Evaluation of quality of life after laparoscopic surgery. Evidence-based guidelines of the European Association for Endoscopic Surgery

• Published in: Surgical endoscopy Vol. 18; no. 6; pp. 879 - 897
• Main Authors: KOROLIJA, D, SAUERLAND, S, POINTNER, R, SCHWENK, W, SHAMIYEH, A, SZOLD, A, TARGARONA, E, URE, B, NEUGEBAUER, E, WOOD-DAUPHINEE, S, ABBOU, C. C, EYPASCH, E, GARCIA CABALLERO, M, LUMSDEN, M. A, MILLAT, B, MONSON, J. R. T, NILSSON, G
• Format: Journal Article
• Language: English
• Published: New York, NY Springer 01-06-2004; Springer Nature B.V
• Subjects: Biological and medical sciences; Cholecystectomy, Laparoscopic - psychology; Cholecystectomy, Laparoscopic - statistics & numerical data; Endoscopy - psychology; Endoscopy - statistics & numerical data; Evidence-Based Medicine; Female; Gastroesophageal Reflux - surgery; Gastroplasty - methods; Gastroplasty - psychology; Gastroplasty - statistics & numerical data; General aspects; Health Sciences; Humans; Hysterectomy - methods; Hysterectomy - psychology; Hysterectomy - statistics & numerical data; Hälsovetenskap; Laparoscopy - psychology; Laparoscopy - statistics & numerical data; Male; Medical and Health Sciences; Medical sciences; Medicin och hälsovetenskap; Meta-Analysis as Topic; Minimally Invasive Surgical Procedures - psychology; Minimally Invasive Surgical Procedures - statistics & numerical data; Nephrectomy - methods; Nephrectomy - psychology; Nephrectomy - statistics & numerical data; Nursing; Omvårdnad; Patient Satisfaction; Prostatectomy - methods; Prostatectomy - psychology; Prostatectomy - statistics & numerical data; Quality of Life; Randomized Controlled Trials as Topic; Europe; Endoscopic surgery; Laparoscopic surgery; Treatment; Evidence-based medicine; Recommendation; Quality of life
• ISSN: 0930-2794; 1432-2218
• DOI: 10.1007/s00464-003-9263-x

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.
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.
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.
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.