Surgical Outcomes of Distal Pancreatectomy in Elderly Patients

2020 ◽  
pp. 000313482098257
Author(s):  
Derek Tessman ◽  
Jesse Chou ◽  
Saad Shebrain ◽  
Gitonga Munene
Keyword(s):  
Distal Pancreatectomy ◽  
Surgical Outcomes ◽  
Hospital Length ◽  
Hospital Length Of Stay ◽  
Improvement Program ◽  
Postoperative Myocardial Infarction ◽  
Significant Difference ◽  
Group A ◽  
Group B ◽  
The Impact

Background The extent to which age impacts surgical outcomes remains poorly characterized. This study aims to evaluate the impact of age on 30-day outcomes in patients after distal pancreatectomy. Methods Using the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) database (2017), distal pancreatectomy patients were identified and age-stratified, groups A (≤75 years) and B (>75 years). Outcomes included 30-day mortality, morbidity, readmissions, operative time (min), and hospital length of stay (LOS, days). Results Of 3042 total patients identified, 1686 (55.4%) were women. A total of 2649 patients (87.1%) were in group A. Overall, both groups had similar baseline characteristics with the exception of the following: diabetes mellitus (24.8% vs. 30.0%, P = .03), smoking (19.3% vs. 4.8%, P < .001), congestive heart failure (.5% vs. 1.8%, P = .010), hypertension (HTN) (47.9% vs. 72.5%, P < .001), bleeding disorders (3.1% vs. 5.3%, P = .036), the American Society of Anesthesiologists (ASA) (III-V) scores (67.6% vs. 85.5%, P < .001), and body mass index (29.2 [±6.7] vs. 27.4 [±5.6], P = .001). Deep surgical site infection was higher in group A (12.1% vs. 6.6%, P = .001), while acute renal failure (ARF) and postoperative myocardial infarction (MI) were higher in group B. 30-day readmissions were higher in group A (17.4% vs. 12.2%, P = .011) despite no statistically significant difference in LOS (7.10 [±6.36] vs. 7.30 [±4.93] days, P = .553) or overall morbidity (29.4% vs. 28.8%, P = .859). Conclusion(s) Those undergoing distal pancreatectomy experienced similar overall morbidity and mortality outcomes regardless of age. However, those older than 75 years had more cardiovascular risk factors, which may have contributed to their higher rates of postoperative ARF and MI.

scholarly journals The Impact of Visual Aids on the Retention of English Word Stress Patterns

2018 ◽  
Vol 7 (2) ◽  
pp. 225 ◽  
Author(s):  
Farid Ghaemi ◽  
Fahimeh Rafi
Keyword(s):  
English Word ◽  
Placement Test ◽  
Visual Aids ◽  
Word Stress ◽  
Significant Difference ◽  
Group A ◽  
Group B ◽  
The Impact ◽  
Stress Patterns

The present study aimed at comparing the effectiveness of three different techniques on learners’ long term memorization of English word stress patterns. After administering a quick placement test, 67 Iranian EFL elementary learners at language institutes were selected to participate in the study. Then they were divided into three groups. Before starting the instruction, a pretest was conducted to classify the participants’ abilities on word stress patterns. Then the new techniques were used to teach English word stress patterns. In all three groups, words were printed largely on a piece of paper and the syllables were clearly specified by dots. In group ‘A’, pronunciation and stress pattern of new words were taught aurally through the repetition of the words. In group ‘B’, all the procedure was exactly similar to that of group ‘A’, the only difference was that the stressed syllables were printed in bold. In group ‘C’, all the procedure was exactly similar to that of group ‘B’,  except that the stressed syllables were not only printed in bold, but also introduced by teacher’s hand gesture. After two weeks, a delayed posttest was conducted to check long term memorization of the word stress patterns. The results of the study indicated that there was a significant difference between pretest and delayed posttest in all three groups. But the most meaningful difference belonged to group ‘C’. That is, the participants in the third group (gesture group) outperformed those in the other groups. Finally, some implications and suggestions provided for further research.   

scholarly journals Comparisons of Visual and Surgical Outcomes after Reuse or Replacement of Dislocated in-the-Bag Intraocular Lens

2018 ◽  
Vol 2018 ◽  
pp. 1-4 ◽  
Author(s):  
Takayuki Baba ◽  
Tomohiro Nizawa ◽  
Toshiyuki Oshitari ◽  
Shuichi Yamamoto
Keyword(s):  
Visual Acuity ◽  
Endothelial Cell ◽  
Intraocular Lens ◽  
Refractive Error ◽  
Surgical Outcomes ◽  
Case Series ◽  
Cell Loss ◽  
Significant Difference ◽  
Group A ◽  
Group B

Purpose. To compare the visual and surgical outcomes after a reuse or a replacement of a dislocated in-the-bag intraocular lens (IOL). Methods. This was a retrospective, nonrandomized case series at a single ophthalmological institution. Cases with an in-the-bag dislocation of an IOL were treated by pars plana vitrectomy and the reuse or the replacement of the IOL. The lens was held by intrascleral fixation of the haptics of the IOL under both conditions. The same dislocated IOL was reused in 6 eyes (group A) or it was replaced with another IOL in the other 9 eyes (group B). The pre- and postoperative parameters analyzed included the visual acuity, refractive error, corneal endothelial cell density, and intraocular pressure (IOP). Results. There was no significant difference between the two groups in the postoperative visual acuity (P=0.388), refractive error (P=0.955), IOP (P=0.529), and endothelial cell loss (P=0.940). A breakage or a tilting of the IOL was observed and required replacement in three eyes in the reuse group (P=0.044). Conclusions. Half of the cases with reused in-the-bag dislocated IOL had a breakage or a tilting of the IOL. The replacement of the in-the-bag dislocated IOL is better than the reuse of the IOL with intrascleral haptics fixation.

Outcomes of Flank-Free Modified Supine Percutaneous Nephrolithotomy Based on BMI

2020 ◽  
pp. 1-6
Author(s):  
Esam Desoky ◽  
Khaled M. Abd Elwahab ◽  
Islam M. El-Babouly ◽  
Mohammed M. Seleem
Keyword(s):  
Percutaneous Nephrolithotomy ◽  
Supine Position ◽  
Normal Weight ◽  
Significant Difference ◽  
Group A ◽  
Morbid Obese ◽  
Group B ◽  
A Prospective Study ◽  
Nonobese Patients ◽  
The Impact

<b><i>Objective:</i></b> To evaluate the impact of body mass index (BMI) on the outcomes of percutaneous nephrolithotomy (PCNL) in the flank-free modified supine position. <b><i>Patients and Methods:</i></b> A prospective study was carried out in the urology department during the period from May 2015 to October 2019 on 464 patients admitted for PCNL. The patients were divided into 4 matched groups according to their BMI: group A, normal weight with 18.5 ≤ BMI &#x3c;25 kg/m<sup>2</sup>; group B, overweight with 25 ≤ BMI &#x3c;30 kg/m<sup>2</sup>; group C, obese with 30 ≤ BMI &#x3c;40 kg/m<sup>2</sup>; and group D, morbid obesity with BMI ≥40 kg/m<sup>2</sup>. All operative data as well as postoperative outcomes are recorded and compared to each other. <b><i>Results:</i></b> The 4 studied groups were matched regarding age. The comorbidities were slightly higher in groups C and D. The operative time and fluoroscopy time were slightly high in obese and morbid obese groups but with no significant difference. The rate of complications either major or minor was comparable in all groups. No significant difference was seen among all groups regarding hemoglobin loss, stone-free rate, hospital stay, and need for auxiliary procedures. <b><i>Conclusions:</i></b> The outcome of PCNL in flank-free modified supine position is not affected by changes in BMI. The procedure can be performed in obese and morbid obese patients safely with results similar to and comparable to nonobese patients.

Efficacy of Negative Pressure Wound Treatment in Preventing Surgical Site Infections after Whipple Procedures

2017 ◽  
Vol 83 (10) ◽  
pp. 1166-1169 ◽  
Author(s):  
Ryan Gupta ◽  
Geoffrey C. Darby ◽  
David K. Imagawa
Keyword(s):  
Negative Pressure ◽  
Average Rate ◽  
Surgical Site Infections ◽  
Whipple Procedure ◽  
Hospital Length ◽  
Hospital Length Of Stay ◽  
Tube Placement ◽  
Wound Treatment ◽  
Improvement Program ◽  
Significant Difference

Surgical site infections (SSIs) occur at an average rate of 21.1 per cent after Whipple procedures per NSQIP data. In the setting of adherence to standard National Surgery Quality Improvement Program (NSQIP) Hepatopancreatobiliary recommendations including wound protector use and glove change before closing, this study seeks to evaluate the efficacy of using negative pressure wound treatment (NPWT) over closed incision sites after a Whipple procedure to prevent SSI formation. We retrospectively examined consecutive patients from January 2014 to July 2016 who met criteria of completing Whipple procedures with full primary incision closure performed by a single surgeon at a single institution. Sixty-one patients were included in the study between two cohorts: traditional dressing (TD) (n = 36) and NPWT dressing (n = 25). There was a statistically significant difference (P = 0.01) in SSI formation between the TD cohort (n = 15, SSI rate = 0.41) and the NPWT cohort (n = 3, SSI rate = 0.12). The adjusted odds ratio (OR) of SSI formation was significant for NPWT use [OR = 0.15, P = 0.036] and for hospital length of stay [OR = 1.21, P = 0.024]. Operative length, operative blood loss, units of perioperative blood transfusion, intraoperative gastrojejunal tube placement, preoperative stent placement, and postoperative antibiotic duration did not significantly impact SSI formation (P > 0.05).

scholarly journals Impact of glycosylated haemoglobin (HbA1c) levels on outcomes in patients with myocardial infarction

2021 ◽  
Vol 8 (2) ◽  
pp. 186
Author(s):  
Prabhat Pandey ◽  
Neeraj Dokania ◽  
Pooja Pandey ◽  
Ajay Singh Raghuwanshi
Keyword(s):  
Myocardial Infarction ◽  
Glycosylated Hemoglobin ◽  
Age Group ◽  
Percentage Mortality ◽  
Coronary Syndrome ◽  
Significant Difference ◽  
Group A ◽  
Group B ◽  
The Impact ◽  
Hba1c Levels

Background: People with diabetes have an increased prevalence of atherosclerosis and coronary heart disease (CHD) and experience higher morbidity and mortality after acute coronary syndrome and myocardial infarction than people without diabetes. Diabetes also appears to be a major cause of the higher rate of both short and long-term mortality observed in women hospitalized with acute MI compared to men. Objective of the study was to observe the impact of glycosylated hemoglobin (HbA1c) levels on outcomes in MI.Methods: The prospective observational study was conducted on 200 patients from the age group more than 36 years and lesser than 95 years presented with acute myocardial infarction (STEMI or NSTEMI). Patients were divided into group A (Diabetics) and group B (non-diabetics). Investigations performed were FBS, RBS, HbA1c, CBC, LFT, RFT, lipid profile, ECG and echocardiography. Patients were followed up till discharge/death and all complications like arrhythmias, cardiac failure, cardiogenic shock and re infarction were noted.Results: Majority of the 34.5% patients belongs to the age group of 56-65 years. No significant difference found between the subject population of the diabetic and non-diabetic group. The percentage of mortality in male patients was reported higher in the group having HbAlc level ≥7 (21.15%) in comparison to a group having HbAlc level <7 (6.15%) whereas in females the percentage of mortality was 11.63% in the group having HbAlc ≥7 , higher than the group having HbAlc level <7, 2.5%. Percentage mortality was higher in the patients having HbAlc >7, in both groups’ patients aged below 60 years 14.81% and 17.65% in the group of patients aged above 60 years.Conclusions: Higher HbAlc level significantly affects the outcome of MI patients. The percentage mortality due to MI was higher in male with aged above 60 years and having HbAlc level >7.

PS01.196: SHORT-TERM AND MEDIUM-TERM OUTCOMES IN PATIENTS OVER 70 DIAGNOSED WITH OESOPHAGEAL CANCER

2018 ◽  
Vol 31 (Supplement_1) ◽  
pp. 105-105
Author(s):  
Anantha Madhavan ◽  
Nicola Wyatt ◽  
Charlotte Boreham ◽  
Alexander Phillips ◽  
S Michael Griffin
Keyword(s):  
Oesophageal Cancer ◽  
Conflicts Of Interest ◽  
Locally Advanced ◽  
Neoadjuvant Treatment ◽  
Major Complication ◽  
Radio Therapy ◽  
Significant Difference ◽  
Group A ◽  
Group B ◽  
The Impact

Abstract Background Oesophageal cancer incidence has increased over the last decade in the UK, particularly in older patients. Surgery, with or without perioperative chemotherapy, remains the gold standard treatment for patients with potentially curable disease. Currently, 41% of new cases of oesophageal cancer are in patients aged over 70. However, only 10% underwent surgery compared to 25% of those aged under 70. Concerns exist that advanced age may prejudice treatment decisions. The aim of our review is to evaluate the impact of age on outcomes in those undergoing planned curative treatment for oesophageal cancer. Methods A retrospective review of patients undergoing oesophagectomy for carcinoma between 2006 to 2016 at a single institution was performed. Patients were divided into two cohorts based on age at the time of diagnosis; under 70 years (Group A) and over 70 (Group B). Patients underwent a standardised staging protocol and treatment was decided by a multi-disciplinary team. Oesophagectomy was performed using a transthoracic approach with two field lymphadenectomy and perioperative chemo (radio) therapy used in those patients with locally advanced disease who were fit enough. Results There were 555 patients in Group A and 241 in Group B. Adenocarcinoma was the prevalent histological subtype in both cohorts: 76% (423) in Group A and 68% (165) in Group B. Median age at the time of diagnosis was 62 in Group A versus 74 in Group B. In Group A, 12% (18/343) did not receive neo-adjuvant treatment for locally advanced cancer versus 47% (101/212) in Group B (P < 0.001). Median hospital stay was longer in Group B (18 v 15 days P = 0.02). There was no significant difference in hospital mortality (Group A 1% vs Group B 2.4% P = 0.37) and major complication rate (Group A 14% vs Group B 20% P = 0.31). Two-year survival was 66% (adenocarcinoma) and 78% (SCC) in Group A compared to 60% (adenocarcinoma) and 64% (SCC) in Group B. Conclusion These results demonstrate that patients over 70 can be treated successfully with minimal additional risk to morbidity and mortality. However, these patients are more likely to be denied neoadjuvant treatment which may compromise their long-term outcomes. Disclosure All authors have declared no conflicts of interest.

Safety and feasibility of laparoscopic surgery for colorectal cancer in elderly patients (YSURG1401 study).

2016 ◽  
Vol 34 (4_suppl) ◽  
pp. 725-725
Author(s):  
Yosuke Atsumi ◽  
Masakatsu Numata ◽  
Toru Aoyama ◽  
Tsutomu Hayashi ◽  
Naoto Yamamoto ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Laparoscopic Surgery ◽  
Elderly Patients ◽  
Surgical Outcomes ◽  
Operation Time ◽  
University Hospital ◽  
Age Group ◽  
Significant Difference ◽  
Group A ◽  
Group B

725 Background: The safety and feasibility of laparoscopic surgery (LAP) for colorectal cancer has not yet been fully evaluated in elderly patients. The aim of this study was to compare the short term surgical outcomes of LAP and evaluate the safety and feasibility of LAP in colorectal cancer patients aged > 75 years. Methods: This retrospective study enrolled consecutive patients who underwent laparoscopic surgery for colorectal cancer between April 2013 and March 2014 at Yokohama City University Hospital and its related general hospitals. The patients were categorized into two groups: elderly patients (≧75 years of age: group A) and non-elderly patients ( < 75 years of age: group B). Surgical outcomes and postoperative complications were compared between the two groups. The severity of complications was evaluated using the Clavien–Dindo classification. Results: A total of 237 patients were evaluated in the present study. Eighty-four patients were classified into group A, and 153 into group B. Preoperative clinicopathological outcomes demonstrated no significant differences except for the ASA score. When comparing the surgical outcomes between group A and group B, the rate of conversion to open procedure (3.6 % vs 5.2 %, P = 0.751), median operation time (232 min vs 232 min, P = 0.318), median blood loss (20 ml vs 12 ml, P = 0.353). There was no significant difference in the surgical outcomes. Although the incidence of Japanese D3 dissection was significantly lower in Group A (56 % vs 69.3 %, P = 0.047), the incidences of postoperative surgical complications of grade ≧ Ⅱ were similar between two groups (15.5 % vs 11.8 %, p = 0.427). The length of postoperative hospital stay was also similar (10days vs 10days, p = 0.347). Conclusions: The present study suggested that laparoscopic surgery for colorectal cancer is safe and feasible, regardless of the age of the patient, especially for elderly patients who may be candidates for colorectal cancer surgery.

Restructuring of inpatient rounds to improve quality of care in patients with cancer.

2018 ◽  
Vol 36 (30_suppl) ◽  
pp. 232-232
Author(s):  
Devika Govind Das ◽  
Courtney Williams ◽  
Kelly Nicole Godby ◽  
Gabrielle Betty Rocque ◽  
Pamela Cargo ◽  
...  
Keyword(s):  
Length Of Stay ◽  
Linear Models ◽  
Hospital Length ◽  
Patient Care Team ◽  
Primary Objective ◽  
Hospital Length Of Stay ◽  
Multidisciplinary Teams ◽  
Calendar Time ◽  
Significant Difference ◽  
The Impact

232 Background: Traditionally, hospital units function as multidisciplinary teams which work in silos and communicate via notes in the Electronic Health System. This often leads to communication breakdown, frequently translating to adverse clinical outcomes and prolonged hospital length of stay. Our primary objective was to introduce Inter-Professional Team (IPT) rounds on the oncology unit and evaluate the impact on length of stay (LOS) within a Plan, Do, Study, Act (PDSA) cycle. Methods: The care transition team planned the IPT rounds structure and training curriculum which included team goals, post-rounds structure for addressing barriers to care progression, and member roles/scripting. Change in LOS and case mix index (CMI)-adjusted LOS post-IPT round implementation ( Do) in July 2017 was analyzed ( Study) using hierarchical linear models for patients with an admission to the oncology service from September 2016 to March 2018. Beta coefficients (β) and 95% confidence intervals (CI) were estimated and models were adjusted for calendar time. Results: Ten attending medical oncologists participated in IPT round implementation. Of 889 oncology admissions, median LOS and CMI-adjusted LOS pre-IPT round implementation (n = 464) was 4 days (IQR 2-6) and 3 days (IQR 1.8-4.7), while post-IPT round implementation (n = 425) was 4 days (IQR 2-6) and 2.9 days (IQR 1.9-4.4), respectively. Three common reasons for admission were septicemia (n = 96), hematologic complications (n = 42, e.g. anemia/neutropenia), and renal failure (n = 25). Adjusted models for LOS and CMI-adjusted LOS showed no significant difference post-IPT round implementation (β = 0.8 days, 95% CI -0.7-2.3; β = 0.5 days, 95% CI -0.3-1.3, respectively) when compared to pre-implementation. Conclusions: We did not observe decreased LOS in early outcomes. However, IDT rounds built on TEAMSTEPPS 2.0 elements with incorporation of key principles desirable in a patient care team. Next steps include further analysis to better understand cancer stages and diagnoses contributing to longer LOS. We also plan to evaluate patient satisfaction, educational needs, and readmission rates to restructure ( Act) IPT rounds to better serve the needs of our unique patient population.

Perioperative complication rates following neoadjuvant therapy in pancreatic adenocarcinoma.

2020 ◽  
Vol 38 (4_suppl) ◽  
pp. 688-688
Author(s):  
Christopher R. Deig ◽  
Blake Beneville ◽  
Amy Liu ◽  
Aasheesh Kanwar ◽  
Alison Grossblatt-Wait ◽  
...  
Keyword(s):  
Length Of Stay ◽  
Neoadjuvant Therapy ◽  
Pancreatic Adenocarcinoma ◽  
Locally Advanced ◽  
Hospital Length ◽  
Hospital Length Of Stay ◽  
Complication Rates ◽  
Significant Difference ◽  
Perioperative Complication ◽  
The Impact

688 Background: Whether upfront resection or total neoadjuvant therapy is superior for the treatment of potentially resectable pancreatic adenocarcinoma (PDAC) remains controversial. The impact of neoadjuvant treatment on major perioperative complication rates for patients (pts) undergoing resection for PDAC is commonly debated. We hypothesized that rates would be comparable among patients receiving neoadjuvant chemoradiation (neo-CRT), neoadjuvant chemotherapy alone (neo-CHT), or upfront surgery. Methods: This is a retrospective study of 208 pts with PDAC who underwent resection within a multidisciplinary pancreatico-biliary program at an academic tertiary referral center between 2011-2018. Data were abstracted from the medical record, an institutional cancer registry and NSQIP databases. Outcomes were assessed using χ2, Fisher’s exact test and two-tailed Student’s t-tests. Results: 208 pts were identified: 33 locally advanced, borderline or upfront resectable pts underwent neo-CRT, 35 borderline or resectable pts underwent neoadjuvant-CHT, and 140 resectable pts did not undergo neoadjuvant therapy. There were no statistically significant differences in major perioperative complication rates between groups. Overall rates were 36.4%, 34.3%, and 26.4% for pts who underwent neo-CRT, neo-CHT alone, or upfront resection, respectively (p = 0.38). No significant difference were observed in complication rates (35.3% v. 26.4%; p = 0.19) or median hospital length of stay (10 days v. 10 days; p = 0.87) in pts who received any neoadjuvant therapy versus upfront resection. There were two perioperative deaths in the neo-CRT group (6.1%), zero in the neo-CHT group, and four in the upfront resection group (2.9%); p = 0.22. Conclusions: There were no significant differences in major perioperative complication rates, hospital length of stay, or post-operative mortality in pts who underwent neoadjuvant therapy (neo-CRT or neo-CHT alone) versus upfront surgery. Notably, neo-CRT had comparable perioperative complication rates to neo-CHT alone, which suggests neoadjuvant radiation therapy may not pose additional surgical risk.

P–318 Short (seven days) versus conventional (fourteen days) estrogen priming in an artificial frozen embryo transfer cycle: a randomised controlled trial

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
A Racca ◽  
S Santos-Ribeiro ◽  
D Panagiotis ◽  
L Boudry ◽  
S Mackens ◽  
...  
Keyword(s):  
Pregnancy Rate ◽  
Embryo Transfer ◽  
Live Birth ◽  
Transvaginal Ultrasound ◽  
Clinical Pregnancy ◽  
Frozen Embryo Transfer ◽  
Significant Difference ◽  
Group A ◽  
Group B ◽  
The Impact

Abstract Study question What is the impact of seven days versus fourteen days’ estrogen (E2) priming on the clinical outcome of frozen-embryo-transfer in artificially prepared endometrium (FET-HRT) cycles? Summary answer No significant difference in clinical/ongoing pregnancy rate was observed when comparing 7 versus 14 days of estrogen priming before starting progesterone (P) supplementation. What is known already One (effective) method for endometrial preparation prior to frozen embryo transfer is hormone replacement therapy (HRT), a sequential regimen with E2 and P, which aims to mimic the endocrine exposure of the endometrium in a physiological cycle. The average duration of E2 supplementation is generally 12–14 days, however, this protocol has been arbitrarily chosen whereas, the optimal duration of E2 implementation remains unknown. Study design, size, duration This is a single-center, randomized, controlled, open-label pilot study. All FET-HRT cycles were performed in a tertiary centre between October 2018 and December 2020. Overall, 150 patients were randomized of whom 132 were included in the analysis after screening failure and drop-out. Participants/materials, setting, methods The included patients were randomized into one of 2 groups; group A (7 days of E2 prior to P supplementation) and group B (14 days of E2 prior to P supplementation). Both groups received blastocyst stage embryos for transfer on the 6th day of vaginal P administration. Pregnancy was assessed by an hCG blood test 12 days after FET and clinical pregnancy was confirmed by transvaginal ultrasound at 7 weeks of gestation. Main results and the role of chance Following the exclusion of drop-outs and screening failures, 132 patients were finally included both in group A (69 patients) or group B (63 patients). Demographic characteristics for both groups were comparable. The positive pregnancy rate was 46.4% and 53.9%, (p 0.462) for group A and group B, respectively. With regard to the clinical pregnancy rate at 7 weeks, no statistically significant difference was observed (36.2% vs 36.5% for group A and group B, respectively, p = 0.499). The secondary outcomes of the study (biochemical pregnancy, miscarriage and live birth rate) were also comparable between the two arms for both PP and ITT analysis. Multivariable logistic regression showed that the HRT scheme is not associated with pregnancy rate, however, the P value on the day of ET is significantly associated with the pregnancy outcome. Limitations, reasons for caution This study was designed as a proof of principle trial with a limited study population and therefore underpowered to determine the superiority of one intervention over another. Instead, the purpose of the present study was to explore trends in outcome differences and to allow us to safely design larger RCTs. Wider implications of the findings: The results of this study give the confidence to perform larger-scale RCTs to confirm whether a FET-HRT can be performed safely in a shorter time frame, thus, reducing the TTP, while maintaining comparable pregnancy and live birth rates. Trial registration number NCT03930706

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