Health-related quality of life after laparoscopic and open nephrectomy.
BACKGROUND
Postoperative recovery often is assessed with parameters (pain and return to work) susceptible to bias. This study sought objectively to compare postoperative health-related quality of life (HRQL) after laparoscopic and open nephrectomy with the Postoperative Recovery (PRS) (a validated questionnaire designed to assess pain), activities of daily living (ADL), and HRQL in postoperative patients.


METHODS
Patients undergoing contemporaneous laparoscopic and open nephrectomy received the PRS pre- and postoperatively. The results were analyzed with analysis of covariance (ANCOV) and survival analysis.


RESULTS
The 33 open nephrectomy and 38 laparoscopic patients in this study were comparable in age, gender, body mass index (BMI) and employment. Laparoscopic operative time was longer (p = 0.015), and the hospital stay was shorter (p<0.001). Laparoscopic patients had higher HRQL scores from postoperative days 3 to 365 (p<0.001), and they returned to preoperative HRQL faster (p<0.001).


CONCLUSIONS
An objective HRQL instrument confirms that laparoscopic nephrectomy patients recover faster and with a higher HRQL than open surgery patients. The PRS can be modified for use after other abdominal procedures, and may prove useful for comparisons of other minimally invasive surgical techniques.
Pace
K T
KT
Division of Urology, St. Michael's Hospital, University of Toronto, Ontario, Canada. kenneth.pace@utoronto.ca
Dyer
S J
SJ
Stewart
R J
RJ
Honey
R J
RJ
Poulin
E C
EC
Schlachta
C M
CM
Mamazza
J
J
D000203:Activities of Daily Living; D000328:Adult; D000704:Analysis of Variance; D015992:Body Mass Index; D005260:Female; D006801:Humans; D007415:Intestinal Obstruction / Q000209:etiology; D007674:Kidney Diseases / Q000601:surgery; D007680:Kidney Neoplasms / Q000601:surgery; D010535:Laparoscopy / Q000009:adverse effects / Q000706:statistics & numerical data*; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D009392:Nephrectomy / Q000009:adverse effects / Q000706:statistics & numerical data*; D009864:Ontario; D010147:Pain Measurement; D017060:Patient Satisfaction / Q000706:statistics & numerical data; D011446:Prospective Studies; D011788:Quality of Life; D012086:Reoperation; D015203:Reproducibility of Results; D013530:Surgical Wound Infection / Q000209:etiology; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D016055:Urinary Retention / Q000209:etiology