腹腔鏡全腹膜外鼠蹊疝氣修補手術後早期回復工作之預後
戴定恩、施冠偉、周安琪、林競哲、蔡曜州
臺北醫學大學附設醫院 泌尿科；
Effect of early return to work after laparoscopic total extraperitoneal inguinal hernia repair
Ting-En Tai1, Kuan-Wei Shi1, An-Chi Chou1, Ching-Che Lin1, Yao-Chou Tsai1,2
1Department of Urology, Taipei Medical University Hospital, Taipei, Taiwan
2Department of Urology, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
Purpose: We compared the effect of early and late return to work after laparoscopic total extraperitoneal inguinal herniorrhaphy (TEP).
Materials and Methods: Between March 2008 and December 2019, we reviewed our prospectively collected database, and 506 cases underwent laparoendoscopic total extraperitoneal herniorrhaphy (TEP) or laparoendoscopic single site incision TEP (LESS-TEP) were identified. Of these, 231 cases, who returned to work within one week after surgery, were in the early group, and 275 cases, who had no job or returned to work later than one week, were in the late group. Primary endpoint is chronic pain, which is defined as persistent pain 6 months after operation. Secondary endpoints are recurrence rate, seroma and modified medical outcome study (MOS) score.
Results: The two group had comparable baseline characteristics, but early group were younger (51±13.1 vs. 58.2±15.9, p<0.001) and had less constipation before operation (10.0% vs. 18.5%, p=0.006). The early return to work group had significant less chronic pain [Odds ratio (OR): 0.319, p=0.003]. There is no difference in post-operative seroma (OR: 1.033, p=0.907), recurrence rate (OR: 0.528, p=0.317) or MOS between early or late group.
Conclusions: Early return to work was associated with less chronic pain and is comparable to late return to work in recurrence and complications. Patients are encouraged to return to work earlier after TEP.