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Background <p>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).</p> Patients and Methods <p>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 (&lt; 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).</p> Results <p>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, <i>p</i> = 0.0368). On POD7, QOR-40J scores also remained significantly lower in the PC group (143.5 ± 18.3 vs. 159.3 ± 19.9, <i>p</i> = 0.0004). No significant intergroup differences were observed on POD2 or POD4.</p> Conclusions <p>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.</p>

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Patient Comprehension of ERAS Protocols and Its Association with Postoperative Quality of Recovery in Head and Neck Cancer Surgery with Free Tissue Transfer Reconstruction

  • 期刊论文

  • 发表日期：

    2026年1月11日

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  • Takayuki Imai,
  • Yumiko Ito,
  • Teiko Takasago,
  • Ayako Nakanome,
  • Yuya Miyakura,
  • Kento Sasaki,
  • Kazutake Yagi,
  • Koreyuki Kurosawa,
  • Takahiro Goto,
  • Yukinori Asada

摘要

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.