title: Quality of life in the first 6 weeks following laparoscopic and open colorectal surgery.
abstract: OBJECTIVE
  Evidence of how health-related quality of life (HRQOL) changes following laparoscopic and open colorectal surgery in the first 6 weeks of postoperative recovery is needed to inform cost-effectiveness evaluations.
  
  
  METHODS
  Pragmatic prospective cohort study design. Consecutive patients requiring elective colorectal surgery were allocated to either laparoscopic or open surgery by administrative staff in a district general hospital in England, 2006-2007. Patients completed two validated, generic measures of HRQOL at baseline (preoperatively) and on multiple occasions in the first 6 weeks postsurgery using diaries (EuroQol five-dimensional [EQ-5D] questionnaire: 16 times; short-form 36 health survey [SF-36]: 4 times; HRQOL was compared between groups at each time point, and overall using repeated-measures analysis.
  
  
  RESULTS
  Of 201 consecutive patients recruited, 32 (15.1%) were unable to complete diaries. Of the remaining 169 patients, 120 (71%) returned completed diaries at 28 days and 105 (62.1%) at 42 days. There was no difference in preoperative HRQOL scores between surgical groups, but the postoperative EQ-5D questionnaire and SF-36 scores were significantly higher in the laparoscopic group (EQ-5D questionnaire P = 0.005, SF-36 P = 0.007). Subgroup analysis showed that patients with a stoma have worse HRQOL than those without. HRQOL did not differ between the laparoscopic and open stoma patients.
  
  
  CONCLUSIONS
  This study presents unique prospective data demonstrating that laparoscopic surgery confers HRQOL benefits for patients in the early recovery period following colorectal surgery, compared with open surgery. Consideration of these data in the context of a cost-effectiveness analysis will be reported separately.
authors.affiliation: Minimal Access Therapy Training Unit, Postgraduate Medical School, University of Surrey, Guildford, UK.
authors.forename: Henry M
authors.initials: HM
authors.lastname: Dowson
authors.forename: Karen
authors.initials: K
authors.lastname: Ballard
authors.forename: Heather
authors.initials: H
authors.lastname: Gage
authors.forename: Daniel
authors.initials: D
authors.lastname: Jackson
authors.forename: Peter
authors.initials: P
authors.lastname: Williams
authors.forename: Timothy A
authors.initials: TA
authors.lastname: Rockall
mesh_terms: D000368:Aged; D016009:Chi-Square Distribution; D003107:Colorectal Surgery / Q000191:economics / Q000379:methods*; D003362:Cost-Benefit Analysis; D017558:Elective Surgical Procedures / Q000191:economics / Q000379:methods; D004739:England; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000191:economics / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011184:Postoperative Period; D011446:Prospective Studies; D011788:Quality of Life; D018434:Sickness Impact Profile; D018709:Statistics, Nonparametric; D011795:Surveys and Questionnaires; D013997:Time Factors