Changes in fatigue and physical function following laparoscopic colonic surgery

The aim of the study was to describe changes in postoperative fatigue, quality of life, physical performance, and body composition in patients undergoing laparoscopic colonic cancer surgery.

MATERIAL AND METHODS: In a follow-up study from 2009-2011 at two regional hospitals in Denmark we examined 62 patients having a right hemicolectomy ora sigmoid resection performed. The main outcome measures were fatigue level subjectively scored from 1 ("fit") to 10 ("fatigued") on a modified visual analogue scale and by objective measurements of hand grip and knee extension strength, work capacity, weight, and lean body mass. Quality of life was assessed using the SF-36 questionnaire and pain using an ordinal scale. Patients were examined preoperatively, 1-2 and 4 weeks postoperatively.

RESULTS: Eight patients (13%) were converted to open surgery and the median bleeding (95% confidence interval of the median) was 75 (50-100) ml. One to two weeks after surgery the fatigue level and pain when moving had increased significantly (p=0.0011 and p=0.0002 respectively) and the SF-36 physical component quality of life score decreased (p<0.0001) when compared to preoperatively. However, at 4 weeks postoperatively fatigue level, pain, and quality of life scores were at the preoperative level. There were no significant changes from preoperatively to postoperatively in any of the measures of physical performance, whereas there was a slight reduction in weight and lean body mass after the operation. CONCLUSIONS. Laparoscopic colonic cancer surgery was associated with a short lasting increased fatigue and pain and reduced quality of life, but no significant reduction in physical performance after surgery.