Patient-Centered Outcomes after Laparoscopic Paraesophageal Hernia Repair
| Autor: | Kristine Kuchta, John G. Linn, Raymond J. Joehl, Stephen P. Haggerty, Michael B. Ujiki, Natalie Warnes, Woody Denham, Herbert M. Hedberg, Tyler Hall, Stephanie Novak |
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| Rok vydání: | 2017 |
| Předmět: |
Male
medicine.medical_specialty Paraesophageal SF-36 medicine.medical_treatment Fundoplication 03 medical and health sciences 0302 clinical medicine Quality of life Medicine Humans Hernia Prospective Studies Prospective cohort study Herniorrhaphy Aged Pain Measurement business.industry Patient-centered outcomes Heartburn Hernia repair medicine.disease humanities Surgery Hernia Hiatal Treatment Outcome 030220 oncology & carcinogenesis Quality of Life 030211 gastroenterology & hepatology Female Laparoscopy medicine.symptom business |
| Zdroj: | Journal of the American College of Surgeons. 227(1) |
| ISSN: | 1879-1190 |
| Popis: | The aim of this study is to investigate patient-centered quality of life (QOL) outcomes in patients undergoing laparoscopic paraesophageal hernia repair.We prospectively followed patients who underwent laparoscopic paraesophageal hernia repair between 2009 and 2016. The QOL outcomes were measured using the 36-Item Short Form Health Survey, GERD Health Related Quality of Life, Reflux Symptom Index, and Dysphagia score surveys administered preoperatively and at 3 weeks, 6 months, 1 year, and 2 years postoperatively. Postoperative QOL outcomes were compared with preoperative baseline scores using paired t-tests.Of 314 total patients who underwent laparoscopic paraesophageal hernia repair, 188 with adequate follow-up were included in analysis. Mean age was 69.1 ± 11.8 years and 22.3% of studied subjects were male. Most of the cohort also underwent laparoscopic fundoplication (95.7%). Prevalent symptoms at initial presentation include heartburn (65.4%) and regurgitation (60.1%). Significant improvements between baseline and all postoperative time points were seen in Reflux Symptoms Index (3 weeks: p0.0001, 6 months: p = 0.005, 1 year: p = 0.0004, and 2 years: p = 0.002) and GERD Health Related Quality of Life scores (3 weeks: p0.0001, 6 months: p = 0.0019, 1 year: p0.0001, and 2 years: p = 0.0003). Dysphagia scores were worse at 3 weeks but lost significance at all other time points. The 36-Item Short Form Health Survey measures of Energy/Fatigue (p = 0.0099), Emotional Well-Being (p = 0.0393), Social Functioning (p = 0.0278), Pain (p = 0.0021), and Role Limitations Due to Physical Health (p = 0.0009) were significantly improved 2 years postoperatively.Laparoscopic paraesophageal hernia repair results in significantly improved QOL as measured by the 36-Item Short Form Health Survey at both short- and long-term intervals. Additionally, Reflux Symptom Index and GERD Health Related Quality of Life scores improved at all postoperative time points. |
| Databáze: | OpenAIRE |
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