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RESUMEN Introducción: La miotomía de Heller laparoscópica es considerada en la actualidad el tratamiento de elección para el alivio de la disfagia. Se ha demostrado que gracias a ella se logra una baja incidencia de reflujo gastroesofágico y una mejoría evidente de la calidad de vida Objetivo: Evaluar la calidad de vida y evolución clínica de los pacientes después de la miotomía de Heller con fundoplicatura de Dor. Método: Estudio observacional descriptivo longitudinal prospectivo mediante la aplicación del cuestionario de índice de calidad de vida gastrointestinal a pacientes operados de acalasia esofágica desde enero del 2010 hasta diciembre del 2017 en el Centro Nacional de Cirugía de Mínimo Acceso. Se aplicó un cuestionario en el preoperatorio y al año de operados. Análisis estadístico: Porcentajes para variables cualitativas, media ± desviación estándar o mediana y rango según corresponda para las cuantitativas, para la comparación de los resultados del cuestionario se emplearon pruebas de hipótesis de comparación de medias, con nivel de significación estadística α= 0,05. Resultados: Fueron incluidos en el estudio 101 pacientes. Las edades oscilaban entre 18 y 78 años con una media de 47 años. El tiempo medio de evolución de los síntomas fue de 62 meses, con una media de 3,3 en la escala de disfagia y una presión de reposo del esfínter esofágico inferior (mmHg) 38,7 ± 16,8, se obtuvo un GIQLI inicial de 85,3 ± 20,4 que aumentó al año a 131,6 ± 10,5 Conclusiones: La miotomía de Heller con fundoplicatura de Dor, mejora la calidad de vida de los pacientes con acalasia esofágica con una evolución clínica excelente(AU)
ABSTRACT Introduction: Laparoscopic Heller myotomy is now considered the treatment of choice for the relief of dysphagia. It has been shown that thanks to it a low incidence of gastroesophageal reflux and evident improvement in the quality of life is achieved. Objective: To evaluate the quality of life and clinical evolution of patients after Heller myotomy plus Dor fundoplication. Method: Prospective, longitudinal, descriptive, observational study carried out by applying the Gastrointestinal Quality of Life Index (GIQLI) questionnaire to patients operated on for esophageal achalasia, from January 2010 to December 2017, at the National Center for Minimum Access Surgery. The questionnaire was applied preoperatively and one year after surgery. Statistical analysis: Percentages for qualitative variables, mean and standard deviation, or median and range, as appropriate for quantitative variables. For the comparison of the results of the questionnaire, we used tests of hypothesis of comparison of means, with statistical significance level of 0.05. Results: The ages ranged between 18 and 78 years, with an average of 47 years. The mean time of evolution of symptoms was 62 months, with an average of 3.3 on the dysphagia scale and a resting pressure of the lower esophageal sphincter (mmHg) 38.7±16.8. An initial gastrointestinal quality of life index of 85.3±20.4 was obtained, which increased to 131.6±10.5 per year. Conclusions: Heller myotomy plus Dor fundoplication improves the quality of life of patients with esophageal achalasia and guarantees an excellent clinical evolution(AU)
Subject(s)
Humans , Male , Female , Middle Aged , Quality of Life , Esophageal Achalasia/surgery , Gastroesophageal Reflux/epidemiology , Heller Myotomy/methods , Epidemiology, Descriptive , Prospective Studies , Longitudinal StudiesABSTRACT
Objective To evaluate the clinical and functional outcomes of Side-to-Side Ileosigmoidostomy Shunting Surgerys for the treatment of elder STC patients.Methods The clinical data of 67 patients all more than 63 years old with severe idiopathic STC treated with this novel approach between June 2010 and July 2017 were retrospectively analyzed.The perioperative complications and defection conditions were followed up by telephone and outpatient.The Wexner constipation score and gastrointestinal tract were compared before and after the operation.SPSS 19.0 software was used for statistical analysis.Independent sample t test was used for measurement data,t and x2 test were used for comparison of count data.Results All the patients received their operations successfully without deaths or serious complication.The center follow-up period (from outpatients or phone) was 12 months (6-29 months).only 16 patients developed complications including 2 and 14 total colonic exclusion.12 of the 14 got better obviously after enema and taken dynamic drugs,Only 2 patients with repeated abdominal pain and distention received jejunostomy.Six months after the operation,only 5 patients needed to take some drugs for defectation.Wexner constipation scores and Gastrointestinal Quality of Life Index (GIQLI) has improved obviously after 6 months and 12 months.Conclusions The novel surgical procedure,side-to-side ileosigmoidostomy Shunting Surgery that practised in our department,is an easy,safe and effective for the treatment of selected elderly patients with STC.Large-sample,randomized,controlled analyses are worth to investigate its clinical effects.
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Objective To investigate the quality of life of post-operative patients with cholecystolithiasis and analyze the influencing factors. Methods About 206 patients with cholecystolithiasis were enrolled in the investigation by gastrointestinal quality of life index (GIQLI). Multivariate linear regression analysis was used to explore the influencing factors of their quality of life. Results The GIQLI score of 206 patients was (115.81 ±9.22) and the index value was 80.42%. Three independent variables such as breakfast habit, exercise, three hyperlipidemia, were the factors that affected the quality of life (P<0.05). Conclusions The quality of life of patients after cholelithiasis is lower than that of normal people. Patients should develop good eating habits and exercise habits, strengthen the interventions with high blood lipids, high blood pressure and hyperglycemia to improve the quality of life of post-operative patients with cholecystolithiasis.