scholarly journals Comparative characteristics of reconstructive surgery and percutaneous balloon dilatation in the treatment of high benign strictures of the bile ducts

2020 ◽  
Vol 25 (2) ◽  
pp. 137-144
Author(s):  
S. A. Trifonov ◽  
Yu. A. Kovalenko ◽  
A. B. Varava ◽  
R. Z. Ikramov ◽  
Yu. A. Stepanova ◽  
...  
Keyword(s):  
Bile Ducts ◽  
Treatment Options ◽  
Long Term Results ◽  
High Recurrence Rate ◽  
Percutaneous Interventions ◽  
Percutaneous Balloon ◽  
Reconstructive Operations ◽  
Type 3

Aim: to compare the long-term results of various surgical treatment options for patients with high benign strictures of the bile ducts.Materials and methods. From 2012 to 2018, 87 patients with strictures of different levels according to the classification of E.I. Halperinwas observed. A stricture of type «0» was detected in 23 patients, type «−1» in 20, type «−2» in 31, type «−3» in 13 (E3 – 43, E4 – 31, E5 – 13 according to classification Bismuth-Strasberg). Open reconstructive interventions were performed in 63 patients, 24 percutaneous endobiliary ones.Results. Long-term results were traced in 77 (89%) patients, the follow-up period after reconstructive operations was 4.7 ± 1.6 years, after percutaneous – 2.0 ± 1.4 years. Excellent and good results according to the Terblanche classification were achieved in 31 (58%) patients after open reconstructive operations and in 18 (78%) after percutaneous transhepatic biliary drainage.Conclusion. Technically the most difficult for reconstructive and percutaneous interventions on the bile ducts with a high recurrence rate are strictures of types «−2» and «−3» (E4 and E5). A comparative analysis of the long-term results of percutaneous and open interventions showed a statistically significant advantage of percutaneous interventions compared with reconstructive (p = 0.05).

scholarly journals RETROSPECTIVE EVALUATION OF SUCCESS OF IMPLANT SUPPORTED PROSTHESIS: EARLY RESULTS

2020 ◽  
Vol 7 (12) ◽  
pp. 189-198
Author(s):  
Zeynep Başağaoğlu Demirekin ◽  
Yavuz Findik ◽  
S. Süha Turkaslan ◽  
Timuçin Baykul ◽  
Merve Erken
Keyword(s):  
Treatment Options ◽  
Clinical Results ◽  
Long Term Results ◽  
Retrospective Evaluation ◽  
Early Results ◽  
Single Crown ◽  
Long Term Follow Up ◽  
Implant Therapy

Introduction: The interpretation of clinical results of dental implant supported prosthesis treatment is very crucial to be able to make a comparison between different implant systems and treatment options and furthermore to benefit the experiences of the other clinicians. However, the clinical outcomes of these studies should be reported in an objective way and be independent from the system used and also be prepared in accordance with certain criteria and standards that have been accepted scientifically world-wide for being reliable and describing long-term results. Aim: Three-hundred and eighty-two consecutive NTA implants were performed on ninety-nine patients. The implants used in 2016 and the constructed restorations were retrospectively analyzed. In addition, the effect of the experience of clinician was evaluated related with the success of the implant therapy. Materials and Method: This retrospective study was conducted in the Department of Prosthodontics Süleyman Demirel University. Three-hundred and eighty-two consecutive NTA implants were performed on ninety-nine patients. The implants used in 2016 and the constructed restorations were retrospectively analyzed. Results: The implants were followed for at least 2 years. In total, 239 implants were inserted. It was found in 143 mandibles. Prosthetic restorations were determined to be partial prosthetics (219), single crown (81) and overdenture prosthetics (64). During the evaluation period, 6 implants failed before prosthetic treatment, ten decementations, six retentive screw loosening and five porcelain chipping were detected. Discussion and Conclusions: The early results of our study are consistent with the results of other studies. However, long-term follow-up is required for more accurate assessments.

Management and outcome of acute and recurrent pericarditis during pregnancy

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
D Lotan ◽  
Y Wasserstrum ◽  
E Itelman ◽  
M Nir-Simchen ◽  
M Arad ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Gestational Age ◽  
Q Fever ◽  
Treatment Options ◽  
Subsequent Treatment ◽  
High Recurrence Rate ◽  
Recurrent Pericarditis ◽  
Long Term Follow Up

Abstract Background Pericarditis in pregnancy is uncommon. Treatment options, including NSAIDs and long term gluco-corticosteroids (CS) have extensive side-effects, while data on the use of Colchicine in pregnant women who suffer from pericarditis is limited. Objective To evaluate the management and outcome of active pericarditis during pregnancy in both acute (AP) and recurrent pericarditis (RP) patients. Methods and results Twelve pregnant women (14 pregnancies) with active pericarditis were followed prospectively in our cardiology-pregnancy clinic; 6 with AP and 8 with RP. Etiology: 11 idiopathic, 2 post-pericardiotomy syndrome and 1 Q fever. Maternal age on presentation was 27±4y vs. 33±3y in RP vs AP respectively. Average gestational age upon diagnosis was lower in RP than in AP (18 weeks, range 6–30 vs 26 weeks, range 5–35). In the RP group, 7/8 women (87%) were treated with CS compared with 2/6 women (33%) in the AP group; 3 women in RP group (37%) failed to respond to subsequent treatment with azathioprine and 1 patient was treated successfully with Anakinra. Colchicine was prescribed in 13/14 (93%) of pregnancies, average colchicine exposure during pregnancy was 25±15 weeks. Recurrence during pregnancy: 6/8 (75%) of RP; 2/6 (33%) of the AP, all of them on CS. All pregnancies culminated in a live birth with a mean gestational age on delivery of 37±1.4 weeks. Average birthweight was 3267±507 grams. There were no fetal anomalies or developmental delays after a mean follow-up of 2.7 years. All newborns and maternal outcomes were normal. On long term follow-up after delivery RP patients treated with colchicine developed less recurrences. Conclusion Active pericarditis is associated with a high recurrence rate during pregnancy despite treatment with CS. Colchicine use in pregnant women with active pericarditis appears to be safe. Funding Acknowledgement Type of funding source: None

Long-term results of percutaneous balloon valvuloplasty in neonatal critical pulmonary valve stenosis: a 20-year, single-centre experience

2017 ◽  
Vol 27 (7) ◽  
pp. 1314-1322
Author(s):  
Petra Loureiro ◽  
Barbara Cardoso ◽  
Inês B. Gomes ◽  
José F. Martins ◽  
Fátima F. Pinto
Keyword(s):  
Pulmonary Valve ◽  
Pressure Ratio ◽  
Balloon Valvuloplasty ◽  
Long Term Results ◽  
Pulmonary Valve Stenosis ◽  
Single Centre ◽  
Percutaneous Balloon ◽  
Percutaneous Balloon Valvuloplasty

AbstractIntroductionPercutaneous balloon valvuloplasty is the primary treatment for critical pulmonary valve stenosis in neonates. Thus far, a few studies have reported long-term results of this technique in neonatal critical pulmonary valve stenosis.MethodsWe carried out a retrospective study of all consecutive newborns with critical pulmonary valve stenosis subjected to percutaneous balloon valvuloplasty at a single centre, between 1994 and 2014, to assess its immediate and long-term safety and efficacy.ResultsA total of 24 neonates presented with critical pulmonary valve stenosis. The mean diameter of the pulmonary annulus was 7 mm (±1.19); 33.3% had a dysplastic pulmonary valve, and 92% were started on prostaglandin E1 treatment. Percutaneous balloon valvuloplasty was performed at a mean age of 4.0±4.3 days using, on average, a balloon-to-pulmonary annulus ratio of 1.18 mm (with a range from 0.9 to 1.43). Immediate success was achieved in 22/24 patients (92%) with a reduction in the pulmonary transvalvular peak gradient (p<0.05) and in the right ventricle/systemic pressure ratio (p<0.05). There was one death (4%) 6 days after the procedure, and 29.2% of them had transient rhythm complications. For a mean follow-up time of 8.4 years, the re-intervention rate was 42.9%. In total, 14 re-interventions were performed in nine neonates, including surgery in six. Freedom from re-intervention was 50% at 8 years and 43% at 10 and 15 years.ConclusionThis series, to the best of our knowledge, has had the longest follow-up of neonates with critical pulmonary valve stenosis. Percutaneous balloon valvuloplasty is a safe and effective treatment, and in our study 75% of the patients were exclusively treated using this technique.

Long-term results of selective internal radioembolization (SIRT) to control progressive liver metastases of gastro-intestinal stromal tumors (GIST) beyond treatment with tyrosine kinase inhibitors (TKI).

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. 11538-11538
Author(s):  
Peter Hohenberger ◽  
Nils Rathmann ◽  
Karen Buesing ◽  
Franka Menge ◽  
Steffen Diehl
Keyword(s):  
Liver Metastases ◽  
Treatment Options ◽  
Hepatic Metastases ◽  
Progression Free Survival ◽  
Long Term Results ◽  
Mutational Status ◽  
Exon 9 ◽  
Exon 11

11538 Background: Liver and peritoneum are the main area of metastatic spread in GIST. Liver resection does not play a role for hepatic metastases in comparison to f.e. colorectal cancer. If hepatic metastases are the only or major area of tumor progression and are resistant to available TKIs due to a missing mutation in KIT/PDGFRA/SDH ( ‘wildtype’) or after treatment with 1st/2nd/3rd/4th line therapy, interventional radioembolization with yttrium-90 (90Y) microspheres are promising treatment options, as radiation doses as high as 200Gy can be applied locally. We analyzed the long-term results of SIRT with respect to hepatic-progression-free survival (HEP-PFS) in a consecutive cohort of patients.. Methods: From 1/2008 to 1/2018, 25 pts (12f, 13m) with biopsy proven liver metastases of GIST which were the only (n = 13) or the dominant site of progression (n = 12) were treated by SIRT. Median age at GIST diagnosis had been 51.8 yrs and when receiving SIRT was 57.6yrs (range, 18–75yrs). The mutational status was ‘wildtype’ (n = 7, 2 NF-1), exon 11 (n = 7), exon 11+2nd mutation (n = 6), exon 9 (n = 3), exon 9+2ndmut (n = 1), and, exon 13 (n = 1). All patients except of two had prior TKI therapy: 1 line n = 3, 2 lines n = 11, 3-4 lines n = 9. Follow-up after SIRT was done via dynamic MRI and contrast-enhanced (CE)-CT, the median follow-up is 30.6 mos (range, 12-100mos) and all patients were followed until death. Results: The median hepatic-progression free survival (HEP-PFS) after SIRT was 17 months (range, 5-53+, 95%CI 11.8-22.1 mos). Of the patients with concomitant extrahepatic disease, the extraHEP-PFS was median 10 months. Twelve patients received next-line TKI therapy for progressive extrahepatic disease, whereas six patients required this for progressive liver metastases. When comparing the results according to the mutational status, patients with a ‘wildtype’ tumor showed a better median HEP-PFS of 19 mos (range, 12-53+, 95%CI 16.7-21.2 mos.) in comparison to KIT exon 9/11/13 mutated patients with only 14 months (range, 4-34 mos., 95%CI 6.5-21.4 mos), p < 0.11 (Wilcoxon). Conclusions: 90Y radioembolization (SIRT) offers a safe and effective treatment for patients with liver metastases of GISTs being the dominant site of tumor progression and with no drug treatment options available. In patients known to have no mutation in KIT/PDGFRA (wt, also NF-1 associated) it looks whether the results might be even more promising and SIRT could be used in early treatment lines.

Neoadjuvant chemotherapy plus surgery for high-risk advanced gastric cancer: Long-term results of KDOG1001 trial.

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. 4521-4521
Author(s):  
Kei Hosoda ◽  
Mizutomo Azuma ◽  
Chikatoshi Katada ◽  
Kenji Ishido ◽  
Masahiro Niihara ◽  
...  
Keyword(s):  
Neoadjuvant Chemotherapy ◽  
Long Term Results ◽  
R0 Resection ◽  
Resection Rate ◽  
Node Metastasis ◽  
Large Type ◽  
Bulky N2 ◽  
Type 3

4521 Background: In the phase 2, open-label, KDOG1001 (UMIN000003642) study, neoadjuvant chemotherapy (NAC) with docetaxel, cisplatin, and S-1 (DCS), followed by gastrectomy with D2 lymph node dissection for high-risk advanced gastric cancer showed feasibility of DCS therapy with an enough R0 resection rate of 90%. Here we present long-term results after a minimum follow-up of 3 years. Methods: Patients with bulky node metastasis (bulky N), linitis plastica (type 4), or large ulcero-invasive-type tumors (type 3) received up to four 28-day cycles of DCS neoadjuvant chemotherapy (docetaxel at 40 mg/m2, cisplatin at 60 mg/m2 on day 1, and S-1 at 40 mg/m2 twice daily for 2 weeks) followed by gastrectomy with D2 lymphadenectomy. This analysis presents the final preplanned assessment of outcomes after 3 years. Primary endpoint was R0 resection rate. Secondary endpoints included overall survival (OS), progression free survival (PFS), completion rate of the protocol treatment, and pathological response rate (pRR) of DCS NAC. Results: Of 40 patients enrolled from May 2010 through January 2017, 7 (17.5%) had bulky N, 18 (45.0%) had type 4, and 16 (40%) had large type 3 with 1 (2.5%) having both large type 3 and bulky N2. All included patients underwent preoperative DCS chemotherapy followed by surgery with D2 lymphadenectomy with 32 (80%) completed postoperative S-1 therapy for 1 year. After a median follow-up for surviving patients of 67 mo (range, 36 mo to 110 mo) at the last follow-up in January 2020, 3-year OS was 78% [95% confidence interval (CI) 62–88%], while 3-year PFS was 63% (95% CI 47–76%). Completion rate of the protocol treatment was 62.5% (25/40) with pRR of 57.5% (23/40). In bulky N2, 3-y OS was 86% and 3-y PFS was 71% with pRR of 100%. In type 4, 3-y OS was 67% and 3-y PFS was 50% with pRR of 44%. In large type 3, 3-y OS was 88% and 3-y PFS was 75% with pRR of 56%. Patients with type 4 had significantly worse OS and PFS than those with the other types [HR 7.20 (95% CI 2.23–32.21) and HR 3.00 (95% CI 1.21–8.19)]. Conclusions: Preoperative chemotherapy with up to four cycles of DCS followed by gastrectomy plus adjuvant S-1 therapy is a promising treatment strategy for patients with bulky node metastasis, type 4 and large type 3 gastric cancers. For type 4 cancer, further improvement of treatment strategy is needed. Clinical trial information: 000003642 .

scholarly journals Ligaments Reconstruction for Posttraumatic Ulnar Translocation of the Carpus: A Case Report

2017 ◽  
Vol 06 (04) ◽  
pp. 325-328
Author(s):  
Marco Innocenti ◽  
Federico Piacentini ◽  
Margaret Fok
Keyword(s):  
Open Repair ◽  
Treatment Options ◽  
Rare Condition ◽  
Long Term Results ◽  
Loss Of Function ◽  
Ligament Tear ◽  
Wrist Fusion ◽  
Partial Wrist Fusion

Background Posttraumatic ulnar translocation of the carpus, a result of radiocarpal ligament tear is a relatively rare condition that may lead to persistent wrist pain and loss of function. Case Description We report a case of radiocarpal ligament tear of which we reconstruct it with a vascularized interosseous membrane with 13 years of follow-up. Literature Review Many treatment options have been proposed for the posttraumatic ulnar translocation, ranging from open repair to partial wrist fusion. However, the long term results have been disappointing. Clinical Relevance Though this technique of reconstruction is technically demanding, it shows promising long term clinical outcome.

scholarly journals Long-term results of open aorto-femoral reconstructions

2021 ◽  
Vol 180 (1) ◽  
pp. 54-59
Author(s):  
T. B. Rakhmatillaev ◽  
A. V. Gusinskiy ◽  
V. V. Shlomin ◽  
O. V. Fionik ◽  
A. V. Shatravka ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Clinical Supervision ◽  
Primary Patency ◽  
Long Term Results ◽  
Secondary Patency ◽  
Femoral Arteries ◽  
Reconstructive Operations

The objective was to analyze the long-term results of open aorto-femoral reconstructions in order to optimize the approach to surgical treatment.Methods and materials. The study included 548 patients with reconstructions of the aorto-femoral segment performed between 1999 and 2007. Of these, 293 patients underwent loop endarterectomy of the iliac arteries, 255 – after aorto-femoral bypass with a synthetic prosthesis. All interventions were performed against the critical lower limb ischemia. The superficial femoral arteries remained occluded in all cases. Outflow was carried out only in the deep femoral arteries and collateral vessels. Patients were under clinical supervision for 5 to 20 years. In the long-term period, most patients underwent interventions on the coronary, brachiocephalic arteries, as well as surgery for cancer.Results. Timely correction of concomitant pathology made it possible to increase the survival rate of patients by the 10-year follow-up period to 72 %, and after 20 years this figure reached 63 %. The primary patency of the reconstructed segment after loop endarterectomy was significantly higher than after aorto-femoral bypass surgery. Secondary patency in the groups did not significantly differ and by 20 years of follow-up reached 76 %. A high level of patency of the operated segment was also provided by a large percentage of preserved limbs (80 % after 20 years). A study of the quality of life showed that, despite the persistence of intermittent claudication at the level of 400–800 meters, the vast majority of patients were satisfied with their life. Suppurations in the transplant area and the formation of false aneurysms in the area of anastomoses were found only in the group of aorto-femoral bypass grafts.Conclusion. Open reconstructive operations on the aorto-femoral segment, such as loop endarterectomy and aorto-femoral bypass with adequate postoperative medical examination have good long-term results of survival, patency of the reconstructed segment, percentage of saved limbs and quality of life of patients. Complications in the form of suppuration in the transplant area and the formation of false aneurysms occur only after bypass.

scholarly journals Long-term Follow-up of Trigeminal Neuralgia Patients treated with Percutaneous Balloon Compression Technique: A Retrospective Analysis

2016 ◽  
Vol 17 (3) ◽  
pp. 263-266 ◽  
Author(s):  
Suman Yadav ◽  
Rajratna M Sonone ◽  
Chandresh Jaiswara ◽  
Shipra Bansal ◽  
Deepak Singh ◽  
...  
Keyword(s):  
Trigeminal Neuralgia ◽  
Retrospective Analysis ◽  
Treatment Options ◽  
Compression Technique ◽  
Balloon Compression ◽  
Percutaneous Balloon ◽  
Percutaneous Balloon Compression ◽  
Long Term Follow Up

ABSTRACT Background Trigeminal neuralgia (TN) refers to sharp, lancinating pain in the areas supplied by trigeminal nerve. Both pharmacological and surgical lines of treatments are available for the treatment of TN. Percutaneous balloon compression (PBC) is one such surgical technique that is usually advocated for the treatment of TN occurring in elderly patients. Hence, we aim to evaluate the follow-up results of the TN patients treated by the PBC technique. Materials and methods A total of 400 patients were selected for the study who had undergone surgical treatment of TN by percutaneous balloon decompression technique. All the postoperative follow-up records of the patients, clinical history, and complication records of the patients were studied and evaluated. Results Of all the patients included in the study, 353 patients showed improvement clinically after PBC therapy. Out 400, 180 were males and 220 were females. Postoperative complications of the patients during their follow-up were also recorded and it was observed that the most common complication arising after treatment with this technique included facial numbness, masseter muscle weakness, paresthesia, diplopia, and corneal anesthesia. Conclusion One of the most common neuralgic pains affecting the face is the pain of TN. Although numerous lines of treatment options are available for its treatment, all these have one or the other drawbacks. From our results, we can conclude that PBC technique offers more advantages than other surgical modalities and, therefore, should be preferred over other techniques of treatment. How to cite this article Yadav S, Sonone RM, Jaiswara C, Bansal S, Singh D, Rathi VC. Long-term Follow-up of Trigeminal Neuralgia Patients treated with Percutaneous Balloon Compression Technique: A Retrospective Analysis. J Contemp Dent Pract 2016;17(3):263-266.

scholarly journals Short-, long-, and very long-term results of secondary anterior sphincteroplasty in 20 patients with obstetric injury

2021 ◽  
Author(s):  
Helene Marie Haug ◽  
Erik Carlsen ◽  
Hans-Olaf Johannessen ◽  
Egil Johnson
Keyword(s):  
Anal Incontinence ◽  
Treatment Options ◽  
Long Term Results ◽  
Stoma Formation ◽  
Long Term Follow Up ◽  
Initial Improvement ◽  
Overlapping Sphincteroplasty ◽  
Reported Data

Abstract Purpose More long-term follow-up studies beyond 10 years after secondary sphincteroplasty for obstetric damage are warranted. This prospective study aimed to compare reported data on incontinence and satisfaction in a cohort of such patients examined at short-, long-, and very long-term follow-up. Methods Twenty out of 33 obstetric patients (61%) operated with secondary anterior overlapping sphincteroplasty during February 1996 to April 2004 were evaluated preoperatively and at short-, long-, and very long-term follow-up. Anal incontinence was scored by a combination of Wexner’s and St. Mark’s incontinence scores. The patients also reported degree of treatment satisfaction. Results Twenty patients were examined preoperatively and after a median (range) of 5 (2–62), 102 (64–162), and 220 (183–278) months. Corresponding incontinence scores were 11.5 (5–18), 5.5 (1–17) (p < 0.01), 10.0 (0–18) (p > 0.05), and 12.0. (1–18) (p > 0.05). With increasing follow-up times, patients reporting a better outcome were 75%, 65%, and 45%. At very long-term follow-up patients, reports were more dismal than expected in those also reporting improved incontinence cores. Incontinence scores did not improve in patients with neuropathy (n = 5) or patients (n = 5) with more than 10 years of symptoms. Conclusion Initial improvement of anal incontinence attenuated with time, in particular from short- to long-term follow-up. Patients with neuropathy experienced no improvement of incontinence. Beyond stoma formation, in compliant patients, one should consider other treatment options like sacral nerve stimulation and neosphincter formation.

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