Vascular Health and Risk Management (Feb 2022)
Quality of Life (QoL) Assessment in the Patients Operated with Either Laparoscopic or an Open Aortobifemoral Bypass for Aortoiliac Occlusive Disease (AIOD): 2 Years Results of a Randomized Controlled Trial
Abstract
Mehdi Sahba,1,2 Anne Helene Krog,1 Erik Mulder Pettersen,3 Torbjørn Wisløff,4 Jon Otto Sundhagen,5 Syed Sajid Hussain Kazmi2,5 1Department of Vascular Surgery, Østfold Central Hospital, Kalnes, Norway; 2Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway; 3Department of Vascular Surgery, Sørlandet Hospital HF, Kristiansand, Norway; 4Health Services Research Unit, Akershus University Hospital, Lørenskog, Norway; 5Department of Vascular Surgery, Division of Cardiovascular and Pulmonary Diseases, Oslo University Hospital, Ullevål, Oslo, NorwayCorrespondence: Syed Sajid Hussain Kazmi, Tel +47 92468309, Email [email protected]: QoL assessment within surgical treatment is seldom investigated and sparsely reported in the medical literature. This study aimed to compare QoL in a randomized fashion in the patients treated with either a laparoscopic aortobifemoral bypass (LABFB) or an open aortobifemoral bypass (OABFB) for the treatment of AIOD.Patients and Methods: Seventy-one consecutive patients with AIOD, Trans-Atlantic Inter-Society Consensus II Type D lesions (TASC II, Type D) were randomized to LABFB or OABFB. Thirty-five patients in the LABFB and thirty-six in the OABFB groups were compared for the changes in the QoL, with the short-form health survey (SF-36), EuroQol 5 dimensions (EQ-5D), and EQ-5D visual analog scale (VAS) preoperatively, and postoperatively at 1, 3, 6, 12 and 24 months. Mann–Whitney U-Test and Wilcoxon sign-rank test were used for group comparison. Mixed model analysis was performed to examine the effect of different variables on the QoL.Results: In the patients treated with LABFB, physical component score (PCS) and mental component score (MCS) in SF-36 were significantly higher than OABFB, at 1 and 3 months postoperatively. PCS was also significantly higher in the LABFB group than OABFB at 24 months postoperatively. The preoperative QoL scores for both the laparoscopy and the open group were significantly lower than the age-matched general Norwegian population. EQ-5D median scores were significantly higher in the LABFB at all postoperative follow-up time points up to 12 months. The patients in the LABFB group also had a statistically significant increase in EQ-5D VAS compared to OABFB, at 1 and 12 months postoperatively (p = 0.005, and p = 0.037, respectively).Conclusion: QoL seems better in patients treated with LABFB than OABFB, particularly during the early months after surgery.Keywords: health-related quality of life, EQ-5D, SF-36, laparoscopy, aortobifemoral bypass, PROMs
