Å A Fretland1,2,3, V J Dagenborg4,5,3, G M Waaler Bjørnelv1,6, D L Aghayan1,3,7, A M Kazaryan1,8,9,7, L Barkhatov1,3,10, R Kristiansen1,11, M W Fagerland12, B Edwin1,2,3, M H Andersen13,14. 1. The Intervention Centre, Oslo University Hospital, Oslo, Norway. 2. Department of Hepato-Pancreato-Biliary Surgery, Oslo University Hospital, Oslo, Norway. 3. Institute of Clinical Medicine, University of Oslo, Oslo, Norway. 4. Department of Tumour Biology, Oslo University Hospital, Oslo, Norway. 5. Department of Gastroenterological Surgery, Oslo University Hospital, Oslo, Norway. 6. Institute of Health Management and Health Economics, University of Oslo, Oslo, Norway. 7. Department of Surgery 1, Yerevan State Medical University after M. Heratsi, Yerevan, Armenia. 8. Department of Surgery, Fonna Hospital Trust, Stord, Norway. 9. Department of Faculty Surgery 2, I. M. Sechenov First Moscow State Medical University, Moscow, Russia. 10. Department of Gastrointestinal Surgery, Haukeland University Hospital, Bergen, Norway. 11. Department of Information Technology, Oslo University Hospital, Oslo, Norway. 12. Oslo Centre for Biostatistics and Epidemiology, Research Support Services, Oslo University Hospital, Oslo, Norway. 13. Department of Transplantation Medicine, Oslo University Hospital, Oslo, Norway. 14. Institute of Health and Society, University of Oslo, Oslo, Norway.
Abstract
BACKGROUND: Most treatments for cancer cause a decline in patients' health-related quality of life (HRQoL). Limiting this decline is a universal goal for healthcare providers. Using minimally invasive instead of open surgical techniques might be one way to achieve this. The aim of this study was to compare postoperative HRQoL after open and laparoscopic liver resection. METHODS: This was a predefined substudy of an RCT comparing open with laparoscopic liver resection. Patients with colorectal liver metastases were assigned randomly to open or laparoscopic parenchyma-sparing liver resection. HRQoL was assessed with the Short Form 36 questionnaire at baseline, and 1 and 4 months after surgery. RESULTS: A total of 280 patients were randomized, of whom 273 underwent surgery (129 laparoscopic, 144 open); 682 questionnaires (83.3 per cent) were available for analysis. One month after surgery, patients in the laparoscopic surgery group reported reduced scores in two HRQoL domains (physical functioning and role physical), whereas those in the open surgery group reported reduced scores in five domains (physical functioning, role physical, bodily pain, vitality and social functioning). Four months after surgery, HRQoL scores in the laparoscopic group had returned to preoperative levels, whereas patients in the open group reported reduced scores for two domains (role physical and general health). The between-group difference was statistically significant in favour of laparoscopy for four domains after 1 month (role physical, bodily pain, vitality and social functioning) and for one domain after 4 months (role physical). CONCLUSION: Patients assigned to laparoscopic liver surgery reported better postoperative HRQoL than those assigned to open liver surgery. For role limitations caused by physical health problems, patients in the laparoscopic group reported better scores up to 4 months after surgery. Registration number: NCT01516710 ( http://www.clinicaltrials.gov).
RCT Entities:
BACKGROUND: Most treatments for cancer cause a decline in patients' health-related quality of life (HRQoL). Limiting this decline is a universal goal for healthcare providers. Using minimally invasive instead of open surgical techniques might be one way to achieve this. The aim of this study was to compare postoperative HRQoL after open and laparoscopic liver resection. METHODS: This was a predefined substudy of an RCT comparing open with laparoscopic liver resection. Patients with colorectal liver metastases were assigned randomly to open or laparoscopic parenchyma-sparing liver resection. HRQoL was assessed with the Short Form 36 questionnaire at baseline, and 1 and 4 months after surgery. RESULTS: A total of 280 patients were randomized, of whom 273 underwent surgery (129 laparoscopic, 144 open); 682 questionnaires (83.3 per cent) were available for analysis. One month after surgery, patients in the laparoscopic surgery group reported reduced scores in two HRQoL domains (physical functioning and role physical), whereas those in the open surgery group reported reduced scores in five domains (physical functioning, role physical, bodily pain, vitality and social functioning). Four months after surgery, HRQoL scores in the laparoscopic group had returned to preoperative levels, whereas patients in the open group reported reduced scores for two domains (role physical and general health). The between-group difference was statistically significant in favour of laparoscopy for four domains after 1 month (role physical, bodily pain, vitality and social functioning) and for one domain after 4 months (role physical). CONCLUSION:Patients assigned to laparoscopic liver surgery reported better postoperative HRQoL than those assigned to open liver surgery. For role limitations caused by physical health problems, patients in the laparoscopic group reported better scores up to 4 months after surgery. Registration number: NCT01516710 ( http://www.clinicaltrials.gov).
Authors: Ioannis A Ziogas; Alexandros P Evangeliou; Konstantinos S Mylonas; Dimitrios I Athanasiadis; Panagiotis Cherouveim; David A Geller; Richard D Schulick; Sophoclis P Alexopoulos; Georgios Tsoulfas Journal: Eur J Health Econ Date: 2021-03-19
Authors: Leonid Barkhatov; Davit L Aghayan; Vincenzo Scuderi; Federica Cipriani; Åsmund A Fretland; Airazat M Kazaryan; Francesca Ratti; Thomas Armstrong; Andrea Belli; Ibrahim Dagher; Giulio Belli; Luca Aldrighetti; Mohammad Abu Hilal; Roberto I Troisi; Bjørn Edwin Journal: Surg Endosc Date: 2021-08-30 Impact factor: 4.584