Washington, D.C. From the Departments of Surgery and Plastic Surgery, Georgetown University Hospital.
Plast Reconstr Surg. 2014 Feb;133(2):408-418. doi: 10.1097/01.prs.0000436860.47774.eb.
Published assessment tools have attempted to investigate patient-centered outcomes after abdominal wall defect repairs, including quality-of-life measures, functional outcomes, pain assessment, and overall satisfaction scores; however, health-related quality of life following hernia repair remains unclear.
The MEDLINE, PubMed, and Cochrane databases were queried and 880 articles were identified. Of these, 22 met inclusion/exclusion criteria. Analysis included health-related quality-of-life metrics focusing on quality of life, pain, physical function, overall satisfaction with surgery, impact of component separation, use of synthetic or biologic mesh, and emotional sequelae of an abdominal wall defect and repair.
Twenty-two studies were reviewed; the mean study size was 117.7 patients (range, 14 to 402 patients). Mean and median ventral hernia defect sizes were 104.5 cm and 71.5 cm, respectively. All studies reported open repairs using synthetic mesh. The Short Form-36 was used most often (11 of 22) in comparison to other assessment methods. Patients had global improvement in quality of life, functionality, impact on social function, and patient satisfaction. Hernia recurrence was found to have a major negative impact on quality of life. Midline repair improved overall pain and abdominal wall functionality in both presurgical patients and those with hernia recurrence. Component separation techniques appear to have a positive impact on global health-related quality of life.
Adopting an abdominal wall procedure-specific quality-of-life assessment tool as the standard is strongly recommended to gain a comprehensive understanding of abdominal wall defects and repairs. The available literature in open abdominal wall repair suggests an improved quality of life.
CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, III.
已发表的评估工具试图调查腹壁缺损修复后的以患者为中心的结果，包括生活质量指标、功能结果、疼痛评估和总体满意度评分；然而，疝修补术后的健康相关生活质量仍不清楚。
检索 MEDLINE、PubMed 和 Cochrane 数据库，共确定了 880 篇文章。其中，22 篇符合纳入/排除标准。分析包括关注生活质量、疼痛、身体功能、对手术总体满意度、分离组件的影响、使用合成或生物网片以及腹壁缺损和修复的情绪后果的健康相关生活质量指标。
共审查了 22 项研究；平均研究规模为 117.7 例患者（范围为 14 至 402 例患者）。平均和中位数腹疝缺损大小分别为 104.5cm 和 71.5cm。所有研究均报告了使用合成网片的开放式修复。与其他评估方法相比，最常使用的是 36 项简短健康调查（22 项中的 11 项）。患者的生活质量、功能、对社会功能的影响和患者满意度均有整体改善。疝复发被发现对生活质量有重大负面影响。中线修复可改善术前患者和疝复发患者的整体疼痛和腹壁功能。分离组件技术似乎对整体健康相关生活质量有积极影响。
强烈建议采用腹壁特定手术的生活质量评估工具作为标准，以全面了解腹壁缺损和修复。开放性腹壁修复的现有文献表明生活质量得到了改善。
临床问题/证据水平：治疗，III 级。
