One-third of patients fail to return to work 1 year after surgery for colorectal cancer.
BACKGROUND
Achieving full recovery after colorectal cancer surgery means a return to normal physical and psychological health and to a normal social life. Recovery data focusses on time to discharge rather than longer term functionality including return to work (RTW). We aim to assess return to normal holistic function at 1 year after colorectal cancer surgery.


METHODS
Questionnaires were created and dispatched to 204 patients who had undergone surgery with curative intent for colorectal cancer, in 2011-2012, in a single teaching hospital.


RESULTS
Response rate was 75 % (153/204), 82 % (129/157) for open surgery (OS) and 51 % (24/47) for laparoscopic surgery (LS). Median age was 68 (48-91) years for OS and 65 (36-84) for LS. Eighty-four per cent of patients felt 'ready' and 95 % had adequate pain control upon discharge (no difference between groups). LS reported earlier 'return to full fitness' (1-3 months) than OS (>6 months; Mann-Whitney U, p < 0.05). Recovery from LS was 'better than expected' compared to OS 'worse than expected' (Mann-Whitney U test, p < 0.05). Forty-nine patients were employed preoperatively and 61 % (n = 30) returned to work. RTW was more frequent after LS (Chi-square test, p < 0.05). Length of time to RTW was significantly less after LS [44 (6-84) days] than OS [71 (14-252) days] (t test, p < 0.05). Levels of self-employment were equal between groups.


CONCLUSIONS
One-third of patients failed to RTW at 1 year post-surgery. Patients having LS returned to full fitness faster, felt recovery was shorter and returned to work earlier than OS. We must invest more in managing expectations and provide better post-discharge support to improve RTW.
Department of Surgery, Royal Derby Hospital, Royal Derby Hospitals NHS Trust, Uttoxeter Road, Derby, DE22 3NE, UK, ashbhalla@doctors.org.uk.
A
A
Bhalla
J P
JP
Williams
N G
NG
Hurst
W J
WJ
Speake
G M
GM
Tierney
S
S
Tou
J N
JN
Lund
D000368:Aged; D000369:Aged, 80 and over; D016009:Chi-Square Distribution; D015179:Colorectal Neoplasms / Q000534:rehabilitation* / Q000601:surgery; D003107:Colorectal Surgery; D004651:Employment / Q000706:statistics & numerical data; D006306:Health Surveys / Q000706:statistics & numerical data; D006801:Humans; D010535:Laparoscopy; D008875:Middle Aged; D059408:Pain Management / Q000523:psychology / Q000706:statistics & numerical data; D011184:Postoperative Period; D062707:Return to Work / Q000706:statistics & numerical data*; D018709:Statistics, Nonparametric; D011795:Surveys and Questionnaires; D013997:Time Factors