Patient-reported outcomes after incisional hernia repair

Abstract Purpose Patient-reported outcomes (PROs) are pivotal to evaluate the efficacy of surgical management. Debate persists on the optimal surgical technique to repair incisional hernias. Assessment of PROs can guide the selection of the best management of patients with incisional hernias. The objective of this cohort study was to present the PROs after incisional hernia repair at long term follow-up. Methods Patients with a history of incisional hernia repair were seen at the out-patient clinic to collect PROs. Patients were asked about the preoperative indication for repair and postoperative symptoms, such as pain, feelings of discomfort, and bulging of the abdominal wall. Additionally, degree of satisfaction was asked and Carolina Comfort Scales were completed. Results Two hundred and ten patients after incisional hernia repair were included with a median follow-up of 3.2 years. The main indication for incisional hernia repair was the presence of a bulge (60%). Other main reasons for repair were pain (19%) or discomfort (5%). One hundred and thirty-two patients (63%) reported that the overall status of their abdominal wall had improved after the operation. Postoperative symptoms were reported by 133 patients (63%), such as feelings of discomfort, pain and bulging. Twenty percent of patients reported that the overall status of their abdominal wall was the same, and 17% reported a worse status, compared to before the operation. Ten percent of the patients would not opt for operation in hindsight. Conclusion This study showed that a majority of the patients after incisional hernia repair still report pain or symptoms such as feelings of discomfort, pain, and bulging of the abdominal wall 3 years after surgery. Embedding patients’ expectations and PROs in the preoperative counseling discussion is needed to improve decision-making in incisional hernia surgery.

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Patient reported outcomes after incisional hernia repair—establishing the ventral hernia recurrence inventory

The American Journal of Surgery ◽

10.1016/j.amjsurg.2015.06.007 ◽

2016 ◽

Vol 212 (1) ◽

pp. 81-88 ◽

Cited By ~ 60

Author(s):

Rebeccah B. Baucom ◽

Jenny Ousley ◽

Irene D. Feurer ◽

Gloria B. Beveridge ◽

Richard A. Pierce ◽

...

Keyword(s):

Incisional Hernia ◽

Hernia Repair ◽

Ventral Hernia ◽

Patient Reported Outcomes ◽

Incisional Hernia Repair ◽

Hernia Recurrence ◽

Patient Reported

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Early Clinical and Patient-Reported Outcomes of a New Hybrid Mesh for Incisional Hernia Repair

Journal of Surgical Research ◽

10.1016/j.jss.2021.03.030 ◽

2021 ◽

Vol 265 ◽

pp. 49-59

Author(s):

Arturo J. Rios-Diaz ◽

Michaela Hitchner ◽

Adrienne N. Christopher ◽

Robyn Broach ◽

Jessica R. Cunning ◽

...

Keyword(s):

Incisional Hernia ◽

Hernia Repair ◽

Patient Reported Outcomes ◽

Incisional Hernia Repair ◽

Hybrid Mesh ◽

Patient Reported

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Incisional hernia repair surgery improves patient reported outcomes

The American Journal of Surgery ◽

10.1016/j.amjsurg.2020.03.027 ◽

2020 ◽

Vol 219 (5) ◽

pp. 874-878

Author(s):

Shiana Manoharan ◽

Guiping Liu ◽

R. Trafford Crump ◽

Ahmer A. Karimuddin ◽

Tracy M. Scott ◽

...

Keyword(s):

Incisional Hernia ◽

Hernia Repair ◽

Patient Reported Outcomes ◽

Incisional Hernia Repair ◽

Patient Reported

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P088 SURGEON AS A RISK FACTOR OF REDUCED EURAHS QOL SCORE AFTER HERNIA REPAIR

British Journal of Surgery ◽

10.1093/bjs/znab395.082 ◽

2021 ◽

Vol 108 (Supplement_8) ◽

Author(s):

Jakub Woleský ◽

Barbora Jíšová ◽

Barbora East

Keyword(s):

Incisional Hernia ◽

Hernia Repair ◽

Internal Audit ◽

Major Complication ◽

Incisional Hernia Repair ◽

Hernia Surgery ◽

Post Surgery ◽

Before And After

Abstract Aim Our aim was to analyze patient’s reported EuraHS QoL (quality of life) scores before and after hernia surgery. And find whether the result is surgeon dependent or not, because hernia repair often serves as a training surgery for young surgeons or is performed by surgeons with no hernia interest. However, even a simple groin hernia repair can lead to life-long pain or reduced QoL and the risk of complications following incisional hernia repair is much higher. Material and Methods We have utilized the EuraHS database and its QoL questionnaire and prospectively entered all patients undergoing any hernia repair at our department since Jan. 2019. Results 519 patients have been included. Many patients in the incisional hernia cohort have reported no or very little symptoms before the operation. Only 251 have completed their 1 month follow-up with the QoL questionnaire. 63 patients have been contacted and questioned 1 year post-surgery to this date. In 6 cases the QoL scores are lower than pre-repair. 45 patients had a record of major complication or reoccurrence requiring surgery so far. Unfortunately 31 of those did not fill up the QoL questionnaire. 37 were operated on by resident with a supervision of a surgeon without a hernia interest. Conclusions Results of hernia repair are surgeon dependent and an internal audit of current practices is needed at many general surgery departments.

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QS39. Patient-Reported Outcomes After Incisional Hernia Repair: What Matters to the Patient?

Journal of Surgical Research ◽

10.1016/j.jss.2008.11.331 ◽

2009 ◽

Vol 151 (2) ◽

pp. 283-284

Author(s):

C.W. Snyder ◽

C.C. Vick ◽

M.T. Hawn

Keyword(s):

Incisional Hernia ◽

Hernia Repair ◽

Patient Reported Outcomes ◽

Incisional Hernia Repair ◽

Patient Reported ◽

What Matters

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Modified Peritoneal Flap Hernioplasty Versus Retromuscular Technique for Incisional Hernia Repair: a Retrospective Cohort Study

Scandinavian Journal of Surgery ◽

10.1177/1457496919863943 ◽

2019 ◽

Vol 109 (4) ◽

pp. 279-288 ◽

Cited By ~ 1

Author(s):

P. Petersson ◽

A. Montgomery ◽

U. Petersson

Keyword(s):

Cohort Study ◽

Incisional Hernia ◽

Hernia Repair ◽

Abdominal Wall ◽

Incisional Hernia Repair ◽

Hernia Recurrence ◽

Short Term ◽

Peritoneal Flap ◽

Incisional Hernia Recurrence

Background and Aims: We present an open retromuscular mesh technique for incisional hernia repair, the modified peritoneal flap hernioplasty, where the fascia is sutured to the mesh and the hernia sac utilized for anterior mesh coverage. The aim was to describe the modified peritoneal flap hernioplasty technique and to compare it to a retromuscular repair, without component separation, regarding short-term complications, patient satisfaction, abdominal wall complaints, and recurrent incisional hernia. Materials and Methods: Consecutive patients operated electively with modified peritoneal flap hernioplasty technique (December 2012–December 2015) or retromuscular technique (Jan 2011–Oct 2014) were included in a retrospective single-center cohort study. Outcomes were evaluated from the Swedish Ventral Hernia Registry, by chart review, physical examination, and an abdominal wall complaints questionnaire. Results: The modified peritoneal flap hernioplasty group ( n = 78) had larger hernias (mean width 10.4 vs 8.5 cm, p = 0.005), more advanced Centers for Disease Control classification ( p = 0.009), and more simultaneous gastrointestinal-tract surgery (23.1% vs 11.5%, p = 0.041) than the retromuscular group ( n = 96). No difference in short-term complications was seen. Incisional hernia recurrence was lower in the modified peritoneal flap hernioplasty group (1.4% vs 10.3%, p = 0.023), and patients were more satisfied (93.8% vs 81.7%, p = 0.032). Follow-up time was shorter in the modified peritoneal flap hernioplasty group (614 vs 1171 days, p < 0.001). Conclusion: This retrospective study showed similar rates of short-term complications, despite more complex hernias in the modified peritoneal flap hernioplasty group. Furthermore, a lower incisional hernia recurrence rate for the modified peritoneal flap hernioplasty technique compared with the retromuscular technique used in our department was found. If this holds true with equally long follow-up remains to be proven.

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Outcomes of open intraperitoneal incisional hernia repair based on patient-reported outcomes

Hernia ◽

10.1007/s10029-012-1041-z ◽

2013 ◽

Vol 18 (1) ◽

pp. 47-55 ◽

Cited By ~ 2

Author(s):

M. A. Beltrán ◽

M.-P. Rioseco ◽

M. Molina ◽

A. Vera ◽

F. R. Arcos

Keyword(s):

Incisional Hernia ◽

Hernia Repair ◽

Patient Reported Outcomes ◽

Incisional Hernia Repair ◽

Patient Reported

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Female Gender and Diabetes Mellitus Increase the Risk of Recurrence after Laparoscopic Incisional Hernia Repair

Annals of The Royal College of Surgeons of England ◽

10.1308/003588414x14055925058751 ◽

2015 ◽

Vol 97 (2) ◽

pp. 115-119 ◽

Cited By ~ 10

Author(s):

ST Hornby ◽

FD McDermott ◽

M Coleman ◽

Z Ahmed ◽

J Bunni ◽

...

Keyword(s):

Diabetes Mellitus ◽

Logistic Regression ◽

Incisional Hernia ◽

Hernia Repair ◽

Incisional Hernia Repair ◽

Risk Of Recurrence ◽

Incisional Hernias ◽

Laparoscopic Incisional Hernia Repair ◽

Increased Risk

Background Laparoscopic hernia repair is used widely for the repair of incisional hernias. Few case studies have focussed on purely ‘incisional’ hernias. This multicentre series represents a collaborative effort and employed statistical analyses to provide insight into the factors predisposing to recurrence of incisional hernia after laparoscopic repair. A specific hypothesis (ie, laterality of hernias as well as proximity to the xyphoid process and pubic symphysis predisposes to recurrence) was also tested. Methods This was a retrospective study of all laparoscopic incisional hernias undertaken in six centres from 1 January 2004 to 31 December 2010. It comprised a comprehensive review of case notes and a follow-up using a structured telephone questionnaire. Patient demographics, previous medical/surgical history, surgical procedure, postoperative recovery, and perceived effect on quality of life were recorded. Repairs undertaken for primary ventral hernias were excluded. A logistic regression analysis was then fitted with recurrence as the primary outcome. Results A total of 186 cases (91 females) were identified. Median follow-up was 42 months. Telephone interviews were answered by 115/186 (62%) of subjects. Logistic regression analyses suggested that only female sex (odds ratio (OR) 3.53; 95% confidence interval (CI) 1.39–8.97) and diabetes mellitus (3.54; 1–12.56) significantly increased the risk of recurrence. Position of the defect had no statistical effect. Conclusions These data suggest an increased risk of recurrence after laparoscopic incisional hernia repair in females and subjects with diabetes mellitus. These data will help inform surgeons and patients when considering laparoscopic management of incisional hernias. We recommend a centrally hosted, prospectively maintained national/international database to carry out additional research.

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