Department of Surgery, Hernia Clinic, Diakonessenhuis, Room Secretariaat Heelkunde, Professor Lorentzlaan 76, Zeist, 3707 HL, Utrecht, The Netherlands.
Hernia. 2020 Oct;24(5):1033-1040. doi: 10.1007/s10029-020-02220-8. Epub 2020 May 23.
There is some consensus on inguinal hernia surgery follow-up in research settings. However, consensus on regular follow-up is lacking. Therefore, patients and surgeons are unnecessarily burdened and not cost-efficient. Moreover, the purpose of follow-up is barely questioned. This study aims to evaluate follow-up after inguinal hernia repair and determine patient satisfaction.
This prospective cohort study was executed in a high-volume specialized hernia clinic. All totally extraperitoneal (TEP) repair patients between July and October 2016 were included. Telephone follow-up was performed at 1 day, 6 weeks and 1 year postoperatively. One year postoperatively it was assessed whether patients visited other healthcare organizations, had remaining inguinal complaints, a Post-INguinal-repair-Questionnaire by telephone (PINQ-PHONE) was executed, and appreciation with follow-up was determined.
Respectively, 6 weeks and 1 year postoperatively, 138 (79.3%) and 130 (74.7%) of 174 included patients were reached. One year postoperatively 15 patients (11.5%) had remaining inguinal complaints, of which only four patients (3.1%) had not already reported their symptoms. Nineteen patients (14.6%) presented with self-reported complaints between 6 weeks and 1 year, and no patients went to other hospitals. Respectively, 107 (82.3%), 61 (46.9%) and 117 (90.0%) patients considered follow-up useful at 6 weeks, 1 year and in general. One hundred nineteen patients (91.5%) preferred telephone follow-up to outpatient clinic appointments.
TEP patients value a telephone follow-up time-point, however, long-term follow-up is not considered useful. Patients report postoperative complaints themselves, therefore performing follow-up serves no clinical purpose. The purpose of follow-up is patient satisfaction and registration for quality objectives.
腹股沟疝手术的随访在研究环境中已达成一定共识。然而，对于常规随访，目前仍缺乏共识。因此，患者和外科医生承受了不必要的负担，且效率低下。此外，随访的目的也几乎没有受到质疑。本研究旨在评估腹股沟疝修补术后的随访情况，并确定患者满意度。
这是一项前瞻性队列研究，在一家高容量的专业疝诊所进行。所有 2016 年 7 月至 10 月间接受完全腹膜外（TEP）修补术的患者均被纳入研究。术后 1 天、6 周和 1 年进行电话随访。术后 1 年，评估患者是否就诊于其他医疗机构、是否存在腹股沟残余症状、通过电话进行腹股沟疝修补术后问卷（PINQ-PHONE）评估、并确定对随访的满意度。
分别有 6 周和 1 年后，174 例纳入患者中 138 例（79.3%）和 130 例（74.7%）可联系到。术后 1 年，15 例（11.5%）患者存在腹股沟残余症状，其中只有 4 例（3.1%）患者未曾报告过其症状。19 例（14.6%）患者在 6 周到 1 年期间出现自报告症状，但无患者去其他医院就诊。分别有 107 例（82.3%）、61 例（46.9%）和 117 例（90.0%）患者在术后 6 周、1 年和总体上认为随访有用。119 例（91.5%）患者更喜欢电话随访而非门诊预约。
TEP 患者重视电话随访时间点，但长期随访并不被认为有用。患者会自行报告术后症状，因此随访无临床意义。随访的目的是患者满意度和质量目标的登记。
