Medium-term surgical outcomes and health-related quality of life after laparoscopic vs open colorectal cancer resection: SF-36 health survey questionnaire

Chao-Ming Hung; Kuo-Chuan Hung; Hon-Yi Shi; Shih-Bin Su; Hui-Ming Lee; Meng-Che Hsieh; Cheng-Hao Tseng; Shung-Eing Lin; Chih-Cheng Chen; Chao-Ming Tseng; Ying-Nan Tsai; Chi-Zen Chen; Jung-Fa Tsai; Chong-Chi Chiu

doi:10.4253/wjge.v15.i3.163

Medium-term surgical outcomes and health-related quality of life after laparoscopic vs open colorectal cancer resection: SF-36 health survey questionnaire

World J Gastrointest Endosc. 2023 Mar 16;15(3):163-176. doi: 10.4253/wjge.v15.i3.163.

Authors

Chao-Ming Hung^{1

2}, Kuo-Chuan Hung^{3

4}, Hon-Yi Shi^{5

6

7

8}, Shih-Bin Su^{9

10

11}, Hui-Ming Lee^{1

12}, Meng-Che Hsieh^{12

13}, Cheng-Hao Tseng^{2

14

15}, Shung-Eing Lin¹⁶, Chih-Cheng Chen^{12

14}, Chao-Ming Tseng^{12

14

15}, Ying-Nan Tsai^{2

14}, Chi-Zen Chen¹⁴, Jung-Fa Tsai^{12

17}, Chong-Chi Chiu^{1

2

18

19}

Affiliations

¹ Department of General Surgery, E-Da Cancer Hospital, I-Shou University, Kaohsiung 82445, Taiwan.
² School of Medicine, College of Medicine, I-Shou University, Kaohsiung 82445, Taiwan.
³ Department of Anesthesiology, Chi Mei Medical Center, Tainan 71004, Taiwan.
⁴ Department of Hospital and Health Care Administration, College of Recreation and Health Management, Chia Nan University of Pharmacy and Science, Tainan 71710, Taiwan.
⁵ Department of Healthcare Administration and Medical Informatics, Kaohsiung Medical University, Kaohsiung 80708, Taiwan.
⁶ Department of Business Management, National Sun Yat-Sen University, Kaohsiung 80424, Taiwan.
⁷ Department of Medical Research, Kaohsiung Medical University Hospital, Kaohsiung 80756, Taiwan.
⁸ Department of Medical Research, China Medical University Hospital, China Medical University, Taichung 40402, Taiwan.
⁹ Department of Occupational Medicine, Chi Mei Medical Center, Liouying 73657, Taiwan.
¹⁰ Department of Occupational Medicine, Chi Mei Medical Center, Tainan 71004, Taiwan.
¹¹ Department of Leisure, Recreation and Tourism Management, Southern Taiwan University of Science and Technology, Tainan 71005, Taiwan.
¹² College of Medicine, I-Shou University, Kaohsiung 82445, Taiwan.
¹³ Department of Hematology-Oncology, E-Da Cancer Hospital, I-Shou University, Kaohsiung 82445, Taiwan.
¹⁴ Department of Gastroenterology and Hepatology, E-Da Cancer Hospital, I-Shou University, Kaohsiung 82445, Taiwan.
¹⁵ Department of Gastroenterology and Hepatology, E-Da Hospital, I-Shou University, Kaohsiung 82445, Taiwan.
¹⁶ Department of Colon and Rectal Surgery, E-Da Cancer Hospital, I-Shou University, Kaohsiung 82445, Taiwan.
¹⁷ Department of Gastroenterology and Hepatology, E-Da Dachang Hospital, I-Shou University, Kaohsiung 80794, Taiwan.
¹⁸ Department of Medical Education and Research, E-Da Cancer Hospital, I-Shou University, Kaohsiung 82445, Taiwan.
¹⁹ Department of General Surgery, Chi Mei Medical Center, Liouying 73657, Taiwan. chiuchongchi@gmail.com.

Abstract

Background: Previous studies that compared the postoperative health-related quality of life (HRQoL) outcomes after receiving laparoscopic resection (LR) or open resection (OR) in patients with colorectal cancer (CRC) have different conclusions.

Aim: To explore the medium-term effect of postoperative HRQoL in such patients.

Methods: This study randomized 567 patients undergoing non-metastatic CRC surgery managed by one surgeon to the LR or OR groups. HRQoL was assessed during the preoperative period and 3, 6, and 12 mo postoperative using a modified version of the 36-Item Short Form (SF-36) Health Survey questionnaire, emphasizing eight specific items.

Results: This cohort randomly assigned 541 patients to receive LR (n = 296) or OR (n = 245) surgical procedures. More episodes of postoperative urinary tract infection (P < 0.001), wound infection (P < 0.001), and pneumonia (P = 0.048) were encountered in the OR group. The results demonstrated that the LR group subjectively gained mildly better general health (P = 0.045), moderately better physical activity (P = 0.006), and significantly better social function recovery (P = 0.0001) 3 mo postoperatively. Only the aspect of social function recovery was claimed at 6 mo, with a significant advantage in the LR group (P = 0.001). No clinical difference was found in HRQoL during the 12 mo.

Conclusion: Our results demonstrated that LR resulted in better outcomes, including intra-operative blood loss, surgery-related complications, course of recovery, and especially some health domains of HRQoL at least within 6 mo postoperatively. Patients should undergo LR if there is no contraindication.

Keywords: Health-related quality of life; Laparoscopic; Medium-term result; Non-metastatic colorectal cancer; Open surgery.