scholarly journals Long-term Results after Total Thyroidectomy in Patients with Graves' Disease in Uzbekistan: Retrospective Study

2011 ◽  
Vol 3 (2) ◽  
pp. 79-82
Author(s):  
Said I Ismailov ◽  
Nusrat A Alimjanov ◽  
Bakhodir Kh Babakhanov ◽  
Murod M Rashitov ◽  
Alisher M Akbutaev
Keyword(s):  
Postoperative Complications ◽  
Total Thyroidectomy ◽  
Thyroid Tissue ◽  
Long Term Results ◽  
Graves Disease ◽  
Nerve Paralysis ◽  
Treatment Groups ◽  
Institutional Experience

ABSTRACT Subtotal thyroidectomy has been advocated as the standard treatment for Graves' disease (GD) because of the assumed lower risk of complications compared with total thyroidectomy, and also it provides the chance to avoid thyroxin therapy. The present study aims to examine our institutional experience with total thyroidectomy for GD. Patients were divided into two surgical treatment groups: Total thyroidectomy (TT) (n = 97) and total thyroidectomy with intraoperative thyroid autotransplantation (TTITA) (n = 74). TTITA performed in 74 patients. 0.5 to 2 gm of thyroid tissue was cut into small pieces and autotransplanted into the forearm muscle of the patient. Postoperative complications included eight cases of RLN palsy, two patients had nerve paralysis, two patients underwent tracheostomy, transient hypoparathyroidism in 25 patients, permanent hypoparathyroidism in two cases, wound hemorrhage in two patients. TPOAb levels were increased in 9% of patients with TT whereas in patients with TTITA TPOAb concentrations were elevated in 65% of patients at 3 months follow-up. TRAb in patients with TT were not detected while 20% patients undergone TTITA had high TRAb levels and 13.3% had terminal concentrations at 3 months follow-up. Serum TPOAb and TRAb were detected in none of the patients who underwent TT and TTITA at 1, 3 and 5 years follow-up. Removal of all thyroid tissue offers the best chance of preventing recurrent hyperthyroidism and we saw no increase in postoperative complications in the TT group. We feel that TT is safe and superior for achieving the goal of treatment of Graves' disease.

Short- and Long-Term Results of Total vs Subtotal Thyroid- ectomies in the Surgical Treatment of Graves' Disease

Swiss Surgery ◽  
2001 ◽  
Vol 7 (1) ◽  
pp. 20-24 ◽  
Author(s):  
Robert ◽  
Mariéthoz ◽  
Pache ◽  
Bertin ◽  
Caulfield ◽  
...  
Keyword(s):  
Recurrent Laryngeal Nerve ◽  
Nerve Palsy ◽  
Recurrent Laryngeal Nerve Palsy ◽  
Laryngeal Nerve ◽  
Long Term Results ◽  
Graves Disease ◽  
Laryngeal Nerve Palsy ◽  
Short And Long Term

Objective: Approximately one out of five patients with Graves' disease (GD) undergoes a thyroidectomy after a mean period of 18 months of medical treatment. This retrospective and non-randomized study from a teaching hospital compares short- and long-term results of total (TT) and subtotal thyroidectomies (ST) for this disease. Methods: From 1987 to 1997, 94 patients were operated for GD. Thirty-three patients underwent a TT (mostly since 1993) and 61 a ST (keeping 4 to 8 grams of thyroid tissue - mean 6 g). All patients had received propylthiouracil and/or neo-mercazole and were in a euthyroid state at the time of surgery; they also took potassium iodide (lugol) for ten days before surgery. Results: There were no deaths. Transient hypocalcemia (< 3 months) occurred in 32 patients (15 TT and 17 ST) and persistent hypocalcemia in 8 having had TT. Two patients developed transient recurrent laryngeal nerve palsy after ST (< 3 months). After a median follow-up period of seven years (1-15) with five patients lost to follow-up, 41 patients having had a ST are in a hypothyroid state (73%), thirteen are euthyroid (23%), and two suffered recurrent hyperthyroidism, requiring completion of thyroidectomy. All 33 patients having had TT - with follow-ups averaging two years (0.5-8) - are receiving thyroxin substitution. Conclusions: There were no instances of persistent recurrent laryngeal nerve palsy in either group, but persistent hypoparathyroidism occurred more frequently after TT. Long after ST, hypothyroidism developed in nearly three of four cases, whereas euthyroidy was maintained in only one-fourth; recurrent hyperthyroidy was rare.

Open Surgical versus Minimally Invasive in Situ Femorodistal Bypass: Long-term Results

2003 ◽  
Vol 10 (1) ◽  
pp. 117-120 ◽  
Author(s):  
Nomdo S. Renken ◽  
Cees H.A. Wittens ◽  
Peter M.T. Pattynama ◽  
Nico A.J.J. Du Bois ◽  
Lukas C. van Dijk
Keyword(s):  
Minimally Invasive ◽  
Limb Salvage ◽  
Long Term Results ◽  
Open Technique ◽  
Treatment Groups ◽  
Closed Technique ◽  
Open Versus

Purpose: To compare long-term patency and limb survival rates for the classical in situ surgical bypass procedure versus a minimally invasive technique for femorodistal revascularization. Methods: From May 1992 to June 1994, a prospective multicenter study was undertaken at 4 centers to evaluate the open versus closed technique for femorodistal bypass grafting. Of 97 patients enrolled in the trial, 73 patients (49 men; mean age 71 years) were assigned to the long-term follow-up protocol and prospectively randomized to the open (n = 38) or closed (n = 35) procedure. The classical open technique is characterized by a long incision over the length of the bypass graft, while the minimally invasive procedure involves only two short incisions over each anastomosis site (the side branches are closed with a coaxial embolization catheter system). Graft patency was evaluated with duplex imaging periodically throughout the 4-year observation period. Results: There was no statistically significant difference between the treatment groups with respect to age, sex, hypertension, ischemic heart disease, or smoking. However, the open group had a significantly greater incidence of diabetes (p = 0.037). Over a median 4.7-year follow-up (range 0.3–6.4), 9 (12%) patients (3 open and 6 closed) were lost to follow-up: 2 died and 7 refused the duplex examination. No significant differences in 4-year patency, limb salvage, or survival was demonstrated between the open versus closed treatment groups; 4-year secondary patency was 62% versus 64%, respectively, and limb salvage was 72% versus 86%. Conclusions: The closed technique for femorodistal in situ bypass procedures yields favorable long-term outcomes compared to the traditional open technique.

scholarly journals Endoscopic Lumbar Discectomy Using Side-Viewing Conical Working Tube: An Institutional Experience

2022 ◽  
Author(s):  
Mohammad Kaif ◽  
Kuldeep Yadav ◽  
Khursheed Alam Khan ◽  
Rakesh Kumar ◽  
Deepak Kumar Singh ◽  
...  
Keyword(s):  
Lumbar Disc ◽  
Minimal Invasive ◽  
Long Term Results ◽  
Lumbar Disc Prolapse ◽  
Endoscopic Discectomy ◽  
Institutional Experience ◽  
The Mean ◽  
Endoscopic Lumbar Discectomy

Abstract Objective The paradigm of surgical therapy for spinal disease especially for lumbar disc herniation (LDH) has gradually shifted from the traditional open surgeries to minimal invasive spinal surgeries. Endoscopic discectomy has been performed widely using various devices and techniques. In this study we present our experience of endoscopic discectomy using a unique device with separate side-viewing channel. Methods Twenty-six patients with LDH treated between March 2015 and April 2018 using the unique conical working tube with separate side-viewing endoscopic channel have been retrospectively analyzed. Their preoperative and postoperative Oswestry Disability Index (ODI) and Macnab scores were used to evaluate the outcome with a mean follow-up of 37.04 months. Results There were 18 males and 8 females with age ranging from 19 to 72 years (mean, 38.4 years). The follow-up ranged from 25 to 60 months with mean of 37.04 months. The mean preoperative ODI score was 72.4, which decreased to a mean of 7.6 and the outcome evaluated by Macnab criteria was 65.3% excellent, 19.2% good, 11.5% fair, and 3.8% poor. One patient underwent second surgery. None of the patients had to change their occupation postoperatively. Complications that occurred were dural tear in one patient and transient foot paresis in one, which improved spontaneously. Conclusion Endoscopic discectomy using conical working tube is a safe and effective technique for lumbar disc prolapse. The long-term results are comparable to the conventional techniques.

Favorable Long Term Results in Patients with Small Differentiated Thyroid Cancer not Treated with Radioiodine

1989 ◽  
Vol 75 (1) ◽  
pp. 57-59 ◽  
Author(s):  
Benedetto Busnardo ◽  
Maria Elisa Girelli ◽  
Domenico Rubello ◽  
Maria Rosa Pelizzo ◽  
Natalino Simioni ◽  
...  
Keyword(s):  
Thyroid Cancer ◽  
Total Thyroidectomy ◽  
Differentiated Thyroid Cancer ◽  
Radioiodine Therapy ◽  
Stage I ◽  
Long Term Results ◽  
Old Patients ◽  
Very Old Patients

Data on a group of 110 patients with differentiated thyroid cancer not treated by radioiodine are reported. Most of them had intrathyroid (stage I) papillary or capsuled follicular cancer of less than 3 cm diameters. They all received thyroxine at TSH suppressive doses. The follow-up ranged between 4 and 25 years, mean 8.7. No patient died of tumor. Two very old patients died free of disease. Four recurrences occurred, within 8 years, all in patients over 45 years, all local or nodal, all papillary, 3 out of 4 after total thyroidectomy. This study shows that radioiodine therapy may be avoided and that lobectomy may be sufficient in patients under 45 years with small papillary or capsuled follicular cancer.

Long-Term Results of Tendon Transfers in Radial and Posterior Interosseous Nerve Paralysis

2006 ◽  
Vol 31 (5) ◽  
pp. 502-506 ◽  
Author(s):  
M. ROPARS ◽  
T. DRÉANO ◽  
P. SIRET ◽  
N. BELOT ◽  
F. LANGLAIS
Keyword(s):  
Nerve Palsy ◽  
Long Term Results ◽  
Posterior Interosseous Nerve ◽  
Nerve Paralysis ◽  
Abductor Pollicis Longus ◽  
Pronator Teres ◽  
Flexor Carpi Ulnaris ◽  
Posterior Interosseous Nerve Palsy

Eighteen cases of tendon transfer for isolated radial or posterior interosseous nerve palsy have been carried out in our unit over a period of 21 years. Fifteen patients were reviewed with a mean follow-up of 9.5 years. Nine had sustained high and six low radial nerve injury. We achieved 11 excellent, two good, one fair and one bad result. The main problems were loss of power of gripping and the occurrence of radial deviation, particularly in patients with flexor carpi ulnaris transfer to the extensor digitorum communis. During this time, our technique has evolved, including changes of the tendons transferred. Our final preference is a modified Tsuge procedure, using the pronator teres to restore extension of the wrist, the flexor carpi radialis for extension of the fingers and the palmaris longus for extension of the thumb. Abduction of the thumb is restored by a tenodesis of the abductor pollicis longus to the brachioradialis. This review justifies the final policy, in particular the preservation of flexor carpi ulnaris to maintain wrist stability and flexion.

Short- and Long-Term Results of Stapedotomy and Stapedectomy with a Teflon-Wire Piston Prosthesis

2001 ◽  
Vol 110 (10) ◽  
pp. 907-911 ◽  
Author(s):  
Maria Izabel Kos ◽  
Pierre B. Montandon ◽  
Jean-Philippe Guyot
Keyword(s):  
Hearing Loss ◽  
Postoperative Complications ◽  
Evaluation Criteria ◽  
Long Term Results ◽  
Hearing Results ◽  
Long Term Follow Up ◽  
Short And Long Term ◽  
Residual Air

We analyzed the results of 604 cases of primary stapes surgery performed between 1974 and 1997 with replacement of the stapes by a 0.6- or 0.8-mm Schuknecht Teflon-wire piston. At long-term follow-up (1 to 21 years; mean, 7 years), the residual air-bone gap was 10 dB or less in 79% of the cases. The hearing results and postoperative complications were comparable to those reported by authors who used the same evaluation criteria. Although the aim of the surgery was to perform a small stapedotomy with a narrow footplate perforation (0.8 mm), a large stapedotomy or a stapedectomy was performed in 134 cases (22.2%) because of surgical or anatomic conditions. Our results show that the larger footplate perforations allowed a better correction of the air-bone gap at the lower frequencies. The ears with larger perforations did not show a higher incidence of sensorineural hearing loss.

Cladribine Alone and in Combination with Cyclophosphamide or Cyclophosphamide and Mitoxantrone in Previously Untreated Patients with Chronic Lymphocytic Leukemia (CLL): Long-Term Follow-up of the the Polish Adult Leukemia Group (PALG CLL2) Study,

Blood ◽  
2011 ◽  
Vol 118 (21) ◽  
pp. 3915-3915
Author(s):  
Tadeusz Robak ◽  
Jerzy Blonski ◽  
Krzysztof Jamroziak ◽  
Malgorzata Calbecka ◽  
Jadwiga Dwilewicz-Trojaczek ◽  
...  
Keyword(s):  
Late Complications ◽  
Long Term Results ◽  
Published Data ◽  
Secondary Neoplasms ◽  
Treatment Groups ◽  
Long Term Follow Up ◽  
Secondary Tumours ◽  
Richter’S Syndrome

Abstract Abstract 3915 Purpose. In 2006 we have published an early report of the prospective, randomized, multicenter study (PALG CLL2) comparing the efficacy and toxicity of cladribine alone and in combination with cyclophosphamide (CC) or cyclophosphamide plus mitoxantrone (CMC) in 508 previously untreated patients with progressive and advanced CLL (Blood. 2006;108:473–9). In this early analysis we found that CMC induced higher CR rate than CC (36% vs. 21%, p=0.004), but no differences in overall response (OR), progression-free survival (PFS) and overall survival (OS) among treatment groups were observed. The aim of the present study was to verify whether long-term follow-up might change originally published data on PFS or/and OS as well as to compare the rate of late complications including secondary neoplasms and Richter's syndrome. Methods. In PALG CLL2 study PFS was defined as the time from the end of first–line therapy to disease progression or death from any cause. OS was measured from the time of randomization to death or last contact. OS and PFS were calculated according to the method of Kaplan and Meier and compared between groups by the log-rank test. Only patients with pathologically-proven tumours diagnosed after chemotherapy initiation were considered as having secondary neoplasms or Richter's syndrome. Frequencies of secondary tumours were compared by chi2 test. Results. The median time of follow-up as of Januar y 2011 was 45.6 months (95% CI: 39.9–51.4). The results of comparison of survival times and late complications in different study arms are shown in Table 1 and Figure 1. Conclusions. Long term results for 508 r andomized patients confirm that cladribine alone, CC and CMC regimens produce comparable PFS and OS in previously untreated progressive CLL. The risk of secondary tumours does not differ in the investigated treatment groups. Disclosures: No relevant conflicts of interest to declare.

Long-term Functional and Radiographic Outcome of a Mobile Bearing Ankle Prosthesis

2016 ◽  
Vol 37 (12) ◽  
pp. 1292-1302 ◽  
Author(s):  
Yvonne R. A. Kerkhoff ◽  
Nienke M. Kosse ◽  
Wieneke P. Metsaars ◽  
Jan Willem K. Louwerens
Keyword(s):  
Postoperative Complications ◽  
Clinical Outcome ◽  
Heterotopic Ossification ◽  
Clinical Results ◽  
Long Term Results ◽  
Complication Rates ◽  
Failure Rates ◽  
Ankle Arthroplasty

Background: Total ankle arthroplasty is an accepted alternative to arthrodesis of the ankle. However, complication and failure rates remain high. Long-term results of the Scandinavian Total Ankle Replacement (STAR) are limited, with variable complication and failure rates observed. This prospective study presents the long-term survivorship and postoperative complications of the STAR prosthesis. Methods: Between May 1999 and June 2008, 134 primary total ankle arthroplasties were performed using the STAR prosthesis in 124 patients. The survivorship, postoperative complications, and reoperations were recorded, with a minimum follow-up period of 7.5 years. Clinical results were assessed using the Foot Function Index and the Kofoed score. The presence of component migration, cysts, and radiolucency surrounding the prosthesis components, heterotopic ossification, and progression of osteoarthritis in adjacent joints were determined. Results: The cumulative survival was 78% after the 10-year follow-up period. An ankle arthrodesis was performed in 20 ankles (14.9%) that failed. Fourteen polyethylene insert fractures occurred (10.4%). Other complications occurred in 29 ankles (21.6%), requiring secondary procedures in 21 ankles (15.7%). Nevertheless, the postoperative clinical results improved significantly. Osteolytic cysts were observed in 61 ankles (59.8%) and the surface area of these cysts increased during follow-up, without any association with the prosthesis alignment or clinical outcome. Heterotopic ossification at the medial malleolus was present in 58 cases (56.8%) and at the posterior tibia in 73 cases (71.6%), with no effect on clinical outcome. Osteoarthritis of the subtalar and talonavicular joint developed in 9 (8.8%) and 11 cases (10.8%), respectively. Conclusion: The long-term clinical outcomes for the STAR were found to be satisfactory. Although these results are consistent with previous studies, the survival and complication rates are disappointing compared to knee and hip arthroplasty. Higher rates of successful outcomes following ankle arthroplasty are important, and these results highlight the need for further research to clarify the origin and significance of the reported complications. Level of Evidence: Level II, prospective comparative study.

Surgical reconstruction for unilateral iliac artery lesions in patients younger than 50 years

VASA ◽  
2011 ◽  
Vol 40 (6) ◽  
pp. 474-481 ◽  
Author(s):  
Radak ◽  
Babic ◽  
Ilijevski ◽  
Jocic ◽  
Aleksic ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Limb Salvage ◽  
Iliac Artery ◽  
Graft Patency ◽  
Long Term Results ◽  
Surgical Reconstruction ◽  
Safe Procedure ◽  
Term Survival

Background: To evaluate safety, short and long-term graft patency, clinical success rates, and factors associated with patency, limb salvage and mortality after surgical reconstruction in patients younger than 50 years of age who had undergone unilateral iliac artery bypass surgery. Patients and methods: From January 2000 to January 2010, 65 consecutive reconstructive vascular operations were performed in 22 women and 43 men of age < 50 years with unilateral iliac atherosclerotic lesions and claudication or chronic limb ischemia. All patients were followed at 1, 3, 6, and 12 months after surgery and every 6 months thereafter. Results: There was in-hospital vascular graft thrombosis in four (6.1 %) patients. No in-hospital deaths occurred. Median follow-up was 49.6 ± 33 months. Primary patency rates at 1-, 3-, 5-, and 10-year were 92.2 %, 85.6 %, 73.6 %, and 56.5 %, respectively. Seven patients passed away during follow-up of which four patients due to coronary artery disease, two patients due to cerebrovascular disease and one patient due to malignancy. Limb salvage rate after 1-, 3-, 5-, and 10-year follow-up was 100 %, 100 %, 96.3 %, and 91.2 %, respectively. Cox regression analysis including age, sex, risk factors for vascular disease, indication for treatment, preoperative ABI, lesion length, graft diameter and type of pre-procedural lesion (stenosis/occlusion), showed that only age (beta - 0.281, expected beta 0.755, p = 0.007) and presence of diabetes mellitus during index surgery (beta - 1.292, expected beta 0.275, p = 0.026) were found to be significant predictors of diminishing graft patency during the follow-up. Presence of diabetes mellitus during index surgery (beta - 1.246, expected beta 0.291, p = 0.034) was the only variable predicting mortality. Conclusions: Surgical treatment for unilateral iliac lesions in patients with premature atherosclerosis is a safe procedure with a low operative risk and acceptable long-term results. Diabetes mellitus and age at index surgery are predictive for low graft patency. Presence of diabetes is associated with decreased long-term survival.

Sign in / Sign up

Export Citation Format

Share Document