Abstract
PurposePatient-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.MethodsPatients 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.ResultsTwo 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.ConclusionThis 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.
Highlights
Patients who develop incisional hernias have a reduced overall quality of life (QoL) because of the impact of incisional hernias on physical functioning and role functioning [1, 2]
This study showed that 63% of patients reported symptoms 3 years after incisional hernia repair
The outcomes of this study show the relevance of evaluating Patient-reported outcomes (PROs) after incisional hernia repair, rendering the need of integrating patients’ expectations in the preoperative counseling discussion
Summary
Patients who develop incisional hernias have a reduced overall quality of life (QoL) because of the impact of incisional hernias on physical functioning and role functioning [1, 2]. 73–80% of patients require surgical repair [2, 3]. Reported success rates for incisional hernia repair vary considerably, depending on the primary outcome and the definition of a ‘successful’ incisional hernia repair. Whereas surgery-specific outcomes such as recurrence and complication rates are improving, a significant proportion of incisional hernia repairs are performed for symptom relief and to improve the QoL of the patient. The focus in hernia research has shifted from surgical outcomes, such as recurrences and complications, to patient-centered outcomes. Outcomes such as chronic pain and QoL are frequently used as primary
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