Literature DB >> 23095614

Prospective, long-term comparison of quality of life in laparoscopic versus open ventral hernia repair.

Paul D Colavita1, Victor B Tsirline, Igor Belyansky, Amanda L Walters, Amy E Lincourt, Ronald F Sing, B Todd Heniford.   

Abstract

OBJECTIVES: To compare laparoscopic ventral hernia repair (LVHR) versus open ventral hernia repair (OVHR) for quality of life (QOL), complications, and recurrence in a large, prospective, multinational study.
INTRODUCTION: As recurrence rates have decreased for LVHR and OVHR, QOL has become an extremely important differentiating outcomes measure.
METHODS: A prospective, international database was queried from September 2007 to July 2011 for LVHR and OVHR. Carolinas Comfort Scale (CCS) was utilized to quantify QOL (pain, movement limitation, and mesh sensation) preoperatively and at 1, 6, and 12 months postoperatively.
RESULTS: A total of 710 repairs included 402 OVHR and 308 LVHR. Demographics were mean age 57.1 ± 13.3 years, 49.6% male, 21.7% recurrent hernias, mean body mass index of 30.3 ± 6.6, and mean defect size of 89.4 ± 130.8. Preoperatively, 56.9% had pain, and 53.2% experienced movement limitation. At 1-month follow-up, 587 (82.7%) patients were provided CCS scores; more LVHR patients experienced pain (P < 0.001) and movement limitations (P < 0.001). At 6 and 12 months, there were no differences in QOL with 466 (65.6%) and 478 (67.3%) patients responding, respectively. After controlling for confounding variables, LVHR was independently associated with more frequent discomfort [odds ratio (OR) = 1.9, confidence interval (CI): 1.2-3.1], movement limitation (OR = 1.6, CI: 1.0-2.7), and overall symptoms (OR = 1.6, CI: 1.0-2.6) at 1 month. LVHR resulted in a shorter length of stay (LOS) (P < 0.001) and fewer infections (P = 0.004), but overall complication rates were equal. Recurrence rates were also equal (P = 0.66).
CONCLUSION: In the largest, prospective QOL study comparing LVHR and OVHR, LVHR is associated with a decrease in QOL in the short term. LOS and infection rates are decreased in LVHR, but overall complication and recurrence rates are equal.

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Year:  2012        PMID: 23095614     DOI: 10.1097/SLA.0b013e3182734130

Source DB:  PubMed          Journal:  Ann Surg        ISSN: 0003-4932            Impact factor:   12.969


  41 in total

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6.  Postoperative complications as an independent risk factor for recurrence after laparoscopic ventral hernia repair: a prospective study of 417 patients with long-term follow-up.

Authors:  Henry Mercoli; Stylianos Tzedakis; Antonio D'Urso; Marius Nedelcu; Riccardo Memeo; Nicolas Meyer; Michel Vix; Silvana Perretta; Didier Mutter
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7.  Laparoscopic versus open hernia repair: outcomes and sociodemographic utilization results from the nationwide inpatient sample.

Authors:  Paul D Colavita; Victor B Tsirline; Amanda L Walters; Amy E Lincourt; Igor Belyansky; B Todd Heniford
Journal:  Surg Endosc       Date:  2012-06-26       Impact factor: 4.584

8.  SAGES guidelines for laparoscopic ventral hernia repair.

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9.  Ventral and incisional hernia: the cost of comorbidities and complications.

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10.  Health-related quality of life scores changes significantly within the first three months after hernia mesh repair.

Authors:  Mette W Christoffersen; Jacob Rosenberg; Lars Nannestad Jorgensen; Peter Bytzer; Thue Bisgaard
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