Long-term Quality of Life and Gastrointestinal Functional Outcomes After Pancreaticoduodenectomy

Abstract Background The transanal approach to ileal pouch-anal anastomosis [Ta-IPAA] provides better access to the lower pelvis with lower short-term morbidity in ulcerative colitis [UC]. The aim of this study was to assess the long-term functional outcomes after Ta-IPAA vs transabdominal IPAA [Abd-IPAA] in UC. Methods A multicentre cohort analysis was performed between March 2002 and September 2017. Patient characteristics, surgical details and postoperative outcomes were compared. CGQL [Cleveland global quality of life] score at 12 months with a functioning pouch was considered the primary end point. Results A total of 374 patients [100 Ta-IPAA vs 274 Abd-IPAA] were included. Ta-IPAA demonstrated a comparable overall quality of life [CGQL score] to Abd-IPAA [0.75 ± 0.11 vs 0.71 ± 0.14; respectively, p = 0.1]. Quality of life [7.71 ± 1.17 vs 7.30 ± 1.46; p = 0.04] and energy-level items [7.16 ± 1.52 vs 6.66 ± 1.68; p = 0.03] were significantly better after Ta-IPAA, while the quality of health item was comparable [7.68 ± 1.26 vs 7.64 ± 1.44; p = 0.96]. Analysis excluding anastomotic leaks did not change the overall CGQL scores. Stool frequencies [>10/24 h: 22% vs 21%; p = 1.0] and the rate of a single episode of major incontinence during the following 12-month period [27% vs 26%; p = 0.89] were similar. The differences in 30-day morbidity rates [33% vs 41%; p = 0.2] and anastomotic leak rates were not significant [6% vs 13%; p = 0.09]. Conclusions This study provides evidence of comparable long-term functional outcome and quality of life after Ta-IPAA and Abd-IPAA for UC.

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The long-term impact of preoperative psychological distress on functional outcomes, quality of life, and patient satisfaction after total knee arthroplasty

The Bone & Joint Journal ◽

10.1302/0301-620x.102b7.bjj-2019-1562.r2 ◽

2020 ◽

Vol 102-B (7) ◽

pp. 845-851 ◽

Cited By ~ 2

Author(s):

Graham S. Goh ◽

Ming Han Lincoln Liow ◽

You Wei Adriel Tay ◽

Jerry Yongqiang Chen ◽

Sheng Xu ◽

...

Keyword(s):

Quality Of Life ◽

Mental Health ◽

Psychological Distress ◽

Functional Outcomes ◽

Knee Score ◽

Sf 36 ◽

Total Knee

Aims While patients with psychological distress have poorer short-term outcomes after total knee arthroplasty (TKA), their longer-term function is unknown. We aimed to 1) assess the influence of preoperative mental health status on long-term functional outcomes, quality of life, and patient satisfaction; and 2) analyze the change in mental health after TKA, in a cohort of patients with no history of mental health disorder, with a minimum of ten years’ follow-up. Methods Prospectively collected data of 122 patients undergoing primary unilateral TKA in 2006 were reviewed. Patients were assessed pre- and postoperatively at two and ten years using the Knee Society Knee Score (KSKS) and Function Score (KSFS); Oxford Knee Score (OKS); and the Mental (MCS) and Physical Component Summary (PCS) which were derived from the 36-Item Short-Form Health Survey questionnaire (SF-36). Patients were stratified into those with psychological distress (MCS < 50, n = 51) and those without (MCS ≥ 50, n = 71). Multiple regression was used to control for age, sex, BMI, Charlson Comorbidity Index (CCI), and baseline scores. The rate of expectation fulfilment and satisfaction was compared between patients with low and high MCS. Results There was no difference in the mean KSKS, KSFS, OKS, and SF-36 PCS at two years or ten years after TKA. Equal proportions of patients in each group attained the minimal clinically important difference for each score. Psychologically distressed patients had a comparable rate of satisfaction (91.8% (47/51) vs 97.1% (69/71); p = 0.193) and fulfilment of expectations (89.8% vs 97.1%; p = 0.094). The proportion of distressed patients declined from 41.8% preoperatively to 29.8% at final follow-up (p = 0.021), and their mean SF-36 MCS improved by 10.4 points (p < 0.001). Conclusion Patients with poor mental health undergoing TKA may experience long-term improvements in function and quality of life that are comparable to those experienced by their non-distressed counterparts. These patients also achieved a similar rate of satisfaction and expectation fulfilment. Undergoing TKA was associated with improvements in mental health in distressed patients, although this effect may be due to residual confounding. Cite this article: Bone Joint J 2020;102-B(7):845–851.

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Long-term functional outcomes and quality of life in adult survivors of childhood extremity sarcomas: a report from the St. Jude Lifetime Cohort Study

Journal of Cancer Survivorship ◽

10.1007/s11764-016-0556-1 ◽

2016 ◽

Vol 11 (1) ◽

pp. 1-12 ◽

Cited By ~ 24

Author(s):

Israel Fernandez-Pineda ◽

M. M. Hudson ◽

A. S. Pappo ◽

M. W. Bishop ◽

J. L. Klosky ◽

...

Keyword(s):

Quality Of Life ◽

Cohort Study ◽

Functional Outcomes ◽

Adult Survivors

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Long-term functional outcomes and quality of life in patients with Hirschsprung's disease

British Journal of Surgery ◽

10.1002/bjs.11059 ◽

2019 ◽

Vol 106 (4) ◽

pp. 499-507 ◽

Cited By ~ 9

Author(s):

R. J. Meinds ◽

A. F. W. van der Steeg ◽

C. E. J. Sloots ◽

M. J. Witvliet ◽

I. de Blaauw ◽

...

Keyword(s):

Quality Of Life ◽

Functional Outcomes ◽

Hirschsprung's Disease ◽

Hirschsprung’S Disease

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Quality of life after coloanal anastomosis for distal rectal cancer: Long-term functional outcomes

European Journal of Surgical Oncology ◽

10.1016/j.ejso.2012.07.025 ◽

2012 ◽

Vol 38 (10) ◽

pp. 981

Author(s):

A. Percivale ◽

E. Benatti ◽

F. Mariani ◽

G. Saccomani ◽

R. Pellicci

Keyword(s):

Quality Of Life ◽

Rectal Cancer ◽

Functional Outcomes ◽

Coloanal Anastomosis ◽

Distal Rectal Cancer

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Faculty Opinions recommendation of Long-term quality of life & functional outcomes after treatment of oropharyngeal cancer.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.739162109.793585231 ◽

2021 ◽

Author(s):

Zhen Gooi ◽

Tatvam Choksi

Keyword(s):

Quality Of Life ◽

Oropharyngeal Cancer ◽

Functional Outcomes

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Impact of functional outcomes on long-term quality of life after open retropubic radical prostectomy.

Journal of Clinical Oncology ◽

10.1200/jco.2013.31.15_suppl.9580 ◽

2013 ◽

Vol 31 (15_suppl) ◽

pp. 9580-9580

Author(s):

Bjoern Loeppenberg ◽

Christian von Bodman ◽

Marko Brock ◽

Joachim Noldus ◽

Jueri Palisaar

Keyword(s):

Quality Of Life ◽

Erectile Dysfunction ◽

Erectile Function ◽

Functional Outcomes ◽

Term Survival ◽

Eortc Qlq C30 ◽

Eortc Qlq ◽

The Impact

9580 Background: Patients who underwent open retropubic radical prostatectomy (ORRP) for prostate-cancer (PCA) have excellent long-term survival. Besides oncologic safety, recovery of continence and erectile function are highly important, as adverse functional outcomes may have a detrimental effect on health-related quality of life (HRQOL). We report the long-term HRQOL of PCA survivors after ORRP using standardized tools. Methods: Men treated between August 2003 and December 2007 with ORRP for localized PCA at a single academic hospital received validated questionnaires (International consultation on incontinence questionnaire (ICIQ), International index of erectile function (IIEF-5), Erection hardness score (EHS), EORTC QLQ-C30) to assess functional outcomes and HRQOL. Results were correlated with the global-health score (GHS) of the EORTC QLQ-C30 to assess the impact of ORRP on HRQOL. Results: In the study period 1936 men underwent ORRP of whom 1156 (59.7%) received a nerve-sparing (NS) procedure. Questionnaire return-rate was 59% (n=1141) comprising the final study cohort. Median follow-up (FU) was 62 months. Mean age at surgery and FU was 63.7±6.2 and 69.2±6.2 years, respectively. Biochemical recurrence (BCR) occurred in 17.5% (n=200/1141) and 2% (n=40/1936) deceased. Mean GHS in the study population was 71.5±20.8. In the ICIQ 28% (n=320) scored 0 indicating complete continence and 9.9% (n=113) scored ≥11 indicating severe incontinence. The corresponding GHS was 78.1±19.5 and 55.4±21.8, respectively. 68.5% (n=782) of patients used no pads and 17.9% (n=204) ≥2 pads. Corresponding GHS scores were 74.9±19.8 and 58.9±20.7. Using the IIEF-5 in men who received NS, 24.1% (n=154) had no erectile dysfunction versus 50% (n=318) using the EHS. Corresponding GHS scores were 82.2±16.3 and 74.7±19.8, respectively. Patients with BCR had a GHS of 66.8±21.8 versus 72.5±20.5 for patients without. Men who achieved the Trifecta and Pentafecta criteria had a GHS of 83.1±15.1 and 83.3±15, respectively. Conclusions: Incontinence severely impacts the HRQOL of long-term survivors after ORRP while erectile dysfunction and BCR have a lesser effect. Every effort should be undertaken to maintain functional integrity.

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