scholarly journals Alveolar Echinococcosis—A Challenging Task for the Hepatobiliary Surgeon

Pathogens ◽  
2021 ◽  
Vol 11 (1) ◽  
pp. 40
Author(s):  
Jens Strohaeker ◽  
Mihaly Sulyok ◽  
Alfred Koenigsrainer ◽  
Silvio Nadalin
Keyword(s):  
Liver Resection ◽  
Alveolar Echinococcosis ◽  
Extrahepatic Bile Duct ◽  
High Volume ◽  
Late Presentation ◽  
Long Term Outcomes ◽  
Single Center Experience ◽  
Resected Patient

(1) Background: Alveolar echinococcosis (AE) is an ultimately fatal disease, whose only curative treatment is surgery. Due to its late presentation extended liver resections are often necessary. The true benefit of extensive surgery has yet to be established; (2) Methods: We present a single center experience of 33 cases of Echinococcus multilocularis that have been treated at a high-volume hepatobiliary surgery center between 2004 and 2021. (3) Results: Of the 33 patients 24 patients underwent major liver resection (73%). In addition to the liver resection patients frequently underwent complex extrahepatic procedures such as lymphadenectomy (n = 21, 61%), vascular resections and reconstructions (n = 9, 27%) or resections and reconstruction of the extrahepatic bile duct (n = 11, 33%). Seven patients suffered from ≥ grade III complications (21%). Complete resection was achieved in 17 patients. Fourteen patients had R1 resections and two had macroscopic parasitic remnant (R2). Progressive disease was reported in three patients (The two R2 patients and one R1 resected patient). At a median follow-up of 54 months no mortality has occurred in our cohort; (4) Conclusions: Liver resection remains the gold standard for AE. Even in extensive disease the combination of complex resection and perioperative benzimidazoles can achieve favorable long-term outcomes.

Encephaloduroarteriosynangiosis for Pediatric Moyamoya Disease: A Single-Center Experience With 67 Cases in China

2018 ◽  
Vol 33 (14) ◽  
pp. 901-908 ◽  
Author(s):  
Chengjun Wang ◽  
Meng Zhao ◽  
Jia Wang ◽  
Shuo Wang ◽  
Dong Zhang ◽  
...  
Keyword(s):  
Moyamoya Disease ◽  
Pediatric Patients ◽  
Positive Impact ◽  
Case Series ◽  
Stroke Recurrence ◽  
Long Term Outcomes ◽  
Single Center Experience ◽  
The Mean

The purpose of this study is to investigate the surgical results and long-term outcomes of encephaloduroarteriosynangiosis for moyamoya disease in pediatric patients. We performed a retrospective analysis of 67 pediatric patients with moyamoya disease who underwent encephaloduroarteriosynangiosis in Beijing Tiantan Hospital. The case series included 36 boys and 31 girls. All the patients underwent surgical revascularization, and a total of 93 encephaloduroarteriosynangiosis procedures were performed (41 unilateral, 26 bilateral). The mean follow-up period after surgery was 30 months. During follow-up, ischemic stroke events were detected in 5 patients and the stroke rate for pediatric patients who underwent encephaloduroarteriosynangiosis procedure was 7.1% per patient-years. At the last follow-up, favorable outcomes (modified Rankin Scale score ≤ 2) were observed in 65 cases (97.0%). Our study suggests that long-term surgical outcome of encephaloduroarteriosynangiosis in pediatric moyamoya disease patients is satisfactory, and this technique has a positive impact on the prevention of stroke recurrence.

scholarly journals 324 Outcomes of the Exeter V40 Cemented Femoral Stem at a Minimum of 10 Years in a Non-designer Centre

2021 ◽  
Vol 108 (Supplement_2) ◽  
Author(s):  
J Mahon ◽  
C McCarthy ◽  
G Sheridan ◽  
J Cashman ◽  
J O'Byrne ◽  
...  
Keyword(s):  
Femoral Stem ◽  
High Volume ◽  
Womac Score ◽  
Long Term Outcomes ◽  
Data Set ◽  
The Mean ◽  
Primary Total Hip Arthroplasty

Abstract Introduction The Exeter V40 cemented femoral stem was first introduced in 2000. The largest single-centre analysis of this implant to date was published in 2018, with excellent results at a minimum of 10-years for the first 540 cases performed at the designer centre in the Exeter NHS Trust. The aim of this current study is to report long term outcomes and survivorship for the Exeter V40 stem in a non-designer centre. Method All patients undergoing primary total hip arthroplasty using the Exeter V40 femoral stem between January 1st 2005 and January 31st 2010 were eligible for inclusion. Outcome measures included data on all components in situ beyond 10 years, death occurring within 10 years with components in situ and all-cause revision surgery. Results A total of 829 stems were included in the data set. Of these, 808 (97.5%) had no further surgery within the follow-up period; 648 stems (78.1%) were in situ beyond 10 years, and 165 (19.9%) were in situ at death before 10 years. The mean preoperative WOMAC score was 61±15.9 with a mean postoperative score of 20.4±19.3. Conclusions The Exeter V40 cemented femoral stem demonstrates excellent functional outcomes and survival when used in a high-volume non-designer centre.

Long term outcomes after pancreaticodoudenectomy: a single center experience from Pakistan

2021 ◽  
pp. 1-12
Author(s):  
Abu Bakar Hafeez Bhatti ◽  
Roshni Zahra Jafri ◽  
Eraj Sahaab ◽  
Faisal Saud Dar ◽  
Haseeb Haider Zia ◽  
...  
Keyword(s):  
Hospital Mortality ◽  
High Volume ◽  
Multivisceral Resection ◽  
Single Center ◽  
Long Term Outcomes ◽  
Female Ratio ◽  
Single Center Experience ◽  
Pancreatic Cancers ◽  
Hepatopancreatobiliary Surgery

Abstract Objective: Pancreaticodoudenectomy (PD) remains a challenging surgical procedure. PD outcomes remain under reported from Pakistan. The objective of the current study was to report PD outcomes from a large single center patient cohort. Methods: A total of 155 patients who underwent PD between 2011 and 2019 were included. Outcome was assessed based on morbidity, in hospital mortality and survival. Results: Mean age was 56.8 ±13.5 years (range=8-85). Male to female ratio was (103/52)1.9:1. Overall morbidity was 84/155 (54.2%). Grade B and C pancreatic fistula (PF) were seen in 5 (3.2%) and 6 (3.8%) patients. In hospital mortality was 5/155 (3.2%). The estimated 5 year overall survival (OS) was 11% and 23% for pancreatic and non-pancreatic cancers (P=0.2). The estimated 3 year OS was lower with multivisceral resection (23% vs 5%, P <0.001), advanced tumors (40% vs 11%)(P=0.008) , nodal involvement (34% vs 12%)(P=0.04) and positive microscopic margins (30% vs 8%, P=0.006). Conclusion: Short and long term outcomes comparable to international high volume centers for PD can be achieved with site specific focus in hepatopancreatobiliary surgery. Continuous...

DOZ047.103: Learning curve and long-term outcomes for jejunal replacement of the esophagus: a single-center experience in the pediatric population

2019 ◽  
Vol 32 (Supplement_1) ◽  
Author(s):  
W J Svetanoff ◽  
B Zendejas ◽  
S Bairdain ◽  
K Hernandez ◽  
K Davidson ◽  
...  
Keyword(s):  
Learning Curve ◽  
Complication Rate ◽  
Pediatric Population ◽  
Oral Intake ◽  
Feeding Tube ◽  
Jejunal Interposition ◽  
Long Term Outcomes ◽  
Single Center Experience

Abstract Introduction Patients with complex esophageal atresia (EA) may require replacement; jejunal interposition is an option that is uncommon in children. This study aimed to identify the procedural learning curve and outcomes of patients undergoing jejunal interposition. Methods In a retrospective analysis, patients were divided into those who had surgery between 2010 and 2015 (incipient cohort–previously reported) and those who underwent surgery between 2016 and 2018 (contemporary cohort). Outcomes included length of paralysis (LOP), time to extubation, length of stay (LOS), and complication rate. Current feeding status and time to full oral intake were recorded. Mann–Whitney U and Fisher's exact tests were used for analysis. Results The cohort included 13 in the incipient group and 40 in the contemporary group. LOP (5.33 vs 1.88 days, P = 0.002), time to extubation (9.50 vs 6.34 days, P = 0.05), ICU stay (54 vs 12.65 days, P = 0.04), and LOS (86.77 vs 32.90 days, P = 0.003) were shorter in the contemporary cohort. The complication rate was similar between the incipient and contemporary cohorts, respectively (69.23% vs 50%, P = 0.231). Fourteen patients (incipient–6, contemporary–8) reached full oral intake by a median follow-up of 6.35 months (0.36–26.63 months); another 23 have consistent oral intake but require some use of a feeding tube. All can handle secretions. Patients who had oral intake preoperatively, even with an esophagostomy, were more likely to be eating all consistencies postoperatively (67.74% vs 27.30%, P = 0.004). Conclusion As our experience has improved, LOP, intubation time, and LOS have decreased. Preoperative oral intake, even if sham feeding, was a significant determinant for consistent oral intake postoperatively.

scholarly journals Long-Term Outcome of Enterprise Stenting for Symptomatic ICAS in a High-Volume Stroke Center

2021 ◽  
Vol 12 ◽  
Author(s):  
Rongrong Cui ◽  
Long Yan ◽  
Kaijiang Kang ◽  
Ming Yang ◽  
Ying Yu ◽  
...  
Keyword(s):  
High Volume ◽  
Long Term Outcomes ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Stent Restenosis ◽  
Atherosclerotic Stenosis ◽  
The Mean ◽  
Stroke Center

Background and Purpose: The Enterprise stent has been used for treating intracranial atherosclerotic stenosis (ICAS), but its long-term outcome remains unclear. The purpose of this study was to evaluate the long-term clinical efficacy of the Enterprise stent used for patients with symptomatic ICAS due to hypoperfusion.Method: Patients with symptomatic ICAS due to hypoperfusion treated with the Enterprise stents from a high-volume stroke center were evaluated. The successful recanalization was defined as the Modified Thrombolysis In Cerebral Infarction (mTICI) ≥ 2b. The stroke and neurological death that occurred within 72 h after the procedure as well as long-term clinical and imaging outcomes were analyzed.Results: Overall, 130 patients with 130 ICAS treated with the Enterprise stent were included in our study. The successful recanalization rate was 100%. The mean pre- and postprocedural stenosis was 82.9 ± 8.9% vs. 15.1 ± 8.4%. Periprocedural complications occurred in 5 (3.8%) patients within 72 h after the procedure. Clinical follow-up data were available in 125 (96.2%) patients (median, 24 months) and any stroke or neurological death was encountered in 6 (4.8%) patients. Angiographic follow-up data was obtained from 118 (90.8%) patients (median, 13.5 months). In addition, 1-year in-stent restenosis (&gt;70%) was found in 17 (14.4%) patients, and among them, 4 (23.5%) patients were symptomatic.Conclusion: Deployment of Enterprise stent is safe for ICAS. The short-term and long-term outcomes were acceptable, but the efficacy of the Enterprise stent needs to be further evaluated in future studies.

Is Central Pancreatectomy Truly Recommendable? A 9-Year Single-Center Experience

2017 ◽  
Vol 35 (6) ◽  
pp. 532-538 ◽  
Author(s):  
Ang Lv ◽  
Hong-Gang Qian ◽  
Hui Qiu ◽  
Jian-Hui Wu ◽  
Chun-Yi Hao
Keyword(s):  
Endocrine Function ◽  
Low Grade ◽  
Central Pancreatectomy ◽  
Long Term Outcomes ◽  
Exocrine Insufficiency ◽  
Severe Diarrhea ◽  
Single Center Experience ◽  
Short And Long Term

Aims: To compare the short- and long-term outcomes in patients with pancreatic benign or borderline neoplasm who underwent central pancreatectomy (CP) and distal pancreatectomy (DP). Methods: The inclusion criteria were as follows: (1) single benign or low-grade malignant tumor; (2) tumor confined to the pancreatic neck or proximal body; and (3) tumor amenable to either CP or DP. Short and long-term outcomes, including complications, pancreatic exocrine and endocrine function, and quality of life (QoL) were analyzed retrospectively. Results: Sixteen patients who underwent CP and 26 patients who underwent DP were included. The median follow-up period was 53 months (range 21–117 months). Patients undergoing CP were significantly more likely to experience complications (68.7 vs. 23%, p = 0.003) especially grade B/C postoperative pancreatic fistula (62.5 vs. 23%, p = 0.011) than those undergoing DP. During the long-term follow-up, 2 patients in the DP group developed new-onset diabetes mellitus, but no patient in CP group developed this condition (8 vs. 0%, p = 0.382). Evidence of exocrine insufficiency, including severe diarrhea or steatorrhea, was not observed in either group. Both groups were equally satisfied with the overall health status and overall QoL. Conclusion: CP is associated with excellent pancreatic function but a significantly increased postoperative morbidity and risk compared to DP. Therefore, the indication of CP should be chosen strictly.

1002: Long Term Outcomes for Patients with High Volume Retroperitoneal Teratoma Undergoing Post Chemotherapy Surgery

2007 ◽  
Vol 177 (4S) ◽  
pp. 331-331 ◽  
Author(s):  
Stephen D.W. Beck ◽  
Richard S. Foster ◽  
Richard Bihrle ◽  
John P. Donohue
Keyword(s):  
High Volume ◽  
Long Term Outcomes ◽  
Retroperitoneal Teratoma
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