Patient Reported Outcomes Following Laparoscopic Ventral Hernia Repair

R M Antiel, MD, MA, S C Dupont, MD, M J Samaha, K V Ballman, PhD, J Bingener, MD. Mayo Clinic, Rochester MN.

Introduction: Approximately 90,000 ventral hernia repairs are performed in the US each year. Patients expect fast recovery after laparoscopic ventral hernia repair (LVHR) and undisturbed postoperative quality of life. Some patients however experience prolonged recovery. We explore the use of a brief, validated 10 point Linear Analogue Self-Assessment (LASA) to discern risk factors for decreased postoperative quality of life.

Methods: Between January 2011 and May 2013, we prospectively assessed patient reported outcomes for patients who underwent LVHR. VAS pain scale and LASA items were recorded: preoperatively, and at 4 hours, 1 day and 7 days postoperatively. Within the LASA scores, specific attention was paid to overall quality of life (QOL), physical well-being (PWB), and level of fatigue (LOF). We assessed the impact of patient age and gender on these outcomes.

Results: 18 patients were included, 11 were female (61%) and 8 >60 years old (44%). Patient reported fatigue increased clinically and statistically from baseline over time (p=0.0069) as did pain (p<0.001). The mean overall QOL and PWB scores did not reveal significant changes from baseline over time (see table). There was a statistically significant difference in QOL scores over time by gender with women reporting lower scores than men (p=0.001). The mean PWB scores were significantly decreased from baseline over time for women compared to men (p<0.001) and for patients less than 60 years old compared to patients older than 60 (p=0.014) There was no significant difference between LOF and VAS scores by age or gender.

Conclusion: Our study detects significant changes from baseline in both fatigue and pain over the 7 days following LVHR. These findings can help surgeons set realistic expectations for postoperative recovery. Further studies should elucidate if individualized targeted interventions can assist with recovery.