title: Patient satisfaction with temporal lobectomy/selective amygdalohippocampectomy for temporal lobe epilepsy and its relationship with Engel classification and the side of lobectomy.
abstract: OBJECTIVE
  The aim of this study was to investigate not only the effectiveness of epilepsy surgery in improving seizure control but also patient satisfaction with the result of the procedure in a sample of patients operated on at a specialized epilepsy unit.
  
  
  METHODS
  Patients with temporal lobe epilepsy who had undergone epilepsy surgery (temporal lobectomy/amygdalohippocampectomy) were interviewed in a standardized telephone survey about their satisfaction with the results of the surgery. The morbidity of the surgery was also analyzed retrospectively. The initial study population consisted of 6 amygdalohippocampectomy and 102 temporal lobectomy patients and was reduced to a final sample consisting of 4 amygdalohippocampectomy and 67 lobectomy patients, as the other patients were not available for interview. Surgical results were based on the Engel classification, and satisfaction with the surgery was assessed by asking patients to rate their result and state whether they would make the same decision (to be operated on) again.
  
  
  RESULTS
  A significant number of patients classified as Engel I or II, who considered the surgical outcome good or excellent, said they would have the surgery again (p<0.001). Left temporal lobectomy patients whose results fell in the Engel III/IV bracket were less satisfied (p=0.001) than right temporal lobectomy patients with the same Engel classifications (0.048). Left temporal lobectomy patients who were classified as Engel class III and IV were less likely to have the surgery again if they had the choice (p=0.016).
  
  
  CONCLUSIONS
  Patient satisfaction with the results of epilepsy surgery may depend not only on achieving seizure control but also on the temporal lobe resected. Since worse results were associated with lower satisfaction rates only for left temporal resection patients, it is possible that the cognitive consequences of this procedure compound the worse surgical result, leading to decreased satisfaction.
authors.affiliation: Neurology Department, Curitiba Neurology Institute, Curitiba, Brazil.
authors.forename: Renato Endler
authors.initials: RE
authors.lastname: Iachinski
authors.affiliation: Epilepsy Surgery Unit, Curitiba Neurology Institute, Curitiba, Brazil.
authors.forename: Murilo Sousa
authors.initials: MS
authors.lastname: de Meneses
authors.affiliation: Epilepsy Clinic and Video-EEG Monitoring Unit, Curitiba Neurology Institute, Curitiba, Brazil.
authors.forename: Cristiane Andréia
authors.initials: CA
authors.lastname: Simão
authors.affiliation: Epilepsy Surgery Unit, Curitiba Neurology Institute, Curitiba, Brazil; Epilepsy Clinic and Video-EEG Monitoring Unit, Curitiba Neurology Institute, Curitiba, Brazil; Neuropsychology Unit, Curitiba Neurology Institute, Curitiba, Brazil.
authors.forename: Samanta Fabricio Blattes
authors.initials: SF
authors.lastname: da Rocha
authors.affiliation: Neurology Department, Curitiba Neurology Institute, Curitiba, Brazil.
authors.forename: Flávia
authors.initials: F
authors.lastname: de Oliveira Braga
authors.affiliation: Neurology Department, Curitiba Neurology Institute, Curitiba, Brazil; Epilepsy Surgery Unit, Curitiba Neurology Institute, Curitiba, Brazil; Epilepsy Clinic and Video-EEG Monitoring Unit, Curitiba Neurology Institute, Curitiba, Brazil. Electronic address: pkowacs@gmail.com.
authors.forename: Pedro André
authors.initials: PA
authors.lastname: Kowacs
mesh_terms: D000293:Adolescent; D000328:Adult; D000679:Amygdala / Q000502:physiology / Q000601:surgery*; D038481:Anterior Temporal Lobectomy / Q000379:methods*; D004833:Epilepsy, Temporal Lobe / Q000523:psychology / Q000601:surgery*; D005260:Female; D006624:Hippocampus / Q000502:physiology / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care / Q000379:methods; D017060:Patient Satisfaction; D011183:Postoperative Complications / Q000145:classification / Q000175:diagnosis / Q000503:physiopathology; D011788:Quality of Life; D012189:Retrospective Studies; D055815:Young Adult
keywords: Epilepsy surgery; Patient satisfaction; Quality of life; Temporal lobe epilepsy; Temporal lobectomy