Julie L Holihan1, Juan R Flores-Gonzalez2, Jiandi Mo2, Tien C Ko2, Lillian S Kao2, Mike K Liang2. 1. University of Texas Health Science Center at Houston, 6431 Fannin St, MSB 5.254, Houston, TX, 77030, USA. Julie.L.Holihan@uth.tmc.edu. 2. University of Texas Health Science Center at Houston, 6431 Fannin St, MSB 5.254, Houston, TX, 77030, USA.
Abstract
BACKGROUND: Little is known about the clinical or patient-reported outcomes with non-operative management of ventral hernias. The aim of this prospective study is to determine the clinical and patient-reported outcomes of patients undergoing initial non-operative treatment of their ventral hernia. STUDY DESIGN: This was a prospective observational study of patients undergoing non-operative management of ventral hernias. Primary outcome was rate of surgical repair of the ventral hernias. Secondary outcomes included rate of emergency repair, elective repair, and emergency room visits. In addition, validated measurement tools for patient satisfaction and cosmetic satisfaction with their abdomen, abdominal pain, and patient function (modified Activities Assessment Scale, AAS) were utilized. RESULTS: Of 128 patients who underwent non-operative management of a ventral hernia, 99(77.3%) patients were followed for a median (interquartile range) of 12.2(10.4-13.5) months. Twenty (20.2%) patients had at least 1 emergency room visit associated with their hernia. One-quarter (n = 2323.2%) underwent ventral hernia repair following enrollment. Twenty (20.2%) underwent elective repair, and 3 (3.0%) underwent emergent repair. Based on the modified AAS survey, patients who were managed non-operatively experienced no change in patient centered outcomes, while patients converted to operative management had improved scores. CONCLUSIONS AND RELEVANCE: While the short-term risk of emergency surgery with non-operative management of ventral hernias is moderate, the chance of an emergency room visit and surgery is high. Patients who undergo non-operative management of their ventral hernias have no change in patient-reported outcomes at one year, while those converted to operative management experience improvement.
BACKGROUND: Little is known about the clinical or patient-reported outcomes with non-operative management of ventral hernias. The aim of this prospective study is to determine the clinical and patient-reported outcomes of patients undergoing initial non-operative treatment of their ventral hernia. STUDY DESIGN: This was a prospective observational study of patients undergoing non-operative management of ventral hernias. Primary outcome was rate of surgical repair of the ventral hernias. Secondary outcomes included rate of emergency repair, elective repair, and emergency room visits. In addition, validated measurement tools for patient satisfaction and cosmetic satisfaction with their abdomen, abdominal pain, and patient function (modified Activities Assessment Scale, AAS) were utilized. RESULTS: Of 128 patients who underwent non-operative management of a ventral hernia, 99(77.3%) patients were followed for a median (interquartile range) of 12.2(10.4-13.5) months. Twenty (20.2%) patients had at least 1 emergency room visit associated with their hernia. One-quarter (n = 2323.2%) underwent ventral hernia repair following enrollment. Twenty (20.2%) underwent elective repair, and 3 (3.0%) underwent emergent repair. Based on the modified AAS survey, patients who were managed non-operatively experienced no change in patient centered outcomes, while patients converted to operative management had improved scores. CONCLUSIONS AND RELEVANCE: While the short-term risk of emergency surgery with non-operative management of ventral hernias is moderate, the chance of an emergency room visit and surgery is high. Patients who undergo non-operative management of their ventral hernias have no change in patient-reported outcomes at one year, while those converted to operative management experience improvement.
Authors: Julie L Holihan; Blake E Henchcliffe; Jiandi Mo; Juan R Flores-Gonzalez; Tien C Ko; Lillian S Kao; Mike K Liang Journal: Ann Surg Date: 2016-10 Impact factor: 12.969
Authors: Julie L Holihan; Zeinab M Alawadi; Jennifer W Harris; John Harvin; Shinil K Shah; Christopher J Goodenough; Lillian S Kao; Mike K Liang; J Scott Roth; Peter A Walker; Tien C Ko Journal: Curr Probl Surg Date: 2016-06-18 Impact factor: 1.909
Authors: Francis Lovecchio; Rebecca Farmer; Jason Souza; Nima Khavanin; Gregory A Dumanian; John Y S Kim Journal: Surgery Date: 2013-12-25 Impact factor: 3.982
Authors: Pieter G L Koolen; Ahmed M S Ibrahim; Kuylhee Kim; Hani H Sinno; Bernard T Lee; Benjamin E Schneider; Daniel B Jones; Samuel J Lin Journal: Plast Reconstr Surg Date: 2014-10 Impact factor: 4.730
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: Robert J Fitzgibbons; Olga Jonasson; James Gibbs; Dorothy D Dunlop; William Henderson; Domenic Reda; Anita Giobbie-Hurder; Martin McCarthy Journal: J Am Coll Surg Date: 2003-05 Impact factor: 6.113
Authors: D V Cherla; K Bernardi; K J Blair; S S Chua; J P Hasapes; L S Kao; T C Ko; E J Matta; M L Moses; K G Shiralkar; V R Surabhi; V S Tammisetti; C P Viso; M K Liang Journal: Hernia Date: 2018-11-14 Impact factor: 4.739
Authors: Esmaeel R Dadashzadeh; Lauren V Huckaby; Robert Handzel; M Shanaz Hossain; Gloria D Sanin; Vincent P Anto; Patrick Bou-Samra; J B Moses; Stephen Cai; Heather M Phelos; Richard L Simmons; Matthew R Rosengart; Dirk J van der Windt Journal: Ann Surg Date: 2022-02-01 Impact factor: 12.969
Authors: J D Thomas; A Fafaj; S J Zolin; R Naples; C M Horne; C C Petro; A S Prabhu; D M Krpata; M J Rosen; S Rosenblatt Journal: Hernia Date: 2020-06-15 Impact factor: 4.739
Authors: Lia D Delaney; Ryan Howard; Krisinda Palazzolo; Anne P Ehlers; Shawna Smith; Michael Englesbe; Justin B Dimick; Dana A Telem Journal: JAMA Netw Open Date: 2021-11-01