Factors associated with postoperative recovery after laparoscopic and abdominal hysterectomy.
OBJECTIVE
To determine whether the day-by-day recovery of general wellbeing was faster in women undergoing laparoscopic hysterectomy than in total abdominal hysterectomy and to analyse the association between stress coping and sick-leave and the day-by-day recovery measured as general wellbeing.


METHODS
A randomised multicentre trial conducted in five hospitals in the South East of Sweden. Hundred and twenty-five women scheduled for hysterectomy for benign conditions were enrolled in the study and 117 women completed the study. Fifty-five women were randomised to abdominal hysterectomy and 62 to laparoscopic hysterectomy. Day-by-day recovery of general wellbeing was measured by a visual analogue scale 1 week preoperatively, 35 days postoperatively, and during 1 week 6 months postoperatively. Stress-coping capability was measured preoperatively using a specific psychometric measurement. Sick-leave was granted with an initial period of 14 days and prolonged on patient demand with 7 days periods. Effects of operating method and stress-coping ability on the day-by-day recovery adjusted for postoperative complications and analgesics were analysed by means of analysis of variance for repeated measurements.


RESULTS
No significant difference was found in the day-by-day recovery of the general wellbeing between the operating methods. Stress-coping ability did significantly influence the day-by-day recovery of general wellbeing. Duration of sick-leave was associated with the occurrence of postoperative complications but not with stress-coping ability.


CONCLUSIONS
The day-by-day recovery of general wellbeing is not faster in laparoscopic hysterectomy than in abdominal hysterectomy. Women with high stress-coping abilities have a better outcome in general wellbeing than women with low stress-coping capacity. Identification of women with low stress-coping abilities and prevention of complications might be of benefit for improving postoperative wellbeing.
Persson
Pär
P
Department of Clinical and Experimental Medicine, Division of Obstetrics and Gynaecology Faculty of Health Sciences, University Hospital, 581 85 Linköping, Sweden. par.persson@akademiska.se
Kjølhede
Preben
P
D000223:Adaptation, Psychological; D000328:Adult; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007044:Hysterectomy; D010535:Laparoscopy; D008875:Middle Aged; D010149:Postoperative Pain; D011183:Postoperative Complications; D011788:Quality of Life; D018582:Sick Leave