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确定个体腹疝修补并发症对患者报告的生活质量的影响。

Determining the impact of individual ventral hernia repair complications on patient-reported quality of life.

机构信息

Center for Abdominal Core Health, Department of Surgery, Ohio State University Wexner Medical Center, 410 W 10th Ave., Columbus, OH, 43210, USA.

Ohio University Heritage College of Osteopathic Medicine, Dublin Campus, Dublin, OH, USA.

出版信息

Hernia. 2023 Jun;27(3):687-694. doi: 10.1007/s10029-023-02800-4. Epub 2023 May 4.

Abstract

PURPOSE

Ventral hernia repair (VHR) postoperative complications vary in presentation, management, and severity. The aim of this study is to determine the impact of individual postoperative complications on long-term quality of life (QoL) after VHR.

METHODS

Data from the Abdominal Core Health Quality Collaborative were analyzed retrospectively. Propensity score matching compared 1-year postoperative Hernia-Related Quality of Life Survey (HerQLes) summary scores between non-wound events (NWE), surgical site infection (SSI), and surgical site occurrence requiring procedural intervention (SSOPI) versus No-Complications.

RESULTS

2796 patients who underwent VHR between 2013 and 2022 met the study criteria. Patients with SSI and SSOPI had lower QoL vs No-Complications (median (Interquartile range): 71 (40-92) vs 83 (52-94), P = 0.02; 68 (40-90) vs 78 (55-95), P = 0.008). NWE vs no-complications HerQLes score differences were similar (83 (53-92) vs 83 (60-93), P = 0.19).

CONCLUSION

Wound events seem to have larger impact on patients' long-term QoL compared to NWE. Continued and aggressive efforts including preoperative optimization, technical points, and appropriate use of minimally invasive techniques can continue to reduce impactful wound events.

摘要

目的

腹疝修补术(VHR)术后并发症的表现、处理和严重程度各不相同。本研究旨在确定个体术后并发症对 VHR 后长期生活质量(QoL)的影响。

方法

回顾性分析腹部核心健康质量协作的数据。采用倾向评分匹配比较非切口事件(NWE)、手术部位感染(SSI)和需要手术干预的手术部位事件(SSOPI)与无并发症患者术后 1 年疝相关生活质量调查(HerQLes)综合评分。

结果

2013 年至 2022 年间,2796 例患者符合研究标准。SSI 和 SSOPI 患者的 QoL 低于无并发症患者(中位数(四分位距):71(40-92)比 83(52-94),P=0.02;68(40-90)比 78(55-95),P=0.008)。NWE 与无并发症的 HerQLes 评分差异相似(83(53-92)比 83(60-93),P=0.19)。

结论

与非切口事件相比,切口事件似乎对患者的长期 QoL 有更大的影响。包括术前优化、技术要点和微创技术的适当应用在内的持续积极努力,可以继续降低有影响的切口事件。

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