Underserved Patients Seeking Care for Ventral Hernias at a Safety Net Hospital: Impact on Quality of Life and Expectations of Treatment

Alawadi, Zeinab M.; Leal, Isabel; Flores, Juan R.; Holihan, Julie L.; Henchcliffe, Blake E.; Mitchell, Thomas; Ko, Tien C.; Liang, Mike K.; Kao, Lillian S.

doi:10.1016/j.jamcollsurg.2016.09.017

Cited by 10 publications

(4 citation statements)

References 45 publications

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“…We obtained baseline demographic information from patients who agreed to participate in the study through a full medical history and standardized physical examination during preoperative clinic appointments. Before the start of this randomized controlled trial, we did qualitative research directed at identifying and understanding what factors patients consider to be important during decision making related to the management of their ventral hernias 56. Among the factors outlined by patients, quality of life and pain were considered the most important variables within their expectations.…”

Section: Methodsmentioning

confidence: 99%

“…Before the start of this randomized controlled trial, we did qualitative research directed at identifying and understanding what factors patients consider to be important during decision making related to the management of their ventral hernias. 5 6 Among the factors outlined by patients, quality of life and pain were considered the most important variables within their expectations. During our study, patient centered outcomes including abdominal wall quality of life and pain scores were obtained preoperatively and one month postoperatively.…”

Section: Methodsmentioning

confidence: 99%

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Robotic versus laparoscopic ventral hernia repair: multicenter, blinded randomized controlled trial

Olavarria

Bernardi

Shah

et al. 2020

BMJ

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ObjectiveTo determine whether robotic ventral hernia repair is associated with fewer days in the hospital 90 days after surgery compared with laparoscopic repair.DesignPragmatic, blinded randomized controlled trial.SettingMultidisciplinary hernia clinics in Houston, USA.Participants124 patients, deemed appropriate candidates for elective minimally invasive ventral hernia repair, consecutively presenting from April 2018 to February 2019.InterventionsRobotic ventral hernia repair (n=65) versus laparoscopic ventral hernia repair (n=59).Main outcome measuresThe primary outcome was number of days in hospital within 90 days after surgery. Secondary outcomes included emergency department visits, operating room time, wound complications, hernia recurrence, reoperation, abdominal wall quality of life, and costs from the healthcare system perspective. Outcomes were pre-specified before data collection began and analyzed as intention to treat.ResultsPatients from both groups were similar at baseline. Ninety day follow-up was completed in 123 (99%) patients. No evidence was seen of a difference in days in hospital between the two groups (median 0 v 0 days; relative rate 0.90, 95% confidence interval 0.37 to 2.19; P=0.82). For secondary outcomes, no differences were noted in emergency department visits, wound complications, hernia recurrence, or reoperation. However, robotic repair had longer operative duration (141 v 77 min; mean difference 62.89, 45.75 to 80.01; P≤0.001) and increased healthcare costs ($15 865 (£12 746; €14 125) v $12 955; cost ratio 1.21, 1.07 to 1.38; adjusted absolute cost difference $2767, $910 to $4626; P=0.004). Among patients with robotic ventral hernia repair, two had an enterotomy compared none with laparoscopic repair. The median one month postoperative improvement in abdominal wall quality of life was 3 with robotic ventral hernia repair compared with 15 following laparoscopic repair.ConclusionThis study found no evidence of a difference in 90 day postoperative hospital days between robotic and laparoscopic ventral hernia repair. However, robotic repair increased operative duration and healthcare costs.Trial registrationClinicaltrials.gov NCT03490266.

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Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Robotic versus laparoscopic ventral hernia repair: multicenter, blinded randomized controlled trial

Olavarria

Bernardi

Shah

et al. 2020

BMJ

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“…However, there is a lack of research or knowledge about what is important or critical to our patients? Two recent studies exploring some of these issues in ventral hernia repair recruited only 22 and 30 patients, respectively, in single centres, making their generalisability less clear cut (4,5).…”

Section: Introductionmentioning

confidence: 99%

Patient Views Around Their Hernia Surgery: A Worldwide Online Survey Promoted Through Social Media

East

Hill²,

Dames³

et al. 2021

Front. Surg.

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Introduction: Hernias are one of the most common surgical diagnoses, and general surgical operations are performed. The involvement of patients in the decision making can be limited. The aim of this study was to explore the perspectives of patients around their hernia and its management, to aid future planning of hernia services to maximise patient experience, and good outcomes for the patient.Methods: A SurveyMonkey questionnaire was developed by patient advocates with some advice from surgeons. It was promoted on Twitter and Facebook, such as all found “hernia help” groups on these platforms over a 6-week period during the summer of 2020. Demographics, the reasons for seeking a hernia repair, decision making around the choice of surgeon, hospital, mesh type, pre-habilitation, complications, and participation in a hernia registry were collected.Results: In total, 397 questionnaires were completed in the study period. The majority of cases were from English speaking countries. There was a strong request for hernia specialists to perform the surgery, to have detailed knowledge about all aspects of hernia disease and its management, such as no operation and non-mesh options. Chronic pain was the most feared complication. The desire for knowledge about the effect of the hernia and surgery on the sexual function in all age groups was a notable finding. Pre-habilitation and a hernia registry participation were well-supported.Conclusions: Hernia repair is a quality of life surgery. Whether awaiting surgery or having had surgery with a good or bad outcome, patients want information about their condition and treatment, such as the effect on aspects of life, such as sex, and they wish greater involvement in their management decisions. Patients want their surgery by surgeons who can also manage complications of such surgery or recommend further treatment. A large group of “hernia surgery injured” patients feel abandoned by their general surgeon when complications ensue.

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“…Иммунологическая реактивность организма на различные по структуре, толщине, жесткости и химической структуре эндопротезы является наиболее актуальным вопросом современной герниологии. Игнорирование этих свойств в контексте течения раневого процесса может сделать сомнительной и неоднозначной оценку результата лечения [5,6].…”

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Dynamics of Immune Reactions in Auto and Alloplastic Methods of Hernioplasty in Surgical Treatment of Inguinal Hernia

Aytiev¹,

Ashimov²,

Dinlosan³

et al. 2021

IJAFR (МЖПФИ)

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В статье приводится анализ динамики иммунологической реактивности у больных двух клинических групп, в которые включены 40 пациентов с паховыми грыжами, которым произведены ауто-и аллопластический метод герниопластики при паховых грыжах. Динамика иммунологической реактивности была изучена при помощи определения уровня субпопуляции лимфоцитов с рецепторами CD3, CD4, CD8, CD20, интерлейкин 6, интерлейкин 10, иммуноглобулины A, M, G. В ходе сравнения полученных результатов исследования отмечено, что в группе аллопластических методов герниопластики в послеоперационном периоде достоверно отличались от исходного в сторону незначительного повышения. Содержание лейкоцитов составило 4,

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Underserved Patients Seeking Care for Ventral Hernias at a Safety Net Hospital: Impact on Quality of Life and Expectations of Treatment

Cited by 10 publications

References 45 publications

Robotic versus laparoscopic ventral hernia repair: multicenter, blinded randomized controlled trial

Robotic versus laparoscopic ventral hernia repair: multicenter, blinded randomized controlled trial

Patient Views Around Their Hernia Surgery: A Worldwide Online Survey Promoted Through Social Media

Dynamics of Immune Reactions in Auto and Alloplastic Methods of Hernioplasty in Surgical Treatment of Inguinal Hernia

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