Department of Surgery at Køge Hospital, University of Copenhagen, Køge, Denmark.
Surgery. 2012 Apr;151(4):556-63. doi: 10.1016/j.surg.2011.08.020. Epub 2011 Oct 19.
Evidence-based recommendations for the expected duration of convalescence after laparoscopic groin hernia repair are not available, and objective reasons for prolonged convalescence are not clear. Our main aim was to establish the expected duration of convalescence using preoperative recommendations to the patient and to identify the limiting factors for early (postoperative) resumption of normal activities after laparoscopic transabdominal preperitoneal inguinal herniorraphy (TAPP).
This was a single-center prospective study. The intervention (the recommendation to the patient) was 1 day for convalescence. Several predefined factors were investigated for their influence on the duration of convalescence and the risk of early postoperative pain. Predefined, clinically justified reasons for not resuming normal activities within the first 3 postoperative days were also registered.
Between August 2009 and August 2010, 185 consecutive male patients with groin hernia were enrolled prospectively, and 162 patients were available for analysis. Convalescences from work and leisure activities were a median of 5 days (range, 1-40) and 3 days (range, 1-49), respectively (P = .34). Preoperative expectations of convalescence from work (the number of days) was the only factor to explain prolonged convalescence from work (P < .001). Postoperative, self-registered planned sick leave, and complaints of pain and fatigue were the dominant reasons for not resuming normal activities within the first 3 days after operation. Younger age was the only factor found to explain the intensity of postoperative pain (P < .001).
Postoperative convalescence (return to work or normal activities) was between 3 and 5 days after TAPP in patients who were counseled about a 1-day expected convalescence. The expectation of convalescence from work was an important reason for delayed convalescence beyond 1 day.
腹腔镜腹股沟疝修补术后恢复期的预期时间尚无循证医学推荐意见，且延长恢复期的客观原因尚不清楚。我们的主要目的是根据术前向患者提供的建议确定预期的恢复期，并确定腹腔镜经腹腹膜前腹股沟疝修补术（TAPP）后早期（术后）恢复正常活动的限制因素。
这是一项单中心前瞻性研究。干预措施（向患者的建议）为 1 天恢复期。研究了几个预先确定的因素，以了解它们对恢复期持续时间和术后早期疼痛风险的影响。还记录了术后前 3 天内未恢复正常活动的预先确定的、有临床依据的原因。
2009 年 8 月至 2010 年 8 月，前瞻性纳入了 185 例男性腹股沟疝患者，其中 162 例患者可进行分析。工作和休闲活动的恢复期中位数分别为 5 天（范围，1-40）和 3 天（范围，1-49）（P =.34）。对工作恢复期（天数）的术前预期是唯一可以解释工作恢复期延长的因素（P <.001）。术后，自我登记的计划病假、疼痛和疲劳的抱怨是术后前 3 天内未恢复正常活动的主要原因。年龄较小是唯一可以解释术后疼痛强度的因素（P <.001）。
在接受 1 天预期恢复期咨询的患者中，TAPP 后 3-5 天即可恢复工作或正常活动。对工作恢复期的期望是延长恢复期超过 1 天的一个重要原因。
