Lee Tae-Gyun, Ryoo Seung-Bum, Oh Heung-Kwon, Cho Yong Beom, Kim Chang Hyun, Lee Ju Hyun, Ahn Hong-Min, Shin Hye-Rim, Choi Mi Jeong, Jo Min Hyeong, Kim Duck-Woo, Kang Sung-Bum
Department of Surgery, Ajou University School of Medicine, Suwon, Republic of Korea.
Department of Surgery, Seoul National University College of Medicine, Seoul National University Hospital, Seoul, Republic of Korea.
Colorectal Dis. 2025 Mar;27(3):e70060. doi: 10.1111/codi.70060.
The aim of this study was to validate the Gastrointestinal Quality of Life Index (GIQLI) and assess its effectiveness in measuring changes in postoperative quality of life (QOL) after laparoscopic colorectal cancer surgery, including factors affecting early QOL impairment.
This multicentre prospective study enrolled patients who underwent laparoscopic colorectal cancer surgery between November 2021 and February 2023. Participants completed the GIQLI and European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire for Colorectal Cancer (EORTC QLQ-CR29) questionnaires preoperatively and at 1 and 3 weeks, 6 months and 1 year postoperatively. We evaluated GIQLI reliability, identified risk factors associated with early postoperative QOL impairment and assessed longitudinal changes in QOL to determine the timing of postoperative recovery.
The GIQLI showed high reliability, with a preoperative intraclass correlation coefficient of 0.930 (95% CI 0.899-0.951) and Cronbach alpha values >0.9 at all time points. The mean global GIQLI score decreased from 106.2 ± 14.7 preoperatively to 92.7 ± 15.2 at 1 week postoperatively (p < 0.001), recovered to 104.6 ± 13.8 at 6 months postoperatively (versus preoperatively, p > 0.99) and increased to 113.4 ± 13.3 at 1 year postoperatively (versus preoperatively, p < 0.001). Early T-stage (T1-2; OR 2.82, 95% CI 1.25-6.40, p = 0.013) and intra-abdominal drain use (OR 3.95, 95% CI 1.09-14.28, p = 0.036) were significant risk factors for substantial impairment of QOL at 1 week postoperatively. The predicted recovery period to 95% of preoperative QOL was 6.4 weeks (95% CI 6.00-8.30 weeks).
The GIQLI reliably assessed longitudinal changes in QOL after laparoscopic colorectal cancer surgery and demonstrated QOL recovery within 2 months postoperatively, providing guidance for patient counselling and optimizing postoperative care.
本研究旨在验证胃肠道生活质量指数（GIQLI），并评估其在测量腹腔镜结直肠癌手术后生活质量（QOL）变化方面的有效性，包括影响早期生活质量受损的因素。
这项多中心前瞻性研究纳入了2021年11月至2023年2月期间接受腹腔镜结直肠癌手术的患者。参与者在术前、术后1周和3周、6个月及1年时完成GIQLI和欧洲癌症研究与治疗组织结直肠癌生活质量问卷（EORTC QLQ-CR29）。我们评估了GIQLI的可靠性，确定了与术后早期生活质量受损相关的风险因素，并评估了生活质量的纵向变化以确定术后恢复的时间。
GIQLI显示出高可靠性，术前组内相关系数为0.930（95%CI 0.899-0.951），所有时间点的Cronbach's alpha值均>0.9。GIQLI总体平均得分从术前的106.2±14.7降至术后1周时的92.7±15.2（p<0.001），术后6个月恢复至104.6±13.8（与术前相比，p>0.99），术后1年增至113.4±13.3（与术前相比，p<0.001）。早期T分期（T1-2；OR 2.82，95%CI 1.25-6.40，p=0.013）和使用腹腔引流管（OR 3.95，95%CI 1.09-14.28，p=0.036）是术后1周时生活质量严重受损的显著风险因素。恢复至术前生活质量95%的预测恢复期为6.4周（95%CI 6.00-8.30周）。
GIQLI可靠地评估了腹腔镜结直肠癌手术后生活质量的纵向变化，并证明术后2个月内生活质量恢复，为患者咨询和优化术后护理提供了指导。
