scholarly journals Methods of Reconstruction for Distal Aortic Dissection

2021 ◽  
Author(s):  
Mark Alekseevich Soborov
Keyword(s):  
Aortic Dissection ◽  
Postoperative Period ◽  
Open Surgery ◽  
Surgical Trauma ◽  
Endovascular Techniques ◽  
Modern Approach ◽  
Conventional Open Surgery ◽  
Methods Of Reconstruction

The modern approach to the correction of aortic dissection involves the most complete reconstruction of the entire pathologically altered segment of the vessel, which is often impossible due to the vastness of the lesion and the associated severity of surgery. Reduction of intraoperative trauma can improve survival in the immediate postoperative period, and the completeness of reconstruction to reduce the number of complications and relapses in the long term. In this chapter, the methods of reconstruction of the aorta in case of distal dissection from a conventional open surgery to endovascular techniques, or usage of their combination for minimization of surgical trauma, are reviewed.

scholarly journals Open Replacement of the Thoracoabdominal Aorta: Short- and Long-term Outcomes at a Single Institution

2018 ◽  
Vol 27 (02) ◽  
pp. 114-120
Author(s):  
Davide Carino ◽  
Young Erben ◽  
Mohammad Zafar ◽  
Mrinal Singh ◽  
Adam Brownstein ◽  
...  
Keyword(s):  
Aortic Dissection ◽  
Open Surgery ◽  
Elective Surgery ◽  
Aortic Diseases ◽  
Long Term Outcomes ◽  
Thoracoabdominal Aorta ◽  
Primary Endpoints ◽  
Short And Long Term ◽  
Optimal Approach

Background Despite much progress in the surgical and endovascular treatment of thoracoabdominal aortic diseases (TAADs), there is no consensus regarding the optimal approach to minimize operative mortality and end-organ dysfunction. We report our experience in the past 16 years treating TAAD by open surgery. Methods A retrospective review of all TAAD patients who underwent an open repair since January 2000 was performed. The primary endpoints included early morbidity and mortality, and the secondary endpoints were overall death and rate of aortic reintervention. Results There were 112 patients treated by open surgery for TAAD. Mean age was 66 ± 10 years and 61 (54%) were male. Seventy-seven (69%) patients had aneurysmal degeneration without aortic dissection and the remaining 35 (31%) had a concomitant aortic dissection. There were 12 deaths (10.7%) and they were equally distributed between the aneurysm and dissection groups (p = 0.8). The mortality for elective surgery was 3.2% (2/61). The rate of permanent paraplegia and stroke were each 2.6% (3/112). The rate of cerebrovascular accident was significantly higher in the dissection group (8.5% vs. 1.2%, p = 0.05). The survival at 1, 5, and 10 years was 80.6, 56.1, and 32.7%, respectively. Conclusion Our data confirm that open replacement of the thoracoabdominal aorta can be performed in expert centers quite safely. Different aortic pathologies (degenerative aneurysm vs. dissection) do not influence the short- and long-term outcomes. Open surgery should still be considered the standard in the management of TAAD.

scholarly journals Lower heart rate in the early postoperative period does not correlate with long-term outcomes after repair of type A acute aortic dissection

2014 ◽  
Vol 30 (3) ◽  
pp. 355-361 ◽  
Author(s):  
Tetsu Ohnuma ◽  
Naoyuki Kimura ◽  
Yusuke Sasabuchi ◽  
Kayo Asaka ◽  
Junji Shiotsuka ◽  
...  
Keyword(s):  
Heart Rate ◽  
Aortic Dissection ◽  
Postoperative Period ◽  
Acute Aortic Dissection ◽  
Type A ◽  
Early Postoperative Period ◽  
Long Term Outcomes ◽  
Lower Heart Rate

scholarly journals Endo-laparoscopic approach versus conventional open surgery in the treatment of obstructing left-sided colon cancer: Long-term follow-up of a randomized trial

2013 ◽  
Vol 6 (2) ◽  
pp. 78-81 ◽  
Author(s):  
Karen Lok Man Tung ◽  
Hester Yui Shan Cheung ◽  
Lawrence Wing Chiu Ng ◽  
Cliff Chi Chiu Chung ◽  
Michael Ka Wah Li
Keyword(s):  
Colon Cancer ◽  
Randomized Trial ◽  
Open Surgery ◽  
Laparoscopic Approach ◽  
Long Term Follow Up ◽  
Conventional Open Surgery

scholarly journals Long Term Survival of Pathological Thoracolumbar Fractures Treated with Vertebroplasty: Analysis Using a Nationwide Insurance Claim Database

2019 ◽  
Vol 9 (1) ◽  
pp. 78
Author(s):  
Kuo-Yuan Huang ◽  
Shang-Chi Lee ◽  
Wen-Lung Liu ◽  
Jung-Der Wang
Keyword(s):  
Conservative Treatment ◽  
Open Surgery ◽  
Claim Database ◽  
Research Database ◽  
Thoracolumbar Fractures ◽  
Term Survival ◽  
Long Term Outcome ◽  
Long Term Survival ◽  
Conventional Open Surgery

Background: There are still debates on the long-term outcome of treating pathological thoracolumbar fractures, including osteoporosis and oncologic problems, using vertebroplasty. Methods: We collected 8625 patients with pathological thoracolumbar fractures (ICD-9-CM codes 733.13 combined with 805.2 or 805.4) between the years of 2003 to 2013, from the two million random samples from the National Health Insurance Research Database in Taiwan. Survival analysis was conducted to estimate the mortality risks of different treatments, including vertebroplasty (n = 1389), conventional open surgery (n = 1219), or conservative treatment (n = 6017). A multivariable Cox proportional hazard model was constructed for adjustment of age, gender, comorbidities and complications. Results: Crude incidence rate of patients with pathological thoracolumbar fractures in Taiwan gradually increased year by year. Compared with conservative treatment, conventional open surgery and vertebroplasty seemed to improve long-term survival with adjusted hazard ratios (aHR) of 0.80 (95% confidence interval (CI) 0.70–0.93), and 0.87 (95% CI 0.77–0.99), respectively. The survival advantage of vertebroplasty appeared more evident for those aged over 75. However, we were unable to rule out confounding by indication. Conclusion: Although conventional open surgery would usually be the best choice for the treatment of patients with pathological thoracolumbar fractures, database information from current real-world practice appears to support vertebroplasty as a viable choice for elderly people over 75 years of age.

Laparoscopic D2 subtotal gastrectomy versus conventional open surgery for advanced gastric cancer: The safety analysis from a multicenter prospective randomized controlled trial in China (CLASS-01 trial).

2015 ◽  
Vol 33 (3_suppl) ◽  
pp. 122-122 ◽  
Author(s):  
Yanfeng Hu ◽  
Changming Huang ◽  
Yihong Sun ◽  
Xiangqian Su ◽  
Ziyu Li ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Open Surgery ◽  
Controlled Trial ◽  
Subtotal Gastrectomy ◽  
Long Term Outcomes ◽  
D2 Gastrectomy ◽  
Randomized Controlled ◽  
Prospective Randomized Controlled Trial ◽  
Conventional Open Surgery

122 Background: The efficacy of laparoscopic D2 gastrectomy for the treatment of advanced gastric cancer (AGC) with curative intent is still controversial. Thus, the Chinese Laparoscopic Gastrointestinal Surgery Study (CLASS) group conducted a multicenter prospective randomized controlled trial, aiming to evaluate the surgical safety and long-term outcomes of laparoscopic D2 gastrectomy compared with conventional open surgery for AGC. (NCT01609309) Methods: The patients with tumor located at distal stomach at clinical T2-4a, N0-3, M0 stage were eligible for enrollment, treated by either laparoscopic D2 distal subtotal gastrectomy (LG) or open D2 gastrectomy (OG) after randomization. Seventeen institutions currently participated in the study. The morbidity and mortality within postoperative 30 days were compared between the two groups. Results: A total of 607 consecutive eligible patients were randomly assigned to either LG group (n=308) or OG group (n=299) between September 2012 and January 2014. The compliance rates of D2 lymphadenectomy in the LG group and OG group were similar (97.4% vs. 98.3%; P=0.591). Open conversion rate was 4.5%. There was no significant differences between the LG group and OG group in the incidence of intraoperative complication (5.8% vs. 4.3%; P=0.402), postoperative morbidity (18.8% vs. 14.7%; P=0.175), and mortality (0.6% vs. 0; P=0.499). The severity grade pattern was also similar according to the Clavien-Dindo classification (P=0.372). Conclusions: Laparoscopic D2 distal subtotal gastrectomy for AGC could be safely performed by experienced surgeons. Thus, our multicenter prospective study on long-term outcomes can be ongoing. Clinical trial information: NCT01609309.

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