scholarly journals Evaluation of Functional Outcomes and Quality of Life in Elderly Patients (>75 y.o.) Undergoing Minimally Invasive Radical Cystectomy with Single Stoma Ureterocutaneostomy vs. Bricker Intracorporeal Ileal Conduit Urinary Diversion

2021 ◽  
Vol 11 (1) ◽  
pp. 136
Author(s):  
Andrea Fuschi ◽  
Yazan Al Salhi ◽  
Manfredi Bruno Sequi ◽  
Gennaro Velotti ◽  
Alessia Martoccia ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Minimally Invasive ◽  
Elderly Patients ◽  
Radical Cystectomy ◽  
Ileal Conduit ◽  
Elderly Subjects ◽  
Group A ◽  
The Mean ◽  
Group B

Background: Diversion after radical cystectomy (RC) is crucial when considering elderly subjects. Data on the quality of life (QoL) impact with different diversions is scarce. This study aims to compare complications and QoL in patients aged > 75 y.o., who underwent minimally invasive (MI) RC with Bricker intracorporeal urinary derivation and single stoma ureterocutaneostomy. Methods: We conducted a retrospective analysis of elderly patients who underwent MIRC and intracorporeal diversion. The 78 subjects were divided into two groups: group A, ileal conduit, and group B, single stoma ureterocutaneostomy. We evaluated the bowel’s recovery time and complications rate. We investigated QoL 3 and 6 months after surgery using the Stoma-QoL questionnaire. Results: Mean age was 77.2 in group A and 82.4 in group B. The mean ASA score and Charlson Comorbidity index were comparable between the two groups. Rates of complications were 57.6% and 37.4% in groups A and B, respectively. The mean postoperative Stoma-QoL score 3 months after surgery was 52.2 and 52.4 in groups A and B, respectively. At 6 months of follow-up the Stoma QoL mean score was 63.4, showing homogeneity between the groups. Conclusion: MIRC with single stoma ureterocutaneostomy represents an alternative to ileal conduit, with comparable QoL and ostomy management 6 months after surgery, reporting fewer complications.

scholarly journals Quality of Life and Renal Functional Status In Patients With Cutaneous Ureterostomy and Ileal Conduit Urinary Diversion after Radical Cystectomy

2020 ◽  
Vol 23 (2) ◽  
pp. 142-150
Author(s):  
Subrata Deb ◽  
Md Golam Mowla Chowdhury ◽  
Mohammad Shafiqur Rahman ◽  
Mohammad Salahuddin Faruque ◽  
Ashraful Islam ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Renal Function ◽  
Radical Cystectomy ◽  
Urinary Diversion ◽  
Ileal Conduit ◽  
Group A ◽  
Muscle Invasive ◽  
Group B ◽  
Cutaneous Ureterostomy

Introduction: Radical cystoprostetectomy in male patients and anterior pelvic exenteration in female patients coupled with en-block pelvic lymphadenectomy and urinary reconstruction or diversion remains the gold standard surgical approach to muscle invasive bladder cancer in the absence of metastatic disease. In Bangladesh, commonly performed urinary diversions are Cutaneous ureterostomy and Ileal conduit. Types of urinary diversion have a great impact on different aspects of quality of life (QoL) as well as post -operative renal function. Aims and Objectives: This study was designed to compare the Quality of Life and Renal Function in between Cutaneous ureterostomy and Ileal conduit urinary diversion after radical cystectomy. Methodology: This was a hospital based Quasi Experimental study in which patients were selected by purposive sampling and, conducted from July, 2017 to September, 2018 in the department of Urology Bangabandhu Sheikh Mujib Medical University. This study was performed among the patients with muscle invasive bladder cancer treated by radical cystectomy with cutaneous ureterostomy or Ileal conduit fulfilling the exclusion and inclusion criteria. Total 34 patients were taken for the study, among them 17 for cutaneous ureterostomy and, 17 for Ileal Conduit Group. Quality of Life was assessed through EORTC-QLQ-C30 questionnaire both pre and post operatively (3 months after operation). Renal function was assessed before and 1st POD, 7thPOD, one month and three months after operation by measuring eGFR. Result: Mean age of the patients was 59.00 ± 8.60 years and 53.35 ± 8.43years in group- A (Cutaneous ureterostomy) and group-B (Ileal conduit) respectively. Three months after operation, overall QoL in all scales were improved in both group but, more improvements were noted in group-B than group-A which were statistically significant (p<0.05). The mean pre-operative eGFR was significantly lower in group-A than group-B (p<0.001). Three months after operation, statistically significant differences in eGFR, were observed within, and in between two groups (p<0.05). Percentage of eGFR changed (renal function deterioration) were significantly more in group-A than group-B (p=0.001). Conclusion: Quality of life, after radical cystectomy with ileal conduit is better than cutaneous ureterostomy and, post- operative renal function deterioration significantly less in ileal conduit group than cutaneous ureterostomy group. So, ileal conduit is an appropriate option of urinary diversion for the patient those who permit prolong operative procedure. Bangladesh Journal of Urology, Vol. 23, No. 2, July 2020 p.142-150

Morbidity and Quality of Life in Elderly Patients Receiving Ileal Conduit or Orthotopic Neobladder After Radical Cystectomy for Invasive Bladder Cancer

Urology ◽  
2008 ◽  
Vol 71 (5) ◽  
pp. 919-923 ◽  
Author(s):  
Filippo Sogni ◽  
Maurizio Brausi ◽  
Bruno Frea ◽  
Carlo Martinengo ◽  
Fabrizio Faggiano ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Bladder Cancer ◽  
Elderly Patients ◽  
Radical Cystectomy ◽  
Ileal Conduit ◽  
Invasive Bladder Cancer ◽  
Orthotopic Neobladder

Quality of life assessment in patients above 60, below 50 years of age during and after curative radiotherapy in head and neck cancers

2006 ◽  
Vol 24 (18_suppl) ◽  
pp. 5552-5552 ◽  
Author(s):  
A. Turaka ◽  
B. K. Mohanti ◽  
S. Chander ◽  
S. V. Deo ◽  
R. Jena ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Elderly Patients ◽  
Phase I ◽  
Head And Neck ◽  
Phase Ii ◽  
Younger Patients ◽  
Curative Radiotherapy ◽  
Group A ◽  
Group B

5552 Background: To evaluate the Quality of life in patients above 60 and below 50 years during and after curative radiotherapy in head and neck cancers. Methods: Head and Neck cancer patients who are to undergo curative radiotherapy (RT) were divided into two groups, 49 patients (Group A,above 60 years) and 40 patients (Group B,below 50). Quality of life assessment was done using EORTC QLQ C-30 version-2 at 4 phases;Pretreatment-Phase I,during RT-Phase II,1-month post RT-Phase III and 6 months post RT-Phase IV.Statistical analysis was done with mean scores using ’t’ test. Results: Physical functioning (PF)scores in both groups were highest in phase I (69.4;77.5, p < 0.035) and lowest in phase II (40; 50, p < 0.008) and the difference was statistically significant. Although PF scores declined in both groups in phase II, overall PF score remained higher in group B than in group A in all phases.Role functioning score remained low in both groups and the difference were not statistically significant at all phases. Emotional functioning score was highest in phase I (68.37; 69.15), but declined as treatment progressed, consequent to depression.The values improved over time, restored to near pretreatment values at phase IV. Cognitive functioning scores in both groups was also highest in phase I (70.07; 79.17). Social functioning of both groups declined during RT (42.52; 45)compared to pre RT values (73.47; 77.09). The mean Global Health Status score was higher in group B compared to group A at all phases, yet there was no statistical significance.The scores declined during RT (66.87 vs 35.62 & 64.79 vs 34.01), improved overtime but did not reach pre RT scores.The symptom scores were all higher for elderly patients compared with younger patients at all phases, implying elderly patients experienced more symptoms, with greater experience of symptoms during RT. Conclusions: Quality of Life of elderly patients was lower compared to younger patients at phase II in terms of physical functioning, social and emotional functioning. Global Health Status score was higher for younger patients than elderly at all phases, and declined in phase II. No significant financial relationships to disclose.

scholarly journals Impact of uterine contractility on quality of life of women undergoing uterine fibroid embolization

2019 ◽  
Vol 2 (1) ◽  
Author(s):  
Vinicius Adami Vayego Fornazari ◽  
Gloria Maria Martinez Salazar ◽  
Stela Adami Vayego ◽  
Thiago Franchi Nunes ◽  
Belarmino Goncalves ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Sexual Function ◽  
Uterine Fibroid ◽  
Life Questionnaire ◽  
Uterine Contractility ◽  
Uterine Fibroid Embolization ◽  
Group A ◽  
The Mean ◽  
Group B

Abstract Background Although changes in uterine contractility pattern after uterine fibroid embolization (UFE) has already been assessed by cine magnetic resonance imaging (MRI), their impact on quality of life outcomes has not been evaluated. The purpose of this study was to evaluate the impact of uterine contractility on the quality of life of women undergoing UFE measured by the Uterine Fibroid Symptom and Quality of Life questionnaire (UFS-QOL). Results A total of 26 patients were included. MRI scans were acquired 30–7 days before and 6 months after UFE for all patients. The UFS-QOL was applied in person on first MRI exam day and 1 year after UFE and the outcomes were analyzed according to the groups of evolution pattern of uterine contractility: Group A: Unchanged Uterine Contractility Pattern, 38%; Group B: Favorable Modified Uterine Contractility Pattern, 50%; and Group C: Loss of Uterine Contractility, 11%. All UFE patients presented a reduction in the mean score for symptoms and increase in mean scores on quality of life. All patients in this cohort presented a reduction in mean symptom score and increase in the mean score of quality of life subscales. Group A had more relevant complaints regarding their sense of self-confidence; Group B presented worse sexual function scores before UFE, which improved after UFE compared to Group A. Conclusions Significant improvement in symptoms, quality of life, and uterine contractility was observed after UFE in women of reproductive age with symptomatic fibroids. Functional uterine contractility seems to have a positive impact on quality of life and sexual function in this population. Level of evidence Level 3, Non-randomized controlled cohort/follow-up study.

Quality of Life in Elderly Continuous Ambulatory Peritoneal Dialysis Patients

2003 ◽  
Vol 23 (2_suppl) ◽  
pp. 95-98 ◽  
Author(s):  
Ai-wu Lin ◽  
Jia-qi Qian ◽  
Qi-ang Yao ◽  
Ai-ping Gu
Keyword(s):  
Quality Of Life ◽  
Peritoneal Dialysis ◽  
Elderly Patients ◽  
Serum Albumin ◽  
Lipid Profile ◽  
Short Form ◽  
Sf 36 ◽  
Group A ◽  
Group B

Objective In the present study, we determined the characteristic of quality of life (QOL) in elderly peritoneal dialysis (PD) patients by using the Medical Outcomes Study Short Form 36 (SF-36) to compare QOL between two age groups of continuous ambulatory PD patients. Patients and Methods Patients were allocated to one of two groups according to age: patients in group A were ≥65 years of age, and patients in group B were <65 years of age. We compared SF-36 scores, serum albumin, prealbumin, hemoglobin, lipid profile, normalized protein catabolic rate (nPCR), dialysis adequacy (Kt/V), creatinine clearance (CCr), and glomerular filtration rate (GFR) between the two groups. Results Group A contained 25 patients, and group B, 53 patients. Mean age in the two groups was 68.6 ± 3.3 years and 47.7 ± 10.2 years respectively. Elderly patients showed lower QOL scores with regard to physical problems. Quality-of-life scores with regard to psychological problems were similar in the two groups. Duration of PD, body mass index, serum albumin, prealbumin, hemoglobin, and lipid profile were not different between the two groups. However, nPCR, GFR, and total solute clearance were lower in group A than in group B (nPCR: 0.70 ± 0.13 g/kg daily vs 0.95 ± 0.21 g/kg daily, p < 0.001; GFR: 1.03 ± 1.21 mL/min vs 3.19 ± 2.22 mL/min, p < 0.001). Conclusions In elderly patients, QOL scores were lower, mainly because of a perception of being more physically impaired. Nutritional indices and QOL scores reflecting psychological processes were similar between the two groups. These descriptive data show that PD is an ideal choice in elderly patients with end-stage renal disease. More attention needs to be paid to “healthy start” dialysis and maintenance of nutritional status in elderly patients because of lower GFR and nPCR.

scholarly journals Clinically relevant results of reverse total shoulder arthroplasty for patients younger than 65 years compared to the older patients

Arthroplasty ◽  
2021 ◽  
Vol 3 (1) ◽  
Author(s):  
Klaus Hanisch ◽  
Michael Boelstoft Holte ◽  
Inge Hvass ◽  
Niels Wedderkopp
Keyword(s):  
Quality Of Life ◽  
Shoulder Arthroplasty ◽  
Older Patients ◽  
Total Shoulder Arthroplasty ◽  
Reverse Total Shoulder Arthroplasty ◽  
Group A ◽  
The Mean ◽  
Group B ◽  
Reverse Total Shoulder

Abstract Background Reverse total shoulder arthroplasty was originally designed for older patients with rotator cuff arthropathy and produces good results. The main objective of this retrospective study was to compare the patients younger than 65 years vs. the older patients in terms of the complications of reverse total shoulder arthroplasty and the functional recovery. Methods From January 2014 to January 2020, 566 patients who underwent the reverse total shoulder arthroplasty were divided into two groups (group A, ≥ 65 years, n = 506; group B, < 65 years, n = 60). The patients reported the quality of life using the patient-reported Western Ontario Osteoarthritis of the Shoulder index. The Constant score was obtained preoperatively and 3 months postoperatively. The complications and reoperations were compared. Statistical significance was set at P < 0.05. Results Clinically relevant improvements were found in group A and B. There was a multivariate statistically-significant but not clinically relevant difference in the change over time between group A and B. The mean 12-month Western Ontario Osteoarthritis of the Shoulder indexes were 58 in group B and 71 in group A. The mean Constant scores were 44 in group B vs. 43 in group A. Compared to group A, group B had a non-significant odds ratio of 1.9, which did not reach the clinically relevant Western Ontario Osteoarthritis of the Shoulder index of group A. Conclusion In patients younger than 65 years of age, RTSA seems to be a safe procedure in short term follow-up. After 1 year, we found no increased risk of complications, revision, or inferior outcomes compared to patients older than 65 years of age. Consequently, after one-year, RTSA provided clinically relevant improvements in the patients’ quality of life and shoulder strength regardless of age.

Complications and quality of life in elderly patients with several comorbidities undergoing cutaneous ureterostomy with single stoma or ileal conduit after radical cystectomy

2016 ◽  
Vol 118 (4) ◽  
pp. 521-526 ◽  
Author(s):  
Nicola Longo ◽  
Ciro Imbimbo ◽  
Ferdinando Fusco ◽  
Vincenzo Ficarra ◽  
Francesco Mangiapia ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Elderly Patients ◽  
Radical Cystectomy ◽  
Ileal Conduit ◽  
Cutaneous Ureterostomy
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