Jakobsson Jenny, Idvall Ewa, Wann-Hansson Christine
Department of Surgery, Skane University Hospital, Inga Marie Nilssons gata 47, 20502, Malmö, Sweden,
Int J Colorectal Dis. 2014 Aug;29(8):989-98. doi: 10.1007/s00384-014-1939-2. Epub 2014 Jul 4.
The concept of enhanced recovery after surgery (ERAS) is a modern regime of care, and numerous studies have proved its beneficial impact on recovery after colorectal surgery. However, little is known about patients' continuing recovery after discharge. Therefore, the purpose of this study was to describe patient-reported recovery after colorectal cancer surgery in the context of ERAS from the day of discharge until 1 and 6 months after surgery.
Assessments were made at discharge, at 1 month and at 6 months after surgery using the questionnaire Postoperative Recovery Profile (PRP). In all, 119 patients recovering from abdominoperineal resection, rectal resection, or colonic resection completed all three assessments.
The global score of recovery showed that no patient experienced being fully recovered at discharge. After rectal resection, patients frequently reported being not at all recovered. One month after surgery, patients recovering from colonic resection reported significant improvements regarding 11 of 17 questionnaire items, whereas abdominoperineal resection patients reported no significant improvements regarding any item. Instead, significantly higher levels of problems were reported in the items fatigue, muscle weakness and feeling down. Rectal resection patients reported significant improvements between 1 and 6 months after surgery regarding 7 of 19 items. However, the item gastrointestinal function distinguished, as patients reported significant deterioration towards higher levels of problems 6 months after surgery.
This study elucidates the difference between groups of colorectal patients and the diverse patterns of their recovery, implying different needs in terms of prolonged support after discharge.
术后加速康复（ERAS）理念是一种现代护理模式，众多研究已证实其对结直肠手术后康复有积极影响。然而，对于患者出院后的持续康复情况知之甚少。因此，本研究的目的是描述在ERAS背景下，结直肠癌手术后患者从出院之日起至术后1个月和6个月的自我报告康复情况。
使用术后恢复概况问卷（PRP）在出院时、术后1个月和6个月进行评估。共有119例接受腹会阴联合切除术、直肠切除术或结肠切除术康复的患者完成了所有三项评估。
康复总体评分显示，出院时没有患者达到完全康复。直肠切除术后，患者经常报告完全没有恢复。术后1个月，结肠切除术后康复的患者在17项问卷项目中的11项上报告有显著改善，而腹会阴联合切除术患者在任何项目上均未报告有显著改善。相反，在疲劳、肌肉无力和情绪低落等项目中报告的问题水平显著更高。直肠切除术后患者在术后1至6个月之间，19项中的7项报告有显著改善。然而，胃肠功能这一项目有所不同，因为患者报告术后6个月问题水平显著恶化。
本研究阐明了结直肠患者群体之间的差异以及他们不同的康复模式，这意味着出院后长期支持方面有不同的需求。
