Beth Israel Deaconess Medical Center, Division of Urology, Boston, MA.
Weill Cornell Medical College; New York, NY.
Urology. 2020 Oct;144:123-129. doi: 10.1016/j.urology.2020.06.020. Epub 2020 Jun 27.
To better characterize recovery after minimally invasive kidney surgery, we present a study describing patient-reported health-related quality of life (HRQOL) following minimally invasive radical nephrectomy (RN) and partial nephrectomy (PN).
Patients who underwent minimally invasive PN or RN for renal cancer were invited to enroll in a prospective, patient-reported HRQOL study using the Convalescence and Recovery Evaluation (CARE) instrument and Short Form-12. Patients completed questionnaires at baseline, 2, 4, 8, and 12 weeks after surgery. Mixed repeated measures model were used to assess time effect on HRQOL scores and predictors of scores within each surgery groups.
One hundred seventy-seven patients were included in the study: 50 had RN and 127 had PN. At 2 weeks, both groups had significant decreases in Overall CARE, as well as the Pain, Gastrointestinal, and Activity domain scores which remained slightly below baseline at 4 weeks. At 4 weeks only 50% of patients in both the RN and PN cohorts returned to baseline overall CARE score. By 12 weeks 82% returned to baseline overall CARE score in the RN group while 76% of patients did so in the PN group.
Convalescence after minimally invasive renal surgery can often extend beyond 4 weeks post-treatment in PN and RN subjects. This information may be used to provide more accurate preoperative counseling in an attempt to improve overall patient satisfaction.
为了更好地描述微创肾手术后的恢复情况,我们开展了一项研究,描述了接受微创根治性肾切除术(RN)和部分肾切除术(PN)的患者的健康相关生活质量(HRQOL)。
我们邀请接受微创 PN 或 RN 治疗肾癌的患者参加前瞻性、患者报告的 HRQOL 研究,使用恢复期和恢复评估(CARE)工具和简化健康调查量表 12 项。患者在手术前、术后 2、4、8 和 12 周完成问卷。混合重复测量模型用于评估 HRQOL 评分的时间效应以及每个手术组内评分的预测因素。
本研究共纳入 177 例患者:50 例行 RN,127 例行 PN。术后 2 周,两组的总体 CARE 评分以及疼痛、胃肠道和活动域评分均显著下降,术后 4 周仍略低于基线。术后 4 周,仅 50%的 RN 和 PN 队列患者的总体 CARE 评分恢复到基线。到第 12 周,82%的 RN 组患者恢复到基线总体 CARE 评分,76%的 PN 组患者恢复到基线总体 CARE 评分。
PN 和 RN 患者微创肾手术后的恢复期常常超过治疗后 4 周。这些信息可以用于提供更准确的术前咨询,以提高整体患者满意度。