Perioperative Expectations of Patients Undergoing Gastrointestinal Surgery for Cancer: A Systematic Review.

Background: Despite the prevalence of surgical intervention in patients with gastrointestinal cancers, little is known about patients' expectations regarding physical recovery, long-term prognosis, and quality of life following surgery.

Methods: This systematic review followed the PRISMA reporting guidelines. Four electronic databases (MEDLINE, Embase, PsycINFO, and CINAHL) were searched. Studies were included if they reported the perioperative expectations of adult patients undergoing curative-intent GI cancer surgery. Data extracted included aims and study design, participant characteristics, disease and treatment characteristics, and findings related to patient expectations.

Results: In total, 22 studies were included for analysis and provided data on 3605 patients. The majority of studies found that patients were uncertain about what to expect from surgery, which contributed to feelings of distress, anxiety, frustration, and isolation. Patients struggled to distinguish between normal postoperative symptoms and signs of potential complications and expressed a desire for more information about anticipated and unanticipated surgical outcomes. Expectations regarding the length of postoperative convalescence ranged from weeks to years, and most patients overestimated the ability of surgery to achieve cure. Only one study evaluated the impact of an intervention on preoperative expectation development.

Conclusions: Patients undergoing surgery for resectable GI malignancies are frequently unprepared for the challenges of postoperative recovery and life after surgery. Many express a desire for more thorough and realistic information about what to expect. There is a clear need for the development and evaluation of supportive interventions.