Faculty Opinions recommendation of Academic performance in adolescence after inguinal hernia repair in infancy: a nationwide cohort study.

Abstract Aim Evidence about factors influencing quality of life after inguinal hernia surgery is scarce. This study aimed to identify predictors of low Quality of Life (QoL) after open inguinal hernia repair, to guide practice and inform patients at high risk. Material and Methods Prospective multicentric cohort study including consecutive patients undergoing elective open inguinal hernia repair in Portuguese hospitals (October-December 2019). The primary outcome was Quality of Life at 3 months after surgery, using the EuraHS-QoL score (higher score correlates with lower QoL). Low QoL was defined as the higher EuraHS-QoL score tertile and multivariate logistic regression was used to identify predictors. Results 893 patients were included from 33 hospitals. The majority were men (89.9% [800/891]), had unilateral hernias 88.7% (774/872) and the most common surgical technique was Lichtenstein’s repair (52.9% [472/893]). The median QoL score was 24 (IQR 10-40) before surgery and 2 (IQR 0-10) at 3 months after surgery, showing significant improvement (p < 0.001). After adjustment, low QoL at 3 months was associated with low preoperative QoL (OR 1.76, 95% CI 1.21-2.57, p = 0.003), non-absorbable mesh fixation (OR 1.64, 95% CI 1.12-2.41, p = 0.011), severe immediate postoperative pain (OR 2.90, 95% CI 1.66-5.11, p < 0.001) and minor postoperative complications (OR 2.23, 95% CI 1.30-3.84, p = 0.004). Conclusions This study supports the use of the EuraHS-QoL score preoperatively to inform consent. Although significant improvement in QoL is expected after surgery, high scores before surgery are associated with low postoperative QoL. Caution should be taken with non-absorbable mesh fixation and immediate postoperative pain control should be optimised.

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Impact of physical workload on risk of inguinal hernia repair: a Danish national male cohort study

Occupational and Environmental Medicine ◽

10.1136/oemed-2011-100382.269 ◽

2011 ◽

Vol 68 (Suppl_1) ◽

pp. A82-A82

Author(s):

M. Vad ◽

P. Frost ◽

M. Bay-Nielsen ◽

S. W. Svendsen

Keyword(s):

Cohort Study ◽

Inguinal Hernia ◽

Hernia Repair ◽

Inguinal Hernia Repair ◽

Physical Workload ◽

Male Cohort

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Portuguese Inguinal Hernia Cohort (PINE) study

10.1101/2020.12.19.20247585 ◽

2020 ◽

Author(s):

◽

J Simões ◽

AA João ◽

JM Azevedo ◽

M Peyroteo ◽

...

Keyword(s):

Chronic Pain ◽

Cohort Study ◽

Inguinal Hernia ◽

Hernia Repair ◽

Inguinal Hernia Repair ◽

Collaborative Research ◽

Research Network ◽

Hernia Surgery ◽

Inguinal Pain ◽

Chronic Postoperative Inguinal Pain

AbstractPurposeRecent comprehensive guidelines have been published on the management of inguinal hernia. Contrary to other European countries, no Portuguese hernia registry exists. This represents an opportunity to assess outcomes of hernia surgery in the Portuguese population. The primary aim is to define the prevalence of chronic pain after elective inguinal hernia repair. The secondary aims are to identify risk factors for chronic pain after elective inguinal hernia repair, to characterise the management of elective inguinal hernia in public Portuguese hospitals.MethodsProspective national cohort study of patients submitted to elective inguinal hernia repair. The primary outcome is the prevalence of chronic postoperative inguinal pain, according to the EuraHS QoL questionnaire at 3 months postoperatively. The study will be delivered in all Portuguese regions through a collaborative research network. Four 2-week inclusion periods will be open for recruitment. A site-specific questionnaire will capture procedure volume and logistical facilities for hernia surgery.ConclusionThis protocol describes the methodology of a prospective cohort study on the elective management of inguinal hernia. It discusses key challenges and describes how the results will impact future investigation. The study will be conducted across a nationwide collaborative research network, with prospective quality assurance and data validation strategies. It will provide the basis for a more accurate prediction of chronic postoperative inguinal pain and the research on adequate patient selection strategies for surgery and therapeutic strategies for postoperative pain.

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Academic Performance in Adolescence after Inguinal Hernia Repair in Infancy

Anesthesiology ◽

10.1097/aln.0b013e31820e77a0 ◽

2011 ◽

Vol 114 (5) ◽

pp. 1076-1085 ◽

Cited By ~ 211

Author(s):

Tom G. Hansen ◽

Jacob K. Pedersen ◽

Steen W. Henneberg ◽

Dorthe A. Pedersen ◽

Jeffrey C. Murray ◽

...

Keyword(s):

Academic Performance ◽

Inguinal Hernia ◽

Hernia Repair ◽

Inguinal Hernia Repair ◽

Test Scores ◽

Odds Ratio ◽

Test Score ◽

Population Sample ◽

Exposure Group ◽

Significant Difference

Background Although animal studies have indicated that general anesthetics may result in widespread apoptotic neurodegeneration and neurocognitive impairment in the developing brain, results from human studies are scarce. We investigated the association between exposure to surgery and anesthesia for inguinal hernia repair in infancy and subsequent academic performance. Methods Using Danish birth cohorts from 1986-1990, we compared the academic performance of all children who had undergone inguinal hernia repair in infancy to a randomly selected, age-matched 5% population sample. Primary analysis compared average test scores at ninth grade adjusting for sex, birth weight, and paternal and maternal age and education. Secondary analysis compared the proportions of children not attaining test scores between the two groups. Results From 1986-1990 in Denmark, 2,689 children underwent inguinal hernia repair in infancy. A randomly selected, age-matched 5% population sample consists of 14,575 individuals. Although the exposure group performed worse than the control group (average score 0.26 lower; 95% CI, 0.21-0.31), after adjusting for known confounders, no statistically significant difference (-0.04; 95% CI, -0.09 to 0.01) between the exposure and control groups could be demonstrated. However, the odds ratio for test score nonattainment associated with inguinal hernia repair was 1.18 (95% CI, 1.04-1.35). Excluding from analyses children with other congenital malformations, the difference in mean test scores remained nearly unchanged (0.05; 95% CI, 0.00-0.11). In addition, the increased proportion of test score nonattainment within the exposure group was attenuated (odds ratio = 1.13; 95% CI, 0.98-1.31). Conclusion In the ethnically and socioeconomically homogeneous Danish population, we found no evidence that a single, relatively brief anesthetic exposure in connection with hernia repair in infancy reduced academic performance at age 15 or 16 yr after adjusting for known confounding factors. However, the higher test score nonattainment rate among the hernia group could suggest that a subgroup of these children are developmentally disadvantaged compared with the background population.

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