C W Snyder1, L A Graham, C C Vick, S H Gray, K R Finan, M T Hawn. 1. Section of Gastrointestinal Surgery, Department of Surgery, University of Alabama at Birmingham, 1922 7th Avenue South, KB 428, Birmingham, AL 35294-0016, USA.
Abstract
PURPOSE: To determine the effects of repair technique and hernia recurrence on patient-reported outcomes after incisional hernia repair. METHODS: This cohort study included patients from sixteen Veteran's Affairs Medical Centers across the United States who underwent elective incisional hernia repair between 1997 and 2002. Technical details and outcomes (repair type and recurrence status) were determined by physician chart review. Patient satisfaction, chronic pain (McGill pain scale and visual analogue scale), and health-related quality of life (Short Form 36) were evaluated with a mailed survey at a median of five years after repair. Multivariable regression modeling was performed to evaluate the effect of repair type and recurrence status on patient-reported outcomes. RESULTS: Of 854 patients alive at the time of survey mailing, 371 responded (43.4%). Patients with active recurrence were more likely to be dissatisfied with their results (odds ratio (OR) 6.2, P < 0.0001), to have chronic sensory hernia site pain (OR 3.2, P = 0.01), to report disturbance from pain (OR 2.1, P = 0.04), and to have significantly worse quality of life on the Physical Function, General Health, and Physical Component Score domains. Repair technique with permanent mesh versus suture had no independent effect on patient satisfaction, chronic pain, or QOL. CONCLUSIONS: Recurrence has a substantial negative effect on patient-reported outcomes after incisional hernia repair, whereas the repair technique has no independent effect.
PURPOSE: To determine the effects of repair technique and hernia recurrence on patient-reported outcomes after incisional hernia repair. METHODS: This cohort study included patients from sixteen Veteran's Affairs Medical Centers across the United States who underwent elective incisional hernia repair between 1997 and 2002. Technical details and outcomes (repair type and recurrence status) were determined by physician chart review. Patient satisfaction, chronic pain (McGill pain scale and visual analogue scale), and health-related quality of life (Short Form 36) were evaluated with a mailed survey at a median of five years after repair. Multivariable regression modeling was performed to evaluate the effect of repair type and recurrence status on patient-reported outcomes. RESULTS: Of 854 patients alive at the time of survey mailing, 371 responded (43.4%). Patients with active recurrence were more likely to be dissatisfied with their results (odds ratio (OR) 6.2, P < 0.0001), to have chronic sensory hernia site pain (OR 3.2, P = 0.01), to report disturbance from pain (OR 2.1, P = 0.04), and to have significantly worse quality of life on the Physical Function, General Health, and Physical Component Score domains. Repair technique with permanent mesh versus suture had no independent effect on patient satisfaction, chronic pain, or QOL. CONCLUSIONS: Recurrence has a substantial negative effect on patient-reported outcomes after incisional hernia repair, whereas the repair technique has no independent effect.
Authors: J Conze; A N Kingsnorth; J B Flament; R Simmermacher; G Arlt; C Langer; E Schippers; M Hartley; V Schumpelick Journal: Br J Surg Date: 2005-12 Impact factor: 6.939
Authors: Mary T Hawn; Christopher W Snyder; Laura A Graham; Stephen H Gray; Kelly R Finan; Catherine C Vick Journal: J Am Coll Surg Date: 2010-05 Impact factor: 6.113
Authors: Jacobus W A Burger; Roland W Luijendijk; Wim C J Hop; Jens A Halm; Emiel G G Verdaasdonk; Johannes Jeekel Journal: Ann Surg Date: 2004-10 Impact factor: 12.969
Authors: Laurel J Blair; Tiffany C Cox; Ciara R Huntington; Steven A Groene; Tanushree Prasad; Amy E Lincourt; Kent W Kercher; B Todd Heniford; Vedra A Augenstein Journal: Surg Endosc Date: 2016-12-30 Impact factor: 4.584
Authors: Juliane Bingener; Jeff A Sloan; Drew K Seisler; Andrea L McConico; Pamela E Skaran; David R Farley; Mark J Truty Journal: J Gastrointest Surg Date: 2015-03-18 Impact factor: 3.452
Authors: Mike K Liang; Marissa Clapp; Linda T Li; Rachel L Berger; Stephanie C Hicks; Samir Awad Journal: World J Surg Date: 2013-03 Impact factor: 3.352