Health-related quality of life after ventral hernia repair with biologic and synthetic mesh

AT Nissen, D Henn, S Moshrefi, D Gupta… - Annals of plastic …, 2019 - journals.lww.com
AT Nissen, D Henn, S Moshrefi, D Gupta, R Nazerali, GK Lee
Annals of plastic surgery, 2019journals.lww.com
Background Quality of life (QOL) is an important outcome measure after ventral hernia repair
(VHR). The Hernia-Related QOL Survey (HerQLes) is a specific survey tool for QOL after
VHR. Studies comparing QOL in patients with biologic mesh repairs (BMRs) and synthetic
mesh repairs (SMRs) are lacking. Study Design A survey based on the HerQLes was
administered via e-mail to 974 patients who had undergone VHR at Stanford Medical
Center. From 175 patients who were included in the study, the mean HerQLes scores and …
Abstract
Background
Quality of life (QOL) is an important outcome measure after ventral hernia repair (VHR). The Hernia-Related QOL Survey (HerQLes) is a specific survey tool for QOL after VHR. Studies comparing QOL in patients with biologic mesh repairs (BMRs) and synthetic mesh repairs (SMRs) are lacking.
Study Design
A survey based on the HerQLes was administered via e-mail to 974 patients who had undergone VHR at Stanford Medical Center. From 175 patients who were included in the study, the mean HerQLes scores and postoperative complications were compared between patients with suture repairs (SR), BMR, SMR, with and without component separation, and different types of SMR.
Results
Quality of life was lower in patients with hernias of 50 cm 2 or greater, obesity, history of tobacco use, previous abdominal surgeries, hernia recurrences, and postoperative complications (P< 0.05). Patients with SR and SMR had a comparable QOL (71.58 vs 70.12, P= 0.75). In patients with Modified Ventral Hernia Working Group grade 2 hernias, a significantly lower QOL was found after BMR compared with SMR. Postoperative complications did not significantly differ between the groups. Recurrence rates were comparable between MR (10.4%) and SR (8.3%, P= 0.79), but higher in BMR (21.7%) compared with SMR (6.6%, P< 0.05).
Conclusions
Previous abdominal surgeries, previous hernia repairs, tobacco use, and hernia sizes of 50 cm 2 or greater negatively affect QOL after VHR. Our data indicate that QOL is comparable between patients with SMR and SR, however, is lower in patients with Modified Ventral Hernia Working Group grade 2 and BMR compared with SMR, raising the benefit of BMR in light of its higher cost into question.
Lippincott Williams & Wilkins
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