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Health-related quality of life after polypectomy with and without additional surgery
John Patrick Browne1, Claire Hopkins, Robert Slack
1Clinical Effectiveness Unit, Royal College of Surgeons of England, London, and the Royal United Hospital Bath, Bath, Somerset, United Kingdom. jbrowne@rcseng.ac.uk
Objective:
The objective of this study was to compare the health-related quality of life of patients undergoing simple polypectomy with that of patients undergoing polypectomy with additional surgery.
Study Design:
This was a prospective, multicenter cohort study of adults undergoing sinonasal surgery.
Methods:
Eight hundred forty-four patients received simple polypectomy and 1,004 patients received polypectomy with additional surgery. Health-related quality of life was compared at 12 and 36 months after surgery using the Sino-Nasal Outcome Test (SNOT-22). Total SNOT-22 scores may range from zero to 110 with lower scores representing better outcomes. We used linear regression to adjust postoperative SNOT-22 scores for baseline characteristics. When comparing the difference between the two surgical techniques, positive SNOT-22 scores represent a better outcome for those undergoing additional surgery.
Results:
There were only small differences between the two groups at 12 months (difference in SNOT-22 -0.5; 95% confidence interval [CI]=-2.3-1.3; P=.58) and 36 months after surgery (difference -2.1; 95% CI=-4.4-0.2; P=.08). The additional surgery group had a slightly higher risk of excessive perioperative bleeding (8.6% vs. 6.0%; P=.04) but a slightly lower risk of revision surgery within 36 months (10.4% vs. 13.3%; P=.12).
Conclusions:
Nasal polypectomy with additional surgery seems to have no benefit over simple polypectomy in terms of health-related quality of life improvement for patients with nasal polyposis.
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