Analysis of the Rehabilitation Efficacy and Nutritional Status of Patients After Endoscopic Radical Thyroidectomy by Fast Track Surgery Based on Nutritional Support

Abstract

Objective: To investigate and analyze the effect of fast track surgery (FTS) based on nutritional support on the improvement of rehabilitation efficacy and nutritional status of patients after radical lumpectomy for thyroid cancer.

Methods: Eighty-six patients admitted to our hospital for radical lumpectomy for thyroid cancer between April 2018 and April 2021 were selected, of which 40 patients admitted between April 2018 and April 2019 were included in the control group with conventional perioperative care. Forty-six patients admitted between May 2019 and April 2021 were included in the trial group with FTS care based on nutritional support. The two groups of patients were compared in terms of postoperative feeding time, length of stay, time out of bed, VAS scores, albumin (ALB), total protein (TP) and prealbumin (PA) levels, negative emotions [Mental Health Test Questionnaire (DCL-90)], quality of life [General Quality of Life Inventory (GQOLI-74)] and complication rates.

Results: The patients in the trial group had shorter feeding time, hospitalization time and time out of bed than the control group (P < 0.05). After the intervention, ALB, TP and PA levels were higher in the trial group than in the control group vs. preoperatively (P < 0.05); VAS scores in the trial group were lower than VAS scores in the control group during the same period (P < 0.05). The postoperative DCL-90 scores of the trial group were lower than those of the control group (P < 0.05); the GQOLI-74 scores and total scores of the trial group were higher than those of the control group at the 3-month postoperative follow-up (P < 0.05). The overall incidence of complications such as hoarseness, choking on water, hand and foot numbness, wound infection, and hypocalemia was lower in the trial group than in the control group (P < 0.05).

Conclusion: The implementation of FTS care based on nutritional support for patients after endoscopic radical thyroidectomyr can effectively improve the postoperative recovery and reduce their pain level, as well as help improve their nutritional status, negative emotions and improve their quality of life, which is worth promoting.

Keywords: fast track surgery; lumpectomy; nutritional status; nutritional support; radical thyroidectomy; rehabilitation outcome.

Figure 1

Comparison of perioperative indicators between the 2 groups (Mean, SD). The contents in (A–D) are the first postoperative meal, the first postoperative bed release, and the 24 h postoperative VAS score with the length of stay, respectively. The difference between the two groups *P < 0.05.

Figure 2

Nutritional status of the 2 groups (Mean, SD). The contents in (A–C) are ALB, TP, and PA levels, respectively. Difference from the same group preoperatively ΔP < 0.05; difference between the two groups *P < 0.05.

Figure 3

Comparison of negative emotions between the 2 groups (Mean, SD). The contents in (A–I) are somatization, obsessive-compulsive symptoms, interpersonal, sensitivity, depression, hostility, phobia, paranoia, and psychoticism, respectively. Difference from the same group preoperatively ΔP < 0.05; difference between the two groups *P < 0.05.

Figure 4

Comparison of the quality of life of the 2 groups after 3 months (Mean, SD). The contents in (A–E) are health status, physical function, social function, mental health and GQOLI-74 total score, respectively. The difference between the two groups *P < 0.05.