Application of fast track surgery in early functional recovery of affected limbs after breast cancer surgery

Abstract

Objective To investigate the application of fast track surgery in early functional recovery of affected limbs after breast cancer surgery. Methods According to the inclusion and exclusion criteria, 124 patients with breast cancer in the Southwest Hospital, Army Medical University from May 2016 to May 2017 were enrolled for a prospective study. The patients were divided into control group and intervention group by random number table, 62 cases in each group. In control group, conventional nursing methods were used for functional exercises of limbs. In intervention group, fast-track surgery was applied, i. e., preoperative and postoperative guidance on functional exercises of the affected limbs was given; after discharge, clinical nursing specialists made an individualized exercise program for each patient after evaluation in clinic and provided guidance and supervision by WeChat. The postoperative wound recovery time, duration of drainage and length of hospital stay were compared between two groups by t test. At postoperative 10 days, 1 and 3 months, the Constant-Murley shoulder assessment was used to evaluate the functional recovery of the affected limbs and the WHOQOL-BREF quality of life assessment was used to evaluate the quality of life of breast cancer patients. The scores were compared between two groups using repeated measures analysis of variance. Results The recovery time of wound, duration of drainage and length of hospital stay were (7.5±2.1) d, (6.3±2.4) d and(7.6±2.4) d in intervention group, which were significantly lower than those in control group[(10.3±3.2) d, (10.2±3.7) d, (10.2±4.2) d; t=5.762, 6.963, 4.232, all P<0.001). The scores on postoperative limb function recovery in intervention group were superior to those in control group (pain: comparison between groups, F=94.553, P<0.001; time point comparison, F=723.882, P<0.001; interaction, F=21.356, P=0.169; daily mobility: comparison between groups, F=351.725, P<0.001; time point comparison, F=1 681.920, P<0.001; interaction, F=20.623, P<0.001; range of motion of the joints: comparison between groups, F=441.381, P<0.001; time point comparison, F=2 458.887, P<0.001; interaction, F=28.420, P<0.001; muscle strength: comparison between groups, F=84.571, P<0.001; time point comparison, F=1 474.775, P<0.001; interaction, F=13.862, P<0.001). The scores on postoperative quality of life in intervention group were also significantly better than those in control group (subjective feeling on quality of life: comparison between groups, F=235.607, P<0.001; time point comparison, F=607.245, P<0.001; interaction, F=1.913 P=0.169; subjective feeling on health status: comparison between groups, F=140.170, P<0.001; time point comparison, F=618.834, P<0.001; interaction, F=1.533, P=0.218; physical health: comparison between groups, F=72.713, P<0.001; time point comparison, F=2 324.181, P<0.001; interaction, F=18.296, P<0.001; mental health: comparison between groups, F=64.987, P<0.001; time point comparison, F=2 613.833, P<0.001; interaction, F=16.158, P<0.001; social relationship: comparison between groups, F=58.654, P<0.001; time point comparison, F=2 775.791, P<0.001; interaction F=16.710, P<0.001; environment: comparison between groups, F=59.818, P<0.001; time point comparison, F=2 638.321, P<0.001; interaction, F=22.660, P<0.001). Conclusion The mode of fast track surgery can significantly improve early functional exercises of affected limbs in breast cancer patients after surgery, increase their compliance and ameliorate their quality of life. Key words: Breast neoplasms; Rehabilitation nursing; Recovery of function; Upper extremity