Assessment of Long-Term Outcomes Associated With a Lobulated Pedicled Nasal Mucosa Flap Technique for Endoscopic Dacryocystorhinostomy Without Stenting

Objective: This study describes a surgical approach wherein a lobulated pedicled nasal mucosa flap technique was employed for endoscopic dacryocystorhinostomy (EDCR) as a means of treating nasolacrimal duct obstructions. This study also assessed the long-term outcomes of this EDCR approach when implemented without stenting. Methods: This was a retrospective study of a total of 63 patients (67 eyes) treated for nasolacrimal duct obstructions between January 2011 and November 2016. All patients had undergone ophthalmic diagnosis followed by EDCR treatment using a lobulated pedicled nasal mucosa flap without stenting. Patients were then monitored for both anatomical patency and sustained symptom relief during the follow-up period in order to assess objective and subjective study outcomes. Results: Patients were followed for a mean of 25.3 ± 1.2 months (range: 24-28 months), with a 100% anatomical patency success rate (67/67) and a 94.03% symptomatic cure rate (63/67). There were no instances of complications. Conclusions: The use of a lobulated pedicled nasal mucosa flap technique for EDCR without stenting is a straightforward, effective, and safe approach that keeps bone exposure to a minimum while offering a high rate of satisfactory outcomes, making it a procedure worthy of consideration as a means of treating patients suffering from nasolacrimal duct obstructions.

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Long-Term Outcomes of Patients with Acromegaly - A Report from the Swedish Pituitary Register

Acta Endocrinologica ◽

10.1530/eje-21-0729 ◽

2022 ◽

Author(s):

Steinunn Arnardóttir ◽

Jacob Järås ◽

Pia Burman ◽

Katarina Berinder ◽

Per Dahlqvist ◽

...

Keyword(s):

High Rate ◽

Hormone Deficiency ◽

Visual Field Defects ◽

Mortality Data ◽

Pituitary Hormone ◽

Biochemical Control ◽

Long Term Outcomes ◽

Over Time

Objective: To describe treatment and long-term outcomes of patients with acromegaly from all health-care regions in Sweden. Design and Methods: Analysis of prospectively reported data from the Swedish Pituitary Register of 698 patients (51% females) with acromegaly diagnosed from 1991-2011. The latest clinical follow-up date was December, 2012, while mortality data were collected for 28.5 years until June, 2019. Results: The annual incidence was 3.7/million; 71% of patients had a macroadenoma, 18% had visual field defects, and 25% had at least one pituitary hormone deficiency. Eighty-two percent had pituitary surgery, 10% radiotherapy and 39% medical treatment. At the 5- and 10-year follow-ups, IGF-I levels were within the reference range in 69% and 78% of patients, respectively. In linear regression the proportion of patients with biochemical control including adjuvant therapy at 10 year follow-up increased over time with 1.23 % per year. The SMR (95% CI) for all patients was 1.29 (1.11-1.49). For patients with biochemical control at the latest follow-up, SMR was not increased, neither among patients diagnosed 1991-2000, SMR 1.06 (0.85-1.33) or 2001-2011, SMR 0.87 (0.61-1.24). In contrast, non- controlled patients at the latest follow up from both decades had elevated SMR, 1.90 (1.33-2.72) and 1.98 (1.24-3.14), respectively. Conclusions: The proportion of patients with biochemical control increased over time. Patients with biochemically controlled acromegaly have normal life expectancy while non-controlled patients still have increased mortality. The high rate of macroadenomas and unchanged age at diagnosis illustrates the need for improvements in the management of patients with acromegaly.

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Besonderheiten in der Nachsorge von gastrointestinalen Tumoren

DMW - Deutsche Medizinische Wochenschrift ◽

10.1055/s-0043-106884 ◽

2018 ◽

Vol 143 (05) ◽

pp. 324-333

Author(s):

Kerstin Artzner ◽

Nisar Malek

Keyword(s):

Colon Cancer ◽

High Rate ◽

Long Term Outcomes ◽

Retrospective Case ◽

Gastrointestinal Malignancies ◽

Cancer Network ◽

Compare And Contrast ◽

Recurrence Frequency

AbstractTreatment for gastrointestinal malignancies has evolved over the past two decades. Long-term outcomes have considerably improved, however a high rate of recurrence persists. With the exception of colon cancer, clear consensus strategies with regards to post-treatment surveillance are lacking. Current surveillance practices in non-colon cancer cases are inadequately based on retrospective case analyses and expert recommendations which are not uniformly consistent.This article presents the key follow-up aspects such as recurrence frequency, timing, localization, and therapeutic efficacy for the most common gastrointestinal tumors, and summarizes current recommendations for early detection of recurrence. In particular, we compare and contrast the recommendations of the German S3 guideline, the European Society for Medical Oncology (ESMO) and the American National Comprehensive Cancer Network (NCCN).

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Long-term outcomes of patients undergoing uncemented or cemented arthroplasty revision following metal-on-metal total hip arthroplasty failure: A retrospective observational study with a mean follow-up of 7 years

10.21203/rs.2.20209/v1 ◽

2020 ◽

Author(s):

Wenli Chen ◽

Mao Shuai ◽

Jinluan Lin ◽

Baomin Chen ◽

Mingdong Zhao ◽

...

Keyword(s):

Total Hip Arthroplasty ◽

Hip Arthroplasty ◽

Functional Outcomes ◽

High Rate ◽

Harris Hip Score ◽

Long Term Outcomes ◽

Total Hip ◽

Metal On Metal

Abstract Background A high rate of complications due to metal-on-metal (MoM) revisions has been relatively commonly documented. The purpose of this retrospective study was to compare the long-term outcomes of patients who had undergone uncemented or cemented total hip arthroplasty (THA) revision for prior primary MoM THA failure.Methods Data from 234 patients (234 hips) who underwent uncemented or cemented THA (UTHA or CTHA) for prior primary MoM THA failure during 2007 - 2018 were retrospectively analysed. Follow-up occurred 3 months, 6 months, 1 year, 2 years, and then every 1 year after conversion. The mean follow-up time was 84.15 months (range, 67 - 101 months). The primary endpoint was the modified Harris Hip Score (HHS). The secondary endpoint was the major orthopaedic complication rate.Results The HHS demonstrated statistically greater differences in the CTHA group than in the UTHA group 12 months after conversion. From the 12th month after conversion to the final follow-up, CTHA yielded better functional outcomes than UTHA. There were significant differences in the rates of re-revision, aseptic loosening, and periprosthetic fracture between the groups (10.3% for UTHA vs 2.5% for CTHA, p = 0.015; 16.3% for UTHA vs 5.9% for CTHA, p = 0.011; and 12.0% for UTHA vs 4.2% for CTHA, p = 0.045, respectively).Conclusion In the setting of revision for primary MoM THA failure, we found definite evidence of the superiority of CTHA over UTHA in terms of improving functional outcomes and decreasing the major orthopaedic complication rate.

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Favourable clinical outcomes following cemented arthroplasty after metal-on-metal total hip replacement: a retrospective study with a mean follow-up of 10 years

BMC Musculoskeletal Disorders ◽

10.1186/s12891-020-03797-y ◽

2020 ◽

Vol 21 (1) ◽

Author(s):

Weiguang Yu ◽

Meiji Chen ◽

Xianshang Zeng ◽

Mingdong Zhao ◽

Xinchao Zhang ◽

...

Keyword(s):

Total Hip Replacement ◽

Hip Replacement ◽

Recurrent Dislocation ◽

High Rate ◽

Functional Score ◽

Long Term Outcomes ◽

Total Hip ◽

Metal On Metal

Abstract Background Given the unexpected high rate of failure following metal-on-metal total hip replacement (MoM-THR), it is expected that more MoM-THR patients will experience revision. The long-term outcomes regarding the primary MoM-THR revised to cemented THR (CTHR) remain controversial. The purpose of this retrospective review was to evaluate the long-term outcomes of patients who underwent conversion from MoM-THR to CTHR. Methods A total of 220 patients (220 hips) who underwent a conversion of primary MoM-THR to CTHR from March 2006 to October 2016 were retrospectively reviewed. The primary outcomes were the functional outcomes assessed using the Harris hip scores (HHS) and major radiographic outcomes. Follow-ups occurred at 3 months, 6 months, 1 year, 2 years, and then every two years after revision. Results Mean follow-up was 10.1 years (5–13 years). Distinct improvements were detected in the mean HHS between the preoperative and last follow-up analysis (62.35[±8.49] vs. 84.70[±14.68], respectively, p < 0.001). The key orthopaedic complication rate was 18.2% (27/148). Seven (4.7%) cases experienced a CTHR failure at a mean of 3.4 (±1.2) years after revision MoM-THR, mostly attributed to recurrent dislocation. Conclusion CTHR might yield an acceptable functional score and a low rate of the key orthopaedic complications.

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Short and long-term outcomes of medical management of patients with a first episode of arrhythmic storm

European Heart Journal ◽

10.1093/ehjci/ehaa946.0357 ◽

2020 ◽

Vol 41 (Supplement_2) ◽

Author(s):

C.M Gonzalez De La Portilla-Concha ◽

J Acosta Martinez ◽

J.L Dominguez Cano ◽

M.R Caballero Valderrama ◽

A Abril Molina ◽

...

Keyword(s):

Catheter Ablation ◽

Confidence Interval ◽

Medical Management ◽

High Rate ◽

First Episode ◽

Long Term Outcomes ◽

All Cause Mortality ◽

Short And Long Term

Abstract Introduction There is few data about long-term outcomes of conservative management (without catheter ablation) of patients with a first episode of arrhythmic storm (AS) in the current context. This study analyzes the short and long-term outcomes of implantable cardioverter defibrillator (ICD) patients with a first episode of AS receiving non-interventional management. Methods Consecutive patients admitted with a first episode of AS between January 2008 and June 2019 receiving medical management without catheter ablation were included. AS was defined as 3 or more appropriate ICD therapies occurring during a 24 h span. Medical management included: correction of triggers, sedation/mechanical ventilation, antiarrhythmic drugs, ICD reprogramming and neuraxial modulation. Baseline clinical characteristics and follow-up data were recorded. All patients were followed every 6 months at the ICD office. The primary end-point was all-cause mortality. Results 60 patients (81% male, 62.8±16.2 years, 43% ischaemic, LVEF 35.4±14%) with a first episode of AS treated conservatively were included. Thirty-day survival was 96.5% and 1-year survival was 82%. During a median (interquartilic range) follow-up of 31 (6–69) months, 31 (51.7%) patients died (51.6% due to cardiovascular aetiology) and 35 (58.3%) patients were readmitted (48.5% due to recurrent arrhythmic events and 45.7% due to heart failure). Age [HR 1.05 (95% confidence interval: 1.01–1.08)] and end-diastolic diameter [HR 1.05 (95% confidence interval: 1–2)] were the strongest independent predictors of all-cause mortality. Conclusion Despite the severity of this entity, medical management (without catheter ablation) of a first episode of AS is reasonable given its good 30-day and 1-year survival. However, a high rate of AS recurrence and readmissions are observed during long-term follow-up. Efforts are needed in order to identify those patients with a first episode of AS that could benefit from an early catheter ablation strategy. Funding Acknowledgement Type of funding source: None

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Long-term outcomes of uncemented or cemented arthroplasty revision following metal-on-metal total hip arthroplasty failure: A retrospective observational study with a mean follow-up of 7 years

10.21203/rs.2.20209/v2 ◽

2020 ◽

Author(s):

Wenli Chen ◽

Mao Shuai ◽

Jinluan Lin ◽

Baomin Chen ◽

Mingdong Zhao ◽

...

Keyword(s):

Total Hip Arthroplasty ◽

Hip Arthroplasty ◽

Functional Outcomes ◽

High Rate ◽

Long Term Outcomes ◽

Total Hip ◽

Metal On Metal ◽

Cemented Arthroplasty

Abstract Background A high rate of metal-on-metal total hip arthroplasty (MoM-THA) has been well-known. The aim of this study was to compare the long-term outcomes of patients who had undergone uncemented or cemented THA(UTHA or CTHA) following initial MoM-THA failure. Methods Data from 234 patients (234 hips) who were treated with UTHA or CTHA following initial MoM-THA failure during 2007 - 2018 were retrospectively compared. Follow-up occurred 3 months, 6 months, 1 year, 2 years, and then every 1 year after conversion. The mean follow-up was 84.15 months (67 - 101 months). The primary endpoint was the Harris Hip Scores (HHS); secondary endpoint was the incidence of major orthopaedic complications. Results The HHS demonstrated statistically greater differences in Group CTHA than in Group UTHA 12 months after conversion. From the 12th month after conversion to the final follow-up, CTHA yielded superior functional outcomes than UTHA. Between-group noteworthy differences were observed regarding the rates of re-revision, aseptic loosening, and periprosthetic fracture (10.3% for UTHA vs 2.5% for CTHA, p = 0.015; 16.3% for UTHA vs 5.9% for CTHA, p = 0.011; and 12.0% for UTHA vs 4.2% for CTHA, p = 0.045, respectively). Conclusion In the setting of revision following initial MoM-THA failure, we found definite evidence of the superiority of CTHA over UTHA in regard to improving functional outcomes and decreasing the incidence of major orthopaedic complications.

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Long-term outcomes of uncemented or cemented arthroplasty revision following metal-on-metal total hip arthroplasty failure: A retrospective observational study with a mean follow-up of 7 years

10.21203/rs.2.20209/v3 ◽

2020 ◽

Author(s):

Wenli Chen ◽

Mao Shuai ◽

Jinluan Lin ◽

Baomin Chen ◽

Mingdong Zhao ◽

...

Keyword(s):

Total Hip Arthroplasty ◽

Hip Arthroplasty ◽

Functional Outcomes ◽

High Rate ◽

Long Term Outcomes ◽

Total Hip ◽

Metal On Metal ◽

Cemented Arthroplasty

Abstract Background: A high rate of metal-on-metal total hip arthroplasty (MoM-THA) has been well-known. The aim of this study was to compare the long-term outcomes of patients who had undergone uncemented or cemented THA(UTHA or CTHA) following initial MoM-THA failure.Methods: Data from 234 patients (234 hips) who were treated with UTHA or CTHA following initial MoM-THA failure during 2007 - 2018 were retrospectively compared. Follow-up occurred 3 months, 6 months, 1 year, 2 years, and then every 1 year after conversion. The mean follow-up was 84.15 months (67 - 101 months). The primary endpoint was the Harris Hip Scores (HHS); secondary endpoint was the incidence of major orthopaedic complications.Results: The HHS demonstrated statistically greater differences in Group CTHA than in Group UTHA 12 months after conversion. From the 12th month after conversion to the final follow-up, CTHA yielded superior functional outcomes than UTHA. Between-group noteworthy differences were observed regarding the rates of re-revision, aseptic loosening, and periprosthetic fracture (10.3% for UTHA vs 2.5% for CTHA, p = 0.015; 16.3% for UTHA vs 5.9% for CTHA, p = 0.011; and 12.0% for UTHA vs 4.2% for CTHA, p = 0.045, respectively). Conclusion: In the setting of revision following initial MoM-THA failure, we found definite evidence of the superiority of CTHA over UTHA in regard to improving functional outcomes and decreasing the incidence of major orthopaedic complications.

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Endoscopic-Powered Dacryocystorhinostomy Without Stenting: Long-term Outcomes of 120 Procedures

American Journal of Rhinology and Allergy ◽

10.1177/1945892418773638 ◽

2018 ◽

Vol 32 (4) ◽

pp. 303-309 ◽

Cited By ~ 4

Author(s):

Ejder Ciğer ◽

Mustafa K. Balci ◽

Seçil Arslanoğlu ◽

Erdem Eren

Keyword(s):

Functional Outcomes ◽

Nasolacrimal Duct ◽

Long Term Results ◽

Success Rates ◽

Long Term Outcomes ◽

Duct Obstruction ◽

The Mean ◽

Anatomical Success

Background The necessity of silicone stenting in endoscopic dacryocystorhinostomy (DCR) procedures is a controversial subject in the literature. Objective The purpose of the present study is to assess the long-term anatomical and functional outcomes of endoscopic-powered DCR (EP-DCR) without stenting or mucosal flaps. Methods One hundred twenty EP-DCR procedures were performed in 107 patients. Anatomical success was defined as a patent ostium on irrigation and functional success as free flow of dye from the ostium and resolution of epiphora. Results The mean follow-up was 46.5 months (range: 24–87). Of the 120 procedures, 13 were bilateral and 94 were unilateral. Anatomical and functional success rates of 92.5% were obtained. Conclusion EP-DCR without stenting is a safe and economic technique that provides satisfactory long-term results and could be considered as the treatment of choice for patients with postsaccal nasolacrimal duct obstruction.

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FA07.06: PERSISTENT DYSPHAGIA IS A RARE PROBLEM AFTER LAPAROSCOPIC NISSEN FUNDOPLICATION

Diseases of the Esophagus ◽

10.1093/dote/doy089.fa07.06 ◽

2018 ◽

Vol 31 (Supplement_1) ◽

pp. 15-15

Author(s):

Milena Nikolic ◽

Katrin Schwameis ◽

Georg Semmler ◽

Reza Asari ◽

Lorenz Semmler ◽

...

Keyword(s):

Conflicts Of Interest ◽

Nissen Fundoplication ◽

Symptom Relief ◽

Gastrointestinal Symptoms ◽

Laparoscopic Nissen Fundoplication ◽

Long Term Outcomes ◽

Clinical Issue ◽

Laparoscopic Nissen

Abstract Background Although around 30% of patients with gastroesophageal-reflux disease (GERD) are insufficiently treated with medical therapy, only 1% opt for surgical therapy. One of the reasons behind this multifactorial phenomenon is the described adverse effect of long term dysphagia or gastric bloating syndrome after surgical treatment. Aim of this study was to evaluate the most common side effects associated with anti-reflux surgery, as well as long term outcomes in a large cohort of highly surgically standardized patients after laparoscopic Nissen fundoplication (LNF). Methods Out of a prospective patients database including all patients that underwent anti-reflux surgery between 01/2003 and 01/2017 at our institution, 350 consecutive patients after highly standardized LF were included in this study. A standardized interview was performed by one physician assessing postoperative gastrointestinal symptoms, proton pump inhibitor intake (PPI), GERD-Health-related-Quality-of-Life (GERD-HRQL), Alimentary Satisfaction (AS), and patients overall satisfaction. Results After a median follow-up of 4 years, persistent dysphagia (PD) after LNF was observed in 8 (2%) patients, while postoperative gas-bloat syndrome in 45 (12.7%) cases. Endoscopic dilatation was needed in 7 (2%) patients due to dysphagia, and 19 (5%) patients underwent revision surgery due to recurrence of GERD. The postoperative GERD-HRQL total score was significantly reduced (2 (IQR, 0–4.3) vs. 19 (IQR, 17–32); P < 0.000) and the median alimentary satisfaction (AS) was 9/10. Heartburn relief was achieved in 83% of patients. Eighty-three percent of patients were free of PPI intake after follow up, whereas 4% of the patients reported irregular PPI-use. Conclusion LNF is a safe and effective surgical procedure with low postoperative morbidity rates and efficient GERD-related symptom relief. PD does not represent a relevant clinical issue when LNF is performed in a surgical standardized way. These results should be the benchmark to which long-term outcomes of new surgical anti-reflux procedures are compared. Disclosure All authors have declared no conflicts of interest.

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