scholarly journals A Six-Year Retrospective Follow-up of 502 Patients with Laparoscopic Cholelithotomy for Gallstone Recurrence: Success or Prospect

2019 ◽  
Author(s):  
Garba Seydou Aliou ◽  
Gang Zhao ◽  
An Hua Huang ◽  
An An Xu ◽  
Jing Li Cai ◽  
...  
Keyword(s):  
Risk Factors ◽  
Recurrence Rate ◽  
The Body ◽  
Gallbladder Contraction ◽  
Risk Of Recurrence ◽  
Contraction Function ◽  
Gallstone Recurrence ◽  
Tongji University ◽  
Better Than

Abstract Background This research was designed to explore the risk factors for gallstone recurrence after laparoscopic cholelithotomy. Methods A total of 502 patients who were diagnosed with gallstones using ultrasonography underwent laparoscopic cholelithotomy between January 2011 and December 2017 at the Shanghai-East Affiliated Hospital of Tongji University. Results Our retrospective study revealed that the gallstone recurrence rate of patients taking tauro-ursodeoxycholic acid (TUDCA) was significantly lower (P<0.05) than that of patients not taking TUDCA. The recurrence rate of gallstones in patients with an incision at the fundus of the gallbladder was significantly lower than that of the patients with an incision on the body of the gallbladder. The risk of recurrence in patients with gallstones combined with polyps was significantly higher than that in patients without polyps; the risk of recurrence of gallstones in patients with gallbladder contraction function < 50% was significantly higher than that in patients with gallbladder contraction function ≥ 50%. Additionally, the prognosis of patients without gallbladder adhesions to the peritoneum was better than that of patients with adhesions. Conclusion During the 6-year follow-up period of this study, the recurrence rate of gallstones after laparoscopic gallbladder-preserving cholelithotomy (LGPC) was 22.91%. Factors related to gallstone recurrence were use of TUDCA, location of the incision, presence of gallstones combined with polyps, gallbladder contraction function and presence of gallbladder adhesions to the peritoneum. The main cause of gallstone recurrence needs further investigation, and laparoscopic cholelithotomy remains promising for treatment of gallstone recurrence but requires thorough follow-up.

Obesity Is a Risk Factor for Recurrent Venous Thrombosis in Young and Middle-Aged Women. Results From Tehs-Follow up, a Nested Cohort Study On 1394 Women with VTE.

Blood ◽  
2012 ◽  
Vol 120 (21) ◽  
pp. 2250-2250
Author(s):  
Maria Ljungqvist ◽  
Kristina Sonnevi ◽  
Annica Bergendal ◽  
Margareta Holmstrom ◽  
Helle Kieler ◽  
...  
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Cohort Study ◽  
Recurrence Rate ◽  
Conflicts Of Interest ◽  
Recurrent Event ◽  
Obese Women ◽  
Risk Of Recurrence ◽  
Recurrent Vte

Abstract Abstract 2250 Introduction: Venous thromboembolism (VTE) is a multifactorial disease with a high risk of recurrence. The risk of recurrence is highest during the first year with an incidence of 10–15%, thereafter recurrence occurs in 3 to 5 % per year. The risk of recurrence is associated with age, gender and whether the first VTE was provoked by a transient risk factor or not. Obesity increases the risk of a first event of VTE but its role for a recurrent event is unclear. Methods: We performed a nested cohort study and included 1394 women 18 to 64 years of age with a previous first episode of deep vein thrombosis (DVT) located in the leg or pelvis or with a pulmonary embolism (PE). All women had taken part in TEHS, a population based case-control study on risk factors for VTE. Information on risk factors was obtained by interviews and DNA-analyses immediately after the VTE and information of recurrent VTE was obtained from a follow-up questionnaire or from data recorded in the Swedish Patient Register. Only women who were not on continues anticoagulant treatment were included for assessment of recurrent VTE. Women with a BMI ≥ 30 were considered obese. Risks of recurrence were calculated in Cox regression models and are presented as hazard ratios (HRs) with 95% confidence intervals. Results: A total of 964 women (mean age 46 ± 13 years) with a median follow-up of 76 months accepted participation in the nested cohort study. The recurrence rate was 10.3% and 221 women (23%) were obese when diagnosed with their first VTE. At follow up 240 women (25%) were obese. The recurrence rate was higher in obese than in non-obese women (15.8% vs. 8.6%, p=0.002). The HR for recurrence was 1.9 (p=0.02, 95% CI 1.3–2.9) for obese women compared to non-obese. The HR was unchanged in a multivariate analysis, adjusting for age, index VTE (provoked or unprovoked by cast/surgery or hormonal treatment) and presence of factor V Leiden or prothrombin gene mutation. Conclusion: Obesity is a strong independent risk factor for recurrent VTE in women. Obese women with a first VTE might benefit from long time treatment with anticoagulants and consultation on weight reduction. Disclosures: No relevant conflicts of interest to declare.

P3850Impact of sex and risk factors for venous thromboembolism on the clinical course of first acute venous thromboembolism. Insights from the PREFER in VTE

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
M Giustozzi ◽  
S Barco ◽  
L Valerio ◽  
F A Klok ◽  
M C Vedovati ◽  
...  
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Venous Thromboembolism ◽  
Baseline Risk ◽  
Major Surgery ◽  
First Episode ◽  
Risk Of Recurrence ◽  
Recurrent Vte ◽  
The Impact

Abstract Introduction The interaction between sex and specific provoking risk factors for venous thromboembolism (VTE) may influence initial presentation and prognosis. Purpose We investigated the impact of sex on the risk of recurrence across subgroups of patients with first VTE classified according to baseline risk factors. Methods PREFER in VTE was an international, non-interventional registry (2013–2015) including patients with a first episode of acute symptomatic objectively diagnosed VTE. We studied the risk of recurrence in patients classified according to baseline provoking risk factors for VTE consisted of i) major transient (major surgery/trauma, >5 days in bed), ii) minor transient (pregnancy or puerperium, estroprogestinic therapy, prolonged immobilization, current infection or bone fracture/soft tissue trauma); iii) unprovoked events, iv) active cancer-associated VTE. Results A total of 3,455 patients diagnosed with first acute VTE were identified, of whom 1,623 (47%) were women. The percentage of patients with a major transient risk factor was 22.2% among women and 19.7% among men. Minor transient risk factors were present in 21.3% and 12.4%, unprovoked VTE in 51.6% and 61.6%, cancer-associated VTE in 4.9% of women and 6.3% of men, respectively. The proportions of cases treated with Vitamin-K antagonists (VKAs) and direct oral anticoagulants (DOACs) were similar between sexes. Median length of treatment of VKAs was 181.5 and 182.0 days and of DOACs was 113.0 and 155.0 days in women and men, respectively. At 12-months of follow-up, VTE recurrence was reported in 74 (4.8%) women and 80 (4.5%) men. Table 1 shows the sex-specific proportion of recurrences by VTE risk factor categories. Table 1 Major Transient (n=722) Minor transient (n=573) Cancer-associated (n=195) Unprovoked (1965) Women (361) Men (361) OR (95% CI) Women (346) Men (227) OR (95% CI) Women (79) Men (116) OR (95% CI) Women (837) Men (1128) OR (95% CI) One-year follow-up, n (N%)   Recurrent VTE, 21 (6.2) 10 (2.9) 0.46 (0.2; 0.9) 9 (2.7) 12 (5.4) 2.09 (0.9; 5.0) 6 (8.0) 5 (4.5) 0.54 (0.2; 1.9) 38 (4.7) 53 (4.7) 1.03 (0.7; 1.6)   Major bleeding, 6 (1.8) 5 (1.5) 0.83 (0.3; 2.7) 5 (1.5) 1 (0.5) 0.30 (0.1; 2.6) 1 (1.3) 3 (2.7) 2.07 (0.2; 20) 10 (1.2) 15 (1.4) 1.11 (0.6; 2.4)   All-cause death, 37 (10.2) 31 (8.5) 0.82 (0.5; 1.4) 10 (2.9) 14 (6.2) 2.21 (0.9; 5.1) 26 (32.9) 49 (42.2) 1.49 (0.8; 2.7) 33 (3.9) 30 (2.7) 0.66 (0.4; 1.1) Conclusions The proportion of patients with recurrent VTE events after first acute symptomatic VTE provoked by transient risk factors was not negligible during the first year of follow-up during in both women and men. These results may have implications on the decision whether to consider extended anticoagulant therapy in selected patients with provoked events. Acknowledgement/Funding This study was funded by Daiichi Sankyo.

GIANT CELL TUMOURS OF TENDON SHEATH OF HAND: CAUSES AND STRATEGIES TO PREVENT RECURRENCE

Hand Surgery ◽  
2011 ◽  
Vol 16 (02) ◽  
pp. 149-154 ◽  
Author(s):  
Azal Jalgaonkar ◽  
Baljinder Dhinsa ◽  
Howard Cottam ◽  
Ganapathyraman Mani
Keyword(s):  
Risk Factors ◽  
Local Recurrence ◽  
Giant Cell ◽  
Recurrence Rate ◽  
Case Series ◽  
Tendon Sheath ◽  
Giant Cell Tumours ◽  
High Incidence ◽  
The Mean

Giant cell tumours of tendon sheath of hand present a surgical dilemma due to their high incidence of local recurrence. We present a case series of 46 patients with 47 histologically confirmed giant cell tumours of tendon sheath over a ten-year period from 1998 to 2008. The mean follow-up was 47 months (range 25–124 months). We identified tumours with bony erosions and piecemeal resections as predictors of recurrence. Our recurrence rate of 9% was at the lower end of spectrum of previously published reports (range 7%–44%). We recommend "en-masse" excision of these tumours. All the patients with suspicion of these tumours should have preoperative radiographs to identify erosions. A thorough curettage of the bone should be done in cases with osseous erosion to prevent recurrence. Patients with these risk factors should be followed up annually for five years and be warned about recurrence.

scholarly journals Incidence of and Risk Factors for Missing Events Due to Wandering in Community-dwelling Older People with Dementia and Mild Cognitive Impairment

2021 ◽  
Author(s):  
seungwon Jeong ◽  
Takao Suzuki ◽  
Kiyoko Miura ◽  
Takashi Sakurai
Keyword(s):  
Risk Factors ◽  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Recurrence Rate ◽  
Community Dwelling ◽  
Disease Assessment ◽  
People With Dementia ◽  
One Year ◽  
The One

Abstract BackgroundThe burden of missing incidents is not only on the person with dementia, but also on their family, neighbors, and community. The extent to which dementia-related wandering and missing incidents occur in the community has not been evaluated thoroughly in the published literature. Therefore, we evaluated the incidence of and risk factors for missing events due to wandering.MethodsWe conducted a non-randomized prospective one-year follow-up cohort study based on symptom registration with missing events due to wandering as the endpoint. In the first consultation, 374 patients with dementia or mild cognitive impairment (MCI) and their caregivers who visited the National Center for Geriatrics and Gerontology in Japan were included. The incidence and recurrence rate of missing events were calculated. Participants were divided into (those with) dementia and (those with) MCI. Patients' basic and medical information was documented at baseline and after one year of follow-up. Furthermore, analysis of variance and logistic regression analysis were performed to clarify the risk factors associated with the missing event.ResultsAmong the 236 patients with dementia enrolled, 65 (27·5%) had a previous missing event at baseline, and 28 had a missing event during the one-year follow-up period (recurrence rate of 43·1%). Of the 171 who did not have a previous missing event at baseline, 23 had a missing event during the one-year follow-up period (incidence rate of 13·5%). The scores of Mini-Mental State Examination (MMSE), Dementia Behavior Disturbance Scale (DBD), and Alzheimer's Disease Assessment Scale (ADAS) were statistically significant as the risk factors for the incidence of wandering leading to a missing event (p<0·05).ConclusionsPrevention of missing event due to wandering requires focused attention on changes in the MMSE, DBD, ADAS scores, and the development of a social environment to support family caregivers.

scholarly journals Risk Factors for Recurrence of Benign Paroxysmal Positional Vertigo. A Clinical Review

2021 ◽  
Vol 10 (19) ◽  
pp. 4372
Author(s):  
Ioanna Sfakianaki ◽  
Paris Binos ◽  
Petros Karkos ◽  
Grigorios G. Dimas ◽  
George Psillas
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Recurrence Rate ◽  
Benign Paroxysmal Positional Vertigo ◽  
Female Gender ◽  
Recurrence Rates ◽  
Positional Vertigo ◽  
Risk Factors For Recurrence ◽  
Paroxysmal Positional Vertigo

Benign paroxysmal positional vertigo (BPPV) is one of the most common peripheral vestibular dysfunctions encountered in clinical practice. Although the treatment of BPPV is relatively successful, many patients develop recurrence after treatment. Our purpose is to evaluate the mean recurrence rate and risk factors of BPPV after treatment. A review of the literature on the risk factors of BPPV recurrence was performed. A thorough search was conducted using electronic databases, namely Pubmed, CINAHL, Academic Search Complete and Scopus for studies published from 2000 to 2020. Thirty studies were included in this review with 13,358 participants. The recurrence rate of BPPV ranged from 13.7% to 48% for studies with follow-up <1 year, and from 13.3% to 65% for studies with follow-up ≥2 years. Pathophysiologic mechanisms and implication of each of the following risk factors in the recurrence of BPPV were described: advanced age, female gender, Meniere’s disease, trauma, osteopenia or osteoporosis, vitamin D deficiency, diabetes mellitus, hypertension, hyperlipidemia, cardiovascular disease, migraine, bilateral/multicanal BPPV, cervical osteoarthrosis and sleep disorders. Patients with hyperlipidemia and hypertension had the highest recurrence rates of BPPV, 67.80% and 55.89%, respectively, indicating that vascular comorbidities increase the risk of BPPV recurrence. In addition, more than half of patients (53.48%) with diabetes mellitus and BPPV experienced recurrence of BPPV. Knowledge and awareness of risk factors for recurrence of BPPV are essential for the assessment and long-term prognosis of patients. Identification of these relapse risk factors may enhance the ability of clinicians to accurately counsel patients regarding BPPV and associated comorbidities.

Extent of resection of epidermoid tumors and risk of recurrence: case report and meta-analysis

2020 ◽  
Vol 133 (2) ◽  
pp. 291-301
Author(s):  
Brian M. Shear ◽  
Lan Jin ◽  
Yawei Zhang ◽  
Wyatt B. David ◽  
Elena I. Fomchenko ◽  
...  
Keyword(s):  
Recurrence Rate ◽  
Meta Analysis ◽  
Systemic Review ◽  
Benign Tumors ◽  
Recurrence Rates ◽  
Mixed Effect ◽  
Risk Of Recurrence ◽  
Epidermoid Tumor ◽  
Cranial Nerve Palsies

OBJECTIVEIntracranial epidermoid tumors are slow-growing, histologically benign tumors of epithelial cellular origin that can be symptomatic because of their size and mass effect. Neurosurgical resection, while the treatment of choice, can be quite challenging due to locations where these lesions commonly occur and their association with critical neurovascular structures. As such, subtotal resection (STR) rather than gross-total resection (GTR) can often be performed, rendering residual and recurrent tumor potentially problematic. The authors present a case of a 28-year-old man who underwent STR followed by aggressive repeat resection for regrowth, and they report the results of the largest meta-analysis to date of epidermoid tumors to compare recurrence rates for STR and GTR.METHODSThe authors conducted a systemic review of PubMed, Web of Science, and the Cochrane Collaboration following the PRISMA guidelines. They then conducted a proportional meta-analysis to compare the pooled recurrence rates between STR and GTR in the included studies. The authors developed fixed- and mixed-effect models to estimate the pooled proportions of recurrence among patients undergoing STR or GTR. They also investigated the relationship between recurrence rate and follow-up time in the previous studies using linear regression and natural cubic spline models.RESULTSOverall, 27 studies with 691 patients met the inclusion criteria; of these, 293 (42%) underwent STR and 398 (58%) received GTR. The average recurrence rate for all procedures was 11%. The proportional meta-analysis showed that the pooled recurrence rate after STR (21%) was 7 times greater than the rate after GTR (3%). The average recurrence rate for studies with longer follow-up durations (≥ 4.4 years) (17.4%) was significantly higher than the average recurrence rate for studies with shorter follow-up durations (< 4.4 years) (5.7%). The cutoff point of 4.4 years was selected based on the significant relationship between the recurrence rate of both STR and GTR and follow-up durations in the included studies (p = 0.008).CONCLUSIONSSTR is associated with a significantly higher rate of epidermoid tumor recurrence compared to GTR. Attempts at GTR should be made during the initial surgery with efforts to optimize success. Surgical expertise, as well as the use of adjuncts, such as intraoperative MRI and neuromonitoring, may increase the likelihood of completing a safe GTR and decreasing the long-term risk of recurrence. The most common surgical complications were transient cranial nerve palsies, occurring equally in STR and GTR cases when reported. In all postoperative epidermoid tumor cases, but particularly following STR, close follow-up with serial MRI, even years after surgery, is recommended.

scholarly journals Incisional hernia rate after laparoscopic colorectal resection is reduced with standardisation of specimen extraction

2015 ◽  
Vol 97 (1) ◽  
pp. 17-21 ◽  
Author(s):  
AV Navaratnam ◽  
R Ariyaratnam ◽  
NJ Smart ◽  
M Parker ◽  
RW Motson ◽  
...  
Keyword(s):  
Risk Factors ◽  
Incisional Hernia ◽  
Smoking Status ◽  
The Body ◽  
Specimen Extraction ◽  
Incisional Hernias ◽  
Extraction Site ◽  
Incision Technique ◽  
Incisional Hernia Rate

Introduction Incisional hernia is a common complication of laparoscopic colorectal surgery. Extraction site may influence the rate of incisional hernias. Major risk factors for the development of incisional hernias include age, diabetes, obesity and smoking status. In this study, we investigated the effect of specimen extraction site on incisional hernia rate. Methods Two cohorts of patients who underwent laparoscopic colorectal resections in a single centre in 2005 (n=85) and 2009 (n=139) were studied retrospectively. In 2005 all specimens were extracted through transverse muscle cutting incisions. In 2009 all specimens were extracted through midline incisions. Demographic variables, rate of incisional hernias and risk factors for hernia development were compared between the year groups. All patients had been followed up clinically for two years. Results A total of 224 patients (mean age: 67.5 years, standard deviation: 16.35 years) were included in this study. Of these, 85 patients were in the 2005 transverse group and 139 were in the 2009 midline group. The total incisional hernia rate for the series was 8.0% at the two-year follow-up visit. For the 2005 group, the incisional hernia rate was 15.3% (n=13) and for the 2009 group, it was 3.6% (n=5) (p<0.01). The body mass index was higher in patients who developed incisional hernias than in those who did not (p=0.02). Conclusions The 2005 group had a significantly higher incisional hernia rate than the 2009 group. This is due to the differences in the incision technique and extraction site between the two groups.

Incidence and Risk Factors for Urolithiasis Recurrence After Endourological Management of Kidney Stones: A Retrospective Single-Centre Study

2021 ◽  
Author(s):  
Faris Baowaidan ◽  
Ahmed S. Zugail ◽  
Youssef Lyoubi ◽  
Thibaut Culty ◽  
Souhil Lebdai ◽  
...  
Keyword(s):  
Risk Factors ◽  
Protective Factors ◽  
Univariate Analysis ◽  
Imaging Study ◽  
The Body ◽  
University Hospital ◽  
Urinary Stones ◽  
Stone Recurrence ◽  
Risk Factors For Recurrence

Abstract Purpose: Almost half of the patients have had recurrent nephrolithiasis despite undergoing effective treatment. Our objective is to determine the recurrence rate of lithiasis after endourological management of nephrolithiasis and identify the risk factors for these recurrences.Methods: Data were gathered retrospectively from all patients who were treated for nephrolithiasis by endourological management from May 2014 to January 2017 in our university hospital. All patients who had postoperative renal colic and/or stone upon an imaging study were considered to have recurrent disease. The patients were devised into two groups: with and without recurrence. Many variables were also compared between these two groups.Results: A total of 190 patients were included in our study. At the end of a median follow-up of 32 months (range, 13–61 months), 25.8% of patients had a recurrent stone. In the multivariate analysis, the risk factors for recurrence were diabetes (HR: 7.9; p <0.001) and smoking (HR: 3.5; p <0.029). While the body mass index greater than 25 kg/m2 (HR: 2; p <0.05) appears as a risk factor for recurrence only in the univariate analysis. However, age (HR: 0.96; p <0.003) and blood hypertension (HR: 0.37; p <0.027) were protective factors. The stone characteristics, urological history, and alcoholism had no apparent effect on stone recurrence.Conclusion: Stone recurrence is common after the management of urinary stones. In this study 25.8% of patients had recurred stone disease after endourological management with a median follow-up of 32 months. Our study findings showed that diabetes and smoking are risk factors for recurrence, while age and blood hypertension are protective factors that decreased the risk of recurrence.

scholarly journals Laparoscopic Unroofing and Aspiration-Sclerotherapy in the Management of Symptomatic Simple Renal Cysts

2006 ◽  
Vol 6 ◽  
pp. 2296-2301 ◽  
Author(s):  
Serdar Arisan ◽  
Ayhan Dalkilinc ◽  
Turhan Caskurlu ◽  
Nurettin Cem Sonmez ◽  
Soner Guney ◽  
...  
Keyword(s):  
Recurrence Rate ◽  
Cyst Wall ◽  
Open Surgery ◽  
Renal Cysts ◽  
Recurrent Pain ◽  
Single Session ◽  
Therapy Failure ◽  
Laparoscopic Unroofing ◽  
Better Than

Simple renal cysts are quite common in adults with an incidence that increases with age. Sclerosant treatment is very common, but the recurrence rate is high. Results are still under investigation for laparoscopic approaches and their long follow-up periods. Between 1998 and 2004, 21 patients were diagnosed with symptomatic renal cysts in our clinics. Initially, all patients underwent aspiration-sclerotherapy with 95% ethanol, the most common sclerosant, under ultrasound, fluoroscopy, or CT guidance. For those with sclerosant therapy failure, the laparoscopic unroofing method was used. Like open surgery, laparoscopic unroofing of the cyst appears to be effective by not only removing part of the cyst wall, but more importantly, by providing adequate drainage of the cyst. After sclerotherapy, 71% of the patients had recurrent pain and cyst on follow-up (at mean 14 months). This group of patients was cured with the laparoscopic unroofing method and there is still no recurrence.We emphasize the unroofing method as better than single session sclerotherapy. And also, laparoscopic unroofing of the cyst is more predictable and has better results than sclerotherapy aspiration.

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