Predictors of low quality of life after open inguinal hernia repair using the EuraHS-QoL score: prospective multicentric cohort study across 33 hospitals

Simões, Joana; Azevedo, José; Costa, João; Cunha, Miguel F.; Ferreira, Joaquim J.; João, Ana Alagoa; Peyroteo, Mariana; Picciochi, Maria; Soares, António Sampaio; Lages, R. R.; Pimentel, Alice; Santos, Teresa; Silva, Sofia Dias da; Carvalho, Lúcia Maria Figueiredo de; Frutuoso, Ana Luísa Pinto; Matias, Rita; Matos, Leonor; Amado, Fabiola; Ferreira, Alexandra; Martins, Isabel P.; Mateia, Estanislau; Praxedes, Vanessa; Seabra, Joana; Sousa, Xavier de; Silva, André; Carvalho, Márcia; Mendes, J.; Caires, Carlos OliveiraFrancisco; Rodrigues, Ana Luísa; Silva, Regina; Falcão, Ana Rita de Sousa Marinho; Ferreira, Ester; Menezes, Carla; Neri, Inês; Nobre, Rafael; Rebelo, Ana Clamouse; Santos, P; Sousa, David Ferra de; Andrade, Ana Carolina Dias Viana de; Barros, Inês; Frade, Sofía; Gomes, João; Nunes, I Renato; Pina, Sofia; Silva, Nádia; Sousa, Rui; Faria, Aldara; Gomes, A; Ramos, Carlota; Santos, Vanessa; Antão, Catarina; Castro, Luís; Ferreira, Joana Rodrigues; Lima, Inês; Policarpo, Filipa; Ramtula, Sara; Silveira, Sara; Romano, Joana; Rombo, Nuno; Baeta, Francisco; Boligo, Ana Sofia; Cardoso, Diogo Vieira; Cardoso, Vasco; Figueiredo, Cláudia; Gil, Isabela; Monte, Ana Rita; Azevedo, Joana RomanoConstança; Cunha, Rui Lacerda; Mendes, Filipa; Semião, Miguel; Almeida, Ana Maria de; Amaral, Maria João; Amaro, André; Guimarães, Andreia; Lopes, Catarina S.; Nogueira, Oriana; Santos, Eva; Silva, Marta Rodrigues da; Devezas, Vítor; Fonseca, Telma; Gomes, Fábio; Monteiro, Joana; Neves, António; Nogueiro, Jorge; Pais, Mariana; Pereira, André; Resende, Fernando; Rodrigues, Sara; Amorim, Edgar; Dias, Beatriz; Hugo, Víctor; Melo, João Henrick Neri de; Miguel, Inês Isabel Sampaio da Nóvoa Gomes; Rachadell, Juan; Rivero, Antonio; Sequeira, Liliana; Veiga, D; Branco, Andreia; Carvalho, Inês; Castro, B.; Fonseca, Sofia; Prata, R G; Queirós, Tatiana; Rita, Ana; Silva, Alexandra; Teixeira, Inês; Torre, Ana; Cunha, Cátia; Ferreira, Marisa Peralta; Miranda, Pedro; Cabral, Ana Maria Bezerra de Oliveira; Gama, Bárbara Olinda Nunes; Rodrigues, Catarina dos Santos; Rosa, Nisalda Carla Melo; Galvão, Diogo; Silva, Anaísa; Soares, Ana Cláudia; Vieira, Bárbara; Couceiro, Ana; Ferreira, M.; Guimarães, Narcisa; Mónica, Inês; Oliveira, Simone Helena dos Santos; Pais, Daniela; Ribeiro, Hugo da Costa; Barradas, Renato; Martins, Sónia Fortuna; Dias, Marta Ferreira; Faustino, Ana; Freitas, Antônio Hilário Alves; Martins, Ana; Moura, Catarina; Parreira, Rafaela; Bolota, Joana; Cinza, Ana Margarida; Leandro, Sofia; Lima, Rita Pedroso de; Oliveira, Joana; Pereira, Mário; Melo, Miguel Rocha; Velez, Cristina; Cardoso, Adalberto; Claro, Mariana; Deus, Ana Cláudia; Ferreira, Andreia; Gameiro, Hugo; Marinho, Diogo; Santos, Daniel Costa dos; Silva, Alberto; Silva, Sara; Sousa, Diogo; Barreira, Ana Lúcia Preto; Borges, Filipe; Botelho, Pedro; Cismasiu, Brigitta; Ferreira, Margarida; Henriques, Susana; Nobre, José Guilherme Gonçalves; BritoSilva, Maria Francisca Rodrigues deDa Areia; Souto, Ricardo Manuel Branco; Carvalho, César; Guerra, Filipe Lamounier Barros; Guerreiro, I.D.C.; Sousa, Paulo; Almeida, Filipe André Ramalho de; Aparício, David; Capunge, Ines; Carmarneiro, Rita Marques de Sá; Cristo, Jorge; Fragoso, Marta; Frazão, Joana; Guimarães, João; Martins, Ana Rita; Martins, Rita Ribeiro Reis Vale; PinheiroOliveira, Maria dede Jesus; Ribeiro, J; Teixeira, Paula Soraya de Carvalho e Azevedo; Brito, Telma Anita Rodrigues; Gomes, Diana Carina Lima; Leite, Mariana; Matos, Carolina Macedo de; Monteiro, C.; Silva, Ana Cristina Mendes da; Silva, Bruno Ribeiro da; Baldino, Carina; Guerreiro, Ana; Jervis, Maria João; Pacheco, André; Paixão, Valter; Pedro, Vera; Pimenta, Joana Sofia; Rocha, Filipa; Mega, Manuela; Monteiro, Rita; Peliteiro, Joana; Romano, Manuela; Soares, Alexandra; Sampaio-Alves, Mafalda; Alves, Natacha Teresa Queiroz; Costa, Gabriel Rahal; Freire, Lígia; Gonçalves, José Pedro; Marques, T; Marrana, Francisco; Marques, Sara Silvério; Pinto, Diogo; Quintela, Catarina; Santos, Irène; Sitchikhina, Evgeniya; Valente, Pedro; Carvas, João Miguel; Durães, Inês; Lopes, Guida; Pires, Carlos; Silva, Joana; Brito, Miguel; Capote, Hugo; Costa, Cristina; Fialho, Guilherme; Mogne, Tamiris; Moráis, Sara; Mourato, B.; Salvador, David; Aguero, Coral; Dominguez, Joaquina; Fernández, M.A. Caínzos; Figueiredo, Carlos; Guerrero, Mónica; Neuparth, Manuel; Reia, Marta

doi:10.1007/s10029-021-02498-2

Cited by 5 publications

(2 citation statements)

References 26 publications

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“…Similarly, younger patients were more likely to undergo a minimal-invasive surgical technique. his distribution of patients among the predominant surgical techniques is also shown by previous studies [ 17 , 18 ]. These distribution might explain why we observed no difference in CPIP between the three surgical procedures in our study.…”

Section: Discussionsupporting

confidence: 72%

Postoperative Analgesics Score as a Predictor of Chronic Postoperative Inguinal Pain After Inguinal Hernia Repair: Lessons Learned From a Retrospective Analysis

et al. 2023

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Background Chronic postoperative inguinal pain (CPIP) is a common complication after inguinal hernia surgery and occurs in up to 10–14% of cases. CPIP has a significant impact on daily life, work ability and thus compromises quality of life. The aim of this retrospective study was an in-depth analysis of patients undergoing inguinal hernia repair to further refine the prediction of the onset of CPIP reliably. Methods A single center retrospective analysis of patients with who underwent open or minimally invasive inguinal hernia repair from 2016 to 2021 was carried out. Complication rates, detailed analysis of postoperative pain medication and quality of life using the EuraHS Quality of Life questionnaire were assessed. Results Out of 596 consecutive procedures, 344 patients were included in detailed analyses. While patient cohorts were different in terms of age and co-morbidities, and the prevalence of CPIP was 12.2% without differences between the surgical procedures (Lichtenstein: 12.8%; TEP 10.9%; TAPP 13.5%). Postoperative pain was evaluated using a newly developed analgesic score. Patients who developed CPIP later had a significant higher consumption of analgesics at discharge (p = 0.016). As additional risk factors for CPIP younger patient age and postoperative complications were identified. Conclusion The prospective use of the analgesic score established here could be helpful to identify patients that are at risk to develop CPIP. These patients could benefit from a structured follow-up to allow early therapeutic intervention to prevent chronification and restore the quality of life.

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Section: Discussionsupporting

confidence: 72%

Postoperative Analgesics Score as a Predictor of Chronic Postoperative Inguinal Pain After Inguinal Hernia Repair: Lessons Learned From a Retrospective Analysis

et al. 2023

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“…The EuraHS QoL assessment is a hernia-specific questionnaire with nine questions divided into three domains: pain (three questions), restriction of activity (four questions), and cosmetic discomfort (two questions). The cumulative minimum score (representing the best QoL) is 0, and the cumulative maximum score (representing the worst QoL) is 90 [ 11 ]. We analyzed the results by averaging the scores documented for questions in their respective domains and calculating the mean value.…”

Section: Methodsmentioning

confidence: 99%

A Comparative Study on Outcomes and Quality of Life Changes Following Ventral Transabdominal Preperitoneal (Ventral-TAPP) and Laparoscopic Intraperitoneal Onlay Mesh (IPOM)-Plus Repair for Ventral Hernia

Kaushik,

Srivastava,

Datta Sai Subramanyam

et al. 2023

Cureus

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Background Ventral transabdominal preperitoneal (ventral-TAPP) repair and intraperitoneal onlay mesh (IPOM) plus repair are two options among the available techniques of laparoscopic ventral hernia repair (LVHR). We conducted a comparative study to evaluate the clinical and quality of life (QoL)-related outcomes between ventral-TAPP and IPOM-plus repair. It was hypothesized that both procedures offered similar outcomes and QoL. Materials and methods The study included 32 consecutive patients undergoing LVHR, divided equally between ventral-TAPP and IPOM-plus groups. In the ventral-TAPP procedure, a peritoneal flap was created around the defect, followed by defect approximation and polypropylene mesh placement in the pre-peritoneal pocket. For the IPOM-plus procedure, the defect was closed and a composite (dual-side) mesh was placed around the defect. The minimum overlap beyond the original defect margin in both groups was 5 cm. Data regarding pre-operative parameters and postoperative outcomes, including pain and QoL at one week, one month, and three months, were recorded. A p-value of less than or equal to 0.05 was considered to be statistically significant. Results While the mean duration of surgery was longer, the cost of treatment was lower in group 1 (ventral-TAPP) with a p-value of <0.05 for both parameters. The length of hospital stay was significantly shorter in group 1 (ventral-TAPP), while the return to normal activity was similar in both groups. The visual analog scale (VAS) score for overall pain perception and the European registry for abdominal wall hernias (EuraHS; hernia-related QoL) score for ‘Pain at Site’ and ‘Restriction of Activity’ domains were significantly higher in group 2 (IPOM-plus) at one week. Conclusion Although the ventral-TAPP procedure requires more time and expertise to perform, the EuraHS QoL assessment at one week was better in group 1 (ventral-TAPP). Ventral-TAPP group scored better in terms of length of hospital stay and cost-effectiveness as well.

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Chronic postsurgical pain (CPSP): an underestimated problem after incisional hernia treatment

Widder,

Reese,

Lock

et al. 2024

Hernia

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Background Chronic postsurgical pain (CPSP) is a potential long-term problem following open incisional hernia repair which may affect the quality of life of patients despite successful anatomical repair of the hernia. The aim of this manuscript was to identify the incidence and outcome of patients following open incisional hernia repair in respect of risk factors to develop CPSP. Methods A single-center retrospective analysis of patients who underwent open incisional hernia repair between 2015 and 2021 was performed. Pre-existing conditions (e.g., diabetes mellitus and malignancy), hernia complexity, postoperative complications, and postoperative pain medication were analyzed using the local database. Quality of life and CPSP were assessed using the EuraHS Quality of Life (QoL) questionnaire. Results A total of 182 cases were retrospectively included in a detailed analysis based on the complete EuraHS (QoL) questionnaire. During the average follow-up period of 46 months, this long-term follow-up revealed a 54.4% incidence of CPSP and including a rate of 14.8% for severe CPSP (sCPSP) after open incisional hernia surgery. The complexity of the hernia and the demographic variables were not different between the group with and without CPSP. Patients with CPSP reported significantly reduced QoL. The analgesics score which includes the need of pain medication in the initial days after surgery was significantly higher in patients with CPSP than in those without (no CPSP: 2.86 vs. CPSP: 3.35; p = 0.047). Conclusion The presence of CPSP after open incisional hernia repair represents a frequent and underestimated long-term problem which has been not been recognized to this extent before. CPSP impairs QoL in these patients. Patients at risk to develop CPSP can be identified in the perioperative setting by the need of high doses of pain medication using the analgesics score. Possibly timely adjustment of pain medication, even in the domestic setting, could alleviate the chronicity or severity of CPSP.

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Predictors of low quality of life after open inguinal hernia repair using the EuraHS-QoL score: prospective multicentric cohort study across 33 hospitals

Cited by 5 publications

References 26 publications

Postoperative Analgesics Score as a Predictor of Chronic Postoperative Inguinal Pain After Inguinal Hernia Repair: Lessons Learned From a Retrospective Analysis

Postoperative Analgesics Score as a Predictor of Chronic Postoperative Inguinal Pain After Inguinal Hernia Repair: Lessons Learned From a Retrospective Analysis

A Comparative Study on Outcomes and Quality of Life Changes Following Ventral Transabdominal Preperitoneal (Ventral-TAPP) and Laparoscopic Intraperitoneal Onlay Mesh (IPOM)-Plus Repair for Ventral Hernia

Chronic postsurgical pain (CPSP): an underestimated problem after incisional hernia treatment

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