Staffan Haapaniemi1, Erik Nilsson. 1. Department of Surgery, University Hospital, Linköping, Sweden. Staffan.Haapaniemi@lio.se
Abstract
OBJECTIVES: To evaluate recurrence rate and chronic groin pain three years after hernia repair and to validate a postal questionnaire with selective physical examination as a method of follow-up. DESIGN: Prospective cohort study. SETTING: County hospital, Sweden. PATIENTS: Prospective data were retrieved from the Swedish Hernia Register for patients aged 15-80 years at the time of groin hernia repair, operated on during 1994. INTERVENTIONS: Three years after operation patients were mailed a three-item questionnaire and invited to have a physical examination. Those examined answered a detailed questionnaire about pain and functional impairment. When appropriate an extended physical examination was undertaken to find out the probable cause of the pain. MAIN OUTCOME MEASURES: Recurrence, pain, and functional impairment. RESULTS: 272 hernias were repaired in 264 patients. 24 patients had died and 16 had a recurrence before the follow-up examination. After a median observation time of 44 months, 218 patients with 223 repairs (96%) were examined. Depending on the definition of recurrence and completeness of physical examination (selective or all patients) the recurrence rate varied between 10% (25/239) and 15% (35/239) including recurrences diagnosed before follow-up. 40 patients (18%) reported groin pain at follow-up, which was considered to be caused by a previous hernia repair in 34 (15%), 12 of whom (5%) had moderate or severe pain. Postoperative complications were associated with an increased risk of chronic pain, whereas type of hernia and use of mesh had no influence. CONCLUSIONS: The incidence of recurrence and chronic pain after hernia repair requires continuous audit in non-specialised units. Participation in a register and follow-up by a three-item questionnaire and selective physical examination provides a solid basis for quality control.
OBJECTIVES: To evaluate recurrence rate and chronic groin pain three years after hernia repair and to validate a postal questionnaire with selective physical examination as a method of follow-up. DESIGN: Prospective cohort study. SETTING: County hospital, Sweden. PATIENTS: Prospective data were retrieved from the Swedish Hernia Register for patients aged 15-80 years at the time of groin hernia repair, operated on during 1994. INTERVENTIONS: Three years after operation patients were mailed a three-item questionnaire and invited to have a physical examination. Those examined answered a detailed questionnaire about pain and functional impairment. When appropriate an extended physical examination was undertaken to find out the probable cause of the pain. MAIN OUTCOME MEASURES: Recurrence, pain, and functional impairment. RESULTS: 272 hernias were repaired in 264 patients. 24 patients had died and 16 had a recurrence before the follow-up examination. After a median observation time of 44 months, 218 patients with 223 repairs (96%) were examined. Depending on the definition of recurrence and completeness of physical examination (selective or all patients) the recurrence rate varied between 10% (25/239) and 15% (35/239) including recurrences diagnosed before follow-up. 40 patients (18%) reported groin pain at follow-up, which was considered to be caused by a previous hernia repair in 34 (15%), 12 of whom (5%) had moderate or severe pain. Postoperative complications were associated with an increased risk of chronic pain, whereas type of hernia and use of mesh had no influence. CONCLUSIONS: The incidence of recurrence and chronic pain after hernia repair requires continuous audit in non-specialised units. Participation in a register and follow-up by a three-item questionnaire and selective physical examination provides a solid basis for quality control.
Authors: M Varga; F Köckerling; F Mayer; M Lechner; R Fortelny; R Bittner; K Borhanian; D Adolf; R Bittner; K Emmanuel Journal: Surg Endosc Date: 2020-06-18 Impact factor: 4.584
Authors: T J Aufenacker; D H de Lange; M D Burg; B W Kuiken; E F Hensen; I G Schoots; D J Gouma; M P Simons Journal: Hernia Date: 2004-12-23 Impact factor: 4.739
Authors: Fritz H Berndsen; U Petersson; D Arvidsson; C-E Leijonmarck; C Rudberg; S Smedberg; A Montgomery Journal: Hernia Date: 2007-04-18 Impact factor: 4.739