Patient perceptions of acute pain and activity disruption following inguinal hernia repair: a propensity-matched comparison of robotic-assisted, laparoscopic, and open approaches.

Autor: Bittner Iv JG; Department of Surgery, Virginia Commonwealth University School of Medicine, PO Box 980519, Richmond, VA, 23298, USA. jbittner4@gmail.com., Cesnik LW; Market Research Department, Intuitive Surgical, Inc., Sunnyvale, CA, USA., Kirwan T; Bruno and Ridgway Research Associates, Lawrenceville, NJ, USA., Wolf L; Bruno and Ridgway Research Associates, Lawrenceville, NJ, USA., Guo D; Department of Clinical Affairs, Intuitive Surgical, Inc., Sunnyvale, CA, USA.
Jazyk: angličtina
Zdroj: Journal of robotic surgery [J Robot Surg] 2018 Dec; Vol. 12 (4), pp. 625-632. Date of Electronic Publication: 2018 Feb 16.
DOI: 10.1007/s11701-018-0790-9
Abstrakt: Few publications describe the potential benefit of robotic-assisted inguinal hernia repair on acute postoperative groin pain (APGP). This study compared patients' perceptions of APGP, activity limitation, and overall satisfaction after robotic-assisted- (R), laparoscopic (L), or open (O) inguinal hernia repair (IHR). Random samples of patients from two web-based research panels and surgical practices were screened for patients who underwent IHR between October 28, 2015 and November 1, 2016. Qualified patients were surveyed to assess perceived APGP at 1 week postoperatively, activity disruption, and overall satisfaction. Three cohorts based on operative approach were compared after propensity matching. Propensity scoring resulted in 83 R-IHR matched to 83 L-IHR respondents, while 85 R-IHR matched with 85 O-IHR respondents. R-IHR respondents recalled less APGP compared to respondents who had O-IHR (4.1 ± 0.3 vs 5.6 ± 0.3, p < 0.01) but similar APGP compared to L-IHR (4.0 ± 0.3 vs 4.4 ± 0.3, p = 0.37). Respondents recalled less activity disruption 1 week postoperatively after R-IHR versus O-IHR (6.1 ± 0.3 vs. 7.3 ± 0.2, p < 0.01) but similar levels of activity disruption after R-IHR and L-IHR (6.0 ± 0.3 vs. 6.6 ± 0.27, p = 0.32). At the time of the survey, respondents perceived less physical activity disruption after R-IHR compared to O-IHR (1.4 ± 0.2 vs. 2.8 ± 0.4, p < 0.01) but similar between R-IHR and L-IHR (1.3 ± 0.2 vs 1.2 ± 0.2, p = 0.94). Most respondents felt satisfied with their outcome regardless of operative approach. Patient perceptions of pain and activity disruption differ by approach, suggesting a potential advantage of a minimally invasive technique over open for IHR. Further studies are warranted to determine long-term outcomes regarding pain and quality of life after IHR.
Databáze: MEDLINE
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