Successful reduction of clinical relevant neovascularization with a modified crossectomy combined with a barrier technique after 10-year follow-up

2012 ◽  
Vol 27 (8) ◽  
pp. 404-408 ◽  
Author(s):  
S Schnyder ◽  
S Gabler ◽  
T O Meier ◽  
C Thalhammer ◽  
F Magnetti ◽  
...  
Keyword(s):  
Varicose Veins ◽  
Perioperative Complications ◽  
Duplex Ultrasound ◽  
Duplex Sonography ◽  
Long Term Results ◽  
Life Questionnaire ◽  
Successful Reduction

Objective The aim of this retrospective study was to assess the long-term results of stripping the insufficient great saphenous vein (GSV) with stump coagulation, closure of the cribriform fascia and some additional measures, which will be described in detail. Methods Patients treated from 1998 to 1999 for varicose veins had been invited in 2009 for follow-up colour-coded duplex sonography and had been asked to answer a quality-of-life questionnaire. In 2009, the examinations for the study were conducted at a clinic of angiology by an independent and experienced sonographer. Results From a total of 165 patients, 91 (136 limbs) had been willing to participate in the study. Duplex ultrasound after a mean follow-up of 10.7 years revealed only clinically non-relevant (Ø < 0.3 cm) neovascularizations in 1.5% of all treated legs. No clinical relevant varicosities from the groin had developed. Conclusion The crossectomy combined with stump coagulation and suture of the fossa ovalis, completed with some additional measures, is a successful method to reduce neovascularization and recurrent varicosities, even for redo-crossectomies, without increasing the risk of perioperative complications.

scholarly journals A One-Year Audit of Varicose Vein Surgery at a Vascular Surgical Unit with a Long-Term Duplex and Quality of Life Follow-Up

2021 ◽  
pp. 1-8
Author(s):  
Olle Nelzén ◽  
Olle Nelzén ◽  
Ingvor Fransson
Keyword(s):  
Quality Of Life ◽  
Varicose Vein ◽  
Open Surgery ◽  
Varicose Veins ◽  
Long Term Results ◽  
Primary Surgery ◽  
One Year

Objective: With the introduction of endovenous treatments, open varicose veins surgery was discarded due to a claimed high risk of neovascularisation. A one-year audit was set up to look at results from performing mainly open surgery. Methods: All varicose vein interventions were registered and prospectively followed with colour Duplex assessments after 4-6 weeks, 1 and >5 years. In addition, Aberdeen Varicose Vein Questionnaire (AVVQ) was used in addition to Varicose Vein Severity Score (VCSS) to assess patients’ quality of life (QoL) and the disease severity. Results: During the year, 236 patients/252 legs were operated and 28% were re-do procedures. Median age was 55 years (16-87) and 70% were females. Duplex at 4-6 weeks showed a primary success rate of 91%. Neovascularisation was noted in 8% one year after primary surgery. The long-term assessment was done after a median of 69 months (39-75) and 67% of all legs were examined. After primary surgery 16% showed neovascularisation compared with and 27% after re-do procedures. VCSS improved significantly from 6 (range 1-22) to 2 at the long-term follow-up (p<0.001). The AVVQ score improved from 20 (range 3-55) down to 10 (p<0.001). Conclusion: The risk for neovascularisation seems to have been overestimated and good long-term results can be achieved following modern open surgery. The major problem is to avoid varicose vein recurrence since results from re-do procedures seem less favourable long term.

Relationships between duplex findings and quality of life in long-term follow-up of patients treated for chronic venous disease

2016 ◽  
Vol 31 (1_suppl) ◽  
pp. 88-98 ◽  
Author(s):  
Ying Huang ◽  
Peter Gloviczki
Keyword(s):  
Quality Of Life ◽  
Clinical Studies ◽  
Varicose Veins ◽  
Long Term Results ◽  
Venous Disease ◽  
Venous Surgery ◽  
Long Term Follow Up

Objective Relationships between duplex findings and data on health-related quality of life (QoL) to assess long-term results of treatment of varicose veins and chronic venous insufficiency (CVI) are not well known. The goal of this review was to correlate duplex findings and QoL assessments in clinical studies with long-term follow-up. Methods A review of the English language literature on PUBMED revealed 17 clinical studies, including 9 randomized controlled trials (RCTs), 6 prospective, and 2 retrospective studies that included patients with at least 5-year follow-up after endovenous laser ablation (EVLA), radiofrequency ablation (RFA), ultrasound-guided foam sclerotherapy (UGFS), and traditional superficial venous surgery. Results At 5 years, great saphenous vein (GSV) occlusion rate on duplex ultrasound ranged from 66% to 82% for EVLA, from 62% to 92% for RFA, from 41% to 58% for UGFS and from 54% to 85% for surgery. Freedom from GSV reflux rates were 82% and 84%, respectively for EVLA and surgery, and ranged between 84% and 95% for RFA. Significant improvements were observed in several domains of generic QoL and in most domains of venous disease-specific QoL, irrespective of the treatment. In at least one RCT, CIVIQ scores correlated well with abnormal duplex findings in patients who underwent treatment with UGFS. In another RCT, long-term AVVQ was significantly better after surgery as compared with UGFS similar to results of duplex findings. Conclusions Analysis of the available literature confirmed that all four techniques were effective in the abolishment of reflux or obliteration of the GSV. Moreover, well-designed RCTs with large sample size are needed to produce robust long-term data on clinical outcome after treatment of varicose veins and CVI and to better understand the relationships between duplex-derived data and QoL assessments.

scholarly journals Surgical management of recurrent disc herniations with microdiscectomy and long-term results on life quality: Detailed analysis of 70 cases

2016 ◽  
Vol 7 (01) ◽  
pp. 87-90 ◽  
Author(s):  
Serdal Albayrak ◽  
Sait Ozturk ◽  
Emre Durdag ◽  
Ömer Ayden
Keyword(s):  
Quality Of Life ◽  
Facet Joint ◽  
Lumbar Disc ◽  
Life Quality ◽  
Early Period ◽  
Long Term Results ◽  
Disc Herniations

ABSTRACT Background: Aim of this paper is to recall the surgical technique used in the recurrent lumbar disc herniations (LDHs) and to share our experiences. Materials and Methods: Out of series of 1115 patients who underwent operations for LDH between 2006 and 2013, 70 patients underwent re-operations, which were included in this study. During surgery, lateral decompression performed over the medial facet joint to the superior facet joint border was seen after widening the laminectomy defect, and microdiscectomy was performed. The demographic findings of the patients, their complaints in admission to hospital, the level of operation, the condition of dural injury, the first admission in the prospective analysis, and their quality of life were evaluated through the Oswestry scoring during their postoperative 1st, 3rd, 6th-month and 1st, 3rd, 5th and 7th-year follow-up. In the statical analysis, Friedman test was performed for the comparison of the Oswestry scores and Siegel Castellan test was used for the paired nonparametrical data. A P < 0.05 was considered statistically significant. Results: Considering the Oswestry Index during the follow-ups, the values in the postoperative early period and follow-ups were seen to be significantly lower than those at the time of admission to hospital (P < 0.05). None of the patients, who re-operated by microdiscectomy, presented with iatrogenic instability in 7 years follow-up period. Conclusion: Microdiscectomy performed through a proper technique in the re-operation of recurrent disc herniations eases complaints and improves the quality of life. Long-term follow-ups are required for more accurate results.

scholarly journals Urethroplasty with dorsal buccal mucosa graft. Is it still the method of choice in long term urethral stenosis?

2017 ◽  
Vol 89 (1) ◽  
pp. 42 ◽  
Author(s):  
Carlo Pavone ◽  
Dario Fontana ◽  
Ninfa Giacalone ◽  
Nino Dispensa ◽  
Marco Vella ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Buccal Mucosa ◽  
Maximum Flow ◽  
Screening Tests ◽  
Life Questionnaire ◽  
Urethral Stenosis ◽  
Buccal Mucosa Graft

The aim of our work was to evaluate the long-term changes in symptoms (median 42 months) and to analyze data for any negative predictive factors for the application of the procedure, in patients who underwent to urethroplasty with dorsal buccal mucosa graft. During the period from 2010 to 2015 27 patients were examined. Than they underwent urethroplasty using dorsal buccal mucosa graft (graft of 4 x 2.5 cm). The evaluation of symptoms has been addressed through the application of the IPSS Quality of Life Questionnaire (International Prostatic Symptoms Score) and the evaluation of urinary flow has been carried out by a comparative analysis between the pre- and post-operative uroflowmetry. As our study has shown, data obtained by the screening tests in the post-operative follow-up indicate that there is an increase in the maximum flow of urine until 1 month after surgery. The results in the long-term follow-up are different because they show a partial reduction of the maximum flow although it is maintained around an average value of 23 ml/s being still higher than the maximum flow in the pre-operative period. According to our results it follows that there is a low failure rate of the procedure after a median of 42 months. Only in patients with urethral stenosis longer than 2 cm, a lower long term success is achieved. From what we could observe, this length of the stenosis seems to be the only negative predictive factor for long-term maintenance of a good Quality of Life in patients undergoing the procedure. The results obtained from our study confirm literature data according to which, the gold standard for 2-cm long bulbar urethral stricture whose lumen is well preserved with circumferential spongiofibrosis limited to 1-2 mm is the dorsal graft urethroplasty with buccal mucosa that in our study showed success rates higher of 80% after a median follow up of 42 months and a percentage of relapse-free patients of 82.1% ( median 3.5 years).

Long-Term Follow-up after Robotic Cholecystectomy

2005 ◽  
Vol 71 (4) ◽  
pp. 281-285 ◽  
Author(s):  
Johannes Bodner ◽  
Elisabeth Hoeller ◽  
Heinz Wykypiel ◽  
Paul Klingler ◽  
Thomas Schmid
Keyword(s):  
Gallstone Disease ◽  
Long Term Results ◽  
Da Vinci Surgical System ◽  
Life Questionnaire ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Blood Tests ◽  
Robotic Cholecystectomy

Most surgeons gain their first clinical experience with surgical robots when performing cholecystectomies. Although this procedure is rather easily applicable for the da Vinci surgical system, the long-term outcome after this operation has not yet been clarified. This study follows up our institutional first series of robotic cholecystectomies (June to November 2001). Patients were assessed on the basis of standardized management including a quality-of-life questionnaire, clinical examination, blood tests, and abdominal sonogram. The follow-up rate for 23 patients after robotic cholecystectomy was 100 per cent and the median follow-up time 33 (30–35) months. There was one (4%) recurrence of gallstone disease in a patient who suffered from solitary choledocholithiasis 29 months after robotic cholecystectomy. Abdominal sonogram, clinical examinations, and blood tests revealed no post-cholecystectomy-specific pathological findings. The main long-term symptoms were bloating (57%), heartburn (43%) and nausea (30%). Of the patients, 96 per cent (22 patients) felt that the operation had cured or significantly improved their specific preoperative symptoms. Long-term results after robotic laparoscopic cholecystectomy are excellent and comparable to those for the conventional laparoscopic procedure. The advanced vision control and instrument maneuverability of robotic surgery might open minimally invasive surgery also for complicated gallstone disease and bile duct surgery.

scholarly journals Percutaneous Closure of PFO in Patients with Reduced Oxygen Saturation at Rest and during Exercise: Short- and Long-Term Results

2020 ◽  
Vol 2020 ◽  
pp. 1-8
Author(s):  
Céline De Cuyper ◽  
Tristan Pauwels ◽  
Eric Derom ◽  
Michel De Pauw ◽  
Daniël De Wolf ◽  
...  
Keyword(s):  
Oxygen Saturation ◽  
Clinical Symptoms ◽  
Systemic Circulation ◽  
Percutaneous Closure ◽  
Long Term Results ◽  
Sf 36 ◽  
Short And Long Term

Background. A patent foramen ovale (PFO) is a rare cause of hypoxemia and clinical symptoms of dyspnea. Due to a right-to-left shunt, desaturated blood enters the systemic circulation in a subset of patients resulting in dyspnea and a subsequent reduction in quality of life (QoL). Percutaneous closure of PFO is the treatment of choice. Objectives. This retrospective multicentre study evaluates short- and long-term results of percutaneous closure of PFO in patients with dyspnea and/or reduced oxygen saturation. Methods. Patients with respiratory symptoms were selected from databases containing all patients percutaneously closed between January 2000 and September 2018. Improvement in dyspnea, oxygenation, and QoL was investigated using pre- and postprocedural lung function parameters and two postprocedural questionnaires (SF-36 and PFSDQ-M). Results. The average follow-up period was 36 [12–43] months, ranging from 0 months to 14 years. Percutaneous closure was successful in 15 of the 16 patients. All patients reported subjective improvement in dyspnea immediately after device deployment, consistent with their improvement in oxygen saturation (from 90 ± 6% to 94 [92–97%] on room air and in upright position) (p<0.05). Both questionnaires also indicated an improvement of dyspnea and QoL after closure. The two early and two late deaths were unrelated to the procedure. Conclusion. PFO-related dyspnea and/or hypoxemia can be treated successfully with a percutaneous intervention with long-lasting benefits on oxygen saturation, dyspnea, and QoL.

Paclitaxel-based high-dose chemotherapy (HDCT) for relapsed or refractory germ cell tumors (GCTs): Clinical outcome and quality of life (QOL) in long-term survivors.

2012 ◽  
Vol 30 (5_suppl) ◽  
pp. 325-325
Author(s):  
Sumanta Kumar Pal ◽  
Virginia Sun ◽  
Courtney Carmichael ◽  
Betty R. Ferrell ◽  
Paul Henry Frankel ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Germ Cell Tumors ◽  
Progression Free Survival ◽  
High Dose Chemotherapy ◽  
High Dose ◽  
Life Questionnaire ◽  
Long Term Survivors

325 Background: HDCT is a viable and potentially curative approach for patients with relapsed or refractory GCTs. However, no comparative data exist to define the optimal chemotherapeutic strategy. Herein, long-term follow-up data and QOL assessments are provided for an expanded cohort of patients treated with high-dose paclitaxel, etoposide, carboplatin, and ifosfamide (TECTIC). Methods: Details of the TECTIC regimen and clinical follow-up data for an initial 33 patients have been previously reported (Margolin Biol Blood Marrow Trans 2005). Surviving patients were surveyed using a modified EORTC Quality of Life Questionnaire-30 (QLQ-C30) and the Functional Assessment of Cancer Therapy-Taxane (FACT-T) questionnaire; results were compared to relevant historical cohorts using a 2-sample t-test. Cardiovascular morbidity (CM) was ascertained through queries regarding use of antihypertensive (AH) or cholesterol-lowering (CL) agents, and presence/absence of diabetes mellitus (DM). Results: Forty-six patients received protocol-based therapy. Of these, 17 patients were progression-free at a median of 112.7 mos (49.5-170.2), and 6 patients remain alive following progression with a median overall survival (OS) of 64.4 mos (43.6-147.1). Median progression-free survival (PFS) and OS were 11.8 mos (95%CI 5.8-NR) and 21.7 months (95%CI 12.7-NR), respectively. Of the 23 patients still alive, 18 patients were accessible and consented to telephonic interview. As compared to historical cohorts (Rossen J Clin Oncol 2009), survivors had a higher global health scale score (87.04 v 75.62; P=0.02) but a lower physical functioning score (68.89 v 92.66; P=0.0001) by the QLQ-C30 scale. No difference in FACT-T scores were observed as compared to historical cohorts (Cella Cancer 2003). Four patients (22%) had DM. Three patients (17%) and 4 patients (22%) reported use of AH and CL agents, respectively. Conclusions: HDCT with the TECTIC regimen produces durable remissions in patients with relapsed or refractory GCTs, with acceptable QOL and CM in long-term survivors.

An Eight-year Follow-up to a Randomized Clinical Trial of Participant Satisfaction with Three Types of Mandibular Implant-retained Overdentures

2004 ◽  
Vol 83 (8) ◽  
pp. 630-633 ◽  
Author(s):  
R. Timmerman ◽  
G.T. Stoker ◽  
D. Wismeijer ◽  
P. Oosterveld ◽  
J.I.J.F. Vermeeren ◽  
...  
Keyword(s):  
Positive Impact ◽  
Controlled Trial ◽  
Long Term Results ◽  
Participant Satisfaction ◽  
Chewing Ability ◽  
Almost All ◽  
Mandibular Overdenture

Studies have shown that mandibular implant overdentures significantly increase satisfaction and quality of life of edentulous elders. Improved chewing ability appears to have a positive impact on nutritional state. Therefore, it is important to determine the best design of this prosthesis over the long term. In this randomized controlled trial, three groups of edentulous participants with atrophic mandibles wore 3 types of implant overdentures. During an eight-year follow-up, only seven of the 110 participants had dropped out of this study. Almost all participants were still satisfied with their overdentures. Participant satisfaction concerning retention and stability of the mandibular overdenture had decreased significantly in the two-implant ball attachment group, whereas the opinion of participants in the single- and triple-bar groups was still at the same level. The long-term results suggest that a mandibular overdenture retained by 2 implants with a single bar may be the best treatment strategy for edentulous people with atrophic ridges.

Single anastomosis or mini-gastric bypass: long-term results and quality of life after a 5-year follow-up

2015 ◽  
Vol 11 (2) ◽  
pp. 321-326 ◽  
Author(s):  
Matthieu Bruzzi ◽  
Cédric Rau ◽  
Thibault Voron ◽  
Martino Guenzi ◽  
Anne Berger ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Gastric Bypass ◽  
Mini Gastric Bypass ◽  
Long Term Results ◽  
Single Anastomosis

Health-Related Quality of Life in Patients Treated for Anaplastic Oligodendroglioma With Adjuvant Chemotherapy: Results of a European Organisation for Research and Treatment of Cancer Randomized Clinical Trial

2007 ◽  
Vol 25 (36) ◽  
pp. 5723-5730 ◽  
Author(s):  
Martin J.B. Taphoorn ◽  
Martin J. van den Bent ◽  
Murielle E.L. Mauer ◽  
Corneel Coens ◽  
Jean-Yves Delattre ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Long Term Results ◽  
Life Questionnaire ◽  
Health Related Quality ◽  
European Organisation ◽  
Related Quality ◽  
Health Related ◽  
Pcv Chemotherapy

Purpose Little is known about the health-related quality of life (HRQOL) of patients treated for anaplastic oligodendrogliomas. The impact of combined procarbazine, CCNU (lomustine), and vincristine (PCV) chemotherapy after radiotherapy (RT) compared with RT alone on HRQOL in the randomized European Organisation for Research and Treatment of Cancer (EORTC) 26951 trial was studied. Patients and Methods Adult patients with anaplastic oligodendrogliomas received RT alone or RT plus PCV chemotherapy. HRQOL was assessed with the EORTC Quality of Life Questionnaire C30 and Brain Cancer Module. Seven prespecified HRQOL end points were selected. We hypothesized that chemotherapy would impair HRQOL during treatment but that there would be a similar HRQOL between treatment arms once off treatment. Assessments were performed at randomization, at the end of RT, and then every 3 to 6 months until progression. Results A total of 368 patients were randomly assigned to one of the two arms; overall, 58% were male, and the median age was 49 years. Compliance with HRQOL was 78% at baseline and dropped to 55% to 72% up to 2.5 years post-RT. Baseline scores demonstrated considerable impairments in HRQOL for both treatment groups. The longitudinal analysis showed a significant increase in nausea/vomiting in the RT plus PCV chemotherapy arm during and shortly after chemotherapy. Because of a difference in baseline scores for fatigue and physical functioning, the differences between treatment arms during PCV did not reach significance. The nonselected scales of appetite loss and drowsiness demonstrated significant differences between treatment arms during chemotherapy in favor of the RT arm. The long-term results showed no difference between arms. Conclusion The major impact of PCV on HRQOL is on nausea/vomiting, loss of appetite, and drowsiness during and shortly after treatment. There are no long-term effects of PCV chemotherapy.

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