title: How to Quantify Recovery After Laparoscopic Adrenalectomy: An Assessment of Patient-reported Health-related Quality of Life.
abstract: OBJECTIVE
  Minimally invasive approaches to adrenal surgery were adopted in an attempt to reduce surgical morbidity. Despite the widespread use, few studies objectively evaluate health-related quality of life (HRQOL) in patients undergoing laparoscopic adrenalectomy (LA). We assessed patients' health status and recovery after LA with the use of validated questionnaires.
  
  
  METHODS
  Patients seen in urology clinic for evaluation of adrenal surgery were enlisted in our prospective, patient-reported, HRQOL study assessing postoperative recovery. HRQOL was measured using Convalescence And Recovery Evaluation (CARE) and Short Form-12 questionnaires administered before surgery and at 2, 4, 8, 12 weeks and annually after surgery. All operations were performed using a laparoscopic transperitoneal approach by a single fellowship-trained surgeon.
  
  
  RESULTS
  A total of 30 patients who met study inclusion criteria from July 2009 to November 2014 were included in our evaluation. Mean patient age was 53 years. Tumor size ranged from 2.0 to 5.5 cm and consisted of benign lesions, adrenal metastasis, and 1 adrenocortical carcinoma. Mean operative time was 98 minutes and median estimated blood loss was 50 mL. Median length of hospital stay was 1 day. Quality of life reflected by the CARE survey was impacted at 2 weeks postoperative and returned to baseline after 4 weeks. Pain and activity domains of CARE showed a significant decrease from baseline status. Physical component summary of Short Form-12 questionnaire supported the finding of negative impact of surgery on activity level within first 4 weeks of recovery.
  
  
  CONCLUSIONS
  Despite minimally invasive approach, patients undergoing LA may require about 4 weeks to return to baseline activity, gastrointestinal, and pain status.
authors.affiliation: *Department of Surgery, Division of Urology, Beth Israel Deaconess Medical Center, Boston, MA †Department of Healthcare Policy and Research, Weil Cornell Medical College, New York, NY.
authors.forename: Ostap
authors.initials: O
authors.lastname: Dovirak
authors.forename: Jialin
authors.initials: J
authors.lastname: Mao
authors.forename: Kimberly
authors.initials: K
authors.lastname: Taylor
authors.forename: Peter
authors.initials: P
authors.lastname: Chang
authors.forename: Andrew A
authors.initials: AA
authors.lastname: Wagner
mesh_terms: D000310:Adrenal Gland Neoplasms / Q000523:psychology / Q000601:surgery; D000315:Adrenalectomy / Q000379:methods* / Q000523:psychology; D016063:Blood Loss, Surgical; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000379:methods* / Q000523:psychology; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D061646:Operative Time; D000071066:Patient Reported Outcome Measures; D011182:Postoperative Care; D011183:Postoperative Complications / Q000209:etiology; D011446:Prospective Studies; D011788:Quality of Life; D011795:Surveys and Questionnaires