Patient Regret After Gastrointestinal Surgery for Cancer: A Narrative Review.

Abstract

Background: Understanding what factors contribute to postoperative regret is crucial for improving clinical decision-making, enhancing patient communication, and increasing patient satisfaction. This narrative review evaluates the limited but growing body of literature focused on patient experiences of regret following gastrointestinal (GI) cancer surgery in the adult patient population.

Methods: A narrative review was conducted using the following keywords: "gastrointestinal", "cancer", "surgery", and "regret". PubMed was searched from inception to July 1, 2024, for articles written in English. Included studies assessed and reported decisional or postoperative regret in adult patients who had undergone curative-intent surgical resection of any GI cancer. Study variables were extracted from the included studies, and a narrative synthesis was conducted.

Results: Of 174 studies screened for eligibility, 5 met the inclusion criteria and were included in the analysis. Postoperative complications and psychosocial comorbidities were consistently associated with regret, while associations between regret and overall physical health, postoperative symptom burden, quality of life, and perceived choice were inconsistent across studies. Preference-concordant decision-making and trust in the surgeon emerged as potentially modifiable factors linked to regret.

Conclusion: Postoperative regret is influenced by postoperative complications, psychosocial risk factors, shared decision-making, and patient trust in their surgeon. Future research should explore longitudinal changes in postoperative regret over time and incorporate both patient and caregiver perspectives to obtain a holistic understanding of postoperative regret. This understanding will help develop evidence-based strategies to mitigate postoperative regret in GI cancer care.