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. 2022 Feb;36(2):1609-1618.
doi: 10.1007/s00464-021-08442-w. Epub 2021 Mar 24.

Inguinal hernia mesh is safe in 1720 patients

Beau Forester  1 , Mikhail Attaar  1 , Maya Lach  1 , Sebastian Chirayil  1 , Kristine Kuchta  1 , Woody Denham  1 , John G Linn  1 , Stephen P Haggerty  1 , JoAnn Carbray  1 , Michael Ujiki  2
Affiliations

Inguinal hernia mesh is safe in 1720 patients

Beau Forester et al. Surg Endosc. 2022 Feb.

Abstract

Background: There is substantial media and patient interest in the safety of mesh for hernia repair. However, there is a lack of data regarding health-related quality of life (HRQOL) outcomes in patients who undergo inguinal hernia repair (IHR) with mesh. The purpose of this study is report short and long-term postoperative quality of life outcomes in patients following IHR with mesh.

Methods: We analyzed outcomes of 1720 patients who underwent IHR with mesh between 2008 and 2019 at a single institution from a prospectively maintained quality database. All surgeries were performed by four board-certified surgeons. HRQOL outcomes were measured using the Surgical Outcomes Measurement System (SOMS) and Carolinas Comfort Scale (CCS) surveys that were administered preoperatively, 3 weeks, 6 months, 1, 2, and 5 years postoperatively. Survey responses were summarized as mean with standard deviation or frequency with percentage. Postoperative SOMS scores were compared to preoperative scores using the two-tailed paired t test with a significance level of p < 0.05.

Results: One (0.1%) patient experienced a mesh infection postoperatively. In terms of complications, 159 (9.2%) developed a seroma, 31 (1.8%) a hematoma, and 36 (2.1%) patients experienced a recurrence. SOMS Pain Impact, SOMS Pain Quality, and SOMS Pain visual analog scale at 3 weeks, 6 months, 1 year, 2 years, and 5 years were all improved from preoperative (all p < 0.05). At 5 years postoperatively, only 3.9%, 3.2%, and 3.1% of patients reported severe or disabling sensation of mesh, pain, and movement limitations, respectively.

Conclusion: Inguinal hernia repair with mesh results in a low rate of complications. A minority of patients had severe or disabling symptoms at 5-year follow-up and generally reported improvements in pain impact and quality in long-term follow-up.

Keywords: Carolinas Comfort Scale; Health-related quality of life; Hernia mesh; Inguinal hernia; Inguinal hernia repair; Surgical Outcomes Measurement System.

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