Dataset Information

Comparison of patient reported symptom burden on an enhanced recovery after surgery (ERAS) care pathway in patients with ovarian cancer undergoing primary vs. interval tumor reductive surgery.

ABSTRACT:

Objective

To compare symptom burden and functional recovery in women undergoing primary cytoreductive surgery (PCS) or neoadjuvant chemotherapy (NACT) and interval cytoreductive surgery (ICS) within an enhanced recovery after surgery program (ERAS).

Methods

Symptom burden was measured using the MD Anderson Symptom Inventory-Ovarian Cancer, a 27-item validated tool that was administered preoperatively, daily while hospitalized, and weekly for 8 weeks after hospital discharge. Mixed-effect modeling was performed.

Results

196 patients (71 PCS, 125 ICS) participated. Patients in the PCS group were younger, median age of 59 vs. 63 in ICS group. Median length of stay was 4 days for PCS and 3 days for ICS group. PCS pts had a significantly higher median surgical complexity score (4 vs. 2, p = 0.002), and longer median surgical time (257 min vs. 220 min, p = 0.03). While patients undergoing PCS had significantly different symptom burden profiles prior to surgery compared to those undergoing ICS, there were no significant differences in symptoms in the immediate in-hospital and extended post-hospital discharge period. Irrespective of the timing of surgery in relation to chemotherapy, patients undergoing intermediate or high complexity surgery had more nausea, fatigue, and higher total interference scores compared to patients undergoing low complexity surgery.

Conclusion

Within a center with a standardized, systematic method for patient selection for PCS and a standardized ERAS care pathway, there were not significant differences in surgery-related symptoms related to recovery between patients undergoing PCS or ICS. However, patient-reported symptom burden and symptom interference did meaningfully differentiate based on surgical complexity score.

SUBMITTER: Meyer LA

PROVIDER: S-EPMC6422048 | biostudies-literature | 2019 Mar

REPOSITORIES: biostudies-literature

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Publications

Comparison of patient reported symptom burden on an enhanced recovery after surgery (ERAS) care pathway in patients with ovarian cancer undergoing primary vs. interval tumor reductive surgery.

Meyer Larissa A LA Shi Qiuling Q Lasala Javier J Iniesta Maria D MD Lin Huei Kai HK Nick Alpa M AM Williams Loretta L Sun Charlotte C Wang Xin Shelley XS Lu Karen H KH Ramirez Pedro T PT

Gynecologic oncology 20190301 3

<h4>Objective</h4>To compare symptom burden and functional recovery in women undergoing primary cytoreductive surgery (PCS) or neoadjuvant chemotherapy (NACT) and interval cytoreductive surgery (ICS) within an enhanced recovery after surgery program (ERAS).<h4>Methods</h4>Symptom burden was measured using the MD Anderson Symptom Inventory-Ovarian Cancer, a 27-item validated tool that was administered preoperatively, daily while hospitalized, and weekly for 8 weeks after hospital discharge. Mixed ...[more]

PMID: 30876495

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Project description:ContextPrevious studies on quality of life (QOL) after lung cancer surgery have identified a long duration of symptoms postoperatively. We first performed a systematic review of QOL in patients undergoing surgery for lung cancer. A subgroup analysis was conducted focusing on symptom burden and its relationship with QOL.ObjectiveTo perform a qualitative review of articles addressing symptom burden in patients undergoing surgical resection for lung cancer.MethodsThe parent systematic review utilized search terms for symptoms, functional status, and well-being as well as instruments commonly used to evaluate global QOL and symptom experiences after lung cancer surgery. The articles examining symptom burden (n = 54) were analyzed through thematic analysis of their findings and graded according to the Oxford Centre for Evidence-based Medicine rating scale.ResultsThe publication rate of studies assessing symptom burden in patients undergoing surgery for lung cancer have increased over time. The level of evidence quality was 2 or 3 for 14 articles (cohort study or case control) and level of 4 in the remaining 40 articles (case series). The most common QOL instruments used were the Short Form 36 and 12, the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire, and the Hospital Anxiety and Depression Score. Thematic analysis revealed several key findings: 1) lung cancer surgery patients have a high symptom burden both before and after surgery; 2) pain, dyspnea, cough, fatigue, depression, and anxiety are the most commonly studied symptoms; 3) the presence of symptoms prior to surgery is an important risk factor for higher acuity of symptoms and persistence after surgery; and 4) symptom burden is a predictor of postoperative QOL.ConclusionLung cancer patients undergoing surgery carry a high symptom burden which impacts their QOL. Measurement approaches use myriad and heterogenous instruments. More research is needed to standardize symptom burden measurement and management, with the goal to improve patient experience and overall outcomes.

Project description:BackgroundPatients' expectations of an anticipated timeline of recovery and fear of anesthesia in aesthetic breast surgery have not been studied.ObjectiveThis study aims to assess patient anxiety, expectations, and satisfaction after Enhanced Recovery after Surgery (ERAS) pathways for aesthetic breast surgery and the progress of postoperative recovery.Materials and methodsAll consecutive patients who underwent aesthetic breast surgery between April 2021 and August 2022 were included in this single-center prospective cohort study. The ERAS protocol consists of more than 20 individual measures in the pre-, intra-, and postoperative period. Epidemiological data, expectations, and recovery were systematically assessed with standardized self-assessment questionnaires, including the International Pain Outcome Questionnaire (IPO), the BREAST-Q or BODY-Q, and data collection forms.ResultsIn total, 48 patients with a median of 30 years of age were included. Patients returned to most daily activities within 5 days. Eighty-eight percent of patients were able to accomplish daily activities sooner than expected. The time of return to normal daily activities was similar across all procedure types. There was no statistically significant difference regarding postoperative satisfaction between patients who recovered slower (12%) and patients who recovered as fast or faster (88%) than anticipated (p=0.180). Patients reporting fear of anesthesia in the form of conscious sedation significantly diminished from 17 to 4% postoperatively (p<0.001).ConclusionEnhanced Recovery after Surgery (ERAS) pathways for aesthetic breast surgery are associated with rapid recovery and high patient satisfaction. This survey study provides valuable insight into patients' concerns and perspectives that may be implemented in patient education and consultations to improve patient satisfaction following aesthetic treatments.Level of evidence ivThis journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Project description:Background Esophageal cancer is a malignant tumor that seriously endangers human health. Compared with surgery alone, enhanced recovery after surgery (ERAS) has been widely used in clinical practice because it can improve perioperative care, minimize complications, and accelerate the recovery of esophageal cancer patients. However, there is a lack of data supporting the cost-effectiveness of ERAS. Methods This retrospective cohort study included 968 esophageal cancer patients according to the pre-determined inclusion and exclusion criteria. Based on the Chinese expert consensus and guidelines, we improved the ERAS protocols consisting of 17 core measures. Subjects receiving >60% of the ERAS optimization measures were classified as the ERAS group, while those receiving <60% were classified as the pre-ERAS group. The demographic information, clinical and cost data of these patients were collected from the medical records. Based on the data distribution, the clinical effects and costs between the two groups were examined using the independent-sample t-test, the rank sum test, or the chi-square test. The effect of cost-effectiveness ratio calculation was measured by the disease cure rate obtained from the discharge report. Results A total of 374 and 594 patients were included in the ERAS and pre-ERAS groups, respectively, and there were no significant differences in gender, American Society of Anesthesiologists (ASA) grade, tumor location, tumor stage, and other basic conditions between the two groups. The intraoperative blood loss, hospital stays, postoperative rehabilitation time, postoperative complications, and the number of secondary admissions within 30 days postoperatively of the ERAS group were lower than those of the pre-ERAS group (P<0.05). Compared with the pre-ERAS group, participants in the ERAS group had lower direct medical cost, direct non-medical cost, and indirect cost (P<0.05). Moreover, the cost-effectiveness ratio of the ERAS group (118,439.0 Yuan) was lower than that of the pre-ERAS group (143,369.0 Yuan) with respect to the cure rate. Conclusions The study demonstrated that compared with pre-ERAS, the application of ERAS in esophageal cancer patients may accelerate postoperative rehabilitation, reduce the length of hospital stays and postoperative complications, and have better cost-effectiveness, highlighting the potential of ERAS to improve the quality of medical care.

Dataset Information

Comparison of patient reported symptom burden on an enhanced recovery after surgery (ERAS) care pathway in patients with ovarian cancer undergoing primary vs. interval tumor reductive surgery.

Objective

Methods

Results

Conclusion

Publications

Comparison of patient reported symptom burden on an enhanced recovery after surgery (ERAS) care pathway in patients with ovarian cancer undergoing primary vs. interval tumor reductive surgery.

Similar Datasets

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