330. Number of Videothoracoscopic Accesses Does Not Influence Self-Perceived Quality of Early Postoperative Recovery
Gianluca Perroni, Federico Tacconi, Alessandro Paolo Tamburrini, Gianluca Vanni, Vincenzo Ambrogi
Tor Vergata University Hospital, Rome, Italy
Objective: It is assumed that uniportal approach may translate into improved patient’s experience after videothoracoscopy. However, no study addressed patient’s subjective perception in this regard. We aimed at assessing differences in self-perceived quality of perioperative recovery after uni-portal or three-portal videothoracoscopic operations.
Methods: A 40-items, validated Quality of Recovery Questionnaire (QOR-40) was administered to 115 consecutive patients on admission and 24 hours after uni-portal or three-portal videothoracoscopic procedures performed in the last 6 months. Absolute changes in global QOR-40 score and its isolated components were analyzed by means of a repeated-measure ANOVA. Uni- and multivariable regression analysis of diverse categorical factors were performed to identify predictors of low-quality recovery.
Results: Mean change in global QOR-40 score was -5.9. More pronounced
changes were found in females (p<0.002), diffusion-capacity <75% predicted (p=0.024), and malignant-disease group (p<0.001). No between-group effect was found according to surgical approach (p=0.183). Thirty-two percent of patients experienced a low-quality recovery. Univariable risk factors were female gender (p<0.001; odds-ratio: 2.4), low diffusion-capacity (p<0.001; odds-ratio: 10.8), malignant-disease group (p=0.003; odds-ratio: 3.9), and a higher comorbidity score (p=0.004; odds-ratio: 3.7). However, only gender and low diffusion-capacity were independent predictors (both: p<0.001, odds-ratio: 12.2 and 23.9 respectively) at multivariable analysis.
Conclusions: In this study, the self-perceived quality of recovery measured by QOR-40 was mainly associated with patient-related factors, whereas the influence of number of videothoracoscopic accesses was irrelevant. These findings might also suggest a certain degree of reverse patient expectation bias with uniportal procedures.