scholarly journals HETEROTOPIC CONTINENT OR INCONTINENT URINARY DIVERSION:MAKING THE OPTIMAL CHOICE

2017 ◽  
Vol 8 (1) ◽  
pp. 50-57
Author(s):  
V A Perepechay ◽  
I M Spitsyn ◽  
O N Vasilyev ◽  
M I Kogan
Keyword(s):  
Quality Of Life ◽  
Survival Rate ◽  
Urinary Diversion ◽  
Statistical Significance ◽  
Late Complications ◽  
Optimal Choice ◽  
Kock Pouch ◽  
Comorbidity Index ◽  
Continent Diversion

Introduction. Quality of life and survival rate of post-cystectomy patients depend on the urinary diversion methods [1,2].Purpose of the study. A comparison of morbidity, survival rate, and quality of life in patients after heterotopic continent or incontinent urinary diversions.Materials and methods. During the period from 1998 to 2016, 36 heterotopic intestinal diversions were performed using urine containment method according to the Kock pouch scheme in our modification, and 61 incontinent heterotopic intestinal Bricker diversions. We evaluated the comorbid conditions (Charlson comorbidity index), postoperative complications (acc. to Clavien-Dindo), survival rate (acc. to E.L. Kaplan, P. Meier), and the quality of life of patients (SF-36) using complex statistical analysis.Results. Early and late complications not related and related to urinary diversion prevailed in the group of patients after Bricker surgery without statistical significance. With longer postoperative monitoring periods the share of complications related to urinary diversion increases, while the frequency of delayed complications and survival rate show no statistical difference in both groups. No reliable differences were revealed in the quality of life in all cases of cutaneous urinary diversion.Discussion. 80% of patients after the Kock pouch surgery (mod.) throughout the medium follow-up period of over 5 years remain continent and enjoy high quality of life. It is necessary to develop and implement in clinical practice new and more advanced statistical tools for evaluation of the patients’ quality of life depending upon the type of urinary diversion after cystectomy.Conclusion. Heterotopic continent diversion (Kock pouch (mod.)) in comparison with the incontinent method (Bricker) does not increase morbidity or decrease the survival rate, and provides for higher quality of life.

scholarly journals Liver Transplantation and Quality of Life

2000 ◽  
Vol 14 (8) ◽  
pp. 693-699 ◽  
Author(s):  
J Rodés ◽  
M Navasa
Keyword(s):  
Quality Of Life ◽  
Liver Transplantation ◽  
Survival Rate ◽  
Late Complications ◽  
Liver Transplants ◽  
Physical Conditions ◽  
The World ◽  
Liver Transplantations ◽  
Validated Instrument

To date, more than 50,000 liver transplantations have been performed around the world; the survival rate five years after transplantation ranges from 60% to 65%. One of the fundamental objectives for liver transplantation teams is to achieve the best possible quality of life (QOL) for the patients. A concise analysis of the methodology used (15 questionnaires) to measure QOL of patients with liver transplants is described. The authors suggest that now is the time to establish a database so that a validated instrument will be available to compare QOL results from all the liver transplantation programs. Liver transplantation is believed to improve QOL, although there are several problems with some of the papers published on this subject. Some studies are retrospective, whereas in others, patients in bad physical conditions are excluded from the study; in quite a few prospective studies, deaths are not included in the data analysis. Finally, the authors provide a brief, concise analysis of late complications and of recurrence of the disease after liver transplantation, which influence QOL.

scholarly journals Modified Mainz Pouch II (sigma rectum pouch) urinary diversion: 12 years experience

2007 ◽  
Vol 54 (4) ◽  
pp. 73-77 ◽  
Author(s):  
I. Ignjatovic ◽  
D. Basic
Keyword(s):  
Quality Of Life ◽  
Postoperative Complications ◽  
Urinary Diversion ◽  
Life Quality ◽  
Late Complications ◽  
Anastomotic Site ◽  
Mainz Pouch Ii ◽  
The Mean

Objective: To analyze the outcome of Mainz Pouch II urinary diversion related to complications and life quality. Patients and Methods: From 1995 to 2006, a total of 67 patients (60 male and 7 female, mean age 58.4 years, range 48 to 70) who underwent modified ureterosigmoidostomy (Mainz Pouch II) procedure have been retrospectively analyzed. The mean follow-up was 18 (1 - 72) months and it was available for 56 patients (84%). Early and late postoperative complications as well as quality of life after surgery were analyzed. An clinical questionairre has been used for examination specific urinary diversion items. Results: Early postoperative complications (<30 days) we-re detected in 9 patients (13%) and late complications (>30 days) in 19 patients (28%). Early complications consisted of urine leakage of moderate degree in 5 (7%) and ileus requiring surgical revision in 4 (6%) patients. The late complications included acute pyelonephritis in 12 patients (18%) and uretero-sigmoidal anastomotic site stenosis in 7 (11%). Ureterosigmoidal anastomotic site stenosis was detected in 7 patients with 7 renoureteric units (RU). In 4 RU, metal Strecker stent was successfully applied. In 3 RU, permanent nephrostomy catheter was applied. Oral alkalizing agents were applied in 22 patients (33%) due to metabolic acidosis. Two patients died due to severe acidosis. Continent rate was 96%. The mean voiding frequency during the day and night was 5.2+1.8 and 2.7+ 0.5, respectively. Global life quality was bad for 3 (8%), acceptable for 15 (38%) and good for 22 (54%) patients. Conclusion: The Mainz Pouch II urinary diversion is simple and safe procedure regarding complications rate, continence and quality of life. It is good alternative to other forms of continent urinary diversion. Patient selection and compliance following by meticulous follow-up are of utmost importance for successful operative outcome.

Comparison of postoperative complications and quality of life between patients undergoing continent versus non-continent urinary diversion after pelvic exenteration for gynecologic malignancies

2019 ◽  
Vol 30 (2) ◽  
pp. 233-240 ◽  
Author(s):  
Martina Aida Angeles ◽  
Estelle Mallet ◽  
Philippe Rouanet ◽  
Bastien Cabarrou ◽  
Pierre Méeus ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Postoperative Complications ◽  
Urinary Diversion ◽  
Pelvic Exenteration ◽  
Continent Urinary Diversion ◽  
Gynecologic Malignancies ◽  
Global Quality Of Life ◽  
Continent Diversion ◽  
Eortc Qlq

BackgroundPelvic exenteration and its reconstructive techniques have been associated with high postoperative morbidity and a negative impact on patient quality of life. The aim of our study was to compare postoperative complications and quality of life in patients undergoing continent compared with non-continent urinary diversion after pelvic exenteration for gynecologic malignancies.MethodsWe designed a multicenter study of patients from 10 centers who underwent an anterior or total pelvic exenteration with urinary reconstruction for histologically confirmed persistent or recurrent gynecologic malignancy after previous treatment with radiotherapy. From January 2005 to September 2008, we included patients retrospectively, and from September 2008 to May 2009, patients were included prospectively which allowed collection of quality of life data. Demographic, surgical, and follow-up data were analyzed. Postoperative complications were classified according to the Clavien–Dindo classification. Quality of life was assessed using the European Organization for Research and Treatment of Cancer (EORTC)-QLQ-C30 (V.3.0) and EORTC-QLQ-OV28 quality of life questionnaires. We compared patients who underwent a continent urinary diversion with those who underwent a non-continent reconstruction.ResultsWe included 148 patients, 92 retrospectively and 56 prospectively. Among them, 77.4% had recurrent disease and 22.6% persistent disease after the primary treatment. In 70 patients, a urinary continent diversion was performed, and 78 patients underwent a non-continent diversion. Median age of the continent and incontinent groups was 53.5 (range 33–78) years and 57 (26-79) years, respectively. There were no significant differences between the continent and non-continent groups in median length of hospitalization (28.5 vs 26 days, P=0.19), postoperative grade III–IV complications (42.9% vs 42.3%, P=0.95), complications needing surgical (27.9% vs 34.6%, P=0.39) or radiological (14.7% vs 12.8%, P=0.74) intervention, and complication type (digestive (23.2% vs 16.7%, P=0.32) and urinary (15.9% vs 16.7%, P=0.91)). There were no significant differences between the groups in global health, global quality of life, and body image perception scores 1 year after surgery.ConclusionContinent and incontinent urinary reconstructions are equivalent in terms of postoperative complications and quality of life scores.

scholarly journals The influence of the Kinesio Taping on selected ultrasonography measurements, and quality of life in patients with rotator cuff lesions

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Aneta Bac ◽  
Magdalena Wróbel ◽  
Katarzyna Ogrodzka-Ciechanowicz ◽  
Edyta Michalik ◽  
Anna Ścisłowska-Czarnecka
Keyword(s):  
Quality Of Life ◽  
Rotator Cuff ◽  
Statistical Significance ◽  
Control Group ◽  
Subacromial Space ◽  
Kinesio Taping ◽  
Significant Difference ◽  
Rotator Cuff Lesions ◽  
Significant Change

Abstract The assessment of the six-week influence of Kinesio Taping combined with a rehabilitation on selected ultrasonography measurements, the level of disability, and the quality of life in patients with rotator cuff lesions. 60 participants were randomly assigned into a taping group (KT combined with a six-week rehabilitating protocol) and a control group (only rehabilitation protocol). In all patients the following assessments were performed twice: USG, UEFI and NHP questionnaires. In the examination of the subacromial space and the subacromial bursa in the taping group, no statistical significance was observed. A statistically significant change in the thickness of the muscles was obtained only for the thickness of the infraspinatus in the taping group. A statistically significant change was obtained in the assessment of tendinopathy only for the supraspinatus muscle in both groups. Within both groups a statistically significant difference was observed in the average UEFI and NHP scores; however, the differences in the scores obtained between the groups were not statistically significant. The use of KT with a rehabilitation program did not yield statistically significantly better results in the improvement of selected shoulder region indicators, the function of the upper limb and the quality of life.

scholarly journals Outcomes of the rotating hinge knee in revision total knee arthroplasty with a median follow-up of 6.2 years

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Jake von Hintze ◽  
Mika Niemeläinen ◽  
Harri Sintonen ◽  
Jyrki Nieminen ◽  
Antti Eskelinen
Keyword(s):  
Quality Of Life ◽  
Total Knee Arthroplasty ◽  
Survival Rate ◽  
Knee Arthroplasty ◽  
Revision Total Knee Arthroplasty ◽  
Patient Reported ◽  
Total Knee ◽  
Revision Tka

Abstract Background The purpose of this study was to determine the mid-term clinical, radiographic and health-related quality of life (HRQoL) outcomes and define the survival rate in patients who had undergone revision total knee arthroplasty (TKA) using the single rotating hinged knee (RHK) design. Methods Between January 2004 and December 2013, 125 revision TKAs were performed at our institution using the single RHK implant. We conducted both a retrospective analysis of prospectively collected outcome data of these patients and a prospective follow-up study of all 39 living patients (41 knees). The follow-up phase included an optional extra follow-up visit, PROM questionnaires, and plain radiographs. Results The ten-year Kaplan-Meier survival rate of the revision RHK knees was 81.7% (95% CI 71.9–91.6%) with re-revision for any reason as the endpoint. Overall, 15 knees (12% of the total) underwent re-revision surgery during the follow-up. The median follow-up was 6.2 years (range, 0–12.7 years) post-operatively for the baseline group. One mechanical hinge mechanism-related failure occurred without any history of trauma or infection. At the time of the final follow-up, the majority of patients evinced a fairly good clinical outcome measured with patient-reported outcome measures and none of the components were radiographically loose. Conclusion We found that in patients undergoing complex revision TKA, fairly good functional outcome and quality of life can be achieved using an RHK implant. Further, it seems that in this type of patient cohort, revision TKA using an RHK implant relieves pain more than it improves ability to function. The NexGen® RHK design can be regarded as a suitable option in complex revision TKA.

scholarly journals The impact of bronchial artery embolisation on the quality of life of patients with haemoptysis: a prospective observational study

2021 ◽  
Author(s):  
Naoki Omachi ◽  
Hideo Ishikawa ◽  
Masahiko Hara ◽  
Takashi Nishihara ◽  
Yu Yamaguchi ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Survival Rate ◽  
Bronchial Artery ◽  
Recurrence Free Survival ◽  
Free Survival ◽  
Kaplan Meier ◽  
Procedural Success ◽  
Bronchial Artery Embolisation ◽  
The Impact

Abstract Objectives Patients with haemoptysis often experience daily physical and mental impairment. Bronchial artery embolisation is among the first-line treatment options used worldwide; however, no evidence exists regarding the health-related quality of life (HRQoL) after bronchial artery embolisation. Therefore, this study aimed to evaluate the effects of bronchial artery embolisation on the HRQoL of patients with haemoptysis. Methods We prospectively enrolled 61 consecutive patients who visited our hospital from July 2017 to August 2018 and received bronchial artery embolisation for haemoptysis. The primary outcome was the HRQoL evaluated using the Short Form Health Survey, which contains physical and mental components, before and after bronchial artery embolisation. The secondary outcomes were procedural success, complications, and recurrence-free survival rate at 6 months. Results The mean age of the patients was 69 years (range, 31–87 years). The procedural success rate was 98%. No major complications occurred. The recurrence-free survival rate estimated using the Kaplan-Meier analysis at 6 months after bronchial artery embolisation was 91.8% (95% confidence interval, 91.1–92.5%). Compared with the pre-treatment scores, the physical and mental scores were significantly improved at 6 months after bronchial artery embolisation (p < 0.05). Conclusion Bronchial artery embolisation improved the HRQoL of patients with haemoptysis. Key Points • Bronchial artery embolisation improved the HRQoL of patients with haemoptysis. • Vessel dilation on computed tomography and systemic artery-pulmonary artery direct shunting on angiography were the most common abnormalities. • The recurrence-free survival rate estimated using the Kaplan-Meier analysis at 6 months after bronchial artery embolisation was 91.8%.

scholarly journals Mini-Implant-Retained Overdentures for the Rehabilitation of Completely Edentulous Maxillae: A Systematic Review and Meta-Analysis

2021 ◽  
Vol 18 (8) ◽  
pp. 4377
Author(s):  
Serena Vi ◽  
Damon Pham ◽  
Yu Yian Marina Du ◽  
Himanshu Arora ◽  
Santosh Kumar Tadakamadla
Keyword(s):  
Quality Of Life ◽  
Systematic Review ◽  
Survival Rate ◽  
Data Extraction ◽  
Meta Analysis ◽  
Empirical Studies ◽  
Implant Survival ◽  
Patient Reported ◽  
Full Text Review

Purpose: Mini-dental implants (MDIs) have been used to support and retain overdentures, providing patients with a less invasive placement procedure. Although lucrative, the use of MDIs to retain a maxillary overdenture is still not an established treatment modality. This systematic review aims to answer the question: Do mini-implant-retained maxillary overdentures provide a satisfactory treatment outcome for complete edentulism? Methods: A systematic search for relevant articles was conducted to include articles published until April 2021 in the following electronic databases: CINAHL, Cochrane, EMBASE, PubMed, and Web of Science. All empirical studies evaluating the biological, survival, or patient-reported outcomes after placing mini-implant-retained overdentures in maxilla were considered for inclusion. The risk of bias was assessed by utilizing the Joanna Briggs Institute critical appraisal checklist. Study screening and data extraction were conducted by three reviewers independently. Results: The electronic search retrieved 1276 titles after omitting duplicates. Twenty articles were considered for full-text review, of which six studies were included in this systematic review. The included studies evaluated a total of 173 participants with a mean age of 66.3 years. The overall mini-implant survival rate was 77.1% (95% CI: 64.7–89.5%) with a mean follow-up time of 1.79 years (range: 6 months to 3 years). Implant survival differed significantly when comparing complete and partial palatal coverage overdentures. Those with complete palatal coverage exhibited less bone loss overall compared to partial coverage overdentures. Participants of all studies reported an increase in the quality of life and in satisfaction after rehabilitation treatment with MDIs. Conclusions: The survival rate of mini-implants retaining an overdenture in the maxilla was observed to be lower than the values reported for traditional implants in the literature. Improvements were observed in all aspects in terms of patient satisfaction, quality of life, oromyofunction, and articulation after the treatment.

Sign in / Sign up

Export Citation Format

Share Document