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Postoperative Quality (postoperative + quality)

Distribution by Scientific Domains

Medical Sciences	100%

Selected Abstracts

Influence of psychopathological changes on quality of life after laparoscopic fundoplication for the treatment of gastroesophageal reflux

DISEASES OF THE ESOPHAGUS, Issue 1 2010
Á. Díaz de Liaño
SUMMARY There are references in medical literature to the influence of psychopathological changes and their negative impact on the results of laparoscopic fundoplication. The objective of this study is to analyze the influence of psychological changes, as assessed by the General Health Questionnaire-28 (GHQ-28), on patients undergoing surgery for gastroesophageal reflux. This is a prospective study in a series of 103 consecutive patients (62 males and 41 females with a mean age of 40 years) undergoing laparoscopic fundoplication. In addition to functional studies, patients completed the SF-36, Gastrointestinal Quality of Life Index, and GHQ-28 before surgery. Functional tests and questionnaires were repeated 6 months after surgery. Patients were also questioned about their degree of satisfaction. Postoperative results of patients with a normal GHQ-28 and patients showing psychopathological changes as defined by the GHQ-28 questionnaire before surgery were compared. Overall, all patients experienced an improvement in their quality of life. Forty-one patients showed a pathological result in the preoperative GHQ-28 questionnaire. No differences were found in functional results and degree of satisfaction with surgery between patients with normal and pathological results in the preoperative GHQ-28 questionnaire. However, patients with a pathological result in the preoperative GHQ-28 had poorer results in all domains of the postoperative Gastrointestinal Quality of Life Index and SF36 quality of life questionnaires as compared to patients with a normal preoperative GHQ-28 questionnaire. Patients with pathological results in the preoperative GHQ-28 had poorer results in terms of postoperative quality of life despite having normal postoperative physiological studies; this decreased quality of life did not have an impact on the degree of satisfaction with surgery performed. The GHQ-28 does not therefore appear to serve as a predictor of postoperative satisfaction. [source]

Long-term outcome of postanal repair in the treatment of faecal incontinence

ANZ JOURNAL OF SURGERY, Issue 9 2005
Saleh M. Abbas
Background: Idiopathic faecal incontinence is a common debilitating problem; the results of surgical treatment are variable with only a small proportion of patients achieving full continence. Objectives: The aim of this study was to evaluate the long-term outcome of postanal repair in idiopathic faecal incontinence. Patients and methods: Patients who had postanal repair in Auckland between 1994 and 2001 were identified and mailed faecal incontinence severity index (FISI) and faecal incontinence quality of life (FIQOL) questionnaires. Preoperative and postoperative incontinence scores were compared and postoperative quality of life scores were calculated. Results: Forty-seven of the 66 patients who had undergone postanal repair from 1994 to 2001 completed the FIQOL questionnaire. FISI scores were complete on 44 patients. Comparison of preoperative and postoperative FISI scores revealed an improvement with mean scores of 34 and 23, respectively (P = 0.0001). Thirty (68%) patients had improved, including four who were fully continent. Fourteen patients were the same or worse. Conclusions: Postanal repair provides lasting benefit for the majority of patients with faecal incontinence. [source]

Prospective evaluation of quality of life in patients with localized oesophageal cancer treated by multimodality therapy or surgery alone

BRITISH JOURNAL OF SURGERY (NOW INCLUDES EUROPEAN JOURNAL OF SURGERY), Issue 9 2006
J. V. Reynolds
Background: Health-related quality of life (HRQL) outcomes are important in assessing new approaches to the treatment of cancer. Neoadjuvant therapy is being used increasingly before surgery in patients with localized oesophageal cancer. This prospective non-randomized study evaluated HRQL in patients treated by preoperative chemotherapy and radiation therapy followed by surgery (multimodal therapy) or by surgery alone. Methods: Data from European Organization for Research and Treatment of Cancer quality of life questionnaires QLQ-30 and QLQ-OES24 were collected prospectively. Questionnaires were completed at diagnosis, after chemoradiotherapy where applicable, and at 3, 6 and 12 months after surgery. Results: The study included 202 consecutive patients with oesophageal cancer considered suitable for curative (R0) resection at the time of staging. Eighty-seven patients received chemotherapy combined with external-beam radiotherapy before surgery. At baseline, 75 (86 per cent) of 87 patients in the multimodal group completed questionnaires, compared with 72 (62·6 per cent) of 115 in the surgery-alone group. There were no significant differences in baseline global HRQL scores between groups. Preoperative chemoradiotherapy significantly reduced physical (P = 0·004) and role (P = 0·007) functioning before surgery, despite a significant (P = 0·043) improvement in the dysphagia score. Oesophageal resection had a negative impact on global, functional and symptom HRQL scores at 3 months in both groups. Most variables had recovered by 6 months in the two groups, but at 12 months physical and role functioning remained impaired in the surgery-alone group, and social functioning and financial worries in the multimodal group. Conclusion: Although the multimodal regimen had a negative impact on HRQL before surgery, postoperative quality of life in patients who had multimodal therapy was similar to that in those who had surgery alone. Copyright © 2006 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd. [source]

Face down posturing for macular hole surgery.

ACTA OPHTHALMOLOGICA, Issue 2009
Is it really required?
Purpose Background: In macular hole surgery pars plana vitrectomy and intravitreal gas injection with or without inner limiting membrane peel, is considered the mainstay of treatment. The requirement for face down posturing is generally regarded as part of the traditional postoperative routine. Several mechanisms have been postulated to explain the action of the gas bubble including exertion of a large floatation force on the macula and prevention of the macular hole exposure to vitreous fluid. Recently the need to face down has been chalenged since this regime compromises patients' postoperative quality of life and it makes macular hole surgery almost impossible for individuals with mental or physical limitations. Methods Review of personal data and systermatic literature review of studies investigating macular hole surgery with shortened or eliminated face down posturing. Results There is considerable body of evidence suggesting successful anatomical and functional outcome in patients with shorter duration of posturing or no posturing at all following macular hole surgery. The pros and cons of each technique will be presented in detail. Conclusion Prone posturing following macular hole surgery provides no functional or anatomic benefit but it is associated with slower progression of cataract. Combined phacovitrectomy without face down positioning may be considered for phakic patients undergoing macular hole surgery. [source]