Background: Generally, treatment of gastroesophageal reflux disease (GERD) in the elderly follows the same principles as for any adult patient. Currently laparoscopic antireflux surgery (LARS) has not been clearly established in the elderly patient. The aim of this prospective study was to evaluate the surgical outcome including quality of life after LARS in patients older than 65 years.
Methods: Since 1993 more than 500 patients underwent LARS in our institute. A total of 72 patients, older than 65 years, has been treated with laparoscopic 'floppy' Nissen (n = 51) or Toupet (n = 21) fundoplication. The patients included 23 women and 49 men, with a mean age of 71 years (range, 66-79 years). Quality of life was evaluated using the Gastrointestinal Quality of Life Index (GIQLI). The GIQLI was evaluated prior to surgery, and 3 months and 1 year after surgery, with 24-h pH monitoring and esophageal manometry being performed.
Results: Intraoperative complications occurred in two patients (both injury of the spleen), successfully managed laparoscopically. Conversion to laparotomy and mortality were 0%. Postoperative complications occurred twice: one patient had a perianal thrombosis; one had an epileptic seizure. Three months and 1 year after surgery 24-h pH monitoring (mean DeMeester score: preoperative, 61.4+/-23.7; 3 months, 8.4+/-6.4; 1 year, 7.8+/-7.2) and esophageal manometry (mean: preoperative, 2.3 = 1.8 mmHg; 3 months, 13.9+/-3.7 mmHg; 1 year, 12.3+/-3.2 mmHg) showed normal values in all patients. GIQLI increased significantly (mean: preoperative, 86+/-9.7 points; 3 months, 120.1+/-8.9 points; 1 year, 119.3+/-10.1 points) after surgery and is comparable to healthy individuals (118.7 points). One patient suffered from severe dysphagia and required dilatation. In two patients laparoscopic refundoplication was necessary 1 year after the initial procedure because of a 'slipping Nissen' and a 'telescope phenomenon'. Three years after LARS (n = 32) data are comparable to I year after surgery.
Conclusion: As our data show, LARS can be a safe and effective procedure that significantly improves quality of life in the elderly patient suffering from GERD. Age should no longer be a contraindication to LARS.
Download full-text PDF |
Source |
---|---|
http://dx.doi.org/10.1080/003655201750065843 | DOI Listing |
BMC Musculoskelet Disord
January 2025
Department of Health Sciences, Faculty of Medicine, Lund University, Box 117, Lund, 221 00, Sweden.
Background: Osteoarthritis (OA) often leads to pain and functional limitations, impacting work and daily life. Physical activity (PA) is an important part of the treatment. Wearable activity trackers (WATs) offer a novel approach to promote PA but could also aid in finding a sustainable PA level over time.
View Article and Find Full Text PDFBMC Oral Health
January 2025
Innovation Center of Nursing Research, Nursing Key Laboratory of Sichuan Province, West China Hospital, Sichuan University, No.37, Guoxue Lane, Wuhou District, Chengdu, China.
Background: Diabetes with its highly prevalence has become a major contributor to the burden of health care costs worldwide. Recent unequivocal evidence has revealed a bidirectional link between oral health and diabetes. In this study, the effects of the Oral Health Promotion Program (OHPP) on oral hygiene, oral health-related quality of life and glycated haemoglobin (HbA1c) levels in diabetic elderly were examined.
View Article and Find Full Text PDFBMC Public Health
January 2025
School of Nursing, Tung Wah College, 16/F, Ma Kam Chan Memorial Building, 31 Wylie Road, Kowloon, Hong Kong SAR, People's Republic of China.
Background/objective: Physical literacy (PL) is "the motivation, confidence, physical competence, knowledge, and understanding to value and take responsibility for engagement in physical activities for life". Recent evidence has shown that PL was associated with mental wellbeing in different populations, yet a comprehensive review examining the association between PL and mental health among tertiary education students was lacking. The aims of this scoping review were to rapidly map relevant evidence on the relationships between perceived PL and mental health in higher education students and to determine the feasibility and value of conducting a full systematic review in this research area.
View Article and Find Full Text PDFOrphanet J Rare Dis
January 2025
Department of Social Work, Child Welfare and Social Policy, Faculty of Social Science, Oslo Metropolitan University, Oslo, Norway.
Introduction: The purpose of this study was to investigate perceptions and opinions on what constitutes determinants for quality of life (QoL) in individuals with syndromic Heritable Aortic Disease (sHTAD), utilizing a qualitative study approach. Further to discuss clinical implications and direction for research.
Method: A qualitative focus group interview study was conducted of 47 adults (Marfan syndrome (MFS) = 14, Loeys-Dietz syndrome (LDS) = 11, vascular Ehlers Danlos syndrome (EDS) = 11, relatives = 11).
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!