scholarly journals Long-term Outcomes of Intervention between Open Repair and Endovascular Aortic Repair for Descending Aortic Syndrome: A Propensity-Matched Analysis

2020 ◽  
Author(s):  
Shin-Ah Son ◽  
Hanna Jung ◽  
Joon Yong Cho
Keyword(s):  
Propensity Score ◽  
Hospital Mortality ◽  
Propensity Score Matching ◽  
Open Repair ◽  
Endovascular Aortic Repair ◽  
Long Term Outcomes ◽  
Short Term ◽  
End Points ◽  
Repair Group

Abstract Background The long-term complication rates of open repair and thoracic endovascular aortic repair (TEVAR) have not yet been determined. Therefore, this study aimed to compare long-term outcomes and aortic reintervention rates between open repair and TEVAR in patients with descending thoracic aortic diseases. Methods Between January 2002 and December 2017, 230 patients with descending thoracic aortic disease underwent surgery. Among them, 45 patients underwent open repair and 91 underwent TEVAR treatment at Kyungpook National University Hospital. The primary end points were in-hospital mortality, and short-term complications. The secondary end points were long-term mortality and reintervention rates. Based on the propensity score matching, 35 patients who underwent open repair were matched to 35 patients who underwent TEVAR (ratio = 1:1). Results The mean follow-up period was 70.2 ± 51.9 months. Shorter intensive care unit and hospital stay were seen in the TEVAR group than in the open repair group (p < 0.001 and p < 0.001, respectively). However, in-hospital mortality, and spinal cord ischemia were not significantly different among the two groups (p = 0.068 and p = 0.211 before matching, p = 0.303 and p = 0.314 after matching, respectively). The cumulative all-cause death and aorta-related death showed no significant difference (p = 0.709 and p = 0.734 before matching, p = 0.888 and p = 0.731 after matching, respectively). However, aortic reintervention rates were higher in the TEVAR group than in the open repair group before and after propensity score matching (p = 0.006 and p = 0.013, respectively). Conclusion The TEVAR group was superior in short-term recovery results but had higher reintervention rates compared to the open repair group. However, there was no significant differences between the groups in long-term survival.

scholarly journals Long-term outcomes of intervention between open repair and endovascular aortic repair for descending aortic pathologies: a propensity-matched analysis

BMC Surgery ◽  
2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Shin-Ah Son ◽  
Hanna Jung ◽  
Joon Yong Cho
Keyword(s):  
Hospital Mortality ◽  
Open Repair ◽  
Long Term Outcomes ◽  
Penetrating Atherosclerotic Ulcer ◽  
Short Term ◽  
End Points ◽  
Before And After ◽  
Repair Group ◽  
Aortic Pathologies

Abstract Background The long-term complication rates of open repair and thoracic endovascular aortic repair (TEVAR) have not yet been determined. Therefore, this study aimed to compare the long-term outcomes and aortic reintervention rates between open repair and TEVAR in patients with descending thoracic aortic pathologies. Methods Between January 2002 and December 2017, 230 patients with descending thoracic aortic pathologies underwent surgery. Of these, 136 patients were included in this retrospective study: 45 patients (10, 2, and 33 with dissection, penetrating atherosclerotic ulcer, and pseudoaneurysm, respectively) underwent open repair and 91 patients (27, 1, and 63 with dissection, penetrating atherosclerotic ulcer, and pseudoaneurysm, respectively) underwent TEVAR. The primary end points were in-hospital mortality, and short-term complications. The secondary end points were long-term mortality and reintervention rates. Based on the propensity score matching (PSM), 35 patients who underwent open repair were matched to 35 patients who underwent TEVAR (ratio = 1:1). Results The mean follow-up period was 70.2 ± 51.9 months. Shorter intensive care unit and hospital stay were seen in the TEVAR group than in the open repair group before and after PSM (p < 0.001 and p < 0.001, respectively). However, in-hospital mortality, and spinal cord ischemia were not significantly different among the two groups (before PSM: p = 0.068 and p = 0.211, respectively; after PSM: p = 0.303 and p = 0.314, respectively). The cumulative all-cause death and aorta-related death showed no significant differences between the two groups (before PSM: p = 0.709 and p = 0.734, respectively; after PSM: p = 0.888 and p = 0.731, respectively). However, aortic reintervention rates were higher in the TEVAR group than in the open repair group before and after PSM (p = 0.006 and p = 0.013, respectively). Conclusion The TEVAR group was superior in short-term recovery outcomes but had higher reintervention rates compared to the open repair group. However, there were no significant differences in long-term survival between the two groups.

scholarly journals Long-term Outcomes of Intervention between Open Repair and Endovascular Aortic Repair for Descending Aortic pathologies: A Propensity-Matched Analysis

2020 ◽  
Author(s):  
Shin-Ah Son ◽  
Hanna Jung ◽  
Joon Yong Cho
Keyword(s):  
Hospital Mortality ◽  
Open Repair ◽  
Long Term Outcomes ◽  
Penetrating Atherosclerotic Ulcer ◽  
Short Term ◽  
End Points ◽  
Before And After ◽  
Repair Group ◽  
Aortic Pathologies

Abstract Background The long-term complication rates of open repair and thoracic endovascular aortic repair (TEVAR) have not yet been determined. Therefore, this study aimed to compare the long-term outcomes and aortic reintervention rates between open repair and TEVAR in patients with descending thoracic aortic pathologies. Methods Between January 2002 and December 2017, 230 patients with descending thoracic aortic pathologies underwent surgery. Of these, 136 patients were included in this retrospective study: 45 patients (10, 2, and 33 with dissection, penetrating atherosclerotic ulcer, and pseudoaneurysm, respectively) underwent open repair and 91 patients (27, 1, and 63 with dissection, penetrating atherosclerotic ulcer, and pseudoaneurysm, respectively) underwent TEVAR. The primary end points were in-hospital mortality, and short-term complications. The secondary end points were long-term mortality and reintervention rates. Based on the propensity score matching (PSM), 35 patients who underwent open repair were matched to 35 patients who underwent TEVAR (ratio= 1:1). Results The mean follow-up period was 70.2 ± 51.9 months. Shorter intensive care unit and hospital stay were seen in the TEVAR group than in the open repair group before and after PSM (p < 0.001 and p < 0.001, respectively). However, in-hospital mortality, and spinal cord ischemia were not significantly different among the two groups (before PSM: p = 0.068 and p = 0.211, respectively; after PSM: p = 0.303 and p = 0.314, respectively). The cumulative all-cause death and aorta-related death showed no significant differences between the two groups (before PSM: p = 0.709 and p = 0.734; after PSM: p = 0.888 and p = 0.731, respectively). However, aortic reintervention rates were higher in the TEVAR group than in the open repair group before and after PSM (p = 0.006 and p = 0.013, respectively). Conclusion The TEVAR group was superior in short-term recovery outcomes but had higher reintervention rates compared to the open repair group. However, there were no significant differences in long-term survival between the two groups.

scholarly journals Comparison of Long-term outcomes between Lynch sydrome and sporadic colorectal cancer: a propensity score matching analysis

2020 ◽  
Author(s):  
Yun Xu ◽  
Cong Li ◽  
Charlie Zhi-Lin Zheng ◽  
Yu-Qin Zhang ◽  
Tian-An Guo ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Propensity Score ◽  
Propensity Score Matching ◽  
Control Group ◽  
Sporadic Colorectal Cancer ◽  
Long Term Outcomes ◽  
Term Survival ◽  
Long Term Survival ◽  
Tumor Stages

Abstract Background Lynch syndrome (LS) is the most common hereditary colorectal cancer (CRC) syndrome. Comparison of prognosis between LS and sporadic CRC (SCRC) were rare,with conflicting results. This study aimed to compare the long-term outcomes between patients with LS and SCRC. Methods Between June 2008 and September 2018, a total of 47 patients were diagnosed with LS by genetic testing at Fudan University Shanghai Cancer Center. A 1:2 propensity score matching was performed to obtain homogeneous cohorts from SCRC group. Thereafter, 94 SCRC patients were enrolled as control group. The long-term survival rates between the two groups were compared, and the prognostic factors were also analyzed. Results The 5-year OS rate of LS group was 97.6%, which was significantly higher than of 82.6% for SCRC group (p = 0.029). The 5-year PFS rate showed no significant differences between the two groups (78.0% for LS group vs. 70.6% for SCRC patients; p = 0.262). The 5-year TFS rates in LS group was 62.1% for LS patients, which were significantly lower than of 70.6% for SCRC group (p = 0.039). By multivariate analysis, we found that tumor progression of primary CRC and TNM staging were independent risk factors for OS. Conclusion LS patients have better long-term survival prognosis than SCRC patients. Strict regular follow-up monitoring, detection at earlier tumor stages, and effective treatment are key to ensuring better long-term prognosis.

scholarly journals Minimally invasive versus open right hepatectomy: Comparative study with propensity score matching analysis

2020 ◽  
Author(s):  
Vinicius Campos Duarte ◽  
Fabricio Coelho ◽  
Alain Valverde ◽  
Divia Danoussou ◽  
Jaime Kruger ◽  
...  
Keyword(s):  
Propensity Score ◽  
Blood Loss ◽  
Minimally Invasive ◽  
Propensity Score Matching ◽  
Liver Tumors ◽  
Perioperative Complications ◽  
Resection Margins ◽  
Long Term Outcomes ◽  
Invasive Approach

Abstract Background Minimally invasive liver resections (MILRs) have been increasingly performed in recent years. However, the majority of MILRs are actually minor or limited resections of peripheral lesions. Due to the technical complexity major hepatectomies remain challenging for minimally invasive surgery. The aim of this study was to compare the short and long-term outcomes of patients undergoing minimally invasive right hepatectomies (MIRHs) with contemporary patients undergoing open right hepatectomies (ORHs). Methods Consecutive patients submitted to anatomic right hepatectomies between January 2013 and December 2018 in two tertiary referral centers were studied. Study groups were compared on an intention-to-treat basis after propensity score matching (PSM). Overall survival (OS) analyses were performed for the entire cohort and specific etiologies subgroups. Results During study period 178 right hepatectomies were performed. After matching, 37 patients were included in MIRH group and 60 in ORH group. The groups were homogenous for all baseline characteristics. MIRHs had significant lower blood loss (400 ml vs. 500 ml, P = 0.01), lower rate of minor complications (13.5% vs. 35%, P = 0.03) and larger resection margins (10 mm vs. 5 mm, P = 0.03) when compared to ORHs. Additionally, a non-significant decrease in hospital stay (ORH 9 days vs. MIRH 7 days, P = 0.09) was observed. No differences regarding the use of Pringle’s maneuver, operative time, major complications or perioperative mortality were observed. OS was similar between the groups (P = 0.13). Similarly, no difference in OS was found in subgroups of patients with primary liver tumors (P = 0.09) and liver metastasis (P = 0.80). Conclusions MIRHs are feasible and safe. Minimally invasive approach is associated with less blood loss, a significant reduction in minor perioperative complications, and did not negatively affect long-term outcomes.

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