News Feed Discussions Evaluation of inguinal hernia repair using post-operative pain…

  • Evaluation of inguinal hernia repair using post-operative pain…

    Posted by Good intentions on November 9, 2022 at 10:04 am

    Here are a couple of new names in the field of studying hernia repair results. From Canada. About the same one in six number for pain, for the Lichtenstein method. They looked at ten years worth of data. Not clear what the “Brief Pain Inventory Short Form (BPI)” is. Maybe another attempt to create a questionnaire that has actual value in determining quality of life.

    Just the abstract, but the full paper is available.

    “Evaluation of inguinal hernia repair using post-operative pain and quality of life metrics
    Michael L Moreton B.Sc., M.Sc & André Truter M.B.ChB, M.Med, FRCSC
    Hernia (2022)”

    “Methods
    A cohort of patients who had received Lichtenstein inguinal hernia repair over the previous 10 years were contacted and surveyed using the Brief Pain Inventory Short Form (BPI) to assess chronic pain and its effects on their QoL. …”

    “Results
    The rate of chronic pain was 17.2% with recurrence of 3.1% at an average post-operative interval of 5.84 years. …”

    “Conclusions
    These long-term considerations of post-surgical impact should be considered alongside potential benefits when advising patients about surgery and may help moderate post-operative expectations to optimize the outcome of common inguinal hernia repairs.”

    Watchful replied 1 year, 3 months ago 2 Members · 2 Replies
  • 2 Replies
  • Watchful

    Member
    November 9, 2022 at 11:49 am

    That is indeed a strange statement. How does lowering expectations optimize outcomes? Is chronic pain any better if you know that it may happen? Perhaps what will improve outcomes is if fewer people decide to have the surgery done when provided with this information. The cure can be worse than the disease, and in some cases watchful waiting is the better option.

  • Good intentions

    Member
    November 9, 2022 at 10:13 am

    Their conclusion statement illustrates the dilemma that the surgeons have. If they inform the patients fully of the risks, more patients will refuse the surgery.

    The mesh repair industry is in the big bind that they are in now because they have not been informing patients (or surgeons) of the potential for long-term problems from the available mesh products. They have to make the sale, and sales are made with positive words. It’s one of the major downsides of the free market. Hiding flaws sells more product.

    This statement, below, is one of those that really doesn’t make sense when you try to break it down. It implies that shifting responsibility for the decision to take on the risk of long-term pain is a better “outcome”. Make it the patient’s problem, not the doctor’s. The pain and recurrence rates will be the same.

    From the Conclusion –

    “may help moderate post-operative expectations to optimize the outcome of common inguinal hernia repairs.”

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