Treatment strategies and long-term results in paediatric patients treated in four consecutive AML-BFM trials

We analyzed 119 files of patients with Zenker's diverticulum who were treated with CO2 laser systems concerning treatment management, complications, and long-term results. Although the tissue bridge was dissected down to the fundus of the diverticulum, opening the mediastinum, mediastinitis was observed in none of the cases. Of the patients followed up for long-term results, 90.3% were completely symptom-free, and 5.8% of the patients reported an improvement in general condition. In view of the low rate of complications and the low level of morbidity and because of the good functional results, microendoscopic laser surgical diverticulotomy can be recommended as suitable therapy, especially as compared to external approaches or even other endoscopic treatment strategies. The main advantage as compared to staple-assisted esophagodiverticulostomy is that no special equipment is needed and that even small pouches can be treated successfully.

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Long term results after pediatric heart transplantation - improved treatment strategies increase survival

The Thoracic and Cardiovascular Surgeon ◽

10.1055/s-0034-1393997 ◽

2014 ◽

Vol 62 (S 02) ◽

Author(s):

S. Schubert ◽

O. Miera ◽

R. Hetzer ◽

C. Knosalla ◽

D. Kemper ◽

...

Keyword(s):

Heart Transplantation ◽

Treatment Strategies ◽

Long Term Results ◽

Pediatric Heart Transplantation

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Decellularization Strategies to Engineer Fibrocartilage Bioscaffolds: A Review

Journal of Biomaterials and Tissue Engineering ◽

10.1166/jbt.2021.2740 ◽

2021 ◽

Vol 11 (8) ◽

pp. 1435-1451

Author(s):

F. Yusof ◽

M. Sha’ban ◽

A. Azhim

Keyword(s):

Treatment Strategies ◽

Meniscal Repair ◽

Long Term Results ◽

Biological Scaffolds ◽

Advantages And Disadvantages ◽

Pros And Cons ◽

Short And Long Term ◽

New Treatment ◽

Cellular Components

Fibrocartilage or known as meniscus tissues located in between the tibia and femur always subjected to extreme forces that can lead to injury especially for the sportsperson. The meniscal injury mean incidence in the general population is 66 per 100,000. The principal methods for the surgical management of fibrocartilage injury have been improvised from meniscectomy to meniscal repair and meniscal reconstruction that portrays different advantages and disadvantages in the short and long-term results. The inability to treat meniscus injury without osteoarthritis development in long-term results also motivates to find new treatment strategies. In this current era, the development of the multidisciplinary fields of tissue engineering and regenerative medicine provides new alternatives for the treatment approaches. This field involves the regeneration of the required tissue using scaffolds such as synthetic, natural, and biological scaffolds to restore the damaged one. Biological scaffolds are preferable because it tremendously mimics the native anatomical structure and has similar ratios and concentration of the proteins and growth factors that influence tissue repair and remodeling. The development of biological scaffolds with low immunogenic levels involves the decellularization process that eliminates all the cellular components while preserved the extracellular matrix (ECM) integrity and mechanics. In this review, the pros and cons of the recent decellularization strategies to engineer fibrocartilage scaffolds have been discussed. We believed that the ideal decellularization methods still need to be explored to develop suitable biological scaffolds that structurally and functionally mimic native tissue as a replacement for new tissue regeneration.

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Long term results of early active extension and passive flexion mobilization following one-stage tendon grafting for neglected injuries of the flexor digitorum profundus in children

Journal of Hand Surgery (European Volume) ◽

10.1177/1753193410395693 ◽

2011 ◽

Vol 36 (4) ◽

pp. 303-307 ◽

Cited By ~ 13

Author(s):

Hiroshi Yamazaki ◽

Hiroyuki Kato ◽

Shigeharu Uchiyama ◽

Norimasa Iwasaki ◽

Hisamitsu Ishikura ◽

...

Keyword(s):

Flexor Tendon ◽

Long Term Results ◽

Flexor Digitorum Profundus ◽

Postoperative Rehabilitation ◽

Active Motion ◽

One Stage ◽

Paediatric Patients ◽

Passive Flexion ◽

Flexor Digitorum

We retrospectively reviewed the long-term clinical outcomes of one-stage flexor tendon grafting for seven paediatric patients with isolated flexor digitorum profundus (FDP) tendon injuries in Zones 1 or 2. Free tendon grafts (one palmaris longus tendons and six plantaris tendons) were used for reconstruction by Pulvertaft’s procedure. The ages of the patients at reconstruction ranged from 7 to 15 (mean 11) years. The time from injury to surgery ranged from three to 78 (mean 25) months. These patients were followed up from 2.5 to 21 years after surgery (mean 8.5 years). All cases were started on early active extension and passive flexion according to the modified Kleinert mobilization for postoperative rehabilitation. The mean active motion after surgery was 49° (range 20–80°) for the DIP joints and 106° (range 95–110°) for the PIP joints. The total active range of motion was on average 237° (range 195–275°). Excellent results were achieved in five patients, good in one, and fair in one. Growth arrest of the distal phalanx was seen in one patient. One-stage flexor tendon grafting in paediatric patients combined with early controlled mobilization can be used to reconstruct neglected isolated ruptures of the FDP tendon with satisfactory results.

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Pediatric vestibular schwannomas: Evaluation of clinical features, treatment strategies and long-term results of 10 cases

The Turkish Journal of Ear Nose and Throat ◽

10.5606/tr-ent.2018.57966 ◽

2018 ◽

Vol 28 (3) ◽

pp. 116-125

Author(s):

İbrahim Başar

Keyword(s):

Clinical Features ◽

Treatment Strategies ◽

Vestibular Schwannomas ◽

Long Term Results

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Long-Term Outcome and Role of Biology within Risk-Adapted Treatment Strategies: The Austrian Neuroblastoma Trial A-NB94

Cancers ◽

10.3390/cancers13030572 ◽

2021 ◽

Vol 13 (3) ◽

pp. 572

Author(s):

Stefan Fiedler ◽

Inge M. Ambros ◽

Evgenia Glogova ◽

Martin Benesch ◽

Christian Urban ◽

...

Keyword(s):

Treatment Strategies ◽

High Dose Chemotherapy ◽

Long Term Results ◽

Mycn Amplification ◽

High Dose ◽

Term Outcome ◽

Primary Tumor Site ◽

Long Term Outcome ◽

Stage 4

We evaluated long-term outcome and genomic profiles in the Austrian Neuroblastoma Trial A-NB94 which applied a risk-adapted strategy of treatment (RAST) using stage, age and MYCN amplification (MNA) status for stratification. RAST ranged from surgery only to intensity-adjusted chemotherapy, single or multiple courses of high-dose chemotherapy (HDT) followed by autologous stem cell rescue depending on response to induction chemotherapy, and irradiation to the primary tumor site. Segmental chromosomal alterations (SCAs) were investigated retrospectively using multi- and pan-genomic techniques. The A-NB94 trial enrolled 163 patients. Patients with localized disease had an excellent ten-year (10y) event free survival (EFS) and overall survival (OS) of 99 ± 1% and 93 ± 2% whilst it was 80 ± 13% and 90 ± 9% for infants with stage 4S and for infants with stage 4 non-MNA disease both 83 ± 15%. Stage 4 patients either >12 months or ≤12 months but with MNA had a 10y-EFS and OS of 45 ± 8% and 47 ± 8%, respectively. SCAs were present in increasing frequencies according to stage and age: in 29% of localized tumors but in 92% of stage 4 tumors (p < 0.001), and in 39% of patients ≤ 12 months but in 63% of patients > 12 months (p < 0.001). RAST successfully reduced chemotherapy exposure in low- and intermediate-risk patients with excellent long-term results while the outcome of high-risk disease met contemporary trials.

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Aortic aneurysm: thoracic aortic aneurysm—therapeutic options

ESC CardioMed ◽

10.1093/med/9780198784906.003.0608 ◽

2018 ◽

pp. 2573-2575

Author(s):

Axel Haverich ◽

Andreas Martens

Keyword(s):

Aortic Aneurysm ◽

Endovascular Treatment ◽

Aortic Arch ◽

Aortic Root ◽

Treatment Strategies ◽

Ascending Aorta ◽

Aortic Root Replacement ◽

Long Term Results ◽

Descending Aorta

Surgical treatment of thoracic aortic aneurysms has to account for anatomical location, patient risk profile, and the surgeon’s experience. Whereas endovascular treatment of the descending aorta has become a valid option for most patients and pathologies, open surgery remains the first choice to treat aneurysms of the aortic root, ascending aorta, and aortic arch and to treat patients with connective tissue disease in elective settings. Minimal invasive access is more frequently used to treat the aortic root, ascending aorta, and proximal aortic arch with excellent results. Long-term results of valve-sparing aortic root replacement undermine the recommendation to preserve the aortic valve, especially in young patients with tricuspid aortic valves. Aortic annulus stabilization either via valve reimplantation or external stabilization techniques in addition to aortic root remodelling ensures stable long-term results. Aortic root replacement using valved conduits remains a durable treatment option. Aortic arch surgery has been revolutionized by multiple technical solutions that facilitate surgical techniques (e.g. branched prefabricated grafts), extend treatment into the proximal descending aorta (e.g. frozen elephant trunk procedure), and minimize organ damage (e.g. cardiac and lower body perfusion during aortic arch repair). If endovascular treatment of the descending and thoracoabdominal aorta is not feasible, open surgical methods remain the standard of care and should routinely include protection methods to preserve organ function (e.g. left heart bypass, partial bypass). Treatment strategies in all patients should be discussed within a dedicated interdisciplinary team. Strict follow-up is mandatory.

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