Longitudinal perioperative patient-reported outcomes in open compared with minimally invasive hysterectomy

There are few prospective studies in the gynecologic surgical literature that compared patient-reported outcomes between open and minimally invasive hysterectomies within enhanced recovery after surgery pathways. This study aimed to compare prospectively collected perioperative patient-reported symp...

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Published in:American journal of obstetrics and gynecology 2024-02, Vol.230 (2), p.241.e1-241.e18
Main Authors: Huepenbecker, Sarah P., Iniesta, Maria D., Wang, Xin S., Cain, Katherine E., Zorrilla-Vaca, Andres, Shen, Shu-En, Basabe, M. Sol, Suki, Tina, Garcia Lopez, Juan E., Mena, Gabriel E., Lasala, Javier D., Williams, Loretta A., Ramirez, Pedro T., Meyer, Larissa A.
Format: Article
Language:English
Subjects:
Abdominal Pain
Fatigue - epidemiology
Female
gynecologic surgery
Humans
Hysterectomy - methods
minimally invasive surgery
Minimally Invasive Surgical Procedures
open gynecologic surgery
Patient Reported Outcome Measures
patient-reported outcomes
Prospective Studies
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Summary:There are few prospective studies in the gynecologic surgical literature that compared patient-reported outcomes between open and minimally invasive hysterectomies within enhanced recovery after surgery pathways. This study aimed to compare prospectively collected perioperative patient-reported symptom burden and interference measures in open compared with minimally invasive hysterectomy cohorts within enhanced recovery after surgery pathways. We compared patient-reported symptom burden and functional interference in 646 patients who underwent a hysterectomy (254 underwent open surgery and 392 underwent minimally invasive surgery) for benign and malignant indications under enhanced recovery after surgery protocols. Outcomes were prospectively measured using the validated MD Anderson Symptom Inventory, which was administered perioperatively up to 8 weeks after surgery. Cohorts were compared using Fisher exact and chi-squared tests, adjusted longitudinal generalized linear mixed modeling, and Kaplan Meier curves to model return to no or mild symptoms. The open cohort had significantly worse preoperative physical functional interference (P=.001). At the time of hospital discharge postoperatively, the open cohort reported significantly higher mean symptom severity scores and more moderate or severe scores for overall (P
ISSN:0002-9378
1097-6868
1097-6868
DOI:10.1016/j.ajog.2023.10.012