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Improvement in the quality of life following cholecystectomy: a randomized multicenter study of health status (RAND-36) in patients with laparoscopic cholecystectomy versus minilaparotomy cholecystectomy

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Abstract

Purpose

The assessment of the quality of life (QoL) in minilaparotomy cholecystectomy (MC) versus laparoscopic cholecystectomy (LC) with the ultrasonic dissection in both groups has not been addressed earlier.

Methods

Initially, 109 patients with non-complicated symptomatic gallstone disease were randomized to undergo either MC (n = 59) or LC (n = 50). RAND-36 survey was conducted preoperatively and at 4 weeks and 6 months postoperatively. The end point of our study was to determine differences in health status in MC versus LC groups.

Results

QoL improved significantly in both groups, and the recovery was similar in the two groups, except from the higher score in ‘health change’ subscale at 4 weeks in MC group [MC score 75.0 (25.0) vs. LC score 56.5 (23.2), p = 0.008]. The MC and LC groups combined, RAND-36 scores increased significantly in ‘physical functioning’ [combined mean (SD) preoperative score 80.5 (23.9) vs. 6-month postoperative score 86.5 (21.7), p = 0.015], ‘vitality’ [64.5 (19.2) vs. 73.5 (18.3), p = 0.001], ‘health change’ [43.0 (21.6) vs. 74.6 (25.4), p = 0.0001] and ‘bodily pain’ scores [57.7 (26.3) vs. 75.5 (25.5), p = 0.001], respectively. Four RAND-36 domains indicated statistically significant health status differences in comparing the preoperative and postoperative RAND-36 scores in LC and MC groups combined.

Conclusions

Four RAND-36 domains indicated a significant positive change in QoL after cholecystectomy.

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References

  1. Ledet, W. P., Jr. (1990). Ambulatory cholecystectomy without disability. Archives of Surgery, 125, 1434–1435.

    Article  PubMed  Google Scholar 

  2. Barkun, J. S., Barkun, A. N., Sampalis, J. S., et al. (1992). Randomised controlled trial of laparoscopic versus mini cholecystectomy. The McGill Gallstone Treatment Group. Lancet, 340, 1116–1119.

    CAS  PubMed  Google Scholar 

  3. McMahon, A. J., Russell, I. T., Baxter, J. N., et al. (1994). Laparoscopic versus minilaparotomy cholecystectomy: A randomised trial. Lancet, 343, 135–138.

    Article  CAS  PubMed  Google Scholar 

  4. Tyagi, N. S., Meredith, M. C., Lumb, J. C., et al. (1994). A new minimal invasive technique for cholecystectomy: Subxiphoid “minimal stress triangle” microceliotomy. Annals of Surgery, 220, 617–625.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  5. McGinn, F. P., Miles, A. J., Uqlow, M., et al. (1995). Randomized trial of laparoscopic cholecystectomy and mini-cholecystectomy. British Journal of Surgery, 82, 1374–1377.

    Article  CAS  PubMed  Google Scholar 

  6. Majeed, A. W., Troy, G., Nicholl, J. P., et al. (1996). Randomized, prospective, single-blind comparison of laparoscopic versus small-incision cholecystectomy. Lancet, 347, 989–994.

    Article  CAS  PubMed  Google Scholar 

  7. Squirrell, D. M., Majeed, A. W., Troy, G., et al. (1998). A randomized, prospective, blinded comparison of postoperative pain, metabolic response, and perceived health after laparoscopic and small incision cholecystectomy. Surgery, 123, 485–495.

    Article  CAS  PubMed  Google Scholar 

  8. Seale, A. K., & Ledet, W. P., Jr. (1999). Minicholecystectomy: A safe, cost-effective day surgery procedure. Archives of Surgery, 134, 308–310.

    Article  CAS  PubMed  Google Scholar 

  9. Ros, A., Gustafsson, L., Krook, H., et al. (2001). Laparoscopic cholecystectomy versus mini-laparotomy cholecystectomy: A prospective, randomized, single-blind study. Annals of Surgery, 234, 741–749.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  10. Srivastava, A., Srinivas, G., Misra, M. C., et al. (2001). Cost-effectiveness analysis of laparoscopic versus minilaparotomy cholecystectomy for gallstone disease. A randomized trial. International Journal of Technology Assessment in Health Care, 17, 497–502.

    CAS  PubMed  Google Scholar 

  11. Thomas, S., Singh, J., Bishnoi, P. K., et al. (2001). Feasibility of day-care open cholecystectomy: Evaluation in an inpatient model. ANZ J Surg, 71, 93–97.

    Article  CAS  PubMed  Google Scholar 

  12. Amjad, N., & Fazal, A. (2002). Mini cholecystectomy now a day stay surgery: Anaesthetic management with multi modal analgesia. J Pak Med Assoc, 52, 291–296.

    CAS  PubMed  Google Scholar 

  13. Harju, J., Juvonen, P., Eskelinen, M., et al. (2006). Minilaparotomy cholecystectomy versus laparoscopic cholecystectomy: A randomized study with special reference to obesity. Surgical Endoscopy, 20, 583–586.

    Article  CAS  PubMed  Google Scholar 

  14. Vagenas, K., Spyrakopoulos, P., Karanikolas, M., et al. (2006). Mini-laparotomy cholecystectomy versus laparoscopic cholecystectomy: Which way to go? Surg Laparosc Endosc Percutan Tech, 16, 321–324.

    Article  PubMed  Google Scholar 

  15. Harju, J., Pääkkönen, M., & Eskelinen, M. (2007). Minilaparotomy cholecystectomy as a day surgery procedure: A prospective clinical pilot study. Scand J Surg, 96, 206–208.

    Article  CAS  PubMed  Google Scholar 

  16. Harju, J., Pääkkönen, M., & Eskelinen, M. (2007). Comparison of the quality of life after minilaparotomy cholecystectomy versus laparoscopic cholecystectomy: A prospective randomized study. Isr Med Assoc J, 9, 147–148.

    PubMed  Google Scholar 

  17. Keus, F., de Vries, J., Gooszen, H. G., et al. (2008). Laparoscopic versus small-incision cholecystectomy: Health status in a blind randomised trial. Surgical Endoscopy, 22, 1649–1659.

    Article  PubMed  Google Scholar 

  18. Harju, J., Kokki, H., Pääkkönen, M., et al. (2010). Feasibility of minilaparotomy versus laparoscopic cholecystectomy for day surgery: A prospective randomized study. Scand J Surg, 99, 132–136.

    Article  CAS  PubMed  Google Scholar 

  19. Rosenmuller, M. H., Thoren Örnberg, M., Myrnäs, T., et al. (2013). Expertise-based randomized clinical trial of laparoscopic versus small-incision open cholecystectomy. British Journal of Surgery, 100, 886–894.

    Article  CAS  PubMed  Google Scholar 

  20. Harju, J., Juvonen, P., Kokki, H., et al. (2013). Minilaparotomy cholecystectomy with ultrasonic dissection versus laparoscopic cholecystectomy with electrosurgical energy: A randomized multicenter study. Scandinavian Journal of Gastroenterology, 48, 1317–1323.

    Article  PubMed  Google Scholar 

  21. Harju, J., Aspinen, S., Juvonen, P., et al. (2013). Ten-year outcome after minilaparotomy versus laparoscopic cholecystectomy: A prospective randomized trial. Surgical Endoscopy, 27, 2512–2516.

    Article  PubMed  Google Scholar 

  22. Aspinen, S., Harju, J., Juvonen, P., et al. (2014). A prospective, randomized study comparing minilaparotomy and laparoscopic cholecystectomy as a day-surgery procedure: 5-year outcome. Surgical Endoscopy, 28, 827–832.

    Article  PubMed  Google Scholar 

  23. Aspinen, S., Harju, J., Juvonen, P., et al. (2014). A prospective, randomized multicenter study comparing conventional laparoscopic cholecystectomy versus minilaparotomy cholecystectomy with ultrasonic dissection as day surgery procedure—1-year outcome. Scandinavian Journal of Gastroenterology, 49, 1336–1342.

    PubMed  Google Scholar 

  24. Aspinen, S., Harju, J., Kinnunen, M., et al. (2016). A randomized multicenter study of minilaparotomy cholecystectomy versus laparoscopic cholecystectomy with ultrasonic dissection in both groups. Scandinavian Journal of Gastroenterology, 51, 354–359.

    Article  PubMed  Google Scholar 

  25. Aspinen, S., Kinnunen, M., Harju, J., et al. (2016). Inflammatory response to surgical trauma in patients with minilaparotomy cholecystectomy versus laparoscopic cholecystectomy: A randomised multicentre study. Scandinavian Journal of Gastroenterology, 51, 739–744.

    Article  CAS  PubMed  Google Scholar 

  26. Korolija, D., Sauerland, S., Wood-Dauphinée, S., et al. (2004). Evaluation of quality of life after laparoscopic surgery: Evidence-based guidelines of the European Association for Endoscopic Surgery. Surgical Endoscopy, 18, 879–897.

    Article  CAS  PubMed  Google Scholar 

  27. Purkayastha, S., Tilney, H. S., Georgiou, P., et al. (2007). Laparoscopic cholecystectomy versus mini-laparotomy cholecystectomy: A meta-analysis of randomised control trials. Surgical Endoscopy, 21, 1294–1300.

    Article  PubMed  Google Scholar 

  28. Keus, F., Gooszen, H. G., & van Laarhoven, C. J. (2009). Systematic review: Open, small-incision or laparoscopic cholecystectomy for symptomatic cholecystolithiasis. Alimentary Pharmacology & Therapeutics, 29, 359–378.

    Article  CAS  Google Scholar 

  29. Califano, A. D., Angelini, P., et al. (2011). Laparo-endoscopic single site cholecystectomy versus standard laparoscopic cholecystectomy: Results of a pilot randomized trial. American Journal of Surgery, 202, 45–52.

    Article  PubMed  Google Scholar 

  30. Wright, B., Alexander, D., Aghahoseini, A., et al. (2016). Does preoperative depression and/or serotonin transporter gene polymorphism predict outcome after laparoscopic cholecystectomy? BMJ open, 6, e007969.

    Article  PubMed  PubMed Central  Google Scholar 

  31. Hays, R. D., & Morales, L. S. (2001). The RAND-36 measure of health-related quality of life. Annals of Medicine, 33, 350–357.

    Article  CAS  PubMed  Google Scholar 

  32. Aalto, A.-M., Aro, A. R., & Teperi, J. (1999). Rand-36 as a measure of health-related quality of life. Reliability, construct validity and reference values in the Finnish general population. Helsinki: National Research and Development Center for Welfare and Health. (Research #101 In Finnish, summary in English).

    Google Scholar 

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Acknowledgements

The study was funded by the Heikki, Aino and Aarne Korhonen foundation and the EVO funding of the Helsinki University Hospital and Kuopio University Hospital. The authors would like to thank the patients for their participation in the study.

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Authors and Affiliations

  1. Department of Surgery, Kuopio University Hospital and School of Medicine, University of Eastern Finland, P.O. Box 100, 70029, Kuopio, Finland

    Samuli Aspinen, Jari Kärkkäinen, Petri Juvonen & Matti Eskelinen

  2. Department of Surgery, Helsinki University Central Hospital, Helsinki, Finland

    Jukka Harju

  3. Department of Anaesthesia and Operative Services, Kuopio University Hospital and School of Medicine, University of Eastern Finland, Kuopio, Finland

    Hannu Kokki

Authors
  1. Samuli Aspinen
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  2. Jari Kärkkäinen
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  3. Jukka Harju
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  4. Petri Juvonen
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  5. Hannu Kokki
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  6. Matti Eskelinen
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Corresponding author

Correspondence to Matti Eskelinen.

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Conflict of interest

The authors declare that they have no conflict of interest.

Ethical standards

The study was approved by the Ethics Committee of Helsinki and Uusimaa University District, Helsinki, Finland (DNRO 120/13/02/02/2010, May 12, 2010), and it was registered in the ClinicalTrials.gov database (ClinicalTrials.gov Identifier: NCT01723540, Consort diagram, Fig. 1).

Human and animal rights

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.

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Aspinen, S., Kärkkäinen, J., Harju, J. et al. Improvement in the quality of life following cholecystectomy: a randomized multicenter study of health status (RAND-36) in patients with laparoscopic cholecystectomy versus minilaparotomy cholecystectomy. Qual Life Res 26, 665–671 (2017). https://doi.org/10.1007/s11136-016-1485-1

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