scholarly journals Early Postoperative Pneumothorax Might Not Be ‘True’ Recurrence

2021 ◽  
Vol 10 (23) ◽  
pp. 5687
Author(s):  
Wongi Woo ◽  
Chong Hoon Kim ◽  
Bong Jun Kim ◽  
Seung Hwan Song ◽  
Duk Hwan Moon ◽  
...  
Keyword(s):  
Temporal Patterns ◽  
Late Recurrence ◽  
Postoperative Recurrence ◽  
Recurrence Rates ◽  
True Recurrence ◽  
Potential Risk Factors ◽  
Multivariable Analyses ◽  
Long Term Prognosis ◽  
Definition Of

Objectives: To date, there is no consensual definition of what constitutes a postoperative recurrence of primary spontaneous pneumothorax (PSP), despite there being many studies reporting a high incidence of recurrence. This study aims to describe the long-term recurrence rates of pneumothorax and to suggest a possible way to differentiate recurrence events based on temporal patterns. Methods: This single-center study retrospectively evaluated all postoperative recurrence of PSP from January 2007 to May 2019. Patients’ demographics, history of pneumothorax, radiologic data, surgical technique, and the time between operation and recurrence were analyzed. Univariate and multivariable analyses were conducted to find potential risk factors related to long-term recurrence. Results: Of the 77 postoperative recurrent cases of pneumothorax, 21 (27.2%) occurred within 30 days after surgery and, thus, were classified as early recurrences (ER), while the remaining cases were classified as late recurrences (LR). There was no difference in preoperative variables between the two groups. However, the rate of incidence of second recurrence (SR), which represented a long-term prognosis, was significantly higher in the LR group (28.6% vs. 4.8%, p = 0.030). On univariate and multivariable analyses, late recurrence was the only significant factor predicting later recurrence events. Conclusion: Postoperative recurrence (PoR) within 30 days had a lower SR rate. Therefore, it might not be a ‘true’ postoperative recurrence with a favorable prognosis. Further studies investigating postoperative recurrence based on temporal patterns would be warranted to improve the classification of PoR.

scholarly journals Surgical treatment of hemorrhoids: a critical appraisal of the current options

2014 ◽  
Vol 27 (1) ◽  
pp. 66-70 ◽  
Author(s):  
Marlise Mello CERATO ◽  
Nilo Luiz CERATO ◽  
Patrícia PASSOS ◽  
Alberto TREIGUE ◽  
Daniel C. DAMIN
Keyword(s):  
Surgical Treatment ◽  
Postoperative Pain ◽  
Treatment Options ◽  
Surgical Techniques ◽  
Postoperative Recurrence ◽  
Long Term Results ◽  
Published Data ◽  
Complication Rates ◽  
Recurrence Rates

Introduction : Surgical treatment of hemorrhoids is still a dilemma. New techniques have been developed leading to a lower rate of postoperative pain; however, they are associated with a greater likelihood of recurrence. Aim : To review current indications as well as the results and complications of the main techniques currently used in the surgical treatment of hemorrhoidal disease. Methods : A systematic search of the published data on the options for treatment of hemorrhoids up to December 2012 was conducted using Medline/PubMed, Cochrane, and UpToDate. Results : Currently available surgical treatment options include procedure for prolapse and hemorrhoids (PPH), transanal hemorrhoidal dearterialization (THD), and conventional hemorrhoidectomy techniques. Excisional techniques showed similar results regarding pain, time to return to normal activities, and complication rates. PPH and THD were associated with less postoperative pain and lower complication rates; however, both had higher postoperative recurrence rates. Conclusion : Conventional surgical techniques yield better long-term results. Despite good results in the immediate postoperative period, PPH and THD have not shown consistent long-term favorable results.

scholarly journals Recurrence Rates After Microvascular Decompression in Patients With Primary Trigeminal Neuralgia and Its Influencing Factors: A Systematic Review and Meta-Analysis Based on 8,172 Surgery Patients

2021 ◽  
Vol 12 ◽  
Author(s):  
Fangyu Chen ◽  
Yuming Niu ◽  
Fan Meng ◽  
Pan Xu ◽  
Chao Zhang ◽  
...  
Keyword(s):  
Systematic Review ◽  
Trigeminal Neuralgia ◽  
Recurrence Rate ◽  
Influencing Factors ◽  
Microvascular Decompression ◽  
Meta Analysis ◽  
Postoperative Recurrence ◽  
Recurrence Rates ◽  
Primary Trigeminal Neuralgia

Background: Primary trigeminal neuralgia (PTN) is known to reoccur following microvascular decompression (MVD) surgery. However, the rates and contributing factors related to PTN recurrence remain controversial. The purpose of this study was to explore the postoperative recurrence rates and related influencing factors of patients with PTN after MVD. Additionally, recurrence rates after different treatments were compared to provide guidelines for clinicians.Methods: We conducted systematic reviews and meta-analyses in accordance with the preferred reporting items of the PRISMA guidelines. We searched nine databases, namely, the PubMed, EMBASE, Cochrane Library, Web of Science, CINAHL, CBM, CNKI, VIP, and Wanfang databases, from establishment to July 13, 2020, selecting for studies about the long-term postoperative efficacy of MVD in the treatment of PTN. Factors associated with higher recurrence rates after MVD and long-term postoperative results of other treatments underwent formal meta-analysis, where odds ratios (ORs) with the corresponding 95% confidence intervals (CIs) were calculated. The dose-response model was used to inspect the associations between several factors and higher recurrence rates.Results: Seventy-four studies (8,172 patients, 32 case series studies, and 42 non-randomized controlled trials) were analyzed in our research. Overall, 956 out of 8,172 patients relapsed, and the pooled recurrence rate was 0.096 (0.080–0.113). Influencing factors of relatively higher recurrence rates included atypical trigeminal neuralgia symptoms, lack of nerve groove, non-arterial compression, patients who were 50–60 years old, and longer disease duration. Dose–response analysis showed that the recurrence rate had a significant trend with the published year and the follow-up time. Simultaneously, the recurrence rate of MVD treatment was much lower than that of conventional drug treatment, gamma knife surgery, percutaneous balloon compression, and radiofrequency thermocoagulation. When the surgical technique was improved or combined with partial sensory rhizotomy (PSR), the postoperative recurrence rates were significantly reduced.Conclusions: Even for PTN patients who have a successful operation, ~10% of them will still relapse. This research identifies several factors that can affect the recurrence rate. Compared with other operations, MVD has a relatively lower recurrence rate. Our analysis suggests that improved surgical techniques and combining PSR and MVD will yield better results.Systematic Review Registration:https://www.crd.york.ac.uk/PROSPERO/, identifier: CRD42020159276.

scholarly journals Laparoscopic Adrenalectomy: Preventive Principles in Intra- and Postoperative Complications

2021 ◽  
Vol 11 (4) ◽  
pp. 284-287
Author(s):  
S. P. Muzhikov ◽  
M. Iu. Eremenko ◽  
A. G. Baryshev
Keyword(s):  
Postoperative Complications ◽  
Laparoscopic Adrenalectomy ◽  
Length Of Hospital Stay ◽  
Operation Technique ◽  
Surgical Trauma ◽  
Satisfactory Condition ◽  
Post Surgery ◽  
Long Term Prognosis ◽  
Definition Of

Background. Laparoscopic adrenalectomy is the current surgery of choice in most adrenal tumours, with a nearly 11 % complication rate and below 1 % mortality. Laparoscopy combines the advantages of minimally invasive surgery with well-known long-term prognosis of a traditional open surgery, at the same time requiring the surgeon’s skill of knowing the technique and avoiding complication.Aim. Concept definition of safe laparoscopic adrenalectomy.Materials and methods. A total of 28 patients with adrenal neoplasms were rendered laparoscopic adrenalectomy by same surgical team under benchmark recommendations during 2016–2019.Results. All patients have been discharged in satisfactory condition, with no intra-, postoperative complications or lethal outcomes.Discussion. Th e evidence presented displays feasibility of using the benchmark principles in laparoscopic adrenalectomy surgery. Laparoscopic adrenalectomy is superior in reducing the recovery time, surgical trauma, complication incidence, length of hospital stay, treatment cost, the improvement of overall wellbeing post-surgery and patients’ quality of life. Th ese principles proved effective to avoid intra- and postoperative complications of laparoscopic adrenalectomy and facilitated revamping of the operation technique in left -sided adrenalectomy.Conclusion. Th e benchmark principles of laparoscopic adrenalectomy enable the procedure higher efficacy and safety and require further implementation and long-term assessment of the outcome.

scholarly journals The Durability of Pain Relief Following Endoscope-Assisted Microvascular Decompression for Trigeminal Neuralgia

Neurosurgery ◽  
2019 ◽  
Vol 66 (Supplement_1) ◽  
Author(s):  
Alexandra D Baker ◽  
Melvin Field
Keyword(s):  
Pain Relief ◽  
Trigeminal Neuralgia ◽  
Recurrence Rate ◽  
Microvascular Decompression ◽  
Retrospective Chart Review ◽  
Postoperative Recurrence ◽  
Pain Scale ◽  
Neurovascular Compression ◽  
Recurrence Rates

Abstract INTRODUCTION Trigeminal neuralgia (TGN) is a facial pain disorder that is paroxysmal, stabbing, and produces a shooting pain that affects the face due to the compression of the trigeminal nerve. Literature has suggested that the use of an endoscope for microvascular decompression (eMVD), as opposed to a microscope alone, is more likely to identify the source of neurovascular compression and ensure that the nerve is adequately decompressed. However, the recurrence of TGN pain continues to be an issue for patients. This project will assess the long-term success of eMVD using the reduction in Barrow Pain Scale score and recurrence rate at 1 yr. METHODS This retrospective chart review aims at exploring the efficacy of eMVD for TGN by studying rates of recurrence in a cohort of 300 patients and comparing them to the literature using descriptive statistics. This is the largest study to date evaluating postoperative recurrence for eMVD for TGN. RESULTS In this cohort, on average, patients reduced their pain scale by 2.99 units on the Barrow Pain Scale. Additionally, 95.5% of patients experienced an immediate pain relief after eMVD surgery, while only 4.3% had no improvement in TGN pain after the procedure. In this eMVD patient cohort, 22% of patients had partial recurrence of TGN pain. CONCLUSION The endoscope seems to provide long-term success for eliminating TGN pain and is at least as successful as traditional MVD. Over 95% of patients with follow-up data experienced an immediate pain relief, indicating that the efficacy of this procedure is excellent. Recurrence rates of TGN pain seem to be comparable to the existing literature on traditional MVD approaches. This cohort had a partial recurrence rate of 22%, while previous MVD studies have shown significant recurrence rates between 3% and 32%. This indicates that significant recurrence rates of TGN need to be further investigated.

Maintenance Therapy for Prevention of Recurrent Peptic Ulcers

1987 ◽  
Vol 21 (6) ◽  
pp. 493-501 ◽  
Author(s):  
Rosemary R. Berardi ◽  
Maureen E. Savitsky ◽  
Timothy T. Nostrant
Keyword(s):  
Maintenance Therapy ◽  
Low Dose ◽  
Response To Treatment ◽  
Gastric Ulcers ◽  
Ulcer Recurrence ◽  
Peptic Ulcers ◽  
Recurrence Rates ◽  
Ulcer Disease ◽  
Potential Risk Factors

Peptic ulcer disease is a chronic, relapsing disease. Successful healing of duodenal and gastric ulcers with antacids, cimetidine, ranitidine, famotidine, or sucralfate is frequently followed by ulcer recurrence. The need for long-term, low-dose maintenance therapy is based on disease severity, ulcer history, complications, therapeutic intervention, response to treatment, and potential risk factors. Comparison of ulcer maintenance trials requires consideration of important factors such as frequency of endoscopy, duration of follow-up period, and the method used to calculate ulcer recurrence rates. Clinical trials indicate that chronic treatment with low-dose cimetidine, ranitidine, famotidine, and probably sucralfate decreases the frequency of duodenal ulcer recurrence and that ranitidine may be superior to cimetidine. Preliminary studies indicate that higher doses of these same medications may be required to prevent gastric ulcer recurrence. Long-term maintenance therapy with these agents must be continuous in order to prevent relapses, but treatment should be limited to one year because of unknown consequences beyond this period.

Retrospective interview-based long-term follow-up study of cats diagnosed with idiopathic cystitis in 2003–2009

2021 ◽  
pp. 1098612X2199030
Author(s):  
Anna V Eggertsdóttir ◽  
Stine Blankvandsbråten ◽  
Páll Gretarsson ◽  
Anna E Olofsson ◽  
Heidi S Lund
Keyword(s):  
Clinical Signs ◽  
Recurrence Rates ◽  
Telephone Interviews ◽  
Long Term Follow Up ◽  
Tract Disease ◽  
Long Term Prognosis ◽  
Related Mortality ◽  
Observation Period

Objectives The aim of this study was to register long-term recurrence rates and mortality rates in cats diagnosed with feline idiopathic cystitis (FIC), with an observation period until death or a minimum of 10 years. Methods Data regarding recurrence of signs of feline lower urinary tract disease (FLUTD) and FLUTD-related mortality in cats diagnosed with FIC between 2003 and 2009 were obtained through structured telephone interviews with the cat owners from December 2018 until February 2019. The interviews were based on a standardised questionnaire covering whether the cat was still alive or not, whether death/euthanasia were due to FLUTD and whether the cat had experienced recurrent episodes of clinical signs of FLUTD. If recurrences had occurred, exact numbers or estimates of 1–3, 4–6 or >6 recurrences were recorded. Results The owners of 50/105 FIC cats included in a previous study (48%) were available for inclusion in the present study. At the time of the interview, only 6/50 cats (12%) were still alive. The FLUTD-related mortality rate was 20% (n = 10/50). Twenty-three cats (46%) had no recurrences, three cats (6%) were euthanased shortly after diagnosis, nine cats (18%) had 1–3 recurrences, three cats (6%) had 4–6 recurrences and six cats (12%) had >6 recurrences. For the remaining six cats, the number of recurrences was uncertain. Conclusions and relevance The long-term prognosis for cats diagnosed with FIC may, based on the results from the present study, be regarded as fairly good, as approximately 70% of the cats either recovered without additional episodes, experienced only a few recurrences, are still alive after a minimum of 10 years since inclusion in the study, or were euthanased for reasons unrelated to FLUTD.

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