Use of health related quality of life tools in upper gastrointestinal surgery

Abstract

SUMMARYThe objective of this article is to review the literature and discuss the various tools used in upper gastrointestinal surgery for the measurement of health related quality of life (HR-QOL) and highlights various outcome variables that affect the HR-QOL among patients of common upper gastrointestinal disorders. The paper reviews HR-QOL articles published in the last 25 years on different upper gastrointestinal curative or palliative procedures. The paper used an HR-QOL method, which is a questionnaire, which is utilized to assess the changes in the health status of patients after a surgical intervention. These surveys are of increasingly importance, as health care providers are challenged to justify treatment approaches and rationale for any surgical intervention. These HR-QOL tools are very helpful for the evaluation of subjective outcome of common upper gastrointestinal surgical procedures like Gastrointestinal Quality of Life Index (GIQLI) and Quality of life in reflux and dyspepsia (QOLRAD) for Nissen fundoplication, Spitzer's QOL index for gastrectomy, Short Form 36 (SF-36) for achalasia and GIQLI for peptic ulcer disease. The paper concludes that use of validated and reliable health instruments in upper gastrointestinal surgery is directed at measuring the impact in a reproducible and valid fashion. Curative or palliative procedures should be offered to the patients of upper gastrointestinal disorders after the assessment by HR-QOL tools. As the impairment of functions that may occur after different operations vary considerably, an operation-specific assessment of HR-QOL for each type of surgical procedure is becoming an essential principle to follow in a successful healthcare system.

Laparoscopic fenestration of non-parasitic liver cysts and health-related quality of life assessment

“…It is equally important to consider the patient's subjective perceptions as a meaningful post-operative outcome, in order to assess the effect of the intervention on patient's actual QoL. This modern concept of HR-QoL has become an important decision making tool for hepatobiliary surgeons in the last decade [18,28,29]. Nowadays the patient is considered as an active participant rather than a passive entity in the treatment and intervention process.…”

“…Since there is no specific questionnaire for non-parasitic liver cyst disease, we used the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core-30 (EORTC QLQ-C30, Version 3.0). This questionnaire is a cancer specific QoL instrument originally used in cancer clinical trials [17,18]. However, this tool was chosen because it addressed all the symptoms that are seen in non-parasitic liver cyst patients and represents a validated tool.…”