Department of Visceral Surgery, Lausanne University Hospital CHUV and University of Lausanne, Rue du Bugnon 46, 1011, Lausanne, Switzerland.
World J Surg. 2020 Jun;44(6):1985-1993. doi: 10.1007/s00268-020-05419-z.
Most elective anorectal procedures are performed in an outpatient setting, and the supposed recovery time is short. The aim of the present study was to assess return to usual physical activity (UPA), return to work and quality of life (QOL).
This prospective single-center cohort study included consecutive patients undergoing outpatient anorectal procedures. Physical and work activities were assessed using the validated International Physical Activity Questionnaire 7 days before surgery and 7, 14 and 30 days thereafter. In addition, patients were inquired daily on their postoperative QOL until postoperative day (POD)10 on a visual analogue scale (0-10). Patients were stratified by their preoperative physical activity score (POPAS; low, moderate and high).
Out of 379 patients, 100 (63 men) were included with a median age of 40 years [interquartile range (IQR) 27]. General QOL was rated at a median of 8/10 (IQR 3.5) at POD10. On POD30, only 69% and 71% of patients had returned to UPA and work, respectively. Patients who returned to UPA at POD30 had a better median QOL at POD10 than those who did not (9 vs. 7/10, p = 0.015). Patients with low POPAS and moderate POPAS returned to UPA earlier than patients with high POPAS (83%, 86% and 44% on POD30, respectively, p = 0.005).
Return to UPA and work after outpatient anorectal surgery took longer than expected despite a good QOL 10 days after surgery. High physical activity was associated with longer recovery time. These elements should be emphasized during preoperative counseling.
大多数择期肛门直肠手术是在门诊进行的,假定恢复时间较短。本研究旨在评估恢复日常体力活动(UPA)、恢复工作和生活质量(QOL)的情况。
本前瞻性单中心队列研究纳入了连续接受门诊肛门直肠手术的患者。使用经过验证的国际体力活动问卷(International Physical Activity Questionnaire)在手术前 7 天和之后的 7、14 和 30 天评估体力和工作活动。此外,患者在术后第 10 天(POD)之前每天通过视觉模拟量表(0-10)询问他们的术后 QOL。患者根据术前体力活动评分(POPAS;低、中、高)进行分层。
在 379 名患者中,有 100 名(63 名男性)入选,中位年龄为 40 岁[四分位距(IQR)27]。一般 QOL 在 POD10 时的中位数为 8/10(IQR 3.5)。在 POD30 时,只有 69%和 71%的患者分别恢复了 UPA 和工作。在 POD30 时恢复 UPA 的患者在 POD10 时的中位 QOL 更好(9 与 7/10,p=0.015)。POPAS 低和中患者比 POPAS 高患者更早恢复 UPA(分别在 POD30 时为 83%、86%和 44%,p=0.005)。
尽管手术后 10 天 QOL 良好,但门诊肛门直肠手术后恢复 UPA 和工作的时间比预期的要长。高体力活动与恢复时间延长有关。这些因素应在术前咨询中强调。