Dr Dowson and colleagues from the United Kingdom compared the health-related quality of life of patients following laparoscopic and open colorectal surgery.
The team performed a systematic review according to Quorum guidelines.
Prospective studies comparing the health-related quality of life of patients after laparoscopic and open colorectal surgery were identified.
The primary outcome measure was postoperative quality of life; performance status and cosmesis were secondary outcome measures.
|3 studies assessing cosmesis reported benefits with the laparoscopy|
The researchers identified 23 studies that satisfied the inclusion criteria, of which 18 assessed health-related quality of life, 4 performance status, and 3 cosmesis.
It was not possible to perform a meta-analysis due to study heterogeneity.
The team reported outcomes for 2946 patients.
The most frequent health-related quality of life instruments employed were Short Form 36, European Organization for Research and Treatment of Cancer, and gastrointestinal quality of life index.
The researchers identified 6 studies, using a total of 12 separate measures, evaluated quality of life during the first 3 postoperative months.
The research team noted that 10 of these measures showed no significant difference, and 2 showed an improved health-related quality of life with laparoscopy.
The team found a further 12 studies that evaluated health-related quality of life up to 5 years postoperatively.
There were 9 studies showing no difference between the 2 groups, and 3 demonstrated a benefit for laparoscopy.
The team identified 3 of 4 studies assessing performance status on discharge, and all 3 studies assessing cosmesis, reported benefits with the laparoscopic approach.
Dr Dowson’s team concluded, “The current evidence suggests there is no significant difference in health-related quality of life following laparoscopic and open colorectal surgery, although there is a lack of good quality data.”
“There is a trend towards improved quality of life outcomes and performance status with laparoscopy in the early postoperative period.”
“There is a need for further research, particularly assessing quality of life in the early postoperative period.”