivantsov ◽  
D. S. Prokhorova ◽  
M. S. Kshanovskaya
Keyword(s):  
Surgical Treatment ◽  
Aortic Arch ◽  
Considerable Improvement ◽  
Long Term Outcomes ◽  
Modern Methods ◽  
Aggressive Surgical Approach ◽  
Arch Reconstruction ◽  
Aortic Arch Hypoplasia

An aggressive surgical approach to early repair of aortic coarctation and concomitant arch hypoplasia results in considerable improvement of the long-term outcomes of surgical treatment by reducing the number of aortic re-coarctation and arterial hypertension persistence events. At present, there exist some methods of determining the degree of aortic arch hypoplasia, which allow for arch reconstruction planning. Our review focuses on the analysis of modern methods of determination of the aortic arch hypoplasia and the outcomes of surgical treatment of this disease.

Surgery for vertigo: 10-year audit from a contemporary vertigo clinic

2015 ◽  
Vol 129 (12) ◽  
pp. 1182-1187 ◽  
Author(s):  
U Patnaik ◽  
A Srivastava ◽  
K Sikka ◽  
A Thakar
Keyword(s):  
Surgical Treatment ◽  
Neck Surgery ◽  
Vestibular Nerve ◽  
Fistula Repair ◽  
Long Term Outcomes ◽  
Nerve Section ◽  
Perilymphatic Fistula ◽  
Disease Modifying ◽  
Surgical Treatments

AbstractObjective:To present the profile of patients undergoing surgical treatment for vertigo at a contemporary institutional vertigo clinic.Study design:A retrospective analysis of clinical charts.Methods:The charts of 1060 patients, referred to an institutional vertigo clinic from January 2003 to December 2012, were studied. The clinical profile and long-term outcomes of patients who underwent surgery were analysed.Results:Of 1060 patients, 12 (1.13 per cent) were managed surgically. Of these, disease-modifying surgical procedures included perilymphatic fistula repair (n = 7) and microvascular decompression of the vestibular nerve (n = 1). Labyrinth destructive procedures included transmastoid labyrinthectomy (n = 2) and labyrinthectomy with vestibular nerve section (n = 1). One patient with vestibular schwannoma underwent both a disease-modifying and destructive procedure (translabyrinthine excision). All patients achieved excellent vertigo control, classified as per the American Academy of Otolaryngology – Head and Neck Surgery 1995 criteria.Conclusion:With the advent of intratympanic treatments, surgical treatments for vertigo have become further limited. However, surgery with directed intent, in select patients, can give excellent results.

Anterior diaphragmatic hernias in children: long-term surgical outcomes

2021 ◽  
Vol 16 (3) ◽  
pp. 7-15
Author(s):  
D.A. Morozov ◽  
◽  
D.V. Khaspekov ◽  
E.A. Okulov ◽  
V.G. Masevkin ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Diaphragmatic Hernia ◽  
Complex Analysis ◽  
Long Term Results ◽  
Long Term Outcomes ◽  
X Ray ◽  
Hernial Sac ◽  
Chest X Ray ◽  
Diaphragmatic Hernias

Anterior diaphragmatic hernia (ADH) is a rare congenital pathology that occurs in children with a frequency of 1:4800 (1–6% of all congenital diaphragmatic hernias). There are many controversial aspects in the surgical treatment of patients with ADH: the choice of surgical approach, the method of diaphragmatic repair and the feasibility of excision of the hernial sac. Objective. To conduct a comparative analysis of the surgical treatment of patients with ADH in different clinics, assessing longterm outcomes. Patients and methods. The medical records of 7 children with ADH who underwent surgical repair in different clinics (in time period from 2009 to 2019) were retrospecively reviewed. Evaluating the long-term results of ADH repair was made by telephone and online surveys of the parents of patients and by outpatient examination of children (chest x-ray in two projections). Results. In a ten-year period, 7 patients (4 boys and 3 girls) were operated on with a diagnosis of “anterior diaphragmatic hernia” at the age of 3 months to 12 years. In most children, a hernia was discovered accidentally by chest x-ray. Laparoscopic correction was performed in 5 (71%) cases, thoracoscopic correction – in 2 cases (29%). The main difference in surgical tactics in ADH patients was the manipulation with the hernial sac – the hernial sac was excised in 4 (57%) patients, but it was left in three cases (43%). The defect closure was performed by “full-thickness” separated sutures that fix the diaphragm to the anterior abdominal wall during laparoscopy (5) and to the chest tissue during thoracoscopy (2); in some cases, additional fixation to the rib (4) was performed. Sutures were tied extracorporeally and buried in the subcutaneous layer in 6 (86%) patients. Average follow-up was 7 years. While evaluating long-term outcomes no ADH recurrence were found. Conclusions. There are still many controversial aspects in the surgical treatment of ADH patients. In our opinion, multicenter studies with complex analysis of long-term results are required to standardize the surgical treatment of such patients. Key words: anterior diaphragmatic hernia, Larrey hernia, long-term outcomes, Morgani hernia

Long-term results of surgical treatment of gastric cancer

1986 ◽  
Vol 67 (2) ◽  
pp. 104-106
Author(s):  
A. S. Abdullin ◽  
F. Sh. Akhmetzyanov ◽  
A. A. Samigullin ◽  
Z. N. Shemeunova ◽  
V. A. Arinin ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Surgical Treatment ◽  
Stomach Cancer ◽  
Stage Iv ◽  
Stage Ii ◽  
Stage Iii ◽  
Disease Stage ◽  
Long Term Results ◽  
Long Term Outcomes

We analyzed long-term outcomes of the treatment of 217 patients (men - 126, women - 91), who underwent radical operations for stomach cancer in the period of 1972 till 1976. 14 patients were under 39, 52 - from 40 to 49, 50 to 59 - 52, 60 to 69 - 80, over 70 years old - 19. The youngest patient was 28 years old and the oldest - 76 years old. Most patients (185) were operated on at stage III of the disease, stage II was diagnosed in 27 patients, and stage IV - in 5 patients.

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