Quality of Life and Surgical Outcome 1 Year After Open and Laparoscopic Incisional Hernia Repair: PROLOVE: A Randomized Controlled Trial. Issue 2 (February 2016)

• Record Type: Journal Article
• Authors: Rogmark, Peder; Petersson, Ulf; Bringman, Sven; Ezra, Emmanuel; Österberg, Johanna; Montgomery, Agneta
• Is Part Of: Annals of surgery. Volume 263:Issue 2(2016:Feb.)
• Page Start: 244
• Page End: 250
• Publication Date: 2016-02
• Subjects: hernia recurrence -- incisional hernia repair -- outcome predictors -- randomized controlled trial -- SF-36 quality of life; Surgery -- Periodicals; 617.005
• DOI: 10.1097/SLA.0000000000001305
• Languages: English
• ISSNs: 0003-4932

Abstract

Abstract : Objective: Patients suffering from an incisional hernia after abdominal surgery have an impaired quality of life (QoL). Surgery aims to improve QoL with a minimum risk of further complications. The aim was to analyze QoL, predictors for outcome, including recurrence and reoperation rates during the first postoperative year. Methods: In a randomized controlled trial comparing laparoscopic and open mesh repair, 133 patients were assessed preoperatively and after 1 year with regard to QoL using the Short Form-36 (SF-36), visual analog scale (pain, movement limitation, and fatigue), and questions addressing abdominal wall complaints. Factors concerning recurrence, reoperations, satisfaction, and improved QoL were analyzed. Results: A total of 124 patients remained for analysis. All SF-36 scores except mental composite score increased, reaching and maintaining levels of the Swedish norm already after 8 weeks with no difference between groups. Event-free recovery was seen in 85% in the laparoscopic group and in 65% of the open cases ( P < 0.010). Five recurrences occurred after laparoscopic surgery and 1 in the open group ( P < 0.112). Overall, abdominal wall complaints decreased from 82% to 13% of the patients; and 92% were satisfied with the result after 1 year. In univariable logistic regression analyses laparoscopic surgery and male sex predicted an event-free recovery. Obesity (BMI > 30) predicted better outcome with regard to QoL. No predictors for recurrence or satisfaction were identified. Conclusions: Patients with incisional hernia benefit substantially from surgery concerning QoL, independent of surgical technique. An event-free recovery occurred frequently after laparoscopic surgery. SF-36 seems well suited for assessing surgical outcome in patients after incisional hernia repair.