title: Patient Satisfaction, chronic pain, and functional status following laparoscopic ventral hernia repair.
abstract: BACKGROUND
  Ventral hernia repairs are one of the most common surgeries performed. Symptoms are the most common motivation for repair. Unfortunately, outcomes of repair are typically measured in recurrence and infection rather than patient focused results. We correlated factors associated with decreased patient satisfaction, chronic pain, and diminished functional status following laparoscopic ventral hernia repair (LVHR) METHODS: A retrospective study of 201 patients from two affiliated institutions was performed. Patient satisfaction, chronic abdominal pain, pain scores, and Activities Assessment Scale results were obtained in 122 patients. Results were compared with univariate and multivariate analysis.
  
  
  RESULTS
  Thirty-two (25.4%) patients were dissatisfied with their LVHR while 21 (17.2%) patients had chronic abdominal pain and 32 (26.2%) patients had poor functional status following LVHR. Decreased patient satisfaction was associated with perception of poor cosmetic outcome (OR 17.3), eventration (OR 10.2), and chronic pain (OR 1.4). Chronic abdominal pain following LVHR was associated with incisional hernia (OR 9.0), recurrence (OR 4.3), eventration (OR 6.0), mesh type (OR 1.9), or ethnicity (OR 0.10). Decreased functional status with LVHR was associated with mesh type used (OR 3.7), alcohol abuse (OR 3.4), chronic abdominal pain (OR 1.3), and age (OR 1.1).
  
  
  CONCLUSIONS
  One-fourth of patients have poor quality outcome following LVHR. These outcomes are affected by perception of cosmesis, eventration, chronic pain, hernia type, recurrence, mesh type, and patient characteristics/co-morbidities. Closing central defects and judicious mesh selection may improve patient satisfaction and function. Focus on patient-centered outcomes is warranted.
authors.affiliation: Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Michael E. DeBakey VA Medical Center, 2002 Holcombe Blvd, OCL (112), Houston, TX 77030, USA. ml3@bcm.edu
authors.forename: Mike K
authors.initials: MK
authors.lastname: Liang
authors.forename: Marissa
authors.initials: M
authors.lastname: Clapp
authors.forename: Linda T
authors.initials: LT
authors.lastname: Li
authors.forename: Rachel L
authors.initials: RL
authors.lastname: Berger
authors.forename: Stephanie C
authors.initials: SC
authors.lastname: Hicks
authors.forename: Samir
authors.initials: S
authors.lastname: Awad
mesh_terms: D000368:Aged; D000704:Analysis of Variance; D059350:Chronic Pain / Q000453:epidemiology / Q000209:etiology / Q000503:physiopathology; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D006555:Hernia, Ventral / Q000175:diagnosis / Q000601:surgery*; D059685:Herniorrhaphy / Q000009:adverse effects / Q000379:methods*; D006801:Humans; D015994:Incidence; D010535:Laparoscopy / Q000009:adverse effects / Q000379:methods*; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D010147:Pain Measurement; D010149:Postoperative Pain / Q000175:diagnosis / Q000453:epidemiology*; D017060:Patient Satisfaction / Q000706:statistics & numerical data*; D012008:Recurrence; D012189:Retrospective Studies; D018570:Risk Assessment; D018709:Statistics, Nonparametric; D016896:Treatment Outcome