The rise of morbidity of morbid obesity (MO) and the presence of concomitant pathologies are important factors affecting both the duration and quality of life in the general population level, and a quality of life is much less studied. Many aspects of quality of life, especially in morbid obesity have been linked to many external factors that determine the complexity of the study and interpretation of data on life quality.
During the period from 2007 to 2011 in the clinic of surgical diseases and new technologies 97 invasive interventions for MO correction were carried out. Diseases, concomitant to obesity, were noted in the absolute majority of patients. Most frequently were encountered cardiovascular disease (in 82.1% of cases), respiratory dysfunction (41.4%) and diabetes (15.8%). Duration of obesity ranged from 5 to 17 years, 11,8 ± 0,8 years in average. Limotherapy was used in 59 (92.2%) patients, but weight loss was negligible (8-10 kg) and quickly restored. All patients were treated conservatively for obesity.
To analyze the surgical treatment of morbid obesity of patients we have studied the outcomes of all patients in the nearest postoperative period, traced the dynamics of weight change within a months after the surgery, the clinical course of concomitant diseases and long-term results in up to 7 years.
Changes in the indices of quality of life (QL) of patients were monitored complexly before and 1 year after the surgery. QL was assessed by questionnaire "The study of health outcomes - Short Form - 36» (SF-36). The calculated averages and standard deviations of QL parameters in 63 patients before treatment and 57 patients a year after the surgery have shown positive changes in the quality of life in almost all patients. Positive changes were more related to physical indices of QL - physical functioning, role (physical) functioning, general health. At the same time changes of indices of mental health - vitality, social functioning, emotional functioning, mental health were not statistically significant. Alongside with surgical treatment essential importance in achievement of stabilization of psycho-emotional sphere of patients should be given to a multidisciplinary approach and a more long-term psychological care with psychotherapeutic techniques.
Thus, it should be emphasized that a surgical treatment of patients with morbid obesity is the only method that allows regaining a person to normal life, to reduce disability and save him from physical, cosmetic and mental discomfort caused by obesity.
QUALITY OF LIFE OF PATIENTS AFTER SUBTOTAL RESECTION OF THYROID GLAND IN PATIENTS WITH DIFFUSE TOXIC GOITER
R.A. GALKIN, I.V. MAKAROV, M.M. ANDREYEV
Samara State Medical University; Samara, RUSSIA
Study and assessment of the quality of life and postoperative rehabilitation of patients with thyroid disease is of significant medical and social importance. Quality of life is considered as an integral characteristic of the physical, psychological, emotional and social functioning of the examined, based on his subjective perception.
The aim of this study was to assess the quality of life of patients operated for diffuse toxic goiter (DTG) within the last 10 years. Employees of the department conducted a retrospective study of the quality of life of 138 patients with DTG operated from 2000 to 2010. To assess the quality of life and results of treatment there was conducted a survey of patients by means of specially prepared questionnaires (Form SF-36).
We obtained the following results: patients with a total score of 30-35, total of 57 (41.3%) persons, were referred to the group with a good quality of life. Patients in the group did not report about any complaints associated with performed surgery and treatment. The surveyed population, with a total score of 20- 30 points - 61 persons (44.2%), - were referred to a group of patients with a satisfactory state of quality of life. They had signs of hyper-or hypothyroidism, and other complaints connected mainly with concomitant diseases. Patients - 20 persons (14.5%) – with total score less than 20 points, were referred to the group of patients with unsatisfactory quality of life. This group of patients is under constant dispensary control of an endocrinologist, physician, and other professionals and needs supportive and symptomatic therapy. Information received about long-term results of treatment and quality of life of patients shows that 41.3% of operated patients feel well and do not need any drug treatment.
Intervention in thyroid gland shall be surgically radical, endocrinologically gentle and performed in specialized surgical departments.