Outcomes reported in high-impact surgical journals

Antonescu, Ioana; Mueller, Carmen L.; Fried, Gerald M.; Vassiliou, Melina C.; Mayo, Nancy E.; Feldman, Liane S.

doi:10.1002/bjs.9450

Cited by 9 publications

(4 citation statements)

References 25 publications

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“…Instead, PROs such as postoperative pain, cosmetic outcome, and functional result are variables that directly concern the patients’ wellbeing. The use of PROs is low in both hernia- and DRAM-related research, and should be increased during the coming years [ 41 ].…”

Section: Considerations For Dram Treatmentmentioning

confidence: 99%

The general surgeon’s perspective of rectus diastasis. A systematic review of treatment options

et al. 2017

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BackgroundDiastasis of the rectus abdominis muscles (DRAM) is characterised by thinning and widening of the linea alba, combined with laxity of the ventral abdominal musculature. This causes the midline to “bulge” when intra-abdominal pressure is increased. Plastic surgery treatment for DRAM has been thoroughly evaluated, though general surgical treatments and the efficacy of physiotherapy remain elusive. The aim of this systematic literature review is to evaluate both general surgical and physiotherapeutic treatment options for restoring DRAM in terms of postoperative complications, patient satisfaction, and recurrence rates.MethodMEDLINE®, Embase, PubMed, PubMed Central®, The cochrane central registry of controlled trials (CENTRAL), Google Scholar, and the Physiotherapy Evidence Database (PEDro) were searched using the following terms: ‘rectus diastasis’, ‘diastasis recti’, ‘midline’, and ‘abdominal wall’. All clinical studies concerning general surgical or physiotherapeutic treatment of DRAM were eligible for inclusion.ResultTwenty articles describing 1.691 patients (1.591 surgery/100 physiotherapy) were included. Surgical interventions were classified as plication techniques (313 patients; 254 open/59 laparoscopic), modified hernia repair techniques (68 patients, all open), and combined hernia & DRAM techniques (1.210 patients; 1.149 open/40 hybrid). The overall methodological quality was low. Plication techniques with interrupted sutures and mesh reinforcement were applied most frequently for DRAM repair. Open repairs were performed in 85% of patients. There was no difference in postoperative complications or recurrence rate after laparoscopic or open procedures, or between plication and modified hernia repair techniques. Physiotherapy programmes were unable to reduce IRD in a relaxed state. Though reduction of IRD during muscle contraction was described.ConclusionBoth plication-based methods and hernia repair methods are used for DRAM repair. Based on the current literature, no clear distinction in recurrence rate, postoperative complications, or patient reported outcomes can be made. Complete resolution of DRAM, measured in a relaxed state, following a physiotherapy training programme is not described in current literature. Physiotherapy can achieve a limited reduction in IRD during muscle contraction, though the impact of this finding on patient satisfaction, cosmesis, or function outcome is unclear.

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Section: Considerations For Dram Treatmentmentioning

confidence: 99%

The general surgeon’s perspective of rectus diastasis. A systematic review of treatment options

et al. 2017

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“…The Short Form 36 (SF-36 Ò ) is a widely used health profile which can be used for reporting surgical outcomes. 27 It includes 36 items that can be divided into eight domains assessing the physical (physical functioning, role physical, bodily pain), psychological (vitality, role emotional, mental health), and social (social functioning) domains, as well as overall health (general health). Each domain is scored on a scale from 0-100, with higher scores being representative of better functioning and well-being.…”

Section: Are There Recovery-specific Qol Instruments?mentioning

confidence: 99%

What outcomes are important in the assessment of Enhanced Recovery After Surgery (ERAS) pathways?

Feldman

Lee

Fiore

2014

Can J Anesth/J Can Anesth

104

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“…Arguably, PROs are the most important outcomes of any medical treatment. Despite the importance of these data, a 2014 review of Antonescu et al states that between 2008 and 2012 only 16% of the 770 clinical articles published in the top five general surgery journals used at least one PRO [ 7 ]. Only ten of these articles concerned hernia-related research.…”

Section: Introductionmentioning

confidence: 99%

Patient-reported outcomes (PROs) after total extraperitoneal hernia repair (TEP)

Mommers

Hunen

Hout

et al. 2016

Hernia

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BackgroundPatient-reported outcomes (PROs) such as quality of life (QoL), patient satisfaction, and work impairment, are arguably the most important outcomes of any medical treatment. In 2011, Staerkle and Villiger developed the Core Outcome Measurements Index (COMI) to standardise PROs and PRO measurement for inguinal hernia patients, in an attempt to increase inter-study comparability. The aim of this study is to prospectively evaluate the short- and long-term postoperative QoL, function, patient well-being, pain, and social/work disability, after total extraperitoneal (TEP) inguinal hernia repair and to provide the first clinical experience with the COMI-hernia questionnaire.MethodsBetween January 2013 and December 2014, all patients ≥18 years that were scheduled for elective uni- or bilateral TEP in a regional hospital were approached to participate in this study. Measurements were taken preoperatively, and 6 weeks and 1 year postoperatively.ResultsOne hundred and twenty patients (113 men, 7 women), mean age 59 years (SD ±12), completed the follow-up of 1 year. Ninety-seven percent of the population reported that the operation improved their complaints. QoL, function, well-being, and pain all improved after 6 weeks and 1 year after surgery. Patients experienced more social and work-related limitations 6 weeks after surgery compared to baseline measurements, though this improved to normal 1 year postoperatively. The incidence of chronic pain was 14% (VAS ≥ 2), which had a negative impact on the patients' sense of well-being.ConclusionPatients recovered well after TEP repair with a good quality of life and fast restore of function. Patient well-being was lower than expected due to a 14% incidence of chronic pain. The COMI-hernia scale provided reasonable insight into the patients' experience, though it was difficult to interpret for both patient and physician.

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Outcomes reported in high-impact surgical journals

Abstract: The predominant reporting of clinical endpoints and the inconsistent use of PROs underscore the need for further research and education to enhance the applicability of these measures in specific surgical settings.

Cited by 9 publications

References 25 publications

The general surgeon’s perspective of rectus diastasis. A systematic review of treatment options

The general surgeon’s perspective of rectus diastasis. A systematic review of treatment options

What outcomes are important in the assessment of Enhanced Recovery After Surgery (ERAS) pathways?

Patient-reported outcomes (PROs) after total extraperitoneal hernia repair (TEP)

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