T Bisgaard1, M Støckel, B Klarskov, H Kehlet, J Rosenberg. 1. Department of Surgical Gastroenterology, H:S Hvidovre Hospital, University of Copenhagen, Hvidovre, University of Copenhagen, Hellerup, Denmark. thuebisgaard@tdcadsl.dk
Abstract
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 (c) 2004 British Journal of Surgery Society Ltd
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 (c) 2004 British Journal of Surgery Society Ltd
Authors: Brice Gaudillière; Gabriela K Fragiadakis; Robert V Bruggner; Monica Nicolau; Rachel Finck; Martha Tingle; Julian Silva; Edward A Ganio; Christine G Yeh; William J Maloney; James I Huddleston; Stuart B Goodman; Mark M Davis; Sean C Bendall; Wendy J Fantl; Martin S Angst; Garry P Nolan Journal: Sci Transl Med Date: 2014-09-24 Impact factor: 17.956
Authors: Gabriela K Fragiadakis; Brice Gaudillière; Edward A Ganio; Nima Aghaeepour; Martha Tingle; Garry P Nolan; Martin S Angst Journal: Anesthesiology Date: 2015-12 Impact factor: 7.892