Long-term Follow-up of Upper Gastrointestinal Subepithelial Lesions Evaluated by Endoscopic Ultrasonography: A Single Tertiary Care Center Study

Objective(1) Characterize a large cohort of patients undergoing total ossicular chain reconstruction with titanium prosthesis. (2) Analyze long-term hearing outcomes of the same cohort.Study DesignCase series with chart review.SettingTertiary care center.Subject and MethodsThis study reviews patients who underwent total ossicular chain reconstruction (OCR) with titanium prostheses (TORPs) at a single tertiary care center from 2005 to 2015. Patient charts were reviewed for demographic data, diagnosis, and operative details. Patients were included in statistical analysis if length of follow-up was 2 years or more. Evaluation of hearing improvement was made by comparing preoperative air-bone gap (ABG) and ABG at follow-up at 2 years.ResultsIn total, 153 patients were identified who met inclusion criteria. The mean age of included patients was 40 years (range, 6-89 years). Sixty patients (39%) had a history of OCR, and 120 patients (78%) had a diagnosis of cholesteatoma at the time of OCR. Preoperatively, the mean ABG was 36 ± 12, whereas the mean ABG at 2-year follow-up improved to 26 ± 13. This was statistically significant ( P < .0001) using a Wilcoxon matched-pairs signed rank test. Twelve patients (8%) required revision OCR. Two revisions were performed due to prosthesis extrusion (<1%).ConclusionTitanium prostheses lead to significant improvement in hearing over long periods. The results are sustained as far out as 5 years following surgery. In addition, rates of revision surgery with titanium TORPs are low. Based on this series, there are no readily identifiable predictors for outcomes following total OCR.

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Carcinoids of the ampulla: Long-term follow-up after endoscopic resection.

Journal of Clinical Oncology ◽

10.1200/jco.2019.37.4_suppl.430 ◽

2019 ◽

Vol 37 (4_suppl) ◽

pp. 430-430

Author(s):

George Nyasha Baison ◽

Nadav Sahar ◽

Morgan M Bonds ◽

Janelle F Rekman ◽

Flavio G. Rocha ◽

...

Keyword(s):

Endoscopic Resection ◽

Care Center ◽

Benign Lesion ◽

Tertiary Care ◽

Case Series ◽

World Health ◽

Long Term Follow Up ◽

Well Differentiated

430 Background: Neuroendocrine tumors (NET) or carcinoids of the ampulla are exceedingly rare in comparison to duodenal NET. Surgical management is widely accepted as the treatment of choice, but for patients that refuse surgery or are poor operative candidates, endoscopic resection may be option. We present a consecutive case series at a tertiary care center describing our experience with endoscopic resection of ampullary NET. Methods: This is a restrospective review with a long-term follow-up of patients with ampullary NET that were endoscopically resected. Outcomes were analyzed based on the histopathologic classification system proposed by the World Health Organization in 2000. Results: Twelve patients (9 male, 3 female), ranging in age from 41 to 86 (mean 59) underwent endoscopic ampullectomy for ampullary NET, with a mean follow-up time of 5 years. Patients had refused surgery or were poor surgical candidates. All, but one incidentally found case, were symptomatic on presentation, with gastrointestinal bleeding being the main symptom. No patients had a hormonal syndrome. The mean size of the lesions was 21 mm (6 mm to 35 cm). Six (50%) patients had a well-differentiated, benign lesion, 6 (50%) patients had a well-differentiated NET with unknown malignant potential (gangliocytic paragangliomas). Eight (67%) were completely excised during the initial endoscopy with 4 requiring re-excision. Only 2 patients developed recurrence, after 2.5 and 10 years and this necessitated a pancreaticoduodenectomy. Five patients had complications (2 for bleeding and 3 for post-ERCP pancreatitis), with zero deaths. Conclusions: Unlike duodenal carcinoids, ampullary NET are rare. Pancreaticoduodenectomy can be offered to fit patients except for gangliocytic paragangliomas that do not require an aggressive operation. However, for those that refuse surgery or are poor candidates, endoscopic ampullectomy can be an option with acceptable short and long-term outcomes.

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FRI0227 PREGNANCY OUTCOMES IN A LONG-TERM FOLLOW-UP COHORT OF PEDIATRIC ONSET SYSTEMIC LUPUS ERYTHEMATOSUS (PSLE) AT A TERTIARY CARE CENTER IN NORTH-WEST INDIA

10.1136/annrheumdis-2019-eular.7770 ◽

2019 ◽

Author(s):

Himanshi Chaudhary ◽

Jasmina Ahluwalia ◽

Rakesh Kumar ◽

Narender Kumar ◽

Anju Gupta ◽

...

Keyword(s):

Lupus Erythematosus ◽

Pregnancy Outcomes ◽

Care Center ◽

Tertiary Care ◽

North West ◽

Long Term Follow Up ◽

Pediatric Onset ◽

Onset Systemic Lupus Erythematosus

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Adherence to Long-Term Follow-up in Patients With Sporadic Vestibular Schwannomas Managed With Serial Observation

OTO Open ◽

10.1177/2473974x211036653 ◽

2021 ◽

Vol 5 (3) ◽

pp. 2473974X2110366

Author(s):

Mallory Raymond ◽

Arian Ghanouni ◽

Kaitlyn Brooks ◽

Sarah M. Clark ◽

Douglas E. Mattox

Keyword(s):

Vestibular Schwannoma ◽

Tumor Size ◽

Care Center ◽

Demographic Data ◽

Tertiary Care ◽

Retrospective Chart Review ◽

Long Term Follow Up ◽

Lost To Follow Up

Objectives To examine the long-term adherence to serial imaging of patients with sporadic vestibular schwannoma and analyze factors associated with being lost to follow-up. Study Design Retrospective chart review with telephone interview. Setting Single tertiary care center. Methods Patients with a sporadic vestibular schwannoma and started on observational surveillance management between January 2005 and December 2010 were included. Demographic data, tumor size, hearing and vestibular changes, and follow-up length were recorded. Patient factors were analyzed for association with being lost to follow-up. Results In total, 122 patients were included with a median length of follow-up of 5 months (range, 0-146). After initial surveillance, 22.1% (n = 27) of patients had a change in management to either microsurgery or radiosurgery. Of the remaining 77.9% (n = 95), nearly half (44.2%, n = 42) never returned for a second visit, and all but 3 were eventually lost to follow-up. There was no association between sex, race, age at diagnosis, initial tumor size, insurance status, household income, or driving distance to hospital and being lost to follow-up. Of 26 interviewed patients initially lost to follow-up, 11 (42.3%) sought care at another institution, 5 (19.2%) chose to no longer receive care, 1 (3.8%) had transportation difficulties, and 9 (36.4%) had poor understanding of their diagnosis or instructions. Conclusions The length of follow-up for patients undergoing surveillance of sporadic vestibular schwannoma varies widely, and patients are commonly lost to follow-up. Further efforts should be made to identify at-risk patients and provide adequate education to improve long-term surveillance.

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