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Thue Bisgaard - One of the best experts on this subject based on the ideXlab platform.
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Convalescence after laparoscopic inguinal hernia repair: a qualitative systematic review
Surgical Endoscopy, 2016Co-Authors: Mette Astrup Tolver, Jacob Rosenberg, Thue BisgaardAbstract: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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Convalescence after laparoscopic inguinal hernia repair: a qualitative systematic review
Surgical endoscopy, 2016Co-Authors: Mette Astrup Tolver, Jacob Rosenberg, Thue BisgaardAbstract: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. 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. 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. 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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Convalescence after laparoscopic inguinal hernia repair a qualitative systematic review
Surgical Endoscopy and Other Interventional Techniques, 2016Co-Authors: Mette Astrup Tolver, Jacob Rosenberg, Thue BisgaardAbstract: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.
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Determinants of a short Convalescence after laparoscopic transabdominal preperitoneal inguinal hernia repair.
Surgery, 2011Co-Authors: Mette Astrup Tolver, Pernille Strandfelt, Gert Forsberg, Flemming P. Hjorne, Jacob Rosenberg, Thue BisgaardAbstract:Background 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). Methods 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. Results 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 Conclusion 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.
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Sick leave and Convalescence after laparoscopic cholecystectomy
Ugeskrift for laeger, 2005Co-Authors: Thue BisgaardAbstract:Lack of recommendations for a short period of Convalescence, pain and fatigue are important factors in explaining prolonged, Convalescence of several weeks after laparoscopic cholecystectomy. However, physiological changes are rapidly normalised after the operation and there is probably no pathophysiologic basis for recommending a postoperative Convalescence of more than two to four days. Recommending a short period of Convalescence may in itself reduce Convalescence time by 50-60% to less than one week in otherwise healthy patients. For practical reasons a Convalescence of one week is recommended for all patients after laparoscopic cholecystectomy, regardless of their type of work and leisure activities.
Henrik Kehlet - One of the best experts on this subject based on the ideXlab platform.
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prospective analysis of Convalescence and early pain after uncomplicated laparoscopic fundoplication
British Journal of Surgery, 2004Co-Authors: Thue Bisgaard, Birthe Klarskov, Henrik Kehlet, M. Støckel, Jörg RosenbergAbstract:Background: The aim of this study was to define factors that limit a short period of Convalescence and to characterize the pain experienced after laparoscopic fundoplication. Methods: This prospective study included 60 consecutive patients who underwent uncomplicated laparoscopic Nissen fundoplication for gastro-oesophageal reflux disease. Patients were recommended to convalesce for 2 days after operation. Duration of Convalescence, dysphagia, fatigue, nausea, vomiting and different pain components were registered daily during the first week and on days 10 and 30 after fundoplication. Results: Thirty-nine patients took a median of 13 (range 3–41) days off work and 60 stayed away from recreational activity for a median of 4 (range 1–22) days. Pain, fatigue and plans made before operation were the main contributors to prolonged Convalescence. Some 30–40 per cent of the patients reported moderate or severe dysphagia during the study period. Fatigue scores were significantly increased for 6 days after surgery (P < 0 · 001). Visceral pain dominated over incisional and shoulder pain throughout the study. At day 30, 17 per cent of the patients reported moderate or severe visceral pain. Conclusion: Pain and dysphagia are significant problems after uncomplicated total laparoscopic fundoplication. The time taken off work and away from recreational activity exceeded the recommended 2 days of Convalescence, justifying further efforts to optimize early clinical outcome after total laparoscopic fundoplication. Copyright © 2004 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd.
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Prospective analysis of Convalescence and early pain after uncomplicated laparoscopic fundoplication
The British journal of surgery, 2004Co-Authors: Thue Bisgaard, Birthe Klarskov, Henrik Kehlet, M. Støckel, Jörg RosenbergAbstract:The aim of this study was to define factors that limit a short period of Convalescence and to characterize the pain experienced after laparoscopic fundoplication. This prospective study included 60 consecutive patients who underwent uncomplicated laparoscopic Nissen fundoplication for gastro-oesophageal reflux disease. Patients were recommended to convalesce for 2 days after operation. Duration of Convalescence, dysphagia, fatigue, nausea, vomiting and different pain components were registered daily during the first week and on days 10 and 30 after fundoplication. Thirty-nine patients took a median of 13 (range 3-41) days off work and 60 stayed away from recreational activity for a median of 4 (range 1-22) days. Pain, fatigue and plans made before operation were the main contributors to prolonged Convalescence. Some 30-40 per cent of the patients reported moderate or severe dysphagia during the study period. Fatigue scores were significantly increased for 6 days after surgery (P < 0 . 001). Visceral pain dominated over incisional and shoulder pain throughout the study. At day 30, 17 per cent of the patients reported moderate or severe visceral pain. Pain and dysphagia are significant problems after uncomplicated total laparoscopic fundoplication. The time taken off work and away from recreational activity exceeded the recommended 2 days of Convalescence, justifying further efforts to optimize early clinical outcome after total laparoscopic fundoplication. Copyright (c) 2004 British Journal of Surgery Society Ltd
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Convalescence after inguinal herniorrhaphy.
The British journal of surgery, 2004Co-Authors: M. Bay-nielsen, H. Thomsen, F. Heidemann Andersen, J. Bendix, O. K. Sørensen, N. Skovgaard, Henrik KehletAbstract:Convalescence after inguinal herniorrhaphy is usually 3-4 weeks and is an important outcome parameter of hernia surgery. The aim of this study was to describe in detail the consequences of recommending a short Convalescence, including the risk of recurrence. This was a multicentre prospective questionnaire study in patients given a recommendation for short Convalescence (1 day); information was recorded on expected length of Convalescence, employment status, physical workload and limiting factors. The reoperation rate in patients included in the study (group 1, n = 1059) was compared with that for comparable patients treated in participating departments but not part of the study group (group 2, n = 1306) and patients in the Danish Hernia Database (group 3, n = 8297). The median time off work was 7 days and the time interval before carrying out the most strenuous leisure activity was 14 days. After 30 days, 6.8 per cent of patients had not resumed employment and 17.0 per cent had not yet resumed strenuous leisure activity. Important reasons for not resuming work and leisure activity were pain (approximately 60 per cent of patients) and wound problems (approximately 20 per cent). The reoperation rate in group 1 at the median observation time was 0.7 per cent, which was no different to that in group 2 (1.6 per cent) (P = 0.186) or group 3 (1.4 per cent) (P = 0.092). Reduced Convalescence after inguinal herniorrhaphy may be recommended without incurring a risk of higher reoperation rates. Pain and wound problems remain the most important factors for not resuming work or leisure activity as recommended. Copyright 2004 British Journal of Surgery Society Ltd.
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Short Convalescence after vaginal prolapse surgery
Acta obstetricia et gynecologica Scandinavica, 2003Co-Authors: Marianne Ottesen, Henrik Kehlet, Mette Sørensen, Bent OttesenAbstract:Objective. Retrospectively to describe the recommended Convalescence according to patients who had undergone vaginal prolapse surgery in 1996-98, and prospectively to describe the need for and limiting factors for Convalescence after vaginal prolapse surgery in 1999-2000 at a Danish University Hospital. Methods. The retrospective study included a validated, postal, questionnaire and review of patient files. In the prospective study, we followed consecutive women after vaginal surgery in a fast-track setting using a multimodal rehabilitation model with well-defined recommendations for the Convalescence period. Results. In the retrospective study, 188 women (79%) with a median age of 66 years (range, 30-88) answered the questionnaire. They had been recommended a Convalescence of median 6 weeks (range, 1-12) for most activities. The subjective recurrence rate was 22% within median 6 months (range, 0-24) after first-time prolapse surgery. In the prospective study, there were 41 consecutive women with a median...
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Combined intra-articular glucocorticoid, bupivacaine and morphine reduces pain and Convalescence after diagnostic knee arthroscopy
Acta orthopaedica Scandinavica, 2002Co-Authors: Sten Rasmussen, Allan S Larsen, Soren T Thomsen, Jan S Lorentzen, Henrik KehletAbstract:We studied the effect of intra-articullar saline vs. bupivacaine + morphine or bupivacaine morphine + methylprednisolone after diagnostic knee arthroscopy. In a double-blind randomized study, 60 patients undergoing diagnostic knee arthroscopy without a therapeutic procedure were allocated to groups receiving intra-articular saline, intra-articular bupivacaine 150 mg + morphine 4 mg or the same dose of bupivacaine + morphine + intra-articular methylprednisolone 40 mg at the end of arthroscopy during general anesthesia. All patients were instructed to resume normal activities immediately after the procedure. Pain during movement and walking, leg muscle force and joint effusion, use of crutches and duration of sick leave were assessed. A combination of bupivacaine and morphine reduced pain, duration of immobilization and of Convalescence. The addition of methylprednisolone further reduced pain, use of more analgesics, joint swelling and Convalescence.
Jacob Rosenberg - One of the best experts on this subject based on the ideXlab platform.
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surgical techniques and Convalescence recommendations vary greatly in laparoscopic groin hernia repair a nationwide survey among experienced hernia surgeons
Surgical Endoscopy and Other Interventional Techniques, 2019Co-Authors: Line Schmidt, Kristoffer Andresen, Stina Oberg, Jacob RosenbergAbstract:Background Laparoscopic groin hernia repair has become increasingly popular. In Denmark, all groin hernia repairs are registered in the Danish Hernia Database. However, many surgical technical parameters are not registered in neither the hernia database nor in other national registries or the patient files. Our aim was to characterize differences in surgical techniques and variations in Convalescence recommendations in laparoscopic groin hernia repair that are not available elsewhere. Methods A questionnaire was sent to all surgeons in Denmark regularly performing unsupervised laparoscopic groin hernia repair. The questionnaire was developed in collaboration with an experienced chief surgeon and face-validated on the target group. It contained demographic details and items on surgical parameters such as the creation of pneumoperitoneum, size of the optic, choice of closure methods, preoperative information, and postoperative recommendation of Convalescence. Results A total of 71 surgeons were eligible for inclusion, and 61 (86%) responded. We found large variations in almost all surgical parameters, i.e. there was no uniform way of performing laparoscopic groin hernia repair. The variation was not due to the level of experience. The median recommended Convalescence period was 1.5 (range 0-28) days for activities of daily living, 4.5 (range 0-28) days for light physical activity, and 14 (range 0-35) days for hard physical activity. Three percent of surgeons routinely informed patients about the risk of sexual dysfunction prior to operation, and 98% informed about the risk of chronic pain. Conclusions Surgical technical parameters and Convalescence recommendations in laparoscopic groin hernia surgery vary widely in a national cohort of experienced hernia surgeons.
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Convalescence after laparoscopic inguinal hernia repair: a qualitative systematic review
Surgical Endoscopy, 2016Co-Authors: Mette Astrup Tolver, Jacob Rosenberg, Thue BisgaardAbstract: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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Convalescence after laparoscopic inguinal hernia repair: a qualitative systematic review
Surgical endoscopy, 2016Co-Authors: Mette Astrup Tolver, Jacob Rosenberg, Thue BisgaardAbstract: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. 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. 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. 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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Convalescence after laparoscopic inguinal hernia repair a qualitative systematic review
Surgical Endoscopy and Other Interventional Techniques, 2016Co-Authors: Mette Astrup Tolver, Jacob Rosenberg, Thue BisgaardAbstract: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.
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Determinants of a short Convalescence after laparoscopic transabdominal preperitoneal inguinal hernia repair.
Surgery, 2011Co-Authors: Mette Astrup Tolver, Pernille Strandfelt, Gert Forsberg, Flemming P. Hjorne, Jacob Rosenberg, Thue BisgaardAbstract:Background 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). Methods 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. Results 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 Conclusion 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.
Denesh C Patel - One of the best experts on this subject based on the ideXlab platform.
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randomized nonblinded comparison of Convalescence for 2 and 7 days after split thickness skin grafting to the lower legs
Dermatologic Surgery, 2009Co-Authors: Ben Tallon, Steven R. Lamb, Denesh C PatelAbstract:BACKGROUND There is an increasing expectation of shortened postoperative recovery times and a suggestion that shorter Convalescence times may not compromise lower leg split-thickness skin graft results. OBJECTIVE To determine whether mobilization after 2 days of Convalescence compromises graft survival or patient morbidity. METHODS AND MATERIALS A pilot study was initiated in which patients undergoing split-thickness skin grafting to the lower legs were randomized to 2 or the routine 7 days of Convalescence. Baseline characteristics were determined, and patients were followed up in dressing clinics and with a standardized telephone interview. RESULTS There was no difference in baseline patient comorbidities and no significant difference in the number of grafts lost, the number of dressing clinics, bleeding, or wound infections. CONCLUSION The results suggest that 2 days of Convalescence after split-thickness skin grafting to the lower legs may not compromise graft survival or increase patient morbidity. Further study with larger numbers is required to confirm this finding.
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Randomized nonblinded comparison of Convalescence for 2 and 7 days after split-thickness skin grafting to the lower legs.
Dermatologic surgery : official publication for American Society for Dermatologic Surgery [et al.], 2009Co-Authors: Ben Tallon, Steven R. Lamb, Denesh C PatelAbstract:There is an increasing expectation of shortened postoperative recovery times and a suggestion that shorter Convalescence times may not compromise lower leg split-thickness skin graft results. To determine whether mobilization after 2 days of Convalescence compromises graft survival or patient morbidity. A pilot study was initiated in which patients undergoing split-thickness skin grafting to the lower legs were randomized to 2 or the routine 7 days of Convalescence. Baseline characteristics were determined, and patients were followed up in dressing clinics and with a standardized telephone interview. There was no difference in baseline patient comorbidities and no significant difference in the number of grafts lost, the number of dressing clinics, bleeding, or wound infections. The results suggest that 2 days of Convalescence after split-thickness skin grafting to the lower legs may not compromise graft survival or increase patient morbidity. Further study with larger numbers is required to confirm this finding.
Birthe Klarskov - One of the best experts on this subject based on the ideXlab platform.
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prospective analysis of Convalescence and early pain after uncomplicated laparoscopic fundoplication
British Journal of Surgery, 2004Co-Authors: Thue Bisgaard, Birthe Klarskov, Henrik Kehlet, M. Støckel, Jörg RosenbergAbstract:Background: The aim of this study was to define factors that limit a short period of Convalescence and to characterize the pain experienced after laparoscopic fundoplication. Methods: This prospective study included 60 consecutive patients who underwent uncomplicated laparoscopic Nissen fundoplication for gastro-oesophageal reflux disease. Patients were recommended to convalesce for 2 days after operation. Duration of Convalescence, dysphagia, fatigue, nausea, vomiting and different pain components were registered daily during the first week and on days 10 and 30 after fundoplication. Results: Thirty-nine patients took a median of 13 (range 3–41) days off work and 60 stayed away from recreational activity for a median of 4 (range 1–22) days. Pain, fatigue and plans made before operation were the main contributors to prolonged Convalescence. Some 30–40 per cent of the patients reported moderate or severe dysphagia during the study period. Fatigue scores were significantly increased for 6 days after surgery (P < 0 · 001). Visceral pain dominated over incisional and shoulder pain throughout the study. At day 30, 17 per cent of the patients reported moderate or severe visceral pain. Conclusion: Pain and dysphagia are significant problems after uncomplicated total laparoscopic fundoplication. The time taken off work and away from recreational activity exceeded the recommended 2 days of Convalescence, justifying further efforts to optimize early clinical outcome after total laparoscopic fundoplication. Copyright © 2004 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd.
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Prospective analysis of Convalescence and early pain after uncomplicated laparoscopic fundoplication
The British journal of surgery, 2004Co-Authors: Thue Bisgaard, Birthe Klarskov, Henrik Kehlet, M. Støckel, Jörg RosenbergAbstract:The aim of this study was to define factors that limit a short period of Convalescence and to characterize the pain experienced after laparoscopic fundoplication. This prospective study included 60 consecutive patients who underwent uncomplicated laparoscopic Nissen fundoplication for gastro-oesophageal reflux disease. Patients were recommended to convalesce for 2 days after operation. Duration of Convalescence, dysphagia, fatigue, nausea, vomiting and different pain components were registered daily during the first week and on days 10 and 30 after fundoplication. Thirty-nine patients took a median of 13 (range 3-41) days off work and 60 stayed away from recreational activity for a median of 4 (range 1-22) days. Pain, fatigue and plans made before operation were the main contributors to prolonged Convalescence. Some 30-40 per cent of the patients reported moderate or severe dysphagia during the study period. Fatigue scores were significantly increased for 6 days after surgery (P < 0 . 001). Visceral pain dominated over incisional and shoulder pain throughout the study. At day 30, 17 per cent of the patients reported moderate or severe visceral pain. Pain and dysphagia are significant problems after uncomplicated total laparoscopic fundoplication. The time taken off work and away from recreational activity exceeded the recommended 2 days of Convalescence, justifying further efforts to optimize early clinical outcome after total laparoscopic fundoplication. Copyright (c) 2004 British Journal of Surgery Society Ltd
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Factors determining Convalescence after uncomplicated laparoscopic cholecystectomy.
Archives of surgery (Chicago Ill. : 1960), 2001Co-Authors: Thue Bisgaard, Jacob Rosenberg, Birthe Klarskov, Henrik KehletAbstract:Detailed information on duration and limiting factors for Convalescence after uncomplicated laparoscopic cholecystectomy is lacking. Duration of Convalescence may be associated with patients' expectations, given recommendations, and postoperative complaints such as pain and fatigue. Prospective, descriptive study. A university hospital. Two hundred consecutive patients who underwent uncomplicated elective laparoscopic cholecystectomy. For sedentary, light, or moderate workload or main recreational activity, we recommended 2 days of postoperative Convalescence; for strenuous workload or recreational activity, we recommended 1 week. Duration and reasons for absence from work. Convalescence from work (n = 85) and recreational activity (n = 198) was 6 days (range, 0-28 days) and 2 days (range, 0-24 days), respectively, in patients recommended for 2 days' Convalescence. In patients recommended for 1 week of Convalescence, Convalescence from work (n = 25) was 10 days (range, 0-52 days), and Convalescence from main recreational activity (n = 2), 8 days (range, 5-11 days). Among 87 patients who resumed work or activity later than recommended, pain was a contributory cause in 41 patients, fatigue in 35 patients, and convalescent period falling on a weekend in 26 patients, while 29 patients had arranged vacation or sick leave preoperatively. Preoperative expectation of Convalescence and pain were independent contributory factors (P<.01) for Convalescence from work for longer than 2 days in patients recommended for 2 days' Convalescence. The period of Convalescence after uncomplicated laparoscopic cholecystectomy is about 1 week from work and 2 days from recreational activity when 2 days of Convalescence is recommended. Improved pain relief and patient information may further reduce Convalescence.
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factors determining Convalescence after uncomplicated laparoscopic cholecystectomy
Archives of Surgery, 2001Co-Authors: Thue Bisgaard, Jacob Rosenberg, Birthe Klarskov, Henrik KehletAbstract:HYPOTHESIS Detailed information on duration and limiting factors for Convalescence after uncomplicated laparoscopic cholecystectomy is lacking. Duration of Convalescence may be associated with patients' expectations, given recommendations, and postoperative complaints such as pain and fatigue. DESIGN Prospective, descriptive study. SETTING A university hospital. PATIENTS Two hundred consecutive patients who underwent uncomplicated elective laparoscopic cholecystectomy. INTERVENTION For sedentary, light, or moderate workload or main recreational activity, we recommended 2 days of postoperative Convalescence; for strenuous workload or recreational activity, we recommended 1 week. MAIN OUTCOME MEASURES Duration and reasons for absence from work. RESULTS Convalescence from work (n = 85) and recreational activity (n = 198) was 6 days (range, 0-28 days) and 2 days (range, 0-24 days), respectively, in patients recommended for 2 days' Convalescence. In patients recommended for 1 week of Convalescence, Convalescence from work (n = 25) was 10 days (range, 0-52 days), and Convalescence from main recreational activity (n = 2), 8 days (range, 5-11 days). Among 87 patients who resumed work or activity later than recommended, pain was a contributory cause in 41 patients, fatigue in 35 patients, and convalescent period falling on a weekend in 26 patients, while 29 patients had arranged vacation or sick leave preoperatively. Preoperative expectation of Convalescence and pain were independent contributory factors (P<.01) for Convalescence from work for longer than 2 days in patients recommended for 2 days' Convalescence. CONCLUSIONS The period of Convalescence after uncomplicated laparoscopic cholecystectomy is about 1 week from work and 2 days from recreational activity when 2 days of Convalescence is recommended. Improved pain relief and patient information may further reduce Convalescence.
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Short Convalescence after inguinal herniorrhaphy with standardised recommendations: duration and reasons for delayed return to work.
The European journal of surgery = Acta chirurgica, 1999Co-Authors: Torben Callesen, Birthe Klarskov, Karsten Bech, Henrik KehletAbstract:To provide a detailed description of post-herniorrhaphy Convalescence. Prospective, descriptive, consecutive questionnaire case series. Public university hospital, Denmark. 100 consecutive patients treated for inguinal hernia. Elective open inguinal herniorrhaphy under local anaesthesia. One day Convalescence for light/moderate and three weeks for strenuous physical activity was recommended. Duration of absence from work or main recreational activity. Overall median absence (including the day of operation) was 6 days (interquartile range 1-16). For unemployed patients it was 1 day (0-7), for patients with a light or moderate workload 6 days (3-12), and for those with a heavy workload 25 days (21-37). Among the 64 patients, who did not follow the recommendations, pain was contributory in 33 and advice from the general practitioner in 12. Pain was the main cause of impairment of activities of daily living. Well-defined recommendations for Convalescence may, together with improved management of postoperative pain, shorten Convalescence; they are essential in the evaluation of effects of different surgical techniques of herniorrhaphy on Convalescence.