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Assessment of the postoperative visit after routine inguinal hernia repair: a prospective randomized trial
Y Khan1, P Fitzgerald, M Walton
1Division of Pediatric Surgery, Children's Hospital at Chedoke-McMaster, Hamilton, Ontario, Canada.
Insights
Routine pediatric inguinal hernia repair does not require a traditional postoperative clinic visit. Providing detailed instructions and accessible follow-up care is as effective and satisfactory for patients.
Area of Science:
- Pediatric Surgery
- Surgical Outcomes
Background:
- Postoperative clinic visits are standard for pediatric inguinal hernia repair.
- The necessity of these routine visits warrants evaluation.
Purpose of the Study:
- To prospectively assess the necessity of traditional postoperative clinic visits for pediatric inguinal hernia repair.
- To compare patient satisfaction and perceived usefulness of routine visits versus detailed instructions and no visit.
Main Methods:
- A prospective study involving 100 pediatric patients undergoing routine inguinal hernia repair.
- Patients were randomized into two groups: traditional follow-up visit (FU) or detailed instruction sheet with no follow-up visit (NFU).
- Parental satisfaction and usefulness of care were assessed via telephone questionnaire.
Main Results:
- In the FU group, 68% found the visit helpful and 59% necessary; 56% would accept a phone call instead.
- In the NFU group, only 4% felt a visit was helpful or necessary, while 96% found the instruction sheet helpful.
- Overall satisfaction was identical between groups (4.7/5), with no significant difference.
Conclusions:
- Accurate postoperative instructions and open access to care are effective alternatives to traditional follow-up visits for routine pediatric inguinal hernia repair.
- This approach maintains high patient satisfaction and is a viable option for streamlining postoperative care.
Abstract:
Treatment of pediatric patients undergoing routine inguinal hernia repair usually includes a postoperative clinic visit. We prospectively assessed the necessity for the traditional postoperative visit. One hundred patients undergoing a routine inguinal hernia repair were randomly selected to receive either a follow-up visit at 4 weeks or a detailed instruction sheet and no follow-up visit. Parents were given a telephone questionnaire to determine overall satisfaction with their child's care and the usefulness of the follow-up visit or instruction sheet. Forty-seven of 50 parents of patients randomly assigned to a follow-up clinic visit (FU) and all 50 parents in the no follow-up group (NFU) completed the questionnaire. Sixty-eight percent of the FU group found the follow-up visit "helpful" and 59% found it "necessary." Fifty-six percent would have been satisfied with a telephone call instead of a visit. In the NFU group only 4% thought a follow-up visit would have been "helpful" and 4% thought a visit was "necessary." Ninety-six percent found the postoperative instruction sheet "helpful." There was no difference between groups in overall satisfaction with the care received as assessed on a 5-point scale (4.7 FU group v 4.7 NFU group). Accurate postoperative instruction and open access to follow-up when required is as effective as the traditional postoperative clinic visit for patients who have undergone routine inguinal hernia repair.