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Patient-centered outcomes following laparoscopic inguinal hernia repair.

AbstractBACKGROUND:
Inguinal hernia repair is the most common surgery in the world. Health-related quality of life (HRQOL) outcomes are arguably the most important elements of successful repair. This study is aimed to describe short- and long-term quality of life outcomes in patients undergoing laparoscopic inguinal hernia repair.
METHODS:
We prospectively followed patients who underwent totally extraperitoneal laparoscopic inguinal hernia repair (TEP) as part of an Institutional Review Board-approved study. HRQOL was measured preoperatively, or 3 weeks, 6 months, and 1 year postoperatively using Short Form 36 Health Survey Version 2 (SF-36v2) and Carolinas Comfort Scale. Postoperative HRQOL scores were compared to baseline using paired t tests.
RESULTS:
Between June 2009 and February 2014, 1,175 patients underwent TEP by four surgeons. Of those, 301 patients with 388 hernias were registered in the database and followed by a research coordinator. Mean age was 56.4 ± 15.2 years and 93% were male. Mean body mass index was 26.1 ± 3.7 kg/m(2). Seventy-eight percent presented with pain, the majority of which were described as mild. Hernias were unilateral right-sided in 43%, left-sided in 28%, and bilateral in 29 %. Eighty-five percent were primary hernias. Average operative time was 43.5 ± 17.9 min and there were no intraoperative complications. Urinary retention occurred in 6%. Visual analog scale at discharge was 1.9 ± 1.7. Analgesics were used an average of 2.5 ± 3.4 days and return to activities of daily living and work occurred on postoperative 5.5 ± 4.4 and 5.6 ± 3.9 days. Recurrence occurred in 2.1%. Significant improvements between baseline and 1 year were found in role limitations due to physical health (81.5 ± 25.6 vs. 91.8 ± 19.4, p = 0.02), social functioning (87.4 ± 21.3 vs. 92.9 ± 15.3, p = 0.02), and pain (78.2 ± 19.7 vs. 86.6 ± 15.9, p = 0.007).
CONCLUSIONS:
TEP results in significant improvement in HRQOL including physical health, social functioning, and pain at 1 year. On average, patients are able to return to activities of daily living and work within a week.
AuthorsMichael B Ujiki, Matthew E Gitelis, Joann Carbray, Brittany Lapin, John Linn, Steven Haggerty, Chi Wang, Ryota Tanaka, Ermilo Barrera, Zeeshan Butt, Woody Denham
JournalSurgical endoscopy (Surg Endosc) Vol. 29 Issue 9 Pg. 2512-9 (Sep 2015) ISSN: 1432-2218 [Electronic] Germany
PMID25480626 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)

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