Laparoscopic myomectomy: quality of life of patients in “fast-track” surgery

Objective. To study the quality of life (QoL) of patients during the first few days after laparoscopic myomectomy (LM) in a “fasttrack” hospitalization. Patients and methods. The study included 230 patients who underwent LM. The principles of “fast-track” surgery were implemented during hospitalization. All patients filled in the EQ-5D questionnaires (quality of life assessment) at admission and discharge, as well as the Picker questionnaire (assessment of patients’ experiences with in-patient care) at discharge. Results. At discharge, 40% of patients showed a decrease in QoL. Decline in mobility was noted in 41%, in daily activity – in 47%, and more severe pain and discomfort – in 53% of patients. A significant impact of the severity of postoperative pain syndrome on QoL was revealed: patients with a visual analog scale score ≥4 in the first day were more likely to experience limitations in mobility (OR = 1.7 (95% CI 1.01 – 2.88, p = 0.049), self-care (OR = 1.76 (95% CI 0.99 – 3.13, p = 0.054) and daily activity (OR = 2.09 (95% CI 1.23 – 3.54, p = 0.006) at discharge. Conclusion. When implementing the principles of accelerated postoperative recovery, it is necessary to consider the changes in QoL indicators that have a direct impact on the functional rehabilitation of patients and their satisfaction with medical care. The key factor reducing QoL in patients after LM is pain syndrome. Key words: uterine myoma, laparoscopic myomectomy, quality of life, pain syndrome, multimodal general anesthesia, fast-track.