Gastrointestinal Quality Of Life Index Score Research Articles

Laparoscopic cholecystectomy plus common bile duct exploration for extrahepatic bile duct stones and postoperative recurrence-associated risk factors

BACKGROUND There remain controversies regarding the surgical treatment of extrahepatic bile duct stones (EHBDSs) in clinical practice. AIM To explore the curative effect of laparoscopic cholecystectomy (LC) plus common bile duct exploration (CBDE) for the surgical treatment of EHBDSs and to analyze the risk factors that affect postoperative stone recurrence. METHODS Eighty-two patients with EHBDSs admitted between March 2017 and March 2023 were selected. Among them, patients treated with open choledocholithotomy plus LC or open cholecystectomy (OC) were set as the control group (n = 40), and those treated with LC plus CBDE served as the observation group (n = 42). The surgical outcomes of the two groups were compared, the surgical complications and Gastrointestinal Quality of Life Index (GIQLI) scores were counted, and the one-year prognostic recurrence was recorded. Independent factors for postoperative recurrence were determined using univariate and multivariate analyses. RESULTS The two groups were comparable in the stone residual rate (P > 0.05). The operation time (P < 0.05), intraoperative bleeding (P < 0.05), and total complication rate (P = 0.005) were lower in the observation group than in the control group. The observation group exhibited a marked increase in the GIQLI score, which was higher than the control group (P < 0.05). A lower one-year recurrence rate was determined in the observation group vs the control group (P = 0.027). Sphincter of Oddi dysfunction [odds ratio (OR) = 5.712, P = 0.007] and the treatment scheme of open choledocholithotomy plus LC or OC (OR = 6.771, P = 0.008) were the independent risk factors for one-year recurrence in patients after surgery. CONCLUSION LC plus CBDE for patients with EHBDSs can reduce stone residuals, intraoperative bleeding, complications, and postoperative recurrence.

Oncological right hemicolectomy in a trimodal comparison: open surgery versus laparoscopic procedures with extra- and intracorporeal anastomosis technique.

This study aimed to investigate the surgical short- and mid-term outcomes, as well as the impact on quality of life and recovery, following oncological right hemicolectomy. To accomplish this, three patient cohorts were examined, which included laparotomy OA), laparoscopy with intracorporeal anastomosis (LIA), and laparoscopy with extracorporeal anastomosis (LEA). Our hypothesis was that the group undergoing intracorporeal anastomosis would demonstrate superior outcomes compared to the other cohorts. The analysis included a total of 135 patients who were enrolled between 2015 and 2020. In addition to retrospectively collected data, we conducted follow-up surveys using a validated Gastrointestinal Quality of Life Index (GIQLI) questionnaire and semi-structured interviews. These surveys were conducted between July and September 2021 to gather comprehensive information regarding the patients' quality of life. The study cohort was divided into OA (n = 67), LEA (n = 14), and LIA (n = 54). The duration of surgery was significantly longer in the laparoscopic groups (median = 200.5 (LEA) and 184.0 (LIA) min vs 170.0 min (OA); p = 0.007), while the length of hospital stay was significantly shorter (median = 6.0 and 7.0 days vs 9.0 days; p = 0.005). The overall postoperative complication rate was significantly higher in the laparotomy group compared to the intracorporeal group (64.2% vs 35.2%; p = 0.006), with the extracorporeal group having a rate of 42.9%. Reoperation within 30 days occurred exclusively in the open surgery group (n = 9; 13.43%; p = 0.007). The overall response rate to the survey was 75%. Overall, the GIQLI score was comparable among the three groups, and there were no significant differences in the questions related to recovery, regained function, and contentment. The laparoscopic approaches demonstrated significantly lower complication rates compared to laparotomy, while no significant differences were observed between the two laparoscopic techniques.

Long-term motor activity, cardiopulmonary performance and quality of life in abdominal wall defect patients

AimTo assess whether patients born with an abdominal wall defect (AWD) have impaired cardiorespiratory performance capacity, motor skills, core stability or quality of life in a long-term follow up.MethodsPatients diagnosed with AWD between 2002 and 2013 were invited to participate in the study, which included clinical examination, spirometry, cardiopulmonary exercise performance testing, assessment of motor activity, ultrasound, electromyography of the abdominal wall and assessment of the Gastrointestinal Quality of Life Index (GIQLI). The results were compared to a healthy control group matched for age, sex, BMI, and physical activity levels.ResultsIn total, 18 AWD patients (mean age 12.6 ± 3.5 years) were included and there were no significant differences in anthopometric data compared to the control group (n = 18). AWD patients had a significantly lower GIQLI score (AWD mean 137.2 ± 6.8 vs. control mean 141.4 ± 4.9; p = 0.038) and were affected by decreased motor abilities with significantly higher Dordel-Koch-Test values (AWD median 3.54/IQR 1 vs. control median 2.8/IQR 1; p = 0.005).ConclusionFollow-up examinations of AWD patients revealed decreased motor abilities and GIQLI scores while cardiopulmonary function was not different compared to healthy controls. The clinical impact of these findings remains to be elucidated.ImpactClinical examination, assessment of the gastrointestinal quality of life, sport medical testing, electromyography and abdominal wall ultrasound were performed in patients with congenital abdominal wall defect and compared to an age and sex matched healthy control group.Results of spirometry and spiroergometry, ultrasound or electromyography did not significantly differ between the groups.Significantly decreased locomotor function and gastrointestinal quality of life were found in patients with abdominal wall defect. However, the clinical impact of these findings remains to be elucidated.

OGBN O03 Quality of life of patients with gastroesophageal reflux disease: findings from a systematic literature review

Abstract Background Gastroesophageal reflux disease (GERD), affecting over a billion people worldwide, is associated with significant impairment and productivity loss. Understanding the quality of life among GERD patients may provide important clinical relevance to treatment management and highlight the patient perspective. The aim of this study was to conduct a systematic review of GERD and quality of life, including any potential effects on treatment management. Methods MEDLINE, Embase, and the Cochrane Library were searched for randomized controlled trials, case-control, and cohort studies published in English from 2013 to 2023. Eligible studies included adult GERD patients with quality of life data from a disease-specific or generic instrument. Data analysis contained a narrative synthesis of pre- and post-procedural total scores. Results Eight trials and 34 observational studies were included. The disease-specific instruments GERD Health-Related Quality of Life (GERD-HRQL) (n = 35) and Gastrointestinal Quality of Life Index (GIQLI) (n = 4) had baseline mean scores ranging from 13.3 to 37.1 and 72.0 to 96.3, which changed to 1.3 to 31.6 and 94.8 to 119.8 post-treatment, respectively. Besides the Reflux Symptom Index (RSI) (n = 3), EQ-5D, Psychological General Well-Being (PGWB), SF-36, and GastroEsophageal Reflux Symptom Score (GERSS) were only used by single studies to evaluate the quality of life among GERD patients. In general, these results indicated an improvement post-treatment. Conclusions As a general finding, patients with GERD have poor quality of life and active treatment seems to influence and improve GERD patients’ quality of life, considering the pre-post results of GERD-HRQL and GIQLI scores. As expected, generic quality of life instruments are seldom used.

The Efficacy of Omentopexy During Laparoscopic Sleeve Gastrectomy: Comparative Analysis of Surgical Outcomes, Complications, and Quality of Life.

The increasing popularity of laparoscopic sleeve gastrectomy (LSG) as a bariatric procedure has been accompanied by concerns about potential complications, including staple line bleeding and leaks. Additionally, postoperative quality of life can be affected by gastroesophageal reflux disease (GERD) and food-related issues. In light of these factors, there is a need to compare the outcomes of standard LSG with LSG with omentopexy. This comparative analysis aims to provide insights into the distinct recovery processes associated with these two approaches. This retrospective study aimed to compare the outcomes of LSGin two groups: LSG alone and LSG with omentopexy. Data collected from January 2022 to April 2022 included patient characteristics, surgical details, complications, medication usage, and follow-up. Gastrointestinal Quality of Life Index (GIQLI) scores were recorded at postoperative intervals of 15 days, one month, and three months. This study analyzed 29 patients who underwent standard LSGand 36 patients who underwent LSG combined with omentopexy. The two groups exhibited similarities in terms of age, gender, body mass index (BMI), comorbidities, surgical duration, complications, hospitalization duration, and medication requirements (p > 0.005). Telephone consultations were significantly higher in the LSG with omentopexy group (p < 0.001). Nausea (p = 0.486) and vomiting (p = 0.603) rates did not significantly differ, but the constipation rate at one month was higher in LSG with omentopexy (p = 0.244). The flatulence rate at one month was significantly higher in LSG with omentopexy (p < 0.007). GIQLI scores were significantly lower in LSG with omentopexy at 15 days (p < 0.001) and one month (p < 0.001), but not at three months (p = 0.884). This study demonstrates that LSG and LSG with omentopexy have similar surgical outcomes and short-term complications. However, differences exist in postoperative symptoms and quality of life experiences.

Identifying Gut Microbiota associated with Gastrointestinal Symptoms upon Roux-en-Y Gastric Bypass

PurposeRoux-en-Y gastric bypasses (RYGB) are frequently accompanied by long-term gastrointestinal (GI) symptoms. Direct mechanistic insight into the causation of these symptoms is lacking, but changes in the intestinal microbiome have been proposed to play a role. With this study, we aimed to investigate whether a microbial predisposition exists before RYGB which is associated with GI symptoms during follow-up and to evaluate which microbial groups are involved.Materials and MethodsIn total, 67 RYGB patients were included. Shotgun metagenomic sequencing was performed on fecal samples obtained just before and 1 year after surgery. To assess GI symptoms, patients filled out Gastrointestinal Quality of Life Index (GIQLI) questionnaires and were divided into groups based on their total GIQLI score and change in score (postsurgery versus baseline). Extremely randomized tree predictor models were used to identify the most distinctive microbial species associated with postoperative GI symptoms.ResultsBeta diversity differed significantly between baseline and 1-year post-surgery samples, with the post-surgery microbiome resembling a more dysbiotic profile. The most predictive species regarding total GIQLI (AUC 0.77) or delta GIQLI score (AUC 0.83) were identified. Many of these species are known butyrate producers or species known to support them and/or species with anti-inflammatory properties, including Coprococcus eutactus, Faecalibacterium prausnitzii, and Ruminococcus callidus.ConclusionBeneficial commensal gut microbiota related to a high GI score were associated to adequate intestinal fermentative capacity, suggesting these species might have protective properties against postoperative GI malfunctioning.Graphical

Quality-of-Life and Recurrence Outcomes Following Laparoscopic Elective Sigmoid Resection vs Conservative Treatment Following Diverticulitis

Both elective sigmoid resection and conservative treatment are options for patients with recurrent, complicated, or persistent painful diverticulitis; understanding outcomes following each can help inform decision-making. To compare outcomes of elective sigmoid resection and conservative treatment for patients with recurrent, complicated, or persistent painful diverticulitis at 2-year follow-up. This multicenter parallel open-label individually randomized clinical trial comparing elective sigmoid resection to conservative treatment in patients with recurrent, complicated, or persistent painful diverticulitis was carried out in 5 Finnish hospitals between September 2014 and October 2018. Follow-up up to 2 years is reported. Of 85 patients randomized and included, 75 and 70 were available for QOL outcomes at 1 year and 2 years, respectively, and 79 and 78 were available for the recurrence outcome at 1 year and 2 years, respectively. The present analysis was conducted from September 2015 to June 2022. Laparoscopic elective sigmoid resection vs conservative treatment (patient education and fiber supplementation). Prespecified secondary outcomes included Gastrointestinal Quality of Life Index (GIQLI) score, complications, and recurrences within 2 years. Ninety patients (28 male [31%]; mean [SD] age, 54.11 [11.9] years and 62 female [69%]; mean [SD] age, 57.13 [7.6] years) were randomized either to elective sigmoid resection or conservative treatment. After exclusions, 41 patients in the surgery group and 44 in the conservative group were included in the intention-to-treat analyses. Eight patients (18%) in the conservative treatment group underwent sigmoid resection within 2 years. The mean GIQLI score at 1 year was 9.51 points higher in the surgery group compared to the conservative group (mean [SD], 118.54 [17.95] vs 109.03 [19.32]; 95% CI, 0.83-18.18; P = .03), while the mean GIQLI score at 2 years was similar between the groups. Within 2 years, 25 of 41 patients in the conservative group (61%) had recurrent diverticulitis compared to 4 of 37 patients in the surgery group (11%). Four of 41 patients in the surgery group (10%) and 2 of 44 in the conservative group (5%) had major postoperative complications within 2 years. In per-protocol analyses, the mean (SD) GIQLI score was higher in the surgery group compared to the conservative treatment group by 11.27 points at 12 months (119.42 [17.98] vs 108.15 [19.28]; 95% CI, 2.24-20.29; P = .02) and 10.43 points at 24 months (117.24 [15.51] vs 106.82 [18.94]; 95% CI, 1.52-19.33; P = .02). In this randomized clinical trial, elective sigmoid resection was effective in preventing recurrent diverticulitis and improved quality of life over conservative treatment within 2 years. ClinicalTrials.gov Identifier: NCT02174926.

Assessment of Exocrine Pancreatic Function Following Bariatric/Metabolic Surgery: a Prospective Cohort Study

BackgroundExocrine pancreatic insufficiency (EPI) can be seen after bariatric/metabolic surgery. Fecal elastase level is a simple test in diagnosing and grading EPI. Quality of life changes in patients with bariatric/metabolic surgery related to gastrointestinal complaints is debated.AimThis study aimed to investigate rates and grades of EPI via fecal elastase levels and association between EPI and quality of life in bariatric surgery patients.MethodsA prospective study was performed for patients with bariatric/metabolic surgery at their second-year follow-up. Fecal elastase levels were used to diagnose and grade EPI as severe or moderate. Patient’s gastrointestinal quality of life index (GIQLI) was calculated. Patients were grouped as sleeve gastrectomy (SG), one-anastomosis gastric bypass (OAGB), single-anastomosis sleeve ileal bypass (SASI), and transit bipartition (TB). Rates of severe or moderate EPI were primary outcome. Secondary outcome was an association between fecal elastase and GIQLI.ResultsThere were 17, 29, 21, and 15 patients in OAGB, SG, TB, and SASI groups. There was no significant difference between groups in GIQLI scores and fecal elastase levels (p = 0.152 and p = 0.361). Rates of patients with moderate EPI in the groups OAGB, SG, TB, and SASI were 23.5%, 17.2%, 14.3%, and 20.0%. GIQLI scores were not significantly correlated with age, postoperative morphometric data, and fecal elastase values (p > 0.05).ConclusionRates of patients with moderate EPI ranged from 14.3 to 23.5% at second-year follow-up. There was no patient with severe EPI. GIQLI scores were not significantly correlated with fecal elastase levels and different types of bariatric/metabolic surgery.Graphical

8795 Impact of Surgical Procedures on Intestinal Function and Quality of Life in Patients with Deep Endometriosis: A Prospective Study

<h3>Study Objective</h3> To analyze the prevalence of intestinal discomforts in patients with deep endometriosis (DE) and the alteration of different surgical procedures on their intestinal function and quality of life at short-term follow-up. <h3>Design</h3> A prospective cohort study. <h3>Setting</h3> A university-based tertiary obstetrics and gynecology hospital. <h3>Patients or Participants</h3> Patients with deep endometriosis infiltrating the rectum treated in the same medical team since April 1, 2018. <h3>Interventions</h3> Patients underwent rectal shaving, disk excision or segmental bowel resection depending on the severity of DE. <h3>Measurements and Main Results</h3> The primary end point was the prevalence of intestinal discomforts, pain symptoms ranked by VAS (visual analogue score). The secondary end points were values of gastrointestinal questionnaires, including GIQLI(gastrointestinal quality of life index), Wexner constipation score, CRADI-8 (colorectal-anal distress inventory 8),and SF 36 to evaluate quality of life. As of March 15, 2019,88 patients were enrolled, including 58 patients in group rectal shaving, 25 in disk excision and 5 in segmental bowel resection.59.04% (49/88) of patients had intestinal symptoms preoperatively, manifested as menstrual diarrhea 26(53.06%), bulge 19(38.78%)and hematochezia 13 (26.53%). However, postoperatively, the discomforts were mainly caused by diarrhea 10.23% (9/17) at 1-month follow-up(V1), constipation 40% (4/10) at 6-month follow-up(V6). According to the follow-up, there are significant improvement in dysmenorrhea in all three group, but the improvement of intestinal discomfort only in group shaving were significant 0(0,2) vs 0(0,0) at V1 and 0(0,2) vs 0(0,0) at V6,<i>P</i><0.05,respectively.Patients in group shaving had mild symptoms preoperatively, who had lower CRADI-8 and Wexner constipation scores than the other two groups. After surgical treatment, patients' gastrointestinal function were mild improved, but the SF-36 and the GIQLI score did not reach statistical significance among these 3 groups compared to the baseline. <h3>Conclusion</h3> For patients with complaints of periodic diarrhea, anal bulge and hematochezia, endometriosis should be considered. Although surgical procedures can improve patients' dysmenorrhea and intestinal discomfort, but, the occurrence of constipation in short term after surgery should be alert, especially in radical procedures.

Clinical effectiveness of fecal microbiota transplantation combined with nutritional support and psychological intervention in patients with "Tetralogy of Tongji"

Objective: To summarize and analyze the clinical effect of fecal microbiota transplantation (FMT) combined with nutritional support and psychotherapy in patients with "Tetralogy of Tongji" (comprising chronic gastrointestinal dysfunction, mental and psychological disorders, malnutrition, and endocrine disorders). Methods: A longitudinal study was conducted. The inclusion criteria were as follows: (1) patients were under 70 years of age; (2) patients exhibited chronic gastrointestinal dysfunction (in accordance with the Rome IV diagnostic criteria for irritable bowel syndrome ie. chronic functional constipation, diarrhea, abdominal pain and abdominal distention) with onset occurring more than one year previously; (3) patients exhibited malnutrition (body mass index ≤ 18.5 kg/m2); (4) patients exhibited depression, anxiety, or state as diagnosed by a psychologist using the Hamilton anxiety rating scale (HAMA) and the Hamilton depression scale (HAMD); (5) patients were women of childbearing age with amenorrhea or menstrual disorder with a duration ≥6 months. Patients were excluded if they exhibited gastrointestinal bleeding, short bowel syndrome, radiation-induced intestinal injury, intestinal obstruction or inflammatory bowel disease, recurrent/metastatic tumors, systemic infectious diseases, life-threatening systemic comorbidities, intorlerate to nasojejunal, percutaneous gastrostomy / jejunostomy or FMT. The clinical data of 43 patients at Shanghai Tenth People's Hospital exhibiting the "Tetralogy of Tongji" and who received microflora transplantation combined with nutritional support and psychotherapy from June 2017 to June 2021 was prospectively collected. There were 12 males and 31 females with a mean age of 35.2±16.7 years. All 43 patients had chronic gastrointestinal dysfunction. Of these, 24 patients had depression and 19 had anxiety. There were 26 women of reproductive age, including 13 cases of menstrual disorder and 9 cases of amenorrhea. The treatment intervention was a combination of FMT (microflora solution or microflora capsule), nutritional support (enteral nutrition) and psychological intervention. The following were assessed before treatment and 1, 3, 6 months after treatment: (1) gastrointestinal function was assessed using the gastrointestinal symptoms rating scale (GSRS), where a higher score is indicative of more serious gastrointestinal symptoms, and the gastrointestinal quality of life index (GIQLI), where a higher score is indicative of higher quality of life; (2) psychological status was assessed using HAMA and HAMD scores, where a lower score is indicative of reduced severity of anxiety or depression symptoms, respectively; (3) nutritional status was assessed by measurements of total blood protein, albumin, fibrinogen and prealbumin, as well as measurements of body mass and body mass index (BMI); (4) neuroendocrine function was assessed by measurement of blood levels of cortisol, dopamine and noradrenaline, as well as menstruation in women of reproductive age. Results: The follow-up rates at 1, 3 and 6 months after treatment were 90.7% (39/43), 72.1% (31/43) and 55.8% (24/43), respectively. The total effective rate for chronic gastrointestinal dysfunction was 81.4% (35/43), of which the average GSRS score decreased from 29.35±3.56 before treatment to 18.25±2.56 in the sixth month (P<0.001). The average GIQLI score increased from 56.23±10.34 before treatment to 91.04±20.39 in the sixth month (P<0.001). All patients had malnutrition before treatment. After 6 months, their body weight had increased from 40.61±8.88 kg to 50.45±6.23 kg (P<0.001), and BMI had increased from 15.17±1.87 kg/m2 to 19.58±1.42 kg/m2 (P<0.001). The average total protein level was 60.99± 5.99 g/L before treatment. After 6 months, this had increased to 64.21±4.23 g/L (F=2.715, P=0.022). The average prealbumin level increased from 150.14±56.04 mg/L before treatment to 258.17±86.94 mg/L after 6 months (F=15.124, P<0.001). In this study, 24 patients with depression/depressed state were included. After treatment, the average HAMD score in these patients decreased from 22.79±6.63 before treatment to 9.92±7.24 after 6 months (P<0.001). There were 19 patients with anxiety disorder/anxiety state. After treatment, the average HAMA score in these patients decreased from 17.15±4.34 before treatment to 7.73±4.10 after 6 months (P<0.001). Observing the endocrine efficacy of 26 women of childbearing age, it was found that the effective rate of this treatment on endocrine regulation was 69.2% (18/26). Although there was no significant change in blood cortisol levels after 6 months, average blood dopamine levels decreased from 32.91±10.65 nmol/L before treatment to 13.02±5.58 nmol/L after 6 months (P<0.001). Average blood norepinephrine levels decreased from 49.75±15.23 ng/L before treatment to 19.21±9.58 ng/L after 6 months (P<0.001). Conclusion: The strategy of FMT combined with nutritional support and psychological intervention is effective in improving the symptoms of the "Tetralogy of Tongji".

Health-Related Quality of Life After Laparoscopic Cholecystectomy.

BackgroundThis study aimed to determine the mean improvement in the quality of life (QoL) after laparoscopic cholecystectomy (LC) in patients with symptomatic cholelithiasis.MethodologyAfter obtaining approval from the hospital’s ethical committee, the Gastrointestinal Quality of Life Index (GIQLI) proforma was filled on admission (T0) and at week six (T1) postoperatively. All data were collected, and GIQLI scores were calculated for individual patients.ResultsIn our study, among the 70 patients undergoing LC, 20% (n = 14) were aged 18-30 years and 80% (n = 56) were aged 31-60 years, with the mean ± standard deviation calculated as 41.56 ± 10.13 years. Overall, 44.29% (n = 31) of patients were men and 55.71% (n = 39) were women. GIQLI scores were 94.64 ± 2.24 for pre-treatment and 106.09 ± 2.40 for post-treatment, with a mean change of 11.44 ± 3.29, and a p-value of 0.001, showing a significant difference.ConclusionsThe mean improvement in QoL after LC in patients with symptomatic cholelithiasis is significantly higher when compared with pretreatment.

O-308 The impact of NOSE colectomy and laparoscopic conventional segmental resection on bowel function and quality of life among patients with rectal endometriosis: prospective randomized trial

Abstract Study question What is the impact of laparoscopic conventional or NOSE colorectal resection on bowel function in patients with deep endometriosis infiltrating the rectum one year postoperatively? Summary answer Both conventional and NOSE colectomy improved the functional outcomes and quality of life among patients with deeply invasive rectal endometriosis one year after bowel surgery. What is known already Conventional laparoscopic approach to the surgical management of deep endometriosis infiltrating the rectum appears to assure improved digestive functional outcomes. NOSE technique for colorectal disease can significantly reduce the duration of hospital stay, accelerate postoperative recovery with better cosmetic results, and in particular, result in less postoperative pain and fewer complications. However, long-term solid data about gastrointestinal well-being after segmental bowel or NOSE resection for deep endometriosis are still missing. Study design, size, duration Between the 1st September 2019 - 31th of December 2020 we performed a 2-arm unblinded prospective randomized trial, enroling 91 patients with deep infiltrating rectal endometriosis up to 15 cm from the anal verge. Patients aged between 18 and 45 years, with deep endometriosis infiltrating at least the muscular layer in depth, and up to 50% of rectal circumference, complaining pain, bowel symptoms and/or infertility were included. The average follow up time was 14±2.6 months. Participants/materials, setting, methods Patients were enroled at Semmelweis University, Department of Obstetrics and Gynecology, Budapest, Hungary and had either conventional laparoscopic bowel resection or NOSE resection. Randomization was performed preoperatively using the simple randomization method. The primary endpoint was to assess the bowel function and quality of life by using the Endometriosis Health Profile 30, the Gastrointestinal Quality of Life Index and the Low Anterior Resection Syndrome score preoperatively, 1 month, 6 months, 1 year after the surgery. Main results and the role of chance A total of 91 patients were enroled. 39 patients were in the NOSE surgery arm, 49 were in the Conventional laparoscopic surgery arm. One patient was lost to follow-up and we had two cases of drop out from the trial after randomization due to performing non intended disc resection. This cases were excluded from the study. There was no conversion to laparotomy.The overall scores on Gastrointestinal Quality of Life Index (GIQLI), Low Anterior Resection Syndrome scores (LARS) and Endometriosis Health Profile 30 (EHP30) scores did not reveal significant differences between the two groups. LARS scores were improved, but did not reveal significant differences 12 months (T3) after the operation compared with the preoperative (T0) values in both groups (Conventional surgery group: T0=21.41 T3= 17.90; p = 0.934, NOSE surgery goup T0= 26.53 T3= 18.23; p = 0.229). GIQLI scores were significantly improved 12 months after the operation compared with the baseline values in Conventional surgery group T0= 95.44 T3= 111.39 p = 0.002. EHP30 scores were significantly improved concerning pain, emotion well-being, control and powerlessness, self-image, social support and sexuality scale 12 months after the operation compared with the preoperative values in both groups. Limitations, reasons for caution An obvious bias of performance is the lack of blinding, however blinding was not feasible due to the clinical nature of our study. We report no imprecision in patient selection, but a potential source of attrition bias in our data occured in a total number of three cases in NOSE-group. Wider implications of the findings Our study does not show a statistically significant difference between conventional or NOSE surgery for short and mid-term functional digestive outcomes. Occurrence of longterm bowel dysfunction does not appear to be related to a specific surgical technique. Trial registration number ClinicalTrials.gov number: NCT04109378

Quality-of-life After Cholecystectomy in Kazakhstan and Sweden: Comparative Study Based on the Gastrointestinal Quality-of-life Index Questionnaire

BACKGROUND: As severe morbidity rarely is the focus in gallstone surgery, health-related quality of life has evolved as the main outcome measure of the management of patients with gallstone disease (GSD). The lack of universally accepted guidelines on treatment of GSD has also resulted in regional differences in the preoperative evaluation and management of patients with GSD. AIM: The aim of this study was to compare quality-of-life (QoL) following gallstone surgery in cohorts from Kazakhstan and Sweden. METHODS: A comparative study on QoL after cholecystectomy (CE) in two cohorts from Sweden and Kazakhstan using the gastrointestinal QoL index (GIQLI) questionnaire. QoL measures of 259 patients in Kazakhstan and 448 patients in Sweden were compared taking into account surgical approach, mode of admission, and indication for surgery. Patients in both cohorts were requested to fill in the GIQLI questionnaire after surgery. Similar routines were applied to ensure high coverage in both countries. RESULTS: The mean overall GIQLI score was higher for patients undergoing CE in Sweden than those in Kazakhstan (p &lt; 0.01). The same was seen when stratifying for open or laparoscopic surgery (both p &lt; 0.05), absence of presence of acute cholecystitis (both p &lt; 0.05), and emergency admission (p &lt; 0.05), but not in case of planned admission (p = 0.54). CONCLUSIONS: There were large differences in QoL, especially in the group having undergone surgery for pain attacks or chronic cholecystitis. These differences in may be explained by differences in attitudes to health status and treatment expectations. Standardized routines for evaluating the outcome after surgery are needed.

Gastrointestinal Quality of Life in Morbidly Obese Patients Undergoing One Anastomosis Gastric Bypass (OAGB): Derivation of a "Mini GIQLI" Score.

One anastomosis gastric bypass (OAGB) is now one of the mainstream bariatric surgical procedures with proven safety and efficacy. However, data on the gastrointestinal quality of life following OAGB is lacking. This is a retrospective analysis of a prospectively collected database, performed at a single tertiary care teaching hospital from January 2016 until March 2021. All patients undertook the Gastrointestinal Quality of Life Index (GIQLI) questionnaire. GIQLI was correlated with various parameters. Principal component analysis (PCA) was used to assess the importance of each question in the questionnaire and devise a "Mini GIQLI score". A total of 60 patients were included. The %TWL at 3 and 5years was 26.2 ± 11.9%, 31.7 ± 11 respectively. The mean weight regain was 5.6 ± 8.5kg. The mean GIQLI score was 125 ± 13.1. The mean scores for questions pertaining to gastrointestinal, social, psychological, and physical domains were 3.49, 3.7, 3.45, and 3.27 respectively. Scree plot of principal component analysis showed that a new score ("Mini GIQLI") combining only 5 questions had good correlation with the overall GIQOL score (r = 0.842). The five questions related to anxiety, fatigue, feeling unwell, loss of endurance, and feeling unfit. Patients report a good score on GIQLI assessment following OAGB. The Mini GIQLI score is a quicker tool with good correlation to the full-length GIQLI score.

The Efficacy and Safety of Fecal Microbiota Transplantation Combined With Biofeedback for Mixed Constipation: A Retrospective Cohort Study.

This study aims to assess the effectiveness and safety of fecal microbiota transplantation (FMT) combined with biofeedback for patients with mixed constipation. Patients who received biofeedback (biofeedback group, n = 40) and those who received FMT combined with biofeedback (FMT combination group, n = 45) were enrolled. Spontaneous bowel movements (SBMs) frequency, Bristol Stool Form Scale (BSFS), and Patient Assessment of Constipation Symptoms (PAC-SYM) score were analyzed to evaluate the effect of treatment. Gastrointestinal Quality of Life Index (GIQLI) scores of patients were used to assess the quality of life, and the safety of FMT combination therapy was evaluated by the presence of adverse events. The 16S rRNA gene sequencing was performed on the fecal samples of 12 donors, feces of 31 patients before and after receiving FMT combination treatment. Comparing the biofeedback group and the FMT combination group 1 month after the treatment, significant differences were observed in the mean value of SBM frequency, BSFS, and PAC-SYM scores, which were 2.15 ± 1.05 vs. 3.61 ± 0.89 (p = 0.0031), 2.1 ± 0.9 vs. 2.5 ± 1.2 (p = 0.008), and 2.4 ± 0.5 vs. 2.2 ± 0.6 (p = 0.0021), respectively. Meanwhile, FMT combination therapy had long-term beneficial effects according to the data collected at six months and 12 months after the treatment. With respect to the quality of life, GIQLI scores were higher in the FMT combination group (103.6 ± 15.1) compared with that in the biofeedback group (88.7 ± 10.1) one month after administration (p = 0.0042). In addition, there were no significant differences between the two groups in adverse events, including abdominal pain, diarrhea, dizziness, nausea, vomiting, and other side effects. Results of 16S rRNA gene sequencing showing some well-known probiotics had significantly increased after FMT combination treatment compared with pre-FMT samples, such as Prevotella and Bifidobacterium. Findings of this study suggested that FMT combined with biofeedback could be effective and safe for patients with mixed constipation.

The Relieving Effects of a Polyherb-Based Dietary Supplement ColonVita on Gastrointestinal Quality of Life Index (GIQLI) in Older Adults with Chronic Gastrointestinal Symptoms Are Influenced by Age and Cardiovascular Disease: A 12-Week Randomized Placebo-Controlled Trial.

Chronic gastrointestinal symptoms (CGS) negatively affect the quality of life in about 15–30% of the population without effective drugs. Recent studies suggest that dietary supplement may improve CGS, but inconsistent results exist. The goal of this study is to evaluate the effect of a polyherbal-based supplement ColonVita on the gastrointestinal quality of life index (GIQLI) in 100 old adults with CGS (63.1 ± 9.6 years) who were randomly assigned to daily ColonVita or placebo tablets (n = 50/group) for 12 weeks in a double-blind, randomized controlled trial design. No significant fibrdifferences were found between ColonVita and placebo in the baseline total GIQLI score (101.12 ± 16.87 vs. 101.80 ± 16.48) (P > 0.05) or postintervention total GIQLI score (114.78 ± 9.62 vs. 111.74 ± 13.01) (P > 0.05). However, ColonVita significantly improved 16 scores of the 19 core GI symptoms compared with 10 items improved by placebo. The ColonVita group significantly improved the remission rate of 5 core GI symptoms compared to placebo and significantly improved the total GIQLI scores (118.09 ± 7.88 vs. 109.50 ± 16.71) (P < 0.05) and core GI symptom scores (64.61 ± 3.99 vs. 60.00 ± 8.65) (P < 0.05) in people ≥60 years of age (n = 49) but not in those under 60 y (n = 51). ColonVita significantly improved the total GIQLI scores and core GI symptom scores in people without cardiovascular diseases (CVD) (n = 56) (116.74 ± 9.38 vs. 110.10 ± 14.28) (P < 0.05) and (63.11 ± 4.53 vs. 59.93 ± 8.03) (P=0.07), respectively, but not in those with CVD (n = 44). Thus, ColonVita was beneficial for old adults with CGS, especially those ≥60 years of age and without CVD. Because a heterogenous pathogenesis of CGS-like irritable bowel syndrome (IBS) and inflammatory bowel disease (ISD) is differentially associated with CVD, different comorbidities may have influenced the outcomes of different trials that should be controlled in further studies.

Impact of Gastrointestinal Diseases on Health-Related Quality of Life of Patients in Pakistan.

ObjectiveThis study aimed to evaluate the impact of gastrointestinal (GI) diseases on health-related quality of life (HRQoL) in Pakistani patients.MethodsA cross-sectional study was conducted from 1st January 2019 to 15th February 2019 at a tertiary care hospital in Pakistan by employing a self-administered questionnaire called Gastrointestinal Quality of Life Index (GIQLI). Questionnaires were distributed among the patients presenting to outpatient gastroenterology clinics to evaluate their HRQoL.ResultsA total of 199 patients were included in this study, and their mean GIQLI score was 87.8 ± 17.8. Results showed that more severe core symptoms can lead to a poorer QoL. Overall GIQLI scores and most of its domain scores were lower in females as compared to males (p-value: 0.02). Obese patients had an overall lower mean GIQLI score including in the GI, psychological, and social domains while advanced age was associated with a higher disease-specific GIQLI score.ConclusionBased on our findings, GI diseases negatively impact the HRQoL in patients. Physicians need to consider the different domains of QoL as part of a holistic approach to treating these patients.

The correlation between postoperative complications of ERCP and quality of life after discharge in patients with choledocholithiasis.

The treatment of choledocholithiasis by endoscopic retrograde cholangiopancreatography (ERCP) is a difficult endoscopic procedure involving a complicated surgical process. During and after ERCP, surgery-related complications may occur, and serious complications can threaten the life of the patient. This study aims to evaluate the correlation between the possible complications of ERCP treatment of choledocholithiasis and the quality of life of patients, and to provide a basis for formulating corresponding intervention measures. Using the Gastrointestinal Quality of Life Index (GIQLI) and the MOS item short from health survey (SF-36), we conducted random telephone follow-ups of 194 patients admitted to The Second Affiliated Hospital of Soochow University who underwent ERCP for the treatment of choledocholithiasis from October 2017 to December 2020. The patients' complications symptoms and quality of life were recorded, and a comparative analysis was performed. During the hospitalization of the included 194 patients, complications occurred in 38 cases (19.6%), including 18 cases (9.3%) of hyperamylase, 11 cases (5.7%) of acute pancreatitis, and 5 cases (2.6%) of cholecystitis. There were 4 cases (2.1%) of gastrointestinal bleeding. The SF-36 scores in the complication group were significantly lower than those in the non-complication group across various dimensions, including bodily pain (BP), general health (GH), vitality (VT), social functioning (SE), and mental health (MH). Furthermore, the GIQLI scores in the complication group were lower than those in the non-complication group across various dimensions, including symptoms, subjective symptoms, physical function status, social activity status, as well as mental and psychological status. Multiple regression analysis showed that dimensions such as PF, BP, and subjective symptoms were more likely to be affected by hyperamylaseemia, acute pancreatitis, and cholecystitis, and the difference was statistically significant (P<0.05). Complications after ERCP result in a poor quality of life after discharge in choledocholithiasis patients, suggesting that nurses need to take effective measures to prevent and actively treat hyperamylase, acute pancreatitis, and acute pancreatitis during the hospitalization of holedocholithiasis patients after ERCP. Common complications, such as cholecystitis, promote the recovery of patients and reduce the impact of the disease on quality of life.

The Effect of Vagus Nerve Preservation on Gastrointestinal Function After One Anastomosis/Mini Gastric Bypass

Background: The effects of Vagus Nerve preservation or division during One Anastomosis/Mini Gastric Bypass (OAGB/MGB) have not been studied before. The aim of this study was to compare Vagus Dividing OAGB/MGB versus Vagus Preserving OAGB/MGB as regards Gastrointestinal Quality of Life, postoperative weight loss, and metabolic outcome. Methods: This randomized controlled study included 200 patients divided into two equal groups. Group I underwent Vagus Dividing OAGB/MGB (VD-OAGB/MGB). Group II underwent Vagus Preserving OAGB/MGB (VP-OAGB/MGB) in whom the neurovascular bundle was preserved till the gastric antrum. Both groups were compared for weight loss, metabolic outcome, postoperative complications, and Gastrointestinal Quality of Life Index (GIQLI) scores for 1 year after surgery. Results: One year after surgery 87 patients in Group I and 84 patients in Group II completed the follow-up. The postoperative GIQLI score significantly improved 1 year after surgery. Patients had improvement in the three domains of general health (social, physical, and emotional function). The domain of specific symptoms worsened after VD-OAGB/MGB and improved after VP-OAGB/MGB. There was no significant difference between both groups in complications, weight loss, or metabolic outcome. Conclusion: VP-OAGB/MGB results in similar weight loss and metabolic outcomes as VD-OAGB/MGB with a better GIQLI score.

Laparoscopic repair of giant hiatal hernia for elderly patients.

BackgroundGiant hiatal hernias are more common in older patients and can significantly reduce their quality of life. However, open surgery for patients of advanced age is thought to be associated with high morbidity and mortality. The aim of this retrospective study was to evaluate the safety of laparoscopic giant hiatal hernia repair for elderly patients as compared to younger patients.MethodsFrom January 2015 to January 2020, 152 consecutive patients underwent laparoscopic mesh repair of giant hiatal hernia. Two cases of missing follow up were excluded. Patients were divided into an elderly group (N=62, age ≥75) and a younger group (N=88, age <75). Interrupted non-absorbable suture was applied for crus closure and as an additional reinforcement, the mesh was fixed with absorbable tacks or medical glue. Procedure-related complications, score-based variation tendency of symptoms, gastrointestinal quality of life index (GIQLI), mortality, recurrence rate, hemoglobin, and the use of PPI were investigated.ResultsAll patients underwent the procedure uneventfully. Dor fundoplication was used in 39 patients (62.9%) in the elderly group and 44 (50.0%) in the younger group and no case was converted to open. While the elderly group had a significantly higher percentage of ASA Class level 3 and cardiovascular and cerebrovascular diseases as compared to the younger group, the two groups had similar operative times, intraoperative blood loss, and percentage of intrathoracic stomach. Elderly group patients tended to have higher perioperative complications including pneumonia (3.2%) and atelectasis (3.2%) without statistical significance, as well as transfer to the intensive care unit compared, to younger patients (9.7% vs. 3.2%; P=0.144). The mean post-operative hospital stay was also significantly shorter in the younger group (2.8 days) compared with the elderly group (3.5 days; P=0.001). There was no mortality, recurrence, mesh-related complications such as visceral erosion, adhesion, or severe dysphagia during follow up in the two groups, and both groups demonstrated significant improvement in GIQLI scores and hemoglobin. The percentage of patients who needed PPI was also reduced in both groups.ConclusionsLaparoscopic mesh repair of giant hiatal hernia for elderly patients is safe and effective when performed at experienced centers.