Fear Of Surgery Research Articles

Perceptions of Gender Disparities in Access to Surgical Care in Malawi: A Community Based Survey.

Gender disparities in surgical care exist but have been minimally studied, particularly in low- and middle-income countries. This study explored perceptions and gender differences in health-seeking behavior and attitudes toward surgical care in Malawi among community members. A survey tool was administered to adults ≥18years old at a central hospital, district hospital, and two marketplaces in Malawi from June 2018 to December 2018. Responses from men and women were compared using chi-squared tests. Four hundred eighty-five adults participated in the survey, 244 (50.3%) men and 241 (49.7%) women. Women were more likely to state that fear of surgery might prevent them from seeking surgical care (29.1% of men, 43.6% of women, P = .0009). Both genders reported long wait times, medicine/physician shortages, and lack of information about when surgery is needed as potential barriers to seeking surgical care. More men stated that medical preference should be given to sons (17.1% of men, 9.3% of women, P = .01). Men were more likely to report that men should have the final word about household decisions (28.7% of men vs 19.5% of women, P < .0001) and were more likely to spend money independently (68.7% of married men, 37.5% of married women, P < .0001). Few participants reported believing gender equality had been achieved (61% of men and 66.8% of women). A multi-pronged approach is needed to reduce gender disparities in surgical care in Malawi, including addressing paternalistic societal norms, education, and improving health infrastructure.

Inductive Stimuli of the Startle Response and Critical Points of Psychological Treatment in a Severe Burn Patient.

Severe burn patients often have anxiety, depression, and stress-related disorders. The case we reported was very nervous and exhibited a long-term high-frequency startle response, which disrupted his sleep seriously and decreased treatment compliance. However, after psychological treatment, his startle response in the daytime and nervousness gradually improved, but the startle response at night remained unchanged. Furthermore, after his wife was given three sessions of psychological treatment to manage her fear of surgery, the startle response at night was significantly reduced. Herein, we summarize the inductive stimuli of the startle response and the critical points of psychological treatment in this case to provide the clinical experience for future research.

Are Radiographs Associated With Patient Satisfaction After Scarf Bunionectomy?

There are over 350,000 bunion surgeries performed in the USA annually, making it one of the most common elective forefoot surgeries. Studies have suggested that as many as 10% of patients remain dissatisfied after bunion surgery. The purpose of this study is to evaluate if radiographic variables are associated with patient satisfaction at 1 year postoperatively. We performed a secondary analysis of prospectively collected data on 69 consecutive adult patients (mean age 45 ± 14 years, 91% female [63/69]) who underwent isolated hallux valgus surgery from January 2016 to January 2017. Subjects completed a standardized 4-item survey inquiring about their satisfaction with regards to pain relief, overall operative result, cosmetic appearance, and ability to wear desired shoe gear. Conventional radiographic indices for hallux valgus were examined preoperatively and 3 months postoperatively. An association model using backward stepwise logistic regression was utilized to determine which variables, if any, are most important in explaining patient satisfaction after surgery. Sixty-nine subjects completed the 4-item satisfaction survey with 53.6% (37/69) of subjects answering they were fully satisfied on all aspects of the survey at 12 months postoperatively. In the final regression model, no radiographic or demographic variables were associated with patient satisfaction including shoe gear, cosmetic appearance, pain relief, and overall operative result. Radiographic variables did not appear to be associated with patient satisfaction at one year postoperatively in our study. Factors such as quality of life, anxiety levels, fear of surgery, and/or preoperative expectations may offer more insight into satisfaction; however, further research should be performed to examine this further.

Role of Pradhamana Nasya in Tridoshaja Pratishyaya w.s.r to Chronic Sinusitis

Sinusitis is considered as one of the most common clinical conditions among chronic diseases. Modification in lifestyle, rise in the cases of antibiotic resistance, deviated nasal septum, nasal polyps, tumors etc. are responsible for increased prevalence of sinusitis. Sinusitis affects 10-30% population whereas Chronic Sinusitis affects approximately 12.5% population each year. Women are more affected in comparison with men. Feature of Sinusitis can be co-related with Tridoshaja Pratishyaya. Acharya Sushruta has mentioned Pratishyaya under 31 Nasagata rogas. In modern science, sinusitis is managed with antibiotics, nasal decongestants sprays, corticosteroids, analgesics etc. Excessive use of decongestant sprays can cause rebound congestion. Person may become resistant to antibiotics. Repeated attacks of sinusitis and fear of surgery may cause depression to the patient. Permanent cure of sinusitis can be achieved through Ayurvedic management. In Brihat Samhita, Nasya has been considered as effective treatment modality for all kinds of Urdhava Jatrugata rogas (diseases of supra clavicular region). Acharya Charaka in Chikitsa Sthana has mentioned Pradhamana Nasya for the management of Kapha Pradhan Pratishyaya. In the present case study, a patient with the symptoms of Kapha Pradhan Tridoshaja Pratishyaya was treated with Manashiladi churna Pradhamana Nasya. Patient got complete relief in sign and symptoms.

“Alas … my sickness becomes my family's burden”: A nested qualitative study on the experience of advanced breast cancer patients across the disease trajectory in Indonesia

IntroductionLimited research exists exploring the experience of living with advanced breast cancer in Indonesia. We sought to explore the narratives of women with breast cancer across the illness trajectory to understand their experiences from diagnosis to accessing and undergoing cancer treatments to inform the development of cancer care. MethodsA nested, exploratory study adopting a qualitative approach. We conducted in-depth face-to-face interviews with women living with advanced breast cancer in Yogyakarta, Indonesia. We purposively sampled participants by age, education and marital status. All interviews were transcribed verbatim with thematic analysis used to identify, analyse and report patterns and themes within the data. FindingsFour main themes were derived: 1) Early experiences, prior to accessing health care; 2) Navigating the system to access treatment; 3) Enduring chemotherapy and advancing disease, with crucial family support; 4) Seeking normalcy and belief in treatment. From initial symptoms through to undergoing treatments, the experience of participants was punctuated by barriers and challenges. DiscussionPresentation delays were driven by dismissing initial symptoms, seeking alternative medicines, and fear of surgery. Access to healthcare required participants to contend with long-distance travel to facilities, tiered and convoluted referral processes, and adverse effects and financial impact of treatments. Individual determination, belief in God, and the role of families were critical throughout the disease trajectory. Adopting a focus across the disease trajectory facilitated the identification of enduring and persistent challenges to care delivery that can inform targeted development and optimisation of care delivery for women with breast cancer.

Influencing Factors for Choosing Korean Medicine Treatments after Spinal Surgery or Spinal Surgery Recommendation in Patients with Spinal Pain: A Semi-Structured Interview Study

Introduction: This study is a qualitative study based on 1:1 semi-structured interviews designed to explore the treatment selection process and factors that influence the treatment decisions of patients with spinal pain undergoing surgery or Korean medicine treatment. Methods: Patients admitted to a Korean hospital for treatment after either undergoing or receiving a recommendation for spinal surgery, aged 19–74 years, able to communicate in Korean, and who provided informed consent were invited to participate in the study. Of the 15 participants selected, 9 underwent spinal surgery, while 6 had spinal surgery recommended but did not choose to have it. Results: Three main themes emerged from the interviews: positive factors for Korean medicine; positive factors for surgery; difficulties in decision-making. Recommendations by and cases of people around them had the greatest influence on patients who chose Korean medicine treatment (their own situation). Patients who chose surgery tended to be influenced by their physicians, whose opinions had the greatest influence on their choice. Conclusions: Treatment decisions are influenced by: recommendation by or cases of personal acquaintances; fear of surgery; trust in physician; physician’s competence; experience of pain; lack of information; patient’s situation. The factors that influence the choice of Korean medicine treatment and surgery clearly differ. The findings would be useful for clinicians and patients who must decide between various treatments modality recommendations.

Cochlear implant aesthetics and its impact on stigma, social interaction and quality of life: a mixed-methods study protocol

IntroductionAwareness of the benefits of cochlear implants is low, and barriers such as fear of surgery and ongoing rehabilitation have been noted. Perceived stigma associated with hearing loss also plays...

Prevalence of cataract and factors associated with cataract surgery uptake among older persons in Malaysia: A cross-sectional study from the National Eye Survey II.

Nationally-representative evidence is limited on factors affecting uptake of cataract surgery in Malaysia. We found the prevalence of cataract among older persons to be 26.8%. The two most common barriers were 'need not felt' (43.5%) and 'fear of surgery or poor result' (16.2%). Reluctance for surgical intervention was greater outside the Central zone.

Understanding Public Perceptions Regarding Cochlear Implant Surgery in Adults.

Approximately 6% of adults eligible for cochlear implantation (CI) undergo surgery. This study aims to understand how general perceptions about CI contribute to barriers causing this low utilization rate. Participants completed an online survey regarding their perceptions about cochlear implantation. They were asked to rank CIQOL-10 Global priorities and corresponding risk tolerance for minor complications (changes in taste, vertigo) and major complications (infections requiring hospitalization, meningitis, reimplantation, facial paralysis, and cerebrospinal fluid [CSF] leak). A total of 615 responses (female 55%, mean age 39 years [range 20-78]) were included. Respondents identified issues with insurance (46%) and fear of undergoing surgery (21%) as barriers preventing eligible adults from receiving CI. Regarding surgical risk, respondents significantly underestimated rates of minor complications (p < 0.0001) and almost all major complications (all p < 0.0001) while overestimating rates of serious infections and need for reimplantation (both p < 0.005). The ability to hear strangers in noisy environments was identified as the highest priority for CI (26%). Individuals who knew someone with a cochlear implantation were willing to tolerate higher rates of all minor and major complications (all p < 0.05). Healthcare workers were similarly willing to tolerate significantly higher rates of meningitis, facial paralysis, and CSF leak to achieve their highest priority (all p < 0.05). Respondents identify insurance coverage and fear of surgery as primary reasons for low utilization of adult CI in the United States. However, healthcare workers or those who knew someone with a cochlear implantation indicated significantly higher rates of risk tolerance to achieve their highest quality of life priorities, indicating the potential that the benefits of cochlear implantation are underappreciated in the general population.

A Study to Evaluate the Causes of Delayed Presentation for Cataract Surgery at a Tertiary Eye Centre, Odisha, India

Introduction: Inspite of being advised surgery by doctor and several health schemes made available by the Government of India for the economically backward section, people still present late for surgery, inviting many complications in the long run. Aim: To study the causes of delayed cataract surgery in Below Poverty Line (BPL) patients in a tertiary health care centre in Eastern India. Materials and Methods: The present hospital-based and cross- sectional study included 58 patients who presented to the Outpatient and Emergency Department of a tertiary care hospital in Eastern India between December 2020 to April 2021. At presentation, detailed history was taken and patients were asked questions related to the cause of delay, which was categorised into- barriers to patient’s attitude and barriers related to cost, affordability and service delivery. Comprehensive ophthalmological examination for each and every patient was done. Routine blood investigations needed for cataract surgery were done. Surgery was done for all cases by a single surgeon and intraocular complications if any were noted. Results: A total of 58 patients included in this study, females (57%) were more than males (43%). Majority of them were from semi urban areas (13.79%). A 60% were dependent on family members for their expenses. About 94.8% had government insurance schemes but still had financial constraints which caused delayed presentation. A 70.7% of people did not attend hospital due to negative peer group effects and almost 84.5% people had no direct means of transportation to the hospital. Fear of surgery (96.6%) and fear of contracting Coronavirus Disease-2019 (COVID-19) (94.8%) were certain other factors which caused delay in presentation for surgery. Conclusion: Through this study, certain possible reasons were found, catering to social, economic as well as factors like fear of surgery, negative peer pressure, financial constraints responsible for the delay in acceptance of cataract surgery in such a set up.

Postoperative pain management in geriatric patients after cholecystectomy and studies of glycemia and cortisol levels.

The purpose of the study was to follow up the cortisol levels in relation to the postoperative pain intensity, its levels after treatment with opiate and non-opiate analgesics, and to monitor the relationship between the blood glucose and cortisol levels. Another goal was to optimize the postoperative analgesia of geriatric patients with the known combinations of analgesics. The cohort comprised 28 geriatric patients undergoing laparoscopic cholecystectomy. The patients were divided according to the intensity of postoperative pain into the groups with opiate and non-opiate analgesia. Furthermore, they were divided according to their physical condition (ASA classification) into two groups, ASA 2 and ASA 3. We evaluated three values ​​of blood glucose levels, on the day before surgery, on the operative and the first postoperative days and those of cortisol on the day of surgery. The patients had the blood glucose levels without significant deviation during the three days of measurements. The cortisol levels increased with the intensity of postoperative pain. High levels of cortisol were observed not only in the patients, who experienced acute pain after non-optimal postoperative analgesia, but also in those treated with strong opiates in the immediate postoperative period. The patients with mild pain intensity, treated with a combination of non-opiate analgesics, had the lowest values. The role of the patient's gender in both blood glucose and cortisol levels was not observed. The cortisol levels have not corresponded so much with the assessment of acute postoperative pain as with the stress that was evoked in the patient due to hospitalization and fear of surgery. It is crucial to eliminate as much as possible all the stressors that can affect the cortisol levels and thus the blood glucose levels (Fig. 6, Ref. 25).

Fracture Management by Traditional Bonesetters: A Tertiary Care Hospital Based Observational Study

Background: Fracture of bone is a persistent problem encountered in orthopaedic practice. The management of fracture of bone depends on reduction and immobility at the fracture site. The traditional bone setters formulate their own methods and practices for the management of fracture. This age-old art has not only survived since ages but also flourished with time and moreover to our surprise is challenging modern orthopaedic science in many ways. Aim of study: To find out various outcomes of fracture management by traditional bonesetters and the possible reason for their high patronage. Methods: Present study was conducted on patients with some kind of prior treatment received from TBS. The detailed history was collected about age, sex, socioeconomic condition, education, habit and habitats from each patient. Each case was subjected to detailed clinical and radiological examinations to evaluate the outcomes of the interventions of TBSs. Results: One hundred and fifty patients in the age group of (1–70) years were included in the study out of which 103 (69%) are male and 47 (31%) are females. 33% belong to age group of 30-45 years and 54% are of literate and fair socio-economic status. Malunion is the predominant form of presentation with 69 cases (46%) followed by non-union in 30 (20%) cases. 41 cases (28%) presented with impending ischemia at initial stages of treatment. Only 9 cases (6%) were presented with chronic osteomyelitis and infected non-union. Eventually 7 cases were ended with gangrene and amputation. Cost of surgery was the major cause (43%) followed by fear of surgery (23%) was observed for non-acceptance of modern orthopaedic system. Conclusion: The results in our study vindicate the fact that TBS play a major role in providing health care to the fracture patients. Lack of basic knowledge and aversion to referral system by TBS is responsible for complications. So, creating public awareness and integrating TBS in the healthcare system through proper training and due legislation seems to be the apt solution to combat this menace. Keywords: Traditional Bone Setters, chronic osteomylitis, Malunion and nonunion

Giant Inguinal Hernia: Two Case Reports and Literature Review

Giant inguinal hernia is a rare entity in developed world but are still occasionally encountered among rural dwellers in developing countries mostly as a result of ignorance, believe in alternate therapy and fear of surgery. Its management is very challenging and requires adequate preoperative preparation. We present two patients with giant inguinal herniae, one of which was left sided Amyand’s her-nia, who successfully had mesh hernioplasty in our center.

KNOWLEDGE AND AWARENESS OF DENTAL IMPLANTS AMONG GENERAL PUBLIC IN INDIA- A WEB-BASED QUESTIONNAIRE SURVEY

BACKGROUND: To develop an evidence based report on the level of knowledge and awareness about dental implants among public in South India through web–based questionnaire. So that this can be utilized for better understanding of patients’ needs and gain of knowledge among dental practitioners. MATERIALS&amp;METHODS: A structured questionnaire survey was done to assess the level of knowledge and awareness about dental implants among the public through Google form. Two interviewers with dental background did the study, for a period of 4 months. All questions were close-ended multiple-choice questions. RESULTS: 1050 participants recorded their responses for this survey. Among them 566 (53.9%) are males and 484 (46.1%) are females, between age groups of 15-75 years. About 59.81% people have heard implant as a treatment procedure and 40.19% not aware, but on the contrary only 7.8% respondents have undergone an implant procedure. CONCLUSION: This survey reflects the clinical scenario of our day-to-day practice. Even though the patient knows of this dental treatment, many are not willing to undergo this procedure. The reason behind may be the fear of surgery or the cost of this treatment but it is in the clinician’s hands to improve this current situation in South India. Based on the result of our study, it is prudent for the clinician to put more effort in order to deliver efficient treatment protocols and glean this evidence to improve patient’s perception and acceptance for this treatment.

Evaluation of Anxiety and Stress Factors before Surgery From the Perspective of Patients Undergoing Spinal Surgery in the Operating Room of Peymaniyeh Hospital in Jahrom City 2021

Background and Objectives: Surgery is always a great experience for the patient because surgery of any kind is a threat to the integrity of the body and life. This study was to evaluate the factors of anxiety and stress before surgery in patients who are candidates for spine surgery. Methods: The present study is a descriptive study that was performed on 120 patients who were candidates for spine surgery in of Peymaniyeh Hospital in Jahrom City 2021. Data collection tools were theoretical questionnaire and colleagues. Data were analyzed using SPSS v.22 and descriptive statistics such as frequency, percentage and Pearson correlation coefficient. Results: The results showed that the highest level of anxiety was related to the area of preoperative anxiety (85.1)and in this area, the components of fear of surgery and not knowing the time of surgery (93.3%)and in the area of stressors in relation to Operating room staff for preoperative care also included the components of the patient being left alone until the start of surgery and the observation and encounter of strangers such as anesthesiologists and operating room nurses, causing the most anxiety (88.3%)in patients. Conclusion: Based on the findings of this study, by identifying the factors affecting preoperative anxiety and eliminating them, the amount of preoperative anxiety can be minimized. Therefore, it is suggested to use various methods to educate patients to eliminate the factors affecting anxiety.

Attitude and related factors towards strabismus among adults living in Gondar town, Northwest Ethiopia: a community-based cross-sectional study

ABSTRACT Cultural belief in Ethiopia showed that strabismus can be caused by exposure to sunlight during infancy, an outrage from God, and looking sideways. In addition, Ethiopians also believe that strabismus can resolve by its self and is a sign of good luck. Due to these reasons many patients with strabismus come to eye care clinics after developing amblyopia. This study aimed to assess the level of attitude and related factors toward strabismus among adults living in Gondar town, Northwest Ethiopia. A community-based cross-sectional study was conducted on a sample size of 634 adults from April 9 to April 23, 2019. Data were collected using a pretested structured questionnaire through face-to-face interviews, and the study participants were chosen by applying a multistage random sampling technique. Data were entered with EPI info version 7 and imported into SPSS version 20 for analysis. Frequency, statistical summary, and cross-tabulations were used for the descriptive analysis of the entered data. Binary logistic regression was fitted, and all independent variables with a P-value of less than 0.2 in the bivariable analysis were entered into a multivariable binary logistic regression. Variables with a P-value of less than or equal to 0.05 were considered statistically significant. Respondents who answered greater than or equal to the median score of attitude-related questions were designated to have a favorable attitude toward strabismus. In this study, 602 adults were participated with a response rate of 94.9% and the median age of the participants was 33 ± 14 years. The overall proportion of favorable attitudes toward strabismus was 71.8%. Having secondary school as an educational status (AOR = 2.8 (95% CI: 1.2, 6.4)) and heard about strabismus (AOR = 7.4 (95%CI: 3.7, 14.9)) were positively whereas being unemployed (AOR = 0.3(95% CI: 0.1, 0.7)) and high monthly income (AOR = 0.5(95%CI: 0.3, 0.9)) were negatively associated with a favorable attitude regarding strabismus. Eighty-five percent (88.5%) of participants agreed that early treatment of strabismus had a better outcome. Besides, 57.6% of participants have agreed that untreated strabismus can cause amblyopia. About three fourth of the study participants had a favorable attitude toward strabismus. Educational status, heard about strabismus, occupation, and monthly income were significantly associated with a favorable attitude toward strabismus. Most of the study participants agreed that untreated strabismus can cause poor cosmoses. Fear of surgery and high cost were reported by study participants as the main barriers to seeking treatment of strabismus.

THE EFFECT OF SPIRITUAL WELL-BEING ON SURGICAL FEAR IN PATIENTS SCHEDULED TO HAVE ABDOMINAL SURGERY

Abdominal surgery and postoperative period are a very risky experience. Individuals with fear of surgery will be under high stress and in a state of depression. In this context, the state of spiritual well-being overcoming surgical fears in patients undergoing planned abdominal surgery was examined. This study was conducted to investigate the effects of the levels of spiritual well-being of patients who are planned to have abdominal surgery on their surgical fear. The study was carried out with the participation of 150 patients at the General Surgery and Transplant clinics at a university hospital between December 2019 and May 2020. It was determined that there was a negative significant relationship between surgical fear and spiritual well-being, and the highest score for surgical fear was observed in the individuals who were 65 years old or older. The awareness of healthcare professionals about spiritual well-being should be raised, and they should provide healthcare which ensures supporting patients in spiritual and social aspects.

Burden of disease experienced by patients following a watch-and-wait policy for locally advanced rectal cancer: A qualitative study.

AimPatient‐reported outcome measures (PROMs) are increasingly being used in routine cancer care to evaluate treatment and monitor symptoms, function and other aspects of quality of life (QoL). There is no suitable PROM for rectal cancer patients following a watch‐and‐wait (W&W) programme. Insight into patient experiences with this programme is an essential step in the development of a PROM. The aim of this qualitative study was to provide insights into the most important functional outcomes and QoL features experienced by patients during our W&W programme.MethodPatients with locally advanced rectal cancer who are enrolled in the W&W programme in the Netherlands were interviewed by telephone using a semistructured interview guide. All interviews were digitally audio‐recorded, transcribed verbatim and coded. A thematic approach was used to analyse the data and identify themes and subthemes of importance to patients.ResultsEighteen patients were interviewed (78% male, mean age 68 years, range 52–83 years). Physical complaints after treatment were present, most notably gastrointestinal problems, neuropathy and fatigue. Furthermore, patients were anxious about a possible recurrence, had a fear of surgery or a stoma, or were experiencing a general feeling of apprehension in daily life. Many patients had different coping mechanisms, such as acceptance, and there were few limitations in daily life.ConclusionWe identified important functional outcomes, such as gastrointestinal complaints, fatigue and neuropathy, in patients who were enrolled in this W&W programme. Furthermore, an emotional burden and unmet needs were reported by these patients. These findings can be used to improve clinical practice and inform the development of a PROM.

Causes of concomitant strabismus surgery delay in teenagers and adults

ABSTRACT To reveal the reasons for strabismus surgery delay and motivations for seeking surgical treatment in adulthood. Prospective survey among 91 adult patients, suffering from concomitant strabismus acquired in the childhood that underwent delayed strabismus surgery. The mean age of participants was 24 years (from 16 to 58 years); 48 females (52.7%), and 43 males (47.3%). Strabismus surgery has been delayed for about 20 years in adult patients who could potentially benefit of it in childhood. The most common reasons for strabismus surgery delay, reported by patients, included the following: lack of awareness about surgery (37.4%); surgery was recommended but declined by patients’ parents/guardians in their childhood (6.6%); fear of surgery (17.6%); eye specialists affirmation that surgery would not lead to strabismus improvement (27.5%); previous poor surgical experience (6.6%); and non-affordability (4.4%). The main motivations for seeking strabismus surgery in adulthood among our patients were the following: appearance improvement (38.5%), strengthening of self-confidence (30.8%), better social relationship (16.5%), better job opportunities (7.7%), and advice from family and friends (6.6%). About 80% of strabismus surgery delays in teenagers and adults were caused by lack of awareness regarding strabismus surgery and even the misconception among primary health-care practitioners and some eye doctors who considered that surgery would not lead to strabismus correction. The main reasons for seeking strabismus surgery in adulthood were: esthetical ones, self-confidence strengthening, and building better social relationship. All factors mentioned below confirmed the negative impact of oculomotor disorders on patient’s psychological condition. The focus on patient’s individual concerns and needs was especially important for recovery and well-being of adult patients with strabismus and formed a central feature of patient centered medical approach.

Tracking the dropout patients of neoadjuvant chemotherapy with locally advanced oral cavity cancer

BackgroundPatients with locally advanced oral cavity cancer sometimes stopped treatment after neoadjuvant chemotherapy. There are no guidelines of the management for these patients. Before designing clinical trials, we conducted this study to investigate their characteristics, reasons of dropout, and the follow-up information.MethodsMedical records were consecutively reviewed of patients with locally advanced oral cavity cancer who underwent neoadjuvant chemotherapy from Jan 2017 to Dec 2019.Variables were compared between patients stopped treating after chemotherapy and completed treatments by student t-test and Chi-square test. Logistic regression model was used to calculate the odd rations of potential predictors of dropout. The dropout patients were followed up for reasons and results of their decision.ResultsA total of 171 patients were included with 23 not undergoing surgery after chemotherapy. The odd ratios of age over 65 and single marital status were 3.11 (95%CI: 1.1, 8.7) and 4.935 (95%CI: 1.5, 16.1), respectively, for the dropout. The median survival of patients without surgery was 7.4 months. Believing that chemotherapy would be effective and being afraid of the consequence of surgery were the main reasons of refusing surgery.ConclusionsThe prognosis was poor of these dropout patients. Symptom relief and fear of surgery were the reasons of dropout. Age and marital status affected their decision. Clinical trials are needed to be designed for these patients.