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Background: The optimal timing, surgical technique, and the influence of Trisomy 21 on the outcome of surgical repair of Complete Atrioventricular Canal Defect remains uncertain. We reviewed our experience in the repair of CAVC to identify the influence of these factors on operative outcomes. Methods: A prospective study included 70 patients, who underwent repair of CAVC at our institute between July, 2016 and October, 2019. Primary endpoint was mortality and the secondary endpoint was a degree of left atrioventricular valve regurgitation. Results: No significant difference was noted between patients operated on, at the first 6 months of age versus later, regarding mortality or LAVV regurgitation. Surgical repair by modified single-patch technique showed a significant reduction in bypass time (71.13 ± 13.507 min versus 99.19 ± 27.092 min, p-value = 0.001). Compared to closure of cleft only, posterior annuloplasty used for repair of LAVV resulted in significant reduction in the occurrence of post-operative valve regurgitation during the early period (LAVV 2 + 43 versus 7 %, p-value = 0.03) and at 6 months of follow-up (LAVV 2 + 35.4 versus 0 %, p-value = 0.01), respectively. Conclusions: Early intervention, in the first 6 months in patients with CAVC by surgical repair gives comparable acceptable results to later repair; Trisomy 21 was not found to be a risk factor for early intervention. Repair of common AV valve by cleft closure with posterior LAVV annuloplasty showed better results with a significant decrease in post-operative LAVV regurgitation and early mortality in comparison to the closure of cleft only.

Background: The optimal timing, surgical technique and the influence of Trisomy 21 on outcome of surgical repair of Complete Atrio-Ventricular Canal Defect (CAVC) remain uncertain. We reviewed our experience in repair of CAVC to identify the influence of these factors on operative outcome. Methods: A prospective study included 70 patients who underwent repair of CAVC at our institute between July 2016 to October 2019. Primary endpoint was mortality and secondary endpoint was degree of left atrio‐ventricular valve (LAVV) regurgitation.Results: No significant difference noted between patients operated on, at the first 6 months of age versus later, regarding mortality or LAVV regurgitation. Surgical repair by modified single patch technique showed significant reduction in bypass time (71.13 ± 13.507 min vs 99.19 ± 27.092 min, P value =0.001). Comparison to closure of cleft only, posterior annuloplasty used for repair of LAVV resulted in significant reduction in the occurrence of post-operative valve regurgitation during the early period (LAVV 2+ 43 % vs 7 %, P value=0.03) and at 6 months of follow up (LAVV 2+ 35.4 % vs 0 %, P value=0.01) respectively.Conclusion: Early intervention, in the first 6 months in patients with CAVC by surgical repair gives comparable acceptable results to later repair; Trisomy 21 was not found to be a risk factor for early intervention. Repair of common AV valve by cleft closure with posterior LAVV annuloplasty showed better results with significant decrease in postoperative LAVV regurgitation and early mortality in comparison to closure of cleft only.

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cytoreductive prostatectomy; C e conventional treatment (ADT, chemotherapy), or local radiotherapy; O e oncological outcomes (CSS, progression-free survival (PFS), overall survival (OS)), functional outcomes (urinary incontinence and erectile function (EF) rates), complications. The primary outcomes were the oncological results: cancer-specific survival (CSS), progression-free survival (PFS), overall survival (OS). The secondary outcomes were complication rates and functional results (urinary continence).RESULTS: In all the studies OS was better or at least comparable in the groups with CRP and no local treatment (NLT). The most essential benefit from CRP was noted by Culp et al. (5-year OS 67.4% for RP vs 22.5 for NLT). CSS showed the same trend. Positive surgical margin rate ranged from 28.6% up to 100%. Urinary continence in CRP was significantly lower, than in RP for localized PCa, 57.4% vs 90.8%, p<0.0001. But severe incontinence occurred seldom (2.5e18.6%). Between 50% and 84.6% of the patients were completely continent. Total complications rate after CRP differed widely, from 7e8.8% to 41.2e43.6%. Rates of grade 1 and 2 events prevailed. The patients on ADT alone also showed a considerable number of complications, varying from 5.9% to 57.7%. A significant proportion (26.8%-44.7%) of them required interventions due to local progression.CONCLUSIONS: CRP improves medium-term cancer control in patients with oligometastatic PCa. This surgery results in what we believe to be an acceptable complication rate with a slightly impaired urinary continence as compared to RP for a localized disease.