Patient-reported recovery after enhanced colorectal cancer surgery: a longitudinal six-month follow-up study

Abstract

The concept of enhanced recovery after surgery (ERAS) is a modern regime of care, and numerous studies have proved its beneficial impact on recovery after colorectal surgery. However, little is known about patients' continuing recovery after discharge. Therefore, the purpose of this study was to describe patient-reported recovery after colorectal cancer surgery in the context of ERAS from the day of discharge until 1 and 6 months after surgery. Assessments were made at discharge, at 1 month and at 6 months after surgery using the questionnaire Postoperative Recovery Profile (PRP). In all, 119 patients recovering from abdominoperineal resection, rectal resection, or colonic resection completed all three assessments. The global score of recovery showed that no patient experienced being fully recovered at discharge. After rectal resection, patients frequently reported being not at all recovered. One month after surgery, patients recovering from colonic resection reported significant improvements regarding 11 of 17 questionnaire items, whereas abdominoperineal resection patients reported no significant improvements regarding any item. Instead, significantly higher levels of problems were reported in the items fatigue, muscle weakness and feeling down. Rectal resection patients reported significant improvements between 1 and 6 months after surgery regarding 7 of 19 items. However, the item gastrointestinal function distinguished, as patients reported significant deterioration towards higher levels of problems 6 months after surgery. This study elucidates the difference between groups of colorectal patients and the diverse patterns of their recovery, implying different needs in terms of prolonged support after discharge.