Postoperative Health Status Research Articles

A longitudinal study of the association between the outcome of bariatric surgery and mental health indicators in Chinese patients: an examination of the interaction effect

BackgroundThe prevalence of obesity currently represents a significant public health concern. Besides the physical burden, obesity is also associated with mental health issues. The mutual relationship between mental health issue and surgical outcome remains unclear, particularly in the population of ethnic Chinese patients. The objective of this Taiwanese study aims to evaluate the changes in physical and mental health before and after surgery and investigate the association between surgical outcome and mental health status.MethodsThe study population comprised patients who had undergone bariatric surgery at least one year prior (with the follow-up durations predominantly within two years). We collected and compared pre- and post-operative mental health status (using the Chinese Health Questionnaire, CHQ, and the Taiwanese Depressive Questionnaire, TDQ) and physical indicators to evaluate and establish their relationships. Furthermore, formal psychiatric diagnoses were confirmed by psychiatrists to analyze the differences between the groups with and without such diagnoses.ResultsA total of 147 patients were included in the study. Following surgery, notable improvements were observed in physical condition and mental health. The average body mass index (BMI) decreased by 13.46 (SD 8.28), the CHQ scores decreased by 1.52 (SD 2.76), and the TDQ scores decreased by 5.08 (SD 8.58). The prevalence of any psychiatric disorder in these patients was found to be 34%. There was no significant difference in the Percentage of Total Weight Loss (%TWL) between individuals with or without psychiatric disorders. However, patients with psychiatric disorders had higher CHQ and TDQ scores after surgery. In multiple linear regression models, the TDQ-by-follow-up duration interaction was predictive of the %TWL, and both married status and the level of tertiary education were identified as negatively associated factors.ConclusionsPatients who underwent bariatric surgery exhibited a high prevalence of psychiatric disorders, but the presence of pre-operative psychiatric disorders did not significantly affect weight change after surgery. Despite the improvements in physical and mental health post-surgery, the findings indicate that the impact of depression on effectiveness of bariatric surgery is modulated by the time elapsed since the surgery, emphasizing the importance of ongoing mental health care for these patients.Clinical trial numberNot applicable.

The value of patient-reported experience in oncoplastic breast conservation following standardized assessment and shared-decision making. A qualitative study

IntroductionPatient-reported outcomes (PROs) are emerging as a quality marker for breast cancer care provision. Patient-reported experience (PRE) is equally important, but challenges in qualitative research and documentation have resulted in limited data on oncoplastic breast-conserving surgery (OPBCS). This qualitative study aimed to explore the experiences of patients who underwent OPBCS. Patients and methodsWomen who underwent OPBCS between 2015 and 2021 at the Breast Unit of Uppsala University Hospital were followed up longitudinally using PROs. All participants were invited to share their experiences beyond PROs through a “diary.” Patients’ experiences with care, pre- and postoperatively, and other insights and thoughts that they considered important were documented and analyzed. A narrative research methodology, along with thematic analysis, was employed. ResultsOf the 122 women, 60 (49.2 %) desired to further elaborate on their experiences beyond PROs-related aspects. The most common themes included postoperative side effects, challenges responding to questionnaires, adverse effects of adjuvant treatment, external factors contributing to the preoperative and postoperative overall health status, and satisfaction with the surgery and medical staff. Specifically, 26.7 % of the respondents stated that they felt that PROs were not adequately specific and had further reflections. ConclusionsPatients did not report different experiences depending on the operative technique. Their experience focused on the perception of wholeness and potential ambiguities in the PRO questionnaires. Documenting PRE is crucial, as it enables individualized assessment following breast cancer treatment, thereby strengthening patient-centered care.

An Investigative Study on the Oral Health Condition of Individuals Undergoing 3D-Printed Customized Dental Implantation.

The advent of three-dimensional (3D) printing technology has revolutionized the field of dentistry, enabling the precise fabrication of dental implants. By utilizing 3D printing, dentists can devise implant plans prior to surgery and accurately translate them into clinical procedures, thereby eliminating the need for multiple surgical procedures, reducing surgical discomfort, and enhancing surgical efficiency. Furthermore, the utilization of digital 3D-printed implant guides facilitates immediate restoration by precisely translating preoperative implant design plans, enabling the preparation of temporary restorations preoperatively. This comprehensive study aimed to assess the postoperative oral health status of patients receiving personalized 3D-printed implants and investigate the advantages and disadvantages between the 3D-printed implant and conventional protocol. Additionally, variance analysis was employed to delve into the correlation between periodontal status and overall oral health. Comparisons of continuous paired parameters were made by t-test. The results of our study indicate a commendable one-year survival rate of over 94% for 3D-printed implants. This finding was corroborated by periodontal examinations and follow-up surveys using the Oral Health Impact Profile-14 (OHIP-14) questionnaire, revealing excellent postoperative oral health status among patients. Notably, OHIP-14 scores were significantly higher in patients with suboptimal periodontal health, suggesting a strong link between periodontal health and overall oral well-being. Moreover, we found that the operating time (14.41 ± 4.64 min) was less statistically significant than for the control group (31.76 ± 6.83 min). In conclusion, personalized 3D-printed implant surgery has emerged as a reliable clinical option, offering a viable alternative to traditional implant methods. However, it is imperative to gather further evidence-based medical support through extended follow-up studies to validate its long-term efficacy and safety.

Effectiveness of preoperative and perioperative pulmonary rehabilitation nursing program for the management of patients undergoing thoracic surgery: A systematic review and meta-analysis.

Several studies have investigated the effectiveness of preoperative or perioperative pulmonary rehabilitation in thoracic surgery patients, but the results are inconsistent and inconclusive. This study attempts to summarize the existing data on the effect of the preoperative and perioperative pulmonary rehabilitation nursing program for the management of patients undergoing thoracic surgery. Systematic search was done in PubMed Central, SCOPUS, EMBASE, MEDLINE, Google Scholar, and ScienceDirect for papers published until December 2022 and reporting data of postoperative complications and pulmonary health status in patients undergoing thoracic surgery and receiving preoperative or perioperative pulmonary rehabilitation nursing intervention or standard care. Meta-analysis was done by random-effects model and pooled standardised mean differences (SMD) or odds ratios (OR) along with 95% confidence intervals (CIs) were reported. Eighteen studies were included and analysed. Pooled SMD was 0.44 (95%CI: -0.21 to 1.08) for forced expiratory volume (FEV-1), -0.34 (95%CI: -0.94 to 0.26) for peak expiratory flow (PEF), 0.61 (95%CI: -0.60 to 1.81) for forced vital capacity (FVC), 0.42 (95%CI: -0.13 to 0.98) for diffusing capacity of carbon monoxide (DLCO). Pooled SMD for length of hospital stay was -0.64 (95%CI: -1.09 to -0.19). Pooled OR was 0.87 [95%CI: 0.32 to 2.37] for all-cause mortality, 0.35 [95%CI: 0.25 to 0.50] for postoperative pulmonary complications, 0.98 [95%CI: 0.45 to 2.12] for respiratory failure, 0.52 [95%CI: 0.38 to 0.78] for pneumonia and 0.50 [95%CI: 0.33 to 0.76] for atelectasis. Perioperative pulmonary rehabilitation nursing program is effective in reducing the postoperative lung complications and shortening the length of hospital stay in patients undergoing thoracic surgery.

SARS-CoV-2 infection status in corneal preservation solution and COVID-19 prevalence after corneal transplantation

The potential risks associated with organs from COVID-19-infected donors were unclear. To determine the SARS-CoV-2 infection status of corneas transplanted during the COVID-19 pandemic, we performed a polymerase chain reaction (PCR) using the corneal preservation solution that was used for corneal transplantation. We also examined the postoperative health status of the recipients. This study included 144 transplants in 143 eyes. Ninety-nine eyes of imported corneas and 10 of the 14 corneas donated in the prefecture were PCR tested at our hospital, and all were SARS-CoV-2 negative. All corneal transplants were performed after confirming their SARS-CoV-2 negativity by a PCR using a corneal preservation solution at our hospital or a nasopharyngeal swab at a previous facility. Despite postoperative steroid administration, no patient developed COVID-19 infection until discharge. Hence, if the donor's nasopharyngeal swab test is SARS-CoV-2 negative, COVID-19 infection in the recipient due to corneal transplantation may be prevented. Since corneal transplant recipients are susceptible to infection due to prolonged steroid administration and are at high risk for severe diseases if infection occurs, SARS-CoV-2 detection testing using nasopharyngeal swabs in donors should be performed.

Early perioperative quality of recovery after hip and knee arthroplasty: a retrospective comparative cohort study.

Increasing our knowledge about postoperative global Quality-Of-Recovery (QoR) after THA and TKA is important to improve perioperative medicine, in particular for preoperative patient information and benchmarking of postoperative patient status. This study is a single centre, retrospective cohort study of prospectively collected data, conducted in Strasbourg University Hospital, Strasbourg, France. The main outcome was the modified French version of the QoR-15 (mQoR-15F) score monitored preoperatively, at postoperative day one, three, 14 and 28. We questioned the hypothesis: would THA and TKA recovery patterns differ and would postoperative health status eventually overreach the preoperative reference? The mQoR-15F was statistically higher in the THA group compared to the TKA group in POD 1 and 28 (112 ± 17 vs. 107 ± 17; p < 0.01 and 131 ± 12 vs. 127 ± 15; p = 0.02, respectively). The mean postoperative time delay to reach preoperative mQoR-15F was seven and 16days for THA and TKA patients, respectively. Early postoperative health status after THA and TKA differs significantly; TKA being associated with a larger early decrease of global health status compared to THA. Both THA and TKA groups global health status overreached preoperative levels after one and twoweeks postoperatively. These surgery-specific recovery profiles may favor improved patient information to steer advised operative decision and set specific recovery goals as part of enhanced recovery pathways.

Construction and application of Chinese breast cancer knowledge graph based on multi-source heterogeneous data.

The knowledge graph is a critical resource for medical intelligence. The general medical knowledge graph tries to include all diseases and contains much medical knowledge. However, it is challenging to review all the triples manually. Therefore the quality of the knowledge graph can not support intelligence medical applications. Breast cancer is one of the highest incidences of cancer at present. It is urgent to improve the efficiency of breast cancer diagnosis and treatment through artificial intelligence technology and improve the postoperative health status of breast cancer patients. This paper proposes a framework to construct a breast cancer knowledge graph from heterogeneous data resources in response to this demand. Specifically, this paper extracts knowledge triple from clinical guidelines, medical encyclopedias and electronic medical records. Furthermore, the triples from different data resources are fused to build a breast cancer knowledge graph (BCKG). Experimental results demonstrate that BCKG can support knowledge-based question answering, breast cancer postoperative follow-up and healthcare, and improve the quality and efficiency of breast cancer diagnosis, treatment and management.

Translation and Validation of the Turkish Version of the Quality of Postoperative Recovery Score QoR-15: A Multi-Centred Cohort Study.

The Quality of Recovery-15 questionnaire is a self-rated questionnaire used to assess the quality of the postoperative recovery and health status of patients in the early period following surgery. The aim of this study was to assess the reliability, validity, and responsiveness of the Turkish version of the Quality of Recovery-15. After approval by the Maltepe University local ethics committee, this observational study was conducted among patients who received surgical interventions at Mersin University Hospital between July 2019 and January 2020. Reliability, feasibility, and validity were assessed to validate the Turkish version of the Quality of Recovery-15. The completion rate of the form was determined to be 92% and a total of 200 patients were enrolled in the study. The Cronbach's alpha of the global Turkish version of the Quality of Recovery-15 was 0.927. Test-retest reliability was 0.84 [CI 95%: 0.75-0.90] and Cohen's effect size was 0.319. The total standardized response mean was determined as 0.53. This is the first study in which the Quality of Recovery-15 scale was translated into Turkish with our knowledge. The Turkish version of the Quality of Recovery-15 showed satisfactory reliability and validity in evaluating the quality of recovery after surgery in the Turkish population.

Hearing Results, Quality of Life, Patient Satisfaction, and Postoperative Complications of Day-case Versus Inpatient Stapes Surgery for Otosclerosis in Adults: A Randomized Controlled Trial.

To investigate the effect of day-case stapes surgery on hearing results, quality of life, patient satisfaction, and complications rates, compared with inpatient stapes surgery. A single-center, nonblinded, randomized controlled trial in a tertiary referral center. One hundred twelve adult patients planned for primary or revision stapes surgery were randomly assigned to either the day-case or inpatient treatment group. The effect on hearing outcomes (primarily), hearing benefits, quality of life, patient satisfaction, postoperative complications, and causes of crossover or readmission (secondarily) were assessed using auditory evaluations, questionnaires, and patients' charts over a follow-up period of 1 year. Audiometric measurements and postoperative success rates were not different between the inpatient and day-case group. There were no statistically significant differences between both groups regarding the overall quality of life (QoL) (HUI3), disease-specific QoL (GHSI), change in postoperative health status (GBI), and postoperative complications rate. We found a high patient satisfaction toward the day-case approach. Six patients allocated to the inpatient group requested same-day discharge. Of the day-case patients, there was a crossover rate to inpatient care of 38% (20 patients), mainly due to postoperative nausea and vomiting (25%), vertigo (20%), or dizziness (40%). We found no significant differences in outcomes of audiometric measurements, QoL, patient satisfaction and postoperative complications following day-case, and inpatient stapes surgery. Therefore, stapes surgery in a day-case setting seems to be a feasible approach in terms of postoperative outcome, safety, and desirability when taking patient selection and surgical planning into account. Besides this, the familiarity with a day-case approach of both patient and the surgical team, will increase the acceptance and feasibility of day-case stapes surgery.

Postoperative Functional Health Status in Older Adults Undergoing Minor Surgery: An Observational Study

Postoperative Functional Health Status in Older Adults Undergoing Minor Surgery: An Observational Study

244.6: Postoperative Health Status and Quality of Life After Pure Laparoscopic Donor Hepatectomy for Living Donor Liver Transplantation

Background: Laparoscopic donor hepatectomy (LDH) for living donor liver transplantation has been performed in several specialized institutes. Surgical outcomes of LDH have shown comparable results to open donor hepatectomy (ODH), but the quality of life (QOL) after LDH is not known. This prospective questionnaire-based study was performed to assess health status and QOL of live liver donors before and after donor hepatectomy (DH). Material and Methods: From May 2017 to February 2020, 70 liver donors who underwent donor hepatectomy (DH) were enrolled, and questionnaire items such as Enhanced Recovery after Surgery (ERAS) mobility scale (EMS), Body Image Questionnaire (BIQ), and EQ-5D-3L were examined up to one year after DH to evaluate postoperative recovery, body image satisfaction, and health status, respectively. During the study period, 45 LDH donors and two ODH donors were finally fully evaluated (Figure 1). Results: Two patients in the OLH group were discharged on POD 8 and POD 10, respectively, with neither of the two achieving the level of being independently mobile (EMS ≥8). On the contrary, patients in the LDH group were considered independently mobile from POD 5 based on the mean EMS of 45 patients. The LDH group had a significantly higher mean EMS than the ODH group on POD 5 and 7 (P = 0.011, and P = 0.004, respectively, Figure 2). Body image score of the LDH group was significantly higher than that of the ODH group at one month after DH (17.8 vs. 15.0, P = 0.017). EQ-5D-3L index value and EQ-5D-3L VAS were not different from preoperative values at six months (P = 0.059) and one month (P = 0.217), respectively (Figure 3). Conclusions: Donors undergoing LDH showed faster (within a month) mobility recovery and body image satisfaction to the level of preoperative status than donors undergoing ODH. In the evaluation of QOL using EQ-5D, donors who underwent LDH recovered to preoperative health status within six months, in accordance with previous studies of donors with ODH. A multicentre prospective study will be needed to compare the LDH and ODH groups.

Analysis of one-year postoperative mortality and risk factors of elderly patients with intertrochanteric fractures after PFNA.

Intertrochanteric fracture is very common in elderly patients, It is one of the main reasons for the elderly to be hospitalized, and is closely related to the mortality rate. With the speeding up of the population aging, the treatment of intertrochanteric fracture is becoming more and more significant. PFNA (Proximal femoral nail antirotation) is the most commonly used surgical method, although the surgical technique has improved a lot, the postoperative mortality rate after one year is still high. If we can take active and effective control measures against the high-risk factors affecting mortality in time, it will help to improve the prognosis. To study the 1-year postoperative mortality rate of elderly patients with intertrochanteric fractures after being treated with proximal femoral nail antirotation (PFNA) and its influencing factors. The data of patients with intertrochanteric fracture treated by PFNA in our hospital during the period from August 2016 to April 2020 were retrospectively studied, and the data of age, sex, type of fracture, preoperative comorbid diseases, American Society of Anesthesiology (ASA) score, the timing of the operation, duration of operation, preoperative and postoperative hemoglobin levels, albumin level, and postoperative complications were collected through medical records, and the survival rate of patients in 1 year after operation was investigated by telephone follow-up, and single-factor analysis was carried out to analyze related influencing factors. A total of 80 patients with complete data were followed up for 1-23 months (mean 12.5 months), and totally 22 patients died within 1 year, the mortality rate was 27.5%. Single analysis results suggested that the differences in factors such as age, number of preoperative combined diseases, ASA score, preoperative and postoperative albumin levels, and postoperative complications between the survival group and the death group were statistically significant (P < 0.05). The risk factors affecting long-term death in the treatment of intertrochanteric fractures in elderly patients with PFNA shall be taken into consideration fully, and the improvement of preoperative and postoperative health status will help to reduce the postoperative mortality and improve the efficacy of surgery.

Modified McKeown vs. traditional McKeown minimally invasive esophagectomy in improving short-term efficacy and the quality of life of esophageal cancers: a retrospective comparative cohort study.

BackgroundTraditional McKeown minimally invasive esophagectomy (MIE-McKeown) with resection of the thoracic and abdominal branches of vagus nerve, the azygos vein and the bronchial artery, is notorious for high complications incidence and sharply decreased quality of life (QoL) postoperatively in esophageal cancer (EC). Recently, reports of preservation of azygos vein arch or the vagus nerve have shown the advantages of decreasing postoperative complication incidence. However, the modified MIE-McKeown with preservation of azygos vein arch, vagus nerve and the bronchial artery has never been investigated in EC. In the present study, we aimed to compare the short-term efficacy and postoperative QoL between modified MIE-McKeown and traditional MIE-McKeown.MethodsA total of 218 eligible patients with esophageal squamous cell carcinoma (ESCC) who met our inclusion criteria between October 2018 and January 2022 in our center were retrospectively enrolled and divided into modified MIE-McKeown group (N=48) and the control group with traditional MIE-McKeown (N=170) according to their surgical procedure. We compared the perioperative parameters (e.g., operation time and postoperative complications) between the two groups. The core quality of life questionnaire (QLQ-C30) (version 3.0) and the EC-specific QoL assessment form (QLQ-OES18) were used to evaluate the QoL in the 2 groups at 1 and 3 months after operation.ResultsThere were no significant differences in baseline characteristics between modified MIE-McKeown group and the control group. Compared with the control group, the modified MIE-McKeown group had significantly lower postoperative drainage volume (551.46±249.45 vs. 812.96±405.82; P<0.001) and a lower incidence of thoracic stomach syndrome (TSS; P=0.001). The bleeding loss in the modified MIE-McKeown group was lower than that in the control group (56.88±20.44 vs. 83.18±97.93; P=0.066), but not significantly. There were no significant differences observed in postoperative complications and other perioperative parameters between the two groups. The results of QLQ-C30 and QLQ-OES18 questionnaire revealed that the modified MIE-McKeown group was associated with better physical function, better global health status and milder symptoms of gastroesophageal reflux and cough.ConclusionsThe modified MIE-McKeown is a safe and efficient procedure and has the potential to improve postoperative health status of patients with EC.

Post-Caesarean Pain on Maternal Quality of Life

Background: Caesarean section (CS) is one of the commonest interventions that women go through during their fertile period. Over the past 30 years rate of CS use has increased by 10-15%. Moreover both acute and chronic pain after the caesarean section may hamper the patient quality of life and newborn’s care. Post-partum quality of life is an important concept. It has mingled with an individual’s physical health, mental state, independence, social contacts, and personal beliefs. Many quality-of-life scoring tools have been used on patients after CS to measure the post-operative health status and outcome.Methods: This narrational review was outlined by searching MEDLINE databases such as- Google Scholar and PubMed. Selected keywords were searched to identify articles. Randomized Controlled Trials, Observational Studies, Case control and Systemic reviews were included.Conclusion: Post-caesarean pain management is prioritized by women after a caesarean section.

Psychological resilience is related to postoperative adverse events and quality of life in patients with glioma: a retrospective cohort study.

BackgroundPsychological resilience has played an increasingly important role in the treatment of different diseases and many glioma patients will experience adverse emotional reactions after being diagnosed. However, it remains unclear whether psychological resilience is related to the adverse events and quality of life of patients with glioma.MethodsPatients with glioma between March 2016 and July 2020 were included in this retrospective cohort study. Psychological resilience was evaluated by the Connor-Davidson resilience scale (CD-RISC) 1 day before surgery. The European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ)-C30 and EORTC QLQ-BN20 were used for the quality of life (QoL) assessment of the included patients. The relationships between psychological resilience and postoperative adverse events/QoL were determined using multivariable logistic and linear regression analysis, respectively. Some patients were evaluated again after admission, and the patients were divided into an increased resilience group and decreased resilience group for subgroup analysis according to the changes between the two CD-RISC scores. All included patients were followed up for at least 6 months.ResultsNinety-seven patients were included in the high resilience group and 284 patients were included in the low resilience group. More neurological complications occurred in the low resilience group than in the high resilience group (18.7% vs. 8.2%, P=0.016). Also, a higher Karnofsky performance scale score and higher psychological resilience contributed to less adverse events. Patients in the high resilience group had higher postoperative global health status scores than those in the low resilience group. Higher educational level, Karnofsky performance scale score, and psychological resilience acted as a protective factor for postoperative QoL. Subgroup analysis showed that the incidence of neurological complications was significantly higher in the decreased resilience group compared to the increased resilience group (22.9% vs. 3.8%, P=0.039). Lastly, better global health status, physical functioning, and role functioning were observed in glioma patients with increased resilience.ConclusionsThe incidence of postoperative adverse events and QoL of glioma patients are closely related to their level of preoperative psychological resilience. Psychological counseling may also be a part of improving the prognosis of glioma patients.

Can baseline quality of life scores predict for morbidity and survival after CRS and HIPEC: a prospective study of 151 patients.

ObjectivesVarious studies have shown that good quality of life (QoL) can be achieved after cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC). There is prognostic value of baseline QoL in post-operative outcome in Western setting. Our prospective study aims to validate these observations and elucidate clinical factors that predict poorer QoL in Asian peritoneal carcinomatosis patients.MethodsEuropean Organization for Research and Treatment of Cancer Core Quality of Life Questionnaire was administered to patients before CRS and HIPEC and thereafter at 3, 6 and 12 months.ResultsA total of 151 patients underwent 155 surgeries. Four hundred and seventy two questionnaires were completed. Median disease-free survival (DFS) was 16.5 months. Three year DFS and overall survival (OS) were 24.0% and 73.0% respectively. Post-operative global health status significantly increased at 3, 6 and 12 months. The decreases in functional scales recovered to baseline by 1-year post-surgery. Peritoneal carcinomatosis index (PCI), presence of stoma, peritonectomy duration, death within one year, post-operative complication and length of SICU stay negatively influenced QoL. Complication rates were higher in patients with lower global health status, physical and role functioning scores and higher symptom summary scores at baseline. Lower social functioning score, and higher pain, dyspnoea and symptom summary scores at baseline were significantly associated with poorer OS.ConclusionsVarious clinical factors can help us predict a patient’s QoL after surgery. Several baseline factors were also able to predict morbidity and survival. Going forward, we can use these factors to help us better select patients who will have a greater benefit from CRS and HIPEC.

Postoperative health status and quality of life after pure laparoscopic donor hepatectomy for living donor liver transplantation

Postoperative health status and quality of life after pure laparoscopic donor hepatectomy for living donor liver transplantation

Postoperative Health Status and Quality of Life After Pure Laparoscopic Donor Hepatectomy for Living Donor Liver Transplantation.

BackgroundLaparoscopic donor hepatectomy (LDH) for living donor liver transplantation has been performed in several specialized institutes. Surgical outcomes of LDH have shown comparable results to open donor hepatectomy (ODH), but the quality of life (QOL) after LDH is not known. This prospective questionnaire-based study was performed to assess health status and QOL of live liver donors before and after donor hepatectomy (DH).Material/MethodsFrom May 2017 to February 2020, questionnaire items such as the Enhanced Recovery after Surgery mobility scale (EMS), Body Image Questionnaire, and EQ-5D-3L were examined up to 1 year after DH to respectively evaluate postoperative recovery, body image satisfaction, and health status.ResultsDuring the study period, 45 laparoscopic DH (LDH) donors and 2 open DH (ODH) donors were finally fully evaluated. The LDH group had a significantly higher mean EMS than ODH on postoperative day (POD) 5, and 7 (P=0.011, and P=0.004, respectively). Body image scores of the LDH group were significantly higher than that of the ODH group at 1 month after DH (17.8 vs 15.0, P=0.017). There were 45 LDH donors who recovered to preoperative values at 6 months and 1 month after DH, with no statistically significant difference in EQ-5D-3L index value and visual analogue scale (P=0.059 and P=0.217, respectively).ConclusionsWithin 1 month after DH, LDH donors showed faster mobility recovery and body image satisfaction to the level of preoperative status than ODH. LDH donors recovered to preoperative health status within 6 months, in accordance with previous studies of ODH donors.

Effects of Gabapentin Enacarbil on Postoperative Pain After Hip and Knee Arthroplasty: A Placebo-controlled Randomized Trial.

Total joint arthroplasties are among the most common elective procedures performed in the United States, and they are associated with postoperative pain. Gabapentin enacarbil is a prodrug with an extended-release formulation that has been proposed for multimodal postoperative analgesia, but the drug's efficacy for major arthroplasties remains unclear. We enrolled 60 adult patients scheduled for primary knee or hip arthroplasty expected to remain hospitalized for at least 3 days. Eligible patients were randomly assigned to placebo or gabapentin enacarbil 600 mg twice daily starting the day before surgery continuing for 3 days thereafter.The primary outcome was analyzed using a joint hypothesis framework of pain (0 to 10 verbal response scores) and cumulative opioid consumption (mg of morphine equivalent) within the first 72 hours. Secondary outcomes were nausea and vomiting, pain persisting 90 days after surgery, duration of hospitalization, and early postoperative health status using quality of recovery score (QoR-15). Twenty-eight patient in gabapentin enacarbil group and 32 in placebo group were analyzed. Since pain scores did not differ significantly (difference of means: -0.2 in pain scores; 95% confidence interval: -1.1, 0.7), nor did opioid consumption, conditions for joint hypothesis testing were not met. Moreover, there were no significant differences between groups for secondary outcomes. We did not identify statistically significant or clinically meaningful differences in our primary and secondary outcomes related to perioperative use of gabapentin enacarbil in patients having primary hip or knee arthroplasties.

Postoperative Health Status and Quality of Life after Pure Laparoscopic Donor Hepatectomy for Living Donor Liver Transplantation: Post-operative Recovery and Outcomes of Laparoscopic versus Open Hemihepatectomy in Donors (POROLOH-D)

Background: Surgical outcomes of laparoscopic donor hepatectomy (LDH) have shown comparable results to open donor hepatectomy (ODH), but the quality of life (QOL) after LDH is not known. The prospective questionnaire-based study was perfumed to compare QOL of LDH versus ODH donors.