Quality Of Life In Surgery Research Articles

Impact of Ocular Conditions and Improvements After Refractive Surgery in Quality of Life for Children With Neurodevelopmental Disorders

This study aims to characterize the eye-related quality of life of children with neurodevelopmental and ocular disorders at baseline and after refractive surgery. Prospective interventional case series. We enrolled children and adolescents 5 to 18 of age with neurodevelopmental disorders undergoing refractive surgery (6 for pre-/postsurgical assessment and 14 for baseline analysis). Eye-related quality of life was measured using the Pediatric Eye Questionnaire (PedEyeQ). Baseline levels of adaptive functioning and social behaviors were measured using the Adaptive Behavioral Assessment System (ABAS-3) and Social Responsiveness Scale (SRS-2). We assessed the correlation between baseline PedEyeQ scores, number of ocular comorbidities, magnitude of refractive error, and ABAS-3 and SRS-2 scores. At baseline, 14 patients demonstrated decreased median eye-related quality of life (<60/100) in 5 of 9 PedEyeQ domains, moderate deficiencies in social behaviors (SRS-2 median 71, range 49-90), and low adaptive functioning (ABAS-3 median percentile for age of 0.100). Baseline PedEyeQ scores did not correlate with magnitude of refractive error or adaptive functioning scores but did correlate with number of ocular comorbidities and social behavior scores. Six patients have undergone refractive surgery without complication. Postoperatively, 11 of 11 eyes were within ±1.5 diopters spherical equivalent. Four of 6 patients exhibited clinically significant improvements in PedEyeQ scores after surgery. Even in the presence of significant social and adaptive impairments, quality of life in children with neurodevelopmental disorders is decreased by ocular disorders. Refractive surgery is associated with clinically significant improvements in eye-related quality of life.

Advantages of laparoscopic hepatic hemangioma surgery in quality of life: a prospective study.

Surgical intervention is the most accurate method for the treatment of hepatic hemangioma. The advantages of laparoscopic surgery on quality of life should be clarified by prospective studies. The sample sizes of the laparoscopic and open surgery groups were calculated based on previous retrospective literature. Intraoperative and postoperative parameters were prospectively collected and analyzed. Quality of life in both groups was predicted by a mixed linear model. Sixty patients were enrolled in the laparoscopic surgery group and open surgery group. The laparoscopic group had a longer operation time (P = 0.040) and more hospitalization expenses (P = 0.001); however, the Clavien-Dindo classification and comprehensive complication index suggested a lower incidence of surgical complications in the laparoscopic group, with P values of 0.049 and 0.002, respectively. After mixed linear model prediction, between-group analysis indicated that the laparoscopic group had little impact on role-physical functioning and role-emotional functioning; in addition, within-group analysis showed a rapid recovery time on role-physical functioning and role-emotional functioning in the laparoscopic group. Quality of life in both groups recovered to the preoperative level within 1 year after the operation. The advantages of laparoscopic hepatectomy for hepatic hemangioma were fewer postoperative complications, lower impact on quality of life and faster recovery from affected quality of life.

Patient-Reported Outcomes after Subpectoral Breast Augmentation with Microtextured or Macrotextured Implants Using the BREAST-Q.

Background Breast augmentation with implants is the most commonly performed cosmetic plastic surgery in Brazil and worldwide. The aim of this study was to assess patient satisfaction and quality of life following subpectoral breast augmentation with either microtextured or macrotextured implants, using the BREAST-Q. Methods A prospective study was conducted with 40 women with hypomastia undergoing subpectoral breast augmentation. The patients were randomly allocated to two groups to receive either microtextured or macrotextured breast implants. All participants were assessed preoperatively (baseline) and after 2 and 4 months of surgery for quality of life and patient satisfaction with the surgical results, using the BREAST-Q augmentation module, a patient-reported outcome measure. Results The patients had a mean age of 28.9 ± 6.45 years. The microtextured ( n = 20) and macrotextured ( n = 20) groups were homogeneous for sex, age, education level, marital status, and number of children ( p > 0.05). Both groups showed significant improvement in satisfaction with breasts ( p < 0.001), psychosocial well-being ( p < 0.001), and sexual well-being ( p < 0.001) at the 2- and 4-month follow-up visits compared with baseline. The observed improvements were associated with high effect size values of 5.09, 3.44, and 3.90, respectively. In contrast, significant decreases from baseline in physical well-being scores ( p = 0.001) were found 2 and 4 weeks after surgery in both groups. Conclusion Subpectoral breast augmentation with either microtextured or macrotextured breast implants improved satisfaction with breasts and quality of life in patients with hypomastia.

Evaluating Patient Preferences in Benign Prostatic Hyperplasia Treatment Using Conjoint Analysis

ObjectiveTo quantify benign prostatic hyperplasia (BPH) patient preferences to promote guidelines-compliant, patient-centered care. Discordance between patient and urologist priorities for the treatment of BPH hinders patient-centered care. Physician assumptions regarding patient preferences lead to dissatisfied patients; a poor outcome in any quality of life surgery. American Urologic Association guidelines urge urologists to consider patient preferences when recommending a BPH treatment. MethodsIn this cross-sectional, online survey study using researchmatch.org, participants were required to decide between theoretical BPH treatments in a balanced, choice-based conjoint analysis. The treatments had varying levels of four attributes: efficacy, recovery difficulty, risk of complications (Clavien-Dindo 2+), and risk of de novo ejaculatory dysfunction. Demographic information and International Prostate Symptom Score were collected and analyzed using comparative statistics. Each attribute was analyzed using a conditional logit model, and attribute importance (range in utility between attribute-levels) was calculated. ResultsOut of 1235 recruited participants, 812 (66%) completed the study. Median International Prostate Symptom Score and age was 6 (IQR 3-12) and 56 (IQR 38-67), respectively. Complication risk was the most important attribute, followed by efficacy, recovery difficulty, and risk of ejaculatory dysfunction. In a subgroup analysis of age quartiles, participants age <38 and >67 held efficacy (31%) and complication risk (47%) to the highest relative importance, respectively. ConclusionMales valued BPH treatments that minimize complication risks, while ejaculatory dysfunction was least impactful. Variation in results between age subgroups emphasizes the need for individualized care to maximize patient satisfaction.

Patient Views Around Their Hernia Surgery: A Worldwide Online Survey Promoted Through Social Media.

Introduction: Hernias are one of the most common surgical diagnoses, and general surgical operations are performed. The involvement of patients in the decision making can be limited. The aim of this study was to explore the perspectives of patients around their hernia and its management, to aid future planning of hernia services to maximise patient experience, and good outcomes for the patient.Methods: A SurveyMonkey questionnaire was developed by patient advocates with some advice from surgeons. It was promoted on Twitter and Facebook, such as all found “hernia help” groups on these platforms over a 6-week period during the summer of 2020. Demographics, the reasons for seeking a hernia repair, decision making around the choice of surgeon, hospital, mesh type, pre-habilitation, complications, and participation in a hernia registry were collected.Results: In total, 397 questionnaires were completed in the study period. The majority of cases were from English speaking countries. There was a strong request for hernia specialists to perform the surgery, to have detailed knowledge about all aspects of hernia disease and its management, such as no operation and non-mesh options. Chronic pain was the most feared complication. The desire for knowledge about the effect of the hernia and surgery on the sexual function in all age groups was a notable finding. Pre-habilitation and a hernia registry participation were well-supported.Conclusions: Hernia repair is a quality of life surgery. Whether awaiting surgery or having had surgery with a good or bad outcome, patients want information about their condition and treatment, such as the effect on aspects of life, such as sex, and they wish greater involvement in their management decisions. Patients want their surgery by surgeons who can also manage complications of such surgery or recommend further treatment. A large group of “hernia surgery injured” patients feel abandoned by their general surgeon when complications ensue.

Patient related outcomes and improvements in quality of life following orthognathic surgery

AbstractAimThe purpose of this systematic review was to summarise the findings and to evaluate changes in patient quality of life (QOL) following orthognathic surgery.Materials and methodsOnline searches were undertaken to identify suitable studies. Prospective cohort or case‐control studies using questionnaires or similar assessment instruments to evaluate pre‐ and post‐orthognathic surgery QOL were included in the analysis. QOL was assessed in the following five domains: physical functioning and limitations, physical pain, psychological well‐being and self‐esteem, self‐perception with regards to aesthetics and social functioning and relationships.ResultsOf the 13 studies included in the analysis most noted significant improvements in all QOL domains. The domains in which the greatest improvements were noted post‐operatively were psychological well‐being and self‐esteem and self‐perception with regards to aesthetics. The results of the Short Form Health Survey (SF‐36) revealed that patients experienced no considerable changes in QOL after orthognathic surgery, while the other assessment instruments used demonstrated that patients experienced changes primarily in self‐perception within the aesthetics domain.ConclusionsThe results indicate that orthognathic surgery significantly improved QOL in the five domains detailed. In particular, surgery elicited the greatest improvements in QOL in the psychological well‐being and self‐esteem and self‐perception in the aesthetics domains.

Laparoscopic uterovaginal prolapse surgery in the elderly: feasibility and outcomes

BackgroundUterovaginal prolapse in very elderly women is a growing problem due to increased life expectancy. Surgeons and anaesthetists may be wary of performing quality of life surgery on this higher risk group. Where surgery is undertaken, it is commonly performed vaginally; there is a perception that this is better tolerated than abdominal surgery.Little data is published about laparoscopic prolapse surgery tolerability in this population, and laparoscopic surgery is perceived within the urogynaecological community as complex and lengthy and hence inherently unsuitable for the very elderly.In Oxford, UK, laparoscopic abdominal surgical techniques are routinely employed for urogynaecological reconstructive surgery. The authors offer abdominal laparoscopic prolapse surgery to patients suitable for general anaesthesia with apical vaginal prolapse, irrespective of age. We here report outcomes in this elderly patient cohort and hypothesise these to be acceptable.This is a retrospective case note review of all patients aged 79 years old and above undergoing laparoscopic prolapse surgery (hysteropexy or sacrocolpopexy) in two centres in Oxford, UK, over a 5-year period (n = 55). Data were collected on length of surgery, length of stay, intraoperative complications, early and late post-operative complications and surgical outcome.ResultsMean age was 82.6 years (range 79–96). There were no deaths. Minor post-operative complications such as UTI and constipation were frequent, but there were no serious (Clavien-Dindo grade III or above) complications; 80% achieved objective good anatomical outcome.ConclusionsLaparoscopic prolapse surgery appears well tolerated in the elderly with low operative morbidity and mortality.

LAS MUJERES SOMETIDAS A REDUCCIÓN MAMARIA MEJORAN SU APARIENCIA ESTÉTICA, AUTOESTIMA, SÍNTOMAS FÍSICOS Y VIDA SEXUAL

effects of breast reduction surgery on the quality life background: The results of breast reduction surgery are usually reported in terms of anthropome tric assessments. However the impact of surgery in quality of life is seldom informed. aim: To assess the effects of breast reduction surgery on the quality of life of patients. material and methods: The “Breast-Q Reduction and Mastopexy Module” was prospectively applied to all women subjected to breast reduction surgery in a University Hospital during one year. results: Twenty women answered the survey in the preoperative period and 20 in the postoperative period. The most commonly cutaneous pattern employed that the inverted T in 10 women, followed by the Wise pattern in six patients. The most commonly used pedicles were superior in 10 patients, followed by superomedial in seven patients. Mean excision weight was 923 g (range 150-2850). Mean Breast Q score improved from 45 to 65%. Satisfaction with breast appearance improved from 31 to 83%, self-esteem from 39 to 80%, sexuality from 50 to 81% and physical symptoms decreased from 48 to 16%. There was a significant association between the magnitude of ex cision and improvement in physical symptoms. conclusions: Quality of life improves notably in women after breast reduction surgery.

Comparison of the Postprocedural Quality of Life between Coronary Artery Bypass Graft Surgery and Percutaneous Coronary Intervention: A Systematic Review.

The treatment of choice between coronary artery bypass graft surgery (CABG) and percutaneous coronary intervention (PCI) has remained unclear. Considering quality of life (QOL) increases life expectancy, we believe QOL should be important in determining the optimum treatment. Thus the objective of this review was to illustrate the comparative effects of CABG and PCI on postprocedural QOL. Methods. We searched PubMed (Medline) and Embase from inception of the databases to May 2014 using “PCI versus CABG quality of life”, “Percutaneous Coronary intervention versus Coronary artery bypass graft surgery Quality of life”, “PCI versus CABG health status”, “Angioplasty versus CABG”, “Percutaneous coronary intervention versus coronary artery bypass surgery health status”, and different combinations of the above terms. 447 articles were found. After applying strict exclusion criteria, we included 13 studies in this review. Results. From the 9 studies that compared QOL scores at 6 months after procedure, 5 studies reported CABG to be superior. From the 10 studies that compared QOL among patients at 1 year after procedure, 9 reported CABG to be superior. Conclusion. It can be established that CABG is superior to PCI in improving patient's QOL with respect to all scales used to determine quality of life.

1936 A treatment threshold for decision making in breast cancer surgery for optimal quality of life

1936 A treatment threshold for decision making in breast cancer surgery for optimal quality of life

P15.06 * QUALITY OF PATIENTS LIFE WITH METASTATIC TUMORS OF THE SPINE AND SPINAL CORD

Reducing pain, regression of neurological symptoms, restoration of pelvic organs, restoring lost function of the spinal cord is the primary goal of palliative treatment of patients with metastatic tumors of the spine and spinal cord. PURPOSE: To improve the quality of patients life with metastatic tumors of the spine and spinal cord, differentiated by the choice of treatment In RSCN in the period from 1996 to 2013 years 112 patients were operated on. Of these, 20 patients underwent dorsion stabilizing operation rear access to the establishment of pedicle fixation system, 10 patients dorsion stabilizing operation of anterolateral access, 14 patients underwent percutaneous vertebroplastics with bone cement, 68 patients underwent laminectomy. Before and after surgery quality of life was assessed by the Karnofsky scale. At the time of discharge on the quality of life of patients operated as follow s: 74 patients with a good result (a measure of quality of life - 70 % and more), 28 patients with satisfactory results (quality of life score - 60 %), 8 patients with unsatisfactory results of quality of life - <40 %. CONCLUSIONS: The analysis of the results of surgical treatment of differentiated showed that by reducing pain, regression of neurological symptoms, restoration of pelvic organs allows patients to get rid of nursing care that leads to improved quality of life.

"Fulfilling the chief of his duties as a physician": Harvey Cushing, selective dorsal rhizotomy and elective spine surgery for quality of life.

At the beginning of the 20th century, the development of safer anesthesia, antiseptic techniques, and meticulous surgical dissection led to a substantial decrease in operative risk. In turn, the scope of surgery expanded to include elective procedures performed with the intention of improving the quality of life of patients. Between 1908 and 1912, Harvey Cushing performed 3 dorsal rhizotomies to improve the quality of life of 3 patients with debilitating neuralgia: a 54-year-old man with "lightning" radicular pain from tabes dorsalis, a 12-year-old boy cutaneous hyperesthesia and spasticity in his hemiplegic arm, and a 61-year-old man with postamputation neuropathic pain. Symptomatic improvement was seen postoperatively in the first 2 cases, although the third patient continued to have severe pain. Cushing also removed a prominent spinous process from each of 2 patients with debilitating headaches; both patients, however, experienced only minimal postoperative improvement. These cases, which have not been previously published, highlight Cushing's views on the role of surgery and illustrate the broader movement that occurred in surgery at the time, whereby elective procedures for quality of life became performed and accepted.

Epilepsy Surgery Quality of Life and Seizure Control Outcomes

A consecutive, retrospective analysis of seizure control and quality of life was performed in 83 patients who underwent epilepsy surgery at Children’s Hospital of Wisconsin, Milwaukee, WI.

How and why should we benchmark clinical outcomes and quality of life for surgery in spinal metastases?

As many as 70% of cancer patients develop spinal metastases, and the incidence is increasing with longer life-expectancy and improvements in medical treatment.[1,][2] Unlike primary bone tumors, fe...

Long-Term Benefits of Roux-en-Y Pouch Reconstruction After Total Gastrectomy

Roux-en-Y reconstruction with and without jejunal pouch was compared in a randomized controlled trial to identify the optimal reconstruction procedure in terms of quality of life. Randomized trials comparing techniques of reconstruction after total gastrectomy have shown controversial results. One hundred and thirty-eight patients with gastric cancer were intraoperatively randomized for Roux-en-Y reconstruction with pouch (n = 71) or without pouch (n = 67) after gastrectomy and stratified into curative or palliative resection. Intra- and postoperative complications were recorded. Body weight and quality of life were determined every 6 months with a follow-up of up to 12 years. Both groups were comparable for age, sex, incidence of concomitant disease, and staging. There were no differences in operative time, postoperative complications, and mortality. Short- and long-term weight loss was similar in both groups. In the first postoperative year, there were no benefits of pouch reconstruction in terms of quality of life, independent of the resection status. In the third, fourth, and fifth year after surgery quality of life was significantly improved for patients with a pouch. Roux-en-Y pouch reconstruction after gastrectomy is simple to perform and safe. Long-term survivors benefit from pouch reconstruction. Therefore, a pouch is recommended for patients with a good prognosis.

Assessment of quality of life in surgery.

The concept of patients' quality of life is assuming increasing importance in modern medicine and surgery. Interventions are increasingly being assessed in terms of their impact on such areas of functioning as mobility, mood, cognitive function, ability to fulfil occupational and social roles, and general life satisfaction. This paper discusses the theoretical underpinnings of the quality-of-life paradigm and its practical relevance for modern surgery.

Reconstructive plastic surgery in cancer treatment: surgery for quality of life

Recent advancements in many treatment modalities and their combination have greatly increased survival rates among cancer patients. In some fields of contemporary cancer surgery, especially, function-preserving or nonradical operations and minimally invasive endoscopic surgery are highly recommended to maintain a patient’s quality of life as well as achieving a high survival rate. However, complete extirpation of carcinoma is still a clear surgical rationale, which frequently requires the sacrifice of wide healthy surrounding tissues, resulting in functional disabilities or aesthetic deformities. Optimal rehabilitation of cancer patients who have undergone wide resection or heavy irradiation appears to be best accomplished by immediate coverage of cutaneous and muscosal defects, restoration of vital functions, and reconstruction of bony support, as well as reconstruction of the aesthetic deformities. Such management can promise a good quality of life for cancer patients, and therefore plastic and reconstructive surgery is indispensable. In this article, we introduce an overview of the versatility of plastic surgical procedures in cancer surgery, mainly based on two representative procedures that are often employed.

A Psychological Support Concept and Quality of Life Research in a Liver Transplantation Program: An Interdisciplinary Multicenter Study

Considering the increasing number of liver transplantations with longer periods of transplant function, there is a growing need for quality of life research in the field. In addition to lethality, mortality and rehabilitation, parameters of 'quality of life' are to be evaluated: the patient's rating of his subjective physical symptoms, psychological condition (anxiety, depression and mental adjustment), social reintegration and life satisfaction. This paper describes our psychological support program that has been established at the Hamburg LTX center as well as the first results of the ongoing QoL research study. Using the methods developed by the Hamburg Study group on 'quality of life in surgery', 38 liver transplantation patients of the University of Chicago (cross-sectional study with control groups of patients with chronic liver disease as well as healthy individuals) and 29 patients of the University Clinic of Hamburg (longitudinal study with points of evaluation before and 2, 6, 12, 24 and 36 months after transplantation) have been evaluated. First results: (1) All successfully transplanted patients show a significant postoperative increase of their overall quality of life. (2) The psychological parameters of quality of life are only partly correlated with physical symptoms. (3) There is a high correlation between rejection crisis periods and the decrease of all quality of life parameters. (4) In both samples men have a lower quality of life than women, (5) Preoperative depression and lack of social support might be considered as being possible risk factors for long-term survival. (6) Long-term survivors rate their quality of life significantly higher than patients with chronic liver disease and--despite some persisting somatic restrictions--as high as healthy controls. (7) A psychotherapeutic support program increases the patient's compliance resulting a better adaption to the transplant procedure including rehabilitation.