331 COVID-19 Mortality After Vascular Procedures During the Initial UK Surge: Moving Forward with Elective Vascular Work

Abstract Aim Following the initial COVID-19 surge in the United Kingdom, there was a national incentive for elective vascular surgery to be restricted to clean sites in order to reduce perioperative cross infection and subsequent mortality. We assessed the risk of dying from perioperatively acquired COVID-19 during the peak of the London outbreak. Method 43 consecutive patients who had vascular (n = 48) procedures in March and April 2020 at a regional hub serving five London hospitals were analysed. The patients were screened for COVID-19 in the 30-day postoperative period and the main outcome measure was mortality from COVID-19. A comparison was then made with patients who underwent minimally invasive procedures from our integrated interventional radiology department. Median follow-up was 41 days (IQR 8- 58 days). Results Three patients (7%) in the vascular group (median age 61 years, all diabetic, two male) died from COVID-19, all of whom tested positive postoperatively. Two others became positive but recovered. In comparison, two patients (2%) in the interventional radiology group died from COVID-19, however one was positive prior to their procedure. Conclusions Only urgent vascular cases should be performed during a COVID-19 surge, with elective work delayed or continued at clean sites. However, with growing waiting lists for elective surgery currently, further restrictions may not be a viable long-term solution. Resumption of care at hot sites should be considered, if resources allow for it and if safety measures can be implemented. The advantages of minimally invasive surgery may inherently reduce risk as well.

Download Full-text

O32 COVID-19 mortality after vascular procedures during the initial UK surge: moving forward with elective vascular work

British Journal of Surgery ◽

10.1093/bjs/znab282.037 ◽

2021 ◽

Vol 108 (Supplement_5) ◽

Author(s):

P Liu ◽

S M Cheema ◽

I Adeoye ◽

N S Theivacumar ◽

S T Hussain ◽

...

Keyword(s):

Interventional Radiology ◽

Minimally Invasive ◽

Elective Surgery ◽

Radiology Department ◽

Safety Measures ◽

The United Kingdom ◽

Reduce Risk ◽

Interventional Radiology Department

Abstract Introduction Following the initial COVID-19 surge in the United Kingdom, there was a national incentive for elective vascular surgery to be restricted to clean sites in order to reduce perioperative cross infection and subsequent mortality. We assessed the risk of dying from perioperatively acquired COVID-19 during the peak of the London outbreak. Materials and Methods 43 consecutive patients who had vascular (n = 48) procedures in March and April 2020 at a regional hub serving five London hospitals were analysed. The patients were screened for COVID-19 in the 30-day postoperative period and the main outcome measure was mortality from COVID-19. A comparison was then made with patients who underwent minimally invasive procedures from our integrated interventional radiology department. Median follow-up was 41 days (IQR 8–58 days). Result Three patients (7%) in the vascular group (median age 61 years, all diabetic, two male) died from COVID-19, all of whom tested positive postoperatively. Two others became positive but recovered. In comparison, two patients (2%) in the interventional radiology group died from COVID-19, however one was positive prior to their procedure. Conclusion Only urgent vascular cases should be performed during a COVID-19 surge, with elective work delayed or continued at clean sites. However, with growing waiting lists for elective surgery currently, further restrictions may not be a viable long-term solution. Resumption of care at hot sites should be considered, if resources allow for it and if safety measures can be implemented. The advantages of minimally invasive surgery may inherently reduce risk as well. Take-home Message Only urgent vascular cases should be performed during a peak outbreak of COVID-19, however we cannot continue to postpone elective procedures indefinitely or restrict all cases to solely clean sites. The resumption of care at hot sites encompasses a fine balance of risks versus benefits.

Download Full-text

Awareness Regarding Radiation Protection Among Residents and Technologist Working in Vascular Interventional Radiology Department: A Multicenter Study from Pakistan

10.1055/s-0041-1729798 ◽

2017 ◽

Author(s):

Syed Amir Raza ◽

Kamran masood ◽

Munawar Hussain

Keyword(s):

Interventional Radiology ◽

Radiation Protection ◽

Multicenter Study ◽

Radiology Department ◽

Interventional Radiology Department

Download Full-text

PTU-173 Long Term Follow Up After Successful Radiofrequency Ablation For Barrett’s Related Neoplasia Is Essential To Diagnose Recurrent Disease: Data From The United Kingdom Patient Registry

Gut ◽

10.1136/gutjnl-2014-307263.247 ◽

2014 ◽

Vol 63 (Suppl 1) ◽

pp. A114.2-A115

Author(s):

RJ Haidry ◽

M Banks ◽

A Gupta ◽

M Butt ◽

G Fullarton ◽

...

Keyword(s):

United Kingdom ◽

Radiofrequency Ablation ◽

Recurrent Disease ◽

Patient Registry ◽

The United Kingdom ◽

Long Term Follow Up

Download Full-text

696 LONG-TERM OUTCOMES OF MINIMALLY INVASIVE ESOPHAGECTOMY COMPARED TO OPEN ESOPHAGECTOMY: A RETROSPECTIVE ANALYSIS OF 2958 CASES IN SINGLE CANCER CENTER

Diseases of the Esophagus ◽

10.1093/dote/doab052.696 ◽

2021 ◽

Vol 34 (Supplement_1) ◽

Author(s):

Xue-feng Leng ◽

Kexun Li ◽

Qifeng Wang ◽

Wenwu He ◽

Kun Liu ◽

...

Keyword(s):

Esophageal Cancer ◽

Minimally Invasive ◽

Minimally Invasive Esophagectomy ◽

Cancer Center ◽

Term Survival ◽

Invasive Esophagectomy ◽

Open Esophagectomy ◽

Single Cancer

Abstract Esophageal cancer is the fourth primary cause of cancer-related death in the male in China.The cornerstone of treatment for resectable esophageal cancer is surgery. With the development of minimally invasive esophagectomy (MIE), it is gradually adopted as an alternative to open esophagectomy (OE) in real-world practice. The purpose of this study is to explore whether MIE vs. OE will bring survival benefits to patients with the advancement of treatment techniques and concepts. Methods Data were obtained from the Sichuan Cancer Hospital & Institute Esophageal Cancer Case Management Database (SCH-ECCM Database). We retrospective analyzed esophageal cancer patients who underwent esophagectomy from Jan. 2010 to Nov. 2017. Patients were divided into two groups: MIE and OE groups. Clinical outcome and survival data were compared using TNM stages of AJCC 8th edition. Results After 65.3 months of median follow-up time, 2958 patients who received esophagectomy were included. 1106 of 2958 patients (37.4%) were underwent MIE, 1533 of 2958 patients (51.8%) were underwent OE. More than half of the patients (56.7%, 1673/2958) were above stage III. The median overall survival (OS) of 2958 patients was 51.6 months (95% CI 45.2–58.1). The MIE group's median OS was 74.6 months compared to 42.4 months in the OE group (95% CI 1.23–1.54, P < 0.001). The OS at 1, 3, and 5 years were 90%, 68%, 58% in the MIE group; 85%, 54%, 42% in the OE group,respectively (P<0.001). Conclusion The nearly 8-year follow-up data from this single cancer center suggests that with the advancement of minimally invasive surgical technology, MIE can bring significant benefits to patients' long-term survival compared with OE. Following the continuous progression of minimally invasive surgery and establishing a mature surgical team, MIE should be encouraged.

Download Full-text

Minimally invasive video-assisted thyroidectomy: a critical analysis of long-term cosmetic results using a validated tool

Annals of The Royal College of Surgeons of England ◽

10.1308/rcsann.2018.0178 ◽

2019 ◽

Vol 101 (3) ◽

pp. 180-185 ◽

Cited By ~ 3

Author(s):

M Sahm ◽

R Otto ◽

M Pross ◽

R Mantke

Keyword(s):

Minimally Invasive ◽

Conventional Group ◽

Long Term Results ◽

Cosmetic Results ◽

Assessment Score ◽

Conventional Thyroidectomy ◽

Video Assisted ◽

Scar Assessment

Introduction Since its first publication in 1997, minimally invasive video-assisted thyroidectomy (MIVAT) has developed into the predominant minimally invasive surgery of the thyroid. A major advantage over conventional thyroid surgery is the superior cosmetic result. However, there are still few data comparing the long-term cosmetic results of the two methods. This paper compares the long-term cosmetic results of the two methods, based on follow-up assessments. Methods Between 2004 and 2011, 143 preselected patients underwent a MIVAT in our department. Additionally, 134 patients underwent a conventional thyroidectomy in our hospital in 2011. A total of 117 patients from the MIVAT group and 102 patients from the conventional thyroidectomy group received follow-up assessments after 23.1 and 23.6 months, respectively, using the patient and observer scar assessment scale. Results The measurable cervical scar length averaged 1.9 cm in the MIVAT group and 3.9 cm in the conventional group (P < 0.001). Some 11.1% of the patients in the MIVAT group and 7.1% of the patients in the conventional group had developed keloid (P = 0.391). The patient scar assessment score was 10.4 for the MIVAT group compared with 9.9 for the conventional thyroidectomy group (P = 0.691) and the observer scare assessment score was 8.6 for MIVAT compared with 9.9 for conventional thyroidectomy (P = 0.011). Conclusion In the patient assessment instrument, conventional thyroidectomy had a small advantage over MIVAT in the cosmetic long-term results. This difference between the two groups was, however, not significant. Our result contradicts short-term cosmetic results of published randomized studies with improvement for MIVAT. The Observer Score demonstrates a significant advantage of the MIVAT.

Download Full-text

Open Surgical versus Minimally Invasive in Situ Femorodistal Bypass: Long-term Results

Journal of Endovascular Therapy ◽

10.1177/152660280301000122 ◽

2003 ◽

Vol 10 (1) ◽

pp. 117-120 ◽

Cited By ~ 1

Author(s):

Nomdo S. Renken ◽

Cees H.A. Wittens ◽

Peter M.T. Pattynama ◽

Nico A.J.J. Du Bois ◽

Lukas C. van Dijk

Keyword(s):

Minimally Invasive ◽

Limb Salvage ◽

Long Term Results ◽

Open Technique ◽

Treatment Groups ◽

Closed Technique ◽

Open Versus

Purpose: To compare long-term patency and limb survival rates for the classical in situ surgical bypass procedure versus a minimally invasive technique for femorodistal revascularization. Methods: From May 1992 to June 1994, a prospective multicenter study was undertaken at 4 centers to evaluate the open versus closed technique for femorodistal bypass grafting. Of 97 patients enrolled in the trial, 73 patients (49 men; mean age 71 years) were assigned to the long-term follow-up protocol and prospectively randomized to the open (n = 38) or closed (n = 35) procedure. The classical open technique is characterized by a long incision over the length of the bypass graft, while the minimally invasive procedure involves only two short incisions over each anastomosis site (the side branches are closed with a coaxial embolization catheter system). Graft patency was evaluated with duplex imaging periodically throughout the 4-year observation period. Results: There was no statistically significant difference between the treatment groups with respect to age, sex, hypertension, ischemic heart disease, or smoking. However, the open group had a significantly greater incidence of diabetes (p = 0.037). Over a median 4.7-year follow-up (range 0.3–6.4), 9 (12%) patients (3 open and 6 closed) were lost to follow-up: 2 died and 7 refused the duplex examination. No significant differences in 4-year patency, limb salvage, or survival was demonstrated between the open versus closed treatment groups; 4-year secondary patency was 62% versus 64%, respectively, and limb salvage was 72% versus 86%. Conclusions: The closed technique for femorodistal in situ bypass procedures yields favorable long-term outcomes compared to the traditional open technique.

Download Full-text