Surgical outcomes and quality of life between laparoscopic and open approach for hepatic hemangioma

ObjectivesThe objective of this systematic review was to study the impact of preoperative physical activity levels on adult cardiac surgical patients’ postoperative: (1) major adverse cardiac and cerebrovascular events (MACCEs), (2) adverse events within 30 days, (3) hospital length of stay (HLOS), (4) intensive care unit length of stay (ICU LOS), (5) activities of daily living (ADLs), (6) quality of life, (7) cardiac rehabilitation attendance and (8) physical activity behaviour.MethodsA systematic search of MEDLINE, Embase, AgeLine and Cochrane library for cohort studies was conducted.ResultsEleven studies (n=5733 patients) met the inclusion criteria. Only self-reported physical activity tools were used. Few studies used multivariate analyses to compare active versus inactive patients prior to surgery. When comparing patients who were active versus inactive preoperatively, there were mixed findings for MACCE, 30 day adverse events, HLOS and ICU LOS. Of the studies that adjusted for confounding variables, five studies found a protective, independent association between physical activity and MACCE (n=1), 30-day postoperative events (n=2), HLOS (n=1) and ICU LOS (n=1), but two studies found no protective association for 30-day postoperative events (n=1) and postoperative ADLs (n=1). No studies investigated if activity status before surgery impacted quality of life or cardiac rehabilitation attendance postoperatively. Three studies found that active patients prior to surgery were more likely to be inactive postoperatively.ConclusionDue to the mixed findings, the literature does not presently support that self-reported preoperative physical activity behaviour is associated with postoperative cardiac surgical outcomes. Future studies should objectively measure physical activity, clearly define outcomes and adjust for clinically relevant variables.RegistrationTrial registration numberNCT02219815. PROSPERO number CRD42015023606.

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Quality of Life and Surgical Outcomes After Soft-Tissue Reconstruction of Complex Oncologic Defects of the Spine and Sacrum

The Journal of Bone and Joint Surgery (American) ◽

10.2106/jbjs.n.01353 ◽

2016 ◽

Vol 98 (2) ◽

pp. 117-126 ◽

Cited By ~ 10

Author(s):

Roisin T. Dolan ◽

Joseph S. Butler ◽

James Wilson-MacDonald ◽

Jeremy Reynolds ◽

Lucy Cogswell ◽

...

Keyword(s):

Quality Of Life ◽

Soft Tissue ◽

Surgical Outcomes ◽

Soft Tissue Reconstruction ◽

Tissue Reconstruction

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Endoscopic Approach for Pituitary Surgery Improves Rhinologic Outcomes

Annals of Otology Rhinology & Laryngology ◽

10.1177/000348940911800905 ◽

2009 ◽

Vol 118 (9) ◽

pp. 630-635 ◽

Cited By ~ 35

Author(s):

Scott M. Graham ◽

Tim A. Iseli ◽

Lucy H. Karnell ◽

John D. Clinger ◽

Patrick W. Hitchon ◽

...

Keyword(s):

Quality Of Life ◽

Endoscopic Surgery ◽

Open Surgery ◽

Pituitary Surgery ◽

Endoscopic Approach ◽

Open Group ◽

Open Approach ◽

Endoscopic Procedures ◽

The Mean

Objectives: We hypothesized that the endoscopic approach to pituitary surgery improves rhinology-specific quality of life and has satisfactory tumor outcomes compared with the open approach. Methods: Cases of pituitary surgery from the Department of Neurosurgery database included an inception cohort of all patients who had endoscopic procedures and consecutive patients who had open procedures between January 1998 and February 2008. The Sino-Nasal Outcome Test-22 was mailed. Results: Since January 1998, 71 endoscopic and 122 open pituitary surgeries had been performed. The mean follow-up was longer for open procedures (49.3 months) than for endoscopic procedures (18.8 months). Recurrence was more common after open surgery (28.4%) than after endoscopic surgery (18.2%; p = 0.219). The most common diagnosis was macroadenoma (77.1% of endoscopic procedures and 93.4% of open procedures). The mean hospital stay was shorter for endoscopic procedures (4.1 days) than for open procedures (6.0 days; p < 0.001). Of patients who presented with visual deterioration, 53.8% with endoscopic surgery and 46.7% with open surgery had improvement. Among patients with normal preoperative hormonal function, 27.5% of patients in the endoscopy group and 29.4% of patients in the open group required medication for more than 2 months after surgery. Complications occurred in 33.3% of endoscopic procedures and 43.4% of open procedures. Cerebrospinal fluid leaks were more common in the endoscopy group (p = 0.035), and diabetes insipidus lasting more than 30 days was more common in the open group (p = 0.017). The mean Sino-Nasal Outcome Test-22 score was lower for patients in the endoscopy group (20.4) than for those in the open group (23.2; p = 0.41). Patients in the endoscopy group had a significantly lower rhinology-specific mean score (6.5) than did patients in the open group (9.2; p = 0.03). Conclusions: The endoscopic approach to pituitary surgery offers tumor outcomes comparable to those of open surgery, with no greater incidence of complications and an improved rhinology-specific quality of life.

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