Short‐term recovery after subtotal and total abdominal hysterectomy ‐ a randomised clinical trial

摘要

Objective: To determine whether the day‐byday postoperative recovery differs between women undergoing subtotal and total abdominal hysterectomy and to analyse factors associated with postoperative recovery and sick‐leave. Design: A prospective, open, randomised multicenter trial. Setting: Seven hospitals and one private clinic in the south‐east of Sweden. Population: 200 women scheduled for hysterectomy for benign conditions were enrolled in the study and 178 women completed the study. 94 women were randomised to subtotal abdominal hysterectomy and 84 to total abdominal hysterectomy. Methods: Day‐by day recovery of general well‐being measured by a visual analogue scale in a diary seven days preoperatively and 35 days postoperatively. Psychometric measurements included depression, anxiety and general psychological well‐being. Main outcome measures: Effects of operating method and preoperative well‐being on the day‐by‐day recovery and sick‐leave duration. Results: No significant difference was found in the day‐by‐day recovery between operating methods. Day‐by‐day recovery of general well‐being and duration of sick‐leave was strongly associated with the occurrence of minor complications but not with major complications. The level of psychological wellbeing preoperatively was strongly associated with the day‐by‐day recovery of general wellbeing and duration of sick‐leave. Conclusions: Day‐by‐day recovery of general well‐being is not faster in subtotal versus total abdominal hysterectomy. Independent of operation method there is an interaction between preoperative psychological wellbeing, postoperative recovery of general wellbeing and duration of sick‐leave. Postoperative complications and preoperative psychological well‐being are strong determinants for duration of sick‐leave. There is a need for intervention studies with focus on complications and preoperative well‐being.