Comparative analysis of the quality of life of patients with some methods of surgical treatment of vasomotor rhinitis

Author(s):  
Alexey Rasulov ◽  
Saifutdin Arifov

Quality of life (abbr. – QOL) is a category with which it characterizes the essential circumstances of the life of the population, determining the degree of dignity and freedom of the personality of each person and a subjective indicator when evaluating the results of treatment of chronic diseases. To determine the quality of life of patients with cavity problems and SNPs, such as rhinitis and sinusitis, special questionnaires have been created, translated into Russian and adapted. The purpose of this study is to examine in a comparative aspect the indicators of the quality of life of patients with vasomotor rhinitis with various treatment methods. Materials and Methods: The study was conducted in the clinic of the Department of Otorhinolaryngology of the Tashkent institute of postgraduate medical education on 43 patients with vasomotor rhinitis in age from 20 to 46 years, average age 28±1.3 years. All patients with BP included in our study, after collecting complaints and anamnesis, underwent an endoscopic examination of the nasal cavity and nasopharynx, a computerized tomogram of the nose and paranasal sinuses, standard laboratory tests and microscopy of a smear from the nasal cavity on eosinophils. Evaluation of QOL was performed according to a special questionnaire Mini Rhinoconjunctivitis Quality of Life Questionnaire (MiniRQLQ). Results: Studies have shown the highest efficiency of laser coagulation with vasomotor rhinitis. After laser surgery, a rapid improvement in QOL was observed, and there was no adverse effect on the mucous membrane of the nasal cavity. Given the well-tolerated laser coagulation, the lack of the need for observation and care of the nasal cavity in the postoperative period, the possibility of outpatient treatment, allows us to recommend this type of exposure as the method of choice in the surgical treatment of patients with vasomotor rhinitis. However, the need for special equipment and the availability of trained personnel who have access to work with laser systems somewhat limits the widespread use of this method. The simplicity of submucosal vasotomy, the availability of tools for carrying out, the rather rapid restoration of QOL, puts it on a par with the laser effect on efficiency. The need to use nasal tampons after surgery, hospital stay and patient monitoring in the early postoperative period reduces the patients' QL and makes this operation strictly inpatient. In our study, electrocautery demonstrated the lowest rate of improvement in QOL than during laser irradiation and submucous vasotomy. The most slow and incomplete restoration of QOL in this method of treatment emphasizes the disadvantage of this method from the point of view of the patient's QOL. Conclusion: Evaluation of the long-term results of surgical treatment of QL and clinical manifestations of BP makes it possible to recommend laser coagulation as the most optimal method providing a long-lasting effect in treating patients with BP. An alternative is to take a submucous vasotomy of the inferior nasal concha.

Author(s):  
Saifutdin Arifov ◽  
Alexey Rasulov

Among chronic forms of rhinitis of great importance is vasomotor rhinitis, which is the most common form of chronic non-allergic rhinitis and the clinician has to deal with it constantly. Treatment of vasomotor rhinitis is a complex and largely unresolved problem, which puts this disease among the important problems of modern rhinology. The variety of methods used in the treatment of patients with vasomotor rhinitis confirms the complexity of the task of choosing the optimal method for clinicians and the difficulty of obtaining a sustainable result from the chosen method. Surgical treatment of patients with of patients with various forms of chronic rhinitis is sometimes the only effective. Currently, the arsenal of methods and means of surgical treatment of the nasal concha is quite wide and varied. The purpose of this study – to study in a comparative aspect the functional state of the nasal cavity after carrying out some methods of surgical treatment ofvasomotor rhinitis. Materials and Methods: The study was conducted in the clinic of the Department of Otorhinolaryngology of the Tashkent institute of postgraduate medical education on 43 patients with vasomotor rhinitis in age from 20 to 46 years, average age 28,0±1,3 years. All patients with BP included in our study, after collecting complaints and anamnesis, underwent an endoscopic examination of the nasal cavity and nasopharynx, a computerized tomogram of the nose and paranasal sinuses, standard laboratory tests and microscopy of a smear from the nasal cavity on eosinophils.Investigated the respiratory (computer rhinopneumocotachometry), transport (saccharin test) functions of the nasal mucosa, performed an adrenaline test and the Flour test (determination of the consistency of inferior nasal concha and the response to pushing with a push-button probe). Results: Studies have shown the highest efficiency of laser coagulation with vasomotor rhinitis. After laser surgery, a long-lasting and sustained improvement in the functions of the nasal cavity was noted, while there was no adverse effect on the mucous membrane of the nasal cavity, which was reflected in the recovery rates of both nasal breathing and mucociliary clearance. Given the well-tolerated laser coagulation, the lack of the need for observation and care of the nasal cavity in the postoperative period, the possibility of outpatient treatment, allows us to recommend this type of exposure as the method of choice in the surgical treatment of patients with vasomotor rhinitis. The simplicity of submucosal vasotomy, the availability of instruments for carrying out, the restoration of free nasal breathing and the positive effect on the functional state of the nasal cavity, although slower than laser coagulation, minimal side effects put it on a par with the laser effect. The need to use tampons after surgery reduces the quality of life of patients, hospital stays and the need to monitor patients in the early postoperative period makes this operation strictly inpatient. Electrocautery of inferior nasal concha demonstrated in our study a negative effect on the function of the nasal cavity, although, of course, there was a definite improvement in nasal breathing, but the severity and speed of improvement was significantly less than during laser exposure and submucosal vasotomy. The slowest and most incomplete restoration of the mucociliary clearance of the nasal cavity once again underlines the disadvantage of this method. Conclusion: Evaluation of the long-term results of surgical treatment based on the combination of effects on the respiratory and transport functions of the nasal cavity, as well as on the clinical manifestations of BP, makes it possible to recommend laser coagulation as the most optimal method providing a long-lasting effect in treating patients with vasomotor rhinitis. Alternatively, you can take a submucosal vasotomy of the inferior nasal concha.


2015 ◽  
Vol 174 (5) ◽  
pp. 32-34
Author(s):  
I. N. Zubarovskiy ◽  
M. V. Mikhailova ◽  
S. K. Osipenko

The article analyzed an experience of treatment of 51 patients with follicular tumors. It was proved, that there weren’t any complications and recurrences in case of typically performed operation and adequate replacement therapy in postoperative period. It was noted a good quality of life from 2 to 5 years.


2021 ◽  
Vol 9 (2) ◽  
pp. 153-162
Author(s):  
Dmitry N. Kokushin ◽  
Michael A. Khardikov ◽  
Sergey V. Vissarionov ◽  
Vera V. Sokolova ◽  
Nikita O. Khusainov ◽  
...  

BACKGROUND: Congenital scoliosis with disorders of the formation of the vertebrae is the most common cause of pronounced deformities of the spine in early childhood. This pathology can be treated surgically using various techniques that differ in invasiveness, severity of the condition in the postoperative period, achieved result of deformity correction, and nature of the long-term prognosis. Numerous studies have assessed the quality of life of patients who underwent surgery for acquired deformities, trauma, and degenerative and neoplastic diseases of the spine in adults. However, features of the childs quality of life following surgical technique for congenital scoliosis have not been sufficiently studied. AIM: This study aimed to compare the quality of life of children with congenital scoliosis of the thoracolumbar localization after extirpation of the hemivertebra from the dorsal and combined approaches. MATERIALS AND METHODS: An intergroup prospective analysis of the results of a survey of 60 patients with congenital deformity of the spine against the background of an isolated violation of the formation of the thoracic or lumbar vertebra was carried out. Patients underwent standard surgical treatment. Patients were divided into two groups according to the surgical approach to the abnormal vertebral body: dorsal group (n = 28) and combined group (n = 32). The average age of the patients was 75 (minmax, 26196) months. The follow-up period was 18 months after surgery. To assess the quality of life, a specialized Russian version of the PedsQL v4.0 questionnaire and a modified visual analog scale were used. RESULTS: After surgical treatment of congenital spinal deformity, quality of life indicators decreased more than two times than the results of a preoperative survey. At 18 months postoperatively, the physical activity and psychoemotional state were restored to the preoperative level, while patients of the combined group had a higher satisfaction score on the quality of life (p 0.05). CONCLUSIONS: The combined approach provides the best correction of congenital deformity of the spine and allows maintaining of the achieved result throughout the observation period. In the early postoperative period, the combined group demonstrated a significant decrease in the level of satisfaction with the quality of life, while the pain syndrome was higher than that in the dorsal group. Dynamic observation revealed the leveling of these differences and a subsequent increase in the level of satisfaction with the quality of life of these patients.


10.12737/6454 ◽  
2014 ◽  
Vol 8 (1) ◽  
pp. 0-0
Author(s):  
Антонов ◽  
A. Antonov

Use elixir Altai ("Vitavis") in combination with ion-activated with water by means of such a complex contingent cancer patients as patients with metastatic bone fractures of the upper and lower limbs can reduce the early postoperative period, and to reduce to a minimum infectious complications and improve quality of life. The problem of postoperative complications, until now, is not solved. In oncologic patients, and those more in by III and As IV stages occurs it immunnodefitsit, which is caused not only by basic disease, but also by conse-quences of khimio- beam therapy. In connection with this appears the difficulty in the surgical treatment, caused by postoperative complications. As a result surgical treatment appears surgical injury, oxidizing stress, disturbance of homeostasis and oppression of immunity, which leads to an even larger disturbance of immunity in oncologic patients, which decreases the unspecific resistibility of organism. The application of adaptogena of the elixir of Altai (“Vitavis”) in combination with the ionic- activated aqueous means makes it possible to level and to reduce on no oxidizing stress, to increase the unspecific resistibility of the organism of oncologic patient and to increase immuni-ty. Moreover, powerful antioxidant - the ionic- activated aqueous means strengthens the action of adaptogena of the elixer of Altai (“Vitavis”), which leads to the decrease of postoperative infectious complications, reduces postoperative period, improves the quality of life and enlarges indications to the surgical treatment in oncologic patients with III it and IV by the stages of diseases.


2007 ◽  
Vol 25 (36) ◽  
pp. 5723-5730 ◽  
Author(s):  
Martin J.B. Taphoorn ◽  
Martin J. van den Bent ◽  
Murielle E.L. Mauer ◽  
Corneel Coens ◽  
Jean-Yves Delattre ◽  
...  

Purpose Little is known about the health-related quality of life (HRQOL) of patients treated for anaplastic oligodendrogliomas. The impact of combined procarbazine, CCNU (lomustine), and vincristine (PCV) chemotherapy after radiotherapy (RT) compared with RT alone on HRQOL in the randomized European Organisation for Research and Treatment of Cancer (EORTC) 26951 trial was studied. Patients and Methods Adult patients with anaplastic oligodendrogliomas received RT alone or RT plus PCV chemotherapy. HRQOL was assessed with the EORTC Quality of Life Questionnaire C30 and Brain Cancer Module. Seven prespecified HRQOL end points were selected. We hypothesized that chemotherapy would impair HRQOL during treatment but that there would be a similar HRQOL between treatment arms once off treatment. Assessments were performed at randomization, at the end of RT, and then every 3 to 6 months until progression. Results A total of 368 patients were randomly assigned to one of the two arms; overall, 58% were male, and the median age was 49 years. Compliance with HRQOL was 78% at baseline and dropped to 55% to 72% up to 2.5 years post-RT. Baseline scores demonstrated considerable impairments in HRQOL for both treatment groups. The longitudinal analysis showed a significant increase in nausea/vomiting in the RT plus PCV chemotherapy arm during and shortly after chemotherapy. Because of a difference in baseline scores for fatigue and physical functioning, the differences between treatment arms during PCV did not reach significance. The nonselected scales of appetite loss and drowsiness demonstrated significant differences between treatment arms during chemotherapy in favor of the RT arm. The long-term results showed no difference between arms. Conclusion The major impact of PCV on HRQOL is on nausea/vomiting, loss of appetite, and drowsiness during and shortly after treatment. There are no long-term effects of PCV chemotherapy.


2019 ◽  
Vol 21 (1) ◽  
pp. 140-143
Author(s):  
V V Parshin ◽  
B R Gvasalia ◽  
D I Stegantsev ◽  
A S Esipov ◽  
A D Kochetov

Objective.Radical prostatectomy (RPE) performed without preserving the neurovascular bundles and the pubovesical complex has a great risk of developing urinary incontinence and erectile dysfunction, which significantly impairs the quality of life of patients with prostate cancer in the postoperative period. Methods. The effectiveness of surgical treatment was assessed in 22 patients (mean age 57.6 ± 6.4 years) with a diagnosis of prostate cancer, who underwent extraperitoneoscopic intrafascial nerve-saving radical prostatectomy with preservation of the pubovesical complex. The criteria for the effectiveness of this technique of surgical treatment were considered the preservation of erectile function and the absence of urinary incontinence in the early and late postoperative period. Results. In the postoperative period, all patients were continent; in 3-4 months, erectile function was restored without additional stimulation by phosphodiesterase-5 inhibitors. Conclusions.The described technique demands detailed understanding by the surgeon of the surgical anatomy of the prostate and the basic surgical principles of nerve preservation in order to significantly improve the quality of life of patients in the postoperative period.


2021 ◽  
Vol 67 (2) ◽  
pp. 40-48
Author(s):  
A. V. Ogorodnikov ◽  
S. S. Kharnas

BACKGROUND. Primary hyperparathyroidism (PGPT) is an increase in the secretory activity of the parathyroid glands (OSH), due to their tumor or hyperplastic changes. Due to the lack of an effective alternative to the treatment of PGPT, the surgical method is still the only correct tactical solution for the management of patients with an established diagnosis of PGPT. The paper presents the long-term results and assessment of the quality of life of patients who underwent surgical treatment from standard and small access. The results obtained showed the promise of a sparing approach to the treatment of PGPT caused by LV adenoma.AIM. To study the effectiveness of surgical treatment of patients with PGPT based on the assessment of the quality of life of patients who underwent parathyroidectomy from standard and small access.MATERIALS AND METHODS. A retrospective study of the quality of life of patients with PGPT after surgical treatment was conducted using the SF-36 questionnaire and the linear analog scale (LAS). Statistical data processing is performed in the R programming language using the FMSB package. The quantitative parameters were presented as median (Median) and interquartile range (25th (1st Qu) — lower quartile and 75th (3rd Qu ) — upper quartile). As a nonparametric statistical criterion, the Mann–Whitney U-test was used, on the basis of which the p-value was calculated. The calculated data of the research results are presented in graphical form — in the form of bar charts, spider plot and barplot.RESULTS. This study involved 264 patients. The patients were divided into 2 groups: GR1 — patients operated from the Kocher access with mandatory revision of all 4 OSH, GR2 — patients who received surgical treatment from the small access with the removal of the altered OSH, without revision of the remaining OSH. When analyzing the quality of life of patients before surgery, there were no statistically significant differences in the groups in terms of PF (Physical Functioning) and VT (Vitality). Small-access parathyroidectomy (patients with GR 2) significantly improved the quality of life in the GH (General Health) and VT (Vitality) domains. The analysis of LAS before surgery between the groups showed no statistically significant differences, while after surgical treatment, the indicators on the linear analog scale differ in the direction of improvement in GR2.CONCLUSION. The results obtained in the course of the study showed the promise of a gentle approach to the treatment of PGPT caused by LV adenoma, which is reflected in higher quality of life indicators.


2017 ◽  
Vol 98 (5) ◽  
pp. 709-713
Author(s):  
S V Tarasenko ◽  
A A Natal’skiy ◽  
O V Zaytsev ◽  
S N Sokolova ◽  
A Yu Bogomolov ◽  
...  

Aim. Comparative analysis of the long-term results of surgical treatment of patients with chronic pancreatitis. Methods. The study included patients with complicated clinical forms of chronic pancreatitis including: ductal pancreatic hypertension, main pancreatic duct concrements, marked fibrous restructuring of the pancreatic parenchyma and presence of calcifications, presence of biliary hypertension, portal hypertension syndrome, duodenostasis syndrome, chronic abdominal pain syndrome, retention and post-necrotic cysts. Patients were divided into 3 groups: group 1 included patients with chronic pancreatitis receiving conservative treatment (n=32), group 2 - patients who underwent the Frey pancreatic resection (n=24) and group 3 - Beger pancreatic resection (n=9). The assessment was performed according to the most spread specific questionnaire in gastroenterology GSRS (Gastrointestinal Symptom Rating Scale). Results. The quality of life of patients who underwent both Frey and Beger pancreatic resection was significantly higher than the quality of life of patients in whom chronic pancreatitis was treated conservatively. Quality of life of patients who underwent Frey or Beger pancreatic resection did not differ significantly. Malabsorption syndrome has a significant effect on the quality of life of patients who underwent surgical treatment of chronic pancreatitis. The GSRS questionnaire demonstrated low sensitivity in detecting malabsorption syndrome. Conclusion. Quality of life of patients who underwent surgical treatment of chronic pancreatitis is statistically significantly higher than in patients receiving conservative treatment; correction of existing quality of life questionnaires is required in order to identify malabsorption syndrome.


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