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Patient-reported rates of chronic pain and recurrence after groin hernia repair

Lundström, K. J.; Holmberg, H.; Montgomery, A. LU and Nordin, P. (2018) In British Journal of Surgery 105(1). p.106-112
Abstract

Background: The effectiveness of different procedures in routine surgical practice for hernia repair with respect to chronic postoperative pain and reoperation rates is not clear. Methods: This was prospective cohort study based on a unique combination of patient-reported outcomes and national registry data. Virtually all patients with a groin hernia repair in Sweden between September 2012 and April 2015 were sent a questionnaire 1 year after surgery. Persistent pain, defined as at least ‘pain present, cannot be ignored, and interferes with concentration on everyday activities’ in the past week was the primary outcome. Reoperation for recurrence recorded in the register was the secondary outcome. Results: In total, 22 917 patients... (More)

Background: The effectiveness of different procedures in routine surgical practice for hernia repair with respect to chronic postoperative pain and reoperation rates is not clear. Methods: This was prospective cohort study based on a unique combination of patient-reported outcomes and national registry data. Virtually all patients with a groin hernia repair in Sweden between September 2012 and April 2015 were sent a questionnaire 1 year after surgery. Persistent pain, defined as at least ‘pain present, cannot be ignored, and interferes with concentration on everyday activities’ in the past week was the primary outcome. Reoperation for recurrence recorded in the register was the secondary outcome. Results: In total, 22 917 patients (response rate 75·5 per cent) who had an elective unilateral groin hernia repair were analysed. Persistent pain present 1 year after hernia repair was reported by 15·2 per cent of patients. The risk was least for endoscopic total extraperitoneal (TEP) repair (adjusted odds ratio (OR) 0·84, 95 per cent c.i. 0·74 to 0·96), compared with open anterior mesh repair. TEP repair had an increased risk of reoperation for recurrence (adjusted OR 2·14, 1·52 to 2·98), as did open preperitoneal mesh repair (adjusted OR 2·34, 1·42 to 3·71) at 2·5-year follow-up. No other methods of repair differed significantly from open anterior mesh repair. Conclusion: The risk of significant pain 1 year after groin hernia repair in routine surgical practice was 15·2 per cent. This figure was lower in patients who had surgery by an endoscopic technique, but at the price of a significantly higher risk of reoperation for recurrence.

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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
British Journal of Surgery
volume
105
issue
1
pages
7 pages
publisher
John Wiley & Sons
external identifiers
  • scopus:85038595880
ISSN
0007-1323
DOI
10.1002/bjs.10652
language
English
LU publication?
yes
id
116e37af-c0d9-476e-83e4-a1742bdf2e5e
date added to LUP
2018-01-02 14:19:54
date last changed
2018-01-10 11:34:26
@article{116e37af-c0d9-476e-83e4-a1742bdf2e5e,
  abstract     = {<p>Background: The effectiveness of different procedures in routine surgical practice for hernia repair with respect to chronic postoperative pain and reoperation rates is not clear. Methods: This was prospective cohort study based on a unique combination of patient-reported outcomes and national registry data. Virtually all patients with a groin hernia repair in Sweden between September 2012 and April 2015 were sent a questionnaire 1 year after surgery. Persistent pain, defined as at least ‘pain present, cannot be ignored, and interferes with concentration on everyday activities’ in the past week was the primary outcome. Reoperation for recurrence recorded in the register was the secondary outcome. Results: In total, 22 917 patients (response rate 75·5 per cent) who had an elective unilateral groin hernia repair were analysed. Persistent pain present 1 year after hernia repair was reported by 15·2 per cent of patients. The risk was least for endoscopic total extraperitoneal (TEP) repair (adjusted odds ratio (OR) 0·84, 95 per cent c.i. 0·74 to 0·96), compared with open anterior mesh repair. TEP repair had an increased risk of reoperation for recurrence (adjusted OR 2·14, 1·52 to 2·98), as did open preperitoneal mesh repair (adjusted OR 2·34, 1·42 to 3·71) at 2·5-year follow-up. No other methods of repair differed significantly from open anterior mesh repair. Conclusion: The risk of significant pain 1 year after groin hernia repair in routine surgical practice was 15·2 per cent. This figure was lower in patients who had surgery by an endoscopic technique, but at the price of a significantly higher risk of reoperation for recurrence.</p>},
  author       = {Lundström, K. J. and Holmberg, H. and Montgomery, A. and Nordin, P.},
  issn         = {0007-1323},
  language     = {eng},
  month        = {01},
  number       = {1},
  pages        = {106--112},
  publisher    = {John Wiley & Sons},
  series       = {British Journal of Surgery},
  title        = {Patient-reported rates of chronic pain and recurrence after groin hernia repair},
  url          = {http://dx.doi.org/10.1002/bjs.10652},
  volume       = {105},
  year         = {2018},
}