scholarly journals Comparison of Conservative versus Surgical Treatment Protocols in Treating Idiopathic Granulomatous Mastitis: A Meta-Analysis

Breast Care ◽  
2019 ◽  
Vol 15 (4) ◽  
pp. 415-420
Author(s):  
Fei Zhou ◽  
Lu Liu ◽  
Liyuan Liu ◽  
Lixiang Yu ◽  
Fei Wang ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Recurrence Rate ◽  
Meta Analysis ◽  
Clinical Effectiveness ◽  
Breast Disease ◽  
Granulomatous Mastitis ◽  
Idiopathic Granulomatous Mastitis ◽  
Treatment Protocols ◽  
Significant Difference ◽  
Conservative And Surgical Treatment

Background: Idiopathic granulomatous mastitis (IGM) is a rare, benign breast disease without any definitive therapeutic strategy. It is controversial whether to use conservative or surgical treatment of IGM and high-level evidence-based medicine data are lacking. The purpose of this study was to systemically evaluate the clinical effectiveness of the conservative versus surgical treatment for IGM. Methods: In this meta-analysis, we searched PubMed, EMbase, ScienceDirect, and Web of Science for comparative studies about the conservative versus surgical treatment of IGM. Two researchers independently identified reports and extracted data. We used Stata 11 for data analysis. A meta-analysis was performed to investigate the differences in the recurrence rate of conservative and surgical treatment using a random effects model. Results: A total of 10 studies involving 1,101 patients were included. The results demonstrated that there was no significant difference in the recurrence rate among patients who were treated by nonsurgical therapy and surgical treatment. No publication bias was detected. Conclusion: This meta-analysis demonstrates that both the conservative and surgical treatment approaches have appropriate efficacy in IGM treatment and relapse. Further randomized controlled trials with longer follow-up periods are required to confirm the advantages of each approach.

scholarly journals A Comparative Study of Conservative versus Surgical Treatment Protocols for 77 Patients with Idiopathic Granulomatous Mastitis

2015 ◽  
Vol 21 (4) ◽  
pp. 363-369 ◽  
Author(s):  
Hakan Yabanoğlu ◽  
Tamer Çolakoğlu ◽  
Sedat Belli ◽  
Huseyin Ozgur Aytac ◽  
Filiz Aka Bolat ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Comparative Study ◽  
Granulomatous Mastitis ◽  
Idiopathic Granulomatous Mastitis ◽  
Treatment Protocols

scholarly journals Combined Treatment Method Comparison Of Medical And Surgical Treatment In Idiopathic Granulomatous Mastitis

2018 ◽  
Vol 5 (4) ◽  
pp. 3737-3742
Author(s):  
Ebubekir Gündeş ◽  
Mehmet Aykut Yildirim ◽  
Tevfik Küçükkartallar ◽  
Faruk Aksoy ◽  
Ahmet Tekin ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Combined Treatment ◽  
Granulomatous Mastitis ◽  
Selective Treatment ◽  
Idiopathic Granulomatous Mastitis ◽  
Therapy Algorithm ◽  
Group I ◽  
Significant Difference ◽  
The Mean

Aim:  Our aim in conducting this study was to ascertain the clinical, pathological, and radiological characteristics of patients diagnosed with idiopathic granulomatous mastitis in our clinic and to contribute to related literature by creating a therapy algorithm for granulomatous mastitis. Method: A total of 62 patients diagnosed with granulomatous mastitis in our clinic were classified into three groups as per the mode of treatment they received. Among these, 20 patients who had only been administered corticosteroids were allocated to Group I, while 18 patients who had received surgical treatment in addition to corticosteroid treatment were allocated to Group II, and 24 patients who had only received surgery were allocated to Group III. Results: All the cases were female patients. The mean age of the patients was 33.67 ± 6.35 (21-48). No statistically significant difference was found among the groups as per the mean age figures, pregnancy, breastfeeding, oral contraceptive administration, smoking and alcohol use, and family history (p>0.05). 49 (77.4%) patients were diagnosed with granulomatous mastitis by thick-needle biopsy, 7 (11.2%) by incisional biopsy, 4 (6.4%) by excisional biopsy, and 3 (4.8%) by fine-needle aspiration biopsy (FNAB) before the onset of treatment. The median value for the follow-up of the patients was 40 (6-81) months and there was no statistically significant difference among follow-up periods (p: 0.51). 15 (24.1%) patients among all the cases had recurrence. There was a statistically significant difference among the groups with regards to recurrence (p: 0.015). Conclusion:  Granulomatous mastitis may simulate breast cancer both clinically and radiologically. Recurrence is observed in patients who only received corticosteroid or surgical treatment. The combination of corticosteroid and surgical treatment significantly reduces the rate of recurrence. Therefore, this combination can be recommended as selective treatment.

scholarly journals Surgical Treatment of Vulvar HSIL: Adjuvant HPV Vaccine Reduces Recurrent Disease

Vaccines ◽  
2021 ◽  
Vol 9 (2) ◽  
pp. 83
Author(s):  
Alessandro Ghelardi ◽  
Roberto Marrai ◽  
Giorgio Bogani ◽  
Francesco Sopracordevole ◽  
Paola Bay ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Hpv Vaccine ◽  
Recurrent Disease ◽  
Current Knowledge ◽  
Hpv Vaccination ◽  
Clinical Effectiveness ◽  
Hpv Infection ◽  
Control Group ◽  
Hpv Test ◽  
Significant Difference

Data suggest that adjuvant human papillomavirus (HPV)-vaccination in women treated for cervical HPV diseases reduces recurrent disease. This study investigates adjuvant HPV-vaccination and the rate of recurrence in women undergoing surgery for vulvar high-grade squamous intraepithelial lesions (HSIL). From January 2013 to April 2020, we enrolled 149 women in a prospective case-control study. The control group (NV-group) was treated by standard surgery alone, while the study group received adjuvant vaccination soon after surgery (V-group). A follow-up was performed by vulvoscopy and HPV test. Statistical analysis was performed by Fisher’s exact test. HSIL recurrence was observed in 24/76 (32%) patients in NV-group and in 8/42 patients (19%) of the vaccinated group. By analysing the recurrence rate related to the incident and reactivated latent HPV infection, we found a significant difference between (17/76) 22.3% in NV-group and (2/42) 4.8% in V-group (p = 0.01). A reduction of 78.5% in incident/reactivated HPV infections was demonstrated. Data results add to the current knowledge about the mechanism of post-surgical adjuvant HPV vaccination. Our prospective study is the first to document the vaccine clinical effectiveness in preventing “reactivation” of latent HPV infections. Quadrivalent HPV vaccine administered after the surgical treatment for vulvar HSIL appears to be useful in preventing recurrent disease.

scholarly journals Out Come of Wide Local Excision with and without Corticosteroid Therapy in Management of Idiopathic Granulomatous Mastitis

2021 ◽  
Vol 107 (1_suppl) ◽  
pp. 13-13
Author(s):  
R Amira Maher ◽  
Ahmed Gamal Eldin Osman ◽  
K Fahmy ◽  
Shinamwi M ◽  
Osama Al Atarash
Keyword(s):  
Recurrence Rate ◽  
Corticosteroid Therapy ◽  
Surgical Excision ◽  
Cosmetic Outcome ◽  
Systemic Steroid ◽  
Granulomatous Mastitis ◽  
Idiopathic Granulomatous Mastitis ◽  
Palpable Mass ◽  
Group A ◽  
Group B

Introduction: Idiopathic granulomatous mastitis is a rare benign breast disease. Initial reports from hospitals in Egypt from Departments of Pathology at Cancer Institutes of Cairo, Tanta and Mansoura Universities; indicate that the disease is not as rare as that in the developed countries. It often mimics breast carcinoma both clinically and radiologically. Histological examination is the gold standard for diagnosis. Management of Idiopathic granulomatous mastitis is still debatable. In our study, we aimed to evaluate the addition of corticosteroid therapy to surgical excision in management of idiopathic granulomatous mastitis. Patients and Methods: This is a comparative study was conducted at Ain-Shams University Hospital’s breast clinic on patients with idiopathic granulomatous mastitis from to August 2015 till September 2018. Thirty patients were divided into 2 groups. Group (A) includes patients who underwent surgical management only. Group (B) includes patients who received corticosteroid therapy according to the severity of the cases then surgical Excision was done for the residual lesion. Follow up of all cases up to 1-2 years was done to document the recurrence rate and compare the cosmetic outcome of both groups. Informed consent was obtained from all patients included in the study. Results: The mean age of the affected women was 38.80 and 33.13 in group (A) and group (B), respectively and it wasn’t statistically different (p value = 0.099). The most common presenting symptom was a palpable mass in the breast (66.7% and 93.3%) in group (A) and group (B) respectively. Recurrence rate was higher in group (A) (40%) with no recurrence documented in group (B) however 2 cases were omitted from the study due to steroid noncompliance and complications. Cosmetic outcome was excellent in 76.9% of group (B) and good in 53.3% of group (A). Conclusion: Systemic steroid therapy with surgical resection is the recommended as first-line treatment strategy for IGM as it shows less recurrence rate and surgical scarring. Increased awareness of IGM will increase their understanding and improve their management.

scholarly journals Idiopathic granulomatous mastitis: challenges of treatment in iranian women

BMC Surgery ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Leyla Shojaee ◽  
Nasrin Rahmani ◽  
Siavash Moradi ◽  
Asieh Motamedi ◽  
Gholamali Godazandeh
Keyword(s):  
Recurrence Rate ◽  
Low Dose ◽  
Unknown Origin ◽  
Surgical Excision ◽  
Chronic Inflammatory Disease ◽  
High Dose ◽  
Granulomatous Mastitis ◽  
Idiopathic Granulomatous Mastitis ◽  
Results Of Treatment ◽  
Information Treatment

Abstract Background and objective As a chronic inflammatory disease of an unknown origin, the treatment of granulomatous mastitis has always been controversial. According to some researchers, surgical treatment and certain medications, especially steroids, are more effective in treating the disease. This study aimed at evaluating the results of treatment in a group of patients with granulomatous mastitis. Materials and methods This longitudinal cohort study evaluated the treatment outcomes of 87 patients with pathology-confirmed granulomatous mastitis referred to the surgical clinic of Central Hospital in Sari, Iran. Demographic, clinical, and pathological information, treatment methods and results, and the recurrence rate were analyzed. Findings A total of 87 female patients with granulomatous mastitis aged 22–52 years with a mean age of 34 years were evaluated. All patients had palpable masses; the breast masses were painful in 48.3% of patients, and 55.2% of patients suffered from erythema and inflammation, and8% had fistulas and ulcers at the inflammation site. The patients were followed-up for an average duration of 26 months (8–48 months) after treatment and recovery. The overall recurrence rate was 24.1%, and the recurrence rate was 29.4% in patients underwent surgery, 34.8% in patients received high-dose prednisolone, and 17% in those received low-dose prednisolone together with drainage (p < 0.001). Conclusions According to the results, the low-dose prednisolone plus drainage was more effective with a lower recurrence rate than only surgical excision or high-dose prednisolone. In fact, the use of minimally invasive methods such as drainage plus low-dose steroids is a more effective method with fewer side effects than the other two methods.

scholarly journals THE EFFICACY OF THE DIFFERENT ENDOSCOPIC TREATMENTS VERSUS SHAM, PHARMACOLOGIC OR SURGICAL METHODS FOR CHRONIC GASTROESOPHAGEAL REFLUX DISEASE: A SYSTEMATIC REVIEW AND META-ANALYSIS

2018 ◽  
Vol 55 (3) ◽  
pp. 296-305 ◽  
Author(s):  
Martin Andrés CORONEL ◽  
Wanderley Marques BERNARDO ◽  
Diogo Turiani Hourneaux de MOURA ◽  
Eduardo Turiani Hourneaux de MOURA ◽  
Igor Braga RIBEIRO ◽  
...  
Keyword(s):  
Systematic Review ◽  
Surgical Treatment ◽  
Gastroesophageal Reflux Disease ◽  
Gastroesophageal Reflux ◽  
Reflux Disease ◽  
Meta Analysis ◽  
Short Term ◽  
Significant Difference ◽  
Objective Outcomes

ABSTRACT BACKGROUND: Endoscopic antireflux treatments for gastroesophageal reflux disease (GERD) are still evolving, and most of the published studies address symptom relief in the short-term. Objective - We aimed to perform a systematic review and meta-analysis focused on evaluating the efficacy of the different endoscopic procedures. METHODS: Search was restricted to randomized controlled trials (RCTs) on MedLine, Cochrane, SciELO, and EMBASE for patients with chronic GERD (>6 months), over 18 years old and available follow up of at least 3 months. The main outcome was to evaluate the efficacy of the different endoscopic treatments compared to sham, pharmacological or surgical treatment. Efficacy was measured by different subjective and objective outcomes. RESULTS: We analyzed data from 16 RCT, totaling 1085 patients. The efficacy of endoscopic treatments compared to sham and proton pump inhibitors (PPIs) treatment showed a significant difference up to 6 months in favor of endoscopy with no heterogeneity (P<0.00001) (I2: 0%). The subgroup analysis showed a statistically significant difference up to 6 months in favor of endoscopy: endoscopy vs PPI (P<0.00001) (I2: 39%). Endoscopy vs sham (P<0.00001) (I2: 0%). Most subjective and objective outcomes were statistically significant in favor of endoscopy up to 6 and 12 months follow up. CONCLUSION: This systematic review and meta-analysis shows a good short-term efficacy in favor of endoscopic procedures when comparing them to a sham and pharmacological or surgical treatment. Data on long-term follow up is lacking and this should be explored in future studies.

scholarly journals Erythritol-Enriched Air-Polishing Powder for the Surgical Treatment of Peri-Implantitis

2015 ◽  
Vol 2015 ◽  
pp. 1-9 ◽  
Author(s):  
Silvio Taschieri ◽  
Roberto Weinstein ◽  
Massimo Del Fabbro ◽  
Stefano Corbella
Keyword(s):  
Surgical Treatment ◽  
Scientific Literature ◽  
Meta Analysis ◽  
Major Complication ◽  
Review Of The Literature ◽  
Implant Surface ◽  
Treatment Protocols ◽  
Air Polishing ◽  
Study Designs ◽  
Viable Treatment

Peri-implantitis represents a major complication that can compromise the success and survival of implant-supported rehabilitations. Both surgical and nonsurgical treatment protocols were proposed to improve clinical parameters and to treat implants affected by peri-implantitis. A systematic review of the literature was performed on electronic databases. The use of air-polishing powder in surgical treatment of peri-implantitis was investigated. A total of five articles, of different study designs, were included in the review. A meta-analysis could not be performed. The data from included studies reported a substantial benefit of the use of air-polishing powders for the decontamination of implant surface in surgical protocols. A case report of guided bone regeneration in sites with implants affected by peri-implantitis was presented. Surgical treatment of peri-implantitis, though demanding and not supported by a wide scientific literature, could be considered a viable treatment option if an adequate decontamination of infected surfaces could be obtained.

scholarly journals Xyloglucan, Hibiscus and Propolis in the Management of Uncomplicated Lower Urinary Tract Infections: A Systematic Review and Meta-Analysis

Antibiotics ◽  
2021 ◽  
Vol 11 (1) ◽  
pp. 14
Author(s):  
Tommaso Cai ◽  
Umberto Anceschi ◽  
Irene Tamanini ◽  
Serena Migno ◽  
Michele Rizzo ◽  
...  
Keyword(s):  
Systematic Review ◽  
Medical Device ◽  
Meta Analysis ◽  
Clinical Effectiveness ◽  
Adult Women ◽  
End Of Treatment ◽  
Significant Difference ◽  
Clinically Significant ◽  
Tract Infections ◽  
Uncomplicated Cystitis

Background: In the era of antibiotic resistance, an antibiotic-sparing approach presents an interesting alternative treatment of uncomplicated cystitis in women. Our aim is to perform a systematic review and meta-analysis to compare the effectiveness and safety profile of a medical device containing xyloglucan, hibiscus and propolis (XHP) in women with uncomplicated cystitis. Methods: Relevant databases were searched using methods recommended by the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines. The primary endpoint was clinical or microbiological success, defined as the complete (cure) and/or non-complete (improvement) resolution of symptoms at the end of treatment, or microbiological resolutions. Results: After screening 21 articles, three studies were included, recruiting a total of 178 patients. All three studies used placebo as comparator. A statistically significant difference was found in terms of clinical or microbiological resolution between the medical device and the comparator (3 RCTs, 178 patients, OR: 0.13; 95% CI: 0.05–0.33; p < 0.0001). No clinically significant adverse effects have been reported. Conclusion: A medical device containing xyloglucan, hibiscus and propolis is superior to comparator regimens in terms of clinical effectiveness in adult women with microbiologically confirmed or clinical suspicion of uncomplicated cystitis and is associated with a high patient compliance.

scholarly journals Outcome of endoscopic vs microsurgical transsphenoidal resection for Cushing’s disease

2018 ◽  
Vol 7 (1) ◽  
pp. R26-R37 ◽  
Author(s):  
Nidan Qiao
Keyword(s):  
Recurrence Rate ◽  
Cushing’S Disease ◽  
Meta Analysis ◽  
Cushing's Disease ◽  
Recurrence Rates ◽  
Microscopic Surgery ◽  
Significant Difference ◽  
Comprehensive Search ◽  
Definition Of

Introduction It is unclear whether the proportions of remission and the recurrence rates differ between endoscopic transsphenoidal surgery (TS) and microscopic TS in Cushing’s disease (CD); thus, we conducted a systematic review and meta-analysis to evaluate studies of endoscopic TS and microscopic TS. Methods We conducted a comprehensive search of PubMed to identify relevant studies. Remission and recurrence were used as outcome measures following surgical treatment of CD. Results A total of 24 cohort studies involving 1670 adult patients were included in the comparison. Among these studies, 702 patients across 9 studies underwent endoscopic TS, and 968 patients across 15 studies underwent microscopic TS. Similar baseline characteristics were observed in both groups. There was no significant difference in remission between the two groups: 79.7% (95% CI: 73.1–85.0%) in the endoscopic group and 76.9% (95% CI: 71.3–81.6%) in the microscopic group (P = 0.485). It appears that patients who underwent endoscopic surgery experience recurrence less often than patients who underwent microscopic surgery, with recurrence proportions of 11.0% and 15.9%, respectively (P = 0.134). However, if follow-up time is taken into account, both groups had a recurrence rate of approximately 4% per person per year (95% CI: 3.1–5.4% and 3.6–5.1%, P = 0.651). Conclusions We found that remission proportion and recurrence rate were the same in patients who underwent endoscopic TS as in patients who underwent microscopic TS. The definition of diagnosis, remission and recurrence should always be considered in the studies assessing therapeutic efficacy in CD.

The therapeutic dilemma of idiopathic granulomatous mastitis

2021 ◽  
Vol 50 (8) ◽  
pp. 598-605 ◽  
Author(s):  
Ee Ling Serene Tang ◽  
Chi Shern Bernard Ho ◽  
Patrick Mun Yew Chan ◽  
Juliana Jia Chuan Chen ◽  
Mui Heng Goh ◽  
...  
Keyword(s):  
Treatment Modality ◽  
Median Number ◽  
Subsequent Treatment ◽  
Treatment Modalities ◽  
Granulomatous Mastitis ◽  
Idiopathic Granulomatous Mastitis ◽  
Young Females ◽  
Significant Difference ◽  
Breast Condition ◽  
Recurrent Breast

ABSTRACT Introduction: Idiopathic granulomatous mastitis (IGM) is a rare, benign, chronic breast condition that can cause repeated abscesses or mass formation in bilateral breasts. The condition can severely impact the quality of life of affected women. This study aims to evaluate effective treatment modalities, as well as understand the demographics and clinical presentation of patients with IGM. Methods: An 11-year retrospective review was performed of patients diagnosed with IGM from 1 January 2008 to 31 December 2018 at a tertiary breast unit. Results: A total of 77 patients were included in the study. The median age at presentation was 36 years old. IGM presented most commonly as a breast lump (98.1%). The median number of flares was 2 (1–12). Of the 77 patients, 68.8% (53) were treated with antibiotics, 50.6% (39) with steroids, and 44.2% (34) underwent surgery, in the course of their IGM treatment. Forty-five (59.2%) of the 76 patients with IGM required a multimodal treatment approach to achieve remission. There was no significant difference in the number of flares no matter the initial treatment (P=0.411), or subsequent treatment modality (P=0.343). Smokers had 10 times greater odds of having a “high flare” of IGM compared to those who did not smoke (P=0.031, odds ratio 10.444, 95% confidence interval 1.092–99.859). Conclusion: IGM is a clinical diagnosis. It is a rare, relapsing breast inflammatory condition that affects young females with no superior treatment modality. Smoking is associated with higher number of flares of IGM and should be discouraged in IGM patients Keywords: Breast inflammation, chronic mastitis, idiopathic granulomatous mastitis, recurrent breast abscess

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