scholarly journals Three-stage approach to resection of left pancoast tumour with spinal and major vessel involvement

2020 ◽  
Vol 2020 (12) ◽  
Author(s):  
Alison M Wallace ◽  
George D Oreopoulos ◽  
Yoga R Rampersaud ◽  
Thomas K Waddell
Keyword(s):  
Quality Of Life ◽  
Left Subclavian Artery ◽  
Neoadjuvant Chemoradiotherapy ◽  
Oncologic Outcome ◽  
Successful Outcome ◽  
Team Collaboration ◽  
Major Vessel ◽  
Vertebral Bodies ◽  
Vessel Involvement

Abstract Here we describe the successful outcome of a complex and challenging resection of a left-sided pancoast tumour involving the left subclavian artery and vertebral bodies. The resection was performed following neoadjuvant chemoradiotherapy in a multi-staged fashion involving multiple teams including thoracic surgery, plastic surgery, neurosurgery and vascular surgery. Each operation was less than 6 h, without complication, and the patient was discharged within 1 week of each procedure. This case report highlights the importance of multidisciplinary team collaboration and planning in order to achieve a successful oncologic outcome and a good quality of life following treatment of these challenging tumours. The patient had a good functional outcome and no evidence of recurrence 1.5 years later.

scholarly journals Subcutaneous Quadrantectomy Is A Safe Procedure in Management of Early Stage Breast Cancer.

2021 ◽  
Author(s):  
Eva Lieto ◽  
Annamaria Auricchio ◽  
Silvia Erario ◽  
Giovanni Del Sorbo ◽  
Francesca Cardella
Keyword(s):  
Breast Cancer ◽  
Quality Of Life ◽  
Axillary Dissection ◽  
Early Stage ◽  
Length Of Hospital Stay ◽  
Oncologic Outcome ◽  
Conservative Surgery ◽  
Early Stage Breast Cancer ◽  
Safe Procedure

Abstract Background: Surgical treatment of breast cancer, the most frequent cancer in women, is deeply changed in the last years turning towards a progressive minimally invasion, both in extend of demolition and in axillary dissection completeness. This is due to the flexibility of the concept of radicality that today is taylored on the patient, rather than on the disease; If oncologic radicality is preserved, a less invasive operation on the breast is mandatory. In the era of mini-invasive surgery, a patient may ask for an aesthetic care without any additional health risk.Methods: In this article, we compared two groups of 75 consecutive patients undergoing conservative surgery for early stage breast cancer; the two groups were randomized for standard quadrantectomy and totally subcutaneous quadrantectomy. Statistical analysis was carried out for comparing data.Results: No difference in oncologic outcome was found with the different surgical procedures; the length of hospital stay and the incidence of late breast deformities were significantly less in subcutaneous quadrantectomy group. Conclusions: We conclude that, in early breast cancer, a totally subcutaneous surgical procedure of resection is feasible and safe and ensures an absolutely better aesthetical result, that involves patient’s quality of life.

Buccal mucosal graft urethroplasty in male cats with traumatic complete urethral rupture

2022 ◽  
pp. 1-7
Author(s):  
Wanchart Yippaditr ◽  
Antja Watanangura ◽  
Disdanai Pencharee ◽  
Nobuo Sasaki
Keyword(s):  
Quality Of Life ◽  
Buccal Mucosa ◽  
Abdominal Cavity ◽  
Positive Contrast ◽  
Successful Outcome ◽  
Indwelling Catheter ◽  
Buccal Mucosal Graft ◽  
Graft Tissue ◽  
Urethral Rupture

Abstract OBJECTIVE To evaluate the feasibility of buccal mucosal graft urethroplasty for repairing complete urethral rupture in cats. ANIMALS 15 male domestic shorthair cats with traumatic complete urethral rupture. PROCEDURES In each cat, a section of buccal mucosa was harvested, sutured, and formed into a tubule by use of an 8F indwelling catheter as support. This tubular graft was connected to both ruptured ends of the urethra to renew the urinary passage. The catheter was left in place until the absence of leakage was confirmed by positive contrast retrograde urethrography. After spontaneous urination was confirmed, cats were discharged from the hospital. Six months later, urethrography was repeated and owners were asked to score their cats’ urinary function and quality of life. RESULTS 13 cats recovered well following surgery, with no complications in the oral cavity or surgical site and no signs of difficulty or discomfort when urinating. Urethrography 2 weeks and 6 months after surgery revealed no stricture or leakage in the abdominal cavity. The 2 remaining cats developed a urethral stricture and underwent second surgery with a successful outcome. At the 6-month follow-up, 14 cats had only mild urinary signs, and 1 cat had incontinency. Owners indicated they were delighted (n = 14) or pleased (1) with their cats’ quality of life. CLINICAL RELEVANCE Buccal mucosa was found to be a good source of graft tissue for performance of urethroplasty in male cats, yielding satisfactory outcomes with few postoperative complications. The described technique may be suitable for severe and complicated cases of urethral rupture in male cats.

PS02.229: ASSESSMENT OF VARYING QUALITY OF LIFE OUTCOMES BASED ON A STRATEGY OF ORGAN PRESERVATION VERSUS SURGERY FOR UPPER GASTROINTESTINAL MALIGNANCIES

2018 ◽  
Vol 31 (Supplement_1) ◽  
pp. 187-187
Author(s):  
Lauren O Connell ◽  
Mary Coleman ◽  
Natalia Kharyntiuk ◽  
Thomas Walsh
Keyword(s):  
Quality Of Life ◽  
Conflicts Of Interest ◽  
External Validation ◽  
Neoadjuvant Chemoradiotherapy ◽  
Complete Response ◽  
Disease Stage ◽  
Control Group ◽  
Gastrointestinal Malignancies ◽  
Upper Gastrointestinal

Abstract Background: Background Neoadjuvant chemoradiotherapy (naCRT) for upper gastrointestinal malignancies induces a pathological complete response (pCR) in 25–85% of patients, depending on disease stage and regimen chosen. All patients with a pCR will have a clinical complete response (cCR). Avoidance of surgery is desirable where feasible, as operative intervention entails morbidity and mortality risks and a reduction in lifelong health related quality of life (HRQoL). Pursuant on a policy of permitting selected patients with a cCR to opt for surveillance, this study aims to compare the QoL of patients who chose surveillance over adjuvant surgery following a cCR to naCRT. Methods: Methods One hundred and fourteen patients participated in the study. These comprised 4 groups; Group 1 (n = 31) were healthy controls; Group 2 (n = 26) had chemoradiotherapy only; Group 3 (n = 31) had oesophagectomy post naCRT and Group 4(n = 26) had gastrectomy alone. A novel 33 point questionnaire assessing 5 functional domains was completed focusing on symptoms of antro-pyloric function, respiratory reflux and post-vagotomy symptoms, as well as a previously validated questionnaire instrument for purposes of comparison and external validation. The data was aggregated to produce a total score ranging from 20–93 with 20 representing the least symptomatic. Results: Results Mean(± sd) overall QoL scores were significantly better in patients avoiding resection (28.9 ± 4.5) vs oesophagectomy (32.3 ± 58. P = 0.042) and vs gastrectomy(33.19 ± 5.9, P = 0.004. Scores did not differ between patients undergoing oesophagectomy or gastrectomy (P = 0.889). Oesophagectomy was associated with a trend towards increased reflux-related respiratory symptoms (7.3 ± 2.2 vs 6.5 ± 1.9; P = 0.396) while gastrectomy patients reported more symptoms related to vagotomy (1.82 ± 0.9 vs 1.4 ± 0.6; P = 0.438) and early dumping (8.2 ± 1.4 vs 7.1 ± 1.7; P = 0.239). The mean score for the control group administered the novel questionnaire was 20.74, approaching the lowest possible score of 20. This was significantly lower than any of the scores recorded for the treatment groups (P = < 0.001). Conclusion: Discussion A strategy of active surveillance in complete responders to neoadjuvant chemoradiotherapy is rewarded with a superior quality of life than in those undergoing surgery. Disclosure All authors have declared no conflicts of interest.

scholarly journals Factors which may predict successful rehabilitation in patients who have undergone coronary artery bypass surgery: A pilot study

1994 ◽  
Vol 50 (2) ◽  
pp. 23-25
Author(s):  
C. Eales ◽  
A. Stewart
Keyword(s):  
Quality Of Life ◽  
Coronary Artery ◽  
Coronary Artery Bypass ◽  
Coronary Artery Bypass Surgery ◽  
Bypass Surgery ◽  
Artery Bypass ◽  
Successful Outcome ◽  
Successful Rehabilitation ◽  
One Year

A study was conducted to determine the factors which may predict the successful outcome of rehabilitation in patients who had undergone coronary artery bypass surgery.Rehabilitation was considered successful if the patient experienced an improved quality of life and had accepted the responsibility for his/her own rehabilitation.Ten patients who had undergone coronary artery bypass surgery one year ago, were selected from the Cardiac Rehabilitation Unit of the Johannesburg Health and Housing Department.The outcome of rehabilitation was determined in these ten patients by judging their improvement in quality of life and their acceptance of self-responsibility.This was done by administering a questionnaire to the patients and their spouses which covered aspects of compliance to a programme to modify risk factors, the patients' ability to manage stress, their fitness and obesity profiles and their exercise habits.From this study the authors concluded that the acceptance of self-responsibility for rehabilitation is an important factor in the outcome of successful rehabilitation.

scholarly journals Gynaecological issues in women with bleeding disorders: CSL Behring Symposium

2019 ◽  
Vol 6 (2) ◽  
pp. 28-38
Author(s):  
Angelika Batorova ◽  
Karin van Galen ◽  
Sylvia von Mackensen ◽  
Ioannis Tsimpanakos ◽  
Evelyn Grimberg
Keyword(s):  
Quality Of Life ◽  
Pelvic Pain ◽  
Successful Outcome ◽  
Severe Bleeding ◽  
Bleeding Tendency ◽  
Bleeding Disorders ◽  
Health Related Quality ◽  
Related Quality ◽  
Health Related

Abstract The symposium focused on issues around surgery, ovulation bleeding, health-related quality of life (HRQoL) and pelvic pain in women with bleeding disorders. Surgery Young women with congenital bleeding disorders, especially those with severe forms, are more likely to experience gynaecological and obstetric disorders than unaffected women. Surgery may be required to manage heavy menstrual bleeding (HMB), ovulatory bleeding, endometriosis and delivery. Major surgery should be undertaken only in hospitals with a haemophilia centre and 24-hour laboratory capability. Correction of haemostasis, either by desmopressin, coagulation factor or platelet transfusion, is essential for a successful outcome of surgery. Management of pregnancy requires a multidisciplinary approach; the mode of delivery is based on the consensus of gynaecologist and haematologist, and with respect to the patient’s diagnosis. Ovulation bleeding Women with bleeding disorders are at risk for excessive gynaecological bleeding associated with menstruation, ovulation, pregnancy and delivery. Ovulation bleeding is associated with the rupture of ovarian cysts and causes abdominal pain; complications include haemoperitoneum, fertility problems and ovarian torsion. Management includes hormonal and haemostatic therapies, in combination if necessary, and surgery as a last resort. Current management is based on experience in a relatively small number of cases and more clinical data are needed. Health-related quality of life In addition to experiencing joint and tissue bleeds, women experience psychosocial and medical issues associated with menstruation, pregnancy, labour and delivery. HMB has the greatest impact, and is associated with impaired HRQoL in almost all and dissatisfaction with the burden of treatment. There is a need for focused psychosocial support and a specific tool for the assessment of HRQoL in women with bleeding disorders. Pelvic pain Gynaecological causes of pelvic pain in women with bleeding disorders include dysmenorrhoea, mid-cycle pain, bleeding into the corpus luteum and endometriosis. There is no correlation between bleeding tendency and endometriosis severity; however, screening for a bleeding disorder should be considered. Pharmacological management may be hormonal or non-hormonal. Gonadotrophin-releasing hormone agonists offer an alternative to surgery for women with severe bleeding disorders who have endometriosis. Paracetamol is the preferred early analgesic option. Endometrial ablation controls heavy bleeding and pelvic pain but is not recommended for women with large fibroids or a large endometrial cavity. Hysterectomy is an option of last resort. Education for health professionals should include raising awareness about the management of pain in women with bleeding disorders.

scholarly journals The influence of parental compliance to treatment of chronic gastroduodenal pathology in children on patient’s quality of life

2020 ◽  
Vol 11 (1) ◽  
pp. 59-64
Author(s):  
Anna S. Barinova ◽  
Andrew V. Nalyotov
Keyword(s):  
Quality Of Life ◽  
Helicobacter Pylori ◽  
Pain Syndrome ◽  
Helicobacter Pylori Infection ◽  
Successful Outcome ◽  
Control Group ◽  
Strict Adherence ◽  
Clinical Criteria ◽  
Parental Compliance

The effectiveness of the treatment of chronic gastroduodenal pathology associated with Helicobacter pylori infection consists not only in the successful eradication of the pathogenic microorganism, but also in eliminating dyspeptic and abdominal pain syndrome, as the main clinical criteria for this pathology. Among the main reasons that affect the successful outcome of therapy, it can be distinguished strict adherence to the prescribed drug regimens. The aim of the work was to assess the effect of parental adherence to their child suffering from chronic gastroduodenal pathology, treatment on the patient's quality of life. 80 children of high school age suffering from chronic gastroduodenal pathology associated with Helicobacter pylori were examined. Anti-Helicobacter therapy using clarithromycin, amoxicillin, omeprazole for 14 days was held in all patients. The training of parental compliance in relation to ongoing therapy for their child was conducted before therapy in patients of the comparison group. The special questionnaire developed by us was used to assess the level of parental compliance. In addition, in all patients, the quality of life indices were studied using the SF-36 questionnaire at baseline and one month after the start of therapy. It was revealed that in children with chronic gastroduodenal pathology the initial indicators on all scales of quality of life were significantly lower compared to the children of the control group. It was found that the greater compliance of parents to their child's prescribed therapy leads not only to the successful eradication of Helicobacter pylori infection, but also to positive dynamics, both physical and psychological aspects of health.

Oncologic Outcome and Quality of Life After Hindquarter Amputation for Sarcoma: Is it Worth it?

2017 ◽  
Vol 25 (2) ◽  
pp. 378-386 ◽  
Author(s):  
Winan J. van Houdt ◽  
Anthony M. Griffin ◽  
Jay S. Wunder ◽  
Peter C. Ferguson
Keyword(s):  
Quality Of Life ◽  
Oncologic Outcome ◽  
Hindquarter Amputation

Quality Of Life Using A Summary Score After Neoadjuvant Treatment And Surgery For Rectal Cancer.

2020 ◽  
Author(s):  
Rodrigo Otavio de Castro Araujo ◽  
Fernando Meton Vieira ◽  
Ana Paula Ornellas ◽  
Claudia Carrada Torres ◽  
Ivanir Martins ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Rectal Cancer ◽  
Rectal Resection ◽  
Locally Advanced ◽  
Neoadjuvant Treatment ◽  
Neoadjuvant Chemoradiotherapy ◽  
Sphincter Preservation ◽  
Summary Score ◽  
Group 2

Abstract Introduction :Neoadjuvant chemoradiotherapy (neoCRT) followed by surgery is the standard of care for locally advanced rectal cancer (LARC), and sphincter preservation is a desirable endpoint, but quality of life (QOL) is often impaired after treatment. Objective To evaluate QOL in five different moments of treatment in a randomized trial comparing two different neoadjuvant regimens. Methods Stage II and III rectal cancer patients were randomized to receive neoCRT with either capecitabine (Group 1) or 5-Fu and leucovorin (Group 2) concomitant to long course radiotherapy. EORTCs QLQ C30 and CR38 were applied before treatment (T0), after neoCRT (T1), after rectal resection (T2), early after adjuvant chemotherapy (T3), and one year after end of treatment or stoma closure (T4). Wexner scale was used for continence evaluation at T4. A C30 summary score (Geisinger et cols) was calculated to compare QOL results.Results 32 patients were assigned to Group 1and 31 to Group 2. QOL was improved comparing T0 to T1 (mean 80.5 vs 88.0, p<0.001), and decreased comparing T1 to T2 (mean 88.0 vs 80.4, p<0.001). No difference in QOL summary was detected comparing T2 to T3 (79.8 vs 82.4, p=0.194) or T3 to T4 (83.0 vs 83.0, p=0.993). No difference in QOL was detected comparing the two treatment groups as clinical response was comparable. Mean Wexner scale score was 9.2, and a score ≥10 correlated with symptoms of diarrhea and defecation problems at T4. Conclusion : QOL improved after neoCRT but worsened following rectal resection, with no significant recovery during follow-up. Capecitabine and 5-Fu/Lv were equivalent in neoadjuvant regimen. Incontinence was high after sphincter preservation. C30 summary score was useful to detect differences in overall Quality of Life in addition to C30 multiple item questionnaire.

scholarly journals Effect of Neoadjuvant Chemoradiotherapy on Health-Related Quality of Life in Esophageal or Junctional Cancer: Results From the Randomized CROSS Trial

2018 ◽  
Vol 36 (3) ◽  
pp. 268-275 ◽  
Author(s):  
Bo Jan Noordman ◽  
Mathilde G.E. Verdam ◽  
Sjoerd M. Lagarde ◽  
Maarten C.C.M. Hulshof ◽  
Pieter van Hagen ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Neoadjuvant Chemoradiotherapy ◽  
Health Related Quality ◽  
End Points ◽  
Treatment Groups ◽  
Cohen’S D ◽  
Related Quality ◽  
Health Related ◽  
Cohen's D

Purpose To compare pre-agreed health-related quality of life (HRQOL) domains in patients with esophageal or junctional cancer who received neoadjuvant chemoradiotherapy (nCRT) followed by surgery or surgery alone. Secondary aims were to examine the effect of nCRT on HRQOL before surgery and the effect of surgery on HRQOL. Patients and Methods Patients were randomly assigned to nCRT (carboplatin plus paclitaxel with concurrent 41.4-Gy radiotherapy) followed by surgery or surgery alone. HRQOL was measured using the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire–Core 30 (QLQ-C30) and –Oesophageal Cancer Module (QLQ-OES24) questionnaires pretreatment and at 3, 6, 9, and 12 months postoperatively. The nCRT group also received preoperative questionnaires. Physical functioning (PF; QLQ-C30) and eating problems (EA; QLQ-OES24) were chosen as predefined primary end points. Predefined secondary end points were global QOL (GQOL; QLQ-C30), fatigue (FA; QLQ-C30), and emotional problems (EM; QLQ-OES24). Results A total of 363 patients were analyzed. No statistically significant differences in postoperative HRQOL were found between treatment groups. In the nCRT group, PF, EA, GQOL, FA, and EM scores deteriorated 1 week after nCRT (Cohen’s d: −0.93, P < .001; 0.47, P < .001; −0.84, P < .001; 1.45, P < .001; and 0.32, P = .001, respectively). In both treatment groups, all end points declined 3 months postoperatively compared with baseline (Cohen’s d: −1.00, 0.33, −0.47, −0.34, and 0.33, respectively; all P < .001), followed by a continuous gradual improvement. EA, GQOL, and EM were restored to baseline levels during follow-up, whereas PF and FA remained impaired 1 year postoperatively (Cohen’s d: 0.52 and −0.53, respectively; both P < .001). Conclusion Although HRQOL declined during nCRT, no effect of nCRT was apparent on postoperative HRQOL compared with surgery alone. In addition to the improvement in survival, these findings support the view that nCRT according to the Chemoradiotherapy for Esophageal Cancer Followed by Surgery Study–regimen can be regarded as a standard of care.

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