Background: Inguinal hernia repair is the most common surgery in the world. Health-related quality of life (HRQOL) outcomes are arguably the most important elements of successful repair. This study is aimed to describe short- and long-term quality of life outcomes in patients undergoing laparoscopic inguinal hernia repair.
Methods: We prospectively followed patients who underwent totally extraperitoneal laparoscopic inguinal hernia repair (TEP) as part of an Institutional Review Board-approved study. HRQOL was measured preoperatively, or 3 weeks, 6 months, and 1 year postoperatively using Short Form 36 Health Survey Version 2 (SF-36v2) and Carolinas Comfort Scale. Postoperative HRQOL scores were compared to baseline using paired t tests.
Results: Between June 2009 and February 2014, 1,175 patients underwent TEP by four surgeons. Of those, 301 patients with 388 hernias were registered in the database and followed by a research coordinator. Mean age was 56.4 ± 15.2 years and 93% were male. Mean body mass index was 26.1 ± 3.7 kg/m(2). Seventy-eight percent presented with pain, the majority of which were described as mild. Hernias were unilateral right-sided in 43%, left-sided in 28%, and bilateral in 29 %. Eighty-five percent were primary hernias. Average operative time was 43.5 ± 17.9 min and there were no intraoperative complications. Urinary retention occurred in 6%. Visual analog scale at discharge was 1.9 ± 1.7. Analgesics were used an average of 2.5 ± 3.4 days and return to activities of daily living and work occurred on postoperative 5.5 ± 4.4 and 5.6 ± 3.9 days. Recurrence occurred in 2.1%. Significant improvements between baseline and 1 year were found in role limitations due to physical health (81.5 ± 25.6 vs. 91.8 ± 19.4, p = 0.02), social functioning (87.4 ± 21.3 vs. 92.9 ± 15.3, p = 0.02), and pain (78.2 ± 19.7 vs. 86.6 ± 15.9, p = 0.007).
Conclusions: TEP results in significant improvement in HRQOL including physical health, social functioning, and pain at 1 year. On average, patients are able to return to activities of daily living and work within a week.
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http://dx.doi.org/10.1007/s00464-014-4011-y | DOI Listing |
Clin Pract
December 2024
Department of Urology, University Hospital of Patras, 26504 Patras, Greece.
Deep or aggressive angiomyxoma is an uncommon neoplasm of the pelvis. Although deep angiomyxoma is a benign tumor, its tendency to infiltrate soft tissues and reach a large size (typically > 10 cm) indicates aggressive biological behavior. It is usually present in female patients, but there have been recent reports of male-aggressive angiomyxoma.
View Article and Find Full Text PDFHernia
December 2024
Department of Surgery, Tsudanuma Central General Hospital, 1- 9-17 Yatsu, Narashino, Japan.
Purpose: In laparoscopic inguinal hernia surgery, proper recognition of loose connective tissue, nerves, vas deferens, and microvessels is important to prevent postoperative complications, such as recurrence, pain, sexual dysfunction, and bleeding. EUREKA (Anaut Inc., Tokyo, Japan) is a system that uses artificial intelligence (AI) for anatomical recognition.
View Article and Find Full Text PDFAnn Surg Oncol
December 2024
Soft Tissue Sarcoma Surgery, Fondazione Policlinico Universitario Campus Bio-Medico, Rome, Italy.
Spermatic cord sarcomas (SCS) are a group of mesenchymal tumors whose rarity and anatomical location often lead to clinical misdiagnosis such as inguinal hernia, testicular tumor, or other conditions. Any inguinoscrotal mass with suspicious characteristics should prompt clinicians to perform imaging assessments (such as ultrasound or, in uncertain cases, magnetic resonance imaging (MRI)) and refer the patient promptly to a specialized center. Histological characterization of all suspicious masses via percutaneous biopsy is recommended, with staging completed through computed tomography (CT) scan for confirmed cases.
View Article and Find Full Text PDFJ Minim Access Surg
December 2024
Department of General Surgery, Shreeji Hospital, Bhilad-Valsad, Gujarat, India.
Background: In recent years, laparoscopic hernia repair, i.e. transabdominal pre-peritoneal and totally extraperitoneal repairs have been considered the method of choice, especially for recurrent hernias after open repair or bilateral inguinal hernias.
View Article and Find Full Text PDFJ Minim Access Surg
December 2024
Department of General Surgery, Buenos Aires British Hospital, Buenos Aires, Argentina.
Introduction: In laparoscopic inguinal hernia repair (LIHR), fixation means for meshes (FMMs) are commonly used to reduce hernia recurrence risk. Their use may result in post-operative pain (PP) and may even increase surgical time (ST). Recently, self-gripping meshes (SGMs) have been developed, which leave aside fixation devices; they could potentially reduce PP and even decrease ST.
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