LONG-TERM RESULTS OF COMBINED TREATMENT FOR DUCTAL PANCREATIC HEAD ADENOCARCINOMA BY MEANS OF INTRAARTERIAL PERIOPERATIVE CHEMOTHERAPY WITH OXALIPLATIN AND GEMCITABINE

2018 ◽  
Vol 64 (1) ◽  
pp. 116-120
Author(s):  
Aleksandr Pavlovskiy ◽  
Aleksey Polikarpov ◽  
Viktor Moiseenko ◽  
Sergey Popov ◽  
Dmitriy Granov ◽  
...  
Keyword(s):  
Operative Treatment ◽  
Combined Treatment ◽  
Survival Rates ◽  
Pancreatic Head ◽  
Celiac Trunk ◽  
Regional Chemotherapy ◽  
Long Term Results ◽  
Ductal Adenocarcinoma ◽  
Perioperative Chemotherapy

Aim. Evaluation of long-term results of perioperative regional chemotherapy with gemcitabine and oxaliplatin in combined treatment of ductal adenocarcinoma of the pancreatic head. Material and methods. The first group consisted of 52 patients who received combined treatment: neoadjuvant chemoembolization (CE) with gemcitabine (400 mg / m2) and oxaliplatin (50 mg / m2) (GemOx), operative treatment, as well as up to 6 courses of chemoinfusion (CI) in the celiac trunk of gemcitabine (1000 mg / m2) and oxaliplatin (75 mg / m2) in the adjuvant regime. In the second group of 51 patients, perioperative regional chemotherapy (neoadjuvant CE and adjuvant CI) with gemcitabine (1000 mg / m 2) (Gem) was performed. 54 patients of the third group performed only operative intervention. Results. No complications associated with medical-diagnostic angiography and catheterization were observed. The median of life expectancy in the group of patients who received only operative treatment was 8.4 ±1.2 months, in the group of perioperative chemotherapy Gem-22.3 ± 1.5, in the group of patients who underwent perioperative regional chemotherapy GemOx-26 ± 1.1 months. Five-year survival rates in the groups were 0%, 10% and 13% and respectively Conclusions. A use of regional chemotherapy with gemcitabine and oxaliplatin can be regarded as a useful and effective step in combined treatment of pancreatic head adenocarcinoma.

scholarly journals Influence of perioperative intraarterial selective chemotherapy on terms of recurrent ductal adenocarcinoma of the pancreatic head after pancreaticoduodenectomy

2018 ◽  
Vol 23 (3) ◽  
pp. 14-22
Author(s):  
A. V. Pavlovskiy ◽  
V. E. Moiseenko ◽  
S. A. Popov ◽  
A. A. Polikarpov ◽  
A. A. Statsenko ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Combined Treatment ◽  
Pancreatic Head ◽  
Celiac Trunk ◽  
Progression Free Survival ◽  
Regional Chemotherapy ◽  
Main Group ◽  
Ductal Adenocarcinoma ◽  
Control Group ◽  
Selective Chemotherapy

Aim. To analyze influence of perioperative intra-arterial selective chemotherapy on terms of recurrent ductal adenocarcinoma of pancreatic head after pancreaticoduodenectomy.Material and methods. 111 patients underwent combined treatment. Surgical stage included conventional pylorussparing pancreaticoduodenectomy in all groups. The main group consisted of 52 patients who received combined treatment: neoadjuvant chemoembolization with gemcitabine (400 mg/m2) and oxaliplatin (50 mg/m2), surgical treatment and 6 courses of regional chemotherapy – infusion of gemcitabine (800 mg/m2) and oxaliplatin (45 mg/m2) into celiac trunk in adjuvant mode. The control group was presented by 59 patients who underwent perioperative regional chemotherapy (neoadjuvant chemoembolization and adjuvant infusion of gemcitabine (800 mg/m2). Progression-free survival (PFS) and terms of recurrence were analyzed in all groups. In case of progression and recurrence we applied regional chemotherapy alone. Systemic chemotherapy was not used in the study.Results. Annual PFS in the main and the control groups was 80%. Three-year PFS in the main group was 37%, in the control group – 14% (p < 0.01). Five-year PFS was 11% in the main group and absent in the control group. Median survival was 26 months in the main group and 22.6 months in the control group. Overall annual, 2-year and 5-year survival in main group was 80%, 57% and 15%, respectively.Conclusion. Regional intra-arterial chemotherapy decreases incidence of recurrences and improves PFS after surgical treatment of pancreatic head adenocarcinoma.Further multi-center studies are necessary to assess the effectiveness of regional chemotherapy.

Long-term Results of Partial Pancreaticoduodenectomy for Ductal Adenocarcinoma of the Pancreatic Head: 25-Year Experience

2003 ◽  
Vol 27 (3) ◽  
pp. 324-329 ◽  
Author(s):  
Axel Richter ◽  
Marco Niedergethmann ◽  
J&#x000F6;rg W. Sturm ◽  
Dietmar Lorenz ◽  
Stefan Post ◽  
...  
Keyword(s):  
Pancreatic Head ◽  
Long Term Results ◽  
Ductal Adenocarcinoma ◽  
Partial Pancreaticoduodenectomy

Transapical versus Conventional Aortic Valve Replacement�A Propensity-Matched Comparison

2012 ◽  
Vol 15 (1) ◽  
pp. 4 ◽  
Author(s):  
David M. Holzhey ◽  
William Shi ◽  
A. Rastan ◽  
Michael A. Borger ◽  
Martin H�nsig ◽  
...  
Keyword(s):  
Aortic Valve ◽  
Survival Rates ◽  
Long Term Results ◽  
Term Survival ◽  
Kaplan Meier ◽  
Risk Patients ◽  
Short And Long Term ◽  
Good Treatment Option ◽  
Matched Comparison

<p><b>Introduction:</b> The goal of this study was to compare the short- and long-term outcomes after aortic valve (AV) surgery carried out via standard sternotomy/partial sternotomy versus transapical transcatheter AV implantation (taTAVI).</p><p><b>Patients and Methods:</b> All 336 patients who underwent taTAVI between 2006 and 2010 were compared with 4533 patients who underwent conventional AV replacement (AVR) operations between 2001 and 2010. Using propensity score matching, we identified and consecutively compared 2 very similar groups of 167 patients each. The focus was on periprocedural complications and long-term survival.</p><p><b>Results:</b> The 30-day mortality rate was 10.8% and 8.4% (<i>P</i> = .56) for the conventional AVR patients and the TAVI patients, respectively. The percentages of postoperative pacemaker implantations (15.0% versus 6.0%, <i>P</i> = .017) and cases of renal failure requiring dialysis (25.7% versus 12.6%, <i>P</i> = .004) were higher in the TAVI group. Kaplan-Meier curves diverged after half a year in favor of conventional surgery. The estimated 3-year survival rates were 53.5% � 5.7% (TAVI) and 66.7% � 0.2% (conventional AVR).</p><p><b>Conclusion:</b> Our study shows that even with all the latest successes in catheter-based AV implantation, the conventional surgical approach is still a very good treatment option with excellent long-term results, even for older, high-risk patients.</p>

Pulmonary Homografts for Aortic Valve Replacement: Long-term Comparison with Aortic Grafts

2011 ◽  
Vol 14 (4) ◽  
pp. 237 ◽  
Author(s):  
Ferdinand Vogt ◽  
Anke Kowert ◽  
Andres Beiras-Fernandez ◽  
Martin Oberhoffer ◽  
Ingo Kaczmarek ◽  
...  
Keyword(s):  
Aortic Valve ◽  
Aortic Valve Replacement ◽  
Valve Replacement ◽  
Survival Rates ◽  
Long Term Results ◽  
Rank Test ◽  
Aortic Graft ◽  
Valve Prostheses ◽  
Retrospective Comparative Study

<p><b>Objective:</b> The use of homografts for aortic valve replacement (AVR) is an alternative to mechanical or biological valve prostheses, especially in younger patients. This retrospective comparative study evaluated our single-center long-term results, with a focus on the different origins of the homografts.</p><p><b>Methods:</b> Since 1992, 366 adult patients have undergone AVR with homografts at our center. We compared 320 homografts of aortic origin and 46 homografts of pulmonary origin. The grafts were implanted via either a subcoronary technique or the root replacement technique. We performed a multivariate analysis to identify independent factors that influence survival. Freedom from reintervention and survival rates were calculated as cumulative events according to the Kaplan-Meier method, and differences were tested with the log-rank test.</p><p><b>Results:</b> Overall mortality within 1 year was 6.5% (21/320) in the aortic graft group and 17.4% (8/46) in the pulmonary graft group. In the pulmonary graft group, 4 patients died from valve-related complications, 1 patient died after additional heterotopic heart transplantation, and 1 patient who entered with a primary higher risk died from a prosthesis infection. Two patients died from non-valve-related causes. During the long-term follow-up, the 15-year survival rate was 79.9% for patients in the aortic graft group and 68.7% for patients in the pulmonary graft group (<i>P</i> = .049). The rate of freedom from reoperation was 77.7% in the aortic graft group and 57.4% in the pulmonary graft group (<i>P</i> < .001). The reasons for homograft explantation were graft infections (aortic graft group, 5.0%; pulmonary graft group, 6.5%) and degeneration (aortic graft group, 7.5%; pulmonary graft group, 32.6%).</p><p><b>Conclusion:</b> Our study demonstrated superior rates of survival and freedom from reintervention after AVR with aortic homografts. Implantation with a pulmonary graft was associated with a higher risk of redo surgery, owing to earlier degenerative alterations.</p>

Analysis long-term results of combined treatment pellucid marginal degeneration

2020 ◽  
pp. 63-64
Author(s):  
I.V. Vasilieva ◽  
◽  
V.V. Egorov ◽  
S.V. Kostenev ◽  
A.V. Vasiliev ◽  
...  
Keyword(s):  
Combined Treatment ◽  
Long Term Results

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.

Long-term results of pyloroplasty

1934 ◽  
Vol 30 (7-8) ◽  
pp. 720-726
Author(s):  
D. S. Klebanov
Keyword(s):  
Operative Treatment ◽  
Central Point ◽  
Long Term Results ◽  
Small Curvature ◽  
Therapeutic Method ◽  
Theoretical Substantiation

The theoretical substantiation of pyloroplasty as a therapeutic method in adults is based on the provisions, which are still very problematic today. Russian authors (Breitsev, Grekov et al.), who first proposed this operation in adults, set indications for this kind of intervention very broadly and considered it indicated not only for pylorospasm without visible ulcer, but also for ulcers of the small curvature and for ulcers of the 12th bowel. At the same time these authors proceeded from the position that pylorospasm is the central point in the pathogenesis and course of ulcers and they considered its elimination to be very important in the operative treatment of ulcers.

LONG-TERM RESULTS AND LATE COMPLICATIONS AFTER INTRACAVITARY YTTRIUM-90 COLLOID IRRADIATION OF RECURRENT CYSTIC CRANIOPHARYNGIOMAS

Neurosurgery ◽  
2007 ◽  
Vol 61 (2) ◽  
pp. 288-296 ◽  
Author(s):  
Jenö Julow ◽  
Erik-Olof Backlund ◽  
Ferenc Lányi ◽  
Márta Hajda ◽  
Katalin Bálint ◽  
...  
Keyword(s):  
Survival Rates ◽  
Late Complications ◽  
Long Term Results ◽  
Actuarial Survival ◽  
Valuable Treatment ◽  
Internal Carotid Artery Injury ◽  
Beta Dose ◽  
Anatomic Localization ◽  
Yttrium 90

Abstract OBJECTIVE Data were analyzed to assess the value of stereotactically applied intracystic colloidal yttrium-90 (YTx) for the treatment of recurrent cystic craniopharyngiomas during a 30-year period. METHODS This article compares data from 73 YTx procedures in 60 patients between 1975 and 2006. The cumulative beta dose aimed at the inner surface of the cyst wall was 300 Gy. RESULTS After YTx, the initial cyst volumes decreased an average of 79%. In 47, the reduction was more than 80%; in 27 of them, the cyst disappeared completely within 1 year. The mean survival after YTx was 9.4 years (range, 0.7–30 yr). Actuarial survival rates at 5, 10, 15, 20, 25, and 30 years were 81, 61, 45, 18, 2, and 0%, respectively. Late complications of YTx were related to the anatomic localization of the cyst, either presellar and retrosellar, e.g., a presellar (prechiasmatic/suprasellar) localization caused neuro-ophthalmological complications in 5.8% and internal carotid artery injury in 1.6%. The treatment of retrosellar (retrochiasmatic, suprasellar) tumors occasionally induced hypothalamic and/or pontomesencephalothalamic damage obviously by untoward radiation to the so-called perforating arteries. This occurred in 3.2% of these latter patients. CONCLUSION Despite sporadic complications, intracavitary YTx irradiation is a valuable treatment alternative for craniopharyngioma cysts, sometimes as part of a multimodality management in these tumors, especially in precarious surgical cases.

scholarly journals A New Aortic Arch Dissection Classification: The Fuwai Classification

2021 ◽  
Vol 8 ◽  
Author(s):  
Juntao Qiu ◽  
Xinjin Luo ◽  
Jinlin Wu ◽  
Wei Pan ◽  
Qian Chang ◽  
...  
Keyword(s):  
Carotid Artery ◽  
Aortic Arch ◽  
Survival Rates ◽  
Innominate Artery ◽  
Long Term Results ◽  
Surgical Mortality ◽  
Left Carotid Artery ◽  
Term Survival ◽  
Long Term Survival

Aims: We describe a new aortic arch dissection (AcD) classification, which we have called the Fuwai classification. We then compare the clinical characteristics and long-term prognoses of different classifications.Methods: All AcD patients who underwent surgical procedures at Fuwai Hospital from 2010 to 2015 were included in the study. AcD procedures are divided into three types: Fuwai type Cp, Ct, and Cd. Type Cp is defined as the innominate artery or combined with the left carotid artery involved. Type Cd is defined as the left subclavian artery or combined with the left carotid artery involved. All other AcD surgeries are defined as type Ct. The Chi-square test was adopted for the pairwise comparison among the three types. Kaplan-Meier was used for the analysis of long-term survival and survival free of reoperation.Results: In total, 1,063 AcD patients were enrolled from 2010 to 2015: 54 patients were type Cp, 832 were type Ct, and 177 were type Cd. The highest operation proportion of Cp, Ct and Cd were partial arch replacement, total arch replacement, and TEVAR. The surgical mortality in type Ct was higher compared to type Cd (Ct vs. Cd = 9.38 vs. 1.69%, p &lt; 0.01) and type Cp (Ct vs. Cp = 9.38 vs. 1.85%, p = 0.06). There was no difference in surgical mortality of type Cp and Cd (p = 0.93). There were no significant differences in the long-term survival rates (p = 0.38) and free of aorta-related re-operations (p = 0.19).Conclusion: The Fuwai classification is used to distinguish different AcDs. Different AcDs have different surgical mortality and use different operation methods, but they have similar long-term results.

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