Radical prostatectomy (RP) is preferred for many patients with clinically localized prostate cancer. Despite the introduction of the nerve sparing technique and progressive modifications on RP, postoperative preservation of penile erectile function remains a challenge to urologists. Earlier initiation of penile rehabilitation can significantly improve the patient's quality of life affected by erectile dysfunction (ED) following RP. Tadalafil, a long-acting PDE5 inhibitor with a unique clinical profile, has proved effective in penile rehabilitation in the treatment of RP-associated ED in both clinical trails and animal models. This article reviews current strategies for the management of ED after RP and evaluates the efficacy and safety of tadalafil in post-RP penile rehabilitation.
Carbolines ; therapeutic use ; Erectile Dysfunction ; drug therapy ; rehabilitation ; Humans ; Male ; Penile Erection ; Prostatectomy ; rehabilitation ; Prostatic Neoplasms ; rehabilitation ; surgery ; Tadalafil

OBJECTIVETo evaluate the effect of the fast track programs (FT) on the postoperative recovery of patients with rectum carcinoma after rectal cancer resection.

METHODSEighty-three patients, undergone elective rectal carcinoma resection in our hospital, were randomly divided into two groups. FT group (44 cases) received the perioperative FT programs care, including bowel preparation reduction, preoperative normal intake, early removal of the nasogastric tube and bladder catheter, early postoperative feeding, early mobilization, and no routine drainage. Control group (39 cases) received the conventional program care. The postoperative hospital stay, surgical complications and readmission rate within 30 days postoperatively were compared between the two groups.

RESULTSThe data of two groups such as gender, surgical procedures, complications, TNM stage of tumor, age, operation time and intra-operative blood loss were similar. The mean postoperative hospital stay in FT group was significantly shorter than that in control group [(4.7+/-2.6) d vs (8.9+/-2.8) d] (P<0.001). The surgical complications within 30 days postoperatively in FT group were significantly less than those in control group (P<0.05). The difference of readmission rate was not significant between the two groups (P=0.326).

CONCLUSIONThe colorectal surgical fast track programs applied to the perioperative period care of rectal carcinoma resection can decrease the hospital stay and surgical complications with no obvious change in readmission rate, so the postoperative recovery of patients with rectal carcinoma resection can be improved.

Aged ; Colorectal Surgery ; rehabilitation ; Female ; Humans ; Male ; Perioperative Care ; Prospective Studies ; Rectal Neoplasms ; rehabilitation ; surgery ; Rehabilitation ; methods ; Single-Blind Method

OBJECTIVETo evaluate rehabilitation effect of Amatsu's tracheoesophageal shunt operation after total laryngectomy with sphincter mechanism.

METHODSVoice rehabilitation were performed for 60 cases with Amatsu's tracheoesophageal shunt operation after total laryngectomy with sphincter mechanism, in which 20 cases were involved in post-operation radiation therapy.

RESULTSFifty two (86.7%)cases developed speech with voice and swallow rehabilitation, but 1 case of them suffered water drip from his tracheoesophageal shunt when drinking. The other 8 (11.3%) cases developed swallow rehabilitation but failed in speech rehabilitation for pharyngeal fistula (4 cases, in which 1 had pre-operative radiation therapy), tracheoesophageal shunt obstruction (2 cases), dyspnea with unknown reason (1 cases), no desire to speech (1 cases). Furthermore, all the 20 cases who were involved in post-operative radiative therapy restore their speech and swallow capability finally.

CONCLUSIONSAmatsu's tracheoesophageal shunt operation with sphincter mechanism brought effective speech rehabilitation results for total laryngectomy even with post-operation radiation therapy.

Aged ; Female ; Humans ; Laryngeal Neoplasms ; rehabilitation ; Laryngectomy ; rehabilitation ; Male ; Middle Aged ; Postoperative Period ; Speech, Alaryngeal ; methods ; Tracheostomy ; rehabilitation

OBJECTIVETo investigate the effects of fast track surgery on patients with gastric cancer in perioperative period.

METHODSNinety-two patients with gastric cancer undergone radical operations were randomly divided into two groups: fast track group (n=46, fast track surgery) and control group(n=46, traditional surgery). Serum levels of tumor necrosis factor-alpha (TNF-alpha), interleukin-6 (IL-6) and C reaction protein (CRP) in the 92 patients were assayed preoperatively and at day 1, 3, 7 postoperatively, and the resting energy expenditure (REE) was also measured by indirect calorimetry in the morning. The postoperative hospital stay, duration of fever, medical cost, postoperative time of flatus and postoperative complications were recorded and compared respectively.

RESULTSAt postoperative day 1 and 3, serum levels of TNF-alpha were (12.67+/-2.68) fmmol/L and (13.19+/-2.75) fmmol/L in fast track group, (14.74+/-3.18) fmmol/L and (15.56+/-2.99) fmmol/L in control group; serum levels of IL-6 were (112.52+/-24.73) ng/L and (129.03+/-22.75) ng/L in fast track group, (123.90+/-22.52) ng/L and (142.67+/-20.33) ng/L in control group. The levels of IL-6 and TNF-alpha in fast track group were significantly lower than those in control group (all P<0.05). At postoperative day 1, 3 and 7, serum levels of CRP in fast track group were significantly lower than those in control group [d1(56.20+/-11.47) g/L vs (71.07+/-17.32) g/L, d3(136.09+/-19.78) g/L vs (157.78+/-28.18) g/L, d7 (48.53+/-12.95) g/L vs (64.72+/-19.73) g/L] (all P<0.05). At postoperative day 1 and day 3, the REE in fast track group were significantly lower those than in control group [d1(5713.96+/-619.44) kJ/d vs (6176.04+/-614.46) kJ/d, d3 (5298.49+/-639.36) kJ/d vs (5627.94+/-656.72) kJ/d] (all P<0.05). The postoperative duration of fever [2(2.0-3.0) d vs 4(2.8-4.0) d], postoperative time of flatus [3(2.0-4.0) d vs 4(3.8-5.0) d], postoperative hospital stay [6(6.0-7.0) d vs 8(7.0-8.3) d] and treatment expense [(27 201+/-3857) Chinese yuan vs (31 006+/-3555) Chinese yuan] in fast track group were also significantly lower than those in control group (P<0.01). There were no significant differences in complications between the two groups(P>0.05). The quality of life score on discharge in fast track group was significantly higher than that in control group (15.74+/-1.82 vs 14.67+/-1.27, P<0.01).

CONCLUSIONFast track surgery can ameliorate stress reaction, decrease postoperative patients' REE during perioperative period and accelerate the rehabilitation of patients with gastric cancer.

Adult ; Aged ; Female ; Humans ; Male ; Middle Aged ; Perioperative Care ; Rehabilitation ; methods ; Stomach Neoplasms ; rehabilitation ; surgery

The objective of this study is to investigate the short-term effects of intensive inpatient rehabilitation in patients with brain tumor. Retrospective data from September 2015 to May 2017 was obtained in 65 patients with brain tumor who were transferred to the department of physical and rehabilitation medicine for comprehensive intensive inpatient rehabilitation. For comparison, data from 140 patients with subacute stroke were also obtained. To measure functional status, we collected data from the following tests: the Korean version of the Modified Barthel Index, the Motricity Index, the Korean Mini-Mental Status Examination, and the Functional Ambulatory Category. Functional efficiency of each assessment was calculated as the gain divided by the inpatient rehabilitation length of stay. Independent t-test was performed to compare functional outcomes between the brain tumor group and the subacute stroke group. There were significant improvements in all functional assessments in both the brain tumor group and the subacute stroke group (p < 0.05). In addition, there was no significant difference in the functional gain and efficiency in all assessments between the 2 groups. The results of the present study revealed that intensive inpatient rehabilitation could have potential to improve the functional levels in patients with brain tumor.
Brain Neoplasms* ; Brain* ; Humans ; Inpatients* ; Length of Stay ; Physical and Rehabilitation Medicine ; Rehabilitation* ; Retrospective Studies ; Stroke

OBJECTIVE: To confirm functional improvement in brain tumor patients after 4-week conventional rehabilitation therapy, to compare the cognitive impairment of brain tumor patients with subacute stroke patients using computerized neuropsychological testing, and to determine the effects on functional outcomes of daily activity. METHODS: From April 2008 to December 2012, 55 patients (29 brain tumor patients and 26 subacute stroke patients) were enrolled. All patients were assessed with a computerized neuropsychological test at baseline. Motricity Index, Korean version of Mini Mental Status Examination, and Korean version of Modified Barthel Index scores were assessed at the beginning and end of 4-week rehabilitation. Conventional rehabilitation therapy was applied to both groups for 4 weeks. RESULTS: Functional outcomes of all patients in both groups significantly improved after 4-week rehabilitation therapy. In brain tumor patients, the initial Motricity Index, cognitive dysfunction, and visual continuous performance test correction numbers were strong predictors of initial daily activity function (R2=0.778, p<0.01). The final Motricity Index and word-black test were strong predictors of final daily activity function (R2=0.630, p<0.01). In patients with subacute stroke, the initial Motricity index was an independent predictor of initial daily activity function (R2=0.245, p=0.007). The initial daily activity function and color of color word test were strong predictors of final daily activity function (R2=0.745, p<0.01). CONCLUSION: Conventional rehabilitation therapy induced functional improvement in brain tumor patients. Objective evaluation of cognitive function and comprehensive rehabilitation including focused cognitive training should be performed in brain tumor patients for improving their daily activity function.
Brain Neoplasms* ; Brain* ; Humans ; Neuropsychological Tests ; Rehabilitation* ; Stroke*

BACKGROUND AND OBJECTIVES: Supracricoid partial laryngectomy is popular due to its satisfactory oncological and functional outcomes in selected laryngeal cancers. Their postoperative management is now well codified, but functional failures still persist. The aims of this study were to analyze the deglutition modification induced by these intervention and to plan a better rehabilitation program of swallowing. MATERIALS AND METHOD: For the evaluation of swallowing function, the swallowing analysis was performed by following the videofluoroscopic evaluation using the modified barium swallow (Logemann, 1983) in 14 laryngeal cancer patients. RESULTS: Asymptomatic aspiration was observed in 4 patients (28.6%), especially in patients with the extended procedures (p=0.032) and delayed decannulation (p=0.035). Aspiration was associated with faulty backward tilting of epiglottis and inadequate movement of the base of tongue (p<0.05). CONCLUSIONS: In planning the swallowing rehabilitation program after supracricoid partial laryngectomy, recuperation of proper epiglottic movement, which is promoted by exercise of backward tongue movement, is the most important concern.
Barium* ; Deglutition* ; Epiglottis ; Humans ; Laryngeal Neoplasms ; Laryngectomy* ; Rehabilitation ; Tongue

OBJECTIVE: To evaluate the condition of cancer-related fatigue (CRF) in breast cancer patients with chemotherapy and to explore the effect of Yoga on it. METHODS: After the completion of Yoga, 100 breast cancer patients with CRF (CFS>0) were selected and were randomly divided into the Yoga group and the control group (n=50). Patients in the control group only received routine cure and care while patients in the Yoga group received extra Yoga exercise, lasting for 4 months. Cancer fatigue scale (CFS) was evaluated in the 2nd, 4th and 6th round of chemotherapy. RESULTS: At the end, 82 cases qualified for the study, 42 cases for the control group and 40 for the Yoga group. The mean score of body fatigue was 12.67±3.46. There was no significant difference in CRF between the Yago group and the control group before the Yoga intervention (P>0.05). After the 4th round of chemotherapy, the mean scores of CFS and body fatigue in the Yoga group were significantly lower than that in the control group (P<0.05). After the 6th round of chemotherapy, the mean scores of CFS, body fatigue and cognitive fatigue in the Yoga group were lower than that in the control group (P<0.05). Repeated analysis of variance showed that the difference in the overall fatigue, body fatigue and cognitive fatigue between the Yoga group and the control group was significant (P<0.05); the time influence on the overall fatigue, body fatigue and emotional fatigue was significant difference between the 2 groups (P<0.05); there were interactions between the effect of Yago and time on the overall fatigue, body fatigue and cognitive fatigue (P<0.05). CONCLUSION The body fatigue was more serious in breast cancer patients with chemotherapy. Yoga intervention could significantly reduce body fatigue, cognitive fatigue, thus reduce the overall fatigue in breast cancer patients with chemotherapy.
Breast Neoplasms ; rehabilitation ; Emotions ; Fatigue ; prevention & control ; Female ; Humans ; Yoga

This first annual report provides a description of patients discharged from rehabilitation facilities in Korea based on secondary data analysis of Korean Brain Rehabilitation Registry V1.0 subscribed in 2009. The analysis included 1,697 records of patients with brain disorders including stroke, traumatic brain injury, brain tumor and other disorders from 24 rehabilitation facilities across Korea. The data comprised 1,380 cases of stroke, 104 cases of brain injury, 55 cases of brain tumor, and 58 cases of other brain diseases. The functional status of each patient was measured using the Korean version of the Modified Barthel Index (KMBI). The average change in the KMBI score was 15.9 for all patients in the inpatient rehabilitation facility. The average length of stay for inpatient rehabilitation was 36.9 days. The transfer rates to other hospitals were high, being 62.4% when all patients were considered. Patients with brain disorders of Korea in 2009 and measurable functional improvement was observed in patients. However, relatively high percentages of patients were not discharged to the community after inpatient rehabilitation. Based on the results of this study, consecutive reports of the status of rehabilitation need to be conducted in order to provide useful information to many practitioners.
Adult ; Aged ; Brain Diseases/*rehabilitation ; Brain Injuries/rehabilitation ; Brain Neoplasms/rehabilitation ; *Disability Evaluation ; Female ; Humans ; Length of Stay ; Male ; Middle Aged ; Outcome Assessment (Health Care) ; Registries ; Rehabilitation Centers ; Republic of Korea ; Stroke/rehabilitation

PURPOSE: The purpose of this study was to investigate the effects of a rehabilitation program on physical health, physiological indicators and quality of life in breast cancer mastectomy patients. METHODS: The subjects included thirty-one patients with breast cancer (17 in the experimental group and 14 in the control group). The subjects in the experimental group participated in a rehabilitation program for 10 weeks, which was composed of an exercise program, teaching, counseling and support for 2 sessions per week. RESULTS: There was a significant increase in flexion, internal rotation and external rotation but no significant increase in extension in the experimental group compared to the control group. The total cholesterol, triglyceride, HDL, LDL, and CD56 in the experimental group compared to the control group was not significantly decreased after the rehabilitation program. Compared to the control group, quality of life in the experimental group was significantly improved and fatigue in that group was significantly decreased after the rehabilitation program. CONCLUSION: The 10-week rehabilitation program showed a large affirmative effect on physical health, physiological indicators and quality of life in breast cancer mastectomy patients.
Adult ; Breast Neoplasms/rehabilitation/*surgery ; Female ; Humans ; Mastectomy/psychology/*rehabilitation ; Middle Aged ; Patient Education as Topic ; Quality of Life