Karla Bernardi1, Alexander C Martin2, Julie L Holihan3, Oscar A Olavarria4, Juan R Flores-Gonzalez5, Deepa V Cherla6, Nicole B Lyons7, Puja Shah8, Lillian S Kao9, Tien C Ko10, Mike K Liang11. 1. McGovern Medical School at University of Texas Health Science Center at Houston, Houston, TX, USA; Center for Surgical Trials and Evidence-Based Practice, University of Texas Health Science Center at Houston, Houston, TX, USA. Electronic address: karlabernardi.m@gmail.com. 2. McGovern Medical School at University of Texas Health Science Center at Houston, Houston, TX, USA. Electronic address: Alexander.C.Martin@uth.tmc.edu. 3. McGovern Medical School at University of Texas Health Science Center at Houston, Houston, TX, USA; Center for Surgical Trials and Evidence-Based Practice, University of Texas Health Science Center at Houston, Houston, TX, USA. Electronic address: Julie.L.Holihan@uth.tmc.edu. 4. McGovern Medical School at University of Texas Health Science Center at Houston, Houston, TX, USA; Center for Surgical Trials and Evidence-Based Practice, University of Texas Health Science Center at Houston, Houston, TX, USA. Electronic address: Oscar.A.Olavarria@uth.tmc.edu. 5. McGovern Medical School at University of Texas Health Science Center at Houston, Houston, TX, USA. Electronic address: juan_r87@hotmail.com. 6. McGovern Medical School at University of Texas Health Science Center at Houston, Houston, TX, USA; Center for Surgical Trials and Evidence-Based Practice, University of Texas Health Science Center at Houston, Houston, TX, USA. Electronic address: cherladv@gmail.com. 7. McGovern Medical School at University of Texas Health Science Center at Houston, Houston, TX, USA. Electronic address: Nicole.B.Lyons@uth.tmc.edu. 8. McGovern Medical School at University of Texas Health Science Center at Houston, Houston, TX, USA. Electronic address: shah.puja33@gmail.com. 9. McGovern Medical School at University of Texas Health Science Center at Houston, Houston, TX, USA; Center for Surgical Trials and Evidence-Based Practice, University of Texas Health Science Center at Houston, Houston, TX, USA. Electronic address: Lillian.S.Kao@uth.tmc.edu. 10. McGovern Medical School at University of Texas Health Science Center at Houston, Houston, TX, USA. Electronic address: Tien.C.Ko@uth.tmc.edu. 11. McGovern Medical School at University of Texas Health Science Center at Houston, Houston, TX, USA; Center for Surgical Trials and Evidence-Based Practice, University of Texas Health Science Center at Houston, Houston, TX, USA. Electronic address: Mike.Liang@uth.tmc.edu.
Abstract
BACKGROUND: We hypothesized that long-term quality of life (QoL) is improved among patients with ventral hernias (VHs) and comorbid conditions managed operatively than with non-operative management. METHODS: This was the 3-year follow-up to a prospective observational study of patients with comorbid conditions and VHs. Primary outcome was change in QoL measured utilizing the modified Activities Assessment Scale (AAS), a validated, hernia-specific survey. Outcomes were compared using: (1)paired t-test on matched subset and (2)multivariable linear regression on the overall cohort. RESULTS: In the matched cohort (n = 80; 40/group), the operative group experienced a significantly greater improvement in QoL compared to the non-operative group (28.4 ± 27.1 vs. 11.8 ± 23.8,p = 0.005). The operative group, had 10 (25.0%) reported recurrences while the non-operative group, reported 4/15 (26.7%) recurrences among the 15 (37.5%) patients that underwent repair. On multivariable analysis of the whole cohort (n = 137), operative management was associated with a 19.5 (95% CI7.0-31.9) point greater improvement in QoL compared to non-operative management. CONCLUSIONS: This is the first long term prospective study showing the benefits of operative as opposed to non-operative management of patients with comorbid conditions and VHs.
BACKGROUND: We hypothesized that long-term quality of life (QoL) is improved among patients with ventral hernias (VHs) and comorbid conditions managed operatively than with non-operative management. METHODS: This was the 3-year follow-up to a prospective observational study of patients with comorbid conditions and VHs. Primary outcome was change in QoL measured utilizing the modified Activities Assessment Scale (AAS), a validated, hernia-specific survey. Outcomes were compared using: (1)paired t-test on matched subset and (2)multivariable linear regression on the overall cohort. RESULTS: In the matched cohort (n = 80; 40/group), the operative group experienced a significantly greater improvement in QoL compared to the non-operative group (28.4 ± 27.1 vs. 11.8 ± 23.8,p = 0.005). The operative group, had 10 (25.0%) reported recurrences while the non-operative group, reported 4/15 (26.7%) recurrences among the 15 (37.5%) patients that underwent repair. On multivariable analysis of the whole cohort (n = 137), operative management was associated with a 19.5 (95% CI7.0-31.9) point greater improvement in QoL compared to non-operative management. CONCLUSIONS: This is the first long term prospective study showing the benefits of operative as opposed to non-operative management of patients with comorbid conditions and VHs.
Authors: J Nigh; D J Wade; G T Rives; S A Karim; A Bhavaraju; M K Kimbrough; R J Reif; K W Sexton; H K Jensen Journal: Hernia Date: 2022-06-28 Impact factor: 4.739
Authors: K K Jensen; B East; B Jisova; M López Cano; G Cavallaro; L N Jørgensen; V Rodrigues; C Stabilini; D Wouters; F Berrevoet Journal: Hernia Date: 2022-02-25 Impact factor: 2.920
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