scholarly journals Concurrent Prophylactic Mastectomy, Immediate Reconstruction, and Salpingo-Oophorectomy in High-Risk Patients: A Case Series

2020 ◽  
Vol 28 (4) ◽  
pp. 243-248
Author(s):  
Josephine A. D’Abbondanza ◽  
Ralph George ◽  
Sari Kives ◽  
Melinda A. Musgrave
Keyword(s):  
High Risk ◽  
Prophylactic Mastectomy ◽  
Brca1 Mutation ◽  
Brca2 Mutation ◽  
Case Series ◽  
Complication Rates ◽  
Immediate Reconstruction ◽  
Dermal Matrix ◽  
High Risk Patients ◽  
Risk Patients

Purpose: There are limited data on coordinated breast and gynecological risk-reduction surgery for high-risk patients in Canada. Therefore, this study aims to evaluate the patient demographics, surgical details, and outcomes of prophylactic mastectomy (PM) with immediate reconstruction and bilateral salpingo-oophorectomy (BSO) in high-risk patients. Methods: We conducted a retrospective chart review at an academic center of patients who concurrently underwent PM with immediate reconstruction and laparoscopic BSO over a 7-year period (March 2010-February 2017) were identified. Results: A total of 16 patients underwent PM with immediate reconstruction and concurrent BSO. The mean age at the time of surgery was 46.2 ± 6.6 years. Thirteen (81%) patients were carriers of the BRCA1 or BRCA2 mutation. Two patients had prophylactic surgical therapy for BRCA1 mutation and 14 (87.5%) patients had prior oncological treatment. The most common type of procedures performed were skin-sparing, nipple-sparing mastectomy (56.2%) and reconstruction with acellular dermal matrix and implants (43.8%). All patients underwent laparoscopic BSO. The average combined case time was 282.5 ± 81.3 minutes with an average postoperative hospital stay of 1.3 ± 0.5 days. Six (37.5%) patients presented with 30-day postoperative complications, with higher rates in the alloplastic group. There were no gynecological complications. Conclusions: In conclusion, our results demonstrate that a combined multidisciplinary surgical approach did not increase length of stay or 30-day complication rates. Furthermore, concurrent risk-reducing strategies are an effective option for patients at high risk of breast or ovarian cancer.

scholarly journals Outcomes and risk factors of cholecystectomy in high risk patients: A case series

2020 ◽  
Vol 50 ◽  
pp. 35-40 ◽  
Author(s):  
A. Musbahi ◽  
P. Abdulhannan ◽  
J. Bhatti ◽  
R. Dhar ◽  
M. Rao ◽  
...  
Keyword(s):  
Risk Factors ◽  
High Risk ◽  
Case Series ◽  
High Risk Patients ◽  
Risk Patients

Evaluation of High-risk Patients Undergoing Spinal Surgery: A Matched Case Series

2010 ◽  
Vol 30 (5) ◽  
pp. 496-502 ◽  
Author(s):  
Nancy Hadley Miller ◽  
Elise Benefield ◽  
Laurel Hasting ◽  
Patrick Carry ◽  
Zhoaxing Pan ◽  
...  
Keyword(s):  
High Risk ◽  
Spinal Surgery ◽  
Case Series ◽  
High Risk Patients ◽  
Risk Patients ◽  
Matched Case

scholarly journals Treatment of acute colonic diverticular bleeding in high risk patients, using an over-the-scope clip: a case series

Endoscopy ◽  
2016 ◽  
Vol 48 (S 01) ◽  
pp. E383-E385 ◽  
Author(s):  
Edris Wedi ◽  
Daniel von Renteln ◽  
Carlo Jung ◽  
Irina Tchoumak ◽  
Victor Roth ◽  
...  
Keyword(s):  
High Risk ◽  
Case Series ◽  
Diverticular Bleeding ◽  
High Risk Patients ◽  
Risk Patients ◽  
Colonic Diverticular Bleeding ◽  
Over The Scope Clip

scholarly journals SuperNOVA Nasal Mask Ventilation Maintains Oxygenation during Deep Sedation in High-Risk Patients: A Case Series

2018 ◽  
Vol 3 (1) ◽  
pp. 15-19
Author(s):  
Rachel Kozinn ◽  
◽  
Lorraine Foley ◽  
Jessica Feinleib ◽  
◽  
...  
Keyword(s):  
High Risk ◽  
Deep Sedation ◽  
Case Series ◽  
Mask Ventilation ◽  
Nasal Mask ◽  
High Risk Patients ◽  
Risk Patients

scholarly journals 1024 The Use of the Pedicled Anterolateral Thigh (ALT) Flap for the Reconstruction of Abdominal Wall Defects in High-Risk Patients: A Case Series and Systematic Review

2021 ◽  
Vol 108 (Supplement_6) ◽  
Author(s):  
N Newall ◽  
C Jones ◽  
W Ho ◽  
A Curnier
Keyword(s):  
Systematic Review ◽  
High Risk ◽  
Abdominal Wall ◽  
Abdominal Wall Reconstruction ◽  
Case Series ◽  
Anterolateral Thigh Flap ◽  
Abdominal Wall Defects ◽  
High Risk Patients ◽  
Anterolateral Thigh ◽  
Risk Patients

Abstract Introduction The pedicled anterolateral thigh (ALT) flap is considered as a suitable option in complex abdominal wall reconstruction. Its use as a reconstructive option is infrequent in the literature, and to date, there has been no systematic review evaluating its long-term outcomes. We report our experience with the pedicled anterolateral thigh flap for abdominal wall reconstruction in high-risk patients. Method A prospective database was created for patients with abdominal wall defects treated with pedicled ALT with extended fascia lata flaps between 2014 and 2017. Patient demographics, aetiology, size, location of defect and post-operative results were reviewed. Abdominal defects were classified into the following zones: 1A, upper midline; 1B, lower midline; 2, upper quadrant; 3, lower quadrant. A systematic review of the literature was conducted using PUBMED and EMBASE. Results 4 patients (mean age 59.5 years, range 50-65 years) underwent reconstruction with pedicled ALT flaps. 3 flaps developed partial necrosis secondary to infection; 1 flap required surgical debridement, and 2 were managed conservatively. There was one flap failure, due to avulsion of the pedicle during inset. At mean follow up of 2.75 years (range 1 to 4 years) 3 patients have clinical bulging or herniation. Conclusions Review of the literature demonstrated 52 patients from 17 case series or reports. The overall infection and partial flap loss rates were both 6%. There were no reported flap failures. Our study demonstrates that the pedicled anterolateral thigh flap is an effective flap option for the repair of large defects of the abdominal wall in high-risk patients.

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