Recovery to Usual Activity After Outpatient Anorectal Surgery

BACKGROUND: Most elective anorectal procedures are performed in an outpatient setting, and the supposed recovery time is short. The aim of the present study was to assess return to usual physical activity (UPA), return to work and quality of life (QOL). METHODS: This prospective single-center cohort study included consecutive patients undergoing outpatient anorectal procedures. Physical and work activities were assessed using the validated International Physical Activity Questionnaire 7 days before surgery and 7, 14 and 30 days thereafter. In addition, patients were inquired daily on their postoperative QOL until postoperative day (POD)10 on a visual analogue scale (0-10). Patients were stratified by their preoperative physical activity score (POPAS; low, moderate and high). RESULTS: Out of 379 patients, 100 (63 men) were included with a median age of 40 years [interquartile range (IQR) 27]. General QOL was rated at a median of 8/10 (IQR 3.5) at POD10. On POD30, only 69% and 71% of patients had returned to UPA and work, respectively. Patients who returned to UPA at POD30 had a better median QOL at POD10 than those who did not (9 vs. 7/10, p = 0.015). Patients with low POPAS and moderate POPAS returned to UPA earlier than patients with high POPAS (83%, 86% and 44% on POD30, respectively, p = 0.005). CONCLUSIONS: Return to UPA and work after outpatient anorectal surgery took longer than expected despite a good QOL 10 days after surgery. High physical activity was associated with longer recovery time. These elements should be emphasized during preoperative counseling.