Understanding the patient perspective after ventral hernia repair

Lee, Ting-Hsuan; Ulisney, K.L.; Choudhuri, A.; Swiger, J. L.; Gibeily, George

doi:10.1007/s10029-019-02015-6

Cited by 12 publications

(11 citation statements)

References 11 publications

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“…Patient QoL has been reported to be severely affected by IH and IH repair [18,19]. When assessed using the Hernia-related Qualityof-life Assessment Tool (HerQLes), patients reported effects on QoL including chronic pain, interference with daily activities and an impact on social and sexual activities [18]. This study has several strengths and limitations relating to the French PMSI database.…”

Section: Discussionmentioning

confidence: 99%

“…Patient QoL has been reported to be severely affected by IH and IH repair [18,19]. When assessed using the Hernia-related Qualityof-life Assessment Tool (HerQLes), patients reported effects on QoL including chronic pain, interference with daily activities and an impact on social and sexual activities [18]. Although we did not carry out a cost analysis of the IH repairs described in this study, the PMSI database contains sufficient data on the healthcare pathway of laparotomy patients at risk of IH to support a health economics study of IH repair in the future.…”

Section: Discussionmentioning

confidence: 99%

“…Mesh repair was an independent protective factor for IH recurrence [1,16,17]. Repeated IH repairs are generally more complicated and can lead to poor quality of life (QoL) [18,19] and a vicious cycle of complications and costs [20,21] as IH occurrence and recurrence after laparotomy involve significant direct and indirect medical costs. The median direct cost of IH repair was estimated by Alli et al in 2018 [21] to be USD 20 000, and Gillion et al reported a mean total cost of IH repair in France in 2011 of EUR 6451, ranging from EUR 4731 for unemployed individuals to EUR 10 107 for employed patients [22].…”

Section: Introductionmentioning

confidence: 99%

“…Mesh repair was an independent protective factor for IH recurrence [1,16,17]. Repeated IH repairs are generally more complicated and can lead to poor quality of life (QoL) [18,19] and a vicious cycle of complications and costs [20,21] Based on data extracted from the PMSI database, the present retrospective study aimed to assess the rate of IH repair after laparotomy in a large cohort of patients. In addition to defining the rate of IH repair, we hope to generate new information on the profiles of patients at risk, the impact of surgery type and comorbidities, the time to IH repair and recurrence rates.…”

Section: Introductionmentioning

confidence: 99%

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Incidence and risk factors for incisional hernia and recurrence: Retrospective analysis of the French national database

Gignoux¹,

Bayon

Martin

et al. 2021

Colorectal Disease

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The aim of this work was to determine the rate of incisional hernia (IH) repair and risk factors for IH repair after laparotomy. Method: This population-based study used data extracted from the French Programme de Médicalisation des Systèmes d'Informations (PMSI) database. All patients who had undergone a laparotomy in 2010, their hospital visits from 2010 to 2015 and patients who underwent a first IH repair in 2013 were included. Previously identified risk factors included age, gender, high blood pressure (HBP), obesity, diabetes and chronic obstructive pulmonary disease (COPD).Results: Among the 431 619 patients who underwent a laparotomy in 2010, 5% underwent IH repair between 2010 and 2015. A high-risk list of the most frequent surgical procedures (>100) with a significant risk of IH repair (>10% at 5 years) was established and included 71 863 patients (17%; 65 procedures). The overall IH repair rate from this list was 17%. Gastrointestinal (GI) surgery represented 89% of procedures, with the majority of patients (72%) undergoing lower GI tract surgery. The IH repair rate was 56% at 1 year and 79% at 2 years. Risk factors for IH repair included obesity (31% vs 15% without obesity, p < 0.001), COPD (20% vs 16% without COPD), HBP (19% vs 15% without HBP) and diabetes (19% vs 16% without diabetes). Obesity was the main risk factor for recurrence after IH repair (19% vs 13%, p < 0.001). Conclusion:From the PMSI database, the real rate of IH repair after laparotomy was 5%, increasing to 17% after digestive surgery. Obesity was the main risk factor, with an IH repair rate of 31% after digestive surgery. Because of the important medico-economic consequences, prevention of IH after laparotomy in high-risk patients should be considered.

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Section: Discussionmentioning

confidence: 99%

“…Patient QoL has been reported to be severely affected by IH and IH repair [18,19]. When assessed using the Hernia-related Qualityof-life Assessment Tool (HerQLes), patients reported effects on QoL including chronic pain, interference with daily activities and an impact on social and sexual activities [18]. Although we did not carry out a cost analysis of the IH repairs described in this study, the PMSI database contains sufficient data on the healthcare pathway of laparotomy patients at risk of IH to support a health economics study of IH repair in the future.…”

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

“…Mesh repair was an independent protective factor for IH recurrence [1,16,17]. Repeated IH repairs are generally more complicated and can lead to poor quality of life (QoL) [18,19] and a vicious cycle of complications and costs [20,21] Based on data extracted from the PMSI database, the present retrospective study aimed to assess the rate of IH repair after laparotomy in a large cohort of patients. In addition to defining the rate of IH repair, we hope to generate new information on the profiles of patients at risk, the impact of surgery type and comorbidities, the time to IH repair and recurrence rates.…”

Section: Introductionmentioning

confidence: 99%

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Incidence and risk factors for incisional hernia and recurrence: Retrospective analysis of the French national database

Gignoux¹,

Bayon

Martin

et al. 2021

Colorectal Disease

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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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Effect of Hernia Mesh Weights on Postoperative Patient-Related and Clinical Outcomes After Open Ventral Hernia Repair

et al. 2021

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IMPORTANCEAlthough multiple versions of polypropylene mesh devices are currently available on the market for hernia repair, few comparisons exist to guide surgeons as to which device may be preferable for certain indications. Mesh density is believed to impact patient outcomes, including rates of chronic pain and perception of mesh in the abdominal wall.OBJECTIVE To examine whether medium-weight polypropylene is associated with less pain at 1 year compared with heavy-weight mesh. DESIGN, SETTING, AND PARTICIPANTS This multicenter randomized clinical trial was performed from March 14, 2017, to April 17, 2019, with 1-year follow-up. Patients undergoing clean, open ventral hernia repairs with a width 20 cm or less were studied. Patients were blinded to the intervention. INTERVENTIONS Patients were randomized to receive medium-weight or heavy-weight polypropylene mesh during open ventral hernia repair. MAIN OUTCOMES AND MEASURES The primary outcome was pain measured with the National Institutes of Health (NIH) Patient-Reported Outcomes Measurement Information System (PROMIS) Pain Intensity Short Form 3a. Secondary outcomes included quality of life and pain measured at 30 days, quality of life measured at 1 year, 30-day postoperative morbidity, and 1-year hernia recurrence. RESULTS A total of 350 patients participated in the study, with 173 randomized to receive heavy-weight polypropylene mesh (84 [48.6%] female; mean [SD] age, 59.2 [11.4] years) and 177 randomized to receive medium-weight polypropylene mesh (91 [51.4%] female; mean [SD] age, 59.3 [11.4] years). No significant differences were found in demographic characteristics (mean [SD] body mass index of 32.0 [5.4] in both groups [calculated as weight in kilograms divided by height in meters squared] and American Society of Anesthesiologists classes of 2-4 in both groups), comorbidities (122 [70.5%] vs 93 [52.5%] with hypertension, 44 [25.4%] vs 43 [24.3%] with diabetes, 17 [9.8%] vs 12 [6.8%] with chronic obstructive pulmonary disease), or operative characteristics (modified hernia grade of 2 in 130 [75.1] vs 140 [79.1] in the heavy-weight vs medium-weight mesh groups). Pain scores for patients in the heavy-weight vs medium-weight mesh groups at 30 days (46.3 vs 46.3, P = .89) and 1 year (30.7 vs 30.7, P = .59) were identical. No significant differences in quality of life (median [interquartile range] hernia-specific quality of life score at 1 year of 90.0 [67.9-96.7] vs 86.7 [65.0-93.3]; median [interquartile range] hernia-specific quality of life score at 30 days, 45.0 [24.6-73.8] vs 43.3 [28.3-65.0]) were found for the heavy-weight mesh vs medium-weight mesh groups. Composite 1-year recurrence rates for patients in the heavy-weight vs medium-weight polypropylene groups were similar (8% vs 7%, P = .79).CONCLUSIONS AND RELEVANCE Medium-weight polypropylene did not demonstrate any patient-perceived or clinical benefit over heavy-weight polypropylene after open retromuscular ventral hernia repair. Long-term follow-up of these comparable groups will elucidate a...

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Understanding the patient perspective after ventral hernia repair

Cited by 12 publications

References 11 publications

Incidence and risk factors for incisional hernia and recurrence: Retrospective analysis of the French national database

Incidence and risk factors for incisional hernia and recurrence: Retrospective analysis of the French national database

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

Effect of Hernia Mesh Weights on Postoperative Patient-Related and Clinical Outcomes After Open Ventral Hernia Repair

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