Quality of life and outcomes for femoral hernia re

Authors: T C Cox C R Huntington L J Blair T Prasad B T Heniford V A Augenstein

Publish Date: 2016/05/21

Volume: 21, Issue: 1, Pages: 79-88

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Abstract

The International Hernia Mesh Registry was queried for femoral hernia repairs Laparoscopic vs open techniques were assessed for outcomes and QOL as quantified by the Carolinas Comfort Scale CCS preoperatively and at 1 6 12 and 24 months postoperatively Outcomes were evaluated using the standard statistical analysisA total of 80 femoral hernia repairs were performed in 73 patients 37 laparoscopic and 43 open There was no difference in mean age 547 ± 146 years body mass index 242 ± 38 kg/m2 gender 603  female or comorbidities p  005 The hernias were recurrent in 21  of the cases with an average of 123 ± 06 prior repairs p  01 Preoperative CCS scores were similar for both groups and indicated that 597  of patients reported pain and 464  had movement limitations p  005 Operative time was equivalent 472 ± 212 vs 459 ± 148 min p = 082 There was no difference in postoperative complications with an overall 82  abdominal wall complications rate p  005 The length of stay was shorter in the laparoscopic group 05 ± 06 vs 13 ± 16 days p = 002 Followup was somewhat longer in the open group 238 ± 102 vs 173 ± 109 months p = 002 There was one recurrence which was in the laparoscopic group 31 vs 0  p = 04 QOL outcomes at all time points demonstrated no difference for pain movement limitation or mesh sensation Postoperative QOL scores improved for both groups when compared to preoperative scoresIn this prospective international multiinstitution study of 80 femoral hernia repairs no difference was found for operative times longterm outcomes or QOL in the treatment of femoral hernias when comparing laparoscopic vs open techniques After repair QOL at all timepoints postoperatively improved compared to QOL scores preoperatively for laparoscopic and open femoral hernia repair While international data supports improved outcomes with laparoscopic approach for femoral hernia repair no data had existed prior to this study on the difference of approach impacting QOL In the setting where recurrence and complication rates are equal after femoral hernia repair for either approach surgeons should perform the technique with which they are most confident as the operative approach does not appear to change QOL outcomes after femoral hernia repairThere are no conflicts of interest for any authors related to this work BTH has WL Gore and Associates Ethicon Novadaq Bard/Davol and LifeCell Inc not related to this work VAA has WL Gore and Associates Ethicon Novadaq Bard/Davol and LifeCell Inc not related to this work TCC has no conflicts of interest related or unrelated to this work CRH has no conflicts of interest related or unrelated to this work LJB has no conflicts of interest related or unrelated to this work TP has no conflicts of interest related or unrelated to this workAll procedures performed in the studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards

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