David Chen – Article- .05 percent complication rate

[Chuck]

Sorry if I am spamming the forum but hernia surgery is the most complicated area I have ever explored while studying health…our Friend Bryant aptly calls it a minefield…and says he felt like he was developing mental illness over the decision…Bryant – I feel the same exact way. And it shows…well this article is interesting because Dr Chen says that he has a .05 percent complication rate. If this includes a chronic pain analysis…then his numbers are a lot better than Kangs—at 16 percent…for chronic pain alone. Who knows if he is being honest…he probably isnt…but even if he is lying by a lot…his chronic pain rates will still be lower than kangs right?
https://www.generalsurgerynews.com/In-the-News/Article/08-21/It%E2%80%99s-Just-a-Hernia-Until-It%E2%80%99s-Not/64278

[Chuck]

make that .5 percent complication rate….still pretty good…

[Good intentions]

The 0.5 % is his “complication rate”. Not chronic pain. He doesn’t talk about his own chronic pain rate. He does mention that the overall rate is “realistically” above 5%. Which is certainly a disingenuous statement, especially for a person in his position. He must know that the vast majority of studies show a rate of ~15%. They just can’t help defending what they do. It’s human nature.

He still seems like a good person, but he is also still captured by the industry talking points. He tries to downplay the real numbers and can only get from 15% to 5%. Which is actually good, he uses real numbers, just not the right ones.

He must realize that his statement about the benefits of lap are muddled. Lower than 5%? Or lower than 15%? Disingenuous.

” Chronic pain rates, realistically, are over 5%, affecting patients’ quality of life. Minimally invasive laparoscopic and robotic techniques have matured to provide excellent outcomes with benefits of early recovery and lower rates of chronic pain.”

Why is he talking about “our personal risk”?

” In inguinal hernia repair, our goal as surgeons is to lower our personal risk for complication to less than 0.5%, but that number can and will never be zero. Whatever can happen in surgery, will happen.”

…

“. While I am still below my aspirational 0.5% complication rate for inguinal hernia repairs”

[Watchful]

Dr. Chen should be a good hernia surgeon, but he does have some bad reviews, and the posts from the body building forum concerned me. The guy there also did a lot of research, and decided on Lichtenstein with Chen. He ended up with some pain and discomfort for months (like the rest of us compulsive researchers…) Not sure if and how it resolved. He said that follow up was lacking. I don’t know how much personal attention you can get there. It’s a university, and Dr. Chen is extremely busy and has very long waiting times.

I did very little research on Lichtenstein surgeons. Without further research and if I had to pick someone now, I would probably go with Dr. Towfigh. If I had time, I would research it first, and then probably end up with chronic pain because we all know that this is the punishment for too much research.

[MarkT]

That last line is very unclear.

“While I am still below my aspirational 0.5% complication rate for inguinal hernia repairs, and thankfully I could operatively clean up my own mess, I could have done better.

If 0.5% is his ‘aspirational’ complication rate, then (by definition) he has not achieved that rate, so what does he mean that he is ‘below’ it? Or does he actually mean ‘below’ in a non-quantitative sense (i.e., that he has not yet reached that low rate)?

In any case, we would need to know what his follow-up protocol is to really judge his (or anyone’s) figures. It is wrong to assume he is ‘lying’…he may simply not have reliable data (or maybe he does and he really is *that* good…we just need more info to judge).

We already have good reason to believe that that most studies looking at long-term outcomes have inadequate follow-up periods (never mind patient attrition issues) to accurately estimate chronic pain and recurrence rates. One study posted here suggested that a significant proportion of such problems occur well beyond most study cut-off dates.

[Author]

Posts