Patient-Reported Recovery after Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy
Sammanfattning: abstract Background: In the past, peritoneal carcinomatosis which develops after dissemination from digestive cancers has been regarded as a terminal disease that would result in the death regardless of the nature of intervention. Today, hyperthermic intraperitoneal chemotherapy (HIPEC) combined with cytoreductive surgery (CRS) is an optional curative treatment reported to improve a rate of survival for selected patients. Despite improved survival rate, patients experience delayed surgical recovery. Aim: The aims of this study were: To describe from the patient self-reported recovery profile, the prevalence of postoperative item variables after cytoreductive surgery and hyperthermic intraperitoneal chemotherapy. To identify factors associated with longer hospitalization period in CRS-HIPEC patients. Methods: During a hospital stay, a prospective cohort pilot study has been performed to observe changes of a recovery status in 25 patients undergoing CRS-HIPEC treatment. Postoperative Recovery Profile questionnaire was used to explore a decrease in dimensional item variables of postoperative recovery. Results: No patient had reached 17 points required for fully recovered on day of discharge. This work shows the global recovery at a low level. However, item variables of postoperative recovery profile decrease. The multiple logistic regression analysis showed that complications (p=.015), reoperation (p=.040) and readmission (p=.005) were significantly associated with longer period of hospitalization. Conclusion: Considering the facts that patients receiving CRS combined with HIPEC demonstrate complex postoperative care needs, a multidimensional assessment is a vital component of nursing care in a postoperative recovery period. This research has created baseline data useful to the current knowledge that will help to detect early complication, assist in self-care while reconsidering early and safe discharge in patients undergoing CRS-HIPEC treatment.
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