Effect of early return to work after laparoscopic total extraperitoneal hernia repair: A retrospective comparative cohort study.

Abstract

<h4>Objectives</h4>Laparoscopic total extraperitoneal (TEP) hernia repair is one of the widely used surgical methods for symptomatic inguinal hernia. Although laparoscopic procedures provide advantages on postoperative complications and shorter convalescence, there is currently no global consensus on the timing for returning to work following laparoscopic hernia repair. This study compared the outcomes of early and late return to work after laparoscopic TEP inguinal hernia repair.<h4>Materials and methods</h4>Between March 2008 and December 2019, we reviewed 506 cases of laparoendoscopic TEP hernia repair. Among these, 231 cases where patients returned to work within 1 week postsurgery were classified as the early group, while 275 cases of patients either unemployed or returning to work after more than 1 week were classified as the late group. The primary endpoint was inguinal hernia recurrence. The secondary endpoints included postoperative chronic inguinal pain (defined as persistent pain 6 months postoperation), seroma formation, and the physical function domain of SF-36 v2.<h4>Results</h4>The two groups had similar baseline characteristics, except that the early return-to-work group was younger (51 ± 13.1 vs. 58.2 ± 15.9, <i>P</i> < 0.001) and had a lower risk of constipation before the operation (10.0% vs. 18.5%, <i>P</i> = 0.006). The early group did not exhibit an increased rate of inguinal hernia recurrence (1.7% vs. 2.9%, <i>P</i> = 0.386). In addition, the early group experienced significantly less chronic pain (4.8% vs. 11.6%, <i>P</i> = 0.006). There were no differences in postoperative seroma formation or scores of the physical function domain of SF-36 v2 between the early and late groups.<h4>Conclusion</h4>Patients who underwent laparoscopic TEP hernia repair and returned to work within 1 week did not show increased hernia recurrence rates or complications. In addition, early return to work was associated with significantly less chronic pain. Returning to work early after TEP repair is both safe and feasible. Patients are encouraged to resume work early following TEP repair.