Health-related quality of life before and after gastrointestinal surgery.
OBJECTIVE
To assess the impact of surgical treatment on health-related quality of life (QoL) and its various dimensions in four common gastrointestinal diseases, to compare it with that of the general population, and to assess the relationship between the patient's and the surgeon's satisfaction.


METHODS
Prospective, observational study.


METHODS
Tertiary care centre, Finland.


METHODS
131 patients, of whom 77 had cholecystectomy, 20 fundoplication, 20 incisional herniorrhaphy, 12 large bowel resection, and 2 construction of a stoma only because of unresectable colorectal cancer.


METHODS
Routine operative treatment of four gastrointestinal diseases.


METHODS
QoL measured by a generic 15-dimensional instrument.


RESULTS
The health-related QoL improved postoperatively in the entire group. Discomfort, symptoms, and vitality were all reduced at 2 months, whereas bowel movements, eating, and usual activities had been restored at 12 months. The health related QoL was comparable with that of the general population at 12 months except for breathing and sleeping. The pattern of recovery varied among diagnostic subgroups, being most improved in patients operated on for biliary disease, those aged 60 years or younger, women and otherwise previously healthy patients. There was a close agreement between the patient's and the surgeon's opinion of outcome.


CONCLUSIONS
Gastrointestinal surgery improves quality of life. Separating a generic health-related QoL measure into dimensions allows a more appropriate estimation of quality of life than a single index score. Because some dimensions were made worse soon after operation and some were restored slowly, a minimum 12-month follow-up may be needed to assess the effect of gastrointestinal surgery on health- related QoL.
Räsänen
J V
JV
Department of Surgery, Kuopio University Hospital, Finland.
Niskanen
M M
MM
Miettinen
P
P
Sintonen
H
H
Alhava
E
E
D000368:Aged; D013505:Digestive System Surgical Procedures; D005260:Female; D005767:Gastrointestinal Diseases / Q000601:surgery*; D006305:Health Status Indicators; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011788:Quality of Life