Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Curated”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 865 records · Page 48Linked to original sources
PubMed1998

Outcome after 'curative' surgery for carcinoma of the lower third of the rectum.

BACKGROUND: Controversy exists about the optimal surgical resection for lower third rectal carcinoma. The aim of this retrospective study was to analyse whether the type of surgery is a significant predictor of outcome after curative surgery alone. METHODS: Eighty-two consecutive patients underwent abdominoperineal rectum excision (APRE, 41 patients) or sphincter-saving operation (SSO, 41 patients) for adenocarcinoma at 3.5-7.5 cm from the anal margin. Cox proportional hazards technique with univariate and corrected (multivariate) analyses and the Kaplan-Meier life-table method were used to evaluate the data. RESULTS: Tumour wall penetration and lymph node involvement, but not the tumour level or the type of surgery, were found to be significant predictors of outcome. The local recurrence rate at 1, 2 and 5 years was 10, 22 and 26 per cent respectively after APRE, and 5, 13 and 21 per cent after SSO. The disease-free survival rate at 1, 2 and 5 years was 85, 67 and 58 per cent respectively after APRE, and 88, 78 and 62 per cent after SSO. CONCLUSION: Tumour-related factors are significant predictors of outcome. The type of surgery (APRE or SSO) did not seem to be a significant variable in this non-randomized study.

Adenocarcinoma↗
PubMed1999

Local recurrence after curative excision of the rectum for cancer without adjuvant therapy: role of total anatomical dissection.

BACKGROUND: The wide variability of reported local recurrence rates after curative resection of rectal cancer without adjuvant therapy may be a consequence of many different factors. However, few studies have investigated the potential effects of such factors on local recurrence by multivariate analysis. The present study examined clinical and tumour characteristics, operation type and operative technique as potential predictors of local recurrence in patients treated by surgery alone. METHODS: Prospective data were analysed by bivariate and multivariate methods including actuarial survival and proportional hazards regression. RESULTS: Local recurrence (pelvic or pelvic and systemic) was diagnosed in 59 of 596 patients. The 5-year actuarial local recurrence rate was 11.1 (95 per cent confidence interval 8.7-14.3) per cent. Independent predictive factors for local recurrence were: positive nodes (hazard ratio (HR) 5.5, P < 0.01); distal margin of 1 cm or less (HR 3.8, P < 0.01); venous invasion (HR 2.0, P = 0.02) and total anatomical dissection of the rectum (HR 2.0, P = 0.01). There was no difference in local recurrence between patients who had the mesorectum divided and those in whom it was totally excised. CONCLUSION: Nodal involvement is the most potent predictor of local recurrence. In patients in whom total anatomical dissection is performed, total mesorectal excision confers no additional protection against local recurrence.

Aged↗
PubMed2000

Recurrence following curative resection for gastric carcinoma.

BACKGROUND: The diagnosis and treatment of recurrent gastric cancer remains difficult. The aim of this study was to determine the risk factors for recurrence of gastric cancer and the prognosis for these patients. METHODS: Of 2328 patients who underwent curative resection for gastric cancer from 1987 to 1995, 508 whose recurrence was confirmed by clinical examination or reoperation were studied retrospectively. The risk factors that determined the recurrence patterns and timing were investigated by univariate and multivariate analysis. RESULTS: The mean time to recurrence was 21.8 months and peritoneal recurrence was the most frequent (45.9 per cent). Logistic regression analysis showed that serosal invasion and lymph node metastasis were risk factors for all recurrence patterns and early recurrence (at 24 months or less). In addition, independent risk factors involved in each recurrence pattern included younger age, infiltrative or diffuse type, undifferentiated tumour and total gastrectomy for peritoneal recurrence; older age and larger tumour size for disseminated, haematogenous recurrence; and older age, larger tumour size, infiltrative or diffuse type, proximally located tumour and subtotal gastrectomy for locoregional recurrence. Other risk factors for early recurrence were infiltrative or diffuse type and total gastrectomy. Reoperation for cure was possible in only 19 patients and the mean survival time after conservative treatment or palliative operation was less than 12 months. CONCLUSION: The risk factors for each recurrence pattern and timing of gastric cancer can be predicted by the clinicopathological features of the primary tumour. Since the results of treatment remain dismal, studies of perioperative adjuvant therapy in an attempt to reduce recurrence are warranted.

Female↗
PubMed2000

Quality of life in long-term survivors after curative transhiatal oesophagectomy for oesophageal carcinoma.

BACKGROUND: Transhiatal resection for oesophageal cancer is a major operation with potentially severe physical, emotional and social consequences. The aim of this study was to assess various aspects of quality of life in long-term survivors following oesophageal resection for cancer. METHODS: Between January 1993 and May 1996, 100 consecutive patients with cancer of the oesophagus or oesophagogastric junction underwent a potentially curative transhiatal oesophagectomy. Patients with a minimum follow-up of 2 years and with no tumour recurrence (n = 35) were mailed questionnaires which consisted of: (a) the Short Form-36 Health Survey to assess general quality of life, (b) an adapted Rotterdam Symptom Checklist to assess disease-specific quality of life, and (c) additional questions about other effects of the operation. RESULTS: All patients returned the questionnaire. General quality of life was comparable with reference values for the same age group. However, more than half of the patients still experienced at least some early satiety, fatigue, dysphagia, heartburn and/or psychological irritability. Nine of 13 patients who worked in paid employment before operation continued to do so. CONCLUSION: Patients who survive 2 years or more after transhiatal oesophageal resection for cancer can lead satisfactory lives. Although some residual symptoms may persist, their general quality of life is similar to that of healthy individuals of the same age.

Adult↗
PubMed2003

Extramammary Paget's disease: outcome of radiotherapy with curative intent.

Six patients with extramammary Paget's disease were treated with curative intent radiotherapy. Two of the patients had associated underlying adenocarcinoma. Radiotherapy was given as primary treatment (two patients), definitive treatment for postexcisional relapse (three patients) and adjuvant treatment (one patient). Radiotherapy techniques included high dose rate mould brachytherapy, electron beam, superficial X-ray and photon treatments. Follow-up durations after radiotherapy were 1.2-14.8 years. Complete response was obtained in five patients while one patient had a partial response. Marginal failure occurred in one complete-responder who was successfully salvaged by surgery. The two patients with underlying adenocarcinoma died of distant metastasis. Radiotherapy side effects were acute confluent wet desquamation and mild late skin atrophy. Our results confirmed the useful role of radiotherapy in the management of extramammary Paget's disease.

Abdominal Neoplasms↗
PubMed2003

Colonoscopic surveillance after curative colorectal resection: results of an empirical surveillance programme.

INTRODUCTION: Colonoscopic surveillance after colorectal cancer resection is widely practised despite little evidence that it improves survival. The optimum protocol for colonoscopic follow-up after colorectal cancer resection has not yet been elucidated. We audited the outcome of an empirical colonoscopic follow-up programme in a cohort of patients who underwent colorectal resection with a minimum of five years follow-up to establish patterns of metachronous neoplasia and suitable surveillance intervals. METHODS: The colonoscopic records, biopsy results and follow-up details of patients diagnosed with colorectal cancer between June 1990 and June 1996 were reviewed. The number and type of metachronous neoplastic lesions diagnosed was recorded. Rates of development of new neoplasms were estimated by calculating the time from operation to their first discovery. Factors predictive of further development of polyps or cancer were sought. Results were compared to published reports of intensive follow-up programmes. RESULTS: Seven hundred and ninety-eight patients underwent colorectal resection with curative intent during the study period. 226 patients had one or more follow-up colonoscopies (mean time post resection 48.8 months). In total 352 colonoscopies, encompassing 1437 patient years of surveillance, were performed. Nine metachronous cancers in eight patients, five of which were asymptomatic were diagnosed by colonoscopy at a mean of 63 months. Three asymptomatic recurrences were diagnosed but all were inoperable. 70 (31%) patients had adenomatous polyps diagnosed after a mean time from operation of 34 months for simple adenomatous polyps and 21 months for those with advanced features. Patients with multiple polyps or advanced polyps at the initial colonoscopy were more likely to form subsequent polyps. Only 5.8% of patients with a single adenoma or a normal colon formed an advanced adenoma over the next 36 months of surveillance. CONCLUSION: The results of an empirical colonoscopic follow-up programme compared favourably to the results of the intensive programmes reported in the literature. Most patients are at very low risk of developing significant colonic pathology over the first five years after resection. Colonoscopic surveillance intervals need not be less than five years unless the patient has multiple adenomas or advanced adenomas at the first colonoscopy. Three yearly surveillance intervals are most probably adequate in these individuals.

Aged↗
PubMed2003

Multi-modality approach in curative local treatment of early rectal carcinomas.

OBJECTIVE: Despite recent advances, surgery remains the mainstay for the management of rectal carcinoma. The conventional surgical treatment for low rectal carcinoma is total mesorectal excision. This results in either abdomino-perineal excision of the rectum (APER) with permanent colostomy or low anterior resection (LAR) usually with a covering stoma. Local resection is an alternative treatment option and this could be offered either using manual trans-anal resection (TAR) or transanal endoscopic microsurgery (TEM) if the tumour is situated higher. PATIENTS: Patient selection is an important factor if local resection is used. No further treatment is necessary for T1 tumours with clear surgical resection margins. Conventional radical surgery should be offered for T1 tumours with close resection margins (<1 mm) or T2 tumours with higher risk of lymph node metastases. Patients were treated by postoperative chemo-radiotherapy or radiotherapy, if further radical surgery was not considered appropriate or if the patient refused further surgery. Using this approach, we describe our experience of 100 patients treated from January 1992 to June 2002. RESULTS: Only 13 patients had surgery alone and 87 patients had radiotherapy either pre-operative (33 patients), postoperative (25 patients) or radical radiotherapy alone (29 patients). Local recurrence occurred in 10% of patients and salvage surgery was offered in over half (6 patients) of these patients. At median follow up of 33 months (range 3-120 months), the overall survival was 77% reflecting the fact that the majority of these patients were elderly with coexisting medical problems. However, cancer specific survival was 96%. More importantly, only 9 patients had colostomies and colostomy-free survival in our cohort of patients from Liverpool was 91%. CONCLUSION: We concluded that in selected patients, who were not medically fit (ASA 111 or above) or those who were unable to accept a permanent colostomy, local treatment could be offered with curative intent using a multimodality approach. In our experience, relapses can be salvaged effectively and we recommend a long-term close follow up policy.

Adult↗
PubMed2003

Motivations and influences on the use of complementary medicine in patients with localized prostate cancer treated with curative intent: results of a pilot study.

OBJECTIVES: To analyse descriptively the use of complementary medicine (CM) by patients with localized prostate cancer treated with curative intent, assessing the major influences on their choice to use CM, and the major critics and advocates of CM. PATIENTS AND METHODS: From January 1997 to June 2000, 351 men with stage T1c-T3 adenocarcinoma of the prostate were treated with either radical prostatectomy (RP) or brachytherapy. On the final date all patients were mailed a questionnaire relating to their use of CM and the results analysed cross-sectionally. RESULTS: In all, 238 (67.8%) patients returned the questionnaires, of whom 37% acknowledged using some type of CM, with a similar overall use of CM among those treated with RP or brachytherapy. Of these, 43% began using CM before and 32% after starting conventional treatment, and most indicated they would never discontinue these therapies. The most common reason for using CM was the patient's impression that it made them feel better, and secondarily that they felt it helped to cure their cancer. Physicians were the most common source of information about CM, with twice as many patients identifying physicians as being advocates rather than critics of CM. Many patients felt their urologist or radiation oncologist was neutral or chose not to discuss CM. However, when these physicians discussed CM, more patients felt that they encouraged rather than discouraged the use of CM. CONCLUSIONS: These data on the motivations for patient choices relating to CM are novel; the sources of information, both positive and negative, that patients find useful in their decision to use these therapies were explored. Interestingly, physicians were generally supportive of the use of such approaches.

Adenocarcinoma↗
PubMed2004

Reirradiation of recurrent head and neck cancers with curative intent.

In patients with recurrent, previously irradiated head and neck cancer, the traditional therapy of palliative single- or multi-agent chemotherapy yields a 30% to 40% response rate with median survival durations of 8 to 10 months. However, long-term survival is rarely observed. Reirradiation with or without concurrent chemotherapy is currently under investigation as a treatment option in these patients. While reirradiation without chemotherapy appears to be effective in recurrent nasopharynx cancer cases, the use of concomitant chemotherapy with reirradiation appears to offer improved outcomes based on phase I/II data in other head and neck sites. Recent studies indicate that long-term survival of patients is possible following reirradiation in a minority of cases despite severe acute and chronic toxicities. Reirradiation with chemotherapy is appropriate for patients with a goal of long-term local control of disease and curative intent, despite the risk of significant acute and late toxicities.

Combined Modality Therapy↗
PubMed2005

A curative approach to peritoneal carcinomatosis from colorectal cancer.

The use of radiation therapy and systemic chemotherapy along with surgery continues to improve survival, optimize quality of life, and maximally preserve function. Gastrointestinal cancer management is increasingly complex as a result of the integration of surgery, radiation therapy, and systemic chemotherapy. Over the past two decades, greater knowledge regarding the natural progression of gastrointestinal cancer has been achieved, and an emphasis in clinical research on "anatomic sites of surgical treatment failure" has given oncologists a target for additional laboratory and clinical investigations. One area of treatment failure for gastrointestinal cancer, the peritoneal surface, presents itself as a dominant need for improved understanding and for concentrated research activities. Until recently, peritoneal carcinomatosis has been regarded as a universally fatal condition; however, recent success toward a curative approach is the result of two treatment innovations specifically developed for management of peritoneal carcinomatosis; these include surgical interventions (collectively referred to as peritonectomy), and the use of perioperative intraperitoneal chemotherapy. Because these combined treatment modalities have been investigated in large numbers of patients, the selection factors for acceptable long-term survival combined with a well-defined morbidity and mortality have become established.

Adenocarcinoma↗
PubMed2000

Intra-arterial chemotherapy in locally advanced or recurrent carcinomas of the penis and anal canal: an active treatment modality with curative potential.

The prognosis of locally advanced or recurrent carcinomas of the penis (PE) and of the anal canal (AC) after conventional treatment is dismal. We report 16 patients (eight with AC carcinomas and eight with PE cancers) treated by intra-arterial (IA) chemotherapy. Fifteen of them were treated for locally advanced or recurrent disease and one in an adjuvant setting. The chemotherapy was administered via a femoral IA catheter with its tip located above the aortic bifurcation, under the inferior mesenteric artery. It consisted of eight push injections, given over a 48-h period, of the following drug combination: cisplatin 8.5 mg m(-2), 5-FU 275 mg m(-2), methotrexate 27.5 mg m(-2), mitomycin C 1.2 mg m(-2), and bleomycin 4 mg m(-2). Leucovorin was given po, 4 x 15 mg day(-1), during the chemotherapy and for 3 days thereafter. A total of 52 cycles of treatment were administered. Of the 15 patients evaluable for response, six obtained a CR (three PE, three AC) and eight a PR. Among the complete responders, four are alive and disease-free 2-15 years after treatment. The other patients enjoyed an objective response lasting 3-25 months (median 7 months). Four patients developed grade III/IV haematological toxicity with three episodes of febrile neutropenia, one of them with a fatal outcome due to patient's failure to obtain medical attention at the onset of his fever, one a grade III mucositis of the glans, and four a grade III/IV cutaneous toxicity, the latter caused by the IA administration of bleomycin. In conclusion, IA chemotherapy is effective and potentially curative in locoregionally advanced or recurrent carcinomas of the penis and of the anus. Its contribution in the primary management of advanced penile or anal carcinoma should be prospectively investigated.

Administration, Oral↗
PubMed2005

[Curative treatment in a patient with exercise induced syncope].

HISTORY: A 38 year old man suffered from exercise-induced reproducible dizziness and syncopes. INVESTIGATIONS AND DIAGNOSIS: During exercise testing a ventricular tachycardia at a rate of 300 beats/min was identified as the cause of the symptoms. Because of the ventricular morphology with inferior axis, left bunde branch block and the typical monomorphic repetitive characteristics, idiopathic adenosine-sensitive ventricular tachycardia was diagnosed. TREATMENT AND CLINICAL COURSE: Curative catheter ablation of the arrhythmogenic focus in the right ventricular outflow tract was performed. The patient has now been free of symptoms for more than two years. The characteristics of idiopathic ventricular tachycardia and the electrophysiological techniques are described. CONCLUSION: Idiopathic ventricular tachycardia is a rare cause of syncope in young patients without underlying heart disease and can be cured by catheter ablation. Exclusion of cardiac diseases, especially arrhythmogenic right ventricular cardiomyopathy, is of prognostic value.

Adult↗
PubMed1999

Intraoperative microwave ablation for curative treatment of atrial fibrillation in open heart surgery--the MICRO-STAF and MICRO-PASS pilot trial. MICROwave Application in Surgical treatment of Atrial Fibrillation. MICROwave Application for the Treatment of Atrial Fibrillation in Bypass-Surgery.

Concomitant microwave ablation for curative treatment of atrial fibrillation (AF) was performed in 18 patients with history of chronic atrial fibrillation and indication for open heart surgery, 11 patients with mitral valve replacement and 7 patients with coronary artery bypass grafting. There were no perioperative complications. During the postoperative period most of the patients had intermittent AF, they received low dose Sotalol therapy and electric cardioversions. Up to now seven patients have reached follow-up day 90. One patient has persistent AF. Two patients had typical atrial flutter that was electrically converted to sinus rhythm (SR), isthmus ablation is planned. The other four patients have SR, one patient without cardioversions. These four patients show recovered atrial function with observed A-wave for transmitral flow. Under visual guidance the continuous atrial lesion lines could be induced effectively and safely by the intraoperative device Lynx.

Aged↗
PubMed1987

Is curative endoscopic treatment of early gastric cancer possible?

Fifty-four lesions found in 51 cases of early gastric cancer were treated with the Nd:YAG laser, N2 dye laser, local injection of ethanol, polypectomy and a combination of these methods between November, 1980 and July, 1986. Among these lesions, 34 were followed for more than one year with the endoscope. In 86% of the lesions treated, no recurrence of cancer was detected during the observation period, nor were there any deaths from gastric cancer. An analysis of the results showed that local cure of early gastric cancer in the mucosal layer could be accomplished with many kinds of endoscopic devices and that the difficulties for curative treatment depended on tumor localization and size. Further, we were able to assess local cure after endoscopic treatment on the basis of the endoscopic features of the tumor; local cure presents as a scarred stage with a smooth surface and with no abnormal granules or irregular redness. At present, endoscopic treatment should however, be limited to inoperable cases, since we cannot definitively diagnose lymph node metastasis or depth of cancer invasion.

Biopsy↗
PubMed1997

[The curative therapy of primary hyperparathyroidism by percutaneous ethanol injections].

HISTORY AND CLINICAL FINDINGS: An 86-year-old woman was admitted because of acute nonspecific upper abdominal symptoms and vomiting. She was occasionally disoriented, generally slower in movement and reaction, apathetic and mainly bed-ridden. She was a known insulin-dependent diabetic who had sustained a posterior wall myocardial infarction and cerebrovascular accident and had undergone a cholecystectomy. On physical examination her upper abdomen was painful to pressure, blood pressure was 180/95 mm Hg, but there were no other findings. INVESTIGATIONS: Sonography demonstrated bile-duct dilatation, confirmed at endoscopic retrograde cholangiopancreatography, and a prepapillary choledochal concrement of about 10 mm. Sonography also revealed an echo-poor tumour of the right caudal parathyroid. The calcium concentration was raised to 2.94-3.16 mmol/l and the parathormone level was also increased (99.5 pmol/l, normal 1.2-5.7 pmol/l), as were amylase (375.6 U/l) and lipase (1038-5394 U/l). TREATMENT AND COURSE: After papillotomy and extraction of the choledochal concrement the acute biliary pancreatitis quickly improved. Operation on the parathyroid tumour was not undertaken because of the patient's various illnesses. Instead, 95% alcohol was instilled, 3.5 and 4.5 ml respectively, into the tumour, under sonographic control in two sessions, 3 days apart. Her clinical condition clearly improved and serum calcium became normal and the parathormone level fell significantly. CONCLUSION: Percutaneous ethanol injection of a parathyroid tumour can be a curative and sparing alternative to operation in patients with hyperparathyroidism seemed too ill for surgery.

Administration, Cutaneous↗
PubMed1990

[The early recurrence of Crohn's disease after "curative" ileocecal resection. A prospective endoscopic and histological study].

The postoperative course of 44 patients (24 women, 20 men; mean age 31.5 [18-63] years) treated by ileocaecal resection for Crohn's disease was investigated prospectively. None of the patients received any prophylactic drug treatment during the 12-month postoperative period of observation. Recurrence of Crohn's disease was endoscopically diagnosed in 21 of the 44 patients during the 12-month period, and in 14 patients recurrence was suspected. Histological confirmation of recurrent Crohn's disease, however, was obtained unequivocally in only 11 patients, while in further 20 patients there was suspicion of recurrence. A large proportion of the recurrences was already confirmed endoscopically and histologically by the end of the third postoperative month. It is concluded that recurrences are frequent and early after a "curative" operation, raising the question of early prophylaxis with drugs.

Adolescent↗
PubMed2000

Liver metastases from breast cancer: long-term survival after curative resection.

BACKGROUND: Liver metastases from breast cancer are associated with a poor prognosis (median survival < 6 months). A subgroup of these patients with no dissemination in other organs may benefit from surgery. Available data in the literature suggest that only in exceptional cases do these patients survive more than 2 years when given chemohormonal therapy or supportive care alone. We report the results of liver resection in patients with isolated hepatic metastases from breast cancer and evaluate the rate of long-term survival, prognostic factors, and the role of neoadjuvant high-dose chemotherapy. PATIENTS AND METHODS: Over the past decade, 17 women underwent hepatic metastectomy with curative intent for metastatic breast cancer. The follow-up was complete in each patient. The median age at the time breast cancer was diagnosed was 48 years. Neoadjuvant high-dose chemotherapy (HDC) with hematopoietic progenitor support was used in 10 patients before liver resection. Perioperative complications, long-term outcome, and prognostic factors were evaluated. RESULTS: Seven of the 17 patients are currently alive, with follow-up of up to 12 years. Four of these patients are free of tumors after 6 and 17 months and 6 and 12 years. The actuarial 5-year survival rate is 22%. One patient died postoperatively (mortality rate, 6%) of carmustine-induced fibrosing pneumonitis. There was no further major morbidity in the other patients. The liver was the primary site of recurrent disease after liver resection in 67% of the patients. Patients in whom liver metastases were found more than 1 year after resection of the primary breast cancer had a significantly better outcome than those with early (< 1 year) metastatic disease (P = .04). The type of liver resection, the lymph node status at the time of the primary breast cancer resection, and HDC had no significant impact on patient survival in this series. CONCLUSIONS: Favorable 22% long-term survival can be achieved with metastasectomy in this selected group of patients. Careful evaluation of pulmonary toxicity from carmustine and exclusion of patients with extrahepatic disease are critical. Improved survival might be achieved with better selection of patients and the use of liver-directed adjuvant therapy.

Actuarial Analysis↗
PubMed2002

Curative treatment of atrial fibrillation with intraoperative radiofrequency ablation: short-term and midterm results.

OBJECTIVE: This report describes the early and midterm results after intraoperative radiofrequency ablation of atrial fibrillation for patients with isolated chronic atrial fibrillation or atrial fibrillation in combination with additional valvular and nonvalvular cardiac diseases. METHODS: From August 1998 to March 2001, a total of 234 patients with chronic atrial fibrillation underwent isolated intraoperative radiofrequency ablation alone (n = 74, 31.6%) or in combination with other cardiac procedures, such as mitral valve reconstruction (n = 57, 24.4%), mitral valve replacement (n = 38, 16.2%), aortic valve replacement (n = 11, 5.1%), coronary artery bypass grafting (n = 8, 5.0%), or a combination of the last with other cardiac procedures (n = 46, 19.7%). In all cases anatomic reentrant circuits confined within the left atrium were eliminated by placing contiguous lesion lines involving the mitral anulus and the orifices of the pulmonary veins through the use of radiofrequency energy application (exposure time, 20 seconds). A median sternotomy was used in 101 cases (43.2%), and video assistance through a right lateral minithoracotomy was used in 133 cases (56.8%). RESULTS: A total of 188 patients (83.9%) were discharged in sinus rhythm, 17 patients (7.6%) had atrial fibrillation, and 19 patients (8.5%) had atypical flutter. Pacemakers were implanted in 23 patients (9.8%). There were 10 in-hospital deaths (4.2%), and 30-day mortality was 5 patients (2.1%). In 3 cases (1.3%) an atrioesophageal fistula developed, necessitating surgical repair. Six months' follow-up was complete for 122 (61.0%) of 200 patients, with 99 patients still in stable sinus rhythm (81.1%, 95% confidence interval 73.1%-89.9%). Twelve months' follow-up was complete for 80 (90.9%) of 88 patients, with 58 patients still in sinus rhythm (72.5%, 95% confidence interval 61.3%-83.2%). CONCLUSIONS: Intraoperative radiofrequency ablation is a curative procedure for chronic atrial fibrillation. It is technically less challenging than the maze procedure and can be applied through a minimally invasive approach. Protection of the esophagus seems mandatory to avoid the deleterious complication of a left atrioesophageal fistula, such as was observed in 3 cases.

Adult↗