Long-term results of surgical treatment of calculous cholecystitis with the use of mini-access

The paper presents the follow-up results of the mini-access surgery for chronic calculous cholecystitis (72 patients) and for calculous cholecystitis (133 patients) performed 3-6 years ago. The long-term results were estimated on two international questionnaires of quality of life (SF-36, GSRS), and on the data of clinical, laboratory and instrumental methods of investigation. All patients operated on for chronic calculous cholecystitis had good long-term results. 99.3 % of the patients with acute calculous cholecystitis had good and satisfactory results of surgical treatment. Only 1 (0.7 %) patient had an unfavourable result, because of choledocholithiasis, identified 2 years after surgery.

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Percutaneous Closure of PFO in Patients with Reduced Oxygen Saturation at Rest and during Exercise: Short- and Long-Term Results

Journal of Interventional Cardiology ◽

10.1155/2020/9813038 ◽

2020 ◽

Vol 2020 ◽

pp. 1-8

Author(s):

Céline De Cuyper ◽

Tristan Pauwels ◽

Eric Derom ◽

Michel De Pauw ◽

Daniël De Wolf ◽

...

Keyword(s):

Oxygen Saturation ◽

Clinical Symptoms ◽

Systemic Circulation ◽

Percutaneous Closure ◽

Long Term Results ◽

Sf 36 ◽

Short And Long Term

Background. A patent foramen ovale (PFO) is a rare cause of hypoxemia and clinical symptoms of dyspnea. Due to a right-to-left shunt, desaturated blood enters the systemic circulation in a subset of patients resulting in dyspnea and a subsequent reduction in quality of life (QoL). Percutaneous closure of PFO is the treatment of choice. Objectives. This retrospective multicentre study evaluates short- and long-term results of percutaneous closure of PFO in patients with dyspnea and/or reduced oxygen saturation. Methods. Patients with respiratory symptoms were selected from databases containing all patients percutaneously closed between January 2000 and September 2018. Improvement in dyspnea, oxygenation, and QoL was investigated using pre- and postprocedural lung function parameters and two postprocedural questionnaires (SF-36 and PFSDQ-M). Results. The average follow-up period was 36 [12–43] months, ranging from 0 months to 14 years. Percutaneous closure was successful in 15 of the 16 patients. All patients reported subjective improvement in dyspnea immediately after device deployment, consistent with their improvement in oxygen saturation (from 90 ± 6% to 94 [92–97%] on room air and in upright position) (p<0.05). Both questionnaires also indicated an improvement of dyspnea and QoL after closure. The two early and two late deaths were unrelated to the procedure. Conclusion. PFO-related dyspnea and/or hypoxemia can be treated successfully with a percutaneous intervention with long-lasting benefits on oxygen saturation, dyspnea, and QoL.

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Long-Term Results of Neurological Outcome, Quality of Life, and Cosmetic Outcome After Cranioplastic Surgery: A Single Center Study of 202 Patients

Frontiers in Neurology ◽

10.3389/fneur.2021.702339 ◽

2021 ◽

Vol 12 ◽

Author(s):

Henrik Giese ◽

Jennifer Antritter ◽

Andreas Unterberg ◽

Christopher Beynon

Keyword(s):

Quality Of Life ◽

Regression Analysis ◽

Neurological Outcome ◽

Long Term Results ◽

Complication Rates ◽

Long Term Outcome ◽

Sf 36

Objective: An increased interest in the surgical procedures of decompressive craniectomy (DC) and subsequent cranioplasty (CP) has emerged during the last decades with specific focus on mortality and complication rates. The aim of the present study was to evaluate long-term neurological and cosmetic outcomes as well as Quality of Life (QoL) after CP surgery.Methods: We retrospectively reviewed the medical records of CP patients treated at our institution between 2004 and 2014 and performed a follow-up examination, with evaluation of neurological outcome using the modified Rankin Scale (mRS) and the Glasgow outcome scale (GOS), QoL (SF-36 and EQ-5D-3L). Furthermore, the cosmetic results after CP were analyzed.Results: A total of 202 CP-patients were included in the present study. The main indications for DC and subsequent CP were space-occupying cerebral ischemia (32%), traumatic brain injury (TBI, 26%), intracerebral or subarachnoid hemorrhage (32%) and infection (10%). During a mean follow-up period of 91.9 months 46/42.6% of patients had a favorable neurological outcome (mRS ≤ 3/GOS ≥ 4). Patients with ischemia had a significant worse outcome (mRS 4.3 ± 1.5) compared with patients after TBI (3.1 ± 2.3) and infectious diseases requiring CP (2.4 ± 2.3). The QoL analysis showed that <1/3rd of patients (31.2%) had a good QoL (SF-36) with a mean EQ-5D-VAS of 59 ± 26. Statistical analysis confirmed a significant worse QoL of ischemia patients compared to other groups whereas multivariate regression analysis showed no other factors which may had an impact on the QoL. The majority (86.5%) of patients were satisfied with the cosmetic result after CP and regression analysis showed no significant factors associated with unfavorable outcomes.Conclusion: Long-term outcome and QoL after CP were significantly influenced by the medical condition requiring DC. Early detection and evaluation of QoL after CP may improve the patient's outcome due to an immediate initiation of targeted therapies (e.g., occupational- or physiotherapy).

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Short- and Long-Term Effects of Rehabilitation after Perimesencephalic Subarachnoid Hemorrhage

Diseases ◽

10.3390/diseases9040069 ◽

2021 ◽

Vol 9 (4) ◽

pp. 69

Author(s):

Jens Schmitz ◽

Sepide Kashefiolasl ◽

Nina Brawanski ◽

Nazife Dinc ◽

Florian Gessler ◽

...

Keyword(s):

Quality Of Life ◽

Subarachnoid Hemorrhage ◽

Long Term Results ◽

Standard Population ◽

Sf 36 ◽

Long Term Follow Up ◽

Subsequent Rehabilitation

In about 25% of patients with spontaneous subarachnoid hemorrhage (SAH), a bleeding source cannot be identified during radiological diagnostics. Generally, the outcome of perimesencephalic or prepontine (PM) SAH is known to be significantly better than after non-PM SAH. Data about long-term follow-up concerning physical and mental health are scarce, so this study is reports on long-term results. We measured the influence of PM SAH on a quality-of-life modified Rankin (mRs) scale after six months. For long-term follow-up, a SF-36 questionnaire was used. Questionnaires were sent out between 18 and 168 months after ictus. In 37 patients, a long-term follow-up was available (up to 14 years after SAH). Data detected with the SF-36 questionnaire are compared to reference applicability to the standard population. In total, 37 patients were included for further analysis and divided in 2 subgroups; 13 patients (35%) received subsequent rehabilitation after clinical stay and 24 (65%) did not. In the short-term outcome, a significant improvement from discharge until follow-up was identified in patients with subsequent rehabilitation, but not in the matched pair group without rehabilitation. When PM SAH was compared to the standard population, a reduction in quality of life was identified in physical items (role limitations because of physical health problems, physical functioning) as well as in psychological items (role limitations because of emotional problems). Subsequent rehabilitation on PM SAH patients probably leads to an increase in independence and better mRs. While better mRs was shown at discharge in patients without subsequent rehabilitation, the mRs of rehabilitants was nearly identical after rehabilitation. Patients with good mRs also reached high levels of health-related quality of life (HRQoL) without rehabilitation. Thus, subsequent rehabilitation needs to be encouraged on an individual basis. Indication criteria for subsequent rehabilitation should be defined in further studies to improve patient treatment and efficiency in health care.

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Optimal time for surgical treatment of chronic pancreatitis or optimal surgery?

GASTROENTEROLOGY ◽

10.22141/2308-2097.55.3.2021.241589 ◽

2021 ◽

Vol 55 (3) ◽

pp. 191-198

Author(s):

V.G. Yareshko ◽

Iu.O. Mikheiev ◽

O.F. Shpylenko ◽

O.M. Babii

Keyword(s):

Quality Of Life ◽

Chronic Pancreatitis ◽

Surgical Treatment ◽

Long Term Results ◽

Early Surgery ◽

Surgery Group ◽

Sf 36 ◽

Eortc Qlq

Background. The majority of studies on the surgical treatment of chronic pancreatitis (CP) compare treatment outcomes by the type of the procedure. However, some studies, especially systematic reviews and meta-analyses, indicate the equality of different surgeries by their long-term results. During last 5–9 years, several studies showed advantages of early surgery in chronic pancreatitis, within three years after symptoms onset. Objective: to analyze the short- and long-term results of surgical treatment for chronic pancreatitis regarding timing and, accordingly, the neglect of the disease. Materials and methods. Retrospective analysis of data of 147 patients from 2001 to 2020, the main intervention was surgery aimed at the main manifestations of CP, such as pancreatic ductal and/or parenchymal hypertension. Patients who suffered from CP symptoms 3 years or more were included in the control group (late surgery), and those who noted symptoms of CP for less than 3 years were included in the study group (early surgery). All patients completed the EORTC QLQ-30, SF-36 questionnaires, as well as the questionnaire developed by the study authors, via telephone or mail, or during the visit. Results. According to all scales of the SF-36 questionnaire, except for Physical functioning, the group of early surgery prevails over the group of late surgery. The early surgery group had the best average scores on all functional scales of the EORTC QLQ-30 questionnaire compared to the late surgery group, except for the Cognitive functioning. Of the symptomatic scales, the early surgery group had the best averages on Pain and Diarrhea. The average Health/Quality of life scale was significantly better in the early surgery group. Conclusions. The quality of life, pain control, pancreatic function in patients operated within 3 years from the onset of CP symptoms were better compared to those with longer disease duration, with the same short-term results. The duration of the disease is a major factor for the success of surgical treatment of chronic pancreatitis in terms of long-term results. The early surgery is effective approach to obtain better long-term outcomes in chronic pancreatitis.

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Сomparative analysis of outcomes of chronic pancreatitis surgical treatment

Siberian medical review ◽

10.20333/25000136-2021-3-80-87 ◽

2021 ◽

pp. 80-87

Author(s):

N.Yu. Sled ◽

◽

O.N. Sled ◽

N.V. Merzlikin ◽

V.F. Tskhai ◽

...

Keyword(s):

Quality Of Life ◽

Chronic Pancreatitis ◽

Surgical Treatment ◽

Pancreatic Head ◽

Long Term Results ◽

Pancreatic Cysts ◽

Combined Resection ◽

Sf 36

Aim of study. To compare short-term and long-term outcomes of surgical treatment for patients with chronic pancreatitis. Material and methods. In the period of 2002-2020, a total of 123 patients underwent surgery for treatment of complications associated with chronic pancreatitis. The patients were divided into three groups depending on the type of intervention. Patients in Group 1 underwent drainage (n=46), patients in Group 2 underwent resection (n=26) and patients in Group 3 combined resection and draining procedures (n=51). Results. After Roux-en-Y cystojejunostomy of cysts in distal parts of the pancreas(n=11), the amount of complications was lower (3 (27 [6; 61]%)) than after distal resection (n=20): 10 (50 [27; 73]%)), and the quality of life (SF-36) was higher in the long term (PSC: 55.75, MCS: 53.53 against PCS: 48.09, MCS – 49,72) after resection repair. The frequency of postoperative complications and lethality rate were higher in patients after different variants of sparing resection of pancreatic parenchyma with duct system drainage than in the group of patients treated with longitudinal cystojejunostomy. In the long term, lower lethality (5 [0; 23]%; p<0.05) and a higher level of physical (PCS – 61.31) and mental (MCS – 61.73) health were registered after the original variant of combined resection and draining intervention in comparison with traditional pancreatojejunostomy and duodenum-preserving surgery. Conclusion. Draining interventions on pancreatic cysts in distal parts of the pancreas is accompanied by better immediate and long-term results. Drainage without consideration for changes in the pancreatic head leads to a higher recurrence rate (27 [8; 55]%, р=0.013). Immediate results of the proposed combined resection and draining intervention are comparable with duodenum-preserving surgery but are characterised by lower mortality (5 [0; 23]%, р=0.06) and higher quality of life (SF-36) in the long term.

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Ross procedure and aortic valve repair: long-term echocardiographic outcomes, quality of life and physical activity of different aortic valve surgery procedures

European Heart Journal - Cardiovascular Imaging ◽

10.1093/ehjci/jeaa356.409 ◽

2021 ◽

Vol 22 (Supplement_1) ◽

Author(s):

F Bianco ◽

M Colaneri ◽

V Bucciarelli ◽

FC Surace ◽

FC Iezzi ◽

...

Keyword(s):

Quality Of Life ◽

Physical Activity ◽

Aortic Valve ◽

Aortic Surgery ◽

Ross Procedure ◽

Valve Repair ◽

Sf 36

Abstract Funding Acknowledgements Type of funding sources: None. Background To compare long-term outcomes of aortic valve repair (AVr) and pulmonary autograft replacement (Ross procedure) in terms of echocardiographic parameters, quality of life (QoL), physical activity (PA). Methods In 2005-19, 129 patients (median age 22 [13, 33 IQR], 75% males) underwent aortic surgery in our Department: 40 were Ross (22 years [19, 51 IQR]), 67 AVr (17 years [1, 50 IQR]) and 22 aortic valve replacements (52 years [30, 80 IQR]). We focused on Ross and AVr. Retrospectively, relevant data were collected from medical records and phone re-calls. Physical activity (spontaneous and active) and QoL were assessed utilizing the IPAQ and SF-36 questionnaires. All patients underwent echocardiography pre/post-surgery and the follow-up lasted 12 ± 4 years. Results At the baseline, Ross patients had more aortic stenosis than insufficiency (P = 0.045). At the follow-up, Ross procedures presented more right-ventricle and aortic annulus dilatation (P = 0.002 and P = 0.030, respectively), but higher left-ventricular global longitudinal strain (LV GLS: 18 ± 3.2 % vs. 16 ± 3.3, P = 0.0027). Conversely, AVr experienced more re-do operations (Log-rank P = 0.005). Ross reported better QoL (SF-36: 0.8 ± 0.07 vs. 19 ± 0.4, P-0.045) and were also more active in daily PA (IPAQ ≥ 2500 Mets: 63.8% vs. 6%; P = 0.006). Ross patients practiced more sports activities than AVr (P = 0.011). Conclusions In a relatively small cohort of young and adults post aortic surgery patients, Ross procedures had better prognosis in terms of re-do operations; presented better ventricular function, as assessed by LV GLS. Ross patients had better long-term QoL and showed more spontaneous PA and involvement in sports activity.

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Treatment of Injuries of the Lumbar Spine

Bulletin of Science and Practice ◽

10.33619/2414-2948/49/15 ◽

2019 ◽

Vol 5 (12) ◽

pp. 156-162

Author(s):

M. Sabyraliev

Keyword(s):

Surgical Treatment ◽

Lumbar Spine ◽

Spinal Canal ◽

Thoracolumbar Spine ◽

Spinal Injuries ◽

Long Term Results ◽

Results Of Treatment ◽

Post Traumatic

Surgical treatment of patients with spinal injuries, accompanied by traumatic stenosis of the spinal canal, is an urgent and discussed problem of modern vertebrology. Surgical treatment of 111 patients with various injuries of the thoracolumbar spine was performed. In 40 patients, post-traumatic stenosis was eliminated using ligamentotaxis using transpedicular osteosynthesis. The immediate results of treatment were followed up in all patients: good results were obtained in 33 (82.5%) cases; satisfactory — in 6 (15.0%), unsatisfactory — in 1 (2.5%). Long-term results with a follow-up of more than 1 year were followed up in 27 (67.5%) patients; good results were obtained in 20 (74.0%), satisfactory in 7 (25.0%).

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OS09.7.A Quality of life outcomes in patients with incidental and operated meningiomas: the QUALMS study

Neuro-Oncology ◽

10.1093/neuonc/noab180.040 ◽

2021 ◽

Vol 23 (Supplement_2) ◽

pp. ii12-ii13

Author(s):

S M Keshwara ◽

A I Islim ◽

C P Millward ◽

C S Gillespie ◽

G E Richardson ◽

...

Keyword(s):

Quality Of Life ◽

Global Health ◽

Cognitive Functioning ◽

Emotional Health ◽

Health Score ◽

Sf 36 ◽

Eortc Qlq

Abstract BACKGROUND Long-term Health-Related Quality of Life (HRQoL) is an important measure of patient wellbeing. There is a paucity of studies evaluating HRQoL in meningioma patients. MATERIAL AND METHODS Cross-sectional study of adult patients with an incidental or symptomatic intracranial meningioma. Patients with less than 5 years of follow-up, a history of craniospinal radiation or neurofibromatosis type 2 were excluded. HRQoL was evaluated with SF-36, EORTC QLQ-C30 and EORTC QLQ-BN20 questionnaires. Outcome determinants were evaluated using a multi-variable linear regression analysis, adjusted for patient, tumour and treatment characteristics, and duration of follow-up. RESULTS 699 patients were invited to participate and 246 responded: 118 (48%) had an incidental meningioma. Mean age at diagnosis was 56.8 years (SD=13) and 81% were female. Median time from diagnosis to completion of questionnaire was 8.5 years (IQR 6.8–11.5). During follow-up, 158 patients (64.2%) had at least one operation for their meningioma and 47 patients (19.1%) had radiotherapy. Of those operated, 126 (79.7%) had WHO grade 1 and 24 (15.2%) had grade 2 meningiomas. Compared to normative population values, meningioma patients reported a worse SF-36 general health score (mean 61.9 vs 56.5, P=0.003) but a similar QLQ-C30 global health score (mean 62.3 vs 65.8, P=0.039), worse SF-36 and QLQ-C30 physical functioning scores (mean 74.1 vs 64.6, P<0.001 and mean 81.8 vs 76.5, P=0.007) and similar SF-36 and QLQ-C30 emotional health scores (mean 72.2 vs 70.9, P=0.367 and mean 71.0 vs 71.9, P=0.960). QLQ-C30 cognitive functioning was worse (mean 80.5 vs 71.4, P<0.001). Compared to the meningioma literature, QLQ-BN20 seizure burden was similar (mean 2.0 vs 1.6, P=0.760). A worse performance status at diagnosis was associated with an inferior QLQ-C30 global health score (β-coefficient=-4.9 [95% CI -9.1-(-)0.6] P=0.024). Number of surgeries was significantly associated with a worse QLQ-C30 cognitive functioning score (β-coefficient=-7.0 [95% CI -13.2-(-)0.9], P=0.025). Anti-epileptic drug use was associated with a significantly worse QLQ-C30 emotional health score (β-coefficient=-10.9 [95% CI -21.7-(-)0.01], P=0.050). CONCLUSION Meningioma patients have long-term HRQoL impairments affecting their physical and cognitive functions. An understanding that multiple surgeries affects cognitive function, and the need for anti-epileptic drugs equate to poorer emotional health, could help target appropriate therapies and support in the future.

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Mid- and long-term efficacy of surgical treatment of Vancouver B2 and B3 periprosthetic femoral fractures

BMC Surgery ◽

10.1186/s12893-020-00891-9 ◽

2020 ◽

Vol 20 (1) ◽

Author(s):

Jian-Ning Sun ◽

Yu Zhang ◽

Ye Zhang ◽

Jia-Ming Zhang ◽

Xiang-Yang Chen ◽

...

Keyword(s):

Surgical Treatment ◽

Survival Rate ◽

Femoral Fractures ◽

First Year ◽

Femoral Prosthesis ◽

Term Efficacy ◽

Kaplan Meier ◽

Sf 36

Abstract Background The incidence of fractures around the femoral prosthesis among patients undergoing hip arthroplasty is increasing and has become the third leading cause of hip revision. While numerous methods for the surgical treatment of periprosthetic femoral fractures (PFFs) have been proposed, only few reports have examined the long-term efficacy of surgical treatment. This study aims to examine the mid-and long-term efficacy of surgical treatment among patients with Vancouver B2 and B3 PFFs. Methods This retrospective study evaluated the surgical outcomes of patients with Vancouver B2 and B3 PFFs between 2007 and 2011. The minimum follow-up time was eight years. Fracture healing, prosthesis stability, complications, patient quality of life SF-36 score, and survival rate were evaluated during the follow-up assessments. Results A total of 83 patients were included and had an average follow-up period of 120.3 months. Among these patients, 69 were classified as Vancouver B2 and were treated with a distal fixation stem, whereas 14 cases were classified as Vancouver B3 and were treated with modular femoral prosthesis by using a proximal femoral allograft technique. A total of 15 patients underwent secondary revision surgery, and prosthesis dislocation was identified as the main cause of secondary revision. 80 (96.4%) cases of fractures were clinically healed. The mortality rate in the first year after surgery was 8.4% (7/83). The overall 5-year Kaplan–Meier survival rate for these patients was 75.9%. Meanwhile, the 5-year Kaplan–Meier survival rate for the implants was 86.9%. The final follow-up SF-36 score of the patients was 48.3 ± 9.8. Conclusions Patients with Vancouver B2 and B3 PFFs show high mortality in the first year after their surgery, and the Kaplan–Meier analysis results showed that such mortality tends to plateau after 5 years. Prosthesis dislocation was identified as the primary cause of secondary revision.

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13-year Follow-up of Treatment of Osteochondral Lesions with MACI

Foot & Ankle Orthopaedics ◽

10.1177/2473011419s00044 ◽

2019 ◽

Vol 4 (4) ◽

pp. 2473011419S0004 ◽

Cited By ~ 1

Author(s):

Chris Kreulen ◽

Trevor Shelton ◽

Jacqueline Nguyen ◽

Eric Giza ◽

Martin Sullivan

Keyword(s):

Social Functioning ◽

Physical Functioning ◽

Bodily Pain ◽

Long Term Results ◽

Osteochondral Lesions ◽

Sf 36 ◽

Significant Difference ◽

And Function

Category: Ankle, Arthroscopy, Hindfoot, Sports, Trauma Introduction/Purpose: Surgical management of osteochondral lesions of the talus (OLT) present an ongoing treatment challenge. Previously, matrix-induced autologous chondrocyte implantation (MACI) demonstrated improved pain and function at 7-years postoperative, providing evidence that MACI is a reliable method for treating cartilage. However, it is unknown the long- term results of MACI in OLT. The purpose of this study was to assess 13-year clinical follow-up data and the long-term success of this implant by comparing patient reported outcome measures (PROMs) pre-operatively, at 7-years post-operative, and at 13- years post-operative. Methods: A prospective investigation of MACI was performed on 10 patients with OLTs who had failed previous arthroscopic treatment. Of the 10 patients, 9 were available for 7-year and 13-year follow-up. Short Form Health Survey (SF-36) and the American Orthopaedic Foot & Ankle Society (AOFAS) hindfoot evaluation were utilized at pre-operative, 7-year, a 13-year postoperative. For each patient, a paired t-test was used to compare 13-year post-operative PROMs to pre-operative PROMs. A single factor analysis of variance (ANOVA) determined whether PROMs were different between pre-operative, 7-year post- operative, and 13-year post-operative time intervals. When a significant difference was detected, a post-hoc Tukey’s determined which time periods were different. Results: SF-36 data at 13-years showed significant improvements in Physical Functioning (p=0.012), Lack of Bodily Pain (p=0.017), and Social Functioning (p=0.007) compared with preoperative data. There were no differences in other components of the SF-36 outcomes (p>0.05). Although the AOFAS was on average 12 points higher at 13-years postoperative, this was not statistically significant (p=0.173). As for comparing PROMs over time, 13-years post-operative PROMs were comparable to 7-years post- operative (Table 1). There were better PROMs for Physical Functioning, Bodily Pain, and Social Functioning at 7- and 13-years post-operative compared to pre-operative while Physical Role Functioning was also better at 7-years post-operative compared to pre-operative. Conclusion: This study shows MACI provides greater pain relief and function at 13-years post-operative with stable long-term follow-up. MACI should be considered for osteochondral lesions that fail initial microfracture.

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