Postoperative Changes and Follow-Up

2010 ◽  
Keyword(s):  
Postoperative Changes

scholarly journals Differences in Postoperative Changes of Cervical Sagittal Alignment and Balance After Laminoplasty Between Cervical Spondylotic Myelopathy and Cervical Ossification of the Posterior Longitudinal Ligament

2018 ◽  
Vol 9 (3) ◽  
pp. 266-271 ◽  
Author(s):  
Hironobu Sakaura ◽  
Atsunori Ohnishi ◽  
Akira Yamagishi ◽  
Tetsuo Ohwada
Keyword(s):  
Cervical Spondylotic Myelopathy ◽  
Sagittal Alignment ◽  
Posterior Longitudinal Ligament ◽  
Kyphotic Deformity ◽  
Sagittal Imbalance ◽  
Patient Age ◽  
Neurologic Recovery ◽  
Postoperative Changes ◽  
Cervical Sagittal Alignment

Study Design: Retrospective cohort study. Objectives: To compare postoperative changes of cervical sagittal alignment (CSA) and cervical sagittal balance (CSB) after laminoplasty between cervical spondylotic myelopathy (CSM) and ossification of the posterior longitudinal ligament (OPLL) and to examine impacts of these radiologic changes on neurologic outcomes. Methods: A total of 168 consecutive patients with CSM (CSM group) and 51 consecutive patients with OPLL (OPLL group) were included. As indicators of CSA and CSB, the C2-7 angle and C1-C7 sagittal vertical axis (SVA) were, respectively, measured before surgery and at 2-year follow-up. Neurologic status was assessed using the Japanese Orthopaedic Association score before surgery and at 2-year follow-up. Results: Whereas both postoperative loss of C2-7 angle and increase of C1-C7 SVA were significantly greater in the elderly subgroup of the CSM group, patient age did not significantly affect these changes in the OPLL group. Preservation of C7 maintained C1-C7 SVA at postoperative 2 years only in the CSM group. Postoperative cervical kyphosis and sagittal imbalance significantly decreased neurologic improvement in the CSM group but not in the OPLL group. Conclusions: Elderly patients with CSM have significantly greater postoperative loss of lordosis and increase in C1-C7 SVA than nonelderly patients, and both postoperative kyphotic deformity and sagittal imbalance significantly deteriorate neurologic recovery. On the other hand, although patients with OPLL, irrespective of patient age and preservation of C7, have significantly more loss of lordosis and increase in C1-C7 SVA than CSM patients, neither postoperative kyphotic deformity nor sagittal imbalance significantly deteriorates neurologic recovery in OPLL patients.

Early postoperative PET-CT in patients with pathological stage III colon cancer may change their outcome: Results from a large single-institution study.

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. e15163-e15163
Author(s):  
Assaf Moore ◽  
Irit Ben-Aharon ◽  
Ofer Purim ◽  
Gali Perl ◽  
Olga Ulitsky ◽  
...  
Keyword(s):  
Colon Cancer ◽  
Preoperative Staging ◽  
Prospective Trial ◽  
Disease Free Survival ◽  
Stage Iii ◽  
Pathological Stage ◽  
Stage Iii Colon Cancer ◽  
Postoperative Changes ◽  
Pet Ct

e15163 Background: Staging of patients (pts) with pathological stage III colon cancer (CC) is currently suboptimal; many pts still recur despite an unremarkable preoperative staging. We previously reported that early postoperative PET-CT can alter the stage and management of up to 15% of pts with high risk stage III CC and later reported also encouraging preliminary results in a larger cohort of consecutive pts with stage III CC, in which staging and management were altered in 14.5%. The aim of the current study was to expand the previous one to a larger cohort and to evaluate the actual impact of early postoperative PET-CT on pts outcome. Methods: A Retrospective study of all consecutive pts with stage III CC who were treated at our institution and underwent early postoperative PET-CT between 2007-2016. Demographic and clinicopathological data were retrieved. Statistical analyses were done using standard methods. Results: 348 pts, 166 (47.7%) males, with a median age of 66 years (range, 29-92), were included. Pathological stage was IIIA, IIIB and IIIC in 21(6%), 254 (73%) and 73 (21%) pts, respectively. The median number of lymph nodes examined and of positive ones were 14 (range, 3-54) and 2 (range, 0-32), respectively. High FDG-uptake was noted in 95 (27.3%) pts, including 23 (6.6%) with clear postoperative changes and 18 (5.2%) with a false positive uptake, of whom 6 underwent invasive diagnostic procedures. PET-CT results modified the management of 52 pts (14.9%) who were found to have true positive findings: 44 (12.6%) with overt metastatic disease and 8 (2.3%) with a second primary tumor. At a median follow-up of 45.6 months, the estimated 5y disease-free survival for true stage III pts was 81.9% and the 6y overall survival of the entire cohort was 76.4%. Interestingly, of the 44 pts found to be metastatic, 12 (27.3%) underwent curative treatments and 8 (66.7%) of those remain free of disease, with a median follow-up of 64.7 months. Conclusions: In this large cohort, early postoperative PET-CT changed the staging and management of 14.9% of pts with resected stage III CC, with encouraging outcome results. We are conducting a prospective trial to further evaluate this strategy.

scholarly journals Using Wearable Devices to Monitor Physical Activity in Patients Undergoing Aortic Valve Replacement: Protocol for a Prospective Observational Study

10.2196/20072 ◽  
2020 ◽  
Vol 9 (11) ◽  
pp. e20072
Author(s):  
Giulia Lorenzoni ◽  
Danila Azzolina ◽  
Chiara Fraccaro ◽  
Alessandro Di Liberti ◽  
Augusto D'Onofrio ◽  
...  
Keyword(s):  
Physical Activity ◽  
Aortic Valve ◽  
Observational Study ◽  
Aortic Valve Replacement ◽  
Physical Function ◽  
Valve Replacement ◽  
Prospective Observational Study ◽  
Wearable Devices ◽  
Postoperative Changes

Background In last few decades, several tools have been developed to measure physical function objectively; however, their use has not been well established in clinical practice. Objective This study aims to describe the preoperative physical function and to assess and compare 6-month postoperative changes in the physical function of patients undergoing treatment for aortic stenosis with either surgical aortic valve replacement (SAVR) or transcatheter aortic valve replacement (TAVR). The study also aims to evaluate the feasibility of wearable devices in assessing physical function in such patients. Methods This is a prospective observational study. The enrollment will be conducted 1 month before patients’ SAVR/TAVR. Patients will be provided with the wearable device at baseline (activity tracker device, Garmin vívoactive 3). They will be trained in the use of the device, and they will be requested to wear it on the wrist of their preferred hand until 12 months after SAVR/TAVR. After baseline assessment, they will undergo 4 follow-up assessments at 1, 3, 6, and 12 months after SAVR/TAVR. At baseline and each follow-up, they will undergo a set of standard and validated tests to assess physical function, health-related quality of life, and sleep quality. Results The ethics committee of Vicenza in Veneto Region in Italy approved the study (Protocol No. 943; January 4, 2019). As of October 2020, the enrollment of participants is ongoing. Conclusions The use of the wearable devices for real-time monitoring of physical activity of patients undergoing aortic valve replacement is a promising opportunity for improving the clinical management and consequently, the health outcomes of such patients. Trial Registration Clinicaltrials.gov NCT03843320; https://tinyurl.com/yyareu5y International Registered Report Identifier (IRRID) DERR1-10.2196/20072

18F-FDG PET-CT postoperative changes after maxillectomy: Findings and pitfalls in interpretation

2021 ◽  
pp. 20200574
Author(s):  
Tima Davidson ◽  
Johnatan Nissan ◽  
Maria Krichmar ◽  
Eyal Lotan ◽  
Shai Shrot ◽  
...  
Keyword(s):  
Fdg Pet ◽  
Ct Scanning ◽  
Fdg Uptake ◽  
Postoperative Changes ◽  
Pet Ct ◽  
The Mean ◽  
Fdg Pet Ct ◽  
Mucosal Thickening ◽  
Ct Features

Objective: We investigated the findings and pitfalls of FDG-PET/CT scanning after maxillectomy with reconstruction/rehabilitation procedures, in patients with head and neck malignancies treated during nine years at one tertiary medical centre. Methods: Fourteen patients (10 males), aged 22–84 years, underwent 17 reconstruction/rehabilitation maxillectomy surgeries and 35 PET/CT scans. Postoperative PET/CT findings were correlated with clinical and imaging follow-up. Results: Increased FDG uptake, mean SUVmax 2.4 ± 1.4 (range 0.3–4.3), was observed at the postoperative bed following 12 of 17 surgeries (71%; 10 obturators, two mesh reconstructions). Following the remaining 5/17 surgeries (three with a fat flap and two without any reconstructions), abnormal FDG uptake was not observed at the postoperative bed. CT features of postoperative sites included: non-homogeneous mixed iso/hyperdense structures (hollow or filled) with multiple surrounding and/or inside air bubbles (“sponge appearance”) and mucosal thickening along the postoperative bed wall (in all cases with obturator implants); rich fat density material in reconstructions with a fat flap and in closures without reconstruction, and radiopaque elongated structures in mesh reconstructions. No correlation was found of the mean SUVmax in initial scans, with the time from the surgery date (10 ± 6 months; r=0.04, P=0.90), or with the mean SUVmax in final scans (at 25± 17 months, P=0.17). Conclusions: : Increased FDG uptake, together with corresponding non-specific CT features, may persist for a prolonged period after surgery with obturators and mesh implantations, mimicking malignancy or infection. Awareness of variations in postoperative PET-CT appearance can help avoid false interpretations and redundant invasive procedures.

Postoperative changes in neurological function after 3-column osteotomy: risk factor analysis of 199 patients

2019 ◽  
Vol 30 (5) ◽  
pp. 568-573 ◽  
Author(s):  
Morsi Khashan ◽  
Micheal Raad ◽  
Mostafa H. El Dafrawy ◽  
Varun Puvanesarajah ◽  
Khaled M. Kebaish
Keyword(s):  
Risk Factors ◽  
Spinal Deformity ◽  
Neurological Deficit ◽  
Adult Spinal Deformity ◽  
Care Center ◽  
Tertiary Care ◽  
Neurological Deficits ◽  
High Grade ◽  
Postoperative Changes

OBJECTIVEThe authors evaluated the neurological outcomes of adult spinal deformity patients after 3-column osteotomy (3CO), including severity and long-term improvement of neurological complications, as well as risk factors for neurological deficit at 1 year postoperatively. Although 3CO is effective for correcting rigid spinal deformity, it is associated with a high complication rate. Neurological deficits, in particular, cause disability and dissatisfaction.METHODSThe authors retrospectively queried a prospective database of adult spinal deformity patients who underwent vertebral column resection or pedicle subtraction osteotomy between 2004 and 2014 by one surgeon at a tertiary care center. The authors included 199 adults with at least 1-year follow-up. The primary outcome measure was change in lower-extremity motor scores (LEMSs), which were obtained preoperatively, within 2 weeks postoperatively, and at 6 and 12 months postoperatively. To identify risk factors for persistent neurological deficit, the authors compared patient and surgical characteristics with a declined LEMS at 12-month follow-up (n = 10) versus those with an improved/maintained LEMS at 12-month follow-up (n = 189).RESULTSAt the first postoperative assessment, the LEMS had improved in 15% and declined in 10% of patients compared with preoperative scores. At the 6-month follow-up, 6% of patients continued to have a decline in LEMS, and 16% had improvement. At 12 months, LEMS had improved in 17% and declined in 5% of patients compared with preoperative scores. The only factor significantly associated with a decline in 12-month LEMS was high-grade spondylolisthesis as an indication for surgery (OR 13, 95% CI 3.2–56).CONCLUSIONSAlthough the LEMS declined in 10% of patients immediately after 3CO, at 12 months postoperatively, only 5% of patients had neurological motor deficits. A surgical indication of high-grade spondylolisthesis was the only factor associated with neurological deficit at 12 months postoperatively.

The role of ultrasound in the follow-up of postoperative changes after pyeloplasty

1998 ◽  
Vol 28 (4) ◽  
pp. 247-249 ◽  
Author(s):  
É. Kis ◽  
Tibor Verebély ◽  
Rita Kövi ◽  
István Máttyus
Keyword(s):  
Postoperative Changes

scholarly journals Optimization of follow-up MRI protocol for malignant neoplasms of the female pelvis

2021 ◽  
Vol 12 (1) ◽  
pp. 7-13
Author(s):  
T. A. Bergen ◽  
V. A. Fokin ◽  
G. E. Trufanov
Keyword(s):  
Contrast Enhancement ◽  
Structural Changes ◽  
Malignant Neoplasms ◽  
Female Pelvis ◽  
Diagnostic Significance ◽  
Pelvic Neoplasms ◽  
Pelvic Mri ◽  
Pelvic Organs ◽  
Postoperative Changes

Introduction. MRI is widely used to follow-up malignant neoplasms of the female pelvis. Aim. To optimize the use of MRI sequences for follow-up of female patients with malignant pelvic neoplasms. Materials and methods. Retrospective analysis of female pelvic MRI has been performed on 1.5 T MR scanner. This study includes 530 protocols. Results. The authors describe different protocols for assessment and differential diagnosis of recurrence, postradiation and postoperative changes. It includes applicable sequences, axis and the structure which require evaluation. In all cases, dynamic follow-up has to include analysis of patient's previous studies, anamnesis, previous treatment, as well as the end of chemotherapy and radiotherapy. All of the above, combined with the oncologist's treatment of choice determines the objective of this study. Nowadays, MRI is the method which most accurately characterizes postoperative and postradiation structural changes. MRI is useful in detection of pelvic lymph nodes. The role of MRI has high potential in assessing the effectiveness of chemotherapy and radiation therapy. Conclusion. In order to make the optimal scan protocol, follow-up of malignant neoplasms of the pelvic organs in women require the use of clinical and anamnestic data along with the results of patient's previous studies. The combined use of various sequences and techniques can improve the diagnostic significance of pelvic MRI at follow-up. Contrast enhancement has additional role in diagnostics of recurrent of pelvic organs in women. The use of different contrast enhancement techniques has proven effective in case of postradiation and postoperative complications.

scholarly journals Photorefractive keratectomy after DMEK for corneal decompensation by phakic IOL

2022 ◽  
pp. 112067212110734
Author(s):  
Nuno Moura-Coelho ◽  
Felicidad Manero ◽  
Renato Papa ◽  
Nicolas Amich ◽  
João Paulo Cunha ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Cell Loss ◽  
Photorefractive Keratectomy ◽  
Postoperative Changes ◽  
Uncorrected Distance Visual Acuity ◽  
Corneal Decompensation ◽  
Keratorefractive Surgery ◽  
Cell Loss Rate

Purpose To provide the first description of photorefractive keratectomy (PRK) for the correction of mild residual refractive error after Descemet membrane endothelial keratoplasty (DMEK). Methods Case report. Results A 45 year-old woman presenting with phakic intraocular lens (PIOL)-related corneal decompensation underwent staged DMEK surgery following PIOL explantation and cataract surgery. Eighteen months after DMEK, uncorrected distance visual acuity (UDVA) was 20/60 and best-corrected visual acuity (BCVA) was 20/22, with a stable refraction. The patient requested refractive surgery to decrease spectacle dependance, and wavefront-optimized PRK was performed. At last follow-up observation thirty-three months after PRK (54 months after DMEK surgery), UDVA was 20/20, the cornea remained clear without signs of rejection or endothelial failure, and the endothelial cell loss rate was not accelerated after PRK. Conclusion Since long-term visual and refractive stability can be expected after DMEK, PRK may be a particular safe and effective approach for the correction of mild residual refractive errors after DMEK. However, we consider that surgeons must exercise caution when considering keratorefractive surgery in these eyes due to postoperative changes in corneal curvature and thickness, and further studies are encouraged.

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