Evaluation of quality of life after laparoscopic surgery: evidence-based guidelines of the European Association for Endoscopic Surgery |
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| Authors: | D Korolija S Sauerland S Wood-Dauphinée C C Abbou E Eypasch M García Caballero M A Lumsden B Millat J R T Monson G Nilsson R Pointner W Schwenk A Shamiyeh A Szold E Targarona B Ure E Neugebauer |
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| Institution: | (1) University Surgical Clinic, Clinical Hospital Center Zagreb, Zagreb, Kispaticeva 12, 10 000 Zagreb, Croatia;(2) Biochemical and Experimental Division, 2nd Department of Surgery, University of Cologne, Ostmerheimer Strasse 200, D 51109 Cologne, Germany;(3) Department of Epidemiology and Biostatistics, School of Physical and Occupational Therapy, McGill University, 3630 Promenade Sir-William-Osler, Montreal, Quebec, H3G 1Y5, Canada;(4) Department of Urology, Centre Hospitalier Universitaire Henri Mondor, 51 Avenue du Marechal de Lattre de Tassigny, F 94010 Creteil, France;(5) Surgical Department, Malteser-Krankenhaus St. Hildegardis, Bachemer Strasse 29-33, D 50931 Cologne, Germany;(6) Department of Surgery, Málaga University, E 29080 Málaga, Spain;(7) Department of Obstetrics and Gynaecology, 3rd Floor, Queen Elizabeth Building, Royal Infirmary, 10 Alexandra Parade, G31 2ER Glasgow, Scotland, United Kingdom;(8) Department of Abdominal Surgery, Hòpital Saint Eloi (CHU) 2, Avenue Bertin Sans F 34295 Montpellier Cedex 5, France;(9) Academic Surgical Unit, University of Hull, Castle Hill Hospital, Castle Road, HU16 5JQ Cottingham, United Kingdom;(10) Department of Nursing, Lund University, Box 157, SE-221 00 Lund, Sweden;(11) Department of General Surgery, Zell am See Hospital, A 5700 Zell am See, Austria;(12) Department of General, Abdominal, Vascular and Thoracic Surgery, Campus Charité Mitte, Schumannstrasse 20/21, D 10117 Berlin, Germany;(13) Ludwig–Boltzmann Institute for Surgical Laparoscopy, 2nd Department of Surgery, Linz General Hospital, Krankenhausstrasse 9, A 4020 Linz, Austria;(14) Department of Surgery B, Sourasky Medical Center, Weizmann Street 6, 64239 Tel Aviv, Israel;(15) Department of General and Digestive Surgery, Hospital de Sant Pau C/Padre Claret 167, E 08025 Barcelona, Spain;(16) Department of Paediatric Surgery, Medical University of Hannover, Carl-Neuberg Strasse 1, D 30623 Hannover, Germany |
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| Abstract: | 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. Second, it was to recommend QoL instruments for clinical research.Methods An expert panel selected 12 conditions in which QoL and endoscopic surgery are important. For each condition, studies comparing endoscopic and open surgery in terms of QoL were identified. The expert panel reached consensus on the relative benefits of endoscopic surgery and recommended generic and disease-specific QoL instruments for use in clinical research.Results Randomized trials indicate that QoL improves earlier after endoscopic than open surgery for gastroesophageal reflux disease (GERD), cholecystolithiasis, colorectal cancer, inguinal hernia, obesity (gastric bypass), and uterine disorders that require hysterectomy. For spleen, prostate, malignant kidney, benign colorectal, and benign non-GERD esophageal diseases, evidence from nonrandomized trials supports the use of laparoscopic surgery. However, many studies failed to collect long-term results, used nonvalidated questionnaires, or measured QoL components only incompletely. The following QoL instruments can be recommended: for benign esophageal and gallbladder disease, the GIQLI or the QOLRAD together with SF-36 or the PGWB; for obesity surgery, the IWQOL-Lite with the SF-36; for colorectal cancer, the FACT-C or the EORTC QLQ-C30/CR38; for inguinal and renal surgery, the VAS for pain with the SF-36 (or the EORTC QLQ-C30 in case of malignancy); and after hysterectomy, the SF-36 together with an evaluation of urinary and sexual function.Conclusions Laparoscopic surgery provides better postoperative QoL in many clinical situations. Researchers would improve the quality of future studies by using validated QoL instruments such as those recommended here.Presented at the 11th International Congress of the European Association for Endoscopic Surgery (E.A.E.S.), Glasgow, Scotland, United Kingdom, June 2003(D. Korolija, S. Sauerland, E. Neugebauer) Conference organizers on behalf of the Scientific Committee of the European Association for Endoscopic Surgery (E.A.E.S.), c/o E.A.E.S. Office, P.O. Box 335, 5500 AH Veldhoven, The Netherlands |
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