scholarly journals Canaloplasty in Pigmentary Glaucoma: Long-Term Outcomes and Proposal of a New Hypothesis on Its Intraocular Pressure Lowering Mechanism

2020 ◽  
Vol 9 (12) ◽  
pp. 4024
Author(s):  
Paolo Brusini ◽  
Veronica Papa
Keyword(s):  
Intraocular Pressure ◽  
Trabecular Meshwork ◽  
Long Term Results ◽  
Pigmentary Glaucoma ◽  
Long Term Outcomes ◽  
Pressure Lowering ◽  
Visual Field Damage ◽  
The Mean ◽  
New Hypothesis

This study presents the long-term results on canaloplasty in a group of patients affected by pigmentary glaucoma, and studies the progression of the disease after surgery. Material and methods: Twenty-nine eyes of 25 patients with pigmentary glaucoma in maximum tolerated medical therapy with significant visual field damage progression underwent canaloplasty and were followed up to 11 years (mean 59.8 ± 30.1 months). All patients underwent a complete ophthalmic examination every 6 months. Results: The pre-operative mean intraocular pressure (IOP) was 31.8 mmHg ± 10.9 (range 21–70) with an average of 3.3 medications. After 1, 2, 3, and 4 years, the mean IOP was 15.9 ± 4.0, 14.4 ± 7.3, 14.1 ± 2.1, and 15.7 mmHg, respectively, with 0.4, 0.5, and 0.7 medications, respectively. Four patients underwent trabeculectomy after 3 to 30 months due to uncontrolled IOP. Gonioscopy showed a significant reduction of pigment in trabecular meshwork in all cases, starting from the sixth month. In some cases, the pigment was almost completely reabsorbed after two years, suggesting an accelerated transit and escape of the granules through the trabecular spaces. Conclusions: Canaloplasty seems to be a reasonable option in treating patients affected by progressive pigmentary glaucoma. The reabsorption of pigment granules from the trabecular meshwork could, at least in part, explain the relatively high success rate observed after this surgical procedure.

scholarly journals Comparative analysis of resection and draining interventions in patients with cystic pancreatic lesions

2020 ◽  
Vol 48 (3) ◽  
pp. 18-22
Author(s):  
A. P. Koshel ◽  
S. S. Klokov ◽  
T. V. Dibina ◽  
E. S. Drozdov ◽  
Yu. Yu. Rakina
Keyword(s):  
Long Term Results ◽  
Pancreatic Pseudocysts ◽  
Cystic Lesions ◽  
Long Term Outcomes ◽  
Duration Of Surgery ◽  
Short And Long Term ◽  
The Mean ◽  
Cystic Pancreatic Lesions ◽  
Length Of Hospitalization

Aim of study: to evaluate the results of draining and resection interventions in patients with pancreatic cystic lesions. Materials and methods. A retrospective analysis of the treatment of 50 patients with pancreatic cystic lesions of various etiologies was conducted. All patients included in the study underwent surgical treatment, namely 20 (40.0%) resection interventions (RI) and 30 (60.0%) draining interventions (DI). Comparison of short- and long-term outcomes of treatment between the two groups was carried out. Results. There were no statistically significant differences in body mass index in the compared groups. The average duration of surgery in DI group was significantly lower than in RI group (142.5±4.9 and 278.5±6.9, p<0.001). The mean intraoperative blood loss, as well as the length of hospitalization, was significantly lower in DI group as compared with RI (390±28.4 ml, 500±27.4 ml, p=0.008; 8.5±0.9 days, 13.8±3.9 days, p<0.001). The severity of postoperative complications was proved to be significantly higher in RI group (p<0.05). However, when analyzing long-term results, the attacks-free course of the disease was observed only in RI group. Conclusion. If technically possible, DI is more preferable than RI in patients with pancreatic pseudocysts. RI should be performed in patients with cystic neoplasia.

scholarly journals Long-Term Outcomes of Initial Trabeculectomy in Glaucoma Associated with Granulomatous and Non-Granulomatous Uveitis

2021 ◽  
Author(s):  
Faisal A. Almobarak ◽  
Ali H. Alharbi ◽  
Ibrahim Aljadaan ◽  
Hassan Aldhibi
Keyword(s):  
Intraocular Pressure ◽  
Postoperative Complications ◽  
Late Onset ◽  
Success Rates ◽  
Long Term Outcomes ◽  
Granulomatous Uveitis ◽  
The Mean ◽  
Retrospective Comparative Study

Abstract Purpose To evaluate the outcomes of initial trabeculectomy in granulomatous and non-granulomatous uveitis. Methods Retrospective comparative study of 68 eyes that underwent an initial trabeculectomy. Results The mean follow-up was 74.18 and 74.86 months in both groups (p = 0.95). The intraocular pressure decreased from 40.03 mmHg (± 7.2) and 36.48 mmHg (± 11.3) to 14.00 mmHg (± 6.2) and 13.48 mmHg (± 5.7), the number of medications decreased from 3.73 (± 0.7) and 3.58 (± 0.9) to 1.00 (± 1.4) and 1.13 (± 1.4) on the last follow-up (p < 0.01) in the granulomatous and non-granulomatous groups, respectively. More eyes in the granulomatous uveitis group developed delayed postoperative complications like cataract, transient hypotony and glaucoma progression. Success rates were 64.9 and 71.0%, while failure rates were 35.1 and 29.0% in both groups (p = 0.84). Conclusions Trabeculectomy seems to have comparable IOP control and survival in granulomatous and non-granulomatous uveitis. Nevertheless, more eyes in the granulomatous uveitis group developed late onset complications.

scholarly journals Urothelial-based reconstructive surgery for upper- and mid-ureteral defects: Long-term results

2016 ◽  
Vol 10 (9-10) ◽  
pp. 290
Author(s):  
Barak Rosenzweig ◽  
Yoram Mor ◽  
Tomer Erlich ◽  
Menachem Laufer ◽  
Harry Winkler ◽  
...  
Keyword(s):  
Renal Function ◽  
Reconstructive Surgery ◽  
Long Term Results ◽  
Obstructive Nephropathy ◽  
Complication Rates ◽  
Long Term Outcomes ◽  
Renal Function Deterioration ◽  
The Mean ◽  
Long Term Preservation

<p><strong>Introduction:</strong> Ureteral strictures can result in obstructive nephropathy and renal function deterioration. Surgical management of ureteral defects, especially in the proximal- and mid-ureter, is particularly challenging. Our purpose was to analyze the long-term outcomes of urothelial-based reconstructive surgery for upper- and mid-ureteral defects.</p><p><strong>Methods:</strong> We conducted a retrospective analysis of a single tertiary centre’s database, including 149 patients treated for ureteral defects between 2001 and 2011. Thirty-one patients (21%) underwent complex urothelial-based surgical repairs for upper- and mid-ureter defects. Patients’ median age was 61 years. The mean length of the ureteral strictures was 2.5 cm, located in upper-, mid-ureter, or in between in 19 (61%), 10 (32%), and two (6%) patients, respectively. All patients were treated with a primary urothelial-based repair. Median followup time was 26 months. The primary outcome of the study was the long-term preservation of renal function and lack of clinical obstruction. The secondary endpoint of the study was the assessment of the intra- and postoperative complication rates.</p><p><strong>Results:</strong> Most of the lesions were benign (22, 71%), while nine strictures (29%) were malignant. Seven patients (23%) suffered from postoperative complications, five of which were infectious. The median pre- and postoperative calculated glomerular filtration rates were 66 ml/min/1.72m2 and 64ml/min/1.72m2, respectively. Success rate was 84%, defined as lack of need for re-operation or kidney drainage at the last followup.</p><p><strong>Conclusions:</strong> Upper- and mid-ureteral defects present a complex pathology necessitating experienced reconstructive surgical skills. Our data suggest good long-term results for primary urothelialbased reconstructions for these pathologies.</p>

scholarly journals Transsphenoidal Surgery for Cushing Disease

Neurosurgery ◽  
2011 ◽  
Vol 70 (1) ◽  
pp. 70-81 ◽  
Author(s):  
Ivan Ciric ◽  
Jin-Cheng Zhao ◽  
Hongyan Du ◽  
James W. Findling ◽  
Mark E. Molitch ◽  
...  
Keyword(s):  
Clinical Evidence ◽  
Statistical Significance ◽  
Long Term Results ◽  
Long Term Outcomes ◽  
Cushing Disease ◽  
Transsphenoidal Microsurgery ◽  
The Mean ◽  
Magnetic Resonance Imaging Mri

Abstract BACKGROUND This is a retrospective study of 136 patients with Cushing disease treated with transsphenoidal microsurgery. OBJECTIVE To evaluate factors influencing immediate postoperative results and long-term outcomes. METHODS Data regarding clinical presentation, endocrine evaluation, imaging studies, surgical technique, immediate postoperative biochemical remission (IPBR), and long-term results were entered into a database and analyzed statistically. IPBR was based on biochemical evidence of adrenal cortical insufficiency and clinical evidence of such insufficiency. RESULTS IPBR for the entire series was 83.4%. In microadenomas, IPBR was 89.8% with a mean immediate postoperative plasma cortisol (IPPC) of 2.1 μg/dL (range, &lt;0.5-5.3). Positive magnetic resonance imaging (MRI) was associated with 18 times greater odds of finding microadenoma at surgery (P &gt; .001) and with 4.1 times greater odds of IPBR (P = .07). In patients with a negative MRI, a positive inferior petrosal sinus sampling (IPSS) test was associated with 93% of IPBR (P = .004). IPBR in macroadenomas was 30.7%. Of patients followed for 12 months or longer, 34.8% required glucocorticoid replacement for the duration of follow-up. The mean follow-up in microadenomas was 68.4 months with a 9.67% incidence of recurrences. The estimated actuarial incidence of recurrences increased with the passage of time and IPPC of greater than 2 μg/dL was associated with higher incidence of recurrences, although without statistical significance (P = .08). CONCLUSION In microadenomas, a positive MRI and positive IPSS test were associated with a higher incidence of IPBR. Recurrences increased with the passage of time, and an IPPC of greater than 2 μg/dL may be associated with higher incidence of recurrences.

Endoscopic-Powered Dacryocystorhinostomy Without Stenting: Long-term Outcomes of 120 Procedures

2018 ◽  
Vol 32 (4) ◽  
pp. 303-309 ◽  
Author(s):  
Ejder Ciğer ◽  
Mustafa K. Balci ◽  
Seçil Arslanoğlu ◽  
Erdem Eren
Keyword(s):  
Functional Outcomes ◽  
Nasolacrimal Duct ◽  
Long Term Results ◽  
Success Rates ◽  
Long Term Outcomes ◽  
Duct Obstruction ◽  
The Mean ◽  
Anatomical Success

Background The necessity of silicone stenting in endoscopic dacryocystorhinostomy (DCR) procedures is a controversial subject in the literature. Objective The purpose of the present study is to assess the long-term anatomical and functional outcomes of endoscopic-powered DCR (EP-DCR) without stenting or mucosal flaps. Methods One hundred twenty EP-DCR procedures were performed in 107 patients. Anatomical success was defined as a patent ostium on irrigation and functional success as free flow of dye from the ostium and resolution of epiphora. Results The mean follow-up was 46.5 months (range: 24–87). Of the 120 procedures, 13 were bilateral and 94 were unilateral. Anatomical and functional success rates of 92.5% were obtained. Conclusion EP-DCR without stenting is a safe and economic technique that provides satisfactory long-term results and could be considered as the treatment of choice for patients with postsaccal nasolacrimal duct obstruction.

Results of 110 IVORY® prostheses for trapeziometacarpal osteoarthritis with a minimum follow-up of 10 years

2020 ◽  
Vol 45 (5) ◽  
pp. 458-464 ◽  
Author(s):  
Alain Tchurukdichian ◽  
David Guillier ◽  
Vivien Moris ◽  
Leslie-Ann See ◽  
Yvan Macheboeuf
Keyword(s):  
Survival Curve ◽  
Long Term Results ◽  
Long Term Outcomes ◽  
Level Of Evidence ◽  
Visual Analogue Pain ◽  
Kaplan Meier ◽  
Trapeziometacarpal Osteoarthritis ◽  
The Mean

The IVORY® prosthesis is a total trapeziometacarpal joint prosthesis used for the treatment of symptomatic trapeziometacarpal osteoarthritis. The aim of this prospective study was to evaluate its long-term outcomes with a minimum follow-up of 10 years. From 2004 to 2007, 110 trapeziometacarpal prostheses (95 patients) were implanted. The implant survival curve was constructed using the Kaplan–Meier method. Five patients were lost from follow-up and two died. Six prosthesis (5.5%) were removed after dislocation or fracture of the trapezium. The survival rate of the prosthesis was 95%. After 10 years, the mean visual analogue pain score was 0.24/10 and the key-pinch force was similar to the other hand. Dislocations occurred for eight implants (7.3%). No radiological loosening was noted. In conclusion, the long-term results with the IVORY® prosthesis are very satisfactory in terms of pain relief, function and survival. Level of evidence: II

scholarly journals Long-term outcomes of aortic valve repair in children with congenital heart disease and their predictors

2020 ◽  
Vol 25 (8) ◽  
pp. 3971
Author(s):  
Z. M. Abdurakhmanov ◽  
I. N. Yemets
Keyword(s):  
Aortic Valve ◽  
Aortic Regurgitation ◽  
Aortic Valve Repair ◽  
Long Term Results ◽  
Composite Outcome ◽  
Valve Repair ◽  
Long Term Outcomes ◽  
The Mean

Aim. To retrospectively analyze the long-term results of primary aortic valve repair (AVR) in children.Material and methods. The study included 163 patients operated on from 2004 to 2019. The mean age was 9,58±9,3 years. The patients underwent commissurotomy, decalcification, raphe resection, Trusler technique, raphe shaving, free margin plication, leaflet replacement, leaflet extension, subcommissural annuloplasty, valve sparing aortic root replacement and neocuspidization. Primary endpoint was a composite outcome of freedom from reoperation, recurrent greater than moderate aortic regurgitation, stenosis, whereas secondary — overall survival.Results. The indications for the procedure were stenotic, regurgitant or mixed defect in 80 (49,1%), 38 (23,3%), and 45 (27,6%) patients, respectively. The 10-year survival rate was 99,4%. The mean follow-up was 3,6±1,8 years. Freedom from reoperation, recurrent moderate and greater aortic regurgitation, stenosis at 1,5 and 7 years was, 95%, 70% and 47%, respectively. In multivariate analysis, Trusler technique, leaflet extension, raphe shaving, use of patch, leaflet retraction, complexity of repair were predictors for composite outcome.Conclusion. Reconstruction of aortic valve in children is effective and safe. Avoidance of predictors may significantly improve the long-term results of aortic valve repair.

Clinical Experience with a New Nitinol Self-Expanding Stent in Peripheral Arteries

1996 ◽  
Vol 3 (4) ◽  
pp. 369-379 ◽  
Author(s):  
Michel Henry ◽  
Max Amor ◽  
Rafael Beyar ◽  
Isabelle Henry ◽  
Jean-Marc Porte ◽  
...  
Keyword(s):  
Long Term Results ◽  
Lesion Length ◽  
Secondary Patency ◽  
Peripheral Arteries ◽  
External Compression ◽  
Nitinol Stent ◽  
Nitinol Stents ◽  
The Mean

Purpose: To evaluate a new self-expanding nitinol coil stent in stenotic or occluded peripheral arteries. Methods: Seventy-three symptomatic patients (58 men; mean age 67 years) were treated with nitinol stents for lesions in the iliac artery (9 stenoses); superficial femoral artery (SFA) (39 stenoses, 6 occlusions); popliteal artery and tibioperoneal trunk (9 stenoses, 7 occlusions); and 3 bypass grafts. Mean diameter stenosis was 84.4% ± 9.9% (range 75% to 100%), and mean lesion length was 45 ± 23 mm (range 20 to 120 mm). Results: Eighty-eight 40-mm-long stents with diameters between 5 and 8 mm were implanted percutaneously for suboptimal dilation (n = 45); dissection (n = 21); and restenosis (n = 7). All stents but one were implanted successfully; the malpositioned stent was removed, and another stent was successfully deployed. There were 3 (4.1%) failures due to thrombosis at 24 hours. During the mean 16-month follow-up (range to 44 months), 4 restenoses (3 femoral, 1 popliteal) have occurred; 2 were treated with repeat dilation and 2 underwent bypass. Primary and secondary patency rates at 18 months were 87% and 90%, respectively, for all lesions (iliac: 100% for both; femoral: 85% and 88%; popliteal: 87% and 100%). Conclusions: This new nitinol stent seems to be safe and effective with favorable long-term results, even in distal SFA lesions and popliteal arteries. Its flexibility and resistance to external compression allow its placement in tortuous arteries and near joints.

scholarly journals Surgical treatment of pulmonary artery sarcoma: a report of 17 cases

2021 ◽  
Vol 11 (1) ◽  
pp. 204589402098639
Author(s):  
Wu Song ◽  
Long Deng ◽  
Jiade Zhu ◽  
Shanshan Zheng ◽  
Haiping Wang ◽  
...  
Keyword(s):  
Pulmonary Artery ◽  
Survival Rates ◽  
Tumor Resection ◽  
Long Term Results ◽  
Pulmonary Endarterectomy ◽  
Pulmonary Artery Sarcoma ◽  
The Mean ◽  
Operative Findings

Pulmonary artery sarcoma (PAS) is a rare and devastating disease. The diagnosis is often delayed, and optimal treatment remains unclear. The aim of this study is to report our experience in the surgical management of this disease. Between 2000 and 2018, 17 patients underwent operations for PAS at our center. The medical records were retrospectively reviewed to evaluate the clinical characteristics, operative findings, the postoperative outcomes, and the long-term results. The mean age at operation was 46.0 ± 12.4 years (range, 26–79 years), and eight (47.1%) patients were male. Six patients underwent tumor resection alone, whereas the other 11 patients received pulmonary endarterectomy (PEA). There were two perioperative deaths. Follow-up was completed for all patients with a mean duration of 23.5 ± 17.6 months (1–52 months). For all 17 patients, the median postoperative survival was 36 months, and estimated cumulative survival rates at 1, 2, 3, and 4 years were 60.0%, 51.4%, 42.9%, and 21.4%, respectively. The mean survival was 37.0 months after PEA and 14.6 months after tumor resection only ( p = 0.046). Patients who had no pulmonary hypertension (PH) postoperatively were associated with improved median survival (48 vs. 5 months, p = 0.023). In conclusion, PAS is often mistaken for chronic pulmonary thromboembolism. The prognosis of this very infrequent disease remains poor. Early detection is essential for prompt and best surgical approach, superior to tumor resection alone, and PEA surgery with PH relieved can provide better chance of survival.

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