학술논문

Sustainability of the relationship between preoperative symptoms and postoperative improvement in quality of life after inguinal hernia repair.
Document Type
Journal Article
Source
Hernia. Jun2019, Vol. 23 Issue 3, p583-591. 9p.
Subject
*GROIN pain
*AMBULATORY surgery
*INGUINAL hernia
*QUALITY of life
*CHRONIC pain
*LOCAL anesthesia
*POSTOPERATIVE pain
*HERNIA surgery
*PREOPERATIVE period
*HEALTH surveys
*SURGICAL meshes
*POSTOPERATIVE period
*LAPAROSCOPY
*QUESTIONNAIRES
*LONGITUDINAL method
*DISEASE complications
Language
ISSN
1265-4906
Abstract
Purpose: Chronic pain and discomfort are common before and after inguinal hernia repair (IHR) and pain is clearly linked to reduced quality of life (QoL). The long-term effect of IHR on QoL in relation to preoperative symptoms is incompletely described.Methods: 309 men (18-75 years) undergoing IHR under local anesthesia and day care surgery were included. Pre- and postoperative symptoms, pain and QoL (SF-36) were measured before and up to 3 years after surgery.Results: Before surgery, 197 patients (64%) reported pain (VAS 0.9-5.4) from their inguinal hernia. 102 patients (33%) had other inguinal symptoms, and 26% were asymptomatic. Patients with preoperative groin pain (P) scored their physical QoL (PCS) lower compared with controls (C) (median (IQR) 43.5 (34.7-50.3) vs. 53.9 (47.8-56.9, p < 0.001)), whereas patients with no pain (N) did not (53.0 (47.9-55.9), p = 0.57). Mental QoL was not affected before or after surgery. At 1, 2 and 3 years after surgery, 14, 12 and 7% of patients, respectively, reported groin pain. In P, PCS increased from 43.5 before surgery to 55.3 (p < 0.001) at 36 months, but was unchanged in N (53.0 vs 55.9, p = ns).Conclusions: The incidence of inguinal pain decreases over time after inguinal hernia repair. Both preoperative reduction and long-term improvement in physical QoL are strongly associated with the presence of preoperative groin pain. This supports, from a QoL perspective, that patients with preoperative pain are those who benefit the most from IHR, also from a long-term perspective. [ABSTRACT FROM AUTHOR]