Center for Perioperative Optimization, Department of Surgery, Herlev and Gentofte Hospital, University of Copenhagen, Copenhagen, Denmark.
Surg Endosc. 2023 Jun;37(6):4443-4448. doi: 10.1007/s00464-023-09913-y. Epub 2023 Feb 15.
Recent international hernia guidelines state that work and leisure activities after inguinal hernia repair can be resumed after a convalescence of three to five days for most patients. There is no specific recommendation for convalescence duration before resuming sport and heavy lifting. This nationwide survey aimed to assess leading hernia surgeons' recommendations for convalescence after groin hernia repair and to explore their general opinions regarding convalescence.
A validated questionnaire was sent to 32 leading groin hernia surgeons covering all Danish private and public hospitals. The primary outcome was convalescence recommendations following Lichtenstein and laparoscopic groin hernia repair for activities of daily living, light work, sport, and heavy lifting.
A total of 29 surgeons (91%) responded to the questionnaire. The surgeons generally agreed on resuming daily activities and light work as soon as possible according to the level of pain. For resumption of sport, the surgeons recommended a median convalescence of 14 days (IQR 10-23, range 7-30) after Lichtenstein repair and 14 days (IQR 10-21, range 7-30) after laparoscopic repair. Most of the surgeons instructed patients with a defined number of days before resuming heavy lifting, which after Lichtenstein repair was median 14 days (IQR 8-28, range 2-30) and after laparoscopic repair was median 21 days (IQR 14-30, range 7-30). None of the surgeons routinely prescribed sick leave. Seventeen surgeons (61%) thought that recommending a too short convalescence could cause complications, primarily recurrence, hematoma, and pain.
This study revealed that surgeons agreed on the resumption of daily activities and light work as soon as possible according to the level of pain. However, a broad spectrum of convalescence recommendations was revealed for sport and heavy lifting.
最近的国际疝指南指出,对于大多数患者,腹股沟疝修补术后的工作和休闲活动可以在 3 到 5 天的恢复期后恢复。对于恢复运动和重体力劳动前的恢复期,没有具体的建议。这项全国性调查旨在评估领先的疝外科医生对腹股沟疝修补术后恢复期的建议,并探讨他们对恢复期的一般看法。
向丹麦所有私人和公立医院的 32 位领先的腹股沟疝外科医生发送了一份经过验证的问卷。主要结果是 Lichtenstein 和腹腔镜腹股沟疝修补术后日常活动、轻工作、运动和重体力劳动的恢复期建议。
共有 29 名外科医生(91%)对问卷做出了回应。外科医生普遍认为,根据疼痛程度,尽快恢复日常活动和轻工作。对于运动的恢复,外科医生建议 Lichtenstein 修复后中位数恢复期为 14 天(IQR 10-23,范围 7-30),腹腔镜修复后中位数恢复期为 14 天(IQR 10-21,范围 7-30)。大多数外科医生在恢复重体力劳动前会给患者规定一定的天数,Lichtenstein 修复后中位数为 14 天(IQR 8-28,范围 2-30),腹腔镜修复后中位数为 21 天(IQR 14-30,范围 7-30)。没有外科医生常规规定病假。17 名外科医生(61%)认为,建议过短的恢复期可能会导致并发症,主要是复发、血肿和疼痛。
本研究表明,外科医生一致认为,根据疼痛程度尽快恢复日常活动和轻工作。然而,对于运动和重体力劳动的恢复期,建议的范围很广。