Sternal Reconstruction with the Omental Flap—Acute and Late Complications, Predictors of Mortality, and Quality of Life

Background The omental flap is a reliable flap for the coverage of sternal defects. However, little is known about the predictors of mortality and the long-term outcome in such patients. Methods We, therefore, performed a retrospective study from 2002 to 2013, including all patients who underwent sternal reconstruction with the omental flap. Results A total of 50 patients were identified and mean follow-up was 3.8 years. Patient data was collected from the charts and 14 patients were available for telephone interviews. The majority of patients suffered from deep sternal wound infections. There was no complete flap loss and an overall success rate was 96%. In-hospital mortality was 14% and overall survival over follow-up was 50%. Significant predictors of mortality were age > 65, American Society of Anesthesiologists' status, defect size, prolonged ventilation, and the need for tracheotomy. Postoperative quality of life was reduced compared with other cohorts, especially with regard to bodily function. Pain was also a major problem for most patients along with herniation. Conclusion The omental flap is a safe option even in patients with severe comorbidities. However, based on the data in this study, we would recommend the omental flap as a reserve option rather than first-line treatment for sternal defects.

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Long-term outcome and quality of life after CNS cavernoma resection: eloquent vs. non-eloquent areas

Neurosurgical Review ◽

10.1007/s10143-021-01572-8 ◽

2021 ◽

Author(s):

Loay Shoubash ◽

Jörg Baldauf ◽

Marc Matthes ◽

Michael Kirsch ◽

Matthias Rath ◽

...

Keyword(s):

Quality Of Life ◽

Short Form ◽

Preoperative Evaluation ◽

Patient Counseling ◽

Surgical Morbidity ◽

Term Outcome ◽

Long Term Outcome

AbstractThe aim of this study is to analyze the long-term quality of life after surgery of cavernoma. A monocentric retrospective study was conducted on 69 patients with cavernoma treated microsurgically between 2000 and 2016. The eloquence was adopted from Spetzler-Martin definition. A most recent follow-up was elicited between 2017 and 2019, in which the quality of life (QoL) was evaluated with the Short Form-12 questionnaire (SF12). Forty-one lesions were in eloquent group (EG), 22 in non-eloquent group (NEG), 3 in orbit, and 3 in the spinal cord. Postoperative worsening of the modified Rankin scale (mRS) occurred in 19.5% of cases in EG versus 4.5% in NEG. After a mean follow-up of 6.5 years (SD 4.6), the neurological status was better or unchanged compared to baseline in 85.4% of EG and 100% of NEG. Regarding QoL assessment of 44 patients (EG n = 27, NEG n = 14) attended the last follow-up. Patients after eloquent cavernoma resection reported a non-inferior QoL in most SF12 domains (except for physical role) compared to NEG. However, they reported general health perception inferior to norms, which was affected by the limited physical and emotional roles. At a late follow-up, the surgical morbidity was transient in the NEG and mostly recovered in the EG. The QoL comparison between eloquent and non-eloquent cavernomas created interesting and new data after prolonged follow-up. These results add value for decision-making as well as patient counseling for future encountered cases. Preoperative evaluation of QoL is recommended for future studies to assess QoL dynamics.

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Long-Term Outcome after Dynamic Graciloplasty for Treatment of Persistent Fecal Incontinence in Patients with Anorectal Malformations

European Journal of Pediatric Surgery ◽

10.1055/s-0038-1641599 ◽

2018 ◽

Vol 29 (03) ◽

pp. 276-281

Author(s):

Johan Danielson ◽

Urban Karlbom ◽

Tomas Wester ◽

Wilhelm Graf

Keyword(s):

Quality Of Life ◽

Fecal Incontinence ◽

Short Form ◽

Anorectal Malformations ◽

Dynamic Graciloplasty ◽

Term Outcome ◽

Long Term Outcome

Purpose Dynamic graciloplasty (DGP) has been used to treat severe fecal incontinence since the 1980s. Previous studies have shown an inferior outcome in patients with anorectal malformations (ARMs). Our experience has been that DGP has been appreciated by ARM -patients. The objective of the study was to evaluate the long-term outcome of DGP in our patients with ARM compared with patients with other underlying conditions. Materials and Methods Twenty-three patients operated with DGP at our institution from 1996 to 2010 were sent validated bowel function and quality of life questionnaires. Eighteen of 23 responded. Seven had ARM and 11 had other etiologies of fecal incontinence. The mean follow-up time was 11.6 years (range, 5–17). Results Four of 7 of the patients with ARM and 8 of 11 of patients with other etiologies used their implants at follow-up. The Miller incontinence score was slightly higher for patients with ARMs, but they had less constipation and higher Fecal Incontinence Quality of Life (FIQL)- and 36-Item Short Form Health Survey (SF-36) scores. None of the differences were statistically significant. Conclusion This study cannot confirm earlier reports in which DGP has an inferior outcome in patients with ARM. We therefore believe that the procedure should remain a treatment option for selected patients.

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Long-term outcome, adhesions, and quality of life after laparoscopic and open surgical therapies for acute abdomen: follow-up of a prospective trial

Surgical Endoscopy ◽

10.1007/s00464-003-9333-0 ◽

2004 ◽

Vol 19 (1) ◽

pp. 81-90 ◽

Cited By ~ 20

Author(s):

W. D. Majewski

Keyword(s):

Quality Of Life ◽

Acute Abdomen ◽

Prospective Trial ◽

Term Outcome ◽

Long Term Outcome

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P5598Long term outcome and quality of life following acute type A aortic dissection

European Heart Journal ◽

10.1093/eurheartj/ehz746.0542 ◽

2019 ◽

Vol 40 (Supplement_1) ◽

Author(s):

E Sbarouni ◽

P Georgiadou ◽

M Manavi ◽

A Analitis ◽

C Beletsioti ◽

...

Keyword(s):

Quality Of Life ◽

Aortic Dissection ◽

Mental Component Summary ◽

Term Outcome ◽

Long Term Outcome ◽

Sf 36 ◽

Over Time

Abstract Introduction Acute aortic dissection (AAD) represents surgical emergency and current literature mainly consists of postoperative outcome reports. Long term outcome and quality of life have not extensively been investigated. Purpose This is a single center study to assess long term outcome and quality of life of patients who underwent emergency surgery for AAD. Methods From January 2007 until December 2009, 74 consecutive patients were operated for AAD type A in our hospital. Seventeen died during hospital stay and 12 died during follow-up. Mean follow up was 108±10 months. Seventeen patients refused to answer the SF-36 questionnaire; therefore our study group consists of 28 patients. The SF-36 Questionnaire was retrospectively obtained by phone calls, the first, fifth and tenth postoperative year and 2 summary scores are reported, physical (PCS) and mental (MCS). Results Our in-hospital mortality was 23%, late mortality 21.1% and the overall mortality was 39.2%. Significant differences in both physical and mental score over time were found among the 28 long-term survivors (Table). Both PCS and MCS at 1st, 5th and 10th year did not differ compared to age-matched general population but compared to subjects with one or more chronic diseases both PCS and MCS were both significantly better at 5yrs in our patients vs controls (p=0.0028 and p=0.0259, respectively). Likewise, at 5 years PCS but not MCS was better in comparison to subjects with a history of one hospitalization the preceding year (p=0.035 and p=0.1, respectively). Descriptive statistics of physical and mental component summary score over time Score 1 year (FU1) 5 years (FU2) 10 years (FU3) p-value Mean (SD) Mean (SD) Mean (SD) PCS 45.4 (7.7) 50.3 (7.0) 46.8 (9.2) 0.008* MCS 42.8 (15.1) 49.7 (12.7) 49.1 (12.3) 0.001** PCS, Physical component summary; *1 vs 5: p=0.003, 1 vs 10: p=0.469, 5 vs 10: p=0.027. MCS, Mental component summary; **1 vs 5: p=0.001, 1 vs 10: p=0.001, 5 vs 10: p=0.939. SD, standard deviation. Conclusion Quality of life improves after the 1st post-operative year and is comparable to healthy subjects. Although acute dissection is a catastrophic event with high mortality despite successful and timely repair, long term survival and quality of life on the long term are favorable.

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Long-term outcome and quality of life of dogs that developed neurologic signs after surgical treatment of a congenital portosystemic shunt: 50 cases (2005–2020)

Journal of the American Veterinary Medical Association ◽

10.2460/javma.20.11.0606 ◽

2021 ◽

pp. 1-9

Author(s):

Antía Escribano Carrera ◽

Anya M. Morrissey ◽

Victoria J. Lipscomb ◽

Michael S. Tivers ◽

Alex Chan ◽

...

Keyword(s):

Quality Of Life ◽

Surgical Treatment ◽

Portosystemic Shunt ◽

Survival Times ◽

Term Outcome ◽

Long Term Outcome ◽

Congenital Portosystemic Shunt

Abstract OBJECTIVE To determine survival time and quality of life of dogs that developed postattenuation neurologic signs (PANS) after surgical treatment of a single congenital portosystemic shunt and survived at least 30 days and identify whether neurologic signs present at the time of discharge would resolve or reoccur. ANIMALS 50 client-owned dogs. PROCEDURES Medical records were retrospectively reviewed, and follow-up data relating to neurologic signs and seizure activity were obtained. Owners were asked to complete a questionnaire related to the presence of neurologic signs, including seizures, and their dog’s quality of life. RESULTS Thirty of the 50 (60%) dogs had postattenuation seizures with or without other nonseizure neurologic signs, and 20 (40%) had neurologic signs other than seizures. Neurologic signs had fully resolved by the time of discharge in 24 (48%) dogs. Signs resolved in 18 of the remaining 26 (69%) dogs that still had PANS other than seizures at the time of discharge. Seizures reoccurred in 15 of the 30 dogs that had postattenuation seizures. Twenty-seven of 33 (82%) owners graded their dog’s long-term (> 30 days after surgery) quality-of-life as high. Forty-five (90%) dogs survived > 6 months. Most (29/43 [67%]) neurologic signs (other than seizures) present at the time of hospital discharge resolved. CLINICAL RELEVANCE Findings highlighted that survival times of > 6 months and a high QOL can be achieved in most dogs with PANS that survive at least 30 days. Most neurologic signs other than seizures resolved within 1 month postoperatively. Half of the dogs with postattenuation seizures had a reoccurrence.

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Long-term outcomes of orbital fat decompression in Graves’ orbitopathy

British Journal of Ophthalmology ◽

10.1136/bjophthalmol-2016-309888 ◽

2017 ◽

Vol 102 (1) ◽

pp. 69-73 ◽

Cited By ~ 8

Author(s):

Anny M Cheng ◽

Yi-Hsuan Wei ◽

Sean Tighe ◽

Hosam Sheha ◽

Shu-Lang Liao

Keyword(s):

Quality Of Life ◽

Occurrence Rate ◽

Term Outcome ◽

Long Term Outcome ◽

Orbital Fat ◽

Fat Removal ◽

Partial Success

PurposeTo evaluate the long-term clinical efficacy of orbital fat decompression in treating proptosis in Graves' ophthalmopathy (GO).MethodsRetrospective review of 1604 eyes of 845 patients with symmetric (1518 eyes) and asymmetric (86 eyes) proptosis who received orbital fat decompression between 2003 and 2014. Changes in Hertel values were evaluated at baseline, 6 months postoperatively and yearly thereafter. Recurrence of proptosis, diplopia and other complications that required additional surgeries were documented and analysed. The surgical outcome was defined as complete success if there was proptosis reduction with no recurrence and improved or no diplopia. Partial success was considered if there was proptosis reduction without recurrence yet persistent or new-onset diplopia. Failure was considered if there was recurrence of proptosis regardless of diplopia. The patient’s quality of life was also evaluated as a long-term outcome.ResultsAfter follow-up for 37.9±24.4 months, 1365 eyes (85.1%) achieved complete success, 219 eyes (13.7%) achieved partial success and 20 eyes (1.2%) had failure. Newly onset diplopia and secondary decompression occurrence rate remained low at 3.3% and 0.6%, respectively. The total proptosis reduction was 4.1±1.3 mm, which was consistent all through the intermediate and long-term (5–10 years) follow-up. The amount of orbital fat removal (4.5±1.1 mL) played a significant role in the long-term Hertel change. Importantly, the overall quality of life increased significantly for GO patients after undergoing orbital fat decompression.ConclusionsOrbital fat decompression has a long-term efficacy in correcting disfiguring proptosis with a low complication rate and without the need of secondary decompression procedures. This was also associated with a significant improvement in quality of life.

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Long-Term Outcome and Quality of Life After Cavernoma Resection: Eloquent vs. Non-Eloquent Areas.

10.21203/rs.3.rs-173091/v1 ◽

2021 ◽

Author(s):

Loay Shoubash ◽

Jörg Baldauf ◽

Marc Matthes ◽

Michael Kirsch ◽

Matthias Rath ◽

...

Keyword(s):

Quality Of Life ◽

General Health ◽

Short Form ◽

Surgical Morbidity ◽

Term Outcome ◽

Long Term Outcome ◽

Physical Role

Abstract Objective: To analyze the long-term quality of life after surgery of cavernoma.Methods: A monocentric retrospective study was conducted on 69 patients with cavernoma treated microsurgically between 2000 and 2016. The eloquence was adopted from Spetzler-Martin definition. A most recent follow-up was elicited between 2017 and 2019, in which the quality of life (QoL) was evaluated with the Short Form-12 questionnaire (SF12).Results: 41 lesions were in eloquent group (EG), 22 in non-eloquent group (NEG), 3 in orbit and 3 in the spinal cord. Postoperative worsening of the modified Rankin scale (mRS) occurred in 19.5% of cases in EG versus 4.5% in NEG. After a mean follow-up of 6.5 years, the neurological status was better or unchanged compared to baseline in 85.4% of EG and 100% of NEG. 44 patients (EG n =27, NEG n = 14) attended the last follow-up. The EG had mostly comparable QoL results matched to NEG except for the physical role (RP). The study population when compared to the norms, did well on only half of the parameters of SF12. Yet, the general health (GH), vitality, physical (RP) and emotional roles (RE) were significantly inferior.Conclusion: At a late follow-up, the surgical morbidity was transient in the NEG and mostly recovered in the EG. Regarding QoL, Patients after eloquent cavernoma resection reported a non-inferior QoL in most SF12 domains (except for physical role) compared to NEG. However, they reported general health perception inferior to norms, which was affected by the limited physical and emotional roles.

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Frey’s procedure - does it improve quality of life? A single centre experience of long term outcome following Frey’s procedure

International Surgery Journal ◽

10.18203/2349-2902.isj20200814 ◽

2020 ◽

Vol 7 (3) ◽

pp. 733

Author(s):

L. Soundararajan ◽

Srinivasan Ulagendraperumal ◽

R. Prabhakaran ◽

O. L. Naganathbabu

Keyword(s):

Quality Of Life ◽

Rating Scale ◽

Numerical Rating Scale ◽

Insulin Requirement ◽

Term Outcome ◽

Long Term Outcome ◽

Frey’S Procedure

Background: The objective of the study was to find out long term outcome of patients who underwent Frey’s procedure for chronic calcific pancreatitis.Methods: This is a prospective observational study from retrospectively collected data of all patients who underwent Frey’s procedure for chronic calcific pancreatitis in Institute of Surgical Gastroenterology, Rajiv Gandhi Government General Hospital, Chennai from January 2012 to December 2014. All patients who have completed at least 48 months after surgery were followed up and their long-term postoperative quality of life were analyzed.Results: Totally 48 patients underwent Frey’s procedure during this period. Eight patients lost follow up. Preoperatively all patients had pain score above six in numerical rating scale but after surgery only two patients in the long term required stronger opioids for pain relief. Exocrine deficiency was present in 24 (60%) patients preoperatively, out of which seven patients showed improvement, eight patients had worsened exocrine deficiency and weight loss. Post operatively there were six patients who developed exocrine deficiency. Endocrine deficiency was seen in 23 (57.5%) patients preoperatively and during follow up none showed improvement, with two (5%) patients developed endocrine deficiency. Seven patients showed worsened endocrine deficiency as documented by increasing insulin requirement. Quality of life analysis using SF 36 showed poor quality of life in patients with worsened exocrine deficiency.Conclusions: Frey’s procedure although in long term showed improved outcome in terms of pain free survival and overall quality of life, exocrine and endocrine deficiency persisted in most and worsened in some patients.

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