5-year Results Research Articles

Surgery for Ascending Aortic Aneurysm and Aortic Valve Insufficiency in Conditions of Active Proceeding Syphilitic Aortitis and Valvulitis.

A syphilitic aortitis is a late cardiovascular lesion of tertiary syphilis that has become exceptionally rare in the antibiotic era but not eradicated completely. Syphilitic aortitis of ascending aorta complicates in ascending aortic aneurysm formation and aortic valve regurgitation, both requiring surgical treatment. After surgery, lifelong surveillance of the remainder of the aorta is recommended because of a priori supposed high incidence of delayed involvement of noninvolved aortic segments. A 3-year follow-up result of surgery of syphilitic ascending aortic aneurysm with aortic valve regurgitation in condition of active ongoing syphilitic aortitis and valvulitis is described with addressing the dimensions of remaining aortic segments. This case demonstrates that the dilatation of the remainder of the aorta does not occur during 3 years, at least when anti-syphilitic course of antibiotic is used just after operation without additional treatment during the follow-up period. A few reports on surgical treatment of syphilitic aneurysms of the ascending aorta are discussed.

Left ventricular assist device and transcatheter edge-to-edge mitral valve repair in advanced heart failure: allies or enemies?

The implantation of left ventricular assist devices (LVADs) has been increasing, with good long-term results, in parallel with a growing population with advanced heart failure (HF). However, in some European countries, LVADs are still underused, with one of the main issues being the patient's late referral. On the contrary, the use of transcatheter edge-to-edge mitral valve repair (TEER) has exponentially increased over the past decade, expanding its potential use even in patients on the heart transplantation waiting list. Even though the study populations of the main trials that investigated the prognostic impact of LVAD and TEER are different, in clinical practice a clear distinction might not be so clear. Therefore, patients with refractory HF symptoms and significant mitral regurgitation should be thoroughly evaluated through a multidisciplinary Heart Team meeting with both an advanced HF specialist and interventional cardiologist, to avoid futile procedures and to define the optimal timing for advanced HF therapies, when they are indicated. We analyzed the main available studies and registries on both TEERs and LVADs and we compared their populations and outcomes, to provide the current evidence on the use of LVAD and TEER in the HF population, especially in the light of the recently released 5-year follow-up results, giving some insights on the Italian situation, and finally to stress the importance of a solid HF network between hospitals, aiming for advanced HF patients' timely referral for LVAD or heart transplants.

Clinical Efficacy of Laparoscopic Sentinel Node Navigation Surgery for Stomach Preservation in Patients With Early Gastric Cancer: 5-year Results of the SENORITA Trial.

This study aimed to compare laparoscopic standard gastrectomy (LSG) and laparoscopic sentinel node navigation surgery (LSNNS) for EGC in terms of 5-year long-term oncologic outcomes. The oncological safety of LSNNS for early gastric cancer (EGC) has not been confirmed. Three-year disease-free survival (DFS), which is the primary endpoint of the phase III multicenter randomized controlled clinical trial (SEntinel Node ORIented Tailored Approach [SENORITA] trial), did not show the non-inferiority of LSNNS relative to LSG. The SENORITA trial, a multicenter randomized clinical trial, was designed to show that LSNNS is non-inferior to LSG in terms of 3-year DFS. In the present study, we collected 5-year follow-up data from 527 patients recruited in the SENORITA trial as the full analysis set (FAS). Disease-free survival (DFS), overall survival (OS), disease-specific survival (DSS), and recurrence patterns were evaluated using the FAS of both LSG (n=269) and LSNNS (n=258). The 5-year DFS was not significantly different between the LSG and LSNNS groups (P=0.0561). During the 5-year follow-up, gastric cancer-related events, such as metachronous cancer, were more frequent in the LSNNS group than in the LSG group. However, ten recurrent cancers in the remnant stomach of both groups were curatively resected by additional gastrectomy and one by additional endoscopic resection. Two of the 198 patients who underwent local resection for stomach preservation based on the LSNNS results developed distant metastasis. However, there was no statistically significant difference in the 5-year OS and DSS (P=0.7403 and P=0.9586, respectively) between the two groups. The 5-year DFS, DSS and OS did not differ significantly between the two groups. Considering the benefits of LSNNS on postoperative quality of life, LSNNS could be recommended as an alternative treatment option for EGC.

P957 Subcutaneous infliximab (CT-P13 SC) for ulcerative colitis: 2-year extension results of the LIBERTY-UC study

Abstract Background Superiority of CT-P13 subcutaneous (SC) infliximab formulation over placebo in maintenance therapy was demonstrated in both ulcerative colitis1 and Crohn’s disease2. LIBERTY-UC study was continued up to Week 102 as an extension phase treatment. We now present the efficacy and safety results up to Week 102 of CT-P13 SC 120 mg group in the LIBERTY-UC study (NCT04205643). Methods Patients who completed the maintenance phase up to Week 54 and, in the opinion of the investigator, would benefit from continued treatment continued the open-label extension phase from Week 56 to Week 102. During extension phase, all patients received CT-P13 SC regardless of previous treatment group randomised at the start of maintenance phase. The patients who had received the adjusted dose of CT-P13 SC 240 mg during the maintenance phase continued receiving CT-P13 240 mg in the extension phase. Patients with dose adjustment to CT-P13 SC 240 mg prior to Week 54 were considered as not to achieve each endpoint. At Week 54 and 102, clinical remission, clinical response, endoscopic-histologic mucosal improvement and corticosteroid-free remission were assessed by among patients who entered and treated in extension phase (Figure 1A), and who entered and treated in extension phase and had valid efficacy results at the visit of interest (Figure 1B). Safety was evaluated throughout the extension phase. Results A total of 237 patients in CT-P13 SC 120 mg group entered into extension phase. Among them, 208 (87%) patients completed extension phase. Proportion of patients who achieved clinical remission, clinical response, endoscopic-histologic mucosal improvement and corticosteroid-free remission at Week 54 and Week 102 among patients who entered and treated in extension phase (i.e., patients who had missing or invalid data were considered as not to achieve each endpoint) are presented in Figure 1A. Among patients who entered and treated in extension phase based on the no imputation for missing or invalid data, each endpoints are generally well maintained or slightly higher in Week 102 compared to Week 54 (Figure 1B). During extension phase, no new safety signals were observed compared to maintenance phase1 (table 1). Conclusion The efficacy of CT-P13 SC 120 mg in UC patients was generally sustained through extension phase. No new safety concerns were found during the extension phase as well. These results indicate that long term use of CT-P13 SC can maintain clinical benefit as well as safety with the convenience of SC administration for patient with moderately to severely active UC. [1] Sands et al., Journal of Crohn's and Colitis, 2023.17(Supplement_1), i623-i624. [2] Colombel et al., Journal of Crohn's and Colitis, 2023.17.Supplement_1: i161-i162

Long-term outcomes with HLX01 (HanliKang®), a rituximab biosimilar, in previously untreated patients with diffuse large B-cell lymphoma: 5-year follow-up results of the phase 3 HLX01-NHL03 study

HLX01 (HanliKang®) is a rituximab biosimilar that showed bioequivalence to reference rituximab in untreated CD20-positive diffuse large B-cell lymphoma (DLBCL) in the phase 3 HLX01-NHL03 study. Here, we report the 5-year follow-up results from the open-label extension part. Patients were randomised to either rituximab plus cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP) or HLX01 plus CHOP (H-CHOP) every 21 days for up to six cycles. The primary efficacy endpoint was overall survival (OS), and secondary efficacy endpoint was progression-free survival (PFS). Of the 407 patients enrolled in HLX01-NHL03, 316 patients (H-CHOP = 157; R-CHOP = 159) were included in the 5-year follow-up for a median duration of 65.1 (range, 2.2–76.5) months. 96.5% of the patients had an International Prognostic Index (IPI) of 1 or 2, and 17.7% had bone marrow involvement. The 5-year OS rates were 81.0% (95% CI: 74.9–87.5%) and 75.4% (95% CI: 68.9–82.6%)( HR: 0.75, 95% CI 0.47–1.20; p = 0.23) while 5-year PFS rates were 77.7% (95% CI: 71.4–84.6%) and 73.0% (95% CI: 66.3–80.3%) (HR: 0.84, 95% CI 0.54–1.30; p = 0.43) in the H-CHOP and R-CHOP groups, respectively. Treatment outcomes did not differ between groups regardless of IPI score and were consistent with the primary analysis. H-CHOP and R-CHOP provided no significant difference in 5-year OS or PFS in previously untreated patients with low or low-intermediate risk DLBCL.

DOP53 Long-term Efficacy and Safety of Risankizumab in Patients With Moderate to Severe Crohn's Disease up to 3 Years of Treatment: Results From the FORTIFY Open-Label Long-term Extension

Abstract Background The ongoing FORTIFY maintenance open-label extension (OLE) substudy evaluates the long-term efficacy and safety of risankizumab (RZB), a p19 interleukin-23 inhibitor, for treatment of moderate to severe Crohn’s disease (CD). Here, we report 2-year results of FORTIFY OLE. Methods The FORTIFY (NCT03105102) OLE enrolled patients (pts) who completed 52-wks maintenance dosing in the FORTIFY substudies or RZB phase 2 OLE.1,2 All pts received 180 mg subcutaneous (SC) RZB every 8 wks (Q8w), starting at wk56, except for pts who had prior rescue therapy (single 1200mg intravenous [IV] RZB dose then 360mg SC Q8w) who continued 360mg SC Q8w in the OLE. Pts with inadequate response (increased symptoms plus objective marker of inflammation) during the OLE could receive rescue therapy as described above. Pooled data from both treatment groups (RZB 180 mg & 360 mg SC) were assessed. Clinical outcomes were evaluated every 24 wks (endpoint definitions in Figure footnote). Endoscopy was performed every 96 wks. Results are reported as observed. Efficacy data for pts receiving rescue therapy in the OLE were included up to rescue initiation. Safety was assessed through the cutoff date of 05MAR2023. As this trial is ongoing, most patients have not reached the wk152 study visit. Any treatment-emergent adverse events (TEAEs) reported on or after the first dose in the OLE were analysed. Results As of the cutoff date, 1147 pts entered the OLE, of which 203 (17.6%) pts received rescue therapy during the OLE. Clinical response and remission rates were generally maintained with RZB from wks 56 to 152 (CD activity index [CDAI] clinical response, 85.8% to 86.5%, respectively; enhanced clinical response, 88.6% to 89.2%; CDAI clinical remission, 68.5% to 77.6%; stool frequency/abdominal pain score clinical remission, 64.4% to 71.0%) (Figure). At wks 56 and 152, respectively, rates of endoscopic response were 53.4% and 74.2%, endoscopic remission were 37.5%, and 58.9%, and ulcer-free endoscopy were 31.0% and 50.0%. There were no new trends for exposure-adjusted rates of TEAEs, and rates of adjudicated major cardiovascular adverse events, malignancies, serious infections and hepatic events remained stable with no new safety risks identified. There were no events of active tuberculosis, serious hypersensitivity, or adjudicated anaphylactic reaction. Three deaths occurred during the OLE (see Table footnote), all assessed by investigators as unrelated to study drug. Conclusion Pts receiving long-term RZB maintenance therapy in FORTIFY demonstrated sustained clinical and endoscopic efficacy with at least 3 years of treatment. The safety profile is consistent and supports long-term RZB treatment. 1doi: 10.1093/ecco-jcc/jjab093 2doi: 10.1016/S0140-6736(22)00466-4.

Treatment of Femoropopliteal Artery Disease with Polymer-Coated Drug-Eluting Stent: 5-Year Results of a Prospective, Non-Randomized Study Including the Halo Phenomenon

PurposeTo investigate the long-term results of the Eluvia drug-eluting stent (DES) implantation for femoropopliteal arterial disease, including the ‘halo’ phenomenon. Long-term data of DES is scarce. A focal reaction (‘halo’) following Eluvia DES deployment has been described. However, the long-term clinical impact of this phenomenon remains unclear.MethodsThis prospective, non-randomized, single-arm study included 130 consecutive patients treated with an Eluvia DES for symptomatic femoropopliteal disease between March 2016 and December 2018. Clinical outcomes and imaging were assessed after 6 months and annually thereafter for up to 5 years. The primary outcome measure was primary patency. Secondary outcomes were freedom from clinically driven target lesion revascularization (CD-TLR), freedom from major amputation, overall survival and amputation-free survival rates.ResultsThe primary patency was 65% at 5 years. The freedom from CD-TLR and from major amputation at 5 years was 79 and 96%, respectively. The overall survival and amputation-free survival rates were 88 and 83% at 60 months, respectively. Out of the 27 patients with a halo sign, two showed an increased (7.4%) and 6 (22.2%) a decreased diameter. In 19 cases (70.4%), the diameter remained unchanged at the latest follow-up. The presence of the ‘halo’ sign was associated with increased primary patency (87% versus 59%, HR: 2.48, 95%CI 1.19–5.16, P = .015).ConclusionsThe presented patient cohort treated with the Eluvia DES for femoropopliteal artery lesions indicates durable efficacy and a good safety profile regardless of the halo phenomenon. The results need to be confirmed in a larger patient cohort.Level of Evidence IIINon-randomized controlled cohort/follow-up study.Graphical

Extended Partington procedure for chronic pancreatitis: One-year follow-up results

Abstract Background Over half of the patients who underwent the Partington procedure for painful chronic pancreatitis developed recurrent pain attacks. This occurs because the proximal ducts at the head of the pancreas, often containing stones, are left undrained. To overcome this pitfall, an extended Partington procedure is recommended. The aim of this study was to assess our 1-year follow-up results of the extended Partington procedure in patients with painful chronic pancreatitis. Materials and Methods This prospective study comprises patients undergoing extended Partington procedures who were followed for at least 1 year. Data were collected preoperatively and postoperatively in a fixed-interval fashion at 3 months, 6 months, and 1 year. Results Thirty-one patients underwent assessment. At 1-year follow-up, effective and complete pain relief was achieved in 81% and 55% of patients, respectively. The Izbicki pain score decreased significantly; the median dropped from 47.5 to 4.4. The quality of life using SF-12 physical and mental component summary improved significantly; the medians increased from 41.7 to 93.8, and 47.5 to 86.7, respectively. Endocrine function remained stable. Exocrine insufficiency developed in most patients as a natural progression of chronic pancreatitis. Two patients had complications directly related to surgical procedures (6%). No early postoperative deaths occurred. Conclusions Extended Partington procedure for chronic pancreatitis results in excellent pain relief and quality of life improvement, with a low morbidity rate, and does not worsen pancreatic function. It should replace the original Partington procedure in treating painful chronic pancreatitis.

Хирургическая коррекция пролапса тазовых органов у женщин с использованием сетчатых эндопротезов на основе титанового «шелка»: результаты 5-летнего наблюдения

Background: pelvic organ prolapse (POP) is a common condition that significantly impairs quality of life and has potentially serious health consequences. Aim: to evaluate the long-term safety and efficacy of using titanium "silk" mesh endoprostheses for the surgical treatment of apical and anterior prolapse in women. Patients and Methods: 103 women with symptomatic POP grade ≥2 were enrolled in this prospective interventional study. Women underwent bilateral sacrospinous and anterior transobturator hysteropexy with implantation of a titanium "silk" mesh endoprosthesis. Early and late postoperative complications and other adverse events were evaluated. Quality of life was assessed with special questionnaires. The women were followed for 5 years postoperatively. Results: the rate of intraoperative complications was insignificant and all adverse events were not associated with the type of implant used. Fistula, tissue granulation, penetration of synthetic material into the urethra and bladder, and other potential complications were not reported during long-term follow-up. Recurrence of cystocele occurred in 3 (3%) women 5 years after surgery. There were no other adverse events reported. Quality of life improved significantly after surgery and remained stable throughout follow-up. The most significant positive changes were observed in the indices of complaints about the sensation of a foreign body in the perineal area, the necessity to reposition the prolapsed genitalia (hernia sac) to urinate. Conclusions: the treatment is characterized by a favorable safety profile and a high level of patient satisfaction, as well as a low recurrence rate. KEYWORDS: mesh, titanium mesh, titanium "silk", pelvic organ prolapse, cystocele, reconstructive surgery. FOR CITATION: Kamoeva S.V., Makovskaya D.S., Dobrokhotova Yu.E. Surgical management of female pelvic organ prolapse using titanium "silk" mesh replacement: 5-year results. Russian Journal of Woman and Child Health. 2024;7(3):227–235 (in Russ.). DOI: 10.32364/2618-8430-2024-7-3-6.

The 1-Year Follow-Up Results Of 47 Scoliosis Patients Operated with MAGEC Rod in Ankara Bilkent City Hospital

The 1-Year Follow-Up Results Of 47 Scoliosis Patients Operated with MAGEC Rod in Ankara Bilkent City Hospital

Left main coronary artery disease treated with beating heart surgery: 10-year single center results.

Left main (LM) coronary disease is believed to represent a complex, advanced, and potentially life-threatening atherosclerotic syndrome that can be treated by either percutaneous or surgical interventions. Despite its satisfactory results, the declined number of off-pump coronary artery bypass grafting (OPCAB) is observed. To compare 10-year survival and point out possible mortality risk factors in patients referred for left main and multivessel OPCAB surgery followed by transit time bypass measurements. There were 159 patients (128 (81%) men and 31 (19%) women) in a median age of 66 (60-70) years enrolled in retrospective analysis who were referred to surgical intervention due to left main (51, 32%) and multivessel (108, 68%) disease. The regression analysis for long-term mortality risk and the Kaplan-Meyer survival curve were analyzed. Multivariable analysis pointed female sex (HR = 1.08, 95% CI: 1.03-1.14, p = 0.001) and diabetes mellitus (HR = 6.33, 95% CI: 1.86-21.52, p = 0.003) as possible risk factors for 10-year mortality risk. There was no significant difference in Kaplan-Meyer 10-year mortality comparison between left main and multivessel disease patients treated by off-pump surgical revascularization (HR = 0.93, 95% CI: 0.40-2.13, p = 0.86). Off-pump surgery in the left main disease, compared to multivessel disease, represents a safe surgical technique with satisfactory long-term results. The female sex and diabetes mellitus were found as possible risk factors for 10-year mortality risk in multivariable analysis.

Abemaciclib combined with endocrine therapy as adjuvant treatment for hormone-receptor-positive, HER2-, high-risk early breast cancer: 5-year Chinese population analysis of the phase III randomized monarchE study.

Abemaciclib was the first cyclin-dependent kinase 4/6 (CDK4/6) inhibitor approved globally in the adjuvant setting for high-risk hormone-receptor positive (HR+)/human epidermal growth factor 2 negative (HER2-) early breast cancer (EBC), based on the phase III monarchE trial. To report an exploratory Chinese population analysis based on the preplanned overall survival (OS) interim analysis with 5-year efficacy results of monarchE. Patients with HR+/HER2-, high-risk (⩾4 positive lymph nodes, or 1-3 nodes and either tumor size ⩾5 cm, histologic grade 3, or Ki-67 ⩾20%) EBC were randomized (1:1) to abemaciclib (150 mg twice daily for 2 years) plus endocrine therapy (ET), or ET alone. This analysis included Chinese patients enrolled in mainland China, Hong Kong, and Taiwan. The primary endpoint was invasive disease-free survival (IDFS); key secondary endpoints included distant relapse-free survival (DRFS), safety, and patient-reported outcomes (PROs). Overall, 501 Chinese patients were included (abemaciclib + ET, n = 259; ET, n = 242). With a median follow-up of 53 months, the addition of abemaciclib to ET resulted in improvements in IDFS (estimated 5-year IDFS rate: 85.9% vs 79.1%; hazard ratio (HR), 0.65 (95% confidence interval (CI) 0.41-1.03)) and DRFS (estimated 5-year DRFS rate: 88.4% vs 82.3%; HR, 0.65 (95% CI, 0.39-1.07)). The most common grade ⩾3 treatment-emergent adverse events in the abemaciclib + ET versus ET groups were neutropenia (24.7% vs 0.8%) and leukopenia (22.4% vs 0.4%). Generally, no clinically meaningful difference in PROs (endocrine symptoms and fatigue) was observed between groups, except for diarrhea. At this prespecified OS interim analysis, which provides 5-year data, the addition of abemaciclib to ET in Chinese patients with high-risk HR+, HER2- EBC was associated with sustained and clinically meaningful improvements in IDFS and DRFS, with acceptable safety and tolerability profiles and minimal impact on PROs. These results represent the first full report of a CDK4/6 inhibitor in Chinese patients with EBC and support the positive benefit-risk profile of adjuvant abemaciclib + ET in Chinese patients. ClinicalTrials.gov identifier: NCT03155997 (first posted: May 16, 2017).

Evaluation of Ultrathin Strut Biodegradable Polymer-Coated Sirolimus-Eluting Stents in an All-Comers Patient Population: 1-Year Results of the S-FLEX Slovakia Registry.

Supraflex (Sahajanand Medical Technologies Limited, Surat, India) is a new-generation, biodegradable polymer-coated sirolimus-eluting stent (SES) designed on an ultrathin (60 µm) cobalt-chromium platform with a flexible 'S-link.' The S-FLEX Slovakia registry aimed to assess the safety and effectiveness of Supraflex SES in an all-comers population, with a subgroup of diabetic patients. This was a prospective, observational, multi-center, post-market registry conducted between February 2018 and May 2019. All consecutive patients with symptomatic coronary artery disease scheduled for percutaneous coronary intervention with Supraflex SES were enrolled. The primary endpoint was target lesion failure (TLF), defined as a composite of cardiac death, target vessel myocardial infarction (TV-MI), or clinically indicated target lesion revascularization (CI-TLR) by percutaneous or surgical methods at 1-year follow-up. Stent thrombosis was a safety endpoint. A total of 413 patients was assessed (145 diabetics and 268 nondiabetics). At 1-year follow-up, the primary endpoint of TLF occurred in 5.1% patients, comprised of 3.9% cardiac deaths, 0.5% TV-MI, and 0.7% CI-TLR. Overall stent thrombosis occurred in 0.5% patients at 1-year follow-up. In the subgroup analysis, TLF occurred in 6.2% diabetics and 4.5% nondiabetics (P =.433) and comprised 4.8% and 3.4% cardiac deaths (P =.447), 0.7% and 0.4% TV-MI (P =.653), and 0.7%, and 0.7% CI-TLR (P =.952) in diabetics and non-diabetics, respectively. Overall stent thrombosis occurred in 0.7% diabetic and 0.4% non-diabetic patient (P =.659). This registry demonstrates favourable clinical outcomes after the implantation of the ultrathin biodegradable polymer coated Supraflex SES in an all-comers population, with event rates that were similar in diabetic and nondiabetic patients.

3-year results of hop hybrids testing

Chuvashia has long been the main hop producer in the Soviet Union. Today, the Tsivilsky district of Chuvashia is the northernmost point of the hop breeding process. To revive this crop in the hop farms of the Chuvash Research Institute of Agriculture, the study of hybrids of common hop (Humulus Lupulus L.), grown from seeds obtained from different combinations of varieties of the hop collection of the Chuvash Research Institute of Agriculture is being carried out. The aim of the work is to breed new high-yielding hop varieties of high quality, adapted to the agroclimatic conditions of Chuvashia. The planting of the selection and control nursery was carried out in 2015. The article presents the results of the research for 2020-2022. As a control, 2 varieties were taken. Standard 1 - Podvyazny, has long been the standard in terms of yield, quality, and stability. It belongs to the medium-maturing group of varieties. Standard 2 - Fakir, the best variety of the mid-early group from a series of recently developed varieties. Plants grown from seeds obtained from female plants of Saxon, Marinka, Late Cluster, Porphyry 16 and Plunscher were studied. Male plants of different varieties were used as pollinators by random pollination or by pollen mixture using isolators. A complex of economically useful traits was investigated. The main ones, yield and alpha acid content in cones, are given in the article. Depending on agroclimatic conditions during the years of research, separate hybrid combinations were assigned. Only two combinations - Porfir 16 × SR - 25.3 kg/ha, which showed itself as a medium-ripening variety with an alpha acid content of 5.2% and Saxon × SR - 33 kg/ha - showed itself as a medium-early variety with an alpha acid content of 6.1%. Several combinations also outperformed Podvyazny in some years, either in terms of yield or quality, but there was no consistent outperformance in all three years.

Long-term result of aortic root remodeling using the Florida sleeve technique in a patient with connective tissue dysplasia and aortic root aneurysm without aortic insufficiency

Aortic root remodeling using the Florida sleeve technique was proposed as a simpler alternative to classical reconstructive interventions in patients with aortic root aneurysm without aortic insufficiency. We present a 10-year result of valve-sparing surgical treatment using the Florida sleeve technique in a patient with connective tissue dysplasia and aortic root aneurysm.

Decompression with or without fusion in Degenerative Lumbar Spondylolisthesis; 5-year results of a randomised trial

Decompression with or without fusion in Degenerative Lumbar Spondylolisthesis; 5-year results of a randomised trial

Double sided vertebral body tethering of double adolescent idiopathic scoliosis curves: Minimum 5-years results of the first 13 patients. Important lessons learned

Double sided vertebral body tethering of double adolescent idiopathic scoliosis curves: Minimum 5-years results of the first 13 patients. Important lessons learned

Clinical and radiological outcomes of gunshot-induced femur fractures: a comparative study of monolateral external fixators and hybrid advanced ilizarov method

Aims: Clinical and radiological outcomes, complication rates, and 10-year follow-up results of comminuted femoral open fractures resulting from firearm injuries were evaluated by comparing the Hybrid Advanced Ilizarov method (HAIM) and monolateral external fixator (MEF) of the limb reconstruction system (LRS) for treatment.
 Methods: Nineteen patients (18 males, 1 female) treated with HAIM and 14 male patients treated with MEF-LRS for femoral comminuted open fractures due to firearm injuries were retrospectively analyzed. Complication rates, pin tract and deep infection rates, time to union, and the need for secondary surgeries were assessed. The Tegner activity score and Short Form-36 (SF-36) were used for comparative evaluation of functional and radiological outcomes and comfort levels with the fixator.
 Results: There were no significant differences between the groups in terms of age, gender, follow-up duration, time to union, union rate, delayed union, or deep infection. No infections were detected in either group that required a change in the fixation method. There were no significant differences in radiological and functional outcomes between the groups. Significant differences were observed in terms of pin tract infections between the groups. The comfort level of MEF-LRS patients was significantly higher than that of HAIM patients.
 Conclusion: In the treatment of femoral fractures due to firearm injuries in early and long-term follow-ups, similar complication rates and functional outcomes were achieved for both MEF-LRS and HAIM methods. When considering external fixator preference, MEF-LRS is a better alternative, with a lower rate of pin tract infections and higher patient comfort level.

The Quantitative Method for Following Radiologic Healing in Endodontic Retreatment; 1-Year Follow-up Study

Objectives: This study aimed to quantitatively evaluate the changes in the internal bone structure at the periapical bone regions after retreatment in endodontics using fractal analysis method on periapical radiographs.
 Materials and Methods: 29 single-rooted, asymptomatic, single-visit retreatment teeth with apical lesion were included in the study. All teeth included in the study were selected from the maxilla anterior region. Periapical radiograph (T0) was taken for baseline diagnosis at the start of retreatment. Second periapical follow-up radiograph (T1) of the patients was taken at the end of 1 year. The first evaluation phase of the 1-year results of endodontic retreatment is based on the periapical index (PAI). Fractal dimension (FD) was calculated by box-counting method. The paired-sample t-test was used to compare T0 and T1 FDs. The independent samples t-test was employed to compare FD changes between the sexes. The significance level was set to 0.05.
 Results: PAI scores were found to be statistically significantly decreased in T1 radiographs compared to T0 (p

Symptomatic Meckel's Diverticulum in adult patients: our single center 6-year clinical experience and results

Amaç: Meckel divertikülü (MD), doğum sonrasında omfalomezenterik veya vitellin kanalın tam olmayan obliterasyonu sonucunda oluşan embriyolojik bir kalıntıdır ve gastrointestinal sistemin en sık gözlenen konjenital anomalisidir. MD genellikle asemptomatik olup; genellikle çocuk hasta popülasyonunda semptom vermektedir. Bu çalışmada; akut batının ayırıcı tanısında önemli yeri olan, preoperatif dönemde tanı konulmasının zor olduğu MD’nin güncel literatür bilgileri eşliğinde klinikopatolojik özelliklerinin analizi ve sonuçların incelenmesi amaçlandı.
 Gereç ve Yöntemler: Ocak 2017 - Ocak 2023 tarihleri arasında genel cerrahi kliniğinde Meckel divertikülü tanısı alan ve ameliyat edilen hastalar retrospektif olarak tarandı. Çalışmaya 18 yaşın altındaki hastalar ve inflamatuar bağırsak hastalığı tanısı olan hastalar dahil edilmedi. Hastaların preoperatif, intraoperatif ve postoperatif verileri incelenerek analiz edildi.
 Bulgular: Çalışmaya dahil edilen 22 olgunun yaş ortalaması 44,6 ± 14,6 yaş (20-74 yaş) idi. 16 olgu erkek, 6 olgu ise kadındı. Erkek/kadın oranı 2,7/1 idi. 7 olguda komorbid hastalık mevcuttu. Karın ağrısı (%72.7) en sık gözlenen semptom iken histopatolojik değerlendirmede 9 olguda heterotopik doku izlendi. Postoperatif cerrahi komplikasyon 6 hastada izlenirken en sık gözlenen komplikasyonun ileus (3 hasta) olduğu saptandı. Postoperatif süreçte bir hastada mortalite gözlendi.
 Sonuç: MD akut batında ayırıcı tanıda her zaman akılda bulundurulması gereken patolojilerdendir. Tanıda gecikilmesi ve ameliyat esnasında gözden kaçması özellikle semptomatik olan hastalarda ve başka akut batın sebepleri ile ilişkilendirilebilen patolojilerde mortalite ve morbidite oranlarını artırmaktadır.