Evaluation of quality of life after laparoscopic surgery: evidence-based guidelines of the European Association for Endoscopic Surgery

  • D. Korolija
  • S. Sauerland
  • S. Wood-Dauphinée
  • C. C. Abbou
  • E. Eypasch
  • M. García. Caballero
  • M. A. Lumsden
  • B. Millat
  • J. R. T. Monson
  • G. Nilsson
  • R. Pointner
  • W. Schwenk
  • A. Shamiyeh
  • A. Szold
  • E. Targarona
  • B. Ure
  • E. Neugebauer
Review article



Measuring health-related quality of life (QoL) after surgery is essential for decision making by patients, surgeons, and payers. The aim of this consensus conference was twofold. First, it was to determine for which diseases endoscopic surgery results in better postoperative QoL than open surgery. Second, it was to recommend QoL instruments for clinical research.


An expert panel selected 12 conditions in which QoL and endoscopic surgery are important. For each condition, studies comparing endoscopic and open surgery in terms of QoL were identified. The expert panel reached consensus on the relative benefits of endoscopic surgery and recommended generic and disease-specific QoL instruments for use in clinical research.


Randomized trials indicate that QoL improves earlier after endoscopic than open surgery for gastroesophageal reflux disease (GERD), cholecystolithiasis, colorectal cancer, inguinal hernia, obesity (gastric bypass), and uterine disorders that require hysterectomy. For spleen, prostate, malignant kidney, benign colorectal, and benign non-GERD esophageal diseases, evidence from nonrandomized trials supports the use of laparoscopic surgery. However, many studies failed to collect long-term results, used nonvalidated questionnaires, or measured QoL components only incompletely. The following QoL instruments can be recommended: for benign esophageal and gallbladder disease, the GIQLI or the QOLRAD together with SF-36 or the PGWB; for obesity surgery, the IWQOL-Lite with the SF-36; for colorectal cancer, the FACT-C or the EORTC QLQ-C30/CR38; for inguinal and renal surgery, the VAS for pain with the SF-36 (or the EORTC QLQ-C30 in case of malignancy); and after hysterectomy, the SF-36 together with an evaluation of urinary and sexual function.


Laparoscopic surgery provides better postoperative QoL in many clinical situations. Researchers would improve the quality of future studies by using validated QoL instruments such as those recommended here.


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Copyright information

© Springer-Verlag 2004

Authors and Affiliations

  • D. Korolija
    • 1
    • 2
  • S. Sauerland
    • 2
  • S. Wood-Dauphinée
    • 3
  • C. C. Abbou
    • 4
  • E. Eypasch
    • 5
  • M. García. Caballero
    • 6
  • M. A. Lumsden
    • 7
  • B. Millat
    • 8
  • J. R. T. Monson
    • 9
  • G. Nilsson
    • 10
  • R. Pointner
    • 11
  • W. Schwenk
    • 12
  • A. Shamiyeh
    • 13
  • A. Szold
    • 14
  • E. Targarona
    • 15
  • B. Ure
    • 16
  • E. Neugebauer
    • 2
  1. 1.University Surgical ClinicClinical Hospital Center ZagrebZagrebCroatia
  2. 2.Biochemical and Experimental Division, 2nd Department of SurgeryUniversity of CologneCologneGermany
  3. 3.Department of Epidemiology and Biostatistics, School of Physical and Occupational TherapyMcGill UniversityMontrealCanada
  4. 4.Department of UrologyCentre Hospitalier Universitaire Henri MondorCreteilFrance
  5. 5.Surgical DepartmentMalteser-Krankenhaus St. HildegardisCologneGermany
  6. 6.Department of SurgeryMálaga UniversityMálagaSpain
  7. 7.Department of Obstetrics and Gynaecology3rd Floor, Queen Elizabeth Building, Royal InfirmaryGlasgowUnited Kingdom
  8. 8.Department of Abdominal SurgeryHòpital Saint Eloi (CHU) 2France
  9. 9.Academic Surgical UnitUniversity of Hull, Castle Hill HospitalCottinghamUnited Kingdom
  10. 10.Department of NursingLund UniversityLundSweden
  11. 11.Department of General SurgeryZell am See HospitalZell am SeeAustria
  12. 12.Department of General, Abdominal, Vascular and Thoracic SurgeryCampus Charité MitteBerlinGermany
  13. 13.Ludwig–Boltzmann Institute for Surgical Laparoscopy, 2nd Department of SurgeryLinz General HospitalLinzAustria
  14. 14.Department of Surgery BSourasky Medical CenterTel AvivIsrael
  15. 15.Department of General and Digestive SurgeryHospital de Sant Pau C/Padre Claret 167BarcelonaSpain
  16. 16.Department of Paediatric SurgeryMedical University of HannoverHannoverGermany

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