scholarly journals Minimally invasive video-assisted thyroidectomy: a critical analysis of long-term cosmetic results using a validated tool

2019 ◽  
Vol 101 (3) ◽  
pp. 180-185 ◽  
Author(s):  
M Sahm ◽  
R Otto ◽  
M Pross ◽  
R Mantke
Keyword(s):  
Minimally Invasive ◽  
Conventional Group ◽  
Long Term Results ◽  
Cosmetic Results ◽  
Assessment Score ◽  
Conventional Thyroidectomy ◽  
Video Assisted ◽  
Scar Assessment

Introduction Since its first publication in 1997, minimally invasive video-assisted thyroidectomy (MIVAT) has developed into the predominant minimally invasive surgery of the thyroid. A major advantage over conventional thyroid surgery is the superior cosmetic result. However, there are still few data comparing the long-term cosmetic results of the two methods. This paper compares the long-term cosmetic results of the two methods, based on follow-up assessments. Methods Between 2004 and 2011, 143 preselected patients underwent a MIVAT in our department. Additionally, 134 patients underwent a conventional thyroidectomy in our hospital in 2011. A total of 117 patients from the MIVAT group and 102 patients from the conventional thyroidectomy group received follow-up assessments after 23.1 and 23.6 months, respectively, using the patient and observer scar assessment scale. Results The measurable cervical scar length averaged 1.9 cm in the MIVAT group and 3.9 cm in the conventional group (P < 0.001). Some 11.1% of the patients in the MIVAT group and 7.1% of the patients in the conventional group had developed keloid (P = 0.391). The patient scar assessment score was 10.4 for the MIVAT group compared with 9.9 for the conventional thyroidectomy group (P = 0.691) and the observer scare assessment score was 8.6 for MIVAT compared with 9.9 for conventional thyroidectomy (P = 0.011). Conclusion In the patient assessment instrument, conventional thyroidectomy had a small advantage over MIVAT in the cosmetic long-term results. This difference between the two groups was, however, not significant. Our result contradicts short-term cosmetic results of published randomized studies with improvement for MIVAT. The Observer Score demonstrates a significant advantage of the MIVAT.

Open Surgical versus Minimally Invasive in Situ Femorodistal Bypass: Long-term Results

2003 ◽  
Vol 10 (1) ◽  
pp. 117-120 ◽  
Author(s):  
Nomdo S. Renken ◽  
Cees H.A. Wittens ◽  
Peter M.T. Pattynama ◽  
Nico A.J.J. Du Bois ◽  
Lukas C. van Dijk
Keyword(s):  
Minimally Invasive ◽  
Limb Salvage ◽  
Long Term Results ◽  
Open Technique ◽  
Treatment Groups ◽  
Closed Technique ◽  
Open Versus

Purpose: To compare long-term patency and limb survival rates for the classical in situ surgical bypass procedure versus a minimally invasive technique for femorodistal revascularization. Methods: From May 1992 to June 1994, a prospective multicenter study was undertaken at 4 centers to evaluate the open versus closed technique for femorodistal bypass grafting. Of 97 patients enrolled in the trial, 73 patients (49 men; mean age 71 years) were assigned to the long-term follow-up protocol and prospectively randomized to the open (n = 38) or closed (n = 35) procedure. The classical open technique is characterized by a long incision over the length of the bypass graft, while the minimally invasive procedure involves only two short incisions over each anastomosis site (the side branches are closed with a coaxial embolization catheter system). Graft patency was evaluated with duplex imaging periodically throughout the 4-year observation period. Results: There was no statistically significant difference between the treatment groups with respect to age, sex, hypertension, ischemic heart disease, or smoking. However, the open group had a significantly greater incidence of diabetes (p = 0.037). Over a median 4.7-year follow-up (range 0.3–6.4), 9 (12%) patients (3 open and 6 closed) were lost to follow-up: 2 died and 7 refused the duplex examination. No significant differences in 4-year patency, limb salvage, or survival was demonstrated between the open versus closed treatment groups; 4-year secondary patency was 62% versus 64%, respectively, and limb salvage was 72% versus 86%. Conclusions: The closed technique for femorodistal in situ bypass procedures yields favorable long-term outcomes compared to the traditional open technique.

Long-Term Results After Policization for Congenital Hand Deformities

Hand Surgery ◽  
1997 ◽  
Vol 02 (02) ◽  
pp. 79-85 ◽  
Author(s):  
Toshihiko Ogino ◽  
Seiichi Ishii
Keyword(s):  
Functional Results ◽  
Long Term Results ◽  
Pinch Strength ◽  
Cosmetic Results ◽  
Opposite Hand ◽  
Hand Deformities ◽  
The Mean ◽  
Congenital Hand Deformities

Thirteen patients — 18 hands — have been treated with pollicization and could be followed-up for 2 years to 19 years with an average of 7.9 years. Surgery was performed according to the Buck-Gramcko method. The mean age at the time of pollicization was 1.7 years. The parents were satisfied with the cosmetic results in all cases, and they were satisfied with the functional results in all except 4 hands. At follow-up, all patients could use the pollicized digit for pinch. Excellent pinch function has been achieved in 11 hands, good in 2, and fair in 1. The average percent pinch strength compared to the opposite hand was 55%. Association of a radial club hand and contracture of the pollicized digit and other fingers seemed to influence the postoperative pinch function.

Early clinical results of minimally invasive coracoclavicular ligament reconstruction can be maintained at a minimum of five years’ follow-up

2020 ◽  
Vol 102-B (7) ◽  
pp. 918-924
Author(s):  
Steffen B. Rosslenbroich ◽  
Katharina Heimann ◽  
Jan Christoph Katthagen ◽  
Clemens Koesters ◽  
Oliver Riesenbeck ◽  
...  
Keyword(s):  
Minimally Invasive ◽  
Constant Score ◽  
Clinical Results ◽  
Long Term Results ◽  
Short Term ◽  
Ac Joint ◽  
Ac Joint Dislocation ◽  
Significant Difference

Aims There is a lack of long-term data for minimally invasive acromioclavicular (AC) joint repair. Furthermore, it is not clear if good early clinical results can be maintained over time. The purpose of this study was to report long-term results of minimally invasive AC joint reconstruction (MINAR) and compare it to corresponding short-term data. Methods We assessed patients with a follow-up of at least five years after minimally invasive flip-button repair for high-grade AC joint dislocation. The clinical outcome was evaluated using the Constant score and a questionnaire. Ultrasound determined the coracoclavicular (CC) distance. Results of the current follow-up were compared to the short-term results of the same cohort. Results A total of 50 patients (three females, 47 males) were successfully followed up for a minimum of five years. The mean follow-up was 7.7 years (63 months to 132 months). The overall Constant score was 94.4 points (54 to 100) versus 97.7 points (83 to 100) for the contralateral side showing a significant difference for the operated shoulder (p = 0.013) The mean difference in the CC distance between the operated and the contralateral shoulder was 3.7 mm (0.2 to 7.8; p = 0.010). In total, 16% (n = 8) of patients showed recurrent instability. All these cases were performed within the first 16 months after introduction of this technique. A total of 84% (n = 42) of the patients were able to return to their previous occupations and sport activities. Comparison of short-term and long-term results revealed no significant difference for the Constant Score (p = 0.348) and the CC distance (p = 0.974). Conclusion The clinical outcome of MINAR is good to excellent after long-term follow-up and no significant differences were found compared to short-term results. We therefore suggest this is a reliable technique for surgical treatment of high-grade AC joint dislocation. Cite this article: Bone Joint J 2020;102-B(7):918–924.

scholarly journals Surgical Treatment of Low- and Intermediate-Risk Papillary Thyroid Cancer with Minimally Invasive Video-Assisted Thyroidectomy

2009 ◽  
Vol 94 (5) ◽  
pp. 1618-1622 ◽  
Author(s):  
Paolo Miccoli ◽  
Aldo Pinchera ◽  
Gabriele Materazzi ◽  
Agnese Biagini ◽  
Piero Berti ◽  
...  
Keyword(s):  
Thyroid Cancer ◽  
Minimally Invasive ◽  
Papillary Thyroid Cancer ◽  
Intermediate Risk ◽  
Papillary Thyroid ◽  
Conventional Thyroidectomy ◽  
Video Assisted ◽  
Group A ◽  
Group B

Abstract Background: Minimally invasive video-assisted thyroidectomy (MIVAT) was introduced in the clinical practice to treat small benign thyroid nodules. This method has recently been demonstrated to produce the same completeness as a conventional thyroidectomy in patients with papillary thyroid cancer (PTC). The low number of treated cases and the limited follow-up of these patients represent the major limitations of these studies. Objective: The aim of the study was to compare the outcome of two groups of PTC patients, one treated with MIVAT and the other with conventional thyroidectomy, after a median follow-up of 5 yr. Study Group: A total of 221 PTC patients were enrolled in this study according to the following criteria: 171 were treated with MIVAT (group A), and 50 were treated with conventional thyroidectomy (group B). Results: The outcome and the cumulative 131I activity administered to achieve curative status were compared. After a mean follow-up of 3.6 ± 1.5 yr (range, 1–8 yr; median, 5 yr), no differences were found between group A and group B. A similar rate of permanent hypoparathyroidism and/or nerve cord palsy was found in both groups. Conclusion: We demonstrated that PTC patients operated on with MIVAT had a good outcome after 5 yr. This was similar to the outcome of patients treated with conventional thyroidectomy and the same degree of exposure to 131I. These results, together with the evidence of a similar degree of completeness and rate of complications between the two surgical techniques, show that MIVAT is a valid option to treat low- and intermediate-risk PTC patients.

scholarly journals A Prospective Controlled Study on Long-Term Outcomes of Facial Lacerations in Children

2021 ◽  
Vol 8 ◽  
Author(s):  
Sonja Fontana ◽  
Clemens M. Schiestl ◽  
Markus A. Landolt ◽  
Georg Staubli ◽  
Sara von Salis ◽  
...  
Keyword(s):  
Treatment Time ◽  
Trial Registration ◽  
Long Term Results ◽  
Controlled Study ◽  
Tissue Adhesives ◽  
Scar Assessment ◽  
Group 2 ◽  
Group 1

Background: Although skin adhesives have been used for decades to treat skin lacerations, uncertainty remains about long-term results, and complications.Methods: In this prospective, controlled, single-blinded, observational cohort study, outcomes were assessed by five plastic surgeons with standardized photographs at 6–12 months using a modified Patient and Observer Scar Assessment Scale (POSAS) and Vancouver Scar Scale (VSS); additionally, the POSAS was performed by the patients/caregivers and the physician; pain, requirement of anesthesia, treatment time, costs, complications, and quality of live (QoL) were assessed.Results: A total of 367 patients were enrolled; 230 were included in the main analysis; 96 wounds were closed using tissue adhesives (group 1); 134 were sutured (group 2). Assessment by the independent observers revealed an improved mean modified overall POSAS score in group 1 in comparison with group 2 [2.1, 95% CI [1.97–2.25] vs. 2.5, 95% CI [2.39–2.63]; p &lt; 0.001, d = 0.58] and mean VSS score [1.2, 95% CI [0.981–1.34] vs. 1.6, 95% CI [1.49–1.79], p &lt; 0.001, d = 0.53]. At the early follow-up, dehiscence rate was 12.5% in group 1 and 3.7% in group 2 (p &lt; 0.001); later on, one dehiscence remained per group. Mild impairment of QoL was found at the early follow-up in both groups, with no impairment remaining later on. Duration of treatment and treatment costs were lower in group 1.Conclusion: Both modalities of wound closure yield favorable esthetic results, and complications are rare. Adhesives are more cost-effective, and its application is less time-consuming; therefore, tissue adhesives offer considerable advantages when used appropriately.Trial Registration: Public trial registration was performed at www.ClinicalTrials.gov (Identifier: NCT03080467).

Excellent long-term results with minimally invasive edge-to-edge repair in myxomatous degenerative mitral valve regurgitation

2020 ◽  
Vol 31 (1) ◽  
pp. 28-34 ◽  
Author(s):  
Igor Belluschi ◽  
Elisabetta Lapenna ◽  
Andrea Blasio ◽  
Benedetto Del Forno ◽  
Andrea Giacomini ◽  
...  
Keyword(s):  
Mitral Valve ◽  
Minimally Invasive ◽  
Cumulative Incidence ◽  
Cardiac Death ◽  
Competing Risk ◽  
Long Term Results ◽  
Left Ventricular Ejection ◽  
Myxomatous Degeneration

Abstract OBJECTIVES Previous series of minimally invasive mitral valve repairs showed excellent results at up to 10 years of follow-up. The goal of this study was to assess the long-term durability beyond 10 years of the edge-to-edge repair for myxomatous degeneration performed through a minimally invasive approach. METHODS Ninety-seven consecutive patients (mean age 35 ± 9 years; left ventricular ejection fraction 63 ± 6%) with severe myxomatous mitral regurgitation (MR) underwent mitral valve repair through a right minithoracotomy between 1999 and 2006. MR was due to lesions involving the posterior leaflet (7.2% of patients), anterior leaflet (12.4%) and both leaflets (80.4%). RESULTS No hospital deaths occurred. At hospital discharge all patients had no or trivial MR. Follow-up was 100% complete (median 15.5 years; interquartile range 13.6–17.0, max 19.3 years). The 16-year overall survival rate was 95.9 ± 2.02% [95% confidence interval (CI) 89.39–98.43]. At 16 years, the cumulative incidence function of cardiac death, with non-cardiac death as a competing risk, was 3.1 ± 1.75 (95% CI 0.83–8.02). Only 3 patients (4.1%) had redo operations for recurrent severe MR. At 16 years, the cumulative incidence functions of reoperation for and recurrence of MR ≥3+, with death as a competing risk, were 3.1 ± 1.76% (95% CI 0.83–8.02) and 5.6 ± 2.47% (95% CI 2.06–11.83), respectively. No predictors of recurrence of MR ≥3+ were identified. At the last follow-up, moderate MR (2+/4+) was detected in 17 patients (17.5%); most of the patients were in New York Heart Association functional class I–II (97%) and in sinus rhythm (90%). CONCLUSIONS Minimally invasive mitral valve edge-to-edge repair through a right minithoracotomy for myxomatous degeneration appears to be an effective and durable approach even in the long-term follow-up (up to 19 years).

Video-Assisted Minimally Invasive Parathyroidectomy: Benefits and Long-Term Results

2009 ◽  
Vol 33 (11) ◽  
pp. 2266-2281 ◽  
Author(s):  
Celestino P. Lombardi ◽  
Marco Raffaelli ◽  
Emanuela Traini ◽  
Carmela De Crea ◽  
Salvatore M. Corsello ◽  
...  
Keyword(s):  
Minimally Invasive ◽  
Minimally Invasive Parathyroidectomy ◽  
Long Term Results ◽  
Invasive Parathyroidectomy ◽  
Video Assisted

Long-term cosmetic results after minimally invasive video-assisted thyroidectomy

2011 ◽  
Vol 25 (10) ◽  
pp. 3202-3208 ◽  
Author(s):  
Maik Sahm ◽  
Beate Schwarz ◽  
Sybille Schmidt ◽  
Matthias Pross ◽  
Hans Lippert
Keyword(s):  
Minimally Invasive ◽  
Cosmetic Results ◽  
Video Assisted

Reply to: Long-term cosmetic results after minimally invasive video-assisted thyroidectomy

2013 ◽  
Vol 28 (4) ◽  
pp. 1399-1400 ◽  
Author(s):  
Maik Sahm ◽  
Matthias Pross ◽  
Hans Lippert
Keyword(s):  
Minimally Invasive ◽  
Cosmetic Results ◽  
Video Assisted

Ten Years’ Follow-Up of Single-Surgeon Minimally Invasive Reparative Surgery for Degenerative Mitral Valve Disease

2012 ◽  
Vol 7 (4) ◽  
pp. 270-273 ◽  
Author(s):  
Alessandro D'Alfonso ◽  
Filippo Capestro ◽  
Carlo Zingaro ◽  
Sacha Matteucci ◽  
Giuseppe Rescigno ◽  
...  
Keyword(s):  
Mitral Valve ◽  
Minimally Invasive ◽  
Long Term Results ◽  
Perioperative Morbidity ◽  
Annular Dilatation ◽  
Surgeon Experience ◽  
Leaflet Prolapse ◽  
Repair Techniques

Objective Granted that minimally invasive mitral valve (MV) surgery short-term results were found to be equivalent to those achieved with traditional sternotomy with respect to perioperative morbidity and echocardiographic outcomes, little is known about the long-term efficacy of this approach. This report analyzes a 10-year single-surgeon experience with minimally invasive MV surgery through a right minithoracotomy with peripheral cannulation and external aortic cross-clamping and MV repair (MVR) by direct vision. Methods We studied 179 patients (48% female) who underwent MVR between December 1999 and December 2010. Mean age was 40.2 ± 10.1 years (range, 15–67 years). One hundred seventy patients (95.0%) had degenerative diseases, and nine patients (5.0%) had endocarditic diseases. Repair techniques for degenerative disease with posterior leaflet prolapse (74 patients, 43.5%) consisted of quadrangular resection (QR) and annuloplasty (AP) combined with sliding plasty (49 patients, 58.1%); for anterior leaflet prolapse (28 patients, 16.5%) and bileaflet prolapse (66 patients, 38.8%), edge-to-edge repair (EE) and AP; in 2 patients (1.2%), annular dilatation alone consisting of AP. Repair techniques for endocarditic disease consisted of EE in six patients (66.7%), perforation closure in two patients (22.2%), and QR combined with AP in one patient (11.1%). Results All patients survived the operation and were discharged with MV regurgitation (MR) less than 2+/4+. At 10 years’ follow-up, overall survival was 98.7% ± 1.2%, freedom from redo was 98.5% ± 1.1%, freedom from MR recurrence (>2+/4+) in QR and in EE repair were, respectively, 91.7% ± 2.2% and 90.0% ± 2.4% (P = not significant). The linearized rates of overall mortality, MR recurrence (>2+/4+), and redo at follow-up are 0.10% ± 0.10% per year, 0.63% ± 0.26% per year, and 0.21% ± 0.15% per year, respectively. Conclusions Minimally invasive MVR can be performed with very good perioperative and long-term results. Freedom from MR greater than 2+/4+ recurrence for patients with QR is equivalent to that with EE repair in our patient cohort.

Sign in / Sign up

Export Citation Format

Share Document