Barkun J S, Keyser E J, Wexler M J, Fried G M, Hinchey E J, Fernandez M, Meakins J L
Division of General Surgery, McGill University Health Center, McGill University, Montreal, Quebec, Canada.
J Gastrointest Surg. 1999 Nov-Dec;3(6):575-82. doi: 10.1016/s1091-255x(99)80078-x.
Over a 28-month period, 123 patients with a unilateral inguinal hernia were recruited into a randomized controlled trial comparing open herniorrhaphy (OH) to laparoscopic inguinal herniorrhaphy (LH). The primary end point was duration of convalescence. Sixty-five patients underwent OH and 58 underwent LH. Both groups were well matched for all baseline parameters, although LH patients anticipated a shorter convalescence than OH patients (14.3 +/- 9.4 days vs. 18.5 +/- 10.8 days; P = 0.021). The median duration of hospital stay was one day in both groups. No difference was observed in the duration of convalescence (LH 9.8 +/- 7.4 days; OH 11.6 +/- 7. 7 days) across groups. However, when the data were analyzed after removing patients receiving disability ("worker's") compensation (21 patients), patients undergoing LH recovered on average 3 days faster (LH 7.8 +/- 5.6 days; OH 10.9 +/- 7.5 days; P = 0.02). Patients not receiving worker's compensation appear to have a shorter convalescence after LH compared to OH. Disability compensation is a major confounding variable in determining convalescence and needs to be controlled for in any future trial design.
在28个月的时间里，123名单侧腹股沟疝患者被纳入一项随机对照试验，比较开放式疝修补术（OH）与腹腔镜腹股沟疝修补术（LH）。主要终点是恢复期的时长。65例患者接受了OH，58例接受了LH。两组在所有基线参数方面匹配良好，尽管接受LH的患者预计恢复期比接受OH的患者短（14.3±9.4天对18.5±10.8天；P = 0.021）。两组的中位住院时间均为一天。两组间在恢复期时长方面未观察到差异（LH 9.8±7.4天；OH 11.6±7.7天）。然而，在剔除接受伤残（“工伤”）赔偿的患者（21例）后分析数据时，接受LH的患者平均恢复快3天（LH 7.8±5.6天；OH 10.9±7.5天；P = 0.02）。与OH相比，未接受工伤赔偿的患者在接受LH后恢复期似乎更短。伤残赔偿是确定恢复期的一个主要混杂变量，在未来任何试验设计中都需要加以控制。
