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- Title
Body image, cosmesis, quality of life, and functional outcome of hand-assisted laparoscopic versus open restorative proctocolectomy: long-term results of a randomized trial.
- Authors
Polle, S. W.; Dunker, M. S.; Slors, J. F.; Sprangers, M. A.; Cuesta, M. A.; Gouma, D. J.; Bemelman, W. A.; Slors, J F M
- Abstract
<bold>Background: </bold>This study aimed to compare quality of life (QOL), functional outcome, body image, and cosmesis after hand-assisted laparoscopic (LRP) versus open restorative proctocolectomy (ORP). The potential long-term advantages of LRP over ORP remain to be determined. The most likely advantage of LRP is the superior cosmetic result. It is, however, unclear whether the size and location of incisions affect body image and QOL.<bold>Methods: </bold>In a previously conducted randomized trial comparing LRP with ORP, 60 patients were prospectively evaluated. The primary end points were body image and cosmesis. The secondary end points were morbidity, QOL, and functional outcome. A body image questionnaire was used to evaluate body image and cosmesis. The Short Form-36 Health Survey and the Gastrointestinal Quality of Life Inventory were used to assess QOL. Body image and QOL also were assessed preoperatively.<bold>Results: </bold>A total of 53 patients completed the QOL and functional outcome questionnaires. There were no differences in functional outcome, morbidity, or QOL between LRP and ORP. At a median of 2.7 years after surgery, 46 patients returned the questionnaires regarding body image, cosmesis, and morbidity. The body image and cosmesis scores of female patients were significantly higher in the LRP group than in the ORP group (body image, 17.4 vs 14.9; cosmesis, 19.1 vs 13.0, respectively). The female patients in the ORP group had significantly lower body image scores than the male patients (14.9 vs 18.3).<bold>Conclusions: </bold>This study is the first to show that ORP has a negative impact on body image and cosmesis as compared with LRP. Functional outcome, QOL, and morbidity are similar for the two approaches. The advantages of a long-lasting improved body image and cosmesis for this relatively young patient population may compensate for the longer operating times and higher costs, particularly for women.
- Subjects
QUALITY of life; BODY image; LAPAROSCOPIC surgery; ENDOSCOPIC surgery; LAPAROSCOPY; RESTORATIVE proctocolectomy; COLECTOMY; RECTAL surgery; AESTHETICS; COMPARATIVE studies; DEFECATION; HEALTH surveys; RESEARCH methodology; MEDICAL cooperation; QUESTIONNAIRES; RESEARCH; SURGICAL complications; ULCERATIVE colitis; EVALUATION research; RANDOMIZED controlled trials; TREATMENT effectiveness; ADENOMATOUS polyposis coli
- Publication
Surgical Endoscopy & Other Interventional Techniques, 2007, Vol 21, Issue 8, p1301
- ISSN
1866-6817
- Publication type
journal article
- DOI
10.1007/s00464-007-9294-9