Olga Kilpiö1, Päivi S M Härkki2, Maarit J Mentula2, Päivi I Pakarinen2. 1. Department of Obstetrics and Gynecology (Drs. Kilpiö, Härkki, Mentula and Pakarinen), University of Helsinki and Helsinki University Hospital, Helsinki, Finland. Electronic address: olga.kilpio@hus.fi. 2. Department of Obstetrics and Gynecology (Drs. Kilpiö, Härkki, Mentula and Pakarinen), University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
Abstract
STUDY OBJECTIVE: To compare the health-related quality of life (HRQoL) and psychological distress after laparoscopic hysterectomy (LH) following enhanced recovery after surgery (ERAS) and conventional recovery protocols. DESIGN: A secondary analysis of a single-center randomized controlled trial SETTING: University hospital. PATIENTS: Women assigned to laparoscopic hysterectomy were randomly divided into two groups: the intervention (enhanced recovery protocol) group (IG; n = 60) and the control (conventional protocol) group (CG; n = 60). INTERVENTION: Women in the intervention group were treated according to the ERAS protocol. MEASUREMENTS AND MAIN RESULTS: The primary outcome was a change in HRQoL assessed by the 15D questionnaire and a change in psychological distress assessed by the GHQ12 questionnaire at baseline before surgery and one month later. One month after surgery, the HRQoL was clinically and statistically better compared to baseline, but with no difference between groups. Following the ERAS protocol, the improvement of HRQoL was clinically greater, the difference in the dimension of sleeping was statistically better (p< .05), and the dimensions of discomfort and symptoms (+0.028), depression (+0.282), distress (+ 0.018) and vitality (+0.040) were clinically better than when following the conventional protocol. No differences were found in psychological distress scores either preoperatively or 1 month after surgery (24 in IG vs 25 in CG (p= .85) and 9 vs 12 (p= .47), respectively). CONCLUSION: The HRQoL improved after LH with no significant difference between ERAS and the conventional recovery protocols. However, clinically the change of HRQoL was greater and the dimensions of sleeping, discomfort and symptoms, depression, distress and vitality were better after ERAS. Psychological distress was equal in both groups. ERAS seems to have a positive impact on recovery after LH.
RCT Entities:
STUDY OBJECTIVE: To compare the health-related quality of life (HRQoL) and psychological distress after laparoscopic hysterectomy (LH) following enhanced recovery after surgery (ERAS) and conventional recovery protocols. DESIGN: A secondary analysis of a single-center randomized controlled trial SETTING: University hospital. PATIENTS: Women assigned to laparoscopic hysterectomy were randomly divided into two groups: the intervention (enhanced recovery protocol) group (IG; n = 60) and the control (conventional protocol) group (CG; n = 60). INTERVENTION: Women in the intervention group were treated according to the ERAS protocol. MEASUREMENTS AND MAIN RESULTS: The primary outcome was a change in HRQoL assessed by the 15D questionnaire and a change in psychological distress assessed by the GHQ12 questionnaire at baseline before surgery and one month later. One month after surgery, the HRQoL was clinically and statistically better compared to baseline, but with no difference between groups. Following the ERAS protocol, the improvement of HRQoL was clinically greater, the difference in the dimension of sleeping was statistically better (p< .05), and the dimensions of discomfort and symptoms (+0.028), depression (+0.282), distress (+ 0.018) and vitality (+0.040) were clinically better than when following the conventional protocol. No differences were found in psychological distress scores either preoperatively or 1 month after surgery (24 in IG vs 25 in CG (p= .85) and 9 vs 12 (p= .47), respectively). CONCLUSION: The HRQoL improved after LH with no significant difference between ERAS and the conventional recovery protocols. However, clinically the change of HRQoL was greater and the dimensions of sleeping, discomfort and symptoms, depression, distress and vitality were better after ERAS. Psychological distress was equal in both groups. ERAS seems to have a positive impact on recovery after LH.
Authors: Hilla Mills; Ronald Acquah; Nova Tang; Luke Cheung; Susanne Klenk; Ronald Glassen; Magali Pirson; Alain Albert; Duong Trinh Hoang; Thang Nguyen Van Journal: Front Surg Date: 2022-06-14