Ankoor A Talwar1, Nikhita J Perry1, Phoebe B McAuliffe1, Abhishek A Desai1, Sheri Thrippleton1, Robyn B Broach1, John P Fischer2. 1. Division of Plastic Surgery, University of Pennsylvania Health System, 3400 Civic Center Boulevard, 14th Floor South Tower, Philadelphia, PA, 19104, USA. 2. Division of Plastic Surgery, University of Pennsylvania Health System, 3400 Civic Center Boulevard, 14th Floor South Tower, Philadelphia, PA, 19104, USA. John.Fischer2@pennmedicine.upenn.edu.
Abstract
PURPOSE: Ventral hernia repair (VHR) can be augmented with biosynthetic poly-4-hydroxybutryate mesh (P4HB). Long-term outcomes, including quality of life outcomes, after VHR with P4HB mesh are not well established. Our study sought to assess these outcomes 5 years after repair. METHODS: Patients who received VHR using P4HB by the senior author between 01/2015 and 09/2017 were retrospectively identified. Patients were prospectively interviewed for quality of life assessment using the Hernia-Related Quality-of-Life Survey (HerQLes) and Abdominal Hernia-Q (AHQ) and screened for recurrence. Those who screened positive were asked to follow up in clinic to confirm recurrence. Both 5-year quality of life and recurrence were univariately assessed with patient and operative factors. RESULTS: 51 patients met inclusion criteria. 43 patients completed 5-year quality of life assessment (84.3% response rate). Quality of life scores at all postoperative time periods were greater than preoperative scores. Further, quality of life at 5 years is greater than that assessed 0-2 years following VHR. Most patients achieve their best quality of life in the 5-year time period. Thirty-five patients had clinical follow-up in the 5-year time period, 7 experienced recurrences (20% recurrence rate). There was no difference in 5-year quality of life assessment between those who had a recurrence and those who did not. CONCLUSION: Patient quality of life following VHR with P4HB improves immediately and continues to improve 5 years following repair. There are no differences in quality of life with onset of recurrence. Quality of life should be the primary outcome of success in VHR.
PURPOSE: Ventral hernia repair (VHR) can be augmented with biosynthetic poly-4-hydroxybutryate mesh (P4HB). Long-term outcomes, including quality of life outcomes, after VHR with P4HB mesh are not well established. Our study sought to assess these outcomes 5 years after repair. METHODS: Patients who received VHR using P4HB by the senior author between 01/2015 and 09/2017 were retrospectively identified. Patients were prospectively interviewed for quality of life assessment using the Hernia-Related Quality-of-Life Survey (HerQLes) and Abdominal Hernia-Q (AHQ) and screened for recurrence. Those who screened positive were asked to follow up in clinic to confirm recurrence. Both 5-year quality of life and recurrence were univariately assessed with patient and operative factors. RESULTS: 51 patients met inclusion criteria. 43 patients completed 5-year quality of life assessment (84.3% response rate). Quality of life scores at all postoperative time periods were greater than preoperative scores. Further, quality of life at 5 years is greater than that assessed 0-2 years following VHR. Most patients achieve their best quality of life in the 5-year time period. Thirty-five patients had clinical follow-up in the 5-year time period, 7 experienced recurrences (20% recurrence rate). There was no difference in 5-year quality of life assessment between those who had a recurrence and those who did not. CONCLUSION: Patient quality of life following VHR with P4HB improves immediately and continues to improve 5 years following repair. There are no differences in quality of life with onset of recurrence. Quality of life should be the primary outcome of success in VHR.
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