PS01.005: HIGH-RESOLUTION MANOMETRY GUIDING SURGICAL PROCEDURE FOR TREATMENT OF ACHALASIA OF THE ESOPHAGUS. LONG-TERM RESULTS OF A PROSPECTIVE STUDY

2018 ◽  
Vol 31 (Supplement_1) ◽  
pp. 51-51
Author(s):  
Tania Triantafyllou ◽  
Georgia Doulami ◽  
Charalampos Theodoropoulos ◽  
Georgios Zografos ◽  
Dimitrios Theodorou
Keyword(s):  
High Resolution ◽  
Prospective Study ◽  
Conflicts Of Interest ◽  
Long Term Results ◽  
Type I ◽  
Laparoscopic Myotomy ◽  
Term Outcome ◽  
Long Term Outcome ◽  
High Resolution Manometry

Abstract Background Laparoscopic myotomy and fundoplication for the treatment of achalasia presents with 90% success rate. The intraoperative use of manometry during surgery has been previously introduced to improve the outcome. Recently, we presented our pilot study proposing the use of the HRM during surgery. The aim of this study is to evaluate the long-term outcome of the intraoperative use of High-Resolution Manometry (HRM) in achalasia patients. Methods In this prospective study, consecutive achalasia patients underwent laparoscopic myotomy and fundoplication along with real-time use of HRM. Eckardt scores (ES) and HRM results were collected before and after surgery. Results Twenty-three achalasia patients (22% Type I, 57% Type II, 22% Type III, according to Chicago Classification v3.0) with a mean age 48 years underwent calibrated and uneventful myotomy and fundoplication. Eleven myotomies were further extended, while sixteen fundoplications were intraoperatively modified, according to manometric findings. During postoperative follow-up, mean resting and residual pressures of the LES were significantly decreased after surgery (16,1 vs. 41,9, P = 0 and 9 vs. 28,7, P = 0, respectively). The ES was also diminished (1 vs. 7, P = 0). Conclusion The intraoperative use of HRM during laparoscopic myotomy and fundoplication for the treatment of achalasia of the esophagus is a safe, promising and efficient approach aiming to individualize both myotomy and fundoplication for each achalasia patient. Disclosure All authors have declared no conflicts of interest.

Long-Term Results of Donor Lymphocyte Transfusions for the Treatment of Relapse After Allogeneic Transplantation for Chronic Myelogenous Leukemia - Is There a Role for Immunotherapy in CML?.

Blood ◽  
2009 ◽  
Vol 114 (22) ◽  
pp. 2258-2258
Author(s):  
Hans-Jochem Kolb ◽  
Dagmar Bund ◽  
Helga Schmetzer ◽  
Christoph Schmid ◽  
Raymund Buhmann ◽  
...  
Keyword(s):  
Conflicts Of Interest ◽  
Allogeneic Transplantation ◽  
Myelogenous Leukemia ◽  
Long Term Results ◽  
Treatment Modalities ◽  
Simultaneous Treatment ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Gm Csf

Abstract Abstract 2258 Poster Board II-235 The long-term outcome of donor lymphocyte infusions (DLI) as first line treatment of relapse of chronic myeloid leukemia (CML) after allogeneic stem cell transplantation was studied and compared to other treatment modalities. Forty five patients were treated with DLI and 36 without DLI. Patients given DLI first did not differ significantly from those given other treatments in gender, age, donor, gender and histocompatibility of the donor, source of stem cells (blood vs marrow), depletion of T cells, stage of the disease, time from diagnosis and year at the time of transplant, acute and chronic graft-versus-host disease (GVHD) and remission duration. The survival of the DLI group was 66.4 percent at 10 and 15 years after transplantation, it was 42.2 and 23.8 percent respectively in the non-DLI group (p=0.019, log rank). Excluding patients with early relapse in the first 6 months the survival of the DLI group was 78 percent at 15 and 20 years, 70 and 26 percent respectively of the non-DLI group (p=0.009). Recurrent leukemia was the predominant cause of death in both groups (11 of 14 patients of the DLI-, 21 of 23 patients of the non-DLI group). Three patients in the DLI group died of recurrent infections, bronchiolitis obliterans (BO) and heart failure respectively, and 2 patients of BO in the non-DLI group. The proportion of surviving patients with positive PCR for bcr/abl was not different in both groups (2 of 13 patients of the non-DLI and 7 of 30 patients in the DLI group). The better survival of the DLI group indicates a better control of residual leukemia by a persistent immune effect. The response to DLI was improved by simultaneous treatment with low doses of interferon-a and GM-CSF. The combination of these cytokines without DLI and transplantation remains to be defined in patients that do not tolerate or respond incompletely to Imatinib. The role of immunotherapy for induction and maintenance of remission is well established in transplant patients. Disclosures: No relevant conflicts of interest to declare.

Long Term Results of Stanford V Regimen and Highly Active Antiretroviral Therapy (HAART) In 59 Patients (pts) with HD and HIV Infection (HD-HIV)

Blood ◽  
2010 ◽  
Vol 116 (21) ◽  
pp. 4827-4827
Author(s):  
Michele Spina ◽  
Jean Gabarre ◽  
Salvatrice Mancuso ◽  
Alessandro Re ◽  
Clara Schiantarelli ◽  
...  
Keyword(s):  
Highly Active Antiretroviral Therapy ◽  
Conflicts Of Interest ◽  
Prognostic Score ◽  
Disease Free Survival ◽  
Long Term Results ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Free Survival

Abstract Abstract 4827 Background: The introduction of HAART has significantly improved the outcome of pts with HD-HIV. However there are no data on the long term follow-up of HD-HIV pts treated with conventional chemotherapy (CT) regimens. In 2002, we reported the results of a prospective phase II study with the intensive 12-week CT with adjuvant radiotherapy (Stanford V) and concomitant HAART in 59 pts (Spina et al. Blood 2002;100:1984-1988). Methods: To analyze the long term outcome of patients included in the Stanford V and HAART protocol. Results: The median follow-up is 67months (range 3–156 months The 5-yr overall survival (OS), freedom from progression (FFP), disease free survival and event free survival are 54%, 52%, 60% and 37%, respectively. The 5-year OS is significantly different in pts with an international prognostic score (IPS) >2 in comparison to that of pts with an IPS <3 (84% vs 36%, p= 0.0005). Similarly, the percentages of FFP at 5 years in these groups are 72% and 45% (p= 0.03). Conclusions: Our data confirm the long term efficacy of Stanford V regimen in combination with HAART in HD-HIV. However, Stanford V is significantly less effective in pts with IPS>2 and therefore new strategies be tested in this setting. Supported by AIRC and ISS grants. Disclosures: No relevant conflicts of interest to declare.

Long-term prospective study of lumbosacral discectomy

1987 ◽  
Vol 67 (1) ◽  
pp. 49-53 ◽  
Author(s):  
P. Jeffrey Lewis ◽  
Bryce K. A. Weir ◽  
Robert W. Broad ◽  
Michael G. Grace
Keyword(s):  
Back Pain ◽  
Prospective Study ◽  
Leg Pain ◽  
Long Term Results ◽  
Complete Relief ◽  
Term Outcome ◽  
Relative Significance ◽  
Long Term Outcome ◽  
Preoperative Factors

✓ A long-term prospective study of 100 patients undergoing lumbosacral discectomy was carried out in an attempt to delineate the natural history of these patients and to assess the relative significance of preoperative factors as determinants of long-term outcome. Neurological findings were documented preoperatively and at 1 month, 1 year, and 5 to 10 years postoperatively. A questionnaire using subjective and objective data was given to patients at 1 year and 5 to 10 years postoperatively. An 83% long-term follow-up result was obtained. At a minimum of 5 years postoperatively, 62% of patients had complete relief of back pain and 62% had complete relief of leg pain; 96% were pleased that they had submitted to surgery and 93% were able to return to work. Nine percent reported that their back pain at 5 to 10 years was as severe as or worse than preoperatively and 11% reported that their leg pain was as severe as or worse than preoperatively. The reoperation rate was 18%. Preoperative factors found to be significantly associated with outcome at 1 year postoperatively were not significantly associated with outcome at 5 to 10 years postoperatively. The results of lumbosacral discectomy appear favorable as evaluated in this study. Preoperative factors useful as predictors of short-term outcome are much less reliable when considering the long-term results.

Mo1900 The Long Term Outcome After the Treatment of Different Subtypes of Achalasia Using High Resolution Manometry

2014 ◽  
Vol 146 (5) ◽  
pp. S-686-S-687 ◽  
Author(s):  
Hiroko Hosaka ◽  
Motoyasu Kusano ◽  
Akiyo Kawada ◽  
Shiko Kuribayashi ◽  
Yasuyuki Shimoyama ◽  
...  
Keyword(s):  
High Resolution ◽  
Term Outcome ◽  
Long Term Outcome ◽  
High Resolution Manometry

scholarly journals Long Term Outcome Following Splenectomy in Children

Blood ◽  
2018 ◽  
Vol 132 (Supplement 1) ◽  
pp. 5887-5887
Author(s):  
Tugberk Akca ◽  
Zafer Salcioglu ◽  
Gonul Aydogan ◽  
Tuba Nur Tahtakesen Güçer ◽  
Cengiz Bayram ◽  
...  
Keyword(s):  
Hereditary Spherocytosis ◽  
Conflicts Of Interest ◽  
Thalassemia Major ◽  
Long Term Results ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Disease Response ◽  
Hematologic Diseases ◽  
Age Of Diagnosis

Abstract Aim: The aim of the study is to evaluate the efficacy, complications and long term results of splenectomy in children with hematologic diseases. Patients and Methods: This study includes retrospective analysis of the medical records of 158 children between 0-18 years old who underwent splenectomy due to hematologic diseases from 1989 to 2017. Gender, splenectomy indications, age of diagnosis, splenectomy age, vaccination status, splenectomy outcomes, complications and mortality were evaluated. Results: Of the cases, 88 (55.7%) were female and 70 were male (44.3%). Indications for splenectomy were hereditary spherocytosis in 59 (37.3%), immune thrombocytopenia (ITP) in 50 (31.6%) and thalassemia major in 40 (25.3%) children. The median age of diagnosis was 3.9 years, the median splenectomy age was 9.2 years, the median time from diagnosis to splenectomy was 5.3 years in all cohort. Mean follow-up time of patients after splenectomy was 7.3±5.2 years. All patients except one were immunized before splenectomy. Responses were assessed based on standart criteria for each disease. Response was seen in 94.7% of patients with hereditary spherocytosis and 80% of ITP patients. Twenty-two percent of splenectomised children with thalassemia major had a decrease in transfusion frequency. Infections following splenectomy were reported in 22.8%. One patient had thrombosis related to splenectomy, none of the cases had major bleeding. There was no death due to sepsis. One patient with ITP died due to Subacute Sclerosing Panencephilitis (SSPE). Conclusion: Splecetomy is associated with good remission rates following ITP and hereditary spherocytosis. Splenectomy should be performed only in selected cases with transfusion dependent thalassemia. Post-splenectomy sepsis is uncommon. Future studies should focus on health quality of life and cost analysis of splenectomy in children. Disclosures No relevant conflicts of interest to declare.

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