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Patient-reported outcomes after inguinal herniorrhaphy.
Mary T Hawn1, Kamal M Itani, Anita Giobbie-Hurder
1Deep South Center for Effectiveness Research, Birmingham VA Medical Center and Department of Surgery, University of Alabama, Birmingham, AL, USA.
Surgery
|August 15, 2006
Summary
Postoperative neuralgia significantly impacts patient-reported outcomes after inguinal hernia repair. Recurrence also affects pain and activity, with open repair showing higher pain post-recurrence.
Area of Science:
- Surgical outcomes research
- Patient-reported health metrics
- Hernia repair effectiveness
Background:
- Patient-reported outcomes (PRO) assess functional results of inguinal herniorrhaphy.
- Investigated impact of hernia recurrence and complications on PRO in a large trial.
Purpose of the Study:
- To evaluate how hernia recurrence and specific complications affect patient-reported outcomes after open or laparoscopic inguinal hernia repair.
Main Methods:
- Utilized Medical Outcomes Study Short Form 36, Surgical Pain Scale, Activities Assessment Scale, and patient satisfaction surveys.
- Analyzed recurrence and complication data (hematoma/seroma, orchitis, neuralgia, other) using regression models.
Main Results:
- Neuralgia adversely affected all PRO (P < .0005); recurrence impacted pain, activity, and satisfaction (P < .05).
- Recurrence after open repair led to more pain than after laparoscopic repair (P = .0001).
- Other complications post-laparoscopic repair resulted in more pain and less activity compared to open repair.
Conclusions:
- Inguinal herniorrhaphy effectiveness should incorporate recurrence and neuralgia rates.
- Postoperative neuralgias significantly impair all patient-reported outcomes.