Randomized Evidence for Laparoscopic Gastrectomy Short-Term Quality of life Improvement and Challenges for Improving Long-Term Outcomes

2009 ◽  
Vol 250 (2) ◽  
pp. 350 ◽  
Author(s):  
Young-Woo Kim ◽  
Hongman Yoon
2020 ◽  
Author(s):  
Michaela Plath ◽  
Matthias Sand Sand ◽  
Peter K. Plinkert ◽  
Ingo Baumann ◽  
Karim Zaoui

Abstract Backround:Parotidectomy may be burdened by numerous complications that may worsen subjects' quality of life (QoL). So far, the literature still lacks of long-term data (> 10 years) answering to the question what impacted the patients the most on QOL after parotidectomy compared to well-published short-term data.Methods:A prospective long-term follow-up study was carried out. Participants were divided into three groups concerning the follow-up: short-term (ST; 6 postoperative weeks), long-term (LT; 13 years postoperative) and short- and long-term (SLT) on same patient collective. QOL was assessed by the Parotidectomy Outcome Inventory (POI-8). Demographic and clinical data were collected from all patients. Operative reports were used to classify all parotidectomies as great nerve auricular (GAN) “preserving” or GAN “sacrificing” surgical preparations.Results:74 LT, 57 ST and 33 SLT patients were enrolled in this study. Hypoesthesia posed the major short- and long-term problem whereas facial palsy posed the minor problem. Pain (p < 0.01) and hypoesthesia (p < 0.001) significantly improved from six weeks to 13 years after parotidectomy as well as the overall POI-8 score (p = 0.04). The disease-specific impairment rate decreased from short (≈ 70%) to long-term (≈ 30%) follow-up. Sacrifice of the auricular nerve was associated with hypoesthesia in the ST-cohort (p = 0.028).Conclusion:To our knowledge, this study represents the longest follow-up of patients undergoing parotidectomy. Hypoesthesia significantly improved but still remains on long-follow-up without impacting QOL. As part of the preoperative informed consent, prolonged or permanent hypoesthesia should be explicitly emphasized.Trial registration:This study was prospectively approved and registered by the local Ethics Committee (Project Trial No: S-300/2007 and S-443/2018).


2017 ◽  
Vol 30 (7-8) ◽  
pp. 541 ◽  
Author(s):  
Francisca Pinho Costa ◽  
Gilberto Costa ◽  
Manuel Santos Carvalho ◽  
António Mendes Moura ◽  
Rui Pinto ◽  
...  

Introduction: Flexible flatfoot is common amongst children, although treatment is rarely indicated. The calcaneo-stop procedure has been reported to be effective in short-term studies. We aim to evaluate the long-term outcomes of the calcaneo-stop procedure in the treatment of flexible flatfoot in children.Material and Methods: Twenty-six calcaneo-stop procedures performed between 1995 and 2006 on 13 patients were evaluated clinically and using photopodoscopy, and the FAOS questionnaire was applied for both feet.Results: Of the 26 feet evaluated, 22 presented with heel valgus, 13 had forefoot supination and 11 had abnormal footprints. Median FAOS questionnaire score was 97.22 for ‘Pain’, 92.86 for ‘Other symptoms’, 98.53 for ‘Function in daily living’, 100 for ‘Function in sports and recreation’ and 93.75 for ‘Foot and ankle-related quality of life’.Discussion: The calcaneo-stop procedure is the least invasive and most simple surgical treatment for symptomatic flexible flatfoot in children. Short-term studies report excellent clinical and radiographic results. The authors report alterations in clinical parameters in a large proportion of patients. These findings can be due to biomechanical alterations in the years following removal of the screw. Patient foot and ankle-related satisfaction data is promising, although hard to evaluate given the absence of preoperative data.Conclusion: Larger, prospective, controlled studies are required to better evaluate the long-term success of this procedure.


2020 ◽  
Author(s):  
Michaela Plath ◽  
Matthias Sand ◽  
Peter K. Plinkert ◽  
Ingo Baumann ◽  
Karim Zaoui

Abstract Background: Parotidectomy may be burdened by numerous complications that may worsen subjects' quality of life (QoL). So far, the literature still lacks of long-term data (>10 years) answering to the question what impacted the patients the most on QOL after parotidectomy compared to well-published short-term data.Methods: A prospective long-term follow-up study was carried out. Participants were divided into three groups concerning the follow-up: short-term (ST; 6 postoperative weeks), long-term (LT; 13 years postoperative) and short- and long-term (SLT) on same patient collective. QOL was assessed by the Parotidectomy Outcome Inventory (POI-8). Demographic and clinical data were collected from all patients. Operative reports were used to classify all parotidectomies as great auricular nerve (GAN) “preserving” or GAN “sacrificing” surgical preparations.Results: 74 LT, 57 ST and 33 SLT patients were enrolled in this study. Hypoesthesia posed the major short- and long-term problem whereas facial palsy posed the minor problem. Pain (p < 0.01) and hypoesthesia (p < 0.001) significantly improved from six weeks to 13 years after parotidectomy as well as the overall POI-8 score (p = 0.04). The disease-specific impairment rate decreased from short (» 70%) to long-term (» 30%) follow-up. Sacrifice of the auricular nerve was associated with hypoesthesia in the ST-cohort (p = 0.028).Conclusion: To our knowledge, this study represents the longest follow-up of patients undergoing parotidectomy. Hypoesthesia significantly improved but still remains on long-follow-up without impacting QOL. As part of the preoperative informed consent, prolonged or permanent hypoesthesia should be explicitly emphasized.Trial registration: This study was prospectively approved and registered by the local Ethics Committee (Project Trial No: S-300/2007 and S-443/2018).


Author(s):  
Teresa Zetzl ◽  
Andre Pittig ◽  
Agnes Renner ◽  
Birgitt van Oorschot ◽  
Elisabeth Jentschke

Abstract Objective To examine the efficacy of reminder e-mails to continue yoga therapy on practice frequency and fatigue in cancer patients and long-term effects of yoga on fatigue, depression, and quality of life. Methodology One hundred two cancer patients who completed an 8-week yoga therapy were randomly allocated to two groups: reminder (N = 51) vs. no-reminder group (N = 51). After completing yoga therapy, the reminder group received weekly e-mails for 24 weeks, which reminded them of practicing yoga, whereas the no-reminder group did not. Primary outcomes were fatigue and practice frequency, and long-term outcomes were fatigue, depression, and quality of life. Data were assessed using questionnaires after yoga therapy (T1) and 6 months after completing yoga therapy (T2). Result A significantly stronger reduction of general (p = 0.038, d = 0.42) and emotional fatigue (p = 0.004, d = 0.59) and a higher increase of practice frequency (p = 0.015, d = 0.52) between T1 and T2 were found for the reminder group compared to the no-reminder group. In the mediation model, practice frequency as a mediator partially explained the changes in emotional fatigue (indirect effect B =  − 0.10). Long-term effects of yoga therapy regarding fatigue, depression, and quality of life were found (F > 7.46, p < 0.001, d > 0.54). Conclusion Weekly reminder e-mails after yoga therapy can positively affect general and emotional fatigue and help cancer patients with fatigue establish a regular yoga practice at home. However, higher practice frequency did not lead to higher physical or cognitive fatigue improvement, suggesting other factors that mediate efficacy on physical or cognitive fatigue, such as mindfulness or side effects of therapy.


2017 ◽  
Vol 28 (05) ◽  
pp. 445-454 ◽  
Author(s):  
Tania Mahler ◽  
Martine Dassonville ◽  
Dinh Truong ◽  
Annie Robert ◽  
Philippe Goyens ◽  
...  

Introduction Patients after pull-through operation for Hirschsprung's disease (HD) are at high risk of defecation disorders. This study aimed at investigating their long-term outcomes and quality of life (QoL) in comparison with controls. Patients and Methods Patients older than 5 years operated on for HD were interviewed to complete detailed questionnaires on bowel function. Patients without neurologic impairment were enrolled in a QoL survey to compare with controls matched for sex and age and selected randomly from the general population using sampling set in a ratio of four controls to one case of HD. Results In total, 53 operated patients were enrolled. Mean age of the patients was 16 ± 8 years, with 68% boys. Rectosigmoid aganglionosis was the most seen form of HD in 38 (72%) cases. Open Soave was performed in 40 (75.5%) cases, and minimally invasive surgery Soave (MIS Soave) in 13 (24.5%) cases. At investigation, prevalence of fecal incontinence and constipation were 22.6 and 13.2%, respectively. Regarding QoL survey, 45 patients and 180 controls were enrolled, excluding 8 patients with neurologic impairment. Thirty-seven (82.2%) patients were classified as having a good QoL (score ≥ 9 points); whereas six had a fair QoL (5–8 points) and two had a poor QoL (< 5 points). QoL score in the cases and the controls were 10.2 ± 2.5 and 11.9 ± 0.4 points, respectively. Long aganglionosis form of HD was significantly associated with a low QoL (score < 8 points), adjusted odds ratio = 9, 95% confidence interval [1.3; 64.1] (p < 0.05). In subscales analyses, the prevalence of each dimension including fecal continence, school absenteeism, unhappiness or anxiety, food restriction, and peer rejection was significantly higher in operated patients than in controls (p <0.001). Conclusion Although the QoL of patients operated on for HD in general was with good outcomes, fecal incontinence and constipation still are problematic issues and challenges in a high percentage of patients. Therefore, a long-term and multidisciplinary follow-up is essentially required for these patients.


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