Evaluation of physical and mental recovery status after elective liver resection

Arnberger, Michael; Vogt, Andreas; Studer, Peter; Inderbitzin, Daniel; Pulver, Carole; Röhrig, Bernd; Jakob, Stephan M.; Greif, Robert

doi:10.1097/eja.0b013e328328f552

Cited by 9 publications

(9 citation statements)

References 29 publications

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“…The postoperative MCS in our patients did not differ significantly from baseline and only 23.5% of the patients had a clinically relevant decrease of postoperative MCS scores. This complies with findings of earlier studies [ 16 , 38 , 39 ]. When measured before surgery and 30 days after surgery, no effects on mental health were apparent in our major surgery patients.…”

Section: Discussionsupporting

confidence: 93%

“…In a cohort of 76 patients, Aljabri and collaborators detected a statistically significant decrease in PCS (measured with SF-36) five weeks after open abdominal aortic surgery (N = 76) [ 14 ]. A statistically significant decrease of PCS at one month was also observed after gastric and colorectal surgery using the SF-12 [ 16 , 38 ] in cohorts of 151 and 223 patients, and a similar pattern was reported for 19 patients with liver resection surgery [ 39 ]. This statistically significant decrease of physical quality of life at one month may be related to an ongoing healing processes consecutive to an postoperative acute systemic inflammatory response syndrome after major surgery including the sickness behaviour [ 2 ], or to incomplete postoperative rehabilitation [ 40 ].…”

Section: Discussionmentioning

confidence: 56%

“…The relatively small sample size limits statistical power, thus observed differences between groups (decreased HRQoL vs. stable HRQoL) should be interpreted with caution, and demands further validation in larger samples. The concept of MCID in this study was only used for decreased HRQoL and not for improved HRQoL based on the valid evidence that HRQoL is decreased after major surgery in the first month [ 14 , 16 , 38 , 39 ].…”

Section: Discussionmentioning

confidence: 99%

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Preoperative and early postoperative quality of life after major surgery - a prospective observational study

Maillard

Elia

Haller

et al. 2015

Health Qual Life Outcomes

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BackgroundChanges in health-related quality of life (HRQoL) several days after surgery have rarely been investigated. We aimed to estimate the perioperative change of HRQoL, to identify patients with clinically relevant decrease in postoperative HRQoL and to establish factors associated with this decrease in HRQoL at day 30 after major surgery.MethodsPatients scheduled for major surgery at a university hospital were enrolled. Based on the HRQoL SF-12 questionnaire, the preoperative physical component summary (PCS) score, preoperative mental component summary (MCS) score, and postoperative PCS and MCS scores at day 30 were recorded. Minimal clinically important difference (MCID) was defined as those with a decrease of at least one half of the standard deviation (SD) of preoperative PCS or MCS scores. Differences between the groups with or without decreased HRQoL were investigated using univariate comparisons. A multiple logistic regression model was performed to evaluate the predictive value of potential perioperative variables.ResultsThe mean ± SD preoperative PCS score was 38.5 ± 10.6, postoperative score was 35.1 ± 7.8 (p = .004) in 85 patients. Thirty-five patients (41.2%) had a clinically relevant decrease of the postoperative PCS score. A normal to high preoperative exercise metabolic capacity measured with metabolic equivalent of task (MET) (p = .01) was a predictor of the decrease in postoperative PCS. The mean preoperative MCS scores (p = .395) were 42.2 (SD 12.8) preoperative, and 43.45 (SD 12.4) postoperative, respectively.ConclusionsMajor surgery decreases postoperative PCS scores of HRQoL at 30 days. A normal to high exercise capacity was a predictor of a clinically relevant decrease of postoperative PCS scores.Trial registration07–107 (Ethical Committee NAC of Geneva University Hospitals).

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Section: Discussionsupporting

confidence: 93%

Section: Discussionmentioning

confidence: 56%

Section: Discussionmentioning

confidence: 99%

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Preoperative and early postoperative quality of life after major surgery - a prospective observational study

Maillard

Elia

Haller

et al. 2015

Health Qual Life Outcomes

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“…Previous study showed a significant decrease of nine-item QoR scores at POD1, POD3 and POD5 compared with baseline in hepatectomy [27]. However, the difference of nine-item QoR scores=18 in the immediate postoperative period was not as evident in the current study.…”

Section: Discussioncontrasting

confidence: 85%

Anything Other than Pain that Matters after Breast Cancer Surgery? A Randomized Controlled Study Comparing Three Anesthetic Modalities

Li¹,

Chen²

2014

Surgery

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Background: Paravertebral block (PVB) was shown to reduce postoperative pain and postoperative nausea and vomiting for breast surgery. However, there is no evidence showing that these benefits were solely provided by PVB and positively influence patient-perceived outcomes after breast cancer surgery. Methods:One hundred breast cancer patients were randomized into three groups: general anesthesia (GA, n=34), GA with PVB (GA+ PVB, n=33), PVB with sedation (PVB, n=33). The quality of recovery (QoR) score was assessed preoperatively as baseline, 6 hours postoperatively, and on postoperative day (POD) 1. Analgesia effects, adverse events, and perioperative satisfactions were also assessed. Results:The rate of QoR 6 hours reaching 18 in GA group (25.53%) seemed to be lower compared with GA+PVB (30.3%) or PVB (42.42%) but without statistical significance. Nevertheless, multivariate logistic regression analysis demonstrated that modality of PVB affected QoR 6 hours (p=0.04). Analgesic consumptions and pain scores were significantly higher and time to first request of analgesics shorter in GA group. The incidences of the GA-related undesired effects were significantly lower and satisfaction with emergence significantly better (P < 0.0001) in PVB group when compared with GA group. There was no difference between GA and GA+PVB in these outcomes. Conclusions:Anesthesia modalities containing PVB provided better pain control. Anesthesia modalities avoiding GA, i.e. PVB alone, led to significantly lower incidences of GA-related adverse events, significantly better satisfaction with the process of emergence, and contribution to QoR 6hours reaching 18.

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“…However, with no specific questionnaire existing for patients undergoing liver resection for benign liver tumors, an individual questionnaire was designed. In this context, elements from the Short Form 36, McGill Pain Score, and European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core [26,29,30] were used. The questionnaire consists of 44 questions composed of multi-item scales to evaluate physical role and emotional, cognitive, and social functioning.…”

Section: Quality Of Life Assessmentmentioning

confidence: 99%

The challenge of liver resection in benign solid liver tumors in modern times – in which cases should surgery be done?

et al. 2017

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Due to improved diagnostical and therapeutical approaches, benign liver tumors represent a challenge in clinical management. We here report our experience with patients undergoing liver resection for benign liver tumors. 188 One hundred eighty-eight consecutive patients, who underwent surgery for solid benign liver tumors from 1992 - 2014, were analyzed retrospectively. The focus was on diagnostic pathways, indications for surgery, and perioperative and postoperative quality of life (QoL). Of 188 patients, 100 had focal nodular hyperplasia (FNH) (53.2 %), 33 had hepatocellular adenoma (17.5 %), and 55 had hemangioma (29.3 %). In most patients, there was more than one 1 indication for liver resection, including tumor-associated symptoms (n = 82, 43.6 %), suspicion of malignancy (n = 104, 55.3 %), tumor disease in the medical history (n = 48, 25.5 %), or tumor enlargement (n = 27, 14.4 %). Serious complications (>grade III;, Clavien-Dindo) occurred in 9.5 % of patients. Perioperative mortality was 0.5 %. Patient pain scores decreased over time (p < 0.001). QoL after liver resection significantly improved (p = 0.007). Uncertainty of the tumor entity remains an issue in preoperative diagnostics. If indicated, liver resection for benign liver tumors represents a safe approach and leads to significant improvements of QoL.

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Evaluation of physical and mental recovery status after elective liver resection

Abstract: The SF-36 indicates that liver resection surgery has a higher impact on physical health than on mental health. QoR-9 determines the feasible time course of recovery with a 1-week return to baseline. Preoperative impaired physical health might predict postoperative complications.

Cited by 9 publications

References 29 publications

Preoperative and early postoperative quality of life after major surgery - a prospective observational study

Preoperative and early postoperative quality of life after major surgery - a prospective observational study

Anything Other than Pain that Matters after Breast Cancer Surgery? A Randomized Controlled Study Comparing Three Anesthetic Modalities

The challenge of liver resection in benign solid liver tumors in modern times – in which cases should surgery be done?

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