BACKGROUND: Ventral hernia repairs are one of the most common surgeries performed. Symptoms are the most common motivation for repair. Unfortunately, outcomes of repair are typically measured in recurrence and infection rather than patient focused results. We correlated factors associated with decreased patient satisfaction, chronic pain, and diminished functional status following laparoscopic ventral hernia repair (LVHR) METHODS: A retrospective study of 201 patients from two affiliated institutions was performed. Patient satisfaction, chronic abdominal pain, pain scores, and Activities Assessment Scale results were obtained in 122 patients. Results were compared with univariate and multivariate analysis. RESULTS: Thirty-two (25.4%) patients were dissatisfied with their LVHR while 21 (17.2%) patients had chronic abdominal pain and 32 (26.2%) patients had poor functional status following LVHR. Decreased patient satisfaction was associated with perception of poor cosmetic outcome (OR 17.3), eventration (OR 10.2), and chronic pain (OR 1.4). Chronic abdominal pain following LVHR was associated with incisional hernia (OR 9.0), recurrence (OR 4.3), eventration (OR 6.0), mesh type (OR 1.9), or ethnicity (OR 0.10). Decreased functional status with LVHR was associated with mesh type used (OR 3.7), alcohol abuse (OR 3.4), chronic abdominal pain (OR 1.3), and age (OR 1.1). CONCLUSIONS: One-fourth of patients have poor quality outcome following LVHR. These outcomes are affected by perception of cosmesis, eventration, chronic pain, hernia type, recurrence, mesh type, and patient characteristics/co-morbidities. Closing central defects and judicious mesh selection may improve patient satisfaction and function. Focus on patient-centered outcomes is warranted.
BACKGROUND:Ventral hernia repairs are one of the most common surgeries performed. Symptoms are the most common motivation for repair. Unfortunately, outcomes of repair are typically measured in recurrence and infection rather than patient focused results. We correlated factors associated with decreased patient satisfaction, chronic pain, and diminished functional status following laparoscopic ventral hernia repair (LVHR) METHODS: A retrospective study of 201 patients from two affiliated institutions was performed. Patient satisfaction, chronic abdominal pain, pain scores, and Activities Assessment Scale results were obtained in 122 patients. Results were compared with univariate and multivariate analysis. RESULTS: Thirty-two (25.4%) patients were dissatisfied with their LVHR while 21 (17.2%) patients had chronic abdominal pain and 32 (26.2%) patients had poor functional status following LVHR. Decreased patient satisfaction was associated with perception of poor cosmetic outcome (OR 17.3), eventration (OR 10.2), and chronic pain (OR 1.4). Chronic abdominal pain following LVHR was associated with incisional hernia (OR 9.0), recurrence (OR 4.3), eventration (OR 6.0), mesh type (OR 1.9), or ethnicity (OR 0.10). Decreased functional status with LVHR was associated with mesh type used (OR 3.7), alcohol abuse (OR 3.4), chronic abdominal pain (OR 1.3), and age (OR 1.1). CONCLUSIONS: One-fourth of patients have poor quality outcome following LVHR. These outcomes are affected by perception of cosmesis, eventration, chronic pain, hernia type, recurrence, mesh type, and patient characteristics/co-morbidities. Closing central defects and judicious mesh selection may improve patient satisfaction and function. Focus on patient-centered outcomes is warranted.
Authors: Francisco Asencio; Javier Aguiló; Salvador Peiró; Juan Carbó; Ramón Ferri; Federico Caro; Marwan Ahmad Journal: Surg Endosc Date: 2008-12-31 Impact factor: 4.584
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: Martin McCarthy; Olga Jonasson; Chih-Hung Chang; A Simon Pickard; Anita Giobbie-Hurder; James Gibbs; Perry Edelman; Robert Fitzgibbons; Leigh Neumayer Journal: J Am Coll Surg Date: 2005-08 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: M Rosen; F Brody; J Ponsky; R M Walsh; S Rosenblatt; F Duperier; A Fanning; A Siperstein Journal: Surg Endosc Date: 2002-09-23 Impact factor: 4.584
Authors: M A Carbajo; J C del Olmo; J I Blanco; C de la Cuesta; F Martín; M Toledano; C Perna; C Vaquero Journal: JSLS Date: 2000 Apr-Jun Impact factor: 2.172
Authors: J C Lauscher; M Leonhardt; P Martus; G Zur Hausen; K Aschenbrenner; U Zurbuchen; H Thielemann; T Kohlert; R Schirren; T Simon; H J Buhr; J-P Ritz; M E Kreis Journal: Chirurg Date: 2016-01 Impact factor: 0.955
Authors: Mette W Christoffersen; Jacob Rosenberg; Lars Nannestad Jorgensen; Peter Bytzer; Thue Bisgaard Journal: World J Surg Date: 2014-07 Impact factor: 3.352