Gastrointestinal Quality of Life in Gastroesophageal Reflux Disease: A Systematic Review.

Background: The Gastrointestinal Quality of Life Index (GIQLI) is a well-established instrument for the assessment of quality of life (QOL) in gastrointestinal (GI) diseases. The purpose of this literature review was to investigate QOL by means of GIQLI in patients with gastroesophageal reflux disease (GERD) prior to any interventional therapy. There are several reports on GIQLI data; however, comparisons from different countries and/or different GERD cohorts assessing the same disease have to date not been conducted.

Effects of supervised aerobic exercise on cardiorespiratory fitness and patient-reported health outcomes in colorectal cancer patients undergoing adjuvant chemotherapy-a pilot study.

Purpose: Colorectal cancer and its treatment are associated with debilitating side effects. Exercise may improve the physical and psychological wellbeing of cancer patients; however, evidence in colorectal cancer patients undergoing adjuvant chemotherapy is limited. This pilot study aimed to explore the effects of supervised aerobic exercise on cardiorespiratory fitness and patient-reported health outcomes in colorectal cancer patients undergoing adjuvant chemotherapy.

Evaluation of quality of life after laparoscopic surgery: evidence-based guidelines of the European Association for Endoscopic Surgery.

Background: Measuring health-related quality of life (QoL) after surgery is essential for decision making by patients, surgeons, and payers. The aim of this consensus conference was twofold. First, it was to determine for which diseases endoscopic surgery results in better postoperative QoL than open surgery.

[Organization of pain therapy in surgery--comparison of acute pain service and alternative concepts].

An acute pain service done by surgeons is one possibility for organizing pain therapy in surgical wards. To do this successfully, some preconditions must be kept in mind, such as 24-h presence, an integrated system of documentation, and teamwork between medical and nursing staff. Comparison of differently structured pain therapy in three different hospitals (with and without acute pain service) showed high levels of patient satisfaction with the pain therapies in all three hospitals.

Laparoscopic versus open appendectomy: between evidence and common sense.

Background: Laparoscopic surgery has been proposed to have diagnostic and therapeutic advantages over conventional surgery. The purpose of this article is to present a recently completed Cochrane review on laparoscopic surgery for suspected appendicitis on the background of daily surgical practice and the developments in the last decade.

Methods: Within the Cochrane review, various medical databases (Medline, Embase, Cochrane, SciSearch) were searched electronically until October 2001.

Quality of life in patients with multiple injuries--basic issues, assessment, and recommendations.

Background: While the primary goal of trauma care continues to be the preservation of life, interest has begun to focus on disability and quality of life of those who survive. Numerous instruments have been developed to measure personal well-being, impairment, or subjective life-satisfaction. But there is no consensus regarding which instruments are most appropriate to use in multiply injured patients, and comparison of results are difficult.

[Preventive and pre-emptive concepts in the acute hospital].

This study aimed at developing an efficient pain therapy with preventive conceptions for the clinical routine. Since 30-75% of all patients suffer from unbearably strong pain. Before establishing an efficient treatment, 100 patients were asked about efficiency of pain treatment.

Laparoscopic fundoplication for gastro-oesophageal reflux disease - a consensus development conference and the evidence-based benefit.

The aim of this paper is to demonstrate an example of evidence-based medicine for a clinically relevant and frequent disease - gastro-oesophageal reflux disease - for which an increasing number of laparoscopic operations is performed. A consensus development conference was performed on this topic in 1996. During the following 3-year period, increase of knowledge shown by the number of publications was monitored and the consecutive changes of the consensus as well as its consequences and impact were analysed.

The individual patient and evidence-based medicine - a conflict?

The doctor-patient relationship is characterised by clinical situations that reflect different degrees of impairment of the patient's quality of life on the one hand and different degrees of threat to the patient's life on the other. Typical patterns of these situations from absent or minimal to severe impairment of well being or threat to life are described. With regard to this, the doctor-patient communication is still suffering from considerable deficits.

Combined abdominal wall paresis and incisional hernia after laparoscopic cholecystectomy.

A case of combined abdominal wall paresis and incisional hernia after laparoscopic cholecystectomy is reported. The paresis possibly occurred by a lesion of the N. intercostalis when extending the incision for stone extraction.

Quality of life more than 20 years after repair of esophageal atresia.

Purpose: To examine the quality of life after repair of esophageal atresia, follow-up studies were performed in 58 of 71 surviving patients (81.7%).

Methods: Fifty patients with primary anastomosis and all eight surviving patients with colon interposition were seen.

Long-term results after laparoscopic cholecystotomy in a child with symptomatic gallstone disease.

Cholecystotomy has been suggested for symptomatic gallstone disease in selected children. This suggestion is supported by a potential reduction in the frequency of the so-called postcholecystotomy syndrome. To our knowledge, laparoscopic cholecystotomy has not been reported yet.

[Allocation of resources in surgery--the role of waiting lists and scoring systems].

International authors who have applied scoring systems to reduce waiting lists conclude that the hope that scoring systems will help is an illusion. Data on queue management are extremely rare.

[Technology assessment of ultrasound in acute diagnosis of blunt abdominal trauma].

In this article a systematic technology assessment was used for ultrasound in blunt abdominal trauma. We found sonography to be a simple, fast and complication-free method with high sensitivity and specificity. Ruptures of the small bowel seemed to be extremely difficult to detect, especially in the early phase after blunt abdominal trauma.

[Auto-dermal hernioplasty--a rare and unknown technique].

The recurrence rates following the "simple" incisional hernia repair procedures (Mayo-procedure or direct adaptation) are unacceptably high, in literature up to 50%. In order to reduce the recurrence rates alternative procedures are necessary, e.g.

[Mayo duplication in treatment of incisional hernia of the abdominal wall after conventional laparotomy. Results of a retrospective analysis and comparison with the literature].

About 10% of patients undergoing conventional laparotomy will develop incisional hernias. Traditionally these hernias are in this country most often repaired by a Mayo-duplication. In this retrospective analysis we investigated a consecutive series of 114 patients (mean age: 53 (11-87) years, gender ratio m:f 1.

[Current practice of incisional hernia reconstruction in Germany].

The results of a nationwide survey regarding the treatment of incisional hernias following open laparotomy revealed that the Mayo-duplication is the surgical technique preferred by the majority of surgeons. However, in exceptional situations alloplastic material is implanted by up to 50% of the surgeons asked. More than one forth of the departments performed more than 30 incisional hernia repairs per year.

[Abdominal wall hernias: epidemiology, economics and surgical technique--an overview].

Surgery of the abdominal wall is a chronically neglected field in general surgery. In fact subcutaneous wound infections and incisional hernias are the most frequent events while wound rupture and laparostomy are the most dangerous complications in abdominal surgery. Based on epidemiological data, a classification of adverse events for the abdominal wall is presented.

[Viscerosynthesis in laparoscopic interventions--concepts and cost benefit relations].

Viscerosyntheses represent an unrenouncable component of several endoscopic procedures. The extra cost for a laparoscopic viscerosynthesis of approximately 2000 DM in the year 1994 are economically well invested with regard to a reduced postoperative pain, a reduced amount of postoperative analgesics, a faster recovery, and most of all drastically reduced morbidity of the abdominal wall. The unfortunate structure of the healthcare system burdens the hospital with additional financial expenditures, thus shifting the profits to the insurance companies.

Laparoscopic and conventional closure of perforated peptic ulcer. A comparison.

Background: After the first successful laparoscopic closure of a perforated peptic ulcer in 1990, 18 patients with laparoscopic closure were compared to 16 patients with conventional surgery.

Methods: The endpoint adverse events (complications), pain intensity, operation time, fever, leucocytosis, and duration of hospital stay showed no clinically relevant differences.

Results: Consumption of analgesics was lower in the laparoscopic group.