Long-Term Outcomes of External Dacryocystorhinostomy in the Age of Transcanalicular Microendoscopic Techniques

Purpose.This study aimed to evaluate long-term results of external dacryocystorhinostomy (DCR) at a tertiary eye care center specializing in lacrimal duct surgery in Germany.Methods.The medical records of 1010 patients with acquired nasolacrimal duct obstruction (NLDO), who had undergone lacrimal duct surgery at a tertiary eye care center, were reviewed. Only adult patients who had undergone external DCR were included. The evaluation included the following parameters: age, gender, duration of symptoms, patient satisfaction, previous dacryocystitis, complication rates, and surgical outcome.Results.154 eyes of 146 patients (14.5%) could be included in the study. The average age was64.1±29.7years. 66.4% of patients were females and 33.6% were males. Acute or chronic dacryocystitis was found in 81 patients (55.5%). Overall, 82.8% of patients had full resolution of symptoms. The success rate of external DCR for patients with previous episodes of dacryocystitis was 82.7% compared to 83.4% for patients without dacryocystitis in their medical history.Conclusion.In cases in which transcanalicular microendoscopic techniques are contraindicated (e.g., after dacryocystitis) or in complex cases where microendoscopic procedures have failed (revision surgery), external DCR is still the surgical treatment of choice with very good postoperative success.

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External dacryocystorhinostomy

Asian Journal of Ophthalmology ◽

10.35119/asjoo.v16i3.510 ◽

2019 ◽

Vol 16 (3) ◽

pp. 179-185

Author(s):

Li Ying Long ◽

Safinaz Mohd Khialdin ◽

Nazila Binti Ahmad Azli

Keyword(s):

Surgical Technique ◽

Success Rate ◽

Case Series ◽

Nasolacrimal Duct ◽

Nasolacrimal Duct Obstruction ◽

Retrospective Case ◽

Duct Obstruction ◽

Posterior Flap ◽

External Dacryocystorhinostomy ◽

External Dcr

Aim: To analyse the epidemiological data, surgical technique, success rate, and complications of patients who underwent external DCR in Hospital Selayang from January 2015 to December 2016. Method: Retrospective case series. Results: A total of 21 eyes of 20 patients who underwent external DCR from January 2015 to December 2016 were identified and reviewed. There were 15 females (75%) and 5 males (25%). Age ranged from 5 to 75 years old, with a median age of 56 years old (IQR 23). Twelve patients presented with epiphora while eight patients presented with symptoms of dacryocystitis. One case was congenital, two were secondary nasolacrimal duct obstruction and the rest were primary nasolacrimal duct obstruction. All patients underwent external DCR under general anaesthesia. Silicone tube were inserted in 21 eyes, of which all were removed 3 months after the surgery except one patient whom had his tube dislodged accidentally. The overall success rate was 90.5% (n = 19), which was defined as no or minimal intermittent epiphora or no reflux on lacrimal irrigation at 12 months postoperative. There was one patient who had a cerebrospinal fluid leak treated successfully with intravenous antibiotics. Conclusion: The surgical success rate for external dacryocystorhinostomy was comparable to that of the global success rate of external DCR. This is attributed to the application of surgical technique such as anterior suspended flap modification and posterior flap excision.

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Is catheter-directed foam sclerotherapy more effective than the usual foam sclerotherapy for treatment of the great saphenous vein?

Phlebology The Journal of Venous Disease ◽

10.1177/0268355518756503 ◽

2018 ◽

Vol 33 (9) ◽

pp. 646-652 ◽

Cited By ~ 3

Author(s):

Orsini Camillo

Keyword(s):

Saphenous Vein ◽

Great Saphenous Vein ◽

Statistical Significance ◽

Long Term Results ◽

Complication Rates ◽

Foam Sclerotherapy ◽

Occlusion Rate ◽

Long Term Experience

Objective This retrospective study presents the long-term results of catheter-directed foam sclerotherapy of the great saphenous vein. Method From January 2003 to June 2017, 277 patients with varices and great saphenous vein incompetence were treated with echo-guided foam sclerotherapy. Forty-six patients were treated with long-catheters guided by foam sclerotherapy. Foaming was carried out with sodium-tetra-decyl-sulphate. Results Results were examined in the two groups: A (long-catheters) and B (other procedures). The median overall follow-up was 52.1 months. In the A-group, the complete occlusion rate was 34/46 pts (73.9%) and partial occlusion was 10/46 (21.7%). In the B-group, respectively, 130/231 (56.2%) and 90/231 (38.9%). Comparisons between groups were statistically significant (p = 0.023; p = 0.021). Failures involved, respectively, 2/46 (4.3%) and 11/231 (4.7%) with no statistical significance. The complication rates were similar in the two groups. Conclusions In this long-term experience (median follow-up exceeding four years), foam-guided sclerotherapy of the great saphenous vein with a long-catheter turned out to be more effective than the usual foam-guided sclerotherapy.

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Transpancreatic biliary sphincterotomy for biliary access is safe also on a long-term scale

Surgical Endoscopy ◽

10.1007/s00464-019-07364-y ◽

2020 ◽

Vol 35 (1) ◽

pp. 104-112

Author(s):

Vilja Koskensalo ◽

Marianne Udd ◽

Mia Rainio ◽

Jorma Halttunen ◽

Matias Sipilä ◽

...

Keyword(s):

Abdominal Pain ◽

University Hospital ◽

Long Term Results ◽

Biliary Duct ◽

Complication Rates ◽

Biliary Sphincterotomy ◽

Significant Difference ◽

Upper Abdominal

Abstract Background Transpancreatic biliary sphincterotomy (TPBS) is an advanced cannulation method for accessing common bile duct (CBD) in endoscopic retrograde cholangiopancreatography (ERCP). If CBD cannulation is difficult, an endoscopist can open the septum between the pancreatic and biliary duct with a sphincterotome to gain access. Long-term results of this procedure are unclear. We wanted to evaluate the short- and long-term complications of TPBS on patients with native papilla and benign indication for ERCP. Patients and Methods ERCPs performed in Helsinki University Hospital between 2007 and 2013 were reviewed. The study group comprised 143 consecutive patients with TPBS and 140 controls (CG). Data were collected from patient records and a phone survey was performed as a follow-up ≥ 4 years after the index ERCP. Results Post-ERCP pancreatitis (PEP) developed in seven patients (4.9%) in TPBS and one patient (0.7%) in CG (p = 0.067). The rates of other acute complications were similar between the groups. ERCP ended with no access to CBD in four cases (2.8%) in TPBS. The median length of follow-up was 6 years in TPBS and 7 years in CG. During this period, three patients (2.1%) in TPBS and six patients (4.3%) in CG suffered from acute pancreatitis (AP) (p = 0.238). One (0.7%) patient in CG and none in TPBS developed chronic pancreatitis (CP). Abdominal pain was suffered by ten patients (6.9%) in TPBS and twelve patients (8.6%) in CG daily, whereas by six patients (4.2%) in TPBS and twelve patients (8.6%) in CG weekly. Conclusion TPBS is a useful procedure, with acceptable complication rates. No significant difference occurred between the groups when evaluating the short-term or long-term complications with a follow-up period of four to 10 years. Additionally, no significant differences occurred in upper abdominal pain, episodes of AP, or development of CP.

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3:54 PM Abstract No. 167 Long-term results of percutaneous biliary balloon dilatation and sequential upsizing of silastic transanastomotic stents for benign hepaticojejunostomy strictures: a tertiary care center experience

Journal of Vascular and Interventional Radiology ◽

10.1016/j.jvir.2018.01.189 ◽

2018 ◽

Vol 29 (4) ◽

pp. S74

Author(s):

K. Nagabhushan ◽

J R ◽

M. Thumu ◽

K. Sunilkumar

Keyword(s):

Balloon Dilatation ◽

Care Center ◽

Tertiary Care ◽

Long Term Results ◽

Tertiary Care Center

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Surgical treatment of hemorrhoids: a critical appraisal of the current options

ABCD Arquivos Brasileiros de Cirurgia Digestiva (São Paulo) ◽

10.1590/s0102-67202014000100016 ◽

2014 ◽

Vol 27 (1) ◽

pp. 66-70 ◽

Cited By ~ 12

Author(s):

Marlise Mello CERATO ◽

Nilo Luiz CERATO ◽

Patrícia PASSOS ◽

Alberto TREIGUE ◽

Daniel C. DAMIN

Keyword(s):

Surgical Treatment ◽

Postoperative Pain ◽

Treatment Options ◽

Surgical Techniques ◽

Postoperative Recurrence ◽

Long Term Results ◽

Published Data ◽

Complication Rates ◽

Recurrence Rates

Introduction : Surgical treatment of hemorrhoids is still a dilemma. New techniques have been developed leading to a lower rate of postoperative pain; however, they are associated with a greater likelihood of recurrence. Aim : To review current indications as well as the results and complications of the main techniques currently used in the surgical treatment of hemorrhoidal disease. Methods : A systematic search of the published data on the options for treatment of hemorrhoids up to December 2012 was conducted using Medline/PubMed, Cochrane, and UpToDate. Results : Currently available surgical treatment options include procedure for prolapse and hemorrhoids (PPH), transanal hemorrhoidal dearterialization (THD), and conventional hemorrhoidectomy techniques. Excisional techniques showed similar results regarding pain, time to return to normal activities, and complication rates. PPH and THD were associated with less postoperative pain and lower complication rates; however, both had higher postoperative recurrence rates. Conclusion : Conventional surgical techniques yield better long-term results. Despite good results in the immediate postoperative period, PPH and THD have not shown consistent long-term favorable results.

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Long-Term Results of Reconstruction with Pelvic Allografts after Wide Resection of Pelvic Sarcomas

The Scientific World JOURNAL ◽

10.1155/2014/605019 ◽

2014 ◽

Vol 2014 ◽

pp. 1-6 ◽

Cited By ~ 11

Author(s):

Mehmet Ayvaz ◽

Senol Bekmez ◽

M. Ugur Mermerkaya ◽

Omur Caglar ◽

Emre Acaroglu ◽

...

Keyword(s):

Functional Results ◽

Long Term Results ◽

Wide Resection ◽

Complication Rates ◽

Allograft Reconstruction ◽

Orthopedic Oncology ◽

Common Causes ◽

Pelvic Resection

Reconstruction after the resection of a pelvic tumor is a challenging procedure in orthopedic oncology. The main advantage of allograft reconstruction is restoration of the bony architecture of the complex pelvic region. However, high complication rates such as infection and allograft resorption had been reported in the literature. In this study, we aimed to retrospectively review nine patients treated with pelvic resection and structural pelvic allograft reconstruction. Functional results, complications, and survival of the patients and the allografts were evaluated. At a mean follow-up of 79 months, three patients were dead. Major complications were detected in eight of the nine patients. Infection (four of the nine patients) and allograft resorption (three of the nine patients) were the most common causes of failure. The cumulative survival of the patients was 66.7 percent at 70 months. However, allograft survival was only 26.7 percent at 60 months. Mean MSTS score was 69. In conclusion, we suggest that other reconstruction options should be preferred after pelvic resections because of the high complication rates associated with massive allograft reconstruction.

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Outcomes of external dacryocystorhinostomy and endoscopic endonasal dacryocystorhinostomy in the management of nasolacrimal duct obstruction

Nepalese Journal of Ophthalmology ◽

10.3126/nepjoph.v7i1.13165 ◽

2015 ◽

Vol 7 (1) ◽

pp. 39-46 ◽

Cited By ~ 3

Author(s):

S Duwal ◽

R Saiju

Keyword(s):

Success Rate ◽

Nasolacrimal Duct ◽

Nasolacrimal Duct Obstruction ◽

Endoscopic Endonasal ◽

Duct Obstruction ◽

Dence Interval ◽

External Dacryocystorhinostomy ◽

Group 2 ◽

External Dcr ◽

Group 1

Introduction: Dacryocystorhinostomy (DCR) is the treatment of choice for nasolacrimal duct obstruction. Although external DCR is regarded as the gold standard, endoscopic DCR is evolving as an equally-effective alternative. Objectives To compare the success rate of treating nasolacrimal duct obstruction by endoscopic endonasal method compared to the conventional DCR surgery.Materials and methods This prospective, comparative, non-randomised study was conducted in 2009 - 2010. Thirty consecutive patients undergoing endoscopic endonasal DCR (Group 1) and 30 consecutive patients undergoing external DCR (Group 2) between July 2009 and September 2010 at the oculoplasty unit of the Tilganga institute of ophthalmology were included in this study. A patent lacrimal passage on syringing and symptomatic improvement at six months after surgery was de¿ned as a successful outcome. The intraoperative and postoperative complications were also compared. Results Our study included 31 eyes of 30 patients in Group 1 and 34 eyes of 30 patients in Group 2. The success rate for endoscopic endonasal dacryocystorhinostomy was 90.3 % (95 % con¿dence interval 80 - 100) and external dacryocystorhinostomy was 94.1 % (95 % con¿dence interval 80 - 100). The difference of surgical success among the two methods was not statistically significant (p = 0.7). The rate of intra-operative and post-operative complications was similar in the two methods (p = 0.5). Conclusion: The short term outcomes and complication rates of endoscopic endonasal dacryocystorhinostomy and external dacryocystorhinostomy were similar.

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Long-Term Results of Neurological Outcome, Quality of Life, and Cosmetic Outcome After Cranioplastic Surgery: A Single Center Study of 202 Patients

Frontiers in Neurology ◽

10.3389/fneur.2021.702339 ◽

2021 ◽

Vol 12 ◽

Author(s):

Henrik Giese ◽

Jennifer Antritter ◽

Andreas Unterberg ◽

Christopher Beynon

Keyword(s):

Quality Of Life ◽

Regression Analysis ◽

Neurological Outcome ◽

Long Term Results ◽

Complication Rates ◽

Long Term Outcome ◽

Sf 36

Objective: An increased interest in the surgical procedures of decompressive craniectomy (DC) and subsequent cranioplasty (CP) has emerged during the last decades with specific focus on mortality and complication rates. The aim of the present study was to evaluate long-term neurological and cosmetic outcomes as well as Quality of Life (QoL) after CP surgery.Methods: We retrospectively reviewed the medical records of CP patients treated at our institution between 2004 and 2014 and performed a follow-up examination, with evaluation of neurological outcome using the modified Rankin Scale (mRS) and the Glasgow outcome scale (GOS), QoL (SF-36 and EQ-5D-3L). Furthermore, the cosmetic results after CP were analyzed.Results: A total of 202 CP-patients were included in the present study. The main indications for DC and subsequent CP were space-occupying cerebral ischemia (32%), traumatic brain injury (TBI, 26%), intracerebral or subarachnoid hemorrhage (32%) and infection (10%). During a mean follow-up period of 91.9 months 46/42.6% of patients had a favorable neurological outcome (mRS ≤ 3/GOS ≥ 4). Patients with ischemia had a significant worse outcome (mRS 4.3 ± 1.5) compared with patients after TBI (3.1 ± 2.3) and infectious diseases requiring CP (2.4 ± 2.3). The QoL analysis showed that <1/3rd of patients (31.2%) had a good QoL (SF-36) with a mean EQ-5D-VAS of 59 ± 26. Statistical analysis confirmed a significant worse QoL of ischemia patients compared to other groups whereas multivariate regression analysis showed no other factors which may had an impact on the QoL. The majority (86.5%) of patients were satisfied with the cosmetic result after CP and regression analysis showed no significant factors associated with unfavorable outcomes.Conclusion: Long-term outcome and QoL after CP were significantly influenced by the medical condition requiring DC. Early detection and evaluation of QoL after CP may improve the patient's outcome due to an immediate initiation of targeted therapies (e.g., occupational- or physiotherapy).

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