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使用卡罗来纳舒适度量表评估腹腔镜切口疝修补术的生活质量:一项为期12年的回顾性观察研究经验

Quality of Life Using the Carolinas Comfort Scale for Laparoscopic Incisional Hernia Repair: A 12-Year Experience in a Retrospective Observational Study.

作者信息

Montauban Pierre, Shrestha Ashish, Veerapatherar Keerthana, Basu Sanjoy

机构信息

Department of General Surgery, William Harvey Hospital, East Kent Hospitals University NHS Foundation Trust, Ashford, United Kingdom.

出版信息

J Laparoendosc Adv Surg Tech A. 2021 Nov;31(11):1286-1294. doi: 10.1089/lap.2020.0878. Epub 2020 Dec 21.

Abstract

Incisional hernias are a common complication of abdominal surgery (10%-35%) and are notorious for recurrence. Laparoscopic incisional hernia repair (LIHR) was first performed in 1991 and is reported to have lower recurrence rates. Few studies to date have assessed quality of life (QoL) resulting from a repair. The purpose of this observational study was to present a 12-year experience performing LIHR, with a focus on the impact on QoL. All adult patients undergoing elective LIHR performed by a single surgeon, whether primary or recurrent, were included in the study. The data collection was performed prospectively between 2007 and 2019 to include demographic details, intraoperative findings and postoperative short- and longterm outcomes. We used the Carolinas Comfort Scale (CCS) to assess QoL following surgery. Ninety-seven patients were included in the study. Patients had a median age of 57 years, body mass index of 32 kg/m, 35% were male and 88% were American Society of Anesthesiologists (ASA) class I or II. The duration of surgery was 90 minutes*. Nineteen percent of patients had complications during or after surgery; 1 (1%) had recurrence. length of stay in hospital was 1* (0-12) days and long-term follow-up period was 42* (2-140) months after surgery. Time of return to daily activities was 14* (1-365) days. Eighty-six percent of patients rated their experience undergoing LIHR as "Excellent" or "Good". Regarding QoL after surgery, scores on the CCS indicated that 82% of patients had minimal or no discomfort following surgery, and only 1% had significant discomfort. *Presented as median. The technique for LIHR displayed in this study is safe and effective. There was an acceptable rate of complications, with a low recurrence rate. Patients were highly satisfied and had a good QoL after the procedure. Research Registry ID Number: researchregistry6056.

摘要

切口疝是腹部手术常见的并发症(发生率为10%-35%),且因易复发而声名狼藉。腹腔镜切口疝修补术(LIHR)于1991年首次开展,据报道其复发率较低。迄今为止,很少有研究评估修补术后的生活质量(QoL)。本观察性研究的目的是展示12年的LIHR手术经验,重点关注对生活质量的影响。所有由单一外科医生进行择期LIHR手术的成年患者,无论初次手术还是复发手术,均纳入本研究。2007年至2019年期间前瞻性收集数据,包括人口统计学细节、术中发现以及术后短期和长期结果。我们使用卡罗莱纳舒适度量表(CCS)评估术后生活质量。97例患者纳入本研究。患者中位年龄57岁,体重指数32kg/m,35%为男性,88%为美国麻醉医师协会(ASA)I或II级。手术时长90分钟*。19%的患者在手术期间或术后出现并发症;1例(1%)复发。住院时长为1*(0-12)天,术后长期随访期为42*(2-至140)个月。恢复日常活动的时间为14*(1-365)天。86%的患者将其LIHR手术体验评为“优秀”或“良好”。关于术后生活质量,CCS评分表明82%的患者术后不适轻微或无不适,只有1%有明显不适。*数据以中位数表示。本研究中展示的LIHR技术安全有效。并发症发生率可接受,复发率低。患者满意度高,术后生活质量良好。研究注册编号:researchregistry6056

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