共查询到20条相似文献，搜索用时 640 毫秒
1.
N. Martinelli A. Giacalone A. Bianchi M. Hosseinzadeh C. Bonifacini F. Malerba 《Foot and Ankle Surgery》2018,24(3):205-207
Background
The aim of this study was to assess clinical and radiological outcomes in patients who underwent distal Akin osteotomy for hallux valgus interphalangeus (HVI).Methods
A series of 15 consecutive patients (17 feet) was retrospectively reviewed. All the patients were preoperatively and post-operatively evaluated with a physical and radiographic assessment (HVI angle). Satisfaction has been assessed through a satisfaction survey, the scale used consisted in three possible choice: very satisfied, satisfied, not satisfied.Results
Among 15 patients the 52.9% (9 patients) stated to be “very satisfied”, the 41.2% (7 patients) “satisfied” and just a 5.9% (one patient) was “not satisfied”.The mean HVI value decreased from 24.9° ± 7.8° preoperatively to 13.1° ± 5.8° postoperatively at last follow up (p < 0.05).Conclusions
Based on these findings we can conclude that the distal Akin osteotomy can be considered safe and effective in the surgical correction of symptomatic HVI deformities. 相似文献2.
Background
Soft tissue release for hallux valgus correction is traditionally performed through a dorsal first web space incision. We performed a single surgeon series review of hallux valgus correction with Scarf ± Akin osteotomy and lateral release using a single medial incision.Methods
192 feet were included. Patient satisfaction survey was conducted at the time of study. Pre-operative and final post-operative radiographic data obtained.Results
All radiological parameters had statistically significant improvement [p < 0.05 for each variable]. Response rate was 71% (completely satisfied 69%, satisfied with minor reservation 14%, satisfied with major reservation 11%, dissatisfied 6%). There was no correlation of any preoperative or postoperative radiographic measure with satisfaction grade. No patient required revision procedure.Conclusions
Single medial incision surgery for hallux valgus correction is a simple, safe and effective technique with very high satisfaction. The results are comparable to traditional two-incision surgery. 相似文献3.
Uğur Şaylı Budak Akman Altuğ Tanrıöver Çiğdem Kaspar Melih Güven Turhan Özler 《Foot and Ankle Surgery》2018,24(5):448-452
Background
Intrinsically stable diaphyseal osteotomy gained popularity in recent years for symptomatic hallux valgus deformities. In this study, Scarf osteotomy results, in surgical management of moderate to severe hallux valgus, are presented.Methods and patients
Study group consisted of 40 feet of 32 (28 females, four males) patients surgically managed by Scarf osteotomy between September 2009 and 2011, with a mean age of 52,98 (range, 31–75) years at the time of surgery. Patient satisfaction and VAS were used for subjective evaluation while for objective measures AOFAS score, first metatarsophalangeal joint ROM and radiological measurements (intermetatarsal, hallux valgus and distal metatarsal articular angles) were evaluated.Results
Mean follow-up period was 38 (range, 24–60) months. Sixteen feet (40%) were reported as very satisfied, 19 (47,5%) as satisfied and the remaining five (12,5%) as unsatisfied resulting with a total of 35 (87,5%) satisfaction. The mean preoperative VAS and AOFAS forefoot scores improved from 8,13 ± 0,791 to 2,68 ± 1,228 (p = 0,0001) and from 58,25 ± 6,15 to 78,25 ± 8,13 (p = 0,0001) on the final follow-up, respectively. The postoperative change of first metatarsophalangeal joint ROM was not statistically significant (p = 0,281). On the radiological evaluation; intermetatarsal and hallux valgus angles improved from a mean value of 14,77 ± 1,76 to 8,13 ± 1,52° (p = 0,0001) and from 35,28 ± 5,86 to 20,10 ± 5,55° (p = 0,0001), respectively. Distal metatarsal articular angle did not show any statistically significant change (p = 0,195).Conclusion
Scarf osteotomy combined with distal soft tissue procedure is a technically demanding procedure. The osteotomy is intrinsically stable and the correction power is high and the results are mostly satisfactory. 相似文献4.
Byung-Ki Cho Ji-Kang Park Seung-Myung Choi Nelson F. SooHoo 《Foot and Ankle Surgery》2019,25(2):127-131
Background
This study was performed to evaluate the intermediate-term clinical outcomes after proximal chevron osteotomy for hallux valgus in patients with generalized ligamentous laxity, and to determine the effect on postoperative recurrence of deformity.Methods
There were 23 cases in laxity group (Beighton score ≥5 points) and 175 in non-laxity group with a mean followup of 46.3 months. Clinical evaluation consisted of the AOFAS score, Foot and Ankle Ability Measure (FAAM), and radiographic measurement of hallux alignment. Risk factors associated with postoperative recurrence were evaluated using univariate analysis.Results
Recurrence rates were 21.7% in the laxity group and 17.1% in non-laxity group (P = .218). There were no significant differences in clinical and radiographic measurements at final followup between the 2 groups. Preoperative HVA and IMA were found to be predictive factors of recurrence (OR = 6.3, 4.2; P = .001, .018, respectively).Conclusion
There were no statistical differences in the clinical and radiographic outcomes between hallux valgus with and without generalized ligamentous laxity. Generalized ligamentous laxity demonstrated no definitive effects on postoperative recurrence of hallux valgus deformity. 相似文献5.
Background
The operative management of failed first metatarso-phalangeal joint (MTPJ) surgery is often complicated by bone loss and shortening of the hallux. Restoration of first ray length and alignment often cannot be achieved with in situ fusion and reconstruction techniques with bone graft are therefore required. We present a novel technique of longitudinal (proximo-distal) bone dowel arthrodesis for first MTPJ arthrodesis with bone loss.Methods
Between August 2007 and February 2015, eight patients have been treated by the senior author with this technique. The mean age at surgery was 60.5 years (range 45–80) with seven females and one male. Index surgery was MTPJ arthrodesis (three patients), Keller excision arthroplasty (two patients), MTPJ hemiarthroplasty (two patients) and silastic arthroplasty (one patient). Clinical and radiological fusion was assessed and other radiological measurements included hallux valgus angle (HVA) and length of the hallux (LOH).Results
All patients achieved fusion at a mean of 9.3 weeks (range 6–12) from surgery and only one patient required removal of metalwork. There were no major complications. The HVA improved in all cases from 21.4 ± 2.8 pre-operatively to 11.6 ± 3.5 post-operatively (p > 0.05). The LOH also increased in all cases from 82.1 ± 8.3 mm to 86.7 ± 8.2 mm (p > 0.05). The subgroup of patients who were revised from an arthroplasty, where maintenance of length rather than increase in length was desirable (hemiarthroplasty, silastic) had significantly lower increase in LOH than those revised from a non-arthroplasty index surgery (arthrodesis, Keller) (p = 0.029).Conclusion
The dowel technique is successful for first MTPJ arthrodesis revision surgery with optimal union rates and satisfactory radiographic and clinical outcomes. It is an effective and versatile option for managing bone loss and deformity of the hallux. 相似文献6.
Background
The purpose of this retrospective study was to evaluate the clinical and radiological results of hallux valgus surgery using a plantar locking plate.Methods
Proximal oblique metatarsal osteotomy combined with distal soft tissue treatment was performed in 59 adult patients (68 feet) with hallux valgus, using an anatomically pre-contoured plantar locking plate for fixation of the osteotomy. The median age was 64.0 years and the median follow-up period was 16.5 months.Results
The mean JSSF scale improved significantly from 56.0 points preoperatively to 95.8 points postoperatively. The mean intermetatarsal angle and hallux valgus angle decreased from 16.4° and 41.8° preoperatively to 4.2° and 10.8° postoperatively, respectively. The mean inclination angle was 19.9° preoperatively and 20.5° postoperatively. Removal of hardware was needed in 2 feet (2.9%).Conclusions
Proximal oblique metatarsal osteotomy is an effective method for relief of pain and improvement of function in correction of hallux valgus deformity. Use of a plantar locking plate provides sufficient maintenance of the correction, and complications associated with the hardware are rare. 相似文献7.
Background
Previous qualitative studies have linked first metatarsal head morphology with hallux valgus (HV) and hallux rigidus (HR). This study used a quantitative measurement of 1st MT radius of curvature to assess if HR MT heads were flatter than HV heads.Methods
Weight bearing foot films were used in HV, HR, and normal patients (no forefoot complaints) to measure the metatarsal head radius of curvature (normalized by dividing the radius of curvature by the first metatarsal length to adjust for magnification and foot size).Results
Radiographs from 299 feet were analyzed (105 normal, 57 HR, and 137 HV). The mean normalized radius of curvature was smaller in HV than HR, with normal feet in between (p < .05 for all comparisons). Metatarsal head curvature did not vary with age, weight, or BMI.Conclusion
These quantitative measurements are consistent with qualitative observations, validating the use of subjective metatarsal head morphology assessments. 相似文献8.
Background
Little is understood about the role that relative sesamoid displacement and chondral wear have on outcome after hallux valgus (HV) surgery. All existing methods to evaluate relative sesamoid displacement have limitations and furthermore, there have been no radiographic studies evaluating metatarso-sesamoid joint wear. Standing CT scan circumvents many of the existing problems in evaluation of relative sesamoid displacement, and also enables the first radiographic study assessing metatarso-sesamoid joint wear.Methods
Fifty feet (in 43 patients) with symptomatic HV (Group A) were compared with a control group of 50 feet (50 patients) (Group B). All images were standardised to enable reproducible measurements. The hallux valgus angle, Intermetatarsal angle, sesamoid rotation angle, sesamoid position and metatarso-sesamoid joint space were measured in all patients.Results
The intra and inter-observer reliability correlation showed that the standing CT assessment of sesamoid position (1.000), rotation (0.991) and metatarso-sesamoid joint space (0.960) were highly reproducible.There was a highly significant difference (p < 0.0001) in sesamoid position, sesamoid rotation and metatarso-sesamoid joint space between Group A and Group B.Conclusions
Standing CT has been shown to be a reproducible and accurate method of assessing the relative sesamoid displacement and metatarso-sesamoid joint space narrowing. The results have been used to propose a novel standing CT based classification of hallucal sesamoids, considering the degree of displacement and wear. This classification may ultimately facilitate research to provide new insight into the effect relative sesamoid displacement and chondral wear have on outcomes from hallux valgus surgery. 相似文献9.
Raju Vaishya Vipul Vijay Edwin O. Edomwonyi Amit K. Agarwal 《Journal of Clinical Orthopaedics and Trauma》2018,9(2):112-115
Purpose
We undertook this study to determine whether it is justifiable to use a fixed femoral valgus angle in patients undergoing TKR.Method
134 knees (59 females and 19 males) were studied by measuring their femoral valgus angle (FVA) on CT scan and the data was assessed statistically.Result
The average FVA was 5.83° ± 0.64 (range – 4–7.5°). There was no statistically significant difference (p > 0.05) between the FVA between males and females and as per age.Conclusion
We conclude that it is justifiable to use a fixed femoral valgus cutting angle in the patients undergoing total knee replacement. 相似文献10.
David C. Lee Cesar de Cesar Netto Jackson Rucker Staggers Rebecca Siegel Richard Chen Su-Young Bae Lew C. Schon 《Foot and Ankle Surgery》2018,24(6):530-534
Background
Bunionette deformity is a painful bony prominence of the 5th metatarsal. We evaluated outcomes of using a Kramer osteotomy to treat this condition.Methods
Retrospective study of patients treated with a Kramer osteotomy from 2003 and 2016. Outcome measures included Foot Functional Index (FFI) and radiographic measurements.Results
38 patients (43?feet) with an average follow-up of 55 months. Mean postoperative FFI1 was 19.4. Mean 4-5 IMA2 improved 3.9°, from 8.3° preoperatively to 4.4° on final postoperative films (p < 0.01). Mean MTP-53 angle improved 13.2° from 13.6° preoperatively to 0.4° at final follow-up (p < 0.01). There were 5 delayed unions (11.6%) and 1 non-union (2.3%).Conclusions
The Kramer osteotomy is an effective treatment option in patients with bunionette deformity, with significant correction of the 4-5 IM2 and MTP-53 angles and few complications. 相似文献11.
Bruno Magnan Ingrid Bonetti Stefano Negri Tommaso Maluta Carlo Dall’Oca Elena Samaila 《Foot and Ankle Surgery》2018,24(5):400-405
Background
Clinical and radiological results of percutaneous distal metatarsal minimally invasive osteotomy (DMMO) of the lesser rays for surgical treatment of primary metatarsalgia due to plantar overpressure with metatarsophalangeal instability are described. The aim of this prospective study was to assess the efficacy, feasibility and safety of this minimally invasive surgical (MIS) technique, verifying the possibility to lower the complication rate related to surgical exposures, to reduce operating times with comparable functional and cosmetic results to those reported with traditional open procedures.Methods
Hundred and six consecutive percutaneous distal osteotomies without fixation (DMMO) of the second, third or fourth metatarsal bones were performed in 57 patients (70 ft) with a mean age at the surgery of 60.2 years (30–81) for treatment of metatarsalgia with metatarsophalangeal instability. Patients were clinically assessed with the AOFAS and Coughlin’s Scores, the latter classifying the results in relation to the patient's subjective satisfaction.Results
The mean follow-up was of 45.0 ± 13.3 months (24–68). All patients reported the disappearance or reduction of the pain that they had experienced prior to the operation around the metatarsal heads. The mean overall AOFAS score improved from 42.7 ± 13.4 points (9–77) to 92.8 ± 8.6 points (44–100) at the time of final follow-up. Patient subjective satisfaction according to Coughlin's classification was excellent in 62 ft (88.6%), good in 7 ft (10.0%), fair in 0 ft and poor in one foot (1.4%).Conclusions
We consider the percutaneous distal lesser metatarsal osteotomy without fixation (DMMO) a reliable surgical option in metatarsalgia due to metatarsophalangeal instability in early stages as in grade I and II according to Coughlin classification. 相似文献12.
Rodrigo Díaz Fernández 《Foot and Ankle Surgery》2019,25(2):106-112
Background
With hundreds of operative methods described for correction of hallux valgus we can state that the ideal surgical treatment is still controversial. The Bösch technique has been used as a percutaneous way of correcting hallux valgus deformities with the use of a pin fixation. The aim of this study is to evaluate a new method of fixation by using a percutaneous locking plate.Methods
Between June 2013 and January 2015, 24 consecutive percutaneous subcapital osteotomies of the first metatarsal bone were performed for the treatment of painful hallux valgus deformities in 24 patients. Additional surgical procedures included DMMO’s (Distal Metatarsal Minimally-Invasive Osteotomies) in 12 of the operated feet (44.44%); minor digits were corrected in 7 cases (25.9%). An Akin procedure was performed in 81% of cases and all cases underwent an adductor hallucis tenotomy. All patients were clinically assessed using the AOFAS score. Radiographic measures included the preoperative and postoperative values of the Hallux Valgus Angle (HVA), Intermetatarsal Angle (IMA), and the Distal Metatarsal Articular Angle (DMAA).Results
The mean correction achieved improved for AHV from 36.57 ± 7.1 to 12.22 ± 8.69°, for IMA from 13.8 ± 1.59 to 7.08 ± 2.72 and for DMAA from 13.98 ± 7.38 to 6.07 ± 4.99. Clinically, scores on the AOFAS scale improved from a 45.8 ± 9.6 to 91.29 ± 9.8.Although healing of the osteotomies was observed radiographically within 6 to 12 weeks, two cases (8.3%) exhibited delayed healing. There were no cases of nonunion. There were no superficial or deep infections or wound healing problems. Plate had to be removed in 3 cases (12.5%).Conclusion
This technique modification is an acceptable procedure to correct hallux valgus in patients with a moderate level of deformity.Level of evidence
Level IV. Case series. 相似文献13.
Chloe Xiaoyun Chan Jonathan Zhi-Wei Gan Hwei Chi Chong Inderjeet Rikhraj Singh Sean Yung Chuan Ng Kevin Koo 《Foot and Ankle Surgery》2019,25(2):119-126
Background
We report our experience with the Minimally Invasive Chevron Akin (MICA) technique for correcting hallux valgus, and evaluate its effectiveness and associated complications.Methods
Case series of 13 feet with mild to moderate symptomatic hallux valgus treated surgically from July 2013 to December 2014, with at least 48-months follow-up. Patients were assessed pre-operatively and post-operatively with radiographical measurements (Hallux Valgus Angle (HVA) and Intermetatarsal Angle (IMA)) and clinical scores (American Orthopaedic Foot and Ankle Society (AOFAS), 36-Item Short Form Health Survery (SF-36), Visual Analog Scale (VAS)).Results
Mean HVA and IMA decreased from 30.4° and 13.9°–10.9° and 10.2° respectively (p < 0.05). The mean AOFAS score improved from an average of 59.0–93.7 (p < 0.05). All patients reported a VAS score of 0 post-operatively, and the 4 SF-36 domains improved significantly (p < 0.05).Conclusions
The MICA technique is a safe and effective method in the surgical correction of mild to moderate hallux valgus deformity, and continued use is justified. 相似文献14.
Brooks Ficke Osama Elattar Sameer M. Naranje Ibukunoluwa Araoye Ashish B. Shah 《Foot and Ankle Surgery》2018,24(6):471-473
Background
Plantar fasciitis is a common foot pathology that is typically treated non-operatively. However, a minority of patients fail non-operative management, develop chronic symptoms, and request a surgical option. Gastrocnemius recession has recently been shown to be effective for the treatment of chronic plantar fasciitis. The purpose of this paper is to present evidence that gastrocnemius recession is safe and effective in the subset of chronic plantar fasciitis patients who are overweight and obese.Methods
We retrospectively reviewed 18 cases (17 patients) of chronic plantar fasciitis in overweight or obese patients who underwent gastrocnemius recession (mean age = 46 years, mean body mass index = 34.7 kg/m2, mean follow-up = 20 months). Data was gathered regarding pre-operative and post-operative pain (visual analog scale, 0–10), Foot Function Index score, and complications.Results
Mean Foot Function Index score improved from 66.4 (range, 32.3–97.7) preoperatively to 26.5 (range, 0–89.4) postoperatively (p < 0.01). Mean pain score improved from 8.3 (range, 5–10) preoperatively to 2.4 (range, 0–7) at final follow-up (p < 0.01).Conclusions
Gastrocnemius recession improved foot function and pain symptoms in overweight and obese patients with chronic plantar fasciitis. 相似文献15.
Karl H. Pang Ruth Groves Suresh Venugopal Aidan P. Noon James W.F. Catto 《European urology》2018,73(3):363-371
Background
Multimodal enhanced recovery after surgery (ERAS) regimens have improved outcomes from colorectal surgery.Objective
We report the application of ERAS to patients undergoing radical cystectomy (RC).Design, setting, and participants
Prospective collection of outcomes from consecutive patients undergoing RC at a single institution.Intervention
Twenty-six components including prehabilitation exercise, same day admission, carbohydrate fluid loading, targeted intraoperative fluid resuscitation, regional local anaesthesia, cessation of nasogastric tubes, omitting oral bowel preparation, avoiding drain use, early mobilisation, chewing gum use, and audit.Outcome measurements and statistical analysis
Primary outcomes were length of stay and readmission rate. Secondary outcomes included intraoperative blood loss, transfusion rates, survival, and histopathological findings.Results and limitations
Four hundred and fifty-three consecutive patients underwent RC, including 393 (87%) with ERAS. Length of stay was shorter with ERAS (median [interquartile range]: 8 [6–13] d) than without (18 [13–25], p < 0.001). Patients with ERAS had lower blood loss (ERAS: 600 [383–969] ml vs 1050 [900–1575] ml for non-ERAS, p < 0.001), lower transfusion rates (ERAS: 8.1% vs 25%, chi-square test, p < 0.001), and fewer readmissions (ERAS: 15% vs 25%, chi-square test, p = 0.04) than those without. Histopathological parameters (eg, tumour stage, node count, and margin state) and survival outcomes did not differ with ERAS use (all p > 0.1). Multivariable analysis revealed ERAS use was (p = 0.002) independently associated with length of stay.Conclusions
The use of ERAS pathways was associated with lower intraoperative blood loss and faster discharge for patients undergoing RC. These changes did not increase readmission rates or alter oncological outcomes.Patient summary
Recovery after major bladder surgery can be improved by using enhanced recovery pathways. Patients managed by these pathways have shorter length of stays, lower blood loss, and lower transfusion rates. Their adoption should be encouraged. 相似文献16.
Céline Vidal Cédric Lukas Bernard Combe Francis Berenbaum Yves Marie Pers Christian Jorgensen Jérémie Sellam Jacques Morel 《Joint, bone, spine : revue du rhumatisme》2018,85(4):461-468
Objective
To compare BASDAI 50 response rate to TNFi in axial spondyloarthritis (axSpA) depending on the presence or not of objective signs of axSpA and to look for predictive factors of TNFi efficacy.Methods
Patients diagnosed with axSpA according to ASAS criteria “clinical arm” and treated between January 2001 and September 2015 with TNFi were included. First group included patients with at least one objective sign such as arthritis, dactylitis, enthesitis, uveitis, inflammatory bowel disease, elevated C-reactive protein or radiological sacroiliitis, and second group included non-radiographic axSpA (nr-axSpA) patients without any objective sign corresponding to patients with inflammatory back pain and either a good response to NSAID or a SpA family history. The primary outcome was the TNFi efficacy, defined as an achievement of BASDAI 50 at 3 months. The secondary outcomes were BASDAI 50 achievement over 1 year and analysis of predictive factors of TNFi response.Results
We included 84 nr-axSpA patients without any objective signs and 84 axSpA patients with objective signs (48.2% r-axSpA and 52.8% nr-axSpA). BASDAI 50 achievement rates were significantly higher in patients with objective signs than in patients without, at 3 months (45.1% versus 13.7%, P < 0.0001) and at any of the visit-time points over the first year (61.9% versus 21.4%, P < 0.0001). In multivariate analysis, overweight/obesity and sacroiliitis on MRI were respectively negative and positive predictive factors of TNFi efficacy in the total population at 3 months (OR = 0.32, 95%CI [0.11, 0.96], P = 0.041 and OR = 6.92, 95% CI (2.41, 19.8), P < 0.0001, respectively).Conclusion
TNFi should be used with caution in axSpA when objective signs are absent as only 13.7% of these patients were BASDAI 50 responders at 3 months. 相似文献17.
Mohamad J. Halawi Sameer R. Oak David Brigati Aretha Siggers William Messner Peter J. Brooks 《Journal of Clinical Orthopaedics and Trauma》2018,9(4):285-288
Objective
The optimal reconstructive method for advanced degenerative hip disease in young adults is a topic of ongoing discussion. The purpose of this study is to report the largest single institution experience from the United States on the outcomes of Birmingham hip resurfacing (BHR) vs. cementless total hip arthroplasty (THA) in patients 55 years or younger at a minimum follow-up of five years. Currently, BHR is the only FDA-approved hip resurfacing implant available in the US.Methods
A cohort of 505 patients representing all BHR cases performed at our institution between 2006 and 2010 was compared with an identical size cohort of consecutive patients who underwent primary cementless THA. Exclusion criteria were age greater than 55 years, non-elective cases, revision procedures, and those performed for fractures, tumors, or by low-volume arthroplasty surgeons. THAs with metal on metal articulation were also excluded.Outcomes
assessed were all-cause reoperations, complications, patient satisfaction, and mortality. After exclusions, 442 patients with BHR and 327 with THA were included.Results
Mean follow-up was 73.2 months. After controlling for potential confounding factors, multivariate analyses showed significant increase in the rates of revision surgery (p < 0.001), overall complications (p < 0.001), all-cause reoperations (p = 0.014), and mortality (p < 0.001) in the THA cohort. Component loosening was the most common cause for revision in the THA group. Patients with THA were also less likely to be satisfied (p = 0.046).Conclusions
This is largest US study to report on the midterm outcomes of BHR vs. THA. The results demonstrate favorable results for BHR in patients 55 years or younger. Long-term multicenter studies are needed to better understand the optimal patient characteristics when deciding between THA versus BHR. 相似文献18.
Objective
The aim of this study was to investigate the clinical efficacy of superficial temporal artery-middle cerebral artery anastomosis (STA-MCA) + encephalo-duro-myo-synangiosis (EDMS) in treating ischemic Moyamoya disease (IMD) in adults.Methods
A total of 30 adult patients with IMD were selected to be included in the study; they underwent STA-MCA + EDMS and were followed up for 3 months to 2 years. The digital subtraction angiography findings, modified Rankin scale (mRs) score, and complications of all the patients were compared.Results
Thirty patients successfully completed the surgery. Three patients had postoperative complications (two patients with cerebral infarction on the surgical side and one patient with poor scalp healing). The postoperative morbidity rate was 10%. Angiography conducted at 3 to 6 months postoperatively showed 28 cases of anastomotic patency; the anastomotic patency rate was 93.3%. The mRs scores of the patients’ neurological function 3 months after surgery were lower than those before surgery.Conclusion
STA-MCA + EDMS is effective in treating Moyamoya disease. 相似文献19.
Sam J. Egger Ross J. Calopedos Dianne L. O’Connell Suzanne K. Chambers Henry H. Woo David P. Smith 《European urology》2018,73(6):859-867
Background
Long-term psychological well-being and quality-of-life are important considerations when deciding whether to undergo active treatment for low-risk localised prostate cancer.Objective
To assess the long-term effects of active surveillance (AS) and/or watchful waiting (WW) on psychological and quality-of-life outcomes for low-risk localised prostate cancer patients.Design, setting, and participants
The Prostate Cancer Care and Outcome Study is a population-based prospective cohort study in New South Wales, Australia. Participants for these analyses were low-risk localised prostate cancer patients aged <70 yr at diagnosis and participated in the 10-yr follow-up.Outcome measurements and statistical analysis
Validated instruments assessed outcomes relating to six health-related quality-of-life and nine psychological domains relevant to prostate cancer patients. Adjusted mean differences (AMDs) in outcome scores between prostate cancer treatment groups were estimated using linear regression.Results and limitations
At 9–11 yr after diagnosis, patients who started AS/WW initially had (1) higher levels of distress and hyperarousal than initial radiation/high-dose-rate brachytherapy patients (AMD = 5.9; 95% confidence interval or CI [0.5, 11.3] and AMD = 5.4; 95% CI [0.2, 10.5], respectively), (2) higher levels of distress and avoidance than initial low-dose-rate brachytherapy patients (AMD = 5.3; 95% CI [0.2, 10.3] and AMD = 7.0; 95% CI [0.5, 13.5], respectively), (3) better urinary incontinence scores than initial radical prostatectomy patients (AMD = –9.1; 95% CI [–16.3, –2.0]), and (4) less bowel bother than initial radiation/high-dose-rate brachytherapy patients (AMD = –16.8; 95% CI [–27.6, –6.0]). No other significant differences were found. Limitations include participant attrition, inability to assess urinary voiding and storage symptoms, and nonrandom treatment allocation.Conclusions
Notwithstanding some long-term differences between AS/WW and various active treatment groups in terms of distress, hyperarousal, avoidance, urinary incontinence, and bowel bother, most long-term outcomes were similar between these groups.Patient summary
This study assessed the long-term psychological and quality-of-life impacts of initially monitoring rather than actively treating low-risk prostate cancer. The results suggest that initial monitoring rather than active treatment has only a minor impact on subsequent long-term psychological and quality-of-life outcomes. 相似文献20.
Grace C. Kunas William Probasco Amgad M. Haleem Jayme C. Burket Emilie R.C. Williamson Scott J. Ellis 《Foot and Ankle Surgery》2018,24(6):495-500