Bozuk Michael, Schuster Rob, Stewart David, Hicks Kathrin, Greaney Gregory, Waxman Kenneth
Department of Surgery, Cottage Hospital, Santa Barbara, California 93102, USA.
Am Surg. 2003 Oct;69(10):839-41.
Proponents of laparoscopic inguinal hernia repair maintain that the associated costs and risks are offset by faster recovery and less postoperative pain. It was our hypothesis that the incidence of chronic pain in both groups of our patients was not as high as reported in the literature. Patients for the study were identified from a community hospital medical record database. A total of 229 patients were available and agreed to participate in the study. Data collected included the patient's current pain level at the hernia site, pain medication currently used, narcotics currently used, return to normal work, and return to normal activity. Overall, 19.7 per cent of patients complained of mild pain, but only 2.2 per cent classified this as moderate or severe. Mild pain was noted more often in the open repair patients compared with the laparoscopic group. However, there was no difference in the frequency of moderate or severe pain. The time to return to work was longer in the open repair group than the laparoscopic repair group, but there were large ranges in both groups. The inability to return to full preoperative activity was infrequent and equivalent in both open and laparoscopic hernia repair groups. In our study of 229 patients undergoing elective open or laparoscopic inguinal hernia repair at a community hospital, we have found a low incidence of moderate or severe chronic pain. In addition, we found that this procedure did not interfere with return to work at 6 months or return to daily activities in either the laparoscopic or open repair group.
腹腔镜腹股沟疝修补术的支持者认为，更快的恢复速度和更少的术后疼痛抵消了相关的成本和风险。我们的假设是，我们两组患者中慢性疼痛的发生率并不像文献报道的那么高。该研究的患者是从一家社区医院的病历数据库中筛选出来的。共有229名患者符合条件并同意参与研究。收集的数据包括患者疝部位目前的疼痛程度、目前使用的止痛药物、目前使用的麻醉药物、恢复正常工作的情况以及恢复正常活动的情况。总体而言，19.7%的患者抱怨有轻微疼痛，但只有2.2%将其归类为中度或重度疼痛。与腹腔镜组相比，开放修补组患者出现轻微疼痛的情况更常见。然而，中度或重度疼痛的发生率没有差异。开放修补组恢复工作的时间比腹腔镜修补组长，但两组的时间范围都很大。在开放和腹腔镜疝修补组中，无法恢复到术前完全活动状态的情况都很少见且相当。在我们对一家社区医院229例行择期开放或腹腔镜腹股沟疝修补术患者的研究中，我们发现中度或重度慢性疼痛的发生率很低。此外，我们发现该手术并未干扰腹腔镜或开放修补组患者在6个月时恢复工作或恢复日常活动。
