Oral intake and plasma citrulline predict quality of life in patients with intestinal failure

Nutrition ◽  
2020 ◽  
Vol 79-80 ◽  
pp. 110855
Author(s):  
Jan Bednarsch ◽  
Elisabeth Blüthner ◽  
Mirjam Karber ◽  
Undine A. Gerlach ◽  
Andreas Pascher ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Intestinal Failure ◽  
Oral Intake ◽  
Plasma Citrulline

Generic and Disease-Specific Health-Related Quality of Life in Pediatric Intestinal Failure

2021 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Jessica K. McCaig ◽  
Owen S. Henry ◽  
Danielle A. Stamm ◽  
Gaby Dorval ◽  
Alexis Hurley ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Intestinal Failure ◽  
Health Related Quality ◽  
Related Quality ◽  
Health Related ◽  
Disease Specific ◽  
Specific Health

scholarly journals 662 MICROVASCULAR MYOCUTANEOUS AND CUTANEOUS FREE FLAP RECONSTRUCTION FOR PATIENTS WITH TERMINAL ESOPHAGOSTOMY AFTER COMPLICATED ONCOLOGICAL ESOPHAGUS RESECTION

2021 ◽  
Vol 34 (Supplement_1) ◽  
Author(s):  
Lukas Pölsler ◽  
Jaroslav Presl ◽  
Christian Brandtner ◽  
Alexander Gaggl ◽  
Jörg Hutter ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Free Flap ◽  
Treatment Options ◽  
Graft Function ◽  
Oral Intake ◽  
Artificial Nutrition ◽  
Severe Problem ◽  
Promising Alternative ◽  
Number Of Patients

Abstract   Persisting anastomotic leak after oncological esophagectomy is a severe problem associated with high mortality and morbidity. Unfortunately, treatment options with promising results are scarce especially when conventional operative and endoscopic methods have failed. Due to limitation of oral intake and need for artificial nutrition quality of life is reduced. Microvascular myocutaneous and cutaneous free flap (MFF) reconstruction could be a promising alternative. Methods This retrospective cohort study presents seven patients treated between March 2017 and November 2020 at our surgical department, with terminal esophagostomy after complicated oncological esophagus resection without further feasible treatment options. All Patients received anastomotic MFF reconstruction. We have examined postoperative outcomes, complications according to Clavien-Dindo-Classification and patient contentment with a questionnaire. Additionally, we described important procedure related facts. Results The included seven male patients had median age of 65.15 years (range: 48–75). MFF function was adequate in six out of seven patients, graft rejection appeared in one patient. Five patients initially had good results, surgical revision was performed in one patient to ensure graft function. Postoperative complications appeared in 6/7 patients (Table 1). Mean duration of inpatient care was 63 days (Range: 24–156). At time of evaluation, one patient has died cancer related. No more additional nutrition was needed in 3/6 patients with adequate graft function. The majority of patients reported an improved quality of life compared to preoperatively. Conclusion MFF free flap can be a safe and feasible treatment option for patients with terminal esophagostomy after complicated oncological esophagus resection without further treatment options or in patients with complicated postoperative course with complex combined defects. The renewed ability of oral food intake results in a significant improvement of quality of life for the patients. No procedure related mortality was observed. Number of patients with regained ability of oral intake is encouraging.

scholarly journals Nutritional Status and Quality of Life in Hospitalised Cancer Patients Who Develop Intestinal Failure and Require Parenteral Nutrition: An Observational Study

Nutrients ◽  
2020 ◽  
Vol 12 (8) ◽  
pp. 2357
Author(s):  
Marina Plyta ◽  
Pinal S. Patel ◽  
Konstantinos C. Fragkos ◽  
Tomoko Kumagai ◽  
Shameer Mehta ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Observational Study ◽  
Nutritional Status ◽  
Parenteral Nutrition ◽  
Cancer Patients ◽  
Screening Tool ◽  
Intestinal Failure ◽  
Normal Body Mass Index ◽  
The Impact

(1) Background: Malnutrition in cancer patients impacts quality of life (QoL) and performance status (PS). When oral/enteral nutrition is not possible and patients develop intestinal failure, parenteral nutrition (PN) is indicated. Our aim was to assess nutritional status, QoL, and PS in hospitalised cancer patients recently initiated on PN for intestinal failure. (2) Methods: The design was a cross-sectional observational study. The following information was captured: demographic, anthropometric, biochemical and medical information, as well as nutritional screening tool (NST), patient-generated subjective global assessment (PG-SGA), functional assessment of cancer therapy-general (FACT-G), and Karnofsky PS (KPS) data. (3) Results: Among 85 PN referrals, 30 oncology patients (56.2 years, 56.7% male) were identified. Mean weight (60.3 ± 16.6 kg) corresponded to normal body mass index values (21.0 ± 5.1 kg/m2). However, weight loss was significant in patients with gastrointestinal tumours (p < 0.01). A high malnutrition risk was present in 53.3–56.7% of patients, depending on the screening tool. Patients had impaired QoL (FACT-G: 26.6 ± 9.8) but PS indicated above average capability with independent daily activities (KPS: 60 ± 10). (4) Conclusions: Future research should assess the impact of impaired NS and QoL on clinical outcomes such as survival, with a view to encompassing nutritional and QoL assessment in the management pathway of this patient group.

A prospective multicenter observational study of surgical palliation examining postoperative quality of life in patients treated for malignant gastric outlet obstruction caused by incurable advanced gastric cancer.

2017 ◽  
Vol 35 (4_suppl) ◽  
pp. 6-6 ◽  
Author(s):  
Kazumasa Fujitani ◽  
Masahiko Ando ◽  
Kentaro Sakamaki ◽  
Masanori Terashima ◽  
Ryohei Kawabata ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Gastric Cancer ◽  
Gastric Outlet Obstruction ◽  
Outlet Obstruction ◽  
Oral Intake ◽  
Malignant Gastric Outlet Obstruction ◽  
Surgical Palliation ◽  
The Mean

6 Background: Decision-making for surgical palliation remains one of the most challenging clinical scenarios since quality of life (QOL) is a key component of cancer care. We conducted this study to examine the impacts of surgical palliation on postoperative QOL in patients (pts) with malignant gastric outlet obstruction (GOO) caused by incurable primary gastric cancer (GC). Methods: Eligibility included (1) no oral intake or liquids only requiring parenteral nutrition (2) aged ≥20 (3) surgically fit (4) ECOG PS of 0-2 and (5) written IC. Patients underwent either palliative distal/total gastrectomy (DG/TG) or gastrojejunostomy (GJS). Treatment choice was left to the discretion of the physician. Validated QOL instruments (EORTC QLQ-STO22 and EuroQol-5D) assessed QOL at baseline, 2 weeks (wks), 1 month (m), and 3 months following the surgical palliation, and two observational outcomes (postoperative improvement of oral intake, and safety of surgical intervention) were evaluated. Results: 104 pts, 71 males and 33 females with a median age of 68 years, were enrolled. The types of surgery were DG in 23 pts, TG in 9 pts, GJS in 70 in pts, and exploratory laparotomy in 2 pts. Baseline QOL questionnaires were completed by 103 (99.0%) pts. Among the 104 pts, 98 (94.2%), 100 (96.1%), and 81 (77.9%) completed the 2-wk, 1-m, and 3-m follow-up survey, respectively. The mean baseline EQ-5D score was 0.74 (SD, 0.21). During the follow-up period, the mean scores remained consistent with the baseline scores; the change from baseline score was within ± 0.05 for the index. Many pts came to eat solid food at 2 wks postsurgery and remained tolerable thereafter (from 0 at baseline to 82, 85, 75 pts at 2 wks, 1 m, and 3 ms, respectively). Overall morbidity rate of ≥grade 3 on Clavien-Dindo classification and 30-day postoperative mortality rate was 9.6% (10 pts) and 2.0% (2 pts) with a median hospital stay of 13 days and re-operation rate of 3.9% (4 pts). Conclusions: In pts with malignant GOO caused by advanced GC, surgical palliation maintained patient QOL while improving solid food intake with an acceptable surgical safety. Clinical trial information: UMIN000023494.

scholarly journals Dysphagia, Speech, Voice, and Trismus following Radiotherapy and/or Chemotherapy in Patients with Head and Neck Carcinoma: Review of the Literature

2016 ◽  
Vol 2016 ◽  
pp. 1-24 ◽  
Author(s):  
B. J. Heijnen ◽  
R. Speyer ◽  
B. Kertscher ◽  
R. Cordier ◽  
K. W. J. Koetsenruijter ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Head And Neck Cancer ◽  
Head And Neck ◽  
Neck Cancer ◽  
Oral Intake ◽  
Aerodigestive Tract ◽  
Upper Aerodigestive Tract ◽  
Treatment Protocols ◽  
Oncological Treatment

Introduction. Patients with head and neck cancer suffer from various impairments due to the primary illness, as well as secondary consequences of the oncological treatment. This systematic review describes the effects of radiotherapy and/or chemotherapy on the functions of the upper aerodigestive tract in patients with head and neck cancer.Methods. A systematic literature search was performed by two independent reviewers using the electronic databases PubMed and Embase. All dates up to May 2016 were included.Results. Of the 947 abstracts, sixty articles met the inclusion criteria and described one or more aspects of the sequelae of radiotherapy and/or chemotherapy. Forty studies described swallowing-related problems, 24 described voice-related problems, seven described trismus, and 25 studies described general quality of life. Only 14 articles reported that speech pathologists conducted the interventions, of which only six articles described in detail what the interventions involved.Conclusion. In general, voice quality improved following intervention, whereas quality of life, dysphagia, and oral intake deteriorated during and after treatment. However, as a consequence of the diversity in treatment protocols and patient characteristics, the conclusions of most studies cannot be easily generalised. Further research on the effects of oncological interventions on the upper aerodigestive tract is needed.

Evaluation and Management of Oropharyngeal Dysphagia in Head and Neck Cancer

2002 ◽  
Vol 9 (5) ◽  
pp. 400-409 ◽  
Author(s):  
Joy E. Gaziano
Keyword(s):  
Quality Of Life ◽  
Head And Neck Cancer ◽  
Nutritional Status ◽  
Head And Neck ◽  
Neck Cancer ◽  
Treatment Strategies ◽  
Oral Intake ◽  
Swallowing Disorders ◽  
Accurate Identification

Background Dysphagia is a common symptom of head and neck cancer or sequelae of its management. Swallowing disorders related to head and neck cancer are often predictable, depending on the structures or treatment modality involved. Dysphagia can profoundly affect posttreatment recovery as it may contribute to aspiration pneumonia, dehydration, malnutrition, poor wound healing, and reduced tolerance to medical treatments. Methods The author reviewed the normal anatomy and physiology of swallowing and contrasted it with the commonly identified swallowing deficits related to head and neck cancer management. Evaluation methods and treatment strategies that can be used to successfully manage the physical and psychosocial effects of dysphagia are also reviewed. Results Evaluation of dysphagia by the speech pathologist can be achieved with instrumental and non-instrumental methods. Once accurate identification of the deficits is completed, a range of treatment strategies can be applied that may return patients to safe oral intake, improve nutritional status, and enhance quality of life. Conclusions To improve safety of oral intake, normalize nutritional status, reduce complications of cancer treatment and enhance quality of life, accurate identification of swallowing disorders and efficient management of dysphagia symptoms must be achieved in an interdisciplinary team environment.

scholarly journals N31 What factors affect quality of life and psychological well-being in patients with intestinal failure? A systematic review of quantitative studies

2020 ◽  
Vol 14 (Supplement_1) ◽  
pp. S671-S671
Author(s):  
D Roberts ◽  
Q Liu ◽  
W Czuber-Dochan ◽  
P Smith ◽  
C Norton
Keyword(s):  
Quality Of Life ◽  
Systematic Review ◽  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Intestinal Failure ◽  
Factors Affecting ◽  
Positive Effects ◽  
Personal Impact ◽  
Quantitative Studies

Abstract Background The most common cause of intestinal failure (IF) is Crohn’s disease (CD). The definition of IF is ‘the reduction of gut function below the minimum necessary for the absorption of macronutrients and/or water and electrolytes, such that intravenous supplementation is required to maintain health and/or growth’. It is a result of the most severe phenotype of CD, where an individual can no longer obtain sufficient nutrients and fluids from their gut to sustain life without supplementation in the form of parenteral nutrition (PN) or intravenous fluids. Home PN (HPN) allows people to receive infusion at home and increases survival rates (65% after 6 years). Whilst HPN improves length of life, studies have demonstrated this treatment can severely negatively affect an individuals’ quality of life (QoL) and employment. The aim of this systematic review was to identify factors affecting QoL in people with IF. Methods A search of databases MEDLINE, PubMed, PsycINFO, Web of Science, Global Health, and Scopus was conducted in July 2019. Search terms included ‘Crohn’s disease’, ‘short bowel syndrome’, ‘intestinal failure’, ‘quality of life’, and ‘health-related quality of life’. Titles and abstracts were screened by one reviewer. Any uncertainties about inclusion of the papers were discussed with two reviewers. Full texts were screened by 3 reviewers. Quantitative studies that measured QoL as an outcome in people with IF were included. Results Nineteen studies including a total of 924 participants met the inclusion criteria. Six key themes of factors affecting QoL were identified: (1) Practicalities of IF and HPN, e.g. sleep disturbances from the noise of the pump; managing a high output stoma. (2) Impact of medical interventions, e.g. blood tests. (3) Social impact/physical activity/personal relationships, e.g. restricted ability to travel, socialise and eat with friends. (4) Personal and sexual impact, e.g. lack of sexual desire. (5) Impact of symptoms, e.g. fatigue. (6) Patient characteristics, e.g. age. Some studies also reported positive effects on health (such as more energy), improved symptoms and QoL with HPN, especially for those who had been very unwell previously. Conclusion People with IF often have poor QoL that is affected by many factors, from their symptoms to practical aspects of HPN. However, themes related to the ‘social’ and ‘personal’ impact of IF dominated in the literature. While there is considerable evidence on what affects QoL in people with IF, there appears to very little research on attempting to improve QoL in this patient group.

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