ABSTRACT
BACKGROUND: Today, antireflux surgery has an established position in the management of gastroesophageal reflux disease. Some case series have shown good short-term results, but there is still little information regarding long-term results. Studies have recently focused on evaluating residual symptomatology and its impact on quality of life. OBJECTIVES: To determine the postoperative quality of life and degree of satisfaction in patients that underwent laparoscopic Nissen fundoplication. PATIENTS AND METHODS: A total of 100 patients (59 women and 41 men) were studied after having undergone laparoscopic Nissen fundoplication. The variables analyzed were level of satisfaction, gastrointestinal quality of life index (GIQLI), residual symptoms, and the Visick scale. RESULTS: No variation was found in relation to sex; 49 men and 51 women participated in the study. The mean age was 49 years. The degree of satisfaction encountered was: satisfactory in 81 patients, moderate in 3, and bad in 2 patients. More than 90% of the patients would undergo the surgery again or recommend it. The Carlsson score showed improvement at the end of the study (p<0.05). In relation to the GIQLI, a median of 100.61 points±21.624 was obtained. Abdominal bloating, regurgitation, and early satiety were the most frequent residual symptoms. The effect on lifestyle measured by the Visick scale was excellent. CONCLUSIONS: The level of satisfaction and quality of life obtained were comparable with reported standards; and the residual symptoms after antireflux surgery were easily controlled.
Subject(s)
Fundoplication/psychology , Gastroesophageal Reflux/surgery , Laparoscopy/psychology , Patient Satisfaction , Adolescent , Adult , Aged , Aged, 80 and over , Deglutition Disorders/epidemiology , Female , Gastroesophageal Reflux/psychology , Humans , Male , Middle Aged , Quality of Life , Treatment Outcome , Young AdultABSTRACT
The genus Orobanche includes chlorophyll-lacking root parasites that parasitize many dicotyledonous species and causes severe damage to vegetable and field crops worldwide. Sunflower broomrape (Orobanche cumana Wallr.) is known in Eurasia as a specific parasite of sunflower, which differs from the nodding broomrape (O. cernua Loefl) in host specificity and morphological characteristics (3). Together with Egyptian broomrape (O. aegyptiaca Pers.), it seriously parasitizes sunflower (Helianthus annuus L.) in Israel (1). Prior to 2000, the local confectionary sunflower cvs. Ambar and Gitit proved to be resistant to the local O. cumana populations in Israel (2). A preliminary study, which we conducted in 1995 using the Vranceanu's differentials (4), indicated that O. cumana populations in Israel behave like the known race C. Using random amplified polymorphic DNA analysis, we also found a very low intraspecific diversity of this species in Israel at that time. However, in 2000, infection of the sunflower cvs. Ambar and Gitit was reported in two fields (Gadot and Afek) in northern Israel. In 2001 and 2002, O. cumana parasitized these cultivars in three more locations as much as 50 km apart (Tel-Adashim, Mevo-Hama, and Bet-Hilel). To determine the virulence of O. cumana populations on sunflower cultivars under controlled conditions, O. cumana seeds were collected in the above mentioned sunflower fields. In addition, we also used seeds from an O. cumana population collected in Alonim in 1997. This latter population did not infect the above mentioned 'resistant' sunflower cultivars in the field (2,); therefore, represented the previously known O. cumana populations in Israel. Resistant (Ambar) and susceptible (D.Y.3) sunflower cultivars were planted in separate pots that were differentially filled with soil that was inoculated with O. cumana seeds of the different populations. The experiment was performed in a full factorial arrangement with six replications. As expected, O. cumana from Alonim failed to attack the resistant sunflower. However, the O. cumana populations that were collected in the five other fields seriously attacked both sunflower cultivars, indicating higher virulence. O. cumana from all five new populations proved more virulent than the Alonim population on cvs. Ambar and D.Y.3. The occurrence of these new virulent populations could have several reasons including: (i) importation of virulent parasite seeds from abroad; or (ii) local development of virulence from previously avirulent populations. The latter could be favored by the continuous and repeated use of the available resistant varieties that are all based on a single resistance response (2). References: (1) H. Eizenberg and D. M. Joel. Orobanche in Israeli agriculture. Workshop of COST Action 849, Parasitic Plant Management in Sustainable Agriculture, 2001. (2) H. Eizenberg et al. Plant Dis. 88:479, 2003. (3) D. M. Joel. Phytoparasitica 16:375, 1988. (4) A. V. Vranceanu et al. Proc. 9th Sunflower Conf. 1:74-82, 1980.