Quality of Life of Minimally Invasive Surgery after Cholecystectomy

• Main Authors: Pei-Wei Liu, 劉佩瑋
• Other Authors: Hon-Yi Shi
• Format: Others
• Language: zh-TW
• Published: 2017
• Online Access: http://ndltd.ncl.edu.tw/handle/01640120885726625558

碩士 === 高雄醫學大學 === 醫務管理暨醫療資訊學系碩士班 === 105 === Purpose Cholecystectomy is a common procedure for the treatment of gallstones, including three types: open cholecystectomy (OC), laparoscopic cholecystectomy (LC) and robotic-assisted cholecystectomy (RAC). The study purposed to evaluate trends of the patients'' health-related quality of life (HRQoL) and to explore the major predictors of HRQoL during the study period. Methods In this prospective and longitudinal study, we conducted questionnaire survey as the research method. From November 2015 to March 2017, patients receiving cholecystectomy in a teaching hospital in southern Taiwan were recruited as subjects of this study. We explored the degree of improvement in different dimensions of assessment tools such as Gastrointestinal Quality-of-Life Index (GIQLI) and Global Taiwan SF-36 Questionnaires. All participants completed both questionnaires at the time points of immediately before surgeries, 3rd month, 6th month, 1st year, and 2nd year postoperatively. We used Generalized Estimation Equation (GEE) and STATA statistical software to analyze the data. Results A total of 601 cases of minimally invasive cholecystectomy were found in this study. There were 75 (12.5%) of the RC and 526 (87.5%) of LC. It showed that 56.6% of the population was female, the average age was 54.4 years, and the average length of stay was 4.13 days. The results also showed that, in GIQLI, patients receiving RC and LC had significant improvement at the 3rd month and the 6th month after the surgery, but there was no significant difference at the first year and the 2nd year after the surgery. In SF-36, patients receiving RC and LC had significant improvement in all facets, especially in the facet of dynamic health, indicating that the patients had less postoperative pain and more ambulatory after the surgery. However there is no significant difference in the facets of physical and mental health (P <0.05). The GEE model found that the prognosis is better in patients with gallstones if they receive early treatment. Conclusions Implementing different types of minimally invasive surgeries is beneficial, regardless of the patient or surgical characteristics. In particular, it would have reduced length of hospital stay, reduced pain, more rapid recovery, and reduced medical resources utilization. The HRQoL at the 3rd to 6th month after surgery improved significantly, but there is no significant difference during the 6th month to the 2nd year after the surgery. The patients had full recovery of health status after the surgery. The restrict of the study is that there are not enough RC patients collected in this study. The number of participants can be increased in the future, and the changes in medical resource consumption and medical performance can be further explored. It can provide reference for hospital decision makers to evaluate future purchases of major instruments.