Prospective analysis of convalescence and early pain after uncomplicated laparoscopic fundoplication

Br J Surg. 2004 Nov;91(11):1473-8. doi: 10.1002/bjs.4720.


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.

MeSH terms

  • Adult
  • Aged
  • Convalescence
  • Deglutition Disorders / etiology
  • Female
  • Fundoplication / methods*
  • Gastroesophageal Reflux / rehabilitation
  • Gastroesophageal Reflux / surgery*
  • Humans
  • Laparoscopy / methods*
  • Male
  • Middle Aged
  • Nausea / etiology
  • Pain, Postoperative / etiology*
  • Pain, Postoperative / prevention & control
  • Prospective Studies
  • Risk Factors
  • Sick Leave / statistics & numerical data
  • Survival Analysis
  • Vomiting / etiology