The postoperative patient-reported quality of recovery in colorectal cancer patients under enhanced recovery after surgery using QoR-40.
BACKGROUND
Enhanced recovery after surgery (ERAS) protocols may reduce postoperative complications and the length of hospital stay. Studies of the effectiveness of ERAS should include not only doctor-reported outcomes, but also patient-reported outcomes, in order to better estimate their impact on recovery. However, patient-reported outcomes are not commonly reported. Thus, it needs to be assessed whether early discharge from the hospital is compatible with a better outcome from the viewpoint of the patients themselves.


METHODS
The 40-item quality of recovery score (QoR-40) is a recovery-specific, and patient-rated questionnaire, which provides a good measurement of early postoperative recovery. Ninety-four colorectal cancer patients undergoing surgery under ERAS protocol management were asked to answer QoR-40 questionnaires preoperatively and on post-operative day (POD) 1, 3, 6 and one month after surgery.


RESULTS
The median (25th, 75th percentiles) preoperative global QoR-40 scores as an indicator of the baseline health status, was 189 (176.75, 197). On POD1 and POD3, the scores had decreased significantly to 154 (132.5, 164.25) and 177 (161.75, 190), respectively. On POD 6, the score dramatically recovered up to 183.5 (167.9, 191), which was not significantly different from the baseline level (p = 0.06). The scores at 1 month after surgery were 190 (176, 197). Younger patients, compared to older patients, and rectal cancer patients, compared to colon cancer patients, had significantly lower scores on POD1.


CONCLUSIONS
This study clearly demonstrated that the quality of recovery based on patient-reported outcomes is in agreement with discharge around POD6 for colorectal cancer patients under ERAS.
Colorectal Surgery Division, National Cancer Center Hospital, 5-1-1 Tsukiji, Cyuo-ku, Tokyo, 1040045, Japan. dshida-tky@umin.ac.jp.
Dai
D
Shida
Department of Surgery, Tokyo Metropolitan Bokutoh Hospital, 4-23-15 Koto-bashi, Sumida-ku, Tokyo, 1308575, Japan. kotarowakamatsu79@gmail.com.
Kotaro
K
Wakamatsu
Department of Anesthesiology, Nara Medical University, 840 Shijo-cho, Kashihara, Nara, 6348522, Japan. tanakayuu717@gmail.com.
Yuu
Y
Tanaka
Department of Anesthesiology, Tokyo Metropolitan Bokutoh Hospital, 4-23-15 Koto-bashi, Sumida-ku, Tokyo, 1308575, Japan. atsu.yoshimura@gmail.com.
Atsushi
A
Yoshimura
Department of Anesthesiology, Nara Medical University, 840 Shijo-cho, Kashihara, Nara, 6348522, Japan. drjkawa@naramed-u.ac.jp.
Masahiko
M
Kawaguchi
Department of Surgery, Tokyo Metropolitan Bokutoh Hospital, 4-23-15 Koto-bashi, Sumida-ku, Tokyo, 1308575, Japan. sachio_miyamoto@tmhp.jp.
Sachio
S
Miyamoto
Department of Anesthesiology, Tokyo Metropolitan Bokutoh Hospital, 4-23-15 Koto-bashi, Sumida-ku, Tokyo, 1308575, Japan. kyoko.tgw@gmail.com.
Kyoko
K
Tagawa
D000368:Aged; D015179:Colorectal Neoplasms / Q000175:diagnosis / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011182:Postoperative Care / Q000379:methods / Q000592:standards*; D011183:Postoperative Complications / Q000175:diagnosis / Q000209:etiology; D011788:Quality of Life; D020127:Recovery of Function; D057566:Self Report / Q000592:standards*; D011795:Surveys and Questionnaires / Q000592:standards