130Long-term outcomes of ventricular tachycardia substrate ablation incorporating hidden slow conduction analysis

EP Europace ◽  
2020 ◽  
Vol 22 (Supplement_1) ◽  
Author(s):  
J Acosta Martinez ◽  
D Soto-Iglesias ◽  
B Jauregui-Garrido ◽  
J Fernandez-Armenta ◽  
D Penela ◽  
...  
Keyword(s):  
Ventricular Tachycardia ◽  
Border Zone ◽  
Procedure Time ◽  
Long Term Outcomes ◽  
Free Survival ◽  
Scar Area ◽  
Slow Conduction ◽  
Substrate Identification ◽  
Short And Long Term

Abstract Introduction Ventricular tachycardia substrate ablation (VTSA) incorporating hidden slow conduction (HSC) analysis allows further arrhythmic substrate identification. This study evaluates whether the analysis and elimination of HSC electrograms (HSC-EGMs) during VTSA procedures result in better short and long-term outcomes.  Methods Consecutive patients (n = 70, 63% ischaemic, 64 ± 14.6 years) undergoing VTSA were prospectively included. Bipolar EGMs with >3 deflections and duration <133 ms were considered as potential HSC-EGM, if located within/surrounding the scar area. Whenever a potential HSC-EGM was identified, a double ventricular extrastimulus was delivered. If a local potential showed up as a delayed component, it was annotated as HSC-EGM. The incidence of HSC-EGM in core, border-zone, and normal-voltage regions was determined. Ablation was delivered at conducting channel entrances and HSC-EGMs. Procedure time, radiofrequency time, VT inducibility after VTSA and VT recurrence at 12 months after the procedure were compared with data from a historic control group (n = 66, 70% ischaemic, 65.2 ± 12 years). Results 5076 EGMs were analyzed. 1029 (20.2%) qualified as potential HSC-EGM, and 453 of them were tagged as HSC-EGMs. Scars in patients with HSC-EGMs (n = 43, 61.4%) were smaller (39.66 ± 28.2 vs 69.4 ± 38.2 cm2; p = 0.005) and more heterogeneous (core/scar area ratio 0.24 ± 0.2 vs 0.43 ± 0.17; p = 0.03). 29.6% of HSC-EGMs were located in normal-voltage tissue; 83.5% were targeted for ablation. Patients undergoing VTSA incorporating HSC analysis needed less procedure time (213 ± 75 vs 242 ± 60 min; p = 0.018), less RF time (15.9 ± 10 vs 25 ± 12,7 minutes; p < 0.001), had a lower rate of VT inducibility (27.5% vs 51.5%; p = 0.005) and a higher 2-year VT/VF-free survival (82.8% vs 59.7%; log rank p = 0.047) after VTSA than the historic controls . Conclusion VTSA incorporating HSC analysis allowed further arrhythmic substrate identification (especially in normal-voltage areas) and resulted in increased  VTSA efficiency and better short and long-term outcomes. Abstract Figure. VT Recurrence-Free Survival

scholarly journals Transanal total mesorectal excision: short- and long-term results of the first hundred cases of a certified colorectal cancer center in Germany

2021 ◽  
Author(s):  
Vinzenz Völkel ◽  
Sabine Schatz ◽  
Teresa Draeger ◽  
Michael Gerken ◽  
Monika Klinkhammer-Schalke ◽  
...  
Keyword(s):  
Local Recurrence ◽  
Tumor Resection ◽  
Operation Time ◽  
Cancer Center ◽  
Transanal Total Mesorectal Excision ◽  
Local Tumor ◽  
Long Term Outcomes ◽  
Free Survival ◽  
Short And Long Term

Abstract Background Since 2010, laparoscopic transanal total mesorectal excision (TaTME) has been increasingly used for low and very low rectal cancer. It is supposed to improve visibility and access to the dissection planes in the pelvis. This study reports on short- and long-term outcomes of the first 100 consecutive patients treated with TaTME in a certified German colorectal cancer center. Patients and methods Data were derived from digital patient files and official cancer registry reports for patients with TaTME tumor surgery between July 2014 and January 2020. The primary outcome was the 3-year local recurrence rate and local recurrence-free survival (LRFS). Secondary endpoints included overall survival (OAS), disease-free survival (DFS), operation time, completeness of local tumor resection, lymph node resection, and postoperative complications. The Kaplan–Meier method was employed for the survival analyses; competing risks were considered in the time-to-event analysis. Results During the observation period, the average annual operation time decreased from 272 to 178 min. Complete local tumor resection was achieved in 97% of the procedures. Major postoperative complications (Clavien–Dindo 3–4) occurred in 11% of the cases. At a median follow-up time of 2.7 years, three patients had suffered from a local recurrence. Considering competing risks, this corresponds to a 3-year cumulative incidence rate for local recurrence of 2.2% and a 3-year LRFS of 81.9%. 3-year OAS was 82.9%, and 3-year DFS was 75.7%. Conclusion TaTME is associated with favorable short and long-term outcomes. Since it is technically demanding, structured training programs and more research on the topic are indispensable.

scholarly journals Comparison of short- and long-term outcomes between 3-field and modern 2-field lymph node dissections for thoracic oesophageal squamous cell carcinoma: a propensity score matching analysis

2019 ◽  
Vol 29 (3) ◽  
pp. 434-441 ◽  
Author(s):  
Ningbo Fan ◽  
Han Yang ◽  
Jiabo Zheng ◽  
Dongni Chen ◽  
Weidong Wang ◽  
...  
Keyword(s):  
Squamous Cell Carcinoma ◽  
Cell Carcinoma ◽  
Squamous Cell ◽  
Disease Free Survival ◽  
Oesophageal Squamous Cell Carcinoma ◽  
Long Term Outcomes ◽  
Free Survival ◽  
Short And Long Term ◽  
Disease Free

Abstract OBJECTIVES Our goal was to compare short- and long-term outcomes between 3-field lymphadenectomy (3-FL) and modern 2-field lymphadenectomy (2-FL) in patients with thoracic oesophageal squamous cell carcinoma. METHODS We reviewed clinical outcomes for 298 patients with thoracic oesophageal squamous cell carcinoma who underwent 3-FL or modern 2-FL from March 2008 to December 2013 at a major cancer hospital in Guangzhou, southern China. Propensity score matching was used to balance baseline differences, and 83 pairs of cases were selected. Postoperative complications, recurrence patterns and survival outcomes were compared between the 2 groups. RESULTS Compared with modern 2-FL, 3-FL led to higher overall operative morbidity rates [78.3% vs 61.4%, odds ratio (OR) 2.266, 95% confidence interval (CI) 1.143–4.490; P = 0.019], with higher recurrent nerve palsy rates (47.0% vs 19.3%, OR 3.712, 95% CI 1.852–7.438; P < 0.0001), more respiratory failures (18.1% vs 6.0%, OR 3.441, 95% CI 1.189–9.963; P = 0.023) and longer postoperative hospital stays (23 vs 17 days, P = 0.002). The 5-year overall survival rate (58.5% vs 59.4%; P = 0.960) and the 5-year disease-free survival rate 50.1% vs 54.5%; P = 0.482) were comparable between the 2 groups. Multivariable analysis showed that additional cervical lymph node dissection was not associated with overall survival [hazard ratio (HR) 1.039, 95% CI 0.637–1.696; P = 0.878] and disease-free survival (HR 0.868, 95% CI 0.548–1.376; P = 0.547). The overall recurrence rate and cervical nodal recurrence rate were not significantly different between the 2 groups. CONCLUSIONS Additional cervical lymphadenectomy did not lead to added survival benefit when compared with modern 2-FL in patients with thoracic oesophageal squamous cell carcinoma. Recurrence was similar in patients undergoing 3-FL and modern 2-FL. 3-FL resulted in more postoperative complications.

999Short-and long-term outcomes of ventricular tachycardia substrate ablation incorporating hidden slow conduction analysis

EP Europace ◽  
2018 ◽  
Vol 20 (suppl_1) ◽  
pp. i188-i188
Author(s):  
J Acosta Martinez ◽  
D Soto-Iglesias ◽  
B Jauregui-Garrido ◽  
M Frutos-Lopez ◽  
M Linhart ◽  
...  
Keyword(s):  
Ventricular Tachycardia ◽  
Long Term Outcomes ◽  
Slow Conduction

Long-Term Outcomes of Carotid Endarterectomy and Carotid Artery Stenting When Performed by a Single Vascular Surgeon

2019 ◽  
Vol 53 (3) ◽  
pp. 216-223 ◽  
Author(s):  
Muhammad Rizwan ◽  
Hanaa Dakour Aridi ◽  
Tru Dang ◽  
Widian Alshwaily ◽  
Besma Nejim ◽  
...  
Keyword(s):  
Carotid Artery ◽  
Carotid Artery Stenosis ◽  
Carotid Artery Stenting ◽  
Artery Stenosis ◽  
Long Term Outcomes ◽  
Vascular Surgeon ◽  
Free Survival ◽  
Carotid Revascularization ◽  
Short And Long Term

Objectives: Carotid artery endarterectomy (CEA) and carotid artery stenting (CAS) are 2 effective treatment options for carotid revascularization and stroke prevention. The long-term outcomes of Carotid Revascularization Endarterectomy versus Stenting Trial (CREST) reported similar stroke and death rate between the 2 procedures. This study presents the short- and long-term outcomes of CEA and CAS of all risk patients performed by a single vascular surgeon in a real-world setting. Methods: We retrospectively reviewed all patients who underwent CEA and CAS from September 2005 to June 2017 at our institute. Student t test, χ2, and Fisher exact tests were used to compare patient’s characteristics. Multivariate logistic, cox regression models and survival analysis were used to compare postoperative and long-term outcomes between the 2 groups. Results: Over 2000 patients were evaluated for carotid artery stenosis during the study period, and 313 revascularization procedures were performed (CEA: 47%, CAS: 53%). Patients’ age (Mean [95% confidence interval, CI] 68.8 [67.2-70.4] vs 69.7 [68.2-71.3], P = .40) was similar between CEA and CAS. Patients who underwent CAS had significantly higher comorbidities (chronic obstructive pulmonary disease [COPD], chronic heart failure [CHF], hyperlipidemia, and prior ipsilateral intervention, all P < .05). No difference was found in 30-day complications after CEA versus CAS including stroke (2.0% vs 1.2%), myocardial infarction (MI; 0.7% vs 1.2%), death (0% vs 1.2%) as well as combined major adverse events (stroke/death/MI; 2.7% vs 3.0%; all P > .05). Overall 7-year survival, stroke-free survival and restenosis-free survival were similar between the 2 groups ( P > .5). Significant predictors of mortality were diabetes (hazard ratio, HR [95% CI]: 2.41 [1.15-5.08]), chronic kidney disease (HR [95% CI]: 4.89 [1.97-12.13]), and COPD (HR [95% CI]: 3.31 [1.43-7.71]; all P values <.05). Statin use was protective with 71% reduction in risk of mortality (HR [95% CI]: 0.29 [0.12-0.67], P = .004). Conclusion: Our experience showed comparable short- and long-term outcomes of CAS and CEA performed for carotid artery stenosis by vascular surgeon. There was no difference between single institutional long-term outcomes and CREST outcomes following CEA and CAS.

Long-term outcomes of ventricular tachycardia substrate ablation incorporating hidden slow conduction analysis

Heart Rhythm ◽  
2020 ◽  
Vol 17 (10) ◽  
pp. 1696-1703 ◽  
Author(s):  
Juan Acosta ◽  
David Soto-Iglesias ◽  
Beatriz Jáuregui ◽  
Juan Fernández Armenta ◽  
Diego Penela ◽  
...  
Keyword(s):  
Ventricular Tachycardia ◽  
Long Term Outcomes ◽  
Slow Conduction

Short- and Long-Term Outcomes of Single Incision Laparoscopic Surgery for Right-Side Colon Cancer

2021 ◽  
Author(s):  
Taishi Hata ◽  
Kenji Kawai ◽  
Atsushi Naito ◽  
Yoshinori Kagawa ◽  
Tomohiro Kitahara ◽  
...  
Keyword(s):  
Colon Cancer ◽  
Laparoscopic Surgery ◽  
Disease Free Survival ◽  
Single Incision Laparoscopic Surgery ◽  
Long Term Outcomes ◽  
Conventional Laparoscopic Surgery ◽  
Free Survival ◽  
Short And Long Term ◽  
Disease Free

Introduction: Currently, there is limited data regarding the long-term outcomes of single incision laparoscopic surgery (SILS) for colon cancer. Therefore, we investigated both the short- and long-term outcomes of SILS for right-sided colon cancer. Methods: We retrospectively compared the short- and long-term outcomes of SILS and conventional laparoscopic surgery (CLS) for right-sided colon cancer (specifically the cecum and ascending colon) in our institution. Inter-group differences of short-term outcomes were evaluated using the chi-squared or Fisher exact test and two-sample Student’s t-test. The disease-free survival rates (long-term outcome) of stage 0 to III patients were estimated using the Kaplan–Meier method and compared using log-rank tests. Results: There were 290 operations conducted for right-sided (cecum and ascending color) colorectal cancers between April 2011 and July 2018. Twelve patients underwent planned laparotomy. Of the remaining 278 patients, 55 underwent planned conventional laparoscopic surgery, 27 patients had planned reduced poet surgery (RPS), and 196 patients had planned SILS. The procedures had been selected by skilled surgeons. One patient underwent intraoperative conversion from SILS to laparotomy for bleeding control. In addition, one port was added to SILS in three cases. These four cases were included in the analysis as the SILS group, according to the principle of intent to treat. Background factors, including age, sex, body mass index, performance status, and tumor stage were not statistically different between the SILS and CLS groups. In the short-term outcomes, the number of harvested lymph-nodes was not statistically different. SILS required less operating time (P<0.001) and resulted in a reduced bleeding volume (P<0.001). There was no statistical difference in the frequency of overall complications (P=0.06). The disease-free survival of stage 0 to III patients was not statistically different between the two groups. Conclusions: Skilled surgeons can achieve adequate oncologic long-term outcomes in selected subgroups of SILS patients. Therefore, SILS could be a treatment option for right-sided colon cancer.

scholarly journals Preoperative prognostic nutritional index predicts both short and long-term outcomes after liver resection for hepatocellular carcinoma.

2019 ◽  
Author(s):  
Yu Saito ◽  
Satoru Imura ◽  
Yuji Morine ◽  
Tetsuya Ikemoto ◽  
Shinichiro Yamada ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Liver Resection ◽  
Disease Free Survival ◽  
Prognostic Nutritional Index ◽  
Long Term Outcomes ◽  
Free Survival ◽  
Nutritional Index ◽  
Short And Long Term ◽  
Disease Free

Abstract Background The aim of this study was to investigate the prognostic significance of the prognostic nutritional index (PNI) for both short and long term outcomes after liver resection for hepatocellular carcinoma (HCC). Methods 162 (without any previous treatment) of 229 surgically treated HCC patients were retrospectively analyzed. The cut off value of the preoperative PNI was 45.0. Patients were divided into two groups, PNI low (n=76) and high (n=86) group. Results Among some immune parameters such as PNI, neutrophil to lymphocyte ratio (NLR) and aspartate aminotransferase (AST) to lymphocyte ratio (ALRI), PNI had most reliable parameters in terms with prediction of both short and long term outcomes. Preoperative PNI tended to correlate with low skeletal muscle mass (SMM). In short term outcomes, PNI low group were more likely to have postoperative complications. The disease-free survival rate in PNI low group was significantly worse than that in the PNI high group (20.5 vs. 48.7 %, 5 year SR, p=0.03). On multivariate analysis, Low PNI was an independent prognostic factor for disease free survival (HR 1.65, p= 0.04). Conclusions The preoperative PNI was the most significant prognostic factor for evaluating both short and long-term outcomes after liver resection for HCC.

P2877The incidence, predictors, and long-term outcomes of new-onset ventricular tachycardia after cardiac surgery

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
K.-J Choi ◽  
M S Cho ◽  
U Do ◽  
J Kim ◽  
G B Nam ◽  
...  
Keyword(s):  
Cardiac Surgery ◽  
Ventricular Tachycardia ◽  
Hospital Mortality ◽  
Index Hospitalization ◽  
Long Term Outcomes ◽  
Short And Long Term ◽  
Long Term Mortality ◽  
New Onset

Abstract Background Incidence and outcomes of new-onset ventricular tachycardia (VT) after cardiac surgery are not fully evaluated. Purpose We retrospectively analyzed the occurrence of new-onset VTs after cardiac surgery, and their implications on short and long-term mortality. Methods Data of 11,004 adult patients who underwent cardiac surgery at our center from 2006 to 2016 were analyzed. VT was diagnosed when 3 or more consecutive wide QRS complexes (>100 bpm) were documented on ECG. The major study outcomes were in-hospital and 5-years overall mortality rates. Results During index hospitalization for cardiac surgery, clinical VTs were documented in 184 patients (1.7%), which included 74 sustained VTs (SusVT, ≥30 seconds) and 110 non-sustained VTs (NSVT). Those patients with SusVT and NSVT showed higher in-hospital mortality compared to those without VTs (31.1% vs. 24.5% vs. 2.0% for SusVT, NSVT, and no VT, respectively, P<0.001). During follow-up after discharge from index hospitalization, patients with SusVT showed higher 5-years mortality than those without VTs, while patients with NSVT did not showed significant differences (22.0% vs. 11.7% vs. 9.2%, P<0.001). In the subgroup of patients with sustained VT who were discharged from index hospitalization (n=51), those with recurrent VTs (>24 hours apart from initial episode) were at higher 5-years mortality rate compared to those without (40.7% vs. 15.8%, P=0.018). Conclusion Patients with SusVT and NSVT were at higher risk of in-hospital mortality, and patients with SusVT were associated with higher risk of long-term mortality. The mortality risk was even higher in those with recurrent episodes of VTs. Acknowledgement/Funding None

scholarly journals Preoperative prognostic nutritional index predicts both short and long-term outcomes after liver resection for hepatocellular carcinoma.

2019 ◽  
Author(s):  
Yu Saito ◽  
Satoru Imura ◽  
Yuji Morine ◽  
Tetsuya Ikemoto ◽  
Shinichiro Yamada ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Liver Resection ◽  
Disease Free Survival ◽  
Prognostic Nutritional Index ◽  
Long Term Outcomes ◽  
Free Survival ◽  
Nutritional Index ◽  
Short And Long Term ◽  
Disease Free

Abstract Background The aim of this study was to investigate the prognostic significance of the prognostic nutritional index (PNI) for both short and long term outcomes after liver resection for hepatocellular carcinoma (HCC). Methods 162 (without any previous treatment) of 229 surgically treated HCC patients were retrospectively analyzed. The cut off value of the preoperative PNI was 45.0. Patients were divided into two groups, PNI low (n=76) and high (n=86) group. Results Among some immune parameters such as PNI, neutrophil to lymphocyte ratio (NLR) and aspartate aminotransferase (AST) to lymphocyte ratio (ALRI), PNI had most reliable parameters in terms with prediction of both short and long term outcomes. Preoperative PNI tended to correlate with low skeletal muscle mass (SMM). In short term outcomes, PNI low group were more likely to have postoperative complications. The disease-free survival rate in PNI low group was significantly worse than that in the PNI high group (20.5 vs. 48.7 %, 5 year SR, p=0.03). On multivariate analysis, Low PNI was an independent prognostic factor for disease free survival (HR 1.65, p= 0.04). Conclusions The preoperative PNI was the most significant prognostic factor for evaluating both short and long-term outcomes after liver resection for HCC.

scholarly journals LongTerm Outcomes of Three-Port Laparoscopic Right Hemicolectomy Versus Five-Port Laparoscopic Right Hemicolectomy: A Retrospective Study

2021 ◽  
Vol 11 ◽  
Author(s):  
Tao Zhang ◽  
Yaqi Zhang ◽  
Xiaonan Shen ◽  
Yi Shi ◽  
Xiaopin Ji ◽  
...  
Keyword(s):  
Disease Free Survival ◽  
Right Hemicolectomy ◽  
Long Term Outcomes ◽  
Short Term ◽  
Free Survival ◽  
Oncological Outcomes ◽  
Short And Long Term ◽  
Laparoscopic Right Hemicolectomy ◽  
Disease Free

PurposeThe aim of this study is to compare the long-term outcomes of three-port laparoscopic right hemicolectomy (TPLRC) and five-port laparoscopic right hemicolectomy (FPLRC) with retrospective analysis.MethodsA total of 182 patients who accepted laparoscopic right hemicolectomy with either three ports (86 patients) or five ports (96 patients) from January 2012 to June 2017 were non-randomly selected and analyzed retrospectively.ResultsMore lymph nodes were harvested in the TPLRC group than in the FPLRC group [17.5 (7), 14 (8) ml, p &lt; 0.001]. There was less blood loss in the TPLRC group [50 (80) vs. 100 (125) ml, p = 0.015]. There were no significant differences in the other short-term or oncological outcomes between the two groups. The overall survival and disease-free survival were equivalent.ConclusionsTPLRC is recommendable as it guarantees short- and long-term equivalent outcomes compared with FPLRC.

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