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Patient Comprehension of ERAS Protocols and Its Association with Postoperative Quality of Recovery in Head and Neck
Takayuki Imai1, Yumiko Ito2, Teiko Takasago3
1Department of Head and Neck Surgery, Miyagi Cancer Center, Natori, Miyagi, Japan. imai-ta479@miyagi-pho.jp.
Background:
Enhanced Recovery After Surgery (ERAS) protocols have been increasingly adopted to improve postoperative recovery. However, the impact of patients' comprehension of ERAS on health-related quality of life (HR-QOL) and quality of recovery (QOR) remains unclear, particularly in head and neck cancer surgery with free tissue transfer reconstruction (HNS-FTTR).
Patients And Methods:
In total, 126 patients who underwent HNS-FTTR at Miyagi Cancer Center between February 2021 and May 2024 were prospectively evaluated. Multidisciplinary preoperative education on ERAS protocols was provided, and patients' comprehension was assessed at discharge using a visual analogue scale (VAS). On the basis of VAS scores, the patients were classified into a good comprehension (GC) group (≥ 80) or poor comprehension (PC) group (< 60). HR-QOL and QOR were assessed preoperatively and on postoperative days (PODs) 2, 4, and 7 using the Quality of Recovery-40 Japanese version (QOR-40J).
Results:
ERAS adherence was very high (95.2%). PC was observed in 21-22% of patients, while 53-63% demonstrated GC. Preoperative QOR-40J scores were significantly lower in the PC group than in the GC group (172.0 ± 18.3 vs. 180.2 ± 19.9, p = 0.0368). On POD7, QOR-40J scores also remained significantly lower in the PC group (143.5 ± 18.3 vs. 159.3 ± 19.9, p = 0.0004). No significant intergroup differences were observed on POD2 or POD4.
Conclusions:
Although adherence to ERAS was excellent, patients with PC exhibited impaired HR-QOL preoperatively and poorer recovery on POD7. These findings highlight the importance of ensuring both patient comprehension and adherence for optimizing postoperative recovery in HNS-FTTR.
