scholarly journals “Surgery of Congenital Breast Asymmetry – Which Objective Parameter Influences the Subjective Satisfaction With Long-term Results?”

2021 ◽  
Author(s):  
Vivien Noisser ◽  
Andreas Eigenberger ◽  
Maximilian Weiherer ◽  
Stephan Seitz ◽  
Lukas Prantl ◽  
...  
Keyword(s):  
Influencing Factor ◽  
Postoperative Outcome ◽  
Long Term Results ◽  
Breast Asymmetry ◽  
Good Tool ◽  
Subjective Satisfaction ◽  
Patient Reported ◽  
The Difference ◽  
3D Scans

Abstract Purpose: Congenital breast asymmetry is a serious gynaecological malformation for affected patients. The phenotyping hits young women in puberty and is associated with a socio-aesthetic handicap, depression and psychosexual problems. Therefore, the time of therapy is usually early in view of the patient's entire life so that a sustainable solution is important. Although, postoperative outcome has been evaluated in several studies before, this study firstly analyses which objective parameters have the most influence on subjective satisfaction with long-term results.Methods: 34 patients with a diagnosed congenital breast asymmetry that underwent either lipofilling or implant therapy in the years of 2008 - 2019 were examined. On average, our collective was seven years postoperatively. Data was mainly gathered by manual measurements, patient-reported outcome measures (Breast Q™) and breast volumetry based on 3D scans (Vectra® H2, Canfield Scientific).Results: Among all analysed parameters, only the areola diameter correlated significantly negative with the subjective outcome satisfaction of the patient. Regarding the subjective assessment of the postoperative satisfaction with similarity of the breasts, again the mean of areola diameter, the difference of areola diameter between right and left breast and the difference of volume assessed with 3D scans correlated significantly negative.Conclusion: The areola diameter was shown to be a significant influencing factor for patient-subjective long-term satisfaction in breast asymmetry patients. Besides, 3D volumetry was shown to be a good tool for objectifying patient subjective assessments. Our findings could lead to further improvement of surgical planning and will be built upon in further studies.

scholarly journals Surgery of congenital breast asymmetry—which objective parameter influences the subjective satisfaction with long-term results

2021 ◽  
Author(s):  
Vivien Noisser ◽  
Andreas Eigenberger ◽  
Maximilian Weiherer ◽  
Stephan Seitz ◽  
Lukas Prantl ◽  
...  
Keyword(s):  
Postoperative Outcome ◽  
Subjective Assessment ◽  
Patient Reported Outcome Measures ◽  
Patient Reported Outcome ◽  
Long Term Results ◽  
Breast Asymmetry ◽  
Subjective Satisfaction ◽  
Patient Reported ◽  
The Right

Abstract Purpose Congenital breast asymmetry is a serious gynecological malformation for affected patients. The condition hits young women in puberty and is associated with socio-esthetic handicap, depression, and psychosexual problems. Surgical treatment is usually early in the patient's lifetime, so a long-term sustainable solution is important. Although postoperative outcome has been evaluated in several studies before, this study is the first to analyze which objective parameters have the greatest influence on subjective satisfaction with long-term results. Methods Thirty-four patients diagnosed with congenital breast asymmetry that underwent either lipofilling or implant therapy between the years of 2008 to 2019 were examined. On average, our collective comprised patients seven years after surgery. Data were mainly gathered through manual measurements, patient-reported outcome measures (Breast Q™), and breast volumetry based on 3D scans (Vectra® H2, Canfield Scientific). Results Among all analyzed parameters, only areolar diameter correlated significantly negatively with the subjective outcome satisfaction of the patient. Regarding the subjective assessment of postoperative satisfaction with similarity of the breasts, again the mean areolar diameter, but also the difference in areolar diameter and breast volume between the right and left breasts correlated significantly negatively. Conclusion Areolar diameter was revealed as being a significant factor influencing subjective long-term satisfaction in breast asymmetry patients. Moreover, 3D volumetry proves to be an effective tool to substantiate subjective patient assessments. Our findings may lead to further improvements to surgical planning and will be expanded in further studies.

scholarly journals Penile fracture: Retrospective analysis of our case history with long-term assessment of the erectile and sexological outcome

2014 ◽  
Vol 86 (4) ◽  
pp. 359 ◽  
Author(s):  
Nicola Pavan ◽  
Giorgia Tezzot ◽  
Giovanni Liguori ◽  
Renata Napoli ◽  
Paolo Umari ◽  
...  
Keyword(s):  
Erectile Function ◽  
Psychological Impact ◽  
Point Of View ◽  
Long Term Results ◽  
Penile Curvature ◽  
Penile Fracture ◽  
Radiological Investigation ◽  
Urinary Disorders ◽  
Patient Reported

Objectives: To review the cases of patients with suspected penile fracture and asses erectile and sexological outcomes. Materials and methods: from 1987 to 2013 presented to the Urology Clinic of Trieste and at the AIED of Pordenone a total of 41 cases that were divided into two groups according to the timing of treatment: 18 patients with anamnestic diagnosis of penile fracture treated nonimmediately and 23 patients treated immediately after the trauma. For all patients we evaluated the type of treatment adopted, the occurrence of complications and reoperations and the follow-up. The erectile function was also evaluated through the IIEF, as well as the psychological impact of the trauma on social and sex life, using a psycho- sexological questionnaire. Results: Among patients treated immediately after the trauma 14 were subjected to surgery. About a year after surgery, penile curvature was reported in 1 patient, pain in 3 patients, urinary disorders in 1 patient, while none reported erectile dysfunction (ED). Out of these, only 3 patients underwent reoperation. Among those treated conservatively 1 patient reported curvature, 1 patient reported pain and none reported ED. Among patients who were admitted at a later date, 14 reported curvature and 4 reported pain whereas urinary disorders were reported in 1 and ED in 4 patients. From a psychological point of view, the trauma caused in most cases a fear of new trauma and of repercussions on erectile function and sensitivity. Conclusions: The diagnosis is mainly clinical; however, radiological investigation is essential to confirm the diagnosis, assess the site and extent of the trauma and possible urethral involvement, so as to plan the most appropriate treatment. In addition, immediate treatment leads to better long-term results, with a lower incidence of ED and penile curvature. Psychologically, penile trauma intensifies the fear of reoccurrence; it decreases, however, with the passage of time.

scholarly journals Long-term Results for the BacJac Interspinous Device in Lumbar Spine Degenerative Disease

2018 ◽  
Vol 80 (01) ◽  
pp. 003-007 ◽  
Author(s):  
Aldo Spallone ◽  
Luigi Lavorato ◽  
Daniele Belvisi
Keyword(s):  
Lumbar Spine ◽  
Influencing Factor ◽  
Relevant Literature ◽  
Long Term Results ◽  
Surgical Technology ◽  
Disability Scale ◽  
Interspinous Device ◽  
Satisfactory Outcome ◽  
The One

Objective To evaluate the long-term results of using the BacJac interspinous device (Pioneer Surgical Technology Inc.) in a series of patients with degenerative lumbar spine disease. Methods Forty-one patients undergoing lumbar surgery with implantation of a BacJac device from 2009 to 2012 were enrolled in the present study. Patients were evaluated using the Oswestry Disability Scale (ODI). Results Although all patients showed a significant improvement of the ODI score immediately after surgery, only 41% of patients showed a satisfactory outcome. We observed worse results in the patients operated on at the L3–L4 level and in whom the device was implanted in a segment different from the one where surgical decompression had been performed. Weight gain in the months after surgery was also a poor outcome-influencing factor. Conclusions This study confirms what is already suggested in the relevant literature regarding the long-term inefficacy of the so-called dynamic stabilization devices.

scholarly journals Patient-reported scar quality of donor-sites following split-skin grafting in burn patients: Long-term results of a prospective cohort study

Burns ◽  
2020 ◽  
Author(s):  
Catherine M. Legemate ◽  
Pauline J. Ooms ◽  
Nicole Trommel ◽  
Esther Middelkoop ◽  
Margriet E. van Baar ◽  
...  
Keyword(s):  
Cohort Study ◽  
Skin Grafting ◽  
Long Term Results ◽  
Burn Patients ◽  
Split Skin Grafting ◽  
Patient Reported ◽  
Scar Quality ◽  
Split Skin

scholarly journals Percutaneous Chevron Akin (Peca) Osteotomy for Treatment of Hallux Valgus Deformity: The Long- Term Results

2020 ◽  
Vol 5 (4) ◽  
pp. 2473011420S0007
Author(s):  
Peter W. Robinson ◽  
Robbie Ray ◽  
Thomas A. Goff ◽  
Paul M. Dearden ◽  
Clare Watt ◽  
...  
Keyword(s):  
Hallux Valgus ◽  
Weight Bearing ◽  
Patient Reported Outcome Measures ◽  
Long Term Results ◽  
Consecutive Series ◽  
Satisfaction Scale ◽  
Hallux Valgus Deformity ◽  
Patient Reported

Category: Bunion Introduction/Purpose: Little is known about the long-term results of percutaneous hallux valgus correction, particularly the recurrence rate and factors leading to recurrence. Methods: We retrospectively reviewed a single surgeon consecutive series of percutaneous chevron and akin osteotomies (PECA) performed between 2012-14 on 127 feet in 86 patients. Mean age was 52+-13 years at surgery and mean follow up (FU) was 69+-7 months. Patient reported outcome measures (PROMs) were completed by 65 patients (MOXFQ, VAS pain (0-100)) and Likert satisfaction scale by 86 patients. Pre-operative, 6 month and final follow up weight bearing radiographs were available for 68 feet. Radiological parameters measured were the hallux valgus angle (HVA) and 1-2 intermetatarsal angle (IMA). The data was normally distributed and presented as mean+-SD. Paired t-test was used to compare pre- and post-operative angles. Ordinal logistic regression was used to test for significant dependent variables on PROMs. Results: Mean MOXFQ was 10+-16 and mean VAS pain was 6+-13 out of 100 at a mean FU of 69+-7 months. 99% (85/86) patients were highly satisfied or satisfied. Mean HVA improved from 28.3+-8.1º to 8.4+-5.6º at final FU (p<0.001). No clinically relevant difference in HVA was seen between 6 months and final FU. Mean IMA improved from 12.7+-2.9º to 6.2+-2.7º at final FU (p<0.001). 2.9% (2/68) had an HVA >20º at final FU, these both started with a pre-operative HVA >40°. Pre-operative HVA >40º was significantly more likely to have an HVA >20º at final FU than those with pre-operative HVA <40º (22% vs 0%, p<0.001). There were 5 re-operations for removal of screws. 1 foot had hallux varus, but was still satisfied. Conclusion: The 5 year results for PECA hallux valgus correction show high levels of patient satisfaction, function and pain relief, with low complication and re-operation rates. Radiological correction is maintained at long term FU.

Tension Band Wiring Provides Excellent Patient-Reported Long-Term Results for Both Comminuted and Simple Displaced Olecranon Fractures

2020 ◽  
Vol 34 (7) ◽  
pp. e239-e244
Author(s):  
Afra L. E. Terstappen ◽  
Pieter Joosse ◽  
Cornelis F. van Dijke ◽  
Boj Mirck ◽  
Johan G. H. van den Brand
Keyword(s):  
Tension Band ◽  
Tension Band Wiring ◽  
Long Term Results ◽  
Patient Reported ◽  
Olecranon Fractures

Outcomes associated with secondary implant removal and arthrolysis in patients with a painful stiff shoulder after proximal humeral fracture fixation

2022 ◽  
Vol 104-B (1) ◽  
pp. 157-167
Author(s):  
Navnit S. Makaram ◽  
Ewan B. Goudie ◽  
C. Michael Robinson
Keyword(s):  
Proximal Humerus ◽  
Plate Fixation ◽  
Multivariable Analysis ◽  
Long Term Results ◽  
Long Term Outcomes ◽  
Patient Reported ◽  
Long Term Follow Up ◽  
Manual Occupation

Aims Open reduction and plate fixation (ORPF) for displaced proximal humerus fractures can achieve reliably good long-term outcomes. However, a minority of patients have persistent pain and stiffness after surgery and may benefit from open arthrolysis, subacromial decompression, and removal of metalwork (ADROM). The long-term results of ADROM remain unknown; we aimed to assess outcomes of patients undergoing this procedure for stiffness following ORPF, and assess predictors of poor outcome. Methods Between 1998 and 2018, 424 consecutive patients were treated with primary ORPF for proximal humerus fracture. ADROM was offered to symptomatic patients with a healed fracture at six months postoperatively. Patients were followed up retrospectively with demographic data, fracture characteristics, and complications recorded. Active range of motion (aROM), Oxford Shoulder Score (OSS), and EuroQol five-dimension three-level questionnaire (EQ-5D-3L) were recorded preoperatively and postoperatively. Results A total of 138 patients underwent ADROM; 111 patients were available for long-term follow-up at a mean of 10.9 years (range 1 to 20). Mean age was 50.8 years (18 to 75);79 (57.2%) were female. Mean time from primary ORPF to ADROM was 11.9 months (6 to 19). Five patients developed superficial wound infection; ten developed symptomatic osteonecrosis/post-traumatic arthrosis (ON/PTA); four underwent revision arthrolysis. Median OSS improved from 17 (interquartile range (IQR) 12.0 to 22.0) preoperatively to 40.0 (IQR 31.5 to 48.0) postoperatively, and 39.0 (IQR 31.5 to 46.5) at long-term follow-up (p < 0.001). Median EQ-5D-3L improved from 0.079 (IQR -0.057 to 0.215) to 0.691 (IQR 0.441 to 0.941) postoperatively, and 0.701 (IQR 0.570 to 0.832) at long-term follow-up (p < 0.001). We found that aROM improved in all planes (p < 0.001). Among the variables assessed on multivariable analysis, a manual occupation, worsening Charlson Comorbidity Index and increasing socioeconomic deprivation were most consistently predictive of worse patient-reported outcome scores. Patients who subsequently developed ON/PTA reported significantly worse one-year and late OSS. Conclusion ADROM in patients with persistent symptomatic stiffness following ORPF can achieve excellent short- and long-term outcomes. More deprived patients, those in a manual occupation, and those with worsening comorbidities have worse outcomes following ADROM. Cite this article: Bone Joint J 2022;104-B(1):157–167.

Reduced Intensity Conditioning (RIC) Allogeneic Stem Cell Transplantation (allo-SCT) for Patients with Acute Myeloid Leukemia (AML): Long Term Results of a “Donor” Versus “No Donor” Comparison.

Blood ◽  
2007 ◽  
Vol 110 (11) ◽  
pp. 1090-1090
Author(s):  
Mohamad Mohty ◽  
Hugues de Lavallade ◽  
Jean El-Cheikh ◽  
Patrick Ladaique ◽  
Catherine Faucher ◽  
...  
Keyword(s):  
Long Term Results ◽  
Donor Group ◽  
No Donor ◽  
Actual Performance ◽  
Intention To Treat ◽  
Related Donor ◽  
The Difference ◽  
Treat Analysis

Abstract RIC regimens have emerged as an attractive modality to decrease transplant-related toxicity (TRM). However, the potential higher relapse rate after RIC allo-SCT is still under considerable debate. This report describes the long term results of 95 consecutive AML patients, diagnosed between Nov. 1999 and Dec. 2003 in a single institution, and who were considered as potential candidates for RIC-allo-SCT. Using a genetic randomization through a “donor” versus “no donor” comparison, the aim was to assess the real benefit of RIC-allo-SCT for adult AML and its impact on outcome. In this series, 35 patients (37%; “donor” group) had an “identified” HLA-identical sibling donor, while the remaining 60 patients had no HLA-matched related donor (“no donor” group). As per institutional policy, HLA-matched unrelated donors were not considered during the study period. No significant differences in patients or AML features were found between the two groups. In the “donor” group, 25 patients (71%; median age, 51 (range, 26–60)) could actually proceed to the RIC-allo-SCT. The 10 remaining patients with an identified donor did not receive allo-SCT because of early relapse after CR (n=2), patient or donor refusal (n=6), and psychiatric disorders appearing before allo-SCT (n=2). The current median follow-up is 60 months. In an “intention-to-treat” analysis, the KM estimate of leukemia-free survival (LFS) was significantly higher in the “donor” group as compared to the “no donor” group (P=0.003; 60% versus 23% at 7 years). When restricting the analysis to patients who could actually receive the RIC-allo-SCT (median follow-up, 40 months from time of allo-SCT), the difference in LFS was also significant between this group of 25 patients (“transplant” group) and the remaining 70 patients (“no transplant” group) who did not receive allo-SCT (P=0.0002; 72% versus 24% at 7 years). In the “transplant” group, RIC-allo-SCT was performed at a median of 209 (range, 119–413) days after diagnosis. No major toxicities were encountered during RIC administration (fludarabine, busulfan and ATG), and only 3 patients died from TRM, for a cumulative incidence of 12% (95%CI, 3–32%) at last follow-up. This relatively low TRM translated towards a significantly higher overall survival (OS) in the “transplant” group as compared to the “no transplant” group (P=0.0003). In the “intention-to-treat” analysis, OS was still significantly higher in the “donor” group as compared to the “no donor” group (P=0.003; Figure below). After controlling for relevant factors, in the multivariate analysis, only actual performance of RIC-allo-SCT (P=0.0005; RR=4.1; 95%CI, 1.8–9.1), was significantly predictive of an improved LFS, further confirming the overall benefit of RIC-allo-SCT for adult AML patients. We conclude that if a matched related donor is identified, RIC-allo-SCT should be proposed since it represents a valid and potentially curative option for AML patients not eligible for standard myeloablative allo-SCT. Figure Figure

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