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Follow-up after laparoscopic inguinal hernia repair, can it be done by phone? A prospective study in 300 patients,
Baukje van den Heuvel1, J A van Jarwaarde2, P Wichers2
1General Surgery, Slotervaart Hospital, Louwesweg 6, 1066 EC, Amsterdam, The Netherlands. baukjevdh@yahoo.com.
Background:
The most important long-term complications after inguinal hernia repair are chronic pain and recurrence. Previous follow-up studies showed that physical examination is the only reliable method of follow-up to detect recurrences. However, physical examination is laborious and time consuming. We designed a telephone questionnaire as a method of follow-up after laparoscopic inguinal hernia surgery; the PINQ-PHONE (Post-INguinal-repair-Questionnaire by telePHONE). The aim of this study is to validate the PINQ-PHONE for detecting both asymptomatic and symptomatic recurrences.
Methods:
This prospective study contained 300 randomly selected patients after laparoscopic inguinal hernia repair. All patients were contacted by telephone and the PINQ-PHONE was carried out. The PINQ-PHONE contains four elements; three questions and a do-it-yourself Valsalva maneuvre. Subsequently, all patients were seen in clinic and physical examination (gold standard) was done.
Results:
The majority (96 %) was male and the mean age was 66 (range 26-93) years old. The mean interval between surgery and study inclusion was 58 (range 6-141) months. In five (1.7 %) patients, a recurrence was found. All of them replied positively to one or more elements of the PINQ-PHONE. Two-hundred-fifty-two (84 %) patients replied negatively to all elements and none of them had a recurrence. The overall sensitivity was 1.00 and the overall specificity was 0.86.
Conclusion:
This study validated the PINQ-PHONE. It is a reliable, practical, and simple method of follow-up after laparoscopic inguinal hernia repair to detect both symptomatic and asymptomatic recurrences.
