Health-related quality-of-life changes after laparoscopic and open incisional hernia repair: a matched pair analysis.
BACKGROUND
The objective of this matched control study in patients suffering from incisional hernia was to compare laparoscopic open repair (LHR) with open hernia repair (OHR) in terms of long-term health-related quality of life (HRQL) according to the SF-36 Health Survey.


METHODS
Twenty-four consecutive patients (18 male, six female; mean age, 55 years) prospectively underwent LHR using expanded polytetrafluoroethylene mesh. The second group, which was matched for age and gender, was subjected to OHR using large pore-sized, low-weight polypropylene meshes. Before and after surgery, HRQL was assessed by the SF-36 Health Survey, which measures eight different health-quality domains, and the SF-36 Physical (PCS) and Mental Component Summary (MCS) score. The SF-36 values were compared to the scores of age-stratified German population controls.


RESULTS
The patients were reevaluated 16 months (range, 12-25) after LHR and 28 months (range, 18-52) after OHR, respectively. Before surgery, all of the eight health-quality domains as well as the PCS and MCS scores of both study groups were significantly lower than the corresponding scores of the age-stratified healthy German population. However, the OHR patients had significantly higher physical functioning and vitality scores than the LHR patients. After LHR and OHR, the scores for all eight SF-36 domains significantly increased but were still lower than those of the controls. The LHR patients were still worse than the norm population on both PCS and MCS scores, whereas OHR patients were worse only on PCS but not on MCS. In the long-term follow-up, none of the SF-36 Health Survey domains or the PCS and the MCS scores revealed significant differences between LHR and OHR patients.


CONCLUSIONS
LHR was not different from OHR for selected indications that measure long-term outcome and HRQL. SF-36 appears to be an appropriate instrument to measure postoperative HRQL, showing responsiveness to changes in objective outcome measures.
Mussack
T
T
Department of Surgery Innenstadt, Klinikum der Universität München, Nussbaumstrasse 20, 80336 Munich, Germany. Thomas.Mussack@med.uni-muenchen.de
Ladurner
R
R
Vogel
T
T
Lienemann
A
A
Eder-Willwohl
A
A
Hallfeldt
K K
KK
D000328:Adult; D000368:Aged; D016145:Endoscopy, Digestive System / Q000379:methods; D005260:Female; D006305:Health Status Indicators; D046449:Hernia, Abdominal / Q000601:surgery*; D006801:Humans; D010535:Laparoscopy; D008297:Male; D016555:Matched-Pair Analysis; D008875:Middle Aged; D011184:Postoperative Period; D011446:Prospective Studies; D011788:Quality of Life; D013526:Surgical Mesh; D013536:Suture Techniques