scholarly journals Quality of life and surgical outcomes of laparoscopic cholecystectomy in patients over the age of 80: a retrospective study

2020 ◽  
Vol 7 (12) ◽  
pp. 3902
Author(s):  
Husam Ebied ◽  
Andrew Refalo ◽  
Mohammed Saad Aboul-Enien

Background: As the United Kingdom’s population ages an increasing number of patients undergoing elective cholecystectomy are over the age of eighty. The current literature base focuses on a younger patient cohort and fails to consider quality of life benefit from the intervention. Assessing quality of life benefit as well as operative morbidity and post-operative complications together is important in the assessment of whether patients of this age should be managed surgically or conservatively.Methods: A retrospective study was conducted on all patients above the age of eighty undergoing elective cholecystectomy between January 2017 to January 2019 at a tertiary care centre in London. Intra-operative morbidity and post-operative complications were obtained from inpatient notes and quality of life was measured using the gastrointestinal quality of life questionnaire (GIQLI) pre and post operatively.Results: 120 patients over the age of eighty underwent laparoscopic cholecystectomy in the three-year timeframe. 11% experienced post-operative complications. A statistically significant improvement in GIQLI score was noted post-operatively across all domains including social function, gastrointestinal symptoms, physical function and emotional function.Conclusions: Post-operative complication rates were higher amongst this cohort compared to series studying a younger cohort of patients. However, quality of life significantly benefited from the intervention for patients over the age of 80. Hence, amongst carefully selected patients, laparoscopic cholecystectomy remains a viable treatment option and can greatly benefit the individual.

2014 ◽  
Vol 191 (4S) ◽  
Author(s):  
Chad R. Ritch ◽  
Michael S. Cookson ◽  
Sam S. Chang ◽  
Peter E. Clark ◽  
David F. Penson ◽  
...  

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Landa Shi ◽  
Dean Chou ◽  
Yuqiang Wang ◽  
Mirwais Alizada ◽  
Yilin Liu

Abstract Objective To investigate the effect of CT-assisted limited decompression in managing single segment A3 lumbar burst fracture. Method A retrospective study (January 2015–June, 2019). One hundred six cases with single-level Magerl type A3 lumbar burst fractures treated with short-segment posterior internal fixation and limited decompression. Patients were divided into two groups: CT-assisted group and non-CT-assisted group. Perioperative factors, clinical outcomes, post-operative complications, imaging parameters, and health-related quality of life (HRQoL) were evaluated. Results Kyphosis, loss of anterior and posterior vertebral body heights, operative time, and post-operative complications were not significantly different between the two groups. The visual analog score (VAS) and spinal canal encroachment in the CT-assisted group were lower compared with the non-CT-assisted group (p < 0.05). The Japanese Orthopaedic Association (JOA) score, the simplified HRQoL scale, and the American Spinal Injury Association (ASIA) Spinal Cord Injury Grade in the CT-assisted group were significantly higher compared with the non-CT-assisted group (p < 0.05). Conclusion CT-assisted limited decompression in the treatment of single-segment A3 lumbar burst fracture can achieve better fracture reduction and surgical results and improve the long-term recovery of the patients’ neurological function and quality of life.


Author(s):  
Luis Pinheiro

Purpose: Zygomatic implants are becoming more common in oral rehabilitation of atrophic maxilla. Successful surgery and rehabilitation are mandatory for the achievement of a well-defined criteria of Quality of Life. However, there is a paucity of studies reporting on the Health-Related Quality of Life in patients undergoing oral rehabilitation. This article aims to developing a specific questionnaire for this particular surgical and rehabilitation procedure that could be an objective quality outcome measure of Quality of Life. This should improve our understanding of the impact of zygomatic implant placement on Quality of Life. Materials and Methods: The study was performed involving the Eastman Dental Institute - University College of London, the Faculty of Sciences - University of Lisbon, and two private practices in Portugal, C.E.R.O-Lisboa and Clitrofa. This was a retrospective study, evolving 30 patients undergoing TransZygomatic Surgery. A modification of the University of Washington – Quality of Life Questionnaire was designed for this work. The evaluation was made in three-time points: TP1 – Before surgery, TP2 - After surgery and TP3 - After final rehabilitation. Results: The means of the increased Quality of Life between the different time-points were found to be statistically significance at the level of 0.05, with a confidence interval of 95%. Conclusion: With this Questionnaire, important data was collected which should allow treatment developments to optimise patients Quality of Life.


HPB Surgery ◽  
1994 ◽  
Vol 7 (4) ◽  
pp. 261-264 ◽  
Author(s):  
R. Smith ◽  
D. Kolyn ◽  
R. Pace

Outpatient Laparoscopic Cholecystectomy was attempted in 98 patients selected from 266 patients presenting for elective cholecystectomy (37%). Two patients required admission following conversion to “open” Cholecystectomy, one patient was admitted for observation because of a technically difficult Laparoscopic Cholecystectomy and 16 patients were admitted because of refractory nausea and vomiting in the early post-operative period. Seventy-nine patients (81%) were able to be discharged home within 4 to 6 hours of surgery, with only one patient requiring readmission to hospital because of the onset of nausea and vomiting. There were no post-operative complications attributable to the outpatient experience. We believe this approach to elective gallbladder pathology can be safely accomplished in selected patients and will be increasingly utilized in the future.


Author(s):  
CJ Touchette ◽  
MA MacLean ◽  
T Brunette-Clement ◽  
FH Abduljabba ◽  
MH Weber ◽  
...  

Background: Despite the inherent importance of physical reserve and ability to tolerate surgery, pre-operative patient-specific surrogate markers of frailty that may improve accuracy of outcome prognostication following surgery for SMD are not well described. Methods: A systematic review was performed according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. MEDLINE, Scopus, EMBASE, Cochrane Registry of Controlled Trials, CINAHL, and Web of Science were searched. Quality of evidence was scored using the Oxford CEBM Scoring Tool. Results: Forty studies accounted for 8,364 patients. Surgical indications included neurological dysfunction, intractable pain, and spinal instability. Tumor histology varied across and within studies. Age, gender, performance status, neurologic function, comorbidities, and biochemical abnormalities were the most frequently analyzed pre-operative surrogate markers of frailty. The most commonly assessed outcomes were overall and progression-free survival; few studies examined health-related quality of life, peri-operative adverse events, and post-operative complications. Conclusions: This study highlights the need for objective measures of frailty in order to improve risk stratification and outcome prognostication among patients receiving surgery for metastatic spinal disease. Future studies should address identified knowledge gaps pertaining to peri-operative adverse events, post-operative complications, and health-related quality of life outcomes.


2013 ◽  
Vol 61 (1) ◽  
pp. 17-26 ◽  
Author(s):  
Katrin Leenen ◽  
Michael Rufer ◽  
Hanspeter Moergeli ◽  
Hans-Jörgen Grabe ◽  
Josef Jenewein ◽  
...  

Aus Untersuchungen in der Normalbevölkerung ist bekannt, dass Menschen mit erhöhten Alexithymiewerten eine verminderte Lebensqualität (LQ) aufweisen. Für Patienten mit psychischen Störungen wurde dieser Zusammenhang jedoch kaum untersucht. Ziel dieser Studie war es, den möglichen Zusammenhang zwischen alexithymen Patientenmerkmalen und der LQ bei Patienten mit Angststörungen zu überprüfen. Bei 79 ambulanten Patienten mit Angststörungen wurden alexithyme Charakteristika mit der Toronto Alexithymia Scale (TAS-20), die LQ mit der Kurzversion des World Health Organization Quality of Life Questionnaire 100 (WHOQOL-BREF) erfasst. Darüber hinaus fand eine Erhebung der psychischen Symptombelastung (SCL-90-R) und depressiven Symptomatik (MADRS) statt. Mittels hierarchischer Regressionsanalysen wurde der Zusammenhang zwischen der alexithymen Charakteristika und den unterschiedlichen LQ-Domänen berechnet. Die Patienten zeigten eine im Vergleich zur Normalbevölkerung deutlich verminderte LQ. Als Hauptergebnis fand sich, auch nach Kontrolle von Depression, Ängstlichkeit und Geschlecht, ein signifikanter Zusammenhang zwischen den beiden TAS-20 Subskalen Schwierigkeiten, Gefühle zu identifizieren und zu beschreiben und vor allem der psychischen LQ. Unsere Ergebnisse sprechen dafür, bei der Diagnostik und Therapieplanung von Patienten mit Angststörungen alexithyme Merkmale einzubeziehen. Im Falle von ausgeprägten alexithymen Merkmalen sollten psychotherapeutische Interventionen zur Verbesserung der Schwierigkeiten Gefühle wahrzunehmen und zu kommunizieren in Betracht gezogen werden.


Crisis ◽  
2003 ◽  
Vol 24 (2) ◽  
pp. 73-78 ◽  
Author(s):  
Yves Sarfati ◽  
Blandine Bouchaud ◽  
Marie-Christine Hardy-Baylé

Summary: The cathartic effect of suicide is traditionally defined as the existence of a rapid, significant, and spontaneous decrease in the depressive symptoms of suicide attempters after the act. This study was designed to investigate short-term variations, following a suicide attempt by self-poisoning, of a number of other variables identified as suicidal risk factors: hopelessness, impulsivity, personality traits, and quality of life. Patients hospitalized less than 24 hours after a deliberate (moderate) overdose were presented with the Montgomery-Asberg Depression and Impulsivity Rating Scales, Hopelessness scale, MMPI and World Health Organization's Quality of Life questionnaire (abbreviated versions). They were also asked to complete the same scales and questionnaires 8 days after discharge. The study involved 39 patients, the average interval between initial and follow-up assessment being 13.5 days. All the scores improved significantly, with the exception of quality of life and three out of the eight personality traits. This finding emphasizes the fact that improvement is not limited to depressive symptoms and enables us to identify the relative importance of each studied variable as a risk factor for attempted suicide. The limitations of the study are discussed as well as in particular the nongeneralizability of the sample and setting.


2007 ◽  
Author(s):  
Laura E. Dreer ◽  
G. McGwin ◽  
K. Scilley ◽  
G. C. Meek ◽  
A. Dyer ◽  
...  

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