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Convalescence after laparoscopic inguinal hernia repair: a qualitative systematic review

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Abstract

Background

Duration of convalescence after inguinal hernia repair is of major socio-economic interest and an often reported outcome measure. The primary aim was to perform a critical analysis of duration of convalescence from work and activity and secondary to identify risk factors for unexpected prolonged convalescence after laparoscopic inguinal hernia repair.

Methods

A qualitative systematic review was conducted. PubMed, Embase and the Cochrane database were searched for trials reporting convalescence after laparoscopic inguinal hernia repair in the period from January 1990 to January 2016. Furthermore, snowball search was performed in reference lists of identified articles. Randomized controlled trials and prospective comparative or non-comparative trials of high quality were included. Trials with ≥100 patients, >18 years of age and manuscripts in English were included. Scoring systems were used for assessment of quality.

Results

The literature search identified 1039 papers. Thirty-four trials were included in the final review including 14,273 patients. There was overall a large variation in duration of convalescence. Trials using non-restrictive recommendations of 1–2 days or “as soon as possible to return to all activities” reported overall a shorter duration of convalescence compared with trials not using recommendations for convalescence. Strenuous physical activity at work, strenuous leisure activity and patients with expectations of a prolonged period of convalescence may be risk factors for prolonged convalescence extending more than a few days after laparoscopic inguinal hernia repair.

Conclusions

Patients should be recommended a duration of 1–2 days of convalescence after laparoscopic inguinal hernia repair. Short and non-restrictive recommendations may reduce duration of convalescence without increasing risk of pain, complications or recurrence rate.

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Authors and Affiliations

  1. Department of Surgery, Herlev Hospital, University of Copenhagen, Herlev Ringvej 75, 2730, Herlev, Denmark

    Mette Astrup Tolver & Jacob Rosenberg

  2. Department of Surgery, Hvidovre Hospital, University of Copenhagen, Kettegård Allé 30, 2650, Hvidovre, Denmark

    Thue Bisgaard

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  1. Mette Astrup Tolver
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  2. Jacob Rosenberg
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  3. Thue Bisgaard
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Correspondence to Mette Astrup Tolver.

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Disclosure

Dr. Rosenberg reports Grants from Baxter Healthcare, Grants from Johnson & Johnson, Grants and personal fees from Bard, personal fees from Merck, outside the submitted work. Dr. Bisgaard reports Grants from Johnson & Johnson, Covidien, Baxter Healthcare and travel/accommodation expenses for international meetings covered by Baxter Healthcare. Mette A. Tolver has no conflicts of interest or financial ties to disclose

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Tolver, M.A., Rosenberg, J. & Bisgaard, T. Convalescence after laparoscopic inguinal hernia repair: a qualitative systematic review. Surg Endosc 30, 5165–5172 (2016). https://doi.org/10.1007/s00464-016-4863-4

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