Js. Barkun et al., Short-term outcomes in open vs. laparoscopic herniorrhaphy: Confounding impact of worker's compensation on convalescence, J GASTRO S, 3(6), 1999, pp. 575-581
Over a 28-month period, 123 patients with a unilateral inguinal hernia were
recruited into a randomized controlled trial comparing open herniorrhaphy
(OH) to laparoscopic inguinal herniorrhaphy (LH). The primary end point was
duration of convalescence. Sixty-five patients underwent OH and 58 underwe
nt LH. Both groups were well matched for all baseline parameters, although
LH patients anticipated a shorter convalescence than OH patients (14.3 +/-
9.4 days vs. 18.5 +/- 10.8 days; P = 0.021). The median duration of hospita
l stay was one day in both groups. No difference was observed in the durati
on of convalescence (LH 9.8 +/- 7.4 days; OH 11.6 +/- 7.7 days) across grou
ps. However, when the data were analyzed after removing patients receiving
disability ("worker's") compensation (21 patients), patients undergoing LH
recovered on average 3 days faster (LH 7.8 +/- 5.6 days; OH 10.9 +/- 7.5 da
ys; P = 0.02). Patients not receiving worker's compensation appear to have
a shorter convalescence after LH compared to OH. Disability compensation is
a major confounding variable in determining convalescence and needs to be
controlled for in any future trial design.