Therapeutics and Clinical Risk Management (2019-06-01)

Improved perioperative quality of life in endoscopic sinus surgery by application of enhanced recovery after surgery

  • Wu X,
  • Kong W,
  • Zhu Q,
  • Wang W,
  • Xu H,
  • Zhou S,
  • Yang Q

Journal volume & issue
Vol. Volume 15
pp. 683 – 688


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Xifu Wu,1,* Weifeng Kong,1,* Qiong Zhu,2,* Weihao Wang,1 Huiqing Xu,1 Shaoli Zhou,3 Qintai Yang11Department of Otolaryngology Head and Neck Surgery, The Third Affiliated Hospital of Sun Yat-sen University; 2Department of Examination Center of Lingnan Hospital, The Third Affiliated Hospital of Sun Yat-sen University; 3Department of Anesthesiology, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, 510630, People’s Republic of China*These authors contributed equally to this work Background: Endoscopic sinus surgery (ESS) has been the definitive treatment for chronic rhinosinusitis (CRS), but the complications caused perioperatively may affect patients’ quality of life (QoL). This study aims to evaluate the effects of enhanced recovery after surgery (ERAS) on improving perioperative QoL in ESS.Materials and methods: Seventy-four patients with chronic rhinosinusitis with nasal polyps (CRSwNP) met the criteria for inclusion. Participants undergoing ESS were randomly divided into an ERAS group and a control group, and QoL assessment was performed using the Chinese version of the 22-item Sinonasal Outcomes Test (SNOT-22). Measurements were administered at baseline, and on postoperative day 1 (POD1), POD3 and POD6. Complications such as nausea/emesis, hemorrhage, aspiration and dizziness were also recorded.Results: The preoperative global SNOT-22 scores (mean ± SD) were 39.89±4.86 in the ERAS group and 40.52±3.61 in the control group (t=0.643, P=0.522). On POD1, the global SNOT-22 scores increased significantly to 51.77±5.59 and 62.02±3.86 (t=9.218, P<0.01), and on POD3 they increased to 48.22±6.22 and 51.11±5.14, respectively (t=2.179, P<0.05). However, the scores recovered to 39.39±4.73 and 40.13±3.31 in the respective groups on POD6, which were lower than but not statistically significant different from the baseline (t=0.786, P=0.434). There were statistically significant improvements across all subdomains of SNOT-22 for patients in the two groups only in POD1 (all P<0.05). The ERAS group did not have an increased incidence of complications such as nausea/emesis (χ2,=0.223, P>0.05), hemorrhage, aspiration and dizziness compared to the control group.Conclusion: ERAS could improve perioperative QoL in patients with CRSwNP undergoing ESS, and SNOT-22 can be used for ERAS evaluation as a patients’ outcome report.Keywords: chronic rhinosinusitis, enhanced recovery after surgery, quality of life, SNOT-22