Département de Chirurgie, Institut de Cancérologie de Lorraine, Université de Lorraine Avenue de Bourgogne, 54519 Vandœuvre-lès-Nancy, France; Département de Gynécologie, CHRU de Nancy, Université de Lorraine, Vandœuvre-lès-Nancy, France.
Département d'anesthésie, Institut de Cancérologie de Lorraine, Université de Lorraine Avenue de Bourgogne, 54519 Vandœuvre-lès-Nancy, France.
J Gynecol Obstet Hum Reprod. 2021 Feb;50(2):101779. doi: 10.1016/j.jogoh.2020.101779. Epub 2020 May 11.
According to the latest recommendations a minimally invasive approach should be used to manage breast cancer and a global policy for minimizing costs encourages shorter periods of hospitalization. The aim of this study was to investigate the impact of length of hospitalization on quality of life, anxiety and depression and postoperative complications.
This is a prospective observational study of 412 female patients with breast cancer requiring a first mastectomy or lumpectomy to assess the impact of the length of hospitalization on quality of life (using the European Organization for Research and Treatment of Cancer Quality of Life QLQ30 and BR23 questionnaires) at postoperative day 14 (D+14), levels of anxiety at d-1 and D+1 (according to the Hospital Anxiety and Depression scale) and postoperative state at D+21.
Our study included 244 patients that had ambulatory surgery and 124 that had non-ambulatory surgery. Global health status was significantly better for ambulatory surgery patients (adjusted p-value=0.014). There were no significant differences between the two groups for levels of anxiety, pain, lymphoceles and postoperative complications. No cases of nausea and vomiting requiring medical treatment were reported for either group.
Breast cancer surgery can be performed using ambulatory surgery with no significant differences compared to non-ambulatory surgery in terms of quality of life, perioperative anxiety, and postoperative complications. Indeed, our study suggests that ambulatory surgery improves patient outcome. It should be determined whether the mode of hospitalization has any long-term impact on the patient, as a shorter hospitalization period would allow decreasing waiting times.
根据最新建议，应采用微创方法治疗乳腺癌，同时全球成本最小化政策鼓励缩短住院时间。本研究旨在探讨住院时间对生活质量、焦虑和抑郁以及术后并发症的影响。
这是一项对 412 名女性乳腺癌患者的前瞻性观察性研究，这些患者需要首次进行乳房切除术或肿瘤切除术，以评估住院时间对生活质量（使用欧洲癌症研究和治疗组织生活质量问卷 QLQ30 和 BR23 问卷）的影响，评估时间为术后第 14 天（D+14）、术前 1 天（d-1）和术后第 1 天（D+1）的焦虑水平（根据医院焦虑和抑郁量表）以及术后第 21 天的状态。
本研究包括 244 例门诊手术患者和 124 例非门诊手术患者。门诊手术患者的总体健康状况明显更好（调整后的 p 值=0.014）。两组患者在焦虑、疼痛、淋巴囊肿和术后并发症的水平方面无显著差异。两组均未报告需要药物治疗的恶心和呕吐病例。
乳腺癌手术可采用门诊手术进行，与非门诊手术相比，在生活质量、围手术期焦虑和术后并发症方面无显著差异。事实上，我们的研究表明，门诊手术改善了患者的预后。需要确定住院模式是否对患者有任何长期影响，因为缩短住院时间可以减少等待时间。
