Effectiveness and Safety of Thermal Ablation in the Treatment of Primary Hyperparathyroidism: A Multicenter Study

Abstract Purpose To evaluate the effectiveness and safety of thermal ablation for primary hyperparathyroidism (pHPT). Materials and Methods From January 2015 to March 2020, data pertaining to patients who received thermal ablation for pHPT at 4 centers were retrospectively analyzed. The median follow-up duration was 18.1months (IQR: 6.5-42.2 months). A cure referred to the reestablishment of normal values of serum calcium and intact parathyroid hormone (iPTH) throughout the entire follow-up period, at least more than 6 months. The technical success, effectiveness, and safety of treatment were analyzed. Results 119 patients (mean age, 57.2 ± 16.3 years; 81 female) with 134 parathyroid nodules were enrolled. The mean maximum diameter of the parathyroid glands was 1.6 ± 0.9 cm. Ninety-six patients underwent microwave ablation (MWA), and 23 patients underwent radiofrequency ablation (RFA). The technical success rate was 98.3% and the cure rate was 89.9%. Significant differences were found in the maximum diameter between the cured patients and the patients who did not undergo ablation of the target lesions. Except the cases with pHPT nodules<0.6cm in diameter, the cure rate was 95%. There were no difference in cure rates at 6 months between the MWA and RFA (MWA vs. RFA, 90.6% vs. 87.0%; χ2=0.275, p = 0.699). The volume reduction rate of the ablation zone was 94.6% at 12 months. The complication rate was 6.7% (8/119). Except one patient with persistent voice impairment, other symptoms were spontaneously resolved within six months. Conclusion Thermal ablation was effective and safe for pHPT.

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Ultrasound-Guided Percutaneous Thermal Ablation of Hepatic Focal Nodular Hyperplasia——A Multicenter Retrospective Study

Frontiers in Bioengineering and Biotechnology ◽

10.3389/fbioe.2021.826926 ◽

2022 ◽

Vol 9 ◽

Author(s):

Xuan Yu ◽

Jiandong Chang ◽

Dezhi Zhang ◽

Qiang Lu ◽

Songsong Wu ◽

...

Keyword(s):

Success Rate ◽

Focal Nodular Hyperplasia ◽

Thermal Ablation ◽

Efficacy Rate ◽

Technical Success ◽

Technical Success Rate ◽

Nodular Hyperplasia ◽

Percutaneous Thermal Ablation ◽

The Mean

Background and Aim: To evaluate the clinical effect of ultrasound (US)-guided percutaneous thermal ablation of hepatic focal nodular hyperplasia (FNH).Methods: A retrospective analysis of the clinical data of patients undergoing US-guided percutaneous thermal ablation of FNH from November 2008 to August 2021 at five medical centers in China was conducted.Results: A total of 53 patients were included (26 males and 27 females). The mean age was 35.1 ± 10.8 years. Sixty-five lesions (46 solitary cases and 7 cases with multiple lesions) were included, 70.8% (46/65) of which were located in the right liver lobe. The mean tumor length was 2.9 ± 1.5 cm. All patients successfully completed the ablation treatment. Immediate postoperative imaging showed that the primary technical success rate was 94.3% (50/53). Two patients underwent ablation 3 and 6 months after the primary ablation, and the secondary technical success rate was 100% (2/2). The incidence of complications was 3.8% (2/53). Imaging follow-up was conducted regularly after ablation, and no residual lesion enlargement or tumor recurrence was observed during the follow-up period. The technique efficacy rate was 98.1% (52/53).Conclusion: US-guided percutaneous thermal ablation is a safe and effective treatment for FNH of the liver.

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Early and midterm results of ductal stent implantation in neonates with ductal-dependent pulmonary circulation: a single-centre experience

Cardiology in the Young ◽

10.1017/s104795112000267x ◽

2020 ◽

Vol 30 (12) ◽

pp. 1772-1782

Author(s):

Mehmet Akif Onalan ◽

Ender Odemis ◽

Murat Saygi ◽

Bahar Temur ◽

Selim Aydin ◽

...

Keyword(s):

Stent Implantation ◽

Single Ventricle ◽

Ductus Arteriosus ◽

Technical Success ◽

Technical Success Rate ◽

Pulmonary Flow ◽

Single Centre Experience ◽

The Mean ◽

Related Mortality

AbstractObjective:We aimed to determine the early and midterm outcomes of ductal stenting in neonates with ductal-dependent pulmonary blood flow.Methods:Between January, 2014 and July, 2018, 102 patients who underwent 115 cardiac catheterisation procedures for ductal stent implantation in our department were retrospectively reviewed. The age of the neonates ranged from 3 to 30 days (median: 11 days) and their weights ranged from 1.8 to 5.8 kg (mean, 2.8 ± 0.53 kg). Fifty-two patients had functional single ventricle and 50 had biventricular physiology. Thirty-one patients’ weights were <2,500 g (30.3%). The patent ductus arteriosus was vertical in 60 patients (58.8%). The mean ductal length was 12.4 ± 4.1 mm (range, 7.8–23 mm), and the mean narrowest ductal diameter was 2.1 ± 0.7 mm (range, 1.2–3.4 mm).Results:The technical success rate was 85.2%. Procedure-related mortality occurred in three patients (2.9%). After the procedure, the aortic oxygen saturation increased from a mean of 73.1 ± 6.2% to a mean of 90.4 ± 4.3% (p < 0.001), and the ductus diameter increased from a mean of 2.1 ± 0.7 mm to a mean of 4.2 ± 0.9 mm (p < 0.001). Either transcatheter or surgical reinterventions were required in 35 patients (34.3%) during the follow-up period after a median of 101 days (2–356 days). Thirty-three patients (32.3%) were bridged to surgical repair after a median of 288 days (163–650 days). The median duration of palliation with ductal stents was 210 days (range, 2–525 days).Conclusion:Ductus arteriosus stenting may be a reasonable and effective alternative to surgery for the initial palliation procedure in neonates with ductus-dependent pulmonary flow.

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Laser Ablation Versus Radiofrequency Ablation for Thyroid Nodules: 12-Month Results of a Randomized Trial (LARA II Study)

The Journal of Clinical Endocrinology & Metabolism ◽

10.1210/clinem/dgab102 ◽

2021 ◽

Author(s):

Roberto Cesareo ◽

Silvia Manfrini ◽

Valerio Pasqualini ◽

Cesare Ambrogi ◽

Gianfranco Sanson ◽

...

Keyword(s):

Radiofrequency Ablation ◽

Laser Ablation ◽

Success Rate ◽

Thyroid Nodules ◽

Reduction Rate ◽

Volume Reduction ◽

Technical Success ◽

Technical Success Rate ◽

Nodule Volume

Abstract Context Radiofrequency ablation (RFA) seems to achieve a significantly larger nodule volume reduction rate (VRR) than laser ablation (LA) in benign nonfunctioning thyroid nodules (BNTNs) Objective To compare the efficacy and safety of both treatments at 12-month follow-up in patients with solid or predominantly solid BNTN. Methods This was a single-center, 12-month, randomized, superiority, open-label, parallel-group trial conducted in an outpatient clinic. Sixty patients with a solitary BNTN or dominant nodule characterized by pressure symptoms/cosmetic problems were randomly assigned (1:1 ratio) to receive either a single session of RFA or LA. Twenty-9 patients per group completed the study. The main outcome measures were VRR and proportion of nodules with more than 50% reduction (technical success rate). Results At 12 months, VRR was 70.9 ± 16.9% and 60.0 ± 19.0% in the RFA and LA groups, respectively (P = .024). This effect was confirmed in the linear regression model that was adjusted for age, sex, nodule baseline volume, and proportion of cellular components (RFA treatment: β = .390; P = .009). No significant between-group difference was observed in the technical success rate at 12 months after treatment. A statistically significant improvement was observed from the baseline to the 12-month follow-up for compression (RFA: 4.6 ± 2.6 and 1.3 ± 0.8, P < .001; and LA: 4.6 ± 2.1 and 1.6 ± 0.8, respectively, P < .001) and cosmetic (RFA: 3.4 ± 0.6 and 1.3 ± 0.5, P < .001; and LA: 3.4 ± 0.5 and 1.4 ± 0.6, P < .001) scores although the between-group differences were not significant. Conclusion RFA achieved a significantly larger nodule volume reduction at 12 months; however, the technical success rate was similar in the RFA and LA groups.

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Complications and Cure Rates of Parathyroidectomy for Primary Hyperparathyroidism with Negative Localization Studies

Surgical Case Reports ◽

10.31487/j.scr.2021.01.19 ◽

2021 ◽

pp. 1-6

Author(s):

Bassam Abboud ◽

Georges Assaf ◽

Fares Yared ◽

Alaa El-Kheir

Keyword(s):

Primary Hyperparathyroidism ◽

Calcium Supplementation ◽

Recurrent Laryngeal Nerve Palsy ◽

Cure Rate ◽

Cervical Hematoma ◽

Group 3 ◽

Group 2 ◽

Cure Rates ◽

Group 1

Purpose: This paper evaluates the outcomes of parathyroidectomy for primary hyperparathyroidism with negative localization studies. Methods: All patients with primary hyperparathyroidism with negative preoperative ultrasound and MIBI scan who underwent parathyroidectomy were retrospectively included. Three groups were defined. Group 1 included the patients with negative ultrasound and MIBI. Group 2 included the patients with negative ultrasound and positive MIBI. Group 3 included the patients with positive ultrasound and negative MIBI. Results: In Group 1, 51% and 86% of patients had one adenoma and atypical localizations respectively. Unique adenoma and atypical localizations were showed in 87% and 93% of patients in Group 2 respectively. In Group 3, 83% and 17% of patients had one adenoma and atypical localizations respectively. No cervical hematoma was noted. Transient recurrent laryngeal nerve palsy occurred in 2 patients. Seven patients required postoperative calcium supplementation for 2 to 5 months, and one had recurrent hypercalcemia at follow-up. Cure rate was 98,3%. Conclusion: When US and MIBI were negative, multiple lesions and atypical localizations were frequent. The success rate and postoperative complications were not affected with this event.

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Long-term outcomes after endoscopic retrograde pancreatic drainage for symptomatic pancreaticojejunal anastomotic stenosis

Scientific Reports ◽

10.1038/s41598-021-84024-z ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Akihiko Kida ◽

Yukihiro Shirota ◽

Taro Kawane ◽

Hitoshi Omura ◽

Tatsuo Kumai ◽

...

Keyword(s):

Adverse Events ◽

Anastomotic Stenosis ◽

Technical Success ◽

Long Term Outcomes ◽

Endoscopic Retrograde ◽

Technical Success Rate ◽

Registration Number ◽

Clinical Trial Register

AbstractThere is limited evidence supporting the usefulness of endoscopic retrograde pancreatic drainage (ERPD) for symptomatic pancreaticojejunal anastomotic stenosis (sPJS). We examined the usefulness of ERPD for sPJS. We conducted a retrospective analysis of 10 benign sPJS patients. A forward-viewing endoscope was used in all sessions. Following items were evaluated: technical success, adverse events, and clinical outcome of ERPD. The technical success rate was 100% (10/10) in initial ERPD; 9 patients had a pancreatic stent (no-internal-flap: n = 4, internal-flap: n = 5). The median follow-up was 920 days. Four patients developed recurrence. Among them, 3 had a stent with no-internal-flap in initial ERPD, the stent migrated in 3 at recurrence, and a stent was not placed in 1 patient in initial ERPD. Four follow-up interventions were performed. No recurrence was observed in 6 patients. None of the stents migrated (no-internal-flap: n = 1, internal-flap: n = 5) and no stents were replaced due to stent failure. Stenting with no-internal-flap was associated with recurrence (p = 0.042). Mild adverse events developed in 14.3% (2/14). In conclusions, ERPD was performed safely with high technical success. Recurrence was common after stenting with no-internal-flap. Long-term stenting did not result in stent failure.Clinical trial register and their clinical registration number: Nos. 58-115 and R2-9.

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Long-Term Outcomes of Patients with Hydrocephalus Secondary to Tectal Plate Glioma versus Idiopathic Aqueductal Stenosis: Results from a Single Center

Pediatric Neurosurgery ◽

10.1159/000515516 ◽

2021 ◽

pp. 1-11

Author(s):

Hamid Reza Niknejad ◽

Melissa Frederickx ◽

Emiel Salaets ◽

Jurgen Lemiere ◽

Lieven Lagae ◽

...

Keyword(s):

Aqueductal Stenosis ◽

Maximum Diameter ◽

Benign Tumors ◽

Term Outcome ◽

Adequate Treatment ◽

Long Term Outcome ◽

Tectal Plate ◽

The Mean

Introduction: Tectal plate gliomas (TPG) constitute a distinct entity of benign tumors of the brain stem which show an indolent clinical course. Adequate treatment of secondary hydrocephalus is undoubtedly a major factor in the outcome. However, little is known about to what degree the tumor itself determines the long-term outcome of these patients. Methods: We retrospectively analyzed and compared the clinical and radiological data of 16 pediatric TPG patients with data of 12 pediatric idiopathic aqueductal stenosis (IAS) patients treated in our center from 1988 to 2018. For both groups, we assessed the long-term outcome in terms of hydrocephalus management, and for the TPG group, we assessed tumor growth during follow-up. In a separate prospective part of the study, we performed a neuropsychological evaluation in a subgroup of patients using a standardized testing battery, covering intelligence, learning, memory, executive functions, and an inventory on depression. Results: In the TPG group, the mean clinical and radiological follow-up was 84 and 70 months, respectively. On average, the maximum diameter of the tumor increased by 11% (p = 0.031) and the estimated tumor volume with 35% (p = 0.026) on radiological follow-up. The fronto-occipital horn ratio (FOHR) decreased by 23% on average after treatment. In the IAS group, the mean clinical and radiological follow-up was 117 and 85 months, respectively. In this group, the FOHR decreased by 21% on average. Neurocognitive testing revealed significant higher scores in the TPG group on global intelligence (TPG = 109, IAS = 85.5, U = 3, p < 0.01, z = −2.71), performance (TPG= 100, IAS = 85, U = 7, p = 0.03, z = −2.2), and verbal intelligence (TPG = 122, IAS = 91.5, U = 2, p < 0.00, z = −2.87) as well as working memory (TPG = 109.5, IAS = 77, U = 0.5, p = 0.01, z = −2.46). Conclusion: Our results suggest that the long-term outcome in TPG patients is acceptable and that cognition is substantially better preserved than in patients with IAS. This puts the idea of a significant contribution of the tumoral mass to disease outcome on the long term in question. Adequate and prompt management of hydrocephalus is the most important factor in long-term cognitive outcome.

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Endoscopic Stricturotomy Is an Efficacious Option for Management of Strictures in Patients With Inflammatory Bowel Disease

Crohn's & Colitis 360 ◽

10.1093/crocol/otaa069 ◽

2020 ◽

Vol 2 (4) ◽

Author(s):

Nabeeha Mohy-ud-din ◽

Gursimran S Kochhar

Keyword(s):

Inflammatory Bowel Disease ◽

Success Rate ◽

Bowel Disease ◽

Chart Review ◽

Common Complication ◽

Technical Success ◽

Technical Success Rate ◽

Safe Technique ◽

Inflammatory Bowel ◽

The Mean

Abstract Background Strictures are a common complication for patients with inflammatory bowel disease. Endoscopic stricturotomy (ESt) is a novel procedure for treatment of these strictures. Methods A chart review was performed for patients with strictures who underwent ESt. Results Eleven patients were included in the study and the total number of strictures treated was 12. The mean length of the strictures was 10.25 ± 4.36 mm. Technical success was achieved in 92% (n = 11) of the procedures. Postprocedural bleeding occurred in 9% (n = 1) of patients, and none of the patients had complications of infection or perforation. Conclusions ESt is a safe technique with high technical success rate.

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Pipeline embolization device treatment of internal carotid artery terminus aneurysms

Journal of NeuroInterventional Surgery ◽

10.1136/neurintsurg-2018-014312 ◽

2018 ◽

Vol 11 (5) ◽

pp. 485-488 ◽

Cited By ~ 5

Author(s):

Amit Pujari ◽

Brian Matthew Howard ◽

Thomas P Madaelil ◽

Susana Libhaber Skukalek ◽

Anil K Roy ◽

...

Keyword(s):

Carotid Artery ◽

Internal Carotid Artery ◽

Internal Carotid ◽

Treatment Strategies ◽

Maximum Diameter ◽

Class Iii ◽

Pipeline Embolization Device ◽

Proximal Internal Carotid Artery ◽

The Mean

BackgroundThe pipeline embolization device (PED) is approved for the treatment of large aneurysms of the proximal internal carotid artery (ICA). Its off-label application in treating aneurysms located specifically at the ICA terminus (ICA-T) has not been studied.MethodsWe conducted a retrospective chart review of patients from 2011 to 7 treated with PEDs. Out of 365 patients, 10 patients with ICA-T aneurysms were included. Patient demographics, procedural information, follow-up imaging, and clinical assessments were recorded.ResultsMean age was 46.9 years (± 8.8), and 6 (60%) patients were women. The mean maximum diameter of the aneurysms treated was 14.7 mm (± 10.7) and the mean neck diameter was 9.3 mm (± 6.6). Reasons for presentation included six incidental findings, one acute subarachnoid hemorrhage (SAH), and three patients with prior SAH. Kamran–Byrne Occlusion Scale scores for the treated aneurysms were as follows: three class IV (complete obliteration), four class III (<50% filling in both height and width for fusiform aneurysms or residual neck for saccular aneurysms), one class II fusiform aneurysm, 1 class 0 saccular aneurysm (residual aneurysm body), and one not classified due to pipeline thrombosis. Two clinically asymptomatic complications were noted: one patient who had a small distal cortical SAH post PED and one patient whose stent was found to be thrombosed on follow-up angiogram. All patients were seen in follow-up, and no patients were found to have worsening of their pre-procedure modified Rankin Scale score.ConclusionThe PED has potential for treating ICA-T aneurysms not amenable to conventional treatment strategies. Further studies are warranted to confirm the long term outcomes.

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Efficacy of a Single Dose versus Triple Dose Regimen of Mebendazole against Hookworm Infection among School Children: A Randomized, Single blinded Trial.

10.21203/rs.2.19725/v1 ◽

2019 ◽

Author(s):

Tegegne Eshetu ◽

Mulugeta Aemero ◽

Ayalew Jejaw

Keyword(s):

Single Dose ◽

Dose Regimen ◽

Reduction Rate ◽

Secondary Outcome ◽

Hookworm Infection ◽

Cure Rate ◽

School Aged Children ◽

Egg Reduction Rate ◽

Triple Dose

Abstract Background: The current control efforts against soil transmitted helminthic infection focused on reducing morbidity and transmission potential through periodic anthelminthic chemotherapy of single dose of mebendazole and albendazole regimen. Single dose mebendazole is one of extensively applicable drug regimen as a preventive chemotherapy in hookworm endemic areas. However, nowadays, studies reveal single dose treatment regimen has poor and unsatisfactory efficacy status against hookworm infection. We evaluated the efficacy status of single dose (500mg) versus triple dose (100mg) of mebendazole against hookworm infection among school aged children.Methods: This randomized, single-blinded clinical trial took place in a primary school on Burie and Debre Elias towns, Northwest Ethiopia among school-aged children (6-14). Using simple randomization, eligible hookworm positive children were randomly allocated (1:1) to either a single dose or triple dose of mebendazole arm. Stool samples were collected at baseline and follow-up period (14-21 days after treatment) for McMaster analysis. The primary and secondary outcome measures in this study were cure rate (CR) and egg reduction rate (ERR), respectively. Results were displayed using tables and figure. Independent t test was used to compare group means, logistic regression was used to calculate odds ratio (OR), and P-value < 0.05 at 95% CI was considered for statistical significance.Result: 109 children were allocated for each treatment arm and 103 children were completed the drug efficacy follow up study. Cure rate against hookworm was significantly higher in triple dose (96.1%) than in single dose (30.8%) with (OR=55.125; 95% CI: 11.92-254.9; P < 0.001). Egg reduction rate against hookworm infection in triple dose (99.5%) was also significantly higher than single dose (68.9%) with difference t (101) =5.38; 95% CI 230.95-505.36; P < 0.001.Conclusion: Single dose regimen of mebendazole for the treatment of hookworm infection showed poor efficacy, while triple dose revealed satisfactory efficacy. Therefore, we recommend for giving special emphasis on current deworming program which implemented through single dose mebendazole for hookworm endemic area.

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Long-Term Management of Recurrent Cholecystitis after Initial Conservative Treatment: Endoscopic Transpapillary Gallbladder Stenting

Canadian Journal of Gastroenterology and Hepatology ◽

10.1155/2018/3983707 ◽

2018 ◽

Vol 2018 ◽

pp. 1-7

Author(s):

Hideki Kamada ◽

Hideki Kobara ◽

Naohito Uchida ◽

Kiyohito Kato ◽

Takayuki Fujimori ◽

...

Keyword(s):

High Risk ◽

Acute Cholecystitis ◽

Success Rate ◽

Clinical Success ◽

Clinical Success Rate ◽

Technical Success ◽

Technical Success Rate ◽

High Risk Patients ◽

Risk Patients

Background. Endoscopic transpapillary gallbladder stenting (ETGBS) is an effective procedure for treating high-risk patients with acute cholecystitis and severe comorbidities. However, the efficacy of ETGBS for recurrent cholecystitis (RC) remains unclear. This study aimed to explore its efficacy in patients with RC for whom cholecystectomy is contraindicated because of its high surgical risk.Methods. Data on 19 high-risk patients who had undergone ETGBS for RC after initial conservative therapy in our institution between June 2006 and May 2012 were retrospectively examined. The primary outcome was the clinical success rate, which was defined as no recurrences of acute cholecystitis after ETGBS until death or the end of the follow-up period. Secondary outcomes were technical success rate and adverse events (AEs).Results. The clinical success rate of ETGBS was 100%, the technical success rate 94.7%, and AE rate 5%: one patient developed procedure-related mild acute pancreatitis. The clinical courses of all patients were as follows: four died of nonbiliary disease, and the remaining 15 were subsequently treated conservatively. The median duration of follow-up was 14.95 months (range 3–42 months).Conclusions. ETGBS is an effective alternative for managing RC in high-risk patients with severe comorbidities.

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