Single Center Experience Research Articles

ALL-223 The Mortality Burden Among Egyptian Children and Adolescents With Cancer: Single-Center Experience

ALL-223 The Mortality Burden Among Egyptian Children and Adolescents With Cancer: Single-Center Experience

A Single-center Experience With >200 Lung Transplant Recipients With COVID-19 Infection.

Although COVID-19 is no longer a declared global health emergency, data remain limited on the impact of COVID-19 in lung transplant recipients. We identified lung transplant recipients who were diagnosed with COVID-19 from March 2020 through August 2022 in our institutional database and investigated clinical outcomes. We then analyzed outcomes based on date of COVID-19 diagnosis (first wave March 2020-October 2020; second wave November 2020-2021; third wave December 2021-September 2022) and compared these results. Of the 210 lung transplant recipients (median age 67; 67% men) enrolled, 140 (67%) required hospital admission. Among admitted recipients, 35 (25%) were intubated and 7 (5%) were placed on extracorporeal membrane oxygenation. Overall survival was 67.1% at 1 y and 59.0% at 2 y post-COVID-19 diagnosis. COVID-19 led to mortality in all 5 patients diagnosed during their index admission for lung transplantation. Although overall survival was significantly better in recipients with COVID-19 during the third wave, in-hospital mortality remained high (first wave 28%, second wave 38%, and 28% third wave). Vaccination (partially vaccinated versus none and fully vaccinated versus none) was the only significant protective factor for hospital admission, and age 70 y and older and partially vaccinated (versus none or fully vaccinated) were independent risk factors for in-hospital mortality. Overall survival after COVID-19 infection in lung transplant recipients continues to improve; however, in-hospital mortality remains remarkably high. Vaccination appears to have been impactful in preventing hospital admission, but its impact on in-hospital mortality is still unclear. Further research is needed to better identify lung transplant recipients at high risk for mortality from COVID-19.

Left Atrial Appendage Closure: A Single-Center Experience in a Population With a High Prevalence of End-Stage Renal Disease.

Background Left atrial appendage closure (LAAC) has emerged as an alternative approach for mitigating thrombotic risk in nonvalvular atrial fibrillation patients. However, existing registries often lack representation of the Hispanic population, motivating this study to elucidate the demographic, clinical, and procedural characteristics, specifically among Hispanic patients undergoing this procedure. Methods Adult patients who underwent percutaneous LAAC between June 2017 and July 2022 at a high-complexity hospital in Bogotá, COL, were included. Baseline and procedural characteristics are reported. For patients with available follow-up data, major bleeding, thromboembolic events, and cardiovascular mortality were assessed. A subgroup analysis was conducted for patients with end-stage renal disease on dialysis. Results We included 33 patients. Follow-up data were available for 27 patients, with a mean follow-up period of 12.4 months. The median age of the cohort was 70 years (SD 9), with 58% being women. The median CHADS2 and HAS-BLED scores were 3 points (IQR 2 to 4) and 4 points (IQR 3 to 4), respectively. The 90-day cardiovascular mortality rate was 3.7%, whereas cardioembolic episodes and major bleeding events were reported at rates of 10.8 and 14.4 per 100 patient years, respectively. The long-term outcomes of patients on dialysis were comparable to those of nondialysis patients. Conclusions Our study reinforces existing evidence supporting the safety of LAAC, particularly in a multimorbid patient population with elevated bleeding and thrombotic risks. In this high-risk cohort, LAAC emerges as a feasible alternative for reducing thromboembolic risk. Notably, patients on dialysis demonstrated comparable long-term outcomes, suggesting the procedure's viability in this subgroup as well.

AML-259 Survival and Toxicity of Acute Promyelocytic Leukemia in Children: Single-Center Experience in Tashkent

AML-259 Survival and Toxicity of Acute Promyelocytic Leukemia in Children: Single-Center Experience in Tashkent

CT-694 Haplo-Identical Stem Cell Transplant Outcomes in Patients with Donor-Specific Antibodies Receiving Desensitization: Insights From A Single-Center Experience

CT-694 Haplo-Identical Stem Cell Transplant Outcomes in Patients with Donor-Specific Antibodies Receiving Desensitization: Insights From A Single-Center Experience

Central liver segments resections vs extended hepatectomies in children: Single-center experience

BackgroundCentral liver segments resection (CLSR) still is not widely used in pediatric surgery due to its technical difficulty, whereas this procedure is widely spread as a parenchyma sparing approach of centrally located liver tumors in adults. The aim of this study is to analyze the outcomes of CLSR in comparison with extended hepatectomy (EH) in children with different liver tumors. MethodsA single-center retrospective analysis of patients who received CLSR (n=14) and EH (n=44) from June 2017 to December 2023 was applied. Patient’s characteristics, preoperative, intra- and postoperative data were compared between 2 groups. ResultsPreoperative CT-volumetry showed that future liver remnant volume was higher in CLSR group compared to EH (FLR-V; (54±29 (40-91) % vs 40±12 (17-73) %, p=0.016). The intraoperative blood loss (200 [90-1150] (20-3000) ml vs 100 [30-275] (10-9000) ml, p=0.088) and transfusion volume (310 [85-590] (0-1860) ml vs 150 [0-310] (0-4770) ml, p=0.484) were similar in both groups, while operation time was longer in CLSR group (420 [320-595] (145-785) min vs 280 [203-390] (125-710) min), p=0.011). There was no difference in biliary leakage (3 (21.4%) vs 12 (27.3%); p=0.479), other complications (4 (28.6%) vs 5 (11.4%), p=0.198) and complications ≥ IIIb by Clavien-Dindo (2 (14.3%) vs 8 (18.2%), p=0.385) postoperatively. ConclusionCLSRs allow to preserve more healthy liver parenchyma compared to EH with similar intraoperative and postoperative outcomes. «Extended mesohepatectomy» allows to achieve R0 resection when central liver tumor extends on the left lateral and/or right posterior section. Type of StudyRetrospective Comparative Study (Level of Evidence III)

ABCL-440 Preliminary Safety and Efficacy Data of Combination Polatuzumab Vedotin Rituximab, Cyclophosphamide Adriamycin, Prednisone (Pola-R-CHP) in Patients With Diffuse Large B-Cell Lymphoma (DLBCL) in the Standard-of-Care Setting: A Single-Center Experience

ABCL-440 Preliminary Safety and Efficacy Data of Combination Polatuzumab Vedotin Rituximab, Cyclophosphamide Adriamycin, Prednisone (Pola-R-CHP) in Patients With Diffuse Large B-Cell Lymphoma (DLBCL) in the Standard-of-Care Setting: A Single-Center Experience

New-onset diabetes mellitus in patients with COVID19 infection admitted to a tertiary care hospital: A single-center experience.

To determine the frequency of new-onset diabetes mellitus (NODM) in patients with COVID-19 in a tertiary care hospital. It was a retrospective descriptive study carried out in Lady Reading Hospital Peshawar, Khyber Pakhtunkhwa province of Pakistan from November 2021 to April 2022. All patients having new onset Diabetes Mellitus (NODM) were identified among a total of 300 patients admitted to the hospital with COVID-19 infection. Patients' data including relevant investigations were accessed through the hospital management information system (HMIS). SPSS version-23 was used for data entry and statistical analysis. Out of 300 COVID-19 patients included in the study, 163 (54.3%) were female and 137(45.7%) were male. The mean age of the patients was 56.80±13.72 (IQR 15) years. Frequency of the new onset diabetes was 44(14.7%); 19 (6.33%) male and 25(8.33%) female. Among the 44 NODM patients, the majority (57%) were female (p=0.720). Most (64%) of the patients with new-onset DM were in the middle age (p=0.018). A significant number of patients with COVID-19 infection are prone to develop new-onset diabetes during their admission to the hospital.

CT-132 Efficacy of Ruxolitinib With Corticosteroids in Idiopathic Pneumonia Syndrome Post-Allogeneic Hematopoietic Stem Cell Transplantation: A Single-Center Experience and Systematic Review

CT-132 Efficacy of Ruxolitinib With Corticosteroids in Idiopathic Pneumonia Syndrome Post-Allogeneic Hematopoietic Stem Cell Transplantation: A Single-Center Experience and Systematic Review

Use of drainage after laparoscopic complicated appendectomy in children: a single-center experience

Use of drainage after laparoscopic complicated appendectomy in children: a single-center experience

Conduction system pacing associated with reduced heart failure hospitalizations and all-cause mortality compared with traditional right ventricular pacing in the Medicare population

BackgroundConduction system pacing (CSP) has emerged as an alternative therapy to traditional right ventricular (RV) pacing. However, most CSP studies reflect small cohorts or single-center experience. ObjectiveThis analysis compared CSP with dual-chamber (DC) RV pacing in a large, population-based cohort using data from the Micra Coverage with Evidence Development study. MethodsMedicare administrative claims data were used to identify patients implanted with a DC RV pacemaker. Lead placement data from Medtronic’s device registration system identified patients treated with CSP (n = 6197) using a 3830 catheter–delivered lead or DC RV (non–3830 lead, non–CSP placement; n = 16,989) at the same centers. CSP patients were stratified into left bundle branch area pacing (LBBAP; n = 4738) and His bundle pacing (HBP; n = 1459). Incident heart failure hospitalizations, all-cause mortality, complication rates, and reinterventions at 6 months were analyzed. ResultsCSP patients with a 3830 catheter–delivered lead experienced significantly lower rates of incident heart failure hospitalization (hazard ratio [HR], 0.70; P = .02) and all-cause mortality at 6 months compared with DC RV patients (HR, 0.66; P < .0001). There was no difference in chronic complications (HR, 0.97; P = .62) or need for reintervention (HR, 0.95; P = .63) with CSP compared with DC RV, although LBBAP patients experienced significantly lower rates of complications (HR, 0.71; P = .001) compared with HBP. ConclusionDC pacemaker patients treated with CSP using a 3830 catheter–delivered lead experienced significant all-cause mortality and heart failure hospitalization benefits compared with DC RV pacing. LBBAP had lower complications compared with HBP. These real-world results align with findings in small clinical studies demonstrating the benefits of CSP.

Early identification of postoperative remission for thyrotropin-secreting adenomas.

Thyrotropin-secreting adenoma (TSHoma) is a rare type of pituitary adenoma, occurring in one per million people. Little is known about TSHoma. We summarized the demographic, clinical and hormonal characteristics of TSHoma based on a single-centre experience. Moreover, we explored the predictive value of postoperative thyroid function for long-term remission. We retrospectively analysed 63 patients who were diagnosed as TSHoma and surgically treated at our hospital from January 2015 to June 2021. The preoperative clinical characteristics were analysed and compared between remission and nonremission groups. Thyroid function was measured at 1 day, 1 month, 3 months, 6 months, 12 months and over 12 months after surgery to determine whether they could predict long-term remission. The male to female ratio for TSHoma was 1.25. The mean age at diagnosis was 45 ± 12 years. Clinical presentation was varied, presenting with hyperthyroidism (68.25%), space-occupying effect (15.87%), amenorrhea (7.14% of female patients) and nonsymptoms (22.22%). 88.14% of patients achieved postoperative endocrinological remission. Larger tumour size and tumour invasion into cavernous sinus and suprasellar with chiasmal compression were strong predictors of lower rates of endocrinological remission. Postoperative thyroid function at 3 months was a viable diagnostic predictor for postoperative remission, especially for FT4 level with a 20.65 pmol/L cutoff. Tumour size and extent are major prognostic factors for remission. Postoperative thyroid function at 3 months could be used as a clinical prediction tool for long-term endocrinological remission.

Long-term results of induction chemotherapy for non-operable esophageal squamous cell carcinoma followed by concurrent chemoradiotherapy: a single-centre experience.

This study aimed to investigate the long-term clinical outcomes and toxicities of induction chemotherapy (IC) followed by concurrent chemoradiotherapy (CCRT) vs. CCRT alone in patients with non-operable esophageal squamous cell carcinoma (ESCC). Between 2008 and 2022, 271 ESCC patients who received definitive CCRT based on intensity modulated radiation therapy (IMRT)/volumetric modulated arc therapy (VMAT) were enrolled. Through a propensity score-matched (PSM) method, 71 patients receiving IC and CCRT were matched 1:1 to patients who received CCRT alone. The Kaplan-Meier method and Cox proportional hazards model were applied to analyze survival and prognosis. The IC + CCRT group had no improvement in 5-year overall survival (OS) rate, recurrence-free survival (RFS) rate, and distant metastasis-free survival (DMFS) rate (all p > 0.05) compared with the CCRT group. The 5-year OS rate (65.6% vs. 17.6% vs. 29.3%, p < 0.001), RFS rate (65.6% vs. 17.6% vs. 26.9%, p < 0.001), and DMFS rate (62.5% vs. 10.3% vs. 27.2%, p < 0.001) of the IC good responders were significantly higher than that of the IC poor responders and CCRT group. Multivariate analysis revealed that total radiotherapy time (≥ 49 days) and stage III/IV were independent predictive factors of OS, RFS, and DMFS. No significant differences were observed in the rates of grade 3-4 toxicities between both groups. Our results showed the addition of IC to CCRT was not superior to CCRT in unselected ESCC patients, while IC responders could benefit from this regime without an increase in toxicities.

Formation of a Dedicated Urology Transition Clinic for Adolescent Patients: A Single-centre Experience

Formation of a Dedicated Urology Transition Clinic for Adolescent Patients: A Single-centre Experience

381. MULTICENTER PAN-CANADIAN EXPERIENCE OF PER ORAL ENDOSCOPIC MYOTOMY (POEM) FOR THE TREATMENT OF ACHALASIA: A RETROSPECTIVE STUDY

Abstract Background Per oral endoscopic myotomy (POEM) has emerged as a modality for the surgical treatment of achalasia using a minimally invasive approach with similar clinical efficacy to laparoscopic Heller myotomy. Japanese, European, American and International clinical practice guidelines now cite POEM as a first line treatment for achalasia. In Canada, single-centre experiences with POEM have shown promising results. This study aims to capture the pan-Canadian national experience with POEM for the treatment of achalasia across multiple institutions. Methods This was a retrospective study of patients who underwent POEM for achalasia across four Canadian institutions (St. Joseph's Healthcare Hamilton, Kingston Health Sciences Centre, Surrey Memorial Hospital and Montreal Sacred Heart Hospital) between 2012 to 2022. Pre-operative, procedural and post-operative data was collected. Our primary outcome was the proportion of patients with normal Eckhardt score (≤ 3) at 4 weeks. Secondary outcomes included procedure related adverse events, length of stay in hospital, post-procedure lower esophageal sphincter pressures, post-procedure gastroesophageal reflux disease (GERD) and response rate at further timepoints. Outcomes are reported as either proportions (%) or medians (IQR). Results POEM was attempted in 369 patients with a success rate of 99%. The median duration of surgery was 64 (47 – 89) minutes and length of stay was ≤1 day in 88% of patients. Peri-operative complications occurred in 11% of patients, all of which were Clavien-Dindo Grade ≤III. The post-operative response rate (Eckhardt score ≤3) was 100%, 98% and 95% at 1, 6 and 12 months, respectively. Additional interventions for achalasia following POEM were required in 6% of patients. High DeMeester scores, endoscopic esophagitis and symptomatic GERD were reported in 36%, 43% and 44%, respectively. 93% of GERD was treated with PPI therapy. Conclusions POEM is safe and feasible in Canadian institutions with efficacy in keeping with current international literature.

49533 308-nm excimer light is effective for palmoplantar pustulosis regardless of the presence or absence of focal infection: Single-center real-world experience of treatment for palmoplantar pustulosis

49533 308-nm excimer light is effective for palmoplantar pustulosis regardless of the presence or absence of focal infection: Single-center real-world experience of treatment for palmoplantar pustulosis

Image Guided Energy-based Ablation of T1 Renal Cell Cancer: A Ten-year Single Centre Experience

Image Guided Energy-based Ablation of T1 Renal Cell Cancer: A Ten-year Single Centre Experience

40-year single center experience of Burkholderia cystic fibrosis airway infections

40-year single center experience of Burkholderia cystic fibrosis airway infections

The Evolving Use of PSMA in the Management of Patients With Prostate Cancer-A Single Centre Experience

The Evolving Use of PSMA in the Management of Patients With Prostate Cancer-A Single Centre Experience

PE062 Sutureless Robotic-Assisted Tumor Enucleation (RATE) for renal masses: Results of an initial single-center experience

PE062 Sutureless Robotic-Assisted Tumor Enucleation (RATE) for renal masses: Results of an initial single-center experience